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An interesting possibility - that taking supplements of  a type of vitamin E known as gamma tocopherol may reduce the inflammation of the airways common in asthma patients – eosinophilic inflammation.

Note that these findings were from a preliminary study of 15 people with mild asthma, done by researchers at the Univ. of North Carolina. Now larger and longer studies need to be done, especially to make sure that side-effects and an increased risk for hemorrhagic stroke won't occur with gamma tocopherol, as it does for the other form of vitamin E (alpha tocopherol) commonly found in supplements. From Medical Xpress:

Can asthma be controlled with a vitamin supplement?

The shortness of breath experienced by the nearly 26 million Americans who suffer from asthma is usually the result of inflammation of the airways. People with asthma typically use albuterol for acute attacks and inhaled steroids to limit chronic inflammation. Both medications come with side effects. But what if it was possible to keep asthma under control by changing one's diet or taking a vitamin supplement? It may happen sooner than you think.

Preliminary research results from the UNC School of Medicine indicate that a type of vitamin E known as gamma tocopherol may reduce eosinophilic inflammation – a kind of airway inflammation common in asthma patients. The results were published in the Journal of Allergy & Clinical Immunology.

"We started looking into vitamin E because epidemiologic data suggested that people with high amounts of vitamin E in their diet were less prone to asthma and allergic disease," said Michelle Hernandez, MD, professor of pediatrics and senior author of the study.  There are several different isoforms of vitamin E. The type commonly found in vitamin supplements – alpha tocopherol – has been studied previously, but the results suggested that alpha tocopherol was not particularly effective. Even worse, the alpha isoform seemed to be associated with an increased risk for hemorrhagic stroke.

So UNC researchers took a different tack and asked whether the kind of vitamin E being used might have an effect on the outcome. They began looking more closely at gamma tocopherol, the type of vitamin E commonly found in a diet rich in nuts and nut oil. .... "While the alpha isoform does have antioxidant activities, gamma tocopherol has both an antioxidant and a very unique anti-inflammatory action as well," she said "That anti-inflammatory effect is what we think made the difference in this study."

Participants in the study were randomized into two groups that received either gamma tocopherol supplement or a placebo for two weeks. At the end of that period, they were asked to cough up sputum..... After a three week "washout period" where they took nothing, subjects were placed in the other group: if they took the supplement for the first two weeks, they took a placebo for the second period.

"The advantage of a cross-over design like this is that we are able to compare the subjects to themselves," said Burbank. "And what we found is that when people were taking the vitamin E supplement, they had less eosinophilic inflammation." In addition to decreased inflammation, those who were taking vitamin E were also found to have lower levels of proteins called mucins, which affect the stickiness of mucus. Mucins are often elevated in asthmatics.

The following study was done in England, but the results should be taken seriously and may (probably) apply to the US also - painted and enameled glassware ("externally decorated glassware") may contain high levels of lead and cadmium. The researchers found that more than 70% of the products (52 out of 72) tested positive for lead, and the metal was found in all colors, including the decorated gold leaf of some items. A similar number (51 out of 72) tested positive for cadmium, with the highest concentrations usually encountered in red enamel.

They found this in products manufactured both in Europe and China - which is why I think the results apply to painted or decorated glassware in the USA also. It probably also applies to some (many?) painted ceramics. So beware!  If you use painted or enameled glassware, you are at increased risk for ingesting lead and cadmium, both of which are linked to health problems - especially for developing fetuses and children. The best safe level of each is zero. The researchers mention that there are newer alternatives that are safe (lead and cadmium free). From Science Daily:

Drinking glasses can contain potentially harmful levels of lead and cadmium

Enameled drinking glasses and popular merchandise can contain potentially toxic levels of lead and cadmium, a study has shown. Researchers at the University of Plymouth carried out 197 tests on 72 new and second-hand drinking glass products, including tumblers, beer and wine glasses, and jars.

They found lead present in 139 cases and cadmium in 134, both on the surface of the glasses and, in some cases, on the rims, with concentrations of lead sometimes more than 1000 times higher than the limit level. Tests showed that flakes of paint often came away from the glass under when simulating sustained use, indicating the substances could be ingested over a prolonged period.

The study, published in Science of the Total Environment, analysed a range of glassware using portable x-ray fluorescence (XRF) spectrometryMore than 70% of the products (52 out of 72) tested positive for lead, and the metal was found in all recorded colours, including the decorated gold leaf of some items. A similar number (51 out of 72) tested positive for cadmium, with the highest concentrations usually encountered in red enamel.

The lead concentrations ranged from about 40 to 400,000 parts per million (ppm), while quantities of cadmium ranged from about 300 to 70,000 ppm. According to the US Office of Environmental Health Hazard Assessment, the limit levels for the externally decorated lip area of drinking glass are 200 ppm and 800 ppm respectively.

In the research, Dr Turner highlights that the Federation of European Screen Printers Associations says organic inks are becoming more popular than metallic pigments because of environmental concerns, and that such inks were evident on a number of newly-purchased products which proved negative for lead and cadmium.

He also says that additional analyses confirmed that hazardous elements are also used to decorate a wider range of consumer glassware that has the potential to be in contact with food, including the exteriors of bottles for the storage of beer, wine or spirits, the external text and logos on egg cups, jugs and measuring cups, and the undersides of coasters and chopping boards. "Given that safer alternatives are available to the industry, the overall results of this study are both surprising and concerning," Dr Turner added. "Why are harmful or restricted elements still being employed so commonly to decorate contemporary glassware manufactured in China, the European Union and elsewhere? " [Original study.]

The following is a nice article about a recently published study finding a link between some bacteria commonly found in the mouth and inflammatory bowel diseases (IBD). The researchers found that some strains of oral bacteria are also found in the gut of people with inflammatory bowel diseases.

They theorize that these bacteria make it down to the gut when saliva is swallowed - and for susceptible people this may trigger inflammatory disease. They did a number of experiments to determine that the antibiotic-resistant, inflammation causing species of Klebsiella pneumoniae and Klebsiella aeromobilis could be triggering IBD. These bacteria are able to replace normal colon microbes after antibiotic therapy.

However, it must be noted that other studies also find other microbial differences among those with IBD and healthy people - e.g. low or absent levels of Faecalibacterium prausnitzii, and even fungal and viral differences. From Harvard Magazine:

Gut Health May Begin in the Mouth

Chronic gastrointestinal problems may begin with what is in a patient’s mouth. In a study published Thursday in Science, an international team of researchers—including one from Harvard—reported on strains of oral bacteria that, when swallowed in the 1.5 liters of saliva that people ingest every day, can lodge in the gut and trigger inflammatory bowel conditions like Crohn’s disease and ulcerative colitis.

“For some time now, we’ve noticed that when we look at the microbiome of patients with inflammatory bowel disease, or IBD, we’ve found microbes there that normally reside in the oral cavity,” says study co-author Ramnik Xavier, chief of gastroenterology at Massachusetts General Hospital (MGH)....

Simultaneously, “There’s always been this other search, asking, ‘Are there pathobionts?’”—in other words, microbes that live innocuously in one part of the body but can turn pathogenic when moved to another. “For some time we have been looking for pathobiont organisms for Crohn’s and colitis.”

The researchers believe they have found them: two strains of Klebsiella bacteria, microbes commonly found in the mouth. ....the researchers pinpointed a strain of Klebsiella pneumoniae as the trigger for the immune response. A subsequent experiment using samples from two ulcerative colitis patients turned up another inflammation-causing strain, of Klebsiella aeromobilis

Checking databases of thousands of IBD patients at MGH and the Hospital of the University of Pennsylvania, Xavier and others found that people with inflammatory bowel conditions had significantly more Klebsiella bacteria in their gut microbiome than healthy patients did. Most likely, he explains, oral bacteria, including Klebsiella, traffics through everyone’s gut in the saliva we swallow. Usually it passes through harmlessly; but in people with a genetic susceptibility to IBD that alters the gut microbiome, the Klebsiella has a chance to take hold in the intestine and proliferate, inducing an immune response that causes the disease. 

And there is another twist: Klebsiella bacteria are often extremely resistant to multiple antibiotics. That explains, Xavier says, “why antibiotics have limited value in treating patients with Crohn’s disease and ulcerative colitis....  “Because we also showed in a 2014 paper that patients who took antibiotics—and this has been seen in the old clinical data accumulated before the microbiome was even examined in IBD—that patients who took antibiotics early in the disease had more complicated outcomes.” 

Klebsiella  pneumoniae Credit: Wikipedia

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Another interesting theory about dyslexia, as well as a great treatment possibility. It is unknown if the study results will hold up with more research (after all, only 60 people were in the study - 30 with dyslexia and 30 without), and whether their suggested treatment really works for larger groups of dyslexics. But what if it helps?

Their main finding is that those who don't have dyslexia have  "asymmetry" in the light-receptor cells in the center of the eye, while dyslexics have symmetry which leads to the brain producing confusing mirror images of letters (e.g."b" and "d"). The researchers conclude that: "the lack of asymmetry might be the biological and anatomical basis of reading and spelling disabilities in people with a normal ocular status but with dyslexia". They found that a flashing LED lamp ("pulse-width modulation light-emitting diode") suppressed the mirror images in those with dyslexia and they could read normally ("restores reading skills"). So this research is definitely worth following. From Medical Xpress:

Scientists may have found a cause of dyslexia

A duo of French scientists said Wednesday they may have found a physiological, and seemingly treatable, cause for dyslexia hidden in tiny light-receptor cells in the human eye. In people with the reading disability, the cells were arranged in matching patterns in both eyes, which may be to blame for confusing the brain by producing "mirror" images, the co-authors wrote in the journal Proceedings of the Royal Society B. In non-dyslexic people, the cells are arranged asymmetrically, allowing signals from the one eye to be overridden by the other to create a single image in the brain.

It offers a "relatively simple" method of diagnosis, he added, by simply looking into a subject's eyes. Furthermore, "the discovery of a delay (of about 10 thousandths of a second) between the primary image and the mirror image in the opposing hemispheres of the brain, allowed us to develop a method to erase the mirror image that is so confusing for dyslexic people"—using an LED lamp.

Like being left- or right-handed, human beings also have a dominant eye. As most of us have two eyes, which record slightly different versions of the same image, the brain has to select one of the two, creating a "non-symmetry." Many more people are right-eyed than left, and the dominant eye has more neural connections to the brain than the weaker one. Image signals are captured with rods and cones in the eye—the cones being responsible for colour. The majority of cones, which come in red, green and blue variants, are found in a small spot at the centre of the cornea of the eye known as the fovea. But there is a small hole (about 0.1-0.15 millimetres in diameter) with no blue cones.

In the new study, Ropars and colleague Albert le Floch spotted a major difference between the arrangement of cones between the eyes of dyslexic and non-dyslexic people enrolled in an experiment. In non-dyslexic people, the blue cone-free spot in one eye—the dominant one, was round and in the other eye unevenly shaped. In dyslexic people, both eyes have the same, round spot, which translates into neither eye being dominant, they found.

Dyslexic people make so-called "mirror errors" in reading, for example confusing the letters "b" and "d". ....The team used an LED lamp, flashing so fast that it is invisible to the naked eye, to "cancel" one of the images in the brains of dyslexic trial participants while reading. In initial experiments, dyslexic study participants called it the "magic lamp," said Ropars, but further tests are required to confirm the technique really works. [Original study.]

 

Cross-section of the human eye. Credit: Wikipedia

Dr. John Mandrola again has a great blog post over at his site and at Medscape. The post is about how employed doctors nowadays are evaluated by a "measure of productivity" - called the relative value unit or RVU. This means one gets a higher score of productivity from the number of procedures done on patients, rather than listening and counseling patients, or reading medical studies or doing medical research.

Which is the opposite of how medical care should be. Also look at the comments after the post. From Dr. John M:

A Corrosive Force in Medical Care

It comes in a large white envelope each month. It’s marked confidential. When I hold it up to the light, I can see through the envelope. I can’t see the details, but the colored graphs give it away. It’s my monthly productivity report. Most employed doctors get these graphs.

These “dashboards” of value include your own productivity as well as many graphs on how you stack up with other doctors across the country. It shows your employer if you are a hard worker. The measure of productivity we use is called the relative value unit or RVU.

Doing an ablation, cath, stent or valve replacement earns a bunch of RVUs. Listening to patients, examining patients, counseling patients, hugging patients earns very few RVUs. Doing important research, teaching colleagues, and reading the medical evidence earns zero RVUs.

Too often, in too many medical systems, RVUs have become the primary unit of success. No, you can’t be a mean and nasty doctor. And no, you can’t be a totally unskilled doctor who has too many complications. But short of those extremes, if you make few waves, have good templates on your electronic health record so documentation is complete, and do tons of procedures, you are valuable.

If, on the other hand, you like slow conservative medicine, or narrative notes rather than templates, or worse, if you are thoughtful and frank about silly policies, you become an outlier. If you do these things, your RVU tally usually does not reach the 75% of standard. Then trouble can come to you.

What’s really scary, though, is that this is the milieu in which a younger generation is learning the craft. I was shocked to learn that a major teaching center (will remain nameless) has its teaching faculty on 100% productivity compensation. Imagine that. Teachers of young people whose paychecks are determined by how many RVUs they generate. This, my friends, is happening in many of the places you go to get health care.... Productivity and the RVU has no place in medical care. There needs to be a different system of valuing the care of people with disease.

Image result for chlamydia wikipediaThe annual Sexually Transmitted Disease Surveillance Report was released today by the US Centers for Disease Control and Prevention (CDC) and the news wasn't good. More than two million cases of chlamydia, gonorrhea and syphilis were reported in the United States in 2016 - the highest number ever. But the CDC acknowledges that the actual numbers are far higher - that most cases of STDs are not reported to the CDC. The CDC estimates that there are actually 20 million new STDs in the U.S. each year, including other sexually transmitted diseases such as genital herpes and human papillomavirus, and half of these are among young people ages 15 to 24 years.

The report discusses the four STDs (sexually transmitted diseases) that are reported to the CDC. The 4th one is chancroid, but there were only 7 cases reported last year. Most of the new cases of STDs involved chlamydia, a bacterial infection that affects both men and women - about 1.6 million cases were reported to the CDC. Gonorrhea also increased among men and women last year, but the steepest rise was among men, especially among men who have sex with men (MSM). The CDC is especially concerned about the threat of gonorrhea becoming resistant to all treatments. Untreated STDs have serious health consequences (e.g. infertility, still-birth in infants)

This report stresses the need for STD screening and treatment, especially among pregnant women (make it part of prenatal care). There is also a need for STD education, and greater use of condoms to reduce risk of STDs. The CDC has a page on STD prevention (practice abstinence, use condoms, have fewer sexual partners and exclusive relationships, get the HPV vaccine, and talk with your partner about safe sex).  Excerpts from CDC:

STDs at record high, indicating urgent need for prevention

More than two million cases of chlamydia, gonorrhea and syphilis were reported in the United States in 2016, the highest number ever, according to the annual Sexually Transmitted Disease Surveillance Report released today by the Centers for Disease Control and Prevention (CDC).

The majority of these new diagnoses (1.6 million) were cases of chlamydia. There were also 470,000 gonorrhea cases and almost 28,000 cases of primary and secondary syphilis – the most infectious stages of the disease. While all three of these STDs can be cured with antibiotics, if left undiagnosed and untreated, they can have serious health consequences, including infertility, life-threatening ectopic pregnancy, stillbirth in infants, and increased risk for HIV transmission.

While young women continue to bear the greatest burden of chlamydia (nearly half of all diagnosed infections), surges in syphilis and gonorrhea are increasingly affecting new populations.

Syphilis rates increased by nearly 18 percent overall from 2015 to 2016. The majority of these cases occur among men – especially gay, bisexual and other men who have sex with men (MSM) – however, there was a 36 percent increase in rates of syphilis among women, and a 28 percent increase in syphilis among newborns (congenital syphilis) during this period. More than 600 cases of congenital syphilis were reported in 2016, which has resulted in more than 40 deaths and severe health complications among newborns. The disease is preventable through routine screening and timely treatment for syphilis among pregnant women.

While gonorrhea increased among men and women in 2016, the steepest increases were seen among men (22 percent). Research suggests that a large share of new gonorrhea cases are occurring among MSM. These trends are particularly alarming in light of the growing threat of drug resistance to the last remaining recommended gonorrhea treatment.

Image result for chlamydia wikipedia Chlamydia trachomatis (chlamydia) - in brown. Credit: Wikipedia

This is part 2 of posts about tiny particles of plastic (microfibers) in our water - which is a form of water pollution. These plastic fibers are smaller than 5 mm, and are found in water (drinking water, rivers, oceans) throughout the world. An investigative study by Orb Media (done by research scientists) took numerous drinking water samples from more than a dozen nations and analyzed them. They found that 83% of drinking water samples worldwide, and 94% of drinking water samples taken in the US (which included tap water from Congressional buildings, the US Environmental Protection Agency’s headquarters, Trump Tower in New York, and bottled waters) contained plastic microfibers.

The last post discussed  research finding plastic microfibers in rivers, and how they are now found in fish and shellfish - and so eventually in us (we eat fish and shellfish, don't we?). The plastic microfibers are in our food chain, and there is tremendous concern over what that is doing to wildlife and to us, especially as the microfibers accumulate. Well, we also now know that the plastic microfibers are found in drinking water, are in the air, and can be found in foods tested (even beer).

So what are these plastic microfibers doing to us? And how can we reduce the number of microfibers being released into the air? The Orb Media site discusses sources of plastic microfibers in the environment (from clothes being washed, tire dust, paint dust, etc.) to how we personally can generate fewer plastic microfibers (try not to use plastic bags or straws, etc.). Excerpts from The Guardian:

Plastic fibres found in tap water around the world, study reveals

Microplastic contamination has been found in tap water in countries around the world, leading to calls from scientists for urgent research on the implications for health. Scores of tap water samples from more than a dozen nations were analysed by scientists for an investigation by Orb Media, who shared the findings with the Guardian. Overall, 83% of the samples were contaminated with plastic fibres.

The US had the highest contamination rate, at 94%, with plastic fibres found in tap water sampled at sites including Congress buildings, the US Environmental Protection Agency’s headquarters, and Trump Tower in New York. Lebanon and India had the next highest rates. European nations including the UK, Germany and France had the lowest contamination rate, but this was still 72%. The average number of fibres found in each 500ml sample ranged from 4.8 in the US to 1.9 in Europe.

The new analyses indicate the ubiquitous extent of microplastic contamination in the global environment. Previous work has been largely focused on plastic pollution in the oceans, which suggests people are eating microplastics via contaminated seafood. “We have enough data from looking at wildlife, and the impacts that it’s having on wildlife, to be concerned,” said Dr Sherri Mason, a microplastic expert at the State University of New York in Fredonia, who supervised the analyses for Orb. “If it’s impacting [wildlife], then how do we think that it’s not going to somehow impact us?”

Mahon said there were two principal concerns: very small plastic particles and the chemicals or pathogens that microplastics can harbour. “If the fibres are there, it is possible that the nanoparticles are there too that we can’t measure,” she said. “Once they are in the nanometre range they can really penetrate a cell and that means they can penetrate organs, and that would be worrying.” The Orb analyses caught particles of more than 2.5 microns in size, 2,500 times bigger than a nanometre. [NOTE: This means they were not able to test for smaller sizes.]

The scale of global microplastic contamination is only starting to become clear, with studies in Germany finding fibres and fragments in all of the 24 beer brands they tested, as well as in honey and sugar. In Paris in 2015, researchers discovered microplastic falling from the air, which they estimated deposits three to 10 tonnes of fibres on the city each year, and that it was also present in the air in people’s homes.

How microplastics end up in drinking water is for now a mystery, but the atmosphere is one obvious source, with fibres shed by the everyday wear and tear of clothes and carpets. Tumble dryers are another potential source, with almost 80% of US households having dryers that usually vent to the open air. “We really think that the lakes [and other water bodies] can be contaminated by cumulative atmospheric inputs,” said Johnny Gasperi, at the University Paris-Est Créteil, who did the Paris studies. “What we observed in Paris tends to demonstrate that a huge amount of fibres are present in atmospheric fallout.”.... Plastic fibres may also be flushed into water systems, with a recent study finding that each cycle of a washing machine could release 700,000 fibres into the environment. Rains could also sweep up microplastic pollution, which could explain why the household wells used in Indonesia were found to be contaminated. 

Microfibers found in the Hudson River. Credit: PBS News Hour, Sara Cathey, Adventure Scientists

You may not think of your clothes as pollutants, but tiny plastic fibers from synthetic textiles (microfibers) are big contributors to water pollution. Clothes and fabrics made with synthetic fibers are using plastic fibers (e.g. polyester, nylon, acrylic, fleece and athletic clothing). When they are washed, they break apart in the washing machine, and so get into the wastewater system, and eventually into our rivers and oceans.

These microplastic particles are smaller than 5 mm. One 2011 study found that "Experiments sampling wastewater from domestic washing machines demonstrated that a single garment can produce greater than 1900 fibers per wash" (which then goes directly into wastewater). And while a 2017 study didn't examine sources of microfibers (air, rain, water treatment plants, etc) found in numerous Hudson River water samples, the researchers estimate that the entire Hudson River dumps 300 million human-made fibers into the Atlantic Ocean each day. Wow.

In the past few weeks a number of articles and studies have been published about these small plastic pieces (microfibers) that are found in our water - yes, in our drinking water, as well as our rivers, seas, and oceans. Which eventually get into birds, fish and shellfish - and so eventually into us. So the microfibers are in our food chain. There is tremendous concern over what that is doing to wildlife and to us, especially as the microfibers accumulate. We all use plastics every day and most of us wear clothing made of plastic fibers (synthetic fibers), and we're not about to stop. (NOTE: No matter what fabrics we wear, our clothing also sheds fibers into the air, so we leave a trail of fibers behind us, including at crime scenes. Synthetic and natural materials - such as cotton and wool, both shed.)

The big questions: Can anything be done to stop this water pollution? And what is it doing to us and wildlife? Today I am posting links to these stories because it is of concern to all of us and to future generations, and we need to think about and address this issue.

Excerpts from PBS News Hour: This New York river dumps millions of fabric microfibers into the ocean daily

The faded, “distressed look” of a favorite pair of blue jeans, may come with a hidden price for the residents of New York. The Hudson River dumps 300 million clothing fibers into the Atlantic Ocean each day, according to a recent study in the Marine Pollution Bulletin. Many of the fibers come from aging clothes, rinsed out with the laundry and into the environment. Approximately half of the fibers were plastic, while the remainder were spun from natural materials like cotton or wool. Invisible to the naked eye, these fibers can cause health problems for animals and humans.

Barrows, who has been studying microfiber pollution in oceans for more than five years, wanted to learn more about what’s happening upstream in freshwater. So last year, Barrows and a team of scientists and volunteers measured microfiber pollution across all 13,300 miles of the Hudson river..... The team found about one microfiber per liter of water, which seems small until you consider the sheer volume of the Hudson River. An average-sized, above-ground swimming pool filled with this water would contain about 10,800 microfibers, and the entire Hudson River dumps 300 million human-made fibers into the Atlantic Ocean each day. [Original Hudson River study.]

If wastewater treatment facilities are not the major culprit, people may want to look their everyday clothes. Fabrics cast off tiny threads at every stage of their life. Even crime scene investigators count on perpetrators leaving behind bits of clothing. “We are just not conscious of it,” Carr said. “It’s invisible, but everywhere you go and everywhere I go, we are leaving a trail of fibers in our wake.”

Pollutants and other fine particles can hang in the air and travel great distances, said George Thurston, who studies the health effects of air pollution at New York School of Medicine. These airborne fibers can also be toxic. During the industrial revolution, byssinosis or brown lung disease, befell textile plant workers due to cotton or other fibers in the factory’s air. But Thurston said more research is needed to ascertain how microfibers get around.

Microfibers found in the Hudson River. Credit: PBS News Hour, Sara Cathey, Adventure Scientists

 

 

An interesting article that describes the difficulty of capturing tiny plastic microfibers at sewage and water treatment plants in Minnesota. From MPR News: Microplastics could pose big treatment challenges

So-called microplastics are tiny — less than 5 millimeters across. They can come from litter or plastic bags that break down over time. ...."These small little threads, they find their way into the wastewater treatment system and then, into our aquatic environment."

Austin Baldwin, a hydrologist with the U.S. Geological Survey, studied the St. Croix, Namekagon and Mississippi rivers in 2015. The results were published earlier this year in a brief issued by the National Park Service. Baldwin's team found microplastics in all of the samples they took of water, sediment, fish and mussels. The level of concentration was surprising: They found as many as 111 microscopic pieces of plastic in a single fish. Scientists worry that microplastics might clog the digestive systems of fish and make them feel full, so they end up starving. Baldwin said there need to be more study of the biological impacts.

Microplastic fibers in the wastewater are so small they slip through filters and screens designed to capture larger particles. Hoellin's team sampled Chicago rivers and found higher concentrations of microplastics downstream of sewer plants. "What I've seen is that some wastewater treatment plants are really effective at retaining 99 percent of the microplastic that comes in as raw sewage," Hoellin said. "But even that 1 percent, when it's added up on a daily, yearly basis, is amounting to a lot of plastic pollution." Hoellin noted there's no legal requirement for wastewater plants to treat for microplastics. "

By the time the treated wastewater is discharged into the Mississippi River, Rogacki [Larry Rogacki, assistant general manager of the Metropolitan Wastewater Treatment Plant in St. Paul, MN] estimates that 96-98 percent of all microplastics have been removed. Retrofitting the plant to eliminate 100 percent of microplastics would require installing sand filters that could capture smaller particles, he said. It would be costly — close to $1 billion. ....What scientists say might be more effective — and less expensive — is to figure out how to keep plastic out of the wastewater stream in the first place.

Tattoos are very popular these days, with about 29% of Americans having one or more. But there also is concern because so little is known about tattoo inks and any health effects on the body, and because adverse effects (e.g. inflammatory reactions) can occur months or years later. One study of 300 people in New York City with tattoos found that 10.3% reported experiencing an adverse tattoo reaction, of which 6% reported suffering from a chronic reaction from a specific color (especially red and black ink) that lasted for more than 4 months.

Now a new study in the journal Scientific Reports reports that microscopic particles from tattoo inks can migrate into the body and wind up in the lymph nodes of the immune system. Most tattoo inks contain particles of varying sizes - with some being very small nanoparticles. The researchers analyzed the skin and lymph nodes of 4 tattooed corpses and 2 corpses with no tattoos. They found the presence of several toxic elements such as nickel, chromium, cadmium, aluminum from the colorful tattoo inks. They found tattoo pigment particles in the skin, and that smaller ink nanoparticles had traveled to the lymph nodes - which leads to chronic enlargement of those lymph nodes, as well as lifelong exposure. From Science Daily:

Nanoparticles from tattoos travel inside the body, scientists find

The elements that make up the ink in tattoos travel inside the body in micro and nanoparticle forms and reach the lymph nodes according to a study published in Scientific Reports on 12 September by scientists from Germany and the ESRF, the European Synchrotron, Grenoble (France). 

The reality is that little is known about the potential impurities in the colour mixture applied to the skin. Most tattoo inks contain organic pigments, but also include preservatives and contaminants like nickel, chromium, manganese or cobalt. Besides carbon black, the second most common ingredient used in tattoo inks is titanium dioxide (TiO2), a white pigment usually applied to create certain shades when mixed with colorants. TiO2 is also commonly used in food additives, sun screens, paints. Delayed healing, along with skin elevation and itching, are often associated with white tattoos, and by consequence with the use of TiO2. 

"We already knew that pigments from tattoos would travel to the lymph nodes because of visual evidence: the lymph nodes become tinted with the colour of the tattoo. It is the response of the body to clean the site of entrance of the tattoo. What we didn't know is that they do it in a nano form, which implies that they may not have the same behaviour as the particles at a micro level. And that is the problem: we don't know how nanoparticles react," explains Bernhard Hesse, one of the two first authors of the study and ESRF visiting scientist.

X-ray fluorescence measurements on ID21 allowed the team to locate titanium dioxide at the micro and nano range in the skin and the lymphatic environment. They found a broad range of particles with up to several micrometres in size in human skin but only smaller (nano) particles transported to the lymph nodes. This may lead to the chronic enlargement of the lymph node and lifelong exposure [Original study.]

Image result for thunderstorm wikipediaThunderstorm asthma? This is an asthma attack triggered by a thunderstorm - it is still relatively rare, but predicted to increase with the coming climate changes. During thunderstorms there are downdrafts of cold air which sweep up particles of pollens and mold spores into the clouds. There they absorb moisture and rupture into small, fragments (into a size easily inhaled into the lungs), which then are dispersed by rain and wind. When inhaled they  can enter the lungs and trigger an asthma attack - thunderstorm asthma. [Note that normally larger pollen grains are usually filtered by hairs in the nose - so they don't make it to the lungs.] It seems that people with "hayfever" and allergies to grass pollen are at highest risk - at least in Australia. From Medscape:

Thunderstorm Asthma on the Rise

For seasonal allergy sufferers, rain is usually thought of as a friend—it washes the pollen out of the air. However, there are circumstances in which a particular type of wet weather event can make things much worse: thunderstorms. Asthma epidemics have occurred under such circumstances and have affected patients who have never exhibited asthmatic symptoms before. The most recent severe episode occurred in Melbourne, Australia, in 2016, with 8500 emergency asthma visits and nine deaths.[1]

Recently in the Journal of Allergy and Clinical Immunology, Dr Gennaro D'Amato and colleagues[1] explored the nature of this phenomenon and implications for the future. The authors point out that although rare, these events are expected to occur more often with anticipated climate change. According to the authors, the evidence for this so far is limited to pollen and outdoor mold seasons—but even in the northeastern United States, that is about three quarters of the year.

Pollen grains are large (up to 35 µm in diameter)[2] and usually do not make their way down to the bronchial tree. During a thunderstorm, however, these grains are swept up by a dry updraft, ruptured by high humidity at the cloud base, then forced down by cold air. These smaller grains contains allergens of the just the right size (< 3 µm) to reach the bronchial tree, resulting in asthma symptoms in patients with allergic rhinitis who perhaps have never exhibited asthma before.

The first reported case of thunderstorm asthma was in the United Kingdom in 1983. Since then it has happened in Australia, Canada, the United Kingdom (Alternaria species), the United States, and Italy (olive and Parietaria pollens). Evidence for the role of the Parietaria pollen in the outbreak in Naples, Italy, was supported by high levels of the pollen grains as opposed to low levels of measured particulates and pollutants, including ozone and nitric oxide.

Certainly, people who are sensitized to the relevant allergens are at risk. Beyond that, we can presume that patients who already have poorly controlled asthma or more bronchial hyperresponsiveness would be at risk, as would patients who have other concurrent risk factors for allergic asthma (such as rhinovirus infection).