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Thursday, June 9, 2005

Canada’s top court has struck down Quebec’s bans on private health care insurance, citing an increased risk to the life and health of Canadians. [1]

The Supreme Court of Canada ruling looked into a patient’s right to pay for faster service in a system that currently treats patients on the basis of equal access to medical care, regardless of income. [2]

Quebec patient George Zeliotis, a chemical salesman who waited in pain for more than a year in 1997 to have his hip replaced, said he should have had the right to pay for surgery.

Under public health care, it’s forbidden to pay for services covered under the system.

Despite free medical treatment, there are often long waiting lists for operations and services with current public health care.[3]

Together with physician, Dr. Jacques Chaoulli, Mr. Zeliotis launched a challenge to the Supreme Court of Canada, after losing their fight in Quebec’s lower courts, arguing that having to wait for surgery violates a patient’s constitutional right to life, liberty, and security of the person. [4]

Mr. Zeliotis and Dr. Chaoulli argued that being able to pay for private medical services wouldn’t be detrimental to the public health care system.

The Quebec Superior Court and the Quebec Court of Appeal had dismissed the case, ruling that the provincial law’s intent was not to discriminate among patients and to provide health care based on need rather than a patient’s ability to pay.

The Canadian Medical Association said the Superior Court of Canada ruling could “fundamentally change the health-care system in Canada as we now know it” but declined to comment any further until it had time to study the decision. [5]

Thursday, December 18, 2008

A team of eight transplant surgeons in Cleveland Clinic in Ohio, USA, led by reconstructive surgeon Dr. Maria Siemionow, age 58, have successfully performed the first almost total face transplant in the US, and the fourth globally, on a woman so horribly disfigured due to trauma, that cost her an eye. Two weeks ago Dr. Siemionow, in a 23-hour marathon surgery, replaced 80 percent of her face, by transplanting or grafting bone, nerve, blood vessels, muscles and skin harvested from a female donor’s cadaver.

The Clinic surgeons, in Wednesday’s news conference, described the details of the transplant but upon request, the team did not publish her name, age and cause of injury nor the donor’s identity. The patient’s family desired the reason for her transplant to remain confidential. The Los Angeles Times reported that the patient “had no upper jaw, nose, cheeks or lower eyelids and was unable to eat, talk, smile, smell or breathe on her own.” The clinic’s dermatology and plastic surgery chair, Francis Papay, described the nine hours phase of the procedure: “We transferred the skin, all the facial muscles in the upper face and mid-face, the upper lip, all of the nose, most of the sinuses around the nose, the upper jaw including the teeth, the facial nerve.” Thereafter, another team spent three hours sewing the woman’s blood vessels to that of the donor’s face to restore blood circulation, making the graft a success.

The New York Times reported that “three partial face transplants have been performed since 2005, two in France and one in China, all using facial tissue from a dead donor with permission from their families.” “Only the forehead, upper eyelids, lower lip, lower teeth and jaw are hers, the rest of her face comes from a cadaver; she could not eat on her own or breathe without a hole in her windpipe. About 77 square inches of tissue were transplanted from the donor,” it further described the details of the medical marvel. The patient, however, must take lifetime immunosuppressive drugs, also called antirejection drugs, which do not guarantee success. The transplant team said that in case of failure, it would replace the part with a skin graft taken from her own body.

Dr. Bohdan Pomahac, a Brigham and Women’s Hospital surgeon praised the recent medical development. “There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Leading bioethicist Arthur Caplan of the University of Pennsylvania withheld judgment on the Cleveland transplant amid grave concerns on the post-operation results. “The biggest ethical problem is dealing with failure — if your face rejects. It would be a living hell. If your face is falling off and you can’t eat and you can’t breathe and you’re suffering in a terrible manner that can’t be reversed, you need to put on the table assistance in dying. There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Dr Alex Clarke, of the Royal Free Hospital had praised the Clinic for its contribution to medicine. “It is a real step forward for people who have severe disfigurement and this operation has been done by a team who have really prepared and worked towards this for a number of years. These transplants have proven that the technical difficulties can be overcome and psychologically the patients are doing well. They have all have reacted positively and have begun to do things they were not able to before. All the things people thought were barriers to this kind of operations have been overcome,” she said.

The first partial face transplant surgery on a living human was performed on Isabelle Dinoire on November 27 2005, when she was 38, by Professor Bernard Devauchelle, assisted by Professor Jean-Michel Dubernard in Amiens, France. Her Labrador dog mauled her in May 2005. A triangle of face tissue including the nose and mouth was taken from a brain-dead female donor and grafted onto the patient. Scientists elsewhere have performed scalp and ear transplants. However, the claim is the first for a mouth and nose transplant. Experts say the mouth and nose are the most difficult parts of the face to transplant.

In 2004, the same Cleveland Clinic, became the first institution to approve this surgery and test it on cadavers. In October 2006, surgeon Peter Butler at London‘s Royal Free Hospital in the UK was given permission by the NHS ethics board to carry out a full face transplant. His team will select four adult patients (children cannot be selected due to concerns over consent), with operations being carried out at six month intervals. In March 2008, the treatment of 30-year-old neurofibromatosis victim Pascal Coler of France ended after having received what his doctors call the worlds first successful full face transplant.

Ethical concerns, psychological impact, problems relating to immunosuppression and consequences of technical failure have prevented teams from performing face transplant operations in the past, even though it has been technically possible to carry out such procedures for years.

Mr Iain Hutchison, of Barts and the London Hospital, warned of several problems with face transplants, such as blood vessels in the donated tissue clotting and immunosuppressants failing or increasing the patient’s risk of cancer. He also pointed out ethical issues with the fact that the procedure requires a “beating heart donor”. The transplant is carried out while the donor is brain dead, but still alive by use of a ventilator.

According to Stephen Wigmore, chair of British Transplantation Society’s ethics committee, it is unknown to what extent facial expressions will function in the long term. He said that it is not certain whether a patient could be left worse off in the case of a face transplant failing.

Mr Michael Earley, a member of the Royal College of Surgeon‘s facial transplantation working party, commented that if successful, the transplant would be “a major breakthrough in facial reconstruction” and “a major step forward for the facially disfigured.”

In Wednesday’s conference, Siemionow said “we know that there are so many patients there in their homes where they are hiding from society because they are afraid to walk to the grocery stores, they are afraid to go the the street.” “Our patient was called names and was humiliated. We very much hope that for this very special group of patients there is a hope that someday they will be able to go comfortably from their houses and enjoy the things we take for granted,” she added.

In response to the medical breakthrough, a British medical group led by Royal Free Hospital’s lead surgeon Dr Peter Butler, said they will finish the world’s first full face transplant within a year. “We hope to make an announcement about a full-face operation in the next 12 months. This latest operation shows how facial transplantation can help a particular group of the most severely facially injured people. These are people who would otherwise live a terrible twilight life, shut away from public gaze,” he said.

Thursday, November 8, 2007

Konami Cup Asia Series 2007 battled in Tokyo Dome today, with 2007 BWC in Taiwan and upcoming 2007 Asian Baseball Championship chained on the qualification of 2008 Summer Olympics, this series may varied Asian’s teams recently.

Saturday, January 21, 2006

Experts are now fearing the worst for the northern bottle-nosed whale that is still swimming in the Thames river London. The Thames Whale was first spotted on Thursday, with widespread media coverage yesterday and huge crowds of spectators attracted to the river.

There were hopes that the whale was heading back out to sea, but these were dashed by a fresh sighting of the whale from Albert bridge in Chelsea.

Experts say that the whale is now looking increasingly distressed, with numerous cuts to its body. The whale has already been partly beached on a few occasions, but each time has managed to free itself.

According to blogger Andrew (eyedropper.co.uk), a BBC picture editor, if the whale should die it would be up to Admiral the Lord Boyce GCB OBE ‘to arrange for a tooth to be extracted and sent to the Natural History Museum, and a proper burial to be made’.

Thursday, March 13, 2008

Members of Australia’s Health Services Union (HSU) will go on strike in Victoria next week in a dispute over stalled wage and career structure negotiations. Over 5000 physiotherapists, speech pathologists and radiation therapists will walk off the job next week, effectively closing the state’s 68 largest health services.

The strike will force the closure of intensive care units and emergency departments across the state.

It is feared the strike could continue into Easter.

National secretary of the HSU, Kathy Jackson said admissions would be crippled, while intensive care patients would have to be evacuated to New South Wales, Tasmania and South Australia as hospitals will not be able to perform tests or administer treatment.

“When an ambulance shows up you can’t admit a patient without an X-ray being available, you can’t intubate them and you can’t operate on them,” she said.

“If something goes wrong in an ICU you need to be able to X-ray, use nuclear medicine or any diagnostic procedure,” said Ms Jackson.

Ms Jackson said the HSU offered arbitration last year, but the state government refused. “They’re not interested in settling disputes, they hope that we are just going to go away.”

“We’re not going away, we’ve gone back and balloted the whole public health workforce in Victoria, those ballots were successful, 97 percent approval rating,” she said.

The HSU is urging the government to commence serious negotiations to resolve the dispute before industrial action commenced.

The government has offered the union a 3.25 per cent pay increase, in line with other public sector workers but the union has demanded more, but stopped short of specifying a figure.

Victorian Premier John Brumby said the claim would be settled according to the government’s wages policy. “The Government is always willing and wanting to sit down and negotiate with the relevant organisations . . . we have a wages policy based around an increase of 3.25 per cent and, above that, productivity offset,” he told parliament.

The union claims it is also arguing against a lack of career structure, which has caused many professionals to leave the health service. Ms Jackson said wages and career structures in Victoria were behind other states.

Victorian Opposition Leader Ted Baillieu said he was not in support of the proposed strike and called on the government to meet with unions. “There could not be a more serious threat to our health system than has been announced today.”

“We now have to do whatever is possible to stop this strike from proceeding,” he said.

The opposition leader will meet with the union at 11:30 AM today.

Victorian Hospitals Industry Association industrial relations services manager Simon Chant said hospitals were looking at the possible impact and warned that patients may have to be evacuated interstate if the strike goes ahead.

Monday, July 25, 2005

Windsor Castle, one of Queen Elizabeth II of the United Kingdom’s official residences, is to get a hydro-electric power scheme.

The £1 million project will consist of a series of under-water turbines to be installed at Romney Weir in the nearby River Thames. The system will generate 200kW, enough to meet approximately one third of the castle’s electricity needs.

The electricity from the four turbines will not be sold into the local electricity grid, but will instead be directly connected to Windsor Castle’s electrical system. It will save 600 tonnes of carbon dioxide from being released into the atmosphere every year.

The scheme was announced after it gained planning permission from the local council, the plans having been submitted in February of last year. A feasability study will now be conducted, with construction scheduled to start next year.

The Windsor Castle is not the only environmentally-friendly Royal scheme. A borehole beneath Buckingham Palace provides cold water for air-conditioning and the Duke of Edinburgh’s taxi runs on liquid petroleum gas.

Wednesday, October 29, 2008

The Mars Reconnaissance Orbiter has found evidence of hydrated silica or opal, a form of mineral, over large areas in the Martian surface, including in the large martian canyon called Valles Marineris. The discovery was made by the Compact Reconnaissance Imaging Spectrometer (CRISM) instrument on the orbiter. The findings are published by Ralph Milliken of Jet Propulsion Laboratory and other scientists in the November issue of the journal Geology.

Opaline minerals were first found recently on Mars by Spirit rover in the Gusev crater. The present find points to more widespread occurrence of the minerals in comparatively younger strata of Mars. The find indicates that liquid water might have been present on the surface of Mars for a longer time than previously thought. The previous view was that liquid water disappeared from the Martian surface three billion years ago. Now it is estimated that water could have been present as late as two billion years ago.

The presence of opal not only indicates water, but also that it was there long enough to alter some of the rocks. CRISM, which detected the mineral measures visible and infrared reflection spectra in 544 channels and has 20 times better resolution than previously deployed instruments.

Hydrated minerals such as opal that indicate presence of water is yet another evidence of presence of liquid water on Mars. Opal found on Earth’s surface usually contain 3 – 10% water, but can be as high as 20%. Other water-bearing minerals found earlier are phyllosilicates and hydrated sulfates. Presence of liquid water is also suggested by suspected water-sculpted land forms on Mars, such as gullies and river channels. Currently water is present only as ice at both polar caps of Mars.

A number of outcrops of opaline minerals are found as thin layers over large distances, rimming the Valles Marineris canyon. It is expected that Martian explorations for past or present life will have to focus on similar younger terrains with hydrated minerals.

“This is an exciting discovery because it extends the time range for liquid water on Mars, and the places where it might have supported life,” said Scott Murchie, from Johns Hopkins University Applied Physics Laboratory in Maryland, one of the co-authors.