Tuesday, May 31, 2022

Some heroes to remember

...
this music was made famous by Glenn Miller and his Army AirForce band, but it was actually published in 1891.

before there was Tom Cruise, there were other hot shot pilots.


....not all heroes are military.

Since I worked in isolated rural areas, we air flighted our critical patients, and the team is heroic but they rarely get much publicity...

My son in law does this:  like other pilots, is a veteran.,

 

take that adsense. worrying about testosterone causing birth defects is not transphobia

I noticed that my daily viewers fell from over 50 to less than 20 a day a few months ago. Hmm... maybe because search engines no longer link to my blogposts?

and now I got a threatening email saying Adsense is upset about something and demaded that I remove it.

Not sure of what, because I promptly put it into my spam file and reported it (after all, how do I know if it's from adsense, especially since it went to my blogger email, not the email I use for adsense

now, you have to realize that as one of the few women in medicine back in the 1960s, I am used to bullies threatening me (the worst ones were ironically women: because when men tried it, I pushed back as if I were a man.

If they told a dirty joke, I told a dirtier one. If they played a dirty trick, well, they learned to watch their back... I grew up with a brother and knew how men thought. Ironically usually it worked and we remained friends. I should add that unlike many feminists I didn't relate to men in a flirty way, and then cry when the men responded to their come hither body language. I became their sister and was accepted.

Anyway, in for a penny, in for a pound.

....

as for medical articles: usually I only post the complicated articles on my medical blog, but hey, I am defending myself against ignorant Karens who are science deniers.

High testosterone levels in women before pregnancy and during pregnancy is not only a problem for trans folk, although their level of testosterone might be higher 
than in women with PCOS or who are on Danazol for medical conditions or who take anabolic steroids to enhance sports ability have high prenatal testosterone levels.

So studies of problems for these patients could point to the problems that cannot be discussed about the danger to the baby of trans women.


Testosterone plays an important role in mammalian brain development. In neural regions with appropriate receptors testosterone, or its metabolites, influences patterns of cell death and survival, neural connectivity and neurochemical characterization. Consequently, testosterone exposure during critical periods of early development produces permanent behavioural changes. In humans, affected behaviours include childhood play behaviour, sexual orientation, core gender identity and other characteristics that show sex differences...prenatal exposure to high levels of testosterone has a substantial influence on sex-typical play behaviour, including sex-typed toy preferences, whereas influences on core gender identify and sexual orientation are less dramatic. In addition: there appears to be little or no influence of prenatal testosterone on mental rotations ability, although mental rotations ability shows a marked sex difference.

Live Science article from 2012 discusses:Testosterone levels during early fetal development might program certain behaviors later in life, according to a new study that found high levels of the sex hormone in the womb might boost boys' impulsivity later on...

then there is this: the influence of androgens during pregnancy on the uterus etc.

Androgens in pregnancy: roles in parturition  states that normally the ovary produces more testosterone during pregnancy and this has an effect on the maturing of the uterus and cervix before delivery.

Again, we see a high miscarriage rate in women with PCOS:

But the high miscarriage rate in PCOS might be due to other factors (e.g. obesity, insulin resistance) rather than testosterone, so this might have implications for trans pregnancies. (on the other hand, side effects of testosterone include obesity )


The role of serum testosterone in early pregnancy outcome: a comparison in women with and without polycystic ovary syndrome... 

Our findings show that early pregnancy testosterone levels do not predict pregnancy outcome, and they call into question the role of testosterone in causing miscarriage in populations of women with PCOS.

.. more in this article.

the problem is that political correctness might stop people from actually observing and reporting such problems, let alone daring to measure testosterone levels during pregnancy to see if the trans women are still taking their male hormone.

so if adsense thinks that discussing real medical problems about the trans craze shows I have a problem, then screw them.

Before Cassanova and James Bond, there was the Genji

 I am working my way thru the Tale of Genji, the 11th century novel of Japan written by a court lady.

Years ago I tried to read it but got bored with the guy who mainly went around seducing ladies while neglecting his wife; but now I am listening to it on Librivox while reading a download of the novel to try to absorb the details... and am pleased to find his promiscuous ways got him into trouble, and after being in exile (and seducing the daughter of the local Buddhist priest who helped him during a flood), he didn't quite stop seducing ladies, but at least he did try to help the women he had seduced, including letting a few of them stay in his house and arranging for the seduced daughter's child to marry the emperor...

Ironically, at the end, his second son by the Third princess turned out to be actually the son of a relative who forcibly seduced her. She is so traumatized she becomes a Buddhist nun after giving birth (one way to avoid sex in those days) and her seducer essentially kills himself out of regret.  But this second son is the hero of the last part of the novel which I haven't read yet.

One feminist blog called Genji a serial rapist.

Sounds about right. The noble women essentially have no power over their lives, and are often married to distant uncaring husbands. So theoretically they are willing to be seduced. Others are single, and/or middle class so have no power to say no. 

Not quite rape, but when women are not expected to say no to men, and have few outlets for their boredom, as a modern woman I have little sympathy for the guy.

did I mention he also seduced his stepmother and made her pregnant?

One might add, unlike James Bond or Cassanova, after his exile, Genji does try to make amends to some of the women and brings several of them into his house as minor wives... something of course that his concubine Lady Murasaki (the same name as the author) has to pretend to go along with.

Sigh.

The author, Murasaki, was a court lady and apparently the chapters were very popular: think of them as the romance novels that women read today, which also tend to have ladies swooning all the time...

There are several films based on the book, but I haven't gotten through any of them so far because I am still getting the characters confused.

The best guide to the book (although with a condensced plot) is the manga found here. which includes a lot of background information.

here is a sample page on what was worn back then:


Part of this is my interest in women who are usually in the background of ancient literature. 

Even though the author is a woman, the Tale of Genji is about a man, not his long suffering wife with the same name as the author.

But it makes one happy that I live in today's world, where a woman can have alternatives to the limited choices of noble women back then.

One thing missing in the book: Ordinary folks. The only place they are mentioned in some detail is when the floods happen in Akashi during Genji's exile.


.......................

Saturday, May 28, 2022

Earendil the morning star

Traditionally, the one who discovers a star can name it.

So why did astronomers name this huge star that dates to the dawning of the universe "Earendil"



Back in March 2022, the Hubble Space Telescope team announced the observation of the furthest ever star detected. That star, nicknamed Earendel, was detected from light that look 12.9 billion years to reach Earth, when the universe was only 7 percent of its current age.

 This ancient star breaks the record of the previous most-distant star by several billion years. The discovery of Earendel was made using data collected by Hubble's RELICS (Reionization Lensing Cluster Survey) program, led by astronomer Dan Coe from the Space Telescope Science Institute (STScI). The paper on the find was published in Nature.

The star gives a view of the very early universe, when the stars were generated from the early matter of the big bang: a star from the morning of the universe.

More here at SkyAndTelescope.

EARENDEL: AN EARLY STAR Based on Earendel’s brightness, the group estimates that it’s massive, containing the equivalent of tens or even hundreds of solar masses, with few elements other than hydrogen and helium. Given the age of the universe it resides in, Earendel is not likely to be one of the very first stars, known as Population III, but at its great mass, it’s nevertheless an early fuser of new heavy elements.
“Knowing that massive stars were present that early on in the universe is an important confirmation of what many of us have predicted and in fact used as assumptions in the work with old Milky Way stars,” says Anna Frebel (MIT), who was not involved in the study. For Frebel, who studies ancient nearby stars for clues to stellar evolution in the infant universe, the discovery is a fantastic find. “Early massive stars must have produced the first elements and driven chemical evolution, so having observations at hand that support this notion is wonderful.”

Earendil, as Tolkien fans know, is an important character in the Simarilion.... but originally the word Earendil was an ancient name for the morning star, and the word Earendil in an Anglo Saxo Poem Crist was the original inspiration for Tolkien's mythology. 

TolkienGateway:

While Eärendil is a Quenya name inside the legendarium, Tolkien created the name based on Anglo-Saxon éarendel. He says that he was struck by the "great beauty" of the name as early as 1913, which he perceived as "entirely coherent with the normal style of A-S, but euphonic to a peculiar degree in that pleasing but not 'delectable' language."...
The Old Norse together with the Anglo-Saxon evidence point to an astronomical myth, the name referring to a star, or a group of stars, and the Anglo-Saxon in particular points to the Morning Star as the herald of the rising Sun (in Crist christianized to refer to John the Baptist). Tolkien was particularly inspired by the lines in Christ, which became the title of his first poem about Eärendel:
éala éarendel engla beorhtast / ofer middangeard monnum sended
"Hail Earendel, brightest of angels / sent over Middle-earth to men."

Tuesday, May 24, 2022

From Chicken lady with love

 the bat lady from Wuhan is at it again... or maybe we should call her chicken lady:

The latest WAGD news article:

A scientific journal published by top Wuhan Institute of Virology researchers shared studies appearing to engage in gain-of-function type research, a controversial method of studying pathogens that can increase their lethality.
I copied the PDF and posted some of it (sans illustrations) on my medical blog webpage to make it easier to read.

Headsup LegalInsurrectionBlog.

no, she isn't trying to make a bioweapon: She just was changing the virus and giving it to animals to see what makes it worse. 

Such mutations occur in nature, of course, but given the poor safety record of her level 3 lab, it does make one wonder.

-Bird flu naturally spreads via migrating birds, and since the Philippines is not on a usual migration path, we were bird flu free for years, until somehow they found some infected birds.

Probably in smuggled in chickens that were infected but sold to us anyway.

The animal rights folks blame the chicken farms: but you know, we monitored our chickens closely, and they were raised inside a shelter so migrating birds could not infect them.

But free range chickens and small farmers who raise chickens are the real risk: they handle the birds personally, and might not monitor or vaccinate them. And of couse they might eat a bird who they didn't know was sick.

Eating infected chickens can give you bird flu, as can close contact e.g. those destroying infected chickens are at risk, as are those who handle fighting cocks..

for awhile Jakarta banned having chickens within city limits: some people have a couple of chickens to provide eggs, but what is more common is men who raise a few fighting cocks in their backyards, under umbrellas or on a leash. Ironically the stray dogs avoid them: they are vicious. But of course, migrating birds who seek their food could spread the disease to these birds.

there is a vaccine for the chickens, which is used for some chicken farms that produce eggs and for fighting cocks, but it is too expensive for small farmers who only have a few chickens. And the broiler chickens, like we used to raise (until the typhoon blew the buildings over) have a short life before they are sent off to Col Sander's heaven, so they are not usually vaccinated.



so if you get it in your broiler chickens, you cull them.

Captain Trips call your office, the chicken lady has a job for you

----------

In another new article: Another outbreak of footandMouth disease in Indonesia.

Agriculture Minister Syahrul Yasin Limpo told a parliamentary hearing on Monday 20,723 head of livestock had been infected in 16 provinces as of last week. He said these provinces had a total livestock population of around 13.8 million.
Lawmakers at the hearing urged the government to investigate where the infection originated from, slamming authorities for being "careless" in letting the virus spread across the country for the first time since around late 1980s.
The infections have spread at a time when Indonesia was already facing rising prices of meat and ahead of Eid al-Adha, one of the most important Islamic holidays, where Muslims traditionally slaughter animals and share the meat with the poor. Lawmaker Anggia Erma Rini said vaccines were urgently needed to tackle the outbreak.

Wikipedia article on Footandmouth disease. 

and until the vaccines were available, they are isolating and inspecting people traveling from these areas. 

-------------------

And of course African Swine Flu is back: we have had cases on and off for the last few years, and one of our neighbors had to kill all his pigs on his small farm... one result is that we are eating a lot less pork... For the first time in ten years, we are eating beef. 

How did it get here, when pork products from infected countries are banned? Smuggling... and mislabling pork products. Probably from China. 

It's not the Chinese government per se that is the problem: it is the culture of corruption.



Monday, May 23, 2022

Jane Austen's world: Being sick

 ProfessorBob has a podcast on Jane Austen's death LINK.

lecture on Austen and patriotism: Remember, her brothers were in the British Navy.

...

.Francis Austen was her brother. Wikipedia page.

more here:
...

.Jane lived at a time of change in England: JaneAusten.org discusses the Regency period, when the decadent prince regent took over from his father... and Jane Austen wasn't exactly pleased when he requested that she dedicate a book to him:

Upon finishing her novel, Emma, the Prince Regent gave her 'the honor' of dedicating it to him. Unable to disregard a royal charge, Jane used her words in the dedication to show her disdain:
'To His Royal Highness the Prince Regent, this work is, by His Royal Highness's permission, most respectfully dedicated to His Royal Highness by His dutiful and obedient humble servant, the Author.'
one background for this is his divorce from Princess Caroline, which had implications not just for discussing divorce, morality, and women's rights, but in questioning the monarchy.



The Regency period is a favorite one for romance novels, because it is remembered for it's elegance and strict social rules.


but Jane wrote about the lives of ordinary middle class people, who were in danger of falling into poverty, hence the stress on money in marriage.

although as a clergyman's daughter she undoubtably was familiar with the poor, she rarely wrote about them or the servants but was mainly writing about issues that she saw in her experience. HistoryExtra discusses.

But what about other social issues in those days?

Rural poverty was real and pervasive.

These did not affect their lives directly, but Jane did hint at these problems in her novels. For example:

....

one of my interests, but not one that I have seen much written about, is the care of the sick in Austen's novels.

Usually they were cared for at home, not in hospitals of course.
 
Sense and Sensibility discusses the pneumonia of Marianne Dashwood as an extension of her overly passionate personality. Essay at JaneAustensWorld website here discusses, and contrasts the novel to how this is portrayed in two films.

and Louisa Musgrove's head injury and treatment is discussed in this article.

Louisa Musgrove, who suffers a severe head injury, requires ten weeks of convalescence and undergoes a marked personality change, which we might today attribute in part to post-concussion syndrome but which may reflect contemporary debate about the biological basis of personality and behavior.
more here:





Sunday, May 22, 2022

Questions that are taboo to ask

 Why is no one questioning about the effect of hormones on the baby when transitioned women have babies? Many stopped these hormones when they planned the pregnancy, of course, but not all... and did the hormones cause atrophy of the uterus or affect the ability of the ovary to produce enough hormones to support the child? 

The problem is that any study about the problem has very very few numbers in it, and the censorship of the gender theory tyrants will silence any question if a testosterone filled person should be getting pregnant. Instead, the woke establishment (including now many medical societies who should know better) pushes the idea that this is normal, and heaven help you if you question it.

Another question: this article is about the women who transitioned but wanted to breast feed. 

a long discussion about why docs should respect them and their pronouns etc. and how they feel when the naive get it wrong.

this is helpful for those of us in the medical profession (politeness in communication is needed: not just pronouns but when docs or nurses call elders by their first name as if they were children is a similar problem)...

however, most of those quoted sound like those of a self centered person insisting that you go along with their mindset (someone who wants to have their own reality imposed on those around them and how dare you not obey their wishes).

Some of these people are probably narcissists trying to gaslight you until you disregard what you see and what thousands of years of Judeo/Christian/Muslim and Confucian ideas have taught about the roles of men and women.

True, this criticism may be harsh, because some girls who transition have autistic spectrum and are trying their best to live in a world they don't quite understand: and others want to escape the milieu of femininity, often because they were  abused. Others want to have the freedom of being a male... 

I understand when a person is insecure who desperately needs to have others agree with them no matter what, to affirm their shaky self esteem, or maybe because deep in their heart they are troubled or ambivalent with transition but in today's woke environment they don't dare question it...

Sigh. 

Life is too complicated for tweets or soundbites.

Here in the Philippines, we have a catholic approach: we accept folks but keep the idea of the law: one description of Catholicism was that we have strict laws, but since we know no one can follow them all, we have confession and forgiveness and acceptance of sinners of all sorts: including those whose behavior is different from us. I mean, our town has fiestas for all sorts of saints, but we also have miss gay gapan city contests.

I mean, when the private armies of mayors and governors have shootouts, and the cops shoot druggies or almost daily find those storing huge amounts of shabu or raid those posting child porn for rich westerners, having a hairdresser dress as Snow White to win a contest isn't exactly something to get one's knickers in a knot.

But accepting those different with loving kindness, while acknowledging traditional laws, is not the same as the woke culture forbidding someone to say that there are two sexes.

Reality check: there are two sexes, with very rare exceptions biologically.

True, there are gay people and those who have problems accepting their gender (or in today's world, where unhappy children find they can get a lot of positive feedback by woke parents or woke teachers by being the opposite gender).

But there is a need to recognize that the gender theory being pushed is not just about not hurting a few sensitive souls, but a pseudo religion that is trying to destroy the idea that there is a difference between male and female, and ultimately destroy the family, which has biological and evolutionary reality and is the basis of society.

and to make things worse, many countries, the UN, and many NGO's are pushing the entire gender agenda religion on poorer countries, something Pope Francis has called cultural imperialism.

 Pope Francis has condemned it as seeking to destroy the difference between man and women, as an attack on the family, which in most countries is the way people care for the young, the sick, and the elderly. 

Francis singled out “gender theory” as an expression of this evil, while noting immediately that “I am not referring to those who have a homosexual orientation” since these people deserve “pastoral care.” Gender theory is “dangerous,” the pope continued, because it implicitly wishes “to destroy at the root that creative project that God wanted for each of us — diversity and distinction — by making everything homogeneous and neutral.” “It is an attack on difference, on God’s creativity, on man and woman,” Francis said...
he also said that the “legal deconstruction of the family”  taking place in many countries cannot bode well for the future of society.

indeed, the pressures by western countries/UN/NGOs to do this by withholding needed aid money has been condemned by the Pope as cultural imperialism. 

Can't we just get along?

Uh, maybe not: at least as long as these woke warriors are allowed to set the agenda and have control of institutions, the media, and even the government to censor those who disagree with them.


Sigh.

 

Mareen Malarky writes about the malarky in the art world institutions: 


They tells us that EFA “stands against oppression, racism, and the exploitation of humans, non-humans, and the land.” Art itself goes unmentioned but “art practices” that agitate for “accountability, reform, equity, justice, and abolition” are grant-worthy. EFA commits to training young adult social justice warriors to organize against “mass incarceration and the police state.” Naturally, EFA means in the U.S., not countries like Myanmar, Cuba, or China. What constitutes police state action is in the eye of social justice bureaucrats.
Send the cavalry to parents at a school board meeting but celebrate NYC’s revised Human Rights Law which urges fines up to $150,000 for a first offense against the mandated pronoun glossary. And up to $250,000 for a “willful” or “malicious” misgendering...

at this point in her essay, she posts photos of one of these activists who work for the Biden administration.

Yes, one can be sympathetic to the angst of some people who feel they were born in the wrong body, and we docs cope with all sorts of people. 

But you know, in psychiatry, we were cautioned that being too sympathetic and empathic with people might lead us to not recognize what they were doing wasn't quite normal. 

So we were told to apply the taxi driver rule: If the average taxi driver would judge that person as crazy, maybe the behavior is not normal but a sign of mental illness. 

or as Ms Malarkey writes:

This pronoun juggernaut is not a small thing, not a craze that will wear itself out. It is a militant program to destabilize, even erase, the concept of normalcy. All norms must go. The force of the propaganda campaign to reduce biology to grammar—and something called gender expression—is a direct attack on human nature. It is a menace to be fought..






Friday, May 20, 2022

The next plague? Not really


monkey pox cases are causing non experts to worry, but actually it is mild... and not easy to catch, which is why one wonders about the question of sexual transmission... is it the sex or the close contact (or as this expert says: "extremely close contact") with open skin lessions or is the HIV status of those catching it? 

more here.

other animals get pox virus infection: Including cows, which can spread to humans and give them mild rashes. Indeed, it was a GP named Jenner who noticed that cowmaids, who often caught cowpox and got rashes on their hands, were famous for having a nice complexion (i.e. they did not have smallpox scars on their face), and figured out that cowpox gave them immunity to smallpox. He then instituted cowpox innoculation to stop small pox... there are anecdotes of humans caring for horses and donkeys with severe pox infections catching mild cases too, and animals with ORF virus infections can spread to humans in close contact with the animal.

The problem is not that an occassional human can catch the virus from the animal, (often on their hands, and one suspects the virus infects the hands through small wound/abrasions there)... but if the virus starts spreading person to person, which means it can cause an epidemic if transmission is not stopped.

Smallpox is airborne and even scab debris can spread it. So far, this is not true of monkey pox, so there is probably no danger of it becoming an epidemic.

However, if you want to be afraid, think Bird flu... BirdFlu, which has caused several hundred human deaths in various asian countries, but has not yet become epidemic: because it does not spread person to person (yet)... but it is only a matter of time.

One worry about the over reaction to Covid is that it will make people cynical.

The danger is that for the next epidemic, people might refuse to go along with advice from the "experts"...

Sigh.

and it doesn't help that an unpopular Biden is hinting he might sign a treaty that lets the W.H.O. have the right to tell the US what to do. Silly me: treaties have to be ratified by the US Senate, but the imperial presidency seems to be the rule right now.

The WHO usually does a good job fighting epidemics, but they botched the fight against the Covid epidemic by following China's lies when anyone with a lick of sense knew China was doing a coverup of the disease.

Sigh. 
--------------
best comment on this video:

I can’t believe it’s Monkey pox season already. I still have my Ukraine decorations up.
--------------
update: Like HIV, monkey pox is being pushed as if it were a danger to ordinary folk and in order to reimpose obedience to masks etc.
But (via Instapundit) it is now being recognized that it requires "very close contact"... as in sexual contact.

The UK Mail is even more explicit on where the epidemic might have started: at a huge gay festival. But even they state that it was not sexually spread, but spread by close contact... as if shaking hands, not genital to genital contact spread it.

sorry: But I had to give the HIV lectures thirty years ago to my National Guard unit, and had to learn a lot of what was behind the explosive spread of the disease. One wonders how many lives would have been saved if Diane Feinstein's order to shut down the SF bathhouses in 1984 (for spreading other STDs) had been allowed to be implemented: it was stopped and the public health authorities were labled as anti sex fanatics.













Thursday, May 19, 2022

Propaganda? We haz it

 we watched a stupid video game inspired film called "uncharted", where apparently gold treaures weigh as much as styroform plastic, people falling 300 feet into the ocean never get hurt, and Tom Holland is doing Spidy type tricks without the ability to throw webs around.

The "Treasure" of Magellen was supposed to be found in Mindanao, but because of Covid, they filmed it in Spain and only added some background from the Philippines shot by the second crew.

Whatever. 

But you know, although the marvel type movies are usually a hit here (Dr Strange is showing in our local theatre), it seems that Uncharted is being censored here:

Because the map includes China's nine dash line implying they own the entire West Philippine Sea/ East Vietnam sea/ aka south china sea which China is slowly trying to steal by building artificial islands there, in defiance of an international court decision that noted their claim to the area is bogus.

as the gov't here noted:


"The nine-dash claim is contrary to national interest, which has been settled in the 2016 Arbitral Award. The Arbitral Tribunal held that China’s nine-dash line has no legal basis as its accession to UNCLOS has extinguished any of its rights that it may have had in the maritime areas in the South China Sea," the DFA said. "China also never had historic rights in the waters within the nine-dash line," it added. Last March, Vietnam blocked "Uncharted" in its cinemas over the same map prior to its screening on March 18.

Yes, they included that piece of propaganda to please their Chinese masters.

and this is not the first time China's propaganda is being pushed by movie companies. As CNN notes:

Sony's Columbia Pictures Industries Inc was ordered to stop screening the film and has complied, the Foreign Ministry said. Sony Pictures did not immediately respond to an emailed request for comment. In 2019, the Philippines' Foreign Ministry requested DreamWorks to shut down cinema screenings of animated film "Abominable" after a scene showed the same Chinese nine-dash line.


Tuesday, May 17, 2022

Tuberculosis: Still a killer

Thirty years ago, I once checked an x ray on one of our patients in New Mexico, noticed her TB scars had changed, so I sent her for a bronchoscopy and indeed they found her tuberculosis had reactivated. The problem was missed by other doctors there, because most younger doctors had never seen a case, but I had: in Africa, but also in medical school where we saw coal miners whose damaged lungs made them vulnerable to the disease.

Thirty years ago, TB essentially was "cured" so many younger docs had never seen a case: but those of us who had trained overseas, and of course those of us who had worked in the IHS had seen cases, since Tuberculosis was a major killer of AmerIndians due to poverty (something to remember the next time you read hysteria about residential school mass graves). 

Ironically, I was not congratulated on my diagnostic ability: the nurses were annoyed because it mean we had to screen all staff and other patients who had been in contact with that patient, and that meant a lot of time and energy on our already overworked staff.

Sigh.


 Nowadays doctors are probably more likely to diagnose TB, because we see more of it:  HIVpostive patients are at risk as are recent migrants and refugees, especially those who didn't get pre immigration screening before entering the USA.

Screening is important to detect silent cases that can lead to clusters of disease. 

Usually if you test positive on a skin test, they check your x ray to see if you have active disease. If the CXR is okay, you are given several months of INH or similar medicine, which theoretically kills the last germ and cuts the rate of the disease being revived when your immune system gets sluggish from old age, diabetes, etc.


For example we started screening our AmerIndian patients and treating our diabetic patients if they had a history of a positive skin test because of the danger of reactivation. Those at risk we treated with a short course of an anti tuberculosis drug.

TB is a two step disease: You get infected and in rare cases, it spreads all over the body and kills you. But usually your body destroys the germ, or walls it off.

When walled off imperfectly, you get classical pulmonary tuberculosis, but most people sucessfully wall off the germ... but a skin test will show you have immune cells so had been infected in the past. But it also means that if your immune system gets sluggish, these germs can reactivate and cause the disease.

In the 1800s TB was a major cause of death: aka the White Plague. 

This is one of a series of lectures at Grescham college about the disease:


So what made me write this long boring essay?

This essay at Crimereadblog (Via TeaAtTrianon) which notes that Jane Austen died of Addison's disease and decides it was due to autoimmune problems. 

Auto immune disease is trendy today, of course, and since we have sensitive tests for these disease is easy to diagnose even mild cases.

But the article is missing the elephant in the living room: Tuberculosis.



When Thomas Addison described his patients with adrenal cortex insufficiency in 1855, all cases were due to destruction of the adrenal cortex by Mycobacterium tuberculosis
Addison's disease is when the adrenal gland doesn't put out enough cortisone.


The most common symptoms of adrenal insufficiency are chronic, or long-lasting, fatigue muscle weakness loss of appetite weight loss abdominal pain

Jane's symptoms are discussed in this medical article::

Jane Austen's letters describe a two-year deterioration into bed-ridden exhaustion, with unusual colouring, bilious attacks and rheumatic pains. In 1964, Zachary Cope postulated tubercular Addison's to explain her symptoms and her relatively pain-free illness. Literary scholars later countered this posthumous diagnosis on grounds that are not well substantiated, while medical authors supported his conclusion.

 Important symptoms reported by contemporary Addison's patients-mental confusion, generalised pain and suffering, weight loss and anorexia-are absent from Jane Austen's letters. Thus, by listening to the patient's perspective, we can conclude it is unlikely that Addison's disease caused Jane Austen's demise.

maybe, or maybe not. She might have had mild Addison's disease, and didn't go into crisis until another disease stressed her body, which is what happened to JFK (discussed below).

or maybe she had caught TB from food or milk? 

(however) Disseminated bovine tuberculosis would offer a coherent explanation for her symptoms, so that Cope's original suggestion of infective tuberculosis as the cause of her illness may have been correct.

 In other words, without an autopsy, it is unlikely to solve the mystery of Jane's early death.

this article is a case study showing that even today it is hard to diagnose Adrenal TB. 

And I answer: well, yes. 

Which is why we often just treat the patient who is suspected of having TB with medicines and see if they get better while waiting for the tests to come back. (in the case study at the link, it took two months to diagnose the poor patient, even though the doctors knew he had TB as a child).

the most famous modern person with TB is Orwell who died, alas, about the time Streptomycin became available to stop the disease.

Over 1.5 million people a year die of TB: 

So yes, TB is a treatable disease, even with the problem of drug resistance. The problem is that you have to take medicine for a long time and get check ups during that time, and alas that takes time, money, and trained personnel.

the covid epidemic made it worse for the same reason that we are seeing increased deaths from heart attacks/ high blood pressure/diabetes/ preventable diseases in kids: screening is not being done, cases are not diagnosed because people are not being screened and/or not presenting themselves to clinics for XRay when they develop a chronic cough, and public health resources are focusing on covid.

Sigh.

TRIVIA QUESTION: WHO IS THE MOST FAMOUS PERSON WITH ADDISON'S DISEASE?

The most famous modern person with Addison's disease was JFK: and his was mild and only caused trouble when his adrenal glands failed to produce more cortisone under the stress of his back surgery. Luckily docs diagnosed it and gave him a new miracle drug called cortisone and saved his life, and wrote up his case in the medical literature to alert other docs about the problem of mild Addison's disease in times of stress. But when the press found out about it, the fact he took small replacement doses of cortisone spawned a thousand conspiracy theories.

as for the source of Jane's possible Addisone disease: staying in crowded boarding homes at spas or catching it from her clergyman father or Naval officer brothers (both occupations that would have contact with poor people with TB), I assumed she had ordinary tuberculosis.

But the article stating she may have caught bovine Tuberculosis does interest me: No, I have never seen a case of that...although about 2 percent of TB cases in Latin America are bovine in origin... 

The reason it is rare today, because cows are tested for TB.

Monday, May 16, 2022

the epidemic that weakened the Roman empire

 Did Malaria weaken the soldiers and the elites in Italy? 

headsup from Librivox has an old audiobook that quotes Roman sources about the problem: it was not a summer disease, but hit when the rains fell in the late summer and early fall. Falciparum malaria kills even adults, but the less virulent strains cause chronic tireness and require you to take time off when the fever hits (every three to four days, hence the term quartan fever).

A problem of empire...brought in by ships and infected passengers coming from malaria areas, and spread via local mosquitoes that breed in standing water.  that may have been made worse by collecting rain water in containers where mosquitoes could breed.

 More here.

it just didn't weaken adults, but caused miscarriages and killed children.

and is still a problem. 

WHO page states:

In 2020, there were an estimated 241 million cases of malaria worldwide. 
Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. It is preventable and curable. 

The estimated number of malaria deaths stood at 627 000 in 2020. 

The WHO African Region carries a disproportionately high share of the global malaria burden. In 2020, the region was home to 95% of malaria cases and 96% of malaria deaths. Children under 5 accounted for about 80% of all malaria deaths in the Region.

 the treatment is to kill the mosquitoes: Ah, but when they stopped using DDT (safe for humans but killed some birds) the death rate soared.

of course, it can be argued that the moquitoes became resistant to DDT, but the reason for stopping it was politics, not this problem.

Basic public health also helps: The phrase "drain the swamp" is about draining swampy areas that were the source of the disease. And critics who ridiculed Victorians etc. for keeping their windows closed at night as if this was a delusion forget that this also stopped the mosquitoes from coming into the house.

what has stopped malaria in most developed countries is mosquito control: 

https://ourworldindata.org/uploads/2021/07/Previous-prevalence-of-malaria-world-map-1.png

The Gates foundation is working on Malaria prevention on many levels: mosquito nets, local surveillence to eliminate outbreaks, injectable medicine for long term prevention, educating people on how to prevent mosquitoes from breeding.

by the way, much of the expertise to stop mosquitoes also works with the (different) mosquito that spreads Dengue fever.

And this report is about how China has eliminated malaria.

China is investing in Africa seeking food and mineral resources. African diseases can infect their workers there, and these workers can even bring home the disease on visits (something that happened when Angola had a yellow fever outbreak).

So can China's expertise in fighting malaria help African countries eliminate the disease? This article is about the Gates foundation working with China to do just that.


more information on malaria here.


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Saturday, May 14, 2022

family news

 have you been reading all those happy happy elitist green essays on using natural resources to grow crops?

Well, the price of chicken Manure is up, and Kuya is trying to find if he can buy it cheaper than from his usual resource. Sigh. And of course diesel is up, meaning more money to prepare the fields for planting rice.

He is hoping to keep the rice organic, but if he can't get organic fertilizer, he might have to plant part of our fields with ordinary chemicals.

By the way: Under the land reform of many years ago, most of Lolo's family's ancestral land was "bought" for low prices by the tenant. There is a limit on how much a person can own, and foreigners cannot own anything here. So much of our rice comes from subcontracted farmers, who we help with finance and equipment and supervise they are actually growing organically (no cheating... at least no cheating that we can detect. This is the Philippines you know)...

Certified organic rice can command a higher price, but it is vulnerable to pests etc. Ducks help keep some of the insects down. Yum.... Balut (fertilized duck embryos)...

Joy is in Manila: The people who rented one of our properties there sort of went broke when everything shut down: They managed to stay afloat by doing e commerce, but this meant long trips to their customers, (with the high price of diesel, and during the epidemic the cost of numerous covid tests)...

Since most of their customers are in more affluent areas,so now that things are open, they plan to movecloser to the customers.

the bad news: The only reason they stayed in our property is that we left them stay rent free for the last year, with the agreement they would make up what they owed us with this year's rent... which now we won't get. 

Theoretically we could sue, but that would probably cost more money than the lost rent, and they probably don't have the money anyway.

So now we have new renters, and once they open we should again be getting a small income from that shop, but first we had to fix the roof, the ceiling, the wiring, the water pipes, and renovate the front for more room. And so more money from my small retirement savings, since although the shop is in Ruby's name, the agreement is that the income goes to my name (although most of it is actually being sent to pay her college expenses, so we are not mixing up the rice businesses finances and our private expenses).

In the meanwhile, I am feeling better... I was tiring and sleeping all the time with a lot of aches and pains but couldn't figure out why. But after reading how one can get slow covid after a mild case of Omicron, I wonder if this was the problem... I had a cold about a month before this started, but didn't get tested because I wasn't sick. I am double vaxxed, but no boosters because they have limited help in the new varients, although if a bad variant comes through I probably will get a third vax.

right now, there are only a few cases (under 100) in the country, which I suspect is because no one is being tested unless quite ill. The bad news is that a handful of cases of the newest omicron 2 varient has been diagnosed in Manila and among tourists. But this one supposedly is less dangerous and more infectious than previous variants.

Only half the country has been vaccinated, and we have been pretty well open for the last month (masks and distancing indoors). Kuya took me to the mall and they wouldn't let him in so he had to borrow my extra mask. But we don't need face shields now, and of course, the cynical take is that the quarantine regulations were lifted for the election campaign rallies, and cynically saying that the quarantine will be restarted after the election. We'll see.

People are tired of being indoors, and the deaths from lack of medicine and poverty are worse than the mild covid variants that are around now.



Friday, May 13, 2022

Musical Interlude of the day

....

remake of a fifty year old song from the Grateful Dead...

why the deplorables here voted for Marcos

 I pointed out in several earlier posts that the staff here (who include those with links to the NPA and Gabriela) backed Marcos.

I use the word "deplorables" in the headline because, like the invisible American blue collar workers (who in the past were called Reagan Democrats) who lost their jobs to immigrants or overseas, revolted and voted for Trumpieboy, to the horror of the NWO types.

which is why I wrote comments on Youtube, on several videos where a FilAm with an American accent was interviewed as an expert on Philippine politics and who (along with others from think tanks) couldn't figure out why Marcos won: I pointed out that maybe they needed to talk to the working class and poor here instead of just the pro American elites living inside the Washington beltway who parrot the talking points of the left such as the US Democratic party/CIA.

Well, the Manila Bulletin actually notes that Marcos won because he had the support of the poor. And like a good news paper, actually talked to a few of them in the Manila area.



Reminds me of when James Carville told Bill Clinton: it's the economy, stupid.

Sigh. Yes the big question is if he will keep his promises, and build up the Phillipine economy (like his father) or revert to stealing everthing in sight and arresting or killing his opponants (like his father).


I should note the MB is the newspaper of the business community. During the time of GMA, they usually had a photo and stories lauding her achievements several times a week... and GMA backed Marcos. 

Of course, she was suspected of corruption and President Ninoy Aquino tried to prosecute her, but she got a pass by Duterte.
 
Yet she did build a road to Pampanga, established an alternative international airport at the old Clark AFB, and put a lot of development funds in her local area (which, like here, was a bastion of communism and insurgency many years ago. Short historical note: this rebellion was quashed by letting the communist rebels essentially take over many areas, and then they become corrupt a la Animal farm... so the government then sent in honest military to defend the rights of the common folk against the corrupt, and got popular support...this anti insurgency tactic is still studied by the US military:  LINK LINK2

So who do you trust? A nice person who is incompetent and lets corruption go on all around him or her (like our beloved Tita Cory?), or a semi corrupt person who is able to attract jobs and economic development (like GMA)? 

Hmmm....things are more complicated than the partisans of either side would admit.

Thursday, May 12, 2022

Who will silence that inconvenient bishop?

China has arrested human rights activist, Cardinal Zen of Hong Kong.
 


Catholic bishops: Pissing off tyranical Emperors who kill civilians since at least 390AD...
St. Ambrose call your office: the tyrants are at it again.
--------------

update: After international pressure, Cardinal Zen was released. LINK

Musical interlude of the day

Wednesday, May 11, 2022

Amazon's Tolkien series: Maybe it will be good?

I've seen a lot of snide stuff on the internet worrying that Amazon will make their Tolkien backstory "woke" and R rated.

So Amazon reached out to the experts in the Tolkien community to counter this.

TheOneRingNet report here:

Several Ph.Ds, published authors, Tolkientubers and TikTokers have shared their first impressions of completed footage from Prime Video’s massive new Lord of the Rings TV series – The Rings of Power. 

read their entire report for more details and links and tweets and videos from many of the best known leaders of the Tolkien fan community. 

and most of the reviews seem to be positive.

and even the Tolkien professor enjoyed it: and  at the meeting learned how to use tictok.


Heh. I feel sympathetic: I don't do tiktok either, nor have I done group meetings like my relatives do all the time for business or school classes.

here is another postive report from a newer podcaster nerdoftherings:


I'm not sure I will be able to watch this, since although we have netflix, we haven't signed up for Amazon prime yet... 

and of course because the copyright law here in the Philippines is weak, many streaming services won't let us see their stuff (I canceled a K drama streaming service because they wouldn't let me watch my favorite K Dramas.... luckily I can download them with lots of ads and occassional virus infections from a Chinese site instead, or by using VPN for the youtube ones that won't let us watch them here).

But anyway, it does sound like maybe Amazon didn't completely ruin it. 

the Tolkien professor's video is called other minds and hands because Tolkien once envisioned that his mythology would be added to by other minds and hands. 

So although the crusty professor might dislike the Jackson treatment, and hate LOTR online games, in theory he would probably be sympathetic to these additions to his mythology.