Funtabulously Frivolous Friday Five 090

Lonomia caterpillars can cause Caterpillar-induced bleeding syndrome.

This syndrome is a venom-induced consumptive coagulaopathy caused by a pro-coagulant toxin, analogous to that caused by some venomous Australian snakes.

The lethal case report by Chan et al (2008) is well worth reading and has some great images (click on the PMCID link below),  However I wonder about the validity of the ‘adding-fuel-to-the-fire” assumption that dictates the avoidance of replacement blood products for venom-induced consumptive coagulopathies.

• Chan K, Lee A, Onell R, Etches W, Nahirniak S, Bagshaw SM, Larratt LM. Caterpillar-induced bleeding syndrome in a returning traveller. CMAJ. 2008 Jul 15;179(2):158-61. PubMed PMID: 18625988; PubMed Central PMCID: PMC2443214.

Obecalp is placebo spelt backwards and is the name of a cherry flavoured dextrose pill produced by a company called Efficacy Brands.

According to the BMJ’s Minerva Obecalp was the brainchild of a couple who wanted to give their hypochondriacal niece something to make her feel better. When they couldn’t find a placebo pill in the drugstore, they decided to invent one.

The understandable controversy over this agent was nicely covered in the NY Times.

Animal feeds

Antibiotics are put in animal feed to help keep them disease free, and thus grow larger and generate more produce.

This use is a major factor contributing to antibiotic resistance.

• “Executive summary from the UCS report “Hogging It: Estimates of Antimicrobial Abuse in Livestock””. Union of Concerned Scientists. January 2001. [fulltext]

A cognitive bias that is evident when presenting the same option in different formats alters people’s decisions. Individuals have a tendency to select inconsistent choices, depending on whether the question is framed to concentrate on losses or gains.

The framing effect is important in medicine as a physician’s perceptions of risk to the patient might be strongly influenced by whether the outcome is expressed in terms of the possibility that the patient might die or that they might live.

To negate this bias, whenever you consider the risk of something reframe the risk in terms of the other possible outcomes and see if you would still make the same choice.

• Crosskerry P, Cosby KS, Schenkel SM, Wears RL. Patient Safety in Emergency Medicine. Lippincott Williams & Wilkins, 2009.

An ice pick

Freeman performed over 3500 lobotomies. In particular he developed the transorbital lobotomy, which became known as the ‘icepick lobotomy’.

The procedure performed by inserting a metal pick into the corner of each eye-socket and moving it back and forth, severing the connections to the prefrontal cortex in the frontal lobes of the brain.

Freeman used to travel across the USA visiting mental institutions in his personal van, which he called the “lobotomobile.” He only charge US$25 for the procedure. A bargain!

Freeman was not a surgeon – he had no surgical training. It was he who nominated his mentor António Egas Moniz for a Nobel prize, which Moniz won in 1949 for the invention of the leucotomy. The Neurophilosophy blog details the sordid but fascinating history of this procedure in The rise & fall of the prefrontal lobotomy.