Surgical instruments & ‘mad cow’ disease

NHS failed to sterilise surgical instruments contaminated with ‘mad cow’ disease
The Independent. 30 November 2013

variant Creutzfeldt-Jakob disease (vCJD)

the lethal prion protein, which sticks to the stainless steel of surgical instruments like superglue and can survive the high temperatures of hospital autoclaves.

“The solution we developed was a combination of enzymes and detergents, if you like a sort of bespoke biological washing powder which very effectively prion-decontaminated metal surfaces,” Professor Collinge said.

“They’ve had to be notified that they’ve had a significant exposure to prions because they are expected to take precautions. They are not allowed to be blood donors and if they go on to have surgery they have to notify the surgeons that they are high risk individuals.

DuPont, an American chemicals company, worked out a way of manufact uring Professor Collinge’s product as a 50C pre-soak for surgical instruments, but because this would involve changing the standard procedures for how medical devices were sterilised, NHS hospitals refused to adopt it

About 200 hospital patients have been told that they have been exposed to the vCJD prion through instruments that were used on other patients who subsequently died of the brain disease. Three out of the 177 people in the UK who have died of vCJD received contaminated blood, and the rest are assumed to have been infected by meat or meat products contaminated with bovine spongiform enceph alopathy (BSE).

There are fears of secondary infections from asymptomatic carriers in the population. Latest estimates suggest that up to one in 2,000 people in Britain could be carriers of vCJD.

Because the prion protein responsible for vCJD is found in a wide range of tissues, such as spleen, tonsils and appendix, the fear is that asymptomatic carriers may spread the infection to others through contaminated surgical instruments and blood donations.

Escaping the here and now

Escaping the here and now: Evidence for a role of the default mode network in perceptually decoupled thought
NeuroImage, 2013, 69, 120-125.
Smallwood, J. et al.

Cognition that is not based on perception can lead to at least two different outcomes.
In some situations, cognition that is independent of perception can allow actions to be selected other than those prescribed by immediate perceptual input.
In others, cognition can be independent of perception and unrelated to the current behavioral goal allowing thoughts to develop that are largely independent of the actions involved in an external task.
The default mode network (DMN) has been implicated in both of these kinds of perceptually decoupled thought.
The current experiment used functional magnetic resonance imaging to explore whether a common region of this network was co-activated by both of these states.
Both the medial pre-frontal cortex and the posterior cingulate – two major hubs of the DMN – showed greater activity when (i) actions that did not depend upon immediate perceptual input were faster and
(ii) when actions based on perceptual input were slower.
Together these data suggest that the DMN is important in cognition that is independent from perceptual input regardless of whether such thoughts result in action, or, instead compete with the behavioral goals of the moment.


  • Absent-minded lapses;
  • Daydreaming;
  • Default mode network;
  • Medial prefrontal cortex;
  • Posterior cingulate;
  • Mind-wandering;
  • Response time;
  • Stimulus-independent thought

see also:
The silver lining of a mind in the clouds: Interesting musings are associated with positive mood while mind-wandering. 
Frontiers in Psychology, 2013, 4
Franklin, M. S., et al.

Neuroscience: Idle minds
Neuroscientists are trying to work out why the brain does so much when it seems to be doing nothing at all.
19 September 2012
the stream of consciousness