Cell Type Sensitivity to Radiation Damage

Radiation therapy is commonly given to oncology patients as an adjunct to surgery and chemotherapy. While the aim of all radiation oncologists is to reduce damage to non-cancerous cells, radiation damage to tissues surround the tumor is unavoidable.

Depending on cell type, each cell has a different sensitivity. In descending order of radiation sensitivity these cells are:

tumor cells
endothelium
fibroblasts
muscle
nerve cells

Doxorubicin and Hyperbaric Oxygen

Doxorubicin and hyperbaric oxygen are considered to be absolutely incompatible and should never be coadministered. One study that used hyperbaric oxygen as a possible antidote for doxorubicin (Adriamycin) extravasation in rats showed a 87% mortality.

Hyperbaric oxygen treatments have been shown to be helpful in healing tissue necrosis from extravasation but should only be administered at least 2-3 days before beginning treatments.

Carbon Monoxide and Cyanide Exposure in Smoke Inhalation

Smoke inhalation is an often lethal injury in house fires and is encountered by trauma surgeons who treat burn patients.

The mortality seen in smoke inhalation patients is sometimes greater than would be expected from the carboxyhemoglobin levels.

This is attributable, in part, to the synergistic effects of the methemoglobin resulting from the cyanide exposure – in addition to the carbon monoxide exposure.

Methemoglobin is not generally cardiovascularly significant at levels of 20 to 40%. However, couple with carboxyhemoglobin, the functional anemia can be life-threatening.

Methemoglobinemia can be treated using hyperbaric oxygen therapy.

How I Would Treat Myself for Ebola at Home

Health officials in Sierra Leone are admitting defeat in the fight against Ebola and are trying to set up self-treat kits for patients to use at home because of the lack of hospital beds to care for the ill.

This sad development started me thinking about what I would do if I was stuck in a place with Ebola and could not receive care from a physician or in a hospital.

***Please note that any one who thinks there might be even a tiny chance that they have Ebola should present immediately to a hospital for definitive care.***

***The information below is not medical advice or recommended treatment on how to treat Ebola and should not be used as such. Treatment for a suspected or known Ebola virus infection MUST be carried out under the care of the appropriate health authorities and by a licensed physician.***

The information listed below is purely an academic exercise for my personal professional growth as a critical care physician and serves solely as a template around which to organize my current reading on the Ebola infection.

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Ebola Patient Ashoka Mukpo To Receive Blood Transfusion

Ebola patient Ashoka Mukpo is to receive a blood transfusion from previous Ebola patient Dr. Kent Brantly the University of Nebraska Medical Center has announced.

In an incredible stroke of luck, Brantly is of the same blood type as Mukpo and was traveling in the Omaha area when contacted about donating blood. Brantly’s serum contains antibodies against the Ebola virus that physicians think might be helpful in fighting Mukpo’s infection.

Mukpo is also receiving supportive care and receiving an experimental antiviral drug from Chimerix.

This is the second blood donation Dr. Brantly has provided. His convalescent serum was given to Ebola patient Dr. Richard Sacra.

Dr. Sacra was discharged from the hospital several weeks ago without suffering the end stage disease such as cardiac, kidney, or liver failure.

Dr. Angela Hewlett of the Biocontainment Unit at the Nebraska Medical Center expressed thanks to Dr. Brantly.

“We are incredibly grateful that Dr. Brantly would take the time to do this, no once, but twice.”

Epidemiologist Calls for Ebola Travel Restrictions

Epidemiologist David Dausey is calling for restrictions to be placed on residents of West Africa ability to travel to the United States.

Dausey, a Yale-trained disease expert, is arguing that the disparity between care levels available in West Africa and the United States will understandably encourage well-to-do Africans who suspect they have contracted Ebola virus disease to lie about their exposure history and travel to the US for world class care that will be paid for by the United States government.

He refutes the argument being promulgated by the Obama Administration that restricting commercial travel will cause a delay in getting supplies and aid to the affected African areas by suggesting the United States military is more than capable logistically to handle the task.

To date only one known case of a traveler who likely surmised that he was infected with subsequent travel to the States has been reported. Thomas Duncan is receiving intensive care and an experimental drug at a Dallas hospital and his family has been moved and lodged at government expense.

Podiatrist Charged with Medicare Fraud

Philadelphia podiatrist Dr. Aileen Gong has been indicted on charges that she fraudulently billed Medicare over $480,000 for procedures that she never performed.

Gong, who practices in the Chinatown section of Philadelphia, was allegedly out of Philadelphia during the times she claimed she performed the procedures.

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