Funtabulously Frivolous Friday Five 233

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Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF…introducing Funtabulously Frivolous Friday Five 233.

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Question 1:

Who popularised museli?

+ Reveal the Funtabulous Answer

  • Dr Maximilian Bircher-Benner (August 22, 1867 – January 24, 1939) was a Swiss physician with a keen interest in the benefits of nutrition to cure his patients. He came across a variation of muesli on a walking trip and later adopted the following recipe:
    • Apples, “[t]wo or three small apples or one large one.” The whole apple was to be used, including skin, core, and pips.
    • Nuts, either walnuts, almonds, or hazelnuts, one tablespoon.
    • Rolled oats, one tablespoon, “previously soaked in 3 tablespoons water for 12 hours”.
    • Lemon juice from half a lemon.
    • Either cream and honey or sweetened condensed milk, 1 tablespoon.
  • His idea met much criticism as “humans are not supposed to be herbivores” but a company called Somalon in 1959 after permission from the Bircher family manufactured a product called Birchermüesli, within a year was being exported to Germany, Austria, Great Britain, the Netherlands and the USA. [Reference]

Question 2

Which orthopaedic surgeon wrote the paper “Hazards of parachute jumping” in 1946 in the British Journal of Surgery?

+ Reveal the Funtabulous Answer

  • Peter Essex Lopresti of the fracture fame. An Essex-Lopresti injury consists of a radial head fracture with dislocation of the distal radioulnar joint (DRUJ) and disruption of the interosseous membrane (IOM).
  • The paper has some brilliant quotes of soldiers sustaining concussion on landing “the period of unconsciousness varied from a few seconds to several days… results were satisfactory provided the patient’s activity was kept below headache threshold”. Also the image below shows “ringing the bell” which consists of hitting your head by not hyperextending it on exit. This results in “buying a round of drinks” and probably a pounding headache.
  • From the 20,777 jumps recorded by the Sixth British Airborne division he recommended:
    • Hyperextending the neck on exit and holding the static line correctly.
    • Landing with the body relaxed but the head well forward, shoulders round, elbows in and watch the ground.  Knees and ankles together, slightly flexed to take the initial impact. Feet parallel to the ground and then roll to the side. [Reference]
  • He unfortunately died at the age of 35 due to an MI. [Reference]

Question 3

What condition may sound appealing to a dairy farmer, but makes afflicted patients cough up blood and have ‘coca cola’ urine?

+ Reveal the funtabulous answer

  • Goodpastures disease. 
  • An Autoimmune disease characterized by hemorrhage of the lungs and glomerulonepheritis. This disease is caused by a type II hypersensitivity reaction to Goodpasture antigen on basement membrane of the glomerulus of the kidneys and the pulmonary alveolus. First signs of the disease are vague such as nausea and fatigue or pallor. Most patients seek medical attention with the development of hemoptysis or hematuria.
  • Dr Ernest W Goodpasture performed autopsies on patients in a 1918 flu epidemic (note influenza was not isolated until 1933) and he was interested in what was killing these young men. He found two unusual patients who had “extensive hemorrhagic consolidation of the lungs associated with focal necrosis of alveolar walls and hyaline membranes as well as necrotising and proliferative glomerulonephritis“. The sections were discarded and Dr Goodpasture thought nothing more of his 1919 report until Drs Clare Stanton and Dr John Range reviewed his literature after having similar patients in their Melbourne Hospital in the 1950s.
  • They wrote an article in 1958 stating “… as the ethology of the condition is obscure, brevity and precedence are urged to justify the name ‘Goodpasture syndrome.” Dr Goodpasture wrote to the two communicating that his name should not be attached as he had not fully studied the disease. It is ironic that his name is attached to a disease he disclaimed knowing about but his other achievements were barely acknowledged:
    • 31 years as the first head of pathology at Vanderbilt University.
    • He discovered that viral inclusions in fowlpox contained active viral particles, that embryonate eggs could be used as a culture medium for viruses. Thus paving the way for vaccine development and to study the pathogenesis of viral and bacterial diseases.
    • He proved mumps was a viral infection. [Reference]

Question 4

What is Willis-Ekbom syndrome and Ekbom syndrome II?

+ Reveal the Funtabulous Answer

  • Willis-Ekbom syndrome is restless legs syndrome. Named after Drs Karl Axel Ekbom and T Willis.
  • Wherefore to some, when being abed they betake themselves to sleep, presently in the arms and legs, leapings and contractions of the tendons, and so great a restlessness and tossing of their members ensue, that the diseased are no more able to sleep, than if they were in a place of the greatest torture’ – The London Practice of Physick: Or the Whole Practical Part of Physick Contained in the Works of Dr. Willis. [Of the Watching Evil, p404]
  • Ekbom syndrome II is a delusional parasitosis. [Reference]

Question 5

How did Jack Barnes determine that the thumbnail-sized jellyfish now known as Carukia barnesi was the cause of Irukandji Syndrome?

+ Reveal the Funtabulous Answer

  • In 1964, Jack Barnes, after managing to catch the tiny jellyfish decided to sting himself, his 9 year-old son and a local surf-lifesaver.
  • They all developed Irukandji syndrome and needed treatment at Cairns Base Hospital.
  • Irukandji syndrome is named after the Irukandji people who live along the coastal strip of North Queensland. Wise enough to know not to go into the water during certain times of the year. Hugo Flecker in 1952 first documented the syndrome but no one had identified the culprit. [Reference]

    The lad reported mild abdominal pain twelve minutes after being stung…

    As systemic effects became manifest, subjects were seized with a remarkable restlessness, and were in constant movement, stamping about aimlessly winging their arms, flexing and extending their bodies, and generally twisting and writhing…

    … muscle groups in tonic contraction, little short of spasm… and the volunteers adopted a stance which I can best liken to that of an infant with a full nappy…

    All had abdominal and back pain, pain in the anterior chest wall with some difficulty in breathing, and diffuse aches in muscles and joints……it was agreed that movement did not relieve symptoms, nor did pressure and rubbing…

    Forty minutes after the stinging, the abdominal musculature of the three subjects was in unrelenting spasm, so rigid as to warrant fully the term “board-like”.

    Vomiting… was not troublesome for some forty minutes.

    The adults obtained complete relief two minutes after the injection of 50 mg pethidine… Symptoms began to return 20 minutes after…

    As the effect of the second injection wore off, all subjects complained of neuralgic pains… and intermittent administration of aspirin was necessary for approximately 24 hours. Thereafter no ill-effects were apparent.

    – Barnes, 1964.

…and finally

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Funtabulously Frivolous Friday Five 233 Neil Long

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Author: Neil Long

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