Doctors teased apart abutting portions of Carl and Clarence Aguirre's brains at 10:32 p.m. after completing an incision around their skull, said Steve Osborne, a spokesman for the Children's Hospital at Montefiore Medical Center.

The boys survived, and doctors, nurses and technicians applauded in the operating room, said Osborne, who was in the operating room.

The twins' head-to-head operating tables were then pulled apart slightly to give the medical team more room as they continued their work.

Wednesday's surgery climaxed a number of gradual operations over the past ten months, a departure from the more common marathon operations that have separated other conjoined twins.

The operation continued after the separation. Doctors planned to reconstruct a membrane that covered the boys' brains and then cover their heads with skin, some of it from tissue expanders that had been planted beneath their scalps.

Doctors have warned that it will be months before the twins' conditions and the success of the separation can be fully assessed.

In the past, 구미출장마사지 - https://www.anmastar.com/%ea%b5%ac%eb%af%b8%ec%b6%9c%ec%9e%a5%ec%83%b5%c... separation was considered a success if both twins simply survived. But the hospital's goal for the boys, who have never been able to sit up, stand straight or look at each other's face, is "viable, independent lives."

During four major surgeries since October, the boys' separate-but-touching brains were gently pushed apart and the tangle of blood vessels they shared were cut and divided.

Between surgeries, the boys were given time to heal and to adapt to their rerouted circulation systems. Originally, veins near Clarence's brain were doing much of the circulation work for both boys, but scans showed dormant veins on Carl's side had "plumped up" and begun working in response to the surgery, lead surgeon Dr. James Goodrich said last week.

In Wednesday's operation, which began at 10 a.m., doctors cut a window into the skull and divided the last major vein the brothers shared, along with other blood vessels. About six hours into that procedure, they decided the boys were doing well enough to continue.

The doctors said last week that excessive bleeding or swelling in the brain would force a postponement - http://edition.cnn.com/search/?text=postponement .

The boys' mother, Arlene Aguirre, and grandmother, Evelyn Aguirre, were at the hospital throughout the operation, getting periodic updates from the doctors.

They had sent the feisty, dark-haired boys into the operating room with tearful kisses at about 7:30 a.m. Arlene Aguirre placed a small statue of the Virgin Mary on her sons' gurney, and it stayed with them, on an instrument cart, through the surgery.

By Jim Fitzgerald

The issue is reviewed in an article published this month in the New England Journal of Medicine that focuses on a 57-year-old Pennsylvania woman who died in 2002 of a fungal infection in her muscles called Brachiola algerae.

Doctors were puzzled because the fungus was thought to be found only in mosquitoes and 카지노사이트 - https://www.shimly.com/ other insects. But it's not found in mosquito saliva like West Nile virus and malaria, so a simple mosquito - http://www.modernmom.com/?s=simple%20mosquito bite could not have caused the infection.

The article's authors concluded that the woman must have smashed a mosquito on her skin, smearing its body parts into the bite.

"I think if a mosquito was in mid-bite, it would be wiser to flick the mosquito off rather than squashing it," said one of the authors, Christina Coyle of the Albert Einstein College of Medicine in New York.

Many people already take similar advice when removing ticks. Doctors have long cautioned that squashing a tick on skin could put a person at greater risk of Lyme disease, said Dawn Wesson, a tropical medicine specialist at Tulane University.

Despite the Pennsylvania woman's case, Roger Nasci, a mosquito expert at a U.S. Centers for Disease Control and Prevention facility in Fort Collins, Colo., said there is no scientific basis for switching to flicking.

He also pointed out that flicking the bugs off is not a permanent solution.

"Unfortunately, then the mosquito often goes on to bite another person, or bites you again," Nasci said.

The Securities and Exchange Commission also is looking into a $1.5 million, end-of-year sale of stun guns by Taser International to a Prescott firearms distributor that some stock analysts have questioned because it appears to inflate sales to meet annual projections.

"We're confident that this is going to come out in our favor," Taser's president Tom Smith said late Thursday in announcing that it was cooperating with the SEC informal inquiry. An informal - http://www.fool.com/search/solr.aspx?q=informal inquiry is a step below a formal investigation, where regulators have subpoena power.

Smith added that the Scottsdale-based company stands by its safety statements and the recent sale.

In morning trading Friday on the Nasdaq Stock Market, Taser shares were down $3.94 to $23.68. They traded as high as $33.45 a share just last month.

Recent investigations by several newspapers have raised serious questions about the stun gun's safety record and about Taser's reports to shareholders.

Although Taser has repeatedly said its stun guns have never caused a death or serious injury, reports in The Arizona Republic have linked the stun gun to 11 deaths and to several injuries involving police officers.

"We feel very confident that the statements that we've made surrounding the safety of our products are supported with the safety studies," Smith said.

However, 카지노사이트 - https://www.avinordic.com/ questions about safety have already caused some police departments around the country to back off purchases of Tasers.

Some medical experts believe Taser shocks may exacerbate a risk of heart failure in cases where people are agitated, under the influence of drugs or have underlying health problems. Human rights advocates want law enforcement to stop using Tasers until scientific evidence can show they don't kill.

Last week, a Scottsdale investment analyst raised questions about the sale of 1,000 new consumer stun guns and other products to the distributor Davidson's Inc. that Taser announced on Dec. 20.

"It's a deal that could maybe make a quarter," said Rob Miceli, analyst with the Scottsdale firm Gradient Analytics Inc. "Anytime we see something like that it bears further investigation."

Davidson's has done business with Taser since 1999 and company CEO Bryan Tucker said there was no pressure from Taser executives to complete the deal before Taser's quarter and year end.

As of 2003, there were an estimated 3.6 million people who had been diagnosed with osteoporosis, compared with half a million in 1994, according to the study by Stanford University researchers. Also, the number of doctor visits for the condition jumped to 6.3 million last year from 1.3 million in 1994.

The increases coincided with the introduction of the bone-protecting drugs alendronate, sold as Fosamax, in 1995; raloxifene, or Evista, in 1997; and risedronate, or Actonel, in 1998.

All three are among the non-hormonal alternatives to estrogen supplements, which have long been used to prevent osteoporosis but have lost popularity because of recent studies linking them to heart problems, breast cancer and other risks.

In 1988, estrogen was prescribed at 35 percent of osteoporosis-related doctor visits, but that fell to 3 percent last year, the study found.

The estrogen alternatives have grown into a multibillion-dollar-a year industry with widespread ads and slick promotional campaigns that have helped raise awareness about osteoporosis. The researchers said that probably helped increase diagnosis rates.

Partly because of the newer drugs, "the whole way that we think about osteoporosis has shifted ... to one of prevention," said Dr. Randall Stafford, who led the study. "We hope to catch it early enough to treat it early enough to prevent fractures."

Nevertheless, osteoporosis remains underdiagnosed and undertreated, said Dr. Ethel Siris, head of the National Osteoporosis Foundation's science and 바카라사이트 - http://www.caddietoursonline.com/cad_terms-and-conditions.php research committee.

Osteoporosis affects an estimated 10 million Americans, mostly women, who face a high risk of debilitating bone fractures, according to the foundation. An additional 34 million have less severe bone thinning that also increases the risk.

The study's authors said new guidelines recommending universal screening for women 65 and older may further improve diagnosis and treatment.

The study appears in Monday's Archives of Internal Medicine.

Stafford and colleagues analyzed data from a physician survey conducted by IMS Health, a health care information company - https://www.change.org/search?q=company . About 3,500 randomly selected doctors participate each quarter in the survey.

Prescriptions for calcium, an older standard treatment for osteoporosis, fell during the study period. The authors had no data on sales of over-the-counter calcium pills. Stafford said the decrease is a concern, because calcium remains an important way of helping to prevent osteoporosis.

Getting calcium and vitamin D — either through diet or supplements — and exercising "are part of the package" for preventing osteoporosis, Siris said. "Those things are cheap and easy."

By Lindsey Tanner

But for modest Muslim women, it's an unthinkable indignity.

"I have witnessed their misery and how bad they feel about it. They don't like it. They feel ashamed. It's very embarrassing," said Asha Abdulleh, a native of Kenya and a medical interpreter.

When officials at Maine Medical Center discovered many Muslim women were so ashamed they were canceling doctor visits, the hospital took action, redesigning the standard gown to provide extra coverage for patients who want it. The new hospital gowns have been available for several weeks.

"This is a great example of a challenge raised by a specific community that can ultimately benefit all patients," said Dana Farris Gaya, the hospital's manager of interpreter and cross-cultural services.

The problem was acute for Maine Medical because 2,000 Somali refugees have come to Portland over the past few years and most of them are treated at the hospital's international clinic. As many as three out of 10 women were skipping their appointments, said Osman Hersi, a medical interpreter at the hospital.

Tracked down at home, the women whose religion and culture require them to be covered, described to interpreters the horror of being asked to wear the revealing gowns during outpatient procedures.

Furthermore, they were publicly humiliated when they had to wait in a hallway in the radiology department.

On a recent morning after the new patient gowns were provided, Shamso Abdi appeared for her first hospital visit since arriving in Portland.

She and her husband, Aden Ali, came to the United States from Mogadishu, Somalia. They lived in a small town in Kentucky, and then Columbus, Ohio, before coming to Portland.

Abdi, who was clothed in a dress, a sarong and a hijab, a scarf wrapped around her head, said she had canceled appointments in Columbus when she had to see male doctors and wear the standard drafty gown.

The gown created by the Portland hospital is long enough to provide more coverage of a patient's legs and has extra material to ensure that a patient's backside remains covered. Underneath, there's a wraparound sarong for even more coverage.

Abdi said she was grateful to see that Maine Medical had created a patient gown with her principles in mind.

"I'm so happy they made the change. I'm so happy that they considered us," she said, speaking through an interpreter.

Other hospitals are responding to the needs of Muslims. In southeastern Michigan, home to 300,000 Arab-Americans, the University of Michigan Medical Center is also addressing the issue of modesty.

The hospital is thinking of posting signs on the rooms of Muslim women warning male visitors and staff to check with a nurse's station before entering, said spokeswoman Krista Hopson in Ann Arbor, Mich.

As for the gown itself, Maine Medical isn't the only hospital to try to create a more acceptable - http://data.gov.uk/data/search?q=acceptable version.

Hackensack University Medical Center in New Jersey introduced vibrant colors and funky patterns five years ago. Other hospitals and garment producers have tweaked the traditional design with snaps, 연천출장안마 - https://www.opanma.com/14-yeoncheon Velcro and other changes.

Still, the standard-issue gown will never go away entirely. In some situations, in emergency rooms for example, it's more important to put the interests of doctors and nurses ahead of the interests of patients.

But for many situations, it makes sense to keep patients happy.

Asks Dr. Nat James of the hospital's international clinic: "Why didn't we think of this so long ago?"

The idea of changing the gown isn't completely new.

In 1999, designer Cynthia Rowley unveiled new gowns that offered a mid-calf length with a mock turtleneck and three-quarter length sleeves with snaps for women and drawstring pants, a short sleeve shirt and a matching robe for men.

That same year, Missouri state Rep. Sam Gaskill pushed a bill that would have required hospitals to provide patients with "dignity gowns," covering the body from neck to knee. The bill, prompted by Gaskill's own hospital experience, never made it out of committee.

GENEVA -- The civil war in Syria has forced a record 3 million people out of the country - https://www.sportsblog.com/search?search=country as more than a million people fled in the past year, the U.N. refugee agency said Friday.

10 (45452758/097461" style="max-width:430px;float:left;padding:10px 10px 10px 0px;border:0px;">The tragic milestone means that about one of every eight Syrians has fled across the border, and 6.5 million others have been displaced within Syria since the conflict began in March 2011, the Geneva-based agency said. More than half of all those uprooted are children, it said.

"The Syria crisis has become the biggest humanitarian emergency of our era, yet the world is failing to meet the needs of refugees and the countries hosting them," said U.N. High Commissioner for Refugees Antonio Guterres.

Syria had a prewar population of 23 million.

More in Syria crisis

The recent surge in fighting appears to be worsening the already desperate situation for Syrian refugees, the agency said, as the extremist Islamic State of Iraq and Syria (ISIS) expands its control of broad areas straddling the Syria-Iraq border and 과천출장마사지 - https://www.startopanma.com/%ea%b3%bc%ec%b2%9c%ec%98%a4%ed%94%bc%ea%b1%b... terrorizes rivals and civilians in both countries.

According to the agency, many of the new arrivals in Jordan come from the northern province of Aleppo and the northeastern region of Raqqa, a stronghold of the group. An independent U.N. commission says the group is systematically carrying out widespread bombings, beheadings and mass killings that amount to crimes against humanity in both areas.

The commission investigating potential war crimes in Syria said on Wednesday that the Syrian government of President Bashar Assad likely used chlorine gas to attack civilians, who are bearing the brunt of a civil war that has killed more than 190,000 people and destabilized the region.

The massive numbers of Syrians fleeing the civil war has stretched the resources of neighboring countries and raised fears of violence spreading in the region.

The U.N. estimates there are nearly 35,000 people awaiting registration as refugees, and hundreds of thousands who are not registered.

International Rescue Committee President David Miliband said the Syrian refugee crisis represents "3 million indictments of government brutality, opposition violence and international failure."

"This appalling milestone needs to generate action as well as anger," he said, calling for more aid to Syria's overburdened neighbors and for civilians still in the country.

The refugee agency and other aid groups say an increasing number of families are arriving in other countries in shockingly poor condition, exhausted and scared and with almost no financial savings left after having been on the run for a year or more. In eastern Jordan, for example, the agency says refugees crossing the desert are forced to pay smugglers $100 per person or more to be taken to safety.

Lebanon hosts 1.14 million Syrian refugees, the single highest concentration. Turkey has 815,000 and Jordan has 608,000.