Sepsis and Septic Shock: Does Plasma Exchange Improve Survival?

The Efficacy and Safety of Plasma Exchange in Patients With Sepsis and Septic Shock: A Systematic Review and Meta-analysis

Rimmer E, Houston BL, Kumar A, et al

Plasma Exchange in Sepsis

Sepsis is a common medical condition and the most common cause of death among critically ill patients.[1,2] Plasma exchange separates plasma from whole blood and exchanges the plasma with normal saline, albumin, or fresh frozen plasma. Plasma exchange thus could improve sepsis outcomes through removal of harmful substances or by replacement of depleted blood components.

Rimmer and colleagues sought to determine whether plasma exchange was associated with improved outcomes by conducting a systematic review of the literature (MEDLINE, EMBASE, CENTRAL, Scopus, reference lists of relevant articles, etc) focusing on randomized trials of patients receiving plasma exchange as part of therapy for septic shock. They found 1957 studies but only four unique trials enrolling a total of 194 patients (one enrolled adults only, two enrolled children only, and one enrolled adults and children).

The use of plasma exchange was associated with a significant reduction in all-cause mortality in adults (risk ratio [RR], 0.63; 95% confidence interval [CI], 0.42-0.96) but not in children (RR, 0.96; 95% CI, 0.28-3.38). None of the trials reported length of intensive care unit or hospital stay. Only one trial reported adverse events associated with plasma exchange, including six episodes of hypotension and one allergic reaction to fresh frozen plasma. The study authors concluded that there is insufficient evidence about plasma exchange for patients with sepsis or septic shock, and randomized controlled trials are required.

This study is very helpful in providing an evidence-based synthesis of data for the effect of plasma exchange as adjunctive therapy in the management of sepsis or septic shock. Not surprisingly, it is difficult to draw definitive conclusions from only four studies (two of which were strictly pediatric trials).[3-6]
However, the data suggest that there could be a benefit to plasma exchange in adults with septic shock, and companies and individual investigators are working to test this further. Given the pathogenesis of sepsis, with increased understanding of the damage resulting from both severe inflammation and anti-inflammation, strategies to modulate the immune response may confer real benefits for these patients, for whom morbidity and mortality remain high. However, whether this strategy is most effectively delivered by plasma exchange or by pharmacologic manipulation of the immune response remains to be seen.


  1. Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med. 2013;369:840-851. Abstract
  2. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348:1546-1554. Abstract
  3. Reeves JH, Butt WW, Shann F, et al. Continuous plasmafiltration in sepsis syndrome. Plasmafiltration in Sepsis Study Group. Crit Care Med. 1999;27:2096-2104. Abstract
  4. Busund R, Koukline V, Utrobin U, Nedashkovsky E. Plasmapheresis in severe sepsis and septic shock: a prospective, randomised, controlled trial. Intensive Care Med. 2002;28:1434–-439. Abstract
  5. Nguyen TC, Han YY, Kiss JE, et al. Intensive plasma exchange increases a disintegrin and metalloprotease with thrombospondin motifs-13 activity and reverses organ dysfunction in children with thrombocytopenia associated multiple organ failure. Crit Care Med. 2008;36:2878-2887. Abstract
  6. Long EJ, Shann F, Pearson G, Buckley D, Butt W. A randomised controlled trial of plasma filtration in severe paediatric sepsis. Crit Care Resusc. 2013;15:198-204. Abstract

How to Stop Snoring

The very often problem that happened to a lot of people is snoring, it affects nearly 90 million men and women in the United States only. You know that this irritating sound can disrupt your sleep as well as your partner’s.

It happens when relaxed structures in the throat vibrate and start making noise. It is very often considered as a sleep disorder about heavy snoring can have serious medical and social consequences.

How to Stop Snoring

So you have this habit of snoring, right away you need to take the necessary steps and fight with the problem. Be thoughtful and realize that everyone need their rest and with the snoring problem your nights simply can not be restful and peaceful.
We know that there are variety of products available to prevent snoring, but jet most of them have not been proven as effective. There is no miracle cure for snoring, but certain lifestyle changes and easy home remedies can be a big help in controlling it.
Here are the 10 home remedies for snoring.


1. Peppermint

The calming property in peppermint helps reduce swelling of the membranes in the coating of the throat and nostrils, in this way advancing simple and smooth breathing. Peppermint cures function well for temporary snoring due to allergies, a cold or dry air.
Add one or two drops of peppermint oil to a glass of water. Gargle with it before going to bed. Make sure not to swallow this solution. Do this daily until you get the desired result.
If dry air and congestion are causing your snoring, add a few drops of peppermint oil (you can also use eucalyptus oil) to a humidifier about 30 minutes before you go to bed and turn it on. Run the humidifier overnight. This will help open up your airways so you don’t snore.
You can also rub a little peppermint oil into the lower portions of each side of your nose before going to bed.

2. Olive oil

Being a strong anti- inflammatory agent, olive oil facilitates the tissues up and down the respiratory entries, lessening the swelling to give a clear passage for air. It can likewise diminish soreness. Utilize this cure frequently to additionally diminish the vibrations in the throat and quit snoring.

Take two or three sips of olive oil before going to bed daily
Combine one – half teaspoon each of olive oil and honey. Take it every night before going to bed.

3. Steam
The one of the main reason behind snoring is nasal congestion. But there is one simple and on of the best solution for reducing congestion and that is to inhale steam.
-In one large bowl pour hot boiling water.
-Add three or four drops of eucalyptus natural essential oil or tea tree natural essential oil.
-Put and hold a towel over your head and inhale the steam deeply through your nose for ten minutes.
-Make this remedy daily before going to bed until your congestion clears.

4. Clarified Butter
Clarified butter is also known as ghee, it has certain medicinal properties that can help you open up blocked nasal passages. This will help you to reduce your snoring and to improve your sleeping.
-Slightly warm a small amount of clarified butter in a microwave.
Use a dropper to put two or three drops of lukewarm clarified butter in each nostril.
-Do this daily before going to bed and again after waking up the next morning.

5. Cardamom
Cardamom is an expectorant and decongestant, making it successful for opening up blocked nasal sections. Free air entry will bring about less snoring.

6. Turmeric
Known by its purpose as powerful antiseptic and antibiotic agent, turmeric can treat inflammation and also help reduce heavy snoring. In the event of treating snoring turmeric should be taken together with milk. This following drink will help you to breathe freely while you sleep and also boost your immune system.
-In a glass with warm milk add two teaspoons of turmeric powder.
-30 minutes before going to bed and sleep drink it
-Do this every night

7. Nettle


There is something like seasonal allergy that causing the nasal passages to get inflamed and you snore only at a particular time of the year. The nettle has the anti- inflammatory as well as antihistamine properties and the temporary snoring can be treated with this.
-Put one tablespoon of dried leaves of nettle in one cup of boiling water.
-Allow it to steep for five minutes, and then strain it.
-Just before bedtime drink the hot tea.
Drinking two to three cups of nettle leaf tea daily during the allergy season can prevent snoring.

8. Garlic


Garlic helps reduce mucus build-up in the nasal passages as well as inflammation in the respiratory system. So, if you snore due to sinus blockage, garlic can give you relief.
Chew on one to two raw garlic cloves and then drink a glass of water. Do this daily, preferably before bedtime to enjoy sound sleep and reduce snoring.
Also use garlic while cooking your dinner and eat your food while it is hot.

9. Honey


The honey can be one of the option for snorers. Due to its anti-inflammatory properties, honey can reduce the swelling around the throat area that can obstruct airways. Plus, honey lubricates the throat, which prevents the snoring vibrations from occurring.
-In a glass of hot water mix one tablespoon of honey and drink it before going to bed. Do this every night.
-Also you can use honey to sweeten herbal tea that you prefer to drink after your dinner.

10. Chamomile


A herbal with very well – known anti- inflammatory effects that can help you stop snoring is the chamomile. But also it is a nerve and muscle relaxant that can ease tense muscles and nerves around the throat and help you sleep and rest better.
Add one tablespoon of chamomile flowers (or one chamomile tea bag) to one cup of water.
Boil it for about 15 minutes.
Strain it and add one teaspoon of honey.
Drink the warm tea before going to bed.
Some additional tips that can help stop snoring include:
In case you’re overweight, get more fit and lose weight. Individuals who are overweight have additional tissues in the throat that add to the process of snoring.
Sleep over your side as opposed to your back. When you think about your back, your tongue and delicate sense of taste rest against the back of your throat, hindering the aviation route and bringing about snoring.
Raise the head of your bed by around four inches or utilize additional pillow to keep the tissues in your throat from falling into your air entries.
Use nasal strips to help you inhale effectively as you rest.
Abstain from drinking alcohol drinks no less than two hours prior to sleep time. Liquor can discourage your central nervous system, causing snoring.
Try singing before going to bed. Singing helps enhance muscle control of the delicate sense of taste and upper throat.

Stopped or eliminate smoking as it can irritate the coating of the nasal cavity and throat, bringing about swelling and eventually snoring.
By incorporating these preventive measures along with any of the remedies above, you’ll be able to reduce or eliminate snoring and get a good night’s sleep.

Foodborne Shigella Illness Spreading in U.S Says CDC

A general view of the Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia. TAMI CHAPPELL/REUTERS

If you’re planning to travel abroad this summer, be wary of Shigella. The drug-resistant pathogen, a form of food poisoning, is spreading quickly in the U.S. and has been linked to international travel, said the Centers for Disease Control and Prevention in a study published on Thursday in the Morbidity and Mortality Weekly Report.

The bacterial illness is extremely contagious, spreading through contaminated water and food. Once contracted, the bacteria spreads to the intestines, inducing vomiting and mucus or bloody diarrhea. Unfortunately, it’s resistant to the most potent available treatment option, Ciprofloxacin, which typically assuages the pain of similar bacterial illnesses.

Experts say that if the resistance continues, Shigella may become virtually untreatable with oral antibiotics. If this happens, antibiotics likely would have to be administered through IV.

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Several outbreaks of Shigella have been reported in recent years, and more than 157 people fell ill during the time of the study, from May 2014 to February 2015. The bacterial strain was detected in 32 states, with sizable numbers of cases in Massachusetts and California.

In the study, researchers discovered that about half of the cases of the foodborne illness had been linked to travel, particularly to Morocco, India and the Dominican Republic. Yet several people who contracted the pathogen hadn’t traveled internationally, leading researchers to believe it may be domestically rooted as well. Authorities caution that the illness has continued to spread since the report was filed.

Researchers advise people to wash their hands often and to be aware of any bowel changes while traveling.

Shigellosis, a full-on infection caused by the bacteria Shigella, afflicts more than 80 million people a year, according to statistics by the CDC, and about 600,000 people a year die from the bacterial disorder.

New research is leading to an understanding of how placebos work — findings that may lead to more effective treatments and better drug research.

Last year, 40 people participated in a study that tested, essentially, the power of their beliefs. University of Colorado at Boulder psychology student and neuroscience researcher Scott Schafer and colleagues asked participants to apply a “powerful analgesic” on their hands and arms. The researchers then administered small bursts of heat where the cream had been applied. The cream was really petroleum jelly, but as expected, participants reported that the so-called powerful cream protected them from feeling as much of a burn as a control cream. Even when the researchers showed participants that the active cream was just petroleum jelly, it made little difference. The participants still reported less pain from the heat when they were re-tested with it versus the control cream (The Journal of Pain, 2015).

Welcome to the world of open-label placebo research, where it’s not a question of whether placebos work, but how.

For decades, placebo response was generally seen as “an uninteresting source of noise that interfered with pharmacological research,” says Bret Rutherford, MD, assistant professor of clinical psychiatry at Columbia University.

But these days, scientists are studying placebos as a psychobiological phenomenon and the placebo response as a potentially important part of the success of many medical treatments. Researchers are using psychological assessments, brain scans and genotyping to better understand how placebo responses work and to identify who may be most likely to respond to them.

The research could lead to changes in how psychologists and others conduct research and in how health-care professionals treat patients.

“Understanding the mechanisms underlying placebo effects can shift our understanding of when and how treatments work and how to use them — not in terms of giving people fake drugs, but in terms of changing the principles by which we learn to care for each other,” says Tor Wager, PhD, an associate professor of psychology and neuroscience at the University of Colorado at Boulder, who worked with Schafer on the open-label cream study.

Like cognitive therapies, Wager says, placebos tap into people’s beliefs that there’s hope and that they can get better.

How the mind makes medicine

Researchers have been examining placebos for centuries. In 1784, Benjamin Franklin tested whether magnetic force fields could cure illnesses, a notion that Austrian physician Franz Anton Mesmer had profitably introduced and used in his practice. In Franklin’s experiments, participants responded dramatically to plain water they were told had been “mesmerized.” These days, researchers use neuroimaging to see how our brains respond to placebos and have found that placebos mimic symptom relief for a number of ills.

For example, a meta-analysis of 25 neuroimaging studies of pain and placebos conducted by Wager and Lauren Atlas, PhD, of the National Center for Complementary and Integrative Health (NCCIH), found that people who took placebos and expected to have reduced pain had less activity in brain regions often associated with pain processing, including the dorsal anterior cingulate, thalamus and insula (Handbook of Experimental Pharmacology, 2014).

Though placebos may work through various mechanisms, research suggests that they have the greatest effect in neural systems involved with processing reward seeking, motivation and emotion. Placebos seem to be particularly effective in patients with depression, Parkinson’s disease and pain. All three conditions, Atlas says, involve the neurotransmitter dopamine.

“They’re also all areas where people can consciously monitor their own treatment results: ‘I know how much pain I’m feeling’ or ‘I know how slow my movements are.’ That’s why neuroimaging markers of placebo response are so important when paired with subjective reports. We can now show that when people say they’re getting better, they really are.”

In one study of patients with Parkinson’s disease, Wager and colleagues found that simply expecting medication altered brain activity in the striatum and ventromedial prefrontal cortices — brain areas associated with reward learning — in ways similar to actual dopaminergic medication (Nature Neuroscience, 2014). And in a recent study of patients with depression, Andrew Leuchter, MD, and colleagues at the University of California, Los Angeles, found that participants who received placebo pills and supportive care did better than those who had only supportive care. These results were closely tied to the patients’ expectations of how well the pills would work (British Journal of Psychiatry, 2014).

Wager says this, too, makes sense according to the neuroscience of placebo effects, noting that depression is a motivational disorder as much as a mood disorder. “Patients can’t get out of bed — they can’t muster up the energy. The disorders that show the most reliable placebo effects are those in which the brain’s motivational circuitry, including the prefrontal cortex and striatum, plays an important role.”

Beliefs and expectations are a potent mix, Wager says, and future neuroimaging research must try to tease out how much of a placebo response is due to conscious expectations versus an unconscious learning from prior experiences. Expectations can be influenced by verbal instructions, nonverbal cues about care, and other elements of the treatment context, whereas unconscious learning requires prior experiences of success (or failure) with a treatment, such as experiencing pain relief after taking a pill. In one study of people with migraines, placebos elicited a response without any verbal cue to effectiveness. Slavenka Kam-Hansen, MD, and colleagues openly labeled placebo pills for some patients, who reported as much pain relief as those who also got a placebo but had been told they’d received a real medication (Science Translational Medicine, 2014).

Identifying responders

Scientists are also exploring who might respond best to placebos. Research suggests that children appear to be particularly receptive to the placebo effect. Peter Krummenacher, PhD, of the University of Basel in Switzerland, tested 6- to 9-year-olds with a placebo or control treatment. The placebo was a “topical analgesic” that the children were told might affect how they sensed applied heat. Their placebo response was 5.6 times greater than adults in a similar study (The Journal of Pain, 2014).

“Conditioning and learning play a crucial role, especially in infants, before we can use the power of language,” says Luana Colloca, MD, PhD, an associate professor at the University of Maryland, Baltimore. “Suggestibility may be higher in children, and they also have less negative experience and experience of disease. And learning mechanisms are powerful at that stage of life.”

Studies also suggest that people who respond more to rewarding stimuli show larger placebo effects, Atlas says. One of the most thorough studies on placebo and personality markers, conducted by John Kelley, PhD, and colleagues at Harvard Medical School, found that patients with irritable bowel syndrome (IBS) who responded best to placebo acupuncture tended to be female, agreeable and extroverts who were open to new experiences, but only in a subgroup of participants who had augmented encounters with a health practitioner — warm, communicative and empathic — when receiving the placebo (Psychosomatic Medicine, 2009).

Since then, a meta-analysis by Kelley and colleagues of 13 studies showed that the quality of clinician-patient relationships in terms of measures like empathy, communication and better attention to nonverbal signals, played a small but significant role in health outcomes for various conditions (PLOS ONE, 2014).

The findings suggest that a focus on human relationships should always be at the forefront of treatment, Kelley says, adding, “I’m very interested in the degree to which [physicians] who have good outcomes are practicing an intuitive form of psychotherapy. They’re listening to the patients, helping the patients believe a treatment works. Although this is often referred to as a placebo effect, it’s really a relationship effect.”

Other research suggests that social influences determine who responds to placebos. Colloca and colleagues found that study participants who watched others benefit from a pain medicine that was actually a placebo had about the same response to it as participants who were exposed to the pain relief. Participants who responded most were also rated as more likely to empathize with other people overall (European Journal of Pain, 2014).

A better knowledge among clinicians of how to create placebo responses using verbal prompts and how to maximize interactions with patients can boost treatment effectiveness, Colloca says. “If you are aware of placebo mechanisms, you are more careful about your communication style, the time you spend with your patient, the words you choose.”

Columbia’s Rutherford says setting expectations may be particularly helpful when it comes to antidepressant medications. While there is debate about how much of their effect for mild depression is due to the placebo response, he advises psychologists to maximize all potential effects by helping patients already on or interested in medication to believe the pills will work.

“Providing supportive care and eliciting a positive expectancy of improvement — obviously within the bounds of truthfulness — seem to be a very powerful treatment for mild depression,” he says. “Whether you use a benign pill or psychotherapy is for researchers to study.”

Genetics may count, too. Kathryn Hall, PhD, and colleagues at Harvard Medical School revisited the patients with IBS in Kelley’s study and found that participants with a specific genotype related to having more dopamine in the prefrontal cortex reported a larger effect from a placebo treatment for their symptoms as compared with participants with a genotype that produces less dopamine in the prefrontal cortex (PLOS ONE, 2012). In addition, those who had the more positive and supportive “augmented” treatment encounter with a health professional had a six-fold greater improvement in symptoms than patients who had a “neutral” encounter.

The psychology of medicine

Most experts agree drug research will benefit from a better understanding of placebos.

“The combined R&D budget for the top pharmaceutical companies is over $90 billion per year, yet probably few or no studies really consider joint behavioral interventions, expectations and the state of a patient’s psychology when they are evaluating drug treatment,” says Wager. “They’re not looking at psychological interactions between patients’ psychological and brain states and drug effects.”

Ongoing placebo research may also help scientists fine-tune studies. In the future, drug researchers might use a multidisciplinary approach to identify who responds to placebo and by how much, based on psychological profiles, DNA studies that identify genetic variants, and brain scans that test for reward response potential, Colloca says. Such tests might even influence how psychologists work, she says.

“Psychologists may take advantage of this phenomenon to develop their strategies and therapeutic plans, perhaps to determine if a person may require longer treatment or multiple approaches, as compared to another patient who may benefit from a specific intervention and placebo responses,” she says.

That said, funding for research in the area is a challenge, says Kelley, adding, “There’s no company with a specific interest in persuading doctors to be more patient-centered.” He is currently doing research on ways placebos might help cancer patients cope with the side effects of oncology medications, an area he says is promising because many patients are eager for approaches that minimize the number of additional drugs they need to take to manage side effects.

In the end, patients’ interests may help drive placebo research. Rather than fearing they’ve been had, patients are often pleased to discover that they can contribute to their own healing, experts say.

“Patients are interested and enthusiastic about it,” says Colloca, who conducted a phone survey of 853 people about their attitudes on placebos in medical care (British Medical Journal, 2013). “They realize that beliefs and expectations and the ritual around a clinical visit are more than just a sugar pill.”

Further reading

How to Disappear On The Internet


Social media has made almost everyone’s life an open book (one that’s a bit too open in some cases). As more and more companies and individuals come to rely on the Internet as a primary source of information about others, so too does the possibility of compromising info reaching the wrong person grow.

As millions of pictures continue to be integrated into CCTV systems to allow for easy identification of “suspects,” and our online behavior is evaluated relative to our risk of being a “social contagion,” disappearing online has never been more attractive.

Even for folks more concerned about their personal information potentially costing them jobs and relationships, or for those dealing with the harsh realities of social media fallout, the decision to “pull the plug” is an increasingly understandable one. And while it might seem impossible to keep your private life private and your Internet presence to a minimum in a 24/7 connected world: the truth is you candisappear online with a little effort and dedication.

The first step to keeping a low profile online is (as you may expect) to stop using social media sites and delete your accounts. If you’re unclear about where to start, sites such as JustDelete.Me offer links and tips to help you review your existing presence and get the process moving (and whether it is actually possible to delete your accounts at all).

To remove information that’s been gathered about you (as compared to information posted by you), you may want to consider the similarly named “DeleteMe”. This service promises to scan popular data collection sites and remove your personal contact information and photos, generating a report every three months to keep you updated on what’s been removed.

Pulling the plug on social media and removing any compromising or personal data is a great start, but unless you’re planning on abandoning the Internet altogether, this is just the beginning.

In order to maintain your new-found anonymity, you must master reputation management, learn to use dummy accounts, and take advantage of anonymous searching. This might seem like a lot of effort, but it sure beats waiting for companies to delete your data on their own.

Disappearing from the Internet isn’t for everyone. But if you’re serious about your privacy, your security, and your reputation, taking the time to make yourself invisible online is worth the time and trouble.

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10 Inspirational Quotes By Sachin Tendulkar Which Will Explain You Why He Is The God Of Cricket.

Sachin Tendulkar

Sachin Ramesh Tendulkar is not only the God Of Cricket but also he is an inspiration to many in and outside cricket. His life has always been of many challenges and he instead of backing off, kept calm and faced them with a gentle smile and a stir determination.
We Bring You 10 Excellent Quotes By Sachin Tendulkar Which Will Inspire You In Your Life To Achieve Your Goals & also will help you understand why Sachin is called the GOD OF CRICKET.


Sachin Tendulkar


Sachin Tendulkar


Sachin Tendulkar


Sachin Tendulkar


Sachin Tendulkar


Sachin Tendulkar


Sachin Tendulkar


Sachin Tendulkar


Sachin Tendulkar


Sachin TendulkarWhat do you think about these Quotes? Feel Free to share your views in the comment box below.

$1 Billion Lawsuit: Government Funded Studies Intentionally Infected People with STDs. Here’s the story

A class action lawsuit has been filed against Johns Hopkins University for performing unethical,government-sponsored studies on Guatemalan citizens in the 1940s and 1950s. Doctors from the hospital, the suit alleges, deliberately infected soldiersprisoners, orphans, and the mentally ill with STDs like syphilis and gonorrhea — without their consent — in order to test whether or not penicillin could cure them. Consent was only granted from authorities in Guatemala.

  The lawsuit involves almost 800 plaintiffs, including affected family members and spouses of the original victims. It is seeking nearly a billion dollars in damages and also names the Rockefeller Foundation as complicit,saying it helped “design, support, encourage and finance” the studies. Additionally, it alleges that pharmaceutical giant, Bristol-Myers Squibb, supplied the penicillin. The revelations came only because Susan Reverby, a professor at Wellesley University, uncovered the evidencein 2010.

The lawsuit claims the following methods were used to infect subjects:

“During the experiments the following occurred:

1. Prostitutes were infected with venereal disease and then provided for sex to subjects for intentional transmission of the disease;

2. Subjects were inoculated by injection of syphilis spirochaetes into the spinal fluid that bathes the brain and spinal cord, under the skin, and on mucous membranes;

3. An emulsion containing syphilis or gonorrhea was spread under the foreskin of the penis in male subjects;

4. The penis of male subjects was scraped and scarified and then coated with the emulsion containing syphilis or gonorrhea;

5. A woman from the psychiatric hospital was injected with syphilis, developed skin lesions and wasting, and then had gonorrheal pus from a male subject injected into both of her eyes and;

6. Children were subjected to blood studies to check for the presence of venereal disease.”

Another disturbing element of the STD studies is that the 696 original “participants” were not notified of what was being done to them. They were not told of the consequences of the studies, provided medical care, or told how to stop the spread of the diseases. Many did not receive what was considered sufficient treatment in those years (only 60 of the plaintiffs in the suit are original victims as most are now dead — many directly because of the diseases they received).

Correspondence between one of the lead researchers and another doctor revealed that the researchers knew what they were doing was unethical. TheGuardian cites the letter, explaining doctors knew

…that if it were discovered by ‘some goody organization’ that the program was testing people who were mentally ill it would ‘raise a lot of smoke.’ The manager continues: ‘I see no reason to say where the work was done and the type of volunteer.’

A 2012 lawsuit against the federal government, rooted in the Federal Tort Claims Act, was dismissed by a federal judge. The judge ruled the United States could not be charged for actions committed outside the country. Unsurprisingly, in the 1940s, leaders of the experiment chose Guatemala because they knew they would not be permitted to conduct the study domestically. One of them, John Cutler, was a U.S. health service physician who was later involved in the notorious Tuskegee syphilis experiments, where 600 black men were left untreated for decades to study the effects of the disease.

When the news of the Guatemalan experiments surfaced in 2010, then-Secretary of State Hillary Clinton and Health Secretary Kathleen Sebelius issued an apology for the government program (after a presidential bioethics commission ruled the studies constituted “unconscionable basic violations of ethics.”)

Their statement said,

The conduct exhibited during the study does not represent the values of the US, or our commitment to human dignity and great respect for the people of Guatemala.

(It ignored the inconvenient detail that in the same time period as the experiments, the CIA ousted a democratically elected leader in order to protect corporate agriculture, which doesn’t exactly imply respect or dignity for the people.)

Both Johns Hopkins and the Rockefeller Foundation are denying guilt, instead shifting it to the originators of the study — the legally-exonerated U.S. government. The Rockefeller Foundation said the plaintiffs were trying “improperly to assign ‘guilt by association’ in the absence of compensation from the United States federal government.”

A spokesperson for Johns Hopkins argued,

Johns Hopkins did not initiate, pay for, direct of conduct the study in Guatemala. No nonprofit university or hospital has ever been held liable for a study conducted by the US government.

The university has vowed to defend itself against the lawsuit.

Though the federal government refuses to compensate the victims, its admission that the studies constituted egregious violations of ethics is telling.

As Marta Orellana, a victim who was nine years old when she was infected, said:

They never told me what they were doing, never gave me a chance to say no…I’ve lived almost my whole life without knowing the truth. May God forgive them.


12 Foods To Eat When You’re Totally Stressed Out

When work deadlines begin piling up and your social calendar is booked, the last thing you want to hear is to steer clear of the vending machine. Who has time for healthy eating? But when it comes to combating stress levels, what you eat may actually help relieve your tension. Indeed, some foods may help stabilize blood sugar or, better yet, your emotional response. Here, 12 foods to reach for when you’ve just about had enough.


Green leafy vegetables.
leafy vegetables

It’s tempting to reach for a cheeseburger when stressed, but go green at lunch instead. “Green leafy vegetables like spinach contain folate, which produces dopamine, a pleasure-inducing brain chemical, helping you keep calm,” says Heather Mangieri, RDN, a spokesperson for the Academy of Nutrition and Dietetics. A 2012 study in the Journal of Affective Disorders of 2,800 middle-aged and elderly people and found those who consumed the most folate had a lower risk of depression symptoms than those who took in the least. And, a 2013 study from the University of Otago found that college students tended to feel calmer, happier and more energetic on days they ate more fruits and veggies. It can be hard to tell which came first — upbeat thoughts or healthy eating — but the researchers found that healthy eating seemed to predict a positive mood the next day.

Turkey breast.
You’ve probably heard that the tryptophan in turkey is to blame for that food coma on Thanksgiving. The amino acid, found in protein-containing foods, helps produce serotonin, “the chemical that regulates hunger and feelings of happiness and well-being,” Mangieri says. On its own, tryptophan may have a calming effect. In a 2006 study published in the Journal of Psychiatry Neuroscience, men and women who were argumentative (based on personality tests) took either tryptophan supplements or a placebo for 15 days. Those who took tryptophan were perceived as more agreeable by their study partners at the end of the two weeks compared with when they didn’t take it. (The study was funded by the Canadian Institutes of Health Research.) Other foods high in tryptophan include nuts, seeds, tofu, fish, lentils, oats, beans and eggs.

If you’re already a carb lover, it’s likely that nothing can come between you and a doughnut when stress hits. First rule of thumb: Don’t completely deny the craving. According to MIT research, carbohydrates can help the brain make serotonin, the same substance regulated by antidepressants. But instead of reaching for that sugary bear claw, go for complex carbs. “Stress can cause your blood sugar to rise, Mangieri says, “so a complex carb like oatmeal won’t contribute to your already potential spike in blood glucose.”


As bizarre as it may sound, the bacteria in your gut might be contributing to stress. Research has shown that the brain signals to the gut, which is why stress can inflame gastrointestinal symptoms; communication may flow the other way too, from gut to brain. A 2013 UCLA study among 36 healthy women revealed that consuming probiotics in yogurt reduced brain activity in areas that handle emotion, including stress compared to people who consumed yogurt without probiotics or no yogurt at all. This study was small so more research is needed to confirm the results—but considering yogurt is full of calcium and protein in addition to probiotics, you really can’t go wrong by adding more of it to your diet.

When you’re stressed, it can ratchet up anxiety hormones, such as adrenaline and cortisol. “The omega-3 fatty acids in salmon have anti-inflammatory properties that may help counteract the negative effects of stress hormones,” says Lisa Cimperman, RD, of the University Hospitals Case Medical Center and a spokesperson for the Academy of Nutrition and Dietetics. In a study funded by the National Institutes of Health, Oregon State University medical students who took omega-3 supplements had a 20% reduction in anxiety compared to the group given placebo pills. One 3-ounce serving of cooked wild salmon can have more than 2,000 milligrams of omega-3s, double the daily intake recommended by the American Heart Association for people with heart disease.

“When you’re stressed, there’s a battle being fought inside you,” Mangieri says. “The antioxidants and phytonutrients found in berries fight in your defense, helping improve your body’s response to stress and fight stress-related free radicals.” Research has also shown that blueberry eaters experience a boost in natural killer cells, “a type of white blood cell that plays a vital role in immunity, critical for countering stress,” says Cynthia Sass, MPH, RD, Health’s contributing nutrition editor.


When you have an ongoing loop of negative thoughts playing in your mind, doing something repetitive with your hands may help silence your inner monologue. Think knitting or kneading bread—or even shelling nuts like pistachios or peanuts. The rhythmic moves will help you relax. Plus, the added step of cracking open a shell slows down your eating, making pistachios a diet-friendly snack. What’s more, pistachios have heart-health benefits. “Eating pistachios may reduce acute stress by lowering blood pressure and heart rate,” Mangieri says. “The nuts contain key phytonutrients that may provide antioxidant support for cardiovascular health.”

Dark chocolate.
Calling all chocoholics: a regular healthy indulgence (just a bite, not a whole bar!) of dark chocolate might have the power to regulate your stress levels. “Research has shown that it can reduce your stress hormones, including cortisol,” Sass says. “Also, the antioxidants in cocoa trigger the walls of your blood vessels to relax, lowering blood pressure and improving circulation. And finally, dark chocolate contains unique natural substances that create a sense of euphoria similar to the feeling of being in love!” Go for varieties that contain at least 70% cocoa.

Fortified milk is an excellent source of vitamin D, a nutrient that might boost happiness. A 50-year-long study by London’s UCL Institute of Child Health found an association between reduced levels of vitamin D and an increased risk of panic and depression among 5,966 men and women. People who had sufficient vitamin D levels had a reduced risk of panic disorders compared to subjects with the lowest levels of vitamin D. Other foods high in vitamin D include salmon, egg yolks and fortified cereal.

pumpkin seeds

Flaxseed, pumpkin seeds and sunflower seeds are all great sources of magnesium (as are leafy greens, yogurt, nuts and fish). Loading up on the mineral may help regulate emotions. “Magnesium has been shown to help alleviate depression, fatigue and irritability,” Sass says. “Bonus: When you’re feeling especially irritable during that time of the month, the mineral also helps to fight PMS symptoms, including cramps and water retention.”

You can’t just reach for slice after slice of avocado toast during crunch time if you don’t want to gain weight, but this superfruit might help shut down stress-eating by filling your belly and making you feel more satisfied. In a 2014 study by Loma Linda University (which, full disclosure, was sponsored by the Hass Avocado Board), researchers had participants add half an avocado to their lunches, which reduced their desire to eat more by 40% for the three hours following the midday meal. That full feeling will make you less inclined to reach for unhealthy snacks when stress kicks in.

One ounce of the buttery nut packs 11% of the daily recommended value of zinc, an essential mineral that may help reduce anxiety. When researchers gave zinc supplements to people who were diagnosed with both anxiety symptoms (irritability, lack of ability to concentrate) and deficient zinc levels over a course of eight weeks, the patients saw a 31% decrease in anxiety, according to Nutrition and Metabolic Insights. This is likely because zinc affects the levels of a nerve chemical that influences mood. If you’re already getting enough zinc, then it may not help your mood to chow down on cashews (or other zinc-rich foods like oysters, beef, chicken and yogurt). But, cashews are also rich in omega-3s and protein, so they’re a smart snack no matter what.


Kefir is all the rage in the natural health community.

It is high in nutrients and probiotics, and is incredibly beneficial for digestion and gut health.

Many people consider it to be a healthier and more powerful version of yogurt.

Here are nine health benefits of kefir that are supported by research:

Kefir is a fermented drink, traditionally made using cow’s or goat’s milk. Photo credit: Shutterstock

1. Kefir is a Fantastic Source of Many Nutrients

Kefir is a fermented drink, traditionally made using cow’s or goat’s milk.

It is made by adding kefir “grains” to milk.

These are not grains in the conventional sense, but cultures of yeast and lactic acid bacteria that resemble cauliflower in appearance.

Over a period of 24 hours or so, the microorganisms in the kefir grains multiply and ferment the sugars in the milk, turning it into kefir.

Then the grains are removed from the liquid, and can be used again.

So basically, kefir is the drink, but kefir grains are the “starter kit” that you use to produce the drink.

Kefir originated from parts of Eastern Europe and Southwest Asia. The name is derived from the Turkish word keyif, which means “feeling good” after eating (1).

The lactic acid bacteria turn the lactose in the milk into lactic acid, so kefir tastes sour likeyogurt, but has a thinner consistency.

A 175 ml (6 oz) serving of milk kefir contains (2, 3):

  • Protein: six grams
  • Calcium: 20 percent of the RDA
  • Phosphorus: 20 percent of the RDA
  • Vitamin B12: 14 percent of the RDA
  • Riboflavin (B2): 19 percent of the RDA
  • Magnesium: 5 percent of the RDA
  • A decent amount of vitamin D

This is coming with about 100 calories, seven to eight grams of carbs and three to six grams of fat, depending on the type of milk that is used.

Kefir also contains a wide variety of bioactive compounds, including organic acids and peptides that contribute to its health benefits (1).

Dairy-free versions of kefir can be made with coconut water, coconut milk or other sweet liquids. These will not have the same nutrient profile as dairy-based kefir.

Bottom Line: Kefir is a fermented milk drink, cultured from kefir grains. It is a rich source of calcium, protein and B-vitamins.

2. Kefir is a More Powerful Probiotic Than Yogurt

Some microorganisms can have beneficial effects on health when ingested (4).

Known as probiotics, these microorganisms can influence health in numerous ways, including digestion, weight management and mental health (5, 6, 7).

Yogurt is the best known probiotic food in the Western diet, but kefir is actually a much morepotent source.

Kefir grains contain about 30 strains of bacteria and yeasts, making it a very rich and diverse probiotic source.

Other fermented dairy products are made from far fewer strains, and don’t contain any yeasts.

Bottom Line: Kefir contains about 30 different microorganisms, making it a much more potent source of probiotics than other fermented dairy products.

3. Kefir Has Potent Antibacterial Properties

Certain probiotics in kefir are believed to protect against infections.

This includes the probiotic Lactobacillus kefiri, which is unique to kefir.

Studies show that this probiotic can inhibit the growth of various harmful bacteria, includingSalmonella, Helicobacter Pylori and E. coli (8, 9).

Kefiran, a type of carbohydrate present in kefir, also has antibacterial properties (10).

Bottom Line: Kefir contains the probiotic Lactobacillus kefiri, and the carbohydrate Kefiran, both of which can protect against harmful bacteria.

4. Kefir Can Improve Bone Health and Lower The Risk of Osteoporosis

Osteoporosis (“porous” bones) is characterized by deterioration of bone tissue, and is a massive problem in Western countries.

It is especially common among elderly women, and dramatically raises the risk of fractures.

Ensuring an adequate calcium intake is one of the most effective ways to improve bone health, and slow the progression of osteoporosis (11).

Kefir made from full-fat dairy is not only a great source of calcium, but also vitamin K2. This nutrient plays a central role in calcium metabolism, and supplementing with it has been shown to reduce the risk of fractures by as much as 81 percent (12, 13).

Recent animal studies have shown that kefir can increase calcium absorption by bone cells. This leads to improved bone density, which should help prevent fractures (14).

Bottom Line: Kefir made from dairy is an excellent source of calcium. In the case of full-fat dairy, it also contains vitamin K2. These nutrients have major benefits for bone health.

5. Kefir May be Protective Against Cancer

Cancer is one of the world’s leading causes of death.

It occurs when there is an uncontrolled growth of abnormal cells in the body, such as a tumor.

The probiotics in fermented dairy products are believed to inhibit tumor growth by reducing formation of carcinogenic compounds, as well as by stimulating the immune system (15).

This protective role has been demonstrated in several test tube studies (16, 17).

One study found that kefir extract reduced the number of human breast cancer cells by 56 percent, compared with only 14 percent for yogurt extract (18).

However, take all of this with a grain of salt, as this is far from being proven in living, breathing humans.

Bottom Line: Some test tube and animal studies have shown that kefir can inhibit the growth of cancer cells. This has not been studied in people.

6. The Probiotics in it May Help With Various Digestive Problems

Probiotics such as kefir can help restore the balance of friendly bacteria in the gut.

This is why they are highly effective for many forms of diarrhea (19, 20).

There is also a lot of evidence that probiotics and probiotic foods can help with all sorts of digestive problems (5).

This includes irritable bowel syndrome (IBS), ulcers caused by H. pylori infection, and various others (21, 22, 23, 24).

For this reason, kefir may be useful if you have problems with digestion.

Bottom Line: Probiotics like kefir can treat several forms of diarrhea. They can also lead to major improvements in various digestive diseases.

7. Kefir is Generally Well Tolerated by People Who Are Lactose Intolerant

Regular dairy foods contain a natural sugar called lactose.

Many people, especially adults, are unable to break down and digest lactose properly. This condition is called lactose intolerance (25).

The lactic acid bacteria in fermented dairy foods (like kefir and yogurt) turn the lactose into lactic acid, so these foods are much lower in lactose than milk.

They also contain enzymes that can help break down the lactose even further.

Because of this, kefir is generally well tolerated by people with lactose intolerance, at least when compared to regular milk (26).

Also keep in mind that it is possible to make kefir that is 100 percent lactose free, by using coconut water, fruit juice or some other non-dairy fluid.

Bottom Line: The lactic acid bacteria have already pre-digested the lactose in kefir. People with lactose intolerance can often eat kefir without problems.

8. Kefir May Improve Symptoms of Allergy and Asthma

Allergic reactions are caused by inflammatory responses against harmless environmental substances.

People with an over-sensitive immune system are more prone to allergies, which can provoke conditions like asthma.

In animal studies, kefir has been shown to suppress inflammatory responses related to allergy and asthma (27, 28).

Human studies are need to better explore these effects.

9. Kefir is Easy to Make at Home

The last one is not a health benefit, but important nonetheless.

If you are unsure about the quality of store-bought kefir, then you can easily make it at home yourself.

Combined with some fresh fruit, it makes one of the healthiest and tastiest desserts I have ever come across.

You can buy kefir grains in some health food stores and supermarkets.

It is also available on Amazon (see here), with hundreds of reviews, testimonials and tips from real customers.

There are some good blog posts and videos on how to make kefir, but the process is very simple:

  • Put one to two tablespoons of kefir grains into a small jar. The more you use, the faster it will culture.
  • Add around two cups of milk, preferably organic or even raw. Milk fromgrass-fed cows is healthiest. Leave one inch of room at the top of the jar.
  • You can add some full-fat cream if you want the kefir to be thicker.
  • Put the lid on and leave it for 12-36 hours, at room temperature. That’s it.

Once it starts to look clumpy, it is ready. Then you gently strain out the liquid, which leaves behind the original kefir grains.

Now put the grains in a new jar with some milk, and the process starts all over again.

Delicious, nutritious and highly sustainable.


Solar energy is often heralded as a clean alternative to coal and oil and gas, a way to save the planet and still ensure everyone’s electrical needs are still met. The technology is still advancing and people are finding new ways to make use of it. One idea is for communities to create their own microgrids and here’s why.

Microgrids are a great way for communities to generate their own solar electricity. Photo credit: Shutterstock

Bills are lower

America is a pretty sunny place, with every state getting a decent amount of sunlight, even Alaska. That’s a lot of untapped potential, so it seems foolish for people to pay for power off the grid when they can get it for free from the sky.

Well, free might be a bit of a stretch, at least at first. There’s still the installation and maintenance costs to consider, so it will take a little while to pay that off, but it’s worth noting the quality of solar panels is increasing every year.

If a community were to come together they could make buying panels a more manageable initial investment. Not only are their combined resources larger, but they’ll most likely be able to strike a better deal with a solar panel company when they’ve covered 30 roofs rather than one or two.

Once everything is set-up and running, electricity can be provided through solar panels to the community. While it won’t be able to replace regular supplies in all and every case, it can help bring down energy bills significantly.

Money can be raised

As well as, or instead of using the power themselves, communities can sell energy back to the grid. This can help create a pool of money that can be shared in the community. Instead of heading out and rattling tins for community initiatives cash can be raised whenever the sun is out. Whether it’s for repairs for a playground to support a local in need, a microgrid can be a great way to build up some money with little effort.

Protection from outages

The main grid isn’t always reliable. It’s susceptible to disasters, attacks, energy shortages and plain old errors. These events can affect thousands, even millions, in an instance and depending on what happened, it can take a long time to rectify.

Microgrids offer some protection from this. If, rather than using or selling all the energy collected, a community stores it, they have a back-up during blackouts. This means when there could be no lights for miles around, a community could still make dinner and watch TV without a big fuss. This puts them in a great position to help nearby people as well.

Cohesion and communication

An important part of a good community is the communication and cohesion between its members. This can be done with a friendly chat on the way out the door or specially organized events. Another way is to make the microgrid an active communal endeavor. Communities can keep everyone updated on progress, use it to teach children about science and space, and get people involved in the running of the grid.

All of this gets people talking to each other, plus if the grid is being used to raise money for something, it gives everyone a common goal and interest to work for too. It’s a perfect and easy way to help people get along.

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