Word of the Day: Days Three to Nine!

 Here's another bunch of "Word of the Day" for those of you who don't have Instagram!

However, if you'd like to check out what's being posted, just click on the tab at the top of the blog labelled "Instagram Page" - you don't need an account! Or click here

- Geeker

Word of the Day: Day One and Two!

I've started a new theme on Haemobloggings' Instagram; Word of the Day!

Here's what's been posted:

- Geeker

BrightMed Out and About: London!

London!

The Hunterian Museum!

 

Wonderful drawing of myself made by Pedro Moreira. (http://galonth2000.deviantart.com/)

Note: if you'd like to learn any more information about the key objects given, then check out the link under their photo! 

 I was greeted by this beautiful display of the disected human body's veins on a wooden board, as soon as I entered the exhibit. This one of four boards was prepared by Giovanni Leoni d'Este in 1645-1646. Now owned by the British Museum, the board was described to contain: "Dried human tissue adhering to a flat wooden board made of planed pine planks butted and glued together. The board and tissue have been treated with several layers of varnish made from animal and plant materials."

Further information: http://surgicat.rcseng.ac.uk/Details/collect/10204

 Next on my list of top sights to see,  was the 7"7 skeleton of Charles Byrne (1761-1783). Mr Byrne suffered from gigantism caused by a pituitary tumour, and hence was named "The Irish Giant".

An extract from SurgiCat says that:

It is now known that Byrne’s skeleton shows evidence of pituitary giantism, in which excessive growth is accompanied by a delay in the onset of puberty. Pituitary giantism is caused by over-production of growth hormone from the pituitary gland in the base of the skull. Growth after puberty leads to acromegaly, in which bones become thicker rather than longer. In 1891 the physiologist Daniel Cunningham (1850-1909) suggested Byrne suffered from acromegaly. In 1909 the American neurologist Harvey Cushing (1869-1939) persuaded Arthur Keith to examine the inside of Byrne’s skull. As Cushing had expected, Keith found that the pituitary fossa (the cavity in which the pituitary gland sits) was enlarged, proving the existence of a tumour

 

The Queen viewing the skeleton

 There has been a lot of controversy however, as the museum was told to obey Mr Byrne's dying wish; to be buried at sea. Read more about this here: http://www.dailymail.co.uk/news/article-2077392/London-museum-told-stop-displaying-skeleton-Charles-Byrne.html

Next to this statue lies the next artefact I wish to bring your attention to: a 39 year old man named Mr Jeffs who suffered from a rare disease of the connective tissue called "fibrodysplasia ossificans progressiva". 

According to the U.S. National Library of Medicine:

"Fibrodysplasia ossificans progressiva (FOP) is a disorder in which muscle tissue and connective tissue such as tendons and ligaments are gradually replaced by bone (ossified), forming bone outside the skeleton (extra-skeletal or heterotopic bone) that constrains movement."

Further information: http://surgicat.rcseng.ac.uk/Details/collect/5495

The next object was a salivary adenoma that was removed from Mr John Burley's neck, at age 37, by John Hunter. The tumour itself weighed over 4kg and took 25 minutes to remove. Impressive!

Further information: http://surgicat.rcseng.ac.uk/Details/collect/4838

After this, I was introduced to the "LifePort" Kidney Transporter where it carries the organ at cold temperatures, of +4°C. Organ-recovery.com describes the LifePort as:

"The LifePort Kidney Transporter provides a sealed, sterile environment where a specially formulated physiologic solution is gently pumped through the kidney at cold temperatures to minimize tissue damage while the organ is being preserved outside the body. LifePort Kidney Transporter is lightweight and portable allowing an organ to be perfused from time of recovery until transplantation. It is designed to travel unaccompanied by land or air, safely transporting the kidney across town or between countries. While the kidney is being perfused, LifePort Kidney Transporter records data on temperature, flow rate, vascular resistance and pressure every 10 seconds, offering clinicians important additional data."

I was particularly fascinated by the next display, which showed A-ke, a Chinese man who had a parasitic twin in the thoracic region. This model commissioned by John Livingstone from memory has been under dispute, as it's note entirely accurate. Livingstone even wrote that "‘it represents the roundness of infancy [which] has disappeared from the original’.".

 

Further information: http://surgicat.rcseng.ac.uk/Details/collect/43177

 Next, a neurosurgical instrument used to carry out trepanation - drilling into the skull. Apparently used like a pair of compasses, the instrument displayed is damaged.

 

Detail from The Extraction of the Stone of Madness, a painting by Hieronymus Bosch depicting trepanation (c.1488–1516).

The next jar shows a part of the spleen's surface which had calcified tissue, which was "likely to have resulted from chronic inflammation of the adjacent peritoneum due to tuberculous peritonitis". 

Peritonitis is a widespread abdominal infection. 

Further information: http://surgicat.rcseng.ac.uk/Details/collect/4302

 I also learnt a few terms:

Enterorrhaphy  - the suturing of sections of bowel together
Anastomosis - the connection of two vessels
Intussusception - where the bowel folds back on itself

As an example, here is a photo of a dog which suffered from a intussusception of the ilieum. 

Further information: http://surgicat.rcseng.ac.uk/Details/collect/4268

  Of course, there were so many more amazing and interesting artefacts, but these were some that I noted down! 

The Wellcome Museum

We begin at Medicine Now!

First on my collection of photos, is "Palindrome" by Willian Cobbing. The Wellcome Collection describes it:

"Palindrome was inspired by a section in J G Ballard's 'The Atrocity Exhibition', in which a character imagines that "the bones of the pelvis may constitute the remains of a lost sacral skull". How does it make you feel?"

I loved their "Transparent Woman" which allowed you to push a button, which would light up the selected body part! I wouldn't mind having that as a feature in my home!

How about John Isaac's sculpture named "I Can't Help the Way I feel" bring to light our body perception, and how someone might view themself.

Source: https://wellcomecollection.org/selection-objects-0/?image=1

 I just have to include the body slice which is a plastinated body specimen, which was vacuumed to be replaced with plastics. It's absolutely beautiful.

Our bodies are made of 70% water

Source: https://wellcomecollection.org/selection-objects-0/?image=3

This collection is absolutely insane! The Genome project, translated into hundreds of volumes is right here in the Wellcome collection!

 I also went to see the Medicine Man collection!

Just check out this: Charles Darwin's walking stick!

 And that's the end of my journey!

There's so many more sights to see, you need to check it out!

- Geeker

BrightMed Session 3: Mental Health and Global Health

It's great to be back! Now I can update you on my BrightMed adventures!

This one is session 3 of this year; so we're going back a long time! I've got one more session to write about after this, and then our day trip out!

In the morning, our focus was on three mental health areas:

• Depression
• Anorexia Nervosa
• Schizophrenia

After a brief intro to mental health, we're discussing a few clinical cases, including anorexia, schizophrenia and depression.

— BrightMed BSMS (@BrightMed) January 21, 2017

First, let's take a look at the WHO's definition of mental health.

"Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community"

What do you think about this?

Some things to consider:

• How can one realise their own potential? What about viewing "beyond" your potential?
• What can we classify as "normal stresses of life"? What does this entail, and would it not differ for others?
• How do we quantify or simply productivity?
• If one doesn't make a contribution to community, do they not have a good state of mind?

Definitely food for thought!

The Thinker by Auguste Rodin

Some facts:

• 1 in 4 adults experience mental health problems every year
• Approximately 450 million people worldwide have a mental health problem
• 30% of GP consultations are for mental health

Previously, physicians used to separate the symptoms into two categories:

Neuroses → Depression, anxiety, etc
Psychoses → Hallucinations, delusions, etc

However, this is not generally used now. Now they use "DSM-V or ICD-10"

As a note, the word "Schizotypal" was brought up", which means that it doesn't necessarily indicate schizophrenia, (even though it displays similar characteristics), as it doesn't meet the full criteria.

Interesting point for further research; we came across a man named "Bryan Charnley" who documented the effects of schizophrenia as artwork.

Self-portrait by Bryan Charnley

Food for thought: perhaps exploring his artwork is a way of becoming more empathetic and understanding of mental health both for careers within medicine and in general life!

After this, we took a brief look at the "Global Burden of Disease Report", which according to the WHO:

"measures burden of disease using the disability-adjusted-life-year (DALY). This time-based measure combines years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health."

 Here were the leading few conditions within Disability Adjusted Life Years:

• Lower respiratory infections
• Diarrhoeal conditions
• Unipolar depressive disorders

 I'd like to look at this DALY further, as well as a general overview of the Global Burden of Disease report - so that's being added to my to-do list!

Next, we were told about Schizophrenia in more detail.

Here's some of the information I have compiled:

• The main presenting symptoms can be:
• Hallucinations
• Ideas of conspiracies - delusions 
• Withdrawn behaviour, nervousness, flattening of mood
• Delusion of passivity - as defined by biology-online.org: a delusion in which one experiences one's feelings, impulses, thoughts, or actions as not one's own, but as being imposed on by some external force

• There is a genetic predisposition
• Folie à deux - a shared psychosis
•  1% of the population in the UK
• The typical ages for being affected are:
• Male: 20-28
• Female: 26-32
• Males are more affect than females
• It's believed to have an African origin in inner city London
• It is more likely to occur if there was a problem during childbirth 

 We then looked at Depression

On discussing the main symptoms, we found that they were:

• Anhedonia - recieving no pleasure from hobbies
• Lack of energy
• Sadness
• Loss of libido

The risk factors are:

•  Stress
• Trauma
• Family history

It occurs at a ratio of men to women at 1:2.

Treatment can be:

• Cognitive Behavioural Therapy (CBT)
• Anti-depressants (We can look at these in more detail in the future)
• SSRI (Selective serotonin reuptake inhibitor)
• SNRI (Serotonin–norepinephrine reuptake inhibitor)
• TCA (Tricyclic antidepressants)
• MAOI (Monoamine oxidase inhibitors)
• E.C.T (Electro-compulsive therapy) 

You have to assess the "capacity" of patients when treating. This involves: understanding, retaining information, weighing up the pros and cons, and communicating.

Our next topic was Anorexia.

You can recognise anorexia by behaviour like:

•  Not wanting to eat
• Feeling full
• Feeling paranoid with calories
• Having a bad body image
• Scared of food consequences 

It is more diagnosed in women - potentially due to "social image".

The most important point in my opinion is that due to underfunding, people can be refused treatment because their BMI isn't low enough, which is absolutely terrible. Not only would this bring on an even further lack of body confidence, but also, we must remember that weight is not the only area affected by eating disorders.

In fact, anorexia is the psychiatric disorder with the highest death rate.

Our afternoon session was based all around Global Health

 This can be expanded to the:

• Biomedical sciences
• Public health
• Social sciences
• Environmental sciences

 We had a little look at health inequalities, refugee health, gender equity, and climate change. Again, I could do a little write up on this topic further in the future!

 

Stay tuned for my next post, with information about my London Day Trip!

Geeker