Biotechnology descriptors

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Whilst giving a presentation at grand rounds recently, I noted that approved names for biological medications in Australia are suffixed with a three-letter abbreviation – the “biotechnology descriptor” – to indicate the biotechnology production system used, e.g. insulin lispro (rbe).

The most common biotechnology descriptors are:

  • ghu – gene-activated human cell line
  • rbe – recombinant bacteria Escherichia coli
  • rch – recombinant Chinese Hamster ovary cell line
  • rmc – recombinant mouse cell line
  • rys – recombinant yeast Saccharomyces cerevisiae

Incidentally, I cringe whenever someone refers to this group of medications as “biologics” – an Americanism that has crept into the Australian medical lexicon. Australian English still retains the “-ical” ending (rather than shortening to “-ic” in American English), therefore we should continue to refer to these medications as “biologicals”.

Marking the border

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There are some places in the world where you barely know that you’re crossing a border – even an international one – such as when driving on the M1/A1 between Dublin and Belfast in the Republic of Ireland and the United Kingdom respectively. The only indication that you’ve crossed into another country is a road sign stating that speed limits are now expressed in miles per hour or kilometres per hour, depending on which direction you’re travelling. There are historical and political reasons for this, of course.

Australian state borders, on the other hand, tend to be clearly marked. Within the twin towns of Tweed Heads NSW and Coolangatta QLD, apart from the usual signs, there is the following marker on Boundary Street.

NSW–Queensland border marker, Boundary Street

The majority of people crossing the border, however, bypass the towns and instead see this abstract sculpture on the M1 Pacific Motorway.

NSW–Queensland border, M1

I suppose it has to be obvious, in case the poorly designed Queensland road signs (one of which is visible above) don’t clue you in to the fact that you’ve crossed the border!

How not to get elected

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Ballots closed recently for the Pharmacy Council of New South Wales 2013 election. Voting as a registered pharmacist in NSW, I was only familiar with a few of the candidates and so had to rely on the Candidate Information Sheet that was sent out. I’ve reproduced page 4 below (de-identified)…

Page 4, Candidate Information Sheet, Pharmacy Council of NSW election 2013

The nomination paperwork clearly indicated that the “candidate information” section would be reproduced exactly as submitted… The candidate at the top of the page did not get elected.

A day in the life of a medical registrar

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14 new patients post-take (1 DOA)
7am consultant rounds
Interviewed by the police
Discussion with an Assistant Coroner
Rescued from a difficult dilemma by one of the geriatricians (again)
Spoke with the hospital Director of Medical Services
AWOL patient urinating on the hospital front lawn
Challenging discussions with families about end-of-life issues
Asked for two consults at 4pm (because my consultant specifically wanted me to ask)
Somehow didn’t get shouted at for the late consults
Finished my ward round after-hours
Left the hospital at 7.30pm

… and very grateful for my fantastic intern Angela!

Leeches in modern medicine

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Leeches have been used medicinally for centuries, with their most well-known role in the former practice of blood-letting. In modern medicine, however, the medicinal leech (Hirudo medicinalis) has found a niche role in plastic/reconstructive surgery where it can be used to reduce venous congestion and encourage microcirculation.

medicinal leeches

medicinal leeches

Specially prepared leeches are attached to the relevant part (e.g. at-risk surgical flap) and allowed to feed. Once gorged they detach themselves and are collected for re-use. Heparin wipes may be used at the bite site to prolong the therapeutic anticoagulation effect.

medicinal leeches

At our centre, collected leeches are prepared for re-use by placing in them saline – apparently this encourages them to regurgitate their initial feed. Subsequent feeds are less effective, so after 1-2 feeds the leech is “retired” using concentrated saline and flushed down a sluice sink.

Outdoor smoking bans in NSW

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Amendments to the Smoke-free Environment Act 2000 (NSW) will come into force next week, further restricting tobacco smoking in public areas in New South Wales.

Smoking is already banned in enclosed public areas in NSW.

From 7 January 2013, smoking will also be banned in the following outdoor places:

  • within 10 metres of children’s play equipment in outdoor public places
  • public swimming pools
  • spectator areas of sports venues
  • public transport stops/platforms (including bus stops and taxi ranks)
  • within 4 metres of entrances to public buildings

Furthermore, from 6 July 2015 smoking will also be banned in commercial outdoor dining areas (i.e. al fresco).

Australia is a world leader in tobacco harm reduction. It’s good to see further action being taken to protect public health through reducing exposure to second-hand smoke.

More information: health.nsw.gov.au/tobacco/Pages/smokefree-areas-faq.aspx