Vargas Caño J (1), Esnaola Iriarte B (2), Aramburu Uriarte O (2), Telletxea Benguria S (3).
(1) Resident physician Anaesthesia department, Galdakao-Usansolo University Hospital, Galdakao, Vizcaya, Spain
(2) Specialist Anaesthesia department, Galdakao-Usansolo University Hospital, Galdakao, Vizcaya, Spain
(3) Head of Service Anaesthesia department, Galdakao-Usansolo University Hospital, Galdakao, Vizcaya, Spain
The optimal target temperature for patients during the perioperative period is about 37ºC.1 Intraoperative hypothermia, defined as the core temperature below 36.0ºC during surgery, is a situation that occurs in both scheduled and urgent interventions, and it is associated with numerous deleterious clinical manifestations and worse outcomes (such as arrhythmias, altered consciousness, increased bleeding or transfusion requirements during surgery). Therefore, patients’ temperature monitoring should always be considered, and strategies should be applied to optimize the most accurate management during all anesthetic phases.
When humans are exposed to a cold environment, different mechanisms are activated. Firstly, vasoconstriction is mediated by adrenergic receptors, and behavioral changes such as using clothing and shelter to keep warm are developed. A cold stress response follows these. As a result, shivering can be present and may be an initial sign of hypothermia. However, shivering cannot be present in children, the elderly, or due to being under the effects of some drugs. Non-shivering thermogenesis is the production of metabolic heat without muscular activity. In contrast, shivering uses increased mechanical work to generate heat as a by-product, increasing muscle oxygen consumption.
Under general anesthesia this control system is severely challenged. Behavioral responses are completely abolished, and vasoconstriction and shivering thresholds decrease from 0.4 to 4.0ºC, being hemodynamics response compromised. In addition, these thresholds may be reduced even further in elderly patients.2
During winter a 75-year-old woman with a previous medical history of alcoholism, hypertension, type 2 diabetes, and atrial fibrillation without anticoagulation, was found on the floor of her home with a low level of consciousness (Glasgow Coma Scale (GCS): 12 (E3V4M5)). A generalized body coldness was perceived by touch, although at that moment it was not granted the necessary importance. Upon arrival at the emergency department, she presented a decreased level of consciousness, GCS 10 (E2V3M5), and signs of neurological focality (mydriatic right pupil with reactivity to light, gaze deviation to the right, and left hemiplegia, and hypoesthesia). She also presented mucocutaneous pallor and shivering refractory to insulation with ultrathin reflective foil (URF). An extremely cold extremity was observed in the right lower limb, in addition to poor peripheral perfusion with cyanosis.
The first blood test showed: Creatine Phosphokinase levels of 8,626 U/L, thrombocytopenia (92 103/µL), prothrombin time: 51%, and activated partial thromboplastin time: 27 seconds.
The stroke code was activated, and a cranial CT scan was performed, showing signs of acute-subacute ischemic stroke established in the deep territory of the right middle cerebral artery. Assessed by the neurology department, it was ruled out thrombectomy and fibrinolysis due to unknown episode onset times. She was diagnosed with severe acute ischemia of the right foot after vascular surgeons’ echo-doppler examination and clinical assessment. Treatment was started with 5000 IU of intravenous sodium heparin, and an urgent thrombectomy was performed on the second and third popliteal and anterior tibial portions with intraoperative arteriography and angioplasty of the anterior tibial artery.
Due to the suspected hypothermia of the patient, active warming measures were started from the patient’s reception in the operating room, using a fluid warmer at 41ºC and placing a heating blanket up to 43ºC. General anesthesia was decided, and rapid sequence intubation was performed following: 100 mcg of fentanyl, 80 mg of propofol and 80 mg of rocuronium. Maintenance was performed using sevoflurane at 0.6 MAC. Volume-controlled ventilation was performed at 6ml/kg, calculated for an ideal weight.
The value of 18 mmHg EtCO2 obtained in the capnography after intubation, and the clinical findings of skin coldness during the physical examination, shivering and decreased level of consciousness before the intervention, led to suspect hypothermia as the first diagnosis, compatible with reduced metabolism. However, it was also compatible with the clinical situation of the stroke and her distal ischemia. That is why it was decided to monitor the temperature with the zero-heat-flux thermometer on the forehead. The initial body temperature was 29.9ºC, so an esophageal probe was placed in the distal third part of the esophagus to corroborate the value, obtaining the same temperature. The EtCO2 remained low during the surgery, but a maximum peak of 31ºC was achieved at the end, with a progressive simultaneous rise in EtCO2 of 22 mmHg.
The surgery lasted 105 minutes and the patient remained hemodynamically stable during the procedure, maintaining mean arterial pressure (MAP) >70 mmHg. Arterial blood sample showed: pH 7,14; pCO2: 33 mmHg; pO2 194 mmHg; bicarbonate 11 mmol/L; base excess: -16,6 mmol/L; Lactate 3,5 mmol/L; Sodium: 142 mEq/L; Potassium: 2,3 mEq/L. A 58 mEq of bicarbonate were administered.
After surgery, the patient was transferred intubated to the ICU and connected to mechanical ventilation, with peripheral saturation of 96% and MAP > 65 mmHg. The core temperature gradually increased to 33ºC in the following hours as shown in Figure 1. During the following days, she remained intubated due to a low level of consciousness in the multiple neurological examinations and bad local clinical evolution requiring rising vasopressor support. As a result of the progression of the patient’s deterioration and her general situation, an agreement was reached with the family on the adequacy of the therapeutic effort, dying at dawn on the seventh day after surgery.
Optimizing the patient’s body temperature undergoing surgery procedures requires some considerations. The knowledge of the risk factors for incidence of inadvertent perioperative hypothermia is essential: ASA grade 2-5 (the higher the grade, the greater the risk); preoperative temperature < 36ºC (and preoperative warming is not possible because of clinical urgency) and environmental cold temperature; undergoing combined general and regional anesthesia; undergoing major or intermediate surgery; at risk of cardiovascular complications; low body mass index; elderly patients (who are at more risk of any of the complications of hypothermia); and more than 30 min duration of surgery.2,3
Likewise, practical strategies to avoid hypothermia by redistribution should be implemented, avoiding the dissemination of heat flow from the central compartment to the peripheral compartment.4 Prior to surgical intervention, warming up patients leads to an increase in the temperature of the peripheral tissue, thus reducing the intercompartmental temperature gradient. Passive and active warming measures are available to optimize the patient’s normothermia. Passive insulation reduces skin heat loss by 30% with a single layer of insulation, reaching 50% with three layers.5 One resource of passive warming measures is insulation with URF. In its application, the layer is usually placed directly on the skin or clothing. If the reflective side is separated from the body surface, there is a trapped air layer between them where air bubbles are warmed by radiation. Strategies such as the hypothermia wrap can be useful and can be trained by emergency personnel. The air volume trapped and the thickness of their layers, the body coverture, the accumulated humidity in the indoor part of the foil, creases, or defects in the foil can reduce the URF effectivity.6 Active rewarming devices are relevant in maintaining normothermia,5 highlighting the two main groups most commonly used: skin surface warming devices and fluid warming devices (although there are more: ECMO, cavity rewarming, dialysis, continuous venovenous hemodiafiltration…). Active external and internal rewarming devices are garments that provide heat by different systems with comparable efficiency: resistive warming, circulating water warming, and forced air warming7 (the latter being the most widely used and can increase body temperature average up to 0.5-4ºC/hour).8 Active fluid warming devices, though they are not used to increase body temperature, play a role during maintenance, especially in patients with high volume requirements (>1000 mL/h). In the case of our patient, despite the absence of initial temperature measurement, passive isolation began in the emergency department. At the same time, measures of active warming by forced air and fluid heating were applied in the operating room, managing to increase the patient’s temperature > 1ºC during the intraoperative time despite the general anesthesia.
Hypothermia during anesthesia develops a typically triphasic pattern. The first phase is mainly determined by the vasodilation induced by general anesthesia since inhibiting thermoregulation at the central level reduces the vasoconstriction and shivering threshold. Furthermore, most anesthetic agents induce direct peripheral vasodilation, facilitating hypothermia by redistribution. The hypothalamus and the spinal cord are affected by volatile anesthetics primarily in a nonlinear, concentration-dependent manner. Propofol reduces the core temperature in a linear, concentration-dependent way.9 Roth et al. investigated different alternative inductions that caused a lower decrease in core temperature. Administration of 160 µg phenylephrine immediately prior to induction with propofol at 2.2 mg/kg (by antagonizing propofol-induced vasodilation) or inhalation inductions with Sevoflurane (because they did not involve as much vasodilation, with a mean thermal advantage of 0.4-0.5ºC) achieve better results than intravenous inductions with propofol alone. Inductions with propofol can cause a rapid drop in core temperature up to 1.5°C.10 Opioids attenuate thermoregulation concentration-dependently but differ in the incidence of postoperative shivering. Ketamine seems to have the most negligible influence on thermoregulation because it maintains the peripheral vascular tone and therefore limits the magnitude of blood redistribution.9 Muscle relaxants do not pass the blood-brain barrier and therefore have no effect on thermoregulation,9 but their effect may prolong because of several reasons, including changes in the volume of distribution, altered local diffusion receptor affinity, changes in pH at the neuromuscular junction, and the net effect of cooling on the various components of neuromuscular transmission.11 An example is the doubling of the action time of vecuronium when the core temperature decreases by 2ºC.5
In the second phase, the hypothermic curve follows a slight decrease in central temperature due to the mechanisms of radiation, conduction, convection, and evaporation exceeding heat production. Active rewarming measures are most effective in this period.4
In the third phase, which is generally reached at 34.5ºC, the core temperature does not usually decrease, since the arteriovenous bypass vasoconstriction effectively retains metabolic heat in the central tissues.7 Currently, there are different devices available to measure temperature, but the most important consideration is the site that produces either a direct measurement of core temperature or a direct estimate of core temperature. These sites are pulmonary artery catheter, distal esophagus, urinary bladder, zero heat-flux (deep forehead), sublingual, axilla and rectum.3 Zero-heat-flux thermometers provide a non-invasive method for estimating tissue temperatures.9 During periods of slow temperature changes – which involve the majority of patients undergoing surgery – biases and limits of agreement of the zero-heat-flux method were equal to 0.1±0.5ºC and -0.1±0.4ºC compared with the esophageal probe and the arterial catheter, respectively.12 However, most of the studies using this device are performed considering a stable blood flow. Critical situations such as acute hemorrhage can produce false values and further studies in these situations are required.
Hypothermia leads to potential adverse consequences. The association between hypothermia and surgical site infection is a matter of debate.13 Classically, perioperative hypothermia affects the host’s defense against contamination via at least three mechanisms. First, perioperative hypothermia triggers postoperative vasoconstriction to constrain metabolic heat to the core and speed rewarm.5,11 As a consequence, tissue oxygen partial pressure drops, which is especially important, as oxidative killing by neutrophils mostly relies on molecular oxygen. Second, perioperative hypothermia reduces systemic immune activation, including T-cell-mediated antibody production, and decreases the motility of key cells, including macrophages.5,11 Third, vasoconstriction-induced tissue hypoxia impairs tissue healing and protein metabolism, which are important to prevent wound dehiscence and recontamination.7
Perioperative hypothermia increases intraoperative bleeding (>16%) and the transfusion requirements (>22%).14 Although platelet counts can be stable or decreased by temperature, perioperative hypothermia affects platelet function because of the reversible impairment of platelet aggregation via reduced release of thromboxane A2. In addition, perioperative hypothermia impairs the function of several enzymes of the coagulation cascade and finally reduces clot formation.11
Shivering is an autonomic thermoregulatory response defined as a rhythmic involuntary muscular activity and can be a physiological response to hypothermia. The goal of postoperative shivering is to produce heat to restore normothermia, but, on average, it increases oxygen consumption by approximately 40%. Consequently, this reaction is associated with increased perioperative morbidity and mortality.11 Furthermore, this oxygen consumption and hypothermia could cause heart complications. Shivering can be absent in different extremes of life and due to drug interaction, such as pethidine or clonidine.
Awareness of hypothermia risks during perioperative hypothermia must be vital in all anesthetic procedures. This case reflects the importance of prompt identification of hypothermia. In addition, early-onset measures avoiding clinical deterioration by hypothermia pathophysiology play a crucial role during all the anesthesia phases. Perioperative hypothermia increases patients’ morbidity, hospitality length of stay, blood loss, and transfusion risk; therefore, every anesthesiologist should always consider it.
The present investigation has not received specific aid from agencies of the public sector, commercial sector, or non-profit entities.
Conflict of interests
The authors declare no conflict of interest.
1. Zaballos Bustingorri JM, Campos Suárez JM. Hipotermia intraoperatoria no terapéutica: prevención y tratamiento (parte II). Rev Esp Anestesiol Reanim. 2003;50(4):197-208 (HTML)
2. Riley C, Andrzejowski J. Inadvertent perioperative hypothermia. BJA Educ. 2018;18(8):227-233. (PubMed)
3. Hypothermia: prevention and management in adults having surgery. London: National Institute for Health and Care Excellence (NICE); December 2016. (PubMed)
4. Baptista W, Rando K, Zunini G. Hipotermia perioperatoria. Anest Analg Reanim 2010; 23(2):24-38. (HTML)
5. Sessler DI. Complications and Treatment of Mild Hypothermia. Anesthesiology 2001; 95(2):531-543. (PubMed)
6. Kosiński S, Podsiadło P, Darocha T, et al. Prehospital Use of Ultrathin Reflective Foils. Wilderness Environ Med. 2022;33(1):134-139. (HTML)
7. Sessler DI. Perioperative temperature management. In: Nussmeier AN, Joshi GP, ed. UpToDate, Waltham, MA. 2020. https://www.uptodate.com/contents/perioperative-temperature-management. Accessed November 20, 2021. (HTML)
8. Paal P, Gordon L, Strapazzon G, et al. Accidental hypothermia-an update: The content of this review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM). Scand J Trauma Resusc Emerg Med. 2016;24(1):111. (PubMed)
9. Rauch S, Miller C, Bräuer A, Wallner B, Bock M, Paal P. Perioperative Hypothermia-A Narrative Review. Int J Environ Res Public Health. 2021;18(16):8749. (PubMed)
10. Roth JV, Braitman LE, Hunt LH. Induction techniques that reduce redistribution hypothermia: a prospective, randomized, controlled, single blind effectiveness study [published correction appears in BMC Anesthesiol. 2021 Apr 12;21(1):112]. BMC Anesthesiol. 2019;19(1):203. (PMC)
11. Ruetzler K, Kurz A. Consequences of perioperative hypothermia. Handb Clin Neurol. 2018;157:687-697. (PubMed)
12. Boisson M, Alaux A, Kerforne T, et al. Intra-operative cutaneous temperature monitoring with zero-heat-flux technique (3M SpotOn) in comparison with oesophageal and arterial temperature: A prospective observational study. Eur J Anaesthesiol. 2018;35(11):825-830. (HTML)
13. Bu N, Zhao E, Gao Y, et al. Association between perioperative hypothermia and surgical site infection: A meta-analysis. Medicine (Baltimore). 2019;98(6):e14392. (PMC)
14. Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008;108(1):71-77. (PubMed)


Eisai and Biogen were jointly developing three experimental drugs for Alzheimer’s: aducanumab, BAN2401 and elenbecestat, all designed to target the brain-destroying protein beta amyloid.
“As we have believed aducanumab was the best hope for treating Alzheimer’s, ending its trials is big negative surprise,” said analyst Motoya Kohtani at Nomura Securities.
BAN2401 has been met with skepticism since the partners reported promising but confusing 18-month results in July. Yet Eisai remains confident in its continued development.
“We still believe that amyloid beta hypothesis is potentially the right approach for the treatment of Alzheimer’s disease,” an Eisai spokesman told Reuters.
Eisai will conduct phase 3 trials of BAN2401 involving 1,566 patients with mild cognitive impairment or mild Alzheimer’s disease dementia with confirmed amyloid accumulation.
Alzheimer’s treatments are known as being particularly difficult to develop, as both diagnosis and the recruitment of appropriate trial participants are challenging.
From 1998 through 2017, only four treatments have been approved with another 146 attempts resulting in failure, according to the Adis R&D Insight database.
Alzheimer’s is the most common form of dementia. In Japan, the government estimates there will be 7 million dementia sufferers in 2025, from 4.6 million in 2012.
The post Eisai starts phase 3 trials for second Alzheimer’s drug after first’s failure appeared first on USNewsRank.


I’m currently reading Brain Rules by John Medina. It’s one of a number of popular books on brain science that have striking relevance to leadership, and to modern life. Here are a few ideas that really struck me:
Research shows that people perform better cognitively when they exercise on a regular basis. There is a simple biological reason for this: exercise makes it easier for critical resources to get to our brains, and for waste products to be removed. Our brains make very heavy demands for glucose and oxygen that provide the energy needed to perform cognitive tasks, and the disposal service to remove the toxins that brain work creates. While our brains account for only 2% of our body weight, they can use 20% of our available energy. And all these resources travel through just one primary set of roads–blood vessels. Regular exercise improves blood flow to and from our brains, improving the delivery system in and out of our brains for glucose, oxygen, and waste products. Medina uses the metaphor of changing from dirt roads to paved roads–exercise vastly improves the brain’s access to what it needs for peak performance.
There’s also an evolutionary explanation of why our brains do better when our bodies are active: we evolved “in motion.” Until only very recently in our history, humans lived our lives mostly outdoors and our survival demanded that we constantly move our bodies. We had to hunt, plant, reap, run away. In other words, the very design of our bodies and brains evolved in a context of high activity. We are meant for that. One statistic Medina sites is that for a significant part of our evolution we were moving on average 12 miles a day. And while our lives have changed enormously in the past century, with many people living sedentary lives, the basic design of our bodies and brains, which evolved over millions and millions of years, hasn’t changed. To get the best from our brains, we need to use our bodies more like our ancestors did.
The positive impact of exercise on brain function goes well beyond “thinking.” Exercise helps ward off dementia and Alzheimer’s, it improves mood and decreases depression, and it makes other positive brain changes that impact a vast number of function and quality of life issues.
Beyond exercise, other self-care issues also have a huge impact on brain function and hence leadership effectiveness. Taking breaks, getting into the sunshine, getting a good night sleep, self-awareness of one’s moment-to-moment thoughts and feelings, and being in the midst of positive relationships–all of these enhance mental function. Viewing this through the lens of leadership and organizational effectiveness, it becomes obvious that we need to change a lot about how we do business. Grueling, long hours with no time for rest and exercise is self-defeating. If the goal is productivity, innovation and success, we have to take more seriously what science is teaching us about the human brain.


This degree program is designed to provide the student with an understanding of the structural and functional relationships between the chemical constituents of cells and their roles in life processes. The requirements include courses in biological sciences and chemistry, and appropriate courses in mathematics and physics. The degree in biochemistry prepares a student for careers in industry, medicine, teaching and research.
In addition to the major requirements, students must complete all CASL Degree Requirements.
Prerequisites to the Major
A solid background in mathematics is essential to success in any of the scientific disciplines. Incoming students who intend to choose a major in Biochemistry should have completed at least three years of high school mathematics. First year students should plan to enroll in MATH 105, MATH 115 or MATH 116 based on the results of their math placement tests. The CHEM 134 and CHEM 136 or CHEM 144 and CHEM 146 sequence is a prerequisite to many other courses in the Natural Sciences Department; students should complete this sequence as early as possible.
|BCHM 210||Biochemistry Laboratory Techniques||2|
& BIOL 140
|Intro Org and Environ Biology|
and Intro Molec & Cellular Biology
|Select one of the following:||8|
|General Chemistry IA|
and General Chemistry IIA
|Gen Chemistry IB|
and General Chemistry IIB
& CHEM 226
& CHEM 227
|Organic Chemistry I|
and Organic Chemistry II
and Organic Chemistry Laboratory
& MATH 116
and Calculus II
|Select one of the following:||8|
|General Physics I|
and General Physics II
|Introductory Physics I|
and Introductory Physics II
|Total Credit Hours||42|
|Biochemistry Laboratory I|
|Biochemistry Laboratory II|
|Complex Systems (Biochemistry Capstone)|
|Physical Chemistry I|
|Any BCHM upper level courses (excluding BCHM 495, BCHM 498, and BCHM 499)|
|Select one of the following:|
|Applied Statistics I|
|Other Science Elective 1||3|
|Any upper level BCHM, BIOL, CHEM, MICR, PHYS courses (excluding BIOL 494, BIOL 495, BIOL 498, BIOL 499, BCHM 370, BCHM 495, BCHM 498, BCHM 499, CHEM 495, CHEM 498, CHEM 499, MICR 495, MICR 498, MICR 499, PHYS 495, PHYS 498, PHYS 499).|
|Total Credit Hours||30-31|
Elective credits needed may vary depending on biochemistry electives credits and statistics credits completed.
- A maximum of 65 hrs. in BCHM, BIOL, CHEM may count towards the 120 hours for degree.
- At least 20 of the 30 upper level hours must be elected at UM-Dearborn.
- A maximum of 6 hrs. of independent study/research in any Dept. of Natural Sciences discipline may count towards the 120 hours required to graduate.
- BCHM 370 cannot be used in the major.
Honors Designation in Biochemistry
The Biochemistry program seeks to recognize exceptional biochemistry majors who are exemplary in coursework and productive in research.
Honors in Biochemistry will be earned by meeting all of the following criteria:
- cumulative GPA of 3.5 or higher in Biochemistry courses
- cumulative GPA of 3.3 or higher in all university courses
- completion of a minimum of 6 six credit hours of Independent/Directed Research (BCHM 495/498/ 499), spread over 2 or more years, under the supervision of one principal investigator, who will serve as thesis advisor. This research must have a biochemical (broadly defined) focus.
- presentation of the research in a public forum (e.g. scientific meeting, College of Arts, Sciences, and Letters (CASL) Research Day, Department of Natural Sciences Poster Day)
- completion of a thesis-like document that thoroughly describes the background, experimental design, methodology and discussion of data generated in the context of the scientific literature.
- defense of the research thesis before a committee of four faculty: the thesis advisor, two full time Faculty from the Biochemistry program committee and one external member of the student’s choosing. The defense should be held a minimum of 2 weeks prior to the final-exams week of the semester in which the student is graduating. The committee must be provided with a draft of the thesis one week prior to the defense.
In order to be considered for Honors in Biochemistry, a student must complete and submit an honors application to the Biochemistry Program committee Chair via his/her advisor no later than the end of the term prior to graduation.
Minor or Integrative Studies Concentration Requirements
A minor or concentration consists of 12 credit hours of upper-level courses in biochemistry (BCHM) from the following:
Required: BCHM 370 or BCHM 470 and BCHM 471
Additional biochemistry (BCHM) courses: 6-9 credits BCHM to equal 12 credits total.
If BCHM 370 is completed, BCHM 470 and BCHM 471 cannot be used in the minor/concentration. If BCHM 470 and BCHM 471 is completed, BCHM 370 cannot be used in the minor/concentration.
At least 9 of the 12 credits must be elected at UM-Dearborn.
- A minimum GPA of 2.0 is required for the minor/concentration. The GPA is based on all coursework required within the minor (excluding prerequisites).
- A minimum of 9 credits must be completed at UM-Dearborn for a 12 credit minor/concentration.
- A minimum of 12 credits must be completed at UM-Dearborn for a 15 or more credit minor/concentration.
- Courses within a minor/concentration cannot be taken as Pass/Fail (P/F)
- Only 3 credit hours of independent study or internship may be used to fulfill the requirements for a 12 credit hour minor/concentration. Only 6 credit hours of such credit may be used in a 15 or more credit hour minor/concentration.
- Minors requiring 12 credits may share one course with a major. Minors requiring 15 credits or more may share two courses with a major. This does not apply to concentrations for the Integrative Studies major.
- Demonstrate an understanding of the underlying laws of Chemistry, Biology and Physics and their applications to organisms.
- Demonstrate proficient knowledge of the biochemical reactions that sustain life.
- Demonstrate an understanding of how biochemical reactions are regulated and integrated, and the flux and exchange of energy and matter between organisms and their surroundings.
- Understand the biochemical foundations for the unity and the diversity of the living organisms.
- Understand and employ the methods and techniques of biochemical research.
- Understand how to analyze, interpret and communicate biochemical data.
- Possess the skills and knowledge to collaborate with researchers in related and interdisciplinary fields.
BCHM 113 Medicinal and Aromatic Plants in Culture and Practice 3 Credit Hours
Medicinal and aromatic plants have been used for thousands of years to treat illness, create aromatic atmospheres, enhance food flavors, and in ritual ceremonies. Recently, use of plants as alternative therapy has increased in medical practices leading to initiatives to regulate and assess their safety and effectiveness. This course is designed for students interested in health-related careers, food, culture and nutrition. The course explores the history, cultural practices, everyday use, and current research on medicinal and aromatic plants. (YR).
BCHM 210 Biochemistry Laboratory Techniques 2 Credit Hours
Biochemical Laboratory Techniques in an introduction to the equipment, procedures, and concepts used in the biochemistry laboratory. The class will cover topics such as scientific literature, keeping a laboratory notebook, statistical analysis and computer programs, as they relate to biochemistry. (W,YR)
Can enroll if Major is Biochemistry
BCHM 352 Introduction to Toxicology 3 Credit Hours
An introduction to the principles of toxicology with an emphasis on environmental toxicology. Major topics include toxic agents, toxicological mechanisms, and use of toxicological reference literature. Discussion of chemical carcinogenesis, genetic toxicology, immunotoxicology, teratology, and toxic responses of the skin, eyes, and nervous system. Three hours lecture. (AY).
Prerequisite(s): CHEM 225
BCHM 370 Principles of Biochemistry 3 Credit Hours
A concise but comprehensive survey of various areas of biochemistry designed for non-biochemistry majors. The course follows the standard approach to the subject including a description of cells, their structure and constituent macromolecules (proteins, nucleic acids, carbohydrates and lipids), enzymology, bioenergetics, intermediary metabolism, and gene regulation. Students cannot take both Biochemistry 370 and 470 or 471 for any combination of concentration, cognate or minor requirement. Three hours lecture. (F).
BCHM 390 Current Topics in Biochemistry 1 to 3 Credit Hours
Special topics current to the field of biochemistry. Topics and format for the course may vary. See Schedule of Classes for current topic. Permission of instructor. (OC).
BCHM 404 Mech. Chronic Human Disease 3 Credit Hours
This course focuses on the biochemical, molecular and cellular mechanisms underlying the progression of chronic diseases, such as diabetes mellitus and atherosclerosis. Techniques in epidemiology, pathology, genetics, molecular biology, and biochemistry are used to understand how relevant physiological processes become pathological. The examination of chronic diseases provides an opportunity to understand biological processes across many scales of life, from extracellular matrix proteins to cells in blood vessel walls to risk factors in patient populations to the pharmacology of treatments. Use of primary literature is emphasized. Three hour lecture.
Can enroll if Class is Junior or Senior
BCHM 413 Extraction, purification, and characterization of Medicinal and Aromatic Plants 3 Credit Hours
Students will learn the techniques behind essential oil extraction and the biological uses of medicinal plants. Independent work throughout the semester will allow students to grow, extract, and analyze an oil from a medicinal plant of their choosing. Through working in groups, students will collaboratively produce a final product of diffusing oils, candles, or soaps with aromatherapy uses. Uses and case studies throughout the semester will appeal to the pre-health student interested in learning about holistic medicine while manufacturing techniques and discussions will interest scientists with an industrial career outlook. (W).
BCHM 430 Bioinorganic Chemistry 3 Credit Hours
This course examines the roles that metals play in biological systems, including the chemical principles that make metal ions well-suited for roles in protein structure, in redox catalysis and in acid base chemistry. The physical and experimental techniques that are applied to explore the structure and function of metals systems will be introduced using case studies from the primary scientific literature in the field. BCHM 370 or its equivalent are strongly recommended but not required.
BCHM 470 Biochemistry I 3 Credit Hours
Life processes from a chemical viewpoint: structure/function relationships of biomolecules with emphasis on proteins, enzyme kinetics, and mechanisms of action. Three hours lecture. (W).
BCHM 471 Biochemistry II 3 Credit Hours
Intermediary metabolism, bioenergetics, energy transformation, metabolic interrelationships, biochemical regulation, highly structured subcellular biochemical systems. Three hours lecture. (W).
BCHM 472 Biochemistry Laboratory I 1 Credit Hour
The techniques of preparative and analytical biochemistry. Preparation and characterization of proteins and nucleic acids. Physical and chemical properties of proteins and nucleic acids. Four hours laboratory. CHEM 344 Recommended. (F).
BCHM 473 Biochemistry Laboratory II 1 Credit Hour
The techniques of preparative and analytical biochemistry. Preparation and characterization of lipids and carbohydrates. Methods in metabolism. Four hours laboratory. (W).
BCHM 474 Molecular Biology 4 Credit Hours
This course will emphasize the molecular biology of eukaryotes, and topics will include genome organization and complexity, chromatin structure and function, gene expression, DNA replication and repair, genetic rearrangements, and the molecular biology of development. The laboratory will emphasize the application of recombinant DNA technology to the study of biological problems. Three hours lecture, four hours laboratory. (W).
Corequisite(s): BCHM 474L
BCHM 480 Biochemical Pharmacology 3 Credit Hours
Pharmacology is a study of drugs. In this course, the biochemical and molecular basis of drug action will be emphasized. Different categories of drugs, their use, abuse, and side effects will be presented. Three hours lecture. Permission of instructor. (OC).
BCHM 485 Nutrition and Metabolism 3 Credit Hours
Full Course Title: The Biochemistry of Human Nutrition and Metabolism Human Nutrition and Metabolism is an introduction to the relationship between food and nutrients, and their integration in the metabolic pathways. An understanding of the molecular basis of nutrition, related diseases, and overall health will be built on previous knowledge of cell biology and biochemistry. (AY)
BCHM 490 Topics in Biochemistry 1 to 3 Credit Hours
A course in special topics that examines research problems of current interest in biochemistry. Topics and format may vary. See current Schedule of Classes. One to three hours seminar. (W).
BCHM 495 Off-Campus Research in Biochem 1 to 3 Credit Hours
Participation in ongoing research at an off-campus laboratory. No more than 6 hours combined from any Natural Science courses numbered 495, 498, and 499 may be credited toward the 120 hours required for a degree. Four to twelve hours laboratory. Permission of concentration advisor. (F,W,S).
BCHM 496 Complex Systems 3 Credit Hours
Full Title: Biochemistry Capstone: Complex systems in Biochemistry A complex system is defined as a system featuring a large number of interacting variables whose combined activity is non-linear and whose seemingly random behavior leads to self-organization. Current topics ** are used to explore how complex systems function in biology. All reading material in the class are taken from the scientific literature giving students a chance to become familiar with how biochemists convey ideas and report their findings. Each student will present a paper to the class to demonstrate the ability to communicate concepts of Biochemistry effectively. Students will also learn the process of proposal writing and will have the opportunity to research and write their own proposal and have it peer-reviewed by their classmates. **The topics for this course will change each year, depending on the instructor, and the focus of current advances in Biochemistry/Complex systems. (W,YR)
Can enroll if Class is Senior
BCHM 497 Seminar in Biochemistry 1 Credit Hour
A seminar course that examines research problems of current interest in biochemistry. The course format may include training students to read and present scientific papers, guest lecturers, and lectures by the instructor on a selected topic. One hour seminar. Permission of instructor. (W).
BCHM 498 Directed Reading in Biochem 1 to 3 Credit Hours
Library research in a specific area of biochemistry performed under the direction of a faculty member. No more than six hours combined from departmental courses numbered 495, 498, and 499 may be credited toward the 120 hours required for a degree. Four to twelve hours readings. Permission of instructor. (F,W,S).
BCHM 499 Laboratory Research in Biochem 1 to 3 Credit Hours
Directed laboratory research performed under the supervision of a faculty member. Research training is encouraged. No more than six hours combined from departmental courses numbered 495, 498, and 499 may be credited toward the 120 hours required for graduation. Four to twelve hours laboratory. Permission of instructor. (F,W,S).
*An asterisk denotes that a course may be taken concurrently.
Frequency of Offering
The following abbreviations are used to denote the frequency of offering: (F) fall term; (W) winter term; (S) summer term; (F, W) fall and winter terms; (YR) once a year; (AY) alternating years; (OC) offered occasionally


Chlamydia is a sexually transmitted infection triggered by a bacterium called "Chlamydia trachomatis". This very bacterium not just infects the reproductive organs but could even infect the urinary tract as well as eyes and throat.
The bacteria resulting in Chlamydia can be transmitted by way of oral, anal or vaginal sex. An unborn kid might acquire this illness during vaginal birth. In the recent years the count of humans infected from Chlamydia have amplified manifold making it the most extensive sexually spread disease among the teenagers and youngsters.
If a woman is struggling with Chlamydia, she is most liable to experience itching in the vagina, vaginal discharge, urination along with burning sensation, painful sex, bleeding between menstrual periods, swelling in the rectum and the lining of the eye, nausea, fever and pain. A man afflicted with this may have penile discharge, urination accompanied with burning sensation, irritation at the opening of the penis, inflammation in the testicles, rectum and lining of the eye.
Chlamydia is also called "silent epidemic" because in majority the cases, i.e. 75% in women and 50% in men, Chlamydia will not reveal any indications. This makes its detection not easy.
Successful antibiotics for Chlamydia are commonly accessible. Azithromycin and doxycycline are 2 best and commonly used antibiotics for Chlamydia. Single dose of Azithromycin is used in the cure. Though, if doxycycline is being administered for the cure, then it will have week long dosage schedule.
These two antibiotics have proved to be helpful in the most severe persistent cases too. Erythromycin, ofloxacin, levofloxacin and amoxicillin are a few other alternate antibiotics for Chlamydia. Erythromycin and amoxicillin are the 2 antibiotics found safe for expectant females too.
Chlamydia can be prevented by using condoms, not having multiple partners and by abstaining sex with infected persons. Sex education must ideally be given to teenagers and youngsters to get them alert about the sexually transmitted illness, how they are triggered, their prevention, symptoms and the cure available for these.


Mechanism and specificities of hydrofluoric acid burns (HF burns)
How does hydrofluoric acid present a specific hazard ?
Hydrofluoric acid has a dual action
- a corrosive action due to the acid ions (H+), which can damage the superficial tissues (such as corneal epithelium or epidermis),
- a toxic action due to the F– ions, which can deeply penetrate thanks to the acid destruction of the superficial layers of the skin or the eye, and can chelate calcium and thus disturb the biological balances, which leads to more or less deep physiological disorders.
By definition, fluorides in acidic medium (such as boron trifluoride, for instance) carry the same kind of hazard.
Advantages of an active rinsing with the HEXAFLUORINE® solution
Because of this specific hazard and in addition to its sweeping effect, an efficient rinsing must quickly and simultaneously
- stop the further spread of the aggressive agent that has yet penetrated into the tissues
- remove the chemical thanks to the flow of osmotic pressures
- absorb all the aggressive potential of the chemical product (H+ et F– )
These three properties define the concept of active rinsing.
For decontamination to be optimal, the three above criteria must be gathered.
Today the HEXAFLUORINE® solution is the only solution that contains a molecule meeting such requirements worldwide.
- Mechanism of the chemical burn and creation of the chemical injury
- Mechanism and specificities of hydrofluoric acid burns
- Worsening factors of the chemical burn
- Summary of the Chemical Burn
- Rinsing instructions of chemical burns with DIPHOTERINE® and HEXAFLUORINE® solutions
- Fluoride ions in acidic medium- corrosive and toxic like hydrofluoric acid, a danger to be considered


If you’d like learn more about and help with our bottlenose dolphin photo-identification research please register below. You’ll assist the research by grading our bottlenose dolphin pictures for quality using a simple step-by-step guide. Grading ensures only the best pictures are chosen, so we correctly identify each individual dolphin. By crowdsourcing this research, photos can be graded for quality faster and more effectively.
Our bottlenose dolphin photo-identification project began in 1989 and is the longest running individual based study of bottlenose dolphins in the UK, and one of the longest in the world. We take photographs of the bottlenose dolphins on the east coast of Scotland each summer. Using the natural marks (nicks and tooth rakes) on the dolphins’ dorsal fins we can identify the individuals and keep track of their movements, how many there are, the number of calves they have and lots more about the dolphins’ ecology and biology.
These are an example of some of our photos. The first is of #11 Muddy who was born in 1988. Next is her mum #9 Guinness who we still see today! Muddy has had 6 calves, who we all still see, the first when she was 14 years old. Her second calf is #1024 Murky who was born in 2007. In 2015 Murky had her own calf, #1200, who is our second 4th generation calf.
Most of our work is in the Moray Firth Special Area of Conservation (SAC) and our main research goal is to support conservation and management of the east coast Scotland population. This SAC is one of only three in the UK and we are tasked by Scottish Natural Heritage to monitor and provide regular conservation status updates. To find out more go to www.abdn.ac.uk/lighthouse.
To REGISTER please click here and then LOG IN with your e-mail address and password below to get started.
If you have already been registered, log in below.


Kokedama Care Guide
Published: Thursday 4 July 2019
Kokedama (in English, literally means "moss ball"). They are a ball of soil, covered with moss or fibre, on which an ornamental plant grows.
TIPS & TRICKS
- On Watering: submerge into a bucket or sink of water for 1-2 minutes, until the bubbles stop. Remove from water and drain. Put back into hanger. Repeat this once a week.
- On Maintenance: Remove dead leaves by cutting close to the base of the plant. When the plant out grows its casing, remove basket fibre & string and replant into a pot or garden.


Views: 55 Author: Site Editor Publish Time: 2019-05-27 Origin: Site
In the daily life, especially when we clean the house, we use brooms and mops. Most of us regard brooms and mops as very common daily necessities that can help our homes become cleaner, however they may be also the items which are most easily affected by bacteria.
How many brooms are there in your house? Does each room have its own broom, or does the whole family use one? Maybe the broom in our house looks clean, but you know, the amount of dandruff and dust mites hidden in our hair and body actually exceeds your imagination. When we feel that there is dust in the house and we need to clean it with a broom, it seems to make the house cleaner, but what you ignore is that the dust in the room will become thicker because of the the air in the whole room became more turbid during cleaning.
As such a common household cleaning item in our life, after we clean the floor with a broom, the whole interior looks neat and orderly. But you will also notice that there is a lot of dust in the air after sweeping the floor with a broom. These dust clouds contain a lot of bacteria, which can easily cause people to breathe poorly and easily cause infection.
Although our human nasal cavity has a certain barrier function to dust and bacteria, the bacteria and microorganisms that can be removed from the nasal cavity are also limited. Generally speaking, the dust and smaller particles larger than 10 microns can be blocked off from the nasal cavity, others tiny dust inhales directly into our respiratory system, which may cause a lot of inflammation in the respiratory tract, or even asthma over time. When these tiny dust invade the body, they deposit in the alveoli of the lungs, gradually causing symptoms such as bronchitis.
The mop is much more prone to breeding bacteria. People usually use a broom to remove the floating ashes and then drag the floor of the whole house with a mop. Most of the dust removed by broomsticks is dry dust, and mops are attached to many harmful bacteria, which is hard to remove. After mopping the ground with a mop, many of harmful bacteria attached to the mop are taken with it from outside to our homes. What's more, the mop is moist in most time, which is very helpful for the reproduction and growth of these bacteria.
Common bacteria that are easily attached to mops, including E. coli, Salmonella typhi, Shigella, etc., which may even be fatal to some children and older people with weak resistance. You may be confused, if the mop used to clean up the house is so dangerous, how should the sanitation of the home be handled? Actually，as long as you use the the brooms and mops in the correct methods, it will be much safer and cleaner.
1.You should have more than one brooms in our house. It's best to use a broom alone in each room for individual use. This can effectively prevent the spread of bacteria in different rooms.
2. When sweeping the floor, we can put the old stockings on the broom and clean the floor. Because stockings are prone to static electricity, the hair and dust on the ground can easily stick to the surface of stockings when sweeping the floor. After cleaning the floor, you can throw away the stockings on the broom directly.
3. Generally speaking, after using the plastic brooms, you can simply rinse them with water, and then leave the broom in the sun for a period of time until it is dry. This process can reduce most of the bacteria attached to the brooms.
4. Clean brooms thoroughly and regularly. The way to wash a broom is to add some bleaching powder to the water. The ratio is about 1:100.
5. When mopping the ground, some low concentration bleaching agent or potassium Permanganate can be sprayed on the ground. This will kill most of the bacteria on the ground during the mopping process, and it can effectively prevent most bacteria from sticking to the mop.
6. After using the mop, wash the mop thoroughly with clean water, and then put it in the sun. The area is exposed to dry conditions in order to effectively prevent bacteria from being contaminated on mops for reproduction.
7. Don't put used mops in the corner of the bathroom. The environment of the bathroom itself is humid and warm, which is easy to breed bacteria.
Broomsticks and mops are important daily necessities for household cleaning. Everyone hopes that the family's living environment is cleaner and more comfortable. So don't ignore the cleaning of the cleaning tools.


- The Health Benefits of Berberine Supplements in Australia
- You might want to read !
The Health Benefits of Berberine Supplements in Australia
In recent years, there has been significant growth in the popularity of natural remedies and alternative medicines for maintaining and improving health. One such herbal supplement that has gained attention is berberine. Berberine is a compound found in various plants and has been used in traditional Chinese medicine for centuries. Its potential health benefits have led to the emergence of numerous supplement brands in Australia, catering to those seeking holistic health and wellness solutions. This report aims to explore the evidence behind the health benefits of berberine, its potential applications in Australia, and provide an analysis of the supplement market.
The Health Benefits of Berberine
Berberine has been extensively studied for its various health properties. Research suggests that berberine may have positive effects on several aspects of health, including:
1. Blood Sugar Control
Studies have shown that berberine may help regulate blood sugar levels. It is believed that berberine activates an enzyme called AMP-activated protein kinase (AMPK), which plays a crucial role in glucose metabolism. By activating this enzyme, berberine can enhance insulin sensitivity and promote the uptake of glucose into cells. This could potentially benefit individuals with diabetes or those at risk of developing the condition.
2. Cholesterol Management
Berberine has also been studied for its potential to lower cholesterol levels. Research indicates that berberine can reduce total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride levels, while increasing high-density lipoprotein (HDL) cholesterol levels. These effects make berberine a promising natural alternative for managing cholesterol, particularly for individuals who cannot tolerate or prefer to avoid statin medications.
3. Gut Health
The gut microbiome plays a crucial role in overall health and well-being. Preliminary studies suggest that berberine may have antimicrobial properties, which can help maintain a healthy balance of gut bacteria. Additionally, berberine has been shown to reduce inflammation in the gut and improve digestive function. These effects make it a promising supplement for individuals with conditions such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD).
4. Weight Management
Obesity is a significant health concern globally, including in Australia. Berberine has shown potential in aiding weight management by increasing fat breakdown and reducing fat storage. Animal studies have demonstrated that berberine can activate brown adipose tissue, which is responsible for burning calories to generate heat. Human studies have also shown promising results, with berberine supplementation leading to significant weight loss in overweight individuals.
The Australian Supplement Market
The growing interest in natural remedies and alternative medicines has led to a boom in the Australian supplement market. Numerous brands now offer berberine supplements, catering to those seeking holistic health solutions outside traditional pharmaceuticals. It is essential, however, for consumers to exercise caution and consider the quality and reliability of the brands they choose.
When selecting a berberine supplement, consumers should keep the following factors in mind:
1. Quality Assurance
Ensure that the supplement brand adheres to high-quality standards and has obtained necessary certifications. Look for products that are tested for purity, potency, and safety by third-party organizations. This helps guarantee the authenticity and reliability of the supplement.
2. Transparency in Ingredients
Review the ingredient list provided by the brand. Ensure that the main active ingredient is berberine and that it is present in an adequate dosage. Avoid brands that use unnecessary fillers, additives, or artificial ingredients.
3. Reputation and Customer Reviews
Research the reputation of the brand and read customer reviews to gain insights into the effectiveness and overall experience of using the berberine supplement. Look for brands with positive reviews and a loyal customer base.
Berberine supplements offer a natural and holistic approach to health and wellness. With potential benefits in blood sugar control, cholesterol management, gut health, and weight management, berberine has gained attention in the Australian health market. However, it is crucial for consumers to be discerning and choose reputable brands that prioritize quality, transparency, and customer satisfaction. As with any supplement, it is recommended to consult with a healthcare professional before incorporating berberine into your regimen, particularly if you have any pre-existing health conditions or are taking medications. While berberine‘s potential health benefits are promising, further research is still needed to fully understand its mechanisms and long-term effects.
<< photo by Jared Rice >>
The image is for illustrative purposes only and does not depict the actual situation.
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- The Berberine Breakdown: Unveiling Australia’s Top Berberine Brands for 2023
- “The Berberine Boom Down Under: Unearthing Australia’s Top Berberine Supplements for 2023”
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John J. and Dorothy Wilson Professor of Health Sciences and Technology and Electrical Engineering and Computer Science at MIT
Dr. Sangeeta N. Bhatia conducts research at the intersection of engineering, medicine, and biology to develop novel platforms for understanding, diagnosing, and treating human disease. Bhatia’s laboratory leverages ‘tiny technologies’ of miniaturization tools used in semiconductor manufacturing to yield inventions with new applications in tissue regeneration, stem cell differentiation, medical diagnostics, and drug delivery. Dr. Bhatia’s findings have produced high-throughput-capable human microlivers, which model human drug metabolism, drug-induced liver disease, and interaction with human pathogens. Her group also develops nanoparticles and nanoporous materials that can be designed to assemble and communicate to diagnose and treat a variety of diseases, including cancer.
Dr. Bhatia directs the Laboratory for Multiscale Regenerative Technologies at MIT. She is a Howard Hughes Medical Institute Investigator and the John J. and Dorothy Wilson Professor of Health Sciences and Technology and Electrical Engineering and Computer Science at MIT. She is a member of the Koch Institute for Integrative Cancer Research, a senior member of the Broad Institute, and a biomedical engineer at Brigham & Women’s Hospital. Dr. Bhatia is an elected member of the National Academy of Engineering and the American Academy of Arts and Science, and is a fellow of the American Institute for Medical and Biological Engineering, the Biomedical Engineering Society, and the American Society for Clinical Investigation. She has been awarded the 2014 Lemelson-MIT Prize, the Heinz Medal for groundbreaking inventions and advocacy for women in STEM fields, the David and Lucile Packard Fellowship given to “the nation’s most promising young professors in science and engineering,” the NSF CAREER Award, the Harvard Medical School Diversity Award, and the Harvard-MIT Thomas McMahon Mentoring Award, among many others.
Dr. Bhatia co-authored the first undergraduate textbook on tissue engineering and has published more than 160 manuscripts that have been cited over 16,000 times. Her work has been profiled broadly such as in Scientific American, the Boston Globe, Popular Science, Forbes, PBS’s NOVA scienceNOW, the Economist, and MSNBC, among many others, and she was recently included in Scientific American’s ‘Worldview 100’ list of the most influential researchers in Biotechnology. She and her 150+ trainees have contributed to more than 40 issued or pending patents and launched 10 biotechnology companies with 70+ products. She is a frequent advisor to governmental organizations, industrial corporations, and think tanks, and advocates for diversity in science and engineering. Dr. Bhatia holds a B.S. from Brown University; M.S. and Ph.D. degrees from MIT; and an M.D. from Harvard Medical School.


The monsoons are among the most eagerly awaited seasons, as they bring much needed respite from the searing heat of the summer. It’s the perfect time to sip on a hot brew coupled with some snacks, and watch the raindrops on their way. However, the monsoon also brings its fair share of hassles, the biggest bother being mosquitoes.
Mosquitoes breed in still water, and soon diseases like dengue, malaria and chikungunya begin to do the rounds. Also to be wary of are diseases like the flu, pneumonia and typhoid, which are communicable via air and water. And infants being the delicate creatures they are, stand at greater risk of contracting these diseases.
Pneumonia and typhoid are potentially deadly for children. So, if you have an infant at home, don’t kick back just yet. Prepare yourself, your home and your child against the worst of the monsoon. We’ve put together a list of 10 things you should do before and around the onset of the monsoons, to keep your infant safe and healthy.


No this is not a ‘you’re naughty ruining your lungs’ smoking rant (although you do know you are don’t you?). But besides the link between tobacco and heart disease, stroke, emphysema, and cancer (especially lung and throat cancers), smoking leads to the following oral health consequences:
- Bad breath – when you have braces, there are just more areas for bacteria and contaminants to loiter. So smoking with braces often leads to more severe odor.
- Tooth discoloration – smoking stains your teeth – when you have braces it is harder to brush increasing the likelihood of obvious tooth discoloration following the removal of your braces.
- Inflammation of the salivary gland openings on the roof of the mouth
- Increased loss of bone within the jaw – which can compromise your treatment time and stabilization.
- Increased risk of developing gum disease, a leading cause of tooth loss
- Delayed healing process – making your mouth ulcers (that we all get when we first have braces) more painful and taking longer to heal.
Do yourself a favour and use your decision to invest in braces an opportunity to quit. There are plenty of resources and support groups out there willing to help.
(primary source QuitNow & WebMD)


Medical Reasons and Symptoms of Extreme Hair Loss
Hair loss is a common condition that affects millions of people worldwide. While it is natural to shed some hair every day, excessive hair loss can be distressing and may indicate an underlying medical issue. In this article, we will explore the medical reasons behind extreme hair loss and discuss the accompanying symptoms that can help identify and address the problem effectively.
- Androgenetic Alopecia: Also known as male or female pattern baldness, is the most common cause of hair loss. It is a hereditary condition where hair follicles become sensitive to dihydrotestosterone (DHT), a hormone derived from testosterone. Over time, DHT weakens the hair follicles, causing them to produce shorter, finer hair until they eventually stop producing hair altogether.
- Telogen Effluvium: Telogen effluvium is a condition characterized by excessive shedding of hair. It is often triggered by a significant physiological or emotional stressor, such as childbirth, surgery, severe illness, or emotional trauma. This stressor disrupts the hair growth cycle, pushing more hair follicles into the telogen (resting) phase, leading to a noticeable increase in hair shedding.
- Alopecia Areata: Alopecia areata is an autoimmune disorder in which the body’s immune system mistakenly attacks hair follicles, resulting in sudden hair loss. It can occur in patches on the scalp or even lead to complete hair loss (alopecia totalis) or loss of hair on the entire body (alopecia universalis). The exact cause of alopecia areata is unknown, but it is believed to be a combination of genetic and environmental factors.
- Hormonal Imbalances: Conditions such as polycystic ovary syndrome (PCOS) and thyroid disorders disrupt the normal hormonal balance in the body. PCOS, for instance, can cause an excess of androgens (male hormones), leading to hair thinning and loss in a male pattern. Similarly, an underactive or overactive thyroid can disrupt hair growth cycles, resulting in hair loss.
- Nutritional Deficiencies: Inadequate intake of essential nutrients can significantly impact hair health. Deficiencies in vitamins, minerals (such as iron and zinc), and proteins can weaken hair follicles and lead to increased hair shedding. Poor diet, crash diets, or certain medical conditions that affect nutrient absorption can contribute to these deficiencies.
- Trichotillomania: Psychological disorder where individuals have an irresistible urge to pull out their hair, resulting in hair loss. It is often associated with stress, anxiety, or other mental health conditions.
- Scalp Infections: Fungal or bacterial infections of the scalp, such as ringworm (tinea capitis), can cause hair loss. These infections can lead to inflammation, damage to the hair follicles, and subsequent hair loss.
- Medical Treatments: Some medical treatments like chemotherapy for cancer, radiation therapy, and certain medications (e.g., antidepressants, anticoagulants, beta-blockers) can cause hair loss as a side effect.
- Skin Disorders: Certain skin conditions like psoriasis and seborrheic dermatitis can affect the scalp, leading to inflammation, itching, and hair loss.
Extreme hair loss can manifest with various symptoms, which may include:
- Excessive Hair Shedding: You may notice an increased amount of hair falling out during activities such as brushing, showering, or even gentle tugging.
- Thinning Hair: The overall volume and density of your hair may gradually decrease, resulting in a visibly thinner appearance, especially on the top of the scalp.
- Receding Hairline: In cases of androgenetic alopecia (male or female pattern baldness), there may be a noticeable receding hairline or the appearance of a widening part in the hair.
- Bald Patches: With conditions like alopecia areata, hair loss may occur in small, round patches on the scalp or other areas of the body.
- Itching or Scalp Irritation: Some hair loss conditions may cause itching, irritation, or inflammation of the scalp, leading to discomfort.
- Changes in Hair Texture: The remaining hair may become brittle, dry, or easily breakable due to the weakening of the hair shafts.
- Excessive Hair on Pillows or Clothing: If you observe an unusual amount of hair left on pillows, bedding, or clothing, it may indicate significant hair loss.
The Final Word
Men and women are equally conscious about their hair loss and baldness issues. Hair loss was earlier considered a sign of aging, but now the story seems to differ. Nowadays, even youngsters are also facing hair loss at the early age of their 20s. Medications can be beneficial for stopping hair loss or thinning, but the results are questionable when talking about permanency.
Therefore, if you want a permanent solution, a hair transplant for men and women can be an ideal solution. However, it is important to consult with a healthcare professional or dermatologist to determine the underlying cause and appropriate treatment. They can provide a proper diagnosis and suggest suitable treatment options based on your specific situation.


Item #: TMI90
The exophthalmometer is an instrument designed to measure the forward protrusion of the eye. This instrument provides a method of evaluating the recording the progression and regression of the prominence of an eye caused by disorders such as thyroid disease and tumors of the orbit.
This instrument consists of a horizontal calibrated bar with movable carriers at each side. Each carrier consists of mirrors inclined at 45 degrees to reflect both the scale reading and the apex of the cornea in profile. Notches on the side carriers are placed on the bony lateral orbital margins of the patient. The patient is then asked to fixated on a point on the examiner's forehead. The apex of the cornea of each eye is superimposed on the millimeter scale reading by the inclined mirrors. The measurement of each eye is recorded by the examiner, alternately viewing with the right and left eye.
The distance along the horizontal bar is also recorded as the bases so that the carriers will be set at the same base at subsequent reading's for comparison of the forward protrusion of each eye in relation to the bony orbit. This instrument is more accurate in detecting changes from year to year than the Luedde.


Mushroom M8 contains 8 of the world's favourite medicinal mushrooms in a single capsule, hand-picked to support immunity, gut health, hormonal function, and the nervous system.
These eight mushrooms were some of the most revered and cherished by the traditional healers the world over, especially the Taoists.
Mushroom M8 is an immunological powerhouse and supports the body to return to harmony through normalising the nervous and hormonal systems as well as regulating the Qi of all major organs.
These convenient capsules are the perfect starting point for someone wanting to get started on their path to radiant health, or for the well versed herbalist to maintain their daily dose of medicinal mushrooms.
Medicinal mushrooms typically work to strengthen the Spleen and Lung channels; this blend also works on the Liver, Kidney, and Heart channels making it a full-power formula to bring overall harmony and vitality to the body.


If you don't see a particular item, shoe, size, or color on our website that you would like to order, we would love to help you out. Please fill out the following FORM and we will contact you with more info.
HOTSHOT is a 1.7oz sports shot that boosts your Neuro Muscular Performance and is scientifically proven to prevent and treat muscle cramps. Invented by a Nobel Prize-winning neuroscientist/endurance athlete and a professor of neurobiology at Harvard Medical School, HOTSHOT works by stimulating Transient Receptor Potential channels located in the mouth, throat and esophagus – preventing neurons from misfiring – ultimately stopping muscle cramps where they start. At the nerve. How To Use: Drink HOTSHOT to prevent, treat and recover from exercise-associated muscle cramps. PREVENT: Drink a 1.7oz HOTSHOT ~15 minutes before exercise to prevent muscle cramps. Feel it work from the first kick to the warm afterglow. TREAT: Drink at the first sign of cramping. It starts working in minutes. RECOVER: Drink after activity to prevent post-exercise cramping.


AES New York 2013 Presenter or Author
Primary Affiliation: Cornell University - Ithaca, NY, USA
Pete Marchetto is the Engineering Physicist for the Hardware Engineering Group in the Cornell Lab of Ornithology's Bioacoustics Research Program. He is also a graduate student in the Department of Biological and Environmental Engineering, working on instrumentation to measure the exposure levels of animals to noise, and to quantify their behavioral responses.
More Info: http://about.me/pete.marchetto


The Burgess Bird Book
By Thornton W. Burgess
This wonderful introduction to the birds of North America is required reading in not only Year 1 of AmblesideOnline, but in many Charlotte Mason and other Classical Studies based curricula.
Through the eyes of Peter Rabbit we become acquainted with a variety of birds as they return to Peter’s neighborhood in the spring. In the context of the story about each bird, we hear about its nesting habits, its feeding preferences, and its interactions with other wildlife. We meet Jenny Wren, Scrapper the King-bird, Redwing the Blackbird, and dozens more.


Oklahoma is home to 44 different kind of snakes, but only a few have venom. Snakes in Oklahoma are most active from April through October.
The venomous snakes of Oklahoma include:
- Western Massasauga Rattlesnake
- Prairie Rattlesnake
- Western Diamond-backed Rattlesnake
- Timber Rattlesnake
- Western Pygmy Rattlesnake
Download, print and share our Oklahoma Snake Brochure
You have probably heard advice about what to do if bitten by a snake. Unfortunately, not all steps people take to treat a snake bite make the situation better.
- Sit down and stay calm.
- Wash the wound with warm soapy water.
- Remove jewelry or tight clothing.
- Keep the bitten area still and rise to heart level.
- Call the Oklahoma Center for Poison & Drug Information.
- If a snakebite victim is having chest pain, difficulty breathing, face swelling or has lost consciousness call 911 immediately.
- Cut the bitten area and try to drain the venom.
- Try to remove the venom by sucking it or using a suction device.
- Ice the area. Ice may cause additional tissue damage.
- Apply a tourniquet or tight bandage. It is better for the venom to flow through the body than for stay in one area.
- Attempt to catch tor kill the snake.
- Give the victim sedatives or alcohol.
If a snakebite victim is having chest pain, difficulty breathing, face swelling or has lost consciousness, call 911 immediately.
Some spiders can cause illness in some people. Two common spiders that can harm you are the female black widow and the brown recluse. A bite from one of these spiders can cause serious problems in a child, a senior, or a person in poor health. However, these bites rarely cause death.
The Black Widow
The female black widow is a black, shiny spider. It has a red or orange hourglass shape on its underside. Within 30 minutes to 120 minutes after being bitten by the female, you may feel stomach pain, dizziness, and headache. The bite may cause a sharp, pinprick-like pain. This pain may subside and reappear as a dull, throbbing ache followed by severe muscle pain and cramps. Black widows prefer dark, quiet places like garages, meter boxes or furniture.
The brown recluse is a yellowish-tan to dark brown spider. It has a small body and long legs. The brown recluse has a brown violin marking on the top side of its middle section. Habitats include cracks, crevices and dark undisturbed places like attics and closets.
Signs and Symptoms
- Mild to severe pain usually develops within two to eight hours. One or two tiny puncture holes may be seen at the site of the bite, surrounded by a white and red "halo".
- Blisters usually appear within 24 hours. An ulcer may be seen within 48 hours. Pain and itching increase.
- The bite area also feels hot, swollen and warm to the touch.
- Within 24 to 48 hours, there may be u-like symptoms, joint pain and rash.
- If you see dark urine within 72 hours after a bite, get medical attention right away.
- Serious symptoms may occur in children.
- The tissue dies and sloughs away and an open ulcer may form within one to two weeks.
- Although rare, serious reactions may cause death. No antidote is currently available. Treatment consists of good first aid care and observing for the above symptoms.
Oklahoma ticks include the Lone Star, American dog and black-legged tick. Ticks are capable of transmitting several diseases, including Rocky Mountain spotted fever, ehrlichiosis, Lyme disease, STARI (Southern tick-associated rash illness) and tularemia. If you become ill within one week of a recent tick bite or after visiting a tick-infested area, call a physician right away!
- Wear light-colored clothing so that ticks can be seen more easily. Wear long-sleeved shirts and long pants tucked into socks. Wear closed-toe shoes, not sandals.
- Examine everyone frequently, including pets, for ticks. The longer the tick remains attached, the greater the risk of tick-borne illness.
- Use an insect repellent on skin and clothing. Follow the directions specified on the container and use the lowest strength for children. Reapply as directed on the label.
Scorpions in Oklahoma can cause a painful sting, but serious, life-threatening symptoms are rare. Swelling is generally limited. The sensation of numbness and tingling may occur but usually stops within 24 hours. A cold pack placed on the sting site is usually quite effective in reducing pain. An additional symptom that can be seen following a scorpion sting is a metallic taste in the mouth. This is not unusual,and does not indicate a problem. General first aid care is usually all the treatment that is required.
Bees, Wasps and Hornets
For a bee sting, remove the stinger from the wound as quickly as possible to prevent the injection of additional venom. Bees have barbed stingers, which are left embedded in the skin, usually with the venom sac still attached. After stinging, the bee will die.
- Remove the stinger by grasping it close to the skin, or scraping across the skin using the edge of a credit card, coin, or other dull object.
- Do NOT squeeze the venom sac, as that will result in more venom being injected into the skin.
- After the stinger has been removed, follow with general first aid care for the wound.
Symptoms usually go away within a few hours. Because their stingers have no barbs, wasps and hornets may sting repeatedly. These stings can easily become infected.
If you have trouble breathing or rapid and severe swelling, call 911 immediately. For any other symptoms outside the immediate area of the injury, such as flu-like symptoms.
Insect bites/stings. Be alert to insects that may bite or sting. After a sting, the site will show redness and swelling. It may be itchy and painful. Be careful around bees, wasps, hornets, and yellow jackets. Some people are allergic to insect stings. To these people, a sting may cause serious problems and even death. Go to a hospital right away if you are stung and have any of these signs: hives, dizziness, breathing trouble, or swelling around eyes and mouth.
- Be sure to check the label on any insect repellent.
- Most contain DEET, which can harm children if used improperly or in large amounts.
- Do not allow children to apply repellent to themselves.
- When using repellent on a child, put a little on your own hands, then rub them on your child.
- Avoid the eyes and mouth.
- Use separate products when there is a need for insect spray and sunscreen.
- Do not use sunscreen that contains DEET.
- Repeatedly applying a product with DEET can increase the risk of harmful effects.
- Always follow the instructions on the label.
- For most products, after returning indoors, wash treated skin with soap and water.
- Call the Poison Helpline with your questions.
Bites and stings are common in Oklahoma. Our staff are here 24/7 to take your calls and questions.


Hyman-Newman Institute for Neurology and Neurosurgery
Founded in 1996 by Drs. Fred Epstein and Alejandro Berenstein, the Hyman-Newman Institute for Neurology and Neurosurgery (INN) in New York City soon became one of the foremost medical institutions specializing in the treatment of neurological disorders in adults and children. Initially based at Beth Israel Medical Center, the INN developed a worldwide reputation for excellence in pediatric and endovascular neurosurgery. Now located at Roosevelt Hospital under the direction of Dr. Berenstein, the institute continues its pediatric concentration along with a heightened focus on the treatment of conditions related to the vascular system of the brain, head, face, spine and spinal cord. Over the years, the INN has remained committed to offering a healing and humanistic environment to its patients.
In 2007, the Argosy Foundation partnered with the INN, a self-described “institute without walls.” Multiple specialized areas are benefiting from the support, including the Vascular Biology Research Program and Pediatric Intensive Care Unit.
Leading the Way
Respected for its contributions to research and its multidisciplinary staff, the INN attracts patients from all parts of the United States and around the world. Its doctors are able to treat a variety of medical disorders without open surgery by using x-rays and other imaging techniques to guide small tubes (catheters) and devices through the blood vessels. Because these procedures involve smaller incisions, less pain and shorter hospital stays, they reduce the amount of stress and risk of complication to the patient.
Established in 2001, the INN’s Vascular Biology Research Program continues to take the lead in the development of new treatments for life-threatening vascular diseases. The program operates a laboratory at St. Luke’s Hospital. The knowledge gained at the laboratory is then applied in clinical practice at the INN at Roosevelt Hospital in the treatment of complex vascular anomalies, including arteriovenous malformations, hemangiomas, stroke and cerebral aneurysms.
The Human Touch
The INN’s philosophy of putting children and their families first is visible throughout the Pediatric ICU at Roosevelt. This unit is dedicated to helping young patients recover from surgery, play, learn, and otherwise resume their normal lives as much as possible. It provides a relaxing atmosphere featuring a beautiful ocean-patterned floor, a nurses’ station decorated like a playful jeep, paintings in each room of animals and flora from across the globe, and a cheerful, soothing color scheme of soft blues, greens and yellows. A small activity playroom, staffed with a Child Life Specialist, helps children escape the rigors of treatment while enjoying arts and crafts, parties and toys.
With the help of a forward-thinking attitude and philanthropic partners such as the Argosy Foundation, the Hyman-Newman Institute for Neurology and Neurosurgery will continue to provide the highest quality care in a compassionate, patient-centered environment.


This menacing Shark was caught under the Gladesville Bridge earlier this month.
Local fishing enthusiast Patrick McLograna tells the tale:
“It was a team effort to bring this beast on board battling with it for 1.45 hours,just past Gladesville Bridge. “
“We’ve since identified it as a Mako shark although we originally thought it might have been a bull shark.
“A group of us were out fishing for Jew fish to celebrate my father’s 81st birthday.
“This is normally a deep sea species, so to see one this far down the harbour is very rare indeed!
“We measured it at over 8ft long and conservatively weighing in around 150kgs.”


Through this semester-long course students will learn how herbs can benefit many acute and chronic conditions including respiratory infections, digestive illness, ear infections, sore throats, auto-immunity, skin conditions, stress, chronic pain, insomnia, mood imbalances, deep immune issues, pathogens and parasites, heart health, lymph flow, urinary infections, and women’s health.
Students will learn about herbal actions and get hands-on experience preparing and using herbal remedies to take home including herbal infusions, decoctions, tinctures, infused oils, salves, medicated soaps, liniments, syrups, infused honey, and more.
The semester series also includes registration for all four of our in-depth, one day specialty topics:
- Natural Perfumery (In-Person)
- Invasive Plant Medicine (Live Online)
- Herbal History, Plants & Practice in Mexican Curanderismo (Live Online)
- Herbal Cocktails (In-Person)
Additionally, this course includes three field classes:
- a field trip in the Sandia foothills focusing on plant identification and medicinal uses;
- a field trip in the Rio Grande Bosque focusing on plant identification, medicinal uses, and land stewardship;
- a morning of field work doing native medicinal plant restoration and habitat improvement with the Yerba Mansa Project (optional)
More extras included: Through this course we will build a booklet of reference handouts from each class that includes a wealth of herbal information, remedy making instructions, recipes, and more.
The cost for semester enrollment includes all 4 of the single-day specialty classes, all of your herbal remedy-making supplies, field trips, medicinal plant restoration experience, class handouts, and 34 hours of herbal instruction.
Semester cost: $655 with all supplies included.
- 2023 Class Dates:
- 13 Tuesdays: August 15-November 14 (except Halloween) (6 pm – 8 pm)
- 4 Saturdays: September 9 (10am – 1pm); September TBA (9am – 12 noon); October 14 (10 am – 1 pm); November 4 (10 am – 1pm)
- Location: Tuesday sessions take place at The Source, 1111 Carlisle Blvd. SE
- Space is limited. Registration is required.
CLASS IS FULL – JOIN US NEXT SEMESTER
Anna Marija Helt
Atava Garcia Swiecicki


Here Are 4 Benefits Of Human Growth Hormone
Anyone into sports and fitness has of course come across the term human growth hormone or HGH as it has been a subject of controversy for a while, with the organization in charge of anti-doping in sports raising the red flag on its abuse by athletes. Well, if you are not in this category then you’re probably wondering what is human growth hormone?
To answer your question, this is a peptide hormone that stimulates growth, cell reproduction, and cell regeneration in humans therefore it’s very essential for human development. When this hormone is secreted, it will remain active in a person’s bloodstream for a couple of minutes, to allow the liver sufficient time to convert the HGH into growth factors.
Here are 4 benefits of human growth hormones and why they may be a concern in athletics.
#1 HGH helps in increasing muscle strength
It’s believed that human growth hormone can improve the physical abilities of an individual as it helps in increasing muscular strength thereby improving a person’s physical performance in exercise as well as in sporting activities. When this hormone is increased naturally by the body, it shouldn’t be a problem however if it’s deliberately increased synthetically then this can be equated to doping.
#2 HGH helps in better healing of fractures
It’s believed that human growth hormone is responsible for the regulation of minerals, bone metabolism as well as the healing of fractures. There are medical organizations that use these hormones as part of the speedy healing of patients with bone fractures, especially athletes. For medical application, an athlete will not be penalized for using HGH in the process of speeding their healing. They just need to ensure that the excess hormones are still not in their body when they return back to competitive sports.
#3 HGH helps in quickening weight loss
For people looking to lose weight fast, using growth hormones can contribute to the process as it helps in the acceleration of the breakdown of fats in the body. This can safely apply not only to overweight athletes looking to lose weight fast after being on holiday but also on individuals suffering from obesity. However, this is still a subject of research therefore there is plenty yet to be discovered on the use of HGH with regards to its application in weight loss.
#4 HGH contributes to stronger bones
Just as HGH promotes healing of fractures, it also contributes to stronger bones. It’s important to note that when individuals are young and healthy, the body tends to produce sufficient HGH targeted at bone development and strength however as they grow older, the amount of HGH produced by the body decreases. This is the reason why athletes will often be tempted to turn to an organization producing synthetic HGH as they seek to strengthen their bones probably after an injury.
It’s important for users of synthetic HGH to be aware that there are side effects to its abuse which could even result in death. Care should be taken to ensure that it’s only used when very necessary.


I am not a hematologist. Nor an immunologist or a virologist. Just an aspiring amateur writer who has recognized that typos fall into two dominant categories. Regular readers have no doubt spotted more than a few.
The first kind of typo comes from stream of consciousness – such as just getting the initial thoughts and sentences tapped in. Misspellings, poor grammar, dreary or ambiguous word choice, double words, lazy punctuation. The long list continues: verb/noun mismatch; change of tense within a paragraph; chronological inconsistencies; using “their” or “your” for “they’re” and “you’re” …
These are all forgivable, and relatively painless. Many make it to draft status, when well over 90% can be cleaned up by a few proofreading passes.
It’s the second kind of typo that is really painful. These result from late edits. The eleventh-hour flash of brilliance that results in a “catastrophic improvement.” At the final moment, with the cake fully iced, the product is ready for a la mode, and full reader enjoyment!
But no! Those last flourishes require just as much proof reading as the original drafts. Yet, it is so easy to skip. I’ve done it many times. Slow learner.
To my readers: Thank
you. Many of you have gently suggested
improvements and corrections to my typos and “facts.” The rest of you have kindly ignored them; or,
perhaps in your brilliance, merely read what I intended, not what I wrote. Exhibit A: My last
essay enfolded references to (a) a famous bathroom fixture
company, (b) its founder, (c) the label for a common convenience, and (d) my
regular tapestry of history, factoids,
and observations. During some
post-published proof-reading I found a few major hiccups. It’s better now, but
only after some help and a couple of paragraph re-writes.
Not only are there two kinds of typo; there are two kinds of Type-O. Positive and negative. We’re talking blood here.
I am O-positive. That’s the most common blood type, nearly 40% of humans have it, despite O’s transmission on a recessive gene. About 85-90% of people in need of transfusion can accept my blood. If I didn’t carry the Rh-positive antigen, 100% could take my blood.
Through the magic of genetics and natural anti-bodies, I am quite valuable to blood banks. There is a virus connection here. How appropriate for this time of novel coronavirus, SARS CoV-2 and international tumult.
Most adult humans have, at some point in their lives, contracted the Cytomegalo Virus (or CMV). As much as 80%. Of those affected, nearly 100% who contract it suffer from only mild symptoms, if any. Except infants. CMV can cause severe long-term damage to new arrivals – especially “preemies” – as their immune systems are just waking up.
Of the many scores of herpes viruses discovered, only eight are known to regularly affect humans. Once infected, our bodies almost always eventually mount a swift and decisive victory, driving the virus from the battlefield – our homeland: tissues, organs, blood. Better, our well-evolved immune systems retain intermediate and long-term immunity via anti-bodies (of the five main types Immunoglobulin-M and -G antibodies are of the most interest here).
Like many types of virus, the herpes family is insidious. Even though thoroughly thwarted by a superior foe, they execute a strategic retreat, never quite leaving the body. They “hang out” in nerve cells. Lying dormant for long intervals, they occasionally “wake up” to see if their host – us! – is healthy enough to fight them off for another round of battle. If the response is “yes”, they retreat again to the sanctuary of our nerves, a place a proper immune system has been trained to not attack.
This happens over and over again, until we die, as sufferers of HSV 1 and 2 can attest (Herpes Simplex 1 or 2); that is, repeated blistering around the mouth, or even in the mouth. Those episodes of re-occurrence are only mildly annoying when compared to what can happen with the Chicken Pox virus (Vicella Zoster Virus, or VZV); later in life it can manifest as what’s commonly called “Shingles” – with an agonizing and often debilitating rash accompanied by stabbing pains.
Since CMV is in the Herpes family there is always a likelihood it is in someone’s blood; that is, if they have ever had it in their life. Hence, their blood must never be used for transfusions to infants.
My blood always tests negative for CMV anti-bodies, both IgM and IgG. This means it is not lying dormant somewhere and I am a safe donor for infants.
I donate blood as often as practicable. I am of some use to society. We Type-Os are also delicious to mosquitoes. My wife says that having me around is better than using insect repellant.
Until the previous turn of the century, blood types were unknown. The micro-biological processes of transfusions and outcomes were a mystery, so it was practiced sparingly and as a last resort. Sometimes with spectacular success. But more often with horrible, painful, fatal results.
At that time Austrian scientist Karl Landsteiner was wondering about this. He hit upon the idea of simply mixing blood from various people together to see what happened. No chemistry. No microscopes. In hindsight, this seems most unsophisticated – even elementary; but no one had done it.
What he found was rather amazing. Some samples got along well together, and most others did not; they made globules: which was the observable effect of one blood trying to obviate the other; or each other. Landsteiner had discovered blood types! For this he was awarded the Nobel Prize in Medicine, decades later, in 1930.
At first he identified 3 types: he labeled them A, B and C.
In the scaled down world of micro-biology and microbes, red blood cells are like titans. Thin and disk-like, they average about 7 microns in diameter, with a thickness of 2 microns, which “squishes” down to about 1 micron at the center, not unlike Life Saver candies. [From now on, I will give sizes in microns, with no units, for simplicity]. This topography gives the red cell a very large surface area compared to its mass and size, which is useful for its main duty: ferrying oxygen and carbon dioxide molecules around the body and passing them across its surface membrane.
A CMV virion’s size is about 0.2. The SARS nCoV-2 is probably smaller than that: about 0.1. Bacteria, like staph and strep are bigger, but still smaller than a reddie: size, on average, about 1.
A and B blood types were found to carry antigens on their surface. Antigens are anything that triggers an “attack” from antibodies. These red blood cell antigens are, surprisingly, sugars of the D-galactose family, size about 0.0005 (or 1/2000th the average thickness of a red blood cell).
A blood type which has no sugar antigens, C, was re-named O, which basically means zero, or none. A little later it was discovered that some types carry both A and B antigens, so they were naturally named “AB” – pretty rare. These 4 types (A, B, AB and O) comprise 99.9+% of all blood types.
Now it’s not at all complicated to tell who can take whose blood for a transfusion. Since my O has no sugar antigens, anyone can take my blood. But my body will “see” the A, B, and AB cells as invaders. We Type-Os are picky. Although anyone can take my blood, I can only take Type-O.
But wait, not quite so simple. There were still problems.
Rh markers were found a few decades later, around 1940 (also, sort of, by Landstein ) – just in time for most of WW2, resulting in fewer multiple-transfusion complications … and a better understanding of baby-to-mother Rh mismatch for the baby-boom that followed WW2.
The Rh markers are proteins (there are actually about 49 of them; the most common is type-D), about size 0.003. About 90% of people have Rh-positive blood.
Floating nearby in the plasma are anti-bodies. For mammals these are about size 0.1 – quite small. In Rh-negative people, these little workers are always “on the ready” to identify Rh proteins as “bad guys.” And also to identify foreign A and B antigens.
People, especially prospective mothers, with no Rh proteins (i.e. Rh-negative) must be careful with donations and pregnancies. The first time the body encounters the Rh antigen the process or pregnancy is usually OK. But the body is stirred up, and it remembers. The next time it’s “attack.” If a Rh-negative patient gets more than one Rh-positive transfusion — or a Rh-negative mom gets a second Rh-positive baby in utero — it can be bad news.
Returning to the red blood cell. It is quite large; a workhorse of the vascular system. Yet, one might wonder: why have we evolved so that its surface is laden with thousands of tag-a-longs and stowaways that seem more trouble than their load is worth?
Well, maybe those labels are a bit harsh. Research suggests that the Rh proteins can provide a sort of osmotic-efficient pathway for the relatively large CO2 molecules (compared to oxygen) to slither through the cell membrane. And it appeared millions of years ago – before anything like a hominoid walked on two legs.
We can consider these ancient genetic tweaks as a sort of typo: a minor transcription mistake in typing out genetic text from DNA to RNA and back again to the DNA of a new cell, thus creating a new or different function for such genes.
Sugar antigens, similar to A and B, appear in the blood of all mammals. Again, these evolved in our pre-hominoid ancestors long ago.  Just why this is so, is a bit of a mystery. Perhaps it was for a weird but clever type of “trick play herd immunity.” A virus sees cell coatings as something that can provide an attach point on, or even pathway into, a cell. If a population has a random collection of these sugars and proteins, then a single type of virus pandemic cannot wipe out the entire species.
Here I like to imagine a sports team cleverly crafted to beat any team at, say, a football match. That team is the Evil Virus. The first games for team EV are easy victories. The next several matches they stampede confidently onto apparently identical pitches, only to be confronted with rules for cricket. Or golf. And then tennis. Then speed skating. Result? Team EV fails. – The species survives; the virus must go off and mutate further or die out.
All these rule changes – different cell coatings among individuals among the same species – makes our bodies suspicious of one another. When there’s a transfusion mismatch the coatings are identified as antigens and marked for destruction by those tiny antibodies.
Interestingly, something similar might be happening with the virus du jour, SARS CoV-2 which causes Covid-19. Early analyses of cases (and deaths) in hard hit areas of Europe suggest that those with Type-A blood are disproportionately susceptible.  How or why this happens is not understood but could give virologists and immunologists an understanding of the virus and our bodies’ machinations. Perhaps the A-type sugar is a sort of 5th column for the virus; or the presence of B-type antibodies somehow distracts, diminishes, or delays the body’s defense.
I expect there will be a plethora of studies of many sorts regarding this coronavirus, its impact, and our reactions in the months and years to come. Brace yourselves.
The improvement and acceptance of blood type science went beyond medicine and into forensics. It helped reduce Charlie Chaplin’s embarrassment, but only a little.
Chaplin, the famous actor-comedian-film maker, was married four times and a well-know philanderer, as well as a misogynist.  A paternity suit against him in the ‘40s resulted in blood testing, and eventually changed family law.
In the 1940s a young actress (with whom he was “friendly” – this during his 3rd marriage) claimed he was the father of her child. She sued him for child support. Blood tests on Chaplin, the child and mother showed that he could not possibly be the father.
Chaplin, with recessive Type-O, could not have been the father of a Type-B child whose mother was Type-A. Case dismissed? No. She pressed her allegation, nonetheless.
Astounding to us in the 21st century, accustomed as we are to such quotidian data as DNA matching, blood tests were not permitted as evidence at the time. Chaplin lost the court case and was compelled to pay child support. Worse: His trysting filled the pages of the days’ print media. His reputation was trashed.
The law was changed a few years later. But not in time for Chaplin. He was so disgraced that – combined with other bad press and McCarthy-era distrust – he was even denied re-entry to the United States, in 1952. (He was not a US citizen, although he’d lived there for over 40 years).
He resided in self-imposed exile in Switzerland for the rest of his life. He returned to America only once before he died, for a few days in 1972, then aged 83, to receive a Lifetime Achievement Award at the Oscars. On stage, with Jack Lemon, he received a 12-minute standing ovation – the longest in Academy Awards history.
Even though Type-O is recessive, it has survived. Not surprisingly, its prevalence is about the same for whites and blacks; we are one race, after all.
Recessive? Well, we Type-Os are sometimes weak, as attested to by Chaplin’s behavior.
That’s a wrap, from typos to Type-Os. Thanks for any corrections or suggestions.
Until next time, peace to you.
Joe Girard © 2020
Thanks for reading. As always, you can add yourself to the notification list for when there is newly published material by clicking here. Or emailing email@example.com
Final footnote on Chaplin. He was soon married a fourth time. He reportedly approached the young 18-year old Oona O’Neill with the line: you look like my next ex-wife. As he was 38 years her elder (in fact nearly the same age as her father, famous playwright Eugene O’Neill) he was disgraced again. Next ex-wife? Wrong! They stayed married for over 30 years, until his death, producing 8 children. The eldest, Geraldine, starred remarkably with Omar Shariff and Julie Christie in Dr Zhivago: at the tender age of 20 when filmed.
 Who discovered the Rh factor? http://www.rvdoon.com/rh-negative-blood-blood-feud-which-scientist-discovered-the-rh-factor/
 Possible purpose of Rh proteins: https://phys.org/news/2005-05-rh-protein-biological-role.html
 Blood Types over 20 million years ago: https://www.smithsonianmag.com/science-nature/the-mystery-of-human-blood-types-86993838/
Could be as recent as 3.5 million years ago: https://www.livescience.com/33528-why-blood-types-exist-compatible.html
 Chaplin paternity, blood tests and court case: https://www.mentalfloss.com/article/63158/how-charlie-chaplin-changed-paternity-laws-america