Medical Fact of the Day

Memorize this word: Recto-vesical fistula.

Hopefully it won't be a word you become personally familiar with. Without getting too graphic, a recto-vesical fistula is a fistulous tract between a patient's bladder and rectum that can occur due to carcinomas, Crohn's Disease, irradiation, or trauma to the affected area.

Once again, a recto-vesical fistula is a fistulous tract between the rectum and the bladder.

There are many more details to this condition, but I think it's best that I leave it to those interested to do their own research. I would post a picture, but it's kind of nasty. Use your imagination.
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Medical Fact of the Day

Do dwarfs, midgets, and giants play baseball? Well, kind of, but not really...

Growth Hormone (GH) is responsible for long bone growth development in pre-pubescent humans, while also stimulating an increase in organ growth and muscle size. Without GH, our bodies would be about the same size as your average pygmy, who is incapable of GH production much like the family below.


But what if your body makes too much GH, or like certain baseball players, what if you happen to rub on some "cream" that may or may not have GH in it?

Gigantism results from too much GH production during childhood and the early teenage years. The result is long bones, extreme height, with large hands and feet like this guy.

While not necessarily fatal, gigantism causes lots of problems with the heart and other organs, so treatment during childhood is usually suggested.

So, if gigantism is the result of too much GH during childhood, what happens if you have too much GH as an adult? Well, something like this happens.

Since long bones (like the femur) in adults have stopped growing, GH primarily effects soft organs, the extremities such as the hands and feet, and cartilage tissue like the ear and nose. Here's an image of the overgrown feet of a man with too much adulthood GH.

The skull is also effected, and usually undergoes abnormal growth and expansion, deforming the individual and causing a myriad of problems including headaches, breathing problems due to an enlarged tongue, arthiritis, heart failure, and diabetes. The condition is called Acromegaly ("acro-" meaning extremities, and "megalos" meaning large) and can ultimately lead to death.

So, do you know any baseball players that suffered from a lack of GH? How about too much GH? Eddie Gaedal, known as the shortest man to ever play major league baseball, stood 3 feet 7 inches tall when he was allowed one plate appearance as part of a publicity stunt during a double header in 1951. Gaedal was an bona fide dwarf, who lacked proper GH secretion.

How about those giants in baseball? Well, there haven't been any recorded cases of true giants playing in the majors, but we've been led to believe that several self-induced acromegaly sufferers have taken the field in the past decade, including this Giant.

I think we can all agree that Barry Bonds has experienced some extreme growth since his days with the Pirates, but is he a real sufferer of acromegaly? In a book titled "Game of Shadows" written by Mark Fainaru-Wada and Lance Williams, it was reported that Bonds not only has a larger head than he did during his 20's, but he also has larger feet. The book states that Bonds' hat size increased from a 7 1/4 to a 7 1/2, while his shoe size went from a 10 1/2 to a 13. Let's take a closer look and see if Bonds displays any of the common symptoms of high GH levels in adulthood.

From these pictures it's not easy to make a clear diagnosis, but if the allegations of increased skull and feet size are true, then the evidence suggests that Bonds probably used either GH or something that mimicked it's effects. The increased size of Bond's feet alone is a significant indication of elevated GH levels, while the current shape of his head looks a bit deformed and has a slight broad appearance around his cheeks and forehead similar to the deformation experienced by the man with acromegaly pictured below Bonds'. It's not my job to say whether Bonds did in fact use GH, but my gut feeling says that he did.

So, dwarfs in fact did play baseball, but giants have not. We've perhaps seen some players with self-induced acromegaly in the past decade or so, and that's close to a giant I guess. Either way, GH plays an important part in all our lives, whether we play baseball or not. ...Read more

Medical Fact of the Day

Have you ever spent hours trying to go to sleep? How about days? Months?...
Fatal Familial Insomnia (FFI) is a rare genetically inherited disease that afflicts just 28 families worldwide, but is passed on to 50% of all offspring. FFI was first discovered in 1974 when an Italian physician learned of 2 women in the same family who had apparently died of insomnia. In 1984, another member of the family began to show similar symptoms. Doctors documented his fatal decline and flew his brain to the U.S. for further studies after his death.

Research has shown that a certain genetic mutation causes a build up of a plaque like substance in the hypothalamus, the part of the brain that regulates sleep. Between the ages of 30 and 60 years old, patients begin to exhibit insomnia-like sleep patterns, developing panic attacks and phobias over a period of 4 months. During the next 5 months, patients begin to hallucinate, followed by a 3 month period during which the patient is unable to sleep at all. At this point, the patient will suffer from extreme weight loss, and will soon suffer from complete dementia before going into a zombie-like state, exhibiting no response to the outside world. Ultimately, the patient dies due to a lack of sleep.

There is no present cure for FFI, and sleeping pills seem to only increase the rate at which the disease attacks the host. Gene therapy appears to be the only viable option, although it has been unsuccessful to date.

So, if you have problems going to sleep at night, just remember that it could be a lot worse.
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Medical Fact of the Day Part II

For those who would like to see what a fetus in fetu looks like...

Here's a photo of the man in India that had a partially developed fetus removed from his abdomen as well as the ABC News Fetus in Fetu Story.

This isn't the same fetus that was removed from the guy above, but it was the fetus involved in a similar case.Finally, an MRI showing a partially developed fetus inside a new born male. You can read the case report that was published in Radiology, a peer-reviewed medical journal.

Weird, but true.

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Medical Fact of the Day

We've all heard of triplets, quintuplets, sextuplets, and so on. But have you ever heard of a twin inside it's twin?

Fetus in fetu is a rarely occurring condition that results when a fetus surrounds and encapsulates it's twin during development in the uterus. Sometimes the encapsulated twin is absorbed, but on rare occassions it can continue to live and grow inside the larger fetus, sometimes for decades. A 36 year old man in India was rushed to a hospital after his abdomen became so swollen that he looked like he was 9 months pregnant. Doctors suspected a tumor, but were surprised to find a partially formed human inside the man's stomach, including hair, genitalia, arms, legs, and a variety of bones.

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Medical Fact of the Day

Do you have extra stretchy skin? How about joints that dislocate easily?
Ehlers-Danlos Syndrome (EDS) is a condition that effects about 1 in 5,000 people that results from a defect in collagen production, the molecule that helps give skin and other body structures their strength and ability to adhere to other parts of the body. Collagen is one of the most abundant compounds in our bodies, making up 25% of our total protein content, and without it our body literally cannot hold itself together. Patients who suffer from EDS may experience a wide range of symptoms, and each patient may suffer a different level of symptom severity.

At it's most extreme, EDS can result in faulty blood vessel development and premature death due to severe internal bleeding (usually a rare development). There are no known cures for EDS, however patients are generally advised to avoid activities that may put excess pressure on joints, skin, and other connective tissues.
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Medical Fact of the Day

As a current dental student, I split my time between baseball and all things medical and dental. In an effort to widen the scope of my blog, I will be posting a daily medical or dental fact that I have recently learned or researched in greater detail. This semester, I am taking neuroscience, physiology, a dentures course, pharmacology, dental occlusion, anesthesiology, and periodontology. Facts may or may not be related to any one of these topics.

Temporal Mandibular Joint (or TMJ) disorders can include a wide variety of conditions and symptoms. Pain, clicking, headaches, vertigo, and poor muscle function are just a few of the complaints made by patients suffering from a TMJ disorder, which can be the result of poor alignment of teeth, trauma to the jaw, bruxing (or teeth grinding), or even hereditary issues. If you suspect that you or a loved one is suffering from a TMJ related condition, see your local dentist or head and neck specialist. ...Read more