Category: learning curve

Best pets for causing chronic inflammatory eye disease

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Having successfully answered the tricky conundrum of which foodstuff is most likely to result in penetration of the oral mucosa by parasite-like sperm bags (spoiler alert: it’s squid), it’s traditionally about this time of year that the question of which pets are best at causing chronic inflammatory eye disease always crops up and, to be honest, previously, we here at 6000 miles… have occasionally struggled to give you a definitive answer.

Not so this year though, thanks to the efforts of Blaikie et al. in the British Medical Journal (BMJ). Yes, we’ve drafted in the big names of Scottish Opthalmology and they’ve told us that if it’s chronic inflammatory eye disease you’re after (with the potential added benefits of reduced visual acuity and raised intraocular pressure, multiple foci of inflammation at all levels within the globe, corneal granulomas, iritis, peripheral anterior synechiae, cataract, vitritis, and chorioretinitis), then you’ll be wanting to get a tarantula.

I know, I know. Many of you will be disputing these findings, probably suggesting instead that the obvious choice would be a porcupine. But with a porcupine, aside obviously from a lot of love and affection, you’re really only going to get the dangers of acute ocular trauma, with none of the awkward side-effects of ongoing discomfort and requirement for long-term systemic steroid use. Not so with your average tarantula – especially if you’re going to grab the bull by the metaphorical horns and plump for the Chilean Rose (Grammastola cala) tarantula, everyone’s favourite choice when hoping for devastating ocular inflammation. Beginners may want to start with the Thailand Black (Haplopelma minax) tarantula though, just to see if agonising keratoconjunctivitis is for them.

It’s the hairs, see? Tiny little hairs from the back of your furry friend that get onto your hand and from there, get into your eye – note the singular form here: most patients presented with far worse problems in one eye, always on the side of their dominant hand – and then irritate the hell out of you for several years (and counting) afterwards.

It was also interesting to note that of the three case studies presented in the paper:

Initially a similar clinical picture was seen in the three patients.  The main findings were of multiple fine intracorneal hairs with an associated keratoconjunctivitis. Two patients associated the onset of symptoms with the handling of a tarantula, and the third case was recognised only by astute history taking.

Which is basically like the doctors asking:

We’ve found some tiny little hairs in your eye, and that’s what seems to be causing your problems. We’re not sure where they’ve come from though. Have you been handling anything with tiny little hairs on prior to the onset of your symptoms?

And two of the patients saying:

Of course. Yes. I was handling a tarantula spider. They must have come from there.

And the third going:

Nope. Nothing springs to mind.
I mean, there’s my porcupine, but obviously I’m always really careful around him.
Tiny little hairs… tiny little hairs… I really can’t think what it could possibly be.
Tiny little hairs… No. Sorry. I’ve got nothing.
Maybe my girlfriend might be able to think of something? I’ll give her a call. I hope she hears her phone. Sometimes she doesn’t hear it when it’s in her handbag. You know how it is, haha. Yeah no, she was popping out to Spiders R Us to get some food in for our forty-seven tarantulas.

What?

So yes, if you’re thinking of getting a pet for the little ones, maybe steer clear of the tarantula route (I’d also probably not recommend a porcupine either), because even though the Chilean Rose is “the most popular and widely available spider on the market because of their hardiness, docility, and apparently harmless, non-venomous nature”, they will possibly, inadvertently, try to blind you.
If you must (and how “must” would be the case, I really don’t know, save perhaps from Oregon’s Mandatory Arachnid Ownership Programme) get a tarantula as a pet, then the authors advise that you:

…wear gloves, avoid rubbing the eyes during handling, and thoroughly wash your hands after handling to minimise the transfer of hairs.

Safety first, eh?

The doctor will see you now. Which is more than you’ll be able to do with him.

Here’s a lovely article on why WE’RE ALL GOING TO DIE HORRIBLE DEATHS SOON

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Herewith the second of the things I saw on The Telegraph website this morning (this being the first), albeit that this one appears to have been around for a short while. It’s all about antibiotic resistance.

The microbiologist in me has been telling you for a long time that we’re about to run out of useful antibiotics and that we’re all doomed buggered. Well, here’s a nice little project from The Telegraph which sums up whole miserable situation up quite nicely. It doesn’t condescendingly spoon-feed the information, but rather, it’s nicely aimed at engaging with an audience which it presumes is interested and intelligent. Yes. I mean you guys.

There are expert quotes:

“We risk going into a post-antibiotic era, and that could start any time in the next 10 or 20 years, when modern medicine becomes impossible. Routine surgical procedures – hip replacements, caesarean sections, modern cancer treatments – all are based on using antibiotics to prevent or treat infections. Without them, people will die.”

…some lovely soundbites:

Sir Alexander Fleming did warn us. During a speech in Stockholm in 1945 after accepting his Nobel Prize, Fleming sounded “one note of warning” over bacteria becoming resistant through inappropriate use of the drug. “The time may come when penicillin can be bought by anyone in the shops.” he said. The idea of his precious discovery being stockpiled by online pharmacies, used to fatten up our fish and livestock, dumped in rivers and sprayed over fields, would have baffled and horrified him in equal measure.

…and a superb interactive graph showing how long it took for our bacterial foes to become resistant to each and every antibiotic from Penicillin (13 years) to Macrolides (a couple of months).

It even mentions Dr Ajit Lalvani, with whom I used to play football every Thursday evening in Oxford (decent, if unenergetic midfield general; good at pointing a lot, in case you were wondering), so it must be good.

If you have a few minutes spare, and you want to read how utterly doomed we all are (because who doesn’t?) and how you can do pretty much nothing about it, go and give it a read.

CPR vs DNR

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One of two interesting pieces I spotted in The Telegraph today, each of which is getting its own post. This one is Max Pemberton’s Why it’s often better not to resuscitate  – something that any of us who have been trained in First Aid probably don’t consider. Part of Max’s article is aimed at medical professionals, and it makes grim reading:

I remember, as a junior working nights, running to cardiac arrest calls, only to be met with a pitying look from nurses as they explained that the call was for an elderly, terminally ill patient without a “do not resuscitate” form. I was therefore obliged to attempt to resuscitate, wincing as I cracked the patient’s ribs with each compression, knowing that I was subjecting a dying person to something futile, painful and cruel. If they had any sentience left, their last moments would be traumatic and brutal.

Aside from the unedited reality of the actual act of CPR, there’s the other issue of the authority and training of the professional (yes, I understand he was “just” a junior doctor here, but still…) being removed from them by the bureaucracy of the system. No thinking for yourself here. No consideration of the best decision for the patient – you will attempt resuscitation and perhaps allow this person to suffer for a while longer.

The second part of the article is the fascinating dichotomy between TV drama and real life, and the effects thereof.
I know, right? Hoodathunkit?

The British Medical Association (BMA) estimates that in TV dramas three-quarters of people survive as a result of CPR (cardio-pulmonary resuscitation). In reality, of those who go into cardiac arrest outside of a medical environment, the figure is less than two per cent. In hospitals, about half survive the initial event, but only 20 per cent live to be discharged. For those who are frail or seriously ill, positive outcomes are vanishingly small.
This skewed portrayal of successful CPR on television has the effect of erroneously raising the public’s expectations –particularly traumatic for the friends and family of those who go into cardiac arrest. And many of those who do survive CPR are left with debilitating conditions such as brain damage, also rarely shown in TV dramas.

Of course, it should be remembered that anyone who has a cardiac arrest in a medical environment (or “hospital”, as we laypersons call them) was most likely within that medical environment because they were already unwell. But the shock for me wasn’t the difference between the figures depending on where you have your cardiac arrest (although, having seen this, I wouldn’t really suggest having one anywhere), but that “less than 2%” chance of survival outside of a medical environment.

Less than 2%? Not. Good. Odds.

Cardiac Arrestees in Seattle (home of ‘really medically accurate hospital drama’, Grey’s Anatomy), have a chance of survival, simply because their EMS service has identified cardiac arrest as their number one priority, and work specifically hone their services to saving these patients. Part of this approach is the widespread availability and publicising of training for citizens, with the result that:

King County has the nation’s highest rate of witnesses of cardiac arrest performing CPR… When done at the scene, CPR doubles the victim’s likelihood of survival.

55% of individuals who suffered a cardiac arrest in 2012 in King County survived the event, and:

…85 percent of those maintained good neurological functioning. That survival rate has doubled in the county since 2002 and is significantly higher than the nation’s average of 8 percent.

So don’t let this dissuade you from trying to help.

The CPR vs DNR decision is for the doctors and their petty managers to sort out. For the man on the street (literally, he just collapsed and he is now flat on the actual surface of the street), no matter how small the chances of success, anything is better than nothing. If you have the training (and you really should have the training – it’s quick, easy and generally free to get), you should always have a go if you end up as first responder in an emergency case.

I fear the day…

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I’d like to begin with a quote:

I fear the day when the ability to share fake Albert Einstein quotes on Facebook surpasses our ability to stop and think first. The world will have a generation of idiots.

Yes, I think it probably has already happened. See, as Abraham Lincoln famously said in 1864:

The problem with quotes on the internet is that you can’t always depend on their accuracy.

But that doesn’t stop people for blindly forwarding this stuff around. The Trevor Mallach letter – recently resurrected ahead of the April elections – is a good example. If it loosely fits their agenda or feelings, the button is clicked and they – in this case, at least – unwittingly become a demonstration of their own concerns.

Of course, Albert Einstein didn’t ever say:

I fear the day that technology will surpass our human interaction. The world will have a generation of idiots.

Sometimes there are subtle variations (e.g. “overlap” instead of “surpass”), but as QuoteInvestigator suggests:

Albert Einstein did not write or say any of the three variant quotations. Individuals who were aggravated by the behavior patterns of cell phone users probably facilitated the construction, evolution, and dissemination of this meme. The efforts of the creators have been successful for now. The basic saying has achieved viral status with its dubious ascription.

There’s no real point to this post. I’m not expecting to change the habits of the average internet user by telling people that they’re being foolish in sharing a fake quotation. It’s more the feeling (much like the Trevor Mallach thing) that I’m almost being complicit in their spreading of falsehoods if I don’t say something. Oh, and the fact that people are sharing it from davidicke dot com, which no-one should ever share anything from.

Anyway, the take home message is that the supposed Albert Einstein quote is actually a fake Albert Einstein quote and that the world would probably be a much better place if people didn’t forward fake Albert Einstein quotes around.

Do your bit.

Moon

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I was alerted to an animation by this tweet:

If the Moon were only a few hundred km away, it would look AMAZING… but you’d be way too dead to notice.

An animation artist has arted an animation of what it would look like if the moon were about 420km above the earth’s surface. That’s about the same altitude as the International Space Station. And yes, it does look amazing:

Here’s the cool stuff:

If the Moon were that close — 420 km (260 miles) over the surface of the Earth — it would be over 100º in size, literally more than half the sky! Right now it’s a mere 0.5º in size, for comparison.
It’s dark in the middle because with the Moon blocking the Sun for so much of the Earth, there’s no light to reflect and illuminate the Moon there!
The motion in the video is sped up; at that distance the Moon would orbit the Earth in about 90 minutes or so. It would cross the sky in very roughly five minutes.

And here’s the kinda weird bit:

The Earth has about 80 times the mass of the Moon, so if you could situate yourself exactly halfway between them, the Earth would pull on you 80x harder than the Moon. But it’s worse than that; gravity drops as the square of the distance, and the Moon is pretty far away. Right now, the center of the Earth is roughly 6400 km below you, and the Moon’s center is about 380,000 km above you. Take the ratio and square it, and you see that the Earth pulls on you 3500 times harder just because it’s closer. Add in the fact that the Earth is more massive, and you’ll find it pulls on you about 300,000 times harder than the Moon!
That’s why you don’t notice the gravity of the Moon. It’s only 0.0003% as strong as what you feel from the Earth.

But if the moon were 420km away,and you redo the gravity calculation, you’d find the force of gravity from the Moon on you is 1/10th that of Earth!
When the Moon passed overhead, you’d weigh 10% less.

Weight Watchers paradise.

But sadly, that’s where the good news ends. Because tides.

If we bring the Moon in really close, suddenly one side of the Earth is a lot closer to the Moon than the other: The Earth’s near side is 2158 km from the Moon’s center, and the far side is nearly 15,000 km away. That’s a huge difference, and the tides felt by the Earth would be amplified enormously — nearly 100,000 times what we experience now! There would be global floods as a tidal wave kilometers high sweeps around the world every 90 minutes (due to the Moon’s closer, faster orbit), scouring clean everything in its path.

That, and the fact that the earth would be so pulled and stretched that the crust would start to fall apart and the sea would probably boil away as the magma beneath the earth’s surface was exposed.

Oh, and the high likelihood that the moon would be pulled apart by the earth’s gravitational forces.

Look, it’s not going to end well.

In fact, the reason we are still here – and that the moon is still there – is exactly that: that we are here and it is there. Anything else would result in certain disaster. So there’s something to brighten your journey home today.

More facts and information here.