One of the most important things we were told today when learning to use the glucose meter was the confounding factors that go along with the blood sugar levels and how that can be a problem when measuring blood sugar.
For instance a blood sugars can be affected by factors such as stress, heat, sickness and even white coat syndrome.
We had a barrister come in and speak to us about how she manages to control her Diabetes. She believes it is her awareness of her condition that keeps it controlled. For instance in her first year of management she found she was guessing her insulin dose, however since she got an insulin pump and began carb-counting, it was only then she began to really mange the condition.
The Obesity Epidemic
Here is the King of YouTube Hank Green talking about the epidemic of obesity that seems to be raging across the western world at the moment. Obviously as we all know one of the largest contributors to high blood pressure, congestive heart failure and most relevantly for us this week Diabetes type 2 a.k.a non insulin dependent diabetes mellitus (NIDDM).
This week in college we are doing a block of both endocrinology, radiology and neurology so I was thinking of concentrating the majority of my posts on those two areas. I will posting about what we do each day in college, anything I find particularly interesting, I and also any interesting articles I find online. Again if you have any posts that you like in these areas feel free to send them on.
Thanks again for your continued dedication to my blog. I know I have been fairly poor at queuing posts both during and before Christmas. I hope to get back into the swing of things now as we begin a new year.
Here is a link to Tom Cruise’s rendition of ”Pour Some Sugar on Me” to make up for that. I also couldn’t stop singing it this morning as we examined diabetic foot and learned how to read blood glucose levels.
Researchers found that women injured during the two weeks leading up to their period (the premenstrual phase) had a slower recovery and poorer health one month after injury compared to women injured during the two weeks directly after their period or women taking birth control pills. The University of Rochester study was published in the Journal of Head Trauma Rehabilitation.
Kathryn Wunderle, Kathleen M. Hoeger, Erin Wasserman, Jeffrey J. Bazarian. Menstrual Phase as Predictor of Outcome After Mild Traumatic Brain Injury in Women. Journal of Head Trauma Rehabilitation, 2013; : 1 DOI: 10.1097/HTR.0000000000000006
The thickness of cartilage in your joints (e.g., knee) are the same thickness as every other animal. From 10 ton elephants to a dog. The joints are bigger or smaller (contact surface area) but the thickness of the cartilage is the same. No matter how much you exercise or stress the cartilage: it will never get thicker.
Placement has started so we are now moving in to the realms of the clinical. I haven’t actually met the consultant I’m shadowing yet. Aside from that I have no desire to either. Apparently the man is a tyrant.
Nonetheless placement is still pretty cool though. Bedside teaching sessions and case study tutorials are incredibly interesting. Dressing sharp is also quite a pro.
In general though stress is high. The transition from second year to third year wasn’t exactly a smooth one. It was quite a shock going from the open sea of free time and sailing into the trashing storm of morning clinics, evening tutorials and dense lectures.
First off I’d like to day a big thank you to all of my loyal followers. The blog has been through somewhat of a drought this summer. I didn’t plan on leaving the blog so long but this summer has been one to remember.
It started in the home of education just outside Harvard in Boston. Unfortunately I wasn’t studying in the college but instead I was moving furniture all summer. The holiday ended with a road trip across the states.
I hope to resume normal service next week when I return to college next week.
Big Think Thursday - Being Gay in the AIDS Generation
I know this is a topic I’ve talked about on this blog before. It’s very interesting that a stigma like this can grow up around a disease even in this day and age. It is strange how a minority in society blamed for an epidemic such as this. This is powerful stuff.
A brief history of microscopy by i-heart-histo
The Chinese use water microscopes made of a lens and a water filled tube to better visualize smaller objects.
Hans Jansen and his son Zacharias Jansen invent the compound microscope.
Galileo Galilei develops a compound microscope with a convex and concave lens. Calling it the occhiolino - the little eye.
The term ‘microscope’ is coined by Giovanni Faber of Bamberg, an anology with the word ‘telescope’
Robert Hooke publishes Micrographia and coins the word ‘cell’ after his examination of cork bark.
Anton van Leuwenhoek develops the compound microscope to optimize it for observing biological specimens.
Ernst Abbe discovers the Abbe sine condition for manipulating the axis of optical systems to improving sharpess of images. This breakthrough in microscope design was exploited by microscope manufacturers Zeiss and Leitz resulting in a microscope boom.
Olympus manufacture their first microscope - the Asahi.
The Olympus DF Biological Microscope becomes the first microscope to feature an attached light source rather than a mirror that reflects light on the specimen.
The popular CH series of Olympus microscopes appear in universities and colleges around the world. Chances are your college still uses these lab teaching scopes (or the slightly newer CH2 version).
Introduction of a unique Y-shaped design for the microscope body for enhancing optics.
Confocal and virtual microscopy are now common place.
Scans show premature-baby brain arrested development
Premature birth may interrupt vital brain development processes, medical scans reveal.
Researchers at King’s College London scanned 55 premature infants and 10 babies born at full term, using a novel type of MRI scan.
The brain scans showed arrested development in the premature babies at a key stage of maturation.
Experts say the work, in PNAS, could further understanding, but that parents should not be alarmed by the findings.
In recent decades there have been big advances in caring for premature babies, which mean most can go on to live a healthy life.
The researchers say the new type of imaging - which tracks the movement of water in the brain - will enable them to explore how the disruption of key processes might cause conditions such as autism.
It could also be used to monitor possible treatments to prevent brain damage.
The scans showed cortical development was reduced in the preterm babies compared with those born at full term, with the greatest effect in the most premature infants - those born at about 27 weeks.
The brain regions affected govern social and emotional processing, as well as memory.
The same children were assessed at two years of age and those who had been born prematurely performed less well on neurodevelopmental tests, which the researchers say suggests the weeks a baby loses in the womb may matter.
Lead investigator Prof David Edwards said: “The number of babies born prematurely is increasing, so it has never been more important to improve our understanding of how preterm birth affects brain development and causes brain damage.
“We know that prematurity is extremely stressful for an infant, but by using a new technique we are able to track brain maturation in babies to pinpoint the exact processes that might be affected by premature birth.”
Andy Cole, chief executive of the premature baby charity Bliss, said: “It is very exciting that this ground-breaking research is being driven forward here in the UK.
“A better understanding of the way that preterm babies’ brains develop is an important step for doctors to help identify improvements in care that will benefit the 60,000 preterm children born every year.
“It is important to mention that most premature babies are unaffected by their early arrival and families of these babies should not be unduly concerned.”
TEDtalk Tuesday - Rebecca Onie: What if our healthcare system kept us healthy?
Rebecca Onie asks audacious questions: What if waiting rooms were a place to improve daily health care? What if doctors could prescribe food, housing and heat in the winter? At TEDMED she describes Health Leads, an organization that does just that — and does it by building a volunteer base as elite and dedicated as a college sports team
Another classic TEDtalk form the eloquent Rebecca Onie
Deep brain stimulation: A fix when the drugs don’t work
Neurological disorders can have a devastating impact on the lives of sufferers and their families.
Symptoms of these disorders differ extensively – from motor dysfunction in Parkinson’s disease, memory loss in Alzheimer’s disease to inescapable cravings in drug addiction.
Drug treatments are often ineffective in these disorders. But what if there was a way to simply switch off a devastating tremor, or boost a fading memory? Recent advances using Deep Brain Stimulation (DBS) in selective brain regions have provided therapeutic benefits and have allowed those affected by these neurological disorders freedom from their symptoms, in absence of an existing cure.
A pacemaker for the brain
Artificial cardiac pacemakers are typically associated with controlling and resynchronising heartbeats by electrical stimulation of the heart muscle.
Neurological disorders can have a devastating impact on the lives of sufferers and their families. Symptoms of these disorders differ extensively – from motor dysfunction in Parkinson’s disease, memory loss in Alzheimer’s disease to inescapable cravings in drug addiction. Drug treatments are often ineffective in these disorders. But what if there was a way to simply switch off a devastating tremor, or boost a fading memory?
Recent advances using Deep Brain Stimulation (DBS) in selective brain regions have provided therapeutic benefits and have allowed those affected by these neurological disorders freedom from their symptoms, in absence of an existing cure.
Turning off tremors
Perhaps the most documented success of DBS is in the control of tremors and motor coordination in Parkinson’s disease. This is caused by the degeneration of neurons in an area of the brain called the substantia nigra. These neurons secrete the neurotransmitter dopamine.
Deterioration of these neurons reduces the amount of dopamine available to be released in a brain area involved in movement, the basal ganglia.
Drug therapy for Parkinson’s disease involves the use of levodopa (L-DOPA), a form of dopamine that can cross the blood brain barrier and then be synthesised into dopamine. The administration of L-DOPA temporarily reduces the motor symptoms by increasing dopamine concentrations in the brain. However, side effects of this treatment include nausea and disordered movement.
DBS has been shown to provide relief from the motoric symptoms of Parkinson’s disease and essential tremors.
For the treatment of Parkinson’s disease electrodes are implanted into regions of the basal ganglia – the subthalamic nucleus or globus pallidus, to restore control of movement. These are regions innervated by the deteriorating substantia nigra, therefore the DBS boosts stimulation to these areas. Patients can then switch on the electrodes, stimulating these brain regions to enhance control of movement and diminish tremors.
Restoring fading memories
Recently, DBS has been used to diminish memory deficits associated with Alzheimer’s disease, a progressive and terminal form of dementia.
The pathologies associated with Alzheimer’s disease involve the formation of amyloid plaques and neurofibrillary tangles within the brain leading to dysfunction and death of neurons.
Brain regions primarily affected include the temporal lobes, containing important memory structures including the hippocampus. Recent clinical trials with DBS involve the implantation of electrodes within the fornix – a structure connecting the left and right hippocampi together. By stimulating neural activity within the hippocampi via the fornix, memory deficits associated with Alzheimer’s disease can be improved, enhancing the daily functioning of patients and slowing the progression of cognitive decline.
Another use of DBS is in the treatment of substance abuse and drug addiction. Substance-related addictions constitute the most frequently occurring psychiatric disease category and patients are prone to relapse following rehabilitative treatment.
Persistent drug use leads to long term changes in the brain’s reward system.
Understanding of the reward systems affected in addiction has created a range of treatment options that directly target dysregulated brain circuits in order to normalise functionality. One of the key reward regions in the brain is the nucleus accumbens and this has been used as a DBS target to control addiction.
Translational animal research has indicated that stimulation of the nucleus accumbens decreases drug seeking in models of addiction. Clinical studies have shown improved abstinence in both heroin addicts and alcoholics. Studies have extended the use of DBS to potentially restore control of maladaptive eating behaviours such as compulsive binge eating.
In a recent study, binge eating of a high fat food in mice was decreased by DBS of the nucleus accumbens. This is the first study demonstrating that DBS can control maladaptive eating behaviours and may be a potential therapeutic tool in obesity.
Despite its therapeutic use for more than a decade, the neural mechanism of DBS is still not yet fully understood. The remedial effect is proposed to involve modulation of the dopamine system – and this seems particularly relevant in the context of Parkinson’s disease and addiction. DBS potentially has effects on the functional activity of other interconnected brain systems. While it can provide therapeutic relief from symptoms of neurological diseases, it does not treat the underlying pathology.
But it provides both effective and rapid intervention from the effects of debilitating illnesses, restoring activity in deteriorating brain regions and aids understanding of the brain circuits involved in these disorders.