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Published on Leave a comment on Microbes Partially Restored To C-Section Babies

I posted about this amazing research while it was still ongoing (Jan. 16, 2015), but now a study has been published. The small well-done pilot study looked at the microbiome (microbial communities) and microbial differences between different groups of infants during the first 30 days of life. They found significant differences in the bacteria of C-section infants (not exposed to their mother's vaginal fluid in the birth canal) compared to C-section infants who were swabbed with a gauze pad right after birth with their mother's vaginal fluids. They found that the microbiota (community of microbes) is partially restored in the swabbed C-section infants and more similar to that of vaginally delivered infants (who were exposed to the maternal bacteria naturally in the birth canal). They found that the procedure restored some bacteria, such as Lactobacillus and Bacteroides, which were nearly absent in the skin and anal samples of non-swabbed C-section babies.

In the C-section group, four mothers who were free of infections that might harm the babies, incubated a sterile gauze in their vaginas for one hour before the operation (C-section). Then, within two minutes of birth, the babies were swabbed with the gauze first over their mouths, then their faces, and then the rest of their bodies. These results are important because it is thought that microbiome differences (depending on method of birth) are long-lasting (with higher incidence of some health problems later in life with C-sections), and because the baby's early microbiome helps educate the baby's developing immune system.

Rob Knight (a leading microbiologist and one of the researchers) pointed out that the study "provides the proof-of-concept that microbiome modification early in life is possible." Now we need to see if these microbial differences persist over time and if it makes a health difference. From Science Daily:

Vaginal microbes can be partially restored to c-section babies

In a small pilot study, researchers at University of California, San Diego School of Medicine and Icahn School of Medicine at Mount Sinai determined that a simple swab to transfer vaginal microbes from a mother to her C-section-delivered newborn can alter the baby's microbial makeup (microbiome) in a way that more closely resembles the microbiome of a vaginally delivered baby. 

Babies delivered by C-section differ from babies delivered vaginally in the makeup of the microbes that live in and on their bodies. These early microbiomes help educate the baby's developing immune system. Previous research suggests a link between C-section delivery and increased subsequent risk of obesity, asthma, allergies, atopic disease and other immune deficiencies. Many of these diseases have also been linked to the microbiome, though the role a newborn's microbiome plays in current or long-term health is not yet well-understood....Other research suggests that microbiome differences between vaginal and C-section babies can persist for years."

In the study, the researchers collected samples from 18 infants and their mothers, including seven born vaginally and 11 delivered by scheduled C-section. Of the C-section-delivered babies, four were exposed to their mothers' vaginal fluids at birth as part of this study. To do this, sterile gauze was incubated in the mothers' vaginas for one hour before the C-section. Within two minutes of their birth, the babies delivered by C-section were swabbed with the gauze starting with the mouth, then the face and the rest of the body.

Six times over the first month after birth, the researchers collected a total of 1,519 anal, oral and skin samples from the mothers and infants. Knight's team then used a gene sequencing technique to map the types and relative quantities of bacterial species present at each body site.

Here's what they found: the microbiomes of the four C-section-delivered infants exposed to vaginal fluids more closely resembled those of vaginally delivered infants than unexposed C-section-delivered infants, though the difference was more distinct in their oral and skin samples than in their anal samples. This partial microbial restoration could be due to the fact that the infants received only one surface application of maternal vaginal fluids, Knight said.

Yet the oral and skin microbiome differences between C-section-delivered infants who received the microbial transfer and those who did not was still noticeable one month after birth. The results were not due to diet differences, as all of the infants received breast milk either exclusively or supplemented with formula during the first month of life. In addition, consistent with previous studies, the babies' microbiome profiles did not correlate with the amount of breast milk they received.

"The present work is a pilot study -- we need substantially more children and a longer follow-up period to connect the procedure to health effects," said Knight...."This study points the way to how we would do that, and provides the proof-of-concept that microbiome modification early in life is possible. In fact, we already have more than 10,000 additional samples collected as part of this study that still await analysis."

Published on Leave a comment on Childhood Antibiotic Use Disrupts Gut Microbiome

This confirms what researchers such as Dr. Martin Blaser (in his book Missing Microbes) and others (such as Drs. Sonnenburg and Sonnenburg) have been saying about antibiotic use in infants and children: that there are negative effects to the gut microbiome from antibiotic use in early childhood, and the more frequent the use, the greater the negative effects. It is because the use of antibiotics  in early childhood "disrupts the microbiome".

Penicillins appear to be less disruptive, but macrolides (e.g., Clarithromycin, azithromycin) much more disruptive - the researchers found that the gut microbiota recovered within 6–12 months after a penicillin course, but did not fully recover from a macrolide course even after 2 years . Antibiotics can be life-saving, but they absolutely should not be used casually because there are hidden costs (such as microbiome changes). From Medical Xpress:

Antibiotic use in early life disrupt normal gut microbiota development

The use of antibiotics in early childhood interferes with normal development of the intestinal microbiota, shows research conducted at the University of Helsinki. Particularly the broad-spectrum macrolide antibiotics, commonly used to treat respiratory tract infections, have adverse effects. Macrolides appear also to contribute to the development of antibiotic-resistant strains of bacteria.  ...continue reading "Childhood Antibiotic Use Disrupts Gut Microbiome"

Published on Leave a comment on Beneficial Bacteria In the Nose

Could the bacteria described in this research be another probiotic or beneficial bacteria (besides Lactobacillus sakei) that helps protect against sinusitis? New research found that the harmless bacteria Corynebacterium accolens is "overrepresented" in children free of Streptococcus pneumoniae (pneumococcus) -  which commonly colonizes in children's noses (and that can live harmlessly as part of a healthy microbiome), but it is also an important infectious agent. Streptococcus pneumoniae is a major cause of pneumonia, septicemia, meningitis, otitis media (ear infections), and sinusitis in children and adults worldwide.

The researchers did an analysis on the microbes in the nasal passages of children and found that the nasopharyngeal (nostrils) microbiome was different in children with and without pneumococcal nasopharyngeal colonization. This revealed that Corynebacterium species and Dolosigranulum were "overrepresented" in children negative for pneumococcal colonization, whereas Streptococcus was "overrepresented" in children positive for Streptococcus  pneumoniae colonization.

The researchers found that higher numbers of  Corynebacterium accolens cells deter and limit S. pneumoniae nostril colonization, which might partly explain why children without S. pneumoniae colonization have higher levels of nasal Corynebacterium species. The researchers write that "there is direct antagonism" between Corynebacterium spp. and S. pneumoniae in the human nose. How do children get this beneficial bacteria? Interestingly, at 6 weeks of age, Corynebacterium species. and Dolosigranulum species are also "overrepresented" in the nasopharyngeal microbiota of breastfed infants compared to formula-fed infants. From Science Daily:

Good bacteria might help prevent middle ear infections, pneumonia

A new study is helping to shed more light on the important connections among the diverse bacteria in our microbiome. According to research published in mBio, scientists at Forsyth, led by Dr. Katherine P. Lemon, along with their collaborator at Vanderbilt University, have demonstrated that a harmless bacterium found in the nose and on skin may negatively impact the growth of a pathogen that commonly causes middle ear infections in children and pneumonia in children and older adults.

This study provides the first evidence that Corynebacterium accolens, a harmless bacterial species that commonly colonizes the nose, can help inhibit Streptococcus pneumoniae (S. pneumoniae) -- a major cause of pneumonia, meningitis, middle ear infection and sinusitis. According to the World Health Organization, S. pneumoniae leads to more than 1 million deaths each year, primarily in young children in developing countries. Although most people that host S. pneumoniae do not develop these infections, colonization greatly increases the risk of, and is a perquisite for, infection and transmission.

The study, titled, "Corynebacterium accolens (C. accolens) Releases Antipneumococcal Free Fatty Acids from Human Nostril and Skin Surface Triacylglycerols," is published on January 5, 2016 in mBio. In this study, first-author Dr. Lindsey Bomar and her colleagues show that C. accolens are overrepresented in the noses of children that are not colonized by S. pneumoniae, which is commonly found in children's noses and can cause infection. In laboratory research, the team further found that C. accolens modifies its local habitat in a manner that inhibits the growth of S. pneumoniae by releasing antibacterial free fatty acids from representative host skin surface triacylglycerols. The team went on to identify the C. accolens enzyme needed for this. These results pave the way for potential future research to determine whether C. accolens might have role as a beneficial bacterium that could be used to control pathogen colonization.

Published on Leave a comment on Traditional Toys and Books Better Than Electronic Toys For Young Children

More evidence that traditional toys and books are superior to electronic toys in both verbal parent-child interactions and non-verbal interactions for young children. Parent-child verbal interactions are so important because they teach young children language, lay the groundwork for literacy skills, teach role-playing, teach emotional and social skills such as turn-taking and accepting others' leads. In other words, put down the electronic gadgets and go spend time talking and interacting with your young child with old style traditional toys and books. From Science Daily:

How does type of toy affect quantity, quality of language in infant playtime?

Electronic toys for infants that produce lights, words and songs were associated with decreased quantity and quality of language compared to playing with books or traditional toys such as a wooden puzzle, a shape-sorter and a set of rubber blocks, according to an article published online by JAMA Pediatrics.

Anna V. Sosa, Ph.D., of Northern Arizona University, Flagstaff, and colleagues conducted a controlled experiment involving 26 parent-infant pairs with children who were 10 to 16 months old. Researchers did not directly observe parent-infant play time because it was conducted in participants' homes. Audio recording equipment was used to pick up sound. Participants were given three sets of toys: electronic toys (a baby laptop, a talking farm and a baby cell phone); traditional toys (chunky wooden puzzle, shape-sorter and rubber blocks with pictures); and five board books with farm animal, shape or color themes.

While playing with electronic toys there were fewer adult words used, fewer conversational turns with verbal back-and-forth, fewer parental responses and less production of content-specific words than when playing with traditional toys or books. Children also vocalized less while playing with electronic toys than with books, according to the results.

Results also indicate that parents produced fewer words during play with traditional toys than while playing with books with infants. Parents also used less content-specific words when playing with traditional toys with their infants than when playing with books. The authors note results showed the largest and most consistent differences between electronic toys and books, followed by electronic toys and traditional toys.

"These results provide a basis for discouraging the purchase of electronic toys that are promoted as educational and are often quite expensive. These results add to the large body of evidence supporting the potential benefits of book reading with very young children. They also expand on this by demonstrating that play with traditional toys may result in communicative interactions that are as rich as those that occur during book reading. ... However, if the emphasis is on activities that promote a rich communicative interaction between parents and infants, both play with traditional toys and book reading can be promoted as language-facilitating activities while play with electronic toys should be discouraged," the study concludes.

EDITORIAL: "Electronic toys that make noises or light up are extremely effective at commanding children's attention by activating their orienting reflex. This primitive reflex compels the mind to focus on novel visual or auditory stimuli. The study by Sosa in this issue of JAMA Pediatrics suggests that they may do more than just command children's attention; they appear to reduce parent-child verbal interactions. Why does this matter? Conversational turns during play do more than teach children language. They lay the groundwork for literacy skills, teach role-playing, give parents a window into their child's developmental stage and struggles, and teach social skills such as turn-taking and accepting others' leads.

Verbal interactions of course are only part of the story. What is missing from this study is a sense of how nonverbal interactions, which are also an important source of social and emotional skills, varied by toy type," write Jenny S. Radesky, M.D., of the University of Michigan Medical School, Ann Arbor, and Dimitri A. Christakis, M.D., M.P.H., of Seattle Children's Hospital and a JAMA Pediatrics associate editor, in a related editorial.

Published on Leave a comment on What Else Do Children Need From Their Parents?

The results of this study lead me to say DUH...of course spending time with children and being responsive to them, talking and interacting a lot with them, being affectionate and loving with them is best. So in this holiday season, don't just give gifts and toys to your children and think you can leave them to their own devices  or with others, but spend time with them, talk a lot to them, play games with them, interact, and do things with them. Put down your own electronic devices (cell phone, laptop, tablet, etc) and go spend time with your child. From Science Daily:

Parent touch, play and support in childhood vital to well-being as an adult

Did you receive affection, play freely and feel supported in childhood? Childhood experiences like these appear to have a lot to do with well-being and moral capacities in adulthood. In a forthcoming article in the journal Applied Developmental Science, University of Notre Dame professor of psychology Darcia Narvaez and colleagues Lijuan Wang and Ying Cheng, associate professors of psychology, show that childhood experiences that match with evolved needs lead to better outcomes in adulthood.

According to Narvaez, one of the reasons that the well-being of children in the United States lags behind that of children in other advanced nations is because "we have forgotten that we are social mammals with specific evolved needs from birth."

"Humans evolved with a nest of care for their young that matches up with the maturational schedule of the child. It was shaped over 30 million years ago and modified through human evolution," Narvaez said. "We call it the evolved developmental niche." In describing this niche, Narvaez emphasizes six components: Soothing, naturalistic perinatal experiences; responsiveness to a baby's needs including sensitivity to the signals of the baby before the baby cries; constant physical presence with plenty of affectionate touch; extensive breastfeeding; playful interactions with caregivers and friends; and a community of affectionate, mindful caregivers.

Narvaez, Wang and Cheng asked adults to reflect on their childhoods according to several components of the evolved developmental niche (EDN): How much did they receive physical affection? Play freely outside and inside? Do things as a family inside and outside the home? Feel supported?

Adults who report receiving more of such parenting practices in their childhoods display less depression and anxiety, greater ability to take the perspective of others and an orientation toward compassion. Adults who report less of these parenting practices in their childhood have poorer mental health, more distress in social situations and are less able to take another's point of view.

"Our research shows that when we don't provide children with what they evolved to need, they turn into adults with decreased social and moral capacities," Narvaez said. "With toxic stress in childhood, the good stuff doesn't get a chance to grow and you become stress reactive. It's hard to be compassionate when you are focused on yourself. We can see adults all around us who were traumatized or undercared for at critical times." In prior research, Narvaez and her colleagues found that children who experienced more of the evolved developmental niche exhibit, for example, more empathy, self-control and conscience.

Published on Leave a comment on Appendicitis in Children Can Be Treated With Antibiotics
Drawing of colon seen from front (appendix is colored red). Credit: Wikipedia

This is the second time I've seen research finding that antibiotics  alone could be used (instead of surgery) for the treatment of uncomplicated appendicitis (June 17, 2015 post), but this time in children. Appendicitis is inflammation of the appendix.  At the one year follow-up the researchers found that 75.7% of patients with uncomplicated appendicitis had been successfully treated with antibiotics alone and had not had any recurrences of appendicitis.

This is a major finding because for years the gold standard for appendicitis treatment has been an appendectomy. The times are a changing.

From Science Daily: Antibiotics alone can be a safe, effective treatment for children with appendicitis

Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery when chosen by the family. A study led by researchers at Nationwide Children's Hospital found that three out of four children with uncomplicated appendicitis have been successfully treated with antibiotics alone at one year follow-up. Compared to urgent appendectomy, non-operative management was associated with less recovery time, lower health costs and no difference in the rate of complications at one year.

"Surgery has long been the 'gold standard' of care for treating appendicitis because by removing the appendix we eliminate the chance that the appendicitis will ever come back," said Dr. Deans. "However, early in our careers we noticed that patients with appendicitis who were placed on antibiotics overnight until their surgery the following morning felt better the next day. So, Pete and I asked ourselves: do they really need to have surgery?"

In the first study conducted and published in the United States examining non-operative management for appendicitis, they enrolled 102 patients age 7 to 17 who were diagnosed with uncomplicated acute appendicitis at Nationwide Children's between October 2012 and October 2013. Participants had early/mild appendicitis, meaning that they experienced abdominal pain for no more than 48 hours; had a white blood cell count below 18,000; underwent an ultrasound or CT scan to rule out rupture and to verify that their appendix was 1.1 centimeter thick or smaller; and had no evidence of an abscess or fecalith, which is hard stone-like piece of stool.

Thirty-seven families chose antibiotics alone and 65 opted for surgery. Those patients in the non-operative group were admitted to the hospital and received IV antibiotics for at least 24 hours, followed by oral antibiotics after discharge for a total of 10 days. Among those patients, 95% showed improvement within 24 hours and were discharged without undergoing surgery. Rates of appendicitis-related medical care within 30 days were similar between the groups with two patients in the non-operative group readmitted within 30 days for an appendectomy. At one year after discharge, three out of four patients in the non-operative group did not have appendicitis again and have not undergone surgery.

Appendicitis, caused by a bacterial infection in the appendix, is the most common reason for emergency abdominal surgery in children, sending more than 70,000 young people to the operating room each year. Although many of these cases are severe and require surgery, there are a good number that would be candidates for treatment with antibiotics alone, Dr. Minneci said.

According to the study results, patients who were transferred to Nationwide Children's from other institutions expressed concerns about the distance and time necessary to come back if the appendicitis recurred. These families opted for surgery more often. Patients whose families spoke primary languages other than English were more likely to choose antibiotics as a course of treatment due to cultural values to avoid surgery if at all possible.

Published on Leave a comment on Taking Antidepressants During Pregnancy and Autism

A large study found that using antidepressants during the second or third trimester of pregnancy increases the risk that the child will have autism by 87%,  especially if the mother takes selective serotonin reuptake inhibitors (SSRIs). A drawback was that the study looked at associations rather than actual cause (which would have meant randomly assigning women to either treatment or no treatment - which is unethical). From Medical Xpress:

Taking antidepressants during pregnancy increases risk of autism by 87 percent

Using antidepressants during pregnancy greatly increases the risk of autism, Professor Anick Bérard of the University of Montreal and its affiliated CHU Sainte-Justine children's hospital revealed today. Prof. Bérard, an internationally renowned expert in the fields of pharmaceutical safety during pregnancy, came to her conclusions after reviewing data covering 145,456 pregnancies.

"The variety of causes of autism remain unclear, but studies have shown that both genetics and environment can play a role," she explained. "Our study has established that taking antidepressants during the second or third trimester of pregnancy almost doubles the risk that the child will be diagnosed with autism by age 7, especially if the mother takes selective serotonin reuptake inhibitors, often known by its acronym SSRIs." Her findings were published today in JAMA Pediatrics.

Bérard and her colleagues worked with data from the Quebec Pregnancy Cohort and studied 145,456 children between the time of their conception up to age ten. In addition to information about the mother's use of antidepressants and the child's eventual diagnosis of autism, the data included a wealth of details that enabled the team to tease out the specific impact of the antidepressant drugs. 

"We defined exposure to antidepressants as the mother having had one or more prescription for antidepressants filled during the second or third trimester of the pregnancy. This period was chosen as the infant's critical brain development occurs during this time," Prof. Bérard said. "Amongst all the children in the study, we then identified which children had been diagnosed with a form of autism by looking at hospital records indicating diagnosed childhood autism, atypical autism, Asperger's syndrome, or a pervasive developmental disorder. Finally, we looked for a statistical association between the two groups, and found a very significant one: an 87% increased risk." 

The findings are hugely important as six to ten percent of pregnant women are currently being treated for depression with antidepressants. In the current study, 1,054 children were diagnosed with autism (0.72% of the children in the study), on average at 4.5 years of age. Moreover, the prevalence of autism amongst children has increased from 4 in 10,000 children in 1966 to 100 in 10,000 today. While that increase can be attributed to both better detection and widening criteria for diagnosis, researchers believe that environmental factors are also playing a part.

"It is biologically plausible that anti-depressants are causing autism if used at the time of brain development in the womb, as serotonin is involved in numerous pre- and postnatal developmental processes, including cell division, the migration of neuros, cell differentiation and synaptogenesis - the creation of links between brain cells," Prof. Bérard explained. "Some classes of anti-depressants work by inhibiting serotonin (SSRIs and some other antidepressant classes), which will have a negative impact on the ability of the brain to fully develop and adapt in-utero".

Published on Leave a comment on Early Pesticide Exposure Linked to Poorer Lung Function

 Just a few years ago the type of pesticide (organophosphate, for example chlorpyrifos) looked at in this study was commonly used everywhere - in schools, homes, agriculture. It was easy to buy in stores (e.g., Raid spray), and was considered "safer" than older pesticides. Over time problem after problem has been found with them - with the latest being decreased lung function in children exposed to organophosphates early in life.

Keep in mind that with all current pesticides we know very little about long-term effects, especially on developing fetuses and children, and so we should be very, very careful about using them and avoid unnecessary use. Yes, that means using them for harmless lawn weeds is an unnecessary use. Common lawn weeds can not give a person cancer, birth defects, health problems, or illnesses, but pesticides can. From Medical Xpress:

Weaker breaths in kids linked to early pesticide exposure

Taking a deep breath might be a bit harder for children exposed early in life to a widely used class of pesticides in agriculture, according to a new paper by researchers at the University of California, Berkeley. A new study has linked the levels of organophosphate pesticide metabolites in the urine of 279 children living in California's Salinas Valley with decreased lung function. Each tenfold increase in concentrations of organophosphate metabolites was associated with a 159-milliliter decrease in lung function, or about 8 percent less air, on average, when blowing out a candle. The magnitude of this decrease is similar to a child's secondhand smoke exposure from his or her mother.

"Researchers have described breathing problems in agricultural workers who are exposed to these pesticides, but these new findings are about children who live in an agricultural area where the organophosphates are being used," said study senior author Brenda Eskenazi, a professor of epidemiology and of maternal and child health. "This is the first evidence suggesting that children exposed to organophosphates have poorer lung function."

The children were part of the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), a longitudinal study in which the researchers follow children from the time they are in the womb up to adolescence. The researchers collected urine samples five times throughout the children's lives, from age 6 months to 5 years, and measured the levels of organophosphate pesticide metabolites each time. When the children were 7 years old, they were given a spirometry test to measure the amount of air they could exhale.

"The kids in our study with higher pesticide exposure had lower breathing capacity," said study lead author Rachel Raanan, who conducted the research while she was a postdoctoral scholar in Eskenazi's lab. "If the reduced lung function persists into adulthood, it could leave our participants at greater risk of developing respiratory problems like COPD (chronic obstructive pulmonary disease)."

The study did not examine the pathways for the children's exposure to pesticides, but the researchers did recommend that farmworkers remove their work clothes and shoes before entering their homes. They also suggested that when nearby fields are being sprayed with pesticides, children be kept away and, if indoors, windows should be closed. Pesticide exposure can also be reduced by washing fruits and vegetables thoroughly before eating.

The authors noted that although organophosphate pesticides are still widely used, most residential uses of organophosphate pesticides in the United States were phased out in the mid-2000s. In California, use of organophosphates in agriculture has also declined significantly from 6.4 million pounds in 2000, when the study began, to 3.5 million pounds in 2013, the year with the most recent pesticide use data. 

Published on Leave a comment on What is “Seeding” the Microbiomes of Babies Born By C-section?

The mother is an important source of the first microbiome for infants by "seeding" the baby's microbiome - from the vaginal birth and then breastfeeding. However, research finds that infants born by C-section acquire bacteria commonly found on skin (Staphylococcus, Corynebacterium, and Propionibacterium) rather than the bacteria acquired during a vaginal birth.

This study examined the source of the skin-type bacteria found on C-section babies. The researchers analyzed the dust from operating rooms (which they collected right after C-sections) and found that it contains deposits of human skin bacteria and human skin flakes. The researchers point out that "Humans shed up to 37 million bacterial genomes into the environment per hour." Operating rooms are occupied by humans, lack natural ventilation, and even though they are regularly cleaned, the humans using the operating rooms shed bacteria and skin flakes. From Microbiome:

The first microbial environment of infants born by C-section: the operating room microbes

Newborns delivered by C-section acquire human skin microbes just after birth, but the sources remain unknown. We hypothesized that the operating room (OR) environment contains human skin bacteria that could be seeding C-section born infants. To test this hypothesis, we sampled 11 sites in four operating rooms from three hospitals in two cities. Following a C-section procedure, we swabbed OR floors, walls, ventilation grids, armrests, and lamps....The bacterial content of OR (operating room) dust corresponded to human skin bacteria, with dominance of Staphylococcus and Corynebacterium. Diversity of bacteria was the highest in the ventilation grids and walls but was also present on top of the surgery lamps. 

We conclude that the dust from ORs, collected right after a C-section procedure, contains deposits of human skin bacteria. The OR microbiota is the first environment for C-section newborns, and OR microbes might be seeding the microbiome in these babies. 

In the present study, we used 16S rRNA gene sequencing to show that OR dust, collected right after a C-section procedure, contains bacteria similar to human skin microbiota. Previous studies using culture-dependent methods also showed that over 85 % of air samples from ORs had skin-like bacteria which were mostly coagulase-negative staphylococci and Corynebacterium. These airborne skin-bacteria could be from individuals present during C-section but could also be shed by cleaning personnel between operations.

In our study, 30 % of samples failed to yield sufficient DNA sequences to be analyzed. While there are no published data on the microbiota in operating rooms using 16S rRNA gene sequencing, very few bacteria (average 3.3–3.5 CFU/10 cm2) were detected in ORs after regular decontamination using standard culturing methods, consistent with the low sequence numbers in our study.

In addition, we found that the microbiota of OR samples was more similar to human skin microbiota than oral microbiota and that OR dust contains deposits of human skin flakes. These results reveal that while the use of surgical masks has limited effectiveness at curtailing oral microbial shedding, skin flakes from individuals present during C-section and/or from cleaning personnel between operations could be a more influential factor contributing to the structure of OR microbiota.

Our SourceTracker analysis results suggest that the OR microbes could play a role in seeding infants born by C-section. C-section born infants, in particular, may be solely receiving this inoculum, while vaginally born infants have exposure to vaginal bacteria. The results of these further studies could be relevant to the possible effects on the priming of the immune system by skin bacteria from environmental sources as the primordial inoculum seeding the infant microbiome. This might be relevant to the increased risk of immune diseases observed in C-section born infants.

Published on Leave a comment on When Do Football Players Recover From Concussions?

New research showed that eight days after a concussion, the concussed athletes (football players) looked and felt like they had recovered (clinical recovery), but MRIs showed that there were still neurophysiological abnormalities (significant blood flow decrease) in their brains. They did not look at if and when the blood flow returned to normal, but that research also needs to be done.

It is very disturbing to look at both this research and also the finding that the off-season is not enough for high school football players to recover from the repeated hits (not concussions, but sub-concussive hits) that they receive during the football season (Nov. 24, 2015 post). Do student football players really know and understand the dangers to their brains from the repeated hits and also concussions that occur in football? From Medical Xpress:

Reduced blood flow seen in brain after clinical recovery of acute concussion

Some athletes who experience sports-related concussions have reduced blood flow in parts of their brains even after clinical recovery, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA). The results suggest a role for MRI in determining when to allow concussed athletes to return to competition.

Decisions to clear concussed athletes to return to action are typically based on symptoms and cognitive and neurological test results. However, there is increasing evidence that brain abnormalities persist beyond the point of clinical recovery after injury. To find out more, researchers from the Medical College of Wisconsin in Milwaukee studied concussed football players with arterial spin labeling, an advanced MRI method that detects blood flow in the brain.

Dr. Wang and colleagues studied 18 concussed players and 19 non-concussed players. They obtained MRI of the concussed players within 24 hours of the injury and a follow-up MRI eight days after the injury and compared results with those of the non-concussed players. Clinical assessments were obtained for both groups at each time point, as well as at the baseline before the football season.

The concussed players demonstrated significant impairment on clinical assessment at 24 hours post-injury, but returned to baseline levels at eight days. In contrast to clinical manifestation, the concussed players demonstrated a significant blood flow decrease at eight days relative to 24 hours post-injury, while the non-concussed players had no change in cerebral blood flow between the two time points.

"In eight days, the concussed athletes showed clinical recovery," Dr. Wang said. "However, MRI showed that even those in clinical recovery still had neurophysiological abnormalities. Neurons under such a state of physiologic stress function abnormally and may become more susceptible to second injury." "For years, we've relied on what athletes are telling us," Dr. McCrea said. "We need something more objective, and this technology may provide a greater measurement of recovery."