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Common Painkillers Tied to Kidney Risks for Children: Study

Children taking the common painkillers known as nonsteroidal anti-inflammatory drugs may be at risk for acute kidney damage, particularly when the kids are dehydrated, a new study finds.

Nonsteroidal anti-inflammatory drugs (commonly called NSAIDs), such as ibuprofen (brand names Advil and Motrin), naproxen (Aleve) and ketorolac (Toradol) are used to relieve pain and fever.

“The one thing we did see that seemed to be connected to kidney damage was dehydration,” said lead researcher Dr. Jason Misurac, a nephrologist at Indiana University School of Medicine in Indianapolis.

For the study, which was published in the Jan. 25 online edition of the Journal of Pediatrics, Misurac’s team looked at the medical records of children admitted to Riley Hospital for Children in Indianapolis from 1999 through mid-2010. Over that time, they identified more than 1,000 cases of children being treated for kidney damage.

In nearly 3 percent of the cases, the damage was related to NSAIDs, the study found. Most kids were teens, but four were under 5 years old. All of them had been given NSAIDs before being hospitalized. Since many other cases involved several causes of kidney damage, it is possible some of those also were related to NSAIDs, the researchers said.

Most children who developed kidney damage had been given the recommended dose and had not been taking NSAIDs for more than a week.

In adults, taking NSAIDs regularly for several years has been tied to kidney problems, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. Cases involving children have previously been reported but only rarely.

Misurac noted that most of the children in the study hadn’t been drinking well and also were vomiting and had diarrhea, all of which can lead to dehydration. When someone is dehydrated the kidneys have a way of protecting themselves, which NSAIDs block, resulting in the damage, Misurac explained.

“Certainly in the way NSAIDs affect the kidneys, it’s reasonable to think that dehydration plus an NSAID has more of an effect than just an NSAID by itself,” he said.

Often the signs of kidney problems aren’t apparent, Misurac said. One sign is a decrease in urine; another is stomach pain. “But most kids who have episodes of acute kidney injury have nonspecific symptoms and there’s no one way to tell,” he said.

“If kids are dehydrated and not drinking well, then parents should think twice about using NSAIDs,” Misurac said. Tylenol (acetaminophen), which acts differently than NSAIDs, might be a better choice for children, he said.

For many of the children in the study, the kidney damage was reversed, Misurac said. The damage, however, was permanent for seven patients and they will probably need ongoing monitoring and treatment for declining kidney function, he said.

All the children under age 5 had to undergo dialysis and were more likely to be treated in an intensive-care unit, the researchers said. They also stayed in the hospital longer.

Although the study showed an association between taking NSAIDs and kidney problems in children, it didn’t establish a cause-and-effect relationship.

One expert agreed that NSAIDs can damage the kidneys.

“This is well known. Unfortunately, it is better known among doctors; the public is not as educated regarding this problem,” said Dr. Felix Ramirez-Seijas, director of pediatric nephrology at Miami Children’s Hospital.

Ramirez-Seijas said NSAIDs are “overused and abused, both by doctors and patients.”

For children, most fevers should not be treated; fever is how the body fights infection, he said. “There is a fear of fever that leads to overtreatment,” Ramirez-Seijas said.

In addition, children who take NSAIDs for aches after vigorous exercise also are at risk, because they may be dehydrated, Ramirez-Seijas said.

His advice to parents is to be sure children are well hydrated if they are going take NSAIDs. In addition, he believes that even these over-the-counter drugs should only be used with the advice of a doctor.

“Most people see taking a couple of Advil like taking a sip of water, but it’s not,” Ramirez-Seijas said.

By Steven Reinberg     HealthDay    Jan. 25




Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

What are NSAIDs and how do they work?

Prostaglandins are a family of chemicals that are produced by the cells of the body and have several important functions. They promote inflammation that is necessary for healing, but also results in pain, and fever; support the blood clotting function of platelets; and protect the lining of the stomach from the damaging effects of acid.

Prostaglandins are produced within the body’s cells by the enzyme cyclooxygenase (COX). There are two COX enzymes, COX-1 and COX-2. Both enzymes produce prostaglandins that promote inflammation, pain, and fever. However, only COX-1 produces prostaglandins that support platelets and protect the stomach. Nonsteroidal anti-inflammatory drugs (NSAIDs) block the COX enzymes and reduce prostaglandins throughout the body. As a consequence, ongoing inflammation, pain, and fever are reduced. Since the prostaglandins that protect the stomach and support platelets and blood clotting also are reduced, NSAIDs can cause ulcers in the stomach and promote bleeding.

What NSAIDs are approved in the United States?

The following list is an example of NSAIDs available:

  • aspirin
  • celecoxib (Celebrex)
  • diclofenac (Cambia, Cataflam, Voltaren-XR, Zipsor, Zorvolex)
  • diflunisal (Dolobid – discontinued brand)
  • etodolac (Lodine – discontinued brand)
  • ibuprofen (Motrin, Advil)
  • indomethacin (Indocin)
  • ketoprofen (Active-Ketoprofen [Orudis – discontinued brand])
  • ketorolac (Toradol – discontinued brand)
  • nabumetone (Relafen – discontinued brand)
  • naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
  • oxaprozin (Daypro)
  • piroxicam (Feldene)
  • salsalate (Disalsate [Amigesic – discontinued brand])
  • sulindac (Clinoril – discontinued brand)
  • tolmetin (Tolectin – discontinued brand)

What are the side effects of NSAIDs?

NSAIDs are associated with several side effects. The frequency of side effects varies among NSAIDs.

Common side effects are

  • nausea,
  • vomiting,
  • diarrhea,
  • constipation,
  • decreased appetite,
  • rash,
  • dizziness,
  • headache, and
  • drowsiness.

Other important side effects are:

  • kidney failure (primarily with chronic use),
  • liver failure,
  • ulcers, and
  • prolonged bleeding after injury or surgery.

NSAIDs can cause fluid retention which can lead to edema, which is most commonly manifested by swelling of the ankles.

WARNING: Some individuals are allergic to NSAIDs and may develop shortness of breath when an NSAID is taken. People with asthma are at a higher risk for experiencing serious allergic reaction to NSAIDs. Individuals with a serious allergy to one NSAID are likely to experience a similar reaction to a different NSAID.

Use of aspirin in children and teenagers with chickenpox or influenza has been associated with the development of Reye’s syndrome, a serious and sometimes fatal liver disease. Therefore, aspirin and non-aspirin salicylates (for example, salsalate [Amigesic]) should not be used in children and teenagers with suspected or confirmed chickenpox or influenza.

NSAIDs increase the risk of potentially fatal, stomach and intestinal adverse reactions (for example, bleeding, ulcers, and perforation of the stomach or intestines). These events can occur at any time during treatment and without warning symptoms. Elderly patients are at greater risk for these adverse events. NSAIDs (except low dose aspirin) may increase the risk of potentially fatal heart attacks, stroke, and related conditions. This risk may increase with duration of use and in patients who have underlying risk factors for heart and blood vessel disease. Therefore, NSAIDs should not be used for the treatment of pain resulting from coronary artery bypass graft (CABG) surgery.

For what conditions are NSAIDs used?

NSAIDs are used primarily to treat inflammation, mild to moderate pain, and fever.

Specific uses include the treatment of:

  • headaches,
  • arthritis,
  • ankylosing spondylitis,
  • sports injuries, and
  • menstrual cramps.
  • Ketorolac (Toradol) is only used for short-term treatment of moderately severe acute pain that otherwise would be treated with narcotics.

Aspirin (also an NSAID) is used to inhibit the clotting of blood and prevent strokes and heart attacks in individuals at high risk for strokes and heart attacks.

NSAIDs also are included in many cold and allergy preparations.

Celecoxib (Celebrex) is used for treating familial adenomatous polyposis (FAP) to prevent the formation and growth of colon polyps.

With which drugs do NSAIDs interact?

NSAIDs reduce blood flow to the kidneys and therefore reduce the action of diuretics (“water pills”) and decrease the elimination of lithium (Eskalith, Lithobid) and methotrexate (Rheumatrex, Trexall). As a result, the blood levels of these drugs may increase as may their side effects.

NSAIDs also decrease the ability of the blood to clot and therefore increase bleeding. When used with other drugs that also increase bleeding (for example, warfarin [Coumadin]), there is an increased likelihood of serious bleeding or complications of bleeding. Therefore, individuals who are taking drugs that reduce the ability of blood to clot should avoid prolonged use of NSAIDs.

NSAIDs also may increase blood pressure in patients with hypertension (high blood pressure) and therefore antagonize the action of drugs that are used to treat hypertension.

NSAIDs increase the negative effect of cyclosporine on kidney function.

Persons who have more than three alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking NSAIDs.


Medical and Pharmacy Editor: Jay W. Marks, MD  
Pharmacy Author: Omudhome Ogbru, PharmD 

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9 Remarkable Healing Properties Of CBD

Cannabis has been stigmatized for decades, but scientists and society cannot deny that the plant’s active ingredients, known as Cannabinoids, provide a natural remedy to a host of health issues. While CBD, extracted from the cannabis plant, is structurally similar to THC, part of the allure is that it won’t get you high.

“CBD is now the most researched cannabinoid on the market and rightly so because the studies go back to the 1940s proving its effectiveness on the nervous and immune systems, with no toxicity, side effects, nor psycho-activity,” says Jared Berry, CEO of Isodiol, a company that produces hemp-extracted CBD for pharmaceutical, nutraceutical, and cosmetic companies.

Cannabis is known to have 85+ different cannabinoids, many of them potentially having health benefits.

“Cannabinoids promote homeostasis at every level of biological life, from the sub-cellular to the organism, and perhaps to the community and beyond,” writes NORML, a foundation that works to reform marijuana laws.

According to research, cannabinoids synergize and help support humans’ built-in Endocannabinoid System (ECS). It was in 1992 that scientists discovered that the ECS plays a direct role in homeostasis, which regulates every metabolic process in the body, such as pain sensation, appetite, temperature regulation, stress reactivity, immune function, and sleep, as well as other processes. Even more interesting is that muscle and fat tissue also utilize these receptors to control their processes.

So basically, CBD communicates with our body’s main command center to keep things running as they should. Pretty amazing.

While the government has arguably made selling CBD quite difficult, the US Department of Health and Services ironically patented cannabinoids in 2001.

The FDA and DEA refuse to change their stance on cannabis.

“Naturally, this shows a certain amount of hypocrisy that there is ‘no accepted medical use’ for cannabis according to federal law,” Sam Mendez, an intellectual property and public policy lawyer who serves as the executive director of the University of Washington’s Cannabis Law & Policy Project recently told the Denver Post.  “And yet here you have the very same government owning a patent for, ostensibly, a medical use for marijuana.”

Politics aside, let’s look at just nine of the myriad ways CBD can help improve  health.

Epilepsy is a neurological disorder caused by unusual nerve cell activity in the brain. Each year, about 150,000 Americans are diagnosed with this condition. Many turn to mind-numbing medications, brain surgeries and invasively implanted electrical stimulation devices, with little to no relief.

Yet, 20 years of research has shown that CBD has anti-seizure activity, and has been used successfully to treat drug-resistant, epileptic children with no side effects.

“CBD oil is also really good option for people with seizures, because you want a method of delivery they can’t choke on. As an oil, it can be rubbed on the gums and under the tongue,” adds Payton Curry, the founder of Flourish Cannabis, and a huge proponent of CBD. Curry views cannabis as a vegetable, and uses everything from the bud to the root stock to maximize its non-psychoactive properties.

These days, just thinking of the future of the health care system in this country and the assaults on our environment is enough to get a person down and out.

According to the Anxiety and Depression Association of America, in any given year, persistent depressive disorder PDD, affects approximately 1.5 percent of the U.S. population ages 18 and older. That’s about 3.3 million American adults.

In 2015, an estimated 16.1 million adults aged 18 or older in the United States had at least one major depressive episode in the past year.

CBD has shown to have antidepressant-like actions, enhancing both serotonergic and glutamate cortical signaling through a 5-HT1A receptor-dependent mechanism.

We live in a Xanax-addled society. Anxiety Disorders today affect 18.1 percent of adults in the United States, which equates to approximately 40 million adults, between the ages of 18 to 54.

One of CBD’s most promising implications is in the realm of anti-anxiety. Studies show that CBD can positively impact behavior and reduce psychological measures of stress and anxiety in conditions such as PTSD, social anxiety disorder and obsessive compulsive disorder.

CBD also significantly reduced cognitive impairment and discomfort in speech performance, and significantly decreased angst surrounding public speaking.

Even some pet owners have reported that using CBD oil on their dogs has calmed them down, writes Gunhee Park, Co-Founder of Ministry of Hemp.

While more research is needed to illustrate optimal dosage for anti-anxiety, consider this an opportunity to experiment and learn what works for you.

Today, chronic disease is on the rise like never before with oxidative stress playing a significant causative role. Oxidative stress occurs when the body has too many free radicals and can’t counteract the damage. People fall prey when eating a nutrient deficient diet or when they experience an onslaught of toxins and the body can’t keep up and detox, causing more symptoms of dis-ease.

Oxidative stress is associated with a number of ailments including neurodegenerative diseases, heart disease, gene mutations and cancer.

How amazing that CBD is particularly beneficial in the treatment of oxidative stress-associated diseases of the CNS, because cannabinoids’ ability to cross the blood brain barrier and exert their antioxidant effects in the brain.

Chronic low-level inflammation can severely erode your health; the silent lurker contributes to at least seven of the 10 leading causes of mortality in the United States, which include heart disease, cancer, chronic lower respiratory disease, stroke, Alzheimer’s disease, diabetes and nephritis.

While real organic food and proper nutrition should be the base of any anti-inflammatory protocol, CBD has shown to significantly suppress chronic inflammatory and neuropathic pain without causing dependency or tolerance.

Studies also indicate that this magical compound can help reduce chronic pain, which is fantastic considering America is witnessing a serious and deadly opioid epidemic. To put things in perspective, we are now losing more people to opioids than from firearms or car crashes – combined.

Cannabis can regulate immune functions and shows positive effects where neurons have been damaged, which makes it a safe and effective treatment for ALS, Alzheimer’s, Parkinson’s and MS. CBD has also slowed down cell damage in diabetes patients and worked effectively to block progression of arthritis.

As if CBD wasn’t already a home run, CBD also plays a positive role on our metabolism, and body weight regulation.

In a published study in the scientific journal Molecular and Cellular Biochemistry

CBD was found to:

  •       Stimulate genes and proteins that enhance the breakdown and oxidation of fat.
  •       Increase the number and activity of mitochondria, which increases the body’s ability to burn calories).
  •       Decrease the expression of proteins involved in lipogenesis (fat cell generation).
  •       Help induce fat browning.

Not sleeping can wreak havoc on your psyche and physique. According to the American Sleep Association, 50-70 million U.S. adults have a sleep disorder today.

Evidence suggests that CBD oil can improve quality of sleep and reduce anxiety. I can attest. One study found that CBD blocked anxiety-induced REM sleep suppression, resulting in better quality of sleep. Another study found that the oil reduced participants’ cortisol levels, which are linked to anxiety and stress in the body.

When it comes to doses for treatment, Gunhee writes that CBD dosing experiments have shown that small doses of CBD have an “active” effect, meaning it actually helps you stay active and focused while interestingly, large dosages have the opposite effect: sedation.

How ironic that we can use a compound belonging to a Schedule 1 Drug (marijuana) to stop the addiction of other narcotics.

CBD is thought to modulate various neuronal circuits involved in drug addiction. A limited number of preclinical studies suggest that CBD may have therapeutic properties on opioid, cocaine and psychostimulant addictions. One of the most promising application is using CBD to curb the habits of cigarette smokers.

CBD can even be effective for the treatment of cannabis withdrawal syndrome and certainly helped me kick Xanax for good.

Many of these could replace synthetic drugs that have flooded the market and allow patients and customers to use a natural non addictive plant compound as a remedy.

In the words of Gunhee, co-founder of Populum: “…maybe that’s the exact reason why progress has been so slow; approval of CBD as a legitimate supplement and drug would be a significant blow to big pharmaceutical companies.”

By: Maryam Henein       May 12, 2017       About        Follow at @MaryamHenein

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Is Strep Linked to Scary Kids’ Behavior Disorder?

When Garrett Pohlman was diagnosed with strep throat in 2007, his illness didn’t respond to antibiotics. Then the strange behaviors began.

Diana Pohlman says her son, who was 7 years old at the time, had been easygoing up to that point. But he developed severe obsessive compulsive disorder (OCD) symptoms overnight. He became paranoid – worrying about things like radiation from the TV and light switches. He had tics and anorexia and started having frequent episodes of rage.

“He was not anyone I recognized. He was a completely different child,” she says. “It was a nightmare. At first I thought maybe he had been molested. Then I thought he had a brain tumor.

“He became so delusional he would climb on the roof thinking it was the front door. He would jump in front of cars and out of moving cars, and he had self-harm fantasies. He was afraid to leave the house. We had to pick him up and wrap him in a sheet to get him out of the house. At the age of 7,” Pohlman says.


He was not anyone I recognized.
He was a completely different child.
Diana Pohlman

The search for answers was long and expensive. After many months, the family found their way to a psychiatrist who knew about a disorder called pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, or PANDAS, a condition she says several specialists didn’t know about. That led to medical treatment that included long-term antibiotics, having his tonsils and adenoids removed, and eventually two rounds of immunoglobulin, or IVIG treatments.

Recovery was slow, but after 2 years, by the age of 9, Pohlman says the severe symptoms stopped. For another 2 years, he had what she calls mild and manageable symptoms that eventually dissipated.

But rather than move on from PANDAS, the boy’s mother decided she needed to help other parents trying to figure out these mysterious symptoms. She founded the nonprofit PANDAS Network in 2009 to raise awareness, support families, and push for more research to better understand how to diagnose and treat the condition.

“When I realized doctors didn’t understand it, I thought I better not quit working on this because how will anyone else ever get help,” Pohlman explains. “It is abysmal. It has been shocking how misinformed doctors are about the term ‘PANDAS.’ ”

Little is known about how or why the syndrome happens, and not all doctors believe there is a connection. The American Academy of Pediatrics does not recognize a link between strep and the syndrome.

“You will not find consensus from pediatric infectious disease doctors that PANDAS even exists, much less what to do about it and how to manage the patients,” says Meg Fisher, MD, a pediatrician and infectious disease specialist at Unterberg Children’s Hospital at Monmouth Medical Center in Long Branch, NJ. “We still haven’t had the definitive article or study or demonstration to really get some solid clinical evidence behind this. My problem is, even if you believe in the syndrome, it’s totally unclear what you should do to help those patients. All of the information is anecdotal.”


Susan E. Swedo, MD, at the National Institute of Mental Health (NIMH), first identified PANDAS in the 1990s after she reported on a link between the fast onset of OCD and group A streptococcus, more commonly known as strep.

You will not find consensus from pediatric infectious disease doctors that PANDAS even exists, much less what to do about it and how to manage the patients.
Meg Fisher, MD, Unterberg Children’s Hospital, Monmouth Medical Center

PANDAS happens when strep triggers a misdirected immune response that causes inflammation in a child’s brain. Pediatric acute-onset neuropsychiatric syndrome, or PANS, is a larger umbrella term that has to do with cases with a trigger other than strep, including infections like walking pneumonia or the flu.

Both disorders appear in childhood, typically between the ages of 3 and 12. While blood tests may help identify infections, there are no lab tests or other indicators for PANDAS or PANS.

Doctors diagnose the syndrome when children suddenly get severe OCD or eat a lot less food, along with at least two of the following symptoms: anxiety, depression, irritability or aggression, behavioral regression, ADD- or ADHD-like symptoms affecting schoolwork, sensory or motor problems, troubled sleep, and frequent urination.

The PANDAS Network says in some cases, the emotional symptoms can weaken children and make them homebound. Other children are OK at school but fall apart at home. The NIMH describes the start of symptoms as “dramatic,” happening “overnight and out of the blue.”

“The consensus of scientists and clinicians is that it needs to be sudden and severe,” says Margo Thienemann, MD, co-director of the PANS program at Stanford University Medical Center in California. “Sudden can be overnight. Some people can say exactly what time it started or that it happened over a couple of days. But they all say this isn’t their child anymore. Even if they don’t believe someone can be possessed, it feels that way. What happened? Why are they doing these things? Why can’t they stop?”

Swedo estimates that it impacts about 1% of elementary school-aged children and is likely under-diagnosed. The PANDAS Network estimates 1 in 200 children have it. Thienemann says her program at Stanford has seen more than 250 patients since it started in 2012. But she says that since their staff is small, they have to narrow down who gets in. One year, they turned away 1,000 patients because they couldn’t handle any more.

Thienemann says this is why they have helped write guidelines to allow health care providers to identify and treat these children. “It takes a multidisciplinary team to manage. A psychiatrist, pediatrician, or rheumatologist can’t do it alone. You need all these different vantage points to diagnose and coordinate care,” she says.

There are now PANS centers in California and Arizona, and some doctors around the country treat the disorder.

The NIMH says research suggests IVIG can ease symptoms and may be used in severe PANDAS cases, but it warns it has many side effects — including nausea, vomiting, headaches, and dizziness — and there is a chance of infection with this sort of procedure. Parents say it is also expensive and often not covered by insurance.

Some families say they also see improvement when they have their children’s tonsils and adenoids removed, although no studies show that works.

streptococcus pneumonia bacteria


Not all in the medical community agree that strep or other infections can trigger these kinds of behaviors. There is also much debate about whether treatments are effective.

While the American Academy of Pediatrics does not recognize a link between strep and PANDAS, a March 2017 article in AAP News, sent to the group’s 66,000 pediatrician members, discusses the disorders and the controversy around them. While it’s not the group’s official policy, the article says pediatricians should consider PANS anytime a child “has an abrupt behavior change with obsessive thoughts,” and it points them to material that shows them how to diagnose it.

Fisher says it’s complicated for pediatricians, since there is no evidence that taking out tonsils and adenoids is helpful or that antibiotics work. She says many pediatricians worry that young patients will become resistant to antibiotics if you prescribe them long-term, and many have concerns about IVIG side effects.

“I understand the parents’ frustration, because finding a physician for these patients is very difficult. There are a lot of doctors who are, quote unquote, PANDAS specialists, but there is nothing that is evidence-based about what they are doing,” she says. “Our goal is first do no harm, and it is hard to know how best to help these patients. It is a very frustrating thing. I wish someone would come up with some solutions.”

Thienemann says most parents who find their way to her program are frantic because they can’t get help anywhere else. “Part of that desperation is nobody would listen to them. People say my pediatrician won’t do anything, and my child is trying to jump out of moving cars or a window. They can’t get out of the house, can’t sleep, are urinating on themselves, and have severe separation anxiety,” she says.


There is something medically wrong. There isn’t a finger to be pointed. There are questions to be asked and answered.
Ali Claypoole

Parents say it is obvious something isn’t right.

“I thought she had schizophrenia or severe mental illness,” says Kelly, a mother in Maryland who asked that we not use her last name to protect the privacy of her 7-year-old daughter, Maggie, who has PANDAS. “It was rapid-onset OCD, and then we were spending our entire life trying to keep her from jumping out of cars, hurting herself, biting us, and losing her mind.”

“There is something medically wrong. There isn’t a finger to be pointed. There are questions to be asked and answered,” adds Ali Claypoole, whose son, now 9 years old, first showed PANDAS symptoms at the age of 6. “Our world is turned upside down, and from where I am, it’s almost like parents are more informed than the doctors. I find the civilian community is much more understanding, interested, and willing to learn about this than the medical community. It makes me mad.”

Going Forward

More research is now being done.

In a 2017 large-scale study of key parts of the PANDAS theory, researchers looked at 17 years of data out of Denmark and found that young patients with a positive strep test had higher chances of having of mental disorders, especially OCD and tic disorders, compared with those without a positive strep test. Non-strep throat infections also carried a higher chance of these types of mental disorders in children, although it was less – perhaps pointing to the chance that other infections can trigger the symptoms.

It is really the brain inflammation  
that is central to this disease.
Dritan Agalliu, PhD, Columbia University Medical Center

In 2016,  Dritan Agalliu, PhD, an assistant professor in the Department of Neurology at Columbia University Medical Center in New York City, published a study showing that immune cells produced in the nose after multiple strep infections appear to be the culprit for the disease. These cells enter the brain via the nerves that are responsible for the sense of smell, and they damage the blood vessels and synapses in the brain.

Agalliu says this research helped explain a crucial step in the disease: how antibodies that the body makes to attack strep or other infections cross the blood/brain barrier in these children and attack parts of their brain by mistake; similar to what happens in other autoimmune diseases of the brain, like multiple sclerosis.

The NIHM recently awarded Agalliu nearly $2 million to keep studying the disorder. He says it should be called post-streptococcal basal ganglia encephalitis, or inflammation of the brain. He’s also doing research funded by a private donor, looking at genetic chances of having the disorders to understand why a small number of children who get multiple strep infections are prone to get the disease.

“It is really the brain inflammation that is central to this disease. If we think about PANDAS/PANS this way, it will relieve a lot of controversy and make therapies more acceptable for patients,” Agalliu says. “I am hoping with our next publication, we can alleviate any potential question that this is an autoimmune disease.”

There’s also increasing interest in looking at PANDAS as a type of Sydenham chorea, defined by abnormal movements, OCD, mood swings, and other emotional symptoms that follow strep infection.

The NIMH now has a group for PANDAS and PANS. The PANDAS Network is working to make information about the disorders part of continuing medical education for pediatricians, and a working group has created handouts to educate school personnel nationwide to help children with these disorders get back to their classrooms.

So will children outgrow PANDAS? Like most other things associated with this disorder, there is no consensus.

Doctors who focus on the disorders say when patients can get to them, improvement is possible. “If we get people as early as possible, maybe even at the onset of illness, I think we do a good job of being able to tamp down inflammation and help them a lot and maybe get them all the way better,” Thienemann says. “If someone has been dealing with it for 10 years, I think they may develop ongoing autoimmune problems and there may be damage to their brain. Recovery might not be as complete, but I think we can still help them.”

Three years after he first showed symptoms, Claypoole’s son had a full remission at the age of 9 after IVIG treatments. But after a few months, he got strep again and the PANDAS symptoms returned, but they were less severe. Kelly’s daughter Maggie has seen her symptoms subside for a while, only to return. Her doctors prescribe antibiotics and anti-inflammatories after each new episode. She takes both medications daily for months on end. She has also had two rounds of IVIG. “Every time we do an intervention, the baseline gets better, but it doesn’t end the problem. She is not symptom-free,” Kelly says.

Pohlman says her son, now 17, is a straight-A student who plays football and the cello and is applying to college. He is symptom-free.

“Once I understood that Garrett’s brain was on fire from an infectious illness, I barely could believe his body would have the capacity for a full recovery,” she says. “Could he have the normal life I had expected for my child? So I look at him now in amazement.”


By Jennifer Clopton       Nov. 10, 2017     WebMD Article Reviewed by Hansa D. Bhargava, MD on November 10, 2017

Ali Claypoole, Maryland.
Kelly, Maryland. (Requested not using last name)
Dritan Agalliu, PhD, Columbia University Medical Center, New York City.
Meg Fisher, MD, Unterberg Children’s Hospital at Monmouth Medical Center, Long Branch, NJ.
Diana Pohlman, executive director, PANDAS Network, Stanford, CA.
Patricia Rice Doran, EdD, associate professor, Department of Special Education, Towson University, Maryland.
Margo Thienemann, MD, Stanford University School of Medicine, Stanford, CA.
AAP News: “PANDAS/PANS treatments, awareness evolve, but some experts skeptical.”
American Academy of Pediatrics Red Book: “Group A Streptococcal Infections.”
National Institute of Mental Health: “PANDAS, Questions and Answers.”
National Institute of Mental Health: “Guidelines published for treating PANS/PANDAS.”
PANDASNetwork.org: “What is PANS?” “What is PANDAS?” Symptoms,” “Statistics,” “Our Mission.”
K. Chang, Journal of Child and Adolescent Psychopharmacology, Feb. 1, 2015.
R. Kurlan, Pediatrics, June 2008.
S Orlovska, JAMA Psychiatry, July 1, 2017.
K.A. Williams, Brain Research, August 18, 2015.
T Dileepan, The Journal of Clinical Investigation, January 4, 2016.

source: WebMD 


Lack Of Sleep May Mess With Your Health On A Molecular Level

The impact goes far beyond grogginess and irritability. In many cases, sleep loss can give certain diseases the upper hand.

You no doubt have heard about the need to get a proper amount of sleep. Public health authorities continually declare we all need on average seven hours of slumber every night to be at our best. Yet while these recommendations come with a warning about the troubles stemming from a lack of sleep, when it comes to what happens inside our bodies, the details are usually few and far between.

Now, thanks to a team of Australian researchers, we have a clearer understanding of what happens at the molecular level when we disrupt these needed times of rest. The work reveals the impact goes far beyond grogginess and irritability. In many cases, sleep loss can give certain diseases the upper hand.

The team focused on the effects of what is known as the circadian rhythm. This biological phenomenon exists in all living organisms — even bacteria — and dictates when bodies should be active or at rest. The discovery was considered of such great importance the original researchers were awarded this year’s Nobel Prize in Medicine.

When the circadian rhythm was discovered, it was a mystery and any connection to health was speculative at best. But by 2007, researchers began to understand how disruptions in this rhythm can lead to health problems. A new branch of sleep medicine was developed in which disorders such as jet lag and altered timing of sleep became conditions worth documenting and treating based on our wake-sleep schedules.

Yet the studies did not stop there. Secondary consequences — known as sequelae — also were investigated and showed symptoms such as weight gain and poor decision making were directly linked to a lack of proper rest. As for the Australian researchers, they focused on a different problem with a much wider scope for health. Their interest lied in inflammation, one of the most troublesome issues in health today.

Body temperature, blood pressure, feeding times 

… are all affected.

The author’s investigations stems from a relatively recent finding from 2015. Researchers learned of a connection between our immunity and a small section of the brain known as the suprachiasmatic nucleus, more commonly known as the SCN. At just under two millimetres in length, you might think this region would have little effect on us. Yet close to 20 years of research has revealed this tiny region seated deep in the brain is the primary regulator of the circadian rhythm. As studies have shown, the area also impacts almost all of our bodily processes.

The extent of influence on our bodily functions by the SCN is fascinating. Body temperature, blood pressure, feeding times and (not surprisingly) the feelings of wakefulness and tiredness are all affected by this little region. The 2015 study shows the immune system also responds to the calls from this region, altering how it functions during the course of a day. During the day and into the early evening, our immunity is active. Late at night and into the early morning hours, it is at rest. The balance ensures the forces maintain a proper balance and do not end up hyperactive or fatigued.

With this in mind, the Australian researchers explored the consequences to immune balance as a result of sleep deprivation. They found studies both in animals and humans revealing even a slight change in our regular circadian rhythm can lead to the development of low-level inflammation. For the authors, the rise of inflammation could worsen chronic diseases such as allergies, asthma and chronic obstructive pulmonary disease. No to mention the inflammation also leads to a poorer response to infection.

Thanks to this overview, the Australian researchers have shown at the microscopic and molecular levels why getting those seven hours of sleep is so important. They underscore the necessity of making sure people take better care of their health when faced with disruptions to the sleep cycle as a result of shift work, time zone travel and other disturbances. Perhaps most importantly, for those who cannot change their sleep schedules, the inner struggles may require us to be more observant of our behaviours.

As to how to accomplish this balance, the authors suggested treatment options focusing on inflammation as a target. While this direction will no doubt take years to achieve, there may be more natural options to improve the outlook. Proper diet and exercise can help to minimize the extent of inflammation. In addition, the use of melatonin also can provide some assistance. Then there is the potential for probiotics. While still in the early stages, we may be able to one day find a mixture designed to help us stay balanced when the world around us is being disrupted.

11/06/2017    Jason Tetro Microbiology, Health & Hygiene Expert


Boost Bacteria to Bolster Your Brain

How can boosting bacteria in your body improve your brain health? Called the “second brain” by leading scientists, a healthy balance of flora in the gut helps to determine whether you’ll have a great memory and a strong resistance to brain disease.

And what happens in the gut plays a significant role in your brain health.  Restoring beneficial bacteria and some healthy yeasts in your intestines (yes, some yeasts are beneficial, just not the ones that cause yeast infections) can go a long way toward protecting your mental faculties and preventing brain diseases altogether.

Frequently when I tell people about this connection between intestinal and brain health—what is known as the gut-brain axis, they tell me that they are covered because they eat yogurt on a regular basis.  While yogurt may (or may not) help boost intestinal flora depending on whether it contains any live cultures at all, we need to give our guts a lot more than yogurt to help us establish a strong and healthy brain for life.

Let’s explore some of the exciting research into the link between beneficial microbes in our gut and our overall brain health.

Some probiotics actually function as antioxidants within the body, which can not only reduce the effects of free radical damage and aging, it is especially good news in the prevention and treatment of brain diseases.

That’s because the brain is vulnerable to free radical damage. Additionally, research at the University of California at Los Angeles (UCLA) found that consuming certain strains of probiotics could actually produce many brain health benefits, including improved sensory and emotional processing.

Since the brain plays a significant role in whether we suffer from mental health conditions like anxiety and depression, probiotics may also be helpful in addressing these serious health concerns. In animal studies conducted by the Department of Medicine at McMaster University, Hamilton, Ontario, Canada, and published in the medical journal Gastroenterology, the probiotic Bifidobacterium longum eliminated anxiety and normalized behavior.  It appeared to work by reducing the excitability of the nerves in the gut that connect through the vagus nerve to the central nervous system, and in doing so, eliminated anxiety.

Hungarian researchers found that intestinal inflammation is one of the key factors involved in depression and that treating the inflammation with probiotics (along with B complex vitamins, vitamin D, and omega 3 fatty acids) reduced depressive symptoms.

Additional French research demonstrates the power of boosting specific strains of probiotics to boost mood and psychological health.  They found that healthy study participants experienced reduced psychological stress, depression, anxiety, and anger and hostility, as well as improved problem-solving skills when taking the Lactobacillus helveticus and Bifidobacterium longum for 30 days.

While you can still enjoy yogurt if you are already doing so, please keep in mind that the above strains are not typically found in yogurt.  I’m not aware of any yogurt that contains the best brain-boosting strains.

Take a probiotic supplement containing proven strains of brain-boosting probiotics such as  Lactobacillus plantarum, Bifidobacterium longum, and Lactobacillus helveticus on a daily basis.  Store your probiotics in the refrigerator, and take them on an empty stomach. First thing in the morning with a large glass of water tends to work well for most people.

Additionally, kimchi—the national dish of Korea which is typically a fermented mixture of cabbage, chilis, and garlic—frequently contains a much more diverse group of beneficial microbes than yogurt, making it an excellent choice as a brain boosting food. Some types contain fish sauce so if you’re vegan be sure to choose a fish sauce-free option. It is delicious on sandwiches, over brown rice, or as a side-dish to many foods.  Be sure to choose kimchi that hasn’t been pasteurized to ensure the cultures are still intact.

By: Michelle Schoffro Cook           October 5, 2017
source: www.care2.com


The Hidden Food Ingredient Linked to Pain and Inflammation

There’s a food additive so ubiquitous in the food industry it is found in most packaged foods, restaurant sauces and even many foods that have been “certified organic.” That ingredient is carrageenan. While the additive starts out harmless enough (it comes from the seaweed known as Irish moss) it is then processed to extract the ingredient known as carrageenan, which acts as a thickener or emulsifier for many prepared foods.

Like most people, I originally thought that carrageenan was a harmless extract from seaweed, so I didn’t give it much consideration. Then I heard that researchers were giving animals carrageenan to induce pain and inflammation as a way to prepare the animals for scientific studies exploring anti-pain drugs. That was the first I’d heard of carrageenan being used for harm. So I began to investigate.

Dr. Joanne Tobacman has conducted many studies on the effects of carrageenan consumption, including one in the Journal of Diabetes Research. After eating carrageenan for only six days, animals fed carrageenan developed glucose intolerance, an umbrella term used to describe impaired metabolism involving excessively high blood sugar levels. Dr. Tobacman found that the food additive caused blood sugar levels to skyrocket, indicating that it may lead to the development of diabetes. She indicates that carrageenan used in animals’ diets so commonly cause diabetes that the additive could be used for mouse models of the study of diabetes.

She also found that carrageenan causes intestinal and systemic inflammation in animal studies. Considering that inflammation is a well-established factor in most chronic disease, including: heart disease, diabetes, cancer, arthritis, pain disorders and many others, any food additive in common use is a serious concern. Dr. Tobacman also indicates that the amount of carrageenan found in most peoples’ diets is sufficient to cause inflammation.


Sources of Carrageenan

Carrageenan is found in common foods, including:

  • infant formula
  • ice cream
  • cream
  • butter
  • soy milk
  • almond milk
  • rice milk
  • cottage cheese
  • sour cream
  • yogurt
  • coffee creamers
  • vegan cheese alternatives
  • egg nog
  • protein supplements
  • aloe vera gel
  • deli meats
  • juices
  • puddings
  • pizzas
  • chocolate bars
  • coffee beverages
  • many packaged foods

Additionally, some supplements, particularly those involving gel caps, commonly contain carrageenan. And, most grocery store rotisserie chickens typically contain the additive.

The Cornucopia Institute has compiled a comprehensive list of organic foods that contain carrageenan, since the ingredient is legally allowed in foods bearing the label “organic” or “certified organic.”

a Care2 favorite by Michelle Schoffro Cook      About Michelle
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source: www.care2.com

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The Case For Drinking Coffee Is Stronger Than Ever

There are few things more more ritualistic—and to many, more sacred—than a morning cup of joe. 64% of Americans drink at least one cup a day—a statistic that’s barely budged since the ’90s. Despite warnings from doctors over the years that coffee may be hard on the body, people have remained devoted to the drink.

Luckily for them, the latest science is evolving in their favor. Research is showing that coffee may have net positive effects on the body after all.

Is coffee bad for you?

For years, doctors warned people to avoid coffee because it might increase the risk of heart disease and stunt growth. They worried that people could become addicted to the energy that high amounts of caffeine provided, leading them to crave more and more coffee as they became tolerant to higher amounts of caffeine. Experts also worried that coffee had damaging effects on the digestive tract, which could lead to stomach ulcers, heartburn and other ills.

All of this concern emerged from studies done decades ago that compared coffee drinkers to non-drinkers on a number of health measures, including heart problems and mortality. Coffee drinkers, it seemed, were always worse off.

But it turns out that coffee wasn’t really to blame. Those studies didn’t always control for the many other factors that could account for poor health, such as smoking, drinking and a lack of physical activity. If people who drank a lot of coffee also happened to have some other unhealthy habits, then it’s not clear that coffee is responsible for their heart problems or higher mortality.

That understanding has led to a rehabilitated reputation for the drink. Recent research reveals that once the proper adjustments are made for confounding factors, coffee drinkers don’t seem have a higher risk for heart problems or cancer than people who don’t drink coffee. Recent studies also found no significant link between the caffeine in coffee and heart-related issues such as high cholesterol, irregular heartbeats, stroke or heart attack.

Is coffee good for you?

Studies show that people who drink coffee regularly may have an 11% lower risk of developing type 2 diabetes than non-drinkers, thanks to ingredients in coffee that can affect levels of hormones involved in metabolism.

In a large study involving tens of thousands of people, researchers found that people who drank several cups a day—anywhere from two to four cups—actually had a lower risk of stroke. Heart experts say the benefits may come from coffee’s effect on the blood vessels; by keeping vessels flexible and healthy, it may reduce the risk of atherosclerosis, which can cause heart attacks.

It’s also high in antioxidants, which are known to fight the oxidative damage that can cause cancer. That may explain why some studies have found a lower risk of liver cancer among coffee drinkers.

Coffee may even help you live longer. A recent study involving more than 208,000 men and women found that people who drank coffee regularly were less likely to die prematurely than those who didn’t drink coffee. Researchers believe that some of the chemicals in coffee may help reduce inflammation, which has been found to play a role in a number of aging-related health problems, including dementia and Alzheimer’s. Some evidence also suggests that coffee may slow down some of the metabolic processes that drive aging.

One downside is that people may become dependent on caffeine (no surprise to any regular caffeine-drinker who takes a coffee break). The symptoms—headaches, irritability and fatigue—can mimic those of people coming off of addictive drugs. Yet doctors don’t consider the dependence anywhere close to as worrisome as addictions to habit-forming drugs like opiates. While unpleasant, caffeine “withdrawal” symptoms are tolerable and tend to go away after a day or so.

How much coffee is safe?

Like so many foods and nutrients, too much coffee can cause problems, especially in the digestive tract. But studies have shown that drinking up to four 8-ounce cups of coffee per day is safe. Sticking to those boundaries shouldn’t be hard for coffee drinkers in the U.S., since most drink just a cup of java per day.Moderation is key. But sipping coffee in reasonable amounts just might be one of the healthiest things you can do.

Alice Park   May 05, 2017    TIME 
source: time.com