sanguinemare

October 8, 2015

Antibacterial Soap is not Better than Regular Soap… and learning from death

So, fun fact of the day: according to our MSTP seminar speaker tonight, apparently the FDA agrees that “antibacterial” soap is not any more effective at preventing disease transmission than regular soap, assuming both are used to wash hands properly!  Did not know that.  And to back that up, here’s an article straight off the FDA site that speaks about that, from 2013.

He also described a painful experience he had had as a clinician, where he did a procedure on a patient, and that patient ended up dying, even though he had done everything technically right.  This, in itself, was one of his lessons – that you can be technically right, but mess up intellectually.  Because, as it turns out, after that, they did a retrospective study, and apparently that patient was at high risk for bleeding out after that procedure, as they’d had a bone marrow transplant before that.  That wasn’t known at the time, but it cost that patient their life.  There are two lessons I learned from this:

The first, which is rather scary and sobering, is that as a doctor, we’re all going to make mistakes at some point.  Mistakes that may even cost people their lives.  And some of them, like the case here, won’t really be our “fault”, in the sense that it wasn’t anything that could be prevented at the time due to lack of knowledge, but in hindsight, for whatever reason – new research coming out, a new technique our clinic/hospital was not aware of, etc… we’ll realize that our decision at that point in time was what directly or indirectly, caused harm to the patient.  To be quite honest, that scares me quite a lot.  I don’t know if I can handle that. I think that would tear me apart from the inside.  And yet… if no one makes those decisions… even more people may come to harm.  It’s a tough job.  I guess time will tell.  I just pray that over the course of my career, I will be fortunate enough not to do anything so bad that it costs a life or cripples someone the rest of their time on earth.

The 2nd is that even in one’s darkest moments/worst mistakes, something good can come of it.  In this case, research that probably has saved at least a few lives since.  He recognized that maybe there was something about this patient that made them susceptible to the procedure, even though he did nothing wrong, and they went back and looked at records and realized this predisposition, and published a paper on it.  So now, anyone encountering this type of patient before this procedure will know that it is a high risk thing to do in these people, so they may be much more cautious about ordering that test to be done.  So even when making mistakes, analyzing it and building off of it may lead to research that helps others in the future.  And I guess that’s how we have to look at it, in order to keep moving forward, lest we crumble from the guilt and sadness of those we were unable to help.

June 8, 2013

Random Step 1 find of the day – Growth hormone

So… you know that growth hormone stuff that are used to help some children grow (if they are legitimately deficient in it) and that some athletes abuse?  Well, it used to be made from either animal carcasses, or ground up and extracted human cadaver pituitary glands.  Ick!  Which also meant that if it was taken from someone with Creutzfeldt-Jakob disease (aka a prion disease), people who got the growth hormone (GH) could develop it 10-15 years later (and die in a not-so-pretty, rather quick, fashion).  This actually happened to some people, apparently. :\

Thankfully, according to wikipedia, that old method of getting GH has been done away with, and now there is a biosynthetic one one on the market.

Also, other causes of Creutzfeldt-Jakob disease (that are known, according to UWorld) are apparently contaminated corneal transplants and implantable electrodes.  And of course if you happen to handle brains in some capacity (neurosurgeon, pathologist, in the morgue…)

Moral of the story: be careful with what medications/treatments you’re getting!  Might be a good idea to check out how they’re made (and any side effects too, as a general rule).

April 8, 2012

GI Fun Facts – Part I (?)

Filed under: Fun facts — sanguinemare @ 2:15 pm
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Here are some fun/medical facts we have learned from GI so far (during material for the first test):

Medical

  • Appendicitis usually starts out hurting near the umbilicus (belly-button) because of referred pain (organs have something called “visceral nerves” which don’t have pain receptors), but when it gets more inflamed, that’s when it starts hurting in the right lower quadrant of your abdomen (because that’s when it presses on your peritoneum (the inside lining of your stomach), which DOES have pain sensors).
  • Cholecystitis (gall stones) are formed if you have either too much cholesterol or if you have too little bile salts (b/c excess cholesterol starts crystallizing around the bile salts).  Treatment?  Synthetic bile salts or surgical removal of the gallbladder (which means bye-bye ability to eat fats :/)

Fun facts

  • Chewing gum actually uses up a lot of energy – if you chew gum continuously while you’re awake for a year, it is estimated that you will lose 5kg!
  • Hiccups are from spasms of the epiglottis and esophagus.
  • Swallowing is a very complex process which involves the food in your mouth turning into a bolus, then your tongue pushing it to the back of your throat (pharynx), the epiglottis (a flap at the opening of your airway) closes to block off the airway so that the food can slide behind the trachea into the esophagus, and then peristaltic waves help push the food down.  Speaking of the esophagus, did you know the top third is skeletal muscle (voluntary), the bottom third is smooth muscle (involuntary), and the middle third is both?
  • Lifesavers were called that because they had a hole in the middle, so if you swallowed it down the wrong tube, you could still breathe.
  • It takes about 10 seconds to get food from your mouth to your stomach (less for liquids of course).  This is called primary peristalsis (you can’t feel secondary peristalsis).
  • Food actually shoots out of your stomach into the small intestine in jets!  (It’s not a smooth transition/squishing out).
  • Food empties completely out of your stomach by ~100 min after you eat.  It takes 2 more hours to empty completely out of the small intestine (food moves at about 5cm/min).
  • You will eat about 30 tons of food in your lifetime.
  • Red bull is called what it is because it has a lot of the amino acid Taurine in it. Tau- as in tauros, the bull.

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