The mesentery: A ‘new’ organ you didn’t know you had

— In case you’ve ever wondered what connects your intestine to your abdomen, there’s a word — and now, a single organ — for that: the mesentery. But don’t worry; you haven’t grown a new organ. It’s always been there, performing important functions that affect systems throughout the body, from cardiovascular to immunological.

Leonardo da Vinci depicted it as one contiguous organ, and it remained that way for centuries until 1885, when Sir Frederick Treves’ findings presented the mesentery as fragmented amongst the small intestine, transverse colon and sigmoid colon.

The research of Dr. J. Calvin Coffey, foundation chair of surgery at the University of Limerick, is reclassifying this part of the digestive system as a contiguous organ. In a new study, Coffey has established the anatomy and structure of the mesentery, using images and compiling research to show that the organ’s continuity can be seen only when it’s exposed in a certain way.

The current findings resonate with those of Carl Toldt, who accurately described the presence of the mesentery in 1878. But his research was largely overlooked. At the time, Treves’ findings supported the statements of Henry Gray, who mentioned multiple mesenteries in the 1858 first edition of his book “Gray’s Anatomy,” the go-to medical textbook for students around the world.

Coffey’s research has already prompted the latest edition of “Gray’s Anatomy” to refer to the mesentery as a continuous organ.

What does it do?

Linking your gut to the rest of your body is an important task, and the mesentery performs it well.

Among its functions, it carries blood and lymphatic fluid between the intestine and the rest of the body. It also maintains the position of the intestine so that it’s connected with the abdominal wall without being in direct contact.

That connection is key.

“Without a mesentery to keep the intestine connected, the intestine would have to attach directly to the body wall,” Coffey said. “It is unlikely that it would be able to contract and relax along its entire length if it were directly in contact. It maintains the intestine in a particular conformation, ‘hitched up,’ so that when you stand up or walk about, it doesn’t collapse into the pelvis and not function.”

Although researchers know that the mesentery plays an important role in the intestinal, vascular, endocrine, cardiovascular and immunological systems, more research is needed to determine the extent of those roles.

But they do have evidence that the mesentery takes environmental signals from the intestine and orchestrates the body’s response, Coffey said. One example is how bacteria are sampled in the lymph glands in the mesentery. In response, the glands then coordinate immune responses.

Why has it been misunderstood?

To look at the shape of the membrane, which Coffey calls remarkable, it’s easy to see why the mesentery has been depicted differently. It has a spiral formation in the abdomen and is packaged along a spinal trajectory, starting in the upper abdomen and ending in the pelvis.

“In between, it fans out, like a Chinese fan, to span the length of the intestine from the upper small intestine to the end of the large bowel,” Coffey said.

The latest anatomy and structure clarifications aid not only doctors, but medical students as well.

“For students, it greatly simplifies the matter of the mesentery,” Coffey said. “This was traditionally regarded as a complex field. The current anatomic model is elegant and simple and will help students understand this structure. It will also provide them with a new perspective from which to view other organs in the abdomen. For example, we now know that the mesentery and intestine intersect along the entire length of the small and large intestine, whereas previously, this was though to occur in some regions only.”

Improving surgery and treatment

More research will allow for better definition of the gut membrane’s function, what happens when it functions abnormally and diseases that affect it. This also allows for mesenteric science to become its own field of medical study, like neurology.

Coffey hopes that creating a better understanding of the mesentery can help with diagnosing issues and less invasive ways of assessing them. Currently, its remote location in the body means the mesentery can be accessed only radiologically or surgically. This research lays the foundation for investigating possible prescriptions and how less-invasive endoscopic procedures during a colonscopy could map the mesentery.

Adopting a universal classification like this in the medical world has benefits that extend to standardizing surgical procedures, such as moving or cutting into the intestine. The mesentery extends from the duodenum, or first part of the small intestine immediately beyond the stomach, all the way to the rectum, the final section of the large intestine.

Because of this, it can factor into diseases such as Crohn’s, colorectal cancer, inflammatory bowel disease or cardiovascular disease and major health concerns like diabetes, obesity and metabolic syndrome. The more doctors know about the exact function of the mesentery, the more measures they can take to investigate the part it plays.

“For doctors, it provides us with an opportunity to refresh our approach to many diseases such as inflammatory bowel disease and others,” Coffey said. “This could help in identifying the mechanisms underlying these conditions and help us in unraveling their cause and how they develop.”

New arrivals: The most popular baby names of 2015

— Now you’re just showing off, Noah and Emma.

For the second year in a row, they are the most popular baby names in the United States, according to the Social Security Administration. 2015 is actually the third consecutive year at the top for Noah.

We said our farewells to other perennial favorites — Daniel for boys and Madison for girls — as two new baby names reached the Top 10: Benjamin for boys and Harper for girls. This is the first time either name has cracked the list of most popular names.

The lists for boys and girls haven’t changed much, with only a few shifts up and down. Perhaps Charlotte, a newcomer to the list last year, is a more popular name after the birth of British royal baby Princess Charlotte Elizabeth Diana in May 2015. James and Michael also swapped places, with the former growing in popularity.

The boy names are a mix of classics and nods to popular actors and pop culture. The name Liam has steadily been on the rise in the top 10 since 2012, when the first “Hunger Games” film, starring Liam Hemsworth, premiered.

The Social Security Administration is able to share the ranking because parents provide the names of children when they apply for Social Security cards. The agency started releasing its popular baby name list by gender in 1997 but has collected names dating back to 1880.

Beyond the top 10, less-traditional names are also on the rise. For girls, Alaia spiked from No. 2,676 in 2014 to No. 664 in 2015. Perhaps this can be traced to Alaia Baldwin, a model and the daughter of actor Stephen Baldwin, or fashion designer Azzedine Alaia, the Social Security Administration noted.

Meilani, Adaline and Zelda are also growing in popularity. Meilani is the name of Jersey Shore star Jenni “JWoww” Farley’s daughter, born in 2014, as well as the middle name of “Soul Surfer” and shark attack survivor Bethany Hamilton. Adaline was Blake Lively’s character in the 2015 film “The Age of Adaline,” and Zelda could be attributed either to popular video game “The Legend of Zelda” or to continued fascination with writer Zelda Fitzgerald, the wife of F. Scott Fitzgerald.

For boys, the name Riaan jumped from No. 2,286 to No. 926. This name is connected with the son of popular Bollywood actor Riteish Deshmukh. Huxley, Omari and Jabari are also rising on the list of popular names. Omari Hardwick is an actor who has appeared on the shows “Power” and “Being Mary Jane,” while Jabari Parker plays basketball for the Milwaukee Bucks.

As for Huxley, the agency is stumped, questioning whether “Brave New World” author Aldous Huxley is receiving renewed attention.

Most popular names for girls in 2015:

  1. Emma
  2. Olivia
  3. Sophia
  4. Ava
  5. Isabella
  6. Mia
  7. Abigail
  8. Emily
  9. Charlotte
  10. Harper

Most popular names for boys in 2015:

  1. Noah
  2. Liam
  3. Mason
  4. Jacob
  5. William
  6. Ethan
  7. James
  8. Alexander
  9. Michael
  10. Benjamin

Healthy New Year’s resolutions aren’t just for adults

If you’ve been wanting to talk to your kids about healthy habits for life, New Year’s resolutions are the perfect place to start, according to the American Academy of Pediatrics.

The AAP has released a list of age-specific resolutions, for kids from preschoolers to teenagers, that you can encourage them to try. The group curated its lists after looking over the health surveillance advice that is usually offered to parents during yearly checkups for their children. Because they represent the “greatest hits” of advice and counseling, these resolution suggestions are also good reminders for parents.

For preschoolers, the AAP suggests simple habit-forming resolutions like being nice to other kids who look like they need a friend, cleaning up toys, helping to clear the table and washing their hands after going to the bathroom.

For kids between the ages of 5 and 12, the list is a little longer and more specific, from drinking enough water and being active to practicing safe habits online and reporting bullying.

For teens, the resolutions cover everything from eating enough fruit and avoiding drugs and alcohol to managing stress, practicing safe and healthy social habits and even volunteering.

One item on the lists for all age groups is talking to a parent or trusted adult when the child feels scared, lonely or confused or has to make a difficult decision. Some of the other resolutions were slightly tweaked to match the developmental level for each age group.

It’s a great idea to start having these conversations with children, even when they’re very young, said Dr. Gayle Schrier Smith, spokeswoman for the AAP. For example, a preschooler wouldn’t necessarily be expected to come up with his or her own resolutions. Parents can use this as a chance to point out what their child has accomplished over the year and how to build on that in the next year, Smith said.

These conversations also don’t have to be daunting or feel like a chore. Introducing kids to the idea of making their own resolutions also introduces them to the idea that they can create their own wellness, Smith said. Given the rapid pace of their lives, kids and teens aren’t usually slowing down to reflect on forming good habits, being a better person or becoming healthier.

“Life doesn’t slow down for parents or kids unless you make time for it,” Smith said. “Parents can create a moment for reflection and dialogue and kids can choose and take ownership of the resolutions they want to.”


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These heroes’ superpower: Preventing the spread of HIV

— A new class of heroes is taking a stand against HIV and AIDS by educating others on how to stop the spread of the epidemic.

It’s part of a superhero-themed campaign, called PrEP Heroes, to spread the word about HIV prevention. It was created by Housing Works, an advocacy organization that works to end AIDS and homelessness, fashion photographer Mike Ruiz and former “Project Runway” design contestant Jack Mackenroth.

Models featured in the campaign all use the drug.

(Photo: Mike Ruiz/Housing Works)

Models featured in the campaign all use the drug. “As a community that’s already dealt with hardship, hatred and discrimination, we don’t need to turn on ourselves,” Peter William Dunn said about breaking stigma around HIV and AIDS. “Treat everyone with respect and empathy, and treat those who are HIV-positive as real human beings not defined by a disease.”

PrEP stands for Pre-Exposure Prophylaxis, a type of drug that prevents HIV from establishing itself if someone is exposed. The nine models who appear in the campaign use PrEP to prevent HIV, and Mackenroth, who was diagnosed with HIV in 1989, is an advocate for PrEP.

“People taking PrEP are protecting the greater community by ending the epidemic with them,” Mackenroth said. “We wanted an edgy, bold and attention-grabbing campaign to embody this idea.”

Andrew Greene, the senior vice president of marketing for Housing Works, said the campaign is working off the New York Department of Health’s blueprint to end the AIDS epidemic within the state by 2020. It is the first state in the nation with such a plan. The three-pronged approach includes “expanding HIV testing, helping those with HIV to get treatment and prevent transmission to others and expanding access to PrEP to prevent new infections.”

The FDA approved the first PrEP drug, called Truvada, in 2012. It’s a once-daily pill for those who might be at risk of HIV infection through sex or injection drug use; it’s marketed to those at high-risk for HIV exposure and transmission. PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92%, according to the Centers for Disease Control and Prevention. In a recent study released by Kaiser Permanente, researchers observed no new HIV infections among patients using PrEP over the course of 2½ years.

Since the flashy campaign debuted this year on social media and on posters in bars and gyms, Greene has already seen people wanting to learn about PrEP, and looking beyond stigma that it’s a drug only for people with many sexual partners or frequent sexual activity.

“Many of them hadn’t heard of PrEP until they saw this,” Greene said. “It concerns me that they didn’t know about it. I hope this helps to destigmatize PrEP and make it more approachable.”

Each year, about 50,000 people are infected with HIV in the United States, according to the CDC. About 1.2 million are already living with it, and out of those people, 12.8% don’t know they are infected.

“Don’t stigmatize people or their behavior and focus on the fact that we can cure HIV,” said Dr. Demetre Daskalakis, the assistant commissioner of New York’s Bureau of HIV/AIDS Prevention and Control. “Be honest with yourself and your provider if you’re at risk for HIV and have real conversations about sexual health.”

However, not everyone supports the preventive drug and awareness campaigns around it. Michael Weinstein, president of the AIDS Healthcare Foundation, is concerned the focus on PrEP could take away from other prevention efforts. Weinstein said he’s concerned that patients won’t adhere to a daily routine or take measures to prevent other sexually transmitted diseases. Truvada is most effective when it’s taken daily, and only prevents HIV.

“We have worked hard to build a condom culture over the last 30 years and we have undone a lot of that,” Weinstein said of PrEP drugs. “The best way to prevent the spread of HIV is the use of condoms. This new generation didn’t live through the worst of the AIDS epidemic in the 1980s and ’90s.”

Mackenroth is also concerned that PrEP could be seen as a license not to use condoms, but he’s frustrated, too, that the drug has been slow to build popularity.

“This is a drug that will prevent a possibly fatal illness, but it hasn’t had an impact domestically or globally,” Mackenroth said. “It’s a major biomedical advance that needs widespread accessibility and focus. There is more light to shine on this cause for young people, who are the most at-risk age group, and their parents. And if this was 1990, everyone would be taking it.”