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Comment: Re:I am a medical student, (Score 1) 83

by tpjunkie (#38971897) Attached to: Virtual Reality Helmet Designed For Deep Space Surgery
Well, that'll handle the trach, but if you can do an open appy with a pen and a knife, I'd be seriously impressed. Anyway, the "black bag" includes drape, sterile gloves, scalpel (he later explained how to get those onto planes), basic surgical tools, 3 different IV antibiotics, strong narcotic analgesics (he was less forthcoming about these), and a variety of other things, for various contingencies. There are a number of issues with operating in free-fall, dealing mostly with positioning, and being unable to get gravity assisting you in moving viscera and blood around. I would thing sterility would be a somewhat lesser concern that could be addressed with draping and antibiotics. Of course, figuring out which other astronaut gets to be your scrub nurse is a whole different story. In any case, anything beyond the most minor of surgeries is pretty much going to be off the table (zing!).

Comment: I am a medical student, (Score 3, Interesting) 83

by tpjunkie (#38971181) Attached to: Virtual Reality Helmet Designed For Deep Space Surgery
I have to ask, why not just send a physician along to any long term deep space mission? There are 5 aerospace medicine residency programs in the country, not to mention the fact that anyone applying for the astronaut positions at NASA gets credited with "work experience" for having completed an MD degree. I believe there are even a few currently active astronauts who are physicians. There isn't much substitute for someone who actually knows what they're doing, and as a (near legendary) trauma surgeon/professor at my medical school is fond of repeating, you can pack a "black bag" with about 10 pounds of equipment that will have you ready for just about anything in the woods, from a emergency tracheostomy to an open appendectomy.

Comment: Immune response immunity (Score 1) 386

by tpjunkie (#37546372) Attached to: HIV Vaccine Trial Shows 90% Immune Response
Just because an immune response in the form of circulating antibodies from B cells is seen does not mean infection and replication will not occur when a person is exposed to HIV; most people with HIV have high levels of HIV antibodies circulating in their blood, but the rate at which the virus mutates, as well as the fact that the epitopes the body naturally develops immune responses to are "hidden" by the way in which the viral capsular proteins are folded means that the antibodies do little if anything to halt infection. Furthermore, the CD4+ T cells which initiate a more effective immune response are one of the two types of cells the virus infects (the others being macrophages). At this point, the article gives no further details or useful specifics. If they had said they had generated a cytotoxic CD8+ cell response, or perhaps an immune response against one of the conserved regions of the gp120 or gp41 viral receptors, then I'd be interested. Till then, I am going to be quite skeptical about this until they have some efficacy data. (I am a medical student with an MS in biomedical science)

Comment: Re:Some info (Score 2, Informative) 551

by tpjunkie (#33762006) Attached to: Animal Farms Are Pumping Up Superbugs
1) This is precisely the "best" possible way to induce antibiotic resistance. You are basically selecting out the bacteria which are able to tolerate low doses of antibiotic, which are then able to outcompete their more susceptible brethren. The result is the "normal" gut flora of these farm animals now has a built in resistance to that particular antibiotic. 2) The gut flora of these animals is excreted in waste. The mechanisms by which super bugs are created is through transmission of plasmids, bacteriophages, and naked DNA uptake, which many species of bacteria are capable of. (For a new fun threat, see http://en.wikipedia.org/wiki/Vancomycin-resistant_enterococcus ) 3) There is no "therapeutic dose" for healthy animals. Antibiotics are given to animals to increase the rate at which they absorb food. The "normal" state of the lamina propria and mucosa of the gut is a constant state of low level inflammation, which serves as a protection from any bugs that manage to work their way out of the lumen of the gut. Antibiotic use lowers the amount of gut flora, likely leading to a reduction in this inflammation that results in greater absorption of food. I am not aware of a conclusive proof of this, but animals raised in sterile conditions and fed sterilized food support this hypothesis in terms of weight gain and histologic appearance of gut tissue. 4) You don't need all bugs to become super bugs. The majority of bacteria can become much more virulent and resistant to antibiotics. It really only takes one or two, and there are nearly innumerable options that live happily as commensals in either our or other species guts. 5) This is true, but it's not really going to cheer up someone whose opportunistic infection is resistant to antibiotics. Anyway, see #3 for a good idea of the mechanism. It's not a chemical reaction, its a physiologic consequence. FWIW, I am a medical student finishing up microbiology.

Comment: Re:Sense of touch (Score 1) 119

by tpjunkie (#33136048) Attached to: Human Tests of Mind-Controlled Artificial Arm To Begin
Possibly, but it seems to me the neurosurgery required to do that might be more difficult than implanting electrodes in the brain. In the arm, there are three main branches of the brachial plexus that travel the length of the arm, the median, ulnar, and radial nerves, and they all contain both motor and sensory fibers. Making all the connections necessary for natural movement and sense would be an incredibly long and tedious surgery for the motor part alone. I'm not even sure how you would manage do to the sensory part under local anesthesia. In the brain on the other hand, the motor and sensory cortex are basically mirror images of each other, somatotopically arranged across the precentral and postcentral gryrii, respectively. With the patient awake, the surgeon can stimulate the proper region of each, and place the electrodes quite precisely on the necessary areas. That's my two cents as a med student.

Work expands to fill the time available. -- Cyril Northcote Parkinson, "The Economist", 1955

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