Daily Rounds: U.S. Lags On Preterm Birth; A Grim Cancer; 200 Years Of Surgery; Scott Brown's Insurance Problem

U.S. Lags In Global Measure Of Preterm Babies (The New York Times) — "Although American hospitals excel at saving premature infants, the United States is similar to developing countries in the percentage of mothers who give birth before their child is due, the study’s chief author noted. It does worse than any western European country and considerably worse than Japan or the Scandinavian countries. That stems from the unique American combination of many pregnant teenagers and many women over 35 giving birth, sometimes to twins or triplets implanted after in vitro fertilization, the authors said. Twins and triplets are often deliberately delivered early by Caesarean section to avoid the unpredictable risks of vaginally delivering multiple full-term babies. Also, many American women of childbearing age have other risk factors for premature birth, like obesity, diabetes, high blood pressure or smoking habits. And the many women who lack health insurance often do not see doctors early in their pregnancies, when problems like high blood pressure or genital infections can be headed off. Seeing similar problems simultaneously in Africa and the United States “is really a tale of two planets,” said Dr. Joy Lawn, director of global policy for Save the Children and the report’s chief author."

'Debulked Woman:' Ovarian Cancer's Grim Reality (NPR) — "Ovarian cancer often goes undetected until it has spread throughout the abdomen, and is typically fatal. To slow the spread of the disease, Gubar underwent a procedure known as the mother of all surgeries — a radical debulking operation in which her ovaries, uterus, fallopian tubes, appendix and parts of her intestine were removed."

Two Hundred Years Of Surgery (The New England Journal Of Medicine) — "He described the operation, performed before the students of Harvard Medical School, as follows: The eye-lids were separated by the thumb and finger of the left hand, and then, a broad cornea knife was pushed through the cornea at the outer angle of the eye, till its point approached the opposite side of the cornea. The knife was then withdrawn, and the aqueous humour being discharged, was immediately followed by a protrusion of the iris. Into the collapsed orbit of this unanesthetized man, Warren inserted forceps he had made especially for the event. However, he encountered difficulties that necessitated improvisation: The opaque body eluding the grasp of the forceps, a fine hook was passed through the pupil, and fixed in the thickened capsule, which was immediately drawn out entire. This substance was quite firm, about half a line in thickness, a line in diameter, and had a pearly whiteness."

Scott Brown Criticized For Keeping Daughter On His Health Insurance (ABC News) — "Brown is the Republican senator whose election in January, 2010, broke the Democrats filibuster-proof majority in the Senate, forcing them to re-organize their plan for passing health care legislation. During his tenure in Congress, he has voted to repeal the Affordable Care Act three times, a provision of which allows children to stay on their health care until they turn 26.
“Brown’s still promising to repeal the very reforms that allow him and the parents of 2.5 million other young adults to keep their kids covered,” Warren spokeswoman Alethea Harney said in a statement. “It’s not right. Scott Brown spells health care: H-Y-P-O-C-R-I-S-Y.” But Massachusetts’ state health care law, which served as a model in many ways for the Affordable Care Act, has the same provision, and Brown has long expressed his support for that law, supporting it when he was in the state legislature."