Andrew Lansley and the NHS reforms

Yesterday I attended a lecture and discussion with Andrew Lansley, the Secretary of state for health, in the houses of parliament. I was invited quite last minute to go by my friend whose father is a member of the Conservative muslim forum, who were running it. I am neither a conservative nor muslim but the event was non selective so I still went.
Obviously as it was organised by a political organisation there was a lot of political behaviour involved in the whole thing which would be unnacceptable in any other social situation, commenting on Andrew Lansley's love of pies and a lot of juvenile eye rolling. The main event was to be a talk by Andrew Lansley on the state of the NHS and the reforms, followed by a question and answer session, but in the words of the man himself, 'he would give a response but it may not be an answer'
he reforms have been met with a striking amount of criticism, but rightly pointed out, it has bubbled down a bit recently. He first started up with the need for the reforms, to improve the care further and to save money to combat the mammoth debts. The
Of course as he was figurehead for the reforms, he undoubtably gave a rather biased view. It is easy to become very believing of the majority viewpoint in such an enclosed area with no means of research and proof so we should always examine credibility and reliability to ensure we get the whole picture.
After there were some interesting questions asked, including one about what we we should expect in the profession of healthcare in the future. According to Mr. Lansley, being a doctor offers a lot of opportunity for career development, the highest salary in Europe for a medic and a great degree of security, I'm sold!
He was also asked about what they were doing to reduce waste of funds, in particular relating to IT, Mr Lansley said that the government reviewed the contracts they had with IT companies and cut the ones which weren't delivering, good for the NHS and their funds, but bad for the company who just lost a major portion of their income and would have to reduce staffing, it will never be a win-win situation. The IT solutions would then be changed up for more personalised services with lots of choice rather than a one size fits all model.
He was asked how the government is using their own social marketing strategies to combat powerful advertising of unhealthy products and he said that they were aiming for a more empowering outlook on the adverts rather than a nagging response and were already running many successful campaigns including the Change 4 life and new invisible smoke ones. The more information is made accessible, the better informed the general public will be.

Legionnaire's outbreak

I am currently following the legionnaire's outbreak on the news. On Saturday there were 36 confirmed cases of legionnaire's disease, all living or working in the west of Edinburgh. There are 15 people in intensive care due to the disease and 1 person, Robert Air, has died due to it. It was predicted that the levels of the illness would peak this weekend as the possible causes of the outbreak are being shut down, investigated and treated. The last outbreak of a large number similar to this was from a cooling tower, which is capable of distributing the virus over a long distance via water droplets which are inhaled. Although they are investigating the source of the outbreak, it is possible that the source may never be identified, as past experiences have shown. This would be very undesirable as it would not aid to the further prevention of similar outbreaks.
Legionella bacteria grow well in warm temperatures, 35 to 46 degrees, but presence of this should only be seen as a problem if there are notably high levels of the bacteria. In addition many people may inhale the bacteria and show little to no symptoms.What makes some people more susceptible to the illness? Well, obviously those who are immunocompromised are more likely to suffer from symptoms, as are those who smoke or have lung illnesses. Most sufferers are middle aged or older. Aside from major outbreaks, it can be difficult to diagnose this disease due to the rarity and wideness of the symptoms, approximately 90% of cases go undiagnosed!
So how are the authorities dealing with this outbreak? Firstly they are treating the patients with antibiotics including erythromycin and clarithromycin. The patients are sustained with fluids to avoid dehydration and an oxygen supply. To prevent further spread, the treatment of possible sources, 3 buildings with cooling towers in the area begins as soon as possible, before confirmation of the presence occurs. Treatment involves using chemicals to kill the bacteria, although all buildings should follow the guidelines to prevent the spread and growth of bacteria, by keeping the water below 20 degrees and by keeping free of impurities and preventing stagnation. This includes households although large factories carry a higher risk. Water samples will be taken from these suspected sources and swabs taken from the cultures will be grown on a variety of agars over a long period of time in the preferred growth conditions in incubation. 
I aim to follow the outbreak over time and hope that this raises awareness for the good practice to prevent the spread and increase the efficiency of diagnosis. I hope that the predictions of the numbers decreasing are realised because this disease has a very high mortality rate, of 5% and otherwise, the symptoms are, like most diseases, unpleasant. The outbreak of the disease must be terrifying for those in the area, not knowing if they, or their relatives, will fall ill. It is not the most friendly of diseases.

Day 3 in the labs- Ward rounds and all the rest

Apologies about the lateness, This is about Friday. Okay so the title is a bit misleading as I spent the majority of the day outside of the lab. At the start of the day I was met by the quality manager who talked to me about his job, it is all about ensuring that all of the data produced from the labs is high quality and that the labs run following strict procedures which includes health and safety. The man regularly carries out audits to ensure reliability and that the correct records are taken, so that, in the event of legal action taken, proof of correct procedure can be shown. This is obviously a very important job as it not only ensures high quality data, but assures patients and doctors of this fact. This is in addition to the external tests carried out and the even more internal controls carried out regularly, it is evident that checks are a very important feature in the pathology labs.  When they didn't use to be, mistakes went unnoticed and it was difficult to make improvements as they weren't sure where anything went wrong.
After this I went to the ward rounds with Dr. Riley. I had assumed that this meant seeing to all of the patients but I was informed this term means different things from hospital to hospital and that in this hospital it meant attending a meeting with all of the consultants about patients on that particular ward. They discussed current treatment, results from the pathology departments and possible courses of action. For example they used their different expertise to decide whether a patient is ready to be discharged, or if they should go onto the medical trial (something which proved very popular in the meeting I was in). An interesting issue raised was a man who was a Jehovah's witness and who therefore could not accept blood transfusions that he needs but could accept blood produced from stem cells from his brother. It doesn't seem to make much sense to me but it is a good way to overcome this issue. Even if it is somewhat more time-consuming and expensive, it is worth it as the care of the patient should always be put first in healthcare, no matter what they believe. Religion can often be used as social support in illness so should not be discouraged if possible.
After the ward round, The doctor and I went to his office and returned calls which he had accumulated during the duration of the meeting. He is a consultant microbiologist so doctors from all over the hospital contact him for advice and guidance on interpreting microbiology results and courses of action to take. As I have no formal training in microbiology, most of the discussion was alien to me, however I did recognise information from my stint in microbiology and the doctor did his best to explain as much as he could to me. This was interesting because it was the first time which I saw the data from pathology applied to the patients and healthcare itself. The doctor expressed his concerns at the lack of microbiological training of the new junior doctors, so I will take the advice to return to pathology work experience during my medical course to gain an extra dimension so I can be one less burden to the consultants and work more independently. However, just because the current junior doctors are not completely understanding of microbiology, it doesn't mean my generation will too, healthcare and healthcare education is developing all of the time. The doctor may just have very biased views as he is the person who receives all of the doubts.
After lunch I was scheduled to be doing practical work in microbiology, when I told the doctor this he laughed and said that they would be using me for slave labour. Ready for this, I returned after lunch but, to my disappointment there was nothing for me to do, the workload varies greatly which can be very difficult to deal with. I got shown the multiple tests done on spinal fluid of patients, checking for cell counts included. During this I saw a red blood cell under the microscope, which did not live up to its name of being red, may I say! Again, several tests were used for the same purpose to ensure reliability.
I was then sent to the receptionists to help them. We went to pick up the mail and collect paper. Although these tasks may seem simple and meaningless, these are necessary for the running of the department, and without the clerical staff to organise it all, the department would fail to function. A woman I know who is a nurse believes that clerical staff are greatly undervalued and underpaid and fears that this may result in resentment and unpopularity of the job. We also did some shredding, the infamous work experience task, which is used to ensure confidentiality of the patients and avoids leakage of private and possibly sensitive information, which is entrusted to the department by the patient and doctor.
I am so glad I have had the opportunity to carry out my work experience here and will remember and apply all of the lessons learnt. It can be difficult to think of finite lessons learnt during work experience, however it often becomes obvious of continuing trends throughout the period, in this experience there was themes of reliability and quality more than anything else, because when you ask for a test to be carried out on a patient's health, one should not have to allow for error.

Day 2 in the labs- Microbiology and Haemotology

Today was very different from yesterday, obviously due to me being in different departments and also because of different people. The people who you shadow and who explain things to you really affect your overall experience. Although the majority of people are very kind and understanding of my low level knowledge, a few seemed very frustrated and annoyed at having to spend the time explaining things to me. I am very greatful for those who are sympathetic because I understand that in many working environments like these where there are important deadlines, it really puts people out to explain every minute detail. This taught me about how precious their time is to get the job done properly.
That aside, I learnt and experienced a great deal today, similarly to yesterday, a lot of great machines have recently taken over many of the jobs which previously had to be done manually, saving time and improving detail. However, controls and tests need to be done both internally and externally; quality assurance schemes send specimens to check that the results in all of the labs around the country are consistent and accurate. These are very important as inaccuracy could mean, in the case of blood transfusion, sudden death for the patient. In science, new developments constantly change the working environment, allowing more precision and ease, this makes it an exciting field to work in. Medicine especially, because there is a great demand for new knowledge so there is a vast amount of research carried out in all fields.
Today I also got the opportunity to look at some bacteria under a microscope, and even with a stain it was very difficult to recognise, also photos of different white blood cells and different bacteria on agar are extremely difficult to differentiate, perhaps I was being very naive thinking that cells would just simply be obvious, there is challenge in the diagnosis, despite all of the handy tests and detail. As one of the ladies I met today said 'bacteria don't read textbooks!'
Whilst in the blood transfusion section the message that blood, platelet and organ donors are still greatly needed despite the recent campaigns raising awareness. When I told the man about the assembly that I plan to give to my year about donating these, he was pleased- especially due to the fact that my school has a high ethnic minority proportion and the demand for donations from these ethnicities are significantly higher than for white British donations. He advised me simply to tell them the facts, to simply educate and not preach in a judgmental fashion. This is probably the best persuasion method, especially in an area like this which some people may be sensitive about.
Similarly to yesterday, whenever the patient record appeared anywhere, I couldn't help but think about the situation of the individual, wanting to know their story and whether they recovered well or not. This leads me more strongly to believe I would like to be a general practitioner, working with the same people over a prolonged period of time and be able to offer continuing support.

Day 1 in the labs- Biochemistry and Histology

I am doing work experience this week in The Royal Marsden's pathology department. This is where a lot of diagnostic work relating to cancers is carried out. Today I was in Biochemistry in the Sutton site and Histology in the Fulham road site.

My mum and I were perplexed as to what the difference between haemotology and biochemistry was but I was told almost immediately that whilst haemotology was the study of the cells in the blood, biochemistry was focused on the blood plasma itself. I was shown around the biochemistry lab and spent a period of time with each member of the team, each relying on one another to keep the system working effectively and on eachother's knowledge to carry out the task efficiently and to constantly improve. One major lesson I learnt was the importance of considering the sample and the results as individual, even with the data being numerical and seemingly objective, for example, if a patient normally had a marker count of 2 which increases to 4, and another patient with a marker count change from 200 to 1000, it may not necessarily make the second person have worse cancer- one always needs to refer to the patient's history before drawing conclusions. At the end of the morning the consultant talked me through the reasons for why they carried out all of the tests, ranging from kidney function via calcium levels to specific enzymes relating to specific cells (if treatment is successful and the cells are broken down the enzymes will be releases). This linked everything together nicely. 

In the afternoon I caught the trust bus to the Fulham road site and managed to make my way to Histology without much trouble. I was shown around by a lovely lady who talked me through the process which a sample goes through whilst in the department. It is a very laborious process involving soaking in fixing agent for several hours and changing between water soluble and fat soluble several times. As the image of the sample varies so greatly from which angle it is viewed from, it is of high importance to follow protocol and place the sample in the wax flat down. Although in every medical environment hygiene is exceptionally important in the histology department it was important not only to protect the reliability of the sample but to protect oneself from the dangerous chemicals used, a constant downdraft was employed to prevent inhalation of the fixing agents. Probably the highlight of the day was being able to see a complete female reproductive system removed, it was different from imagined, much more sturdy and I've always envisioned it as a series of negative spaces rather than the organ it is. 

During both the morning and the afternoon validation was continually highlighted as a major issue, incorrect readings or values can result in misdiagnoses and potentially fatal consequences. When dealing with tissue samples and tubes of blood it is easy to forget why the tests are being carried out in the first place, and that they belong to a person and their life may depend on the result. Personally, my eyes kept being drawn towards the names and the dates of births of the people to which the samples belong, remembering the importance of the results. 

Despite the obvious mammoth importance of the accuracy and speed of the diagnostic work from the lab aiding treating the patient, Today has made me more sure of my desire to work as a clinician rather than in a laboratory, I'd prefer to access the patient and be able to support and care for them through the illness (when a jaw bone was brought out of the box to be cut up to be made into slides, the only thing in my mind was concern for the poor individual now without a jaw bone!) 

I very much look forward to tomorrow and if today is anything to go by, I expect to learn a lot. An early night for me then!

The Wellcome collection

As mentioned yesterday I went to the Wellcome collection on Thursday, it was primarily to see the temporary exhibit about the brain- 'mind as matter' which I had read about in a magazine. The Wellcome collection is 'a free visitor destination for the incurably curious' I liked that phrase so much I renamed my blog after it!
This exhibition was fascinating and covered a lot of topic from the old fascination with measuring intellect in brain size to modern day brain surgery. There were many different displays which I loved but I had 2 favourites. There was this amazing video of bloodflow to different regions of an individuals brain, by brain scan whilst he was listening to some music, you could listen to the music and it really does demonstrate how music can affect brain functioning, with there being sudden bursts of red (signifying high levels of blood flow) as the music climaxes. There was also photos and testimonies of several different people who planned to donate their brains to medical science and research, it was weirdly peaceful to hear their motives to donate and it did make me stop for a minute and think about the end of life, to me it seems daunting and distant but to read such objective accounts makes me think that it is not so terrifying and that good (furthering of knowledge of brains) can come out of the worst events.
Upstairs there were two more exhibitions, Medicine man and Medicine now. Medicine man is a selection of artefacts collected by Sir Henry Wellcome and contains all manner of items, some unusual, such as napoleon's toothbrush or a mourning hair brooch, but all really interesting. There was an audio tour and after trying to use it and discarding it as useless, i tried again and heard a very easy to follow commentary on certain objects.
Medicine now fast forwarded everything into the present, the clue was in the name. This contained many pieces of artwork centric on medicine and the human body. There was a terrifying piece which mechanically opened and shut an eye at long intervals, just when you were not expecting it! I'm embarrassed to admit I did scream... At the end there was a large wall full of visitors artwork on particular topics, I chose sleep, I thought this was nice as it allowed everyone to leave their marks (until they get replaced by the next people, that is).
I highly recommend visiting this collection as it would be interesting for all ages and as a plus, It's completely free! We spent a long time in the Wellcome collection, more than we had anticipated, probably due to me getting encapsulated in every artefact and struggling to more on quickly. We had to rush our dinner, not desirable... ;)

HIV and Immigration

Yesterday I had very a busy day; I went to the Wellcome collection's exhibition and to the Royal Society of Medicine's lecture about HIV and immigration. I'll post about the Exhibition tomorrow but for now I'll tell you about the lecture.
At first I was very apprehensive about attending the lecture as, despite being told otherwise by my well seasoned friends, I was expecting it all the be a bit over our heads- degree level information. It was in the very impressive Royal Society of Medicine in London and although it was a public event, there didn't seem to be anyone below medical student level, except us.
Expectations aside, I really, really enjoyed the lecture. We all understood it all,apart from a pesky 'CD4 count' (which I promptly looked up- a marker on the outside of many immune cells apparently), and the speakers were all very engaging. The lecture was mostly centred on the troubles with preventing HIV vertical transmission in the UK and how we could apply effective methods from Africa to the UK.
Obviously I cannot recall word for word the lecture but I'll try to give the 'highlights' and basic gist of it all. Firstly, There are several issues involved with diagnosing those of African origin with HIV, either because people don't think they need it because they are not one of 'those' people or because it is simply not offered- many doctors believe that they are not well trained enough to carry out the councelling if a positive result did occur. There is a high percentage of late diagnoses in African individuals in comparison to other ethnic groups, which is bad because the earlier treatment begins, the higher success of avoidance of vertical transmission. In addition, if a positive result is shown, due to the shame and stigma surrounding HIV (HIV is positively correlated with domestic abuse in Africa) , many individuals, women especially, do not tell anyone about it, and therefore lack the social support so badly needed, perhaps resulting in depression. Although offering social support, their religious faith may negatively affect their health, encouraging them to rely on prayer and God rather that the Antiretrovirals they have been prescribed.
There are two solutions that  have been put into practice to combat these issues, firstly a peer scheme, with each woman diagnosed with HIV being paired with a woman living with HIV can give her hope and support from someone who knows what she is going through and all of the questions that are running through her head. Secondly, christianaid is working with many faith leaders to try and bridge the gap between healthcare and religion, to try and ensure that the two can work together and are not mutually exclusive, both successfully promoting the other.
Although both these methods are proving to be quite successful, there is a long way to go yet. It will be an uphill battle against HIV in this country,  a doctor from the audience told us about a group operating called HEALlondon, HIV denialists, who could potentially cause the deaths of many by spreading their unfounded beliefs. We should continue to review all courses of action about HIV to ensure the methods are as effective, and appropriate as possible to prevent the loss of future lives to the vicious virus.
^^^^^^^ this was what I have learnt from the lecture, I found it thoroughly interesting and look forward to finding out about more social impacts and solutions to illnesses such as this one, and has made me only more driven to gain a place at medical school, so I can spend my life learning about such issues and evaluting treatments. I have it all to come!

Teaching paralysed rats to walk

I just read this,http://www.bbc.co.uk/news/health-18257077 scientists are investigating whether or not they can restore movement in paralysed areas using new methods to stimulate the nerves. They investigated it using rats, by injecting chemicals, electrically stimulating then supporting in a harness before teaching them to move towards rewards. The rewards were used to show how motivation is necessary and how rehabilitation and training is needed in humans to accompany the treatment. The rats gradually became able to run and tackle obstacles well. Similar therapy has been used to allow a previously paralysed man to stand independently. However, the effects are only seen when electrical stimulation is present, as this mimics the stimulation of the nerves in a normally processing nervous system, with the small signals from the brain pushing it over to produce movement. As always there are drawbacks in animal research in terms of validity, for example real world injuries may be more complex, and lack of biological similarity but it is a start and a basis to which further research can be carried out.
Whilst I'm on the topic of animal testing I may as well discuss animal rights rather than just glossing over them. There are a lot of animal rights protesters who complain that it is cruel to mess around with animals and harm them and admittedly this study does raise ethical issues as it involves cutting the spinal cord of the mouse. However this is being done in the hope of improving the lives of humans, which, as far as most people are concerned, are of more value than animal's lives. This research could also be used to benefit other animals lives in the future if it results in therapy. However, the effects of the electrical stimulation are not permanent like the cutting of the spinal cord so these animals have been paralysed for life, which is actually necessary to secure the validity of the experiment rather than just the ability of the chemicals and electricity to reverse the temporary damage. As with all ethical issues, things are never black and white and need to be dealt with sensitively and empathetically to avoid being too reductionist.
However all in all, this research is exciting and offers hope for paralysis treatment in the future.

Hospital nursing levels and care of older people

A royal college of nursing report has found the most hospitals do not meet the safe level of care as older people's wards regularly have a shortage of nurses and healthcare assistants. There is a higher patient to staff ratio on older people's wards, between 9.1 and 10.3 in comparison to general adults, 6.7, and children's wards. However, this may not mean that they are half as well cared for, perhaps the care of the elderly is less acute in hospital in comparison to younger people, and is more involved in maintenence of health and monitoring. However, the report has found that the shortage of nurses does impact patients as it reduces time and skill assigned to patient to carry out every day tasks and reduces the caring manner.
http://www.nhs.uk/news/2012/03march/pages/nursing-staff-levels-elderly-care.aspx

Factors affecting food absorption and digestion

As food plays a big part of my life, I often wonder about the process it goes through in my body. It would be cool to find out about what affects absorption of nutrients in the body from foods. A couple of factors I thought would be relevant is speed of eating, dispersion and density of eating and mixtures of different food types. Of course it is possible that these would not affect nutrient absorption but if they are they might be important in advising those wanting to improve their diets or tailor them to their needs.
An idea of investigating these would be to use a radioactive tracer built into certain food types to measure their absorption with varying factors. A radioactive material with 2 days or less half life should be used and gamma radiation to minimise ionisation damage and to maximise ease of detection. Obviously the same people will need to be used for different conditions as there are so many extraneous variables. Percentage change of absorption should be used as the presented data. My hypothesis would be that absorption would increase with an increase or dispersion of meal times and variety of food and with a decrease in speed and density of eating.

Pollution and noses

These are two completely unrelated topics today, but who says anything needs to associate.
Why is our nose red when it is cold?
This question is asked because I had learnt that when we are cold the body's response is to restrict blood to the extremities, nose included, which I assumed would result in a paler colour. Apparently, it s not so simple.The body will periodically dilate the constricted vessels to allow a brief burst of blood to flow into the area and then constrict the vessels again. This burst of blood causes the nose to turn red.


More people die as a result of air pollution than either alcoholism and obesity in Wandsworth, according to the Wandsworth Environment Forum. There are extremely high levels of Nitrogen oxide which damages lung tissue and can reduce lung function in those who are vulnerable, for example children and those with asthma. This is shocking becuse the risks of alcohol and obesity are widely publicised and air pollution dangers get little publicity. Perhaps there should be more attention on the personal risks of pollution which may help pursuade people to reduce their driving. The worrying thing is that it is the buses, which are always billed as the eco friendly vehicles, which, by burning diesel are contributing greatly to the nitrogen oxide. 

It is worth baring in mind though that this is only data from Wandsworth and it is always difficult to establish fully causal relationships in life because we cannot rule out different factors. 

Should smokers be allowed free NHS treatment?

There has been question about whether overweight and smoking individuals should be withheld treatment. Even though it is self inflicted, the NHS is for public health. It would be immoral and unfair to deny individuals who live in this country treatment. The NHS professionals are taught to be non-judgemental and the policies of the NHS should follow suit. The NHS should care for, not punish, sick people, after all overweight people and smokers have a far higher incidence of illness.

An aspirin a day keeps the cancer away

Aspirin, originally used as a painkiller and to combat fever, has other, perhaps more useful, uses. Daily low doses of the drug have been known to help prevent coronary heart disease, as it interferes with the clotting action. A series of papers in the lancet have also now found that aspirin can prevent the spread of cancer and after five years of taking cancer there was a 30-40% reduction in deaths from cancer.
But it is not an easy solution to all of these problems and it would be unwise to introduce a blanket scheme for example for everyone over the age of 45 because of the risks of serious excessive bleeding, especially gastrointestinal which can even cause death. It is also not as effective as Statins in CHD prevention and is no more effective than paracetamol in pain reduction.
Because of this I believe aspirin should be recommended to those in the risk categories for cancer and CHD but only on prescription or after advice from the chemist. This is because the risk of internal bleeding is so severe and after the recent headlines for the benefits of aspirin may cause a surge of people who shouldn't take aspirin putting themselves in danger instead of helping themselves stay in health.

here

http://www.dh.gov.uk/health/files/2012/02/A1-Overview-of-the-Bill.pdf

Cannabis memory effects examined

Cannabis floods the brain with a host of chemicals which lead to changes in mood and memory

Scientists believe they are closer to understanding how taking cannabis disrupts short-term memory.

The Canadian team from Ottawa University narrowed the effect down to a particular type of brain cell called an astrocyte.

Writing in the journal Cell, they said it might be possible to block it in medicines based on cannabis.

A UK researcher said it could reveal more about natural brain chemicals.

Cannabis floods the brain with a host of chemicals which mimic one of its own subtle signalling systems, leading to pronounced changes in mood and memory. Scientists are trying to harness the power of these chemicals, called cannabinoids, in pharmaceuticals aimed at conditions such as multiple sclerosis and chronic pain. The doses of cannabinoid are carefully controlled to avoid the "high" feeling. The work by the Ottawa University researchers may shed light on how one of the best known cannabinoids, THC, acts on the brain.

Memory matters

Their work suggests that, when it comes to affecting memory, THC is acting not, as might be expected, on the brain's neurons, but on a brain cell called an astrocyte.

We may find a way to deal with working memory problems in Alzheimer's.”

They bred mice whose astrocytes could not be affected by THC, and found that their spatial memory was unaffected by the dose. This discovery could help drug companies reduce the risk of unwanted side effects when using THC in their products, they suggested. However, possibly more importantly, it could shed light on the brain's own chemical pathways, the "endocannabinoid" system.

Dr Xia Zhang, one of the researchers, said: "Just about any physiological function you can think of in the body, it's likely at some point endocannabinoids are involved."

Understanding how this system works could lead to ways to make it work better, he suggested. "We may find a way to deal with working memory problems in Alzheimer's," he said.

Prof Heather Ashton, from the University of Newcastle, said that memory problems were an established feature of cannabis use, and understanding the mechanism behind them was "interesting".

She said: "When someone is taking cannabis, in some cases you find that they cannot even remember starting a sentence by the time they reach the end."

But she agreed that the practical benefits of such research might ultimately lie in a better understanding of the body's own endocannabinoid system, rather than the effects of cannabis itself.

Cannabis may actually be useful in helping to understand a lot about our brains. If we study cannabis and

Cannabis acts on astrocytes

A couple of non medical-related questions

These are just 2 questions which I have been wondering recently.


Why does salt melt ice?
Water and ice are at equilibrium at 0°c, adding solute to the system will disrupt this equilibrium. They dissolve into the water and do not pack uniformly into a solid, so the rate of freezing decreases, along with the melting point of ice. Any solute could be used, but salt is used on roads in icy conditions because it is cheap and readily available.


How is coffee decaffeinated?- (My Dad drinks decaf coffee as otherwise he gets heart palpitations)
Coffee is decaffeinated using 2 main methods: Water extraction and supercritical carbon dioxide extraction. Water extraction involves soaking the beans in hot water and passing this over hot charcoal before restoring the flavour by soaking the beans in this water again. Supercritical carbon dioxide involves heating CO_{2 under high pressure, forming a supercritical fluid which is like gas and liquid, when forced through coffee beans this absorbs up to 99% of the caffeine as it is gas-like and can penetrate deeply into the beans. Caffeine extracted using these methods can be used for soft drinks and medicines.}
However caffeine extraction is expensive and loss of some flavour is common. So as an alternative, there is potential to inactivate the gene in tea and coffee plants which codes for the caffeine synthase, which catalyses the synthesis of caffeine. 
Well now I know!

'The immune response to infection

I attended a lecture last night on microorganisms and their effect on our everyday lives. It was very interesting to see the special adaptations that bacteria and viruses have which allow them to alter the way the body's cells work to their favour, like using the cells contents to replicate. Whilst we can harness microorganisms for our own good; there is potential for producing highly nutritious food aid for developing countries using fungi, the majority of the time the microorganisms that we notice most are harmful.
There are loads of different points in the infection's cycle that it would be possible to develop treatments to stop it from progressing, including: the binding to the cell, the markers on it's surface, the replication and assembly. However we should really focus on treatments available now and to make sure they are effective we should educate the public so that they know the importance of taking their antibiotics to full term and keep all their vaccinations up to date. This could be done via a variety of mediums including schools, workplaces and media. Research is ongoing into treatments for other illnesses which we currently have no cure for, and hopefully when these are released they will be used by the public as instructed, so that all the effort developing them is not wasted.

http://www.bbc.co.uk/news/world-europe-17230102

The fight against polio

http://www.bbc.co.uk/news/health-17072769

Congenital abnormalities and maternal age

Whilst I was away I was flicking through my medical dictionary and read the definition of Down's syndrome. It is well known that this condition develops before birth and is therefore a congenital disorder. In addition, the risk of giving birth to a baby with Down's syndrome increases with maternal age, as with all congenital disorders. At first this seemed logical to me, because obviously with the aging process there is a greater percentage of mutated cells and therefore processes are compromised. However, I remembered that all of the ova are produced during the foetal stages and mutations occur mostly during mitosis, which doesn't occur until fertilisation. Therefore the time when these are fertilised should make no difference to whether or not these cells are mutated as there is no change in the ova over time.
A little bit of research helped to solve my predicament.Firstly, I discovered that congenital disorders needn't be as a result of genetics but can also be induced by a poor intrauterine environment, errors of morphogenesis and infection. 

post

Cancer Found in Ancient Mummy Caused by Genetics

It has been found that a 2200 year old mummy has the second oldest known case of prostate cancer, and it is believed to be caused by genetics. 

This is because in anient egypt there would not have been the common environmental factors associated with this cancer. There may be some types of cancer where genetics play a larger role than predisposition, perhaps retrospective evidence of diseases may lend considerable support for the nature/nurture debate however we can't really state a direct causal link in those cases.

Haemophilia in european royalty

xx

Definitions of the day- A-C

Hi I have decided that it would be a fun idea to extend my medical knowledge somewhat by picking a term from my medical dictionary for specific letters and writing about them. Obviously, it would be of no use if I already knew the word so I am attempting to find some that I haven't even heard of before!

Aminoglycoside drugs- A type of antibiotics, injected, generally reserved for treatment of serious conditions. This is because they may damage the inner ear or kidneys. Examples are gentamicin and streptomycin.

Bradycardia- Abnormally slow heart rate, sometimes as a result of regular vigorous exercise but in other cases indicates an underlying problem such as hypothyroidism. May be as a result of taking beta-blockers. Sudden bradycardia may cause a drop in blood pressure, therefore fainting.

Chigoe- An small, itchy, painful swelling caused by a sand flea from Africa and Tropical America. It penetrates the skin and lays eggs. The wound should be treated with an antiseptic after the removal of the fleas with a sterile needle.

What does rotting flesh smell like?

I am fortunate enough to not have ever been in a situation where there was a smell of rotting flesh but every time I hear it mentioned I wonder what it's like. It may seem weird, I know, but I am simply curious. What is it that makes rotting flesh smell so 'bad'? Whilst researching this I found out about the whole process of human decomposition, which is truly a very interesting process.
The process of decomposition begins with autolysis, cells in the body are poisoned by the carbon dioxide in the blood, the decrease in pH and the accumulation of wastes. Also enzymes in cells start to digest the cells themselves, causing ruptures and releasing nutrient rich fluids. After enough fluids are available. The stage of putrefaction, which produces the infamous odour, begins.
Microorganisms, destroy the soft tissues of the body and these are broken down into gases, liquids and simpler molecules. When these are excreted by the bacteria, they include amines like putrescine and cadaverine, which are responsible for the smell. These gases diffuse through the body and show as an obvious bloating of the torso and then limbs. These bacteria consume all availible proteins, before the next stage begins, skeletonisation.

Senescence

Whilst searching for topics for my biology case study I stumbled across research into the theories surrounding biological aging; Senescence. I find this topic really interesting as it

But, I don't think that research into senescence should be used for the promotion of 'biological immortality', but perhaps for prevention of specific diseases. In any case, biological mortality would not ever promise absolute mortality as one must always have risks in life.

I've just come back from the care home where i volunteer weekly and there is one lady with severe alzheimer's disease, Janet. It is difficult to see Janet so distressed, calling out for people who aren't there. When this first happened I expected the care staff to rush and comfort her. Instead they consistently ignore her, one can't even begin to imagine the desperate loneliness felt by this woman. But I don't blame the carers, I simply think they don't know what to do when she has an 'episode', this is unfair for them as well as Janet. Perhaps people working with Alzheimer's patients should have regular training to learn how to care compassionately and appropriately for the individual. I do, however, acknowledge, that there isn't a lot of money in care homes and the money saving is usually held very highly, meaning that care workers are underpaid. They probably wouldn't want to shell out money for what they might seem as supplementary.

Last Friday, at 4am, a close friend of mine was admitted to hospital with a bowel obstruction.
About exomphalus, scar tissue, adhesions.
Unpredictability.

hehe

hello

Should the government pay for the removal of PIP breast implants?

Recently it was discovered that breast implants which about 40000 British women have had fitted contained industrial grade silicon gel, which can be more irritative. The french government have recently paid for the removal of any french women who would like their implants removed after finding an increased rupture rate of 5%. The British Government review has found no increased rupture rate to normal (1%) and together with the fact that the removal operation may itself come with a risk, recommends for British women not to have these, or any other breast implants removed. 


There must be a reason for the discrepancies in the rupture rates, according to the president of the British Association of Aesthetic Plastic Surgeons it is because of lack of knowledge or rupture, changing clinicians or moving to NHS care when problems arise. But could that really account for 4% less rupture rates? It doesn't seem likely to me, perhaps the two countries were investigating the issues differently, it's probable that there has been some manipulation of figures on the side of the plastic surgery companies to seem as if the implants weren't as dangerous so as to not have to pay for removal.The health secretary has encouraged private companies to fulfill their responsibilities to care for and support the patients and there is going to be a review into this rupture rate data.


However, all this just raises the question, even if they were a risk to health, should the government foot the bill? Aside from the 3000 patients who recieved the implants for reconstruction after cancer treatment, the breast implants were paid for by the customer. Surely by doing so, one is accepting the relative risk of rupture and complications. But then again, if the rupture rates for the PIP breast implants are far higher than the norm it could be argued that they did not buy into such a high risk. 


Would it be fair for funding to be taken away from other non-self inflicted problem treatment to pay for the removal of primarily cosmetic problems? Sadly the majority of the cases the NHS has to deal with is self-inflicted, If the NHS refused to pay for treatment of cases caused by obesity, smoking and alcohol abuse, the general public would not be getting the service which they are entitled to as citizens of this country. However even if , it is still an issue that the NHS is undergoing widespread funding cuts and the 


A possible solution to this problem would be to introduce either compulsory insurance on plastic surgery to cover the cost of any problems which may occur. Or similarly to cigarettes, put a high taxation rate to cover the extra costs of complications to surgery in the NHS. I'm not sure which would seem a more attractive option for the recipients of the surgery, perhaps the taxation rate would be less as it would not have profit margins added by the private sector. However, the general public may not understand that the extra taxation rate is for their own benefit and may feel as if they are being targeted or 'robbed' by the government. 


Even just one health scandal can lead to a series of problems and issues.


Thanks for reading!

New year, New blog!

I wanted my first post to be about something i am really interested in, the topic of organ donation.
It's not debatable that organ donation is essential for the maintenance of the health in this nation but the methods of persuading the general public to sign on to the register need to be vastly improved in order to reduce the 10000 strong waiting list and to put a stop to the unbelievable 1000 per year death rate of these people. With money becoming a more and more greater part of the way the NHS runs, organ donation is the financially attractive solution to a lot of problems, 1 kidney transplant saves the NHS on average £214k.

That's not to say nothing has been done about it already, there has been many public campaigns targetting the issue through many different mediums http://www.youtube.com/watch?v=RX7D4QzAVGo&feature=player_embedded