Nick Griffin

Oops! I didn’t watch it myself but oh my, did I hear about it... a lot! Newspapers, TV reports, family discussions, even meeting up with friends. The guy is definitely getting the attention he wanted... probably just not the type he wanted ;)

Raising doctors the beta way

You see what I* did there? Ok… well I thought it was good, meh!

We got an email recently telling us about how although Facebook and Twitter are becoming a growing trend in society, we should be mindful of the way in which we use them in our lives both professionally and personally. And I suppose this applies to everyone regardless of their chosen careers.

It seems that in the medical area, Twitter is acceptable for say sharing opening hours etc, but not consultations or having personal conversations with your patients which obviously is wrong and lacks common sense.

I’ve know classmates in previous years who have got into trouble for posting certain Facebook updates which may contain personal details of other people (very rare occurrence) or perhaps adding the relatives of a patient as a ‘friend’ on Facebook (weirdly more common, especially with guys – sorry to be stereotypical!)

I think it goes without saying that – yes, technology is useful but we should be careful about how and when we use it. I particularly like this final article 'Raising doctors the beta way' – a clever title, which I borrowed for my post :P

* I say ‘I’ but I actually borrowed the title from this article ;p

They live on

Definition of death: the termination of biological functions that define a living organism. It refers both to a particular event and to the conditions that result thereby.

Death is something that is celebrated, embraced and feared all across the world. It has no qualms, about who it encounters - social class, religion, gender, age; these all are irrelevant. If there is one thing we can be certain of in life is that eventually, one day we will all die. Some people have a hard time adjusting whilst others seem to accept it effortlessly. No matter how prepared you think you may be, spiritually, practically etc, somehow it never seems enough. What’s worse than your own death is losing a loved one; knowing that you can’t help and leaving you to helplessly watch on. There is nothing that can compare to the feeling of losing a loved one and it is something that I feel you never really get over.

When I read this story, I found it incredibly sweet and sad at the same time. I was amazed at how such a small young mind was able to accept her imminent death and not only that but she had the strength to see her family through the tough times that would follow after her departure and help them in her own special way.

ARTICLE:
To say that “Notes Left Behind” is a book about a 6-year-old girl who died is accurate, but woefully inadequate. By filling her family’s house with hidden messages of love and hope, Elena Desserich continues to celebrate life long after she succumbed to pediatric brain cancer...
Please continue reading the article here.

Wedding invite

A friend of mine recently got married and it was a lovely day. Unfortunately some of her family abroad couldn’t make it to the ceremony and as there was a delay in the wedding DVD, she decided to place bits of the wedding video online. Whilst searching for it, I come across a plethora of wedding videos, first dances and what not. I have no idea why this particular one stood out and I’m sure many will think that there are better videos out there. Whilst watching it I just thought what a way to make an entrance - a fun couple for a) having the initiative to do it and b) for getting their family to join in :)

Also whilst we’re on the topic of weddings, I might as well mention a few other bits and bobs :)

First up a paper clipping of someone’s wedding announcement wedding announcement. It’s such a different way to announce your wedding compared to the other announcements in the paper. It definitely brought a smile to my face reading their story. Knowing how the couple got together makes you feel a part of it and makes it a lot more personal. So cute! :)

Flicking through the articles online, I found this. So the writer’s main focus of the article was on Kate Moss and the number of celebrities that were present at this wedding. However it was the final two pictures right at the end that caught my eye. How many weddings have you heard of where the bride and the mother-in-law wear matching outfits? Isn’t the general rule assumed to be that you do NOT upstage the bride on her wedding day?

Also I love listening to guests that give the newly wedded couple advice on how to build a successful marriage. Social scientists have felt the need to add to this barrage of advice by conducting some scientific research. According to this research, wedded bliss only lasts a year after which the magic fades – which let’s face it, is kind of depressing isn’t it? The article states that if you make it past the 3 to 5 year mark, then they may be some hope for the couple. Personally I believe life is what you make it. Running along this same train of thought, another article suggested that accepting misery and conflict is a key part of a happy and healthy relationship. So I guess the take home message there is that it IS good to argue... err sometimes.

I have to say this latest article is perhaps my favourite so far. Experts have discovered that the key thing is for men to have a smarter and younger wife (who is preferably not a divorcee); if they would like to have a long and happy marriage. Switch the situation around however (older woman and younger man) and the odds are not in the couples favour. Ooh err, somewhat sexist and ageist? Honestly, I cannot wait for the next new piece of social research, lol. :)

Demetri Martin

Another favourite comedian of mine… :)

Demetri Martin and some of his quotes.

Bags

As usual at the beginning of each year, I buy a new messenger bag and it has become part of a regular routine for me. It's not because I like to buy a new bag every year - (Ok I lie; that may be a small part of it!) - but mostly because a lot of the bags don't last longer than a year*.

The Jeep bag I had during sixth form was pretty strong, had a big main compartment/zipped pockets/ seperate orgnaiser and it didn't look to bad either. However after two years it began to look a bit frayed due to the wear and tear. For the beginning of my undergraduate degree, I bought a grey Animal bag. Although it only had one main compartment, it did have numerous zipped pockets and padding which gave it some shape and made it A LOT more comfortable to carry around. The bag lasted longer than a year (three in fact!) and the only reason I stopped using it was because I decided it was time for a change during my clinical placement. In place of it, I went out and bought a light blue Ripcurl bag; again it looked good, had lots of different compartments but it was disappointing however as the bag only made it up to about 6 months before the stitching gave way. With no time to shop around (shocking I know!) I reverted back to my old animal bag.

A new year has begun and again I'm searching for a new bag. Herein lies the problem;

-Bags that I want do NOT exist any longer

-Those bags that do sort of match my checklist are ridiculously over priced.

So after shopping around a bit and a lot of feedback (Twitter's great for that sorta thing), I compiled the following list.

Timbuk2
Heard of these guys from numerous sources and I like the fact you get to design your own bag. However that in turn pushes the price right up and also not many of these bags looked very feminine yet the Aeon bag caught my eye. I thought it was a tad expensive (roughly £50). However after shopping around a bit, I thought why not. I’d heard from various people that they were really good quality bags (Twitters recommendations) and settled on the aeon bag in a gunmetal grey colour with the logo in bright blue. By the time I got round to ordering it, the grey colour had been discontinued and I have no idea why?! Very annoying!

Crumpler
Liked a lot of these designs and also loved the fact that I could order these bags without any hassle (i.e. those countries that do not ship internationally or that have extortionate shipping costs like Timbuk2). I quite like the ‘Cheesytina’ bag and again roughly priced around the £40/£50 mark. The added bonus was that I could actually have a look at some of these bags, as certain stores do stock them. So off I went to TK Maxx to have a look at some samples and I even found the one that I wanted (Cheesytina). It had a good organiser section and it was well padded. The shoulder strap was a bit too big for my liking but it was detachable so I bought the bag. After getting home, I realised that the bag couldn’t quite fit a A4 folder and kept the zip kept snagging when I tried to close it. Unfortunately it had to be returned :( Built
I have to say none of these really appealed in terms of functionality but in terms of deigns and colour, they look fab. A friend of mine at uni who bought a laptop bag, mentioned how although he liked the neoprene material, he hated the fact that it didn’t really retain its’ shape when it was packed full of his books, laptop and other stuff. Pakuma
Recommended by my uncle. I did like some of the designs, specifically the Choroka K3s but felt it was a bit on the small side and felt that the Choroka K2 would be a better size - a cross between the two would be nice. Also the padding for the laptop compartment I thought was a bit in excess perhaps, but I guess it’s better to be cautious sometimes.
Rickshaw
I have NEVER heard of these guys before and I totally love their designs (thank you twitter!). The Med commuter messenger bag is a great size, lots of separate compartments and great designs such as the ‘London Plaid’ which is my favourite design. The only thing holding me back is the price. £50 for a bag was pushing it but double the price at nearly £96 seems to be a little bit too much. I do really like it though :p *The only exception to this would be the grey animal bag that I still have as my 'back up bag' as numerous successors have let me down on more than one occasion.

Dementia

This is just quick overview summarising the current ongoing work in the area of neurosciences, specifically dementia. Dementia (meaning ‘deprived of mind’) is a serious cognitive disorder which affects areas such as memory, attention, language and problem solving. It can be a result of a single brain injury or of a progressive long term illness. As we age, we will all experience some form of change in our cognitive ability which a normal sign of ageing. However it is when these changes seem to increase more than the expected level, that dementia is diagnosed.

Neurological disorders including dementia are set to rise in the future due to an ageing population.

Types:
The type of dementia is dependent on the pathophysiology. The different forms can be dependent on;
- Age (often the same illness can be given different names as they arise in different age groups)
- Gender (some types of dementia seem to be higher in women than in men)
- Pathology (the change in size and shape of the cells i.e. plaques, neurofibrillary tangles, lesions and the location of the changed area i.e. frontal lobe, temporal lobe.
Consequently the pathology in turn determines the symptoms that characterise the illness.

Diagnosis:
When a person is suffering from dementia, the clinician will usually take a clinical history to see if there is a familial link within the family. This will involve enquiring about the patient’s diet, sleep patterns, medications and a history recent illnesses such as stroke, heart disease, cholesterol, blood pressure and diabetes. A mini-mental state examination (MMSE) is also carried out to test the level of cognitive impairment in combination with other clinical diagnostic tests.

It is common practice to also conduct psychological tests and blood tests to exclude other possible causes. The clinical tests may involve scans and neuroimaging techniques (MRI, CAT) as well as an electroencephalography (EEG), analysis of the cerebrospinal fluid (CSF), tissue biopsies, genetic testing. When all other possible clinical causes have been eliminated then further testing of the cognitive domain is conducted to determine the type of dementia.

There are a number of different scales and assessment methods used to test the cognitive domain however used on their own they are not sufficient, as there is large variation between guidelines and thus the potential for misdiagnosis is possible. Often the histological examination of the brain post mortem is used confirm the diagnosis.

Treatment:
Something to bear in mind is that certain types of dementia are multifactorial meaning that they have numerous causes. For this section if we look specifically at Alzheimer’s and the treatments associated with this disease.

Prevention:
Prevention is the best course of treatment and a number of risk factors have been identified for Alzheimer’s disease;
- A diet that is healthy, low fat, rich in B vitamins and avoidance of alcohol and smoking
- Cognitive fitness - maintaining intellectual and physical activity is a protective risk factor against cognitive decline
- Reducing cardiovascular risk factors is beneficial i.e. hypercholesterolemia, hypertension, hyperhomocysteinemia, dietary saturate fats, cholesterol, antioxidants,diabetes mellitus, cardiovascular disease and cerebrovascular disease.
- the presence of the ε4 allele of the apolipoprotein E (apoE) gene has been identified as a strong genetic risk factor

Pharmaceutiacal:
Although there is no actual cure as this moment in time, there drugs avaliable to help alleviate the symptoms.
- Cardiovascular risk factors can be controlled by the use of antiplatelet drugs such as aspirin to decrease platelet aggregation and statins such as Atorvastatin to reduce serum cholesterol.
- The use of acetylcholinesterase inhibitors such as galantamine, donepezil and rivastigmine. It is thought that the degradation of acetylcholine is a contributing factor and so these drugs slow down the degradation, allowing levels to remain elevated and prevent further neuronal damage.
- Other drugs include the regulation of neurotransmitters using glutamate, NSAIDS and statins.
- Pharmaceutical intervention such as antidepressants, neuroleptics and mood-stabilizers help alleviate the behavioral changes.

The future:
There are numerous groups working on different theories and possible treatments; selections of which are described below.
- Improvements in diagnostic criteria to allow earlier detection thus leading to more positive outcomes.
- Numerous pharmaceutical drugs such as Protollin, Dimebon, Rember are currently undergoing clinical trials.
- Recent work at the University of Manchester has shown that the herpes simplex virus (usually found in cold sores) may be linked to the build of plaques associated with Alzheimer’s. If this is the case then anti viral agents may be used to treat Alzheimer’s.
- To reduced the levels of amyloid protein that cause plaques by using immunotherapy or the development of a vaccine.
- Using the brain’s own neuroprotective strategies to protect against possible causes such as stroke. This novel approach is called ischemic ‘postconditioning’ that involves the activation of the protein kinase Akt, may go onto to produce a suitable treatment.
- the role of metals such as aluminium and spices such as tumeric have also been highlighted in recent work.

Rather than give up on life as so many dementia patients do, I discovered that a few people I know, regularly keep journals throughout their illness. The purpose of this is sort of two fold; firstly it helps the person keep track of their thoughts thus giving their mental capacity a workout and secondly it may help give carers an insight into how the patient is feeling and try and solve some of the problems that they may be facing. During my research, I also found that quite a few people who suffer from dementia or have loved ones living with this illness have set up online blogs.

This I feel is a great idea because for the sufferers it is a way to maintain their intellectual ability as I mentioned before and for the carers it is a way to release some of those feelings of frustration and helplessness. The fact that their journals are online mean that anyone can read them and know that they are not alone with this illness, that they have someone to share their thoughts and feelings with. Personally from the patients that I've seen that is one of the key things; the fear/feeling of isolation and to alleviate some of those fears can only be a positive step forward.

The death of a brain

Due to my area of interest, I read a lot of articles linked to most aspects of brain neurology – anatomy, function, biochemistry, as all of it adds to the overall picture. The brain is clearly as important organ and can make everything go haywire if the slightest thing goes wrong. Stating the obvious I know. Independent of my past research project in dementia, I’ve recently seen an increase in the number of articles focussing on cognitive function.

During my clinical placement, I saw what memory loss can do to a patient and the effects it can have on family and friends. It really is a terrible thing to be stripped of all your memories and I can only imagine what a terrifying experience it must be. Have you ever had those sort of dreams where you are transported to some place you don’t recognise and have no recollection of how you got there? It makes your heart race just a little bit faster, the anxiety kicks in and you begin to feel restless and uncomfortable. Now imagine having that same feeling in real life where you are fully awake and you have to deal with all those emotions on a daily basis. Actually scratch that, imagine having to deal with that situation every 30 or so minutes because that’s how long your brain can retain such information. Just think of the sheer exhaustion your body goes through when the adrenaline kicks every half hour or so – physically tired as well as mentally. Sounds like a horrifying situation doesn’t it?

It’s one of the reasons why so much research time and effort is directed towards manipulation of brain functions. So how can we solve this problem? Perhaps we should have some sort of external method of storing our thoughts. Although this is veering a little towards the bionic side and science fiction, I remember the film ‘6th Day’ in which people could have a new body made should their old one get damaged and have their thoughts transferred over to their new clone. An interesting transition and something that perhaps may be used in the future, one way or another. There is also talk of an artificial brain being developed that is only 10 years away. An article in Medscape magazine raises the issue of who decides when a brain has fulfilled it's lifespan? Also who is it that will make that key decision? As it is an organ, surely is has the capacity to be regenerated? A jolt of electricity would be sufficient to kick start the neuronal activity again and resume normal brain wave patterns surely? Furthermore researchers in the USA are also looking at ways of editing memories. On the whole, it all sounds rather exciting doesn’t it?

So why in the back of my mind is there this niggling feeling? I agree something should be done but why does the idea of a researcher/scientist editing my memory scream ‘lobotomy’ to me? The thought that someone else other than me will have the power to decide which memories I should or shouldn’t keep. I told a friend of mine about this article and she stated that without any control over what your own thoughts what difference is there between you and someone with dementia? I don’t think she fully understood the concept but she did raise an important issue – control. Whether it was a manipulation of stored memories or the implantation of a ‘new’ brain, it all boils down to an individual wanting some control over their life; that is the key thing to bear in mind. Just wanted to end with this final article in which David Blunkett has promised to donate his brain to research after his death. The donation of healthy organs is something which would help tremedously and I agree with Dr Chris Morris on how a lot more time, money and effort is required in this area of research.

Nobel prize

You get to a point in your life where things stop surprising you. Today I switched on the TV to find the news to find that Barack Obama has been awarded the Nobel peace prize. As much as I like the guy, I just think that maybe he should have been a chance to prove his worth, after all he has inherited a country that is involved with an ongoing war. War and peace aren’t exactly easily exchangeable terms. Anyway I know all the Nobel prizes are well documented but whilst surfing the web I came across the IG nobel awards; an award that celebrates the unusual side of nature and has no cash prize, just a certificate.

I picked the following as the most funniest/ interesting from the IG winners from each year as they made me chuckle...

2009 –
PUBLIC HEALTH PRIZE:
People – Elene N. Bodnar, Raphael C. Lee, and Sandra Marijan of Chicago, Illinois, USA.
Research – Inventing a brassiere that, in an emergency, can be quickly converted into a pair of protective face masks, one for the brassiere wearer and one to be given to some needy bystander.
Paper – U.S. patent # 7255627, granted August 14, 2007 for a “Garment Device Convertible to One or More Facemasks.”

2008 –
CHEMISTRY PRIZE:
People – Sharee A. Umpierre of the University of Puerto Rico, Joseph A. Hill of The Fertility Centers of New England (USA), Deborah J. Anderson of Boston University School of Medicine and Harvard Medical School (USA).
Research –Discovering that Coca-Cola is an effective spermicide, and to Chuang-Ye Hong of Taipei Medical University (Taiwan), C.C. Shieh, P. Wu, and B.N. Chiang (all of Taiwan) for discovering that it is not.
Paper 1 – "Effect of 'Coke' on Sperm Motility," Sharee A. Umpierre, Joseph A. Hill, and Deborah J. Anderson, New England Journal of Medicine, 1985, vol. 313, no. 21, p. 1351.Paper 2 – "The Spermicidal Potency of Coca-Cola and Pepsi-Cola," C.Y. Hong, C.C. Shieh, P. Wu, and B.N. Chiang, Human Toxicology, vol. 6, no. 5, September 1987, pp. 395-6.

2007 –
PEACE PRIZE:
People – The Air Force Wright Laboratory, Dayton, Ohio, USA.
Research – Instigating research and development on a chemical weapon - the so-called "gay bomb" - that will make enemy soldiers become sexually irresistible to each other.
Paper – "Harassing, Annoying, and 'Bad Guy' Identifying Chemicals," Wright Laboratory, WL/FIVR, Wright Patterson Air Force Base, Ohio, June 1, 1994.

2006 –
MEDICINE PRIZE:
People –
1) Francis M. Fesmire of the University of Tennessee College of Medicine
And
2) Majed Odeh, Harry Bassan, and Arie Oliven of Bnai Zion Medical Center, Haifa, Israel,
Research –
1) His medical case report "Termination of Intractable Hiccups with Digital Rectal Massage"
and
2) Their subsequent medical case report also titled "Termination of Intractable Hiccups with Digital Rectal Massage."
Paper 1 - "Termination of Intractable Hiccups with Digital Rectal Massage," Francis M. Fesmire, Annals of Emergency Medicine, vol. 17, no. 8, August 1988 p. 872.
Paper 2 - "Termination of Intractable Hiccups with Digital Rectal Massage,"Majed Odeh, Harry Bassan, and Arie Oliven, Journal of Internal Medicine, vol. 227, no. 2, February 1990, pp. 145-6. They are at the Department of Internal Medicine, Bnai Zion Medical Center, Haifa, Israel.
Paper 3 - "Hiccups and Digital Rectal Massage," M. Odeh and A. Oliven, Archives of Otolaryngology -- Head and Neck Surgery, vol. 119, 1993, p. 1383.

Some of them do make you wonder why or how they even came up with the idea for this research, lol.