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Published on Leave a comment on Fungi and Bacteria In The Sinus Microbiome

The sinus microbiome consists of bacteria, viruses, and fungi all coexisting in the sinuses. Research has long focused on how the bacteria in sinus microbiomes in people with chronic sinusitis is different than in healthy persons without sinusitis (and yes, there are differences). Differences in the mycobiome (the fungi) of the sinuses appear to also play a role in chronic sinusitis.

A few recent studies found that there are differences in the fungi living in the sinuses in those without sinusitis and those with sinusitis (but results varied among the studies). Whether fungi play a role in the development of sinusitis has long been debated. Additionally, when samples are taken with a swab compared to sinus tissue samples during surgery - the results are different.

Sinuses
Credit: Nat. Library of Medicine

In a recent study, researchers found differences in both the fungi (mycobiome), as well as bacteria, in persons with chronic sinusitis compared to healthy persons (the controls). There were differences in bacterial diversity (diminished diversity in those with chronic sinusitis), as well as the composition of the microbes. The researchers thought that fungal alterations can play a part in sinusitis.

By the way, when microbes in the sinuses are out of whack it is called dysbiosis. Researchers point out that the same microbes can be commensal or pathogenic (if numbers increase to high numbers) or have no effect on sinusitis.

Excerpts from The Laryngoscope: Fungal and Bacterial Microbiome in Sinus Mucosa of Patients with and without Chronic Rhinosinusitis

Abstract  Objectives - Dysbiosis of the sinonasal microbiome has been implicated in the pathogenesis of chronic rhinosinusitis (CRS). However, the mycobiome remains largely understudied, and microbial alterations associated with specific CRS subtypes have yet to be delineated. The objective of this study is to investigate the fungal and bacterial microbiome of sinus mucosa in CRS patients with and without nasal polyposis (CRSwNP and CRSsNP) versus healthy controls. ...continue reading "Fungi and Bacteria In The Sinus Microbiome"

Published on Leave a comment on Patient Experiences Worsen In Hospitals Acquired By Private Equity

Everyone reading this will say: Ah ha...of course. When profits come first, then patient care suffers. A recent study looked at 73 private-equity acquired hospitals compared to 293 hospitals that weren't, and found that the patient care experience and patient-staff responsiveness worsened in hospitals taken over and managed by private equity.

And with each additional year of private equity ownership, these measures further worsened. As the study authors noted: this is due to profit-driven changes made by private equity. One of the researchers noted: "The evidence to date suggests that when private equity takes over a hospital, things generally get worse for patients."

From Medical Xpress: Patient care declines after private equity buys hospitals, study finds

In a paper published in JAMA, health policy experts at Beth Israel Deaconess Medical Center (BIDMC) report that patient care experience worsened after private equity (PE) acquisition of US hospitals, as did patient-reported staff responsiveness.

Rishi Wadhera, MD, MPP, Anjali Bhatla, MD, and colleagues demonstrated that patient care continued to worsen at PE-acquired hospitals with each additional year following acquisition relative to non-acquired hospitals, suggesting that profit-driven changes made by PE may have downstream effects that accumulate over time. ...continue reading "Patient Experiences Worsen In Hospitals Acquired By Private Equity"

Published on Leave a comment on Last Year Was the Warmest Year Since Global Records Began in 1850

Well, well... this is not a surprise. 2024 was the hottest year since temperature records began in 1850. And the second hottest year on record was 2023.

Unfortunately, this also means that we exceeded the goal of limiting temperature increases to 1.5 degrees C that was agreed to at the Paris Agreement in 2016. Remember that agreement? The goal was to keep temperature increases to no more than 1.5 degrees C over pre-industrial temperatures (as defined by the 1850 - 1900 average). But last year was 1.6 degrees C over pre-industrial levels.

It's been 48 years since the last time the world had a cooler year than average year. You can thank rising greenhouse emissions for the overall upward trend in heat.

Sooo....what will 2025 be like? Stay tuned.

Excerpts from Ars Technica: Everyone agrees: 2024 the hottest year since the thermometer was invented

Over the last 24 hours or so, the major organizations that keep track of global temperatures have released figures for 2024, and all of them agree: 2024 was the warmest year yet recorded, joining 2023 as an unusual outlier in terms of how rapidly things heated up. At least two of the organizations, the European Union's Copernicus and Berkeley Earth, place the year at about 1.6° C above pre-industrial temperatures, marking the first time that the Paris Agreement goal of limiting warming to 1.5° has been exceeded. ...continue reading "Last Year Was the Warmest Year Since Global Records Began in 1850"

Published on Leave a comment on Snot Transplants for Sinusitis?

There are 2 small studies that recently looked at the issue of snot transplants as a treatment for chronic sinusitis. The idea behind snot transplants or sinonasal microbiota transplants is similar to fecal transplants - it's a transplant containing the entire microbial community (fungi, bacteria, viruses) in the form of a sample of snot or nasal mucus from a healthy donor to a recipient with chronic sinusitis (sign of an unhealthy sinus microbiome).

This idea has huge potential as a treatment. The goal in a sinus snot transplant is to have the healthy donor's snot (the mucus) take over and change (engraftment) the recipient's unhealthy sinus microbiome. The hope is that this will restore a healthy sinus microbiome in the person with chronic sinusitis, resulting in sustained improvement in sinus health.

The results from the studies are definitely encouraging, but also a bit mixed. For example, there was sustained improvement (up to 180 days) in 2 out of 3 patients in the 2024 study, but why not the third person? Also, illness may appear in the recipient of the transplant (see patient narratives in the first study). Also, why did some people drop out after the first snot transplant in the 2022 study? In both small studies, most of the the healthy donors were the recipient's spouse or a close friend.

The one concern that everyone has is of the possibility of some unknown disease being transferred from the donor to the recipient. [Note: Post about the Swedish study before it started]

Excerpts from Dec. 2022 Allergy and Rhinology: Upper airway microbiome transplantation for patients with chronic rhinosinusitis

The study, involving patients with CRSsNP, was of an open pre-post interventional design and involved 13 days of antibiotics (amoxicillin/clavulanate 875 mg/125 mg three times daily or, in case of penicillin-allergy, clarithromycin 500 mg two times daily) followed by five daily upper airway microbiome transplants.....All patients had over several years (i.e., far longer than the time span of this study) failed repeatedly on medical therapy and had undergone endoscopic sinus surgery (ESS) with a minimum of bilateral middle meatus antrostomies/ethmoidectomies

3.1 Patient narratives and adverse events Three patients opted not to participate further after visit 1 (V1). The remaining 22 patients completed the trial. Eighteen reported airway symptoms such as cough, sore throat, blocked or runny nose, or common cold-like symptoms during or soon after the transplant procedure. Seven indicated gastrointestinal problems, mainly diarrhea. One patient developed acute purulent rhinosinusitis and pneumonia 34 days after the last transplant. One patient developed a urinary tract infection, and one was diagnosed with diabetes type 2 (2 weeks before V8). One patient developed fever and cough during, and one experienced sinusitis-like symptoms 5 days after the transplant series. The latter two incidents were considered potentially caused by the microbiome transplant series. ...continue reading "Snot Transplants for Sinusitis?"

Published on Leave a comment on Hospital Foods Can Be Very Unhealthy
Vanilla pudding

Well, well, well...it was a rocky holiday season. Lots of people got Covid, including myself. It hit everyone I know harder than expected, with symptoms much worse than with a flu virus.

Anyway, while visiting someone in a hospital I happened to be there when dinner was served. I was absolutely shocked that much of the hospital meal contained ultra-processed foods with absolutely garbage ingredients.  Artificial colors, high fructose corn syrup (e.g., ginger ale), etc.

This is what sick people are given? Food ingredients linked to gut inflammation and a number of health problems? Perhaps they're making sure they get lots of repeat business.

Vanilla pudding ingredients: Water, nonfat milk, sugar, modified corn starch, palm oil, salt, sodium stearoyl lactylate, disodium phosphate, natural and artificial flavors, yellow 5, yellow 6. (This was dessert.)

The Lemon Tea ingredients: Water, citric acid, instant tea powder, sodium benzoate, potassium sorbate, caramel color, acesulfame-K, sucralose, natural flavors.

Published on Leave a comment on We’ve Known About the Harms of Endocrine Disruptors For Over 30 Years
Book: Our Stolen Future

A few weeks ago was the 10th anniversary of the death of Dr. Theo Colborn. She was a pioneering giant that actually started the whole field of endocrine disruption from chemical pollutants in the environment.

It was due to her efforts that the term "endocrine disruption" (hormonal disrupting effects) was coined in 1991. Dr. Theo Colborn co-authored the groundbreaking 1996 book on endocrine disruptors: Our Stolen Future: Are We Threatening Our Fertility, Intelligence, and Survival? A Scientific Detective Story.

I read the book when it first came out, and my advice is to: YES - please read this book! It is absolutely worth it. By the way, one of the co-authors is Pete Myers, who is the founder of Environmental Health Sciences, which publishes Environmental Health News.

Unfortunately, even with all the knowledge we have about endocrine disruptors and the harms to humans and wildlife - they are still all around us, including personal care products (e.g., parabens in many lotions). Industry pushback is huge, of course.

Excerpts from Environmental Health News (EHN): Ten years after her passing, Theo Colborn's legacy continues to grow

Dr. Theo Colborn, who passed away December 14, 2014, was the founder of the endocrine disruption field, connecting the dots among the different health problems seen in wildlife with those seen in humans, tying them to the endocrine system and to chemical pollutants. ...continue reading "We’ve Known About the Harms of Endocrine Disruptors For Over 30 Years"

Published on Leave a comment on Bacteria In The Kidney Microbiome Can Prevent Or Promote Kidney Stones
Kidney stones Credit: Wikipedia

Finally, a study was done examining whether the kidneys have a microbiome (community of fungi, viruses, and bacteria). The answer is yes, the kidneys have a microbiome and the composition of the microbes plays a role in kidney health and whether a person develops kidney stones or not. This makes sense - all our other organs have microbiomes.

This multi-part study showed that the urinary tract is not sterile, and that low levels of bacteria are normal. Additionally, they found that the presence of the beneficial bacteria L. crispatus is found in the absence of kidney stones, while E.coli is associated with the development of kidney stones. (Interestingly, L. crispatus is also found in the healthy vagina and can treat bacterial vaginosis.) 

The researchers found that the L. crispatus somehow blocked E.coli's ability to form kidney stones.

Antibiotic use was associated with bacteria that promoted the development of kidney stones because antibiotics kill off Lactobacillus species and promote the growth of kidney stone forming species (e.g., E. coli). Other studies also find that bacteria such as E.coli (as well as Proteus and Klebsiella) are frequently associated with UTIs, kidney stone formation, and kidney infection (pyelonephritis). 

From Medical Xpress: First full characterization of kidney microbiome unlocks potential to prevent kidney stones

Cleveland Clinic researchers have found definitive proof of a kidney microbiome that influences renal health and kidney stone formation, demonstrating that the urinary tract is not sterile and low levels of bacteria are normal. ...continue reading "Bacteria In The Kidney Microbiome Can Prevent Or Promote Kidney Stones"

Published on Leave a comment on Eating Nuts Daily Associated With Lower Risk of Dementia

Many people to this day avoid eating nuts because they view them as high calorie and high fat (umm...probably because the medical establishment said that for years). However, studies in the past decade repeatedly found that frequent nut consumption has health benefits.

A recent study found that high consumption of nuts is associated with a lower risk of dementia (about 12% lower risk than in those not consuming nuts). The researchers found that the protective effect was strongest in those who consumed up to a handful of unsalted nuts daily, especially if they were unsalted. However, consuming more than a handful of nuts per day did not have additional benefits.

From the science news website PsyPost: Can a handful of nuts a day keep dementia away? Research suggests it might

A new study, published in the journal GeroScience, highlights a promising link between nut consumption and a reduced risk of dementia. The findings suggest that middle-aged and older adults who regularly consume nuts have a 12% lower chance of developing dementia compared to non-consumers. This protective effect was particularly strong for those who consumed up to a handful of unsalted nuts daily, which appeared to yield the most significant cognitive benefits. ...continue reading "Eating Nuts Daily Associated With Lower Risk of Dementia"