Drug-Resistant , Hospital Acquired Fungal Pathogen

"[They're not] thermo-tolerant. They don't grow well in hot conditions and by hot, I mean body temperatures, like us. Like, 37 degrees [Celsius]."

"Fungi are an entire kingdom of life of their own. They're quite distinct from other organisms."

"[They're microscopic, in many cases] except when they come up as mushrooms." 

"They consist of everything from yeast that raise bread and make beer, to moulds and mildews and all the terrible things that affect our crop plants."

"[But they're also] fantastic chemists. They make such amazing molecules. [Penicillin comes from a fungus; the antibiotic era was launched out of the discovery of penicillin]."

"It probably jumps onto your skin first. You can imagine, especially if you're in a hospital, where there's lots of lines into you, and you're being poked and prodded a lot, it creates an opportunity for the skin to break and the fungus to get in."

Professor Gerry Wright, Department of Biochemistry and Biomedical Sciences, McMaster University

Also concerning was a tripling in 2021 of drug-resistant cases. Photograph: Shawn Lockhart/AP

 

The name of the fungus that is causing such consternation for its lethality and its future spread considered a new and burgeoning "urgent threat" to humans is candida auris. Unlike most fungi that affect humans this one is able to reproduce in warm-blooded bodies and it is "intrinsically resistant" to multi antifungal drugs. Candida auris has alarmed American hospitals where it has been spreading at an alarming rate. According to the U.S. Centers for Disease Control and Prevention, candida auris cases tripled between 2020 and 2021,

People who are extremely ill or who are immunocompromised represent those at increased risk of acquiring C. auris; generally it does not represent a health threat to healthy people. Its death rate is 28 to 53 percent, According to the World Health Organization. Canada's Public Health Agency has reported a total of 43 cases. In the U.S. the total is 4,041.

Professor Wright has focused on the study of fungi for the past 40 years, beginning when the HIV crisis was peaking. "Folks were dying", because their collapsing immune systems were unable to fend off "opportunistic" infections such as fungal infections.  Candida Auris is a form of yeast first discovered in 2009 in Japan, when a 70-year-old-woman's ear canal was found to be hosting the fungus. Infections of the blood, heart, central nervous system, eyes, bones and internal organs can be caused by the organism.

Candida auris, CDC

Candida Auris has been found on sinks in hospitals, on bed rails, on curtains and floors "where it can persist for up to a month", according to the University of Minnesota Centers for Infectious Disease Research and Policy. "Right now this is not something that people walking down the street should be frightened of", cautions Professor Wright. Those with weak immune systems and hospital patients with "indwelling" medical devices such as ventilators and catheters are the most vulnerable.

"We really didn't know anything about candida auris until the first report [in 2009]. But almost simultaneously, it was discovered pretty much all around the world, and it sort of emerged all at once", explained Professor Wright. According to one hypothesis, as the world's temperature increased, the fungus adapted to survive in warmer environments "and that provided it with an opportunity to infect humans", stated Dr. Wright. In the mid-1980s once antiretroviral drug cocktails became "groundbreakingly" effective against HIV, invasive fungal infections were reduced in number to a dramatic extent.

And now, Professor Wright believes the time is right to take infectious diseases as seriously as medical science takes chronic diseases like diabetes and cancer. Complacency surrounding infectious diseases because of vaccines and antibiotics has led medical science to neglect the need to focus on research that will prepare the world for ever greater numbers of emerging pathogens and the steps needed to deal with their presence either through cures, new vaccines or therapies that can prolong life, not the pathogens.

dpa picture alliance/Alamy Stock Photo

"This is like the genie out of the bottle. These bugs are here,they're in our hospital systems, they're in our long-term care facilities. They're not going to get any easier to treat."

"We don't know how bad it's going to be, but people are going to die, and we need to be aware of it and find ways to detect it in the first place, but also to treat it."

"...If you're in a long-term care facility it's unlikey that you're going to be able to detect it until there's an outbreak. It's not routinely looked for. It might be in the future, as this starts to grow."

"[The result:] You have this sort of almost perfect storm. You don't have a lot of drugs available to treat a fungal infection in the first place, you've got a pathogen that has evolved the ability to infect us because it's learned how to live at higher temperatures, and that fungus happens to be intrinsically drug-resistant to begin with."

Professor Gerry Wright

Awaiting Alzheimer's Brain Untangling Drug : Second Time Around

"People affected by Alzheimer's have waited a long time for a life-changing       treatment and today's announcement offers hope that one could be in sight."        "It is reassuring that this devastating disease remains a priority concern for drug regulators and with no disease-modifying Alzheimer's drugs getting this far before, we are in uncharted territory."                                                                                Samantha Benham-Hermetz, director, policy and public affairs, Alzheimer's Research UK

"[Approval of the drug would be a] historic milestone."                                "Reducing clinical decline and maintaining the ability to live an independent life for as long as possible are things that people living with Alzheimer's and their families value in a potential treatment."                                                                                 "If aducanumab is approved, we expect it will make a difference in the lives of people living with Alzheimer's." Haruo Naito, chief executive, Eisai, Japanese pharmaceutical firm

Back in 2019 manufacturers Biogen and Eisai took steps to put an end to two late-stage Alzheimer's drug trials, making the tough decision to set aside plans that the treatment be developed. Studies had indicated the treatment would be of no benefit to Alzheimer's sufferers. A new analysis has been undertaken since then using a greater amount of data available once the trials were stopped, finding the drugs did indeed work. They had to be administered at an early stage in a sufficiently high dosage to be effective, leading the two drug developers to seek approval a second time.

Alzheimer's disease at the present time is without any kind of truly effective treatment. A cure may be possible, but it may also be a long way into the future. Now, however, experts feel that the first drug that may halt Alzheimer's, will be fast-tracked for approval, representing the most hopeful breakthrough in dementia treatment yet devised. Because the drug is being given "priority review" it is possible that within six months it can be prescribed. Answering the hopes of those who suffer from the relentless mind-occluding disease.

Medicines currently prescribed for Alzheimer's do no more than mask the symptoms. The new treatment works by helping to untangle plaque clumps in the brain and in so doing may be the first successful drug to stop the deterioration the disease causes, according to trial results. Patients given aducanumab were seen to be improved in language skills and time-tracking, along with a more reduced loss of memory. Targeting early signs of dementa will lead to halting the progression of the disease; at the very least slowing its progress before total incapacitation.

The review is expected to take six months in establishing whether the drug is safe and effective, thus ushering it to licensing first in the United States, and then placing it under consideration elsewhere around the world. Its efficacy has been monitored by scientists around the world, following initially uncertain trial results. 

Five months following the decision to halt the aborted trials, there is now enough confidence to allow the trials to continue, with the knowledge that a higher dosage and earlier application leads to aducanumab's treatment success. This is the first time in 17 years the U.S. Food and Drug Administration is preparing to review a drug for the treatment of Alzheimer's disease, and it would represent the first treatment designed to deter progression of the disease, to be approved by regulators.

Aducanumab is designed to untangle clumps of amyloid beta, the protein plaques which form in the brain, a hallmark of Alzheimer's disease. It is an anti-body drug. The plaques are held to be partially responsible for memory loss and cognitive decline. Chief executive at Biogen, Michel Vounatsos, a multinational biotech firm in Cambridge, Massachusetts stated: "We believe that aducanumab marks the beginning of a new era of potential treatments for Alzheimer's disease".

A review of brain scans of patients with dementia at the Banner Alzheimer’s Institute in Phoenix. Biogen, a drug company, said on Tuesday that it would seek approval for a drug to treat early Alzheimer’s disease. Credit...Matt York/Associated Press

The Mystery of Life and Death

"We can then look at survivors and see if they can recall any of these stimuli, and when they were able to receive information, and how that relates to their brain resuscitation quality."
"What happened to this person's mind and consciousness, this sweet human being that I was talking to just a half an hour ago? Is he conscious? Is he able to see us, hear us? When did he lost it, if he did lose his consciousness?:
"Transcendental mystical or spiritual experiences close to death have been described for millennia. The problem with all those studies are that none of them are causative -- none of them show you how brain cells could possibly generate a thought, which is the fundamental problem of consciousness."
"Why would my brain cells, millions of them connected together, suddenly feel guilty, or have a sentiment of guilt, like if I were to throw a brick in my neighbour's window, or be rude to somebody or do something immoral?"
"Yet, paradoxically, what we started to see is that millions of people have now been resuscitated, and many of them have reported these very lucid, well-structured thought processes [able to to form memories, describe conversations and what people were wearing] Except that their brain has shut down and they've gone through death. Which is completely a paradox, it should not happen."
"We're all conscious, thinking beings. Everything we do starts with consciousness. Yet we don't know fundamentlaly where it comes from."
Dr. Sam Parnia, author, AWARE, awareness during resuscitation, resuscitation specialist, NYU Langone Medical Center

Cornelia Li for National Post

"If you take that organ [the brain] away or kill that organ or that organ dies, you cannot be conscious. [While there is no identified conscious centre of the brain, nothing to point to and claim] 'there, that's where it all happens."
"And I know of no case in the literature of a brain dead patient coming back."
Adrian Owen, neuroscientist, Western University

"Serotonin in particular was very high [in dying brains]. We know that the serotonin is associated with hallucinations and other mental functions."
"But the part that is at least partly responsible for conscious information processing is actually increased tremendously in the dying brain [for 30 seconds at least]."
Jimo Borjigin, associate professor, University of Michigan Medical School

Dr. Parnia believes that human consciousness may very well go on even after our heart stops beating for an undetermined period of time. He has taken the testimony of many people whose detailed descriptions of their out-of-body-at-death experience he gives credence to. A man, for example who suffered a cardiac arrest, and his brain "flatlined", with no sign of brain activity of any meaning. He described someone beckoning to him from the ceiling, and then the next second, "I was up there, looking down at me", a corpse, surrounded by doctors, nurses.

He witnessed his blood pressure being taken, a doctor placing something down his throat, saw a nurse pumping on his chest. He described the people, the sounds and the events of his eventual "resurrection". The man experienced conscious awareness for three to five minutes in the absence of detectable brain activity, "When no human experience should be happening whatsoever", stated Dr. Parnia, who cited the case in his study published in 2014 called AWARE.

According to Dr. Parnia, who has made himself an expert on the phenomenon, evidence from AWARE along with other related studies brings in the possibility that the mind or consciousness; the psyche, the "self", the spirit that reflects our uniqueness may not originate after all in the brain as popularly imagined as reality, but may rather reflect a separate, as yet-undiscovered scientific entity. Modern science at the present time lacks the tools required to demonstrate this, that when we die, what we name consciousness or the self does not become "immediately annihilated".

Dr. Parnia is not religious, he is not looking for proof of an afterlife; he and others who believe as he does are attempting to discover improved methods whereby the brain can be saved to avoid "disorders of consciousness", such as that which afflicted a Florida woman who suffered massive brain damage which resulted in a permanent vegetative state following a cardiac arrest. He is also searching for a method whereby he can test the accuracy of fantastical claims of near-death experiences with the use of objectively scientific approaches.

He plans to measure, second by second, oxygen levels inside the brain through a planned study of 1,500 people in cardiac arrest when a "code" is called so participating researchers, once alerted can dispatch themselves to resuscitation rooms with backpacks carrying portable brain oxygen monitoring devices. A portable EEG will measure whether the brain is functioning, and patients will be fitted with wireless headphones where random words and sounds will be transmitted and images beamed upwards as people undergo CPR.

The ultimate goal is to understand the optimal brain oxygen levels to be targeted by doctors during cardiac arrest and CPR to be able to optimize survival and bring a whole person back from cardiac arrest, with intact brain and mind and full functionality for their living future. This reflects advances in resuscitation where death can be reversed in those who have lacked a pulse for hours. Even greater numbers of people could be brought back across the death threshold, believes Dr. Parnia, if more hospitals implemented advanced techniques; chilling bodies to protect the brain, or using automated mechanical devices for chest compressions beyond what a human could perform.

Most people ultimately die of cardiac arrest, irrespective of how it has come about; the drop of blood pressure, the heart's inability to pump sufficient blood to supply the body, the heart eventually stops, respiration stops, electrical activity to the brain stops, and the brain flatlines. Studies suggest that six to 23 percent of cardiac arrest survivors report having clear memories fitting the parameters of a near-death experience. From a functional perspective, the moment the heart stops, the brain shuts down, said Dr. Parnia; even so, people become resuscitated, they form memories, describe conversations, "Except that their brain has shut down and they've gone through death".

The notion of a soul or mind existing separate from the body, charge his detractors is absurd. "I thought to myself, we can probably figure this [conundrum of brain-mind and near-death phenomenon] out in, like, a year, year-and-a-half of research", muses Dr. Parnia. He's still struggling with it after twenty years, with no end in sight, but opportunities to conduct further research, looking for that elusive "eureka!" moment of discovery.

Cornelia Li for National Post

Opioid Addiction : Probuphine Implant

"We are early in our launch. What we're trying to do is make sure that if a physician has a patient who they feel would benefit from Probuphine what we would do is co-ordinate with that physician so that if they're not trained they have access to someone who is trained and is close enough to them and their patients."
Samira Sakhia, president, Knight Therapeutics

"It's so important to have a number of treatment options because there's no one-size-fits-all for turning the tide on the opioid crisis", explained clinical researcher Dr. Seonaid Nolan, with the B,C. Centre on Substance Use. Dr. Nolan is an addiction medicine physician at St.Paul's Hospital in Vancouver, who happens also to be medical director of the addiction program at Providence Health Care.

She is referring to a slender rod the size of a matchstick containing the medication buprenorphine used as an implant subcutaneously (under the skin) of the upper arm, marketed under the brand name Probuphine, the first of its kind in treatment of opioid addiction. Dr. Nolan considers the implant another option for treating opioid addiction, followed by methadone.

The advantage of the implant is that there are no impediments to its function; no longer must patients remember to take their daily tablets of Suboxone, an especial challenge for people in addiction mode confused with poverty, homelessness, unemployment. Use of the implant would negate the need for patients to be supervised while taking their drug, to ensure compliance and to eliminate the risk of the drug being diverted or misused.

This photo provided by Braeburn Pharmaceuticals shows the Probuphine opioid implant. Federal health officials on Thursday, May 26, 2016, approved the innovative new option for Americans struggling with addiction to heroin and painkillers: a drug-oozing implant that curbs craving and withdrawal symptoms for six months at a time.    Braeburn Pharmaceuticals / ASSOCIATED PRESS

A doctor at St.Paul's Hospital has been trained on the method whereby the implant should be inserted, a procedure considered a preferential option for people leaving correction facilities, residential treatment programs and hospital stays of any duration because of their reduced tolerance to illicit opioids, placing them at higher risk of overdose.

The recommendation has gone forward for provincial drug plans to reimburse the cost of the implant to patients who have been stabilized on no more than eight mg of buprenrphine, linked with counselling. That recommendation from the Canadian Agency for Drugs and Technologies in Health, tasked with reviewing all drugs and devices approved by Health Canada.

Their drug-expert committee feels the cost of the implant should ideally not exceed the cost of a total drug plan of buprenorphine at a cost not to exceed 8 mg daily. In the hardest-hit province in Canada, the Health Minister of British Columbia has stated the independent Drug Benefit Council is undertaking its own review of the implant initial to determining whether the cost will be covered in light of more than 3,000 overdose fatalities in the past two  years.

Knight Therapeutics in Montreal has licensed the implant from an American company, enabling ti to commercialize and distribute the implant in Canada, where its cost is slated to be $1,495 for each implant of four devices, equivalent to six months of treatment with Suboxone -- and to that end, the company has trained doctors in major Canadian cities on the therapeutic implant procedure.

Four 1” implants are placed discreetly in the underside of the upper arm, just beneath the skin.  

Overcoming Bacterial Resistance to Antibiotics

"We've developed a technique that we could see how the antibiotics are trying to stab the bacterial cells."
"The big challenge that we are facing is that the drugs we used to treat diseases with are in the process of not working anymore because bacteria are becoming more and more resistant to these drugs."
"The idea we had is every disease and bacteria is treated differently so we tried the opposite -- to see if there are common properties of all bacteria, if there is a general mechanism for this bacterial resistance that one could tackle."
"The antibiotics kind of poke into that membrane [surrounding the bacteria] and stab the cell to death. But the bacteria found a mechanism to reduce the [electrical] charge they have, which makes them less attractive to antibiotics, and they made their membranes tougher."
"There are many, many bacteria out there, and so many antibiotics, but by proposing a basic model that applies to many of them, we can have a much better understanding on how to tackle and predict resistance better."
Maikel Rheinstadter, physics professor, McMaster University, Hamilton

"For the drug, it's like going from cutting Jell-O to cutting through rock."
"We wanted to find out how this bacteria, specifically, was stopping this drug in this particular case. If we can understand that, we can design better antibiotics."
"If you take the bacterial cell and add this drug, holes will form in the wall, acting like a hole-puncher, and killing the cell. But there was much debate on how these holes were formed in the first place."
Andree Khondker, undergraduate bio-chemistry student, McMaster University

Maikel Rheinstädter (left) and Andree Khondker. (Photo by JD Howell)

Two researchers out of McMaster University in Toronto, one a professor of physics, the other an undergraduate in bio-chemistry, have recently published a research paper in Nature Communications Biology outlining and explaining their finding, that bacteria fight off antibiotics through stiffening their cell membranes, altering the electrical charge in the barrier, thus appearing a less inviting target to the drugs.

Their focus was on polymyxin B, used when all other antibiotics have failed. Chinese researchers had earlier discovered the presence of a gene permitting some bacteria to evolve resistance to this most powerful of drugs. Dr. Rheinstadter explained how his team made use of X-ray imaging, alongside computer simulations, to achieve molecular-level resolution to enable them to view the polymyxin B interacting with the antibiotic-resistant bacteria.

Using this technique they were able to view bacteria at a resolution one-millionth the diameter of a human hair. The application from a physics perspective with the use of techniques most frequently found in materials research succeeded admirably. There is a membrane wrapped around bacterial cells often negatively charged -- while many antibiotics have a slightly positive charge and so they become attracted to the soft membrane.

By hardening the membrane, that attraction is no longer viable. About 700,000 people die annually around the world as a result of drug resistance to illnesses, according to the World Health Organization. With this knowledge of how bacteria resist antibiotics, researchers will be more geared toward designing drugs to circumvent this bacterial defence strategy.

"We also think we can use it to screen through potential antibiotic drug candidates", explained Dr. Rehinstadter. "If researchers come up with new ideas, we can quickly test them [to determine whether they will work]."

Bacterial Membranes Influence Antibiotic Resistance   ChemistryViews

Risks of Underage Cannabis Use

"My study clearly shows that cannabis does not cause schizophrenia by itself. Rather, a genetic predisposition is necessary."
"It is highly likely, based on the results of this study and others, that cannabis use during adolescence through to age 25, when the brain is maturing and at its peak of growth in a genetically vulnerable individual, can initiate the onset of schizophrenia."
Dr. Lynn E. DeLisi, Harvard Medical School

Cannabis, also known as marijuana, is a product of the plant Cannabis Sativa.

"It has long been known that cannabis use can cause an acute psychotic episode in some individuals and recent epidemiologic studies suggest that frequent cannabis use in adolescents may lead to an acute psychosis that by itself develops into chronic schizophrenia. However, the majority of individuals who use cannabis do not develop a psychosis or schizophrenia. Thus, some additional mechanism must underlie the development of schizophrenia in those that are affected. If cannabis use can interact with an underlying genetic basis for the illness, changes in brain structure characteristic of patients with schizophrenia will be seen in those cannabis users who later develop schizophrenia. The brain changes may represent the genetic vulnerability for schizophrenia and be predictive of who develops the illness. Thus, Aim #1 (primary aim) of this proposal is to determine whether brain structural deviances in temporal and frontal lobes and their white matter connections will predict which cannabis users develop schizophrenia. To accomplish this we will evaluate consecutive admissions with a first psychotic episode subsequent to cannabis use admitted to two large NYC psychiatric emergency rooms. These patients will be compared with adolescent cannabis users who never had a psychotic episode, and age, sex, and social class matched non-cannabis using controls. The presence of brain structural anomalies, particularly those characteristic of patients with chronic schizophrenia psychoses will be determined by MRI scans. All cannabis using subjects will have a diagnostic follow-up evaluation one and two years subsequent to the first psychotic episode to determine who developed a diagnosis of schizophrenia or whether the initially non-psychotic individuals remained symptom-free." "Aim #2 of this proposal is to examine whether brain abnormalities among cannabis users with a first schizophrenic-like psychosis are associated with increased genetic risk for schizophrenia. This will be achieved by obtaining family information from reliable family informants. This study will ultimately have implications for early treatment strategies in adolescent cannabis users who are at high genetic-risk for psychosis and suggest early biological warning signs through MRI evaluations of individuals who have an acute psychosis following cannabis use."
Abstract:   Biological Prediction of Psychosis Susceptibility among Adolescent Cannabis Users  Delisi, Lynn Eleanor    Harvard University, Boston, MA, United States

During the teenage years of brain development unneeded connections between brain cells in the prefrontal cortex are stripped away; this is the area that controls thinking and planning. This is also the region that becomes perturbed when psychotic conditions arise, a region rich in CBI (cannabinoid) receptors involved in pruning the brain, and which become engaged by the use of cannabis. The result is the potential for alterations to the pruning process to occur. leading to an increase in the risk of schizophrenia, according to recent research. 

Circumstantial evidence exists that a biological mechanism can be triggered with the use of cannabis, causing a psychotic disorder with a tendency to emerge in late adolescence or early adulthood, matched to a period of rapid brain development. There is a realization that an inherited genetic vulnerability is involved, since psychotic conditions tend to be genetically inherited as a familial trait. Studies suggest that people are likelier to experience paranoia with cannabis use when they are already at a heightened risk of psychosis.

A study conducted in 2014 found a heightened schizophrenia risk among those with a family history, irrespective of cannabis use, leading to the understanding that familial risk for psychotic disorders outweigh possible added effects of cannabis use. According to Dr. DeLisi of Harvard Medical School, it appears likely that cannabis use during adolescence to age 25 can have the effect of initiating schizophrenia onset. However, research that might finally settle the question is scarce since marijuana has been illegal for a long period of time.

With the legalization of marijuana, policy makers and physicians are increasingly aware of the potential dangers of recreational marijuana use given that experts make a distinction between the "new cannabis" strains that are legal and far more potent now available in edibles and vapes, as opposed to the old version which comes in as a much milder weed. T.H.C., the chemical producing marijuana's narcotic effect has been rising for the past three decades. But well before then, about 70 years ago the suspicion among doctors that a link existed between marijuana and psychosis in the young existed.

Other stimulants such as caffeine, nicotine, alcohol can also be viewed as a potential cause of psychosis and hallucinogenic effects when taken in excess, just like marijuana. The temporary disorientation with peculiar imagined sights and sounds, on occasion accompanied by paranoia are the symptoms of psychosis yet the vast majority of those who experience a psychotic episode fail to develop a persistent condition such as schizophrenia, characterized by episodes of psychosis recurring for years.

The debate now ongoing revolves around the distinction between correlation and causation where people with psychotic problems often use cannabis on a regular basis, but on the other hand what is as yet unclear is which came first, the habit of using cannabis or the psychosis. And, to date, insufficient evidence exists to define whether heavy cannabis use causes schizophrenia or other syndromes. This issue is quite aside from that of possible brain damage occurring with the constant use of marijuana by under-aged users.

The end result of studies and conclusions and alternating theories rests with the issue that everyone agrees with, that the regular use of the newer, high-potency cannabis may be regarded as a risk for youth who have a family history of psychosis. 

 

Proactive Anti-Oral Health Remedy : Red Wine -- Indulge! ?

"Traditional therapies used for the maintenance of oral health present some limitations, and the search of natural-origin therapies is gaining attention."
Spanish researchers

"Mouthwashes and chewing gums have been proposed as interesting matrices for the application of dietary polyphenols in the management of oral health."
"We tested concentrations in the range normally found in wine - 50 and 10 g/ml."
"Working with cells that model gum tissue we found the two wine polyphenols - caffeic and p-coumaric acids - were generally better than the total wine extracts at cutting back on the bacteria's ability to stick to the cells."
"When combined with Streptococcus dentisani the polyphenols were even better at fending off the pathogenic bacteria."
Dr. Victoria Moreno-Arribas, Spanish National Research Council, Madrid

"It's wonderful, important work. Pretty well every university involved in oral health research is looking at ways to interrupt the process by which plaque adheres and causes dental damage."
"[A test-tube study] is miles from being a product that can be helpful in the real world. But that's how scientific breakthroughs are made."
"The ultimate goal would be to have a rinse or toothpaste or some other dental product that would do both [keep bacteria from adhering to teeth or render it incapable of causing disease]."
"If you remove that sticky layer [conventionally; brushing and flossing at least once daily] nothing else adheres. [Briefly washing red wine alternatively through one's teeth would have little effect] And you still have the alcohol content and other things in wine. I don't think we know what the long-term effects would be."
Dr. Larry Levin, president, Canadian Dental Association

"It's important not to brush your teeth immediately after drinking wine, because the wine is acidic [again, red, white, rosé and even Champagne] and so the enamel can be temporarily softened [wait 30 minutes after your last glass and then brush]."
"We always advise patients to swish around with water in between glasses of wine [to avoid having the acid settle on the teeth]."
Dr. Sivan Finkel, eNews

Chemicals in wine have been found to combat mouth bacteria that potentially causes gum disease   Getty

This week a study produced by a Spanish team of researchers was published in the Journal of Agricultural and Food Chemistry. The study discovered two polyphenols in red wine to have antioxidant effects appearing to aid in preventing plaque-causing bacteria from forming the sticky films on teeth and gums that we know as plaque, the plague of teeth hygiene maintenance. These natural compounds, according to the researchers, are capable of producing results superior to the conventional methods used in dental hygiene, promoted by the medical-dental community.

How the polyphenols work to reduce the stickiness of accumulated bacteria is unknown as yet. Others in the field caution that the experimental doses appeared much higher in concentration than would normally occur when drinking wine. This is, however, clearly an important step forward in the search for protocols that would aid in combating tooth decay. Cavities and gum disease leading to tooth loss affect 60 to 99 percent of the global population. The bacterial plaque comprised of colonies of bacteria are stubbornly difficult to destroy.

This same Spanish team of researchers earlier grew laboratory cultures of cavity-causing bacteria, then proceeded to immerse the biofilms in various liquids. Red wine turned out the clear winner in destroying the bacteria. Furthermore as the researchers manipulated cells mimicking gum tissue, they discovered two red wine polyphenols in particular; caffeic and p-Coumaric acid to be a vast improvement over total wine extracts in their capacity to disrupt porphyromonas gingivalis and other like bacteria from sticking to gums.

With the addition of 'friendly' bacteria (probiotics) the decay-preventive effects were even more pronounced. The working hypothesis seems to be that metabolites forming when polyphenols are digested in the human mouth may play a vital role. From this important data extracted thus far it is hoped that new treatments may be discovered using these findings as a base. The universal search by scientists for new protocols to keep bacteria from adhering to teeth and gums causing disease has been given a huge boost.

Bottoms up! And rinse afterward. Wait awhile, and brush your teeth....

There are however risks associated with drinking wine due to its acidic content   Getty

 

That Diet Drink You Just Ordered? Change it to Tea....

"We have little data on the health effects of diet drinks and this is problematic because diet drinks are popular amongst the general population."

"More research is needed to study the health effects of diet drinks so that consumers can make informed choices concerning their health."

"The sample sizes are different because we studied people of different ages. Dementia is rare in people under the age of 60 and so we focused only on those aged over 60 years for dementia. Similarly, stroke is rare in people aged under 45 and so we focused on people older than age 45 for stroke."

"So, it was not surprising to see that diet soda intake was associated with stroke and dementia. I was surprised that sugary beverage intake was not associated with either the risks of stroke or dementia because sugary beverages are known to be unhealthy."

Matthew Pase, senior research fellow, department of neurology, Boston University School of Medicine

"The FDA, World Health Organization, European Food Safety Authority and others have extensively reviewed low-calorie sweeteners and have all reached the same conclusion -- they are safe for consumption."

"While we respect the mission of these organizations to help prevent conditions like stroke and dementia, the authors of this study acknowledge that their conclusions do not -- and cannot -- prove cause and effect. And according to the National Institutes of Health (NIH), many risk factors can increase an individual's likelihood of developing stroke and dementia including age, hypertension, diabetes and genetics. NIH does not mention zero calorie sweeteners as a risk factor."

"America's beverage companies support and encourage balanced lifestyles by providing people with a range of beverage choices — with and without calories and sugar — so they can choose the beverage that is right for them."

Lauren Kane, spokeswoman, American Beverage Association

"This article provides further evidence though on artificially sweetened beverages and their possible effects on vascular health, including stroke and dementia."

"We believe the pathways of which artificially sweetened beverages would affect the brain are probably through vascular mechanisms."

"When the authors controlled for hypertension and diabetes and obesity the effects diminish, which implies that some of the effects of artificially sweetened beverages could still be going through a vascular pathway."

"Many strokes are caused by hardening of arteries; and the risk of dementia is also increased by the hardening of arteries in large and small vessels. So, I believe the mechanisms may be through vascular disease, though we can't prove it."

Dr. Ralph Sacco, professor, chair of neurology, University of Miami Miller School of Medicine

Sales of diet versions of soft drinks have boomed in recent years, with full-sugar drinks now retaining just 38% of the market. Photograph: Lewis Whyld/PA

Scientific researchers into the popular consumption of diet drinks which use artificial sweeteners in place of sugar appear increasingly convinced that the advertising of these drinks as an answer to concerns over weight gain, attracting people who are interested in losing weight, are complicating these peoples' lives by making them more susceptible not only to weight gain, confounding expectations, but accelerating the onset of serious chronic diseases which have the effect of shortening life-spans.

 

The conventional wisdom that held soft drinks sweetened with artificial sweeteners in lieu of sugar aid a weight-loss diet is being turned on its head, however counter-intuitive that may seem. Artificial sweeteners used in the manufacture of soft drinks may instead, according to a great number of studies, increase weight through stimulation of sweet taste receptors, increasing appetite and cravings for sweet foods. A finding that artificially sweetened drinks increase body mass index in children resulted from a systematic review of 18 studies published in the International Journal of Pediatric Obesity.

Some increasingly common and serious health impacts are demonstrably impacted by diet soft drinks. For example, people with diabetes often reach for diet soft drinks in the belief they are an assist in managing blood sugar levels even though research shows these artificially sweetened drinks lead to glucose intolerance development, a condition thought to arise by intestinal bacteria being negatively affected. In other words artificial sweeteners may in fact promote diabetes in healthy people, according to research published in the journal Nature.

Another study concluded that consuming two or more sodas daily could double the occurrence risk of kidney disease and oddly enough the researchers involved in this study made the discovery that whether or not the soft drink was sugar sweetened or sweetened artificially the outcome was the same. Women who daily consume soft drinks end up with significantly reduced bone mineral density and according to research published in the American Journal of Clinical Nutrition bone density saw no improvement in women using diet soft drinks.

Drinking one or more soft drinks daily, whether sweetened with sugar or artificial sweeteners was seen to increase the risk of stroke by 16 percent, according to a study published in the American Journal of Clinical Nutrition. An 8 percent increased risk of a stroke occasioned by artificially sweetened drinks was identified through a meta-analysis of 217 observational studies published in the International Journal of Clinical Practise, and when people who consumed the most of these drinks were compared to those who used the least, there was a 44 percent risk increase in vascular events.

Independent Co.U.K.

 

Manufacturers of these soft drinks were inspired to build a lucrative new market in the sale of artificially sweetened soft drinks, advertising them as a solution for weight control. It was an argument that people found irresistible; they could indulge in drinking nutritionally deficient, sweetened drinks without penalty of weight gain, yet this growing research body of evidence is negating these claims. 

 

A study published in the Journal of the American Geriatrics Society where researchers followed 749 subjects over age 65 for close to ten years discovered that those consuming a daily soft drink added 3.05 centimetres to waist circumference, though occasional consumers added 1.76 cm. Those who never consume diet soft drinks in comparison, added 0.77 cm. Consideration was given to variables such that people struggling with weight gain being more likely to choose diet soft drinks.

A recent large-scale study out of Canada, published in the Canadian Medical Association Journal reflects evidence that artificial sweeteners fail to accomplish intended benefits and may in fact increase risk of obesity, cardiovascular disease and diabetes. This meta-analysis reviewed data from 30 studies following 405,907 people and seven controlled studies of 1,003 people where it was discovered artificial sweeteners had no significant benefit for body mass index.

As for the 30 studies which had followed their subjects for an average ten years, artificial sweeteners were seen to have been responsible for an increase in body mass index. The studies found artificial sweeteners to be associated however, with increases in weight, waist circumference, obesity, high blood pressure, cardiovascular events, metabolic syndrome, and Type 2 diabetes.

Diet coke -- Independent, U.K.

Marijuana and Impaired Fertility

"The weight of the evidence is that marijuana does affect sperm counts. [Though the odd use here and there is not likely to cause harm, with] heavy users it will definitely affect the quality of the sperm."
"The weight of the evidence is that marijuana probably has a negative impact not only for sperm counts but sperm function."
"[The male fertility effect is notable because] sperm is a very rapidly turning-over cell."
Dr. Victor Chow, clinical associate professor, University of British Columbia 

"The science of it is not very strong, I have to say, because we don't have that many clinical or experimental studies."
"Even though we may not have the strongest data on this, there's some evidence to support what I am saying [suspend marijuana use to conceive]."
Dr. Armand Zini, associate professor of urology, McGill University

"Regular marijuana smoking more than once per week was associated with a 28 percent ... lower sperm concentration and a 29 percent ... lower total sperm count after adjustment for confounders [such as additional factors like weight, smoking and time between the sample given and last ejaculation]."
"Our findings are of public interest as marijuana use is common and may be contributing to recent reports of poor semen quality."
2015 Danish study

Heavy pot smoking may lower your sperm count says a new study.(Photo: Jim Mone, AP)

There it is, studies that point to regular pot smoking leading sperm to become "more mellow and swimming in circles". Rather than aggressively seeking out their target resulting in conception. Studies have taken place to focus on lowered sperm counts, but Dr. Chow's new study appears to validate that marijuana affects sperm's motility, the manner in which it moves. With marijuana legalization on the near horizon in Canada, experts are focusing more directly on discussing the issues of sperm count and function.

The emerging consensus appears to be that heavy marijuana use can lead to immediately affecting sperm production in view of the fact that males produce new sperm every three months. Dr. Chow is at pains to point out that women too attempting to conceive should be aware that they should treat marijuana in the same cautious manner as they would other drugs, tobacco and alcohol, before and during pregnancy.

As far as Dr. Zini is concerned, in his research on male infertility he is committed to advising heavy marijuana users experiencing problems conceiving to cut back on their marijuana use in view of the growing evidence relating to the direct effect of pot use and lower sperm counts and their deteriorating quality. He is also anxious to see more clinical studies so that the issue can be more fully understood.

Herb.co

In the 2015 study undertaken in Denmark, with over 1,200 young men participating, allowed the researchers to determine that smoking marijuana more frequently than once weekly was definitely associated with lower sperm concentration and count. Clearly, not everyone is impressed with these findings and simply doesn't believe the conclusions. The owners of Cannabis Culture who advocate for marijuana appear to feel that Health Canada should remove lowered sperm count from its list of marijuana side effects.

Past studies often focused on THC, the mood elevating component in marijuana, while the complex cannabinoids in pot must also be brought into account, for the complex nature of the drugs may          aid men struggling with infertility. A specific cannabinoid receptor was tagged as a potential aid in triggering cannabinoid receptors enhancing sperm production, resulting from a 2015 study published in the British Journal of Pharmacology.

Disparate claims that only add to the confusion about cannabis use and fertility.  By triggering one element another may be impacted, pointing to the need to embark on further research elaborating on the characteristics of cannabis use, focusing on both its benefits and its hindrances to optimum human health.

Credit: Stokkete/Shutterstock.com   Live Science

The Sunshine Vitamin

"This sun-phobic atmosphere has been promoted for so long. But the abstinence recommendation of not being exposed to one direct ray of sunlight for your entire life defies good logic."
"There is good evidence that the lower the latitude that you live [in the Northern Hemisphere], the lower your risk for high blood pressure, having a heart attack, multiple sclerosis, Type I diabetes, infectious diseases, cognitive dysfunction, and the list goes on."
"You essentially [your body] make no vitamin D before 9 a.m. and after 4 p.m. or 5 p.m., even if  you're at the equator with the sun shining brightly."
"Its just like everything else in life. You have to do it [exposure to the sun's rays] in moderation. And you need to understand the consequences of what you're doing."
Dr. Michael Holick, endocrinologist, Boston University Medical Center

For decades medical authorities have been warning people to stay out of the sun; have no direct sun contact, use Vitamin D supplements to obtain the requisite daily Vitamin D. At one time people were regularly exposed to direct sunlight throughout the course of their daily lives. The Industrial Revolution had the increasing effect of producing soot and smog and before long city landscapes were clouded with particulate matter to the extent that little sunlight penetrated. Children began presenting with rickets, and doctors across the Western world realized that lack of sun had warped growing bones.

The curative powers of the sun and of fresh air were noted by the ancients. The father of medicine, Hippocrates, treated various ailments with a regimen of direct sun exposure. In the late 19th Century, sunshine was prescribed as a treatment for tuberculosis, among other diseases. More latterly, the risk of skin cancer has led the medical community to warn people of the risks inherent in direct, prolonged exposure to the sun. But the key here is 'prolonged' exposure, not limited exposure. Any kind of exposure, however brief, was decried as too risky.

But although Vitamin D has been industrially added as a vital supplement to all manner of foods, most notably dairy products, research reveals that there are a myriad of benefits derived from direct sun exposure. Chemical changes occur when photons in sun penetration of the skin  takes place. The sun influences the creation of nitric oxide, causing blood vessels to relax, lowering blood pressure. Skin cells stimulated by UV radiation produce other hormones to modulate the immune system, and to produce beta-endorphin, making us feel good in sunlight.

Dr. Holick, specializing in vitamin D, sees the value in supplementation, but he also stresses that sun exposure is a requirement for optimum health outcomes. He explains that avoiding the sun may raise risk of other diseases like breast cancer, heart disease and colon cancer. His book, The UV Advantage: The Medical Breakthrough That Shows How to Harness the Power of the Sun for Your Health, recommends people receive five to ten minutes of direct exposure to the sun at least two to three times weekly.

He is a professor of medicine, physiology and biophysics at Boston University. And he also acts as the director of the Heliotherapy, Light, and Skin Research Center at the medical centre of the university. Many of his colleagues, long accustomed to warning patients off sun exposure under the fear that even minute exposure can damage DNA are yet to accept Dr. Holick's arguments fully.

A study out of the UK where light-skinned people were exposed to simulated sunlight produced an interesting effect. "There was some DNA damage, but what was remarkable was that at the end of the study, it looked like there were mechanisms at play to help correct the DNA damage", Dr. Holick pointed out.

Two studies from the Journal of the National Cancer Institute reported that those with daily sun exposure experienced a lower risk of non-Hodgkins' lymphoma. As well, survival rates were increased for patients with early-stage melanoma.

Even while the sun is associated with damage to the epidermis, small doses in exposure appear to effectively heal skin problems, as Dr. Bobby Buka, a dermatologist in New York points out. Inflammatory skin conditions like psoriasis, eczema and acne can be seen to improve when people are exposed to UV radiation for limited periods of time.

Promoting Healthy Skin Microbiome

"Our hope is that by correcting bacteria on the skin, [eczema] patients won’t have to do constant treatment."
"Those bacteria [colonizing the skin of eczema patients] are deficient compared to the same bacteria taken from a healthy volunteer."
"We have done some genetic testing that tells us definitively that those bacteria are different. We took the bacteria from healthy people and we saw that the bacteria does everything you would want it to do to improve atopic dermatitis in a petri dish and in mice. In mice, we can actually make their disease go away with this bacteria."
Dr. Ian Myles, National Institute of Allergy and Infectious Diseases, National Institutes of Health

Most eczema drugs are creams or lotions designed to soothe the inflammation that makes eczema so uncomfortable. aniaostudio / Getty Images

The human skin’s microbiome — the collection of bacteria, fungi and other microorganisms that live on the skin are there to protect us. New research appears to indicate that people suffering from eczema have faulty microbiome, which fail to do the work they have been assigned, to protect those whose skin they colonize. Now, it seems that a promising new treatment is on the horizon, and its cost, when proven beyond a doubt to represent the solution scientists hope it will, is estimated to be around $100 for treatment for a year.

That certainly compares most favourably with, for example, a new eczema drug which the Food and Drug Administration has recently approved called Dupixent, an injectable drug that comes with a $37,000 yearly price tag to help ease the intolerable itch, swelling, redness and crusting (typical of the most sever cases of eczema) that comes with eczema. And while most such medications come in the form of creams or lotions whose purpose is to soothe eczema inflammation (atopic dermatitis), this new drug alters the immune system response underlying inflammation, as a monoclonal antibody.

That's the old way of treatment, and Dr. Myles and his colleagues feel that they are on to something simpler and possibly far more 'natural', and useful in its capacity to overturn the disharmony of skin microbiota whose faulty presence promotes the presence of eczema. Dr. Myles and his researchers appear to have validated in their research that the species of bacteria populating the skin of people with eczema while appearing the same as those of healthy people, are in reality weak and incapable of guarding against harmful bacteria like Staphylococcus aureus.

From left, a mouse with ordinary eczema, a mouse treated with Roseomonas bacteria from an eczema patient and a mouse treated with healthy Roseomonas. Dr. Ian Myles, national Institute for Allergy and Infectious Diseases

Their laboratory results have been encouraging in the growth of bacteria resourced from healthy volunteers and those with a topic dermatitis, both. With the focus on one species in particular, Roseomonas mucosa, human skin cells in lab dishes and on mice render test results showing that healthy versions of R.mucosa are capable of eradicating eczema, producing healthier skin cells.
Theirs is not the only research team attempting to prove that good bacteria can help treat eczema.

The National Institutes of Health is also funding research whereby Dr. Richard Gallo of the University of California, San Diego and his colleagues are working on producing a lotion with two benign staph bacteria -- Staphylococcus hominis and Staphylococcus epidermidis -- to challenge the harmful effects of the Staphylococcus aureus.Dermatologist and biologist Dr. Gallo has concocted with his colleagues what is considered an innovative microbial eczema treatment.

The discovery that Dr. Gallo made was that Staphylococcus hominis and Staphococcus epidermis have the capacity as friendly microbiome, to kill Staphylococcus aureus, known to be involved in eczema production. S. hominis and S. epidermidis were swabbed from volunteers' skin with eczema  to grow the bacteria in the laboratory, then to produce a lotion incorporating the microbes. Following which the balm was applied experimentally to the forearms of volunteers, vastly increasing their own helpful skin bacteria.

The results were seen in 24 hours when the probiotic lotion succeeded in almost eliminating S.aureus from the volunteers' skin. Enabling the researchers to identify compounds used by the beneficial bacteria to deter S.aureus. Their results were published in Science Translational Medicine. Last year another study had Dr. Gallo and other researchers inject a beneficial strain of Staphylococcus epidermidis with food it digested into mice ears, thus encouraging the growth of S.epidermidis, in turn reducing both the number of P.acnes and the level of inflammation.

A team in South Korea and the United States demonstrated that an extraction from Heliocobacter pylori, commonly found in the human stomach, also can inhibit P.acnes, decreasing skin inflammation in mice, in 2014. It was demonstrated by scientists in Canada that people who take both probiotics and antibiotics result in significantly fewer acne lesions in the space of 12 weeks, in comparison with others taking only one or the other.

These promising new treatments' potential have alerted private companies to the obvious, that they want to be next in line to capitalize on a growing market for consumers prepared to switch their preferences to probiotic cosmetics, toiletries and topical treatments, even to the point where one enterprising biotech company now promotes a "live probiotic spray", to replenish beneficial skin bacteria.

As far as Dr. Gallo is concerned, his experimental lotion represents an "evolutionarily honed" treatment. "There are so many new potent medicines right under our nose", he stated.

Desperately Seeking Sleep!

"Can the next doctor wanting to prescribe Seroquel for sleep, just not?"
"Over the last decade, I have seen several patients who have had quetiapine as part of, or one of the contributing causes to NMS [neuroleptic malignant syndrome]."
"I've certainly seen people who have been diagnosed with Parkinson's disease that I'm confident were from quetiapine. It's getting to the point now where, when I admit a patient with Parkinson's, I reflexively look at their other medications to see, 'Are they on quetiapine?'"
"But what's really driving this is a societal expectation that we should all get eight hours of sleep a night, a pill is a way to go about it, and the willingness of some providers to accede to requests for sleeping pills."
Dr. David Juurlink, clinical toxicologist, Sunnybrook Health Sciences Centre, Toronto

David Juurlink‏Verified account @DavidJuurlink  

David Juurlink Retweeted David Juurlink

Feeling the need to repeat this after rounds this morning ...

David Juurlink added,

David JuurlinkVerified account @DavidJuurlink

Can the next doctor wanting to prescribe Seroquel “for sleep” just not because diabetes DVT Parkinson’s akathisia dystonia sudden death?

"It's popping up as a patient's typical medication for insomnia all the time."
"It's not well supported by any science for use in sleep, it has significant side effects and yet it's massively prescribed."
Dr. Ian Mitchell, emergency physician, Kamloops, British Columbia

"Seroquel is not benign."
"It may be more dangerous than our standard sleeping pills, but without research we cannot know or quantify its risks."
Dr. David Gardner, professor of psychiatry and pharmacology, Dalhousie University, Halifax, N.S.

Seroquel, an antipsychotic drug intended to treat schizophrenia and bipolar disorder.
THE CANADIAN PRESS/Michelle Siu

The drug in question was developed as an antipsychotic medication, not a medication to treat insomnia, yet it is commonly prescribed by attending physicians to treat insomnia. Its trade name is Seroquel, among other more generic types and the active ingredient is quetiapine, which has been approved for use in Canada to treat schizophrenia, bipolar disorder and serious depression, and those conditions only.

Experts in drug safety have taken due note of its common use for a condition having nothing whatever to do with the drug's properties gearing it as an antipsychotic medication, and its increasingly prescribed use as a sleeping pill has caused bells of alarm to ring in the realization that there has been a tenfold increase in quetiapine prescriptions between 2004 and 2012, to treat insomnia.

Although the drug has sedating properties, making people drowsy, it comes complete with a smorgasbord of potential side effects, some of which are extremely worrisome. Some of which include Parkinson's-like tremors and abnormalities in movement; weight gain, high blood sugar impacting on diabetes and rarely but alarmingly, heart arrhythmia which can progress to sudden cardiac death.

Another rare, but life-threatening reaction to the drug which is particularly nasty is a condition known as neuroleptic malignant syndrome, potentially life-threatening. A Health Canada review recently recognized a link between quetiapine and allied 'atypical' antipsychotics to increased risk of sleep apnea. Little wonder that Dr. Juurlink and other health professions have been alerted and are warning of the dire inappropriateness of its use.

One quarter of the 33 million prescriptions for tranquilizers that leave pharmacies in the hands of users were for quetiapine, according to IMS Brogan, a drug market research company. And while doctors claim the drug has been prescribed in low-dose formulations to people without psychiatric conditions, to ameliorate their inability to sleep normally, it was discovered that 48 percent of B.C. quetiapine prescriptions in 2010 were for the 25 mg tablet, whereas the range dose of 150 to 180 mg per day relates to prescriptions for psychiatric conditions for which the drug was formulated.

Side effects like tardive dyskinesia, the abnormal movements of the face and jaw have been reported resulting from low-dose regimens of the drug, according to the UBC Therapeutics Initiative. Additionally, non-medical abuse of quetiapine is on the rise, with people inhaling or injecting crushed or dissolved tablets whose street names mask quetiapine in cute street talk like "Suzy Q" and "baby heroin".

Needless to say, no small amount of responsibility in this situation must be acknowledged by the pharmaceutical industry. Its public relations and sales representatives are all geared toward influencing the sale of drugs, for purposes both appropriate and clearly not. Their major concern is not patient health or furthering the cause of achieving relief from the effects of various conditions, but to persuade both prescribing physicians and pharmacists that their product should be considered first and foremost.

It is their profit and that alone that commands their attention.