What is tetralogy of Fallot – the disorder Jimmy Kimmel's son has?

Published: Tuesday, May 02, 2017 @ 10:12 AM

Jimmy Kimmel (L) and his wife, screenwriter Molly McNearney attend the premiere of Paramount Pictures'
Jimmy Kimmel (L) and his wife, screenwriter Molly McNearney attend the premiere of Paramount Pictures' "Office Christmas Party" at Regency Village Theatre on December 7, 2016 in Westwood, California. (Photo by Matt Winkelmeyer/Getty Images)(Matt Winkelmeyer/Getty Images)

On Monday, late-night talk show host Jimmy Kimmel told viewers in an emotional monologue that his newborn son had been diagnosed with a heart defect and underwent open heart surgery.

Kimmel said his son Billy, born on April 21, was discovered to have a disorder called tetralogy of Fallot (teh-TRAL-uh-jee of fuh-LOW), a congenital (meaning present at birth) disorder where the wall that separates the two sides of the heart is missing. 

Kimmel said his son had surgery last Monday and is now home recovering. 

Here’s a look at tetralogy of Fallot and pulmonary atresia, the other problem Kimmel said his son is suffering from.

What was Kimmel’s son diagnosed with?
The disorder is called tetralogy of Fallot. It is a rare condition – only about 5 children out of 10,000 are diagnosed with it each year.

What is it?
The disorder happens because of a structural problem with the heart. Tetralogy of Fallot is caused by a combination of four heart defects that are present at birth.

What are the defects?

According to the Centers for Disease and Control, the defects are:

1. A hole in the wall between the two lower chamber – or ventricles – of the heart. This condition also is called a ventricular septal defect.

2. A narrowing of the pulmonary valve and main pulmonary artery. This condition also is called pulmonary stenosis.

3. The aortic valves, which opens to the aorta, is enlarged and seems to open from both ventricles, rather than from the left ventricle only.

4. The muscular wall of the lower right chamber of the heart (right ventricle) is thicker than normal. This also is called ventricular hypertrophy.

What happens because of the problems?

The structure of the heart is affected and the defects cause blood that is oxygen-poor – meaning it has gone through the body and is being pumped back to the heart for recirculation – to be incorrectly routed through the body. Oxygen-poor blood is usually moved to the lungs to be infused with oxygen then routed through the heart to the brain and other organs. 

With tetralogy of Fallot, the blood mixes in the heart, sending the oxygen-poor blood throughout the body. Because the blood does not have enough oxygen, it leaves a baby’s skin with a blue tinge.

What is the treatment?

Surgery is needed soon after birth. During the surgery, doctors widen or replace the pulmonary valve and place a patch over the ventricular septal defect to close the hole between the two lower chambers of the heart. 

The surgery is incredibly delicate. Dr. Jennifer Ashton on “Good Morning America” Tuesday, offered this perspective on the complicated nature of the surgery: Try to imagine operating on an organ the size of a walnut with veins the diameter of angel-hair pasta.

Is it always diagnosed at birth?

No, not always, but usually. Sometimes it is diagnosed when the baby is still in the womb. Sometimes it is not diagnosed until later in life.

What about the other problem Kimmel mentioned – pulmonary atresia?

Pulmonary atresia (PULL-mun-airy ah-TREE-sha) is a birth defect of the pulmonary valve. That valve controls the blood flow from the right lower chamber of the heart into the blood vessel that carries blood from the heart to the lungs. Pulmonary atresia means that no pulmonary valve ever formed in the baby’s heart.

What caused these problems?

The cause of the defects is not known. Some are caused by gene or chromosome changes, some by something the mother and baby are exposed to – environmental factors or food, drinks or medication the mother uses. 

What is the prognosis? Can children with this lead normal lives?

The baby needs surgery not long after birth to repair the problem if possible. When the defects are caught early and the child is treated, most lead fairly normal lives. Usually, three surgeries are required to fix the defects. 

(Sources: Centers for Disease and Control, Mayo Clinic;

University of California San Francisco)

 

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Romaine lettuce likely safe to eat again, per CDC report

Published: Friday, May 18, 2018 @ 12:34 PM

E. Coli Outbreak in At Least 25 States Linked to Romaine Lettuce

The latest update from the Centers for Disease Control and Prevention on the deadly multistate E. coli outbreak linked to romaine lettuce from the Yuma, Arizona, growing region brought a bit of positive news.

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While the CDC reported 23 more cases of illness from 13 states since the agency's May 9 update, the affected produce should no longer be available for sale.

The latest news release from the CDC posted on Wednesday said that the "last shipments of romaine lettuce from the Yuma growing region were harvested on April 16, 2018 and the harvest season is over. It is unlikely that any romaine lettuce from the Yuma growing region is still available in stores or restaurants due to its 21-day shelf life."

The CDC reports that, as of May 15, 172 people infected with the outbreak strain of E. coli O157:H7 have been reported from 32 states. 

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Infertility 'breakthrough': Human eggs fully grown in lab for the first time

Published: Friday, February 09, 2018 @ 6:37 PM

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A group of scientists are touting an infertility "breakthrough" after human eggs have been grown in a lab from their earliest stages to the point of potential fertilization for the first time.

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Researchers from the United Kingdom and the United States conducted the research, recently publishing their results in the scientific journal Molecular Human Reproduction

Taking ovarian tissue from 10 women in their late 20s and 30s, the scientists activitated the eggs to develop from their earliest stage to maturity, using different cocktails of nutrients. In total, 48 eggs reached the second to the last stage of maturity and nine reached full maturity.

"It's very exciting to obtain proof of principle that it's possible to reach this stage in human tissue," Dr. Evelyn Telfer, one of the researchers, told the BBC, discussing the results.

However, Telfer cautioned that much more research needs to be conducted before the technique could be used by fertilization clinics. Widespread implementation of the procedure could still be years away.

"But that has to be tempered by the whole lot of work needed to improve the culture conditions and test the quality of the oocytes [eggs]," she said.

"Apart from any clinical applications, this is a big breakthrough in improving understanding of human egg development."

The process would make it much easier for women to undergo in vitro fertilization (IVF), if developed fully, The Telegraph reported. They would simply have a small tissue biopsy, instead of distressing rounds of hormone-triggered ovulation.

Experts also suggest the breakthrough could lead to new approaches to fertility preservation for women at risk of premature fertility loss, such as those undergoing radiotherapy or chemotherapy. Young girls who have not yet gone through puberty could even preserve and freeze their ovarian tissue for future implantation.

At the same time, some scientists caution that the approach could have drawbacks for those with cancer.

"The big worry, and the big risk, is can you put cancer cells back," Dr. Stuart Lavery, a consultant gynecologist at Hammersmith Hospital, who was not involved with the study, told The Guardian.

At the same time, Telfer pointed out that it could be the only option for young girls who hope to get pregnant later in life after beating cancer.

"[For young girls] that is the only option they have to preserve their fertility." she said.

This new method could also dramatically increase the viable number of eggs that could be harvested from an individual woman about to undergo chemo.

With current techniques, patients must "go through the quick cycle of IVF before their chemo, so it can sometimes delay things, and also you may only get 15 eggs or so; because IVF is so inefficient, only having 10 or 15 eggs is not going to guarantee them a baby," Lavery explained.

"With this [new] procedure, you could potentially get thousands or hundreds of eggs," he said.

In the past, scientists have only managed to achieve partial growth of the human egg cells in a lab. The new study is groundbreaking in that the same human eggs were brought from their very earliest stages of development to the point when they would be released from the ovaries, ready for fertilization.

However, even as scientists are hailing the breakthrough, they also recognize potential problems and drawbacks. 

The lab grown eggs reached maturity in just 22 days, while the process takes five months in the body. This makes it unclear whether they can readily combine with sperm to make a healthy embryo. Telfer thinks the quicker growth may simply be due to many inhibitory signals from the body being absent, but more research is needed to determine exactly.

"Significant further research is now needed to confirm that these eggs are healthy and functioning as they should do," Dr. Helen Picton, an expert in reproduction and early development from the University of Leeds, said.

Despite the remaining questions and need for further study, experts are hailing the results as "extraordinarily important."

"It has real potential for application," Kyle Orwig, a stem cell biologist at the Magee-Womens Research Institute at the University of Pittsburgh in Pennsylvania, who was not involved with the study, told Science Magazine.

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Teacher contracts both flu strains, now on life support

Published: Saturday, February 10, 2018 @ 3:41 PM

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A special education teacher in Texas is fighting for her life after contracting both flu strains.

Crystal Whitley, 35, was physically active and had no underlying physical conditions, friends told WFAA, when she contracted both strains of influenza two weeks ago. She then developed pneumonia in both lungs and a MRSA infection.

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While she is showing some signs of improvement, Whitley remains on life support at Baylor Scott & White, WFAA reported.

Whitley received a flu shot after giving birth in October, friends told WFAA.

Doctors are cautiously optimistic about Whitley's chances for recovery, but told family that she could remain in the hospital for months, WFAA reported.

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Obesity surgery safer than traditional treatments, study suggests

Published: Monday, January 22, 2018 @ 1:05 PM

Anti-Obesity Drug May Allow You To Lose Weight Without Changing Food Intake

Having surgery to treat obesity may seem like a drastic option, but a new study suggests it may actually be a safer route than more traditional options.

Researchers at Northwestern University Feinberg School of Medicine and the Clalit Research Institute in Israel, recently published their findings in the Journal of the American Medical Association.

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The analyzed data, which traced patients history for 10 years, revealed that middle-aged men and women who had bariatric surgery have a death rate 50 percent lower than those who had traditional obesity treatments (such as dietary changes, behavioral adjustments and exercise).

"We showed that a long-term effect of bariatric surgery is a longer life for obese patients," study co-author Dr. Philip Greenland, professor of preventive medicine at Northwestern University said in a news release. "They had half the death rate, which is significant."

Among individuals who did not have surgery, the rate of death was 2.3 percent as opposed to 1.3 percent in those who had surgery. Researchers analyzed the medical data of 8,385 people who had the surgery (65 percent women and 35 percent men), compared to 25,155 who chose non-invasive treatments.

After the data was adjusted to take into account factors such as sex, age and related diseases, the researchers noted that individuals who did not have a bariatric procedure were twice as likely to be dead within the ten year period of the study.

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Additionally, bariatric surgery patients showed a greater reduction in body mass index (BMI), improved blood pressure and lower rates of new diabetes diagnosis. A higher percentage of those who had diabetes, and chose surgery, went into remission as well.

"Surgery sounds like a radical approach to managing obesity, and a lot of people reject it because it seems like a risky thing to do, but it's actually less risky to have the surgery," Greenland told The Guardian.

At the same time, the studies authors have cautioned that surgery may not be right for everyone. The new study also has limitations, as it was an analysis of patient data and not randomized. It's possible that those who chose to forego surgery were already sicker than their counterparts.

The risks of obesity surgery and its potential complications have long been highlighted by physicians as well.

Ray Shidrawi, a leading doctor in the United Kingdom, warned against the procedure in an interview with The Independent in 2015. Citing serious complications, Shidrawi said the surgery can "ruin people's quality of life and can affect you for the rest of your life – or at least for months and years afterwards."

"I've got patients who've not eaten solid food for four years. They have to live on soup. They can't go to a restaurant in case they vomit up their food because it gets stuck in their throat," he explained.

But another smaller recently published study also appears to corroborate the potentially greater health benefits of bariatric surgery.

Looking at 113 patients, who had been treated for obesity through traditional methods and/or surgery, the research showed those who underwent a bariatric procedure lost more weight after one year. A higher percentage of those who underwent surgery had also achieved their goals for cholesterol, systolic blood pressure and a benchmark for glucose.

"Bariatric surgery is an increasingly frequent treatment for severe obesity," Dr. Laura Rasmussen-Torvik, an assistant professor of preventive medicine at Northwestern, who was a co-author of the first-mentioned study, said, according to Jerusalem Post.

"It's highly effective in promoting weight loss but is also invasive and can lead to short and long-term complications. For patients and doctors to make the best-informed decisions about what weight-loss strategies to pursue, they need to understand the true costs and benefits of the procedures."

Although Greenland believes bariatric surgery may be a lifesaver for many, he also cautions of taking the new studies findings as the all-encompassing answer on obesity.

"We don't think this [new study] alone is sufficient to conclude that obese patients should push for bariatric surgery, but this additional information certainly seems to provide additional support," he said.

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