Tiny Antibiotic Beads Fight Infections After Joint Replacement


https://speciality.medicaldialogues.in/tiny-antibiotic-beads-fight-infections-after-joint-replacement/

European study finds raw milk boosts immunity, prevents colds and infections. 


The U.S. Food and Drug Administration (FDA) claims that it’s basically a death sentence for you and your children. But raw milk consumption, according to a new study published in The Journal of Allergy and Clinical Immunology, can actually help prevent colds, viruses and respiratory tract infections (RTIs) from forming in kids, as opposed to commercially processed milk which provides little or no health benefits.

Raw milk

A cohort of researchers, doctors and other medical professionals from across Europe investigated the effects of raw milk versus boiled farm-fresh milk and commercial processed milk as part of a larger investigatory project known as “PASTURE.” A group of women, roughly half of whom lived and worked on livestock farms in rural areas of mostly central Europe, were recruited to participate in the research.

All of the women were in their third trimesters of pregnancy at the time of the study, and detailed consumption and lifestyle patterns, including milk-drinking habits, were carefully evaluated and compared. In total, 983 children were included in the final data set, which revealed that milk in its pure, raw, unobstructed form is superior in terms of immune-boosting nutrition.

According to the research, raw milk works a lot like breast milk in providing protective, anti-infective health benefits to children. Compared to highly processed commercial milk, raw milk was found to help lower C-reactive protein levels, which are directly associated with inflammation. Raw milk, in other words, works against inflammation, while processed milk may help promote it due to its altered proteins.

“The main finding of this analysis was an inverse association between consumption of unprocessed cow’s milk and rhinitis [cold or runny nose], RTI [respiratory tract infections], and otitis [ear infection],” wrote the authors. “The effect was strongest when cow’s milk was consumed raw; boiled farm milk exhibited an attenuated effect.”

Does ultra-heat-treated commercial milk promote respiratory and other health problems?

Conversely, consumption of ultra-heat-treated commercial milk, the most widely available milk product on the market, was not found to decrease levels of C-reactive protein, which appear to be a leading cause of disease. With fevers specifically, commercial milk was found to actually increase their prevalence compared to raw milk.

Raw milk, on the other hand, is associated with a roughly 30 percent decrease in respiratory infections and fever, and could help babies and young children overcome these common ailments. Even minimally processed milk boiled directly on the farms was found to be beneficial, though much less so than true raw milk.

“[W]e are now not talking about asthma and allergies, but fever and infections in young children,” stated Dr. Ton Baars, a professor and senior scientist for milk quality and animal welfare at the Research Institute of Organic Agriculture in Germany, and one of the lead authors of the study. “It means there is additional new evidence that raw milk is a protective agent in infectious diseases in young children.”

Unlike in the U.S. where irrational superstition and paranoia have landed raw milk in the “dangerous” category, Europe is already widely accepting of raw milk, and increasingly so. In many countries, raw milk vending machines are prevalent on busy city streets, providing quick and easy access to fresh milk from local farms.

“In Europe, the consumption of unpasteurized milk has repeatedly correlated with protection against allergic disease,” wrote Moises Velasquez-Manoff in a piece for The New York Times late last year.

“In America, 80 percent of the Amish studied by Dr. [Mark] Holbreich consume raw milk. In a study published earlier this year, Dr. [Bianca] Schaub’s group showed that European children who consumed farm milk had more of those regulatory T-cells, irrespective of whether they lived on farms. The higher the quantity of those cells, the less likely these children were to be given diagnoses of asthma.”

Sources:

http://www.jacionline.org

http://www.en.uni

http://www.realmilk.com*
*[A Google web cache of this page is available here]

http://thebovine.wordpress.com

http://www.nytimes.com

http://www.drfranklipman.com

http://science.naturalnews.com

 

Smoking Gun for Stomach Drugs


Proton pump inhibitors (PPIs) are among the most widely used medications in the U.S. This class of drug is used to treat chronic heartburn. Although the pain often happens in the lower to mid chest area, it is not related to heart disease or a heart attack.

Heartburn Treatment

Story at-a-glance

  • Proton pump inhibitors (PPIs), medications used to treat chronic heartburn, can cause more health problems than they fix
  • Research has linked PPIs to kidney disease, dementia, heart attack, overgrowth of bacteria, infections, bone fractures and the fastest growing type of esophageal cancer
  • There are several much safer and natural ways of dealing with your heartburn, including changes to your clothing, weight, foods, finding your triggers and adding acid to your meals

Instead, heartburn pain happens when acid refluxes up your esophagus, burning the tissue. The fluid in your stomach is highly acidic, necessary for digestion of your food, protection against bacteria and absorption of many nutrients.

A variety of different reasons can cause this acidic fluid to pass the lower esophageal sphincter (LES) and burn your esophagus, but most cases of heartburn are due either to a hiatal hernia or Helicobacter pylori (H. pylori) infection.

Occasional heartburn is best treated with simple lifestyle changes, such as drinking a bit of apple cider vinegar in water right before or after your meals. Unfortunately, when you experience chronic pain over many weeks, your physician may prescribe a daily medication. PPIs are one class of those medications.

The top selling PPIs include Nexium, Prilosec and Prevacid, all available both as a prescription and over-the-counter (OTC). However, your doctor’s orders may actually do more harm than good in this instance, as these drugs tend to make your situation worse rather than better.

Smoking Gun Points to PPIs

Your cells use a proton pump to produce acid. PPI medications are designed to inhibit the proton pump and reduce the amount of acid produced. PPIs do not specifically target the cells in your stomach, and stomach acid is usually not the primary trigger behind chronic heartburn.

This class of drug is not specific, and instead will inhibit any cell with a proton pump producing acid, whether those cells are in your stomach or not. Researchers from Stanford University and Houston Methodist Hospital in Texas believe this is the smoking gun behind the variety of dangerous side effects linked to PPIs.1

The production of acid in your cells is associated with a specific cleanup process. The cells use acid to clean out end products and garbage from metabolism and cell function. When the acid is not present, there is a buildup of these toxins in the cells, which may lead to the development of a variety of significant health conditions.2

Excess stomach acid is not often the cause for your heartburn. Quite the opposite is true. Low amounts of stomach acid and the subsequent overgrowth of bacteria changes the digestion of carbohydrates, producing gas. The gas increases the pressure on the LES, releasing acid into the esophagus, creating heartburn.

While you may experience speedy relief of heartburn from immediate acting acid neutralizing medications such as TUMS, long-acting medications such as PPIs may increase your risk of heartburn over time.3

When Acid Levels Change, It Damages Your Body’s Ability to Function Properly

When PPIs were first approved by the U.S. Food and Drug Administration (FDA), they were designed to be taken for no more than six weeks. However, today it is not uncommon to find people who have been taking these drugs for more than 10 years.4 Long-term use has been associated with a number of different problems, including:

Bacterial Overgrowth

Long-term use of PPIs encourages overgrowth of bacteria in your digestive tract.5 Bacterial overgrowth leads to malabsorption of nutrients and has been linked to inflammation of the stomach wall.6

Reduced Absorption of Nutrients

One of the most common causes of impaired function of digestion and the absorption of nutrients is the reduction of stomach acid production.

This occurs in both the elderly and individuals on long-term antacid treatments, such as PPIs.7 Acid breaks down proteins, activates hormones and enzymes and protects your gut against overgrowth of bacteria.

Lack of acid results in iron and mineral deficiencies and incomplete digestion of proteins. This may also lead to a vitamin B12 deficiency.8 PPIs are also linked to a reduced absorption of magnesium. Low magnesium levels may lead to muscle spasms, heart palpitations and convulsions.9

Low Stomach Acid

PPIs reduce the amount of stomach acid. Symptoms include heartburn, indigestion, bloating, diarrhea, burping, burning and flatulence.10

Decreased Resistance to Infection

Your mouth, esophagus and intestines are home to a healthy growth of bacteria, but your stomach is relatively sterile. Stomach acid kills most of the bacteria coming from your food or liquids, protecting your stomach and your intestinal tract from abnormal bacterial growth.11

At the same time, the acid prevents the bacteria growing in your intestines from moving into your stomach or esophagus.

Reducing stomach acid changes the pH of your stomach and allows external bacteria to grow. PPIs may reduce acid between 90 and 95 percent, increasing your risk of salmonella, c. difficile, giardia and listeria infections.12,13

Other studies have linked the use of acid-reducing drugs to the development of pneumonia, tuberculosis (TB) and typhoid.14,15,16

The distortion of the gut microbiome affects your immune system and may increase your overall risk of infection. In vitro studies, those done on cells in test tubes, have found PPIs damage the function of white blood cells, responsible for fighting infection.17

Increased Risk of Bone Fractures

Lowering stomach acid production may also reduce the amount of calcium absorption, which in turn may lead to osteoporosis.

Researchers have linked long-term, dose-dependent use of PPIs with increased risk of hip fracture. The longer you take the medication and the more you take, the higher your risk of fracture.18

Antacids and Aspirin

In addition to the side effects listed above, researchers are discovering other health conditions associated with the use of PPIs and other acid reducing drugs.

Even while on PPI medication, you may experience occasional heartburn. Immediate acting antacids used to neutralize the acid in your esophagus may offer relief. Just be aware that this is really only adding insult to injury.

What’s worse, some antacids also contain aspirin, which may heighten your risk of adverse effects. In 2009, the FDA issued a warning about severe bleeding associated with the use of aspirin.

Since that time, the FDA has recorded eight cases of severe bleeding resulting from using over-the-counter antacids to neutralize heartburn.19 In some of those cases, the individual required a blood transfusion to stabilize their condition.

In a statement, Dr. Karen Murry Mahoney, deputy director of the division of nonprescription drug products, said:

“Take a close look at the Drug Facts label, and if the product has aspirin, consider choosing something else for your stomach symptoms.

Unless people read the Drug Facts label when they’re looking for stomach symptom relief, they might not even think about the possibility that a stomach medicine could contain aspirin.”20

What Barrett’s Esophagus Means to You

Long-term gastric reflux and heartburn may lead to Barrett’s Esophagus. This is a change in the cellular structure of the lining of your esophagus in response to chronic exposure to acid. Risk factors for Barrett’s Esophagus include:

Males Older age Tobacco use
Obesity Alcohol use Caucasian or African-American

The risk of developing cancer of the esophagus is significantly higher when you have Barrett’s Esophagus. In past years, the more common form of skin cancer has been squamous cell carcinoma. However, researchers have now discovered if you have taken PPIs for an extended period of time and have developed Barrett’s Esophagus, you have an increased risk of a more aggressive form called adenocarcinoma.

As recently as 1975, 75 percent of the esophageal cancers diagnosed were squamous cell carcinomas. More amenable to treatment and less aggressive then adenocarcinoma, the numbers have radically shifted in the past 30 years.21 The rate of squamous cell carcinoma has declined slightly, but the number of diagnosed adenocarcinoma of the esophagus has risen dramatically.

In 1975, 4 people per million were diagnosed with adenocarcinoma, and in 2001 it rose to 23 people per million, making it the fastest growing cancer in the U.S. according to the National Cancer Institute (NCI).22

Adenocarcinoma is now diagnosed in 80 percent of all esophageal cancers.23 Researchers theorized PPIs would protect people with Barrett’s Esophagus from adenocarcinoma, but found the reverse to be true. Not only did PPIs not protect the esophagus, but instead there was a dramatic increase in the risk of this deadly cancer, discovered in two separate studies.24,25

PPIs May Raise Your Risk for Dementia, Kidney Disease and Heart Attacks

PPIs affect all cells in your body, which may explain why they have been linked to such deadly conditions as kidney disease, heart attacks and dementia. In the past, PPIs were linked to acute interstitial nephritis, an inflammatory process in the kidneys. In a recent study of over 10,000 participants, researchers found another link to chronic kidney disease.26

The team found that those using PPIs to treat heartburn were more likely than other individuals on different heartburn medications to suffer chronic kidney disease or kidney failure over a five-year period.27

Dr. Ziyad Al-Aly, one of the researchers and a kidney specialist with the Veterans Affairs St. Louis Health Care System, said the findings illuminated a significant point: “I think people see these medications at the drug store and assume they’re completely safe. But there’s growing evidence they’re not as safe as we’ve thought.”28

PPIs have also been linked to dementia in people over age 75. In a study evaluating over 73,000 people over age 75 without any signs of dementia at the outset of the study, researchers made a startling connection. Of the individuals who developed dementia in the following seven years, those who regularly used PPIs had a significantly higher risk of the condition.29

A large data-mining study performed by researchers from Stanford University discovered PPIs were also associated with an increased risk of heart attack, while other long-term heartburn medications were not.30

What Can You Do to Prevent or Treat Heartburn?

In many cases, the root cause of heartburn is not linked to an overproduction of acid, but rather an underproduction. So before risking your health by using heartburn medications like antacids and PPIs, try these natural options:

Address Your Diet

The answer to heartburn and acid indigestion is to restore your natural gastric balance and function. To do that, eat lots of vegetables and other high-quality, ideally organic, unprocessed foods, and make sure you’re getting enough beneficial bacteria from your diet by regularly consuming fermented foods. This will help balance your bowel flora, which can help eliminate H. pylori bacteria — which is a very common cause of heartburn — naturally.

Add Acid

It might seem counterintuitive to add acid to an acidic environment, but as you’ve already discovered, many cases of heartburn are triggered by low acid production. One strategy is to take 3 teaspoons of raw, unfiltered apple cider vinegar in 6 to 8 ounces of fresh water before each meal.31 For a list of other alternatives that can help promote acid production, please see my previous article, “15 Natural Remedies for the Treatment of Acid Reflux.”

Work With Gravity

Heartburn tends to be worse at night, and/or after you lie down. Rather than lying down right after a meal, stay seated or standing for at least three hours, as food pressing on your LES will increase your risk of heartburn. Elevate the head of your bed using blocks sold for that purpose so your bed doesn’t slip and cause injury.32

Avoid stacking pillows to elevate your head, as this can increase pressure on your LES. High pillows also cause poor alignment of your neck and spine, increasing your risk for neck pain.

Ginger Root Tea

Ginger root has been traditionally used against gastric disturbances since ancient times. Its gastroprotective effect comes from blocking acid and suppressing H. pylori. To make your own tea, simmer three slices of raw ginger root in 2 cups of water for about 30 minutes. Drinking it 20 minutes before your meal can help prevent heartburn from developing.

Avoid Tight-Fitting Clothing

Tight clothing increases the pressure on your LES and increases the risk of an acid leak into your esophagus.

Maintain a Healthy Weight

Excess weight around your middle places excess pressure on your LES. Even losing 15 pounds can make a positive difference in your symptoms.

Avoid Triggers

Track the foods that increase your risk of heartburn. It might take some time, but it is well worth the effort.

Organic Coconut Oil

Coconut oil is a natural antibacterial, helping to reduce any overgrowth of bacteria in your stomach. It also helps to soothe your esophagus on the way down, and is a very healthy fat that is good for your overall health. Start with 1 teaspoon to see how your body responds. Common side effects are headache and slight nausea. Gradually work up to 3 tablespoons a day. You could also try adding 1 tablespoon to a cup of tea or coffee.

‘Super Bacteria’ Found At Brazil Olympic Venues, Beaches


The diseases can cause infections, meningitis and lead to death.

Scientists have found dangerous drug-resistant “super bacteria” off beaches in Rio de Janeiro that will host Olympic swimming events and in a lagoon where rowing and canoe athletes will compete when the Games start on Aug. 5.

The findings from two unpublished academic studies seen by Reuters concern Rio’s most popular spots for tourists and greatly increase the areas known to be infected by the microbes normally found only in hospitals.

They also heighten concerns that Rio’s sewage-infested waterways are unsafe.

A study published in late 2014 had shown the presence of the super bacteria – classified by the U.S. Centers for Disease Control and Prevention (CDC) as an urgent public health threat – off one of the beaches in Guanabara Bay, where sailing and wind-surfing events will be held during the Games.

The first of the two new studies, reviewed in September by scientists at the Interscience Conference on Antimicrobial Agents and Chemotherapy in San Diego, showed the presence of the microbes at five of Rio’s showcase beaches, including the ocean-front Copacabana, where open-water and triathlon swimming will take place.

The other four were Ipanema, Leblon, Botafogo and Flamengo.

The super bacteria can cause hard-to-treat urinary, gastrointestinal, pulmonary and bloodstream infections, along with meningitis. The CDC says studies show that these bacteria contribute to death in up to half of patients infected.

The second new study, by the Brazilian federal government’s Oswaldo Cruz Foundation lab, which will be published next month by the American Society for Microbiology, found the genes of super bacteria in the Rodrigo de Freitas lagoon in the heart of Rio and in a river that empties into Guanabara Bay.

Waste from countless hospitals, in addition to hundreds of thousands of households, pours into storm drains, rivers and streams crisscrossing Rio, allowing the super bacteria to spread outside the city’s hospitals in recent years.

Renata Picao, a professor at Rio’s federal university and lead researcher of the first study, said the contamination of Rio’s famous beaches was the result of a lack of basic sanitation in the metropolitan area of 12 million people.

“These bacteria should not be present in these waters. They should not be present in the sea,” said Picao from her lab in northern Rio, itself enveloped by stench from Guanabara Bay.

Cleaning the city’s waterways was meant to be one of the Games’ greatest legacies and a high-profile promise in the official 2009 bid document Rio used to win the right to host South America’s first Olympics.

That goal has instead transformed into an embarrassing failure, with athletes lamenting the stench of sewage and complaining about debris that bangs into and clings to boats in Guanabara Bay, potential hazards for a fair competition.

SITUATION GETTING WORSE

Picao’s study, which has undergone internal reviews at Rio’s federal university, analyzed water samples taken between September 2013 and September 2014. Using 10 samples taken at five beach locations, the study found super bacteria were most present at Botafogo beach, where all samples were positive.

Flamengo beach, where spectators will gather to watch Olympic sailors vie for medals, had the super bacteria in 90 percent of samples. Ten percent of Copacabana’s samples had the microbes.

Ipanema and Leblon beaches, the most popular with tourists, had samples that tested positive for super bacteria 50 and 60 percent of the time, respectively.

The Oswaldo Cruz study of the Olympic lagoon, which was peer reviewed, is based on water samples taken in 2013. It found that the lake is a potential breeding ground for super bacteria and their spread through the city.

While the studies both use water samples that are from 2013 and 2014, Picao and other experts said they had seen no advances in sewerage infrastructure in Rio to improve the situation.

Valerie Harwood, an expert in recreational water contamination and antibiotic-resistant bacteria at the University of South Florida who was not involved in the studies, said that if anything, things were getting worse, as the super bacteria naturally spread by infecting other microbes.

The contamination has prompted federal police and prosecutors to investigate whether Rio’s water utility Cedae is committing environmental crimes by lying about how much sewage it treats. Investigators are also looking into where billions of dollars in funds went since the early 1990s, money earmarked to improve sewage services and clean Guanabara Bay.

Cedae has denied any wrongdoing. It said in an emailed statement that any super bacteria found at the beaches or the Olympic lagoon must be the result of illegal dumping into storm drains. Cedae said it carries out sewage treatment and collection in the entire “south zone” of Rio, where the bodies of water are located and where the water samples were taken.

‘LIKE CANDY’

Five scientists consulted by Reuters said the immediate risk to people’s health when faced with super bacteria infection depends on the state of their immune systems.

These bacteria are opportunistic microbes that can enter the body, lie dormant, then attack at a later date when a healthy person may fall ill for another reason.

Super bacteria infect not only humans but also otherwise-harmless bacteria present in the waters, turning them into antibiotic-resistant germs.

Harwood said the super bacteria genes discovered in the Olympic lagoon were probably not harmful if swallowed by themselves: they need to be cocooned inside of a bacterium.

“Those genes are like candy. They are organic molecules and they’ll be eaten up by other bacteria, other organisms,” Harwood said. “That’s where the danger is – if a person then ingests that infected organism – because it will make it through their gastrointestinal tract and potentially make someone ill.”

The presence of the super bacteria genes in the lagoon indicates the bacteria themselves had recently died or simply were not detected by testing, Harwood said.

Health experts say Rio’s poor wastewater management has already created endemic illnesses associated with sewage that disproportionately impact the city’s poor, including gastrointestinal and respiratory problems, Hepatitis A and severe heart and brain conditions.

Rio’s Olympic organizing committee referred questions on water quality to state authorities.

Rio state’s Inea environmental agency said in an emailed statement it follows the World Health Organization’s recommendations for testing recreational water safety, and that searching for super bacteria is not included in that. It also said there was a lack of studies about the bacteria in water and health outcomes.

Gum disease opens up the body to a host of infections


For centuries, the mouth and the body have been disconnected — at least when it comes to health care. Through the Middle Ages and beyond, teeth fell under the care of barbers, who could shave a customer and pull a molar with equal skill. In the 1700s, French surgeon Pierre Fauchard published the Treatise on Teeth, establishing dentistry as its own science.

Across the channel in England, as physicians gained stature in the 19th century, surgeons and dentists engaged in a power struggle. In the modern United States, after medicine became linked to employer insurance and Medicare, the fissure between medicine and dentistry widened. Insurance coverage began at the throat.

So when Salomon Amar, a periodontal specialist at Boston University, began exploring links between oral bacteria and heart disease in animal studies in the late 1990s, reactions were lukewarm. “Many cardiologists thought we were a bit crazy,” he says. Skepticism still abounds, but the same molecular tools that have dramatically changed understanding of the gut microbiome are now allowing scientists to track and examine bacteria in the mouth. Advocates of a connection between the artery disease atherosclerosis and microbes are hoping to find convincing proof of their suspicions, while exploring links between ailing gums and other conditions, including cancer, arthritis, diabetes and even Alzheimer’s disease.

The work has profound implications for public health, given that more than 65 million American adults are thought to have periodontal disease, which occurs when bacterial overgrowth inflames the gums and can lead to erosion of gums and bone. If it turns out that periodontal decay drives other diseases, doctors would have a new, and relatively simple, means of prevention.

Wenche Borgnakke, a dental researcher at the University of Michigan in Ann Arbor, has been making this case for years, citing “solid evidence that periodontal treatment has an effect on systemic disease.” Shepoints to a study published last year in the journal Medicine comparing patients on dialysis who received periodontal treatment with those who did not. Those getting treatment had an almost 30 percent lower risk of pneumonia and hospitalization from infections. Another study published earlier this year found that gum disease is associated with a roughly 10 percent higher mortality over 10 years among patients with kidney problems.

Researchers working in the field often point out that about half of all deaths from atherosclerosis occur in people who do not have any classic risk factors, such as high cholesterol or obesity. Something else — something as yet unknown — is also contributing to heart disease. Even the root cause of many cancers is largely unexplained. Most women with breast cancer, for instance, have no risk factors other than older age. SaysJean Wactawski-Wende, a cancer epidemiologist at the State University of New York at Buffalo: “The more I work on oral health and cancer, the more I think, ‘Oh my gosh, I’ve got to keep my teeth clean.’ ”

Foul mouth

To date, more than 500 scientific papers have weighed in on the connection between atherosclerosis and gum disease. Officially, the theory remains “biologically plausible,” but unproven, according to the American Heart Association’s formal position. Some concepts are undisputed: For one, the microbes that live in the mouth don’t stay in the mouth. The simple act of brushing allows bacteria clinging to the teeth and gums to leak into the bloodstream.

As the posters at the dentist’s office attest, neglected oral hygiene encourages bacterial growth, allowing the microbes to breed on and between teeth, as well as under the gums. What the illustrations don’t show is that these microorganisms form a biofilm, a tough microbial community bound together with sugar molecules in a thin coating. This is the plaque your dentist warns you about.

“If you do not brush your teeth, it will sit there and accumulate. As that plaque gets thicker and thicker, there is less and less oxygen in the deepest layers,” Borgnakke says. Safely sheltered, the innermost plaque starts to favor anaerobic bacteria, which, when they escape into the blood, can survive in the oxygen-starved nooks and crannies deep inside the body.

As plaque builds up, gums get irritated, swell and draw more blood into the distressed tissue. Eventually, chemicals produced by the biofilm break down the thin layer of cells that form a boundary between the gums and the blood vessels. Periodontitis officially occurs when gum and bone tissue starts to deteriorate. The space between the tooth and gums forms a pocket; dentists measure the depth of the pockets to determine the severity of infection. “We usually think of an infection as some bug from the outside that attacks the body,” says Borgnakke. “In this case, it’s an internal infection.”

It was once thought that only a handful of microbial species were involved in the development of periodontitis, but the latest studies have revealed that many of the microbes responsible for gum diseasecome from “previously underappreciated species,” according to a 2015 report in Advances in Experimental Medicine and Biology. Because many bacteria resist growth in a laboratory, only a small portion of some 500 to 700 species of oral microbes have been well characterized.

One aggressive pathogen, an organism called Porphyromonas gingivalis, has antennae that stick out and can pry open the space between two cells, Borgnakke says. “This is a really, really nasty bug.” Within minutes of invading blood vessels, P. gingivalis and its gang of accomplices are ferried to distant sites, where they can set up outposts. “Bacteria that normally live in the mouth are found in every organ in the body, and even muscle cells,” she says.

The body doesn’t take this assault lying down. The immune system gets agitated and tends to stay in a state of slow simmer. But the bacteria that cause periodontal disease have a knack for turning the body’s defense on its head, according to a 2015 review in Nature Reviews Immunology. Case in point: Common white blood cells called neutrophils are deployed to the failing gums — where they not only fail to control the infection, but also end up releasing enzymes that further destroy tissue. The immune system also releases an avalanche of chemicals designed to help control the infection. For example, the liver starts producing C-reactive protein, a molecule that has such an important role in signaling the rise of heart disease that it is considered a risk factor by some researchers.

Smoking gums

Even after two decades of study, it has been hard to directly link periodontal dynamics to blocked arteries, despite hundreds of studies that have tried. There are seemingly smoking guns. Among them, P. gingivalis is commonly found lodged inside arteries, and the development of plaque in the arteries is driven by many of the same inflammatory chemicals triggered by periodontal disease. Many researchers also point to C-reactive protein, which is probably present long before atherosclerosis develops.

Story continues after graphic

But people with periodontitis also tend to share well-known risk factors for heart disease, such as high cholesterol, smoking and obesity. A sugar-sweetened diet that promotes oral decay is no friend to your arteries. The relationship is also hard to study because both atherosclerosis and periodontitis unfold slowly over time, so epidemiologists must rely on indirect measures of disease.

Experts line up on both sides. “If there is an association, it’s a very weak one,” says Peter Lockhart, former chairman of oral medicine at Carolinas HealthCare System in Charlotte, N.C. An expert on heart valve infections, Lockhart was one of the leaders of an American Heart Association panel that reviewed the evidence before releasing an official statement in 2012. “I think the question has been answered for now,” he says. For cardiologists, the threat from periodontal disease “pales by comparison to the known risk factors that need to be focused on.”

Others aren’t ready to abandon the hypothesis. In 2015 in the journal Atherosclerosis, a team of German researchers reviewed studies released since the AHA statement. They pointed out that a large body of work published in the previous three years, using more refined tools and study design, shows that a connection between the two “cannot be ruled out.” One study, published in PLOS ONE in 2014 from researchers at the University of Florida in Gainesville, Meharry Medical College in Nashville and elsewhere, claims to have found a causal relationship, at least in mice. A significant portion of animals that drank water containing P. gingivalis experienced inflammation and bacterial accumulation in their hearts and blood vessels. Very few unexposed animals did.

Into the brain

While the artery studies carry on, new research is finding oral bacteria in surprising places. The brain, for one. In 2013, a team of researchers from Florida and the United Kingdom compared brain tissue samples from 10 people who had died from Alzheimer’s disease with samples from 10 people who had died from other causes. Signs of P. gingivalis infection showed up in four Alzheimer’s patients but in none of the comparison patients, the researchers reported in the Journal of Alzheimer’s Disease. In a follow-up experiment published in the same journal, the researchers inoculated P. gingivalis into the mouths of 12 mice genetically protected from Alzheimer’s. Six months later, evidence of the same bacteria appeared in the brains of three-fourths of the animals.

Tissue from the brain of an 84-year-old woman who died of Alzheimer’s disease shows evidence of infection with an oral species of Trepemona (dark blue).

Another type of oral bacteria, spirochetes calledTreponema denticola, “are already known to enter the brain,” says neuroscientist Sim Singhrao of the University of Central Lancashire in England. Traveling along the nerves that connect to the jaw, “they are a bit like jellyfish, crawling up into neurological tissue.” Once nestled inside the brain, oral bacteria could trigger an inflammatory chain reaction that eventually destroys certain nerve cells and leads to Alzheimer’s disease, says StJohn Crean, Lancashire’s executive dean of the College of Clinical and Biomedical Sciences.

He points out that Chinese researchers, writing last year in the Journal of Periodontal Research, found that people carrying certain versions of APOE, a gene linked to Alzheimer’s, were also more likely to suffer aggressive periodontal infection. Finally, a study published in March in PLOS ONE found that among 59 people with hallmarks of Alzheimer’s disease followed for six months, those with periodontitisexperienced cognitive decline at more than six times the rate as those without gum disease.

“We’ve moved on from that ‘this-can’t-be-right’ feeling,” Crean says. He is hoping to get funding for a study that would compare progression of Alzheimer’s among people who receive intensive oral hygiene, such as frequent dental-office–style cleanings, compared with those who brush and floss regularly. But he also notes that the arrow connecting gum disease and Alzheimer’s could point in both directions. “When your memory goes, you’re not going to remember to brush your teeth.”

Teeth and tumors

Providing still more reason to invest in dental floss, new research is raising questions about cancer’s link to gum health. Aside from oral cancers, the cancer connection was barely on the scientific radar before 2008, when a study appeared in Lancet Oncology. Some research had suggested that gum disease is associated with higher cancer mortality, but questions remained about the influence of smoking. In the study in Lancet Oncology, researchers from Imperial College London, Harvard Medical School and elsewhere reviewed data for almost 50,000 men enrolled in the Harvard Health Professionals Follow-Up Study. That study found a small increased risk of cancer mortality in men with periodontal disease.

A second study, published in February in Annals of Oncology, found that men with advanced periodontal disease who had never smoked nonetheless had a 2.5 times higher risk of cancers associated with smoking, such as lung, bladder and esophageal tumors. The researchers hypothesize that gum disease might trigger the same sort of immune response that tobacco does. Another study examined data from more than 73,000 participants of the Women’s Health Initiative, which gathered health information from volunteers over 15 years. Participants diagnosed with periodontal disease had a 14 percent increased risk of breast cancer compared with women with healthy gums. “It’s a modest increase, but when 50 percent of adults are diagnosed with periodontal disease, you could see this becoming a very important factor for prevention,” says Buffalo’s Wactawski-Wende, who led the study, published in January’s Cancer Epidemiology, Biomarkers & Prevention.

Laboratory studies are also offering compelling evidence of associations with certain cancers. Almost a dozen studies conducted over the last five years have found one particular species of mouth bacteria,Fusobacterium nucleatum, living in seeming abundance in colorectal tumors. Like P. gingivalis, F. nucleatumthrives in diseased gums and in low-oxygen areas. Wactawski-Wende is studying samples of various tumors to look for oral organisms.

Story continues after table

Burning questions

Given that periodontal disease causes the immune system to remain in a state of irritation, other lines of research have tried to tie diseased gums to inflammatory diseases like rheumatoid arthritis and diabetes. Writing last year in the journal Mediators of Inflammation, researchers from the University of Ceará in Brazil reviewed published studies on rheumatoid arthritis, concluding that “the majority of the articles have confirmed that there is a correlation,” especially among women. Both gum disease and arthritis, they wrote, could even feed off one another, amplifying a hyperactive immune system that makes both conditions worse.

A long line of research has also examined the relationship between diabetes and periodontal disease. In 2013, Borgnakke and an international team reviewed the evidence in the Journal of Clinical Periodontology. Of the 17 studies they found to have sufficient quality, the evidence suggests that people with poor periodontal health have a greater chance of developing early symptoms of diabetes and having greater complications from the disease once it develops. But she acknowledges that diabetes, and in fact all conditions under study, have multiple causes, making the role of any one culprit difficult to determine.

It’s also hard to account for the role of genetics. “You could have two patients with the same amount of plaque. One patient will have really deep pockets [between teeth and gums], and the other one will have no consequences,” she says. “That’s why it’s so hard to say anything in general.”

Even as research continues, those involved concede that they may never satisfy skeptics, given the slim chance of ever having a long-term prospective study. That research would need to monitor the cardiac health of a large population over an extended time, half with gum disease and half without, to determine if those with periodontal problems experienced worse cardiac health. But given the length of time it takes for both gum disease and systemic disease to reveal themselves, a study would need to involve thousands of participants over many years to be definitive, Amar says. “It would be financially prohibitive.” And he points out that pharmaceutical companies, which often help fund large clinical trials, would not back a study that has no product for them to eventually sell.

“Causality may not ever be demonstrated,” he says. To most doctors, the mouth will probably remain unconnected to the body. Amar and others will nonetheless continue, in hopes their work may one day give health professionals a little more to chew on.

FDA OKs New Infection Drugs


Antibacterial and anti-flu products add to weapons against disease.

A new antibacterial drug and an anti-influenza medication got the nod from the FDA.

The agency approved the combination of ceftolozane, a cephalosporin antibacterial drug, and tazobactam, a beta-lactamase inhibitor, which will be sold as Zerbaxa and used to treat complicated intra-abdominal infections and complicated urinary tract infections.

And it also approved peramivir (Rapivab), an anti-influenza drug delivered by intravenous injection and intended for patients unable to take medication orally or by inhalation.

The approval of ceftolozane/tazobactam is an important milestone, according to the Infectious Diseases Society of America (IDSA), which has been pushing for the development of 10 new systemic antibacterial drugs by 2020.

That campaign — dubbed the 10 x ’20 Initiative — began in 2010, so this approval comes at the halfway mark, the society noted in a statement.

It’s also the fifth new drug since the campaign was launched and the first to address “certain serious and resistant Gram-negative bacteria,” the IDSA statement said.

Zerbaxa’s OK comes in a busy year for antibiotic development. The FDA this year has already approved dalbavancin (Dalvance), tedizolid (Sivextro), and oritavancin (Orbactiv).

The other new antibacterial is ceftaroline fosamil (Teflaro), approved late in 2010.

“The FDA approval of several new antibacterial drugs this year demonstrates the agency’s commitment to increasing the availability of treatment options for patients and physicians,” according to Edward Cox, MD, of the agency’s Center for Drug Evaluation and Research.

“We must continue to help foster the development of new antibacterial drugs and encourage prudent use of existing treatments to conserve their utility,” Cox said in a statement.

On the other hand, the fight is not over, the IDSA said.

“Even this important approval doesn’t address all of our antibiotic needs,” the society statement said. “Patients still face life-threatening infections for which additional new antibiotics are urgently needed.”

Ceftolozane/tazobactam got approval as a qualified infectious disease product under the Generating Antibiotic Incentives Now (GAIN) title of the FDA Safety and Innovation Act as “an antibacterial or antifungal human drug intended to treat a serious or life-threatening infection,” the agency said in a statement.

The combination’s efficacy in complicated intra-abdominal infections (in combination with metronidazole) was established in a clinical trial with 979 adults, randomly assigned to receive the combination plus metronidazole or meropenem.

Efficacy in complicated urinary tract infections was established in a clinical trial where 1,068 adults were randomly assigned to receive the combination or levofloxacin (Levaquin).

The drug’s label notes that efficacy was observed to be lower in patients with renal impairment. The most common side effects in clinical trials were nausea, diarrhea, headache, and fever.

Meanwhile, the agency has also approved peramivir, according to the drug’s maker, BioCryst Pharmaceuticals, of Research Triangle Park, N.C.

The drug is a neuraminidase inhibitor, like oseltamivir (Tamiflu) and zanamivir (Relenza), but given as a single-dose IV shot. Oseltamivir is an oral medication, while zanamivir is inhaled.

Peramivir is intended to be used by adult patients who have uncomplicated flu, but can’t take oral or inhaled drugs. The approved indication specifies that patients must have been symptomatic for no more than 2 days.

Copper bed rails kill hospital-related infections on contact


  • Copper is a bacterium’s worst nightmare, so researchers are coating hospital bed rails in it to curb the hundreds of millions of cases of healthcare-acquired infections around the world.
  • You know what’s not cool? Checking yourself into hospital for one illness, only to contract another illness purely by virtue of the fact that you’re currently in a hospital. That’s bad news for everyone, because you have to stay in hospital for longer, which means more cost for hospital to keep you there and treat you.

    But new research has come up with a way to curb all the gross infections spread in hospital wards – copper bed rails. Because, apparently, copper kills everything.

    According to the US Office of Disease Prevention and Health Promotion, one in 25 hospital patients are affected by hospital-related infections, such as pneumonia, urinary tract infections, and methicillin-resistant Staphylococcus aureus (MRSA), and it costs $40 billion a year to treat them.

  • For developing countries, that rate is even higher. In Australia, there are reportedly around 200,000 cases in hospitals every year. Sometimes people die from these infections.

    Eighty percent of these infections are spread because of surface contact in hospitals, and the biggest offender is the bed safety railing, touched by all manner of staff and patients throughout the day. Calling them “the most contaminated surface”in the room, researcher Constanza Correa from a Chile-based start-up called Copper BioHealth has installed 150 copper bed rails in four hospitals around the country to see if they can curb the rate of infection.

    It sounds odd, but copper is actually a known microbe killer. In fact, according to Hannah Bloch at NPR, people have known about its antimicrobial properties since at least 2,600-2,000 BC, when an ancient Egyptian medical text was written about how it could be used to sterilise wounds and treat water. “Bacteria, yeasts and viruses are rapidly killed on metallic copper surfaces, and the term ‘contact killing’ has been coined for this process,” Correa and her team report in the journal Applied and Environmental Microbiology

    Talking to Goats and Soda, Correa says these copper railings cost between $60 to $100 per bed per month, which seems pretty steep, but she says by reducing the cost of infection treatment, they’ll have paid for themselves within three years.

    While the results of Correa’s copper bedrail experiment are yet to be published,Bloch points to another study that was published by US researchers last year. Reporting in the journal Infection Control and Hospital Epidemiology, the team led by Cassandra D. Salgado from the Medical University of South Carolina in the US reported that the presence of copper bed rails “reduced the number of healthcare-acquired infections from 8.1 percent in regular rooms to 3.4 percent in the copper rooms”.

    It’s not entirely clear why copper, as Correa puts it, “kills everything”. It’s been suggested that the process occurs in two stages – firstly as soon as a single-cell bacterium comes into contact with a copper surface, the interaction causes its outer membrane to rupture and become full of holes.

    According to the International Copper Association (ICA), this occurs because this outer membrane is maintained by a “stable electrical micro current”, also known as a transmembrane potential, which causes a voltage difference between the inside and outside of the bacterium. “It is strongly suspected that when a bacterium comes in contact with a copper surface, a short circuiting of the current in the cell membrane can occur,” says the ICA. “This weakens the membrane and creates holes.”

    The other option is that copper molecules can actual cause ‘rust’ to occur in the cell membrane.

    Now that the bacterium’s outer membrane is full of holes, we arrive at the second deadly stage – copper ions start rushing into the single-cell bacterium, overwhelming it and grinding its metabolic activity to a halt. “The bacterium can no longer ‘breathe’, ‘eat’, ‘digest’ or ‘create energy’,” says the ICA, and so it dies.

    Correa says if their experiment proves a success, she’ll push for copper surfaces elsewhere in hospitals, such as on bedside tables, IV poles, and mattress covers.

    Sources: NPR, International Copper Association

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Scientists Develop Drug to Replace Antibiotics


New medicine effective against superbugs

A small patient trial showed that the new treatment was effective at eradicating the MRSA superbug which is resistant to most antibiotics. The drug is already available as a cream for skin infections and researchers hope to create a pill or an injectable version of it in the next five years.

Antibiotics have been one of the most important drugs since the invention of penicillin almost 90 years ago. But the World Health Organization has repeatedly warned of the threat of antimicrobial resistance, saying “a post-antibiotic era – in which common infections and minor injuries can kill” is a very real possibility in the 21st century.

But scientists say this new technology is less prone to resistance than antibiotics because the treatment attacks infections in a completely different way. The treatment uses enzymes called endolysins — naturally occurring viruses that attack certain bacterial species but leave beneficial microbes alone.

Mark Offerhaus, the Chief Executive of the Dutch biotech firm Micreos which is leading the research, said the development of the new drug marks “a new era in the fight against antibiotic-resistant bacteria”, adding that millions of people stand to benefit from this.