Funtabulously Frivolous Friday Five 266

Babies.

Babies when first born produce/excrete a multitude of colours into the nappy; black meconium, turning to green or yellow stools. White vaginal discharge and also orange or red, brick-dust coloured stained nappy in the first couple of days after birth.

Often mistaken for blood, this stain is from urate crystals; a sign of over concentrated urine which is normal and resolves once milk intake increase.

• Reference: What’s in a nappy – NHS Source

He has claudication from peripheral vascular disease.

When he walked his dog he had to stop at every lampost so the dog could urinate. [Story credit: Dr Tim Koelmeyer] 

• Breakfast club: A reflection on Dr Tim Koelmeyer – Chris Nickson

Involuntary swearing or the involuntary utterance of obscene words or socially inappropriate and derogatory remarks.

The term comes from the Greek κόπρος (kopros) meaning “feces” and λαλιά (lalia) from lalein, “to talk”.

Coprolalia is a form of tic. Tics are usually simple, non-verbal sounds or can be emotionally charged words occurring in a seemingly inappropriate context. Tics can sometimes arise from a variety of underlying brain disorders such as stroke, encephalitis, seizure disorders, Sydenham Chorea, Huntington chorea, cerebral tumours and dementia.

Tics are most commonly seen in Gilles de la Tourette syndrome which usually occurs in childhood, overlaps with obsessive-compulsive disorder, and is often familial.

While obscenities have culturally determined meaning, they are also usually short, explosive words consisting of high-frequency phonemes, and this is true in most languages. A computer program which randomly generates high-frequency phonemes can also swear at you. Interestingly, there are reports deaf patients with Tourette syndrome who involuntarily swear using sign language (classic 2 fingers up – with no recall of events) thus providing the possibility that tics are determined by phenological features, brief explosive actions rather than semantic content.

• Morris HR et al. Sign language tics in a prelingually deaf man. Movement Disorders 2000. 15(2):318-320
• LITFL: Tourette syndrome – a fathers perspective

Coronary artery constriction.

Following from this a group in Papworth hospital, UK studied 35 patients with Syndrome X (cardiac microvascular dysfunction causing angina in patients with normal epicardial coronary arteries on angiography) and 24 heart transplant patients and instilled hydrochloric acid into the distal oesophagus while monitoring the coronary blood flow.

It was noted the patients with Syndrome X had a significant reduction in coronary blood flow with the introduction of acid whereas the denervated hearts in the transplant group were unaffected. The group hypothesised a cardio-oesophageal neural reflex is responsible and maybe a trap for young players when sending patients home with reflux sounding chest pain who infect have underlying cardiac disease. Other studies have shown oesophageal acid can produce bradycardia and apnoea in neonates and atrioventricular block has occurred in patients with oesophageal spasm.

• Chauhan A, Petch MC, Schofield PM. Cardio-oesophageal reflex in humans as a mechanism for “linked angina’. Eur Heart J. 1996 Mar;17(3):407-13.

A number of conditions, not just alcohol withdrawal or anticholingeric delirium.

Lilliputian hallucinations have been associated with dementia, schizophrenia, toxoplasmosis, basilar migraine, mesencephalic lesions, visual loss (Charles Bonnet syndrome) and narcolepsy.  

Fortunately Jonathan Swift did not appear to be suffering from any of the above but wanted the irony of representing the tiniest race visited by Gulliver to be the most vainglorious and smug, symbolising humankind’s wildly excessive pride in its own puny existence (well thats one theory anyway).

His novel however resulted in the adoption of hallucinations of tiny people or animals being coined ‘lilliputian’ in the medical literature from 1909.

• Chand PK, Murthy P. Understanding a Strange Phenomenon: Lilliputian Hallucinations. German Journal of Psychiatry. 2007;10:21-24
• Charles Bonnet (1720 – 1793)
• Charles Bonnet syndrome (1760)