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Category Archives: Medical Issues

Do Astronauts Hallucinate?

It has long been known that isolation can lead to all sorts of psychological problems, including delusions and hallucinations. Prisoners in isolation, who have limited interaction with others, can suffer just such effects.

In medicine, we see it frequently. Someone has surgery, and then for whatever reason (complex surgical problems, complications, co-morbidities, etc.) must linger in the ICU for a few days. This is a form of isolation as they are limited in their activity and in who they see and talk with on a regular basis. Sort of like prison isolation. Not to mention they might be receiving medications for pain, sleep, or agitation, each of which can alter mental function. After as little as a couple of days, the person can become confused and disoriented and suffer delusions, such as everyone is trying to kill them, or they are being held prisoner and undergoing some alien experimentation, as well as hallucinations where they see, feel, and hear things that don’t exist. Seen it hundreds of times. It’s that common.

icu

It even has a name: ICU Psychosis.

Astronauts are in a similar situation. They spend months in an enclosed, monotonous environment, interacting with the same people, day after day. It’s like prison, or an ICU. Do they also develop delusions and hallucinations? It seems that the do. In fact, I would be surprised if they didn’t.

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So, during a trip to Mars, where isolation is very real, could such psychiatric problems jeopardize the mission? You bet. NASA takes this seriously and has begun studies into such long-term deprivations.

HI-SEAS

MedNet: ICU Psychosis: http://www.medicinenet.com/icu_psychosis/article.htm

NIH: Intensive Care Unit Psychosis: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2154033/

Astronauts and Hallucinations: http://www.theguardian.com/science/2014/oct/05/hallucinations-isolation-astronauts-mental-health-space-missions

NASA Trains Astronauts to Bins, Tranquilize Unstable Crewmates: http://www.foxnews.com/story/2007/02/25/nasa-trains-astronauts-to-bind-tranquilize-unstable-crewmates/

NASA Has Guidelines for Dealing With Psychosis in Space: http://www.utsandiego.com/uniontrib/20070224/news_lz1n24read.html

Mars One Astronaut Training Program: http://www.mars-one.com/faq/selection-and-preparation-of-the-astronauts/how-are-the-astronauts-prepared

NASA’s HI-SEAS Training Program: http://www.sci-news.com/space/science-nasas-hi-seas-team-hawaii-mars-mission-02220.html

 

Medicine Is Strange: Stone Man Syndrome

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Medicine has a lot of very strange disorders in its catalog of maladies.

Fibrodysplasia Ossificans Progressiva (FOP or Stone Man Syndrome) is one of them.

http://thechirurgeonsapprentice.com/2014/12/17/disturbing-disorders-fop-stone-man-syndrome/

 

Hacking Pacemakers For Murder No Longer the Perfect Crime

Pacemakers can be hacked but that’s not news. We’ve known that for a while.

St_Jude_Medical_pacemaker_in_hand

Newer models are even easier to hack than were the older models. Progress being what it is. Most pacemakers are interrogated and adjusted in the doctor’s office or the Pacemaker Clinic by placing a “wand” over the pacemaker and then using an attached computer to retrieve data stored inside and/or change the parameters of the pacemaker—-changing sensing, pacing thresholds and rates, that sort of thing. Many newer models allow for more remote access—-from several feet away. Think “blue tooth” for a pacemaker.

Heart-039-s-Natural-Pacemaker-2

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This more “remote” access allows for hacking to take place without direct contact with the patient. The pacemaker can be changed, even turned off, which in someone who is “pacemaker dependent” for their heartbeats can be catastrophic, even deadly. Fortunately most pacemaker recipients are NOT pacer dependent so even if the device is turned off they would still do fine. Maybe a bit weak, tired, and dizzy, but not dead from heart stoppage.

Now it seems that, though this can still be done, traces are left behind. Makes getting away with such tampering more difficult.

Guess you crime writers will have to find another way to off your characters who have pacemakers.

 
 

Want To See Something Very Small? DNA Replication Visualized

This is cool. You probably remember from high school biology that DNA copies itself as the first step in cell division. This is how we grow and how we replace lost or damages cells.

 

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The replication process begins when the two strands of our double-stranded DNA “unzip.” That is, they split form one another. Then each stand rebuilds its complementary strand in a complex biological process. This yields two identical strands of double-stranded DNA, each of which becomes the nuclear material for the two identical cells when the division process is completed.

Current DNA analysis mirrors this natural phenomenon. State of the art DNA profiling employs the combination of the Polymerase Chain Reaction and Short Tandem Repeat analysis (PCR-STR). It’s the PCR portion that utilizes this natural process of replication, which is also called “amplification.”

Now it seems someone has used electron microscopy to visualize this process.

Amazing.

DNA Replication RCN.com: http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/D/DNAReplication.html

You Tube: DNA Replication Video: https://www.youtube.com/watch?v=27TxKoFU2Nw

How Stuff Works: DNA Replication: http://science.howstuffworks.com/life/cellular-microscopic/dna3.htm

DNA Forensics: From RFLP to PCR-STR and Beyond: http://www.forensicmag.com/articles/2004/09/dna-forensics-rflp-pcr-str-and-beyond

 

 

Honey and “Super Bugs”

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Here’s a first aid tip——if you find yourself out in the boondocks and suffer an injury and help is far away, clean the wound as best you can and find a beehive. Yes, a beehive. It just might save your life.

Honey applied to open wounds lessens the chance of infection. This has been empirically known for a couple of millennia. Hopefully you’ll never have to test this treatment method, but if so it just might help.

But can honey’s unique antibacterial properties be useful in treating the new antibiotic-resistant “super bugs” that seem to appear with increasing frequency? The answer is a definite maybe.

Check out these articles:

ACS: http://www.acs.org/content/acs/en/pressroom/newsreleases/2014/march/honey-is-a-new-approach-to-fighting-antibiotic-resistance-how-sweet-it-is.html

NIH, NLM: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609166/

 
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Posted by on January 8, 2015 in Medical Issues

 

Can Learned Fear Be Inherited?

Every species has information necessary for individual and species survival hard-wired in its DNA. It’s all part of the evolutionary dictum of survival of the fittest. Some “know” to hang together in groups to ward off predators and survive; others “know” to hunt in packs to ward off group starvation. Some “know” to burrow into the ground to hide during the vulnerable sleep period; others “know” to climb the tallest trees for the same reason. Much of this behavior is ingrained; some is learned from other group members. Of course the ingrained knowledge is passed along but can the learned behavior be also?

So the question becomes: can learned fear be inherited? Can it be passed on to future generations? Can this fear alter the DNA of the individual and can this altered DNA be passed along to its offspring?

For mice, at least, it seems that it is. In an interesting study conducted at Atlanta’s Emory School of Medicine, mice were found to pass on learned fear to their offspring. And then to the offspring’s offspring.

 

White Mouse

I wonder which one of my parents passed on a fear of sharks? No, wait a minute, that was Jaws. Or perhaps it’s simply common sense.

 

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6 Comments

Posted by on January 4, 2015 in Medical Issues

 

Q and A: Will Ingestion of Bee Venom Kill Someone Who Is Allergic to Bees?

Q: If a person is allergic to bee venom and the venom is ingested, would the person be likely to die? Would the venom show up on a tox screen at autopsy?

Bee-apis

A: Bee venom is a protein toxin and would be digested by the acids in the stomach if swallowed. And once digested it would not likely cause an allergic reaction. However, an allergic reaction would happen once the venom contacted the buccal mucosa—big word for the lining of the mouth. This could cause an anaphylactic reaction and kill the victim.

Anaphylaxis is a rapid allergic reaction to some antigen. These antigens are typically foods, drugs, or insect venoms. Common foods are peanuts and shellfish; common drugs are penicillin and iodine, which is found in many radiographic dyes; and common insects are bees as in your story. There a myriad other foods, drugs, and bugs that can cause anaphylaxis in the allergic person.

This rapid immune (or allergic) reaction involves antigens (the food, drug, the bee venom, etc.) and antibodies, which are manufactured by the body and react to the specific antigen that they are directed against. This reaction is a critical part of our defense against bacteria and viruses. The body recognizes the antigen (virus, let’s say) as foreign and builds antibodies that will recognize and attach to the virus. This reaction attracts white blood cells (WBCs), which release chemicals that kill or harm the virus, which is then consumed by the WBCs and destroyed.  This process is essential for each of us to survive in our bacteria and virus-filled world.

But, in allergic individuals, this reaction is rapid and massive and causes a release of large amounts of the chemicals from the WBCs and it is these chemicals that cause the problems. They cause dilatation (opening up) of the blood vessels, which leads to a drop in blood pressure (BP) and shock. They cause the bronchial tubes (airways) to constrict (narrow severely), which leads to shortness of breath, wheezing, and cough. This is basically a severe asthmatic attack and prevents adequate air intake and the oxygen level in the blood drops rapidly. The chemicals also cause what is known as capillary leak. This means that the tiny microscopic blood vessels in the tissues begin to leak fluids into the tissues. This leads to swelling and various skin lesions such as a red rash, hives (actually these are called bullae and are fluid-filled, blister-like areas), and what are called wheel-and-flare lesions (pale areas surrounded by a reddish ring). These are also called Target Lesions because they look like targets with a pale center and red ring.

In the lungs this capillary leaking causes swelling of the airways, which along with the constriction of the airways, prevents air intake. In the tissues it causes swelling of the hands, face, eyes, and lips. The net result of an anaphylactic reaction is a dramatic fall in BP, severe wheezing, swelling and hives, shock (basically respiratory and cardiac failure), and death.

Usually anaphylaxis onsets within minutes (10 to 20) after contact with the chemical, but sometimes, particularly with ingested foods, it may be delayed for hours—even up to 24 hours. With a bee sting it would begin in a matter of minutes. Bee venom in the mouth might take only a few minutes to instigate the reaction.

Your victim would suffer swelling of the tongue and face—particularly of the lips and around the eyes—as well as swelling of his hands. Hives and wheel-and-flare lesions would pop out over the skin. He would begin to gasp for breath and develop progressively louder wheezing. As the oxygen content of his blood began to drop he would appear bluish around his lips, ears, fingers, and toes. This would progress until his skin was dusky blue. He would sweat, weaken, and finally when his BP dropped far enough would lose consciousness, lapse into a coma and die. Unless treatment was swift and effect that is.

Untreated anaphylaxis leads to shock and death in anywhere from a very few minutes to an hour or more, depending upon the severity of the reaction and the overall health of the victim. Treatment consists of blood pressure (BP) and respiratory support, while giving drugs that counter the allergic reaction. BP support may come from intravenous (IV) drips of drugs called vasopressors. The most common would be Dopamine, Dobutamine, epinephrine, and neosynephrine. Respiratory support may require the placement of an endotracheal (ET) tube and artificial ventilation. The victim would then be given epinephrine IV or subcutaneously (SubQ) and IV Benadryl and steroids. Common steroids would be Medrol, Solumedrol, and Decadron. These drugs work at different areas of the overall allergic reaction and reverse many of its consequences. The victim could survive with these interventions. Or not. Your call.

If you decide that your victim will die, then at autopsy, the findings are non-specific. That is, they are not absolutely diagnostic that an anaphylactic reaction occurred. The ME would expect to find swelling of the throat and airways and perhaps fluid in the lungs (pulmonary edema) and maybe some bleeding in the lungs. He may also find some congestion of the internal organs such as the liver. He must however couple these findings with a history of the individual having eaten a certain food, having ingested or being given a certain drug, or having receives an insect bite or sting and then developing symptoms and signs consistent with anaphylaxis. And in the case of insects, such as the bee you are using, he may be able to find antibodies to the insect’s venom in the victim’s blood. Maybe not. So you can have it either way—yes he finds the antibodies or no he doesn’t.

Originally published in the October, 2014 issue of Suspense Magazine

 
6 Comments

Posted by on December 14, 2014 in Medical Issues, Poisons & Drugs, Q&A

 
 
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