STORY OF IDA
///////////////PROSIMIANS OR ANTHROPOIDS
/////////////LEMUR EVOLN SIDE BRANCH
/////////////////Statistics means never having to say you're certain.
////////////////////How's Your Baby? Recalling The Apgar Score's Namesake
By MELINDA BECK
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In the 1950s, babies named Linda and Bobby came home from the hospital in Studebakers with Fats Domino on the radio. Many were given a new score a minute after birth to assess how well they made the transition from womb to room. Today, the Apgar score is still given to nearly every baby born in a hospital world-wide.
Many parents know Apgar as an acronym for what it measures: Appearance, Pulse, Grimace, Activity and Respiration. But the score was first named for Virginia Apgar, the gutsy anesthesiologist who, in 1949, scribbled it on the back of a card in a hospital cafeteria that read "Please Bus Your Trays."
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Mount Holyoke College Archives and Special Collections
Dr. Virginia Apgar, circa 1950
The score laid the foundation for the field of neonatology, and Dr. Apgar became a legendary figure in medicine. She died in 1974. She would have been 100 years old next month. She was also my friend.
The score came about, indirectly, because of the sexism long rampant in medicine. The cash-strapped graduate of Mount Holyoke waited tables and caught stray cats to sell to the lab while earning her medical degree from Columbia University in 1933. She excelled at surgery, but a mentor convinced her she'd never make a living that way. "Even women won't go to a woman surgeon," Dr. Apgar said.
She went into anesthesiology and helped build it into a medical specialty. But she was passed over for a man to head the new department at Columbia. So she threw herself into teaching and patient care, becoming the first woman full professor at Columbia's College of Physicians and Surgeons. She was particularly drawn to obstetrical anesthesia, and was increasingly concerned about what she saw.
As late as the 1940s, delivery-room doctors focused on mothers and paid little attention to babies. Those who were small or struggling were often left to die, since doctors assumed little could be done for them. "It was considered better not to be aggressive. You dried them, you shook them, and some doctors patted them on the backside and that was it," says Alan Fleischman, medical director of the March of Dimes.
Assigning an Apgar Score to Newborns
5:50
It's said that "every baby born in a modern hospital in the world is looked at first through the eyes of Dr. Virginia Apgar." In a 1964 video, Dr. Apgar assists a nurse through checking a newborn's reflexes.
In the cafeteria one morning, a med student asked Dr. Apgar how a newborn might be evaluated. "That's easy, you'd do it like this," she said, dashing down heart rate, respiration, muscle tone, color and reflexes. Then she rushed off to try it, according to Selma Calmes, a retired anesthesiologist who has written about her. After testing the score on more than 1,000 newborns, Dr. Apgar presented it at a conference in 1952 and it caught on quickly.
As simple as it was, the score transformed deliveries by requiring staffers to carefully observe and assess each baby, assigning a score of 0, 1 or 2 to each of the five categories. Then, as now, few babies get a perfect 10 one minute after birth, since most have bluish toes and fingers until oxygenated blood starts circulating fully. Some doctors became competitive about the scores, and many hospitals began repeating the test at five or 10 minutes to measure whether newborns had improved.
Discussion
Do you know your Apgar score -- or that of your child? Was the test , named for its inventor, Dr. Virginia Apgar, useful in getting needed attention to your newborn? Share your experiences.
Most importantly, babies who needed care started to get it, gradually spurring the development of newborn-size resuscitation tools, infant heart-rate monitors and neonatal intensive-care units. Thanks to all those efforts, and the philosophy that came with them, U.S. infant mortality dropped from 58 per 1,000 in the 1930s to 7 per 1,000 today. By the 1970s, it was said, "every baby born in a hospital around the world is looked at first through the eyes of Virginia Apgar."
Dr. Apgar, who never made any money from the test, moved on to become a senior medical official at the March of Dimes in 1959, devoting the rest of her life to preventing birth defects and other conditions that caused newborns to have low Apgar scores. She was among the first to recognize and warn pregnant women about the dangers that infections, viruses, RH incompatibility and certain medications could pose to unborn babies. After a rubella outbreak in 1964 caused 20,000 birth defects and 30,000 fetal deaths, she helped win funding for widespread vaccinations. Dr. Apgar was also one of the first at the March of Dimes to look for ways to prevent preterm birth, the organization's current focus, and coined the slogan, "Be good to your baby before it's born."
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March of Dimes
Apgar Test Still Helping Newborns
I knew Dr. Apgar because she co-authored a book to help would-be parents avoid birth defects, entitled "Is My Baby All Right?," with my mother, Joan Beck. Dr. Apgar was in her 60s then, with a corona of white hair, a wicked sense of humor and more energy than anybody I've ever met. This eminent physician sometimes met me at the school bus. She would regale us with tales of resuscitating collapsed strangers; she carried a pen knife and an airway tube just in case. "Nobody, but nobody, is going to stop breathing on me," she'd say.
Another of her favorite sayings was, "Do what is right, and do it now."
Dr. Apgar took up flying in her 50s, and also played -- and made -- stringed instruments. One night, she and a colleague famously snuck into Columbia-Presbyterian Hospital and stole a maple shelf from a phone booth that she thought would make a splendid violin. She died in 1974, having never married. "I never found a man who could cook," she often said.
These days, there are many high-tech ways to evaluate newborns, and some doctors say they would assign more importance to heart rate than the other conditions if the score were being designed today. But much of its genius was its simplicity: the Apgar score can be taught quickly and administered almost anywhere, from a remote hospital to a mobile emergency van. And despite other innovations, The New England Journal of Medicine concluded in 2001 that the Apgar score "remains as relevant for the prediction of neonatal survival today as it was almost 50 years ago."
Apgar scores are also listed on birth certificates, used in epidemiological studies, and bragged about, so they have taken on social as well as medical value. "Moms want a good grade. Doctors want a good grade, too," says the March of Dimes's Dr. Fleischman. That's just what Dr. Apgar would have wanted.
Write to Melinda Beck at HealthJournal@wsj.com
////////////////Did you hear about the politician who promised that if he were elected he'd make certain that everybody would get an above-average income? (And nobody laughed....)
////////////////////Numbers are like people; torture them enough and they'll tell you anything.
Lottery: A tax on the statistically-challenged.
////////////////ida the lemur-monkey
HOW MUCH MONKEY?
/////////////////ife would be a hell of lot better and more productive if you have the energy of a teenager for many more years then we have now. Think about it . Remember what it was like? Ahh, to be young again. If you are older let me know if you agree, if not you don’t count yet. Wait a few years , you’ll be on my side. Normally my blogs are funny but,the health care systems treament of my uncle has got me down.
////////////////////When? The optimum timing for the use of MRI in the term infant with suspected perinatal injury is within 1 to 3 weeks postdelivery, when the lesions are the most obvious on conventional sequences. In the severely ill neonate, information may be required earlier, in order to make informed decisions about the withdrawal of intensive care. In such situations, diffusion-weighted imaging should always be used, as recently acquired lesions may not be obvious on conventional sequences. In the preterm infant, the best prognostic information may be obtained at term-equivalent age, although with severe lesions, an earlier image may have the ability to predict a poor outcome.
In summary, MRI is a valuable adjunct to ultrasound in preterm and term infants. Correct timing and appropriate imaging techniques are critical in obtaining relevant information.
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Is it possible to live to 125 or maybe 150? It's certainly a possibility, as discussed on Oprah Winfrey's recent show on longevity. She visited me at my farm to learn how, at 86, I am enjoying the robust health, energy, and mental creativity of someone many decades younger. My secret: large quantities of fruit and vegetables, plus an hour of daily exercise.
No pills, not even aspirin, and certainly no supplements ever enter my mouth -- everything I need comes from my fish-vegetarian diet, which incorporates 30-40 different kinds of fruit and vegetables every week. Even though I am Chairman and Owner of Dole Food Company, I do most of my own grocery shopping, and even took Oprah on an impromptu trip to Costco, in a day that included bike riding, exercise in the gym, and juicing vegetables in the kitchen. Oprah marveled at how much I eat, and yet never gain a pound. In fact, I expend a lot of energy in my 50-60 minutes of cardio and strength training every day. Plus there's the fact that fruit and vegetables tend to be lower in calories, but higher in filling fiber and other nutrients that help you feel satisfied.
////////////////////"Weekends don't count unless you spend them doing something completely pointless." - Bill Watterson
/////////////////////////ida-has humanoid talus -KEY TO BEAR WT-TO WALK UPRIGHT-NOT FOUND IN PROSIMIANS BUT ONLY IN ANTROPOIDS
///////////////////SO IDA IS ONE OF US-VERY VERY EARLY ANTHROPOID
/////////////////Scientists hail stunning fossil
By Christine McGourty
Science correspondent, BBC News
Christine McGourty takes a look at the beautifully preserved primate fossil
The beautifully preserved remains of a 47-million-year-old, lemur-like creature have been unveiled in the US.
The preservation is so good, it is possible to see the outline of its fur and even traces of its last meal.
The fossil, nicknamed Ida, is claimed to be a "missing link" between today's higher primates - monkeys, apes and humans - and more distant relatives.
But some independent experts, awaiting an opportunity to see the new fossil, are sceptical of the claim.
And they have been critical of the hype surrounding the presentation of Ida.
The fossil was launched amid great fanfare at the American Museum of Natural History in New York, by the city's mayor.
Although details of the fossil have only just been published in a scientific journal - PLoS One - there is already a TV documentary and book tie-in.
She belongs to the group from which higher primates and human beings developed but my impression is she is not on the direct line
Dr Jens Franzen
Ida was discovered in the 1980s in a fossil treasure-trove called Messel Pit, near Darmstadt in Germany. For much of the intervening period, it has been in a private collection.
The investigation of the fossil's significance was led by Jorn Hurum of the Natural History Museum in Oslo, Norway.
He said the fossil creature was "the closest thing we can get to a direct ancestor" and described the discovery as "a dream come true".
The female animal lived during an epoch in Earth history known as the Eocene, which was crucial for the development of early primates - and at first glance, Ida resembles a lemur.
But the creature lacks primitive features such as a so-called "toothcomb", a specialised feature in which the lower incisor and canine teeth are elongated, crowded together and projecting forward. She also lacks a special claw used for grooming.
In a David Attenborough-narrated BBC programme, the fossil is revealed in virtual reality
The team concluded that she was not simply another lemur, but a new species. They have called her Darwinius masillae, to celebrate her place of origin and the bicentenary of the birth of Charles Darwin.
Dr Jens Franzen, an expert on the Messel Pit and a member of the team, described Ida as "like the Eighth Wonder of the World", because of the extraordinary completeness of the skeleton.
It was information "palaeontologists can normally only dream of", he said.
In addition, Ida bears "a close resemblance to ourselves" he said, with nails instead of claws, a grasping hand and an opposable thumb - like humans and some other primates. But he said some aspects of the teeth indicate she is not a direct ancestor - more of an "aunt" than a "grandmother".
"She belongs to the group from which higher primates and human beings developed but my impression is she is not on the direct line."
Independent experts are keen to see the new fossil but somewhat sceptical of any claim that it could be "a missing link".
Dr Henry Gee, a senior editor at the journal Nature, said the term itself was misleading and that the scientific community would need to evaluate its significance.
"It's extremely nice to have a new find and it will be well-studied," he said. But he added that it was not likely to be in the same league as major discoveries such as "Flores man" or feathered dinosaurs.
The BBC's Fergus Walsh takes a look inside the Messel Pit
Dr Chris Beard, curator of the Carnegie Museum of Natural History and author of The Hunt for the Dawn Monkey, said he was "awestruck" by the publicity machine surrounding the new fossil.
He argued that it could damage the popularisation of science if the creature was not all that it was hyped up to be.
Dr Beard has not yet seen scientific details of the find but said that it would be very nice to have a beautiful new fossil from the Eocene and that Ida would be "a welcome new addition" to the world of early primates.
But he added: "I would be absolutely dumbfounded if it turns out to be a potential ancestor to humans."
In the PLoS paper itself, the scientists do not actually claim the specimen represents a direct ancestor to us. But Dr Hurum believes that is exactly what Ida is.
He told BBC News that the key to proving this lay in the detail of the foot. The shape of a bone in the foot called the talus looks "almost anthropoid".
He said the team was now planning a 3D reconstruction of the foot which would prove this.
"We're not finished with this specimen yet," said Dr Hurum. "There will be plenty more papers coming out."
A TV documentary about Ida will be broadcast on BBC One at 2100 BST, Tuesday, 26 May
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