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New Jersey twins receive matching heart surgeries after Marfan syndrome diagnosis: 'A better life'

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New Jersey twins receive matching heart surgeries after Marfan syndrome diagnosis: 'A better life'

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The notion that twins do everything together has met a new standard.

Identical twin brothers Pablo and Julio Delcid, 21, underwent matching heart surgeries on the exact same day following their diagnosis of Marfan syndrome.

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The duo, of Dover, New Jersey, had been alerted to their risk of Marfan syndrome because a majority of their family members also have it, the twins told Fox News Digital in an on-camera interview.

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“We’re a family of five. I have two older sisters who have it,” Julio Delcid said. “My older brother doesn’t have it as much … But I also have other family members who have it, too — pretty much through my whole family on my mom’s side.”

Left to right, Pablo Delcid and Julio Delcid celebrate Christmas with some of their family members. (Pablo and Julio Delcid)

“It’s very genetic,” Pablo Delcid added. “When we were younger and were first diagnosed with it, nobody knew what it was.” 

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He added, “Nobody knew they even had it until tests kept coming in, and they were like, ‘Yeah, it’s pretty genetic. Everyone should get tested.’”

What is Marfan syndrome?

Fox News Digital spoke with Dr. Benjamin Van Boxtel, surgical director at the Atlantic Aortic Center at Morristown Medical Center, in a separate interview about the condition; he performed the twins’ surgeries.

The cardiovascular surgeon said that while Marfan syndrome is mostly genetic, it can also occur at random. It’s a defect of the gene that creates connective tissues in the human body, he said.

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“Because it’s a broad defect in these connective tissues, it can affect many different parts of the body,” he said. “So, this could be anywhere from the eyes to the spine and … the heart.”

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“The most dangerous symptom you could develop with Marfan syndrome is a dilation of the aorta, specifically in the root,” he added.

Van Boxtel said the aortic root in Marfan syndrome can become dilated or enlarged, which can cause an “immediately fatal” tear or rupture.

van boxtel holding graft model

Van Boxtel holds up a “tube-shaped graft” model used during a valve sparing root operation, in which the surgeon “replaces the aortic root and then hand-sews leaflet by leaflet inside that graft.”  (Angelica Stabile/Fox News Digital)

“Or it can cause something called an aortic dissection, which is also potentially very fatal, and becomes a surgical emergency,” he said. “That’s unfortunately how a lot of people who have Marfan syndrome pass away.”

Many of those people don’t even know they have the syndrome, Van Boxtel noted.

A valve-sparing root procedure performed before a dilated aorta dissects can be a life-saving operation.

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Marfan syndrome can be difficult to spot, according to Van Boxtel, as it’s often marked by common symptoms such as chest pain, poor vision — or being tall and having long limbs.

“When you have an aneurysm [from a] dilated aorta, it’s generally asymptomatic, meaning you feel absolutely nothing,” he said. “You feel completely fine … Aneurysm disease is silent, it’s asymptomatic — which can be really dangerous.”

pablo, julio and mom delcid

Left to right, Julio Delcid, the twins’ mother, Betulia Miranda, and Pablo Delcid snap a selfie. (Pablo and Julio Delcid)

Pablo Delcid, for his part, said there’s “not much you can feel when you’re growing into the condition.”

He added, “What we didn’t know was that our bodies were changing … obviously with height, vision, the length of our arms, feet, legs, even with our chest.”

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Surgery on the same day

The twins’ mother, Betulia Miranda, had an emergency procedure on Oct. 8, 2023, after experiencing an aortic dissection, which the boys described as “excruciating” for her.

After their mother’s surgery was a success, the twins decided to seek preventative surgery performed by Dr. Van Boxtel – but their one request was that they do it together.

“Of course they’re like, ‘Can we go at the same time?’” the doctor said with a laugh.

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Van Boxtel, a father of twins himself, said the double surgery was like “nothing I’ve ever done before.” 

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He said, “I’ve done this procedure hundreds of times. But to do it back-to-back on twin brothers — it was an experience, that’s for sure.”

It was decided that Pablo Delcid would go first, since he was born five minutes before his brother, followed by Julio Delcid several hours later.

julio and pablo delcid

Julio Delcid, left, and Pablo Delcid underwent heart surgery on Jan. 5, 2024. (Pablo and Julio Delcid)

“We always do everything together,” Pablo Delcid said. “We live together, go through everything together … We didn’t think we could get the operation done together, but everything [was] successful.”

The twins agreed that they felt “safer” knowing they were going through the procedure together.

“You kind of feel like you’re not going to lose that person,” Julio Delcid said. “They’re sticking with you, side by side.”

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“Aneurysm disease is silent, it’s asymptomatic — which can be really dangerous.”

Pablo Delcid added, “It’s like your gut’s telling you, ‘All right, if I make it, he’s going to make it.’”

On surgery day, Jan. 5, 2024, Van Boxtel and his team distinguished the twins from one another using color-coded ankle bracelets.

The surgeon emphasized the rarity of double heart surgery on twins, especially at such a young age of 21. “This is like the ultimate twin study,” he said. 

Van Boxtel said it was “freaky” when he realized that the brothers’ hearts were also identical.

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“I knew they could be different on the inside, but it ended up that they were the exact same,” he said.

Julio Delcid said he was “shocked” that a surgeon like Van Boxtel could take on both surgeries back to back.

“He did the best he could,” he said. “He successfully saved our aortic valves, replacing the aneurysm … We were very appreciative.”

More about Marfan 

Marfan syndrome affects about one in 5,000 people, according to Van Boxtel, and impacts men and women equally.

“About 75% of those cases are genetic,” he said. “But about 25% of Marfan cases are actually not inherited. They’re not from a parent. They’re a spontaneous mutation.”

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Along with a dilated aortic root (enlarged aorta) or narrow dissection (tear in an artery), patients also run the risk of having a leaky valve, which can lead to heart failure symptoms like shortness of breath, chest pain, dizziness and inability to perform normal exertional activity, Van Boxtel said. 

Since Marfan syndrome is often hard to spot on the surface, the Delcid twins emphasized the importance of getting tested, especially for those within the Latin and Hispanic communities.

delcid twins at rockefeller tree in nyc

Julio Delcid said that those at risk of Marfan syndrome should “take the time to get yourself checked out.” (Pablo and Julio Delcid)

“It’s pretty lethal,” Pablo Delcid said. “We almost lost our mother, and that was a traumatic experience.”

People with symptoms or with a family history of Marfan syndrome should educate themselves on how best to prevent an aneurysm and connect with a cardiology team, Julio Delcid reiterated.

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“It’s just very important to take the time and the opportunity to get the best treatment that they could possibly get, because if they wait, consequences will happen later,” he said.

“Don’t fear anything. Just take the time to get yourself checked out and get the help that you need to live a better life.”

Looking ahead with new hope

With the stresses of heart surgery behind them, the twins said they’re looking forward to getting outside, playing sports and exercising more than they could before.

“Both their valves were saved,” Van Boxtel said. “They weren’t leaking at the end. All the things that we look for in a very successful repair they had, and they’re going to go on and live normal, healthy lives.”

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“It’s a very serious problem … but there’s prevention available, and if you get it at the right time, it can be very successful.”

He said he hoped that “these valves last a really, really long time, if not the rest of their lives. They’re much better off now than they were walking around with aneurysms.”

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Van Boxtel thanked his team for handling the complex, same-day operations on young men with their “whole lives ahead of them.”

van boxtel heart surgeon

Dr. Benjamin Van Boxtel is a cardiovascular surgeon and the surgical director of the Atlantic Aortic Center at Morristown Medical Center. (Atlantic Health System)

The Marfan Foundation has various resources for patients at all stages of the condition, the doctor noted.

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“I can’t underscore how important it is for patients with aneurysms to be seen by a surgeon or a team who is comfortable performing that,” he said.

“It’s a very, very serious problem … but there’s prevention available, and if you get it at the right time, it can be very successful.”

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3 signs your aging loved one may be ready for assisted living

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3 signs your aging loved one may be ready for assisted living

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As Mom and Dad grow older, the big question might be looming in the background: When is the right time to provide living support?

Dr. Macie P. Smith, a licensed social worker and gerontologist based in South Carolina, shared with Fox News Digital that there may be a few telltale signs that it’s time to make a move, whether it’s hiring an at-home aide or seeking out a living facility.

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1. They’re at risk of harming themselves

Most importantly, Smith noted that if a senior is at risk of hurting themselves or getting into dangerous situations, it’s most likely time to call in help.

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Smith, who specializes in seniors living with Alzheimer’s disease and cognitive impairment, recommended starting with enlisting at-home aid before pulling a loved one out of their home.

Memory loss can cause dangerous environments and behaviors for aging adults, experts warn. (iStock)

“The last thing anybody wants to lose is their independence,” she said. “The last thing anybody wants is to live in a space with 50 other strangers.”

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At-home support can help lower the risk of self-inflicted danger from incidents like leaving the stove on, or mobility issues that could lead to falls.

2. The person is having memory issues

As people age, their capacity to remember things begins to naturally slow down.

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Sometimes, this presents in the form of diseases like Alzheimer’s or dementia. The severity of memory loss in seniors dictates whether living support is necessary, according to experts.

Smith mentioned how forgetting familiar tasks and activities, like eating, can pose a danger to someone’s health.

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Grandmother and granddaughter together outdoors

“Respect them enough to have the conversation, because they still have the ability to make decisions about their life.” (iStock)

“If their nutrition is poor, it may be because they are dealing with some pain that they are not expressing to anyone else,” she said. “They may be dealing with some depression and, frankly, they just don’t have the motivation.”

“Respect them enough to have the conversation, because they still have the ability to make decisions about their life.”

The expert advised watching out for signs of spoiled food in the refrigerator. 

The person may also forget how to do simple tasks like making a bed, doing laundry, washing the dishes or following cooking instructions.

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“If they’re having trouble cognitively, they’re having trouble making decisions, and that’s going to ultimately impact … how they live independently,” Smith said.

3. They repeat themselves

Repetition of thoughts is also common in individuals living with Alzheimer’s disease and dementia.

For more Health articles, visit www.foxnews.com/health

Smith noted that if your loved one is repeating themselves more frequently, it’s a good idea to bring in some support not only for help with day-to-day living, but also for attention and friendship.

senior father bonding with his son

The repetition of thoughts is common in individuals who suffer from Alzheimer’s disease and dementia. (iStock)

“In some cases, it’s because they’re lonely,” she said. “It’s because they’re living by themselves, and they don’t have any type of engagement or motivation.”

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‘Very difficult’ decision

Smith emphasized how difficult it can be to make the decision to place a loved one into care, especially if it means removing them from their home.

The senior should “always be a part of the conversation” when it comes to deciding the next steps, she urged.

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“The last thing you want to do is come in and uproot them from the place where they feel the most comfortable and safe, just because you feel they shouldn’t be there,” Smith said. 

“Always include them in the conversation, even if they’re in the early stages of dementia,” she encouraged. “They still have a lucidity … to be able to participate in the decision-making process.”

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Bonding moment of father and son embracing and giving emotional support

Taking away your loved one’s control and independence can cause issues, the expert warned. Instead, “we need to be there to support them and wrap services around them.” (iStock)

Whether the decision is to bring in care or move somewhere new, Smith said the senior should never be made to feel unsafe or unfamiliar, as this can increase dangerous behaviors, cause agitation and lead to health decline.

The conversation also should not start with the assumption that the senior will not accommodate your request or suggestion.

“Don’t assume they’re not going to remember,” Smith said. “Don’t assume they’re going to be irritable and combative.”

“Respect them enough to have the conversation, because they still have the ability to make decisions about their life.”

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Cancer Remission Like Catherine’s Does Not Always Mean the Illness Is Cured

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Cancer Remission Like Catherine’s Does Not Always Mean the Illness Is Cured

Princess Catherine, wife of Prince William, reported on Tuesday that her cancer was in remission. But what does it mean to be in remission from cancer?

Doctors discovered her cancer unexpectedly last March when she had abdominal surgery. She has not revealed the type of cancer she has, nor how advanced it was when it was discovered.

But she did say she had chemotherapy, which she said had been completed in September. She told the British news agency PA Media that she had a port, a small device that is implanted under the skin and attached to a catheter that goes into a large vein. It allows medicines like chemotherapy drugs to be delivered directly to veins in the chest, avoiding needle sticks.

Catherine told PA Media that chemotherapy was “really tough.”

“It is a relief to now be in remission and I remain focused on recovery,” she wrote on Instagram.

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Her announcement “certainly is good news and is reassuring,” said Dr. Kimmie Ng, associate chief of the division of gastrointestinal oncology at the Dana-Farber Cancer Institute in Boston.

But cancer experts like Dr. Ng say that the meaning of remission in a patient can vary.

In general, when doctors and patients talk about remission, they mean there is no evidence of cancer in blood tests or scans.

The problem is that a complete remission does not mean the cancer is gone. Even when a cancer is “cured” — defined as no evidence of cancer for five years — it may not be vanquished.

That makes life emotionally difficult for patients, who have to have frequent visits with oncologists for physical exams, blood tests and imaging.

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“It’s really scary,” Dr. Ng said. “The amount of uncertainty is very very hard,” she added.

But that ongoing surveillance is necessary, despite the toll it takes on patients.

“Different cancers have different propensities of returning or not returning,” said Dr. Elena Ratner, a gynecologic oncologist at the Yale Cancer Center.

As many as 75 to 80 percent of ovarian cancers, she noted, can come back in an average of 14 to 16 months after a remission, depending on the stage the cancer had reached when it was found and on the cancer’s biology.

“Once the cancer returns, it becomes a chronic disease,” Dr. Ratner said. She tells her patients: “You will live with this cancer. You will be on and off chemotherapy for the rest of your life.”

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Dr. Ratner’s gynecological cancer patients have to come back every three months for CT scans to keep an eye out for evidence that the cancer has returned.

“The women live CT scan to CT scan,” she said. “They say that for two and a half months, they have a wonderful life, but then, in time for the next CT scan, the fear returns.”

“It costs them — it costs them a lot,” she said.

“It’s awful, yet I am amazed every day by their strength,” she said of her patients.

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Death Toll in Gaza Likely 40 Percent Higher Than Reported, Researchers Say

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Death Toll in Gaza Likely 40 Percent Higher Than Reported, Researchers Say

Deaths from bombs and other traumatic injuries during the first nine months of the war in Gaza may have been underestimated by more than 40 percent, according to a new analysis published in The Lancet.

The peer-reviewed statistical analysis, led by epidemiologists at the London School of Hygiene and Tropical Medicine, used modeling in an effort to provide an objective third-party estimate of casualties. The United Nations has relied on the figure from the Hamas-led Ministry of Health, which it says has been largely accurate, but which Israel criticizes as inflated.

But the new analysis suggests the Hamas health ministry tally is a significant undercount. The researchers concluded that the death toll from Israel’s aerial bombardment and military ground operation in Gaza between October 2023 and the end of June 2024 was about 64,300, rather than the 37,900 reported by the Palestinian Ministry of Health.

The estimate in the analysis corresponds to 2.9 percent of Gaza’s prewar population having been killed by traumatic injury, or one in 35 inhabitants. The analysis did not account for other war-related casualties such as deaths from malnutrition, water-borne illness or the breakdown of the health system as the conflict progressed.

The study found that 59 percent of the dead were women, children and people over the age of 65. It did not establish what share of the reported dead were combatants.

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Mike Spagat, an expert on calculating casualties of war who was not involved in this research, said the new analysis convinced him that Gaza casualties were underestimated.

“This is a good piece of evidence that the real number is higher, probably substantially higher, than the Ministry of Health’s official numbers, higher than I had been thinking over the last few months,” said Dr. Spagat, who is a professor at Royal Holloway College at the University of London.

But the presentation of precise figures, such as a 41 percent underreported mortality, is less useful, he said, since the analysis actually shows the real total could be less than, or substantially more. “Quantitatively, it’s a lot more uncertain than I think comes out in the paper,” Dr. Spagat said.

The researchers said their estimate of 64,260 deaths from traumatic injury has a “confidence interval” between 55,298 and 78,525, which means the actual number of casualties is likely in that range.

If the estimated level of underreporting of deaths through June 2024 is extrapolated out to October 2024, the total Gazan casualty figure in the first year of the war would exceed 70,000.

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“There is an importance to war injury deaths, because it speaks to the question of whether the campaign is proportional, whether it is, in fact, the case that sufficient provisions are made to to avoid civilian casualties,” said Francesco Checchi, an epidemiologist with an expertise in conflict and humanitarian crises and a professor at the London School of Hygiene and Tropical Medicine who was an author on the study. “I do think memorializing is important. There is inherent value in just trying to come up with the right number.”

The analysis uses a statistical method called capture-recapture analysis, which has been used to estimate casualties in other conflicts, including civil wars in Colombia and Sudan.

For Gaza, the researchers drew on three lists: The first is a register maintained by the Palestinian Ministry of Health, which mainly comprises the dead in hospital morgues and estimates of the number of unrecovered people buried in rubble. The second is deaths reported by family or community members through an online survey form the ministry established on Jan. 1, 2024, when the prewar death registration system had broken down. It asked Palestinians inside and outside Gaza to provide names, ages, national ID number and location of death for casualties. The third source was obituaries of people who died from injuries that were published on social media, which may not include all of the same biographical details and which the researchers compiled by hand.

The researchers analyzed these sources to look for individuals who appear on multiple lists of those killed. A high level of overlap would have suggested that few deaths were uncounted; the low amount they found suggested the opposite. The researchers used models to calculate the probability of each individual appearing on any of the three lists.

“Models enable us to actually estimate the number of people who have not been listed at all,” Dr. Checchi said. That, combined with the listed number, gave the analysts their total.

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Patrick Ball, director of research at the Human Rights Data Analysis Group, and a statistician who has conducted similar estimates of violent deaths in conflicts in other regions, said the study was strong and well reasoned. But he cautioned that the authors may have underestimated the amount of uncertainty caused by the ongoing conflict.

The authors used different variations of mathematical models in their calculations, but Dr. Ball said that rather than presenting a single figure — 64,260 deaths — as the estimate, it may have been more appropriate to present the number of deaths as a range from 47,457 to 88,332 deaths, a span that encompasses all of the estimates produced by modeling the overlap among the three lists.

“It’s really hard to do this kind of thing in the middle of a conflict,” Dr. Ball said. “It takes time, and it takes access. I think you could say the range is larger, and that would be plausible.”

While Gaza had a strong death registration process before the war, it now has only limited function after the destruction of much of the health system. Deaths are uncounted when whole families are killed simultaneously, leaving no one to report, or when an unknown number of people die in the collapse of a large building; Gazans are increasingly buried near their homes without passing through a morgue, Dr. Checchi said.

The authors of the study acknowledged that some of those assumed dead may in fact be missing, most likely taken as prisoners in Israel.

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Roni Caryn Rabin and Lauren Leatherby contributed reporting.

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