The Scan by 2 Minute Medicine®: Miracle Intestinal Transplant, Bird Flu Fears, On to the Olympics and Shedding Light on Sweeteners: | 2 Minute Medicine

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Miracle Intestinal Transplant:

The Story: After hearing that parts of her intestine had died, Danielle Perea, a Louisiana woman received an extremely rare and unconventional treatment – an intestine transplant

What is Mesenteric Ischemia?

Mesenteric ischemia is a term describing the loss of blood flow to the small intestine. This can result in life-threatening situations, as this loss of blood flow may starve the cells of essential nutrients, and lead to necrosis of the small intestine.

What causes Mesenteric Ischemia?

Mesenteric ischemia can be either acute or chronic, but the causes are often the same. The development of blood clots in the blood vessels supplying the small bowel can prevent adequate blood flow to the small intestine, as in the case of Perea. Perea had sections of her small intestine that were dead, with such severe damage that doctors did not expect her to live. Against all odds, and with the help of the medical team, Perea became one of the 95 patients in the USA to receive an intestine transplant in 2020

What is an intestinal transplant?

In situations where an organ fails, an organ transplant may be attempted. In the case of an intestinal transplant, an area of the small bowel may be replaced by part of the small intestine from a healthy donor, to restore some function to the digestive system.

These transplants are extremely difficult, due to a myriad of factors including the probability of transplant rejection. When an organ is transplanted from one donor to the other, the immune system may recognize this foreign organ as a threat, and attack it, in a process termed ‘rejection’. This is relatively common for intestinal transplants, with 30-50% of people developing rejection within a year, possibly due to the increased number of bacteria that live in the small intestine. Symptoms of transplant rejections include fever, nausea, and diarrhea among others, and these rejections can be life-threatening due to the potential for death of the new organ! To prevent this, a wide array of anti-rejection medications are used, to reduce the immune response to the new organ. Despite Perea’s successful surgery, she takes over 30 medications to prevent rejection and other transplants, though this does not get in the way of her living a happy life 4 years after her initial emergency.

Bird Flu Fears:

In the wake of the COVID-19 Pandemic, a new threat has emerged. Scientists are now expressing concern about the avian flu, H5N1. As the name suggests, avian flu or bird flu is a virus transmitted primarily through birds, by way of farming.

The symptoms of bird flu are very similar to symptoms of other diseases, with fever, coughing, and muscle aches being very common symptoms in humans. Individuals coming in contact with infected birds or animals are at the greatest risk of contracting bird flu, with only 4 positive cases in the USA.

Luckily, not many humans are currently affected by bird flu, however, livestock are becoming increasingly infected. McDonald’s breakfast services have been shortened in Australia, after a shortage of eggs due to over 1 million chickens contracting bird flu and being slaughtered. In the USA, outbreaks among dairy cattle are leading to concerns about contaminated milk, as well as poor health of the cattle and decreased milk production. Pasteurization, the process of killing microorganisms using heat, should be sufficient to inactivate the bird flu virus present in milk, so while it is not of major concern now, care must be taken to avoid the spread of bird flu among animals.

On to the Olympics:

As the 2024 Paris Olympics draws near, the USA Olympic trials are in full swing. Unfortunately, some stories have been marred by injuries. Particularly during the gymnastics trials, athletes have suffered serious injuries.

Star athletes Kayla DiCello and Skye Blakely suffered injuries to the Achilles tendon, while Shilese Jones experienced a knee injury. All 3 athletes cannot compete in the Paris Olympics, but the Team USA squad is still as solid as ever, with Simone Biles returning for another Games.

Achilles injuries are the bane of many athletes’ careers. The Achilles tendon is a tendon running from the heel bone to the calf muscle, and when ruptured, prevents the individual from walking and running normally. These injuries often require surgery and physiotherapy and can take upwards of 4 months to return to normal function.

While the road to an Achilles tendon recovery is long, there is still potential for athletes to have a great career after their recovery. Kevin Durant, the famed NBA player, suffered an Achilles injury and has enjoyed an illustrious career with multiple teams since that injury. Durant was set to play as part of Team USA’s basketball squad but suffered a calf strain that resulted in him being sidelined during practice. The legendary Kobe Bryant experienced an Achilles injury, and returned to the court after a long recovery, with no signs of his Achilles slowing him down. Though these trials have been sullied by injuries, it is no doubt that the Olympic Games will have a strong Team USA presence and that the athletes will bounce back from these injuries and return to play.

Shedding Light on Sweeteners:

This isn’t the first time that artificial sweeteners have been discussed, but a recent study has linked the artificial sweetener xylitol, to an increased risk of blood clots, heart attacks, and stroke.

Artificial sweeteners are considered a replacement for sugar since overconsumption of foods sweetened with sugar can lead to weight gain. Artificial sweeteners help mitigate this, by adding sweetness to food and drink while being very low in calories. As a result, artificial sweeteners are thought to be helpful in maintaining a healthy body weight. While many individuals do not need to worry about the levels of sugar in their blood, individuals with diabetes do. In addition to being low in calories, many artificial sweeteners, including xylitol, do not cause spikes in blood sugar. This is beneficial for individuals living with diabetes, given that diabetes is a condition of elevated blood sugar.

While it all sounds great, sweeteners do not come without their issues. In a recent study of xylitol, the authors discovered that individuals consuming the highest amount of xylitol were the most likely to have a cardiovascular event, such as a heart attack or stroke. While this is concerning, it is important to note that this does not prove that xylitol causes events. It may be the case that individuals who consume high levels of xylitol, may not be exercising frequently, or eating as many fruits and vegetables, therefore it is impossible to know whether xylitol is the reason for increased risk, or whether it is due to other health factors.

The study also showed that consumption of xylitol-sweetened beverages in healthy volunteers increased markers of platelet function and blood clotting. This may pose a risk, as blood clot formation is a cause of heart attacks and strokes. Despite increases in these markers of platelet function, none of the volunteers experienced blood clots. The clinical impact of these findings is yet to be known, but the FDA has approved these sweeteners, which are generally regarded as safe when consumed within daily recommended intake levels.

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