Kids' urinary infections usually not a kidney risk
“If there is no structural abnormalities in the kidney ultrasound after the first UTI, the parents should not be worried at all” about the risk of chronic kidney disease, said lead researcher Dr. Jarmo Salo of the University of Oulu in Finland.Recurrent UTIs in young children have been seen as a possible risk factor for chronic kidney disease later in life. That’s especially true if a child has what’s called vesicoureteral reflux, or VUR.About 1 percent of children have VUR, where some urine backs up from the bladder into the kidneys. The reflux itself does not damage the kidneys, but because bacteria in the urine can get into the kidneys, these children are more prone to kidney infections that can lead to scarring.But the idea that repeat UTIs and VUR are risk factors for chronic kidney disease later in life is not universally accepted – nor is the practice of testing children for VUR when they have a urinary tract infection.So for the new study, reported in the journal Pediatrics, researchers in Finland combed the medical literature to look for evidence that childhood UTIs are a risk factor for chronic kidney disease.They also reviewed the records of all 366 patients who were treated for chronic kidney disease at their hospital over one year.The team found 10 published reports that either looked at the history of childhood UTIs in people with chronic kidney disease, or that followed children with UTIs to see how their kidney health fared.Among the 1,576 patients in those studies, there was no evidence that childhood UTIs – even along with VUR – were the main cause of chronic kidney disease, according to the researchers.And of the kidney disease patients who did have a history of childhood UTIs, all also had structural abnormalities in their kidneys. Similarly, of the 366 patients at their center, the researchers found that only three had repeat childhood UTIs that might have contributed to their chronic kidney disease – and all had structural abnormalities in the kidneys.Such structural abnormalities – problems like an obstruction in the kidneys – can be picked up by an ultrasound when a young child is diagnosed with a UTI.But Salo told Reuters Health in an email that the findings suggest that kids with VUR are at no increased risk of kidney disease, as long as there are no structural abnormalities in the kidneys.NO LONGER LOOKING IN FINLANDWhen VUR is diagnosed, it is usually because doctors specifically look for it in a young child with a UTI. That takes a special test called a cystogram, where a catheter is placed in the bladder and the bladder is filled with fluid. X-rays allow the doctor to see if the fluids back up into the kidneys.Salo said doctors in Finland no longer “actively” look for VUR because there’s evidence that it is a “normal phenomenon,” and that treating it does not prevent long-term kidney damage.“We suggest that the (x-ray) imaging studies are not necessary if the child has structurally normal kidneys in ultrasound,” Salo said.But a pediatric urologist not involved in the study cautioned against making a “sweeping” recommendation against VUR testing.“The good news for parents is yes, the chances of your child developing kidney disease will be very low,” said Dr. Hiep T. Nguyen of Children’s Hospital Boston.However, he told Reuters Health, repeat UTIs in young children (generally younger than 5) are not the same as those in older kids or adults. And some of those children are at increased risk for kidney damage – particularly if they have more-severe, “high-grade” VUR.What’s more, Nguyen said, there is evidence that finding and treating high-grade VUR may prevent kidney damage. Treatment involves low doses of antibiotics to prevent repeat UTIs and periodic testing to see if the reflux has gone away. Some children with severe VUR end up having surgery to correct the problem if they keep getting infections.Mild reflux typically goes away on its own – though, in North American, doctors still prescribe low-dose antibiotics to prevent the UTIs.Nguyen said that a young child with a UTI should have an ultrasound “at a minimum” to look for structural abnormalities in the kidneys. Salo agreed.SHOULD DOCTORS TEST?But the area of controversy is in testing for VUR. Essentially, Nguyen said, pediatricians are increasingly moving away from recommending VUR testing for children with urinary tract infections.Pediatricians, he noted, see a lot of children with UTIs, and most of those kids will have no long-term kidney disease as a result. But urology specialists see the people with chronic kidney disease, and they are apt to see the value in testing for VUR so that kids with reflux can be treated.“We are looking from two different viewpoints,” Nguyen said.VUR has a strong genetic component, and researchers are working on gene tests – where a child will just have to “spit in a cup,” Nguyen said – that could help pinpoint the kids with UTIs who would be the best candidates for VUR testing.For now, the decision to do VUR testing is basically case-by-case.Dr. John Gearhart, director of pediatric urology at Johns Hopkins Children’s Center in Baltimore, said the current findings “should reassure mothers and fathers."But he agreed that there are cases where testing for VUR is appropriate: if there’s a family history of the condition, for example, or if a young child has more than one urinary infection that includes fever.Testing for VUR does involve radiation, albeit as low a dose as possible, Gearhart noted in an interview. So limiting the number of children who have it is important.There can also be side effects from the low-dose antibiotics given to children with VUR – such as stomach upset, diarrhea and yeast infections.There is an ongoing North American clinical trial looking at whether giving antibiotics to young children with mild to moderate VUR prevents kidney scarring (which, down the line, might contribute to chronic kidney disease).That, according to Gearhart, should give more insights into whether it is helpful to give all children with VUR preventive antibiotics.
The hunt for a deadly superbug that sickened 22 patients at a Dutch hospital began just before noon on a spring day in 2012.
a lab in the tiny hamlet of Zoeterwoude, a technician carefully peeled
back the tip of a state-of-the art medical scope. Watching him intently
was a small group of hospital officials and executives from Olympus
Corp., maker of the device.
The Olympus technician found trouble right away. He spotted a
brown, grimy film inside parts of the flexible scope - parts that were
supposed to be sealed. A rubber ring designed to keep bacteria out was
cracked and worn. The same bacteria that had sickened the patients were
found on the scope.
An investigator hired by Olympus and the hospital concluded that
the scope’s design could allow blood and tissue to become trapped,
spreading bacteria from one patient to another. In his report, he called
on Olympus to conduct a worldwide investigation and recall all its
scopes if similar problems turned up.
Over the next three years, 21 people died and at least two dozen
more became ill from infections related to scopes in Pittsburgh,
Seattle and Los Angeles. An unknown number of other patients have been
infected. The U.S. Food and Drug Administration has identified 10
outbreaks, seven of which involve Olympus scopes.
Even as patients died and others were put at risk, Olympus
continued to sell the device and failed to warn U.S. hospitals that the
scopes were tied to dangerous infections, according to interviews with
dozens of hospital officials, doctors, regulators and former Olympus
After each outbreak, Olympus contended that its scopes did not
cause the infections and blamed the hospitals for not cleaning them
properly. The company treated each case as an isolated incident, not
telling the U.S. hospitals that they there were others.
“Olympus’ silence on this important issue was unethical,
irresponsible and dangerous,” said Dr. Andrew Ross, chief of
gastroenterology at Virginia Mason Medical Center in Seattle, where 18
patients sickened by tainted scopes died and 21 other were infected.
Olympus controls 85 percent of the multibillion-dollar U.S.
market for gastrointestinal scopes. U.S. prosecutors and congressional
investigators are looking into how Olympus and two smaller scope
manufacturers responded to the superbug outbreaks.
Yellow fever is a viral disease spread by mosquitoes that still kills 30,000 people each year despite there being an effective vaccine available. In the past epidemics of yellow fever would spread through North America and people would regularly leave cities for the safer countryside during ‘the fever season.’ Since it was such a peril a young medical student called Stubbins Ffirth decided to investigate. Certain that it was impossible for the disease to pass from one person to another he tried to infect someone using samples from victims. The person he tried to infect, as you might guess from this list, was himself. He took vomit from yellow fever patients and drank it. He also rubbed it in cuts on his own body for good measure. He did not contract the disease. Perhaps that was not the infectious route, he considered; so he then poured vomit onto his eyeballs. Still no fever. He then progressed through blood, saliva, and pus. Still in robust health Ffirth decided he had confirmed yellow fever was not infectious and published his results. Unfortunately all his samples had come from patients who had passed the infectious stage of the illness and yellow fever is very much a transmissible illness. He never found out he had drunk vomit for nothing.
Just In Time for Flu Season, a Scarf Built to Withstand Chemical Warfare
Japan has taken the surgical mask to particularly high heights of fashion. A quick search yields coughing mouths covered by animal faces, knock-off Louis Vuitton prints, Geisha lips, and more—dutifully strapped on to prevent the spread of germs.
We should be so stylishly courteous here in the States. Happily, the kind germaphobes at Scough have stitched up an American answer to the commuter surgical mask: Sumptuous scarves, embedded with ultra-high-grade germ filters.
After consulting with medical professionals, the Scough team homed in on filters made from silver-impregnated activated carbon, a material used in masks designed to help wearers survive chemical warfare. It actively traps and kills germs as well as pollutants. The filters last up to three months, and can be slipped in and out of a pocket inside the Scough for easy Scoughwashing.
Infections damage our ability to form spatial memories
Increased inflammation following an infection impairs the brain’s ability to form spatial memories – according to new research. The impairment results from a decrease in glucose metabolism in the brain’s memory centre, disrupting the neural circuits involved in learning and memory.
Inflammation has long been linked to disorders of memory like Alzheimer’s disease. Severe infections can also impair cognitive function in healthy elderly individuals. The new findings published in the journal Biological Psychiatry help explain why inflammation impairs memory and could spur the development of new drugs targeting the immune system to treat dementia.
In the first trial to image how inflammation impairs human memory, the team at Brighton and Sussex Medical School scanned 20 participants before and after either a benign salty water injection or typhoid vaccination, used to induce inflammation. Positron emission tomography (PET) was used to measure the effects of inflammation on the consumption of glucose in the brain and after each scan participants tested their spatial memory by performing a series of tasks in a virtual reality.
A reduction in glucose metabolism within the brain’s memory centre, known as the Medial Temporal Lobe (MTL), was seen following inflammation. Participants also performed less well in spatial memory tasks, an effect that appeared to be directly mediated by the change in MTL metabolism.
“We have known for some time that severe infections can lead to long-term cognitive impairment in the elderly. Infections are also a common trigger for acute decline in function in patients with dementia and Alzheimer’s disease,” explains Dr Neil Harrison, a Wellcome Trust Intermediate Clinical Fellow at BSMS who led the study. “This study suggests that catching a cold or the flu, which leads to inflammation in the brain, could impair our memory.”
Infections are unlikely to cause long-term detrimental impact in the young and healthy but the findings are of great significance in the elderly. The team now plan to investigate the role of inflammation in dementia, including insight into how acute infections such as influenza influence the rate of progression and decline.
“Our findings suggest that the brain’s memory circuits are particularly sensitive to inflammation and help clarify the association between inflammation and decline in dementia,” says Dr Harrison. “If we can control levels of inflammation, we may be able to reduce the rate of decline in patients’ cognition.”
Despite the progress we’ve made in vaccines, drugs, and sanitation, infectious diseases—a category that includes everything from the run-of-the-mill flu to antibiotic-resistant “superbugs"—still kill some 170,00 Americans each year.
But most states—33, to be exact—have taken fewer than half of the recommended steps to prevent the spread of things like whooping cough, HIV, and hospital infections, according to a new report the Trust for America’s Health, a nonprofit that works to prevent outbreaks, and the Robert Wood Johnson Foundation, a public health philanthropy.
The Surprisingly Tricky Task of Outsmarting Bacteria
Bacteria are literally brainless single-celled organisms. They don’t even have cell nuclei. But the future of fighting bacterial infections may involve outsmarting the critters.
We’ve been trying to outfight them for the past hundred years with a range of antibiotics, which have been pretty successful in developed countries with easy access to medical resources. (If you’re reading this, it’s more likely that you’ve seen tuberculosis as portrayed by an actor wearing red eyeliner than in real life.) But as it turns out, all that sheer force has built badder bugs. The CDC estimates that >23,000 people die every year as a direct result of infection by antibiotic-resistant bacteria – just in the United States. And it’s only gonna get worse.
But researchers have found that bacteria can communicate with each other through what they’re calling quorum sensing – the production, release, and detection of signal molecules. And they’re working on ways of jamming those bacterial signals. There’s still lots of testing to be done, but this could be the replacement for traditional antibiotics that humanity needs.
Maryn McKenna breaks down a scary new study that found that hog farmers in Iowa are six times more likely to carry some strain of drug-resistant staph. McKenna illuminates how difficult it is to get sufficient data about the relationship between antibiotic use in agriculture and superbug infections in humans. The study does, however, show an association between being in recent contact with swine and testing positive for resistant bacteria—and that, McKenna writes, “is a useful thing to know.”
In the first study to look at would-be diseases carried by New York City rats, scientists at the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health identified bacterial pathogens, including E. coli, Salmonella, and C. difficile, that cause mild to life-threatening gastroenteritis in people; Seoul hantavirus, which causes Ebola-like hemorrhagic fever and kidney failure in humans; and the closest relative to human hepatitis C. Results appear in the journal mBio.
The researchers trapped 133 Norway rats at 5 sites in New York City, focusing on rats trapped inside residential buildings. In the lab, targeted molecular assays confirmed the presence of 15 of the 20 bacterial and protozoan pathogens they looked for and one virus: Seoul hantavirus was present in eight rats. It is the first time the virus has been documented in New York City, and genetic clues suggest that it may be a recent arrival. Human infection has been associated with multiple cases of hemorrhagic fever with renal syndrome, and chronic renal disease in Maryland and Los Angeles. The virus has also been implicated in cases of hypertension.
“New Yorkers are constantly exposed to rats and the pathogens they carry, perhaps more than any other animal,” explains Dr. Firth, who conducted the study as a research scientist at Columbia’s Center for Infection and Immunity. “Despite this, we know very little about the impact they have on human health. ”