Heme Review

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Health & Fitness
**Heme Review**

The official podcast of Chubbyemu. Heme Review is a podcast about case reports in medicine. Each episode will tell a patient’s story, while teaching about the pathogenesis of disease, the treatment modalities and the dilemmas that arise during their care.

Latest Episodes:

The Student Who Ate 5-Day Old Pasta And His Liver Shut Down Apr 18, 2022

Show notes

Video version of this podcast: https://youtu.be/bq1kwlGhPyE

Original Chubbyemu video: https://youtu.be/5ujTYLV2Qo4

Tweet me: https://twitter.com/hemereview

IG me: https://instagram.com/hemereview

Music by Lifeformed

References:

Fulminant Liver Failure in Association with the Emetic Toxin of Bacillus cereus. https://www.nejm.org/doi/full/10.1056/NEJM199704173361604

Sudden Death of a Young Adult Associated with Bacillus cereus Food Poisoning. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232990/

Acute Liver Failure after Ingestion of Fried Rice Balls: A Case Series of Bacillus cereus Food Poisonings. https://doi.org/10.3390/toxins14010012

Fatal Family Outbreak of Bacillus cereus-Associated Food Poisoning. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1233987/

Bacillus cereus and its food poisoning toxins. https://pubmed.ncbi.nlm.nih.gov/9435100/

Liver Zonation – Revisiting Old Questions With New Technologies. https://www.frontiersin.org/articles/10.3389/fphys.2021.732929/full

Bacillus cereus food poisoning. https://www.nejm.org/doi/full/10.1056/NEJM197801192980306

Tox and Hound: D and Toxin-Induced Hepatic Microvesicular Steatosis https://toxandhound.com/toxhound/ff-microvesicular-steatosis/

ENCEPHALOPATHY AND FATTY DEGENERATION OF THE VISCERA. A DISEASE ENTITY IN CHILDHOOD. https://pubmed.ncbi.nlm.nih.gov/14055046/

Whatever happened to Reye’s syndrome? Did it ever really exist? https://pubmed.ncbi.nlm.nih.gov/10470768/

Regulation of the structure and activity of pyruvate carboxylase by acetyl CoA. https://pubmed.ncbi.nlm.nih.gov/22120519/

Prevalence of Alcoholic Fatty Liver Disease Among Adults in the United States, 2001-2016. https://pubmed.ncbi.nlm.nih.gov/31063562/

Goldfrank's Toxicologic Emergencies 11th ed.

Interview With A Rare Renal Medullary Carcinoma Survivor Aug 21, 2021

Show notes

Chubbyemu video: https://youtu.be/3E75UvmY9GA

Heme Review video on Renal Medullary Carcinoma: https://youtu.be/j7WGP6sJBLk

Herman Connor

Contact Cora Connor (Herman's sister): https://www.twitter.com/RMCAwareness

Cora Facebook: https://www.facebook.com/RMCSupport

IG me: https://www.instagram.com/hemereview

Tweet me: https://www.twitter.com/hemereview

Renal Medullary Carcinoma: A Kidney Cancer Associated with Sickle Cell Trait and Disease Aug 18, 2021

Show notes

Video version of this podcast: https://youtu.be/j7WGP6sJBLk

Chubbyemu video A Man Felt Pain In His Back. This Is What Happened To His Kidney. https://youtu.be/3E75UvmY9GA

References:

Renal medullary carcinoma. The seventh sickle cell nephropathy. Am J Surg Pathol. 1995 Jan;19(1):1-11. https://pubmed.ncbi.nlm.nih.gov/7528470/

A Model Linking Sickle Cell Hemoglobinopathies and SMARCB1 Loss in Renal Medullary Carcinoma. Clin Cancer Res. 2018 May 1;24(9):2044-2049. https://pubmed.ncbi.nlm.nih.gov/29440190/

Updated Recommendations on the Diagnosis, Management, and Clinical Trial Eligibility Criteria for Patients With Renal Medullary Carcinoma. Clin Genitourin Cancer. 2019 Feb;17(1):1-6. https://pubmed.ncbi.nlm.nih.gov/30287223/

Five decades of urologic pathology: the accelerating expansion of knowledge in renal cell neoplasia. Hum Pathol. 2020 Jan;95:24-45. https://pubmed.ncbi.nlm.nih.gov/31655169/

GG Malouf, NM Tannir, P Rao, P Msaouel. Renal Medullary Carcinoma in Rare Kidney Tumors.

Comprehensive Molecular Characterization Identifies Distinct Genomic and Immune Hallmarks of Renal Medullary Carcinoma. Cancer Cell. 2020 May 11;37(5):720-734.e13. https://pubmed.ncbi.nlm.nih.gov/32359397/

The DNA sequence of human chromosome 22. Nature. 1999 Dec 2;402(6761):489-95. https://pubmed.ncbi.nlm.nih.gov/10591208/

High-intensity exercise is a risk factor for renal medullary carcinoma in individuals with sickle cell trait. Preprint.

Atypical carcinoma of kidney originating from collecting duct epithelium. Urology. 1982 Jan;19(1):89-92. https://pubmed.ncbi.nlm.nih.gov/7058597/

Genes affecting the regulation of SUC2 gene expression by glucose repression in Saccharomyces cerevisiae. Genetics. 1984 Dec;108(4):845-58. https://pubmed.ncbi.nlm.nih.gov/6392017/

Purification and biochemical heterogeneity of the mammalian SWI-SNF complex. EMBO J. 1996 Oct 1; 15(19): 5370–5382. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC452280/

On Breast Malignancy and Military Burn Pit Exposure Jun 21, 2021

Show notes

Video version of this podcast: https://youtu.be/B8LLf7DkR5U

Chubbyemu video of KT: https://youtu.be/LKNfFm0QDXQ

Dr Bora Lim can be reached at https://www.twitter.com/naborala

Burn pits are a waste management tool for armed forces overseas. However, the nature of waste today is different than half a century ago. The smoke, fumes, and particulate matter that have been observed emanating from these pits contain a heterogeneous variety of materials. Exact exposure levels are not known in veterans, however many of these materials are known to be linked to long term health effects and some have been classified and recognized as carcinogens via retrospective analysis in humans and laboratory experiments. The particulate matter produced from these burn pits can also deposit into the earth and during weather events such as dust storms, can circulate the particles to local inhabitants, potentially causing health effects for them, years later. Recognizing these long term health effects will enable people to not make these mistakes again, and to help those who have been exposed.

References:

VA Burn Pit Registry: https://veteran.mobilehealth.va.gov/AHBurnPitRegistry

Source Apportionment of Airborne Dioxins, Furans and Polycyclic Aromatic Hydrocarbons at A U.S. Forward Operating Air Base During Iraq https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978146/

Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan https://www.nap.edu/catalog/13209/long-term-health-consequences-of-exposure-to-burn-pits-in-iraq-and-afghanistan

Polychlorinated Dibenzo-para-Dioxins and Polychlorinated Dibenzofurans. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans Volume 69. https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Polychlorinated-Dibenzo--Em-Para-Em--Dioxins-And-Polychlorinated-Dibenzofurans-1997

Dioxin Revisited: Developments Since the 1997 IARC Classification of Dioxin as a Human Carcinogen https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1247514

Serum dioxin concentrations and breast ca risk in the Seveso Women's Health Study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1240906/

Detection of hyperdiploidy and chromosome breakage in interphase human lymphocytes following exposure to the benzene metabolite hydroquinone using multicolor fluorescence in situ hybridization with DNA probes. https://pubmed.ncbi.nlm.nih.gov/7517507/

A Discussion On Over-The-Counter Cough Syrup Misuse May 24, 2021

Show notes

Video version of this podcast: https://youtu.be/oP_mJmWrfTQ

Chubbyemu video of this case: https://www.youtube.com/watch?v=WPxb2IG9MOk

Featuring: Dr Sonal Jagasia, MD, MPH. Psychiatrist in private practice.

Tweet me: https://www.twitter.com/hemereview

IG me: https://www.instagram.com/hemereview

FB me: https://www.facebook.com/hemereview

Dextromethorphan is an over the counter cough medicine. It is for coughs. Misuse of it can cause life threatening side effects.

References:

Dextromethorphan, chlorphenamine and serotonin toxicity: case report and systematic literature review. https://pubmed.ncbi.nlm.nih.gov/21175434/

Case of Serotonin Syndrome Initially Presenting as Diffuse Body Pain. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196581/

Serotonin Syndrome. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865832

Bromism: An overlooked and elusive toxidrome from chronic dextromethorphan misuse. https://pubmed.ncbi.nlm.nih.gov/31864868/

Dextromethorphan-induced serotonin syndrome. https://pubmed.ncbi.nlm.nih.gov/19238739/

Cognitive Deterioration from Long-Term Misuse of Dextromethorphan:A Case Report. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1188627/

Pediatric Fatalities Associated With Over the Counter (Nonprescription) Cough and Cold Medications. https://pubmed.ncbi.nlm.nih.gov/19101060/

"DXM": a new drug of. https://pubmed.ncbi.nlm.nih.gov/9624331/

Hepatitis From Possibly Contaminated Alkaline Water Apr 12, 2021

Show notes

This episode is up to date as of 11 April 2021

Statement from water company CEO: https://www.youtube.com/watch?v=faCsru9Ctgk

Inside Edition video about this case: https://www.youtube.com/watch?v=lmEpmyc7g9Y

Local News talking about the water: https://www.youtube.com/watch?v=oGQJcnlk5ag

On March 13, the FDA was alerted to five cases of acute non-viral hepatitis (resulting in acute liver failure) in infants and children that occurred in November 2020 with an unknown cause reported to the Southern Nevada Health District. All five patients had been hospitalized but have since recovered. All patients were reported to have consumed “Real Water” brand alkaline water. These patients came from four different households. Five additional people, two adults and three children, from two of the four households were reported to have experienced other symptoms as well. Less severe symptoms included fever, vomiting, nausea, loss of appetite, and fatigue.

A Grandma Collapsed From Abdominal Pain. This Is What Happened To Her Colon. Apr 05, 2021

Show notes

Chubbyemu video: https://www.youtube.com/watch?v=1MggKIfEld4

Heme Review video: https://www.youtube.com/watch?v=mPHXldh4_H4

Tweet me: https://www.twitter.com/hemereview

IG me: https://www.instagram.com/hemereview

FB me: https://www.facebook.com/hemereview

Chubbyemu YouTube channel: https://www.youtube.com/channel/UCKOvOaJv4GK-oDqx-sj7VVg

Heme Review YouTube channel: https://www.youtube.com/channel/UCNSoNc9s67nfOGlCXSu5VsA

References:

Potential Benefits of Dietary Fibre Intervention in Inflammatory Bowel Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926452/

Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia https://academic.oup.com/ajcn/article/70/4/466/4729069

Anaphylaxis following psyllium ingestion https://pubmed.ncbi.nlm.nih.gov/6736485/

Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia https://academic.oup.com/ajcn/article/71/6/1433/4729388

Potential Benefits of Dietary Fibre Intervention in Inflammatory Bowel Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926452/

Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia https://academic.oup.com/ajcn/article/70/4/466/4729069

Anaphylaxis following psyllium ingestion https://pubmed.ncbi.nlm.nih.gov/6736485/

Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia https://academic.oup.com/ajcn/article/71/6/1433/4729388

Small Bowel Obstruction Secondary to a Metamucil Bezoar: Case Report and Review of the Literature https://pubmed.ncbi.nlm.nih.gov/29085697/

The role of dietary fibre in the human colon https://pubmed.ncbi.nlm.nih.gov/6257366/

Intestinal obstruction caused by a laxative (Psyllium): A case report and review of the literature https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6197948/

Interview With A Stage 4 Lung Cancer Survivor (Jill Hamer-Wilson) Mar 30, 2021

Show notes

Video version of this interview: https://youtu.be/oLe9UdL-qIk

Jill's Blog: https://throughthevalley.ca

White Ribbon Project: https://twitter.com/TheWRP4LC

LUNGevity Foundation: https://lungevity.org

GO2 Foundation: https://go2foundation.org

Lung Cancer Canada: https://www.lungcancercanada.ca

Lung Foundation Australia: https://lungfoundation.com.au

Lung Cancer Europe (LUCe): https://www.lungcancereurope.eu

Tweet me: https://www.twitter.com/hemereview

IG me: https://www.instagram.com/hemereview

FB me: https://www.facebook.com/hemereview

Some Chubbyemu Videos That I Might Not Be Able To Make Mar 20, 2021

Show notes

Please note the CONTENT WARNING at the beginning-- there's a reason I can't make the videos as described in this episode. They may surface in a different form at some time in the future.

Heme Review YouTube: https://www.youtube.com/channel/UCNSoNc9s67nfOGlCXSu5VsA

Tweet me: https://www.twitter.com/hemereview

IG me: https://www.instagram.com/hemereview

FB me: https://www.facebook.com/hemereview

Interview With A Rare Dinitrophenol Accident Survivor (DNP For Weight Loss) Mar 03, 2021

Show notes

Video of this interview: https://youtu.be/o15HCjtSkug

Chubbyemu video https://youtu.be/ChPeG19qKUo

Christopher's recount of his case: https://youtu.be/7BpymtR2vpA

Tweet me: https://www.twitter.com/hemereview

IG me: https://www.instagram.com/hemereview

FB me: https://www.facebook.com/hemereview

2,4-Dinitrophenol (DNP) is a chemical that is not approved for weight loss. It is a classic case of efficacy, but without safety in the setting of weight loss. This setting of weight loss can be prone to chemical misuse, further exacerbating understanding in human systems. Christopher is one of 2 - 3 cases documented in literature to have survived an accident with DNP for weight loss. As of 2021, one organization has permission from the US FDA to investigate DNP in some neurodegenerative disorders. These are rare diseases with limited standards of care, therefore extenuating circumstances to find anything that could potentially improve patient outcomes.

References:

Role of dantrolene in dinitrophenol (DNP) : A continuing question? Am J Emerg Med. 2019 Jun;37(6):1216.e1-1216.e2. https://pubmed.ncbi.nlm.nih.gov/30948257/

2,4-dinitrophenol (DNP): a weight loss agent with significant acute toxicity . J Med Toxicol. 2011 Sep;7(3):205-12. https://pubmed.ncbi.nlm.nih.gov/21739343/

Ambient temperature and mortality from unintentional . JAMA. 1998 Jun 10;279(22):1795-800. https://pubmed.ncbi.nlm.nih.gov/9628710/

Beware the yellow slimming pill: fatal 2,4-dinitrophenol. BMJ Case Rep. 2016 Apr 4;2016. https://pubmed.ncbi.nlm.nih.gov/27045052/

Dantrolene is not the answer to 2,4-dinitrophenol poisoning: more heated debate. BMJ Case Rep. 2018 Dec 19;11(1):e225323. https://pubmed.ncbi.nlm.nih.gov/30573533/

The effect of 2,4-dinitrophenol on adipose-tissue metabolism. Biochem J. 1969 Feb;111(4):431-44. https://pubmed.ncbi.nlm.nih.gov/4388239/

The mechanism of uncoupling of oxidative phosphorylation by 2,4-dinitrophenol. J Biol Chem. 1967 Oct 25;242(20):4577-83. https://pubmed.ncbi.nlm.nih.gov/4964808/

MECHANISMS OF DINITROPHENOL TOXICITY. Simon E.W. Biological Reviews. Vol 28. (4). Nov 1953.

Identification and Importance of Brown Adipose Tissue in Adult Humans. https://www.nejm.org/doi/full/10.1056/NEJMoa0810780

Mitochondrial uncoupling as a target for drug development for the treatment of obesity. Obes Rev. 2001 Nov;2(4):255-65. https://pubmed.ncbi.nlm.nih.gov/12119996/

LC-MS-MS analysis of 2,4-dinitrophenol and its phase I and II metabolites. J Ana Toxicol. Jan-Feb 2007;31(1):55-61. https://pubmed.ncbi.nlm.nih.gov/17389084/

Uncouplers of oxidative phosphorylation. Environ Health Perspect. 1990 Jul;87:213-8. https://pubmed.ncbi.nlm.nih.gov/2176586/

Texas Woman Charged with Selling Misbranded

https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/press-releases/texas-woman-charged-selling-misbranded-drug

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