Tag: ScienceEveryday

Fuel Injection Death

mary Zeman via Melissa Bryan posted about an accident where a student nurse in training (3rd day on the job) administered a feeding bag of coffee and milk instead of a unit of blood. http://goo.gl/otI4e  For starters, I don’t think coffee mixed with milk looks like a unit of blood. Nevertheless, in Mary’s post I explained what I think likely happened, e.g., COD.

Nutritional specialist Dr. Armando Carreir told the network that Ribeiro’s death “would have been as if [she] was suffocating.” from HuffPuff: http://goo.gl/euhoM

So how can the patient be suffocating? It was likely due to pulmonary edema (fluid in the lungs). So how did the patient get fluid in the lungs? Not knowing the exact mixture of coffee and milk, I’m guessing that the mixture was hypertonic. Let me back up and talk briefly about intravenous (IV) pharmaceuticals.

When you adminster a large volume of fluids IV, it has to be at physiologic pH (7.4), isotonic, and iso-oncotic. There are cases where you can give a fluid that is not one of these three properties to correct for the patients condition.

Tonicity

From the Wiki:

Tonicity is a measure of the osmotic pressure gradient (as defined by the water potential of the two solutions) of two solutions separated by a semipermeable membrane. It is commonly used when describing the response of cells immersed in an external solution. Like osmotic pressure, tonicity is influenced only by solutes that cannot cross the membrane, as only these exert an osmotic pressure. Solutes able to freely cross the membrane do not affect tonicity because they will always be in equal concentrations on both sides of the membrane.

There are three classifications of tonicity that one solution can have relative to another. The three are hypertonic, hypotonic, and isotonic. There’s a good figure in the Wiki that shows what happens to the blood cells in the three types of tonicity. 

http://en.wikipedia.org/wiki/Isotonicity#Isotonicity

Colloid osmotic pressure (COP) or Oncotic pressure

COP  is an osmotic pressure caused by protiens in the vasculature which opposes the hydrostatic pressure. The normal COP of plasma is between 20-25 tor.  An increase in COP above normal levels will lead to water leaving the interstitium and entering the vascular space.  http://en.wikipedia.org/wiki/Oncotic_pressure

Here’s a great guide on IV fluids for nurses: http://goo.gl/bilmc

Image Source: http://goo.gl/jrwtK

#ScienceEveryday when it isn’t #ScienceSunday

Buzz about when natural remedies become real medicine

Buddhini Samarasinghe ,others, and I often mention how alternative medicine becomes medicine when it’s rigorously tested. Here’s an example from the The University of Chicago . Chih-Pin Chuu et al, in Dr. Richard Jones’ lab report how Caffeic Acid Phenethyl Ester (CAFE) suppress cell proliferation of prostate cancer cells. CAPE is the active ingredient in beehive propolis (see below). They started with cancer cells in vitro and then moved to a mouse model.

From the University of Chicago news blurb (http://goo.gl/vtJ22): 

But if CAPE were to truly make the crossover from holistic remedy to clinical option, the scientists would also have to demonstrate how the compound freezes cancer cells in a non-proliferative state. Enter the micro-western array, the innovative proteomics technique first described in 2010 by Jones and colleagues. 

Once they found their target pathway from the micro-western array, they over-express components of those pathways to block the effect of CAPE. This kind of follows my diet post earlier today (http://goo.gl/vlUWT). CAPE makes the cancer cells think there is no nutrients available. There is mention of patent issues in the article, i.e., it would be hard to get a drug company to pay for the clinical trials on this because propolis cannot be patented. For more on that issue, check out my Bench to Bedside post. http://goo.gl/xpu7W

Caffeic acid phenethyl ester suppresses the proliferation of human prostate cancer cells through inhibition of p70S6K and Akt signaling networks.

Chuu CP, Lin HP, Ciaccio MF, Kokontis JM, Hause RJ Jr, Hiipakka RA, Liao S, Jones RB.

Cancer Prev Res (Phila). 2012 May;5(5):788-97.  http://goo.gl/iwFGW

In searching for a good eye catching photo to go along with the article, I realized that the image in the news blurb is a stock image from Wikipedia. It was also used in this interesting article.

Image of propolis, the sticky resin that bees line their hive with. In a PLosONE article Michael Simone-Finstrom and Marla Spivak report it’s anti-fungal properties.  http://goo.gl/duvSC

#ScienceEveryday  when it isn’t #ScienceSunday  

Overselling preclinical results – Orac

Here’s an article by an anti-quack blogger extraordinaire. http://goo.gl/DRpQk    It says a lot of what I said in my comments about the Telegraph article discussed here and the linked discussion within:

Bench to Bedside

http://goo.gl/63mKa

Of course Orac does a much better job of taking the article apart.

Attached image:

A scanning electrom microscopic image of HIV. The glycoprotein complex on its surface enables the virus to attach to and fuse with target cells to initiate the infectious cycle.

http://goo.gl/VaU8M

#ScienceEveryday  when it isn’t #ScienceSunday  

Bench to Bedside

A little background on translational research or medicine, often also called “bench to bedside”. In a post by Max Huijgen (http://goo.gl/VNT3Z) there was a lively discussion about an article in the Telegraph about a seemingly miracle cancer drug sitting in a freezer in Sweden. The article stated that because the scientist had published the work, no pharmaceutical company would touch it, to bring it to market. The idea was, no patent means no profit. A large part of the discussion was about crowdfunding for this frozen drug.

There were three things that Rajini Rao some others, and I tried to explain, about the article and the conversation. First, the cost of getting a drug “from bench to bedside” was grossly underestimated by people suggesting crowdfunding. Here’s the reference Rajini provided regarding the cost of clinical trials (http://goo.gl/YXD55). It can be $28k per patient, just to get started, i.e., Phase I. Which leads to the second issue; lack of understanding what is drug development or discovery. How do you get a compound from idea, to bench work, and finally to market. The last issue is the treatment in the story itself.

The figures below are from an excellent overview of the process of drug development. The example is for cancer research but it is applicable to essentially all drug discovery.  So when you hear scientist like me, talk about Phase III clinical trials or INDs, you’ll know what they mean. http://goo.gl/ZF88v

There is also a good, albeit a bit old, review on translation research.

Review: Translational science: past, present, and future by S. H. Curry

BioTechniques 44, 2008   http://goo.gl/B5DV6

In that review, they mention acetaminophen being published and therefore the university couldn’t capitalize on the discovery. If the premise of the Telegraph article were true then acetaminophen should not be in every medicine cabinet today. Clearly the inability to directly patent a compound does not preclude getting it to market. I say directly because acetaminophen was patented at some point.

History of acetaminophen or paracetamol

http://en.wikipedia.org/wiki/Paracetamol#History 

Getting back to the Telegraph article and the miracle drug. The Swedish group’s current paper, that has in vivo data (the rest are in vitro) has a 40% survival rate at 100 days, using six mice per group. I also find it curious that the virus is supposed to be targeted but they did not inject it systemically. It was injected directly into the tumor.

J Virol. 2011 Dec;85(24):13114-23.

http://www.ncbi.nlm.nih.gov/pubmed/21957304

Although it is interesting and promising work, I wouldn’t put any money towards it with such a small study. Typically, much more pre-clinical work is done before even thinking of putting a therapeutic agent into humans. As others stated in the thread, there are tons of therapies that cure mice but do not work in humans.

The adenovirus that I have worked on is not targeted per se. It has to be injected directly into the tumor. However, the gene is activated only where you irradiate. The tumor gets a double whamy: radiation and damage from the gene therapy. It was in a phase 1 trial, published here: Clin Cancer Res. 2004 Sep 1;10(17):5747-53.  http://www.ncbi.nlm.nih.gov/pubmed/15355902?

I want to emphasize that I have nothing against the research done by the Swedish group. I do have an issue with the Telegraph article. The author talks about his keen investigative skills to find the Swedish group but yet doesn’t do due diligence in finding out the true potential of this therapy. Again, it’s interesting work but a 40% survival rate in mice, in a small single study, is not a miracle drug. The author even mentions the Amgen “investigation” (but gives no reference) as a reason to be cautious. It’s actually a commentary, not a peer-reviewed publication. My commentary about it was posted a while ago, here: http://goo.gl/98HmX?  One should be cautious because a lot promising pre-clinical studies don’t pan out, not because of a commentary in reproducibility.  Reproducibility is certainly important and is a problem in some areas of research. It’s frustrating that the post follows the same tone as the Telegraph article. However, as a proponent of science, I’m happy that there was a lively discussion and there was an opportunity to educate.

#ScienceEveryday  when it isn’t #ScienceSunday  

Moore Nuclear Energy

Joanne Manaster posted this re-share from Jim Carver. The post was of a video from The Guardian about a video entitled How to build a nuclear power plant. The video is 13 min. long but it is informative. I would link directly to Jim’s post with a hat tip but it appears that he’s blocked me. Maybe he’s a Colorado Avalanche fan.  http://goo.gl/0yteQ

Anyway, the post reminded me that I had promised some of my G+ pals that I would post pictures of Henry Moore’s Nuclear Energy sculpture, which marks the location of the first self-sustaining nuclear chain reaction. It was accomplished on 2 December 1942 under the supervision of Enrico Fermi along with Leó Szilárd, discoverer of the chain reaction. You can read more in the Wiki: http://en.wikipedia.org/wiki/Chicago_Pile-1 

The site is next to the new Mansueto Library at the University of Chicago, which you can see in my profile scrapbook. The site is both a National Historic Landmark and a Chicago Landmark. You can read more about Henry Moore’s sculpture here: http://en.wikipedia.org/wiki/Nuclear_Energy_(sculpture) 

The site for the new nuclear plant, in the video, is in Finland. I couldn’t think of a Finnish singer so I came up with Lykke Li who is Swedish. Geographically that’s close enough. I know in hockey, there’s a big difference.

I leave you with Lykke Li- I know places 

Edit so as not to offend anyone from Finland, I found a Finnish band in my music collection.

Husky Rescue – My World

http://en.wikipedia.org/wiki/Husky_Rescue

Interested in LFTR, here are a couple of posts.

http://goo.gl/nf0md

http://goo.gl/9Sj5r

Tommy Leung mentioned today, on his #ScienceSunday  post, if science and art can go together. Of course they can. Science is beautiful. Science is everywhere just tag ScienceSunday curated by Allison Sekuler Rajini Rao Robby Bowles and me (with guest curator Buddhini Samarasinghe ) For the rest of the week tag #ScienceEveryday  and mention one of us. Circle ScienceSunday so that it is easier to mention you back and interact with you in general.