Medical Anthropology

From YoKim

Contents 1 January 25, 2005 2 February 2 2.1 Pertussis 2.2 Thailand's response to the tsunami 3 Feb 24 4 rita's explanation of homozygots and heterozygots 4.1 structure 5 feb 17 6 feb 15 7 January 27

[edit] January 25, 2005

case HIVNET012 NIH trials on drugs in Ugandan women pregnant with HIV to reduce transmission from mother to child 2/3 see transmission rate reduction, but it decreases responsiveness to retroviral drugs on mothers

• -> [so mothers pick between saving their child or cutting off their chances of receiving effective treatment]

not fully informed consent. also, who makes the decisions?

older americans tend to take more drugs.

• -> expensive -> go to Canada, where the helath plan is better.

busing over the border just to get the medication was a big business in states like minnesota. was picked up by pharmaceutical companies in canada and boomed through internet business.

• Bush has an interest in defending national pharmaceutical industry's interests
• at the same time, Canadian govt has an interest in continued export of beef (major industry). initial cases of BSE

iraq war flu vaccines from germany, france. Canada has a regiment change.

• as soon as both govts agree to allow import of canadian beef and not to mark the country of origin of beef, Canadian prime minister (?) declares it is dangerous for canadian pharmaceutists to give drugs prescribed by american doctors

governor of MN is begging Canada to reconsider the policy

Bill & Melina Gates

• they donate large amounts to be used in pharmaceuticals to be sent to Africa, but
• the Gates personally have large investments in u.s. pharmaceutical companies.

[learned yesterday] any "aid" needs to spend as much of the national economy as possible. thus, it is american pharmaceutical products being sent along with american doctors, volunteers, etc (that's where 77% of the money goes).

• thus the Gates are at the same time incurring in an investment in an industry in which they already have large stocks.

[edit] February 2

• I may move this over to a wiki format soon - thus i'm using wiki format for the moment to make transition smooth.
• problem #1: i keep on falling asleep in this class. I don't get a lot of technical terms. I really need to revamp Culhane-Pera and Townsend. But this is the only class that fits the my schedule well. hmm.
• problem #2: there isn't a "last minute rush" time before this slot as there is another class right before it.

[edit] Pertussis

I reported on the Pertussis case in WV that happened in december and observed that there seems to be unequal distribution of resources across hospitals regionally. In the comparative study of PA, KY and OR, KY fell back in terms of responsiveness. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5403a4.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5403a3.htm

Terms:

• nosocomial: infected through HCW (health care workers)
• iatrogenic: could bring secondary diseases, or the secondary diseases become the primary concern of the original disease. (i think first AIDS)

Other stuff

• treatment of nosocomial infectious diseases: treat everyone who had contact.
• herd immunity: requires an infectious disease team (why did I write this?)
• petussis is not vaccinated well in 3rd world countries

[edit] Thailand's response to the tsunami

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5403a1.htm

• a series of factors that increase infectious disease probability emerge immediately: clean water, sanitary disposal of humanb wastes, etc, that may bring about cholera, typhol, diphteria, poleo, etc
• there was an emergency team organized to deal with the tsunami. among those was the massage team, which also provided massage (it sounds like it was primarily) to the HCW themselves. mental and physical health of the HCW is somehting that needs to be considered, I think, even if it might sound self-centered and/or unethical/thick-faced (?) to some standards - you don't want these people to die or to stop functioning as HCW, they need to be able to function long-term to aid as many people as possible.
• the Tsunami was on Dec 26, and on Dec 30th the Thai govt switched from a passive to an active surveillance mode, which means that teams started looking for clusters of disease. (is this what the TB extermination team did in that country between the two Indian wings? what was that country?)

Someone mentioned an evolutionary approach to Syphillis (what's the source?) Patten mentions that there is an increasing instance of correlation between Syphillis and HIV.

Tay Sachs disease.

• neurodegenerative
• starts early in infancy
• infant starts by not presenting basic functions, to eventually lose critical functions and to die.
• most affected as eastern european jewish people, in particular if they are homozygos to Tay Sachs

=> FIND OUT what homozygos and heterozygos is, I missed this part.

Polgrams occur in ghettos, missed that.

(I think this is where I started falling asleep?)

Hepatitis B

• traditional medical wisdom assumed it was inherited, therefore no rpevention methods were sought, just curative methods.
• high prevalence in asian communities
• a recent wave of southeast asian immigrants brought new alarm to the issue.

Dickie (sp?) who was a medical anthropologist decided to exmine it.

• found out that it was transmittable.
• first vaccines were blood based, no one wanted to try it for fear of HIV.
• non-blood products were developed, vaccinations spread off starting with HCW.
• Hepatitis B can be sexually transmitted.
• adolescents who were just beginning to become sexually active were vaccinated prioritatively.

A remark about how HEpatitis C works with insurance companies in the U.S.

• doctors would advice against testing for Hepa C since there isn't much you can about it, and insurers won't cover it next time (I didn't get this)

Hepatitis evolves according to patient conditions.

Current trends (general): some med anths are trying to reconstruct paths of disease distribution, in particular those that have always been with us.

• easiest ones are those that implicate bone deformations
• TB, leprosy, sleeping streets or triponosomysis are ancient
• mummified materials keeps bodily fluids (I don't think I wrote that down right. but mummies keep SOMETHING)
• there are light-hearted political arguing back and forth as for where the diseases got started. (future referrence: the politics of blame and HIV in haiti, a book Patten used for a med anth class the previous year, with Grace? because she was using it.)
• another path of study, that is challenged methodologically (for its obvious naive evolutionary assumptions) is the hypothesis that isolated "primitive" foraging, hunting groups maintain old diseases given their isolations.

diseases on different groups: nomad/foraging survival beyond reproduction

TB: schistomeies in a snail a portion of their styles try to save some portion outside humans passages that live long term / commensal relations w/us were successful festro int anthrax => evolutionary success

macro evolutionary: measles spreads quickly => no persistence, evolution of humans & infections disease, diverrsity/sedentarism

malnutrition large/dense use conquest & exploitation

[edit] Feb 24

something is gonna happen next thursday, i missed that

Ebola is an re/emerging infectious disease

institutional statistical approach does not consider quality of life third transition of agriculture

DDT to treat malaria anti-microbial resistance

ebola pre- symptoms: "ecky" muscles, during symptoms: internal external bleeding 80% mortality,

1976 discovered virus in Zaire no treatment (no known antibiotic) no known host (a rainforest animal is assumed to be host) highly transmissible - any bodily fluid, just touching the skin, etc

affects other primates (ex: gorillas in congo) infected while working w/carcass of chimpanzees four (five?) kinds of ebola, based on the country in which it was found: zaire (1976), Sudan, Ivory Coast, and Reston VA

Zaire, Isangeni, Yambuku mission hospital, catholic nuns from Belgium a man with first hemorragic symptoms no disposable syringe -> infection to other patients

Late 1994-95 no education sysem in zaire independence from belgium lumumba with socialist leanings, aligns to soviet union CIA organizes the killing of lumumba (all of this in public archives now), puts Joseph Mobutu, a low-ranking officer

[edit] rita's explanation of homozygots and heterozygots

(feb 22)

you receive 1 DNA from each (Q: is this the DNA? I thought it was the gene?)

B = curly hair (dominant) b= not curly hair (recessive)

two of the same= homozygot one of each = heterozygot

B B = homozygot (dominant) B b = heterozygot b b = homozygot (recessive)

structure

nucleotides -> DNA -> genes -> chromosomes -> traits (?)

nucleotides = G, C, T, A = the "sticks" the spiral = DNA /RNA genes = ? chromosomes = the little spots within the cells

[edit] feb 17

film screening: pest, black death washed in vinager /663 plague/anthrax = similar symptoms

stephen J. O'brien, geneticist from the u.s. investigating pest resistance

CC5 mutates into ∆32

Margaret drank beacon of fat and recovered Stace

[edit] feb 15

class notes. medical anthro feb 15, 2005

gay men in NY. anti-retro-viral resistant HIv that spreads quickly to AIDS

is meth a amphetamine aplifier? meth - all 3 uses

infectios disease -> tracing is basic procedure

chicken pox (chunyundoo) shingles -> resurface of chicken pox stress as a source

mecca Yemen immigrant polio -> symptoms stress -> decreased of white cell count Haji -> polio vaccines -> elderly and infants-. school children Calif -> one person flu

Yanamano, mi/me afte 1987 Gold was discoursed on Brasilian soil loggers film: contact 35->72 where do gold miners come from? Bella vista Shamans white miners. sorcery w/fire, coughhog bi (<nes) malaria movement of gold, jungle national treasure "cultural" explanations of high mortality (but they come with infection) make manipulation to Reservation Mission stations / hospitals -> amplifiers napoleon chagnon: workerd James Neel. ("the forest people") Measlers -> accusation of knowingly spreading disease for coacine to be effective -> hard immunity partly not true Chagnon / Neels, no proper informant consent procedure. patients were led to believe they would receive medical treatment 1968 : medical treatment provided, but shortly interrupted. Doddy Coppenchawa argues no full disclosure was provided

[edit] January 27

class notes. january 27, 2005 med anthro

ground beef from u.s. military installations

nPEP: nonoccupational post-exposure prophilaxis

• occupational here stands for health industries

treatment for early HIV exposure fertilized ladder -> def of pregnancy 72 hours -> Primary studies Macaque, it shows in the blood.

FDA Over-theCounter committee (OTC) reproductive health

behind the counter:

1. pharmacist doesn’t open 24 hours.
2. pharmacists are not always there
3. pharmacists may personaly refuse to provide nPEP, what then?

If you can’t prove it, then it’s a clinical call. (re: nPEP, I think)

HIV/AIDS

• company is allowing countries to get them at lower prices
• generic drugs
• Bush has promised $15 billion over the next 5 years.
• (drugs initially not allowed in the us)

FDA fast track -> Senate

Carol Betemy (UNICEF) a bush appointee, argues that children shuld have right to go to school. Ahn Benany, Bush’s former secretary of agriculture. now focuses on child survival

Bird flu, ABA flu infectious agents: bacteria, prions, parasites, single-cell parasites, (e.g. hellminth < - round worms)

infectious diseases -> technological advance some language

ICD - 9 -10 human being with infection specific genetic material, specific test kickroom

malaria human biology & human c example? zoonose

microrelationships