Baby with 6 legs stressed to survive

The boy had a premature conjoined twin, which resulted in the additional limbs, according to the Institute’s director, Jamal Raza. One of the babies is not fully developed, generous the present physical structure to the baby.

The child was born previous week in Sukkur, a city in southeastern Pakistan. His father is currently seeking help from charities and the Pakistani government, since he said he can’t afford to travel to Karachi to see his son, and he cannot afford the baby’s surgery. According to Raza, the Institute is brainstorming options for surgery and is allowing for getting aide from foreign experts.

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New Clues to How Gastric Bypass Surgery Combats Diabetes

Gastric bypass surgery has been known to improve blood sugar control, often sending people with type 2 diabetes into remission, but experts have long wondered exactly how that happens. Now, a new study provides some clues. Circulating amino acids linked with insulin resistance decline dramatically in those who have the bypass surgery, the researchers discovered. They compared 10 obese people with diabetes who had the surgery with 11 who lost weight through dieting. "Something happens after gastric bypass that does not happen as much after the diet-induced weight loss," said Dr. Blandine Laferrere, an associate professor of medicine at St. Luke's Roosevelt Hospital Center and Columbia University, both in New York City.

The surgery, which reduces the stomach to the size of a small pouch, also modifies the junction between the stomach and small intestine. It leads to a dramatic reduction in the level of circulating amino acids that have been linked with diabetes. "The fact that gastric bypass results in the remission of diabetes in the majority of patients is not new," said Laferrere. According to background information in the study, 50 percent to 80 percent of diabetes cases go into remission after the surgery. What doctors have been trying to figure out, she said, is why the bypass surgery is so good at making the diabetes disappear. "The diabetes improves almost immediately, before a significant amount of weight loss occurs," she said. "That points out it is something other than the weight loss."

In the new study, the researchers evaluated biochemical compounds involved in metabolic reactions in the participants. Each group had lost about 20 pounds. The investigators found that the bypass patients had much lower levels of amino acids known as branched-chain amino acids, and the amino acids phenylalanine and tyrosine. "Those changes in the amino acids could be implicated in the mechanism of diabetes remission after gastric bypass," Laferrere said. Experts know the amino acids are linked with insulin resistance partly due to animal studies, she said. "If you supplement the diet of rats with branched-chain amino acids, you can induce more insulin resistance," she explained.

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Weight Loss Surgery May Cut Knee Osteoarthritis Pain

Losing weight can help reduce the amount of pain experienced by obese people with knee osteoarthritis, researchers say. The new study included 24 obese adults, aged 30 to 67, with knee osteoarthritis who underwent weight loss surgery. The patients' knees were assessed before surgery and at six and 12 months after surgery. Patients who lost an average of 57 pounds within six months of having bariatric surgery showed significant improvements in knee pain, stiffness and physical function, the investigators found.

These patients also experienced improvements in quality of life, the ability to perform day-to-day tasks and sports activity. None of the patients received other treatments for their knee osteoarthritis. The findings were scheduled to be presented Saturday at the American Orthopaedic Society for Sports Medicine's Specialty Day program. "Each individual had some kind of improvement in their pain from losing weight, some more than others," lead researcher Christopher Edwards, of the Penn State College of Medicine, said in a society news release.

"There are few studies that have investigated the role of isolated weight loss in the absence of additional arthritis treatment on those individuals with radiographically confirmed osteoarthritis," he added. "Further research still needs to be performed to investigate whether knee arthritis symptom improvement continues over time and applicable to those individuals who are simply overweight, but our research suggests a strong possibility of improvement."

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Depression, Anxiety May Raise Surgery Risks

People with depression and anxiety have a slightly increased risk of death after undergoing surgery, a new study suggests. U.S. researchers analyzed data from 35,539 surgical patients admitted to intensive care units between Oct. 1, 2003 and Sept. 30, 2006. Of those patients, 8,922 had an existing psychiatric condition, including 5,500 with depression, 2,913 with post-traumatic stress disorder, 2,473 with anxiety, 793 with bipolar disorder, and 621 with psychosis. Initial analysis showed that the death rates within 30 days after surgery were similar for patients with and without psychiatric illness 3.8 percent and 4 percent, respectively.

when the researchers adjusted for other factors, the death rate was higher for patients with a psychiatric condition, according to the report in the October issue of the journal Archives of Surgery. Further analysis showed that the increased risk of death was associated with depression and anxiety, but not any other psychiatric condition. Also, death rates were higher among patients with psychiatric conditions who had respiratory or digestive system surgery, but not for those who had surgery involving the circulatory, nervous or musculoskeletal systems.

"Several potential mechanisms exist to explain these findings," Dr. Thad E. Abrams, of the Iowa City Veterans Affairs Medical Center and University of Iowa Carver College of Medicine in Iowa City, and colleagues wrote in a news release from the journal's publisher. "First, studies indicate that patients with depression frequently do not adhere to medical recommendations for underlying medical conditions," the study authors noted. "It is therefore plausible that such undertreated conditions may affect postoperative care and outcomes. Second, patients with existing psychiatric comorbidity may be more likely to undergo surgery by a lower-quality surgeon or hospital. Third, pre-existing psychiatric comorbidity may serve as an indicator for greater severity of surgical risk."

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As Science Unlocks Secrets, Cancer Rates Fall

Cancer is one of the most feared diseases on the planet, and the second leading cause of death in the United States. But medical science is slowly conquering cancer, according to an assessment of cancer trends produced by the U.S. National Cancer Institute in conjunction with the U.S. Centers for Disease Control and Prevention, the American Cancer Society and the North American Association of Central Cancer Registries. Death rates and diagnosis rates from all cancers combined are declining significantly, both for men and women overall, and for most racial and ethnic populations within the United States, the report found.

New diagnoses for all types of cancer combined decreased an average of almost 1 percent a year from 1999 to 2006, and deaths attributed to cancer decreased 1.6 percent a year from 2001 to 2006, according to the report, an annual evaluation released each December. Doctors predict that the rates will keep falling because research has begun unlocking the secrets of how different cancers begin and develop. "We're beginning to understand that each cancer has an individual pathway to development," said Dr. Alan G. Thorson, president of the American Cancer Society, a clinical professor of surgery and director of colon and rectal surgery at Creighton University in Omaha, Neb. "We know now how to look at cancer, find its source and go for that source, which makes all the difference in the world."

The decrease in cancer incidence and deaths has been driven mainly by advances in detecting and treating the major types of cancer in men and women, according to the report. Incidence and death rates are declining for lung, prostate and colorectal cancer in men, and for breast and colorectal cancer in women, the report said. Also, increases in the other major cancer for women, lung cancer, have tapered off, with rates remaining stable since 2003. There's no single explanation for the decrease in these major cancers, doctors said. Rather, the decreases are chalked up to effective detection and treatment tools designed for each form of cancer. For example, public tobacco policy has been crucial in reducing lung cancer rates in men and leveling them out for women, said Dr. Brenda Edwards, associate director of the Surveillance Research Program at the U.S. National Cancer Institute.

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Surgery May Be Best for Irregular Heartbeat in Young

Young people with the kind of irregular heartbeat known as atrial fibrillation may be better off undergoing surgery to fix the problem instead of taking medication first, a new study suggests. Atrial fibrillation, which causes a person's pulse rate to change from minute to minute, can boost the risk of stroke and cause other problems. The condition is rare in younger people and can occur for no known reason. There are a number of treatments for atrial fibrillation, including medication, cardioversion and catheter ablation. A heart specialist who's familiar with the new study findings said ablation is indeed a worthwhile alternative. "Younger patients tend to respond very well to this therapy," said Dr. John Day, medical director of heart rhythm services at Intermountain Medical Center in Murray, Utah.

In the study, which was released online Sept. 21 in advance of publication in the journal Circulation: Arrhythmia & Electrophysiology, researchers examined the medical records of 1,548 patients who underwent catheter ablation between 2000 and 2008 in the University of Pennsylvania Health System. The average age of the patients was 56 years, and 70 percent were men. The investigators found that younger patients had fewer complications than older ones and did just as well after the surgery. A year after surgery, 87 percent of the patients under the age of 45 had experienced little or no atrial fibrillation.

Why choose the surgery instead of medication? "While atrial fibrillation is more common with increasing age, clinical experience has suggested that younger patients tend to be more symptomatic and less willing to take long-term medications," Dr. Peter Leong-Sit, study lead author and an arrhythmia physician at London Health Sciences-University Hospital in London, Ontario, Canada, said in a news release from the American Heart Association. The surgery isn't cheap. It can cost $30,000-$40,000, Day noted. But studies have shown it can be cheaper in the long run if the alternative is a lifetime of medications and complicated testing and care, he added.

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Injections May Relieve Drooling in Nerve-Damaged Kids

Botulinum toxin injections may temporarily relieve drooling in children with certain neurological conditions, a new European study has found. Depending on its severity, drooling can lead to stigmatization and social neglect, numerous daily clothing changes, skin irritation around the mouth, aspiration pneumonia and dehydration, Dr. Arthur Scheffer of Radboud University Medical Center in Nijmegen, the Netherlands, and colleagues noted in a news release about their study. In the study, Scheffer's team gave botulinum toxin injections to 131 children, average age 10.9 years, with cerebral palsy or other non-progressive neurological conditions, as well as moderate to severe drooling.

The injections were confined to the submandibular glands, which are responsible for 70 percent of saliva production while a person is resting. Two months after the injections, the average drooling quotient had fallen to 15.5 (on a scale of zero to 100) from 28.8 at the start of the study. And, the study authors noted, 61 patients achieved a 50 percent reduction in drooling. At the eight-month follow-up, the average drooling quotient was 18.7, according to the report in the September issue of the journal Archives of Otolaryngology Head & Neck Surgery.

The findings "indicate that most patients who initially respond well to injection can expect an effect to last between 19 and 33 weeks. Although the 46.6 percent success rate might appear low, its safety and efficacy make botulinum toxin a useful first-line invasive treatment if conservative measures have failed," the researchers concluded in the news release from the journal's publisher. Botulinum toxin injections have been used safely for years, according to the American Academy of Pediatrics. Side effects can include rash, whole-body muscle soreness, difficulty swallowing and weakness in the injected muscles, but they usually go away quickly, the AAP notes.

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High Blood Sugar Levels Increase Infection Risk From General Surgery

High blood sugar levels can increase the risk of surgical site infections in patients having general surgery, researchers report. Doctors have long been aware that people with diabetes are more prone to surgical infections, and the relationship between high blood sugar and increased risk of infection after surgery is well known in heart and intensive care unit surgery, where blood sugar is carefully monitored. But this appears to be the first study to quantify the risk after general surgery, noted the study authors, from Albany Medical College in New York.

"We wanted to find out how much increased glucose in your blood had a role in infection in general surgery," said lead researcher Ashar Ata, from the College's Department of Surgery. "Surprisingly, we did find that by the time your glucose is higher than 140 milligrams per deciliter, the infection went from 1.8 percent to almost 10 percent." When blood sugar levels reach that point, medical staff should intervene to control them, Ata said, adding, "We found the higher the blood glucose, starting at about 110 milligrams per deciliter, the more likely you are to have an infection."

The report is published in the September issue of the Archives of Surgery. The procedures Ata's group looked at included appendectomy, colon surgery, hemorrhoid removal and gallbladder removal, he said. These operations all fall under the definition of general surgery. For the study, Ata's team looked at medical records of 2,090 patients who had had general or vascular surgery between Nov. 1, 2006, and April 30, 2009. Among these patients, the researchers studied the blood sugar levels of 1,561 patients, including those who had vascular surgery, colorectal surgery and other types of general surgery.

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