Medicine

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Es war einmal das Leben - Folge 15 - Das Abwehrsystem

This video in German presents a very good, playful introduction to the complexity of the immunesystem at a level which most children beyond the 2nd grade should be more or less able to follow.

Dr. med. Bodo Schiffmann on the Corona Virus

It's shocking for me to see that this well-made, medically sound and informative video by doctor Schiffmann has been censored. This censorship alone is a sad commentary on what we should expect to be a democratic internet!

What really happens when you Die | End-of-life-phenomena • At Home with Peter Fenwick

Peter Fenwick (born 25 May 1935) is a neuropsychiatrist and neurophysiologist who is known for his pioneering studies of end-of-life phenomena. In this interview he talks about near-death-experiences (NDE), death-bed-visitors and how we can achieve a good death. NDE research is at the cutting edge of consciousness research and offers a convincing model for the understanding of what happens when we die. Peter Fenwick describes the different transitional phases of the dying process and highlights the importance of letting go at the end of ones life. He offers fascinating insights into common phenomena at the end of life, such as premonitions, seeing a light, death-bed-visions and coincidences. In his opinion everybody should know about death and the dying process, because it is a normal part of living.

Interviewer: Jens Rohrbeck

Editor: Werner Huemer

Director: Mehmet Yesilgöz © 2018 by thanatos.tv

PLEASE SUPPORT OUR WORK WITH YOUR DONATION: Thanatos

IBAN: AT13 1400 0862 1017 7770 BIC: BAWAATWW

Women are lucky, they get to have the only organ in the human body dedicated exclusively for pleasure: the clitoris! In this humorous and instructive animated documentary, find out its unrecognized anatomy and its unknown herstory.

A young girl spends the evening alone at home. She decides to have some sweet solo pleasure session, but not everything goes according to plan.

 

(Okay, so this doesn't have so much to do with medicine, but I found it cute and it fits here as a kind of humorous touch to the film above!)

The mathematics of weight loss | Ruben Meerman | TEDxQUT (edited version)

Watch this video then through away all your books on dieting and other scams to lose weight!

Just eat less and breathe more!

Watch this video then through away all your books on dieting and other scams to lose weight!

Just eat less and breathe more!

Alzheimer's disease is an area of intense preclinical and clinical research. In this animated video, produced for Nature Neuroscience by Fusion Medical Animation (http://www.fusionanimation.co.uk), the molecular, cellular and physiological mechanisms associated with the disease are introduced, highlighting some of the most recent advances in our understanding of the onset and progression of this devastating neurological condition. The video also illustrates current gaps in our scientific knowledge that will be important to address to generate effective treatments for the disease.

Wounds suffered during the daytime heal faster than those suffered during the nighttime!

Hoyle NP, Seinkmane E, Putker M, Feeney KA, Krogager TP, Chesham JE, Bray LK, Thomas JM, Dunn K, Blaikley J O'Neill JS (2017) Circadian actin dynamics drive rhythmic fibroblast mobilization during wound healing. Science translational medicine 9(415)

Abstract: 

Fibroblasts are primary cellular protagonists of wound healing. They also exhibit circadian timekeeping, which imparts an approximately 24-hour rhythm to their biological function. We interrogated the functional consequences of the cell-autonomous clockwork in fibroblasts using a proteome-wide screen for rhythmically expressed proteins. We observed temporal coordination of actin regulators that drives cell-intrinsic rhythms in actin dynamics. In consequence, the cellular clock modulates the efficiency of actin-dependent processes such as cell migration and adhesion, which ultimately affect the efficacy of wound healing. Accordingly, skin wounds incurred during a mouse's active phase exhibited increased fibroblast invasion in vivo and ex vivo, as well as in cultured fibroblasts and keratinocytes.

Our experimental results correlate with the observation that the time of injury significantly affects healing after burns in humans, with daytime wounds healing ~60% faster than nighttime wounds. We suggest that circadian regulation of the cytoskeleton influences wound-healing efficacy from the cellular to the organismal scale.

Additional Information:

Out of 1,608 proteins, 237 changed their concentration according to the cellular clock. Many proteins are involved in the reorganization of the cytoskeleton, a requirement for cells to migrate into open wounds to repair tissue. The differences were recorded in the above video.

"We were able to show that the daily cycles that control our internal clocks influence how well cells repair damaged tissue by affecting an essential structural protein called actin," explains Hoyle. During the day, some of the associated genes are significantly more active than at night. The cellular clock modulates actin-dependent processes such as cell migration and adhesion, and thus the effectiveness of wound healing.

If patients suffered burns between 8:00 pm and 8:00 am, the injuries required an average of 60% more time to heal compared to daytime burns. The difference was 28 versus 17 days. Here the researchers see only a correlation but no causality. Their in vitro data consolidate the hypothesis.

Terminal Spreading Depolarization

Dreier JP, Major S, Foreman B, Winkler MKL, Kang EJ, Milakara D, Lemale CL, DiNapoli V, Hinzman JM, Woitzik J, Andaluz N, Carlson A Hartings JA (2018) Terminal spreading depolarization and electrical silence in death of human cerebral cortex. Ann Neurol 83(2):295-310

Abstract: 

Objective: Restoring the circulation is the primary goal in emergency treatment of cerebral ischemia. However, bet- ter understanding of how the brain responds to energy depletion could help predict the time available for resuscita- tion until irreversible damage and advance development of interventions that prolong this span. Experimentally, injury to central neurons begins only with anoxic depolarization. This potentially reversible, spreading wave typically starts 2 to 5 minutes after the onset of severe ischemia, marking the onset of a toxic intraneuronal change that even- tually results in irreversible injury.

Methods: To investigate this in the human brain, we performed recordings with either subdural electrode strips (n 4) or intraparenchymal electrode arrays (n 5) in patients with devastating brain injury that resulted in activation of a Do Not Resuscitate–Comfort Care order followed by terminal extubation.
Results: Withdrawal of life-sustaining therapies produced a decline in brain tissue partial pressure of oxygen (ptiO2) and circulatory arrest. Silencing of spontaneous electrical activity developed simultaneously across regional electrode arrays in 8 patients. This silencing, termed “nonspreading depression,” developed during the steep falling phase of ptiO(intraparenchymal sensor, n 6) at 11 (interquartile range [IQR] 7–14) mmHg. Terminal spreading depolariza- tions started to propagate between electrodes 3.9 (IQR 2.6–6.3) minutes after onset of the final drop in perfusion and 13 to 266 seconds after nonspreading depression. In 1 patient, terminal spreading depolarization induced the initial electrocerebral silence in a spreading depression pattern; circulatory arrest developed thereafter.Interpretation: These results provide fundamental insight into the neurobiology of dying and have important implica- tions for survivable cerebral ischemic insults.

How to get a cork out of a bottle without breaking the bottle!

Ok, you're probably asking yourself: "What does the above video have to do with medicine?"

That's the same question I would have asked myself, had I not read about the 60-year-old automobile mechanic Jorge, Odon. Sechs years before viewing this video, Jorge had to helplessly stand by and watch how two midwives sat on the tummy of his pregnant wife while the gynecologist, Professor Dr. med. Javier Schvartzman, tried - unsuccesfully - to pull his daughter, Anna, out of his wife's womb with a pair of delivery forceps before finally saving the infant's life by performing a C-section. Jorge presented his idea to Professor Schvartzman who, in turn, utilized it for a WHO-sponsored research project leading a patented «Odon Device». This revolutionary device has already been successfully used for the very first time to deliver a baby from a 35-year-old singing teacher. It has also been tested successfully in a clinical study involving 130 pregnant women. (For a German summary, see the column by Peter Hartmann: Im Auge "Eine Märchengeburt" in the Swiss weekly newspaper DIE WELTWOCHE Nr. 29.14, p. 9, from which I first heard about all this.)

Roughly every 20th baby is delivered today as it would have been 400 years ago, namely, with delivery foreceps or a suction cup; roughly 1/3 of all deliveries today are via C-section. But 5 million infants and ca. 150'000 mothers die from complications during delivery, 99% of these in developing countries.

So, who is the greater genius: The guy who came up with the «Cork-out-of-the-bottle Trick» or the guy who thought of using this trick to deliver a baby?

By the way, Jorge is no longer working as a car mechanic. He spends most of his time travelling from congress to congress as manager and salesman for his brilliant device. Congratulations, Jorge!

Here's the reference for my medical friends:

World Health Organization Odon Device Research G, Schvartzman JA, Krupitzki H, Betran AP, Requejo J, Bergel E, Fiorillo AE, Gadow EC, Vizcaino FM, von Petery F, Althabe F, Belizan J, Borruto F, Boulvain M, Di Renzo GC, Gulmezoglu M, Hofmeyr J, Judge K, Leung TY, Nguyen MH, Saugstad OD, Temmerman M, Treisser A, Vayena E Merialdi M (2013) Feasibility and safety study of a new device (Odon device) for assisted vaginal deliveries: study protocol. Reproductive health 10:33

BACKGROUND: Intrapartum complications are responsible for approximately half of all maternal deaths, and two million stillbirth and neonatal deaths per year. Prolonged second stage of labour is associated with potentially fatal maternal complications such as haemorrhage and infection and it is a major cause of stillbirth and newborn morbidity and mortality. Currently, the three main options for managing prolonged second stage of labour are forceps, vacuum extractor and caesarean section. All three clinical practices require relatively expensive equipment (e.g., a surgical theatre for caesarean section) and/or highly trained staff which are often not available in low resource settings. The specific aim of the proposed study is to test the safety and feasibility of a new device (Odon device) to effectively deliver the fetus during prolonged second stage of labour. The Odon device is a low-cost technological innovation to facilitate operative vaginal delivery and designed to minimize trauma to the mother and baby. These features combined make it a potentially revolutionary development in obstetrics, particularly for improving intrapartum care and reducing maternal and perinatal morbidity and mortality in low resource settings.

METHODS/DESIGN: This will be a hospital-based, multicenter prospective phase 1 cohort study with no control group. Delivery with the Odon device will be attempted under normal labour and non-emergency conditions on all the women enrolled in the study. One-hundred and thirty pregnant women will be recruited in tertiary care facilities in Argentina. Safety will be assessed by examining maternal and infant outcomes until discharge. Feasibility will be evaluated by observing successful expulsion of the fetal head after one-time application of the device under standardized conditions (full cervical dilation, anterior presentation, +2 station, normal fetal heart rate).

TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR). Identifier: ACTRN12613000141741.

You can meet the inventor Jorge Odon on TEDx: https://www.youtube.com/watch?v=N-D8nt2EHQU

Intestinal Bacteria and Health (Video in German)

Extraordinary People with unusual Medical Conditions

You might be (have been) shocked by these pictures, but it is important to realise that people with such unsual medical conditions could hardly have existed normally in the past without medical insurance and the societal openness that we have in most of the developed countries of today!

Once again - see the video by Bodo Schiffmann - it's quite shocking to see that this well-made, informative video has been censored.

I cannot emphasize too strongly: This censorship alone is a sad commentary on what we should expect to be a democratic internet!