Tag Archives: Cdiff reasearch

Medicine, Like All Science, Is Dynamic and Forever Evolving and Why It Is Regarded As “The Practice Of Medicine.”

Medicine, like all science, is dynamic and evolving—that’s why it is referred to as “the practice of medicine.”

Accepted treatments of one era might be discarded later as “pseudoscience.” What is considered “experimental” today might become the standard of treatment tomorrow.

Fortunately, there is something called peer review and scientific standards. Also, most health care providers have embraced the process of gathering as much evidence as possible instead of treating patients like lab rats.

There is no safe substitute for the intimate, one-on-one relationship between a patient and a physician. This will continue to be true as long as doctors remember that medicine is a science and an art, full of both expected outcomes and surprising solutions.

The phrase “Nine out of 10 doctors recommend…” is often used to promote widely accepted treatments, so that one outlier doctor must be responsible for all the rather wacky treatments that we other physicians get asked about every week. And although some of these treatments seem beyond bizarre, they can also be incredibly interesting.

At least they were to the three physicians listed in this article’s byline, including
Dr. H. Eric Bender, who says his fascination with peculiar medical practices started in medical school. During one of his early rotations, he was shocked to learn that not only could he order leeches for a patient in the hospital but he could specify where they were to be placed as well: left leg, right arm or whole body. (In case you’re wondering, to precisely “aim” a leech, place it in a small cup with a very small hole cut in the bottom. That hole is then aligned with the area on the patient requiring blood removal and voilà! Bloodthirsty segmented worms are suddenly hard at work.
(Dr. Bender does not recommend trying this at home.)

Now, thanks to our internet-sparked society of do-it-yourselfers, Bender’s fascination with the unconventional cure has continued to grow as he has contemplated conversations with his patients and researched a wide range of (seemingly) ridiculous but sometimes effective remedies.
“Unfortunately, the physician’s oath to “do no harm” has been replaced in many
clinics with “do clean up this mess.”

For example, a physician or two in the not so distant past recommended that children smoke tobacco to treat pica, a condition in which people feel compelled to chew on non-nutritious substances like rocks, sand or glass. Some doctors over the years suggested that patients use cocaine and heroin to remedy toothaches and persistent cough, respectively. (In addition to references, the book includes pictures as evidence.) Alcohol has been recommended to pregnant women for its health benefits—Guinness beer is rich in iron—and not just by Irish physicians. Others practicing medicine have suggested using hookworms to cure asthma (causing dangerous infections).

The list of dangerous substances, organisms and animal byproducts that people have used over the years to treat everything from low libido to sexually transmitted diseases goes on and on. Fortunately, most of the practices did not, as further research demonstrated the dangers of many of them.

“Weird medicine” is not limited to just medical practices and treatments. A look into the medical literature reveals that it is replete with research and studies that aren’t particularly well-designed or are far-fetched to the point of absurdity.

Some fascinating practices seemed like terrible ideas but are actually so well-supported by research that they are considered the gold standard for treatment of certain illnesses.

As an example, consider that antibiotics frequently kill good bacteria while also killing the bad bacteria doctors are trying to eliminate.

“Good” bacteria suppress the growth of bad bacteria. So when the good bacteria are wiped out, many individuals develop a type of intestinal infection known as Clostridium difficile
(or C. diff
). C. diff is often difficult to treat with antibiotics, since they typically caused the problem in the first place. Fortunately, one treatment has a  high rate of s
uccess: fecal transplantation. Yes, you read that correctly. Doctors place stool from a donor inside the patient’s gastrointestinal system. Intuitively, you might think putting my feces into your gut would cause serious infections, but the donated good bacteria help eradicate infection.

To learn more about FMT:  https://cdifffoundation.org/2016/03/02/fecal-transplants-fmt-treating-clostridium-difficile-infections-u-s-food-and-drug-administration-fda-seeks-comment-on-what-investigational-new-drug-ind-requirements-to-waive/

IHow about maggots instead? Maggot therapy involves using those little legless larvae to prevent a wound infection. Maggots selectively target and eat dead tissue that is difficult to remove surgically without taking healthy tissue with it. Although doctors have been aware of this fact since at least the 1930s, this treatment was not regularly used for decades, particularly as antibiotic use to treat and manage wounds rose in popularity. However, after a recent “rediscovery” of maggot therapy, more than 800 health care institutions use it today. You can be sure pharmaceutical companies are already working on a way to charge exorbitant prices for the little larvae.

Patients performing their own research online can spark informative conversations with their doctors, even if they do sometimes suggest things that make a person want to scream, or puke.

Nevertheless, although “Dr. Google” is punctual and doesn’t require a co-pay, it is still not qualified to diagnose and treat.

There is no safe substitute for the intimate, one-on-one relationship between a patient and a physician. This will continue to be true as long as doctors remember that medicine is a science and an art, full of both expected outcomes and surprising solutions.

So to our patients: Be wary of charlatans but keep an open mind. Bring all your questions to a physician and ask away. To our fellow physicians: Listen to your patients. Talk with them, not to them. And remember: If you can’t do any good, at least do no harm.

 

H. Eric Bender, Murdoc Khaleghi and Bobby Singh are the authors of 1 Out of 10 Doctors Recommends: Drinking Urine, Eating Worms, and Other Weird Cures, Cases, and Research from the Annals of Medicine.

 

To read this article in its entirety, click on the link below:

http://www.newsweek.com/2016/08/26/weird-medicine-doctor-google-pseudoscience-491240.html

Researchers at MGGen Are Part Of a Community Study In Flagstaff, AZ On Two Serious Infection-Causing Bacteria; Clostridium difficile and Staphylococcus aureus

RESEARCH

RESEARCH

Researchers at Northern Arizona University’s Center for Microbial Genetics and Genomics, or MGGen, are putting out a call for poop.

The request is part of a community study on two nasty infection-causing bacteria in order to identify how the bugs are being carried around Flagstaff,  AZ and how they are making their way into the hospital.

The researchers say the pathogens could be present on any number of things, from dogs to ground meat to humans themselves.

It is hoped that confirming those reservoirs and tracking how the bacteria are transmitted will lead to new recommendations for how people and hospitals can better prevent the infections, the researchers said.

DNA MAPPING

The two bacteria, Clostridium difficile, or C. diff, and Staphylococcus aureus, or Staph, are important to study because they are notorious for causing hospital-acquired infections that are often difficult to treat.

Staph can cause skin and respiratory infections while symptoms of C. diff infections include diarrhea and fever.

For the research project, MGGen scientists are comparing Staph and C. diff bacteria collected from sick patients at Flagstaff Medical Center to those bacteria carried by healthy people.

Samples of the latter come from volunteers willing to provide a swab from inside their nose and a swab of their fecal material from used toilet tissue. The researchers have received 65 healthy community member samples and their goal is to get 500 by next April.

MGGen’s specialty is whole genome sequencing, which allows scientists to compare even the tiniest genetic variations between the samples. With that, they can tell how closely the samples are related, indicating potential transmission paths.

The study has found:  that the bacteria strains in ill patients don’t match those found in other hospital cases, indicating the organisms aren’t lingering in the hospital and being transmitted from patient to patient but are being acquired by people before they get into the hospital, said Heidie Hornstra O’Neill, research project coordinator at MGGen.

both bacteria species can live on and in healthy people without causing any problems, one possibility is that the pathogen hangs out in people’s bodies without causing any symptoms and then proliferates when the immune systems is weakened.

It could also be that only certain strains of the bacteria cause disease while others do not. About a third of people carry Staph bacteria, for example, but only a small percentage of people get a Staph infection, which could mean only some strains are dangerous, said Paul Keim, lab director at MGGen.

The researchers are collecting demographic information as well to see if a person’s gender, ethnicity or access to healthcare plays a role in whether they carry the bacteria.

SIDEWALK SCANNING

DOG POO SAMPLES:   Another potential source of C. diff bacteria, especially in a place like Flagstaff, is dogs, said Nate Stone, a research specialist at MGGen. Stone searched the sidewalks of Flagstaff for four months in the fall of 2014, collecting samples of dog poop to test them for C. diff. He found the bacteria were present in 17 percent of the 200 samples and half of the strains found are common in human C. diff infections. 

“We don’t know if dogs are giving humans C. diff or humans are giving dogs C. diff, but we do know dogs are carrying C. diff strains that can cause infections in humans, so they are probably one part of the story,” Stone said.

Next up, he’ll use genetic analysis to see if any bacteria from the dog poop samples match human samples, suggesting direct transmission.

Another possible C. diff reservoir is meat, and that’s also on Stone’s future research agenda.

The end goal of providing more data on these infection-causing bacteria is to help everyone from ordinary citizens to medical organizations figure out better ways to prevent them, Stone and Keim said.

“The reservoir stuff is fascinating because we think we can affect the way people live,” Keim said.

 

To read article in its entirety:

http://azdailysun.com/news/local/nau-researchers-track-path-of-infection-causing-bugs/article_3c0e8bc9-b432-5e6d-988e-53eee1e47bd4.html