Disclaimer: This interview with Taylor Zakhar Perez about Amazon Prime Video’s film Red, White & Royal Blue was conducted before the start of the SAG-AFTRA strike.

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TREVOR, Wis.--(BUSINESS WIRE)--Sep 18, 2023--

Surgeons worked all day and into the night to ensure Britain’s first womb transplant went smoothly. Its success is down to meticulous research, years of sharing knowledge between experts around the globe, and the hard work and dedication of doctors Professor Richard Smith, from Imperial College London, and Isabel Quiroga, from the Oxford Transplant Centre. Around 50 babies have been born worldwide as a result of womb transplants, which give women missing a functioning uterus a chance to have a baby. In the first UK case, the operation to remove the womb from the recipient’s 40-year-old sister lasted eight hours and 12 minutes, with surgeons leaving her ovaries behind to prevent pushing her into early menopause. One hour earlier, surgeons began operating on the 34-year-old recipient, preparing her body to receive the donated organ. This operation lasted nine hours and 20 minutes, with the surgical team experiencing some difficulties including a higher-than-expected blood loss of two litres. However, after just 10 days, the recipient was well enough to leave the hospital and has continued to have a good recovery. She is also having regular periods, which shows the womb is working well. Her sister was discharged five days after her donor operation and has also made a good recovery. Removing a womb is a similar operation to a radical hysterectomy, according to Prof Smith, who as well as being a gynaecological surgeon is the clinical lead at the charity Womb Transplant UK. He and Miss Quiroga led the team of more than 30 staff who worked on the transplant one Sunday in February. Prof Smith and Miss Quiroga removed the older sister’s womb, cervix and fallopian tubes, plus crucial blood vessels around the organ. The main vessels are the uterine arteries running into the womb, but the surgeons also aimed to collect some of the larger internal vessels that lead into the smaller branch of the womb. Prof Smith said surgeons doing these operations have to retrieve veins involved in the drainage of the womb. “One of the amazing things is that my surgical skill-mix as a cancer surgeon is to remove organs with a margin of normal tissue, while sealing the vessels as I go,” he said. “Transplant surgical skills are different – that is to remove a normal organ with the best number of non-sealed vessels as you can. “Isabel and I operate together with no ego – it just flows backwards and forwards across the table.” He added: “The day itself was truly humbling. We turned up at 7am at the Churchill transplant centre with the donor and the recipient families, then we went into a pre-op huddle. Those in the huddle included surgeons, nurses, anaesthetists and technicians. Prof Smith and Miss Quiroga worked to remove the womb, before the organ was prepared for transplantation by a “back table” team. “This was an organ which had a very, very unusual blood supply,” Prof Smith said. “In fact, it had a set of blood vessels which I’ve never seen in my entire career. They made my dissection a bit harder than it might have been, but we got there.” In the theatre next door, one hour before the retrieval of the womb was completed, surgeons began to operate on the donor’s younger sister to enable her to receive the womb. Prof Smith and Miss Quiroga switched from donor to recipient and Prof Smith removed the vestiges of the underdeveloped womb the recipient was born with. Meanwhile, the organ was packed and transported between the two theatres under sterile conditions to prevent contamination. A sterile bag with a cold perfusion solution contained the womb, which was then placed into a container with ice. During surgery, ligaments attached to the womb were attached to the recipient to help the womb stay in a relatively fixed place so it does not move around the pelvis. The most important part of the transplant operation was the joining of the very small vessels that give the blood supply to the womb. This was the most delicate and difficult part of the operation and was led by Miss Quiroga. Once all the vessels were connected, the donor’s vaginal cuff – around a 1cm part – was stitched into her sister’s vagina. If and when the recipient is able to complete her family, the womb will be removed six months later to prevent her from needing immunosuppressants for the rest of her life. Prof Smith said: “We know that the chance of failure at the point where the uterus goes in – if you look at the world literature – is 20 per cent to 25 per cent. And that failure is usually on the basis on sepsis and thrombosis. So technically, we are up to the job, but what happens thereafter can be scary. “Once you get to three or four days later, the chance of failure drops to probably less than 10 per cent. “Once you get to two weeks – and at the point where the woman has a period – the chance of her having a baby at that point is very high and the chance of failure has dropped to low. But those first two weeks – it’s very scary as a surgeon to watch and wait.” Biopsies to check the womb was functioning were read in London but then also confirmed by an expert team in the US at Baylor University Medical Centre in Dallas, where other womb transplants have been performed. Prof Smith said the procedure gives new hope to women born with devastating conditions. He said: “You’ve got girls, maybe 14, who have not had periods, they go to the GP and a scan shows there is no uterus. Absolute catastrophe. “Up until now, there’s been no solution for that, other than adoption or surrogacy... That’s not the case now. It’s really exciting.” On whether transgender women may also benefit from the operation, Prof Smith said that was still a long way off. He said the pelvic anatomy, vascular anatomy and shape of the pelvis are different, and there are microbiome issues to overcome. “My own sense is if there are transgender transplants that are going to take place, they are many years off. There are an awful lot of steps to go through. My suspicion is a minimum of 10 to 20 years.” Miss Quiroga said the living donor programme to date in the UK has focused on women with relatives who are willing to give their wombs. “It will come to a point where we will have friends or altruistic donors, like we have with many other transplants, but at the moment we’re only focused on people who have come forward with relatives,” she said. 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A father-of-three who was told he looked like “Casper the ghost” before being diagnosed with acute myeloid leukaemia (AML) and given three weeks to live, meaning he has planned his own Requiem Mass and funeral, has defied doctors’ expectations by outliving his prognosis by more than a year and said he is going to “keep fighting”. Dennis Blackman, 62, a former chartered building surveyor and carer who lives in Eltham, London, said he has always been active – playing rugby, lifting weights, and going to the gym at least three times a week. However this all changed when he suffered an unexpected stroke in 2015. His health deteriorated over the following years, he had a hip replacement at 58, and after experiencing symptoms of extreme exhaustion, cold hands, and muscle weakness in early 2022, his wife Sally, 62, a former flooring showroom manager, suggested he book a doctor’s appointment. After weeks of blood tests and blood transfusions in hospital and being told he looked like “Casper the ghost” because he was so pale, he underwent a bone marrow biopsy, and this led to the devastating news in March 2022 that he has AML – a type of blood cancer – and three weeks to live. Dennis told PA Real Life: “I just broke down and I had this unbelievable feeling of guilt because I said to the consultant: ‘What have I done wrong? How do I tell my children and wife?’ “It’s a huge burden to put on someone, to tell them that you’re dying and it’s going to be very quick. “We had many dark days, and every time I looked into my children’s eyes I just burst into tears… it was a very emotional period for all of us.” Dennis, who has lost 50kg (7st 9lbs) since his diagnosis, did not start chemotherapy until months later due to him being too weak, and in January 2023, he was told the chemotherapy was “not working any more”. From that point on, he said he wanted to “enjoy each day” rather than pursuing more aggressive forms of treatment – and since then, he has planned his own Requiem Mass with hymns such as How Great Thou Art and Ave Maria (As I Kneel Before You), as well as the arrangements for his funeral. Now, Dennis continues to drive, go shopping, and enjoy time with his family, and he said he is going to “keep fighting” during the time he has left as “you only have one life”. “Every day you go to bed and you think: ‘Am I going to wake up tomorrow?’ And then each morning you think: ‘Is it going to be today that I’m going to die?’” Dennis explained. “It was extremely difficult in the beginning and I tried to shut the world out… but as time went on, I realised you can’t live like this forever. “You only get one life, so I’m going to do everything I can to keep fighting.” During his 40s and early 50s, Dennis said he enjoyed going out for meals with his wife Sally, playing rugby with his sons James, 37, and Joe, 31, and keeping fit by going to the gym several times a week. He foresaw spending his days in retirement with his family, out in the garden, or fishing, but he said this all changed when he had a stroke in 2015, aged 54, and his health declined from then on. In early 2022, he spent six weeks at Queen Elizabeth Hospital in London after noticing some unusual symptoms and was told: “You look like Casper (the ghost), you’re very anaemic.” He then underwent several blood tests and blood transfusions, and although he had “an idea” that he may have cancer, he said he could never have prepared himself for his diagnosis on March 31 2022. “About one o’clock, I had a knock at the door and I thought: ‘That’s ominous’,” Dennis said. “The consultant and the specialist nurse came in and they said: ‘Unfortunately it’s bad news, you’ve got severe AML and there’s not a lot we can do at this stage.’ “’You’ve got three weeks to live, and I’d advise you to go home and tell your wife and family, and make sure everything’s in order because you haven’t got long left’.” Given Dennis has severe neutropenia as well – a low number of white blood cells – he is at a higher risk of contracting serious infections, and this meant he missed several family celebrations in the months that followed, including his grandson’s birthday party and stepdaughter’s wedding. He developed multiple chest infections and fevers and was not deemed fit enough to start chemotherapy straight away, and he ended up spending three months in hospital from July to October. “We thought we were going to lose him, he was so ill,” Sally, who has been married to Dennis for 10 years, explained. “Even the consultant thought we were going to lose him. “I was scared because I just thought: ‘How can this be happening when we’ve only just met each other?’ We just thought we were going to have the rest of our lives together.” However, Dennis, who is Catholic, said he “fought and prayed every day”, adding: “I said to the consultant: ‘If you promise to me you won’t give up on me medically, I promise I’ll fight this all the way.’” Dennis was determined to get better and, with the help of a physiotherapist, he built up his strength – and at one point, he was walking 10,000 steps a day along the hospital corridor. Towards the end of October 2022, Dennis said “everything seemed hunky dory” and he commenced the first of four rounds of chemotherapy, where he experienced nausea, exhaustion, and “tremendous leg bone pain”. By January, he was told the chemotherapy was “not working”, but rather than trying other forms of treatment, he said he wanted to “enjoy the little things” and the time he has left. He has planned his own Requiem Mass and funeral to relieve any pressure from his family, but also to give him “strength” and some control over his destiny – and aside from his regular check-ups and blood tests each week, he is setting himself small milestones, such as attending a Madness concert at the O2 in December. Although he is “struggling to survive”, he said he would do “anything to get another day” – and that is why he is holding onto hope and wants to encourage others never to give up. “Even though I pray every day, not once have I asked God to take it away from me – all I ask is that He’s with me when I need him, to give me the strength to carry on fighting,” he said. “Leukaemia is painful and every day I question whether I’ll see another day, but we just try and keep going and I hope that my story gives hope to others. “I’ve still got lots of memories to make yet, so I’m going to fight this all the way.” For more information and support, visit Leukaemia Care’s website at leukaemiacare.org.uk Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live One in 10 ‘spending beyond their means’ – try these 7 cutbacks guaranteed to save families money What is combination cholesterol therapy, as study suggests it could save lives? 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