Link Between Antibiotics, Bacterial Biofilms and Chronic Infections Found

The bacteria called non-typeable Haemophilus influenzae are a common cause of infection in the upper respiratory tract. By attaching to surfaces in the body the bacteria form a biofilm. Researchers have reported that when the bacteria encounter non-lethal amounts of specific antibiotics they are stimulated to form a biofilm, a structure that causes chronic infection and which can be highly resistant to antibiotics.

“This research addresses the long standing issues surrounding chronic ear infections and why some children experience repeated ear infections even after antibiotic treatment,” said Paul Webster, PhD, lead author, senior staff scientist at USC and senior faculty at the Oak Crest Institute of Science. “Once the biofilm forms, it becomes stronger with each treatment of antibiotics.”

During the study, non-typeable Haemophilus influenzae (NTHi) bacteria a common pathogen of humans was exposed to non-lethal doses of ampicillin, a class of antibiotics commonly used to treat respiratory, sinus and ear infections, or other beta-lactam antibiotics. The dose of the antibiotic was not enough to kill the bacteria which allowed the bacteria to react to the antibiotic by producing glycogen, a complex sugar often used by bacteria as a food source, to produce stronger biofilms when grown in the laboratory.

Biofilms are highly structured communities of microorganisms that attach to one another and to surfaces. The microorganisms group together and form a slimy, polysaccharide cover. This layer is highly protective for the organisms within it, and when new bacteria are produced they stay within the slimy layer. With the introduction of antibiotic-produced glycogen, the biofilms have an almost endless food source that can be used once antibiotic exposure has ended.

There are currently no approved treatments for biofilm-related infections. Therefore, bacteria forced into forming stronger biofilms will become more difficult to treat and will cause more severe chronic infections. Adults will suffer protracted lung infections as the bacteria hunker down into their protective slime, and children will have repeated ear infections. What may appear to be antibiotic resistance when an infection does not clear up may actually be biofilms at work.

Webster believes modern medicine needs to find ways of detecting and treating biofilm infections before the bacteria are able to form these protective structures. The difficulties of treating biofilm infections, which can be up to 1,000 times more resistant to antibiotics, have prompted some physicians to propose a gradual move away from traditional antibiotic treatments and toward non-antibiotic therapies.

“If antibiotics are to continue to be relevant for treating bacterial infections it is important that their effects on biofilms be explored,” says Dr. Webster. “One step in this direction would be to develop routine screening methods to test the effects of antibiotics on in vitro formed biofilms.”

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Potential Link Between Marijuana and Heart Risks Discovered by Cardiologists

As more states legalize marijuana for both medicinal and recreational use and use increases nationwide, cardiologists should advise patients about the potential risks, including effects of marijuana with some commonly prescribed cardiovascular medications, according to a research review published today (January 20, 2020) in the Journal of the American College of Cardiology.

The authors estimate that more than 2 million cardiovascular disease patients are currently using marijuana or have used marijuana previously. This includes recreational use and approved medical uses, such as human immunodeficiency virus-related weight loss, treatment of seizure disorders, or chemotherapy-associated nausea and vomiting.

"Some observational studies have suggested an association between marijuana and a range of cardiovascular risks,” said lead author Muthiah Vaduganathan, MD, MPH, of Brigham and Women’s Hospital’s Heart and Vascular Center in Boston. “We also know that marijuana is becoming increasingly potent. Our review suggests that smoking marijuana carries many of the same cardiovascular health hazards as smoking tobacco. While the level of evidence is modest, there’s enough data for us to advise caution in using marijuana for our highest-risk patients, including those who present with a heart attack or new arrhythmia, or who have been hospitalized with heart failure.”

Certain cardiovascular medications, including statins and blood thinners, can be affected by marijuana use, the review found. For example, statin levels can increase in the blood when used together with marijuana because both are metabolized through a network of liver enzymes called the cytochrome P450 system. Levels of blood thinners such as warfarin also can be expected to increase when used together with marijuana.

“The review provides detailed tables of many drugs administered for various cardiovascular conditions, with the anticipated effects of marijuana on each one,” Vaduganathan said. “These will be helpful to cardiologists and pharmacists reviewing patients’ medications and will help them collaboratively decide whether they need to adjust dosing if the patient continues to use marijuana.”

The reviewers recommend that cardiologists screen their patients for marijuana use, asking them how often and how much they use. They also should ask about how they use marijuana.

“Vaping marijuana is becoming more and more common, and we know vaping marijuana increases the pharmacological effects of the drug,” Vaduganathan said.

For patients who wish to continue to use marijuana, or who have other medically indicated reasons for use, the reviewers recommend limiting use as much as possible and for clinicians to inform patients that vaping and certain synthetic forms of cannabinoids are particularly potent and may have greater adverse effects.

In some patients, cardiologists should test for marijuana use by urine toxicology screening, the reviewers recommend. These include patients being considered for heart transplantation or those who present with early-onset heart attacks or heart failure at a young age.

The review also analyzed the current state of evidence linking marijuana use with cardiovascular health and disease.

Data on the exact health effects of marijuana on the cardiovascular system are limited, largely because federal laws that classify marijuana as a Schedule I drug have limited the ability of scientists to conduct high-quality research, Vaduganathan said.

“Now that we have seen marijuana use become more popular than tobacco smoking, we need more rigorous research, including randomized clinical trials, to explore the effects of marijuana on cardiovascular health,” he said.

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The surprising link between stress and skin problems

Whether it is emotional, physical, or mental, stress is an unavoidable part of the modern-day busy life. It all starts with your mind, but the impact is so powerful that it affects the entire body. While it is still easy to manage mild stress related to work or family issue, the real problem begins when it turns chronic. Prolonged and chronic stress can throw your immune system, digestive tract, metabolism, and hormones out of whack. Moreover, it can serve as a base for diseases like obesity, heart issues, Alzheimer's, diabetes, depression, gastrointestinal problems, and asthma.

However, very fewer people are aware of the fact that there is a direct link between stress and skin related ailments. If at times your skin feels excessively dry or if you notice unexplained rashes in your face, stress can be one of the reasons behind them. 

The connection between stress and your skin
 
You might have read about the impact of stress on your emotional and mental health, but do you know that the pimple that erupts on your skin before a major event can be due to stress? The most common skin problems triggered by prolonged stress are rashes or acne, which can be stimulated before a job interview or due to some personal issues. The situation can get worse if you are already suffering from skin problems, such as psoriasis or rosacea.

Dr Kusumika Kanak, Consultant Dermatologist, shared, "Stress and skin problems are directly associated with each other in various ways." She explained that "when a person is stressed, the body releases adrenaline and free radicals, which increase the sensitivity and reactivity of the skin. In this way, stress not only causes skin problem but also aggravates it."

Not only this, if you are already suffering from skin issues, then stress might delay the healing process and at times make it worse. It can even have a negative effect on your nails and hair.

As per Geneticist Pranav Anam, Founder of The Gene Box, continuous and long-term stress may also increase skin ageing. He further revealed that "about 10 per cent of the population who experience any kind of skin eruption have a genetic predisposition to skin conditions like hives or acne. They are more likely to be vulnerable to disorders like anxiety or depression and experience a skin condition in response to stress."

Easy ways to ease the effect of stress on your skin
Stress is certainly unavoidable but is not unmanageable. You cannot run away from it, but you can keep yourself calm, cool and composed in all the situations. To deal with the symptoms of stress on your skin, here are a few things you can do:

- Even if you are tired, swamped with work or stressed, take good care of your skin. Neglecting it may be harmful to you.

-One of the best ways to manage your stress level is practising yoga or meditation. Take some time out to enjoy some quality time in your own company.

-Sleep is another important aspect. A good quality sleep of 7-8 hours is important for your overall health and to manage your stress level.

When should you worry?

Stress-related skin issues can be treated by both medicines and lifestyle modifications. Generally, hives go away in some ways without any treatment, but if your bumps are hard and filled with pus, do not underestimate the situation. This can be due to some underlying health conditions. If your skin problem persists from more than a 2-3 days then consult a dermatologist. 

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Heart failure and diabetes: Research suggests a link

Individuals with diabetes have an elevated risk of heart failure, new research indicates.
 
An association between heart disease and diabetes is understood. New findings published in Mayo Clinic Proceedings suggests diabetes to be an indicator of heart failure in its own right. 

The research analysed the long-term impact of diabetes on developing heart failure, surveying 116 individuals with diabetes and 232 without diabetes. Researchers compared the age and sex of the participants and the prevalence of conditions including coronary heart disease, heart relaxation dysfunction, and hypertension. Over the ten-year follow-up period, one-fifth of those with diabetes experienced heart failure irregardless of other factors, compared to twelve percent of non-diabetics. There was no statistical difference between both groups of cardiac death, heart attacks, or stroke.  

The research suggests, according to Mayo Clinic cardiologist and senior study author Dr Horng Chen, “that diabetes mellitus alone is an independent risk factor for the development of heart failure.” The news is concerning for a country such as India, where heart disease is the leading cause of death. 
Diabetes is on the rise. By some estimates, diabetes is the country’s fastest-growing disease with a combination of lifestyle factors conducive to developing the disease and a genetic predisposition to the same driving the increase. 

Already, India’s diabetic population outnumbers the entire populace of some countries. In 2017, Diabetes affected 8.8 percent of India’s adult population with 72,946,400 cases. Some projections anticipate that India will see 98.0 million cases of type-2 diabetes alone by 2030. Some estimates anticipate an overall total of 134 million diabetes cases by just 2025. As such, the prospect of a link between heart failure and diabetes heightens the need for scrutiny of the country’s diabetes crisis and a need to investigate the connection further. 

“Our hope is that this study provides a strong foundation for further investigations into diabetes and heart failure,” comments Chen. “There is still much to learn and study in terms of this association and how to best diagnose and treat this condition.”

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Safety warning! Paracetamol use in pregnancy linked to attention-deficit hyperactivity disorder in kids

Paracetamol has been the preferred choice and used routinely during all stages of pregnancy to reduce a high temperature and for pain relief. There's no clear evidence, it has any harmful effects on an unborn baby. But, a new study has found strong links between its use during pregnancy to attention-deficit hyperactivity disorder in kids.

Obtaining a strong link between the use of paracetamol in mid-pregnancy and behaviour of off-spring, a study showed that paracetamol use between 18 and 32 weeks gestation is linked with negative neuro-cognitive outcomes leading to hyperactivity and attention problems in pre-school of the child. 

Backing the previous studies which have suggested possible adverse effects of paracetamol ( acetaminophen) consumption in pregnancy on the cognition, and childhood behaviour, particularly involving hyperactivity and / or attention problems, the present study used a large prospective cohort of 14, 062 children, linked to information on child cognitive and behavioural outcomes from 6 months to 17 years and have come into a conclusion that paracetamol consumption between 18 and 32 weeks gestation was associated with adverse trends in pre-school child behaviour, but the associations were no longer present by the end of primary school ( age 10-11 years). This particular Trend was more profound in boys than girls.

Our findings add to a series of results concerning evidence of the possible adverse effects of taking paracetamol during pregnancy such as issues with asthma or behaviour in the offspring. It reinforces the advice that women should be cautious when taking medication during pregnancy and to seek medical advice where necessary.

Using questionnaire and school information from Bristol's Children of the 90s study, researchers examined 14,000 children. When they were 7 months pregnant 43% of their mothers said they had taken paracetamol ' sometimes' or more often during the previous 3 months. Researchers examined results of the children's memory. IQ and pre-school development tests, temperament and behaviour measures.

They found an association between paracetamol intake and hyperactivity and attention problems as well as with other difficult behaviours with young children that were not accounted for by the reasons why the medication was taken or social factors. However, this was no longer the case by the time the children reached the end of primary school. Boys appeared to be more susceptible than girls to the possible behavioral effects of the drug.

The author commented that , " It is important that our findings are tested in other studies-- we were not in a position to show a casual link, rather an association between two outcomes. It would also be useful now to assess whether older children and adults are free of behavioural problems if their mother had taken paracetamol.

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Read more at Speciality Medical Dialogues: Safety warning! Paracetamol use in pregnancy linked to attention-deficit hyperactivity disorder in kids https://speciality.medicaldialogues.in/paracetamol-mid-pregnancy-cognitive-decline-in-pre-school-of-offspring/

Read more at Speciality Medical Dialogues: Safety warning! Paracetamol use in pregnancy linked to attention-deficit hyperactivity disorder in kids https://speciality.medicaldialogues.in/paracetamol-mid-pregnancy-cognitive-decline-in-pre-school-of-offspring/

Link between stress, cervical cancer uncovered

A new study has established an association between cervical cancer and stress in patients, stating that females having cervical cancer with stress-related disorders are at a higher risk of succumbing to the disease.

"Patients receiving a cancer diagnosis are at increased risk of several stress-related psychiatric disorders, such as depression, anxiety, and stress-reaction and adjustment disorders," said the study's author.

The author added, "Emerging evidence from both experimental and epidemiological studies indicates that psychological distress might affect the progression of many cancer types."

For the following study, researchers gathered and examined records of 4,245 patients diagnosed with cervical cancer in Sweden between January 1, 2002, and December 31, 2011.

At the same time, researchers also identified patients who had experienced a stressful life event, such as the death or severe illness of a family member, divorce, or being between jobs, as these events would increase emotional burden on patients.

Moreover, researchers also identified women who had cervical cancer or unspecified uterine cancers as their cause of death. During the study, 1,392 patients died, and cervical cancer was listed as the cause of death for 1,005 of them.

In all, researchers found that 1,797 patients either had stress-related disorders or had undergone stressful life events. Patients with either a stress-related disorder or a stressful life event were 33 per cent more likely to die of the disease.

Those who had stress-related disorders were 55 per cent more likely to die of their cervical cancer, while those who had experienced a stressful life event were 20 per cent more likely to die of their disease.

There are several possible explanations for the link between psychological stress and cervical cancer-specific mortality.

One reason can be that a woman suffering from a psychological disorder may be less likely to seek treatment and may be diagnosed at a later stage, added the author.

"Our findings support that oncologists or gynecologists perform an active evaluation of psychiatric status on return visits to see how patients with cervical cancer are doing, not only somatically, but also mentally," said co-author.

"If confirmed in other populations and countries, psychological screening and intervention may be considered as an integral component in cervical cancer care,"she added.

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High levels of oestrogen in the womb linked to autism

Researchers have identified a link between exposure to high levels of estrogen sex hormones in the womb and the likelihood of developing autism.

Published in the journal Molecular Psychiatry, the discovery adds further evidence to support the prenatal sex steroid theory of autism first proposed 20 years ago.

 

In 2015, the researchers measured the levels of four prenatal steroid hormones, including two known as androgens, in the amniotic fluid in the womb and discovered that they were higher in male fetuses who later developed autism. 

 

These androgens are produced in higher quantities in male than in female foetuses on average, so might also explain why autism occurs more often in boys. They are also known to masculinise parts of the brain and to have effects on the number of connections between brain cells.

 

"This new finding supports the idea that increased prenatal sex steroid hormones are one of the potential causes for the condition. Genetics is well established as another, and these hormones likely interact with genetic factors to affect the developing foetal brain," said the study lead author.

 

Now, the same scientists have built on their previous findings by testing the amniotic fluid samples from the same 98 individuals sampled from the Danish Biobank, which has collected amniotic samples from over 100,000 pregnancies, but this time looking at another set of prenatal sex steroid hormones called estrogen. 

 

This is an important next step because some of the hormones previously studied are directly converted into estrogens. All four estrogen were significantly elevated, on average, in the 98 fetuses who later developed autism, compared to the 177 fetuses who did not.

 

High levels of prenatal estrogen were even more predictive of the likelihood of autism than were high levels of prenatal androgens (such as testosterone). 

 

Contrary to popular belief that associates estrogen with feminisation, prenatal estrogen have effects on brain growth and also masculinise the brain in many mammals.

 

"This finding is exciting because the role of estrogen in autism has hardly been studied and we hope that we can learn more about how they contribute to foetal brain development in further experiments. We still need to see whether the same result holds in autistic females," said one of the researchers.

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