Bacteria and Humans

Pathology
               
          What is pathology? Pathology is the study of disease. Disease is caused by toxins that are released by bacteria. There are two types of these toxins that bacteria produce. Exotoxins are created by some Gram-positive bacteria which they release directly into their environment. An example of a bacteria that produces this toxin is Clostridium tetani which causes tetanus, a disease that affects skeletal muscle fibers.[1] Endotoxins are made of lipids and carbohydrates instead of proteins. This type of toxin is released by Gram-negative bacteria when the cells die. An example of a bacteria that releases this type of toxin is E. coli. Bacteria also cause disease by secreting digestive enzymes on body cells which kills them. This allows for the microbes to grow rapidly as long as nutrients are provided.

Antibiotic Resistance
         
           Antibiotic Resistance is when a population of pathogenic bacteria evolve in such a way that antibiotics no longer have an effect on them. First off, antibiotics disrupt regular cellular processes within bacteria. Some antibiotics such as penicillin make bacteria unable to repair their cell walls, this means that osmosis becomes irregular and the cell dies. Antibiotics are made from fungi and some bacteria.Penicillin, a popular antibiotic, was discovered when Alexander Flemming left a culture of staphylococci open for a few days. He returned to find that the bacteria had grown all over the dish except for around a spot of mold that had grown.[2] Antibiotic resistance is a huge threat for modern medicine. Resistance can develop by a mutation that gives a bacterium resistance to a certain antibiotic which is then spread throughout a given population of bacteria through conjugation.

Historical Bacterial Outbreaks

         The Plague of Athens is a historical event that isn't a well known epidemic case. The outbreak was in Athens during the summer of 430 B.C.E. which lasted two years. The cause of the epidemic is linked to the Peloponnesian War. At the time, Athens was under attack by Sparta, this forced citizens inside the city walls to live in close quarters with poor hygiene. Similar conditions also lead to the black plague epidemic in Europe many years later. The mortality rate was 33% the first time and the second outbreak four years later was 26%. The first outbreak occurred in the summer, the warm humid climate created a perfect environment for the contagion to multiply. What bacteria/virus that caused this outbreak is still up for debate. This is one reason I found this case so interesting. The accounts of Thucydides, a Greek historian, suggest that the plague could have been a mixture of diseases and not just one. The symptoms recorded as a fever, inflammation of the eyes, redness of the tongue and throat and fetid breath. After these symptoms coughing and vomiting would occur. The skin would also have blisters and sores, although he did not specify where. After 7 to 9 days the sufferer would die. The bubonic plague is one of the leading theories although some discredit it. Scientists have suggested that the outbreak could have been caused by Typhus of Typhoid fever as well while others disagree. When compared with diseases of today and the last couple hundred years, some scientists think that the disease could have been a type of bacteria similar to the bubonic plague that has gone extinct. This would explain why scientists have had a difficult time figuring out exactly what type of bacteria caused the outbreak. Viruses were ruled out as the cause because animals in the area also became infected. [3]



Remains of Victims of the Plague of Athens
http://www.toptenz.net/wp-content/uploads/2009/05/plague-of-athens.jpg


         The Great Plague of London was one of the last major outbreaks of the bubonic plague in England. The plague took place from 1665 to 1666. When the plague started the nobility left for their estates far from London. Sir Isaac Newton was someone who fled to the countryside during this outbreak, and there he developed his theory of universal gravitation. An interesting thought to entertain is whether Newton would have not discovered the law of gravity if it had not been for the plague. Over 100,000 people died as a result of this bacterial disease. The symptoms of the bubonic plague are gangrene, chills, high fever, swelling of the lymph glands and sometimes skin discoloration. The plague spread from fleas found on rats to humans. Since the disease is bacterial, antibiotics such as doxycycline are administered. Outbreaks of this particular disease is quite rare in today's world. The reason that the disease was prevalent in the past was because of poor sanitation and rodent problems. Today's society also has better medical protocols, patients that have this disease are usually quarantined and cared for. There have been a few isolated incidences in the United States but the plague can still happen in countries such as India where sanitation is not as good.[4][5]


http://upload.wikimedia.org/wikipedia/commons/thumb/1/1e/Great_plague_of_london-1665.jpg/220px-Great_plague_of_london-1665.jpg

-Kyle-



Sources:

1.http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/tetanus.pdf

2.http://www.ideafinder.com/history/inventions/penicillin.htm

3.http://www.ancientgreece.com/essay/v/the_plague_of_athens/

4.http://www.britainexpress.com/History/plague.htm

5.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235949/

Bioethics III Case Study #4: Siamese Twins

*Disclaimer - I am sorry if I offend anyone. Everyone is entitled to their opinion including myself. I can take criticism but remember that I recognize your right to an opinion and I hope you recognize mine. Thanks!*

The case study my group was given to discuss was about the Lakeberg Siamese twins:

Joey Lakeberg, the mother, found out after five months of pregnancy that her twins would not be normal. The twins, Angela and Amy, were fused together at the chest, they shared a liver and heart between the two of them. The twins were born on June 29, 1993 and were put on a respirator; their lungs could not function properly because of the place in which they were conjoined. The doctors at the hospital said that the twin could not be separated and both survive. There have been nine cases out of 190 where twins conjoined at the chest were separated and did not live more than three months after the operation. The mother of the twins expressed her concern that she could not live without if she couldn't at least save one of their lives. At this point, the twins were transferred to a hospital that was daring enough to attempt such a procedure. Their surgery took a total of five hours and Amy died in the process. Her sister, Angela, lived for 11 months following the surgery which broke the record for longest survivor of a separation where the two children were fused at the chest. Angela never had the chance to leave the hospital and was hooked to a breathing machine for most of her short life. The staff at the hospital took care of Angela following the surgery; her mother only held her three times after separation. Her father was in jail at the time and never got the chance to hold his surviving daughter.

Below will be questions that the member of the group were tasked with answering individually. These are the answers and opinions of myself.

Q: Do you think that a record of nine unsuccessful attempts at separating Siamese twins is enough to establish that such an operation could never be successful.
A: No, it is not nearly enough! It would be bad science to have something fail 9 times and give up. If we quit doing things just because we failed some of the time we would get nowhere technologically, scientifically or even within in our own lives, if you look at it from a philosophical perspective. There were 9 failures out of 190 tries. Those are not bad odds in my opinion. Every case is different, every pair of children are different, there are just too many variables to take into account.

Q:Some critics said that the decision to put the twins on a respirator "sentenced" Angela to life. They argue that, by putting the twins on the respirator, it was then not possible to halt the process,even though medical opinion held that the twins or even one twin could never survive off the respirator. Should this first step have been more fully evaluated before it was taken or do you think that it was the right first step to take in the Lakeberg's case?
A: The twins were unable to breath because their lungs could not probably expand with how they were joined. The two options the medical staff had were to either not put them on a respirator and let them die or put them on a respirator and keep them alive artificially. I think this decision should be up to the parents, but I understand that the medical staff may not have had time to consult the parents or acted out of instinct. This is fine but the parents should ultimately decide. If I were in that situation I would not keep the children alive artificially, had they been born with perfectly functioning lungs then I can see keeping them alive. But they are not my children and my opinion doesn't matter, what matters is what the parents think the best thing is for their kids.
Q:The Lakebergs lived in a trailer and had financial and martial problems. Do you think the instability of the Lakeberg home should have been taken into account when the decision was made to try to save Angela? Would this home environment have been adequate to meet Angela's heavy medical needs had she been able to leave the hospital? When, if ever, do you think it is appropriate for medical decisions to be made for non-medical reasons?
A: Yes  and no, I think that a social worker should have been involved in the event that one of the children lived. If the child, or both, survived the operation how does one know whether they would get the proper care? If the family cannot provide the proper care, by the sounds of it they couldn't, the surviving child/children should have been put up for adoption, put in foster care or given to relatives willing to take care of them. The father was a drug addict who used money sent to the family to help the children to buy a new truck and drugs, this family is obviously not stable. He also got in a fist fight at the one child's funeral. I'm not saying that if you use illegal substances that you are a bad person, because you are not, but the level of abuse that he would dish out really did not help his case, with me at least. I think that a social worker should have gotten involved and consulted the parents not the hospital or medical staff.

Q: Do doctors have an ethical obligation to try to save every baby?
A: No they do not and should not have that obligation, although most think they do. It would seem that most doctors have a god complex in which they feel obligated to try to save every patient, young or old, they come across and that they are infallible. I can see where they are coming from though, they see a life as a precious thing and they feel it is their duty to save the life, which that's what doctors do. This is really where the Pro-life/Pro-choice debate comes in to play. The Pro-life people would say, save the kids life and keep it alive and do anything you can to keep that child alive. Someone who aligns their philosophical values with Pro-choice would say, it is up to the parents to decide. Both groups value life but have different ways of looking at life. I look at it a bit differently which may seem harsh to some people. The reason why we care about out children and care for each other is a evolutionary adaptation. If we as a species didn't take care of our children then they would die and we would be unable to become "fit" (in a biological sense). I also understand that I may have a different way of looking at things if the situation directly involves myself, my child etc. I don't find life as valuable as some people because it isn't hard to create. People create life all the time, it is nothing new. If a child was born conjoined 1 m.y.a. when our species, or an ancestor, was living in groups of 30 to 50 people, they would not survive. That is how I feel but I can guarantee that if I was a parent I would feel much differently. Keeping a child that is brain dead or severely disabled alive artificially is doing it for the wrong reasons. To me that is selfish, the parents would keep the child alive in its suffering just so they feel better about themselves.

Q:Not all parents of Siamese twins oft for separation. There are cases where Siamese twins survive into adulthood and lead productive lives. How does their description of their lives affect your thinking about Siamese twins and the lives they lead.
A: I think that is it great that Siamese twins are able to live productive suitable lives. But once more, it depends on the case. Every case is slightly different and for some they would not be able to live fulfilling lives. It seems to me that the cases of Siamese twins that have survived into adulthood overcome their "disability" much like someone in a wheelchair would. They don't know any different. I think that in most cases, conjoined Siamese twins lead good lives.

Q:Would you make different decision for Siamese twins whose brains are normal than for those whose brains are not.
A: It would depend on the abnormalities in the brain that we are talking about. If by "normal" you mean perfectly functioning and have no brain damage I wouldn't have as much of a problem with them being separated or kept alive. If Siamese twins are born and one is brain damaged and the other is healthy I would say remove the one that exhibits brain damage. If both children had brain damage then neither should be kept alive. This goes back to the Terri Schiavo case on whether or not someone that is severely brain damaged is alive or not.

Bioethics II: Bioethics and Athleticism: Oscar Pistorious

"You're not disabled by the disabilities you have, you are able by the abilities you have."
- Oscar Pistorius

Oscar Pistorius was born without fibulae. He had both of his legs amputated before he was even one year old .  Without having fibulae, his legs did not have the proper skeletal support, he would have been unable to stand. If his parents wouldn't have acted quickly, he would have been confined to a wheelchair for the rest of his life. Because he had his legs amputated at a young age, he knew nothing else except prosthetics legs which he has used since. Oscar is an Olympic athlete despite his disability.

Some people think that Oscar has a disadvantage over other athletes because with his artificial limbs he gains height and doesn't have lactic acid build up that regular limbs would receive. Oscar says that his artificial limbs have disadvantages as well, such as, being difficult to control in wind and rain, more energy is needed to start running, it takes him longer to start because he must get his blades under control, he has to maintain balance in a different way because he has no feet, and his stride is less efficient because of the muscles being used. The International Association of Athletic Federations has taken measures to ban technical devices that could give an athlete an upper hand.

Some bio-ethical questions that arise from this case can be found below, the type of question will be in parenthesises following the question, legal, ethics, or scientific.

1. Do the artificial limbs give him an unfair advantage over other athletes? (Logic)

2. Should Pistorius be excluded just because he has a disability? (Ethics)

3. Will athletes try replacing their limbs with more technologically advanced versions some day in the future? (Ethics/Science)

4. Is it discriminatory to single Pistorius out over other athletes who use alternative means of competing? (Legal)

5.Should all athletes with artificial limbs be investigated as well? (Legal)


-Kyle-

Bioethics: The Terri Schiavo Case

For our Bioethics unit we were given a controversial topic involving a discipline of biology. My partner and I received the Terri Schiavo case. We were then tasked with creating a glogster, both of ours are located below, and then presenting our subject to the class. We were required to stay unbiased in our work and not present our opinion.

The Terri Schiavo case was very interesting to me because it was a bioethical event I was unfamiliar with. A few of the other cases given such as the Tuskegee Syphilis Experiment, the Jack Kevorkian case, and Dolly the sheep, I knew about but with this particular assignment I was able to learn something new. The entire case was a court battle waged between Terri's husband, Michael Schiavo, and her parents, The Schindlers. There were 14 appeals and many petitions and hearing spread out over a 15 year time period. (1990-2005) I did not describe every court appearance and every legal action in our presentation because many were repetitive. I included, what I thought to be, the most important parts of the case. In 1990 Terri collapsed in her home from what was thought to be a potassium imbalance brought on by an eating disorder called bulimia. Her eating disorder was kept secret from her family and friends leading some to believe that her husband was responsible. Her parents thought that Michael had tried to strangle Terri but there has been no evidence to show such a hypothesis to be true. When she collapsed oxygen was cut off from her brain for too long, resulting in her entering a persistent vegetative state. A persistent vegetative state (PVS) is a condition where the has person has lost cognitive functions, awareness, but still maintain non-cognitive functions like a heartbeat and breathing. A legal battle that lasted 15 years occurred between her husband and her parents, which finally ended in March, 2005 when Terri died from starvation and dehydration after having her feeding tube removed two weeks later.

The Terri Schiavo case was important to bioethics because it was one of the first popular cases that involved a patient in a persistent vegetative state. There was a few cases before the Schiavo case but they were not as popular as this one. This case was so popular because of the 15 year legal battle and the numerous petitions and activists that got involved. After the case, many people questioned whether or not the government and courts had the right to step in and decide her fate when the choice was originally left to her husband. After the judge ruled that Schiavo's feeding tube was to be removed for the last time, George W. Bush tried to find a way to overturn the ruling using the authority of Congress. A poll was taken after this was found out and most people found this unconstitutional. This case inspired pro-life groups and disability rights groups in the years following as well.

The bio-ethical debates that this particular case poses involves the right to die and when life begins and ends. These two questions have been been talked about at the same decimal level for decades. In this case, Terri's husband is trying to honor her wish to not be kept alive unnaturally which she verbally commented on before her incident and her parents who want to keep their daughter alive. Terri's parents refused to believe that their daughter was essentially brain dead and wanted rehabilitation for her, despite the fact that her doctors and nurses said there was no hope. Her parents went on to say,"where there is life, there is hope."

After reading this far I am guessing that you already have an idea of what side of the argument you reside on. Before you close your mind off to the opposing argument, I ask you to try and put yourself in each sides shoes. I know how hard this can be, close mindedness can be explained neurologically though which I will now attempt to demonstrate. I read this in a book entitled, Fringe-ology, this book was about a man trying to explain the unexplainable. Normally, I hold no respect for psuedoscience or parapsychology because they aren't real sciences and have little to no empircal evidence, but this book was different. The author explained that as humans our brains interpret a threat on world views the same way it would process a threat on our lives. Basically, if I were to tell you that your life philosophies were incorrect, you would become furious with me (pretty obvious). Everyone experiences this, it is part of the human condition and we cannot help it. Our amygdala, the center of emotional reactions, was once used by early humans while hunting to quickly decide if the shadow they just saw was a predatory animal or simple grass blowing in the wind. I am not entirely sure on the whole process and correct me if I am wrong. In today's world, we use the amygdala slightly different since many of us are not being hunted by big cats. Now that you know why you may get angry when someone tells you that you are wrong, try and change your way of thinking to better understand the other side. View our glogs below and decide for yourself who you think was right. Afer reading, take part in the poll found on the right side bar. Thanks for reading!

-Kyle-










By Dominique By Kyle
Sources:
http://www.terrisfight.org/
http://www.nndb.com/people/435/000026
http://www.wnd.com/2005/03/29516/
http://www.washingtonpost.com/wp-dyn/articles/A64459-2005Mar24.html
http://rationalwiki.org/wiki/Terri_Schiavo_case
^(used as a reference for other sources, check footnotes)
http://www.balancedpolitics.org/assisted_suicide.htm      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1734190/pdf/v031p00376.pdf