“Tina Wu was thrilled to learn that New York University had accepted her for residency training in emergency medicine. She was among 167 graduates of the David Geffen School of Medicine who attended Match Day on March 20 to learn where the future will take them for advanced training in their specialties…”

http://www.msnbc.msn.com/id/35766818/ns/health-diet_and_nutrition/

I think it might be due to the proanthocyanidins (PACs) and I hope more studies come out of red wine and it’s beneficial effects!

The Spread of Superbugs

http://www.nytimes.com/2010/03/07/opinion/07kristof.html?hp

By NICHOLAS D. KRISTOF
Published: March 6, 2010

Until three months ago, Thomas M. Dukes was a vigorous, healthy executive at a California plastics company. Then, over the course of a few days in December as he was planning his Christmas shopping, E. coli bacteria ravaged his body and tore his life apart.

Mr. Dukes is a reminder that as long as we’re examining our health care system, we need to scrutinize more than insurance companies. We also need to curb the way modern agribusiness madly overuses antibiotics, leaving them ineffective for sick humans.

Antibacterial drugs were revolutionary when they were introduced in the United States in 1936, virtually eliminating diseases like tuberculosis here and making surgery and childbirth far safer. But now we’re seeing increasing numbers of superbugs that survive antibiotics. One of the best-known — MRSA, a kind of staph infection — kills about 18,000 Americans annually. That’s more than die of AIDS.

Mr. Dukes, 52, picked up a kind of bacteria called ESBL-producing E. coli. While it’s conceivable that he touched a contaminated surface, a likely scenario is that he ate tainted meat, said Dr. Brad Spellberg, an infectious-diseases specialist and the author of “Rising Plague,” a book about antibiotic resistance.

Vegetarians are also vulnerable to antibiotic resistance nurtured in hog barns. Microbes swap genes, so antibiotic resistance developed in pigs can jump to microbes that infect humans in hospitals, locker rooms, schools or homes.

Routine use of antibiotics to raise livestock is widely seen as a major reason for the rise of superbugs. But Congress and the Obama administration have refused to curb agriculture’s addiction to antibiotics, apparently because of the power of the agribusiness lobby.

The ESBL E. coli initially remained in Mr. Dukes’s colon, causing no particular damage. But then he suffered an inflammation that perforated his colon — and the bacteria escaped.

Mr. Dukes began suffering stomach pains and saw his doctor, who gave him Cipro, a strong antibiotic that had previously worked against the infection. This time, the pain grew worse. The next evening, he was in surgery to remove eight inches of his colon.

A culture attributed the infection partly to ESBL E. coli. Doctors inserted a tube to administer an intravenous antibiotic in an effort to save his life.

If ESBL E. coli is frightening, there are even more potent superbugs emerging, like Acinetobacter.

“We are seeing infections caused by Acinetobacter and special bacteria called KPC Klebsiella that are literally resistant to every antibiotic that is F.D.A. approved,” Dr. Spellberg said. “These are untreatable infections. This is the first time since 1936, the year that sulfa hit the market in the U.S., that we have had this problem.”

The Infectious Diseases Society of America, an organization of doctors and scientists, has been bellowing alarms. It fears that we could slip back to a world in which we’re defenseless against bacterial diseases.

There’s broad agreement that doctors themselves overprescribe antibiotics — but also that a big part of the problem is factory farms. They feed low doses of antibiotics to hogs, cattle and poultry to make them grow faster.

A study by the Union of Concerned Scientists found that in the United States, 70 percent of antibiotics are used to feed healthy livestock, with 14 percent more used to treat sick livestock. Only about 16 percent are used to treat humans and their pets, the study found.

More antibiotics are fed to livestock in North Carolina alone than are given to humans in the entire United States, according to the peer-reviewed Medical Clinics of North America. It concluded that antibiotics in livestock feed were “a major component” in the rise of antibiotic resistance.

Legislation introduced by Louise Slaughter, a New Yorker who is the only microbiologist in the House of Representatives, would curb the routine use of antibiotics in farming. The bill has 104 co-sponsors, but agribusiness interests have blocked it in committee — and the Obama administration and the Senate have dodged the issue.

After weeks of receiving intravenous antibiotics, Mr. Dukes is now recovering at home in Lomita, Calif. He must use a colostomy bag, but he hopes to be patched up and ready to return to work next month. Still, he knows that the ESBL E. coli remains in his gut.

“As long as it’s contained in my colon, I’m a happy camper,” he said. “But if it gets out again, I’m in trouble.”

Dr. Martin J. Blaser, chairman of the department of medicine at New York University Langone Medical Center, and a former president of the Infectious Diseases Society of America, agrees that agricultural use of antibiotics produces cheaper meat. But he says the price may be an enormous toll in human health.

“You could have very lethal pandemics,” he said. “We’re brewing some perfect storms.”

Prostatitis is loosely the male equivalent of a UTI in women as far as frequency goes. Prostatitis is an inflammation of the prostate gland, in men. A prostatitis diagnosis is assigned at 8% of all urologist and 1% of all primary care physician visits in the United States.^[1]

According to uptodate: In one five-year survey of 58,955 ambulatory visits to physicians by men over the age of 18 years, genitourinary tract symptoms accounted for five percent of all complaints [2]. Prostatitis was listed as a diagnosis in nearly two million encounters annually in the United States National Ambulatory Medical Care Surveys.

The symptoms are very similar to a UTI.  The typical story goes like this:

45 year-old otherwise healthy male experiencing urinary frequency in the past 2 days.  His urine burns each time he goes to urinate.  He also has lower back pain with a fevers and chills.

The big bad E.Coli is the cause of bacterial prostatitis 80-90% of the time.  Treatment is with antibiotics for 2 weeks.

In theory, You-T!, and anything else with proanthocyanidins should reduce the incidence of prostatitis because it interferes with the adherence of e.coli.  I need to do more research on prostatitis and proanthocyanidins.  More to come.

A 52 year old woman comes to clinic complaining of persistent UTI.  She tells you that she has had a burning, almost scalding sensation when she urinates.  These symptoms have lasted months.  Additionally, she has suffered from intermittent urinary incontinence for the last year, which has tended to correlate with the symptoms.  Her PCP treated her with trials of trimethoprim-sulfamethoxazole and levofloxacin, but she has had no improvement in her symptoms.  She denies fevers, flank pain, discharge or recent sexual activity, though she notes that she is having hot flashes.  Physical exam reveals a think, friable vaginal mucosa with multiple small punctate hemorrhages.

Sound familiar?  If so, your PCP may be treating you for a UTI when you don’t have one.

This is a typical case of atrophic vaginitis and the treatment is not an antibacterial medication.  Instead, it is estrogen.  Atrophic vaginitis can cause urinary incontinence and is another mimicker of UTIs.  A topical estrogen can help dramatically.

Kidney Stones

Introduction

Kidney stones (nephrolithiasis) are relatively common with up to 12% of men and 5% of women having a stone in their lifetimes. The annual incidence of urinary tract stones in the industrialized world is estimated to be 0.2%.

Pathophysiology

Kidney stones are caused by crystal aggregations formed in the kidneys from dissolved urinary materials.  Kidney stones are mainly made of calcium oxylate crystals or uric acid (~75%).  Nearly 15% are caused by magnesium-ammonium-struvite (phosphate) which is usually the result of recurrent UTIs.

Treatment

Nearly 90% of stones 4mm or less will pass spontaneously and 99% of stones greater than 6mm will require some sort of intervention.

When a patient comes to the emergency department with a kidney stone the standard treatment is:

1. Pain control with an opiate (morphine, dilaudid) and/or anti-inflamatory (toradol)
2. Anti-nausea medication
3. Antibiotics, if evidence of infection
4. Intravenous hydration is recommended but using fluids to flush out stones is not shown to be beneficial.

Kidney Stones and Cranberry Juice

Apple and cranberry juice contain oxalates, and both have been associated with a higher risk for risk for calcium oxalate stones. Cranberry juice has properties that may increase the risk for both calcium oxalate and uric acid stones. On the other hand, cranberry juice helps prevent urinary tract infections and so may be helpful for reducing the risk for struvite and brushite stones. (These stones are far less common, however.) For many years it was believe cranberry juice could be used as a home remedy to help prevent kidney stones. After the latest research results were concluded it is now believed cranberries may very well be the causes of kidney stones.

References:

UptoDate.com

About.com

Emedicine

Newton CR, Khare R, “Emergency Medicine”

YouTea! delivers an over-the-counter solution to a prevalent women’s health problem. YouTea! is a start-up consumer health company that aims to improve women’s health through prevention and relief.  We are first targeting certain diseases to gain initial adoption but will position YouTea! as a general women’s health product as we grow our business.  We have developed a prototype that is less than 10 calories per serving and tastes great!

The YouTea! is looking for 1-2 experienced people to assist in multiple projects. The YouTea! is undergoing rapid growth and needs an intern to assist in marketing, strategy, and business development. We are looking for full time or part time interns to start immediately but we are flexible with the start date.   The intern can work remotely, but we would prefer for the intern to be in Boston.

We are looking for an intern to work very closely with the co-founders. The intern will also interact with many experts including Harvard Business School professors, beverage company CEOs, and other entrepreneurs. He/she will participate in many meetings, focus groups, and will learn a great deal about entrepreneurship and building a business.

The ideal candidate will have experience in marketing, supply chain, or advertising. Interest in women’s health or healthcare is preferable. You must be excited to work in an entrepreneurial environment. You must be enthusiastic, trustworthy, bright, and industrious. We will not be able to offer visa sponsorship for our interns.  The internship will be at least 8 weeks with the opportunity to convert to a full time position.

Potential responsibilities include, but are not limited to:
• Conducting focus groups
• Product Development
• Contacting manufacturing companies
• Press Releases
• Contacting medical doctors
• Business Development

Please email your cover letter and resume to jobs@drinkyoutea.com.  Please state in your cover letter:
1.    Available start date
2.    Preferred end date
3.    Number of hours available to work per week (full time or part time)
4.    Current location
5.    Whether you have transportation
6.    Why you are interested in interning with YouTea!

This time urinary tract infection had terrible consequences though.  Normally, she would just drink gallons of cranberry juice and sometimes take antibiotics, but she wasn’t able to slow the progression of this UTI.  Her simple bladder infection kept getting worse and worse and she soon got a kidney infection too.  We think that this kidney infection may have precipitated her miscarriage.

Getting UTIs during pregnancy is potentially dangerous.  According to healthline.com “Pyelonephritis [kidney infection/UTI] during pregnancy is also a leading cause of preterm labor, which puts the baby at high risk for serious complications and even death.”

Unfortunately, many women are uneducated about the consequences of UTIs, especially in pregnancy.  Try to prevent UTIs – your health and your unborn child’s health depends on it.

Alex: "Wow, so cool, RATM drummer" Brad: "Wow, dork"

Natural Products Expo East. THE place to be for all types of natural products: foods, beverages, dietary supplements, health and beauty products. All the hippest trends of the natural world came out to play. Probiotics. Acai Berry. Homeopathic Flu Remedies. Gluten-Free Pizza. Gluten-Free Brownies. Gluten-Free Tortilla Chips. Gluten-Free Salsa. Gluten-Free Shampoo. Gluten-Free Acai Berry. Rage Against The Machine?!?

Natural Products Expo was one of the best experiences of my life, up there with my wedding day and the day I touched down @ Fort Drum, NY from Baghdad International Airport. Well not quite. Still, much more than I expected. What did I expect? To learn a lot about manufacturing and marketing natural products. Check. To spot the latest industry trends. Check. To meet some movers and shakers among manufacturers, distributors, brokers, retailers and investors. Check. To meet one of my rock & roll heroes? Hadn’t quite expected that, but check.

From the opening keynote, I knew it was going to be a good conference. Bryant Terry, a self-described “food justice activist,” “eco chef” and omnivore who paradoxically wrote The Vegan Soul Kitchen kicked things off bright and early day one. Interesting and thought-provoking speech. Food is more than just what’s on the plate. A lot more. He made some salient points about revitalizing local farms and local food, retelling tales of summers in his grandparents’ urban oasis filled with fresh beans, peas, peaches and cabbage. Why must we now settle for Ho-Hos and Doritos today? He asked. I agreed, distracted by visions of his grandparents’ fresh vegetables. Some points I did not agree that seem to be more political than food-related. Such is life. Then he told us about THE song that changed his life. He started rapping it. “Beef, what a relief . . .” he began, with a decent impression of KRS ONE. I knew the song. Had heard it probably 2000 times. I loved Boogie Down Productions. I took the liberty of chiming in. He looked annoyed and stopped rapping. I blurted out “KRS ONE, Boogie Down Productions Edutainment!” As if I were a lifeline on “Who wants to be a millionaire” and my wife had just phoned me. Turns out I was the only one who knew the song in the entire audience. It must have looked pretty bizarre to everyone else in the audience, particularly considering I was wearing wool slacks and a blue button down shirt. I looked something like this dude (not really).

Great conference moment 2: Mark Bittman. Forget Bobby Flay or Julia Child, this dude is my culinary hero. He wrote a cookbook called How to Cook Everything. Why would I need anything else? I have used his cookbook 1000 times (sometimes while listening to KRS ONE). I’ve cooked everything from noodle kugel to buckwheat pancakes to steak au poivre to asparagus quiche with some help from my boy Mark. Contrary to my expectations, turns out seeing him was not the conference highlight . . .

I was checking out the Olade booth. Love the logo, the packaging. Tastes great too, especially for a stevia-sweetened product. Talked to the brokers at the booth, and they told me the story of the product: this guy Brad woke up one day with blurry vision. Turned out he had Type I diabetes and lost part of his vision. He had a tough job and used to crush energy drinks. The kind with tons of sugar (incidentally, Red Bull and RockStar and Monster have fewer calories and less sugar per serving than Cranberry Juice Cocktail, but I digress). After the diabetes, he launched a crusade for drinks without tons of sugar and that nasty high fructose corn syrup. Hence Olade. “Oh yeah,” the broker said, “Brad is Brad Wilk, the drummer from Rage Against The Machine.”

OMG OMG OMG OMG. I blushed like a schoolgirl at a Backstreet Boys concert (ok I’m dating myself). I LOVE RATM. It all started in the weightroom. Blasting RATM to crank out that extra rep. Then in the Army. RATM to keep us going on patrol. The first Platoon that I led was nicknamed “The Renegades,” and I decided to adapt “Renegades of Funk” as our official theme music, blasting the song from a boombox during big events. Even today, nothing better than a little “Bulls on Parade” after a tough day on the Bolt Bus.

Who could’ve imagined that I would meet my favorite drummer from my favorite band at a natural products show? I wonder if RATM will soon release a gluten-free CD?