Things I've Learned: Chinese Lunar New Year & Hereditary Angioedema

Happy Chinese New Year! I'm switching over from working night to day shifts in the emergency department, so I was lucky enough to get today off in between. I've been really enjoying my emergency shifts, which fly by with the quick turnover and interesting cases. I've gotten past the hurdles of doing my first suturing and pelvic exams in over a year (yikes!) and was relieved that I wasn't too clumsy in front of the patients. I'm seeing a great variety of things, some of which (peds, psych, obs/gyne) I haven't dealt with since my third year of med school -- so I'm definitely (re)learning lots! Here are one medical thing and two others I've learned in the past seven days:

1. Year of the Sheep (a.k.a. Goat or Ram) -- Today is the first day of the Chinese Lunar New Year, a celebration that spans fifteen days and sees hundreds of millions of overseas Chinese returning home in the year's largest human migration. Chinese New year falls on the second new moon after the winter solstice, on a date that varies between January 21 and February 20. Each year is associated with a zodiac animal/earthly branch (rotating on a 12-year cycle), heavenly stem (10-year cycle), element (5-year cycle), and yin or yang (2-year cycle). We are entering the year of the yi yin wood sheep, which last occurred 60 years ago. Apparently "yin wood" predicts rain and wind storms. Here are supposed characteristics of those born in the year of the sheep; wood sheep in particular are said to be amicable, gentle, and compassionate.

   

   (http://www.chinahighlights.com/travelguide/chinese-zodiac/goat.asp)

2. hereditary angioedema (HAE) -- HAE is a rare (1 in 10,000 to 50,000 people) autosomal dominant blood disorder, due to low serum levels of C1 esterase inhibitor proteins. C1 esterase inhibitors have a role in controlling fluid influx and efflux from cells. A low plasma level of C1 inhibitor leads to increased activation of pathways that release bradykinin, which increases vascular permeability (leading to angioedema) and causes pain. Patients experience episodic attacks of swelling of the face, upper airway, extremities, genitals, and GI tract (which may lead to vomiting and abdominal pain). Such episodes may be triggered by trauma, surgery, viral illnesses, stress, or menstruation. Patients are managed prophylactically with daily C1 inhibitor replacement; tranexamic acid is sometimes added. Acute attacks are managed with i.v. doses of these same medications.

   

   (http://upload.wikimedia.org/wikipedia/commons/1/17/Swollen_hand_during_a_hereditary_angioedema_attack..jpg)

3. nabob -- I had always thought of "nabob" as the name of a Canadian coffee brand, but the common noun refers to a wealthy individual, or, back when the Nabob company started in 1896, "a person who returned from India to Europe with a fortune". I guess Nabob was trying to market classy coffee! (Bonus: this great Nabob ad!)

   

   (http://www3rs.nabob.ca/en/mission.html)

   

What is something interesting that you learned this week?