#immunology notes

[er-cryptid]

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[scientific-tricorder]

Something that I noticed and started really bothered me, is that it makes no sense for Trill to be very sensitive to allergies. If anything, it should be the other way around.

Allergies happen when your immune system recognizes a substance and decides that it must die, even though said substance is generally pretty innocuous. So, a tiny bit about the immune system, or at least the part of it that's relevant to this discussion. The immune system is activated by little molecules, which you might know as antigens. They're basically just tiny bits of protein that the immune system can sense and bind to. Self antigens are stuff that's just normally in the body, and the immune system generally ignores them, and non-self antigens are anything from outside the body, which the immune system may decide is an attack.

And how does this relate to the Trill? A symbiont is basically a giant chunk of non-self antigens that's inserted into the body (kind of like an organ transplant), so the immune system will freak out, which is generally pretty bad. Which means that the immune system is likely somewhat dampened in a joined Trill, which would also dampen an allergic response. I.e. Being very sensitive to allergies is the exact opposite of what would be expected to happen.

[all-pacas]

Bear with me here.

In Failure to Communicate, Chase is going to give the patient an MRI and the patient suddenly grabs his arm and says something unintelligible. Chase assumes he's talking about drugs and says they won't tell the wife, then continues the procedure. Later in the episode, Cameron finds Chase's notes:

CAMERON: He mentioned stain once before when Chase was giving him the MRI. Before we scared him. CHASE: He did? CAMERON: It's in your notes.

So even though Chase totally and utterly forgot the conversation (on brand tbh), he not only recorded that it happened but wrote down the guy's exact words.

And then in Teamwork:

LUCAS: You're good at [writing notes], by the way. CHASE: Why are you reading my charts? LUCAS: Because I’m worried about my girlfriend. […] Which brings us to the fact that you have elevated noting to an art form. LUCAS: Most doctors write "9:00 a.m." if they scrub in at 9:00 or anything near it. You write 9:03, and you make little notations when procedures are delayed. CHASE: You're easily impressed. LUCAS: Well, yeah. I was, till I saw that you had virtually stopped writing them about four weeks ago. CHASE: Been busy. Got a backlog. LUCAS: Yeah… People with your level of precision don't really just "get" backlogs. No one knows why you're leaving PPTH. CHASE: Because it's personal.

Chase is apparently really meticulous. He records conversations verbatim, he is exact with his times, he notes delays and the reasons for delays. He is precise, enough that it's apparently glaringly obvious when he stops. And that's really interesting to me, like, he has this in-universe reputation as being lazy, he's certainly unambitious, he doesn't try to flex his intelligence or abilities like, say, Foreman does. Chase is rarely treated as an expert, someone to consult or turn to in the way Foreman is on neurology and Cameron is on immunology: he's not an idiot, but he's not a specialist in the same way, yeah?

But he really is very, very solid. In his intensivist days, his job is to keep people alive and he's very good at it. He's stated repeatedly to be the best surgeon in the hospital. He apparently takes just incredible notes. It's honestly pretty funny how competent Chase is, despite his reputation. Even his noted observation skills and ability to solve cases kind of ties into this: maybe he's not the most book smart of the team, he forgets he had a conversation two days later, but he wrote it down anyway. He's meticulous, and that isn't the flashiest skill but it's a very good one in his position.

[studentbyday]

week 1. a stuttering start.

i can't believe autumn is already approaching. i feel like i haven't done much to truly live on my own terms this year... (the majority of my time was spent either chained to my desk, living the studying hermit life as usual, or...and this is a new one for this era of my life, feeling like a child following the real adults around on my travels which @zzzzzestforlife documents way better tbh. the travels, that is...)

in addition i've been feeling very unmotivated and numb this school year. even more so than usual. i've never been as zesty as...well, Zesty when it comes to new school years, but it has slowly been getting worse since i started uni and i think i'm getting dangerously close to falling off some cliff i'll later realize was an important cliff to not fall off of. do you get what i mean? i'm only speaking vaguely because i myself do not quite know.

i oscillate between wanting to be extraordinary and extra ordinary. i have fallen back into bad habits, which do not set a good precedent. and overall i feel lost. so so lost that i started reading designing your life. and dulled by the isolation of school i can hardly focus. it's not a new problem, i've just finally been able to put words to it after all these years. engaging and/or cathartic verbal conversation brings me back to life, whether i'm listening or speaking, but i don't get enough of that in my daily life...this is just a very weird mundane state to be in. don't get me wrong, i was relieved to get back to this life with a very predictable pattern after the hectic-ness of travel, but something about it always felt off and i almost can't believe that only now i've realized why.

anyway, feelings pass. and i have overcome the jet lag, so i am that much more energized (and perhaps a little more desperate) to bulldoze through this problem.

Study:

Read/skimmed all the syllabi for anything new (much of it is the same year-to-year as they're all courses in the same faculty and i am resigned to the fact that there will be weighty group work in at least one course out of every year)

Caught up on course announcements

Finished microbiology module for this week (hmmm i read like half of this module last year when i attempted and then dropped this course so it wasn't the most interesting the second time around but i think it'll get better as i get to the new stuff and the nitty-gritty details 🔬 mwahahaha 🦠 i also decided last minute to make flashcards for these and had to transfer my notes to anki. i wish there weren't so many isolated facts or similar but distinct processes i need to remember.)

Made flashcards for half of this week's immunology content (seems to be a memorization-heavy course and i think i really need the active recall since i barely remember the pre-req info 😅 luckily they review it in the module... 🤭)

Reviewed some of the flashcards made this week

Worked on (but didn't finish) global health slides for this week (i'm...not entirely sure what i should be taking notes on or how because...this all seems either very common sense or kind of..."woo-woo" based on my way of understanding the world...but ig that's my own biases talking? i hope they'll just test us on the common sense stuff. that will be easier for my brain 🥴)

Around half of pathology slides are left from this week (probably the most work intensive course i'm taking rn based on the timeline 😵 but also it's shaping up to be my favorite subject this semester because the modules are so well designed AND it's large processes or, even if it's smaller concepts, they're all connected to each other so i don't need flashcards!...i think! i can just pull on the thread of memory and it all unspools (...ideally...)!)

Wrote down due dates for all assessments this semester

Other life things: (yeah idk what to call this section)

I became a 6AM girlie!!! 🥰🥰🥰

Unpacked

Washed my water bottle

Caught up with a friend 💗

Health:

Yoga x2

Journalled x2

Early morning walk in nature x1 (the air smelled so so fresh i was so glad i went out...and even gladder that i went out when i did because after that the air quality got super bad from wildfire smoke 🥺)

Pilates x1 (i made it! in 2 split sessions, but still! and i feel great!!! 😃 i'm so glad i found this channel because she explains the moves in a way that i can get it even with my bad coordination 😅 she also goes slowly and there is no annoying workout music so i can completely focus on the movements and how they feel, it's perfect. 😊)

Music in My Head:

Blue Danube Waltz (OG piano version)

Treat People With Kindness

On the Sunny Side of the Street

Hikaru Nara (the perfect song for my current ambivalent mood because the whole theme of the anime, which is reflected in the sound of this arrangement, is the need to reignite your spark for the things that mean something to you and make the absolute most of it because life is short)

a few dark academia playlists that i put on loop to study to (links under the cut) (somehow the ones with new age music are the only ones i can listen to...light/quiet enough that it doesn't interrupt my thoughts but intense and melodic enough that it puts me in the mood to focus 😅)

[mitsuyeaah]

study session.

— sanzu haruchiyo x f! reader

cw: nsfw (mdni), smut, fingering, sex toy (vibrator), swearing, pet names (darling, baby), sanzu being a lil’ shit

a/n: lovely nonnie has inspired me to write a lil drabble with sanzu since i am studying for my finals as well. thank u for this idea hehe <3 sorry in advance for any typos, i wrote this with tears in my eyes.

it was a rough night to say the least, you didn’t even notice the sun beginning to set under the horizon since your eyes were too focused on your notes before you. it was only then you realised how much time you’ve spent studying when your boyfriend made his presence known by kissing the crown of your head.

it all started innocently, really. a gentle exchange between the two of you—telling him how you’ve been very stressed and worried for your upcoming finals. of course, being the good boyfriend he was, he offered to take your mind off your worries for a bit.

now, as innocent as the offer was, your boyfriend’s fingers deep inside your wet cunt as he stood behind you was not what you initially had in mind. one knee was propped on the desk, resting above your notes as your hips pressed against the edge of your desk. the chair that you previously sat on was whisked away, somewhere in the room.

“ah, fuck! sanzu—ngh!” you breathlessly moaned as he added a third slender digit inside, your hands turning into fists against your immunology notes, causing the paper to crumple under your touch. sanzu peppered your nape with open-mouthed kisses, goosebumps forming at your skin.

“mmm, my darling has been diligently studying that i just had to treat her..” he sent vibrations down your spine as he spoke against your skin.

at this point, your study notes were long forgotten. the constant worry that plagued your mind of failing your finals disappeared, and the only thing in your pretty little head was how much pleasure your boyfriend was giving you. how delicious his fingers felt inside you. how the deep pit in your stomach bubbled at the sensation.

the next thing you knew, your cheek was pressed against your notes, and the crown of your head making contact with the edge of your laptop. both your wrists were pinned against your lower back by one of sanzu’s hand, while the other held your favourite vibrator against your puffy clit.

it was turned to the highest setting. little shit.

you didn’t even know your ears were ringing until it finally subsided and you could hear sanzu’s sly voice cutting through, “c’mon, baby, answer the question. how’re you going to prepare for your exam, hm?” you couldn’t see him but you knew he had a shit-eating grin plastered on his pretty face. as always.

you didn’t even hear his question because of the loud ringing in your ears. “aah! w-what..?” your voice came our quieter than you intended but it was loud enough for sanzu to hear above the buzzing of the sex toy.

“i said, describe antibody, IgM.” his cerulean eyes quickly scanned over the notes on your laptop screen before returning them to you. he tilted his head to the side, waiting for an answer.

opening your mouth to answer, a loud whine escaped your lips as sanzu pushed the vibrator past your wet folds. you closed your eyes shut, face contorting with pleasure as he started thrusting the device in and out. “haah! fuck! I-IgM antibody is the largest antibody molecule—ngh!”

sanzu absentmindedly leaned down to connect his clothed chest with your back to suck on your nape, waiting for you to continue. the mixed sensation of the vibrator inside you and sanzu sucking on your skin absolutely drove you crazy. the answer inside your head suddenly dissipated into thin air like smoke.

“shit.. this antibody is mostly confined to the—ah! to the.. to the blood and lymphatics since it cannot be transported across—hmph sanzu! it can’t be transported across the fucking placenta.” it took all your willpower to get all those words out, it didn’t help how your boyfriend picked up the pace of the vibrator.

tears rolled down to your notes as he brought the vibrator back to your clit, earning a loud shameless moan from you. you didn’t even care if the ink was going to be smudged from your tears, all you wanted was to reach your orgasm.

“good girl.” sanzu breathlessly chuckled against your skin, his free hand travelling down to your chest to squeeze and grope at your breast over the fabric of your shirt.

“what are the two major sites for establishment of immunological tolerance? tell me, baby or you won’t get to cum.. need to get you prepped for your exam.” your heart sank to your stomach at the mention of your orgasm denial. despite your lust-fogged brain, you tried to wrack your mind for a coherent answer but the only thing that came out your mouth were moans and incoherent sentences.

“aah! shit shit! i don’t fucking know! please, just let me cum, sanzuuu..” you opened your eyes, vision obstructed by tears as you craned your neck to try and meet his gaze. “oh? are you telling me you spent hours studying just for you to not answer the question? a pity.. looks like no orgasm for you then..”

you hastily shook your head against your desk, your notes rustling beneath every movement of your head. “no, no, no! please—ah! just let me.. let me think!” you shut your eyes, brows furrowing as you tried to concentrate on the answer, ignoring the familiar sensation that was making itself known.

you panted against your notes, mouth parted, “fuck! i’m so near” you didn’t mean for that to come out but it just did, and you never regretted anything as fast. “the answer, baby. or you’re not cumming.” sanzu clicked his tongue and pressed the vibrator harder onto your clit, earning another loud whine from you.

“c-central tolerance at the—ngh! the primary lymphoid organs! a-and—haah! peripheral tolerance at the secondary lymphoid organs. fuck!” your nails dug into your palms as you answered his question, trying your best not to cum right then and there.

sanzu grinned at your answer, “that’s right. m’baby is so smart, huh? now, why don’t you cum for me?” he didn’t have to tell you twice, you came before he even finished his sentence. a chain of profanities leaving your lips as your vision blurred, and ears ringing once again.

your legs shook from the intense pleasure, a fresh set of hot tears rolling down to pool at your notes. sanzu rode out your orgasm by pressing the vibrator even further onto your clit and whispering sweet praises against your ear, earning small whines from you as you cried out his name like a prayer.

you didn’t expect sanzu to take your worries away by giving you a mind blowing orgasm but you weren’t complaining. if anything, you’d definitely encourage him to accompany you whenever you studied because,

to say the least, study sessions with sanzu were much more interesting and fun.

© mitsuyeaah

[covid-safer-hotties]

Also preserved on our archive (Check in for daily updates!)

By Blake Murdoch

Since the COVID pandemic began, claims that the disease poses only minimal risk to children have spread widely, on the presumption that the lower rate of severe acute illness in kids tells the whole story. Notions that children are nearly immune to COVID and don’t need to be vaccinated have pervaded.

These ideas are wrong. People making such claims ignore the accumulating risk of long COVID, the constellation of long-term health effects caused by infection, in children who may get infected once or twice a year. The condition may already have affected nearly six million kids in the U.S. Children need us to wake up to this serious threat. If we do, we can help our kids with a few straightforward and effective measures.

The spread of the mistaken idea that children have nothing to worry about has had some help from scientists. In 2023 the American Medical Association’s pediatrics journal published a study–which has since been retracted—reporting the rate of long COVID symptoms in kids was “strikingly low” at only 0.4 percent. The results were widely publicized as feel-good news, and helped rationalize the status quo, where kids are repeatedly exposed to SARS-COV-2 in underventilated schools and parents believe they will suffer no serious harm.

In January 2024, however, two scientists published a letter with me explaining why that study was invalid. Some of the errors made it hard to understand how the study survived peer review. For example, the authors claimed to report on long COVID using the 2021 World Health Organization definition, but didn’t properly account for the possibility of new onset and fluctuating or relapsing symptoms, even though that definition and the subsequently released 2023 pediatric one emphasize those attributes. Any child with four symptom-free weeks—even nonconsecutive ones—following confirmed infection was categorized by the study authors as not having long COVID.

In August, the authors of the study retracted it. They did not admit to the errors we raised. But they did admit to new errors, and said these mistakes meant they understated the rate of affected children.

And that rate, according to other research, is quite high. The American Medical Association’s top journal, JAMA, in August published a key new study and editorial about pediatric long COVID. The editorial cites several robust analyses and concludes that, while uncertainty remains, long COVID symptoms appear to occur after about 10 percent to 20 percent of pediatric infections.

If you’re keeping score, that’s as many as 5.8 million affected children in the U.S.—so far. And we know studies and surveys of adults have found that repeat infections heighten the risk of long-term consequences.

The JAMA study comparing infected and uninfected children found that trouble with memory or focusing is the most common long COVID symptom in kids aged six to 11. Back, neck, stomach and head pain were the next most common symptoms. Other behavioral impacts included “fear about specific things” and refusal to go to school.

Adolescents aged 12 to 17 reported different leading symptoms. Change or loss in smell or taste was most common, followed by body pains, daytime tiredness, low energy, tiredness after walking and cognitive deficits. The study noted that symptoms “affected almost every organ system.” In other words, these symptoms reflect real physiological trauma. For example, SARS-COV-2 can cause or mediate cardiovascular, neurological and immunological harm, even increasing the relative risk of new onset pediatric diabetes when compared with other lesser infections.

Children in schools today are often described as struggling with emotional regulation, attention deficits and developmental problems. Adolescents have some of the worst standardized test scores in decades. Pandemic measures such as school closures—most of which were short-lived and occurred several years ago—have been blamed almost entirely for children’s present-day behavioral and learning problems.

While it is clear these early pandemic disruptions negatively impacted many children, the unproven notion that “the cure was worse than the disease” has become dogma and sometimes involves reimagining history. For example, the Canadian Pediatric Society’s most recent COVID vaccination guidance fails to even acknowledge the existence of pediatric long COVID, while stating without evidence in its preamble that children were more affected by pandemic disruptions in activities than direct viral effects. It’s hard to imagine how this wording could encourage pediatricians and parents to vaccinate children against a disabling virus.

Consider also a small but widely publicized Bezos Family Foundation–funded study which unscientifically claimed accelerated cortical thinning, a type of brain restructuring that occurs over time, is caused by “lockdowns.” The study design could not demonstrate cause and effect, however, but only correlation. Pediatric brain experts have critiqued the research, pointing out that “no supporting evidence” was provided for the claim cortical thinning is from social isolation, and that it isn’t necessarily pathological. “Lockdowns” were neither defined nor controlled for in the study, which relied on 54 pandemic-era brains scans from different children than the prepandemic scans they were compared to—meaning there was no measurement of brain changes in specific individuals. The pandemic-era scans came from months when relevant CDC seroprevalence data estimate that the number of children with one or more infections rose from about one in five to around three in five. We might reasonably predict that many of the studied brain scans were therefore from children who recently had COVID.

It is understandably disturbing to entertain the idea that we might currently be recklessly allowing millions of children to be harmed by preventable disease. That may be part of why problematic studies such as these have gotten headlines. It is more disturbing, however, that almost no public attention has been given to infection itself as a potential cause of children’s behavioural and learning problems.

This makes no sense. We know that COVID harms the brain. Neuroinflammation, brain shrinkage, disruption of the blood-brain barrier and more have been documented in adults, as have cognitive deficits. These deficits have been measured as equivalent to persistent decreased IQ scores, even for mild and resolved infections. Millions of people have, or have experienced, “brain fog.” What, then, do we guess a child’s COVID-induced “trouble with focusing or memory” might be?

When you put together the estimate that 10 to 20 percent of infected kids may experience long-term symptoms, that many of the most common symptoms affect cognition, energy levels and behavior, and that children are being periodically reinfected, you have a scientific rationale to partly explain children’s widely reported behavioural and learning challenges.

We can do something to protect our kids. We can vaccinate them every season, which somewhat reduces the risk of long COVID. We can keep sick children home by passing laws that create paid sick leave and end attendance-based school funding. We can normalize rather than vilify the use of respirator masks that help prevent the spread of airborne diseases.

Finally, we can implement fantastic new engineered indoor air quality standards designed to greatly reduce the spread of germs. Clean indoor air should be expected as a right, like clean water. The cost of providing cleaner indoor air is low relative to the economic benefits, which even when conservatively modeled are in the tens of billions annually in the U.S. and more than ten times the costs. These costs are also small compared to the price children and their families would pay in suffering as a result of preventable long-term impairment.

By regulating, publicly reporting and periodically inspecting building air quality, similarly to how we oversee food safety in commercial kitchens, we can greatly reduce the spread of disease and reap huge benefits for everyone—especially children.

[outofangband]

Possible medicinal plants in Beleriand part one /?

This is a resource I created upon commission for @creativity-of-death regarding medicinal plants that do have more evidence behind them with the treatment of wounds. Thank you again for the commission! Commission information in the bottom of my pinned post

I am also very interested in both botany and herblore so I really enjoyed doing this. This post is heavy on plant information and light on world building but I absolutely plan on writing more detailed world building!

This is going to focus primarily on the plant thyme which are primarily used to treat superficial wounds.

Some notes first!

Elves do not suffer full body infection under most circumstances however, wounds can still worsen, become inflamed, and there are factors that can prevent healing which herbs like these can aid in in. I’m going to make a longer post about my thoughts on immunology and elves and the differences between them and humans going through different aspects of human immune systems and the similarities and differences with elven ones but essentially, while I do believe there are microbial infections in the middle earth, elves are largely immune to communicable diseases that affect humans! however, they are not immune to all poisons, venoms and toxins, as we know from certain examples in canon, for example Aredhel’s death

Ethnobotany is notoriously difficult to research as there are so many conflicted sources and it is often difficult to tell what species have been studied, tested, and proved to have medicinal value, which have been proven to not have significant use in this regard and which have simply not been the subject of much research. Especially when it comes to traditional medicinal practices from marginalized cultures and peoples, information is often dismissed, buried or lost. Oral histories or works in translation are often not included in English literature research.

Second note: understanding of the body and of medicine varies tremendously in my opinion throughout the timeline of middle earth. The information included here is largely the information that we know from modern studies, and the language will not necessarily be the same terms of understanding the characters have, for example boards, like “anti-microbial properties” Would largely be understood by first age, elves, and humans to mean plants that assist in the healing of wounds, prevent them from worsening and prevent illness from falling as a result. Throughout history, we see terms like contamination, blood poisoning, and corruption in place of infection before germ theory was widely understood.

OK now for the plants!

Thyme has been proven in some forms to have significant microbial properties. They are some of the best well antimicrobial properties. Thymol a name for oil of thyme* is and has been used in pesticides and medical disinfectants.

Historically, bandages would be coated in oil of thyme to prevent infection, even before the processes of infection were understood. Thyme contains several different subspecies and tends to grow in Mediterranean climates however has been widely naturalized elsewhere.

In Beleriand it likely grew primarily in Ossiriand and Dorthonion but could easy be naturalized in other temperate regions.

* this compound is also found in other plants to varying degrees, but was named after the substance that was first extracted from common thyme

Wormwood, or Artemisia absinthium has also been studied fairly extensively and has been proven to have antimicrobial properties. I know you mentioned spiders and though it has never been tested on spider venoms, it is proven to have anti parasitic properties and has been used to kill other arachnids such as mites and ticks. Interestingly, it has been examined to have neuroprotective properties which might make it useful in antivenoms. These have not been studied as extensively as its antimicrobial properties however.

In Beleriand this is plant that can be easily naturalized throughout temperate regions, especially in fields and foothills. Dimbar, the region of Nargothrond, and the southern hills are some examples.

Calendula (common marigold)

Evidence has shown that topical application can aid in the healing of wounds and in preventing or treating infection. Tinctures and ointments are the most common forms. These flowers grow throughout the temperate world. Overuse could lead to endangerment/extinction easily. Mount Sinai Hospital’s online medical library discusses these properties as does the National Institute of Health. The properties seem to be well proven, especially by ethnobotanical standards!

Marigold primarily grows in warm regions, including warm temperate ones. In Beleriand it probably grew primarily in the west and central regions.

Common tormentil has mild astringent properties which can aid in blood stopping. Creeping jenny or field balm also has similar properties. These both grow throughout temperate climates though tend towards colder regions.

In Beleriand common tormetil could likely grow in Hithlum and in the plains of Eastern Beleriand. Creeping Jenny would likely be found near ponds such as near the Fen of Serech or Twilit Meres.

[springstick]

100 days of productivity: #024-028

Notes : So it turns out that I was wrong. I do not post more when studying for finals because finals take up literally all of my energy. I would have had content if I wasn't so stressed, lol. Today is Sunday, the calm before the storm, and the last day of sanity before my extra cram sessions and hermit mode.

Finals: Monday: Basic Medical Lab Techniques ; Tuesday: General Immunology ; Wednesday: Organic Chemistry ; Thursday: General Microbiology. Day #024 Study: BMLT Practical ; Orgo - Light Dusting of All Chapters [~3hrs] Day #025 Study: BMLT Practical (& Took it That Day) [~1hr] Day #026 Study: Orgo - Mass Spectrometry & Infrared Spectroscopy (Using Them Together) ; Immunology - Peyer's Patches and Practice Exam [~4.5hrs] Day #027 Study: Full Break Day [~0hrs] Day #028 Study (Today): Orgo - Extra Credit ; Immunology - Allergy Types [~6hrs]

I'm honestly more stressed about my flight home than I am about my finals, but I need to put that to the side. I've never been through TSA as an amputee before, but I've heard it's rough.

[larstudy]

✍🏻 6.11.2023 // I was really tired from my weekend which has been a bit chaotic (mostly on Sunday) but I managed to go to the library and study for 3 hours and attend to a meeting about the pharmaceutical industry! It was really interesting even if it's not what I want to do in the future.

I studied the different syringe and detector used to do gas chromatography with their advantages and inconvenients, their characteristics and for which molecule they are used. It's pretty interesting even if I had to do drawings and it takes so much time ugh

I also finished to take notes on my galenic lecture (which is not that interesting imo) and I began an immunology lecture about transplant and graft (it is mostly recalls for now).

🎧 Adélaïde - requin chagrin

[doresworld]

This afternoon I had one of the worst doctors appointments ever, which is saying something, but at least I didn’t have a panic attack this time. 

So in no particular order, I was told:

I obviously present feminine - in response to asking me my pronouns (they also gestured to my outfit, cane, and decorated rucksack, so I’m burning all of this and never wearing it outside again) 

There’s nothing they can do as I’ve tried everything they can offer 

To stop taking my meds as they’re not working, but no attempts to offer me anything new

That said medications aren’t even down as repeat prescriptions as they’re all for ‘acute treatment’ (note that I’ve been on these for almost two years for most of them) 

Told that there’s no point me doing anything about my gender identity as the waiting lists are too long, and I wouldn’t be classed as a priority

That because I’m unemployed it doesn’t matter that I don’t sleep properly because it’s not like I need to get up for anything 

The only place in the country that does immunology tests won’t test me as I’m not actively in anaphylactic shock so I need to find my own ways to treat my symptoms 

When asking me about why I’m unemployed, they asked if it was due to pain, I said yes, but also because I don’t have the right qualifications because I had to drop out when I got sick, and they said ‘how sick? And how was it serious enough to drop out’ - I guess they completely forgot that I am permanently sick as in disabled ??

[er-cryptid]

Cell-Mediated Immunity

Patreon

[justkidneying]

Fever

I see a lot of misconceptions about fever floating around the web, so I'm gonna try and set some things straight. We're gonna talk about what fever is, how it is caused, and types of fever. Then I'll give some writing tips. Just a note, with a lot of things, there are exceptions and special cases. I'm going to go over the most common stuff cause this isn't an immunology course.

What is a fever? The normal body temp (the average of a bunch of people) is 98.2°F. Individuals can differ from this within a degree. A fever is usually a temperature greater than 100°F. There's some leeway to this, and it takes a lot of experience to get a feel for what should be a normal temperature. But if someone comes into the office with a 100°F temp, I'm going to say that they have a fever.

So with fever (ignoring the symptoms of whatever caused it), you're generally going to have malaise, chills, paleness, and rigors (muscle contractions). There may also be behavioral symptoms such as seeking warmer environments, altered mental status, and assuming a fetal position to help warm the body. The peripheral vessels will constrict in order to keep blood in the central body. Once the fever has passed, there will be chills and sweating.

What causes fever? Fever is caused by pyrogens. These can be endogenous (from you) or exogenous (from something else). The main endogenous ones are interlueukin-1, interferon gamma, and tumor necrosis factor α. These are made by immune cells and a few other cell types. Exogenous pyrogens are made by other microorganisms. An example of this is lipopolysaccharide, which is made by gram-negative bacteria. Exogenous pyrogens induce the production of endogenous pyrogens, which induce the production of Prostaglandin E2. PGE2 acts on the hypothalamus to set the body's thermostat higher. This induces the effects seen in order to raise the body's temperature. Fever helps to stimulate the immune system and inhibits microorganism growth (too hot for them). So it's a good thing, unless it gets too high and your organs shut down and your brain melts like butter (i'm kidding...but really, it's bad). I'd say over 110°F and you're probably going to die.

What are the patterns of fever? There are three fever patterns, and they are associated with different pathologies. They are sustained, intermittent, and remittent fever. Sustained fevers are exactly what they sound like. They don't fluctuate more than a degree in a day and never touch normal baseline temp. These are typically seen with pneumonia, typhoid, bacterial meningitis, and UTI.

Intermittent fever is a fever that is only present for a few times throughout the day, with the temp going up above normal and back down to normal. This is seen with malaria, septicemia (a serious bacterial infection -> think septic shock), pyogenic infections (bacteria that cause pus formation), and TB.

Remittent fever fluctuates more than two degrees throughout the day, but does not ever touch normal baseline temps. These are seen with infectious diseases.

These patterns are okayish, but sometimes people don't always have a disease that matches the fever type. I think typhoid, TB, and tick-borne diseases (they cause a relapsing fever) are the best diseases to use fever patterns for.

Writing Tips

Okay, so first off I think fever is great for writing. So to find out what's going to happen, you need to pick out what the nature of the illness is. The most common one I see is infection from a wound of some kind. So this is going to be bacterial. I would say that you are most likely to have an infection with staph, strep, or pseudomonas. These are naturally found on the body, but are not meant to be inside you. A cut in your skin lets them in. This is bad. So your immune system will notice them and release pyrogens, and then you get PGE2, and then you get fever.

I would probably say you'd get the standard symptoms above, plus pain, swelling, and redness at the site of the infection. It's going to be an intermittent fever probably (could end up as remittent). So you would want to treat the infection itself. If there are no antibiotics or antipyretics (anti fever drugs), then you would have to clean and disinfect the wound, and basically hope that the immune system can do its thing. You can wipe the person down or use a cool compress on them, but this doesn't really reduce fever that much and is more of just a temporary relief.

Anyways, I hope this was helpful and as always, sources are in the comments. You can let me know if you have a specific situation you would want some info on in the comments/askbox/DM.

[buggbuzz]

my biotech exam today involves immunology so now im going through my old bio 2 notes and sending them to my classmates. and man do i miss being able to take the time to draw this stuff for my notes

[studentbyday]

the great reset. (aka reading week*)

this week is dedicated to self-care, including the different types of rest i need and doing the proactive things**. as part of this, i'm letting myself sleep as much as i want all week (but this time, with a consistent early wake-up alarm!!!). i'm so relieved.

**hehe. i may have overestimated how many of those proactive things i can actually do this week. i need to prioritize my list...

also sometimes i feel like making a commonplace book except i don't have a notebook with numbers...so i'd have to number the pages myself. a part of me is like “ugh i don't have time for this” and another part of me is like “but i do really have a lot of quotes and things i'd like to collect! 🐿️” and another part of me is like “numbering pages may be just the kind of mind-numbing thing i need to recover from the first half of the semester 😑👍” we'll see what happens... it's not high on my priorities list rn 😅

*i drafted and queued this post early last week when i was feeling very idealistic about the near future. it's serving as an unexpected reminder to just...take a deep breath. i can handle it if i take care of my basic needs. it's sunday and i had a much longer to-do list for today, but the day will be a win even if i only finish re-organizing my notes for all my courses and the fourth immunology module. oh yes, and a hair mask bc my hair will not survive the winter without a big chop if i don't keep it moisturized. and (1) i don't have time for a haircut and (2) i'm curious what i'd look like with longer hair.

[science-lover33]

Complement system

1. Activation: The complement system can be activated through three main pathways: the classical pathway, the alternative pathway, and the lectin pathway. Each pathway involves different initiating events but converges on a common cascade of reactions.

2. Cascade of Reactions: Once activated, the complement system triggers a cascade of enzymatic reactions that result in the cleavage of complement proteins. This cascade ultimately leads to the formation of several key components, including C3b, C4b, and C5b.

3. Opsonization: C3b and C4b are opsonins, which means they can bind to pathogens and label them for phagocytosis by immune cells like macrophages and neutrophils. This enhances the removal of pathogens from the body.

4. Inflammation: Complement activation also results in the release of small peptides called anaphylatoxins, such as C3a and C5a. These peptides promote inflammation by increasing blood vessel permeability and attracting immune cells to the site of infection.

5. Membrane Attack Complex (MAC): The final step of complement activation involves the assembly of the membrane attack complex (MAC). C5b, C6, C7, C8, and multiple C9 molecules come together to form the MAC, which can create pores in the membranes of target cells, leading to cell lysis and destruction of pathogens.

References:

1. Walport, M. J. (2001). Complement. First of two parts. New England Journal of Medicine, 344(14), 1058-1066.

2. Ricklin, D., Hajishengallis, G., Yang, K., & Lambris, J. D. (2010). Complement: a key system for immune surveillance and homeostasis. Nature Immunology, 11(9), 785-797.

3. Merle, N. S., Church, S. E., Fremeaux-Bacchi, V., & Roumenina, L. T. (2015). Complement system part I – molecular mechanisms of activation and regulation. Frontiers in Immunology, 6, 262.

Please note that for the most current and detailed medical information on the complement system, I recommend consulting recent textbooks or academic journals in immunology and microbiology.

[covid-safer-hotties]

Also preserved in our archive

A new Cleveland Clinic-led study published in The EMBO Journal shows that mild and asymptomatic SARS-CoV-2 infections can trigger immune responses in a pregnant individual that may cause serious inflammatory responses in the developing fetus. The study's findings also suggest that vertical transmission of the virus from a pregnant individual to the fetus is more common than previously estimated; and that even without this transmission, a pregnant individual's immunological response to infection may impact the fetus.

Typically, healthcare providers test for SARS-CoV-2 infection, the virus that causes COVID-19, in a newborn through a nasal swab after birth. For this study, Cleveland Clinic researchers collected samples from the placenta and the fetal compartment (tissues that surround a fetus while still in utero), and then analyzed them for the presence of inflammatory markers and virus. They found higher instances of the virus in those tissues than what could be found in a traditional nasal swab, and even in the absence of a full infection they found small proteins from the virus had passed through the placenta. The researchers hope their study will help ensure pregnant individuals can rapidly and reliably receive evidence-based medical care needed during novel outbreaks and public health crises.

When the COVID-19 pandemic first began, OB/GYN Ruth Farrell, MD, and colleagues at Cleveland Clinic and other major medical centers wanted to determine the best way to prevent and manage the infection in their pregnant patients. Pregnant individuals required different medical considerations during the pandemic compared to their nonpregnant counterparts; Dr. Farrell notes that many of the prevention and treatment approaches used in non-pregnant patients either did not have enough data to use in pregnant patients or were not feasible to perform.

"During the early stages of the pandemic, there were significant delays in determining how best to prevent and treat pregnant patients with SARS-CoV-2 infection," explains Dr. Farrell, who also serves as the Vice Chair of Research for Cleveland Clinic's Obstetrics & Gynecology Institute.

Dr. Farrell worked with clinical colleagues across the Clinical and Translational Science Collaborative (CTSC) of Northern Ohio to develop methods for examining the impact of SARS-CoV-2 infection on pregnant patients, including researchers from University Hospitals of Cleveland and MetroHealth Medical Center.

She then teamed up with Cleveland Clinic maternal-fetal virologists Jolin (Suan Sin) Foo, PhD and Javier (Weiqiang) Chen, PhD from the Infection Biology Program to determine how the virus impacted the immune systems of both mother and child.

When the standard-of-care COVID-19 test is used to detect the virus in newborns (nasal swabs upon birth) they only detect infections in about 2% of children whose mothers tested positive for the virus during pregnancy. However, when Drs. Chen and Foo looked at tissues that surrounded the newborns when they were still in utero-; including the amniotic fluid, chorion and umbilical cord plasma -; they detected high levels of the virus in over a quarter (26%) of study participants.

The team also found elevated immune and inflammatory responses affecting the pregnancies of about 66% of study participants. Dr. Foo had previously shown elevated levels of fetal inflammation in pregnant individuals who experience severe SARS-CoV-2 infections during pregnancy, but few had asked whether asymptomatic or mild infections had the same effect. Now that they have their answer, however, the team were faced with even more questions.

"Even though we only saw vertical transmission of the full virus infection a quarter of the time, we saw strong immune and inflammatory responses in over two thirds of the cases," Dr. Foo says. "It was clear that even when the fetuses were not technically infected, they were still being impacted by their mothers' viral infection. But we weren't quite sure how."

Elevated levels of inflammation during pregnancy, in COVID and other conditions, can have negative impacts on the offspring long after birth. Further research can define how inflammation affects children in the long term.

Dr. Chen noted that the SARS-CoV-2 virus has a protein called ORF8 that physically resembles a human immune protein called immunoglobulin G that passes through the placenta from mother-to-fetus during development. He wondered whether the viral protein could also pass through the placenta's defenses to cause inflammation in the fetal compartment.

Drs. Foo and Chen, alongside co-first authors Tamiris Azamor, PhD and Débora Familiar-Macedo, PhD (a former and current postdoctoral researcher, respectively, in Dr. Foo's lab), were able to prove that the virus-made ORF8 did indeed pass through the placenta into the fetus. ORF8 then bound to immune proteins and "turned on" a process called the complementary immune response.

At normal levels, the complement system is a good thing during pregnancy and helps the fetus develop properly, Dr. Familiar-Macedo explains. At higher levels, the complement system can cause dangerous inflammation in a developing fetus. Lab studies supported that this immune response directly led to the elevated levels of inflammation seen in the fetuses of pregnant patients infected with the SARS CoV-2 virus.

"Our findings challenge the currently accepted definition of vertical transmission, or what it means to transmit an infection from mother-to-fetus," Dr. Chen says. "We have shown that it is indeed possible for only a small part of a virus to slip through and affect a pregnancy."

Dr. Foo adds that she hopes her team's findings will serve as guidance for healthcare practitioners, researchers and policymakers alike on further research into vertical transmission and long-term care.

"We've shown that the misconception that uninfected babies born from infected mothers are fine, is sometimes just that: a misconception," she says. "Pregnancy is such a vulnerable nine-month period where any change from the norm can cause long-term impacts on the baby, so we need to work more closely with these individuals to understand their unique healthcare needs during public health crises. It's the only way to make sure they receive the care they need."

Source: Cleveland Clinic

Journal reference: Azamor, T., et al. (2024). Transplacental SARS-CoV-2 protein ORF8 binds to complement C1q to trigger fetal inflammation. The EMBO Journal. doi.org/10.1038/s44318-024-00260-9. www.embopress.org/doi/full/10.1038/s44318-024-00260-9