Category Archives: Health

Is this common pain medication wrecking your stomach?

As far as medical emergencies go, this one was at least pretty straightforward. On a cloudless early recent morning, I found myself careering toward the hospital in an Uber, my 18-year-old daughter sobbing beside me and puking into a plastic bag. Three days earlier, she’d had surgery to remove her wisdom teeth. Now, her insides were staging a violent rebellion. The source of her pain? Her pain reliever itself, in the form of a bottle of prescription strength ibuprofen.

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used medications in the world. They alleviate pain by blocking the production of the enzyme cyclooxygenase. That process in turn inhibits the production of prostaglandins, which leads to less swelling and inflammation. You probably have several over-the-counter and prescription NSAID varieties in your medicine cabinet right now — aspirin, ibuprofen, Naproxen, Celecoxib. They’re what you reach for when the menstrual cramps kick in, you overdo it at the gym, your arthritis or back pain flare up. Writing for Harvard Health in 2020, Robert H. Shmerling, MD, reported that roughly “15% of the US population takes an NSAID regularly (including those that are over the counter and prescription strength),” and that, along with “sporadic users,” adds up to “more than 30 billion doses … taken each year.”

Most of the time, taking NSAIDs is a good thing. Appropriate medication means not missing days of work or school. It means being able to participate in cherished activities. There’s even now a growing body of research into the use of NSAIDs in patients to help combat the opioid epidemic. With one-fifth of us living with chronic pain, managing it effectively is a serious issue — and a basic right.

NSAIDs can be hard on your stomach — harder than you may ever have bargained for.

But NSAIDs can be hard on your stomach — harder than you may ever have bargained for. Speaking to Mayo Clinic News Network in 2018, family physician Dr. Summer Allen noted that “one of our greatest concerns with NSAIDs for patients is the fact that it can lead to bleeding in their GI, or stomach lining or tract.” That can be particularly risky for people using them regularly or long-term. The Canadian Society of Intestinal Research estimates that “15–30% of long-term NSAID users are at risk of developing ulcer disease, with 2–4% of these ulcers leading to complications.”

Where things get even trickier — like, sitting on a stretcher hooked up to an IV drip for 12 hours-level tricky — is in the ever widening realm of adverse drug interactions, comorbidities and overprescription. Consumer Reports notes that “More than half of us now regularly take a prescription medication — four, on average.” And they don’t all play well together. 

RELATED: This is why your stomach hurts

Are you among the approximately 20 million Americans on antidepressants? A 2021 study out of Creighton University School of Medicine found that for patients already on NSAIDs, adding SSRIs meant “the odds of developing an upper gastrointestinal bleed increased by 75%.”

Are you on blood-thinning medicines, ACE inhibitors, beta blockers or other NSAIDs? All of those combinations can cause stomach irritation or other side effects.

Do you have Crohn’s disease? NSAIDs can make your symptoms feel worse.

Are you over 65? More than a decade ago, research in the journal of the American Medical Directors Association warned that chronic NSAID use “increases the risk of peptic ulcer disease, acute renal failure, and stroke/myocardial infarction” in the elderly.

By the time we heard the word “gastritis,” she’d been in the hospital for half a day.

But even for the otherwise perfectly healthy, there are important considerations to understand before taking NSAIDs. A 2016 report in the British Journal of General Practice warns, “From the first day of use, all NSAIDs increase the risk of gastrointestinal (GI) bleeding, myocardial infarction, and stroke.” And in yet another example of the boomerang effect, research out of Canada released just last month suggests that taking “drugs like ibuprofen and steroids to relieve short-term health problems could increase the chances of developing chronic pain.”

My daughter was, at the time of her oral surgery, already on two prescription medications, including the NSAID Naproxen. After her procedure, she came home with two more prescriptions — one for ibuprofen and one for antibiotics (which can also lead to stomach problems including diarrhea, cramping, and even in some cases C. Diff infections). In retrospect, it’s lucky she didn’t have a worse reaction to everything than she did.


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Her symptoms did not, at first, seem like they were NSAID-related. They didn’t even seem of a digestive system nature at all. Her initial complaint was intense back pain, followed soon after by stomach pain. By the time it moved down to her abdomen, she was vomiting. By the time we heard the word “gastritis,” she’d been in the hospital for half a day.

My daughter’s experience was far from unusual, even within my own family. Three years ago, while my older daughter was on medication and recovering from an autoimmune issue, she acquired a brand new gastroenterologist for all the NSAID side effects she developed in the bargain. The American Journal of Medical Care estimates that “11% of preventable drug-related hospital admissions could be attributed to NSAIDs,” noting that some figures put the annual number at “more than 100,000 patients hospitalized for NSAID-related GI complications alone.”

So what can you do to end the cycle of pill popping and stomach aching? First of all, weigh the risks and rewards. Talk to your doctor about all the medications you take, including over the counter ones, before any new procedure or prescription. When you have an ache, don’t go with a “more is more” attitude and exceed the recommended dosage. A 2018 study out of Boston University found that about “15 percent of adults taking ibuprofen or other NSAIDs exceeded the maximum recommended daily dose for these drugs… increasing their risk of serious side effects like internal bleeding and heart attacks.” Take your NSAIDs with food, and avoid irritants like alcohol. And don’t hesitate to consult with your doctor or go to the hospital if you are experiencing serious and persistent symptoms. 

“The best way to prevent complications from NSAID use is to speak to a medical professional. If you are experiencing pain beyond three days you should have an exam and be evaluated to see what the underlying cause of pain is,” said Ashley Allen of Allen Health & Wellness, a nurse practitioner specializing  in pain management. “Many times there are other, more appropriate, medications that can be given to treat a condition. For instance, if someone has a sinus headache, it may be best that they are treated with antibiotics for an infection or an antihistamine to decrease swelling, not a NSAID. For some individuals, it may be appropriate to also take a proton pump inhibitor like Prilosec (omeprazole) to help protect the stomach lining from damage.”

My daughter is fortunate. She’s young and strong; she’s bounced back from the oral surgery itself just fine. In her surprise detour to the hospital, she received excellent and thorough care that didn’t detect any other underlying conditions. But her insides are still recovering from the flamethrower effects of her recent experience, and her doctor has put her on a bland diet of small meals for two months. It is not a small thing to be actively fending off pain for such a long time.

And it’s a chronic problem for a whole lot of us, casually swallowing our way through bottle after bottle of ibuprofen, chased soon after by bottle after inevitable bottle of Pepto Bismol. I don’t think it’s any coincidence that a Consumer Healthcare Protection Association list of the top selling over the counter drugs in America places oral analgesics high on the list — with heartburn remedies coming in strong right behind them.

More on keeping digestive system strong: 

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Miniature, Implantable Nerve Coolers for Targeted Pain Relief

Summary: Researchers have developed a new implantable device that can “cool” nerves and provide on-demand pain relief for those suffering from neuropathic or chronic pain.

Source: AAAS

An implantable device designed to “cool” nerves can provide targeted, on-demand pain relief, researchers report. When tested on rats with neuropathic pain, the device produced highly localized cooling.

“An implantable cooling device with on-demand local analgesia will be a game changer for long-term pain management,” write Shan Jiang and Guosong Hong in a related Perspective. It offers a promising path toward creating a class of analgesic devices for long-term, nonopioid pain management.

Pain management is a pressing health issue for many, who often must turn to effective yet highly addictive and sometimes deadly opioid pain medications. This has made the development of localized, nonopioid, and nonaddictive alternatives highly attractive.

One such approach is analgesic nerve cooling, which holds promise as an effective and reversible way to alleviate pain, including after amputations, nerve grafts, or spinal decompression surgeries, as examples. Like putting ice on a sore joint or muscle, targeted application of cold temperature directly to nerves can block the conduction of pain signals, providing temporary relief.

However, conventional nerve cooling devices are bulky and rigid with non-specific cooling and high power requirements – qualities that prevent practical clinical use.

To address this, Jonathan Reeder and colleagues developed a soft, miniaturized, and implantable nerve cooling system based on state-of-the-art microfluidic and flexible electronic technologies.

Borrowing from electrical nerve cuffs, Reeder et al. use a liquid-to-gas phase transition within microfluidic channels in an elastic band that wraps around peripheral nerves to provide targeted cooling. An integrated thermal thin film sensor in the device provides real-time temperature monitoring and control.

Borrowing from electrical nerve cuffs, Reeder et al. use a liquid-to-gas phase transition within microfluidic channels in an elastic band that wraps around peripheral nerves to provide targeted cooling. Image is in the public domain

Since the device is made from water-soluble and biocompatible materials, it is bioresorbable (meaning it degrades), reducing necessary surgery risk.

To demonstrate the device’s ability, the authors performed in vivo experiments in rat models of neuropathic pain, rapidly and precisely cooling peripheral nerves to provide local and on-demand pain relief.

“Besides the demonstrated strengths of the miniaturized flexible cooling device for pain mitigation,” write Jiang and Hong in the related Perspective, “the technology presents further opportunities for neuroscience research and neurological practice.”

About this neurotech and pain research news

Author: Press Office
Source: AAAS
Contact: Press Office – AAAS
Image: The image is in the public domain

See also

Original Research: Closed access.
“Soft, bioresorbable coolers for reversible conduction block of peripheral nerves” by Jonathan T. Reeder et al. Science


Abstract

Soft, bioresorbable coolers for reversible conduction block of peripheral nerves

Implantable devices capable of targeted and reversible blocking of peripheral nerve activity may provide alternatives to opioids for treating pain. Local cooling represents an attractive means for on-demand elimination of pain signals, but traditional technologies are limited by rigid, bulky form factors; imprecise cooling; and requirements for extraction surgeries.

Here, we introduce soft, bioresorbable, microfluidic devices that enable delivery of focused, minimally invasive cooling power at arbitrary depths in living tissues with real-time temperature feedback control. Construction with water-soluble, biocompatible materials leads to dissolution and bioresorption as a mechanism to eliminate unnecessary device load and risk to the patient without additional surgeries.

Multiweek in vivo trials demonstrate the ability to rapidly and precisely cool peripheral nerves to provide local, on-demand analgesia in rat models for neuropathic pain.

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First probable monkeypox case reported in Iowa

Iowa health officials reported the state’s first probable case of monkeypox on Friday as infectious disease experts warn the country is at risk of losing control of the disease.

The Iowa Department of Health and Human Services said it is conducting contact tracing to identify those who were in direct close contact with the patient.

“The patient was likely infected during international travels and is isolating, receiving outpatient care and in regular communication with health department staff,” the department said in a statement.

States typically test for orthopoxvirus, the family of viruses that monkeypox belongs to, before sending samples to the Centers for Disease Control and Prevention (CDC) for confirmatory testing.

The CDC as of Friday had reported a total of 460 monkeypox cases in 30 other states, Washington, D.C., and Puerto Rico.

Health officials continue to stress that the risk to the public remains low.

The disease spreads through close contact with an infected animal or person, generally through lesions, body fluids or respiratory droplets. But unlike the coronavirus, monkeypox droplets travel only up to a few feet and usually require prolonged contact for transmission.

Monkeypox causes swelling of the lymph nodes, which makes the virus distinctive from other, similar diseases, experts say. Patients also usually first present symptoms such as fever, headache, muscle aches, chills and exhaustion. 

Within one to three days after initial symptoms, infected individuals develop a rash that typically spreads from the head to other parts of the body. 

“Risk to the general public is low, but anyone with a rash that looks like monkeypox should talk to their healthcare provider, even if they don’t think they had contact with someone who has monkeypox,” the Iowa Department of Health and Human Services said.

Some jurisdictions have begun administering smallpox vaccines in response to the outbreak. The CDC suggests the smallpox vaccine is at least 85 percent effective against monkeypox.

“People with direct close contact are directed to watch for symptoms of illness and are offered a vaccine series that can prevent symptoms from developing or developing severe illness,” Iowa health officials said. “The CDC does not recommend broader use of the vaccine at this time; however, their evaluation of vaccine guidance is ongoing.”

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Intermittent Fasting May Help Heal Nerve Damage

Intermittent fasting may help heal nerve damage by changing the gut microbiome.

Intermittent fasting alters the gut bacteria activity of mice and increases their ability to recover from nerve damage.

Scientists observed how fasting led to the gut bacteria increasing the production of a metabolite known as 3-Indolepropionic

“When IPA cannot be produced by these bacteria and it was almost absent in the serum, regeneration was impaired.” — Professor Simone Di Giovanni, Chair in Restorative Neuroscience

Although this novel mechanism was discovered in mice, it is hoped to also hold true for any future human trials. The research team states that the bacteria that produce IPA, Clostridium sporogenesis, is found naturally in the guts of humans as well as mice and IPA is present in human bloodstreams too. 

“There is currently no treatment for people with nerve damage beyond surgical reconstruction, which is only effective in a small percentage of cases, prompting us to investigate whether changes in lifestyle could aid recovery,” said study author Professor Simone Di Giovanni from Imperial’s Department of Brain Sciences.

“Intermittent fasting has previously been linked by other studies to wound repair and the growth of new neurons – but our study is the first to explain exactly how fasting might help heal nerves.”

Fasting as a potential treatment

The experiment assessed nerve regeneration of mice where the sciatic nerve, the longest nerve running from the spine down the leg, was crushed. Half of the mice underwent intermittent fasting (by eating as much as they liked followed by not eating at all on alternate days), while the other half were free to eat with no restrictions at all. These diets continued for a period of 10 days or 30 days before their operation, and the mice’s recovery was monitored 24 to 72 hours after the nerve was severed.

The length of the regrown axons was measured and was about 50% greater in mice that had been fasting.

Professor Di Giovanni said, “I think the power of this is that opens up a whole new field where we have to wonder: is this the tip of an iceberg? Are there going to be other bacteria or bacteria metabolites that can promote repair?”

Investigation reveals metabolism link

The scientists also studied how fasting led to this nerve regeneration. They discovered that there were significantly higher levels of specific metabolites, including IPA, in the blood of diet-restricted mice.

To confirm whether IPA led to nerve repair, the mice were treated with antibiotics to clean their guts of any bacteria. They were then given genetically-modified strains of Clostridium sporogenesis that could or could not produce IPA.

“When IPA cannot be produced by these bacteria and it was almost absent in the serum, regeneration was impaired. This suggests that the IPA generated by these bacteria has an ability to heal and regenerate damaged nerves,” Professor Di Giovanni said. 

Importantly, when IPA was administered to the mice orally after a sciatic nerve injury, regeneration and increased recovery were observed between two and three weeks after injury.

The next stage of this research will be to test this mechanism for spinal cord injuries in mice as well as testing whether administering IPA more frequently would maximize its efficacy.

“One of our goals now is to systematically investigate the role of bacteria metabolite therapy.” Professor Di Giovanni said.

More studies will need to investigate whether IPA increases after fasting in humans and the efficacy of IPA and intermittent fasting as a potential treatment in people.

He said: “One of the questions that we haven’t explored fully is that, since IPA lasts in blood for four to six hours in high concentration, would administering it repeatedly throughout the day or adding it to a normal diet help maximize its therapeutic effects?”

Reference: “The gut metabolite indole-3 propionate promotes nerve regeneration and repair” by Elisabeth Serger, Lucia Luengo-Gutierrez, Jessica S. Chadwick, Guiping Kong, Luming Zhou, Greg Crawford, Matt C. Danzi, Antonis Myridakis, Alexander Brandis, Adesola Temitope Bello, Franziska Müller, Alexandros Sanchez-Vassopoulos, Francesco De Virgiliis, Phoebe Liddell, Marc Emmanuel Dumas, Jessica Strid, Sridhar Mani, Dylan Dodd and Simone Di Giovanni, 22 June 2022, Nature.
DOI: 10.1038/s41586-022-04884-x



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Advocates warn US at risk of losing control on monkeypox

Infectious disease experts and public health advocates are warning that the Biden administration has been too slow to respond to the monkeypox outbreak and that the U.S. is at risk of losing control of the disease. 

The response to monkeypox is mirroring the worst parts of the early days of the coronavirus pandemic, they say, with severely limited testing and a sluggish rollout of vaccines leading to a virus that’s spreading undetected.

“Where we have lagged is streamlining testing, making vaccines available, streamlining access to the best therapeutics. All three areas have been bureaucratic and slow, and that means we haven’t contained this outbreak,” said David Harvey, executive director of the National Coalition of STD Directors (NCSD).

Unlike COVID-19, monkeypox is not a novel virus, and the strategies to reduce the spread are well known. Biden administration officials said they are confident in their approach.

“We as a global community have known about it for decades. We know how it spreads. We have tests that help identify people who are infected. We have vaccines that are highly effective against it,” White House coronavirus response coordinator Ashish Jha said during a recent briefing.

According to the Centers for Disease Control and Prevention (CDC), there are 460 cases in 30 states, Puerto Rico and D.C., though experts say that number is almost certainly an undercount, as many people who may be infected don’t yet have access to widespread testing.

The administration is ramping up its response by expanding testing capacity and broadening access to vaccinations, though critics say the efforts may be coming too late.

“We’ve been sort of screaming for a month about how bad the diagnostic situation is for monkeypox. And that really was a clear error, preventable, and it’s very clear that this administration has not learned lessons from early COVID,” said James Krellenstein, co-founder of the HIV treatment advocacy group Prep4All. 

Jon Andrus, an adjunct professor of global health at George Washington University’s Milken Institute School of Public Health, said the U.S. is lucky that monkeypox is not as contagious as COVID-19, or as deadly, because the public health system is underfunded and overly fractured.

“I think we’ll continue to repeat these mistakes because that’s been our track record. That’s been our track record. We’ve had, what, more than five or six waves of COVID, and we seem every time to be a little bit caught off guard,” Andrus said. “Stopping transmission requires that we’re all reading from the same page. We all have the same road map.”

The administration expanded testing to commercial labs in late June, so providers will soon be able to order tests directly from the labs where they have established relationships and can jump through fewer hoops.

But it took more than a month for that move to happen, which increased testing capacity from about 8,000 tests a week to 10,000 across the entire system. 

Demand is also not evenly spread across the public health laboratory networks; it is concentrated in urban areas such as New York City, leading to backlogs and frustrated patients who wait days for test results.  

Biden administration health officials this week touted efforts to expand testing.

“I strongly encourage all health care providers to have a high clinical suspicion for monkeypox among their patients,” CDC Director Rochelle Walensky said during a call with reporters. “Patients presenting with a suspicious rash should be tested.”

Testing for monkeypox is a relatively simple process that involves swabbing a skin lesion. Unlike with COVID-19, the CDC already had a previously developed test, but patients were limited to a narrow set of specific criteria in order to qualify for testing. 

“We already had testing available. We already had vaccines available. We should have really been much more aggressive with testing … and I think this speaks to some of the bureaucracy of both FDA [Food and Drug Administration] and CDC,” said Celine Gounder, an infectious disease specialist and editor-at-large for public health at Kaiser Health News.

“Getting the commercial labs on board they could have done sooner. Getting academic medical centers to do testing, hospital labs to develop their own PCR tests. I mean, that’s not a very difficult thing to do,” Gounder said.

The White House is also working to scale up its vaccination program and announced a plan to immediately send out tens of thousands of doses of Jynneos, the only FDA-approved vaccine specifically for monkeypox. 

More than a million doses will be made available throughout the year. The CDC is also broadening the eligibility criteria so individuals with confirmed monkeypox exposures and presumed exposures can be vaccinated, rather than only those who have a confirmed case.

But activists and experts say the administration moved too slowly and that the updated vaccination strategy is not nearly sufficient.

“We believe this outbreak is already out of control. So, we have not contained it. Vaccines are not going to contain it at this point. Because we don’t have enough. Getting them into arms is an expensive and intense process,” said NCSD’s Harvey.

New York City and Washington, D.C., began offering the vaccines to men who have sex with other men or may have been exposed to the virus. But both cities ran through their supplies less than a day after launching their local immunization initiatives. D.C. Health had to shut access about 10 minutes after making shots available. 

There are about 56,000 Jynneos doses in the Strategic National Stockpile that will be allocated immediately, officials said, and the administration plans to allocate 296,000 doses over the coming weeks.

The U.S. has tens of millions of doses of the smallpox vaccine ACAM2000, but that shot has more dangerous and severe side effects.

According to a spokesman for Jynneos’s Denmark-based manufacturer Bavarian Nordic, 300,000 doses have already been delivered or will be arriving over the next few days.

An additional 1.1 million filled doses are still being inspected by the FDA, which should finish in the next couple weeks.  

The government also owns bulk materials totaling as many as 15 million doses, but they are still frozen, and the administration has not told the company how it wants those doses filled. 

“American taxpayers spent money buying and manufacturing these doses precisely so they can be used rapidly in the event of an outbreak,” said Krellenstein of Prep4All. 

“Here we have an outbreak, and my friends are literally being turned away from being vaccinated because the Biden administration can’t figure out how to get a million doses out of a freezer in Denmark into the United States,” Krellenstein added.

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Cockroaches are evolving to prefer low-sugar diets. That could be bad news for humans

Apparently, humans aren’t the only animals going keto. The German cockroach (Blattella germanica), one of the most common pests in the world, is evolving to have a glucose-free diet. Unlike many humans, it’s not because they’re suddenly watching their figure; rather, German cockroaches have inadvertently outwitted human pest control tactics by evolving to dislike sugar, specifically glucose.  That could have huge implications for the population of cockroaches worldwide, which is of particular concern given their propensity to spread bacteria and disease.

The not-so-sweet insight emerged from new research coming out of North Carolina State University, where scientists study roach reproductive habits and evolutionary adaptations. There, Dr. Ayako Wada-Katsumata and a team of entomology researchers found evidence of significant changes involving sugar-averse German cockroaches and mating habits. 

According to Dr. Coby Schal, professor of Urban Entomology, Insect Behavior, Chemical Ecology, Insect Physiology and head of the eponymous Schal Lab at North Carolina State University, the team’s new research shows that cockroaches have begun to deviate significantly compared to previously observed roach-mating behavior. Female lab roaches, housed in North Carolina lab originating from a Florida-strain, included a significant population of glucose-averse roaches; glucose is a simple sugar that is intrinsic to the processes of plant and animal life.

Surprisingly, researchers found these roaches were unwilling to complete traditional roach mating behavior (accepting what the research study refers to as “nuptial gifts” or “nuptial feedings.”) Further, these glucose-adverse female roaches chose not to complete the mating process, meaning there wouldn’t be any reproduction.

Lest your heart leap for joy at the idea of a significant population drop among roaches, curb your enthusiasm: these male roaches eventually found a workaround. That’s the bad news.

This new behavioral trait among roaches throws a wrench in traditional pest management control techniques that use sweet poison.

The good news — well, good news for roaches, that is — is that researchers found male roaches ingeniously overcame female glucose aversion during mating time. Roach mating — and foreplay, if you can call it that — traditionally lasts for up to 90 minutes. Male roaches adapted to female roach glucose hesitancy (meaning dislike for sugar) and shortened their mating rituals down to minutes or even seconds, while successfully completing fertilization. (If you read that and feel tempted to anthropomorphize female roaches and their sexual satisfaction — just don’t.)

The studies showed the most successful mating pairs were males and females who were both glucose averse. The least successful mating pairs were females who were glucose averse roaches with wild-type or glucose-loving males. While there were short-term population dips among glucose-averse females and wild-type males mating pairs, other more successful matches, including male/female roaches that were both glucose averse. Ultimately, the entire roach population within the lab study stayed within normal predicted ranges, despite this population of sugar-eschewing insects. 

According to Dr. Schal, researchers are wondering if new behavioral traits like this could spread through different populations, making this mutation more prevalent. 

So why is this research important? For one thing, roaches are a prominent pest — they tend to spread through human settlements, and can spread disease and cause other health problems in humans. And it is possible that this mutation could increase the roach population.

The majority of roaches, experts believe, consistently like sweet food — meaning food with sugar in it, like glucose.

“One of the takeaways is that animals, including roaches, have adaptations that they evolve in terms of natural selection,” Dr. Schal said. He noted that the “German cockroach, a pernicious household pest, plays an important etiological role in allergic disease and asthma. It also serves as a mechanical vector of pathogens, including antibiotic-resistant microbes.”  

In other words, this new behavioral trait among roaches throws a wrench in traditional pest management control techniques that use sweet poison. Likewise, it’s obviously impossible for a lay person to know visually whether their local roach population is glucose-averse or not. 

The problem with roach bait

So what is glucose aversion exactly, and why does it matter? Well, roaches are omnivorous scavengers. They can go for days without eating, but generally do poorly without any kind of liquid or water. When hungry, roaches will eat anything — including hair, paper, books, building material and a wide range of decaying life forms (including other dead roaches). But the majority of roaches, experts believe, consistently like sweet food — meaning food with sugar in it, like glucose.

According to Dr. Schal, roaches typically dislike bitter-tasting food items and prefer sweet food items. Traditionally, roach pest management has tried to improve the taste of bitter-tasting poisonous bait by wrapping sweetening-agents around the roach poison. Turns out, roaches have been on to our game for a while. They know we’re trying to kill them, and they’ve raised the stakes and adapted and evolved. It is something any evolutionary biologist could have predicted, though it’s frightening that this research actually confirms it.

How did this evolutionary adaptation happen? Well, roaches who quickly eat the sugar-laced poisoned bait die quickly; consequently, the glucose-loving roaches saw their lives-and reproductive capabilities cut short. Previously-published North Carolina State University research found that roaches were more likely to survive if they were glucose averse, meaning they avoid sweetened bait. Naturally, these roaches became more prevalent compared with glucose-loving roaches, and their genes spread through the population. 

These glucose-averse roach offspring are normal in almost every way, said Dr. Schal, but future generations of roaches will carry this genetic mutation. And roach offspring will most likely be glucose averse as well, he said, as these genes are passed down from the parent roach to offspring. If a roach is glucose averse, he said, means glucose tastes bitter or unpleasant to roaches. But if glucose-averse roaches are in starvation mode, they may temporarily eat glucose to survive, Dr. Schal said.

Among urban roaches, it is currently unclear what the ratio is of glucose-averse to glucose-loving roaches — at least, as compared with other kinds of roaches, such as those raised in the lab. But if this trend is ongoing among urban roaches, the majority may become glucose-averse at some point in the future.

Roaches are already notorious survivalists

Before you spiral contemplating the rise of mutant roach populations conquering the world (or is that just me?), it’s important to note that no recent entomological research has shown any concrete evidence that roach populations will necessarily have wildly increased population numbers because of this, or because of anything else — at least, not any time soon. The fact is, we already know that roaches are pretty adaptable: they can survive about ten times as much radiation as humans, can live without their heads for a month, and can live off dead and decaying matter alone.

When it comes to roach population growth, it’s hard to say how many roaches there are in any given geographic area, said Dr. Phililp G. Koehler , University of Florida Professor Emeritus of Entomology and Nematology.

“Roaches are pretty much endemic,” he said.

Urban roaches have a  relatively short lifespan. A German cockroach’s lifespan is typically 8-10 months, said Dr. Schal. A female German cockroach can produce up to 320 roach offspring.  On the other hand, an American cockroach can live 1-2 years, he said. One American roach female roach is capable of producing an average of 240 roaches throughout its average lifetime.

Regardless of species variations, roach population numbers can thus increase dramatically if uncontrolled. And this doesn’t even take into account asexual roach reproduction, through which female roaches can continue to reproduce for years without a resident male.

According to Dr. Koehler, any building structure that is older and/or has structural problems will be more likely to have thousands of cockroach residents. “There are always more roaches hidden in the walls that you actually see,” he said.

Roaches can be found in every state in the country. There are a handful of roach species that have adapted to live around and inside human habitats, including the German cockroach, the Asian cockroach, the American cockroach and the Turkestan cockroach (Notably, the German cockroach is not actually from Germany, nor is the American cockroach originally from the U.S.) According to a U.S. Census Bureau 2021 survey, about 14 million households self-reported seeing roaches in their home over the last 12 months. The survey is mum on whether these households observed a single roach, or thousands.

According to Dr. Koehler, any building structure that is older and/or has structural problems will be more likely to have thousands of cockroach residents. “There are always more roaches hidden in the walls that you actually see,” he said. 

So while some may incorrectly assume that roach infestations are primarily a scourge among low-income or untidy households, the presence of urban roaches is an unfortunate fact of life for many, regardless of income or socio-economic status or household cleanliness. Increased reports of roach sightings in multiple states stem from the fact that sewer roaches or aquatic roaches may simply be looking for new living quarters. 

Roaches and disease

Most humans find roaches disgusting, but can they actually make you sick? Potentially. And what kinds of pathogens can you get? Experts believe that roaches have transmitted plague, typhoid, cholera and dysentery in the past. But they also spread modern diseases. Indeed, cockroaches are thought to carry bacteria that, if deposited on food or around humans, could potentially cause salmonella, staphylococcus, and streptococcus, which can result in serious stomach issues. (Fortuitously, COVID-19 is not one of these diseases; research experts like Dr. Schal affirmed that roaches cannot transmit SARS-CoV-2, the COVID virus, to humans.)

But throughout pandemic lockdowns — with people staying at home, working at home, and yes, eating at home more — roach infestations have followed. Why? Well, human habits, mostly. Roaches follow the food, Dr. Schal said.

Dr. Phililp Koehler says his academic interest in roach research started during his Naval military career as a Lieutenant, Medical Entomologist, in the U.S. Navy’s Medical Service Corps over 50 years ago. In those years, rampant roach infestations were common on both military and civilian ships. Many more leisure travelers traveled from point A to point B on a ship for extended periods, for both domestic and international travel, he said. This, Dr. Koehler noted, is most likely how different non-native roach species like the Asian cockroach ended up in unexpected regions in North America, including port cities in Florida. The Asian roach then spread to other states, a trend that he researched extensively decades ago. 

Returning to the implications of the North Carolina research study on glucose averse roaches, Dr. Schal says there are actually additional findings that might be published as soon as this year. “This study also represents the best understood case of behavioral resistance of pest species to pest control at the evolutionary, behavioral, and cellular level,” he added.  It is possible that this newly-emerged roach behavior could prophesy future roach adaptations. Furthermore, this research is important not only for pest-management knowledge, he said, “but also it could potentially have public health implications when it comes to disease transmission.”

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Researchers: Improving Eyesight May Help Prevent Dementia

Dementia cases are climbing along with an aging world population, and yet another much-anticipated Alzheimer’s medication, crenezumab, has proved ineffective in clinical trials — the latest of many disappointments. Public health experts and researchers argue that it is past time to turn our attention to a different approach — focusing on eliminating a dozen or so already known risk factors, like untreated high blood pressure, hearing loss and smoking, rather than on an exorbitantly priced, whiz-bang new drug.

“It would be great if we had drugs that worked,” said Dr. Gill Livingston, a psychiatrist at University College London and chair of the Lancet Commission on Dementia Prevention, Intervention and Care. “But they’re not the only way forward.”

Emphasizing modifiable risks — things we know how to change — represents “a drastic change in concept,” said Dr. Julio Rojas, a neurologist at the University of California, San Francisco. By focusing on behaviors and interventions that are already widely available and for which there is strong evidence, “we are changing how we understand the way dementia develops,” he said.

The latest modifiable risk factor was identified in a study of vision impairment in the United States that was published recently in JAMA Neurology. Using data from the Health and Retirement Study, the researchers estimated that about 62 percent of current dementia cases could have been prevented across risk factors and that 1.8 percent — about 100,000 cases — could have been prevented through healthy vision.

Though that’s a fairly small percentage, it represents a comparatively easy fix, said Dr. Joshua Ehrlich, an ophthalmologist and population health researcher at the University of Michigan and the study’s lead author.

That’s because eye exams, eyeglass prescriptions and cataract surgery are relatively inexpensive and accessible interventions. “Globally, 80 to 90 percent of vision impairment and blindness is avoidable through early detection and treatment, or has yet to be addressed,” Dr. Ehrlich said.

The influential Lancet Commission began leading the modifiable risk factor movement in 2017. A panel of doctors, epidemiologists and public health experts reviewed and analyzed hundreds of high-quality studies to identify nine risk factors accounting for much of the world’s dementia: high blood pressure, lower education levels, impaired hearing, smoking, obesity, depression, physical inactivity, diabetes and low levels of social contact.

In 2020, the commission added three more: excessive alcohol consumption, traumatic brain injuries and air pollution. The commission calculated that 40 percent of dementia cases worldwide could theoretically be prevented or delayed if those factors were eliminated.

“A massive change could be made in the number of people with dementia,” said Dr. Livingston. “Even small percentages — because so many people have dementia and it’s so expensive — can make a huge difference to individuals and families, and to the economy.”

In fact, in wealthier countries, “it’s already happening as people get more education and smoke less,” she pointed out. Because the odds of dementia increase with age, as more people reach older ages, the number of dementia cases keeps rising. But the proportions are dropping in Europe and North America, where the incidence of dementia has fallen by 13 percent per decade over the past 25 years.

Dr. Ehrlich hopes the Lancet Commission will add vision impairment to its list of modifiable risks when it updates its report, and Dr. Livingston said it would indeed be on the commission’s agenda.

Why would hearing and vision loss contribute to cognitive decline? “A neural system maintains its function through stimulation from sensory organs,” explained Dr. Rojas, a co-author of an accompanying editorial in JAMA Neurology. Without that stimulation, “there will be a dying out of neurons, a rearrangement of the brain,” he said.

Hearing and vision loss could also affect cognition by limiting older adults’ participation in physical and social activity. “You can’t see the cards, so you stop playing with friends,” Dr. Ehrlich said, “or you stop reading.”

The link between dementia and hearing loss, the single most important factor the Lancet Commission cited as a modifiable risk, has been well established. There is less clinical data on the connection to impaired vision, but Dr. Ehrlich is a co-investigator of a study in southern India to see whether providing older adults with eyeglasses affects cognitive decline.

Of course, this approach to reducing dementia is “aspirational,” he acknowledged: “We’re not going to eliminate low education, obesity, all of these.”

Some efforts, like raising education levels and treating high blood pressure, should begin in youth or at midlife. Others require major policy changes; it’s hard for an individual to control air pollution, for example. Altering habits and making lifestyle changes — like stopping smoking, reducing drinking and exercising regularly — are not simple.

Even fairly routine medical practices, like measuring and monitoring high blood pressure and taking drugs to control it, can be difficult for low-income patients.

Moreover, older Americans will be likely to notice that routine vision and hearing care are two services that traditional Medicare does not cover.

It will pay for care related to diabetic retinopathy, glaucoma or age-related macular degeneration, and it covers cataract surgery. But for more common problems correctable with eyeglasses, “traditional Medicare is not going to help you out much,” said David Lipschutz, associate director of the nonprofit Center for Medicare Advocacy. Nor will it cover most hearing aids or exams, which are much higher expenses.

Medicare Advantage programs, provided through private insurers, usually do include some vision and hearing benefits, “but look at the scope of coverage,” Mr. Lipschutz cautioned. “They might apply $200 or $300 or $500 towards hearing aids” — but at a typical $3,000 to $5,000 a pair, “they still might be far out of reach,” he said.

Expanding traditional Medicare to include hearing, vision and dental benefits was part of the Biden administration’s Build Back Better Act. But after the House passed it in November, Republicans and Senator Joe Manchin III, a Democrat, scuttled it in the Senate.

Still, despite the caveats and cautions, reducing modifiable risk factors for dementia could have enormous payoff, and the Centers for Disease Control and Prevention has incorporated that approach into its National Plan to Address Alzheimer’s Disease.

A focus on these factors could also help reassure older Americans and their families. Some important risks for dementia lie beyond our control — genetics and family history, and advancing age itself. Modifiable factors, however, are things we can act on.

“People have such fears of developing dementia, losing your memory, your personality, your independence,” Dr. Livingston said. “The idea that you can do a lot about it is powerful.”

Even delaying its onset can have a great effect. “If, instead of getting it at 80, you get it at 90, that’s a huge thing,” she said.

Eye and hearing exams, exercise, weight control, stopping smoking, blood pressure medications, diabetes care — “we’re not talking about expensive interventions or fancy surgery or seeing specialists who are hours away,” Dr. Ehrlich added. “These are things people can do in the communities where they live.”

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Sure Signs Your Blood Sugar is Too High — Eat This Not That

High blood sugar may not get as many headlines as health concerns like COVID, heart disease and cancer. But chronically high blood sugar—commonly known as diabetes—is a silent epidemic in the U.S., a condition that can cause serious health consequences and can even be fatal. To protect yourself, have your blood sugar checked regularly and be aware of the potential signals that it’s elevated. These are some sure signs that your blood sugar is too high. If you notice any of them, it’s worth giving your doctor a call. Read on to find out more—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

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One of the most common signs of high blood sugar is urinating more than what’s normal for you. That happens because when sugar (glucose) builds up in the bloodstream, the body tries to flush it out through urine. If you’re urinating more frequently than usual, it’s a good idea to check in with your doctor.

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Another common symptom of high blood sugar is frequent thirst. Increased urination can cause dehydration on two fronts—urinating more often deprives the body of fluids, and blood sugar actually leaches fluid away from tissues as it leaves the body. That can result in increased thirst, and drinking more water may not satisfy it.

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Blood sugar often becomes chronically elevated because the body has become resistant to insulin, the hormone that helps cells use sugar for energy. Lacking that energy source, someone with high blood sugar might feel frequently fatigued.

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People with high blood sugar may feel hungry more frequently, and they might lose weight despite eating more. That’s because the body, deprived of energy from glucose, demands more food to use as fuel. Chronically high blood sugar may also result in unexpected weight loss, as the body may start to burn fat stores for energy.

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Chronically high blood sugar levels can damage nerves throughout the body, a condition called diabetic neuropathy. The most common form is peripheral neuropathy, which affects the feet, legs, hands and arms. It can produce tingling, burning, numbness, decreased sensitivity to pain or temperature or sharp pains or cramps in the affected areas. The symptoms tend to get worse at night.

High blood sugar levels can swell and distort the lenses of the eyes, causing blurry or double vision. Diabetes can cause blood vessels in the retina to leak, or abnormal new blood vessels to grow, leading to vision problems. This is called diabetic retinopathy. According to Johns Hopkins Medicine, diabetic neuropathy is the leading cause of blindness in American adults. And to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID.

Michael Martin

Michael Martin is a New York City-based writer and editor whose health and lifestyle content has also been published on Beachbody and Openfit. A contributing writer for Eat This, Not That!, he has also been published in New York, Architectural Digest, Interview, and many others. Read more

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The #1 Best Drink To Keep Your Brain Young, New Study Suggests — Eat This Not That

While it’s understandable why some people who feel overly dependent on a cup of java might want to give up coffee despite—or perhaps because of—their desperate need for it, there are plenty of benefits that you can enjoy if you drink a reasonable amount of coffee on a regular basis.

Along with coffee habits that can help with inflammation, coffee can even increase your lifespan. Beyond that, you’re surely aware of the fact that it can give both your brain and body a boost by amping up your alertness and energy level. At the same time, it turns out that coffee can also keep your brain younger.

In a study that was recently published in Nutritional Neuroscience, information was collected from National Health and Nutrition Examination Surveys that took place from 2011 to 2014. The data focused on the relationship between caffeine and cognitive function in the 827 participants who were all 60 years old or older. The results showed that caffeine helped to prevent cognitive function from getting worse over time.

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“The more that coffee is studied, the more often health benefits are elucidated from coffee,” Dana Ellis Hunnes, PhD, MPH, RD, senior clinical dietitian at UCLA medical center, assistant professor at UCLA Fielding school of public health, tells Eat This, Not That!.

When it comes to how coffee benefits the brain beyond the mere boost from caffeine, Hunnes explains that the beverage “has a lot of polyphenols and antioxidants in it that are anti-inflammatory and likely play a role in reducing the risk of cognitive impairment.”

As for how much coffee you might want to drink to see this kind of potentially positive effect, Hunnes says “most studies on coffee benefits point to three to four cups per day as the optimal dose.” However, she adds that “these are six to eight-ounce cups of coffee, not 20-ounce ventis.” It’s also important to note that “benefits occur most” when you opt for coffee that’s “taken black or with minimal additives.”

To find out more about how to keep your cognitive function super sharp, be sure to read The #1 Best Eating Habit for Your Brain, Says Science.

Desirée O

Desirée O is a freelance writer who covers lifestyle, food, and nutrition news among other topics. Read more

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Viral Infection Might Attract Mosquitoes to Humans

This article was originally published in The Conversation.

Mosquitoes are the world’s deadliest animal. Hundreds of thousands of deaths a year are attributed to mosquito-borne diseases, including malaria, yellow fever, dengue fever, Zika, and chikungunya fever.

How mosquitoes seek out and feed on their hosts are important factors in how a virus circulates in nature. Mosquitoes spread diseases by acting as carriers of viruses and other pathogens: A mosquito that bites a person infected with a virus can acquire the virus and pass it on to the next person it bites.

For immunologists and infectious-disease researchers like me, a better understanding of how a virus interacts with a host may offer new strategies for preventing and treating mosquito-borne diseases. In our recently published study, my colleagues and I found that some viruses can alter a mouse’s, and perhaps a person’s, body odor to be more attractive to mosquitoes, leading to more bites that allow a virus to spread.

Mosquitoes locate a potential host through different sensory cues, such as your body temperature and the carbon dioxide emitted from your breath. Odors also play a role. Previous lab research has found that mice infected with malaria have changes in their scents that make them more attractive to mosquitoes. With this in mind, my colleagues and I wondered if other mosquito-borne viruses, such as dengue and Zika, can also change a person’s scent to make them more attractive to mosquitoes, and whether there is a way to prevent these changes.

To investigate this, we placed mice infected with the dengue or Zika virus, uninfected mice, and mosquitoes in one of three arms of a glass chamber. When we applied airflow through the mouse chambers to funnel their odors toward the mosquitoes, we found that more mosquitoes chose to fly toward the infected mice than toward the uninfected mice.

We ruled out carbon dioxide as a reason for why the mosquitoes were attracted to the infected mice, because though Zika-infected mice emitted less carbon dioxide than uninfected mice, dengue-infected mice did not change emission levels. Likewise, we ruled out body temperature as a potential attractive factor when mosquitoes did not differentiate between mice with elevated or normal body temperatures.

Then we assessed the role of body odors in the mosquitoes’ increased attraction to infected mice. After placing a filter in the glass chambers to prevent mice odors from reaching the mosquitoes, we found that the number of mosquitoes flying toward infected and uninfected mice were comparable. This suggests that there was something about the odors of the infected mice that drew the mosquitoes toward them.

To identify the odor, we isolated 20 different gaseous chemical compounds from the scent emitted by the infected mice. Of these, we found three to stimulate a significant response in mosquito antennae. When we applied these three compounds to the skin of healthy mice and the hands of human volunteers, only one, acetophenone, attracted more mosquitoes compared with the control. We found that infected mice produced 10 times more acetophenone than uninfected mice.

Similarly, we found that the odors collected from the armpits of dengue-fever patients contained more acetophenone than those from healthy people. When we applied the dengue-fever-patient odors on one hand of a volunteer and a healthy person’s odor on the other hand, mosquitoes were consistently more attracted to the hand with dengue-fever odors.

These findings imply that the dengue and Zika viruses are capable of increasing the amount of acetophenone their hosts produce and emit, making them even more attractive to mosquitoes. When uninfected mosquitoes bite these attractive hosts, they may go on to bite other people and spread the virus even further.

Next, we wanted to figure out how viruses were increasing the amount of mosquito-attracting acetophenone their hosts produce. Acetophenone, along with being a chemical commonly used as a fragrance in perfumes, is also a metabolic by-product commonly produced by certain bacteria living on the skin and in the intestines of both people and mice. So we wondered if it had something to do with changes in the type of bacteria on the skin.

To test this idea, we removed either the skin or intestinal bacteria from infected mice before exposing them to mosquitoes. Though mosquitoes were still more attracted to infected mice with depleted intestinal bacteria compared with uninfected mice, they were significantly less attracted to infected mice with depleted skin bacteria. These results suggest that skin microbes are an essential source of acetophenone.

When we compared the skin-bacteria compositions of infected and uninfected mice, we identified that a common type of rod-shaped bacteria, Bacillus, was a major acetophenone producer and had significantly increased numbers on infected mice. This meant that the dengue and Zika viruses were able to change their host’s odor by altering the microbiome of the skin.

Finally, we wondered if there was a way to prevent this change in odors.

We found one potential option when we observed that infected mice had decreased levels of an important microbe-fighting molecule produced by skin cells, called RELMα. This suggested that the dengue and Zika viruses suppressed production of this molecule, making the mice more vulnerable to infection.

Vitamin A and its related chemical compounds are known to strongly boost production of RELMα. So we fed a vitamin-A derivative to infected mice over the course of a few days and measured the amount of RELMα and Bacillus bacteria present on their skin, then exposed them to mosquitoes.

We found that infected mice treated with the vitamin-A derivative were able to restore their RELMα levels back to those of uninfected mice, as well as reduce the amount of Bacillus bacteria on their skin. Mosquitoes were also no more attracted to these treated, infected mice than uninfected mice.

Our next step is to replicate these results in people and eventually apply what we learn to patients. Vitamin-A deficiency is common in developing countries. This is especially the case in sub-Saharan Africa and Southeast Asia, where mosquito-transmitted viral diseases are prevalent. We will investigate whether dietary vitamin A or its derivatives could reduce mosquito attraction to people infected with Zika and dengue, and subsequently reduce mosquito-borne diseases in the long term.

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