StemCell Therapy

When I was a little girl, I had high-flying dreams and they had very little to do with my juvenile arthritis, a childhood illness similar to rheumatoid arthritis (RA). First, I wanted to be a ballerina and practiced dance moves on my parents' Persian rug. Then I watched Jacques Cousteau and his crew of marine biologists diving in waters all over the world and scuttled the dancing dream in favor of serving on his ship, the Calypso, and spending much of my life under water. But at age 16, I went home after a two-year hospital stay in a power wheelchair, trailing recommendations from my then-medical team to lower my expectations of life to those resembling a turnip's. Because of the disease, y'know.

It would be easy to dismiss this as a function of attitudes in a land and time far away from now. But these perceptions persist, if not in others, then certainly in ourselves. Its a strange thing, this shift in assumption and expectation. The minute you get a diagnosis of chronic illness, its as if the rug is pulled out from under you. Your future, which had just shone with possibility, now seems dull, hopeless, and framed in less-than.

Do you really have to give it all up and accept a life of sitting on the sidelines? No. Not by a long shot. The key is to adapt and change your approach. But more on that in a bit. First, lets take a look at the obstacles.

I've lived with RA for more than half a century and have learned that the only predictable thing about this condition is that you never know what it'll do next. Sometimes, you're lucky and find a medication that works, suppressing the symptoms so you can get back to your life. At other times, its all you can do to get dressed in the morning. And, of course, all the stages in between.

Fifty years ago, an American psychologist by the name of Martin Seligman did a study that led to a classic theory of depression. He divided dogs into two groups. Both would receive shocks, but one group of dogs would be able to escape, the other not. The dogs that had no control over the situation curled up in a ball, whimpering. Seligman developed a theory called learned helplessness, stating that when people have no agency (that is, no control), they are more likely to develop depression.

When you have no ability to predict how your RA will feel in the morningand therefore what you will be able to doyou can feel helpless. If youre feeling that kind of helplessness for weeks or months, it spreads into other areas of your life, making you feel depressed. It may even be accompanied by its bratty cousin, "Feel Like Giving Up." And that's OK. Because RA affects every part of your life and it's hard to re-learn how to be you. There's nothing wrong with having a moment (or 10) of intense frustration. But what's really important is to make sure it doesn't stick around.

So much of living with RA is about kicking that cousin out of your psyche. Again, your doctor can help, as can therapy, family and friends, and a community of others like you. Having support will help you fight back and find other ways of taking up the reins of your life.

The great thing about life is that there is no one way to do anything. Whether it's opening a jar, having a family, or building your own business, there are ways around that big boulder called RA in the middle of your path. These tips can help:

Talk to your doctor. Your rheumatologist is one of the most important members on your team. If your RA is getting in the way of you creating a life, call them. You might need to adjust your treatment so you can start the journey back to living first, with RA just muttering in the background. Many people also include diet, exercise, supplements, and alternative treatments in how they approach living with RA.

Give yourself extra time to achieve your goals. Maybe your RA diagnosis won't require a complete change in direction for your life. You might be able to stay on your current career path or even keep training for that big race you've been wanting to tackle, but it's probably going to take a little extra time to get there. Getting the right treatment working for you can take time, and flares don't respect your "to-do" list.

Don't expect to follow "normal" timelines when it comes to working toward big goalsRA is bound to get in the way. When it comes to dreams, pursuing them is what matters, not how you go about it. You are free to create your own path, one that respects and accommodates your RA. For instance, I used to work as a policy analyst, frequently working from home four days a week on research and writing tasks. This enabled me to work much more effectively, with fewer sick days.

When RA brings physical limitations, use your mental muscle instead. I will forever be grateful to my parents for the way they dealt with the lost teenager who came home from the hospital. They told me that although my body might not work very well, there was nothing wrong with my mind and they expected me to use it. This meant working hard in school so I could get to college. By then, I had realized the importance of focusing on what I was able to do (and not just because I couldn't swim, so working with Cousteau was a wash).

Finding alternate routes to getting where I wanted to go eventually became a bit of a hobby and by now, I can almost always find a way around an obstacle. Remember that although your condition might get in the way of you becoming a trapeze artist, you can absolutely find another way to be in the circus.

Go easy on yourself, but not too easy. Frustration about struggling with RA might get misdirected toward yourself. Try not to be angry at yourself or your body. It'll get you nowhere, except derailed, and it isnt something you would tolerate for anyone else. Be kind and understanding to yourself.

Human beings have a gift of adaptation, being able to live in almost any climate, under any conditions, and changing their approach to survive. Use that gift to create your life. Yes, with RA, but a life in which you tear down limits of low expectations.

Following your dreams is a process, sometimes a long one, with side tracks and pauses, and often infuriatingly so. But persevering, accommodating your own needs to move slower, to take pauses, but then reassessing and getting back to your path is possible. The only way to live with RA is to become as stubborn as a goat and refuse to stay down. You learn to withstand long periods of having to put your dream (and your life) on hold while you deal with your condition and its nonsense. During those times of flares and pain, you hone a single-minded focus by getting through each day. When it is over, when you are better and get your life back, you use that focus to pick up your dream and work on it some more.

After many years of attending university, with many challenges, I graduated with my masters degree in social work. After immigrating to Canada from Denmark, and with the offer of a government job in human rights, I thought of those doctors who'd had zero expectations of the girl with a chronic illness and disability. In that moment, I wanted very much to write them a letter, telling them how their assumptions of my inability had had the exact opposite effect: They had only spurred me on.

In my family, that's called the "Show the Bastards" gene. I'll bet you have one, too.

Read this article:
Rheumatoid Arthritis Will Change Your Life. It Doesn't Have to Ruin It. - HealthCentral.com

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Arthritis treatment safe for cats with kidney disease [Ask the Vet's Pets] - Reading Eagle

Dear Doctor: Im a 66-year-old man whose right knee really hurts from arthritis. My sister keeps talking about something called prolotherapy. What is it, and can it help?

Dear Reader: Prolotherapy is an injection-based approach to treating pain in the soft tissues of the joint. Specifically, a small amount of a liquid irritant is introduced at the site where a tendon or ligament attaches to the bone. The idea is that the irritant will set off a localized inflammation reaction, which will then trigger the release of growth factors that promote the healing of soft tissues.

The roots of prolotherapy date back to the ancient Greeks, who believed that deliberately causing inflammation in a certain area of the body could stimulate the tissues to repair themselves. In the 1930s and 1940s, several physicians expanded on the concept. They experimented with various solutions and developed techniques sometimes referred to as needle surgery to target connective tissue in the joints.

Today, prolotherapy injections typically consist of sugar- or salt-based solutions to which a local anesthetic, such as lidocaine, is added. Patients seek the treatment to help with joint pain and stiffness resulting from injury, overuse or inflammatory conditions such as arthritis and degenerative disc disease. Areas of the body targeted by the practice include the knees, back, hips, ankles, shoulders and hands.

Treatment protocols usually consist of a series of three to eight injections given over weeks or months, depending on the specific case. The injections can be moderately painful, and patients often use Tylenol or stronger medications to manage localized aches and tenderness. Patients are advised to limit activity for several days after each injection, and they may be asked to supplement the therapy with specific exercises that focus on range of motion.

Since creating inflammation is the point of prolotherapy, the use of NSAIDs, or non-steroidal anti-inflammatories, to address the resulting pain and discomfort is not recommended. Possible side effects of the procedure include bleeding, bruising or swelling at the injection site. These can last for a week or more. Allergic reactions to the injected solution, infection and nerve damage are possible, but rare.

Does prolotherapy work? In some case studies, patients report improvement in pain and strength in the affected areas. But studies of the treatment have yielded mixed results. Some have argued that the studies showing benefit have been too small and not scientifically rigorous. The one area of agreement appears to be the need for large and scientifically rigorous studies.

Although prolotherapy is gaining in popularity, the National Institutes of Health identify it as a complementary and alternative medical treatment. And since its considered an experimental therapy, many insurance companies wont cover it. Costs can range from $400 to $1,000 per treatment, depending on the provider.

As with all alternative therapies, we think its wise for you to check with your doctor to see whether prolotherapy may be helpful for you.

Send your questions to askthedoctors@mednet.ucla.edu.

Originally posted here:
Ask the doctors: Arthritis pain may be relieved by prolotherapy - The Spokesman-Review

Millions of patients in England will be stopped from having an X-ray on their sore back, hernia repair surgery or scan of their knee to detect arthritis under controversial plans from NHS and doctors to ration unnecessary treatment.

The Guardian has seen a list of 34 diagnostic tests and treatments that in future patients will only be able to get in exceptional circumstances as part of a drive to save money and relieve the pressure on the NHS.

The sweeping changes they are set to propose include many forms of surgery, as well as ways of detecting illness including CT and MRI scans, and blood tests, for cancer, arthritis, back problems, kidney stones, sinus infections and depression. Three of the procedures have since been dropped from the list.

If implemented, the clampdown would involve an unprecedentedly radical restriction on patients right to access and doctors ability to recommend procedures, some of which have been used routinely for decades.

It would also see patients told to use physiotherapy or painkillers to dull the pain of an arthritic knee rather than undergo an exploratory operation called an arthroscopy. Kidney stones would no longer be removed in an operating theatre and instead would be treated with sound wave therapy to reduce the pain.

Similarly, in future adenoids would not be removed because evidence now shows that it is not necessary, doesnt work well and can cause problems like bleeding and infection, according to the rationale set out in the document for curtailing that procedure.

Disclosure of the list prompted fears that the move amounts to a major escalation of NHS rationing.

An NHS spokesperson said the document was out of date and had not been approved or implemented. They added there was strong support from senior doctors in the Academy of Medical Royal Colleges for action to eliminate wasteful interventions that dont benefit patients.

The Patients Association warned that if implemented the changes would force patients to either endure the pain of their condition or pay for private care to tackle it.

Putting barriers in the way of people expecting to have so many previously commonplace tests and treatments would lead to harm and distress, said Rachel Power, the associations chief executive.

Patients have seen the range of treatments offered by the NHS cut back over recent years, and the NHS has been upfront about this being to save cash. Often there are good reasons for not using these low value treatments as a first choice, but they are appropriate for some patients.

We are unhappy at any new barriers being erected between patients and the treatments they need.

This is of a piece with the restrictions on prescribing over the counter medicines [which NHS England brought in last year], and patients have told us of the harm and distress this broad programme of restrictions has caused them, she added.

As a result of this rationing, we know that patients who can afford to pay privately are doing so, while those who cant are going without and suffering. This is exactly what having an NHS is supposed to prevent.

The 50-page document is the result of months of detailed and until now secret discussions between four key medical and NHS bodies involved in the NHSs evidence-based interventions programme, which aims to identify procedures that do not work.

They are NHS England; the Academy of Medical Royal Colleges (AOMRC), which represents the UKs 220,000 doctors professionally; NHS Clinical Commissioners, which speaks for GP-led clinical commissioning groups; and the National Institute for Health and Care Excellence (Nice), which advises the government and NHS which treatments are effective and represent value for money.

They believe many of the interventions should be scrapped, or at most used very sparingly, because they could make patients anxious or even put them in danger. For example, they are suggesting that the prostate-specific antigen test, which is used to detect prostate cancer the commonest form of cancer in men is used much less often.

The document says: Blood tests to check your prostate are not needed except for very specific cases. Blood tests can lead to further investigation that may also be unnecessary and can cause anxiety.

The four medical bodies planned to put the proposals out to public consultation this month but had to delay because of general election purdah rules.

Hospitals would be told not to operate on patients to try to slow the progress of osteoporosis (brittle bone disease), or if they have sinusitis, or to remove a disc from the spine of someone suffering from crippling pain.

Dr Richard Vautrey, chair of the British Medical Associations GPs committee, said any changes should be based on the best available evidence and not cost-cutting.

In the current climate, NHS resources must be used wisely but any restriction on treatments must be based on up to date clinical evidence and not solely on cost.

Doctors must always be able to provide the best care possible and use their clinical expertise to refer patients for the most appropriate treatments when that is needed.

Prof Carrie MacEwan, chair of the AOMRC, defended the planned restrictions. Medicine continually evolves and its right that we dont carry out tests, treatments or procedures when the evidence tells us they are inappropriate or ineffective and which, in some cases, can do more harm than good.

The list is drawn up by medical experts and senior specialist clinicians who have reviewed the latest evidence from around the world and its absolutely right we act on that evidence in the best interests of patients and so that we can focus our resources on things that we know do work, she added.

Read more:
Revealed: NHS plans to ration 34 everyday tests and treatments - The Guardian

(Photo : pixabay)

Theresearchprovided by the Oregon State University provided the first complete cellular-level look at what goes on in joints that are affected by osteoarthritis, which is considered as a costly and debilitating condition that affects almost one-quarter of adults in America.

The study was published inNature Biomedical Engineering, and it gave an insight into how factors like drugs, diet, and exercise can affect the joint's cells, which is important because cells do the work of maintaining, developing and repairing the tissue.

Arthritis treatment

Theresearchdone by the OSU College of Engineering's Brian Bay and the scientists from the Royal Veterinary College in London and University College London created a sophisticated scanning technique to view joints of mice that have arthritis and joints of healthy mice.

Brian Bay said that the techniques for quantifying changes in arthritic joints had been constrained by a lot of factors. Restrictions on the length of scanning time and the sample size are two of them, and the level of radiation used in some of the techniques ultimately damages or destroys the samples that are being scanned. The nanoscale resolution of intact, loaded joints had been considered unattainable.

Brain Bay and scientists from 3Dmagination Ltd, the University of Manchester, Edinburgh Napier University, the Diamond Light Source, and the Research Complex at Harwell created a way to conduct nanoscale by capturing the images of bones and whole joints under precisely controlled loads.

The scientists enhanced the resolution without compromising the study's field of view, decrease the total radiation exposure to preserve the tissue mechanics, and to prevent movement during the scanning.

Brian Bay stated that with a low-dose of pink-beam synchrotron X-ray tomography and mechanical loading with nanometric precision, scientists could measure the structural organization simultaneously and functional response of the tissues. That means that scientists can look at the joints of the patient from the tissue layers down to the cellular level with a large field of view and high resolution without having to cut out the samples.

He also stated that the two features of the study make it helpful in advancing the study of osteoarthritis. By using intact joints and bones, all of the functional aspects of the complex tissue that is layering are preserved. The small size of the mouse bones leads to imaging that is seen on the scale of the cells that maintain, develop, and repair the tissues.

The effect of osteoarthritis on health

Osteoarthritis is the degeneration of joints, and according to the Centers for Disease Control and Prevention, it affects more than50 million American adults. Around 18% of men and 25% of women suffer from osteoarthritis.

As the senior population in America increases, the prevalence of arthritis will likely rise in the coming years. The CDC estimates that by 2040 there will be 78 million arthritis patients, more than one-quarter of the projected total adult population, two-thirds of those with arthritis are expected to be women. By 2040, 34 million adults in America will have limits in the activities that they do because of arthritis.

Brian Bay said that osteoarthritis will affect most of the adults during their lifetime to the point where a hip joint or a knee joint needs replacement with a difficult and costly surgery after years of pain and disability. This new treatment that OSU has to develop can prevent any severe arthritis from forming that could save millions of adults from having to go through the difficulties of arthritis.

See more here:
Oregon State University Has Provided a New Treatment for Athritis - Science Times

A new discontinuation strategy for infliximab in patients with rheumatoid arthritis, in which the biologic dose was determined by the serum level of tumor necrosis factor (TNF)-, was unsuccessful for sustained biologic-free remission, say researchers recently writing in Annals of the Rheumatic Diseases.

It is well known that proinflammatory cytokines such as TNF- play central roles in the occurrence and progression of rheumatoid arthritis. As the therapeutic effects of infliximab, an inhibitor of TNF-, plus methotrexate have been demonstrated in several clinical studies, the goal of rheumatoid arthritis treatment has expanded from the achievement of clinical remission to sustained remission without biological disease-modifying antirheumatic drugs (bDMARDs), out of concern for adverse events or treatment cost. Several studies have suggested that few patients with established rheumatoid arthritis can discontinue bDMARDs without losing remission, while those in sustained deep remission are more likely to be able to discontinue bDMARDs. Moreover, a significant interaction has been demonstrated between the infliximab dose and TNF- level in the clinical response, suggesting that serum levels of TNF- could be a key indicator for optimal dosing of infliximab to achieve a clinical remission and a sustained discontinuation of infliximab for the treatment of rheumatoid arthritis. However, this hypothesis has not been confirmed in a randomized controlled trial.

The aim of this study is to determine whether the programmed infliximab treatment strategy (for which the dose of infliximab was adjusted based on the baseline serum TNF-) is beneficial to induction of clinical remission after 54 weeks and sustained discontinuation of infliximab for oneyear, wrote the authors of the study, led by Yoshiya Tanaka, M.D., Ph.D., of the University of Occupational and Environmental Health in Kitakyushu, Japan.

This multicenter trial, dubbed RRRR, included 337 patients with infliximab-nave rheumatoid arthritis with inadequate response to methotrexate. Participants were randomized to receive either the programmed treatment of 3mg/kg infliximab until week six and after 14 weeks the dose of infliximab was adjusted based on the baseline levels of serum TNF- until week 54, or standard treatment with 3mg/kg of infliximab. Patients who achieved a simplified disease activity index (SDAI) 3.3 at week 54 discontinued infliximab. The primary endpoint was the proportion of patients who sustained discontinuation of infliximab at week 106.

At week 54, 39.4 percent of the programmed group and 32.3 percent the standard group attained remission (SDAI 3.3). At week 106, the one-year sustained discontinuation rate was 23.5 percent and 21.6 percent, respectively, representing a nonsignificant 2.2 percent difference (95%CI 6.6 percentto 11.0 percent; p=0.631).

In both arms, baseline SDAI <26 was a statistically significant predictor of sustained discontinuation at one year (OR=2.97 in the programmed arm and 2.83 in the standard arm), the authors wrote. This exploratory analysis implies that the success of sustained discontinuation of infliximab depends on disease activity at baseline, and that sufficient disease control by adequate dose ofmethotrexate is required before infliximab is administered.

There was no statistically significant difference in the proportion of deep remission (DAS28 <2.2), at the last administration of infliximab between the groups, which could result in failure of sustained discontinuation of infliximab. Still, the incidence rates of infections and other safety signals were comparable between the groups, suggesting that dose escalation was tolerated in the study.

Thus, the fine tuning of infliximab-dose based on serum levels of TNF represents a key factor for achievement of remission defined by SDAI and DAS28-ESR, but may not be related to deep remission.

If serum levels of rheumatoid factor are less than 45, serum levels of TNF- are higher than 1.65, or disease activity is controlled with less than 10mg/kg of methotrexate, standard treatment may be intense enough to achieve successful discontinuation of infliximab, the authors wrote.

In order to facilitate decision-making bypatients and rheumatologists, the authors suggested that more effort is needed to determine the patient profile most likely to benefit from discontinuation of bDMARDs.

"Taken together, the findings of the RRRR study (Remission induction by Raising the dose of Remicade in RA) reveal that the programmed treatment strategy using different doses of infliximab based on the baseline levels of serum TNF- did not increase the sustained remission rate 1year after withdrawal of infliximab treatment at week 106. However, in order to facilitate decision-making by patients and rheumatologists, more efforts are needed to determine the patient profile most likely to benefit from discontinuation of biological DMARDs," the authors wrote.

REFERENCE

Yoshiya Tanaka, Koji Oba, Takao Koike, et al. Sustained discontinuation of infliximab with a raising-dose strategy after obtaining remission in patients with rheumatoid arthritis: the RRRR study, a randomised controlled trial. Annals of the Rheumatic Diseases. October 19, 2019. doi: 10.1136/annrheumdis-2019-216169

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Sustained Remission in RA Fails with Programmed Infliximab Treatment - Rheumatology Network

The ability to fight disease is a driving force in human survival. Inflammation has emerged as a key weapon in this process. As pathogens change and evolve, the immune system adapts to keep up.

However, to what extent might such evolutionary adaptations also give rise to autoimmune conditions such as lupus and Crohn's disease?

This was a central question in a recent Trends in Immunology review by two scientists from Radboud University, in Nijmegen, Netherlands.

To address the issue, first author Jorge Domnguez-Andrs, a postdoctoral researcher in molecular life science, and senior author Prof. Mihai G. Netea, chair of experimental internal medicine, examined studies in the fields of virology, genetics, microbiology, and immunology.

They focused on people of African or Eurasian descent and how their ancestral origins may have influenced their risk of autoimmune diseases.

Of particular interest was how common pathogens in different communities related to changes in people's DNA, particularly when this involved inflammation.

The team found that the genetic changes made it harder for pathogen infections to take hold.

Over time, however, it seems that inflammation-related diseases, such as inflammatory bowel disease, Crohn's disease, and lupus, have emerged alongside improvements in immune defenses.

The findings also suggest that the human immune system continues to evolve and adapt to changes in environment and lifestyle.

"There seems to be a balance," says Domnguez-Andrs.

"Humans evolve to build defenses against diseases," he continues, "but we are not able to stop disease from happening, so the benefit we obtain on one hand also makes us more sensitive to new diseases on the other hand."

He observes that autoimmune diseases in today's humans tend to emerge later in life. These would not have caused health problems for our ancestors because their lives were much shorter.

"Now that we live so much longer," he explains, "we can see the consequences of infections that happened to our ancestors."

One of the examples that Domnguez-Andrs and Netea cover in detail in their review is malaria.

"Among various infectious diseases," they write, "malaria has exerted the highest evolutionary pressure on the communities across the African continent."

Malaria is a mosquito-borne disease that makes people very ill with flu-like symptoms, such as chills and a high fever.

While there has been much progress in the fight to control and eliminate the potentially fatal disease, it continues to threaten nearly half of the world's population, according to the World Health Organization (WHO).

The cause of malaria is parasites belonging to the species Plasmodium. These parasites spread to humans through the bites of infected female Anopheles mosquitoes.

Domnguez-Andrs and Netea note that Plasmodium has been infecting people in Africa for millions of years. During that period, the immune systems of those human populations have evolved stronger resistance to infection by increasing inflammation.

However, the downside of increasing inflammation to withstand infectious disease is that it favors health problems that tend to occur later in life.

Modern humans of African descent are more prone to developing such conditions, which include atherosclerosis and other cardiovascular diseases.

Another example of how ancestral changes in DNA leave imprints in the immune systems of modern humans is the interbreeding of early Eurasians with Neanderthals.

Modern humans whose genomes harbor remnants of Neanderthal DNA have immune systems that are better able to withstand staph infections and HIV-1. However, they are also more prone to asthma, hay fever, and other allergies.

Improvements in technology are making it more possible to find the downsides that can accompany disease-fighting adaptations.

Next generation sequencing, for example, is allowing scientists to delve more deeply into what happens at the DNA level between pathogens and the organisms that they infect.

Not only is new technology getting better at revealing genetic changes that occurred in our ancestors, but it is also showing that the human immune system continues to evolve and adapt.

In Africa, there are still tribes that hunt for food as their ancestors did. Thanks to new tools, scientists can see how the gut bacteria of these tribes are more diverse than those of, for example, contemporary African American people, who buy food in stores.

Other changes that have had an effect on DNA are the improvements in hygiene that have occurred in recent centuries. These have reduced exposure to pathogens and the diversity of gut bacteria.

"This reduced microbiota diversity in Western societies," the authors observe, "has been associated with a higher incidence of the so-called 'diseases of civilization,' such as cardiovascular diseases, diabetes, obesity, and autoimmune disorders, which are very unusual in hunter-gatherer societies, compared with communities living a Western-type lifestyle."

Domnguez-Andrs and Netea are extending their research to populations whose ancestry is other than African or Eurasian.

"Today, we are suffering or benefiting from defenses built into our DNA by our ancestors' immune systems fighting off infections or growing accustomed to new lifestyles."

Jorge Domnguez-Andrs, Ph.D.

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Humans and autoimmune diseases continue to evolve together - Medical News Today

The burden of flu on our society is tremendous The Centers for Disease Control and Prevention (CDC) estimates that influenza has resulted in between 9.3 million 49.0 million illnesses, between 140,000 960,000 hospitalizations and between 12,000 79,000 deaths annually since 2010.

The CDC recommends that everyone 6 months of age and older should get an influenza (flu) vaccine every year, with rare exceptions.

The primary reason to not get the flu vaccine is an allergy to one of the components of the vaccine (for example gelatin) or an allergy to eggs (because the virus is raised in eggs). If you have had the rare neurologic condition called Guillian-Barre Syndrome, you also should not get the vaccine.

The standard flu shot is given into the muscle of the arm and this is the form recommended for most persons. There is an intradermal form that is injected into the skin using a much smaller needle. This form can be given to persons age 18 to 64 years.

Persons over age 65 are recommended to get the high dose form of the vaccine Fluzone high dose. This form of the vaccine contains four times as much antigen (the part of the vaccine that causes the body to form antibodies against the flu virus) as the standard vaccine. The higher dose is intended to give older persons better protection by causing a better immune response. Vaccines are also available that contain an adjuvant. An adjuvant is an ingredient that helps to cause a greater immune response. This form of the vaccine is recommended for persons age 65 and older.

A nasal form of the vaccine is also available. This form of the vaccine provides protection against two forms of influenza A and two forms of influenza B. It may be given to persons age 2 through 49 years. This form of the vaccine contains a weakened but living form of the viruses. It is not recommended for pregnant women, persons with weakened immune systems and young children with asthma or who are taking aspirin. Ask your doctor if you can use this form of the vaccine.

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The flu vaccine is especially important for persons at high risk of complications from the flu. High risk groups include: persons over the age of 65 years; persons with diabetes; persons with asthma or chronic lung diseases (chronic obstructive pulmonary disease and cystic fibrosis); persons with chronic kidney or liver disease; persons with weakened immune systems (those with HIV or AIDS). Certain cancers (especially leukemia), persons receiving chemotherapy or radiation therapy for cancer and persons on drugs that weaken the immune system are also at increased risk. Again it is important to ask your healthcare provider about your risk and whether it is safe for you to get the vaccine.

If despite getting the vaccine you get the flu, avoid contact with other persons (as much as possible except to seek medical help) until your fever has been gone for 24 hours.

Dr. Samuel Abbate is a local physician practicing in Wasilla.

Originally posted here:
Who needs the flu vaccine? | Valley Health - Mat-Su Valley Frontiersman

Early treatment with antiretroviral therapy, an HIV drug not usually administered right after birth, can help babies born with the virus that infects 300-500 infants in sub-Saharan Africa every day, Boston doctors have determined.

We find that ART initiation within hours after birth is doable and translates into multiple benefits for the infants lower frequencies of reservoir cells and improved immune responses, said corresponding author of the study published in Science Translational Medicine, Dr. Mathias Lichterfeld, associate infectious disease physician at Brigham and Womens Hospital.

Antiretroviral therapy is a combination of at least three drugs that are highly effective at suppressing HIV and stopping its progression.

The therapy is not typically given to babies right after birth, but new research shows the number of infected cells in HIV-positive babies given the treatment within days or hours of birth was extremely small compared to infected infants who started treatment later.

What excites me most about this work is that making a comparatively small change in the timing of treatment may have a large impact on long-term treatment outcomes, said Lichterfeld.

The study was conducted in two major maternity hospitals in the Francistown and Gaborone regions of Botswana, a country with the third-highest HIV-1 prevalence in the world.

HIV progresses much faster in infants than in adults because of their weaker immune systems.

Infants enrolled in the study began treatment right after birth and researchers compared their results to those of infants not in the study who received the drug within a median of four months after birth. The babies were then followed for two years with blood sampling at regular intervals.

The study was small and focused on 10 HIV-positive babies that were enrolled. A total of 40 infants have been recruited into the study and samples from the remaining babies are now being analyzed.

A new clinical trial has also been started with some of the same infants in which a different treatment is being evaluated.

As of June, an estimated 24.5 million people globally were accessing antiretroviral therapy, according to the Joint United Nations Program on HIV/AIDS.

Antiretroviral therapy does not cure HIV, but helps infected patients live longer and healthier lives. It also reduces the risk of HIV transmission by lessening the amount of the virus in the body, which in turn gives the immune system a chance to recover.

Nearly 38 million people across the globe were living with HIV as of last year and about 8 million didnt know they were infected.

See the article here:
Boston docs: Early treatment helps African babies with HIV - Boston Herald

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"People will judge me, but I'd just say walk a mile in my shoes."

Jane, not her real name, was 17 years old when she was diagnosed with HIV.

"I'd only slept with one person when I got HIV, I know people will hear that and think it's a sob story, but it's the truth," she told BBC News NI.

When Jane was diagnosed she was one of the youngest women in Northern Ireland known to have the virus.

HIV is a virus which, over time, damages the human immune system leading to illness and infection.

There are 1,130 people receiving treatment for HIV in Northern Ireland. It is not known how many more people are living with the virus undiagnosed.

The charity Positive Life says there is still a myth that it's a "gay man's disease".

Figures show that in Northern Ireland almost 40% of those living with HIV contracted the virus through heterosexual contact and more than 200 women have been diagnosed HIV-positive.

"When I was first diagnosed, I started to research stuff online and I watched some films where people had HIV and it really scared me," said Jane.

"It showed people getting really sick and their skin started to get really bad and it showed people dying. I thought: 'Is this what is going to happen to me?'"

In 2018, 96,142 people were receiving HIV-related care across the UK.

HIV - Human Immunodeficiency Virus - is a virus which, over time, damages the human immune system.

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The immune system is the body's defence against infectious organisms and infections. Problems with the immune system can lead to illness and infection.

Aids - Acquired Immunodeficiency Syndrome - is the result of damage to the immune system caused by HIV.

Jane's mother admits she initially struggled with her daughter's diagnosis.

"At the start, I had all the stereotypes and stigmas in my head that you could think of.

"I just thought: 'This can't be happening to her.' And how unfair it was to be happening to someone her age, to someone who wasn't promiscuous.

"But I know now it doesn't matter if you're promiscuous or not, it only takes one time, and the rest of your life can be changed forever."

Those living with HIV have the same life expectancy as those without the condition, thanks to antiviral treatments used since 1996.

Following her diagnosis, Jane began medication which suppressed the virus and made HIV levels virtually undetectable in her system.

This meant it couldn't be transmitted - even through sexual activity.

Since then, Jane has given birth to a baby boy.

"During my pregnancy I was on three different types of tablets to make sure that my baby wouldn't get HIV," she said.

"I have a wee boy now, but the medication worked, because he doesn't have HIV.

"HIV isn't going to stop me being there for my son. I still have a roof over my head, I have family support."

There were 4,500 pregnancies to HIV-positive women in the UK and Ireland between 2015 and 2018.

Of those, less than 20 have transmitted the virus to their children, either through pregnancy, birth or breastfeeding.

There are still many misconceptions about HIV, according to the charity Positive Life.

"People will still ask if you can catch HIV off a toilet seat or by using the cutlery of people who are HIV-positive - there is still a lot of negative language around it, " said Positive Life's Jacquie Richardson.

"The three biggest myths we hear are that it's a gay man's disease, that it's contracted as a result of a promiscuous lifestyle and that you'll die if you've a diagnosis.

"We're working very hard to counter those myths."

GETTY

in Northern Ireland

There is still a lot of work to be done to educate the public about women and HIV, said Ms Richardson.

"Many people wouldn't even consider that if a woman is HIV-positive she can now, through early diagnosis and medication, have a baby that doesn't have HIV, and that's a powerful message," she said.

"That's why stories like Jane's are so important in challenging all the myths and misconceptions.

"This is a young woman from Northern Ireland, engaging in her first sexual activity, in a heterosexual relationship and she contracts HIV - all of the stereotypes and assumptions people associate with HIV are turned on its head by this very powerful story."

Jane's mother believes more should be done to educate young people about the risks of contracting HIV.

"HIV is still such a taboo subject," she said. "My daughter's story shows it's possible for a young girl in her prime to get HIV and I believe more could be done around sexual education in schools."

She added: "Because of organisations like Positive Life, we're more informed now. We know her HIV can't be cured, but it can be treated.

"But that also means she is going to be on very strong medication for the rest of her life and that does worry me."

Jane is determined not to be defined by being HIV-positive.

"I can't change the past, but what I would say to anyone, if you're sexually active, whether it's your first time or not, just be safe," she said.

"I have to live with the fact that I'm HIV-positive, but I won't let it ruin my life."

Continued here:
HIV, my baby and me: 'I was 17 years old when I was diagnosed' - BBC News

Longstanding research has found that exercise that increases our cardiovascular activity brings a number of health benefits, including lowered blood pressure; improved cardiovascular health; strengthening of the immune system; regulation of weight; and moderation of blood sugar. Interestingly, it appears that vigorous aerobic activity (maintaining more than 60% of aerobic capacity) brings greater cardiovascular health benefit than moderate activity. Exercise therapy has been found to improve a measure called heart rate variability, which is associated with greater levels of psychological well-being and resilience in the face of stress. One strand of research finds that aerobic exercise conducted in a mindful state (i.e., with enhanced self-awareness, such as yoga and Feldenkrais) brings greater mood benefits than routine vigorous or moderate cardio workouts. Many of the activities we associate with self-development, from counseling and psychotherapy to meditation, are pursued in a state of reduced physical activity and enhanced self-awareness. Might it be the case that vigorous aerobic activity is an equally promising path toward emotional well-being and a positive psychology?

According to the National Institutes of Healths National Center for Complementary and Integrative Health, yoga, a discipline of meditative movement is associated with such benefits as stress relief, pain reduction, and emotional well-being. There is also evidence that yoga also improves the aforementioned heart rate variability and lessens symptoms of depression. In an excellent review article, Julia Belluz notes the limitations of much of the research on the benefits of yoga, but cites fascinating evidence that yoga may be uniquely helpful in reducing inflammation in the body. Similar amounts of time spent in yoga and general physical activity yield greater inflammation benefit for the yoga participants, presumably because of the added components of mindfulness.

In a review of brief approaches to psychotherapy that I conducted with two colleagues at SUNY Upstate Medical University in Syracuse, an important conclusion was that these methods are effective to the degree that they generate novel, constructive experiences for clients. Such corrective emotional experiences deal with maladaptive patterns of emotion and behavior by activating more constructive ones. Thus, for instance, when a client retreats from a therapist out of fear of rejection, the therapist may encourage engagement and provide an active experience of acceptance and understanding. Such emotional experiences are readily internalized, helping people build new modes of construing and doing. This is the basis for many behavioral and cognitive therapies, where we learn to face and challenge our patterns of anxiety, negative thinking, and depression in emotionally impactful ways.

The unexpected benefits of aerobic exercise, yoga, and similar disciplines may arise from their ability to provide similar corrective emotional experiences, albeit outside of a therapeutic relationship. Through vigorous exercise, we directly challenge our limits and experience ourselves as efficacious and achieving. Through mindful movement, we experience enhanced levels of self-control and mastery. A great example of this occurs among the money managers and traders I work with, who make active use of meditation to deal with the stresses of markets and their inherent risks and uncertainty. In the midst of threat, direct experiences of calm and focus promote a unique experience of the self as being in control, facilitating sound decision-making. Exercise, like coaching, counseling, and psychotherapy, is a vehicle for generating fresh experiences of the self, reinforcing and expanding our strengths.

In recent articles, Ive explored the psychological benefits of living a purposeful life and the importance of emotionally connecting with a positive vision of our future selves. All of these can be paths toward emotional resilience, increased mindfulness, and an enhanced capacity to pursue life goals. In a recent interview, Steven Goldstein and Mark Randall explore the mindfulness associated with special forces operations, highlighting the idea of mindfitness. A well-constructed program of exercise, expanding our abilities to extend our limits and sustain self-control and efficacy, provides a uniquely effective form of self-developmenta promising therapy for the mentally well and program for mindfitness.

More:
The Unexpected Psychological Benefits Of Aerobic Fitness - Forbes

FOXBOROUGH, Mass. In a Patriots locker room thats battling widespread illness recently and plenty of injuries during the season, quarterback Tom Brady said hes managed to stay unaffected.

Im a pretty healthy guy. Cant avoid it all the time. I try to for the most part. I keep my immune system nice and strong if possible, he said Friday as the Patriots prepare for Sunday nights game at Houston.

His immune system might be able to stop the flu, but it cant hold off opposing defenders.

I wouldnt be in the self-preservation business if I was trying to be a football player, said Brady, who is expected to play Sunday. Youre going to get hit. You just have to understand thats part of the game. You have to understand when they blitz, you dont have as much time to throw. So you have to throw the ball a little quicker. ... Taking hits is part of it. My whole objective is standing there and trying to get the ball to someone who can do something with it.

He said throwing the ball away is more about protecting a drive and protecting possession than protecting himself.

Im throwing it away because I dont want to take a sack, Brady said. I think negative plays actually have a big impact on the game. Turnovers and negative plays I think really keep you from winning games. So, if you can drop-back pass, because Im not really a scrambler ... But, if Im going to hold it back there, then usually good things arent going to happen. So, I try to throw the ball away to save plays and live for the next down.

Pats getting healthier

All that Vitamin C is finally paying off for the Patriots. After a flu bug ripped through their locker room eight players missed Wednesdays practice with illness they were almost at full strength for Fridays walkthrough.

Kyle Van Noy was a new absence, and Ryan Izzo has been out all week with the flu. One of the leagues best linebackers, Van Noy will be sorely missed if he isnt good to go by Sunday.

Donta Hightower, Isaiah Wynn and JoeJuan Williams all returned. All three players were healthy enough for Fridays walkthrough. The biggest takeaway from Friday: The Patriots seem to have weathered the worst of their flu bug.

Players listened to an assortment of college football fight songs on Friday. With rivalry games all weekend, the Patriots were listening to band songs. Tom Brady pumped his fist when Michigans The Victors began.

See the original post here:
Hey, Brady's healthy; Pats' Hightower, Wynn return to practice - The Union Leader

Despite the fact that we live in a highly advanced technological society, when it comes to important things like health and nutrition, a lot of people are still willing to take most of their advice from bloggers and social media influencers who have little to no scientific training. This is especially true when it comes to gut health and the gut microbiome. Luckily, the scientists and researchers at Viome are on a mission to change all that.

Over the past few decades, the scientific community has made some incredible advancements in our understanding of the human gut microbiome. We now know, for example, that the complex community of bacteria and other microorganisms that live in our digestive tract affects almost every system in the body, including the digestive system, immune system, and cardiovascular system. There have also been studies that specifically link gut health to a number of human diseases and conditions, such as diabetes, obesity, irritable bowel syndrome, and colon cancer. But how do we put this information to use?

A lot of people have been led to believe that you can ward off all these illnesses and conditions simply by eating a bunch of exotic fermented foods you saw on Instagram. Unfortunately, thats like throwing a bunch of random ingredients into a pot and hoping they turn into your favorite soup. The stuff you put into the pot might be delicious, but different soups call for different ingredients.

Similarly, one of the most important things weve learned about the human gut microbiome in recent years is that everyone is totally unique. Thus, whats good for one gut isnt necessarily whats good for the next. Thats why, if you want to get serious about gut health, you need to start by taking the Gut Intelligence Test by Viome.

At Viome, their goal is to take the guesswork out of building a healthy gut. To do that, theyve created the worlds most scientifically advanced microbiome test.

A microbiome test is like a DNA test, only instead of mapping out genes, it maps out the specific strains of bacteria and other microorganisms that live in your digestive tract. What makes Viomes test superior to any others currently available is its proprietary microbe identification technology and its advanced analytics engine.

Viome is the only company in the world that uses advanced metatranscriptomic sequencing technology, which was originally developed at the Los Alamos National Laboratory for national security purposes. This technology helps them identify and quantify all the strains and species of microorganisms in your gut and determine exactly how active they all are. Then Viome runs all this data through an advanced AI algorithm called VIE, which uses a massive and continually growing database of information to come up with personalized nutrition recommendations.

When your gut microbiome is out of balance, your body doesnt absorb nutrients the way it should. It can also produce toxins that cause inflammation, which scientists now realize is at the root of almost every chronic disease. The foods Viome recommends are intended to stimulate your microbiome so that it maximizes the production of healthy nutrients and minimizes the production of toxins.

With the Gut Intelligence Test by Viome, you dont have to go to a cold sterile lab to be poked and prodded. The entire process is pain-free and takes place in the comfort of your own home. Once you place your order, Viome will send you an easy to use, non-invasive at-home kit to collect your sample. Then you simply return your sample using the postage-paid box provided, and Viome will process it and send you the results.

With Viome, all test results and dietary recommendations come with detailed explanations, and all of them are conveniently delivered straight to your phone via the Viome mobile app, which makes them incredibly easy to put into action.

The default reports and recommendations are aimed at increasing microorganism species associated with overall wellness and decreasing species typically associated with poor health. However, you can also customize your recommendations based on specific health and wellness goals, including weight loss, better sleep, or increased mental clarity.

Viome does not promise that everyone who takes their test will see the same level of results because not all health and wellness issues can be fixed by diet alone. What Viome does promise is a better, more scientific understanding of whats going on in your body.

Right now, Viomes Gut Intelligence Test is 62 percent off the regular price. If youre tired at guessing about matters related to your health and wellness, order your test from Viome today.

Futurism fans: To create this content, a non-editorial team worked with Viome, who is offering Futurism readers $20 off with code FUTURISM. They help us keep the lights on, and Futurism may receive a commission from sales. This post does not reflect the views or the endorsement of the Futurism.com editorial staff.

Read the original:
Unlock the Mysteries of Your Gut Microbiome With Viome's Gut Intelligence Test - Futurism

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Findings, in mice, could guide research into future therapies

A new study led by Washington University School of Medicine in St. Louis reveals details about how gut microbes interact with norovirus infection in the mouse gut. The research opens up new ways of thinking about potential therapies for this intestinal infection. Shown are Norovirus particles.

The highly contagious norovirus causes diarrhea and vomiting and is notorious for spreading rapidly through densely populated spaces, such as cruise ships, nursing homes, schools and day care centers. Each year, it is responsible for some 200,000 deaths, mostly in the developing world. There are no treatments for this intestinal virus, often incorrectly referred to as stomach flu.

Now, a new study led by scientists at Washington University School of Medicine in St. Louis has shown that gut microbes can tamp down or boost the severity of norovirus infection based on where along the intestine the virus takes hold.

The study, published Nov. 25 in the journal Nature Microbiology, suggests new routes to possible therapies for norovirus infection. Collaborators included researchers at the University of Florida, the University of Michigan and Yale University Medical School.

There are currently no treatments for norovirus, which is very easily spread through fecal-oral transmission, said co-senior author Megan T. Baldridge, MD, PhD, an assistant professor of medicine at Washington University. Norovirus is especially dangerous in young children, older adults and people with compromised immune systems. We are trying to understand how the gut microbes interact with norovirus in an effort to pursue new therapeutic strategies.

In these mouse studies, the researchers found that normal gut bacteria boosted the severity of viral infection in the lower small intestine, which is in line with past work in the field. But simultaneously, normal gut bacteria blocked or inhibited viral infection in the upper small intestine. In other words, gut microbes can have totally opposite effects on norovirus infection depending on the infections location along the length of the gut.

These results were a huge surprise to us, Baldridge said. We showed that different parts of the intestine can show dramatically different responses to this type of infection. Our research reveals that we cant view the gut as a homogeneous tube that responds to infection in a uniform way.

Baldridge and her colleagues found that the difference in response was driven by bile acids, which are mainly known for their roles in digestion.

Bile acids are powerfully regulated by bacteria all along the gut, Baldridge said. But there had not been a realization that these bile acids could prime the gut to mount an immune response against intestinal viruses.

In the new study, the researchers showed that bile acids in the upper small intestine but not the lower stimulated the immune system to respond to the infection. The researchers determined that bile acids in that region of the gut triggered a molecule called interferon III one of the bodys key antiviral defenses in the intestine to become activated.

Baldridge noted that this complexity of interactions between gut microbes and bile acids could explain some of the variability seen in norovirus infections. Some people become extremely ill with this virus; others develop no symptoms at all.

The different ways people respond to viral infections could be related to their individual gut microbial community, Baldridge said. The severity of an infection could be tied to where exactly along the gut you get an infection, and that might be controlled by your individual microbiome. Subtle differences along the intestine could end up having dramatic effects on how the gut perceives the virus and responds to it.

Baldridge also said that this changes how researchers might think about strategies to protect against or treat norovirus infection. They might seek ways to expand the immune interferon signaling that they observed only in the upper small intestine such that it extends along the entire length of the gut, for example.

She and her colleagues are planning more studies to help investigate whether there may be ways to manipulate the gut environment through bile acids or the microbiome itself to stimulate the immune system in ways that could shut down norovirus infection.

This work was supported by the National Institutes of Health (NIH), grant numbers R01AI116892, R01AI081921, R01AI141478, R01AI141478, K22 AI127846-01, P30 DK052574, R21 AI103961, T90DE021990, T32DK094775, K08 AI28043; the Global Probiotics Councils Young Investigator Grant for Probiotics Research; the University of Michigan Host-Microbiome Initiative; and the Burroughs Wellcome Fund.

Grau KR, Zhu S, Peterson ST, Winesett E, Philip D, Phillips M, Hernandez A, Turula H, Frasse P, Graziano VR, Wilen CB, Wobus CE, Baldridge MT, Karst SM. The intestinal regionalization of acute norovirus infection is regulated by the microbiota via bile acid-mediated priming of type III interferon. Nature Microbiology. Nov. 25, 2019.

Washington University School of Medicines 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

See original here:
Gut microbes alter characteristics of norovirus infection - Washington University School of Medicine in St. Louis

Sarah Ross guessed it was leukemia long before the doctors confirmed it. Five years ago, she had been feeling lousy in a way she had never experienced before. When a blood test came back with some indicators pointing to the disease, Ross stalled for a while before doing a follow-up.

In her heart, she said, she already knew what was happening. Ross, who had worked for years as a veterinarian's technician, would eventually need a bone marrow transplant at Roswell Park Comprehensive Cancer Center. She has spent the last few years in recovery, receiving treatment for some related complications.

A few days ago, lost in thought after an appointment at Roswell, she was headed toward a lobby exit lobby when any worries or fatigue vanished from her mind. Her stride accelerated as she made a sharp pivot, and she asked her mother, Frances Ross, to wait for just one minute.

Ross had spotted Bella, which meant the dog was doing her job even before Ross, of Tonawanda, realized just how much they have in common.

Bella is a Weimaraner, a memorable breed whose striking appearance has led to the nickname of "gray ghost." About three years ago, the dog moved in with Sue and Shane Currey of Tonawanda after their dog, Sophie, another Weimaraner, died at 11. Bella came to them from a breeder near Erie, Pa. he called the dog Bertha, a name the Curreys decided to change and made her available for adoption.

She is perfect, it turns out, for the role she plays at Roswell.

In the lobby, Ross made a beeline to the dog, who wore a bright red bandana. She asked Currey if it was OK to say hello, then dropped onto her knees, where a few strokes of velvet fur and the dog's long ears quickly shifted into a full embrace.

Ross loves animals. She explained how she often distracts herself during appointments at Roswell by thinking of her rabbits, Quake and Thunder, and she offered a gentle gasp when she heard Bella's story.

The dog is also a cancer survivor.

Roswell Park Comprehensive Cancer Center patient Donato Morgante gets a kiss from Bella at the hospital as Bella's owner Sue Currey, left and Jacquie Morgante, Donato's mother, enjoy the moment. (Mark Mulville/Buffalo News)

Sue Currey, an executive assistant at Roswell, had seen the difference therapy dogs can make for patients. Sue dreamed someday of bringing in her own dog for those duties. Bella went through a sequence of training sessions, tests and community interactions to become one of roughly a dozen dogs who provide that service at Roswell, which Bella did even before the Curreys knew about her illness.

Bella, it turns out, had a form of cancer that required the surgical removal over the summer of six malignant tumors. Sue, for a while, feared for Bella's life. But the dog recovered quickly from surgery, and she was back to her rounds at Roswell by this fall.

Ross, her forehead pressed against Bella's soft fur, was not surprised at the tale.

"Dogs and kids," she said. "They put no limitations on themselves."

Dr. Philip McCarthy, director of Roswell's blood and marrow transplant program, said the demeanor of each dog is critically important. Any scratch or bite from a restless or anxious animal could lead to infections for patients with fragile immune systems, he said.

When you find such dogs as Bella, animals of serene and soulful demeanor?

In that case, McCarthy said, they often "emanate good feelings and unconditional love."

[Related: Sean Kirst: Cancer survivor rides for Roswell and for the doctor who saved him]

"The effect these dogs have is amazing," said Barb Lenahan, who certifies the animals as part of Therapy Dogs International.

From the lobby, Sue and Bella followed Jim Hickey, a Roswell volunteer, through the hospital corridors, where the dog touched off lightning transformations. Doctors, nurses, patients, weary relatives: They crouched down, tired faces instantly softening. They spoke in familiar, quiet tones to Bella, whose curious eyes did a long study of each of them.

[Related: Murphy, the therapy dog, spreads joy at Oishei Children's Hospital, Roswell Park]

The point made by Ross about childhood resilience was evident in a reception area for the pediatric clinic. When Bella entered the room, Owen Chase of South Buffalo, a 5-year-old in Teenage Mutant Ninja Turtles pajamas, was tugging around a rolling IV, followed by his mother, Colleen.

She and her husband, Michael, learned of Owen's leukemia more than 11 months ago, just before Christmas, and the child is now receiving "infusions of chemo," Colleen said. He is doing well, and Colleen said the couple is buoyed each day by an avalanche of love and support.

"A lot of families," she said, "go through a lot worse."

Owen and Bella stood eye to eye, and the little boy whose dog at home, Gemma, often sleeps on his bed dropped his hand delicately onto the dog's neck. After a moment or two of communion, Bella turned to walk directly into a nose-to-nose encounter with 1-year-old Donato Morgante.

Not long ago, Jacquie and Joe Morgante of Clarence learned their child had a grapefruit-sized growth on his kidney, the result of a rare childhood cancer known as Wilms tumor. That sent him into surgery, and then chemotherapy.

"He's been really good with all of it," said Jacquie, who talked it over with Joe and then stayed home with their son on Thanksgiving, because his system remains too vulnerable for a big family crowd.

Owen Chase, left, who is at Roswell Park for leukemia treatment, and his mother, Colleen Chase, visit with Bella and her owner Sue Currey, in the pediatric unit at the hospital. (Mark Mulville/Buffalo News)

When the toddler saw Bella, there was instantly no Roswell, no chemo, no waiting room. It was only Donato and this dog with ears as soft as Hush Puppies.

"Fantastic," Jacquie said. "It just relieves all the stress."

The response was the same for Krista Gabler, a Florida resident and native of West Seneca who has spent two months in Buffalo while her mother, Sandy Mussehl, receives radiation treatment for cancer of the tongue. Gabler had just stepped through the door of a waiting room, fatigue in her expression, when she noticed Bella approaching in the corridor.

Instantly, Gabler dropped down, bowed her head and placed it alongside the dog's.

"I needed something uplifting today," she said.

Brendon Edwards shared in that communion. At 14, he is a freshman at Frewsburg High School in Chautauqua County, a teen who loves football and has played on youth teams since he was in grade school. His favorite Buffalo Bill, he said, is Dawson Knox, an interesting choice: Brendon picked a rookie, not one of the big names on that ascending squad, a guy whose quiet contributions are filling a hole.

Bella wandered straight to Brendon, who had thrown himself deep into the soft cushions of a couch. The kid began petting the dog and scratching her neck, and boy and dog stayed that way for a long time while the adults around them talked.

His aunt, Brandy Davies, said she figured it was just a bug when Brendon had some stomach problems this autumn. She took him to a doctor. It was colon cancer, and it had already started to spread. Brendon is now in chemotherapy at Roswell, where his love for football is a kind of gleaming template, with his goal of playing again a central theme as he receives each treatment.

The teenager has always loved dogs, Brandy said, and Bella clearly sensed this was a guy who understood. At Roswell, the dog flipped onto her back and allowed him to scratch her stomach, revealing the scars from her own cancer surgery.

Asked for his dream in life, Brendon replied, "Beating this."

The proof that it can happen watched him speak, and wagged her tail.

Sean Kirst is a columnist with The Buffalo News. Email him at skirst@buffnews.com or read more of his work in this archive.

Excerpt from:
Column: At Roswell, dog that beat cancer provides joy and comfort to patients - Buffalo News

Hilary celebrated Thanksgiving with her family (Picture: NBCU Photobank/Getty Images)

Hilary Duff made sure to spend some quality family time as she celebrated Thanksgiving and it looks like one family member was enjoying eating something that is not considered edible.

Her youngest daughter, Banks, 13 months, thought it was funny to eat some dirt rather than turkey which is what most Americans eat at the dinner table for Thanksgiving.

Taking to Instagram, Hilary shared an adorable picture of her alongside partner Matthew Koma, and her oldest kid, seven-year-old Luca and of course, Banks, with dirt all over her face.

HAPPY THANKSGIVING, she wrote. Banks just ate dirt.

As you do.

Banks you ate better than me today!!!! one fan wrote in the comments.

All that good food and you eat dirt, Banks, LOL, another added.

Banks is my spirit animal, another fan commented.

And one fan actually thought that the dirt on Banks face was a speck of dirt on their phone screen.

I kept trying to wipe my screen thinking it had something on it, they wrote.

But then I read your caption, Banks is building up her immune system.

Hilary is no stranger to sharing the love and appreciation she has for her kids on social media and more recently, she found herself struggling to help Luca with his school homework as she claimed she left real school in the third grade.

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This guy with his spirit and kindness?Homework is already no joke in 2nd grade. I stopped going to “real” school in 3rd grade so I’m actually doomed... I am left scratching my head alll the time looking at his homework and I’m terrified for next year! Although Singapore math is the shit....also learned a lot about tick birds this week. #rhinosbegrateful

A post shared by Hilary Duff (@hilaryduff) on Oct 19, 2019 at 7:09pm PDT

Taking to Instagram, she shared a selfie of her and Luca at the table while in the middle of hitting the books.

This guy with his spirit and kindness. Homework is already no joke in 2nd grade, she wrote.

I stopped going to real school in 3rd grade so Im actually doomedI am left scratching my head all the time looking at his homework and Im terrified for next year!

In the meantime, the 32-year-old has been currently busy filming for the upcoming Lizzie McGuire revival and her co-star Adam Lamberg, who played David Gordo Gordin, will also be making a return.

If you've got a celebrity story, video or pictures get in touch with the Metro.co.uk entertainment team by emailing us celebtips@metro.co.uk, calling 020 3615 2145 or by visiting our Submit Stuff page - we'd love to hear from you.

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Hilary Duff's daughter Banks gets dirt on her face in Thanksgiving pic - Metro.co.uk

The holiday season is a time for decorations, presents and winter getaways. Its also when you and everyone you know gets sick. Yes, flu and cold season are upon us, and those nasty viruses never seem to care if you have travel plans. But should you be pushing through and getting on a plane if youre feeling sick?

As you head off on your holiday travel, the last thing you want to experience is a health emergency in the air where you cant get medical attention, Dr. Nate Favini, medical lead at Forward (a membership-based preventive care clinic), told The Points Guy. Theres also the risk of getting kicked off your flight and, of course, you dont want to spread an infection to other passengers.

In fact, according to theJournal of Environmental Health Research, you are 100 times more likely to catch a cold on a plane. And the Wall Street Journal previously cited a study that said the likelihood increases by 20%. So many people got sick at once during a 2008 flight from Boston (BOS) to Los Angeles (LAX) after an ill passenger with norovirus boarded that the plane actually made an emergency landing three hours into the trip.

With this in mind, we consulted several experts to learn how to tell when youre too sick to fly, for your sake as well as the safety of other passengers.

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A good rule of thumb is to never fly when you have a fever, according to New York-based internist Dr. Frank Contacessa. Of course, this would include having the flu. In addition to the obvious risk of spreading your germs, the cabin environment is not a friendly place when you are sick, he said. Having a fever, in general, will accelerate fluid loss from your body. The very low humidity of the cabin air will dehydrate you even faster. Dehydration makes you feel even worse, increasing weakness, headaches, lightheadedness, etc.

Sure, there might be vomit bags in the seatback pocket. But you probably shouldnt be using them if youre throwing up before you get on the plane. If you have a fever over 100.4 degrees or are experiencing vomiting, theres a really good chance that youre contagious, said Favini. Airlines have been known to remove passengers who are experiencing these symptoms.

Related: Its flu season heres how to avoid getting sick on a plane

Another potential problem can arise if you have a lower respiratory infection such as bronchitis or pneumonia. The pressurized cabin air has less oxygen, which can make you feel short of breath if your airways are already inflamed from an infection, said Contacessa.

Favini added, Flying is stressful on your body and your immune system in particular, so it can reduce your ability to fight off an infection. The air onboard is incredibly dry, and even healthy people end up extremely dehydrated at the end of their flight. You may end up being sicker or sick for longer because of flying while ill.

If you have the flu and youre still experiencing any symptoms, including fever, cough, runny nose, congestion, nausea, vomiting or diarrhea, you are still contagious and should avoid flying, according to Favini. The CDC states that people with flu are most contagious in the first 3 to 4 days after their illness begins.

Not only are you able to infect someone up to six feet away, but you could also feel horrendous on the plane. Anyone who has flown with sinus congestion will agree that the headache can be unbearable, Contacessa added. So, having a fever and sinus congestion should be good reasons to ask for a medical note from your doctor to change your flight reservation.

Related: How to boost your immune system so you dont get sick while traveling

Do you know how your ears sometimes pop during taking off or landing? Well, if you have ear pain and pressure, then that brief moment of discomfort can become severe. The changes in pressure during the flight can cause your eardrum to burst if you have an ear infection and its not properly treated before you take off, said Favini.

Even if you dont have the sniffles or more obvious symptoms of being sick, there is one tell-tale warning sign that you absolutely shouldnt fly. If you do, you could experience a serious medical emergency.

If youre experiencing chest pain or a racing heartbeat, especially if this is new or severe, dont get on your flight, said Favini. This can be a sign of a life-threatening medical condition, and even if the pilot does land your flight, it might not be fast enough for you to get the help you need. The same goes for shortness of breath.

Related: The best travel insurance policies and providers

Ok, lets say youve determined youre too sick to fly. When can you reschedule your trip?

If you do change your plans and postpone your trip, you should wait until you have been without a fever for at least 24 to 48 hours, said Contacessa. If you are recovering from the flu, you should wear a mask to protect your fellow travelers. If in doubt, use your common sense. If you think that you are too sick, stay home.

Featured photo by Roos-Koole/Getty Images.

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How to tell when youre too sick to fly - The Points Guy

Pain under the left armpit can be concerning, and many people associate any pain on the left side of their body with a heart attack. However, most of the time, pain under the left armpit has a less serious cause.

The armpit is a complex meeting point for muscles and connective tissues, lymph nodes, and blood vessels. As such, many issues in this area can lead to pain.

Causes range from pulled muscles and mild allergic reactions to more severe issues, such as an underlying infection.

While many of the causes of left armpit pain are not harmful in the long term, anyone experiencing breathing difficulties and pain in their chest, jaw, or neck should see a doctor immediately.

Causes of left armpit pain include:

Many muscles around the shoulder and armpit can cause pain if a person injures them.

People can pull a muscle when reaching for an object, twisting incorrectly, or overstretching.

People who exercise regularly, especially those who do weight training, may be more likely to experience muscle pulls and strains.

In these cases, the pain should go away over time, as long as the individual rests the injured muscle and does gentle stretches.

If the pain does not go away after about a week, it is best to see a doctor.

Armpits are a frequent location for allergic reactions, which could cause pain under the left armpit or both armpits.

Most allergic reactions in this area will occur due to chemicals people apply to their bodies or clothes that touch the armpits.

Possible allergens include:

These products may contain chemicals or perfumes that irritate the skin. A rash may also form.

Anyone who suspects that their skin is sensitive to a particular allergen should note the products they used that day and report them to a dermatologist.

Allergy testing may help find the irritating product. Avoiding products with any harsh chemicals or other ingredients can also improve symptoms in these cases.

Simple cosmetic procedures, such as shaving or waxing, can also be to blame for pain under the armpit. These hair removal techniques may lead to other issues, such as ingrown hairs, cysts, or general irritation and chafing in the armpit.

A skin infection under the armpit may cause itching and pain. Bacteria thrive in warm, damp environments such as the armpits.

An overgrowth of bacteria in this area may lead to an infection, which could cause redness, swelling, and pain, among other symptoms.

Other forms of infection, such as fungal infections due to ringworm or yeast, may also cause similar pain and irritation in the area.

Mild skin infections should clear up without treatment if a person keeps the area clean and dry. However, a doctor may recommend antibiotic creams or medications to treat more severe cases.

Hidradenitis is a chronic condition that causes similar symptoms to severe acne. Hidradenitis occurs due to clogged hair follicles and glands. It is common in areas such as the armpits, where the skin rubs together.

Hidradenitis can lead to multiple cysts or boils developing in the area. In addition to these breakouts, the person will likely experience pain and tenderness.

Doctors can treat hidradenitis with anti-inflammatory medications. Some cases may require surgery.

The varicella zoster virus causes chickenpox and shingles. Breakouts of both illnesses are possible under the armpits, although chickenpox usually begins on the face, back, and chest.

A shingles rash usually develops as a single strip on one side of the face or body, left or right. A person with shingles may also experience:

A person may feel pain and tingling in the area before the visible rash develops.

A doctor may prescribe antiviral medications to speed up the healing process, as well as pain medications to help ease symptoms.

Lymph nodes are small, bean shaped bundles of tissue that play a vital role in the immune system. Lymph nodes help filter toxins from the lymph and deliver white blood cells to help fight disease.

The armpit houses a large number of lymph nodes. Lymph nodes swell as part of an overall reaction by the immune system, such as to an infection or illness.

Swollen lymph nodes in the armpit may cause:

If the swelling does not go down after an infection, such as the common cold, goes away, or the person is not feeling any other symptoms, they should speak to a doctor.

Psoriasis is an autoimmune condition that leads to an overgrowth of skin cells. The buildup of skin cells forms patches called plaques. These plaques can cause symptoms such as itching and pain.

Psoriasis plaques can form anywhere, including the armpit. Some forms of psoriasis are more common in this area, including inverse psoriasis.

Psoriasis treatment typically includes both topical and oral medications to control symptoms.

Nerve damage may also cause pain under the armpit. Nerve damage can be the result of a physical injury, such as one from overuse during sports or from an accident or fall.

Nerve damage can feel like:

Certain conditions, such as diabetes, may also lead to nerve damage or neuropathy. The National Institute of Diabetes and Digestive and Kidney Diseases note that up to half of people with diabetes have peripheral neuropathy, which is nerve damage.

While peripheral neuropathy typically affects the feet and legs, it may also affect the arms in some individuals. Diabetes treatment may help slow nerve damage progression.

Angina occurs due to a lack of oxygen-rich blood flow to the heart. This can be because one of the arteries leading to the heart is narrow or blocked.

Angina causes chest pain and discomfort, which is sometimes severe. It may also cause pressure and pain in other areas, including the:

Some people may also experience a feeling similar to indigestion.

Angina is a symptom of an underlying heart condition, for example, coronary heart disease, which can lead to a heart attack.

There are also many other types of angina. Anyone who suspects they have angina should talk to their doctor.

In rare cases, pain under the left armpit that does not go away may be a sign of a cancerous growth, including breast cancer.

Cancer can cause the lymph nodes under the armpit to swell painfully. An individual may notice a lump under their arm or in their armpit that causes persistent pain or discomfort.

Underarm pain may also be the result of a specific cancer treatment, such as lymph node removal or mastectomy.

Anyone noticing texture changes or lumps in their chest or breast tissue should seek medical attention.

Treatment options for cancer will depend on its stage, which refers to how much it has spread. In general, earlier stages are easier to treat.

Anyone noticing the following symptoms along with left armpit pain should seek immediate medical attention:

A doctor can also diagnose and treat pain from other issues, such as infections or swollen lymph nodes.

Pain under the left armpit from sources such as a pulled muscle should go away within about a week in most cases. Anyone who experiences symptoms beyond this time frame should see a doctor for a full diagnosis.

There are many possible causes of pain under the left armpit. The person may have pulled a muscle or may have swollen lymph nodes from an infection.

Other causes can be more serious, such as angina. Anyone concerned about their symptoms should see a doctor for a full diagnosis and treatment.

Originally posted here:

Pain under left armpit: Causes and what to do - Medical News Today

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INDIANAPOLIS, Ind. Local tennis coach Matt Moores eyesight has baffled the doctors whove treated him in the last few years. And while its cost him much of his vision, what hes gained is nothing short of miraculous.

Legendary tennis champion Martina Navratilova once said, the mark of great sportsmen is not how good they are at their best, but how good they are at their worst.

Ive dealt with some adversities in life but nothing like this, Matt Moore said.

Matt went on to play tennis at Hanover College where he studied social work. He went on to teach at Ball State University and tennis stayed in his life.

Its meant so much to me and the development of who I am as a person and the connections and friendships along the way, Moore said. Theres individual elements, theres still a sense of team that comes with it.

Matt translated those elements he learned as a player, to his time as a coach. First at Zionsville High School from 2009 to 2017, then at Butler University for two years.

In a sport like tennis youre trying to teach individuals how to think critically youre trying to teach them about technique and tactic, but on the reverse end of that youre teaching them the values about taking care of their body physically and also preparing for what life is going to throw at you from a mental aspect, Moore said.

Life threw something at Matt midway through 2015. Something he could never have seen coming.

Matt was having a conversation with a colleague when he noticed something strange.

I looked at her and somethings not right, I see about 200 to 300 black floaters streaming right through my eye. Almost like a rain shower of floaters in the eye, where you couldnt count them, theres nothing to get rid of it. Look in one direction, look in the other it wasnt going to change it, Moore said.

A trip to the optometrist showed a tear in Matts retina. Later it detached. Its more common in older people. Matt was in his early 30s. He felt good about his odds.

But what followed, scared him.

Thats when you start to question man whats going on here, this is abnormal and its got doctors baffled, Moore said.

Matt went through eight surgeries on his left eye. Each time, another detachment.

Most of my procedures required that I lie face down 20 hours a day, Moore said. Its tougha lot of alone, isolated time that youre sitting there left to ponder the 'what ifs' in the world.

Matt's doctor says his ruptures were brought about extreme near-sightedness.

Then youre thinking, God I hope nothing goes wrong with this one, Moore said.

His doctors at the Midwest Eye Institute recommended he stop coaching, fearing an impact that would forever blind him.

Earl Allen was Matts assistant coach at Zionsville High School.

It was devastating, I mean, think about it, your professional career, your family life, the things you give up, how your life would change, Allen said.

Then, a year later, the unthinkable happened: a detachment in his healthy eye.

More surgery, more questions. And more vision loss.

I went several weeks, well over a month, with no vision at all, this eye had been removed, this eye had a 90% gas bubble, I couldnt see anything, Moore said.

And heres where our story turns. With the agony and uncertainty, Matt sought counseling to deal with the emotional and psychological trauma. And as he was learning how to face the unknown, he made a life-changing realization.

I drew the short straw I supposed at first, later you find out that sometimes these life challenges put you in a better position to have appreciation or respect for the things that are going on your life, Moore said. One thing I tried to keep perspective on, is even if you lose your vision its not life-threatening is it life-altering? Absolutely this whole experience is life-altering.

He wasnt just a tennis coach to me, that wouldnt do him justice, Nina Bertino said.

Nina Bertino played for Coach Moore her sophomore and junior years at Butler. When Nina learned about his condition, she organized an event at Pearson Automotive Tennis Center.

His life is all about serving other people, Bertino said. He had such an impact on me, and the minute I found out he was struggling, I wanted to make a difference. He understood how to respond to my negativity, pouting, all my emotions on court, he always knew the comforting words to say.

Now that comforting goes both ways.

You look for pick me ups and things that lift your spirit, Moore said, all these players came out, its phenomenal.

Matts in a better place now. Hes recovering from another surgery and the vision in his right eye is stable. He and wife Lindsay and their three kids, Brooklyn, Bronson and Maverick, and even visiting exchange student, Matilda are in the present.

It did take a toll on everyone, but we also tried for the kids to keep their lives as normal as possible, Lindsay Moore said.

And Matt, Dr. Moore, already a published author on sports social work has a few lessons worth sharing in an ongoing blog he wrote called Flashes of Light from Heaven.

For now, Matt is back at work teaching full time. He's able to drive during the day.

As he continues his recovery, he says he hopes to inspire not just athletes, but anyone who's living with a challenge they're trying to overcome.

Originally posted here:
Vision Quest: Taking a glimpse into the world of a man losing his vision - FOX 59 Indianapolis

Caring for patients eyes is an essential nursing skill. Nurses need to be able to carry out a baseline assessment of the eye and vision and deliver essential care including eye cleansing

Eyes should be assessed as part of a holistic patient assessment and eye care is an essential part of daily personal care. This article outlines the principles of eye assessment and the procedure for eye cleansing.

Citation: Gwenhure T, Shepherd E (2019) Principles and procedure for eye assessment and cleansing. Nursing Times [online]; 115: 12, 18-20.

Authors: Tendai Gwenhure is clinical educator, Moorfields Eye Hospital NHS Foundation Trust; Eileen Shepherd is clinical editor, Nursing Times.

The eyes have a vital role in helping us carry out our daily activities safely (Shaw, 2014). Light entering the eye is converted into nerve impulses that are transmitted to the occipital region of the brain, where they are converted into the images we see. Patients may present to hospital with pre-existing eye conditions or need help to care for their eyes during a period of illness. Nurses need to be able to:

The external structures of the eye (Fig 1) serve an important function in protecting the eye from injury. For example, the eyelashes provide a barrier to grit and debris and eyebrows prevent sweat from running into the eyes. Eyelids contain muscles that enable them to open and close (Dougherty and Lister, 2015) and the lacrimal apparatus is responsible for tear production and drainage. Tears provide:

Tears drain away from the eyes into the nasal cavity via the lacrimal puncta (singular punctum) (part of the lacrimal apparatus), which are found on the upper and lower eye lids (Fig 1).

Eyes should be assessed as part of a holistic patient assessment and as part of personal care. It is important to discuss any long-term eye problems the patient has and document how these are managed; for example, glaucoma requires regular eye drops, or blepharitis (inflammation of eye lid margin) may require a personalised plan of care.

Falls are linked to poor eyesight so eye assessment is an integral part of falls prevention. Older people with impaired vision fall 1.7 times more often, and sustain hip fractures 1.3-1.9 times more frequently than those with normal eyesight (College of Optometrists, 2014; College of Optometrists and British Geriatrics Society, 2011). In response to these concerns, the Royal College of Physicians (2017) has produced a bedside tool to help check older patients eyesight and reduce hospital falls risk.

Patients should be asked whether they have any new problems with their vision. These should be reported immediately, as acute eye problems such as acute glaucoma, orbital cellulitis or retinal detachment may result in serious eye complications if treatment is delayed.

It is important to record any sight aids the patient uses such as glasses, contact lenses and a prosthetic eye. If necessary, patients should be given support to use these aids, such as ensuringthat patients glasses are clean; nurses should seek expert help if they lack skills to meet a patients needs.

Eye cleansing is an essential aspect of daily hygiene and patients in hospital or residential/care home, or those who are dependent on care at home may need support to maintain this aspect of their care. Those with reduced vision or blindness may struggle to maintain independence in an unfamiliar environment, such as hospital, and may need help to manage their eye care (Dougherty and Lister, 2015).

Indications for eye cleansing are outlined in Box 1. The procedure aims to maintain healthy eyes and it is important that infection from one eye is not transferred into the other. General principles underpinning the procedure are outlined in Box 2.

Box 1. Indications for eye care

Sources: Dougherty and Lister (2015); Shaw (2014)

Box 2. The underpinning principles of eye cleansing

Nurses need to assess individual patients for risk of exposure to blood and body fluids (Royal College of Nursing, 2018) and be aware of local policies for glove use for this procedure. When gloves are required they must be single-use and should be disposed of according to local infection prevention and control policy (Loveday et al, 2014).

College of Optometrists (2014) Focus on Falls. London: College of Optometrists.

College of Optometrists, British Geriatrics Society (2011) The Importance of Vision in Preventing Falls.

Dougherty L, Lister S (2015) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. Oxford: Wiley-Blackwell.

Loveday HP et al (2014) epic3: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. Journal of Hospital Infection; 86: S1, 1-70.

McDermott AM (2013) Antimicrobial Compounds in Tears. Experimental Eye Research; 117: 53-61.

Ring L, Okoro M (2016) A Handbook of Ophthalmic Standards and Procedures. Oxford: M&K Publications.

Royal College of Nursing (2018) Tools of the Trade: Guidance for Health Care Staff on GloveUse and the Prevention of Contact Dermatitis.

Royal College of Physicians (2017) Look Out! Bedside Vision Check for Falls Prevention.

Shaw M (2014) How to administer eye drops and ointments. Nursing Times; 110: 40, 16-18.

World Health Organization (2009) WHO Guidelines for Hand Hygiene in Health Care.

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Principles and procedure for eye assessment and cleansing - Nursing Times