TIME medicine

There’s Yet Another Downside To Overusing Antibiotics

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Scientists have found yet another reason not to overuse the drugs—they’re turning bacteria into better infectious agents

Scientists have been warning for decades that we use too many antibiotics, both in people to treat relatively mild infections and in agriculture to bulk up farm animals and keep them free of disease. The consequences, they caution, are dire—and already emerging in hospitals with bacteria that can’t be treated with any of our existing antibiotic medications.

But the thinking went that to become resistant to the drugs we use on them, bacteria have to pay a price. They may be able to survive the pharmaceutical onslaught, but they’re less fit and therefore less able to reproduce, less likely to remain for long in their host of choice and otherwise sapped of the energy needed to really wreak havoc on human or animal immune systems.

MORE: Study Links Widely Used Pesticides to Antibiotic Resistance

At least, that was the theory (and perhaps the hope) until now. In a study published in Science Translational Medicine, however, researchers show how misguided that belief is. Delving into the genetic code of certain common bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii — both of which are resistant to multiple antibiotics— and Vibrio cholerae, the researchers identified genes that change in the presence of these drugs. In animal models, they observed how these changes affected the different bacteria’s ability to infect and populate in hosts.

To their surprise, rather than being compromised, the antibiotic-resistant bacterial strains seemed to be stronger, more robust and better able to infect cells than less resistant strains.

MORE: Why Reducing Antibiotic Resistance Is Harder Than It Seems

“With all the possible mutations in the bacteria, there is a battle royale, a competition among all the mutants, and we see that the most fit, the most virulent were the ones that were resistant to the antibiotics,” says Dr. David Skurnik, senior author of the paper and assistant professor of medicine at Brigham and Women’s Hospital and Harvard Medical School. In the case of P. aeruginosa, he says, “the acquisition of antibiotic resistance was associated with the most increased fitness in all the possible mutations in P. aeruginosa.”

That means that the problem of antibiotic-resistant bugs just got more complicated. Overuse of antibiotics increases the number of bacterial strains that have mutations which make them better able to withstand the drugs, and this latest research shows that these strains may also be more adept at infecting hosts and causing disease. “We’ve gotten a double whammy with the acquisition of antibiotic resistance,” says Gerald Pier, a co-author of the paper and professor of medicine, microbiology and immunobiology at Brigham and Harvard Medical School. “Not only does antibiotic resistance make it more difficult to treat infections because we have fewer drugs they will respond to, but it makes the organism better able to cause infection.”

While still important, the conventional solution of cutting back on antibiotic use may not be enough, he says. Using antibiotics more appropriately will certainly reduce the appearance of new drug-resistant strains, but it won’t be enough to tamp down the emergence of these fitter, more virulent bacteria that also happen to be adept at evading the effects of antibiotics. For that, he says, other infection-fighting strategies, including boosting the immune system with vaccines or antibody treatments, may be needed.

That’s what Pier and Skurnik are working on currently, and so far, they’ve developed encouraging options for treating infections that may keep the more robust bacteria at bay. They’re targeting parts of bacteria that many strains have in common and developing new says to recognize these targets and neutralize the bacteria so they can’t cause serious infections and disease. “These results show that, yes, the problem of multi-drug resistant bacteria is more complex than we thought, but there are solutions,” says Skurnik.

TIME Innovation

How Damaged Brains Can Learn From Healthy Ones

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

These are today's best ideas

1. Could damaged brains learn to heal from healthy ones?

By Brian Handwerk at Smithsonian Magazine

2. From VOA to Radio Free Europe, the U.S. needs a single news voice abroad.

By Al Pessin at Defense One

3. Here’s how the dwindling teacher supply is complicating education reform.

By Paul Bruno in the Brown Center Chalkboard at the Brookings Institution

4. The mobile web sucks.

By Nilay Patel in the Verge

5. What’s better than a clinical trial for understanding drug side effects?

By Aviva Rutkin in New Scientist

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME medicine

Dad Bod Is Explained By Science In a New Study

A first-of-its kind study to follow men for up to 20 years from adolescence shows that dads do get a little squishier after the kids

According to Clemson student Mackenzie Pearson, who wrote a viral essay essay on the appeal of the dad bod, it’s a physique that’s a “nice balance between a beer gut and working out,” the result of going to gym but indulging in a few pizzas once in a while and being okay with that. (Think John Hamm, and Chris Pratt before he went Jurassic.)

And according to scientists, Pearson and her demographic have pretty much nailed it. The source of that “more human, natural and attractive” body is unique to fathers and can be traced to simply having kids.

In a study published in the American Journal of Men’s Health, Dr. Craig Garfield, a pediatrician at Northwestern University Feinberg School of Medicine and his colleagues dove into a database of 10,263 men beginning when they were 12 years old and followed them for up to 20 years. They looked specifically at how body mass index (BMI), a combination of height and weight, changed over time as the men either became fathers or did not, and for those who did, whether they were what the researchers called resident fathers who lived with their children, or non-residents who lived separately.

Read more Why We Accept ‘Dad Bod’ on Rich Men

Whether or not they lived with their kids, becoming a father was linked to around a four pound increase in weight over the study period, while remaining child-free was associated with a 1.4 pound weight loss for a six-foot-tall man.

“It’s a unique look at the influence that a social phenomenon, becoming a father, has on a biological marker, namely BMI,” says Garfield. “It really plants fatherhood as a potential social determinant of health for men.”

That’s a critical finding, especially since men, and in particular young men, are typically less proactive about taking care of their health. Garfield notes that while many men will quit smoking and drink less and otherwise try to become healthier when they become fathers, there may be other factors associated with caring for kids that counteract those good intentions, such as being surrounded by more kid-friendly, high calorie foods and snacks, as well as their leftovers.

“From my own point of view, we wouldn’t have as many pizzas in the house if the kids weren’t around, and we wouldn’t have the brownies my wife makes if the kids weren’t around,” says Garfield. “Having kids around changes not only the food in the house and what is available to you for meal, but also for snacks. It also changes whether you are able to find time to get out and exercise and get enough sleep and take care of yourself.”

Read more Dadbod, Mombod and Our Pretty Bad Bod Prob

Dads, of course, are not alone in experiencing these effects of parenthood. But this is the first study to tease out specifically the effects of fatherhood on weight gain over time. Since men are less likely to be seeing doctors regularly, if they are joining their partners during prenatal visits or pediatric visits, says Garfield, those are good opportunities to talk to them about their own eating, exercise and sleep habits to make them aware of the sneaky way that pounds can creep up on dads and potentially affect their health (even if the look seems to have its own kind of physical appeal).

Read next: For the Dad Who Is Confident About How He Looks in Swim Trunks

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TIME HIV/AIDS

A Woman Born HIV-Positive Is in Remission Despite Stopping Treatment Years Ago

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Doctors believe early rather than continuous treatment with antiretrovirals is key

The first case of a woman in long-term HIV remission despite not receiving treatment for many years has been documented in France.

The 18-year-old was HIV-positive at birth and given antiretroviral drugs as a child, but her family decided to cease the treatment when she reached the age of 6. Twelve years have passed and today her viral load is too low to be measured. Doctors can’t figure out why the women’s HIV has stalled.

“With this first, highly documented case of this young woman, we provide the proof of concept that long-term remission is possible in children, as in adults,” Dr. Asier Sáez-Cirión, from the Institute Pasteur in Paris, told the BBC.

“However, these cases are still very rare,” he said.

Some experts believe that early treatment is the key to future remission, but large-scale studies still need to be conducted to nail down this theory.

Although there is still much to learn, predicting HIV remission has been the subject of studies in the past. Sáez-Cirión previously led a research group of 14 patients who had no sign of the virus re-emerging after coming off antiretroviral drugs. Thirteen years passed and the patients’ viral loads remained low.

[BBC]

TIME medicine

What You Should Know About Leaky Gut Syndrome

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What’s a leaky gut, and how do I know if I have one?

“Leaky gut syndrome,” on its own, is a diagnosis that’s not recognized across the board by conventional medicine. The theory is that having a poor diet or ingesting too many antibiotics or painkillers can damage the mucosal barrier, the layer of cells lining your intestine. Normally, this barrier lets nutrients through but blocks larger molecules and germs from getting into your bloodstream. It’s thought that a porous, or “leaky,” intestinal lining can allow food particles or germs to pass into the blood, causing inflammation throughout your body.

Symptoms of a leaky gut are said to include everything from bloating, gas and abdominal pain to recurrent vaginal infections, asthma and mood swings. Some experts even claim that leaky gut can put you at risk of serious conditions such as migraines, rheumatoid arthritis and food allergies.

Is it for real? There is evidence that having high “intestinal permeability” is involved in the development of certain autoimmune diseases, like Crohn’s and type 1 diabetes, in people who are already predisposed to these conditions. But it remains unclear whether intestinal permeability causes issues such as irritable bowel syndrome, food allergies or asthma—or if it’s just a symptom of them. In my experience, having a “leaky gut” is mostly a symptom of a disease, not a disease on its own.

There are tests your doctor can perform to measure how well your intestines are absorbing nutrients and blocking the bad stuff. The most common one involves drinking a mixture of mannitol (a small sugar molecule) and lactulose (a large one) and then testing your urine for each over six hours. But these tests are time-consuming and expensive, and they don’t reveal anything that your doctor can use to recommend treatment. So, honestly, there is no point in getting them.

Some alternative medicine practitioners recommend supplements or home tests (which they conveniently sell on their websites), but ignore these. The best advice for keeping your gut and its lining healthy is to eat plenty of fiber and fermented foods like kefir, or take a probiotic supplement, and stay hydrated.

This article originally appeared on Health.com

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TIME health

This is How Alzheimer’s Disease Got Its Name

Alois Alzheimer
Apic / Getty Images An undated portrait of Alois Alzheimer, German psychiatrist and neurologist

It was coined on July 15, 1910

It was on this day, July 15, in 1910 that the second volume of the German book General Psychiatry was published. Though the book was written by eminent psychiatrist Emil Kraepelin, it ended up preserving the name of a different doctor: it was the first time that a type of dementia was described as “Alzheimer’s disease.”

The name was in honor of Alois Alzheimer, another German psychiatrist, who in 1906 identified the cases of dementia described by Kraepelin. The pair were quite familiar with each others’ work. As recounted in Konrad and Ulrike Maurer’s Alzheimer: The Life of a Physician and the Career of a Disease, Kreapelin worked closely with Alzheimer, who even filled in for the former at work when he was busy writing General Psychiatry. Alzheimer had originally been Kraepelin’s research assistant in the medical school in Munich, and it was there that he was able to create a lab dedicated to research in brain science.

As TIME described in a 1983 article about the disease’s prevalence, Dr. Alzheimer had noticed that the brain of one of his patients—known as Auguste D—looked different from other brains:

His patient, a 51-year-old woman, suffered loss of memory, disorientation and later, severe dementia. After her death, Alzheimer conducted an autopsy on her brain and found the two distinctive characteristics of the disease: tangled clumps of nerve fibers and patches of disintegrated nerve-cell branches. Because Alzheimer’s patient was relatively young, AD was at first considered a disease of middle age; similar symptoms in elderly people were simply regarded as a natural consequence of aging. Today this view has been discarded. Even in an octogenarian, severe mental confusion “is a disease, not a natural decline,” says Catherine Bick, acting deputy director of the National Institute of Neurological Communicative Disorders and Stroke (NINCDS).

Alzheimer died in 1951.

Read the full story from 1983, here in the TIME Vault: Slow, Steady and Heartbreaking

TIME medicine

Just How Unsafe are Painkillers?

The FDA has added to its warning about the risks of certain painkillers

The U.S. Food and Drug Administration (FDA) has strengthened its warning that certain painkillers can cause heart problems.

On Thursday, the FDA updated its warnings for prescription and over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to say they increase the chance of heart attack or stroke. The drugs, like ibuprofen (Advil) and naproxen (Aleve), already carry warnings that they “may cause” increased risk of heart attack and stroke, but the new labels will say that they “cause an increased risk” of heart failure, the New York Times reports. The FDA came to the decision after reviewing new evidence about the risks.

How great is the risk?
“There is no period of use shown to be without risk,” said Dr. Judy Racoosin, deputy director of FDA’s Division of Anesthesia, Analgesia, and Addiction Products, in a statement. Research suggests that higher doses of the drugs can be more problematic.

One 2013 study looked at more than 600 trials and found that compared to placebos, high doses of NSAIDs like coxibs and diclofenac increased the risk of serious heart problems, including heart attacks, by one-third. The research also showed that ibuprofen more than doubled the risk of major coronary events, and all NSAIDs studies were linked to a 2- to 4-fold increased risk of gastrointestinal complications.

Who is most at risk?
According to the FDA, people who have underlying heart disease are at greater risk, but the risk exists for everyone. “Today we know that the risk of heart attack and stroke may occur early in treatment, even in the first weeks,” the FDA says.

The FDA is also planning to add additional warnings for people who have already had a heart attack. “This vulnerable population is at an increased risk of having another heart attack or dying of heart attack-related causes if they’re treated with NSAIDs, according to studies,” the FDA said in a statement.

What should I do?
To keep risk lower, the FDA recommends users take the drugs at the lowest dose for the shortest duration possible. People should consult their doctor about whether or not they should take them if they have high blood pressure and should stop taking them if they have any symptoms of a heart-related issue, the FDA says.

Read next: Heroin Use in U.S. Reaches Epidemic Levels

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TIME Drugs

Some Antidepressants Linked to Higher Risk of Birth Defects

Drugs Prozac and Paxil are linked to certain defects in a new study

A new study finds women who used certain antidepressants could be more likely to have babies born with rare birth defects.

According to the study of 28,000 women by the Centers of Disease Control and Prevention (CDC), certain birth defects were more common among users of antidepressants Prozac and Paxil.

Prozac usage was linked to defects like misshapen skulls and Paxil was associated with defects such as intestines growing outside of the baby’s body and missing parts of the brain and skull. Both drugs were linked to heart defects, according to the study.

The study’s authors note that the risks are very small and that there is no proof that the drugs cause defects, but they did discover a link between using the drugs in early stages of pregnancy and some defects. Women were asked if they used certain antidepressants in the time just before they conceived and during the first three months of pregnancy.

The study, which was published Wednesday in the British Medical Journal, follows several studies that linked the entire class of antidepressants to defects. The study, however, did not find links with birth defects in antidepressants Celexa, Lexapro or Zoloft.

 

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