Coffee and Tea Drinkers Less Likely to Carry MRSA

Original post can be found on Medpagetoday.com

People who drink hot tea or coffee are less likely to carry methicillin-resistant Staphylococcus aureus (MRSA) in their noses, researchers found.

Drinking either beverage was associated with about a 50% relative reduction in the odds of nasal MRSA carriage, and drinking both was associated with a 67% reduction, according to Eric Matheson, MD, of the Medical University of South Carolina in Charleston, and colleagues.

The findings, reported in the July/August issue of Annals of Family Medicine, "raise the possibility of a promising new method to decrease MRSA nasal carriage that is safe, inexpensive, and easily accessible," they wrote.

The clinical importance of the finding is not entirely clear, however, as the relationship between nasal MRSA carriage and the chances of systemic infection has not been resolved, they added.

Previous studies have shown that tea and coffee have antimicrobial properties when applied topically, and to find out whether drinking the beverages had systemic effects the researchers turned to the 2003-2004 National Health and Nutrition Examination Survey (NHANES).

The analysis included 5,555 individuals ages 2 and older, representing 182.1 million people. About half (48.6%) reported consuming hot tea over the past month and 60.8% reported drinking coffee over the past month.

Overall, 1.4% of the participants carried MRSA in their noses.

After adjustment for age, race, sex, poverty status, current health status, hospitalization in the past 12 months, and use of antibiotics in the past month, there were lower odds of nasal MRSA carriage among individuals who drank any amount of hot tea (OR 0.47, 95% CI 0.31 to 0.71), coffee (OR 0.47, 95% CI 0.24 to 0.93), or both (OR 0.33, 95% CI 0.16 to 0.70), compared with those who drank none.

A separate analysis of just the adult participants provided similar results.

Consumption of iced tea, however, was not associated with nasal MRSA carriage. The reason is unclear, but it could be that iced tea has lower levels of polyphenolic compounds than hot tea, or that the volatile antimicrobial compounds in coffee and tea reach the nose in vapor form, according to the researchers.

Although the study -- cross-sectional in design -- could not establish a causal relationship between drinking coffee and tea and nasal MRSA carriage, there are some possible mechanisms to explain the finding.

"In the case of coffee, particular attention has focused on the potential antibacterial properties of trigonelline, glyoxal, methylglyoxal, and diacetyl," Matheson and colleagues wrote. "For tea, attention has focused on the antimicrobial properties of tannic acid and catechins."

In addition, they wrote, drinking both coffee and tea decrease iron absorption, which could affect the growth of S. aureus.

The authors acknowledged that the study was limited by the exclusion of some individuals because of missing data and the inability to determine when the participants last drank coffee or tea.

They noted that the study could not address the larger question of whether nasal MRSA carriage is associated with systemic infection.

"Given this debate, the benefits of any treatment for MRSA nasal carriage should be carefully balanced against the risk," they wrote.

Original article here

Placebo Effect Powerful in Asthma

This article was originally posted on Medpagetoday.com

Asthma inhalers have a real impact on airways, but the symptom relief isn't any greater than that achieved with placebos, researchers found.

Stable asthma patients reported the same degree of symptom improvement with inhalation of albuterol as occurred with a placebo inhaler or sham acupuncture (50%, 45%, and 46% improvement, respectively, P=NS) in a blinded pilot study led by Michael E. Wechsler, MD, of Harvard and Brigham and Women's Hospital in Boston.

All three were equally better than no treatment at all (21% improvement, P<0.001), they reported in the July 14 issue of the New England Journal of Medicine.

"Placebo effects can be clinically meaningful and can rival the effects of active medication in patients with asthma," the group concluded in the paper.

Yet the results also suggested that physicians need to keep a close eye on objective measures of asthma control, Wechsler and colleagues noted.

Albuterol had a strong objective effect on airflow, with a mean 20% improvement in forced expiratory volume in 1 second (FEV₁) -- nearly three times the 7% boost seen in all three other groups (P<0.001).

But "patients could not reliably detect the difference between this robust effect of the active drug and the effects of inhaled placebo and sham acupuncture," the researchers warned.

So "subjective improvement in asthma should be interpreted with caution and objective outcomes should be more heavily relied on for optimal asthma care," they recommended.

However, patients' subjective experiences are not wrong simply because they don't fit the objective facts of FEV₁ and actually should trump physician judgment in such symptom-defined conditions, Daniel E. Moerman, PhD, of the University of Michigan in Dearborn, argued in an accompanying editorial.

"It is the subjective symptoms that brought these patients to medical care in the first place," he wrote. "They came because they were wheezing and felt suffocated, not because they had a reduced FEV₁."

A treatment should be acceptable as long as it yields significant improvement for patients, has a reasonable cost, and doesn't have negative effects over the short or long term, Moerman suggested.

The study included 46 patients randomized to double-blind treatment with an albuterol inhaler, a placebo inhaler, sham acupuncture, or no intervention administered in a crossover design during a total of 12 sequential office visits three to seven days apart after a washout period for short- and long-acting bronchodilators.

The no-intervention group acted as a control for the placebo groups, which few prospective studies have tried, the researchers noted.

The most likely explanation for the greater efficacy of placebo was expectation of improvement as "the mere ritual of treatment may affect patients' self-monitoring and subjective experience of their disease," they wrote.

The study was limited by use of a nonvalidated subjective measure of asthma symptom improvement that didn't include a measure of worsening as well as by unknown generalizability to chronic asthma, the group cautioned.

Original article can be found here

Thankful Thursday - Time with Nana & Coaching

It's thankful Thursday time! We all have so much to be thankful for and we love to take this opportunity just to write down each and everything that comes to mind. as I mentioned, I no longer have the "linkytools" but I invite you to share your thankful blog in the comments section. Without further ado, here's what we're thankful for:

Mandi's List:

Mandi went night-night nice and early last night and I didn't have the heart to wake her up to have her list what she is thankful for.

Ronnie's List:

I'm thankful for this exchange at my spin class yesterday -

Instructor: Alright, turn it up one gear!

Me: [Turned it up one gear]

Instructor: Alright, turn it up another gear!!

Me: [Turned it up another gear]

Instructor: One last time, turn it up another gear!!

Me: [Did not turn it up another gear]

Instructor: [While pointing directly at me and calling me out in front of the whole class] What are you waiting for, you still haven't turned it up another gear?!?!?!

Why am I thankful for that? Because I need it. I'm pretty new to this whole spin thing, but one part I really like about it is the constant coaching. It's usually not so direct, as I will just follow whatever commands he barks out, but this time, he was only looking at me. When I'm pouring sweat, feeling like I'm about to barf and convincing myself that I can't push any further - what he did was exactly what I needed. I take coaching well and this was no exception. After he called me out I was able to finish the class at a higher pace than any previous class I had done before. As a bonus, I only dry heaved into my towel twice :)

I'm thankful for the extra time I was able to spend with my mom-in-law. We were able to spend a whole week with both Nana and Papi, but we were able to spend an additional week with Nana. Mandi and her mom were able to bond over some nursery shopping and were also able to pick out some fabrics to be used in Peanut's room. Can you believe that Nana has sewn most of our curtains and is now working on all of the nursery stuff?!!?! If only she could build cribs :)

So, what are you thankful for today?

Workout Wednesday: Toughest Part About Vacations

The toughest part for me about going on vacation (or going into the Hole) is getting thrown out of my routine and then trying to "get back in the groove" upon my return. I recently visited with some family friends in South Carolina to celebrate the 4th of July. The trip was an absolute blast that including a lot of fishing, boating, swimming and relaxing. Notice what was missing there? Exercise. We certainly didn't sit on our butts all day (quite the contrary), but I also wasn't getting to the gym and doing cardio daily like I'm used to. In that way, going on vacation is much like a stay in the Hole for me. I'm thrown off of my routine and knowing that the feeling of "fighting" to find my mojo back can sometimes be a little bit disheartening.

I really wanted to write about this because I know that it is a common occurrence in our community. We fight our butts off to exercise, do our treatments and take care of ourselves only to get a monkey wrench thrown into the motor to knock us off our feet. There's been plenty of times in my life that I have stopped working out because of a fast approaching hospital stay. Since I knew that I would have to stop going to the gym in two weeks, I figured "why push myself if I'm only going to be knocked off track?". It's funny, writing it down and reading it seems so silly, but it's a feeling that I'll feel often and I know that you feel it too.

It's the same thing with vacations. I have such a hard time getting back into the gym and back on a regular exercise schedule. Like I said before, we weren't completely inactive on this vacation, but it was still hard to get back into rhythm. For a real example - we got back on Friday and my first day back to the gym was on Tuesday. No bueno. If my number one priority in life is my health, which in turn allows me to focus and be there for my 1a priority, my family, I just need to suck it up and figure out a way to get back on track.

I wish I had a bunch of magical solutions for you all, but I really don't. I struggle with this just like you do. I was actually hoping that some of you would have some advice to offer. Other than repeating to myself often that my wife needs me around for a long time, and I'm convinced that exercise will play a big role in that, I got nothing. So what do you do? What do you do to find your grove again once you've been thrown off of your routine?

Worrying vs Caring

I was reading a great article yesterday about different ways that we can deal with stress. Now, I've got to say that I'm not a stress ball, but I have said some of these very same things to some people close to me who tend to stress. Often times, me not stressing about stuff comes off as not caring. I love that this snippet of the article does such a great job detailing the difference between worrying and caring. It's like music to my ears! (The entire article is great, but I have just provided one point out of ten)

Sometimes, our mindset can boost stress, so a small issue mushrooms into a pile of problems. We continue worrying, somehow thinking that this is a productive — or at least inevitable — response to stress. But we mistake worry for action.

Clinical psychologist Chad LeJeune, Ph.D, talks about the idea of worrying versus caring in his book, The Worry Trap: How to Free Yourself from Worry & Anxiety Using Acceptance & CommitmentTherapy. “Worrying is an attempt to exert control over the future by thinking about it,” whereas caring is taking action. “When we are caring for someone or something, we do the things that support or advance the best interests of the person or thing that we care about.”

LeJeune uses the simple example of houseplants. He writes: “If you are away from home for a week, you can worry about your houseplants every single day and still return home to find them brown and wilted. Worrying is not watering.”

Similarly, fretting about your finances does nothing but get you worked up (and likely prevent you from taking action). Caring about your finances, however, means creating a budget, paying bills on time, using coupons and reducing how often you dine out.

Just this small shift in mindset from worrying to caring can help you adjust your reaction to stress.

So, what do you think? Does this author have a point?

Time for a Tune-Up?

Now, before I lose your attention and you don't read the rest of the blog let me state, it is not actually time for a tune-up. Ronnie is feeling good and we don't foresee another tune-up in our near future. So again, let me repeat: it is NOT time for a tune-up.

However, I thought I'd share a funny thought I had yesterday. I randomly thought to myself, "Is it time for Ronnie to go in for a tune-up? I kinda miss tune-up time." Now let me reassure you that I hadn't been drinking - I'm pretty sure they frown on that when you're pregnant ;-). But totally sober and in a non-insane state of mind I actually "missed" the hospital. Let me explain..

As we've said before, we do everything we can to make the most out of our time while Ronnie's in the hole, so tune-ups are actually a relatively enjoyable time (besides the fact that Ronnie's not always feeling great and he's tethered to an IV poll 80% of the day). While Ronnie's in we do things we don't do while we're at home. So when it's been awhile since we've had a hospital stay, there are little things I actually miss, and begin to look forward to. I thought I'd share what they were because if they're enough to make me "eager" (that's a bit of an exaggeration) for a hospital stay, than they're likely a good thing to give a whirl when you're in the hole. Some of these you maybe can't do, but variations would be just as fun!

Dunkin Donuts - When Ronnie's in, we get DD every weekend morning - coffee, a breakfast sandwich and a donut if Ronnie is feeling really hungry. I love the feeling of getting up, nice and early (generally when his first treatment arrives at 7am), jumping in the car (obviously just me, Ronnie stays and does his treatments) and heading to DD to get our food. Everything is so calm at that time of day, so it's always a nice and relaxed feeling. I bring it back and we sit and eat our breakfast while listening to podcasts of our favorite radio segments.

Afternoon Walks - This is when we get to spend some quality time together, without the interruption of nurses, doctors, etc. It's always a nice time to get out, stretch our legs, and enjoy some beautiful sunshine. I absolutely love our afternoon walks, and look forward to getting down with work so we can go.

Family Dinners - We get take out and/or Ronnie's mom makes us dinner almost every night. Home-cooked food or yummy take out is always delish, but even better, we normally enjoy the food with members of Ronnie's family. His brothers come almost daily, and his mom or step dad comes once or twice a week. It is always a really special thing when we get to spend time with family...and getting 2-4 weeks straight of quality time is awesome.

Lazy Saturdays (ok...Sundays too) - At home, there always seems to be chores begging to be done on the weekends, but in the hole, there are no chores. Weekends become a time to totally veg out, watch TV and best of all, NAP! I take a nap at least once a weekend...and it is glorious.

Date nights and Game Nights - Sometimes these are one in the same, but we try to force a romantic date night at least once or twice a hospital stay. We find a secluded spot, light candles, and have dinner. Something about these nights feels so incredible. I don't know if it's the different locations or the chance to feel like we're "escaping," but man, I love these nights.

So those are the things I look forward to most for the next tune-up. Hopefully it won't be for another few months, but since I was having the silly thoughts of "man, I'm kind of looking forward to the next tune-up's activities" I thought I'd share. Maybe all these hormones are messing with my brain :)