Stem Cells, Sex Offenders & Synaesthesia

So many things I could write about this week, it's hard to know where to start really.

Stem Cell Spare Parts - following the story of the woman who had the first stem cell trachea transplant. What is the future of stem cell transplantation? Student BMJ.

In June 2008, a patient became the first recipient of a trachea grown from bone marrow stem cells and chondrocytes. There is still a great deal of ethical considerations and legislation surrounding stem cell transplantation but in this case the treatment was able to save the patient's life. Looking ahead to the future, the author stated that it was unlikely that it would be possible to grow full organs from stem cells because there are too many different cell types (13 in the kidney) whereas in the trachea there are only two. However it may be possible in the near future to develop parts of 'hollow' organs from stem cells, such as the colon, blood vessels and nerves.

Should sex offenders be castrated?

An article appeared in the BMJ this week on this highly controversial topic, written by a professor of criminal psychology and a professor in forensic psychiatry. In Poland in November 2009 following a series of sex offences , the Polish President signed a law allowing the chemical castration of some sex offenders using antiandrogenic drugs. The drugs reportedly offer a dramatic clinical effect with offenders reporting no longer being preoccupied by sexual thoughts and having a markedly decreased sexual drive. Overall I think the general message is that this could only be ethically applied if patients were to consent to having the treatment. Whether or not this has a role in 'forced' castration against the patient's will, I don't think so

Synaesthesia

This is a harmless neurological condition where senser are exaggerated and stimulation of one sense results in a number of abnormal perceptual experiences, such as Tuesdays are green and music is not only seen but tasted. There are a number of different types of synaesthesia described by different people eg spatial-sequence synaesthesia where a person experiences seqwuences of numbers in a 3D form eg Monday is infront of them to the right etc... Perceptions are usually besic eg a colour as opposed to "when I hear that music I see a flowery vase on the table". Synaesthesia was first described in Nature 126 years ago however it is only recently that a diagnostic test for the condition has been created. The abnormal perceptions are thought to originate from 'crosstalk' between areas of the brain which are not normally involved with one another. There is a high prevalence of synaesthesia in the general population although it's important that people with the condition are not labelled and stigmatised. It is apparently harmless but important to know about to save the patient being made concerned for no reason.

WHO Surgical Safety Checklist to be started as of 01/02/2010

In England and Wales as of this date, for every surgical procedure carried out, it will be mandatory to complete this surgical checklist. See the checklist here:

http://www.who.int/patientsafety/safesurgery/ss_checklist/en/index.html

Depression in Adults with a Chronic Health Problem

NICE have created a new set of guidelines in October 2009 on the management of these patients:

Depression is approximately 3 times more common in patients with long term chronic health conditions, with around 30% of patients affected. Severity of depression is determined by the number and severity of symptoms, and the degree of functional impairment. Presence of a physical illness can complicate the assessment of depression. The key goal of intervention in depression should be to achieve complete remission of symptoms.