Q: The medical and forensic issues in Speaking in Bones are detailed in so many areas, not just bones. Will you talk about that?

A: I use a lot of medical details. I work closely with pathologists, so when I have a question, I direct it to the appropriate expert. I don’t want every book to be driven only by bones. I try to bring different kinds of forensic science into each story–whether it’s blood spatter pattern analysis, gunshot wounds, trajectory analysis, toxicology, or DNA analysis. I double check all those facts to make sure I’m getting them right.

Q: So the takeaway is: rely on experts in areas beyond your own expertise.

A: Exactly. Those are the only parts of my manuscript I let anyone read before submitting it to my editor. For instance, I’ll have a forensic odontologist review two paragraphs in the manuscript dealing with bite mark analysis, to make sure I got it right.

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Southern Flannel Moth - Megalopyge opercularis 

The Southern Flannel Moth, Megalopyge opercularis (Lepidoptera -Megalopygidae), is an attractive small moth that is best-known because of its larva, commonly known as the Puss Caterpillar (bottom photo), which is one of the most venomous caterpillars in the United States.

Occasionally, in outbreak years, puss caterpillars are sufficiently numerous to defoliate some trees. However, their main importance is medical. The venomous spines of puss caterpillars are hollow and each is equipped with a venom gland at its base. All larval instars, as well as exuviae, may sting but the toxicity of the stings increases with increasing size of the larvae. Envenomation from the spines of the caterpillar causes severe pain, burning, swelling, nausea, abdominal distress, and headache.

This moth is distributed throughout the southern United States, Mexico and Central America.

Reference: [1] - [2]

Photo credits: [Top: ©Patrick Coin (CC BY-NC-SA 2.0) | Locality: Durham County, North Carolina, US, 2004] - [Bottom: ©Donald W. Hall]

The Dirty Side of Soap
Triclosan, a common antimicrobial in personal hygiene products, causes liver fibrosis and cancer in mice

Triclosan is an antimicrobial commonly found in soaps, shampoos, toothpastes and many other household items. Despite its widespread use, researchers at University of California, San Diego School of Medicine report potentially serious consequences of long-term exposure to the chemical. The study, published Nov. 17 by Proceedings of the National Academy of Sciences, shows that triclosan causes liver fibrosis and cancer in laboratory mice through molecular mechanisms that are also relevant in humans.

“Triclosan’s increasing detection in environmental samples and its increasingly broad use in consumer products may overcome its moderate benefit and present a very real risk of liver toxicity for people, as it does in mice, particularly when combined with other compounds with similar action,” said Robert H. Tukey, PhD, professor in the departments of Chemistry and Biochemistry and Pharmacology. Tukey led the study, together with Bruce D. Hammock, PhD, professor at University of California, Davis. Both Tukey and Hammock are directors of National Institute of Environmental Health Sciences (NIEHS) Superfund Programs at their respective campuses.

Tukey, Hammock and their teams, including Mei-Fei Yueh, PhD, found that triclosan disrupted liver integrity and compromised liver function in mouse models. Mice exposed to triclosan for six months (roughly equivalent to 18 human years) were more susceptible to chemical-induced liver tumors. Their tumors were also larger and more frequent than in mice not exposed to triclosan.

The study suggests triclosan may do its damage by interfering with the constitutive androstane receptor, a protein responsible for detoxifying (clearing away) foreign chemicals in the body. To compensate for this stress, liver cells proliferate and turn fibrotic over time. Repeated triclosan exposure and continued liver fibrosis eventually promote tumor formation.

Triclosan is perhaps the most ubiquitous consumer antibacterial. Studies have found traces in 97 percent of breast milk samples from lactating women and in the urine of nearly 75 percent of people tested. Triclosan is also common in the environment: It is one of the seven most frequently detected compounds in streams across the United States.

“We could reduce most human and environmental exposures by eliminating uses of triclosan that are high volume, but of low benefit, such as inclusion in liquid hand soaps,” Hammock said. “Yet we could also for now retain uses shown to have health value — as in toothpaste, where the amount used is small.”

Triclosan is already under scrutiny by the FDA, thanks to its widespread use and recent reports that it can disrupt hormones and impair muscle contraction. 

10 of the Deadliest Proteins on Earth

Proteins are the building blocks of life, and the reason we’re all here on this planet. So it’s weird to realize that proteins can be some of the deadliest poisons of all. We’ve already told you about the most dangerous chemicals — but some proteins that are found in nature can be the deadliest substances of all.

Here are 10 proteins that can kill you quickly and efficiently in nano-level qualities — and one of them is already inside you.

10. Ricin
Readily available from castor beans, ricin is an extremely potent toxin. Ricin prevents the synthesis of proteins by disrupting the ribosome, effectively inhibiting the activities of the human body on a cellular level.

Chewing a handful of castor beans can lead to death, and one of the scariest terrorist threats is inhalation of ricin in a purified powder form. If you inhale powdered ricin, respiratory and digestive problems occur within six to eight hours, and death follows in 36 to 72 hours.

9. Cholera toxin
Cholera toxin is interesting from a structural standpoint. The active form of the protein is created from two different subunits that must be assembled correctly in order to create the working toxin. The two subunits have different functions, and when working together, they cause a flood of negatively charged chloride ions, a flood quickly followed by an increase in the presence of positively charged sodium and potassium ions as well as water in the intestine.

Intestinal chaos quickly ensues, with infected individuals becoming dehydrated as the body sheds several liters of fluid in the form of watery diarrhea in hopes of restoring order.

8. Major Prion Protein
Remember “Mad Cow Disease,” aka bovine spongiform encephalopathy? This is the protein that causes it. Major prion protein (also known as PrP) is already found throughout the human body, particularly within the nervous system. A slight change in the three-dimensional structure of the protein leads to a variety of debilitating and deadly diseases.

7. Pertussis toxin
Another multi-subunit protein, pertussis toxin shuts down communication between cells inside your body.

Pertussis toxin is released by the bacteriaBordetella pertussis, with the protein interfering with the body's immune system. This combination of a compromised immune system and intercellular communication problems aids Bordetella pertussis in causing cases of whooping cough.

6. Ectatomin
The primary toxic component of venom from Ectatomma tuberculatum ants, ectamonin maneuvers into the plasma membrane of cells. Once settled within the plasma membrane, this relatively small protein (a little less than 8 kDa) creates pores within the membrane. These new pores allow for passage of cations across the membrane and a rapid change in electrical gradient, killing the cell.

5. Conopeptides
A series of short molecules made up from the same amino acid building blocks as proteins, conopeptides originate from poisonous marine cone snails. The snails deliver the peptides through their tooth-like, disposable radula (which you can see on the left).

Conopeptides are a hot topic inpharmacology, with researchers attempting to derive neurological and cardiac drugs using the basic structure of these poisons.

4. Abrin
The lesser known cousin of ricin, abrin is a protein found in seeds of the rosary pea. The CDC labels abrin as a potential agent for chemical terrorism, because it’s significantly more potent than ricin and there’s no antidote. Vomiting, bloody diarrhea, and hallucinations follow the ingestion of abrin — with death often occurring in three days due to complications from spleen, kidney, and liver failure.

3. Verotoxin
I’m a big fan of this one just because of the name. Verotoxin is often found in cattle feces, making for an easy way to spread the dangerous protein to humans.

This toxin interferes with the creation of proteins within small blood vessels in the kidneys and gastrointestinal tract. Eventually, the damage to the blood vessels will result in decreased organ efficiency or complete organ failure.

2. Tetanospasmin
This neurotoxin eventually causes muscle spasms, the telltale symptom of tetanus. The protein travels through the body with the aim of finding the nervous system. Once in the nervous system, tetanospasmin irreversibly binds to neurons.

While bound, tetanospasmin blocks the release of neurotransmitters by degrading the protein synaptobrevin. This increases muscle sensitivity, leading to the spasms associated with tetanus. Contact with tetanospasmin is extremely deadly, with as little as 200 nanograms capable of causing death in a human. To put this in perspective, an ant weighs about 1500 times the lethal dose of tetanospasmin.

1. Botulinum toxin
First discovered in improperly handled meat products, botulinum toxin is the most toxic substance known to humankind. As little as100 nanograms of pure botulinum toxin can kill the average human. The onset of symptoms varies from six hours to ten days, with the toxin leading to paralysis of muscles involved in breathing and death.

Botulinum toxin also the protein behind the commercial product Botox, the cosmetic product that paralyzes facial muscles in order to eliminate wrinkles.

Cadaver Charred in Car Fire

Despite loss of the outer layers of the body (including the outer arteries and veins), it’s generally still possible to do all of the internal autopsy, as well as collect toxicology samples.

Vitreous fluid (from the eyes) is the most likely to be destroyed or too contaminated to test, but was still found to be available over 40% of the time in Eastern US autopsies performed after fire exposure (where exposure caused 75%-100% of the body to be charred past the dermis). Blood can be obtained from central and femoral areas, rather than peripheral veins.

POISONING PREVENTION IN KIDS

A new U.S. study in the Journal of Pediatrics suggests that there has been an increase in the number of children 5 years old or younger who were accidentally poisoned by pharmaceutical products.  Between 2001 and 2008 there was a 22% increase in these poisoning incidents, even though the population under 5 years old only increased by 8% in that period.  More than half of the hospital visits for accidental poisonings were because of prescription medications, especially narcotic pain medications, tranquilizers or sleeping pills, and heart medications.

In Canada, both over the counter and prescription drugs account for 2/3 of accidental poisonings in kids under the age of 14.  But with the proper precautions, these accidents can be prevented.  The main strategy is to secure your medications, lock them away out of reach of kids, even if you use them daily. 

You may want to think about storing your medications in a box that you can lock with a key, or secure with a padlock.

Or if you keep your medications in a cabinet, make sure you can lock the doors.

Keeping the medications in the original packaging can provide an extra level of safety, especially if the container is childproof.  This can also help to avoid confusion as to whether the pills are candy.

And remember to keep the phone number of your local poison control service in a place where you can easily access it in an emergency – sticking the number to your refrigerator may be a convenient choice.  And of course if you don’t know the poison center’s number call emergency services at 9-1-1 if you think someone may have been poisoned.

For a full list of tips to prevent child poisoning, see: http://bit.ly/oK9iPl