The Surgeon General of the United States: Antonia Novello, M.D

Article Abstract:

In 1990, Antonia Novello became the first woman and the first Hispanic to become Surgeon General of the United States. She was born in Puerto Rico in 1944 into a middle-class family. She had a chronic illness (congenital megacolon) that caused her to be hospitalized for a part of each summer for the first 18 years of her life, and remembers that when she was in the hospital her doctors and nurses were very kind to her. She hoped that she could find a way to prevent others from having to go through what she was going through. These factors influenced her greatly and led her to the decision that she should become a doctor. Novello attended the University of Puerto Rico, where she completed her undergraduate studies and her medical training, and in 1970 received her M.D. degree. She married Joseph Novello, a physician and naval officer, and they moved to Ann Arbor, Michigan, were she completed her residency in pediatrics. Novello started her own private practice in Springfield, Virginia, and from there went on to work for the National Institutes of Health (NIH). In 1981, she attended the Johns Hopkins University, where she studied for a masters degree in public health. In 1986, Novello became the deputy director of the National Institutes of Child Health and Human Development. While at NIH, she had two role models, a man and a woman, and she made it a point to be on committees with her role models so that she could learn from them. By rising up through the ranks at NIH, and achieving great success and visibility, she went on to became the Surgeon General. She feels that the key to success is hard work, and that anyone can achieve their goals if they work hard. Currently, she is focusing on education for the prevention of AIDS, and teenage smoking and alcohol abuse. She opposes abortion and says that "women have to move a little bit away from abortion as the only important issue to tackle". She hopes to develop plans and programs that will be relevant to and beneficial for all women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Achievements and awards, United States. Public Health Service, Novello, Antonia C.

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The surgeon and gut maintenance

Article Abstract:

Although the surgeon's major involvement with the stomach and intestine is repair of injury or disease, equal attention should be given to maintenance of the gut and its function. The gut is the most metabolically active group of cells in the body; it replaces its entire mucosal surface every two to three days. Recently, attention has been focused on the nutrient requirements of the gut. As a person's skin interacts with the environment, so does the respiratory tract and the gut. The mucosal barrier of the gut prevents the bacteria contained inside it from escaping the confines of the gastrointestinal tract. Loss of this barrier function in the gut can result from changes in the gut wall, stress, and changes (both in quality and quantity) of its bacterial content. Alterations in the permeability of the gut wall result in the passage of bacteria through the wall into the body. Loss of this barrier has been implicated in multi-organ failure in critically ill patients. In order to maintain the gut, efforts should be directed toward: giving enteral feedings that pass through the gut (as opposed to parenteral, or intravenous, feedings); providing the nutrients specifically required by the gut for performance of its functions; and avoidance of unnecessary disturbance of the normal flora (bacterial content) of the gut. Standard parenteral nutrition does not adequately stimulate the gut and does not provide its specific nutrients. Gut-specific nutrient research has focused on the role of glutamine and short-chain fatty acids (a specific fuel of the colon). The normal gut flora can be adversely changed by the administration of medication used to treat ulcers, and by antibiotics. It is important that careful consideration be given to the effects of these drugs. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Intestinal mucosa

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A surgeon looks at cervical lymph nodes

Article Abstract:

Squamous cell carcinoma is a common cancer of the skin and mucous membranes. It commonly occurs in the upper digestive tract, and has been associated with alcohol and tobacco abuse. This type of cancer can spread (metastasize) to the lymph nodes in the neck (cervical nodes), which may negatively effect the prognosis. It is often difficult to detect the enlarged lymph nodes until they are substantially progressed. To date, there is no effective method of identifying cervical lymph node metastases. Analysis of nodes that have been surgically removed after predicting metastasis has revealed a high degree of false positive and negative diagnoses. The extent of the spread of disease within the lymph nodes is a good predictor of disease outcome. Also predictive of metastasis is an original tumor (primary tumor) that has spread into the underlying tissue. Lymph node metastasis may be treated with radiation and surgery; both therapies have side effects and are not always effective. It is hoped that more advanced imaging technology will provide an accurate means of locating metastasis at earlier stages. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Surgery, Squamous cell carcinoma, Lymphatic metastasis

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