By Rob Stein

The Washington Post

First came kidney, liver and heart transplants. Then a few doctors started transplanting hands. French surgeons did a face.

Now, doctors are planning the first uterine transplant in the United States.

A team based in Manhattan has begun screening women left barren by cancer, injuries or other problems who want a chance to bear their own children.

“The desire to have a child is a tremendous driving force for many women,” said Giuseppe Del Priore, of the New York Downtown Hospital, who is leading the team. “We think we could help many women fulfill this very basic desire.”

But the planned operation, which Del Priore and his colleagues could attempt later this year, is stirring objections among some transplant experts, fertility specialists and medical ethicists.

They question whether the procedure has been tested enough on animals and whether the benefit of being able to carry a pregnancy outweighs the risks for the woman and fetus.

“This raises a set of very difficult medical and ethical questions,” said Thomas Murray, who heads the Hastings Center, a biomedical-ethics think tank in Garrison, N.Y. “I think it’s very questionable.”
(more…)

By Joe Fahy
Pittsburgh Post-Gazette

When she needed to schedule her annual mammogram last fall at Canonsburg General Hospital, Georgiann Robbins turned to her personal computer.

A friend had told her about Sched-uleConnect, a service that allows patients of the West Penn Allegheny Health System to request diagnostic tests online.

A link on the health system’s home page, www.wpahs.org, takes patients through a secure online process that allows them to choose the tests they need. A scheduler then calls back to confirm a specific time and date.

Using the system wasn’t complicated, said Ms. Robbins, 61, of Canonsburg, who said she also shops and conducts personal banking online.

The health system began accepting online requests for mammograms and bone density tests in October 2005. Other tests, such as ultrasounds, CT and MRI scans and X-rays, were added about six months ago, said Nicholas Valadja, a system vice president and chief information officer.

“The whole concept behind it is convenience to the patient,” Mr. Valadja said, noting that patients can request appointments online at any time rather than needing to telephone during business hours.

Not everyone, of course, has online access, Mr. Valadja acknowledged, and officials noted the vast majority of people still request appointments by telephone.

About 350 people have used Sched-uleConnect so far, but officials expect the number of users to grow significantly. (more…)

By Barb Berggoetz
http://www.indystar.com

Swaddled in a red and white blanket, Ann Therese Felts slept soundly at Riley Hospital for Children on Tuesday, unaware a rare, life-threatening tumor removed from her heart will afford her a place in medical journals.

Her parents, Paje and Chris Felts, have endured more since the tumor was discovered in October than many parents experience in a lifetime, culminating with surgery Friday to remove the racquetball-size tumor the day after her birth.

“I think she’s an absolute miracle,” Paje Felts said Tuesday, admiring the 6-pound baby, who’s on a ventilator. She’s only been able to hold her child once, right before the surgery.

Cardio-thoracic surgeon John Brown said the tumor was 11/2 to two times the size of the baby’s heart — which is about as big as a plump strawberry. Only 46 other similar cases, called cardiac teratoma tumors, have been recorded in medical history, said Brown, who led the operating team.

“Of all the ones we’ve looked at in the literature, this was the largest in size,” he said. “The shadow of the heart and tumor went from one side of her chest to the other.” (more…)

Harvard Health Letters
http://www.orlandosentinel.com

When a patient was admitted to a hospital one night with chest pains, she expected her primary-care doctor to come by in the morning. Instead, she got a visit from a hospitalist — a physician who manages patient care in a hospital, then transfers responsibility to a personal physician when the stay ends.

Hospitalism is the fastest-growing medical specialty in the United States. According to a survey by the Society of Hospital Medicine, the number of hospitalists has grown from about 800 in the mid-1990s to more than 15,000 in 2006. Demand for this specialty was initially fueled by managed-care efforts to bolster efficiency, cut costs and improve care.

The term “hospitalist” was introduced in 1996 to describe “a new breed of physicians” who provide care only in hospital settings. Though relatively new as a full-time specialty, the concept is a variation on certain established practices, such as the rotation system, in which one member of a group practice supervises its hospitalized patients while his or her partners remain in the office. Hospitalists also share features with emergency-room doctors, who see patients only during their ER “shifts” and are in charge of patients’ care only while they’re in the ER. (more…)

By Lauran Neergaard
Associated Press
http://www.philly.com

Needing a wheelchair isn’t always the biggest complaint of people left paralyzed by spinal-cord injury – it’s the loss of bladder control. Last week, Michigan doctors began a unique experiment to see if rerouting patients’ nerves just might fix that problem.

It’s a delicate operation: Surgeons cut open a spot on the spine and sew two normally unrelated nerves together – one from the bladder to one from the thigh – with a single, hair-thin stitch. It will take months for this new nerve bridge to heal, an anxious waiting period for the first volunteers.

If it works, however, merely scratching the thigh should signal the bladder to empty, allowing patients to ditch their despised catheters and restore a longed-for degree of freedom, as well as fewer bladder infections and other serious complications.

“I’ve got nothing to lose by doing this,” is the way a cautiously hopeful Kevin Bryant, 19 and paralyzed from the waist down by a car crash, approached the experiment.

It’s a technique pioneered in China that is starting to garner international attention – and surgeons at William Beaumont Hospital in Royal Oak, Mich., hope their new study will prove whether the approach really is a solution, for at least some patients. (more…)