Social Media as it Affects Young Black Adults

I am greatly entranced by the idea of social determinants of health; it is awe striking to think that the social activities within our lives impact our health. Recently I was scrolling through facebook and came across an article that stated that a PTSD-like trauma is triggered for Black Americans as the deaths of people that look like them go viral. (I have included the link for said article below)

For myself, it was hard and often impossible to go on social media sites the past few years after so many men and women of color were murdered and displayed. For me, it felt like a new platform to display the murders of Black bodies as what was once done with the mutilations and hanging of black bodies in the past. Where there was once a gathering of people to see the strange fruit upon trees, there is now a share or retweet button.

Knowing my own sentiments, I was curious as to the validity of the statements within the article, especially being that over the years there has been a horde of Black deaths that have gone viral; replaying over and over and popping up over and over on social media feeds.

The dissertation of Morgan Maxwell, Rage and social media: The effect of social media on perceptions of racism, stress appraisal, and anger expression among young African American adults, studied the effects of social media on young Black adults. Maxwell’s findings indicated that social media is maladaptive to young Black adults which correlates to negative psychological and health outcomes. Being that young Black adults use social media sites, namely Twitter, the most, Maxwell indicates that perceived racism via social media sites leads to weakened cardiovascular and immune functioning, affecting a multitude of other health-related problems.

Going forward I believe that the content of social media feeds need to be thoroughly vetted to be cognizant of its audience. I understand that there is a desire to get information, but at what cost?

With all of this research, I wonder if social media is having a two-pronged effect on society, triggering an extreme stress response for some and an indifference and hate toward the Black body. Scrolling through a social media feed and noting the comments made can in and of itself be heart-wrenching and stressful.

http://www.pbs.org/newshour/rundown/black-pain-gone-viral-racism-graphic-videos-can-create-ptsd-like-trauma/

https://scholarscompass.vcu.edu/cgi/viewcontent.cgi?article=5244&context=etd

Base editor

I think that what is so exciting about the future is that we cannot even imagine or comprehend some of the scientific advances. A major area of interest is inheritable diseases and embryos. In some cases the only way to cure some of these inheritable diseases is for them not to occur in the first place. CRISPR, a gene-editing technique has gain a lot of popularity and also some controversy. A new method called base editor technique is similar to CRISPR, but directly makes changes to a targeted site in DNA without any of the cutting. The base editor is a RNA-protein complex. Since many genetic diseases are caused by single point mutations the precision of base editor technique will be more effective. This technique was recently used to correct a gene mutation in human embryos linked to beta thalassemia. The diseases leads to a reduction of red blood cells ultimately leading to organ dysfunction/failure.
In order to have embryos with beta thalassemia, skin fibroblast cells from a patient homozygous for the mutation were collected. Then nuclear transfer embryos were constructed by fusing skin fibroblast with the enucleated in vitro matured oocytes. There were two base editors used, BE2 and BE3, with BE3 showing higher editing efficiency.Therefore, BE3 was used on the embryos. Over 23% of the embryos were fixed using the base editor method, leaving over 75% for more research and improvement.
Although these methods are controversial they will make a big difference on how science deals with genetic disorders. I think that if we have the opportunity to make a human not have to endure the pain that comes along with some of these genetic disorders, then that is what we have to do ethically.

https://link.springer.com/article/10.1007/s13238-017-0475-6

Alternative Emergency Treatment for Opioid Abuse

The United States is currently in the midst of an opioid epidemic, and intravenous drug use (IVDU) is significantly increasing.  The New York Times claims that over 20 million people are affected by opioid addiction.  As a result, protocol for physician prescribed opioids, especially int the emergency department has been revisited (Sinnerg et al., 2017).  The most prominent issues that are eliciting change are related to withdrawal symptoms and overdose symptoms.

A new approach to emergency department treatment for opioid-addicted patients is the implementation of a drug called Suboxone, which contains buprenorphine and naloxone.  Previously, Suboxone did not contain naloxone and only buprenorphine, ultimately leading to the intravenous abuse of buprenorphine, which I will explain later.  

To start, the mechanism for buprenorphine is a partial agonist and partial antagonist for the mu receptor, which is where endorphins bind.  Likewise, outside opioids, such as heroin, are considered full agonists, binding all the mu receptors, causing the induced effects.  Buprenorphine induces a decreased effect, or a 'ceiling effect,' in which all the mu receptors are activated, but only to a certain extent.  As a result, some of the effects, like euphoria, are still present, but others, like respiratory depression, are not, or are decreased (Lutfy & Cowan, 2004).  This seems to be promising in treatment of opioid overdose related fatalities.  Furthermore, an increase in concentration of buprenorphine will not increase the effects, like heroin would, due to the very high affinity buprenorphine has for the mu receptors (Walsh & Eissenberg, 2003).  

The issue occurred in that drug-users were now abusing buprenorphine, by intravenous use.  Although the effects would not be as much as something like heroin, buprenorphine could be prescribed as covered by insurance.  As a result, Suboxone now adds naloxone, an opioid antagonist, to prevent further abuse and diversion (Yokell et al., 2011).

What is now starting to be implemented is the use of Suboxone as part of emergency medicine treatment for IVDU patients who present with opioid-related issues.  With the safe alternative of Suboxone, a myriad of physiological side effects can be controlled, including fatal respiratory depression and withdrawal symptoms.    

With this being a relatively new practice among emergency departments, Denver Health Adult Emergency Department has been approved to conduct research on the matter beginning this year.  

References

Bankowitz, R. (2017). Addressing America’s Opioid Epidemic. The New York Times. Retrieved from https://www.nytimes.com/2017/09/21/opinion/opioid-addiction.html?mcubz=0

Lutfy, K., & Cowan, A. (2004). Buprenorphine: a unique drug with complex pharmacology. Current neuropharmacology, 2(4), 395-402.

Sinnenberg, L. E., Wanner, K. J., Perrone, J., Barg, F. K., Rhodes, K. V., & Meisel, Z. F. (2017). What factors affect physicians' decisions to prescribe opioids in emergency departments? SAGE Journals, 2(1). doi:10.1177/2381468316681006

Walsh, S. L., & Eissenberg, T. (2003). The clinical pharmacology of buprenorphine: extrapolating from the laboratory to the clinic. Drug and alcohol dependence, 70(2), S13-S27.

Yokell, M. A., Zaller, N. D., Green, T. C., & Rich, J. D. (2011). Buprenorphine and Buprenorphine/Naloxone Diversion, Misuse, and Illicit Use: An International Review. Current Drug Abuse Reviews, 4(1), 28-41.

The Unknown of Multiple Sclerosis

Multiple Sclerosis (MS) is a disease that occurs in the central nervous system (CNS). Within the CNS, the immune system attack myelin which is the fatty substance that protects the nerve fibers. The immune system also attacks the nerve fibers themselves. The myelin then forms scar tissue, and the damaged nerve fibers can no longer send normal nerve impulses to and from the brain and spinal cord. Experts consider this disease to be an immune-mediated disease rather than an autoimmune disease because the target of the immune cells is still unknown. There is still so much that is unknown about why this disease occurs. However, there are many ideas of why this disease occurs, but it is believed that there are several interactions of many different factors. These factors can include immunologic, environmental, infectious, and genetic.

Immunologic: Researchers have been able to identify which immune cells are attacking the myelin, the factors that cause them to attack, and the sites that appear to be "more attractive" for the cells to attack.

Environmental:

1. MS seems to be more frequent further away from the equator.
2. People born in an area with higher risk of MS rather than lower risk, but move to the area of lower risk before the age of 15 bring about the idea that someone exposed to some environmental agent before puberty may predispose them to develop MS. 
3. Higher levels of naturally-produced vitamin-D helps support immune function and could help protect against an immune-mediated disease.
4.  Smoking increases the risk of MS. 

Infectious: Exposure to bacteria, viruses, and other microbes at a young age could increase chances of getting MS because viruses are well known for inflammation or the destruction of myelin.

Genetic: MS is not hereditary, but having a family member with MS can increase the chances of getting developing the disease.

There are so many different ideas and theories behind MS, and studies are still being done. MS is most commonly diagnosed in ages 20 to 50 and is more common in women as well. The more that is understood, the closer we are to finding a cure for MS or a way to get it under control. Hopefully, sometime soon, this disease will have a known cause and someway to cure it.


Citation: 
What Is MS? (n.d.). Retrieved September 28, 2017, from https://www.nationalmssociety.org/What-is-
       MS

Rabies Podcast: Rodney Versus Death

Radiolab: Rodney Versus Death


This podcast which talks about the 15 year old girl, Jeanna, who became the world's first known survivor of rabies (without vaccination) and the protocol that was developed from her treatment. I highly recommend it; the science behind it is really fascinating and it's only 30 minutes.

It explains rabies in simplest terms- how it travels from a bite wound site into your nervous system, and its neurologic manifestations, including behavior changes, convulsions, inability to drink, and eventually complete system shut down. The actual physiology of the disease is not very well known.

Dr. Rodney Willoughby at Children's Hospital of Wisconsin, in a last-ditch effort, developed a treatment which essentially put the patient in a coma to "ride out" the disease. Once Jeanna arrived to Children's, Dr. Willoughby started going through dozens of case reports, and began to hypothesize that rabies causes excito-toxicity. In other words, there is no physical damage to the brain, but the neurons become overstimulated, and therefore shut down because they are overwhelmed. He suggested putting Jeanna in a coma to allow her immune system time to fight the virus.

Such a treatment had never been done, or even formally considered/suggested, and Dr. Willoughby discusses the ethical dilemma of potentially "locking the patient in," or causing brain damage but having the patient remain in a coma, leaving her "trapped" in her body. With the fatality rate of rabies being 100%, Dr. Willoughby was more concerned with this notion, saying he might "be doing worse than death."

The treatment worked, and they named it The Milwaukee Protocol. It has since been implemented for others infected with rabies, but its efficacy has come under question. The role of immune system is discussed and critics of the protocol suggest that this patient had the ability to fight the disease regardless of implemented treatment. According to an article by New Scientist, only six of the 35+ who have undergone treatment have survived.


Here are some links discussing the protocol:

Critical Appraisal of the Milwaukee Protocol for Rabies: This Failed Approach Should Be Abandoned

The "Milwaukee protocol" (MP) hope does not succeeds for rabies victim

An unlikely remedy for brain cancer: Zika virus

An unlikely remedy for brain cancer: Zika virus

When people think of treating brain cancer, or any other cancer for that matter, most people think of chemotherapy, radiation, or surgery as standard treatment options. There are very few people who would think to utilize a virus to treat brain cancer, especially the Zika virus. However, a team of researchers have now found that Zika virus can be used to treat cancer, more specifically, glioblastoma. If glioblastoma sounds familiar, that is because Senator John McCain was recently diagnosed with this type of cancer (Mohney, 2017). Glioblastoma is the most common brain cancer in adults with a survival rate of only two years (Roberts, 2017; Zhu et al., 2017). The glioblastoma is usually removed with surgery; however, tumorous stem cells cause the cancer to grow back. In addition, glioblastomas do not metastasize outside of the central nervous system (CNS), meaning the cancer tends to stay localized (Zhu et al., 2017).  It is for these reasons that researchers have been hoping to utilize a virus, such as Zika, to fight the cancer (Mohney, 2017).   

Zika virus is an RNA virus of the flavivirus genus that also includes dengue, West Nile virus, and yellow fever viruses (Zhu et al., 2017). Zika virus made headlines for causing microcephaly in infants and was linked to birth defects in 30 countries. The virus is spread through infected mosquitoes (Roberts, 2017). Zika primarily attacks the CNS, mainly stem and progenitor cells, which are prominent in the developing infant brain (Zhu et al., 2017) 

Because Zika targets the CNS, Zhu et al. (2017) wanted to study the effects of Zika virus on glioblastoma stem cells in mice. The researchers found that Zika virus killed glioblastoma stem cells but not normal cells. This is in contrast to the West Nile virus that killed both tumor and normal cells. Furthermore, when mice were inoculated with a mouse strain of Zika virus, they had significantly longer survival rates compared to a wild-type virus. However, the researchers are still unsure of the exact mechanisms by which the virus works.

Zhu et al. (2017) point out that safety is still a concern with utilizing this virus because of some of the unknown factors, but the results of the mouse studies are promising for glioblastoma treatments. In addition, the researchers acknowledge that the virus would be used with other conventional therapies. There is also work being done on other viruses for treating glioblastomas. These studies are exciting because they offer new therapies for patients with a type of cancer that significantly reduces their life spans. These are also targeted therapies that could potentially reduce unwanted side effects associated with more conventional therapies. Although more studies need to be done, there is progress being made in finding alternative treatments for patients with these types of cancers.     

References:

Mohney, G. (2017). Researchers Hope Zika Virus Can Treat Deadly Brain Cancer. Retrieved September 23, 2017, from https://www.healthline.com/health-news/zika-virus-can-treat-brain-cancer

Roberts, M. (2017). Zika virus used to treat aggressive brain cancer. Retrieved September 23, 2017, from http://www.bbc.com/news/health-41146628

Zhu, Z., Gorman, M. J., Mckenzie, L. D., Chai, J. N., Hubert, C. G., Prager, B. C., . . . Chheda, M. G. (2017). Zika virus has oncolytic activity against glioblastoma stem cells. The Journal of Experimental Medicine,1-15. doi:10.1084/jem.20171093

            

Mary Jane and IBD

With public perception of marijuana use becoming increasingly more positive, its physiological effects, social implications, and potential benefits have continued to be widely debated. In this article, researchers were interested in assessing the therapeutic role of marijuana use on inflammatory bowel disease (IBD). The article bases its research on previous knowledge that two cannabinoid receptors have been isolated. It notes that CB1 receptors are located all throughout the gastrointestinal tract while CB2 receptors have been expressed in the ileum. These endocannabinoid receptors may participate in a variety of responses such as secretion, gut motility, and inflammation.  Marijuana contains the active ingredient, tetrahydrocannabinol (THC), which bind these receptors potentially mediating the therapeutic roles. With this research, a cross-sectional survey and questionnaire was administered to 291 patients with IBD to assess characteristics such as their diagnosis, the need for conventional IBD medication, analgesics for abdominal pain, their overall quality of life, and cannabis use. Overall, the study demonstrated that a significant portion of the patients used cannabis to relieve their IBD-related symptoms, particularly those with a lower rated quality of life and a history of chronic abdominal pain and surgery. Unfortunately, this research (like many other marijuana research) lacks evidence for the drug’s direct impact on disease activity. This brings to mind a conversation that I had with Dr. Hutchison at CU Boulder in regards to the limits of marijuana in health research. First, it is a class 1 drug that makes it difficult to obtain for academic researchers. When it is finally obtained, its external validity is lacking because its THC levels are not representative of what is available to the population making any type of this research lacking. Meanwhile, there is still some negative public perception that is prevalent socially and politically and is preventing any possibility of demonstrating marijuana’s efficacy. Since marijuana research is lacking in many domains, there will always be this cycle that presents marijuana in a negative light further limiting the potential to demonstrate its pros and cons. While the particular article discussed in this blog is a bit older, progress of marijuana research is still very slow even to this day. Hopefully with the years to come, more valid research will come out and maybe it can be decided, once and for all, whether marijuana is helpful or harmful. The CU school of medicine has a news article that discusses these ideas as well. 

The Resurgence of Tuberculosis

When many people think of tuberculosis (TB) they imagine an archaic or even eradicated disease. Unfortunately, this is far from reality. In the World Health Organization's 2016 Global Tuberculosis Report, it was estimated that in 2015, 10.4 million new TB cases emerged worldwide. Of note, people living with HIV accounted for 1.2 million (11%) of all new TB cases. The resurgence of TB is a cause of serious concern for global health monitoring organizations and it may be attributed to several factors including a comorbidity with immunosuppressive diseases and antibiotic resistance (World Health Organization, 2016).

TB is an infection primarily of the lungs caused by a mycobacteria, predominantly Mycobacterium tuberculosis. TB is a communicable disease that is usually acquired by inhalation of the bacteria as it spreads through the air from the cough, sneeze, or spit of an individual with an active infection. When the bacteria invades the lungs, the immune response causes the pathogens to be isolated in a tubercle. As the disease progresses, caseous necrosis results in the tissue within the tubercle (Huether and McCance 86). Symptoms of an active infection include coughing, bloody sputum, extreme weight loss, and fatigue. The mycobacterium is an opportunistic pathogen and it preys on the immunocompromised. In people with healthy immune systems, the pathogen is defeated 90% of the time without the host every knowing he/she was infected (Tortora, Funke, and Case 687). Up to 95% of those infected do not have any symptoms of the disease. This is called a latent TB infection. Without treatment, the remaining 5-10% of people infected by the bacteria will develop active and contagious TB (CDC.gov).

Tuberculosis is comorbid with many diseases that depress the immune system such as malnutrition, diabetes, malaria, and HIV. The immunodeficiency that manifests in people living with HIV leaves them susceptible to the initial TB infection. Additionally, those with HIV who are infected with the mycobacterium, are much more likely to rapidly develop active and contagious TB over those who are not HIV positive. The higher prevalence of active TB in HIV positive patients significantly attributes to the resurgence of TB, especially in sub-Saharan Africa and Asia (CDC.gov). Antimicrobials are used to treat TB, usually a combination of antimicrobials for a minimum of 6 months and up to 130 doses of the antibiotic cocktail. Some patients fail to finish the full course of treatment which results in mycobacterium resistance to the antibiotics. There are now multi-drug-resistant (MDR) strains which are resistant to isoniazid and rifampin, two first-line antimicrobials. Additionally, there are emerging strains that are resistant to all first and second-line treatments called extensively drug-resistant (XDR) strains. These XDR strains are almost untreatable with current drug-therapies and have also contributed to the resurgence of TB (Tortora, Funke and Case 684-687).

TB is usually spread through aerosols and therefore susceptible populations in very close quarters contribute to the prevalence of the disease. Overcrowded correctional facilities, homeless shelters, and refugee camps are breeding grounds for TB. Additionally, extensive international travel or immigration also contribute to the rise of the disease as individuals can contract TB in another country and carry it to less infected populations (CDC.gov). The mycobacteria that cause TB are different from other bacteria primarily in their cell wall composition. The cell wall of mycobacteria contain a high lipid content and mycolic acids. Two first-line treatments against the mycobacteria that cause TB are isoniazid and ethambutol which both act on mycolic acid. Isoniazid can effectively penetrate the tubercles or macrophages that hold the bacteria inside the host. Isoniazid then inhibits the synthesis of mycolic acids, disrupting the bacterial cell wall and causing cell death. Ethambutol prevents mycolic acid from being incorporated into the cell wall, causing cell death. It is less effective at penetrating tubercles but is used as a secondary drug to prevent drug resistance. Both isoniazid and ethambutol are used worldwide (Tortora, Funke and Case 559). Fluoroquinolones in combination with other antimicrobials can be used especially against drug resistant strains. Fluoroquinolones work by inhibiting bacterial DNA gyrase during DNA replication. Fluoroquinolones are used primarily in less developed countries where TB is prevalent and drug-resistant strains are spreading (Tortora, Funke and Case 562).

References

Bates, Matthew, Ben Marais, and Alimuddin Zumla. “Tuberculosis Cormorbidity with Communicable and    

          Noncommunicable Diseases.” Cold Spring Harb Perspect Med (2015): 5:a017889. Retrieved from      

          Perspectivesinmedicine.cshlp.org. 
Huether, Sue, and Kathryn McCance. Understanding Pathophysiology. St. Louis: Mosby, Inc, 2012. Print.

Tortora, Gerard, Berdell Funke, and Christine Case. Microbiology: An Introduction. United States of America: 

          Pearson, 2016. Print.

“Tuberculosis (TB) Fact Sheets.” CDC.gov. Centers for Disease Control and Prevention, n.d. Web. Retrieved from   
          www.cdc.gov.
World Health Organization (2016). Global Tuberculosis Report 2016. Retrieved from http://apps.who.int/ 
          iris/bitstream/10665/250441/1/9789241565394-eng.pdf

What the study of inner speech tells us about neurologic studies overall

Psychological and neurological studies often run into the same problem over and over again: Many thought patterns and behaviours can be elicited on demand, yet the underlying mechanism in the brain that causes the thought may be altered from what may happen if the thought occurs naturally. In the article referenced, researchers were interested in the cause of "self talk", or inner speech occurring in the mind. Almost everyone experiences this, be it psyching oneself up for a sports match, or going over an argument and wondering what could have been said differently after the fact. The researchers in the referenced study used fMRI to monitor subject's brains while they were first prompted to start an internal monologue, and then start an internal conversation. The brains behaved as predicted; the monologue caused the areas affiliated with speech to light up, whereas the dialogue caused the areas affiliated with both speech and monitoring the speech of others activated. However, the experimenters designed an alteration to the study, where the subjects were not prompted to have any sort of inner speech and instead were monitored constantly in the machine, and prompted by random beeps to transcribe what they were thinking. This resulted in discovering a completely different area of the brain associated with inner speech.
This study demonstrates one of the key failings of studying human psychological experience. While fMRI provides useful information, it doesn't always capture the whole picture of how we think, since lying very still inside of a large and very loud metal tube is not the most natural setting. Yet there doesn't seem to be much alternative. Survey studies about mental experience are indeed possible, but often people are not inclined to share their deepest thoughts with a strange researcher. We also do not have the technology to monitor brain function at the level of an fMRI while people are just walking around. Morally, would that even be something we would want to do? In order to map natural brain function, necessity demands that some sort of portable monitor be developed, yet is that too much of an invasion into what is usually considered the most private of places, the mind?
I apologize for the formatting, the original article was from Scientific American and was only accessible in a paid format online, so I scanned my print copy.