Podcasts about Pseudomonas

In this episode, we review the high-yield topic of⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Pseudomonas aeruginosa⁠⁠ ⁠from the Microbiology section.Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets

David Jernigan 0:15Hello! Dr. Deb 0:16Hi there, sorry for all the confusion. David Jernigan 0:19Oh, no worries, you gotta love it, right? Dr. Deb 0:21Oh, I can’t hear you. David Jernigan 0:23No way, let’s see, my mic must be turned off? Dr. Deb 0:27Hang on, I think it’s me. Let’s see…Okay, let’s try now. David Jernigan 0:40Okay, can you hear me? Dr. Deb 0:42Yep, I can hear you now. David Jernigan 0:43Excellent, excellent. And, how are you today? Dr. Deb 0:48I am good, thank you. How about yourself? David Jernigan 0:50I’m good. Well, it’s good to finally meet you and get this thing rolling. Dr. Deb 0:56Yes, yes, I’m so sorry about that. David Jernigan 0:58That’s alright, that’s alright.So… Dr. Deb 1:01Yeah, go ahead. David Jernigan 1:03So, tell me about yourself before we get going. Dr. Deb 1:06Yeah, so I am a nurse practitioner. I’m also a naturopath. I have a practice here in Wisconsin. I’ve been treating Lyme for about 20 years, so I’m really excited to have this conversation and learn what you’re doing, because it’s so exciting and new. David Jernigan 1:21Well, thank you. Dr. Deb 1:22Yeah, so we treat a lot of chronic illness patients, do some anti-aging regenerative things as well, so… David Jernigan 1:30Yeah, I went to your website and saw you guys are killing it, looks like. Dr. Deb 1:35Yeah. David Jernigan 1:35Got a lot of good staff, it looks like. Dr. Deb 1:37Yeah, we’ve got great staff, great patients, busy practice. We have 5 practitioners, so we have about 15,000 patients in our practice right now. David Jernigan 1:46Well, excellent. Yeah. Excellent. Yeah, yeah.So, I’m excited for this discussion. Dr. Deb 1:53Good, me too. So I pre-recorded our intro, so we can just kind of dive right in, and I’ll just ask you to kind of introduce yourself a little bit, tell us a little bit about yourself, and, and then we can just dive right into it. David Jernigan 2:08All right. I’m Dr. David Jernigan, and I own the Biologic Center for Optimum Health in… Franklin, Tennessee, and I’ve been in practice for over 30 years. I shook Willie Bergdurfer’s hand, if anybody knows who that is. It’s kind of infamous now with some of the revelations that have happened about Lyme being a bioweapon and weaponized. But, you know, I’ve been doing this, probably longer than almost anybody that’s still in the business in the natural realm. It chose me. I did not choose Lyme. Matter of fact, there were many times in my career that I was like. You know, cancer’s easier because of the fact that everybody agrees, you know, what we’re dealing with. And in the 90s, it was a whole different reality, where nobody actually understood that you could have Lyme disease and not be coming from New England.You know, so I had actually the first documented case of a Lyme disease, CDC positive.Patient that had never left the state of Kansas before. So they couldn’t say that it wasn’t in Kansas, and so she had actually been, pregnant with… twin boys, and they were born CDC-positive as well, and so it is transmitted across the placenta we know.So, I, you know, the history of how I did all this was, in the 90s, probably 1996, probably, somewhere in there, 97. With this woman, you know, I… if you go into Robin’s pathology books from back then. Which we all used, medical doctors and everybody else studying. you know, there was basically a paragraph about Lyme disease, and on the national board tests, as you recall, it was probably like, what causes, or what is, bullseye rash associated with? And you’d had to guess Lyme disease, of course. Dr. Deb 4:07Female. David Jernigan 4:08But that was, you know, considered to be more a New England illness, and you would never see it anywhere else. But here was this woman. I knew… nothing about Lyme beyond what we had gotten taught in college, which was, like I say, next to nothing. And she would not let me stop feeding me information. I mean, you gotta remember, the internet wasn’t even hardly in existence in those years. I mean, it was brand new. It was supposed to be this information highway, and So I started purchasing, like a lot of doctors do even now, they start purchasing every kind of new supplement that’s supposed to work for bacteria. There was no product in those days that actually was Lyme-specific. I mean, nobody was really dealing with it naturally. It was always a pharmaceutical situation. Dr. Deb 5:04And a very short course at that. David Jernigan 5:06Yeah, 2 weeks of doxy and you’re cured, whether your symptoms are gone or not, which… she’d had the 2 weeks of doxy, and her symptoms and her son’s symptoms were not gone. And so, I absolutely just purchased everything I could find. Nothing would work. I mean, I could name names of products, and you would recognize them, because they’re still out there today. Dr. Deb 5:28Which is. David Jernigan 5:30Kind of a… A sad thing that natural medicine is still riding on these things that have the most marketing. Dr. Deb 5:37As opposed to sometimes the things that actually have the documented research. David Jernigan 5:42Behind it, and I am a doctor of chiropractic medicine, and I specialized all these years in chronic, incurable illnesses of all types. That may sound odd to a lot of people, but doctors of chiropractic medicine are trained just like a GP typically would be. The medical schools, as I understand it, got together, decades ago and said, wow, if all we did was… Crank out general practitioners for the next 10 years, we wouldn’t have still enough general practitioners to supply the demand. Dr. Deb 6:17Right. Everybody in medicine, in medical schools, wanted to be a specialist, because that’s where the money was, and it was… David Jernigan 6:24Easier, kind of, also, to… you know, just focus on one part of the body, and specialize in that. Dr. Deb 6:31Expert in that one area. David Jernigan 6:32So we all now have the same training. We all go through pre-med. We got a bachelor’s degree, I got my bachelor’s degree in nutrition, and through, Park University in Parkville, Missouri. And so, you know, when I ran out of options to purchase, I just used a technology that I developed, which was an advancement upon other technologies, but I called it bioresonance scanning. And I coined the term back in the 90s. It was a way to kind ofKind of like a sensitive test, you know, like you might. Dr. Deb 7:09I wouldn’t. David Jernigan 7:09Of applied kinesiology, then clinical kinesiology, then chiro plus kinesiology, then, you know, you can just keep going with all the advancements that were made. Well, this was an advancement upon those things, so… I developed… I was the first in… in… my known world of doctors to develop a way to detect adjunctively, obviously we can’t say it’s a primary diagnosis. Adjunctively detect the presence of a given specimen. So we could say, thus saith my test. It’s highly likely you have Borrelia burgdurferi. And, but I had to have the specimen on hand to be able to match what I call frequency matching to the specimen. Brand new concept in those days. And so I was able to detect whether or not my treatments were successful or not. This is something even now that’s really difficult for doctors, because antibody tests, even the most advanced ones, it’s still an antibody test. It’s still an immune response to an infection.And accurately, you know, some doctors will slam those tests, saying, well. That doesn’t mean you actually have the infection, that just means your body has seen it before, which is a correct statement, kind of. So being able to detect the presence, and even where in the body these infections are was a way huge advancement in the 90s, for sure it’s kind of funny, I think about a conference I went to, and cuz… I’m kind of jumping ahead. Because I ended up developing my own formula, just for this woman and her children, and it worked. And I was like, wow! Their symptoms were gone, all the blood tests came back negative. In those days, we were using the iGenX. Western blot, eventually. And the, what was called a Lyme urine antigen test. I don’t know if you remember that, because it… Only decades later did I meet, the owner of iGenX, Nick Harris. Dr. Deb 9:17Person. And I was like, whatever happened to the Luwat test? Because I took it off the market after a while. He said, honestly, we lost the antigen and couldn’t find it again. Oh, no. David Jernigan 9:27And so… but that was a brilliant test. It was the actual gold standard in those days. Again, the world… it can’t be understated how different the world was in the 90s. Dr. Deb 9:40Yeah. David Jernigan 9:41Towards natural medicine, even. Dr. Deb 9:44Oh, yeah. We think… we think it’s bad now, but, like, when I started, too, I started in the early 2000s, like, we were all hiding under the radar, like, you didn’t market, we would have never been on social media, we didn’t run ads, we didn’t do any. David Jernigan 10:00Right. Dr. Deb 10:01Because the medical boards were coming for us. David Jernigan 10:04Came after me. Dr. Deb 10:05Because I had the word Lime on my page, my website. David Jernigan 10:10You know, not saying that I treat Lyme. Dr. Deb 10:13Hmm? David Jernigan 10:13Yes Dr. Deb 10:15Just talking about mind. David Jernigan 10:16And it’s funny, because, once I had this formula, it was something… and I trained in Germany, in anthroposophical medicine, and they’ve been trained in herbal… making herbal extracts, making homeopathic remedies in the anthroposophical methodology, and I trained with the Hahnemann versions of homeopathy, which is just slightly different. Yeah. And, so I was well-versed with making some of my own formulas by that time. And so, it was really something that I wrote on the bottle, you know, and I had to call it something, so I called it Borreligin, which is still in existence, and it’s still a phenomenal herbal remedy right now. And to my knowledge, it’s the only frequency-matched herbal formula. Maybe still out there. Because unless you knew how to do my testing, the bioresonent scanning, there was no way to actually do frequency matching. Matter of fact, as a really famous herbalist attacked me online, saying, oh, none of these herbs will kill anything. And I’m like, that wasn’t what I was saying. I was saying, back in those days, I was saying, well, if… what would the body need to address these infections?You know, not, like, what’s gonna kill the infections for the body. Dr. Deb 11:38Right. David Jernigan 11:39Right? So it was a phenomenal way, but the LUAT test was amazing because what you’d do is you would give your treatment, like an MD would give an antibiotic for a week, ahead of time. Trying to increase the number of dead spirochetes showing up in your urine one day out of 3 days urine catch. So you’d wake up in the morning, you’d collect your urine 3 days in a row, and any one of those being positive is a positive. But it was a brilliant test because it wasn’t an antibody test. They were literally counting the number of dead pieces of Lyme bacteria in your urine. I mean, it was pretty irrefutable. So I had a grand slam on the… the Western blot on patients, and I’d also have a grand slam on the LUAT, and their medical doctors would say, oh, that doctor in the lab are probably in cahoots change some lab. Dr. Deb 12:38Of course. David Jernigan 12:39That come in. And I still see that today. You know, it’s like, oh my gosh, the better the tests are getting. There’s still a bias if you do your own research. Well, if you happen to be a doctor who loves research. And you’re a clinician, so you actually treat patients who’s gonna write the research study? Well, of course, the doctor who did the study, well, he’s biased, and I’m like, I still can’t influence lab tests. Well, lab tests aren’t everything. People scream over the internet at me. It’s like, well, a negative lab test doesn’t mean anything. I was like… I get that with the old Western blot testing. Dr. Deb 13:16Right. David Jernigan 13:16The more sensitive tests, which are very close to 100%, Sensitivity, and 100% specificity. So, meaning, like, they can… if you have the infection, they’re gonna find it. Dr. Deb 13:30They’ll find it, yeah. David Jernigan 13:31And if they… if you have the infection, they’re going to be able to tell you exactly 100% correctly what kind of infection it is. Back in those days, you couldn’t, you could just count the dead pieces, which was… Dr. Deb 13:43Yeah. David Jernigan 13:43Significant, but It’s funny, because when medicine does that, you know, mainstream medicine that’s backed by all the nice foundations who donate millions of dollars towards the research. Their negative tests are significant, but if you fund your own, Yours isn’t that significant. Dr. Deb 14:04Right, or what if we call something a seronegative autoimmune disease, like lupus or rheumatoid arthritis, because none of the tests are positive, but you have all the symptoms. Here, let me give you this $100,000 a year drug. David Jernigan 14:19Yeah. Dr. Deb 14:19And instead of looking for what might actually be causing the symptoms. That’s all okay, but what we do is not okay. David Jernigan 14:27Right. Yeah, it’s a double standard, and it’s getting better. I want to do… tell the world it is getting better. Some of the dinosaurs are retiring. Dr. Deb 14:36No. David Jernigan 14:37Way for people who are… Are more open-minded to new ideas. But, getting back to that woman, she… that formula that I made just for her and her son, I… She went online. Dr. Deb 14:54Which, I had never been on a news group. David Jernigan 14:58Not even sure I knew what one was, you know? Imagine, I’m kind of that dinosaur that… Cell phones were, like, these really big things with a big antenna sticking out of it, and… Dr. Deb 15:09Nope. David Jernigan 15:10So I thought I was pretty hot stuff, just that I actually had a computer software program that was running my front desk. And even then, it was an Apple IIe computer. Dr. Deb 15:21Right. David Jernigan 15:22Probably be pretty valuable right now if I’d kept it, but… Dr. Deb 15:25Mmm… David Jernigan 15:26It being an antique. But, suddenly people were calling my clinic, because the lady with the twin boys that was well was telling people on these research, I mean, these Lyme disease forums and boards online. And, I started going, oh my gosh, you know, as a doctor, it’s one thing to treat a person in your clinic, it’s a different thing to have your clinic name on the label. Like, we all do, Even now, and you’re supposed to write everything that’s on the label, and… all these guidelines, and I’m like, wow, I need to split this off. I mean, I def… I definitely want to help people, and this is… I was pretty excited about the results we were getting. Pre-treat… Pre-treatment and post-treatment. And, so… that’s where I developed, my nutraceutical business in the 90s called Journey Good Nutraceuticals. My advice to anybody thinking about doing the same thing, don’t put your last name on it. Dr. Deb 16:25– David Jernigan 16:25You know, because anytime negative anything comes out, there goes the Jernigan name, you know, the herbal, you know, there’s just all these, and especially nowadays, with all the bots that are just designed to slam natural medicine. Dr. Deb 16:38Yeah. David Jernigan 16:39And that is out there in a… and just ugly people. Dr. Deb 16:42Or should we just say, people with a different opinion? How’s that? David Jernigan 16:46Yeah. That are being less than supportive. Dr. Deb 16:49But. David Jernigan 16:51It was amazing, because by 1999, I presented my research, my first research, I’d never done research. This is what I would… I would say to a lot of people who go, my doctor did… I don’t know, my doctor doesn’t know what you’re doing, my doctor… I was like going, you know, most doctors don’t do research. They don’t publish anything. Their opinion is their opinion, but they don’t back it up in peer review, right? And so that’s what I always tried to do, was back it up in peer review and publish. And so, in 1999, I presented at the International Tick-Borne Diseases Conference in New York City. I’m telling you, it was like the country boy going to the city, you know, I got my… I got my suit on, and I looked all right, and my booth was wonderful, and all these different things, and it was just a big wake-up call.Because what we had demonstrated… let’s get back to the… and this was what I demonstrated with that first study. was that… A positive LUAC test, that Lyme urine antigen test for my Gen X, was a score of 32. Meaning, one of those 3 mornings urine had 32 pieces in the amount of urine they checked of deadline bacteria spirochetes. Okay? Okay. With antibiotic challenges, a highly positive was a score of 45. Dr. Deb 18:19Wow when I would give one dropper 3 times a day for a week. David Jernigan 18:24Ahead of time, and then do the person’s LUAT test, We were getting scores 100, 200… And at that point, we only had a couple, but we had a couple that were greater than 400. Yeah, dead pieces, where the lab just quits counting. They just said, somewhere over 400, right? Dr. Deb 18:45Yeah. David Jernigan 18:46Which, when the medical system at the conference, you know, I was the only natural doctor in the world that was… had any kind of proof of anything naturally that could outperform antibiotics. Can you imagine? Dr. Deb 18:59Yeah. And… David Jernigan 19:01They were just, oh my gosh, incredulous. They’re like, I’ve given the most… one guy came up to me, and to my face, and he goes, I’ve given the most aggressive antibiotic protocols And I’ve only seen one patient over 100. I was like, that makes this pretty significant, doesn’t it? But, it didn’t just, like, make us take off, because guess what? In Lyme world, if a pharmaceutical antibiotic made you feel horrible. That meant it was working. Dr. Deb 19:28That’s right. We used to, back in the day, if you didn’t herx. And had that horrible die-off reaction, for those of you who don’t know what a herx is, but if we didn’t make you herx, we weren’t doing our job right. David Jernigan 19:40You’re looking for your patients to feel horrible, and sometimes to the level of committing suicide. Dr. Deb 19:46Yes. David Jernigan 19:47So bad. Dr. Deb 19:48Yes. David Jernigan 19:49And I was the first doctor, I think, in the world to start screaming and hollering and saying, stop using the worsening of your patient’s symptoms as a guide to good treatment, because they’re… I wasn’t seeing it with my formulas. Because I was doing a comprehensive program of care. I think I was also one of the first doctors to say, we need to detoxify these people as we’re doing this. And you would sit there and say, well, sure you were. I was like, well, remember, there wasn’t a lot of communication. There wasn’t anybody on the internet saying, do this, do that. And, It was, it was interesting in those days. It was, how do you… How do you help the world heal from these things? That they don’t know they have. So later, I actually had a beautiful booth at a health… a big health expo in Texas, I remember, and I was like, you know, you spend a lot of money on the booth, and… Dr. Deb 20:43Yup. David Jernigan 20:43And you’re thinking about it because you’re funding the whole thing, you say, wow, if I only sell one case, I’ll at least cover my cost. Dr. Deb 20:51Yep. Yeah, you’re great. David Jernigan 20:52And I had this beautiful banner of, like, a blown-up tick’s mouth under microscope. You know those beautiful pictures of, like, all the barbs sticking out, and how they anchor themselves in your skin, and… And, thousand people walking by my booth, and they’re just like, keep walking, because they didn’t know they had Lyme. There was, like, and they had MS, maybe, but they don’t have Lyme, and so they just would keep walking. Nobody even knew. Why would I go to a conference in Texas? And I’m trying to say, no, guys, it’s everywhere. Dr. Deb 21:24Yeah. David Jernigan 21:24And… and everybody, you know, yes, you probably have this, you know, kind of thing. If you’re… if you… are chronically ill, almost, of any kind of way. You know, kind of trying to tell people this was… Again, in Robin’s pathology textbooks, one of the few things that it did tell you about Lyme was that it was called the Great… the New Great Imitator. Because it would imitate up to 200 or more different illnesses. So, it’s been an interesting journey, of… educating people, writing articles, but it was interesting, the lady who I first fixed, Laboratory verified, everything like that, symptoms went away, all that kind of fun stuff. Her children were fine, they’ve been fine for years now. When she went on the newsboards in the Lyme disease support groups, It created a war. Oh my goodness, it was like, how dare you? And, say that something natural might actually help, right? Dr. Deb 22:30Right, exactly. David Jernigan 22:32And, I even had… A… one of those first calls to… with a marketing company at one point, way a long time ago. And the lady got on the phone, the owner of the marketing company goes, I would have blood on my hands if I actually took your clinic on. Yeah, you can’t treat Lyme disease, and… Even the big, big associations that are out there are still largely that way. I mean, they’re getting better, but it’s just like… you know, a lot of the times, it’s herbs are good. Herbs will help. Good, you know, but they’re safe. So, it’s still a challenge to… to… present in mainstream Lyme communities, even. Because there’s this… Fear of doing anything outside of antibiotics. Dr. Deb 23:32Yeah, so let me ask you this. From your perspective. Why do you think so many chronic infections exist these days, like Lyme and the co-infections, Babesia, Bartonella, mold illness? And we talked a little bit about herbs and why they, antibiotics and things like that fail, but let’s talk a little bit about that. David Jernigan 23:53So, it’s fascinating. When I trained in Germany, they said that we, as humanity, has moved away from what they called the inflammatory diseases. You know, in the old days, it was. Lots of high fevers, purulent, pus-generating bacterial infections. And I said, as a society, we have… Dr. Deb 24:14Have shifted from those to what they call cold sclerotic diseases, which are your… David Jernigan 24:21Cancers, your diabetes, your atherosclerosis, your… and they said, we’re starting to see what used to only be geriatric diseases in our children. That’s how bad it’s gotten. We have suppressed fevers, we don’t… we don’t respect the wisdom of the human body. So, you know, the doctors say, step aside, body, I will fix this infection for you with this antibiotic. And so, what we’ve done with the, overuse of antibiotics, and this isn’t me just talking from a natural perspective, this is… Right, it’s everybody around the world is acknowledging. I’ll show you… I could show you a, a presentation, if we can do a screen-sharing situation. Yeah. About the antibiotic situation in the world, because it’s really concerning. But what I would say, and kind of like an advancement forward, is we are seeing mutated bacteria. You know, they talked about… do you remember when they found the Iceman, you know, the… You know, the prehistoric guy that’s… In the eyes, and he had Lyme bacteria. I was like, he had spirochetes, maybe. Dr. Deb 25:33Yeah. David Jernigan 25:33That isn’t a modified, mutated version. That’s just maybe the… Lyme… you know, Borrelia… call it Borrelia something, you know, it’s a spirochete, but what we’re dealing with today. Even under strep or staph, as you know, you know, Pseudomonas aeruginosa, you name it, whatever kind of infection a person has is not the same bacteria that your grandparents dealt with. Dr. Deb 26:01That’s right. David Jernigan 26:32It’s a much mutated, stronger, more resistant to treatment type of thing. So, I think that’s one reason. I think the, It’s great that we’re seeing, you know, Secretary Robert F. Kennedy Jr. bringing awareness to things that Like it or not, yeah, seed oils do create inflammation, and everyone in the natural realm, as you know. Has been trying to say this for probably how long? Dr. Deb 26:35Yeah, 25, 30 years. 20 years each. David Jernigan 26:48Yes. You know, thank goodness for people like Sally Fallon and her beautiful book, Nourishing Traditions, that started you know, Dr. Bernard Jensen’s books way back in the day, Dr. Christopher’s books way back in the day. Dr. Deb 26:48Damn. David Jernigan 26:49You know, all of them were way ahead of their time, saying, by the way, your margarine is only missing one ingredient from being axle grease. Dr. Deb 26:58Yeah. David Jernigan 26:58I think that was Dr. Jensen saying that at one point, probably 50, 60 years ago, I don’t know. Dr. Deb 27:03Yep. David Jernigan 27:04So, we’ve created this monster. We, we live in a very controlled environment, you know, of 72, 74 degrees at all times, we don’t sweat, we don’t have to work that hard, typically. You know, most of us aren’t out there like our ancestors were, so that’s making us more and more… Move towards the cold sclerotic diseases, of which even Lyme disease is, you know, which… Yes, it has inflammation, yes, but as a presentation, it’s very often associated with some of these Cold sclerotic diseases of mankind that we see now. Dr. Deb 27:46You have it. David Jernigan 27:47Yeah. Dr. Deb 27:48So, tell me, what is phage therapy? David Jernigan 27:52Well, may I show you a cool video? Dr. Deb 27:55Yeah, I’d love that. David Jernigan 27:56I did not make this video, this is just one of my favorites, because it’s from the National Institute of Health. Let’s see if I can just… Click the share screen thing. And get that to pop up. That’s not what I’m looking for, but it’s gonna be soon. Let’s go here… Alright, can you see that? Dr. Deb 28:18Yeah. David Jernigan 28:19Okay. Modern medicine faces a serious problem. Thanks in part to overuse and misuse of antibiotics, many bacteria are gaining resistance to our most common cures. Researchers are probing possible alternatives to antibiotics, including phages. So, bacteriophages, or we like to call them phages for short, are naturally occurring viruses that infect and kill bacteria. The basic structure consists of a head, a sheath, and tail fibers. The tail fibers are what mediate attachment to the bacterial cell. The DNA stored in the head will then travel down the sheath and be injected inside the cell. Once inside the cell, the phage will hijack the cellular machinery to make many copies of itself. Lastly, the newly assembled phages burst forth from the bacterium, which resets their phage life cycle and kills the bacterium in the process. Someday, healthcare providers may be able to treat MRSA and other stubborn bacterial infections using a mixture of phages, or a phage cocktail process would be first to identify what the pathogen is that’s causing the infection. So the bacterium is isolated and is characterized. And then there’s a need to select a phage in a process known as screening of phage that are either present in a repository or in a so-called phage library. That allows for many of the phages to be evaluated for effectiveness against that isolated I don’t know, bacterium. Phages were first discovered over 100 years ago by a French-Canadian named Felice Derrell. They initially gained popularity in Eastern Europe, however, Western countries largely abandoned phages in favor of antibiotics, which were better understood and easier to produce in large quantities. Now, with bacteria like these gaining resistance to antibiotics, phage research is gaining momentum in the United States once again. NIAID recently partnered with other government agencies to host a phage workshop, where researchers from NIH, FTA, the commercial sector, and academia gathered to discuss recent progress. NIH… So… That is… That is what phage therapy in… is. in what I call conventional phage. Let’s see, how do I get out of the share screen? Hope you already don’t see it. Dr. Deb 30:58Yep, at the top, there should just be a button. David Jernigan 31:00I don’t. Dr. Deb 31:00Stop sharing, yeah. David Jernigan 31:01So… Conventional phage therapy, as you just saw, is a lot like what it is that we’re doing, only the difference is they’re taking wild phages from the environment. They’re finding phages anywhere there’s, like, a lot of bacteria. And then they isolate those phages, and like he said, the gentleman at the very end said we put them in a library, and so there are banks of phages that they can actually now use, and One of the largest banks that I know of has about 700 different bacteriophages, or phages. In their bank that they can pull from. Dr. Deb 31:43Wow. Do you want to take a guess? David Jernigan 31:46How many bacteriophages they’ve identified are in the human gut, on average? Dr. Deb 31:52Oh my god, there’s gotta be more… David Jernigan 31:53Kinds, different kinds of phages, how many? Dr. Deb 31:56There’s gotta be millions. David Jernigan 31:57Well… In population, there’s… humongous numbers, numbers probably well beyond the trillions, okay? Hundreds of trillions, quadrillions, maybe, even. But in the gut, a recent peer-reviewed journal article said that there were 32,242 different types of bacteriophages that live naturally in your intestines, your gut. Dr. Deb 32:25Boom. David Jernigan 32:2632,000. Okay, so… If you read any article on phage therapy that’s in peer review, almost every single one in the very first paragraph, they use the same sentence. They go, Phages are ubiquitous in nature. They’re ubiquitous in nature. So my brain, when I find… when all this finally clicked together, and when we clicked together 5 years into my research, I could not get it to work for 5 years. I just kept going. But that sentence really got me going. I was, like, going, you know. If you look at what ubiquitous means, it says if Phages were the size of grains of sand. Like sand on the beach. They would completely cover the earth and be 50 miles deep. How crazy is that? Dr. Deb 33:24Wow. David Jernigan 33:25That’s how many phages are on the planet. There’s so many… they outnumber every species collectively on the planet. So, it’s an impossibility in my mind. I went, huh, it’s an impossibility that… You catching a, a sterile Bacteria, it’s almost an impossibility. Since the beginning of time, phages have been needing to use a reproductive host. And it’s very specific, so every kind of bacteria has its own kind of phage it uses as a reproductive host. Because phages are… and this is a clarification I want to make for people. just like in the old days, we were talking about the 90s, I talked to a veterinarian that had gotten in trouble with the veterinary board in her state. Dr. Deb 34:14Back in the old days. David Jernigan 34:16Because she gave dogs probiotics. And the board thought she was giving the dogs an infection so that she could treat them and make money off of the subsequent infection. Dr. Deb 34:28Oh my god. David Jernigan 34:29Nobody actually had heard of good, friendly bacteria in the veterinary world, I guess she said she had gotten in trouble, and she had to defend herself, that, no, I’m giving friendly, benevolent, beneficial bacteria. Okay, to these animals, and getting good results.So, phages… Are friendly, benevolent, beneficial viruses. That live in your body, but they only will infect a certain type of bacteria. So… What that means is if you have staff.Aureus, you know, Staphylococcus aureus bacteria. That bacteria has its own kind of phage that infects it called a staph aureus phage. E. coli has an E. coli phage. Each type of E. coli has its own phage, so Borrelia burgdurferi has its own Borrelia burgdurferi type of phage, whereas Borrelia miyamotoi alright? Or any of the other Borrelia species, or the Bartonella species, or the… you just keep going, and Moses has its own type of phage that only will infect that type of bacteria. So that’s… You know, when you realize, wow, why are we going to the environment Was my thought. Dr. Deb 35:54Yeah. David Jernigan 34:55Trying to find wild phages and put them into your body, and hopefully they go and do what you want them to do. What if we could trigger the phages themselves that live in your body to, instead of just farming that bacteria that it uses as a host, because what I mean by farming is the phages will only kill 40% of that population of bacteria a day. Dr. Deb 36:20Wow. David Jernigan 36:20And then they send out a signal to all the other phages saying, stop killing! Dr. Deb 36:24It’s like. David Jernigan 36:2560% of the bacteria population left to be breeding stock. It’s kind of like the farmer, the rancher, who… he doesn’t send his whole herd to the butcher. Dr. Deb 36:35Right. David Jernigan 36:36Just to, you know, he keeps his breeding stock. He sends the rest, right? So, the phages will kill 40% of the population every day, just in their reproduction process. Because once there’s so many, as you saw in the video, once the phage lands on top of the bacteria, injects its genetic material into the bacteria, that bacteria genetic engine starts cranking out up to 5,200 phages per bacteria. Dr. Deb 37:06I don’t know who counted all those… David Jernigan 37:08Inside of a bacteria, but some scientists peer-reviewed it and put it out there. that ruptures, and it literally looks like a grenade goes off inside of the bacteria. I wish I’d remembered to bring that video of a phage killing a bacteria, but it just goes, oof. And it’s just a cloud of dust. So, you’re breaking apart a lot of those different toxins and things. So… That’s… That was the impetus to me creating what I did. That and the fact that I looked it up, and I found out that phages will sometimes go… Crazy. I don’t know how to say it. Wiping out 100% of their host. And it could be a trigger, like change in the body’s pH levels, it could be electromagnetically done, you know, like, there’s been documentation of… I think it was, 50 Hz, electricity. Triggering one kind of phage to go… Crazy and annihilate its host population. There’s other ways, but I was, like, going, none of those fit me, you know? It’s not like I’m gonna shock somebody with a… Jumper cable or something to try to get phages to… to do that kind of thing. But the fact that it could be done, they can be triggered, they can switch and suddenly go crazy against their population. But what happens when they kill 100% of their host? The phages themselves die within 4 days. Dr. Deb 38:45Hmm. Because they can’t keep reproducing. David Jernigan 38:47There’s nothing to reproduce them, yeah. Dr. Deb 38:49Yeah. Especially… unless they’re a polyvalent phage, that means a phage that can segue and use. David Jernigan 38:54One or two other kinds of bacteria. To, as a reproductive host. But a lot of phages, if not the majority, are monovalent, which means they have one host that they like to use. And so… Borrelia, so… my study that I ended up doing, and I published the results in 2021, And it’s a small study, but it’s right in there at the high end, believe it or not, of phage research. Most phage research is less than 30 people. In the study. But, we did 26 people.And after one month of doing the phage induction that I invented, which only… Appears to only, induce or stimulate the types of phages that will do the job in your body. I don’t care what kind of phage it is. I don’t care if it’s a Borrelia phage, it may be a polyvalent phage that normally doesn’t use the Borrelia burgdurferi as its number one. Host, but it can. To go and kill that infection. And the fascinating thing is, there was a brand new test that came out at the same time I came out with the idea, literally the same weekend they presented. Dr. Deb 40:1511. David Jernigan 40:15ILADS conference in Boston in 2019. It was called the Felix Borrelia phage Test. So the Felix Borrelia phage test. Because Borrelia are often intracellular, right, they’re buried down in the tissue, they’re not often in the blood that much. And therefore, doing a blood test isn’t really that accurate. But you remember how there’s, like, potentially as many as 5,200 phages of that type erupt from each bacteria when it breaks apart. It’s way easier to detect those phages, because they’re now circulating, those 52, as you saw in the video. 5,200 different phages are now seeking out another Borrelia that they can infect. And so, while they’re out in circulation, that’s easy to find in the bloodstream. So, 77% of the people, so 20 out of 26, were tested after a 2-week period. After only a 4-day round of treatment. Because according to my testing, remember, I can actually test adjunctively to see if I can find any signatures for those kinds of bacteria. And I couldn’t after 4 days, so we discontinued treatment and waited Beyond the 4 days that would allow the phages themselves to die, so we waited about a week and a half.And redid the test. And 77%, so that 20 out of 26 of the people, were completely negative. Dr. Deb 41:50Wow. David Jernigan 41:52Which, you go, well, it’s just a blood test. Well, no, we actually had people that were getting better, like, they’d never gotten better before. We had one woman who was wheelchair-bound, and in two weeks was able to walk, and even ultimately wanted to work for my clinic. I’m just, like, going… Dr. Deb 42:07I didn’t want to write about all that. I wanted to write about the phages. I was like… David Jernigan 42:12article, I probably should have put some of those stories, because, Critics would say, well, you got rid of the infection, maybe, but… Did you fix the Lyme disease? Well, that’s… there’s two factors here that every doctor needs to understand. There’s the infection in chronic illness, there’s the infection, and then there’s the damage that’s been done. Because sometimes I have these people that would come in and say, well, Dr. Jernigan, it didn’t work for me, I’m still in the wheelchair. And I’m like, no, it worked. Repeat lab test over months says it’s gone, it’s gone, it’s gone. It’s like, we would follow, and 88% of the people we followed long-term were still negative, which is amazing to me. Dr. Deb 42:56And then they have to repair the damage. David Jernigan 42:59It’s the damages why you still have your symptoms. And that’s where the doctor has to get busy, right? Dr. Deb 43:06Right David Jernigan 43:06They were told erroneously by their doctor that originally treated them that they’d be well, they’d get out of the wheelchair, if he could actually kill all these infections. Dr. Deb 43:15It’s not true. David Jernigan 43:16Unless it’s caught early. So I love the analogy, and I’ve said it a thousand times.that Lyme disease and chronic infections are much like having termites in the wood of your house. If you find the termites early, then yeah, killing the infection, life goes back to normal, the storm comes and your house doesn’t fall down. But if it’s 20 years later. Killing the termites is still a grand idea. Right. But you have the damage in the wood that needs to be repaired as well. All the systems… when I talk about damage to the wood, I mean, like. All the bioregulatory aspects of the body, how it regulates itself, all the biochemical pathways, the metabolic pathways we all know about, getting the toxins that have been lodged in there for many years, stopping the inflammatory things that have been running crazy. Dealing with all those cytokines that are just running rampant through the body, creating this whole MCAS situation. Which are largely… Dr. Deb 44:21Coming from your body’s own immune cells called macrophages, which are not even… David Jernigan 44:26It’s not… a virus at all, it’s part of the immune system, it’s like a Pac-Man, and research shows that especially in spirochetes. There is no toxin. Now, I wrote 4 books. I think I wrote the very first book on the natural treatment of people with Lyme disease back in the 90s. Why did I write that? Not because I wanted to be famous, it’s a tiny book, actually, the first one was.I was just trying to help people get out of this idea that you will be well when you kill all the bugs. I was saying, it’s… you need to be doing this. If you can’t come to my clinic, at least do this. Try to find somebody that will do this for you. And that ultimately led to a bigger book.as I kept learning more, and I was like, going, well, okay, now at least do this amount of stuff. And you need to make sure your doctor is handling this, this, this, and this. And so, the third book was, like, 500 and something pages long. And then the fourth book was 500 and something pages long, and now they’re all obsolete with the whole phage thing, because this just rewrites everything. Dr. Deb 45:34Yeah. David Jernigan 45:34It’s pretty fascinating. Dr. Deb 45:37Do you think the war on bugs, mentality created more chronic illness than it solved? David Jernigan 45:44Because of the tools that doctors had to use, yes. We’re a minority, we’re still a minority, you and I. Dr. Deb 45:54Yep. Our doctoring… David Jernigan 45:56Methods I never had, and you’d never… maybe you did, but I’d never had the ability to grab a prescription pad and write out a prescription. I had to figure out, how do I get… and this was… and still my guiding thing, is like, how do I identify, number one, everything that can be found that’s gone wrong in the human body. And what do I need to provide that body? Like, the body is the carpenter. That has to do the repair, has to regenerate, has to do everything, has to get… everything fixed right? We can’t fix anything. If you have a paper cut, there isn’t a doctor on the planet that can make that go away. Dr. Deb 46:38Right. David Jernigan 46:39Of their own power, much less chronic illnesses. So, all the treatments are like the screws, saws, hammers, you know the carpenter must be able to use. So a lot of the time, doctors are just throwing an entire Home Depot on top of the carpenter. In the form of, like, bags of supplements, you know, hundreds of supplements, I’ve seen patients walk in my door with two suitcasefuls. And they were taking 70 bottles, 65 to 70 bottles of supplements, and I’d be just like, wow, your carpenter who’s been working for 24 hours a day, 7 days a week. He’s exhausted. There’s chaos everywhere, you don’t know where to. Dr. Deb 47:22Starting. David Jernigan 47:22He goes, you want me to do what with all this stuff? Dr. Deb 47:25Yep, I’ve seen the same thing. People… thousands, you know, several thousand dollars a month on supplements, and not any better. But they’re afraid to give up their supplements, too, because they don’t want to go backwards, either, and… there’s got to be a better way on both sides, the conventional side and the alternative side, although you and I don’t say it’s alternative, that’s the way medicine should be, but… David Jernigan 47:48Right. Dr. Deb 47:49We have to have a good balance on both sides. David Jernigan 47:52And I will say, too, in defense of doctors using a lot of supplements, I do use a lot of supplements. Dr. Deb 47:57Yeah, I do too. David Jernigan 47:58but I want to synergize what I’m giving the patient so that the carpenter isn’t overwhelmed and can actually get the job done. Like, everything has to work harmoniously together, so it’s not that… It’s not the number of supplements, and why would you need a lot of supplements? Well, because every system in your body is Messed up. My kind of clientele for 30 years. Our clientele, yours and mine. Dr. Deb 48:25Yeah. David Jernigan 48:26They have been sick, For decades, many of them. Dr. Deb 48:31Yeah. David Jernigan 48:31And if they went into a hospital, they honestly need every department. They need endocrinology, they need their kidney doctor, they need their… They’re a cardiologists, they need a neurologist, they need a rheumatologist. I mean, because none of those doctors are gonna deal with everything. They’re just gonna deal with one piece of the puzzle. And if they did get the benefit of all the different departments they need, yeah, they’d go out with a garbage bag full of stuff, too. Dr. Deb 48:57Hey, wood. David Jernigan 48:58Only, they’re not synergized. They don’t work together. You’re creating this chemistry set of who knows how much poison. And I want to tell your listeners, and I mean, you probably say this to your patients as well. There is a law of pharmacy that I learned eons ago, and it applies to natural medicine, too. Dr. Deb 49:21Yep. David Jernigan 49:22But the law says every drug’s primary side effect Is its primary action. So, if you listen to TV, you can see this on commercials. I love… I love listening to these commercials, because I’m like, wow. let’s… let’s… I don’t want to say I’ve named Brandon. I don’t know if that’s…Inappropriate to name a name brand, but let’s just say you have a pharmaceutical that is for sleep. After they show you this beautiful scene of the person restfully sleeping and everything like that, they tell you the truth. It’s like, this may cause sleepiness… I mean, sleeplessness. Dr. Deb 50:04Yeah. David Jernigan 50:04Found insomnia. Dr. Deb 50:06And headaches, and diarrhea. David Jernigan 50:08All the other things, and if it’s an antidepressant, what does the commercial do after it finishes showing you little bunny foo-foo, jumping through a green, happy people? They tell you, this may create depression, severe depression, and suicidal tendencies, which is the ultimate depression. So, I want everyone to understand you need to figure out what your doctor’s tools are that they’re asking you to take, and they’re wanting you to take it forever, generally in mainstream medicine, right? In the hospitals and everything. They don’t say, hey, your heart has this condition, take this medicine for 3 months, after which time you can get off. Dr. Deb 50:48Yep. David Jernigan 50:49not fixing it, right? So… That, on a timeline, there is a point, if it was truly even fixing anything. That you… it’s done what it should do, and you should get off, even if it’s a natural product. It’s just like. Dr. Deb 51:03Right David Jernigan 51:03It’s done what it should do, and you should get off, but instead. you go through the tree… the correction and out the other side, and that’s where it starts manifesting a lot of the same problems that it had. So, anti-inflammatories, painkillers, imagine the number one side effects are pain inflammation. So, the doctor says, well. If you say, hey, I’m having more pain, what does he do? He ups the dosage. And if he… if that doesn’t work, if you’re still in a lot of pain, which he would be, he changes it to a more powerful thing, right? But it starts the cycle all over again. So when you ask me, it’s like, why are we having so much chronic illness? It’s because of the whole philosophy. is the treatment philosophy of mainstream medicine that despises what you and I do. Because we’re… our philosophy from the start is the biggest thing. It’s like… We’re striving for cure. That dirty four-letter word, cure, we’re not even supposed to use it. And yet, if you look it up in Stedman’s Medical Dictionary, it just means a restoration of health. Remission. Everyone’s like, oh, I’m in remission. I’m like, remission is a drug term. It’s a medical term. Again, look it up in a medical dictionary. It is a pharmaceutical term for a temporary pause Or a reduction of your symptom, but because it’s just… symptom suppression, it will come back. It’s… remission is great, I suppose, in… At the end of, like, where you’ve exhausted everything, because I can’t fix everything, I don’t know about you. Dr. Deb 52:41No, I can’t either, yeah. David Jernigan 52:43you know, on my phone consults, I try to always remind people, as much as I get excited about my technologies gosh, I see so much opportunity to fix you. I always try to go, please understand, I’m gonna tell you what most doctors may not tell you on a phone consultation. I can’t fix everything. Dr. Deb 53:03Yeah. David Jernigan 53:03For all of my tricks, I can’t fix everything. Not tricks, but you know, all my technologies, and all my inventions. Phages, too. They are a tool. You know, antibiotics. I think I wrote a blog one time, it should be on my website somewhere, that says, Antibiotics do not… fix… neurological disease, or… I don’t know, something like that. You know, you’re using the wrong tool. I mean, it does what it does. Dr. Deb 53:32Yeah, you’re using a hammer to do what a screwdriver needs to. David Jernigan 53:35Yeah, you know, it’s like it’s… And yet, you can probably tell her… that you’ve had patients, too, that they go, Dr. Jernigan. My throat was so sore, and as soon as I swallowed that antibiotic. I felt better, and I’m, like, going… How long did it take? Oh, it was immediate! I was like, dude, the gel cap didn’t even have time to dissolve, I mean… Dr. Deb 53:58SIBO. David Jernigan 54:00But, it’s not going to repair the tissues that were all raw. kind of stuff. So, I mean, that ulceration of your throat that’s happening, the inflammation, there’s no anti-inflammatory effect of these things. So, I digress a little bit, but phages, too… I wrote an article that’s on the website, that’s setting healthy expectations for phages, because they want… we can see some amazing things happen, things that in my 30 years, I wish I had all my career to do over again, now having this tool. It’s just that much fun. I… when doctors around the country now are starting to use our inducent formulas, there’s, 13 of them now, formulas. For different broad-spectrum illness presentations. I tell them all the same thing, I was like, you are gonna have so much fun. Dr. Deb 54:53That’s exciting. Women. David Jernigan 54:54Winning is fun, you know? I was like. You know, mainstream medicine may never accept this, I don’t know. I feel a real huge burden, though, to do my best to follow a, very scientific methodology. I’ve published as much as I can publish at this time by myself. I never took money from the… the sources that are out there, because what do they do? They always come… money comes with strings. Dr. Deb 55:22Yes, it does. David Jernigan 55:23I don’t trust… I don’t trust… I mean, if you listen to the, roundtable that Our Secretary Robert F. Kennedy Jr. Dr. Deb 55:35Yeah. David Jernigan 55:36On Lyme disease last week the first couple of speakers were, like, pretty legit. I mean, all of them were legit, but I mean, they were, like, senators and congressmen or something like that, I think. And then you have… RFK Jr. himself, who’s legit. Yeah they were fessing up to the fact that, yes, they were suppressing anything to do with Lyme. Dr. Deb 56:00Yeah. David Jernigan 56:00Our… our highest levels of, marbled halls and pillars and… of medicine were doing everything the way I thought they were. They were suppressing me. I was like, how can you ignore the best formulas ever, and still, I think Borreligen, and now, induced native phage therapy are still, I believe, I don’t… I’ve never seen it, I could be wrong. The only natural things that have been documented in a medical methodology. Dr. Deb 56:34Hmm in the natural realm. I mean, all the herbs that we talk about. David Jernigan 56:39You know, there’s one that was really famous for a while, and it said, we gave… so many patients. This product, and other nutritional supplements. And at the end, X number of them were… dramatically better. That’s not research. Dr. Deb 56:57Right. That’s observation. David Jernigan 56:59The trick there was we gave this one thing, and then we gave high-dose proteolytic enzymes, we gave high dose this, we gave high dose that, but at the end of the study, we’re going to point back at the thing we’re trying to sell you as being what did it. Dr. Deb 57:12Which is what we do in all research, pretty much. David Jernigan 57:15Well… Dr. Deb 57:16tried to… David Jernigan 57:17Good guys, I hope. Dr. Deb 57:18Do the way we want, right? In… in conventional… David Jernigan 57:22Yeah. Dr. Deb 57:22Fantastic David Jernigan 57:23Very often, yeah, in conventional medicine, definitely. Yeah. And, it’s kind of scary, isn’t it, how many pharmaceuticals are slamming us with, because they’re… Dr. Deb 57:33Okay. David Jernigan 57:34There’s a new one on TV every day, and there’s. Dr. Deb 57:36Every day, yes. David Jernigan 57:37It’s like, who comes up with these names? They’re just horrible. Dr. Deb 57:40Yeah, you can’t pronounce them. David Jernigan 57:41I want to be a marketing company and come up with some Zimbabwehika, or something that actually they go with, and I’m like, I just made a million bucks coming up with it. I’ll be glad when that’s not on the TV anymore, which… Oh, me too. Me too. Dr. Deb 57:54Dr. Jaredgen, this was really wonderful. What do you want to leave our listeners with? David Jernigan 58:00Well, you know, everyone’s calling for a new treatment. Dr. Deb 58:05Yeah. You bet. David Jernigan 58:08I have done everything I can do to get it out there, scientifically, in peer review, so that if you want to look up my name. Dr. Deb 58:16I published an open access journal so that you didn’t have to buy the articles. Like, PubMed, you have to be a member. If you want to look at a lot of the research, you have to buy the articles. David Jernigan 58:26I’ve done everything open access so that people had access to the information. I honestly created induced native phage therapy to fix my own wife. I mean, I… I was… I used to think I could actually fix almost anything. Gave me enough time. And, I could not fix her. You know, the first 10 years, she was bedridden. Dr. Deb 58:49Wow. David Jernigan 58:50People go, oh, it’s easy for you, Dr. Jernigan, you’re a doctor. Dr. Deb 58:54Oh yeah, right? Yeah. David Jernigan 58:56Oh my gosh, how many tears have been shed, and how much heartache, and how much of this and that. I mean, 90% of our marriage, she was in, bed, just missing Christmas. All the horror stories you hear in the Lime world, that was her, and I could not get her completely well. And, she’s a very discerning woman. I say that in all my podcasts, because it’s. Dr. Deb 59:19Just… David Jernigan 59:16Amazing. It’s like, every husband, I think, should want a wife that’s… Always, right? Not that you surrender your own opinion, but it’s like, it’s… it was literally, I don’t know what, 6 months before the ILADS conference in Boston in 2029… in 2019 that She said, are you going to the ILADS conference this year? And I’m like, I’ve been going for, like, 15, 20 years, however long it’s been going on, and I was like, I’m not gonna go to this one. And, 3 days before the conference, she says, I think you should go. And I go, okay. Like I say, she’s generally right. And that… I bought a Scientific American magazine at the newsstand in the Nashville airport. Started reading a story about phages in that that copped that edition of the Scientific American, and It was a good article, but it wasn’t super meaty, you know. very deep on those, but I just was stimulated. Something about being at elevation. Dr. Deb 1:00:02Yeah. Your own mountains, I don’t know, I get all inspired. David Jernigan 1:00:25And I wrote in the margins and highlighted this and that until it was, like, ultimately, I spent the entire conference hammering this out. And it worked. And it’s been working, it’s just amazing. It’s… We’re over 200 different infections that we’ve… we’ve clinically or laboratory-wise documented. There’s a new test for my GenX called the CEPCR Lyme Panel. like, culture. 64 different types of infections, and I believe right now the latest count is something like 10 for 10 were completely negative. Dr. Deb 1:01:03Wow. David Jernigan 1:01:03These chronically infected people. And so, that hadn’t been published anywhere. So, in my published article, remember I was talking about that 20 out of the 26 were tested as negative for the infection? That doesn’t mean they’re cured, okay? Remember, they’re chronically damaged. That’s how we need to look at it. Dr. Deb 1:01:23funny David Jernigan 1:01:24damaged. You’re not just chronically infected. And, but with 30-day treatment.24 out of the 26 were tested as negative. Dr. Deb Muth 1:01:34That’s amazing. David Jernigan 1:01:35So 92% of the people were negative.Okay? The chances of that happening, when you run it through statistical analysis.The chances… when you compare the results to the sensitivity percentages, you know, the 100% specificity and 92% sensitivity of the…Of the lab testIt’s a 4.5 nonillion to 1 chance that it was a fluke. Isn’t that amazing? Now, nearly… I’m not even sure how many zeros that is, but it’s a lot. Dr. Deb Muth 1:02:08That’s is awesome. David Jernigan 1:02:09Like, if I just said, well, it’s a one in a million chance it was a fluke.Okay.So, lab tests don’t lie. You’re not done, necessarily, just because you got rid of the infections. Now that formula for Lyme has grown to be 90-plusmicrobes targeted in the one formula. So, we figured out we can actually target individually, but collectively, almost like an antibiotic that’s laser-guided to only go after the bad guys that we targeted.So, all the Borrelia types are targeted, all the Babesias, for,the Bartonellas, the anaplasmosis, you name it, mycoplasma types are all targeted in that one formula, because I said.Took my collective 30 years of experience and 15,000 patients.that I would typically see as co-infections and put them into that one formula, so…When we get these tests coming back that are testing for 64, it’s because of that.So, there’s a lot of coolnesses that I could actually keep going and going. Dr. Deb Muth 1:03:15That’s exciting. David Jernigan 1:03:15I love this topic, but I thank you for letting me come on. Dr. Deb Muth 1:03:18Thank you for joining us. How can people find you? David Jernigan 1:03:22Two ways. There’s the Phagen Corp company that is now manufacturing my formulas.That is P-H-A-G-E-N-C-O-R-P dot com. Practitioners can go there, and there’s a practitioner side of the website that’s very beefy with science, and… and all the formulas that were used, what’s inside of all the formulas, meaning what microbes are targeted by each one. Like, there’s a GI formula, there’s a UTI formula, there’s a SIRS formula, there’s a Lyme formula, there’s a central nervous system type infection formula, there’s… And we can keep going, you know, SIBO, SIFO formula, mold formula… I mean, we’ve discovered so many things that I could just keep going for hours, and… Dr. Deb Muth 1:04:05Yeah. David Jernigan 1:04:06About the discoveries, from where it started in its humble beginnings, To now, so… There’s another way, if you wanted to see our clinic website, is Biologics, with an X, so B-I-O-L-O-G-I-X, Center, C-E-N-T-E-R dot com. And, if somebody thinks they want to be a patient and experience this at our clinic, typically we don’t take just Easy stuff. All we see is chronic.Chronic cases from all over the world. Something like 96% of our patients come from other states and countries. And typically, I’ve been close to 90% for my whole career.About 30-something percent come from other countries in that, so… we’ve gotten really good and learned a lot in having to deal with what nobody else knows what to do with. But if you do want to do that, you can contact us. And, if you… If you don’t get the answers from my patient care staff, then I do free consultations. With the people that are thinking about, whether we can help them or not. Dr. Deb Muth 1:05:13Well, that’s excellent. For those of you who are driving or don’t have any way of writing things down, don’t worry about it, we’ve got you. We will have all of his contact information in our show notes, so you will be able to reach out to him. Thank you again for joining me. This has been an amazing conversation. David Jernigan 1:05:30Thank you, I appreciate you having me on. It was a lot of fun. The post Episode 252 – Induced Native Phage Therapy (INPT) & advanced natural therapies first appeared on Let's Talk Wellness Now.

Pool Pros text questions hereOn this Talking Pools episode, host Natalie Hood, Director of Education and Network Development for The Grit Game, sits down with Jodi O'Grady, Director of Commercial Sales for API Water and long-time industry chemist, to unpack one of the most misunderstood topics in pool care: specialty chemicals.Chlorine gets all the attention, but oxidizers, enzymes, and flocculants quietly decide whether your water is comfortable, clear, and compliant—or a cloudy, smelly headache full of disinfection byproducts and complaints. Jodi draws on decades with Taylor Water Technologies and her work on PHTA's Technical Advisory Council to bust myths, explain the science in plain language, and show how specialty products can support (not replace) chlorine to keep pools safer and easier to manage.If you've ever wondered whether non-chlorine shock actually does anything, if enzymes are all “basically the same,” or what Flock It Friday is really about, this episode connects the dots.In This Episode, You'll Learn:Chlorine's job vs. specialty chemicals' jobWhy chlorine (or bromine/PHMB) is irreplaceable as a sanitizer and must be EPA-registered to be counted as such.The difference between sanitizing (killing pathogens like Pseudomonas and brain-eating amoeba in properly chlorinated water) and oxidizing (burning off non-living contaminants).Why “chlorine can be replaced by specialty chemicals” is a myth—and how crypto is a different beast entirely.Non-chlorine oxidizers: the quiet workhorseReal-world impact of high chlorine levelsEnzymes: not “all the same”Myth-busting with real storiesFlock It Friday and how flocculants actually workClarity as a safety standard, not a luxuryThe payoff for pros and operatorsGuest Info – Jodi O'Grady, API WaterDirector of Commercial Sales, API WaterNearly 30 years in the pool industry, starting with Taylor Water Technologies (a Fluidra brand)Chemistry degree and long-time volunteer with PHTA, currently Vice Chair of the Technical Advisory Council, with prior work on the Recreational Water and Air Quality Committee.Jodi is available for follow-up questions and industry conversations via LinkedIn and direct contact (details provided in the episode outro).Host Info – Natalie HoodDirector of Education and Network Development, The Grit Game, and regular host on the Talking Pools Podcast, focused on education, professional development, and giving pool pros real-world tools they can use on deck tomorrow. Support the showThank you so much for listening! You can find us on social media: Facebook Instagram Tik Tok Email us: talkingpools@gmail.com

It's World AMR Awareness Week (WAAW) and we have prepared a special episode in light of that. In this week's Communicable, Navaneeth Narayanan and Thomas Tängdén host Aula Abbara (London, UK), Guido Granata (Rome, Italy) and Tuomas Aro (Helsinki, Finland) to discuss the phenomenon of AMR in conflict and crisis zones. They elaborate on how difficult conditions and austere environments amplify the spread of AMR, drawing on findings from the ongoing conflicts in Ukraine, Gaza, Syria and other regions. Other topics covered include adapting antimicrobial stewardship and infection prevention and control (IPC) practices as well as the need for genuine political will and international collaboration to end conflicts and their exacerbation on AMR.This episode follows the webinar “Beyond the frontlines” organised by ESCMID's AMR Action Subcommittee for WAAW 2025, featuring the same guests, and is available on ESCMID Media. This Communicable episode was peer reviewed by Arjana Zerja of Mother Theresa University Hospital Centre, Tirana, Albania.  Related ESCMID and Communicable mediaESCMID Media, Part 1: Beyond the frontlines - tackling AMR in conflict and crisis zones, webinar Communicable episode 11: Nightmare series, part 2 – how to deal with carbapenemase producers Communicable episode 16: Climate change and infections – effects on clinical practice & sustainabilityResourcesTrainee Association of ESCIMD (TAE) Doctors without Borders (Médecins sans Frontières), Antibiogo, https://www.antibiogo.org/Doctors without Borders (Médecins sans Frontières), Mini-lab, https://fondation.msf.fr/en/projects/mini-lab Further ReadingAbbara A, et al. Unravelling the linkages between conflict and antimicrobial resistance. NPJ Antimicrob Resist. 2025. DOI: 10.1038/s44259-025-00099-yAbbara A, et al. A summary and appraisal of existing evidence of antimicrobial resistance in the Syrian conflict. Int J Infect Dis. 2018. DOI: 10.1016/j.ijid.2018.06.010Abu-Shomar R, et al. Multidrug-resistant Pseudomonas isolated from water at primary health care centers in Gaza, Palestine: a cross-sectional study. IJID Reg. 2025. DOI: 10.1016/j.ijregi.2025.100671Aldbis A, et al. The lived experience of patients with conflict associated injuries whose wounds are affected by antimicrobial resistant organisms: a qualitative study from northwest Syria. Confl Health. 2023. DOI: 10.1186/s13031-023-00501-4Aro T, et al. War on antimicrobial resistance: high carriage rates of multidrug-resistant bacteria among war-injured Ukrainian refugees. Clin Microbiol Infect. 2025. DOI: 10.1016/j.cmi.2025.07.010  Bazzi W, et al. Heavy Metal Toxicity in Armed Conflicts Potentiates AMR in A. baumannii by Selecting for Antibiotic and Heavy Metal Co-resistance Mechanisms. Front Microbiol. 2020. DOI: 10.3389/fmicb.2020.00068 Dewachi O. War Biology and Antimicrobial Resistance: The Case of Gaza, AMR Insights, 2024.Granata G, et al. The impact of armed conflict on the development and global spread of antibiotic resistance: a systematic review. Clin Microbiol Infect. 2024. DOI: 10.1016/j.cmi.2024.03.029 Huang XZ, et al. Molecular analysis of imipenem-resistant Acinetobacter baumannii isolated from US service members wounded in Iraq, 2003-2008. Epidemiol Infect. 2012. DOI: 10.1017/S0950268811002871Hujer KM, et al. Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center. Antimicrob Agents Chemother. 2006. DOI: 10.1128/AAC.00778-06Karah N, et al. Teleclinical Microbiology: An Innovative Approach to Providing Web-Enabled Diagnostic Laboratory Services in Syria. Am J Clin Pathol. 2022. DOI: 10.1093/ajcp/aqab160Keen EF 3rd, et al. Evaluation of potential environmental contamination sources for the presence of multidrug-resistant bacteria linked to wound infections in combat casualties. Infect Control Hosp Epidemiol. 2012. DOI: 10.1086/667382Murray CK, et al. Recovery of multidrug-resistant bacteria from combat personnel evacuated from Iraq and Afghanistan at a single military treatment facility. Mil Med. 2009. DOI: 10.7205/milmed-d-03-8008Petersen K, et al. Diversity and clinical impact of Acinetobacter baumannii colonization and infection at a military medical center. J Clin Microbiol. 2011. DOI: 10.1128/JCM.00766-10Scott P, et al. An outbreak of multidrug-resistant Acinetobacter baumannii-calcoaceticus complex infection in the US military health care system associated with military operations in Iraq. Clin Infect Dis. 2007. DOI: 10.1086/518170Sensenig RA, et al. Longitudinal characterization of Acinetobacter baumannii-calcoaceticus complex, Klebsiella pneumoniae, and methicillin-resistant Staphylococcus aureus colonizing and infecting combat casualties. Am J Infect Control. 2012. DOI: 10.1016/j.ajic.2011.03.025World Health Organization. Fourth WHO Global Evidence Review on Health and Migration stresses that equitable access to and appropriate use of antibiotics for refugees and migrants is essential to tackling Antimicrobial Resistance, News, 2022.

In this Micro Minutes episode, Luis breaks down classic microbiology traits that usually hold true, but not always.  From indole-negative E. coli to non-swarming Proteus and oxidase-negative Pseudomonas, this quick episode highlights real-world exceptions that can catch techs and students off guard. Learn how to spot: Indole-negative E. coli (98% rule + inactive biotypes) Lactose-fermenting look-alikes like Citrobacter freundii Proteus species that don't swarm Pseudomonas species that test oxidase negative A fast, practical reminder that no single biochemical test should stand alone.   Stay connected with Let's Talk Micro: Website: letstalkmicro.com Questions or feedback? Email me at letstalkmicro@outlook.com Interested in being a guest on Let's Talk Micro? Fill out the form here: https://forms.gle/V2fT3asjfyusmqyi8 Support the podcast: Venmo Buy me a Ko-fi  

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No episódio dessa semana, Klinger e Lino seguem na segunda parte da Diretriz Brasileira de Bacilos Gram Negativos Multirresistentes, agora explorando os não fermentadores!Eles discutem os principais mecanismos de resistência e as recomendações para o tratamento de Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia e Burkholderia cepacia.Dê o play e embarque na continuação da diretriz mais aguardada pelos Infectologistas!

Matters Microbial #113: Microbes That Swim, Swarm, Stand Up—and ‘Walk' October 24, 2025 Today Dr. Joshua Shrout, Professor of Civil and Environmental Engineering and Earth Sciences at the University of Notre Dame joins the #QualityQuorum to discuss the work of his research team on sociomicrobiology. This includes how bacteria sense a surface, move together in groups, and communicate with one another.   Host: Mark O. Martin Guest: Joshua Shrout Subscribe: Apple Podcasts, Spotify Become a patron of Matters Microbial! Links for this episode Here is a wonderful video about the late great Dr. Esther Lederberg.  Here is another article on that same subject. Here is an article about prodigiosin synthesis and Serratia marcescens.   An introduction to the concept of sociomicrobiology. An overview of bacterial swarming.  Here is a wonderful swarming video. An overview of bacterial swimming in liquid. An article about group/social motility in Myxococcus. A fine video explaining the amazing bacterial flagellar motor. An article about Vibrio parahaemolyticus and swarming. An overview of quorum sensing. Bacteria cultivated in the laboratory undergo mutational changes during “domestication.”  Pigments produced by Pseudomonas, including pyoverdin and pyocyanin. An article from Dr. Shrout's laboratory group describing interactions between Pseudomonas and Enterococcus described in this episode. The Type IV pili-based motility system. An article from Dr. Shrout's laboratory describing how Pseudomonas can “walk” on one pole during swarming. Here is a video from Dr. Shrout's laboratory showing Pseudomonas “walking” on their poles. An overview video of the Shrout laboratory's research interests. Dr. Shrout's faculty website. Dr. Shrout's truly beautiful research website. There are wonderful microbial videos there.  Very much worth your time. Intro music is by Reber Clark Send your questions and comments to mattersmicrobial@gmail.com

In this episode Ed interviews Dr. Deb Samac of the USDA-ARS. They discuss the long-overlooked disease of alfalfa, bacterial stem blight. Additional Resources https://apsjournals.apsnet.org/doi/10.1094/PHYTO-02-23-0059-R?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Time Stamps (0:00) Introductions (4:06) Overview of alfalfa production Skip to the main topic: (16:30) Bacterial stem blight (21:33) The role of frost (25:00) Pathogen differentiation (30:15) Pseudomonas and ice nucleation (39:02) Disease management (49:15) wrap-up How to cite the podcast: Zaworski, E. (Host)  Samac, D.(Interviewee). S4:E38 (Podcast). Blightmare on Stem Street: Alfalfa Bacterial Stem Blight. 10/22/2025. In I See Dead Plants. Crop Protection Network.   Transcript

Cefepime is a fourth-generation cephalosporin antibiotic with broad-spectrum activity against both gram-positive and gram-negative organisms, including Pseudomonas aeruginosa. It works by inhibiting bacterial cell wall synthesis through binding to penicillin-binding proteins, leading to cell lysis and death. Clinically, cefepime is commonly used in hospital settings for serious infections such as pneumonia, febrile neutropenia, urinary tract infections, skin infections, and intra-abdominal infections. It's typically administered intravenously, with doses often ranging from 1 to 2 grams every 8 to 12 hours depending on the indication and renal function. From a pharmacokinetic standpoint, cefepime is primarily renally eliminated, so dose adjustments are required in patients with impaired kidney function. Failure to reduce the dose appropriately can lead to neurotoxicity — one of the key adverse effects associated with cefepime — manifesting as encephalopathy, confusion, myoclonus, or seizures, particularly in elderly or renally impaired patients. Common side effects include gastrointestinal upset and rash. Cefepime has relatively limited drug interactions, though concurrent nephrotoxic agents can increase the risk of renal injury.

Zosyn (piperacillin/tazobactam) is a broad-spectrum β-lactam/β-lactamase inhibitor combination used widely in hospitals. Piperacillin covers gram-positive, gram-negative, and anaerobic bacteria, while tazobactam helps protect against β-lactamase breakdown. It is commonly used for pneumonia, intra-abdominal infections, skin and soft tissue infections, and febrile neutropenia. An important pharmacology pearl for exams is understanding that Pseudomonas, but it doesn't cover MRSA. The drug is renally eliminated, so dosing adjustments are needed in kidney impairment. Many institutions use extended or prolonged infusions to maximize time above the MIC, which can improve efficacy. Standard dosing is 3.375 g to 4.5 g every 6–8 hours, with modifications for dialysis patients. Adverse effects include hypersensitivity, gastrointestinal upset, electrolyte imbalances like hypokalemia, and blood count changes with prolonged therapy. A key clinical concern is nephrotoxicity risk, especially when used with vancomycin. Monitoring renal function and electrolytes are important. Methotrexate and probenecid are two medications that can interact with Zosyn. Concentrations of Zosyn can be increased when these medications are used in combination.

Die Themen in den Wissensnachrichten +++ Lebenswichtige Systeme der Erde überlastet +++ Styropor mit Hilfe von Bakterium recycelt +++ Phänomen "Zoom-Fatigue" überschätzt? +++**********Weiterführende Quellen zu dieser Folge:Planetary Health Check 2025, Planetary Boundaries Science, 24.09.2025Biological upcycling of polystyrene into ready-to-use plastic monomers and plastics using metabolicallyBiological upcycling of polystyrene into ready-to-use plastic monomers and plastics using metabolically engineered Pseudomonas putida, Chemical Engineering Journal, 15.09.2025 engineered Pseudomonas putida, Chemical Engineering Journal, 15.09.2025First detection of Crimean Congo Hemorrhagic Fever antibodies in cattle and wildlife of southern continental France: Investigation of explanatory factors, Plos One, 24.09.2025Mummified cave Cheetah inform rewilding actions in Saudi Arabia, Research Square, 01.09.2025Volcanic crisis reveals coupled magma system at Santorini and Kolumbo, Nature, 24.09.2025Alle Quellen findet ihr hier.**********Ihr könnt uns auch auf diesen Kanälen folgen: TikTok und Instagram .

NT is a 55-year-old man admitted to the general medicine service with cellulitis of his left leg. When the attending sees him the morning after admission, he notices the patient's “Medical Center Trustee” hospital ID on his bedside table. After gathering a history and examining the leg, the attending leaves the room. In the hallway, he crosses paths with the hospital president, who is there to make a “social call”. She smiles and says to the attending, “Don't let anything bad happen.”Sensible Medicine is reader-supported. If you appreciate our work, consider becoming a free or paid subscriber.Every clinician is familiar with the Very Important Patient, the VIP. Defining the VIP is challenging. In the most general sense, the VIP is a patient whose care imposes an additional burden on the clinician. The VIP is perceived to have an elevated social status, typically due to fame, wealth, connections, or power.The VIP may come to his or her status in several ways. The VIP might claim that status herself. The status might be granted by a third party, such as the source of the referral, or outside realities (fame, fortune, power). Sometimes, VIP status is granted by the physician alone.The physician recognizes that an untoward outcome in the care of the VIP — clinical or otherwise, expected or unexpected — will be acknowledged by a wider community and might be particularly unpleasant for the treating physician.VIP patients are a threat to healthcare. They need to be eradicated from hospitals and clinics as ruthlessly as we would eradicate E. coli from a well, Pseudomonas from a hot tub, or Legionella from a hotel HVAC system.Why should we eliminate the VIP? Because a patient's wealth, station, or connections should have no bearing on the tests that are done, the treatments that are offered, or the haste with which care is provided.I have heard people argue about whether basic healthcare is a human right. I have heard people who agree that basic healthcare is a human right argue about what makes up basic healthcare and who should decide what qualifies. I have never heard people argue about whether people deserve different care based on their identity.The most obvious threat the VIP poses is to himself. We recognize that when people are treated as special, they are at risk of getting worse healthcare. This fact underlies the guidance that physicians avoid caring for close friends and relatives. The AMA Code of Medical Ethics states:When the patient is an immediate family member, the physician's personal feelings may unduly influence his or her professional medical judgment. Or the physician may fail to probe sensitive areas when taking the medical history or to perform intimate parts of the physical examination. Physicians may feel obligated to provide care for family members despite feeling uncomfortable doing so. They may also be inclined to treat problems that are beyond their expertise or training.You could easily replace family member with VIP. While we can all avoid treating family members and close friends, VIPs are a reality in every physician's life. Transferring their care to another physician usually does not change the circumstances.Ben Kean, an exceptionally colorful character and my parasitology teacher in medical school, shared a story about the risks VIP healthcare poses to the VIP. He once suggested that a patient with pneumonia — a patient who was also famous, wealthy, and important — be transferred from a private hospital to a public one, and treated under a pseudonym."But why a public hospital, when I have a good private clinic here with the best doctors and nurses?""There are two ingredients essential to your recovery," I explained, "that can't be found here and that you cannot buy. These are things found only at a large public institution, where hundreds of patients are seen each day, many of whom suffer from pneumonia. First, you need a large house staff -- bright, young people with new ideas and with daily experience in dealing with desperate situations. Second, you need a laboratory with specialized technicians available around the clock to monitor your breathing, to do special culture work for bacteria and parasites. This is a lovely private hospital, but the kind of help you need isn't available here."Then there is the reality that if you treat VIPs differently, and it becomes known, it is a bad look. Just ask the leadership of NYU Langone Health.But the threat of the VIP goes beyond personal risk. The overtesting, overtreatment, and early diagnosis that have been described not only threaten the VIP but are also bad for our healthcare system. Overspending and excess erode other people's care. An unnecessary MRI ordered for the VIP's week of sciatica may delay the diagnosis of cord compression in the non-VIP with back pain and prostate cancer.VIP treatment can lead to ill will among members of the healthcare team. Teams bond when they work together for the benefit of a patient. With VIPs, team members most under the patient's sway may suggest management at odds with that proposed by team members less influenced by the patient's status. It is not hard to imagine moral injury if a healthcare worker perceives they are acting because of who a patient is rather than because of what the patient needs.If a team bows to pressure, the ethics of medicine are compromised. Other patients will perceive a tiered system, and this will undermine their faith in medicine.Eradicating the VIP from healthcare is certainly more difficult than getting rid of E. coli, Pseudomonas, or Legionella. How do we ensure that the homeless man, with no wealth, power, or family, receives the same care as the woman for whom the hospital is named?It may be hard to eradicate the VIP when healthcare itself has played a significant role in creating the VIP. Hospital marketing and rankings promote the idea that doctors and hospitals are not equal. They do this to attract the “best payer mix” so they can build shiny new facilities. If patients, with their expensive, private insurance, are drawn to a medical center because of the rankings, should we be surprised if they expect something for their money and effort?I wish there were an easy answer. There is not. It is possible that Mick and Keith are our best guides here.As clinicians, we know that we need to provide the best care possible for our patients. We also recognize that different people want different things from their healthcare. Some people just want to be left alone at night, others want an extra cup of tea with breakfast, and others want a visit from the hospital president. If these allowances truly do not affect the care of patients, all patients, then there is no harm in providing the desired care in addition to the necessary care. Once management of the VIP threatens to affect care, hers or that of her fellow patients, then physicians need to recommit to their pledge to care for everyone equally, regardless of who they are. This is at the core of the practice of medicine. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

On episode #89 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the weeks of 8/18/25 – 9/11/25. Host: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, RSS, email Become a patron of Puscast! Links for this episode Viral Antibody Responses are Sustained 2 Years Post-Mpox Infection but not Following Modified Vaccinia Ankara–Bavarian Nordic Vaccination (OFID) Intestinal mucosal immune responses to novel oral poliovirus vaccine type 2 in healthy newborns (CID) Efficacy of Baloxavir Treatment in Preventing Transmission of Influenza (NEJM) Fulminant Viral Myocarditis Associated with Thogotovirus (NEJM) Bacterial Risk factors for 30-Day mortality and the role of empirical therapy in Pseudomonas aeruginosa bloodstream infections(Infection) The Impact of a Nationwide Blood Culture Bottle Shortage in 2024 on Healthcare Facilities in the United States (CID) The effect of commonly used non-antibiotic medications on antimicrobial resistance development in Escherichia coli(NPJ: antimicrobials and resistance) Preoperative Enterosignatures Predict Surgical Site Infections After Abdominal Surgery (OFID) Fungal The Last of US Season 2 (YouTube) Association between Duration of Candidemia and Clinical and Healthcare Resource Utilization Outcomes among Hospitalized Adult Patients with Candidemia Who Received Empiric Treatment with an Echinocandin Across United States Hospitals (CID) Updating the epidemiology of blastomycosis and histoplasmosis in the United States, using national electronic health record data, 2013–2023 (JID) Parasitic Stocking African catfish in Lake Victoria provides effective biocontrol of snail vectors of Schistosoma mansoni (PLoS Neglected Tropical Disease) Miscellaneous Music is by Ronald Jenkees Information on this podcast should not be considered as medical advice.

À l'ère du smartphone et du télétravail, les écouteurs font désormais partie de notre quotidien. Que ce soit pour écouter de la musique, téléphoner ou suivre une visioconférence, ils restent des heures durant dans nos oreilles. Mais ce geste anodin est-il sans risque pour notre santé ? Plus précisément, peut-il favoriser l'apparition d'otites ?La réponse est oui, dans certains cas. Les spécialistes ORL s'accordent sur un point : l'usage prolongé et répété d'écouteurs intra-auriculaires peut créer un environnement propice aux infections, en particulier les otites externes, c'est-à-dire les inflammations du conduit auditif.Une étude publiée en 2008 dans le Journal of Laryngology and Otology (par Leong et al.) a comparé le conduit auditif de deux groupes : un groupe portant régulièrement des écouteurs, et un groupe n'en utilisant jamais. Résultat : les utilisateurs fréquents d'écouteurs présentaient un taux significativement plus élevé de bactéries pathogènes, notamment Staphylococcus aureus et Pseudomonas aeruginosa, des germes souvent impliqués dans les otites externes.Pourquoi ce lien entre écouteurs et otites ? Plusieurs mécanismes sont en cause :1. Obstruction du conduit auditif : les écouteurs, surtout intra-auriculaires, empêchent la bonne ventilation du canal. L'humidité naturelle ne s'évacue pas correctement, créant un terrain chaud et humide, idéal pour la prolifération des bactéries.2. Microtraumatismes : le frottement régulier des embouts ou leur insertion brutale peut irriter la peau du conduit, facilitant l'entrée des agents infectieux.3. Manque d'hygiène : peu d'utilisateurs nettoient leurs écouteurs régulièrement. Or, ces dispositifs sont souvent posés sur des surfaces non stériles ou partagés entre plusieurs personnes. Les germes présents sur les écouteurs peuvent ainsi être introduits dans l'oreille à chaque usage.Les symptômes d'une otite externe liée aux écouteurs sont classiques : douleurs, démangeaisons, rougeur du conduit auditif, voire écoulement. Dans certains cas, l'audition peut temporairement diminuer. Si ces signes apparaissent, il est recommandé d'arrêter immédiatement l'usage des écouteurs et de consulter un médecin.Pour limiter les risques, quelques gestes simples suffisent :Ne pas porter d'écouteurs plus de deux heures d'affilée.Les désinfecter régulièrement avec un chiffon doux imbibé d'alcool à 70 %.Éviter de les partager.Aérer ses oreilles entre deux utilisations.En conclusion, si les écouteurs ne sont pas à l'origine directe de toutes les otites, leur usage excessif et négligent peut en augmenter la probabilité, notamment en cas de mauvaise hygiène. Pour écouter en toute sécurité, mieux vaut penser aussi à… laisser respirer ses oreilles. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

On this podcast, I cover ciprofloxacin pharmacology. Ciprofloxacin is one of the most widely recognized fluoroquinolone antibiotics and has been on the market for decades. Because of its broad utility, it often comes up in practice, but it also carries significant adverse effect concerns and boxed warnings that pharmacists and prescribers need to keep in mind. From a pharmacology standpoint, ciprofloxacin works by inhibiting bacterial DNA gyrase and topoisomerase IV, enzymes that are essential for bacterial DNA replication, transcription, and repair. This action gives ciprofloxacin bactericidal activity against a variety of gram-negative organisms, including E. coli, Klebsiella, Enterobacter, and Pseudomonas aeruginosa. It also has some gram-positive activity, though it is generally not the best choice for strep infections. Ciprofloxacin comes in multiple dosage forms, including oral tablets, oral suspension, and intravenous formulations, which makes it flexible across care settings. I discuss the conversion of IV and PO formulations. Pharmacokinetics are important to consider. Ciprofloxacin is primarily renally eliminated, so dose adjustments are necessary in patients with impaired kidney function. Distribution into tissues is generally good, but it has limited activity in the lungs against Streptococcus pneumoniae, which is why it is not a first-line option for community-acquired pneumonia. Adverse effects are a major concern. The fluoroquinolone class carries multiple boxed warnings. Ciprofloxacin has been associated with tendon rupture, peripheral neuropathy, CNS effects such as agitation or seizures, and exacerbation of myasthenia gravis. More recent warnings include the risk for aortic aneurysm and hypoglycemia or hyperglycemia, particularly in older adults or those with comorbidities. On top of these boxed warnings, ciprofloxacin can also prolong the QT interval and cause GI upset. Drug interactions are another big factor in practice. Ciprofloxacin is a CYP1A2 inhibitor, which can raise levels of drugs like theophylline, tizanidine, and clozapine. It also interacts with polyvalent cations such as calcium, magnesium, iron, and aluminum, which can dramatically reduce its absorption—sometimes by more than 50%. This is a common reason for treatment failure if counseling isn't provided. From a dosing perspective, ciprofloxacin is usually given 250–750 mg orally twice daily or 400 mg IV every 8–12 hours depending on the indication and severity of infection. Renal dosing adjustments are needed as kidney function declines. In summary, ciprofloxacin is a powerful antibiotic when used appropriately. It remains an option for urinary tract infections, complicated intra-abdominal infections, and some cases of hospital-acquired pneumonia, but its use must be balanced with the potential for significant adverse effects and interactions. For pharmacists, educating patients on drug interactions, counseling about boxed warnings, and ensuring correct dosing in renal impairment are some of the most valuable interventions when ciprofloxacin shows up on a medication list.

Listen in as Michael Satlin, MD, MS, FIDSA,explores rapid syndromic testing for bloodstream infections and discusses how to apply best practices for diagnostic and antimicrobial stewardship in syndromic testing.Topics covered include:Types of upper and lower respiratory infection panelsConsiderations for when to use respiratory syndromic testingHow to use syndromic testing to guide both therapy escalation and de-escalationHow syndromic testing fits in with traditional testing methods, such as culture, antimicrobial susceptibility testing, Gram stain, and BAL cell count Presenter:Michael Satlin, MD, MS, FIDSAAssociate Professor of Medicine and Pathology and Laboratory MedicineWeill Cornell MedicineNew York, New YorkLink to full program: https://bit.ly/3UAB1oUGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

It is really difficult to know what topical treatment options to consider when dealing with a ruptured tympanum. When a difficult multi-drug resistant Pseudomonas otitis occurs, it is very common to have the tympanum ruptured. So, what do you do? Being cautious and upfront with owners about labeling is important. However, bad infections are also ototoxic and it is important we treat them appropriately.On this week's episode of The Derm Vet podcast, I discuss things to consider when dealing with a ruptured TM, what to do if you do experience a case with ototoxicity, and considering the risks/benefits of selecting treatment for difficult otitis cases.00:00 Intro00:25 Treating ear infection02:23 Ear Exams04:36 Most commonly reported to be ototoxic09:15 Dogs with ear infections going on for a long time10:28 Risk vs Benefit11:20 Summary/Outro

In this inspiring episode of the BioBuilder Podcast, Dev and Joshua, co-founders of the startup AIVON, take listeners through their personal journeys of curiosity, innovation, and social impact. The conversation weaves through their formative experiences with science and technology, their time in the BioBuilderClub, and their ambitious venture into the world of AI-powered healthcare. Origins of Scientific CuriosityDev recounts how growing up in a science-loving household, with parents and an aunt deeply engaged in the subject, laid the groundwork for his fascination. From tinkering with technology alongside his dad to wondering about disease mechanisms, he developed an early love for biology and engineering. This curiosity eventually led him to Alliance Academy, where he joined the BioBuilder Club, a decision that would define much of his scientific identity. The BioBuilder ExperienceAs part of the BioBuilder program, Dev and his team designed a sustainable biofiltration system that uses genetically engineered bacteria (E. coli, Bacillus subtilis, and Pseudomonas putida) to remove heavy metals from water. The bacteria were enhanced with plasmids encoding metal-detoxifying enzymes and embedded in a biochar-based medium for stability and efficiency. Their modular, scalable filter design bridged biology and engineering in a way that was both educational and impactful. Dev credits BioBuilder for teaching him adaptability, technical rigor, and how to bring abstract ideas to life. Collaboration & DiscoveryThe episode explores how Dev collaborated with peers to develop their project, noting “aha!” moments when the science began to click. The iterative nature of their work, coupled with expert guidance from mentors like Dr. Grace Vezeau and Ms. Caroline Matarrese, helped deepen their understanding of real-world science. Soft skills like communication and teamwork were just as vital as technical prowess, a lesson Dev carries into his startup journey into career paths, possibly through an MD-PhD program.Building AIVON and MedisenseShifting to the theme of innovation, Dev and Joshua introduce their startup AIVON, based in Atlanta. Their flagship product, MediSense, is an AI-powered diagnostic platform that allows users to input symptoms and receive real-time health assessments. The idea was born from the intersection of their scientific training and the urgent need for accessible, intelligent healthcare tools.They share how conversations with patients, doctors, and mentors shaped MediSense's design and functionality, emphasizing the importance of user feedback in product development. Their goal is to make fast, affordable, and intelligent diagnostics available to everyone, especially in underserved areas. Despite challenges—from building the tech to managing startup logistics—they remain focused on scaling the product and seeking potential partnerships with hospitals and schools.Learn more about BioBuilder's programs for students, educators, and industry professionals here

Matters Microbial #95: Bacteria and Aphids — A Symbiotic Story June 12, 2025 Today, Dr. Tory Hendry, Associate Professor of Microbiology at Cornell University, joins the #QualityQuorum to tell us about the relationship between plant munching aphids and fluorescent Pseudomonas . . . and why we should care. Host: Mark O. Martin Guests: Tory Hendry Subscribe: Apple Podcasts, Spotify Become a patron of Matters Microbial! Links for this episode An overview of siderophores in microorganisms. An essay about aphid life cycle and characteristics. An article describing parthenogenesis in aphids. An essay describing aphids and color vision. The agricultural costs of aphids as pests. An article describing aphids and one type of bacterial symbiont. An overview of microbes of the phyllosphere. An overview of quorum sensing. An overview of pyoverdin, a fluorescent siderophore.  An old essay I wrote for the Small Things Considered blog about semiochemicals, bacterial, and insect predation. A nice description of the work Dr. Hendry talked about during today's podcast.  The actual article by Dr. Hendry and collaborators. A preprint by Dr. Hendry's research group, following up on the above research.  Dr. Hendry's faculty website. Dr. Hendry's research group website (with SO MANY cool projects to think about, including the topic discussed today). Intro music is by Reber Clark Send your questions and comments to mattersmicrobial@gmail.com

Vidcast:  https://www.instagram.com/p/DJw-DmORycV/These tattoo inks are contaminated with dangerous bacteria including Pseudomonas aeruginosa. Affected are: Sacred Tattoo Ink, Raven Black - Lot#: RB0624, Best Before: June 28, 2027; Sacred Tattoo Ink, Sunny Daze - Lot#: SD1124, Best Before: November 1, 2027. These inks cause serious infections with rashes, lesions, and permanent scarring.If you are planning to get some ink, inquire about the inks used and avoid the ones I just mentioned. For more information or to report a complications, visit the FDA's SmartHub at https://safetyreporting.fda.gov/smarthub.https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/fda-advises-consumers-tattoo-artists-and-retailers-avoid-using-or-selling-certain-sacred-tattoo-ink#sacredtattoo #tattoo #ink # bacteria #pseudomonas #infection #recall

TWiV reviews universal vaccine initiative at NIAID, shut down of the Integrated Research Facility at Ft. Detrick, modeling the reemergence of infectious diseases as vaccination rates drop, and bacterial outer membrane vesicles bound to bacteriophages modulate neutrophil responses to bacterial infection. Hosts: Vincent Racaniello, Alan Dove, and Jolene Ramsey Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode Support science education at MicrobeTV ASV 2025 Paul has Measles (YouTube, virology blog) Universal vaccine project (NIAID, CIDRAP) Measles update (US, Texas) Integrated Research Lab closed (Telegraph) Modeling reemergence of infectious diseases (JAMA) Outer membrane vesicles attached to phage (Front Cell Inf Micro) Pf phage review (Front Immunol) Letters read on TWiV 1215 Timestamps by Jolene Ramsey. Thanks! Weekly Picks Alan – A Paradise Built in Hell, by Rebecca Solnit (and here's my review of it) Jolene – Virology course student communication projects, Spring 2025 Vincent – Vaccine Education Center Intro music is by Ronald Jenkees Send your virology questions and comments to twiv@microbe.tv Content in this podcast should not be construed as medical advice.

Matters Microbial #88: Microbial Interactions in Cystic Fibrosis April 24, 2025 Today, Dr. Reed Stubbendieck, Assistant Professor of Microbiology & Molecular Genetics at Oklahoma State University joins the #QualityQuorum to discuss how microbes and the host communicate with one another in the cystic fibrosis lung. Host: Mark O. Martin Guest: Reed Stubbendieck Subscribe: Apple Podcasts, Spotify Become a patron of Matters Microbial! Links for this episode An overview of cystic fibrosis as a disease with a genetic link. A review of the microbiome of the cystic fibrosis lung. An overview of biofilms. An interesting role for extracellular DNA itself as a “building block” of biofilms. An overview of polymicrobial communities. Life in mucus—an interesting essay. An overview of Pseudomonas aeruginosa. Pseudomonas and the siderophore pigment pyoverdin which is not only about iron, but also bacterial conflict and cooperation.   An interesting overview of microbe-microbe interactions, often called “sociomicrobiology,” and an introductory article on this topic. A review of the nasal microbiome. The organism Rothia, understudied and of interest to Dr. Stubbendieck's research group.  Some work from Dr. Stubbendieck's group describing how Rothia is helpful in inhibiting some disease causing bacteria. The organism Dolosigranulum pigrum, also understudied and of interest to Dr. Stubbendieck's research group. More work from Dr. Stubbendieck's group with another possibly probiotic bacterium,  Dolosigranulum pigrum, that may protect against disease causing microbes.  Dr. Stubbendieck's faculty website. Dr. Stubbendieck's very interesting research group website.  Intro music is by Reber Clark Send your questions and comments to mattersmicrobial@gmail.com

We're on a gram negative run! Join the Curious Clinicians as we learn: Why does Pseudomonas smell like grapes? Watch this episode on our new YouTube channel here, and read the show notes here! Click here to obtain AMA PRA Category 1 Credits™ (0.5 hours), Non-Physician Attendance (0.5 hours), or ABIM MOC Part 2 (0.5 hours). Audio edited by Clair Morgan of Nodderly.com. Medical student Giancarlo Buonomo is our producer. 

Show notes at pharmacyjoe.com/episode1000. In this episode, I’ll discuss time to positivity as a predictor of catheter-related bacteremia and mortality in adults with Pseudomonas aeruginosa bloodstream infection. The post 1000: Should Pharmacists Be paying Attention to This Bacteremia Metric? appeared first on Pharmacy Joe.

Die Themen in den Wissensnachrichten: +++ Aktuell hohe Feinstaubwerte in Deutschland +++ Forschende bringen ein Bakterium mit Gentechnik zum Nylon-Fressen +++ Allergiker-freundliche Apfel-Sorte kommt im Herbst +++**********Weiterführende Quellen zu dieser Folge:Umweltbundesamt, 12.02.2025Upcycling of polyamides through chemical hydrolysis and engineered Pseudomonas putida, Nature Microbiology, 10.02.2025Lack of successful sexual reproduction suggests the irreversible parthenogenesis in a stick insect, Ecology, 29.01.2025Consumer responses to smoke-impacted pinot noir wine and the influence of label concepts on perception, ScienceDirect, Vol. 203. 2025**********Ihr könnt uns auch auf diesen Kanälen folgen: TikTok auf&ab , TikTok wie_geht und Instagram .

On episode #73 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the weeks of 1/16/25 – 1/29/25. Hosts: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, RSS, email Become a patron of Puscast! Links for this episode Viral AGA clinical practice guideline on the prevention and treatment of hepatitis B virus reactivation (Gastroenterology) Host-microbe multiomic profiling identifies distinct COVID-19 immune dysregulation in solid organ transplant recipients (Nature Communications) Insect-specific RNA viruses detection in Field-Caught Aedes aegypti mosquitoes from Argentina using NGS technology (PLoS Neglected Tropical Diseases) Bacterial Oral regimens for rifampin-resistant, fluoroquinolone-susceptible tuberculosis (NEJM) Impact of antibiotic treatment and predictors for subsequent infections in multidrug-resistant Pseudomonas aeruginosa catheter-associated asymptomatic bacteriuria (American Journal of Infection Control) Identification of the skip phenomenon among patients With Staphylococcus lugdunensis infective endocarditis (OFID) Emergence of infective endocarditis due to Serratia spp. (OFID) Reduction of vancomycin-associated acute kidney injury with montelukast (JID) Fungal The Last of US Season 2 (YouTube) Pulmonary co-infection of Pneumocystis jirovecii and Aspergillus species (OFID) Impact of fluconazoleon outcomes of patients with primary pulmonary coccidioidomycosis (CID) Parasitic Comparative outcomes of Babesiosis in immunocompromised and non-immunocompromised hosts (CID) Miscellaneous Hidradenitis suppurativa (LANCET) A severe case associated with mixed infections of Pasteurella multocida, Bacteroides pyogenes and Fusobacterium necrophorum due to a snow leopard bite (CMI: Clinical Microbiology and Infection) INSIDE-OUT: Introduction of speakers at IDWeek events (OFID) Music is by Ronald Jenkees Information on this podcast should not be considered as medical advice.

Producer Giancarlo Buonomo is back! Join the Curious Clinicians as we learn: Why do we worry about Pseudomonas infection in diabetic patients? Watch this episode on our new YouTube channel here, and read the show notes here! Click here to obtain AMA PRA Category 1 Credits™ (0.5 hours), Non-Physician Attendance (0.5 hours), or ABIM MOC Part 2 (0.5 hours). Audio edited by Clair Morgan of Nodderly.com. Medical student Giancarlo Buonomo is our producer. 

On episode #72 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the weeks of 1/2/25 – 1/15/25. Hosts: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, RSS, email Become a patron of Puscast! Links for this episode Viral Human infection with a novel tickborne Orthonairovirus species in China(NEJM) Antiviral medications for treatment ofnonsevere influenza(JAMA Network: JAMA Internal Medicine)  Xofluza (GoodRx) NoroSTATData Table (CDC Norovirus) The discovery of the 27-nm Norwalk virus: an historic perspective (JID) Why the “Ferrari of viruses” is surging through the northern hemisphere (Science) Bacterial Beta-lactams toxicity in the intensive care unit: an underestimatedcollateral damage? (Microorganims) What is the most effective antibiotic monotherapy for severe Pseudomonas aeruginosa infection? (CMI: Clinical Microbiology and Infection) Doxycycline postexposure prophylaxis and bacterial sexually tansmitted infections among individuals using HIV preexposure prophylaxis(JAMA Network: JAMA Internal Medicine) Fungal The Last of US Season 2 (YouTube) Epidemiology and prognostic factors associated with mold-positive blood cultures: 10-year data From a french prospective surveillance program (2012–2022) (CID) Parasitic Safety and efficacy of immunization with a late-liver-stage attenuated malaria parasite (NEJM) Dr. Glaucomflecken explains: late-liver-stage attenuated malaria vaccine (YouTube) Dr. Glaucomflecken X NEJM (YouTube) Albendazole–ivermectin co-formulation for the treatment of Trichuris trichiura and other soil-transmitted helminths: a randomised phase 2/3 trial (LANCET: Infectious Diseases) Miscellaneous A comparison of peripherally insertedcentral catheter materials(NEJM) Considering Islamic frameworks to infectious disease prevention (OFID) Music is by Ronald Jenkees Information on this podcast should not be considered as medical advice.

Guest: Dr. Christian de Virgilio is the Chair of the Department of Surgery at Harbor-UCLA Medical Center. He is also Co-Chair of the College of Applied Anatomy and a Professor of Surgery at UCLA's David Geffen School of Medicine. He completed his undergraduate degree in Biology at Loyola Marymount University and earned his medical degree from UCLA. He then completed his residency in General Surgery at UCLA-Harbor Medical Center followed by a fellowship in Vascular Surgery at the Mayo Clinic.   Resources:  Rutherford Chapters (10th ed.): 174, 175, 177, 178 Prior Holding Pressure episode on AV access creation: https://www.audiblebleeding.com/vsite-hd-access/ The Society for Vascular Surgery: Clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access: https://www.jvascsurg.org/article/S0741-5214%2808%2901399-2/fulltext  KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update: https://pubmed.ncbi.nlm.nih.gov/32778223/    Outline: Steal Syndrome Definition & Etiology Steal syndrome is an important complication of AV access creation, since access creation diverts arterial blood flow from the hand. Steal can be caused by multiple factors—arterial occlusive disease proximal or distal to the AV anastomosis, high flow through the fistula at the expense of distal arterial perfusion, and failure of the distal arterial networks to adapt to this decreased blood flow.  Incidence and Risk Factors The frequency of steal syndrome is 1.6-9%1,2, depending on the vessels and conduit choice Steal syndrome is more common with brachial and axillary artery-based accesses and nonautogenous conduits. Other risk factors for steal syndrome are peripheral vascular disease, coronary artery disease, diabetes, advanced age, female sex, larger outflow conduit, multiple prior permanent access procedures, and prior episodes of steal.3,4  Long-standing insulin-dependent diabetes causes both medial calcinosis and peripheral neuropathy, which limits arteries' ability to vasodilate and adjust to decreased blood flow. Patient Presentation, Symptoms, Grading Steal syndrome is diagnosed clinically.  Symptoms after AVG creation occurs within the first few days, since flow in prosthetic grafts tend to reach a maximum value very early after creation. Native AVFs take time to mature and flow will slowly increase overtime, leading to more insidious onset of symptoms that can take months or years. The patient should have a unilateral complaint in the extremity with the AV access. Symptoms of steal syndrome, in order of increasing severity, include nail changes, occasional tingling, extremity coolness, numbness in fingertips and hands, muscle weakness, rest pain, sensory and motor deficits, fingertip ulcerations, and tissue loss.  There could be a weakened radial pulse or weak Doppler signal on the affected side, and these will become stronger after compression of the AV outflow. Symptoms are graded on a scale specified by Society of Vascular Surgery (SVS) reporting standards:5  Workup Duplex ultrasound can be used to analyze flow volumes. A high flow volume (in autogenous accesses greater than 800 mL/min, in nonautogenous accesses greater than 1200 mL/min) signifies an outflow issue. The vein or graft is acting as a pressure sink and stealing blood from the distal artery. A low flow volume signifies an inflow issue, meaning that there is a proximal arterial lesion preventing blood from reaching the distal artery. Upper extremity angiogram can identify proximal arterial lesions. Prevention Create the AV access as distal as possible, in order to preserve arterial inflow to the hand and reduce the anastomosis size and outflow diameter.  SVS guidelines recommend a 4-6mm arteriotomy diameter to balance the need for sufficient access flow with the risk of steal. If a graft is necessary, tapered prosthetic grafts are sometimes used in patients with steal risk factors, using the smaller end of the graft placed at the arterial anastomosis, although this has not yet been proven to reduce the incidence of steal.  Indications for Treatment Intervention is recommended in lifestyle-limiting cases of Grade II and all Grade III steal cases. If left untreated, the natural history of steal syndrome can result in chronic limb ischemia, causing gangrene with loss of digits or limbs. Treatment Options Conservative management relies on observation and monitoring, as mild cases of steal syndrome may resolve spontaneously. Inflow stenosis can be treated with endovascular intervention (angioplasty with or without stent) Ligation is the simplest surgical treatment, and it results in loss of the AV access. This is preferred in patients with repetitive failed salvage attempts, venous hypertension, and poor prognoses. Flow limiting procedures can address high volumes through the AV access. Banding can be performed with surgical cutdown and placement of polypropylene sutures or a Dacron patch around the vein or graft. The Minimally Invasive Limited Ligation Endoluminal-Assisted Revision (MILLER) technique employs a percutaneous endoluminal balloon inflated at the AVF to ensure consistency in diameter while banding Plication is when a side-biting running stitch is used to narrow lumen of the vein near the anastomosis. A downside of flow-limiting procedures is that it is often difficult to determine how much to narrow the AV access, as these procedures carry a risk of outflow thrombosis. There are also surgical treatments focused on reroute arterial inflow. The distal revascularization and interval ligation (DRIL) procedure involves creation of a new bypass connecting arterial segments proximal and distal to the AV anastomosis, with ligation of the native artery between the AV anastomosis and the distal anastomosis of the bypass. Reversed saphenous vein with a diameter greater than 3mm is the preferred conduit. Arm vein or prosthetic grafts can be used if needed, but prosthetic material carries higher risk of thrombosis. The new arterial bypass creates a low resistance pathway that increases flow to distal arterial beds, and interval arterial ligation eliminates retrograde flow through the distal artery.  The major risk of this procedure is bypass thrombosis, which results in loss of native arterial flow and hand ischemia. Other drawbacks of DRIL include procedural difficulty with smaller arterial anastomoses, sacrifice of saphenous or arm veins, and decreased fistula flow. Another possible revision surgery is revision using distal inflow (RUDI). This procedure involves ligation of the fistula at the anastomosis and use of a conduit to connect the outflow vein to a distal artery. The selected distal artery can be the proximal radial or ulnar artery, depending on the preoperative duplex. The more dominant vessel should be spared, allowing for distal arterial beds to have uninterrupted antegrade perfusion. The nondominant vessel is used as distal inflow for the AV access. RUDI increases access length and decreases access diameter, resulting in increased resistance and lower flow volume through the fistula. Unlike DRIL, RUDI preserves native arterial flow.  Thrombosis of the conduit would put the fistula at risk, rather than the native artery.  The last surgical revision procedure for steal is proximalization of arterial inflow (PAI). In this procedure, the vein is ligated distal to the original anastomosis site and flow is re-established through the fistula with a PTFE interposition graft anastomosed end-to-side with the more proximal axillary artery and end-to-end with the distal vein. Similar to RUDI, PAI increases the length and decreases the diameter of the outflow conduit. Since the axillary artery has a larger diameter than the brachial artery, there is a less significant pressure drop across the arterial anastomosis site and less steal. PAI allows for preservation of native artery's continuity and does not require vein harvest.  Difficulties with PAI arise when deciding the length of the interposition graft to balance AV flow with distal arterial flow. 2. Ischemic Monomelic Neuropathy Definition Ischemic monomelic neuropathy (IMN) is a rare but serious form of steal that involves nerve ischemia. Severe sensorimotor dysfunction is experienced immediately after AV access creation. Etiology IMN affects blood flow to the nerves, but not the skin or muscles because peripheral nerve fibers are more vulnerable to ischemia. Incidence and Risk Factors IMN is very rare; it has an estimated incidence of 0.1-0.5% of AV access creations.6 IMN has only been reported in brachial artery-based accesses, since the brachial artery is the sole arterial inflow for distal arteries feeding all forearm nerves. IMN is associated with diabetes, peripheral vascular disease, and preexisting peripheral neuropathy that is associated with either of the conditions. Patient Presentation Symptoms usually present rapidly, within minutes to hours after AV access creation. The most common presenting symptom is severe, constant, and deep burning pain of the distal forearm and hand. Patients also report impairment of all sensation, weakness, and hand paralysis. Diagnosis of IMN can be delayed due to misattribution of symptoms to anesthetic blockade, postoperative pain, preexisting neuropathy, a heavily bandaged arm precluding neurologic examination. Treatment Treatment is immediate ligation of the AV access. Delay in treatment will quickly result in permanent sensorimotor loss.   3. Perigraft Seroma Definition A perigraft seroma is a sterile fluid collection surrounding a vascular prosthesis and is enclosed within a pseudomembrane. Etiology and Incidence Possible etiologies include: transudative movement of fluid through the graft material, serous fluid collection from traumatized connective tissues (especially the from higher adipose tissue content in the upper arm), inhibition of fibroblast growth with associated failure of the tissue to incorporate the graft, graft “wetting” or kinking during initial operation, increased flow rates, decreased hematocrit causing oncotic pressure difference, or allergy to graft material. Seromas most commonly form at anastomosis sites in the early postoperative period. Overall seroma incidence rates after AV graft placement range from 1.7–4% and are more common in grafts placed in the upper arm (compared to the forearm) and Dacron grafts (compared to PTFE grafts).7-9 Patient Presentation and Workup Physical exam can show a subcutaneous raised palpable fluid mass Seromas can be seen with ultrasound, but it is difficult to differentiate between the types of fluid around the graft (seroma vs. hematoma vs. abscess) Indications for Treatment Seromas can lead to wound dehiscence, pressure necrosis and erosion through skin, and loss of available puncture area for hemodialysis Persistent seromas can also serve as a nidus for infection. The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines10 recommend a tailored approach to seroma management, with more aggressive surgical interventions being necessary for persistent, infected-appearing, or late-developing seromas.   Treatment The majority of early postoperative seromas are self-limited and tend to resolve on their own Persistent seromas have been treated using a variety of  methods-- incision and evacuation of seroma, complete excision and replacement of the entire graft, and primary bypass of the involved graft segment only. Graft replacement with new material and rerouting through a different tissue plane has a higher reported cure rate and lower rate of infection than aspiration alone.9     4. Infection Incidence and Etiology The reported incidence of infection ranges 4-20% in AVG, which is significantly higher than the rate of infection of 0.56-5% in AVF.11  Infection can occur at the time of access creation (earliest presentation), after cannulation for dialysis (later infection), or secondary to another infectious source. Infection can also further complicate a pre-existing access site issue such as infection of a hematoma, thrombosed pseudoaneurysm, or seroma. Skin flora from frequent dialysis cannulations result in common pathogens being Staphylococcus, Pseudomonas, or polymicrobial species. Staphylococcus and Pseudomonas are highly virulent and likely to cause anastomotic disruption. Patient Presentation and Workup Physical exam will reveal warmth, pain, swelling, erythema, induration, drainage, or pus. Occasionally, patients have nonspecific manifestations of fever or leukocytosis. Ultrasound can be used to screen for and determine the extent of graft involvement by the infection.   Treatments In AV fistulas: Localized infection can usually be managed with broad spectrum antibiotics.  If there are bleeding concerns or infection is seen near the anastomosis site, the fistula should be ligated and re-created in a clean field. In AV grafts: If infection is localized, partial graft excision is acceptable. Total graft excision is recommended if the infection is present throughout the entire graft, involves the anastomoses, occludes the access, or contains particularly virulent organisms Total graft excision may also be indicated if a patient develops recurrent bacteremia with no other infectious source identified. For graft excision, the venous end of the graft is removed and the vein is oversewn or ligated. If the arterial anastomosis is intact, a small cuff of the graft can be left behind and oversewn. If the arterial anastomosis is involved, the arterial wall must be debrided and ligation, reconstruction with autogenous patch angioplasty, or arterial bypass can be pursued. References   1. Morsy AH, Kulbaski M, Chen C, Isiklar H, Lumsden AB. Incidence and Characteristics of Patients with Hand Ischemia after a Hemodialysis Access Procedure. J Surg Res. 1998;74(1):8-10. doi:10.1006/jsre.1997.5206 2. Ballard JL, Bunt TJ, Malone JM. Major complications of angioaccess surgery. Am J Surg. 1992;164(3):229-232. doi:10.1016/S0002-9610(05)81076-1 3. Valentine RJ, Bouch CW, Scott DJ, et al. Do preoperative finger pressures predict early arterial steal in hemodialysis access patients? A prospective analysis. J Vasc Surg. 2002;36(2):351-356. doi:10.1067/mva.2002.125848 4. Malik J, Tuka V, Kasalova Z, et al. Understanding the Dialysis access Steal Syndrome. A Review of the Etiologies, Diagnosis, Prevention and Treatment Strategies. J Vasc Access. 2008;9(3):155-166. doi:10.1177/112972980800900301 5. Sidawy AN, Gray R, Besarab A, et al. Recommended standards for reports dealing with arteriovenous hemodialysis accesses. J Vasc Surg. 2002;35(3):603-610. doi:10.1067/mva.2002.122025 6. Thermann F, Kornhuber M. Ischemic Monomelic Neuropathy: A Rare but Important Complication after Hemodialysis Access Placement - a Review. J Vasc Access. 2011;12(2):113-119. doi:10.5301/JVA.2011.6365 7. Dauria DM, Dyk P, Garvin P. Incidence and Management of Seroma after Arteriovenous Graft Placement. J Am Coll Surg. 2006;203(4):506-511. doi:10.1016/j.jamcollsurg.2006.06.002 8. Gargiulo NJ, Veith FJ, Scher LA, Lipsitz EC, Suggs WD, Benros RM. Experience with covered stents for the management of hemodialysis polytetrafluoroethylene graft seromas. J Vasc Surg. 2008;48(1):216-217. doi:10.1016/j.jvs.2008.01.046 9. Blumenberg RM, Gelfand ML, Dale WA. Perigraft seromas complicating arterial grafts. Surgery. 1985;97(2):194-204. 10. Lok CE, Huber TS, Lee T, et al. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis. 2020;75(4):S1-S164. doi:10.1053/j.ajkd.2019.12.001 11. Padberg FT, Calligaro KD, Sidawy AN. Complications of arteriovenous hemodialysis access: Recognition and management. J Vasc Surg. 2008;48(5):S55-S80. doi:10.1016/j.jvs.2008.08.067

In this episode I talk about the cutting-edge world of bionic eye technology, diving into how devices like the Argus II Retinal Prosthesis are helping patients with retinitis pigmentosa and age-related macular degeneration regain rudimentary vision. Alongside this futuristic topic, I also reflect on the challenges of practicing in the ICU as a young intern and the complexities of addressing patient needs with innovative surgical techniques. Takeaways: Ophthalmology Subspecialties: Dr. Flannery provides an overview of the subspecialties within ophthalmology, from refractive and cornea surgery to retina, pediatric, and neuro-ophthalmology, highlighting their unique roles in patient care. The Power of Second Opinions: He emphasizes the importance of seeking a second opinion for high-cost treatments like LASIK or in-office dry eye therapies to make informed decisions about eye care. Foreign Bodies in Eyes: Dr. Flannery describes the tools and techniques he uses to remove foreign objects, from cat hair to rust rings, showcasing one of the more unusual aspects of his work. Sixth Nerve Palsy Case: He shares a compelling story about a young patient diagnosed with a cerebral venous sinus thrombosis, illustrating the importance of timely and accurate diagnoses in eye care. Safe Eye Drops Matter: He answers fan questions about redness-relieving drops like Lumify, advising against generics linked to dangerous Pseudomonas infections and explaining the benefits of trusted brands. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link:  Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 Today's episode is brought to you by DAX Copilot from Microsoft. DAX Copilot is your AI assistant for automating clinical documentation and workflows helping you be more efficient and reduce the administrative burdens that cause us to feel overwhelmed and burnt out. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode I cover a wide range of topics, including a detailed breakdown of the subspecialties in ophthalmology. From the most common fields like cataract and refractive surgery to the rare gems of neuro-ophthalmology and pediatric ophthalmology, I explain what each specialty focuses on and why some are harder to find than others. I also discuss the importance of getting a second opinion for high-cost treatments, share stories about removing foreign bodies like cat hair from patients' eyes, and recount a memorable case of sixth nerve palsy caused by a life-threatening cerebral venous sinus thrombosis. Takeaways: Ophthalmology Subspecialties: Dr. Flannery provides an overview of the subspecialties within ophthalmology, from refractive and cornea surgery to retina, pediatric, and neuro-ophthalmology, highlighting their unique roles in patient care. The Power of Second Opinions: He emphasizes the importance of seeking a second opinion for high-cost treatments like LASIK or in-office dry eye therapies to make informed decisions about eye care. Foreign Bodies in Eyes: Dr. Flannery describes the tools and techniques he uses to remove foreign objects, from cat hair to rust rings, showcasing one of the more unusual aspects of his work. Sixth Nerve Palsy Case: He shares a compelling story about a young patient diagnosed with a cerebral venous sinus thrombosis, illustrating the importance of timely and accurate diagnoses in eye care. Safe Eye Drops Matter: He answers fan questions about redness-relieving drops like Lumify, advising against generics linked to dangerous Pseudomonas infections and explaining the benefits of trusted brands. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link:  Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 Today's episode is brought to you by DAX Copilot from Microsoft. DAX Copilot is your AI assistant for automating clinical documentation and workflows helping you be more efficient and reduce the administrative burdens that cause us to feel overwhelmed and burnt out. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

On episode #70 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the weeks of 12/5/24 – 12/18/24. Hosts: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, RSS, email Become a patron of Puscast! Links for this episode Viral Epidemiology of Dengue— Puerto Rico, 2010–2024(CDC MMWR) Takeda Announces Voluntary Withdrawal of U.S. Biologics License Application (BLA) for Dengue Vaccine Candidate TAK-003(Takeda)  Global health and economic burden of chikungunya from 2011 to 2020 (BMJ Global Health) Bacterial Biomarker-Guided Antibiotic Duration for Hospitalized Patients With Suspected Sepsis (JAMA Network) Say it ain't Steno: a microbiology nudge comment leads to less treatment of Stenotrophomonas maltophilia respiratory colonization(Infection Control & Hospital Epidemiology) Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults(JAMA Network) Epidemiology and Outcomes of Antibiotic De-escalation in Patients with Suspected Sepsis in US Hospitals (CID) Effectiveness of ceftazidime–avibactam versus ceftolozane–tazobactam for multidrug-resistant Pseudomonas aeruginosa infections in the USA (CACTUS): a multicentre, retrospective, observational study (LANCET Infectious Diseases) Bedaquiline Monotherapy for Multibacillary Leprosy (NEJM) Fungal The Last of US Season 2 (YouTube) Histoplasmosis Associated With Bat Guano Exposure in Cannabis Grower (OFID) Parasitic TWiV 1175: A hitchiker's guide to virology(microbeTV) Diverse RNA viruses of parasitic nematodes can elicit antibody responses in vertebrate hosts (Nature Microbiology) Neurocysticercosis school outbreak in Belgium (LANCET) Miscellaneous Maintenance of Certification: Is a Knowledge-Based Assessment Really Necessary? (CID) Living happily ever after? The hidden health risks of Disney princesses (BMJ) How to transport a polar bear, and other idiosyncrasies in providing emergency medical services in the Arctic (BMJ) Music is by Ronald Jenkees Information on this podcast should not be considered as medical advice.

The Daily Shower Thoughts podcast is produced by Klassic Studios. [Promo] Check out the Daily Dad Jokes podcast here: https://dailydadjokespodcast.com/ [Promo] The Daily Facts Podcast. Get smarter in less than 10 minutes a day. Pod links here Daily Facts website. [Promo] The Daily Life Pro Tips Podcast. Improve your life in less than 10 minutes a day. Pod links here Daily Life Pro Tips website. [Promo] Check out the Get Happy Headlines podcast by my friends, Stella and Mickey. It's a podcast dedicated to bringing you family friendly uplifting stories from around the world. Give it a listen, I know you will like it. Pod links here Get Happy Headlines website. Shower thoughts are sourced from reddit.com/r/showerthoughts Shower Thought credits: hacksoncode, Steinmetal4, LetMeExplainDis, MenInBlerg, Savage-Monkey2, Boatwhistle, wimpykidfan37, JonoProBono, Snoo_19146, SheriffColtPocatello, Ok-Software-1902, hearsdemons, natural1dave, OldTimeyMedicine, lionstigersbearsomar, Stock_Surfer, Tentmancer, TIFUstorytime, Sapphiregangster, , tuber_simulator, InfinityScientist, Pseudomonas_xx, Edawg661, dropkicked_eu, Terrible-Swim-6786 Podcast links: Spotify: https://open.spotify.com/show/3ZNciemLzVXc60uwnTRx2e Apple Podcasts: https://podcasts.apple.com/us/podcast/daily-shower-thoughts/id1634359309 Stitcher: https://www.stitcher.com/podcast/daily-dad-jokes/daily-shower-thoughts iHeart: https://iheart.com/podcast/99340139/ Amazon Music: https://music.amazon.com/podcasts/a5a434e9-da18-46a7-a434-0437ec49e1d2/daily-shower-thoughts Website: https://cms.megaphone.fm/channel/dailyshowerthoughts Social media links Facebook: https://www.facebook.com/DailyShowerThoughtsPodcast/ Twitter: https://twitter.com/DailyShowerPod Instagram: https://www.instagram.com/DailyShowerThoughtsPodcast/ TikTok: https://www.tiktok.com/@dailyshowerthoughtspod Learn more about your ad choices. Visit megaphone.fm/adchoices

On tomorrow's episode of The Wholesome Fertility Podcast, I welcome Dr. Sarah Wilson of @embracefertility. Dr. Sarah Wilson shares her personal journey with reproductive health and how she overcame challenges with her period and fertility. She emphasizes the importance of understanding one's own body and advocating for oneself in the medical system. Dr. Wilson discusses the role of the immune system and gut health in reproductive health, highlighting the connection between inflammation, gut bacteria, and hormonal balance. She explains how basic blood work can provide valuable insights into one's health and offers practical tips for addressing gut health issues. Dr. Sarah Wilson discusses the importance of gut health and its impact on overall well-being. She explains how the gut microbiome plays a crucial role in maintaining a healthy immune system and how imbalances in the microbiome can lead to various health issues. Dr. Wilson emphasizes the need to create a hospitable environment for beneficial bacteria to thrive and shares insights on the use of probiotics and spore-based organisms. Dr. Wilson provides practical tips for improving gut health, such as eating whole foods, avoiding processed foods, and managing stress.   Guest Bio:   On today's episode of The Wholesome Fertility Podcast, I welcome Dr. Sarah Wilson, ND. Dr. Sarah Wilson discusses the importance of gut health and its impact on overall well-being. She explains how the gut microbiome plays a crucial role in maintaining a healthy immune system and how imbalances in the microbiome can lead to various health issues. Dr. Wilson emphasizes the need to create a hospitable environment for beneficial bacteria to thrive and shares insights on the use of probiotics and spore-based organisms. Dr. Wilson provides practical tips for improving gut health, such as eating whole foods, avoiding processed foods, and managing stress.   Takeaways:   Advocate for yourself and seek answers when faced with reproductive health challenges. Understanding the role of the immune system and gut health is crucial for reproductive health. Basic blood work can provide valuable insights into one's health and help identify patterns and tendencies. Addressing gut health issues, such as inflammation and imbalances in gut bacteria, can positively impact reproductive health. Maintaining a healthy gut microbiome is essential for overall well-being and a strong immune system. Creating a hospitable environment for beneficial bacteria to thrive is crucial for gut health. The gut-brain connection and the enteric nervous system play a significant role in gut health. Managing stress, eating whole foods, and avoiding processed foods are important for improving gut health.       Dr. Sarah Wilson, ND, is the visionary founder of Advanced Women's Health, leading a healthcare revolution across Canada with clinics in Ontario and British Columbia. Overcoming her own health challenges, Sarah is dedicated to empowering women to reclaim their vitality naturally, merging research-backed expertise with her passion for Naturopathic Medicine. Beyond her professional pursuits, she is the Mom to two latino boys under 5 and is a self-proclaimed personal development and mindset fanatic.   www.advancedwomenshealth.ca Instagram: @embracefertility @drsarah_nd @advancedwomenshealthclinics https://www.youtube.com/@embracefertility https://www.linkedin.com/in/naomi-woolfson/     For more information about Michelle, visit: www.michelleoravitz.com   The Wholesome FertilityFacebook group is where you can find free resources and support:  https://www.facebook.com/groups/2149554308396504/   Instagram: @thewholesomelotusfertility   Facebook: https://www.facebook.com/thewholesomelotus/     Transcript:   Michelle (00:00) Welcome to the podcast, Dr. Wilson.   Sarah Wilson (00:02) Thank you so much for having me. I am so excited. I just really can't get enough of sharing all of the information that women need about reproductive health and empowerment. So thank you for having me.   Michelle (00:14) Love it. So I'd love for you to share your background and how you got into the work with reproductive health.   Sarah Wilson (00:21) It's such a huge conversation, I think such an important one because for so many of us, we get into it because we needed the medicine, right? And we explored that. So my story I always say is a really winding one. I was in and out of hospital my whole life until I was 18 and I was diagnosed with celiac disease, but I didn't fit the bill. And it was a naturopathic doctor that really pushed for that initial diagnosis. And so then, as we all do,   Michelle (00:28) Mm -hmm, yeah.   Mm -hmm.   Sarah Wilson (00:49) I avoided my calling and was trying to figure out how to recover and how to work within this and lost my period for almost five years. And so during this time, I was a researcher and I was seeing different naturopathic doctors. I was seeing different conventional doctors and specialists and people just kept saying they didn't know what was going on and they couldn't figure out why I was, like I wasn't exceptionally lean during much of that period of time. Like they just couldn't piece it together.   Michelle (00:58) wow.   Sarah Wilson (01:18) I had a doctor, think it was 21, 22, that was like, you might never have kids on your own. If you wanna get pregnant, come back to me, I'll give you a pill, we'll wish you the best.   Michelle (01:28) So nonchalant.   Sarah Wilson (01:31) And I just, I always say there's a few breakdown to breakthrough moments in my life and that was a big one where I was just like, absolutely not. I have the world available to me. I have all of this research. There must be something I can figure out. So that proceeded to really get me to push to work and find the research and piece things together. And I did bring back my period. And then when it came back, it was exceptionally painful. I was passing out. I had been on birth control.   Michelle (01:37) Mm -hmm. Yeah, good.   Mm -hmm.   Sarah Wilson (02:00) since I was 13 because of the amount of pain and heaviness. And so that's what it was like, okay, now we have to navigate this world of endometriosis and what that means. so yeah, now fast all the way forward, I became an astrophysicist doctor. I have two babies with two tries. I do not live in chronic pain and I'm just so passionate about taking all that research. I had to figure out myself and...   Michelle (02:09) Mm   Mm   Mm   Sarah Wilson (02:26) had to bring into practice and navigate how to bring into practice to now be able to give that to patients across advanced women's health clinics in Canada. it's just, it's a very empowering end to a really challenging journey, which I think so many people listening have.   Michelle (02:44) Yeah, for sure. What I love about what you were saying is that knowing that inner knowing you're like, no, absolutely not. Like you knew it in your heart. Because a lot of people hear that. And then they're like, okay, I guess that's just my fate. And I love, you know, I love when people are like, no, I'm gonna take no for an answer. I'm gonna figure it out. and it's also an intuition. It's like your own intelligence within you telling you, no, there's more to look into. I had a similar   thing a little different, but similar. so what was it, let's kind of go back just because people might be in similar situations with their period, listening to this. What was it that really caused the five years without period? was it being on a pill for a long time? What was it that caused that?   Sarah Wilson (03:29) So I was actually, my presentation of celiac disease was very different. I was 100 pounds heavier than I am now. I perfectly, I exercised and I was obese. And so what, the brain is such a beautiful thing. And what I believe happened is that being obese, going through puberty programmed my brain for what body fatness, quote unquote, I needed to have in order to be safe to have a baby.   Michelle (03:36) Mm   Mm   Mm -hmm.   Mm -hmm.   Sarah Wilson (03:59) And so for most people, they lose their periods around 16, 18 % body fat. I tend to hover around 23, 24. If I dip below that, then my period starts to go as long, it goes wonky. It's much better now, but the research suggests that when you have inflammation interacting with your brain, when you have cortisol interacting with your brain, what happens is we actually change how sensitive we are to the signals between the brain and the ovaries.   Michelle (04:08) Mm   Mm   Sarah Wilson (04:28) And so I think that in combination with all these set point theories, there's so many things happening now in the world of set points, that combination is what it was. So for me, getting my inflammation under control, which we'll talk about, getting an understanding that I had stress, but it was physiological stress. I had nutrient deficiencies, I had bacterial overgrows, I had inflammation, like I had all of those pieces.   that were interacting with my brain and my hormones. And so I just needed to go through step by step. I needed to work on my gut microbiome. I needed to work on the nervous system component. But fundamentally, I needed to understand that my body, the way it works and its sensitivity is set at a slightly different point than other people's.   Michelle (05:18) Yeah, well, for sure. I mean, I think that that's really at the crux of everything is that everybody has their own different set point and different like, you know, responses, their bodies respond to different foods, different environments, different stress factors, just so many things. And I think that that's the key. I often see a lot of people sometimes come in to see me and they're well, I'm taking this kind of like,   combination herbs that I saw online or, you know, so, that's, that's one of the things that I really try to stress to people is that everybody's so different. And so when you were going through that, you were uncovering it. Obviously you had a natural path that you were working with. Yeah, multiple. So they, you had a team.   Sarah Wilson (05:58) And multiple. Yeah, absolutely. And I think I always say I'm the most energetic scientist you'll ever meet in your whole life. Like data informs every single decision. And then you sit in front of the person in front of you and you say, OK, what's their energy? Right. Like what? How do you need to to build those things together? And so, yeah, I had a team I had.   Michelle (06:09) Mm   Mm right. Totally.   Sarah Wilson (06:23) And I had multiple naturopathic doctors try to work their way through it. I had OB -GYNs and my family healthcare team trying to help navigate it. And it was just, I was in the typical situation. I was in the situation that 90 % of my patients are in. Everyone's like, you're fine. It's fine. Your blood work is fine. Right? And that's, think, even for me doing research, one of the projects I was on was we were studying metabolically healthy people, metabolically unhealthy people.   Michelle (06:41) Right, exactly. Yeah.   Sarah Wilson (06:52) We were studying them in lean and obese categories. And so the labs going through and they're pulling all this data. And it was the first time that I'm sitting there going, huh, okay. So we can have people that are metabolically very healthy and overweight. And we can have people that are very lean and extremely metabolically unhealthy. And this was, it was such a formative experience because I remember sitting there going.   Michelle (06:55) Mm   Mm -hmm, right.   Sarah Wilson (07:20) The blood work, the way we're reading it right now means nothing. Right? Like we need to be rude.   Michelle (07:25) There's so much more. It's just a snapshot. It's like a small, it's a small little slice. And I think that's something that I often see too, is that we make such generalized assumptions based on such a small little snapshot. And while that snapshot is very important, it's, it's kind of a piece to the puzzle. It's not the end all be all it's part of the whole picture.   Sarah Wilson (07:28) Exactly.   Exactly, and if we use a conventional reference range that's defined based on disease, like I think in North America, we've really lost the understanding that there's a line between health and disease. Like you don't just jump from one to the other like long jump, right? It's not like I'm healthy today and tomorrow I have a disease. Like there's this spectrum of dis -ease as we make our way to a condition. And I think identifying patterns in labs.   and identifying tendencies is arguably more important than the snapshot itself, you're 100 % correct. And so we have to look at that data holistically and say, how is that changing? How is that modifying over time? But also I think there's so much research now where we can give people back the keys to the castle with that basic blood work, right? Even for example, everyone has had what we call a complete blood count. We've had multiple of them. So that's...   A complete blood count is when we're looking at your red blood cells and your white blood cells. We're looking at the breakdown of those things. It's the thing you get when you walk into the doctor's office, when you get when you walk into the hospital, et cetera. They're always just saying, what's your white blood cells? What's your red blood cells doing, et cetera. And there's two white blood cells called neutrophils and lymphocytes. They are just representing two aspects of our immune system that are fighting bacteria and viruses and they're helping to support the system.   But there is a ton of research coming out to show that the ratio between neutrophil and lymphocytes can tell us about the inflammatory status of the body. So if your NLR, as we call it, neutrophil to lymphocyte ratio, is higher than 2 .5 or 3, chances are you've got an immunological underpinning to what's going on. And so for me with endometriosis, I was in the hospital a while ago now, and I was having a flare, and I was worried about ovarian torsion, because at one point I had had a 10 centimeter endometrial.   Michelle (09:30) Mm -hmm.   Sarah Wilson (09:40) like it was very, very large and it's not there now, but I just wanted to go in and make sure that there wasn't something happening because it felt different. And my NLR was six, but outside of that, it was one or two. So this is something I always say to patients, you can even empower yourself just looking at that number and being like, if that number is jumping high and it's correlating with my symptoms, if I have worse menstrual pain or worse mood challenges or   Michelle (09:42) Mm -hmm.   Mm   Mm   Mm -hmm.   Sarah Wilson (10:08) I get pregnant and these things jump and then I have a loss, what could that be telling you about your immune system? And I think there's such simple things. Of course, we can run super comprehensive panels of labs and get all of the autoimmune tests. And like I've heard you talk about them on the podcast before, right? You can get really comprehensive panels and that's wonderful. And I love that as a doctor and a researcher, I love data. But what I love even more is saying, let's look at the past two or three years.   Michelle (10:26) Mm   Mm   Right.   Sarah Wilson (10:37) What are these basic blood markers telling us about your tendencies and how much we need to dig into different components of health, like your immune system, your blood sugar, those types of things?   Michelle (10:48) So you could see this basically on just general blood work.   Sarah Wilson (10:53) Exactly. And so that's where I think for me.   Michelle (10:55) And do people often look like, do doctors even know to look for that specific thing? So it's kind of one of those things that people don't really look for, but you can kind of dig up your own stuff and just look at the ratio yourself.   Sarah Wilson (11:07) Exactly. Exactly. And that's why I think I come on these podcasts and I do these things because not everyone has access to a naturopathic doctor. Not everyone can be a researcher. Exactly. So to be able to look at that and start to question, even when I was in the hospital, I was like, are you concerned about that? And they're like, maybe you have a bacterial infection. It's not a big deal. Okay. Okay. Right? But it's...   Michelle (11:16) Yeah, that's very empowering.   Mm -hmm. Yeah.   Sarah Wilson (11:30) It's those things that I want people to be able to grab onto and access for themselves because what I know to be true in my practice, seeing so many people, is when you give women access to information about their bodies, they change communities, households, everything. Like it is the most empowering thing for me to come on a podcast and talk about something and then...   Michelle (11:46) Mm   Yeah.   Sarah Wilson (11:57) get someone message me and be like, my friend of a friend of a friend told me to look at this and now I'm concerned about it. And I'm like, yeah, you should probably get that investigated. And then it's ovarian cancer. You know what I mean? Like this is how powerful just these conversations are.   Michelle (12:08) my God, yeah.   Yeah, it's very powerful. mean, obviously when you do see that something's off, it'll get you at least to take the next steps or to investigate it more because you can't really make, you know that something's going on, but you have to like really move further and see what it is. But at least it's going to be an alarm to let you know something's going on.   Sarah Wilson (12:35) Mmm.   And a direction, right? I, every day, pretty much at this point, I'm talking to someone who's like, everything I was told was unexplained, right? And in the fertility world, if you're unexplained infertility, you either have a baby or you don't, right? So there's clarity in that, no one's saying, your infertility is in your head. But in every other aspect, there's not those clear end points. And so,   Michelle (12:40) Mm   Mm -hmm.   Mm   Sarah Wilson (13:07) if someone's dealing with chronic pain and they aren't getting investigated for endometriosis or some other condition, they can be told it's all in their head. So even if they can see on basic blood work, one or two things that are off, it's like, there, go there, let's do this. And I think that's what's so exciting to me.   Michelle (13:24) Mm -hmm. Right, right.   Yeah, definitely huge. So talk about the immune system. this is one of the things that you can look at, I know that there is a lot of a connection with autoimmune conditions and the gut health and, high inflammation and leaky gut. So talk about that, how people can look into it and how they can address it.   Sarah Wilson (13:53) Absolutely. So I actually also was a microbiome researcher at one point in my profession. It's so important. And even now, like post pandemic, we've seen it so much more important because historically, what do we always say? Is 60 to 80 % of your immune system lives in your gut. Okay. So there is within your gut, there is, it's so interesting. Picture a PVC pipe, right? On the inside, if there's Play -Doh.   Michelle (13:59) awesome. Amazing, though, but it's so important.   Mm   Mm   Sarah Wilson (14:23) that's where the bacteria live, right? But that's actually outside of your body. And so that play -doh is either poop, in those of us who are lovingly chronically constipated, or it's the mucosal lining that the bacteria live within. So that's where the immune system is really, really critical, is within that putty lining. And so what happens is that immune system's job, because it's technically outside of your body, mouth.   Michelle (14:26) Mm   Mm   Sarah Wilson (14:51) all the way down to your anus is outside of your body. Its whole job is to say, are you a food and you're safe? Are you a bacteria and you're safe? Are you a virus and you're not safe? Are you a bacteria and you're not safe? And the whole job of that immune system is to sample and navigate. Do I need to kick off an inflammatory response or do I not? Am I safe or am I not? And so what we're looking at is when we start to have allergies.   and we start to have food responses and all these food sensitivities when we start to have bloating and gas changes in bowel movements. That's all telling us that our immune system either one has identified a bacteria or virus that needs to go and it's kicking off a response to it or two, it has what we call lost oral tolerance. It has lost the ability to know between what's good and what's bad.   Michelle (15:46) Mm.   Sarah Wilson (15:47) And so in both of those situations, that is going to result in inflammation, not just local to our gut, but throughout what we call our peritoneal cavity, right? So that's gonna be your ovaries. I always say, your bowel and your ovaries and your uterus are friends. Like for those of you who can't see it, they're touching, they're friends. So we have that inflammation in our reproductive system. We have that inflammation affecting our liver.   then it goes into our bloodstream. It affects our joints, it affects our brain. That's why we talk so much about the gut brain connection, because there's that inflammation there. But as a practitioner, my job is to sit here and say, is it that we have so much inflammation? There is this absence of an ability to regulate, should I fight this or should I not?   Is it that there's so much damage being caused by inflammation that now we have leaky gut or impermeability, right? Because the immune system will cause damage and it's trying to fight something and there's collateral damage. So is it that or is it that there's bacteria that need to be modified? And so I think it's really helpful, even like thought experiment to think about it in that way, because so much of the time when it comes to the gut, we   Michelle (16:43) Mm   Mm   Sarah Wilson (17:05) are assuming that our symptoms are wrong. Like, what's wrong with my gut? Right? Like, we're a victim to it. Like, our immune system is doing something bad. But nine times out of 10, it's trying its best to protect us. And so our job is to say, what is it protecting you against?   Michelle (17:08) Mm -hmm. Right.   Mm   Mm   Right.   Sarah Wilson (17:25) So when we're navigating and we're going through then, we hear all about probiotics and we hear all about these different things and all of them can be helpful and have their place, right? We hear about armor colostrum all the time these days on different podcasts, right? We hear about all these things. And so I always say, think about them and put them in the context of what I just said. So if we don't have enough good bugs and we add probiotics, which are good bugs,   Michelle (17:36) Mm   Mm right, yeah.   Sarah Wilson (17:52) then that will take us so far. for, again, for those of you who can't see, I've got my hands up, right? Picture it like a bar graph. So if you don't have enough good bugs and that bar is low and you have too many bad bugs, then the dominant state is bad bugs. So if you add a whole bunch of good bugs, then eventually you can turn that dominant state into good bugs. But probiotics are transient, they leave the system. So you still have that low grade bad bug situation.   Michelle (18:06) Mm   Sarah Wilson (18:21) So this is where we hear about berberine, right? We hear about oregano, we hear about black cumin seed, we're hearing so much about all of these herbs now, because what they're doing is they're breaking down the bad bugs to allow the good bugs to grow, to repair the lining. it's, there's such a huge dance with the bugs in the gut and the immune system and how that affects the rest of your body, but what we know for darn sure is that   Michelle (18:23) Mm   Right.   Right.   Sarah Wilson (18:49) There are overgrowths that are happening more than they ever have been before of bad bugs. We know that.   Michelle (18:55) Right. So we're talking about things like SIBO, you know, just that, because that ultimately it starts to kind of go from like the bowels all the way up.   Sarah Wilson (19:04) Yeah, exactly. So SIBO is small intestinal bacterial overgrowth. So it's overgrowth of good bugs in the small intestine. We also have what we call CFO or overgrowth of yeast in the small intestine because the immune system can't defend against the yeast. Then we have bad bugs and parasites, right? So this is where we hear an overgrowth of, I'll throw some names, like Pseudomonas, C. difficile, Clostridium species, E. coli. We have an overgrowth of bad bugs in that situation. And those can be   Michelle (19:11) Mm   Mm   Mm   Mm -hmm. Bye.   Mm   Sarah Wilson (19:34) upper but they can also be lower down. And so that's always what we're navigating is saying, okay, is there, if you have an overgrowth of good bacteria and you add more good bacteria, you're gonna be the person who feels awful on probiotics. You take them, you're gassy, you're distended, okay, in that, yeah.   Michelle (19:49) Right.   Unless, unless they're spore based.   Sarah Wilson (19:56) The SBOs are such an interesting conversation. They're such an interesting conversation because most of the research is coming out of two labs. And so I agree to some extent and I'm pensive. Yeah.   Michelle (19:59) Yeah.   Mm -hmm.   Okay. No, tell me, tell me. I want to hear it because, because I've always been told and I've always learned that spore -based probiotics, because, they, they bypass the small intestine, they go all the way down to, you know, the colon that, and then they, and then they flourish and they change the pH and they, they make it so that it's more hospitable for the good bacteria to grow and not the bad bacteria. A lot of times there's like die -off symptoms and it   Sarah Wilson (20:32) Exactly.   Michelle (20:36) kind of shifts, even though it's transient, it does shift the pH to create it where it's better for a healthier environment.   Sarah Wilson (20:47) Absolutely. So it's just like that bar graph, right? I always say if you give the environment for the good bugs to grow and there's not too many bad ones, then they will grow and take over. If you ever, I always tell people picture like an octopus or a cuttlefish, you know they change colors really rapidly? Our bacteria do the same thing. It's called quorum sensing. And so essentially if you create a hospitalable environment, you have enough mucus. This is the other thing, right? Bacteria need mucus.   Michelle (20:49) Mm   Yeah.   Yeah.   Mm -hmm. Yeah. Mm -hmm.   Mm The mucosal lining. Yeah.   Sarah Wilson (21:13) Exactly. So if you have that integrity, you add probiotics, and then you can change from a red environment, inflamed, the pH is off, there's bad bugs growing to a good environment. If you don't have that mucosal lining, if your immune system is too grumpy, or if you're in a situation where there's too many bad bugs, then you can't fix it by adding more.   Michelle (21:17) Mm -hmm.   Mm   Mm   Mm   Sarah Wilson (21:40) And so that's where we're using antibiotics and antimicrobial herbs and things like that to get that down. Going back to the SBOs, the thing I find really interesting is there's so many, I could like nerd out on this stuff all day long as you can tell, but there's so many factors, right? So when we talk about it bypasses the small intestine, what they mean in that situation is that all bugs are either acid sensitive, temperature sensitive,   Michelle (21:54) It's great stuff though.   Sarah Wilson (22:09) oxygen sensitive or yeah, I went through acid. Those are honestly the main ones. There's nitrogen sensitive, things like that, but those are the main ones. So what they're saying is the acid sensitivity means that they will get, and the temperature and oxygen sensitivity means they're gonna get lower down. But what we're seeing more and more and more is that people's stomach acid is off, their pH is off throughout their whole system. They have all kinds of,   Michelle (22:32) Mm   Sarah Wilson (22:37) you know, temperature sensitivity changes. And we have all kinds of changes in the hydrogen, methane and oxygen levels within our gastrointestinal tract. So what happens is we're not actually controlling where it's going. We're controlling at what environment it takes hold. And because there's so much dysfunction within the gastrointestinal tract in so many of our patients, I'm concerned that it actually could take hold.   and be present at higher levels of the gastrointestinal tract contributing to issues. And I've seen some... Yeah, that's BOs. Yeah.   Michelle (23:10) You mean the spore based ones, the spore based? you, because from what I understand, looking into it is that it won't activate until it gets to the large intestine.   Sarah Wilson (23:23) And that's based on the pH, the oxygen level and the temperature and all of those pieces.   Michelle (23:29) Okay, I see. So you're saying that it could be a different pH and everything will shift if things are so off, up, you know, higher. Got it.   Sarah Wilson (23:36) Exactly.   Exactly. And I've seen severe constipation in patients that take SBOs. It's like the only side effect I see, because you're right, there is a lot less bloating gas, those like three to five day battle between the good and the bad bugs. There's less of that for sure. But I have seen like enough patients that got me saying, okay, what's going on there that take it.   Michelle (23:47) Mm   Mm -hmm. Mm -hmm. Yeah.   Mm   Sarah Wilson (24:04) and immediately they're super constipated. So we actually use them a lot in diarrhea because of the benefit of that. But it's definitely a space I'm watching the research. It's super interesting. I think just like, so I was, my God, how many years ago now was I a probiotic researcher? least 10. It's a different world, right? Like how exactly, so.   Michelle (24:10) Mm -hmm.   Yeah.   Mm -hmm. yeah, they're learning so much so fast. Yeah.   Sarah Wilson (24:30) Exactly. So that's where I always say, you know, you're a good practitioner when you want to refund everyone every five years. You're like, what was I doing? So I think it's just an evolving conversation, but they definitely do have utility for sure. I think there's just, for me, just having been in a research environment, I know how controlled all of those situations are. And so then when they come out into our patient situations,   Michelle (24:35) Yeah.   Yeah.   Sarah Wilson (24:56) We just need to apply different lenses of thought to it.   Michelle (25:01) Or I mean, you can also add something like Trifola while they're doing that so that you're kind of like counteracting the constipation aspect or maybe some more fiber eventually when they're ready, you know, because sometimes too much of that when things are not great can exacerbate.   Sarah Wilson (25:17) Absolutely. And like we have studies now that are coming out to show that it's alarming. Over 50 % of people have what we call retained fecal matter, which is like constipation when they don't know constipation. And so I think there's so much that we're finding out and there's so much that's going on within the gut microbiome world that will be.   Again, I'm just always so curious to see where it goes and to see what happens with it. Because even I wrote a book in 2018, I guess. So I was writing in 2017 on insulin resistance and how that worked. And like I talked about in Cretins in a big section of that book. This was like pre -Ozempic days. And people at that point were like, what is she talking about? And now it's so accepted. And that's what six years later, right? They're just like, of course.   Michelle (26:08) Yeah.   Sarah Wilson (26:11) So, so much changes so quickly. And I think just staying on top of it is something I value so much. Like even today, I'm teaching an intensive on post -viral immunology for other practitioners, right? So, I'm always trying to navigate what do I see in practice? Because we see thousands of people in advanced women's health. And how is that showing up in the research? And how do we mesh those things and adapt with those things? Because things change so quickly.   Michelle (26:14) Yeah, for sure.   Mm   yeah, definitely. No, I agree. mean, everything just kind of out does itself. Something new comes along. what I find really fascinating is the gut brain relationship and the enteric nervous system and also the vagus nerve and how that impacts. It's kind of like the go between our brain and our gut. And, and also   Sarah Wilson (26:50) Yeah.   Michelle (27:01) the research on that where they've done like studies on meditators and like people in Tibet, Tibetan Buddhists, compared to people that are neighbors that eat the same food, they live in the same environment, but the gut microbiome of the meditators is so much more enriched. So it's kind of like a buy between, yes, we could work from the gut to the brain, then we can also work from the brain to the gut. And it's pretty fascinating.   Sarah Wilson (27:12) Yeah. Yeah.   Absolutely, and even to see the amount of research on people's levels and how that is directly related to yeast infections. We know that that whole gastrointestinal tract, vaginal microbiome, they are so, so, so closely tied to our nervous system and stress response. There's so much, I do.   Michelle (27:34) Mm   Mm That's interesting.   Yeah.   Sarah Wilson (27:52) stool testing on myself pretty frequently. I would say even more so than patients, I do it on my family. And it's so interesting to see how it shifts because again, diet and lifestyle can stay very similar. So it's like interesting what caused that shift, what caused that shift, how was stress involved with these things. it's, yeah, it's so fun. It's so fun.   Michelle (27:58) Yeah.   Mm -hmm.   Yeah, it's fascinating for sure. And then also, think about the gut microbiome, I think about the changes, I think about inflammation. I think about the additives we're eating and we're exposed to. mean, those are the biggest things because it feels like it's outside of our control. I mean, it kind of is until we know about it. It's, know, we go eat some places, we have no idea what they're adding and we know that   Sarah Wilson (28:33) Mm   Michelle (28:40) thickeners, I mean, there's so many things that can be added. We know that they can really throw off the gut microbiome and that throws off inflammation. So it's kind of like an unintended consequence because you're not, most of us don't know that unless we're doing what we're doing and learn about it.   Sarah Wilson (29:00) And then you're looking, is there SLS in this? Is this disrupting my microbiome?   Michelle (29:04) Yeah, but that's what it is. And that's why when people say, I guess, to simplify it is just don't eat processed food as much as, try to avoid it as much as possible. Because even like the good kind can impact your gut. mean, like good processed food, because of all of the excess ingredients that they add in there, that could really throw off your microbiome. That's why when people say just, I guess, like, if you want to say something that's more generalized, is more whole foods, foods that come from the   earth and also foods that are not sprayed with toxins, know, I mean, to try to avoid it. It does feel like an uphill battle.   Sarah Wilson (29:44) Patients are so overwhelmed, right? It's you're trying to eat whole foods and then you look and they're like, okay, well, what about genetically modified agents? And then what about what's being sprayed on them? And I always say that in of itself is a stress response, right? So we talk about stress and then we make food such a stress. And so I always say to people, the reality is that you could probably do better than you're doing right now.   Michelle (29:45) Yeah.   Sarah Wilson (30:12) and what feels reasonable, what doesn't feel overwhelming, right? And we'll actually sit there and go through and say, okay, I need you to eat a low insulin demand approach, because insulin is such a huge inflammatory compound. Insulin is the hormone that controls blood sugar, but it's like 75 plus percent of us are insulin resistant in today's day and age. So it's a huge, it's an epidemic. So I'm like, okay, don't eat a ton of carbohydrates,   Michelle (30:14) Mm   Yeah. Yeah.   Sarah Wilson (30:43) I hate good carbs, bad carbs, but berries, all of those highly colorful fruits and vegetables, don't count them. Eat away, enjoy your life. I'm not talking about that. We all know we shouldn't eat as much bread. Deep fried foods are not helping anyone, right? The starchy carbohydrates, rice, like that. We have to watch those things. We built a culture on creating addiction to carbohydrates. So we have to be careful of those things. But it's like, how can you add two servings of vegetables? If you can...   Michelle (30:52) Yeah.   Nope.   True.   Sarah Wilson (31:12) buy local and you know where they're coming from, rock on. Like it's summer here right now. There's farms that I know do not spray anything, but they cannot certify organic because they can't afford it. Okay, wonderful. I can go there, right? Buy frozen organic. It is pretty much the same price to buy frozen organic as it is to buy broccoli right now, right? And saves my life prepping it. It is picked right.   Michelle (31:26) Yeah.   Mm -hmm. 100%.   Yeah.   Sarah Wilson (31:41) It is frozen right away. There's benefits to it. So it's like, do that. Okay, then we look at our meat. How, or if you're eating meat or not, How is it being raised? Would you want to go visit that farm? Because if you would not feel good around that, then energetically that has an impact, right? What hormones are going into it? We look at those things. And the reality is, if you can't...   afford to make those choices wonderful. That happens. What do we do to feel the best about the options that we have in front of us? Fundamentally, I always say balance blood sugar and a nervous system that is stable and you're not having anxiety every time you put food in your mouth because you don't know what's in it. That is going to take us almost just as far as micromanaging every piece and every ingredient. Whole foods more often   eaten away that fills you up, that makes you feel good. And everything else from there is customizable. But I think I hear so many patients, they get so caught up in fresh, organic, grass fed, grass finished, researching the farm, and then they end up in McDonald's.   Michelle (32:57) Yeah, that's not good. Yeah, yeah. Yeah.   Sarah Wilson (32:59) because they're so overwhelmed, right? They're like, I'm just hungry. And so I always say like a happy balance is always gonna be the goal.   Michelle (33:08) Yeah, no doubt, for sure.   Sarah Wilson (33:10) And your microbiome loves colors and there's not many of those at McDonald's, so. Exactly.   Michelle (33:14) Yeah, variety for sure. Yes, totally. And then you were talking about like symptoms even without a diagnosis,   Sarah Wilson (33:24) So the blood work is one piece, right? So even without a diagnosis, you can do complete blood count. You can do something called a C -reactive protein, which is a marker of gut inflammation, liver inflammation. You can do an arethrocytes sedimentation rate. These are blood markers. But I also say, if you are struggling with joint aches and pains, if you feel like you're just getting older, if you are dealing with brain fog, if you...   Michelle (33:26) Mm   Mm   Sarah Wilson (33:53) have pain with your periods that we have normalized so much as a society. If you have period poops, if you have PMS that is affecting your quality of life, like we have so many of these symptoms that we've been told, I'm just getting older, I have aches and pains, I'm just bloated and gassy, it's not a big deal, I just have brain fog, I'm losing my memory, right? I can't remember where I put my keys.   I'm dealing with like menstrual challenge. That is all inflammation based, all of it. And as someone I think who lives in this world all the time, it's so easy to forget what it feels like to feel crappy until you get hit. And I have two small children. I have a two and a five year old. And so we're sick all the time, right? Like it's just the reality, daycare, school, people get sick. And   It's so easy to just again, lose track of what good actually feels like. And it doesn't include those things, right? You should wake up in the morning feeling rested, unless you have a child who has nightmares about monkeys, which happened to me. Right? But you should be able to sustain that energy throughout the day without eating food. You shouldn't have to compromise your activity and your work schedule based on pain.   Michelle (35:05) Right.   Sarah Wilson (35:17) and energy levels and your menstrual cycle or your digestion. And so many people are living in that state where they are.   Michelle (35:22) Yeah.   And so when you do have people that come in with inflammation, what are some of the ways that you address that   Sarah Wilson (35:33) absolutely. So my belief structures, there's only five to seven causes of disease, right? So we go through blood sugar dysregulation and insulin resistance, the gut microbiome, immune dysregulation, we've got liver issues, we have nutrient deficiencies, the nervous system, and then we have the components of cellular energy production, or what we call our mitochondria, right? So these are the components of health. And at the end of every piece of that,   you're going to have a stress response and an inflammatory response, which is what most people are dealing with in today's day and age is they're struggling between that balance of stress response and inflammation. So my job is always going through those components and saying, which are the top two or three for you, right? If we're talking about microbiome issues and the immune system as two key pieces.   And then we say, okay, let's compliment that with the nervous system because we just talked about that. If those are someone's top three pieces, then first and foremost, we have to go through and say, what are the biggest obstacles? What are your gut symptoms? Does that suggest that you might have an overgrowth of methane species? Right? Does that, that tends to be constipation, lots of gas that doesn't smell great. Is it suggesting that you have hydrogen overgrowth? Right?   that's lots of gas that doesn't necessarily have a smell. We can go through, pick those apart. Do you have a history of parasites? Right, do you camp a lot? Those pieces, we're using antimicrobials in those situations to try to create some stability. We're trying to understand how that's gonna relate to blood sugar, et cetera. When it comes to looking at the immune system, there are key nutrients like vitamin D. If you don't have vitamin D,   at the right level, which most of us do not, that's a master controller of your immune system. So we need to have that in place. We also need to look at your viral history. So we know right now, research is showing that you can retain components of viruses for years. We've seen that people have reactivation of chronic viruses and those are directly affecting the lining of their uterus, they're directly affecting their ovaries.   Michelle (37:44) Mm   Sarah Wilson (37:55) and their whole pelvic health. So in that situation, we're saying, okay, what antivirals need to come into the mix? And what do we need, again, to look at from a holistic perspective? I know you've had so many people on here that talk about NAC and N -acetylcysteine and alpha -lipoic acid and CoQ10. And oftentimes what they're doing is just helping with those inflammatory cycles.   Michelle (38:22) Mm   Sarah Wilson (38:22) right, they're helping to restore balance to that inflammatory pathway. And then the nervous system comes in because that affects blood flow that affects your immune system's ability to do its job. And we say what works for you? Is that nerve nerves, right? That's where our valerian our passionflower, our zycephos come into the mix and are so beautiful. Is that going to be something where it's we're looking at meditation and walking?   and all of those pieces. that's really the approach I take, is I say, in those five to seven different causes that someone could have, what are the most important pieces for them? And then we dig into it at depth to say what components, whether that's using blood work, whether that's using functional testing, honestly, at this point, having seen as many patients as I've seen, sometimes it's insane. You're like, okay, I think we need anti -microbials.   some valerian and passion flower, and we need to correct the nutrient deficiencies that are present with respect to vitamin D and some of those antioxidants. We need to get enough protein, more colors, Bob's your uncle. But it's, I always say, health is so simple, and we have so much time and energy dedicated to making it really hard. And...   Michelle (39:31) Right.   Sarah Wilson (39:42) the more sophisticated I get, the more sophisticated the research gets, the more I go down rabbit holes, the more I come back to the same things. And I think there's so much peace in that too, to know that, yes, I have a lot of patients with very chronic health issues, with very significant imbalances, but the body wants to come back to those places and we just need to figure out which levers to pull to get it back to health.   Michelle (39:49) Right.   I love how you put that. It's true. It's just like, are the levers to pull, to try to help it do its job. what it wants to do really, it's like its purpose.   Sarah Wilson (40:24) Exactly. it's so, like sometimes you're pulling the same levers in rotation, right? You're like, okay, blood sugar, stress response, liver. And then you're like, inflammation, gut microbiome, stress response, blood sugar, liver. It's, you sometimes have to cycle back to those pieces. There's like the layers of the healing onion. So as we always say, but it's, there's so much simplicity that can be had within all of it. And I really want people to feel that because I think,   Michelle (40:28) Mm -hmm.   Right. Yeah.   Sarah Wilson (40:50) There's a lot of energy now being dedicated to feeling like health is gate kept and it's not, right? This is why we come on these podcasts. This is why we do these things. If anyone today says, I feel empowered, I can take action here. I'm gonna add more vegetables. I'm gonna add more colors. I'm gonna go for a walk after my meals, ideally in nature. I'm gonna look at what brings me joy.   Michelle (40:57) Yeah.   Sarah Wilson (41:17) and include more of that. I'm gonna work on my boundaries, I'm gonna correct my nutrient deficiencies, and I'm gonna look at my microbiome. You will get so far, so far in your health. And that to me is just, it's so beautiful.   Michelle (41:26) Yeah.   yeah, for sure. mean, it's really empowerment. So, well, this is great. You shared so much amazing information. I could definitely keep talking to you because there's just so much that we can keep unpacking. But if people are interested in working with you, want to find out more about you, how can they find you?   Sarah Wilson (41:53) Yeah, absolutely. Well, thank you. know I was, these are always such loaded conversations because we start and it's like, do we go here? Do we go here? So exactly.   Michelle (42:00) I know. There's just a, a, branches out and it has, it starts to take a life of its own. And then I'm like, okay, well, we still can't keep going, going, going. at one point.   Sarah Wilson (42:11) I know totally. Yeah, so I, as I said, for anyone listening in Canada, I own Advanced Women's Health. So we have clinics across Ontario and BC and we're expanding. I have a whole team of practitioners that do clinical rounds every day and I work with all the time. For those of you in the US, I do have courses where I train naturopathic doctors. So if you like this approach and you want people who are in the US and beyond.   then you can always reach out to my team as well. Their email is just info at advancedwomenshealth .ca and they've got that list of practitioners. So in either situation, we can help you out. I also poke around on Instagram. I do not post on there as much as I should, but it's always a goal. And yeah, I'm just so happy to connect with the audience.   Michelle (42:52) Amazing. Well, Dr. Wilson, this was very informative and I love the fact that you do so much research and this is based on like real data and real information and you really understand it. Your mind tends to work that way, which is awesome because you have to find a career where your mind is really able to absorb that information and then apply it. And it sounds like you found a perfect.   career for what you do and you're passionate about it as well.   Sarah Wilson (43:20) Thank you. Yeah, no, I'm so fortunate. I love what I do. And like, I'm so fortunate that I get to build a team of people that begrudgingly love my brain. They're always on calls because we meet every day. So our team of practitioners meets every day and they're always asking questions and I'll spin out on something and I'll be like, welcome to the Ted Talk. Sorry, that just happened.   Michelle (43:31) No, it's very interesting.   Amazing.   That's great. Well, that's how you know you love it. That's how you know it.   Sarah Wilson (43:44) Yes. Yeah, exactly. Exactly. Well, thank you so much for having me. It's been such a joy. yeah, I just I love sharing this information. I'm happy to come back and share more anytime.   Michelle (43:55) Yes. So thank you so much for coming on.    

From the Viruses of Microbes meeting in Cairns, Australia, TWiV speaks with Krystyna and Rob about their research on using bacteriophages to treat bacterial infections. Hosts: Vincent Racaniello and Jolene Ramsey Guests: Krystyna Dabrowska and Rob Lavigne Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode MicrobeTV Discord Server Viruses of Microbes 2024 Immune responses to phages (Front Immunol) Engineering bacteriolytic enzymes (Front Immunol) 100 cases of phage therapy (Nat Micro) Synthetic biology potential of bacteriophages (Nat Micro) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your virology questions and comments to twiv@microbe.tv Content in this podcast should not be construed as medical advice.

Free book is here at https://www.memorizingpharm.com/books In this episode we return to turning the open educational nursing resource for nursing pharmacology into audio, we'll start with the 1st edition antimicrobials then move on to the new second edition with the next topic.  Summary - 3.8 Monobactams Overview and Quiz  Chapter 3.8 of the Nursing Pharmacology guide covers monobactams, a narrow-spectrum antibiotic class primarily effective against gram-negative bacteria like Pseudomonas aeruginosa. Monobactams disrupt bacterial cell wall synthesis and are administered intravenously, intramuscularly, or via inhalation. Nurses should monitor for GI symptoms, skin sensitivities, and coagulation abnormalities. Patient education emphasizes watching for signs of superinfection or allergic reactions. Multiple Choice Questions Monobactams work primarily by: a) Inhibiting protein synthesis b) Disrupting cell wall synthesis c) Blocking DNA replication d) Preventing RNA transcription Monobactams are most effective against: a) Gram-positive bacteria b) Viruses c) Gram-negative bacteria d) Fungi How are monobactams commonly administered? a) Orally b) Topically c) Intravenously, intramuscularly, or via inhalation d) Subcutaneously What should patients monitor for when taking monobactams? a) Increased appetite b) Hair growth c) Signs of superinfection d) Weight gain Patients with allergies to which medication classes should be cautious with monobactams? a) Tetracyclines b) Penicillins, cephalosporins, or carbapenems c) Macrolides d) Antivirals Answer Key b) Disrupting cell wall synthesis c) Gram-negative bacteria c) Intravenously, intramuscularly, or via inhalation c) Signs of superinfection b) Penicillins, cephalosporins, or carbapenems  

On the verge of a post-antibiotic reality, there is an urgent clinical need for new antibiotics. Luckily, new candidates are in the pipeline and older agents are getting a second breath of life through combination therapy.  In this episode of Communicable, host Erin McCreary invites Dr. Markus Zeitlinger of the University of Vienna (Austria) and scientific expert for the European Medicines Agency (EMA) and Dr. Michael Dudley, president and CEO of Qpex Biopharma, to discuss antimicrobials in the clinical development pipeline.  Together they unpack how the WHO curate the priority list of pathogens and how companies adapt such lists into their antimicrobial development business plans. They also discuss the unique challenges and complexities of developing antibiotics, from return on investments and defining the ‘novelty' of an agent to the conundrum of balancing post-market approval and antimicrobial stewardship. Beta-lactamase inhibitors and oral carbapenems in the pipeline targeting ‘the big three' (Enterobacterales, Pseudomonas and Acinetobacter) are the primary focus. This episode was edited by Kathryn Hostettler and peer-reviewed by Dr. Benjamin Berinson of the Medical Centre Hamburg-Eppendorf (UKE), Germany. For more information on the WHO Priority Pathogens List and its 2024 update, check out our previous episode, Communicable E3 (see Literature).  Literature  Communicable E3 - The New WHO Priority Pathogens List: which bugs to target first? 17 June 2024. https://communicable.transistor.fm/episodes/communicable-e3-the-new-who-priority-pathogens-list-which-bacteria-to-target-first  WHO Bacterial Priority Pathogens List, 2024: bacterial pathogens of public health importance to guide research, development and strategies to prevent and control antimicrobial resistance. Geneva: World Health Organization; 17 May 2024. https://www.who.int/publications/i/item/9789240093461  C. Le Terrier et al, NDM-9 resistance to taniborbactam. Lancet Infect Dis 23, 401-402 (2023). doi 10.1016/S1473-3099(23)00069-5      P. B. Eckburg et al, Oral Tebipenem Pivoxil Hydrobromide in Complicated Urinary Tract Infection. N Engl J Med 386, 1327-1338 (2022). doi: 10.1056/NEJMoa2105462  A Study of Oral Tebipenem Pivoxil Hydrobromide (TBP-PI-HBr) Compared to Intravenous Imipenem-cilastatin in Participants With Complicated Urinary Tract Infection (cUTI) or Acute Pyelonephritis (AP) (PIVOT-PO). https://clinicaltrials.gov/study/NCT06059846 Meiji Seika Pharma Initiated the Global Phase III Clinical Trials of OP0595, a Novel beta-Lactamase Inhibitor for Combatting Antimicrobial Resistance (AMR). Tokyo: Meiji Seika Pharma Ltd; 26 April 2023. https://www.meiji.com/global/news/2023/pdf/230426_01.pdf

On episode #63 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the weeks of 8/29/24 – 9/13/24. Host: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, RSS, email Become a patron of Puscast! Links for this episode Viral Postacute Sequelae of COVID (PASC or Long COVID): An Evidenced-Based Approach (OFID) A New Orthonairovirus Associated with Human Febrile Illness (NEJM) Farmed fur animals harbour viruses with zoonotic spillover potential(Nature) A Cross-Sectional Evaluation of the Virtual Outpatient Management of People With Mpox (OFID) A randomized, placebo-controlled, dose-escalation phase I/II multicenter trial of low-dose cidofovir for BK polyomavirus nephropathy (Transplant Infectious Disease) A Decade of Chronic Norovirus Infection Surveillance at the NIH Clinical Research Center: Clinical Characteristics, Molecular Epidemiology, and Replication (JID) Bacterial FDA clears newLyme disease test (CIDRAP) Lyme ImmunoBlot Receives FDA Clearance(Accesswire) The Utilization Of Echocardiography In Children With Staphylococcus aureus Bacteremia (Journal of Pediatric Infectious Diseases Society) Duration of antibiotic therapy for multidrug resistant Pseudomonas aeruginosa pneumonia: is shorter truly better?(BMC Infectious Diseases) Short Versus Long Antibiotic Duration in Streptococcus pneumoniae Bacteremia (OFID) FDA Marketing Authorization Enables Increased Access to First Step of Syphilis Diagnosis FDA) Clinical impact of pleural fluid Streptococcus pneumoniae PCR testing in children with complicated pneumonia (CID) Duration of antibiotic therapy for multidrug resistant Pseudomonas aeruginosa pneumonia: is shorter truly better? (BMC Infectious Diseases) Short Versus Long Antibiotic Duration in Streptococcus pneumoniae Bacteremia (OFID) Fungal The Last of US Season 2 (YouTube) Incidence and risk factors for invasive fungal infections in patients initiating TNF-alpha inhibitors for inflammatory bowel disease and rheumatoid arthritis (CID) Parasitic Intestinal helminth infection impairs vaccine-induced T cell responses and protection against SARS-CoV-2 in mice(Science Translational Medicine) Miscellaneous Successful Treatment of Refractory Cutaneous Protothecosis With MAT2203, an Oral Lipid Nanocrystal Formulation of Amphotericin B (OFID) The Impact of Infectious Diseases Scholarly Mentorship on Subsequent Infectious Disease Fellowship Application (CID) Music is by Ronald Jenkees Information on this podcast should not be considered as medical advice.

Heteroresistance is a phenomenon that has been well characterized for many years. However, we are only now starting to understand its mechanistic basis. Indeed, the manner how bacteria respond to antibiotics is complex and phenomena such as persistance, tolerance may be overlapping with heteroresistance. Furthermore, heteroresistance seems to be common in real clinical scenarios and understanding its basis is likely to open new avenues on how we deploy antibacterials in clinical practice., Today, we have experts in the field to discuss this important topic. Watch this episode at https://youtu.be/qcIcyn1bIHU. Topics discussed: The differences between heteroresistance, persistence and tolerance The mechanistic basis both in Gram-positive and Gram-negative bacteria The clinical implication and diagnosis of heteroresistance Guests: David Weiss, Ph.D. Professor of Medicine and Director Center for Antimicrobial Resistance, Emory University School Of Medicine, Atlanta. GA. William Miller, MD. Assistant Professor of Medicine, Houston Methodist, Houston, TX and Weill Cornell Medical College, New York, NY. Links: Cefiderocol heteroresistance associated with mutations in TonB-dependent receptor genes in Pseudomonas aeruginosa of clinical origin This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal.  Visit asm.org/aac to browse issues and/or submit a manuscript. If you plan to publish in AAC, ASM Members get up to 50% off publishing fees. Visit asm.org/joinasm to sign up. Follow Cesar on twitter at https://twitter.com/SuperBugDoc for AAC updates.  Subscribe to the podcast at https://asm.org/eic.

“It is a team effort to protect public health from Legionella.” - Alberto Comazzi, Ph.D. We are excited to welcome back Alberto Comazzi, Ph.D. of Sanipur US, for his third appearance on the Scaling UP! H2O Podcast. As an expert in waterborne pathogens, Alberto shares his invaluable insights and experiences about Legionella to help our audience stay informed and proactive in managing water systems. In this episode, we cover a wide range of topics from handling positive Legionella tests to the effectiveness of monochloramine in disinfection. Let's dive into the key points of our discussion. How do you handle a call from a client panicking about their first positive Legionella test? Alberto advises us to stay calm and follow the pre-established plan outlined in the Water Management Plan (WMP). First, review the WMP to understand the specific steps to take for this scenario. Consider the positivity rates and the location where Legionella was found. By following the agreed-upon plan, you can address the client's concerns effectively and ensure proper action is taken.  Why have we seen Legionella increase by nearly ten times over the past few years? “5-6 years ago there wasn't much information about Legionella, and today so many people are interested in this field which protects public health.” - Alberto Comazzi, PhD Dr. Comazzi highlights two key factors behind the significant rise in Legionella cases: 1. Enhanced Water Testing and Awareness: The past few years have seen a substantial increase in both awareness and testing for Legionella. Healthcare professionals are now more informed about the risks of Legionella and are conducting more tests. Since 2017, the requirement for Water Management Plans (WMPs) in healthcare facilities has led to more comprehensive water testing, contributing to the rise in detected cases. 2. Increased Water Age in Buildings: Efforts to conserve water, which have important environmental benefits such as saving energy and reducing costs, have inadvertently led to higher water age in building systems. When water remains in systems for longer periods, it can lead to reduced disinfectant levels and higher water temperatures—conditions that promote Legionella growth. While water conservation is crucial, balancing it with effective Legionella control measures is essential for maintaining public health. By understanding these factors, we can better address and mitigate Legionella risks, ensuring a safer environment for everyone. What advice do you have for those putting together a WMP but who doesn't have the ASSE 1280 Certification? Get Certified or Seek Expert Help: Creating a comprehensive Water Management Plan (WMP) can be complex. While obtaining ASSE 1280 certification is highly recommended, you can also consider hiring a consultant to help you draft your plan. However, it's crucial to ensure that you execute and document the plan effectively. Proper training for facility operators on temperature control, flushing procedures, disinfectant management, and documentation is essential. “A Water Management Plan that's just sitting on the shelf isn't doing anyone any good. If no one implements the plan, it is useless.” Dr. Alberto Comazzi emphasizes, “Proactive measures are better and more cost-effective than reactive ones.” With upcoming due diligence plans addressing various waterborne pathogens, being prepared is key. Who has responsibility when it comes to municipal water? Alberto reminds us that there is a division between the municipality and the building. Municipal Water Responsibility: Municipal water suppliers are responsible for providing water that meets regulatory standards up to the distribution system. They conduct primary disinfection to inactivate most microorganisms and secondary disinfection to maintain a residual disinfectant. However, there are no enforceable limits for Legionella in the municipal water supply, and testing for Legionella is not required. Building-Level Responsibility: Once water leaves the municipal system and enters a building, the responsibility for water safety, including Legionella control, falls to the building owner or manager. Building environments, with their complex plumbing systems, cooling towers, and hot water systems, can foster Legionella growth. Therefore, effective management and control measures at the building level are crucial for ensuring water safety. Monochloramine vs. Chlorine: Which is better Disinfection and Legionella Control in Building Water Systems? Alberto highlights the advantages of monochloramine over chlorine: Case Study Results: A case study in San Francisco showed that switching from chlorine to monochloramine in the municipal water supply significantly reduced Legionella positivity rates in buildings—from 60% to 3-4%. This demonstrates the effectiveness of monochloramine in providing better overall disinfection due to its stability and ability to maintain higher disinfectant levels in building plumbing systems. Comparison with Chlorine: Monochloramine, unlike chlorine, is less reactive with organic materials in water and thus produces fewer regulated disinfection byproducts. It is a more stable disinfectant, which makes it less likely to form harmful byproducts while still providing effective disinfection. Effectiveness in Building Systems: In building water systems, especially those with low water usage or higher temperatures, monochloramine's stability is advantageous. It provides a more consistent and longer-lasting disinfectant presence throughout the system, reaching all areas effectively, which is crucial for preventing Legionella growth. What long-term effects on sustainability and equipment should we consider when balancing water conservation with the use of additional disinfectants in buildings? Alberto outlines key considerations: Corrosion Impact: When installing additional disinfectants, consider their potential to corrode plumbing systems. High levels of corrosive disinfectants can damage plumbing, so it's crucial to balance disinfection effectiveness with the preservation of the building's infrastructure. Water Quality Effects: Assess whether the chosen disinfectant might increase other harmful molecules in the water. Evaluate disinfection efficacy not only in the lab but also in real-world building settings to ensure it does not negatively impact overall water quality. Review Published Data: Refer to peer-reviewed literature and research from credible sources like the EPA to verify the long-term effects of disinfectants on water systems. Reliable data helps ensure that the disinfectant does not introduce unintended consequences and maintains water quality over time. How did monochloramine perform in controlling Pseudomonas compared to traditional methods? In a case study, monochloramine was implemented in facilities with Pseudomonas issues and proved effective in reducing colonization. "Unlike short-term solutions like flushing and hyperchlorination, monochloramine's stability allowed it to reach all parts of the distribution system, providing long-term control" shares Alberto. Timestamps 01:00 - Trace Blackmore invites you to celebrate Legionella Awareness Month  05:50 - Upcoming Events for Water Treatment Professionals 11:00 - Interview with Alberto Comazzi, Ph.D. 01:01:30 - Drop by Drop with James McDonald Connect with Alberto Comazzi, Ph.D. Phone: 267-326-2353 Email: a.comazzi@sanipur.com Website: www.sanipur.com    Linkedin: /in/alberto-comazzi-phd-132637128/  company/sanipur-us-llc Technical Paper: Emerging Waterbone Pathogens in Buildings' Premise Plumbing System Links Mentioned All links mentioned on this episode can be found on our Legionella Resources page HERE The Rising Tide Mastermind Scaling UP! H2O Academy video courses Drop By Drop with James In today's episode, I have a challenge for you.  Today's challenge is…test boiler sulfite both immediately after sampling and again an hour later on the same, open sample.  Is there a difference?  Why is there a difference?  What would be the impact of waiting until later to run the sulfite test versus running it immediately?  How might your recommendations be different?  Could the way you run your test impact your results, such as how much you agitate the sample? 2024 Events for Water Professionals Check out our Scaling UP! H2O Events Calendar where we've listed every event Water Treaters should be aware of by clicking HERE.

We've recorded a series of podcasts on the microbiome and its wide ranging impacts. But boy is this a field that moves rapidly. As soon as you think you've covered much of the territory, along comes some new and exciting findings, and this is the case today. We're going to describe research done by our guest, Dr. Ibrahim Javed. He has done innovative work on links between the gut microbiome and the brain, particularly focused on Alzheimer's disease. Dr. Javed is an Enterprise Fellow and National Health and Medicine Research Council Emerging Leadership Fellow in Clinical and Health Sciences at the University of South Australia. Interview Transcript So let's begin, if you wouldn't mind, with an explanation from you about what the gut brain axis is and tell us how it's important. Yep. Now we see a lot of, a lot of researchers around the globe building on investigations around the gut brain axis. But if we, if we investigate what this gut brain axis actually is, It's kind of like a bi-directional communication between two organs in our body, the gut and the brain. And when we particularly talk about gut, we have our stomach and our different portions of the intestine. What we're actually interested in is the microbiome and all those small little things living inside the gut. There are around 100 trillion microbes in the gut, which is three times more than the number of cells in our body. So, we are kind of like more microbes than, than human cells. And they communicate with different organs in our body and how they communicate with the brain that we can describe it as a, as a gut brain axis. And then this whole gut brain axis thing was somehow kind of invisible to us. We were just looking at it as a fecal material or waste coming out of our body. But now we see a lot of importance to these gut microbes. They help us in a lot of daily things that we do. They shape our behavior, our response to stress, our immune system, and then how we respond to different medicines, and how we do our daily tasks. So, they have a lot of roles in that. They help us digest food, that's their main obvious function. But now we are more. getting more and more information about them, that how they are integrated with a lot of different things in our body. So, kind of like they are partners in our life. That's a very, very nice explanation. Can you tell us about the importance of microbial diversity? Yep. So microbial diversity, we can, we can refer to, to as a composition of all those bacteria, viruses, and fungi to some extent that, that live in, in our body. Digestive track and, and in a lot of other animals as well. And this diversity is very crucial in maintaining the gut health and on overall well-being of, of humans. And, and this microbiome whole thing is like, it is obviously associated with a lot of health benefits and, and how we develop disease, but it's also right from the beginning of life they help us in developing our brains. They help us mature the brain system and the immune system. Obviously, they help us in digesting food. So, generally, we can actually divide them in two portions. One, we can call them a good gut bacterium. They help us with all these things. And then they are bad gut bacteria, which are kind of like kept within a within a bay. They are kept under control by this good gut bacteria with the help of the rest of our body. And in somehow in some conditions with the age or with the dietary habits or environmental factor or lifestyle, if they overcome and, and they take over the control in the gut, that's where the thing starts going haywire. When I was growing up, microbes were a bad thing. You didn't want to have microbes. And now, now we hear that there are good microbes and now you're talking about the balance. There are still bad ones, but good ones. And the balance of those two was a really important thing. Let's talk about how bad bacteria find their way to the brain. How do they get access? So, as we discussed, they are kept within the bay or kept under control by good bacteria and also by other different immune systems in the body. We have different checkpoints, like we have different barriers or three different compartments, the gut and the blood and the brain. And we have barriers that separate out these compartments and these barriers are very tightly controlled, very good health cells tightly integrated with each other and they police that whole things what need to go across and what does not need to go across what we need to stop it within that compartment. If we have adverse environmental factors, or poor dietary habits and these bad gut bacteria overcome, they produce a lot of different molecules to communicate with each other. And they produce a lot of different molecules to take over the good bacteria. And these molecules, they can get across those barriers, and specifically if they can get into the brain (that's what we are researching), they can do a lot of different bad things in the brain. They can do that by hijacking this gut brain axis. And this compartmental thing is one pathway that they can get from gut to the blood and then from the blood to the brain. But there is also a direct highway that connects gut to the brain and that's our enteric nervous system. These are specific nerves or neurons, for example, vagus nerve, they're quite famous. It's a direct link between the gut and brain. This nerve system helps us in a lot of different daily tasks without us even knowing about it, like digestion and heart rate and respiration, and emptying the stomach. And these are kind of like a pathway for bidirectional communication. So, a lot of molecules go up and down across these highways and the bad gut bacteria can actually hijack it and they can put their stuff into this highway and they can send it across the brain. It's a very, very nice explanation you have of a very complicated process, and I find it absolutely fascinating. So, you've spoken about how bad bacteria can be opportunistic pathogens and can trigger problems or enhance the progression of existing problems. How does all that work? So, we are investigating bad gut bacteria in connection with dementia and Alzheimer disease. We are specifically working on Pseudomonas aeruginosa and E. coli and they are quite common, like a lot of school kids. They know about these bacteria. They are quite commonly studied in high school microbiology. So, these bacteria produce some molecules which help to make biofilms around them. They kind of build a castle around them to protect their colonies and for their own survival and they keep surviving then until they get an opportunity to expand their castles and build more biofilms. These molecules are quite similar in terms of their structure and in terms of how they communicate. With some proteins which are not related to bacteria anyhow, they are produced in the brain to do some normal stuff in the brain, but they also aggregate in Alzheimer disease using the same mechanism as the nature that these bacteria use for these proteins to make their biofilms. Based on this common similarity, if they can somehow see each other, or if those gut bacteria can send those proteins or aggregate of those proteins across the brain through using those highways. They can induce the aggregation of those normal, naive, working, innocent proteins, which we have in our brain that have nothing to do with the bacteria. But if they can be accessed by those bacterial proteins, they go haywire and, and they trigger the onset of the disease, or if there is already going on, that they can actually accelerate that whole process. And this is a concept, actually, we have seen that concept before in prion disease, whereby eating infected food that have those prion particles, they can actually go from gut to the brain, and they can induce the normal prion protein in the brain to start making aggregates in a similar way. Are there interventions that can stop the pathogenic bacteria from in the gut that might in turn affect the brain? We should focus more on preventive measures. We can focus on maintaining a good diversity within the gut of having or supporting those good bacteria in that fight and keeping them healthy and alive as we age. Because as we age over the period of life, we keep losing those good bacteria. If we can have all those good things of exercise, balanced sleep, and more importantly, good food and a balanced variety of food. Then we have a lot of different varieties to support that variety of gut bacteria in the gut. So that's, I think, the most important preventive measure to keep that balance intact. But of course, in the future as a therapeutic intervention, we are moving towards developing microbiome therapies where we can modulate those compositions. If that composition is not in a very good situation, we can actually modulate that by using probiotics and prebiotic dietary factors or some microbial compositions like yogurt and a lot of other foods. We can modulate that to inoculate those bacteria which are missing in the gut and, and try to achieve that balance and, and that balance will accelerate the effectiveness of the medicine which we are taking for any other disease. The advice we've heard from some of our other guests is to eat a diet rich in fruits and vegetables. You know, consume things, you mentioned yogurt, kefir, kombucha, sauerkraut, and things like that. Sound like they're very good for enhancing the health of the microbiome. Is there anything else beyond that that might be relevant for the brain in particular? For brain health, there are some antioxidant foods. For example, we have Curcumin, and some senolytic compounds. We cannot call them drugs because they are kind of like a food supplements. They are available in any pharmacy and super stores by a lot of different names. Mostly these are polyphenolic compounds. They are usually available in green tea and in green tea extracts. They are quite well known for their healthy and antioxidant and anti-inflammatory effects. Research around the globe has shown that there are good effects directly on the brain by these polyphenolic compounds. So, these are green tea extracts, quercetin and, and some other galectin compounds. BIO Dr Ibrahim Javed is currently an Enterprise Fellow (Senior Lecturer) and NHMRC Emerging Leadership Fellow at the Clinical and Health Sciences, University of South Australia. He is also an adjunct Senior Research Fellow at the Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland. He completed his doctoral studies at the Monash Institute of Pharmaceutical Sciences in 2020 and postdoctoral research at AIBN, The University of Queensland. He joined the University of South Australia in 2023 where he is now directing the laboratory of Gut-Brain Axis, Aging and Therapeutics. Research in Javed's lab focuses on the gut-brain axis and its implications for aging and Dementia. His research team is working to unfold the specific role of bad/pathogenic gut bacteria in the aging paradigms and Dementia associated with Alzheimer's and Parkinson's diseases. His team has discovered and published the molecular details of how bad bacteria in the gut can trigger a younger onset (aged under 65) and accelerate Dementia and how the brain can develop Dementia when fighting with microbial biofilms in the gut – the infectious etiology of Dementia. With this research trajectory, his vision is to develop a multifaceted therapeutic intervention for aging-associated diseases and Dementia. 

TWiM explores evolution and host adaptation of Pseudomonas infections of plants, and the impact of COVID-19 on ESBL-producing E. coli on urinary tract and blood infections. Hosts: Vincent Racaniello and Michael Schmidt. Become a patron of TWiM. Links for this episode Evolution and host adaptation of Pseudomonas (Science) Type III secretion system, infection by injection (Nat Comm) Demographic inference with skyline plots (Peer J) Skyline plots (Taming the Beast) Panaroo, a bacterial genome analysis pipeline (Wellcome Sanger Inst) Impact of COVID-19 on ESBL-producing E. coli infections (Antimicro Resist Inf Control) Take the TWiM Listener survey! Music used on TWiM is composed and performed by Ronald Jenkees and used with permission. Send your microbiology questions and comments (email or recorded audio) to twim@microbe.tv

Episode 173: Acute OsteomyelitisFuture Dr. Tran explains the pathophysiology of osteomyelitis and describes the presentation, diagnosis and management of acute osteomyelitis. Dr. Arreaza provides information about    Written by Di Tran, MSIII, Ross University School of Medicine. Editing and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.What is osteomyelitis?Osteomyelitis, in simple terms, is an infectious disease that affects both bone and bone marrow and is either acute or chronic.  According to archaeological findings of animal fossils with a bone infection, osteomyelitis was more than likely to be known as a “disease for old individuals”.Our ancestors over the years have used various vocabulary terms to describe this disease until a French surgeon, Dr. Nelaton, came up with the term “Osteomyelitis” in 1844. This is the beauty of medical terms, Latin sounds complicated for some people, but if you break up the term, it makes sense: Osteo = bone, myelo = marrow, itis = inflammation. So, inflammation of the bone marrow.Traditionally, osteomyelitis develops from 3 different sources:First category is the “hematOgenous” spread of the infection within the bloodstream, as in bacteremia. It is more frequent in children and long bones are usually affected. [Arreaza: it means that the infection started somewhere else but it got “planted” in the bones]Second route is “direct inoculation” of bacteria from the contiguous site of infection “without vascular insufficiency”, or trauma, which may occur secondary to fractures or surgery in adults.  In elderly patients, the infection may be related to decubitus ulcers and joint replacements.And the third route is the “contiguous” infection “with vascular insufficiency”, most seen in a patient with a diabetic foot infection.Patients with vascular insufficiency often have compromised blood supply to the lower extremities, and poor circulation impairs healing. In these situations, infection often occurs in small bones of the feet with minimal to no pain due to neuropathy.They can have ulcers, as well as paronychia, cellulitis, or puncture wounds.Thus, the importance of treating onychomycosis in diabetes because the fungus does not cause a lot of problems by itself, but it can cause breaks in the nails that can be a port of entry for bacteria to cause severe infections. Neuropathy is an important risk factor because of the loss of protective sensation. Frequently, patients may step on a foreign object and not feel it until there is swelling, purulent discharge, and redness, and they come to you because it “does not look good.”Acute osteomyelitis often takes place within 2 weeks of onset of the disease, and the main histopathological findings are microorganisms, congested blood vessels, and polymorphonuclear leukocytes, or neutrophilic infiltrates.What are the bugs that cause osteomyelitis?Pathogens in osteomyelitis are heavily depended on the patient's age.  Staph. aureus is the most common culprit of acute hematogenous osteomyelitis in children and adults.  Then comes Group A Strep., Strep. pneumoniae, Pseudomonas, Kingella, and methicillin-resistant Staph. aureus.  In newborns, we have Group B Streptococcal. Less common pathogens are associated with certain clinical presentations, including Aspergillus, Mycobacterium tuberculosis, and Candida in the immunocompromised.Salmonella species can be found in patients with sickle cell disease, Bartonella species in patients with HIV infection, and Pasteurella or Eikenella species from human or animal bites.It is important to gather a complete medical history of the patient, such as disorders that may put them at risk of osteomyelitis, such as diabetes, malnutrition, smoking, peripheral or coronary artery disease, immune deficiencies, IV drug use, prosthetic joints, cancer, and even sickle cell anemia. Those pieces of information can guide your assessment and plan.What is the presentation of osteomyelitis?Acute osteomyelitis may present symptoms over a few days from onset of infection but usually is within a 2-week window period.  Adults will develop local symptoms of erythema, swelling, warmth, and dull pain at the site of infection with or without systemic symptoms of fever or chills.Children will also be present with lethargy or irritability in addition to the symptoms already mentioned.It may be challenging to diagnose osteomyelitis at the early stages of infection, but you must have a high level of suspicion in patients with high risks. A thorough physical examination sometimes will show other significant findings of soft tissue infection, bony tenderness, joint effusion, decreased ROM, and even exposed bone. Diagnosis.As a rule of thumb, the gold standard for the diagnosis of osteomyelitis is bone biopsy with histopathology findings and tissue culture. There is leukocytosis, but then WBC counts can be normal even in the setting of acute osteomyelitis.Inflammatory markers (CRP, ESR) are often elevated although both have very low specificity. Blood cultures should always be obtained whenever osteomyelitis is suspected.  A bone biopsy should also be performed for definitive diagnosis, and specimens should undergo both aerobic and anaerobic cultures.  In cases of osteomyelitis from diabetic foot infection, do the “probe to bone” test. What we do is we use a sterile steel probe to detect bone which is helpful for osteomyelitis confirmation.Something that we can't miss out on is radiographic imaging, which is quite important for the evaluation of osteomyelitis.  Several modalities are useful and can be used for the work-up plan; plain radiographs often are the very first step in the assessment due to their feasibility, low cost, and safety.  Others are bone scintigraphy, CT-scan, and MRI.  In fact, the MRI is widely used and provides better information for early detection of osteomyelitis than other imaging modalities.  It can detect necrotic bone, sinus tracts, and even abscesses. We look for soft tissue swelling, cortical bone loss, active bone resorption and remodeling, and periosteal reaction.  Oftentimes, plain radiography and MRI are used in combination. Treatment:Treatment of osteomyelitis actually is a teamwork effort among various medical professionals, including the primary care provider, the radiologist, the vascular, the pharmacist, the podiatrist, an infectious disease specialist, orthopedic surgeons, and the wound care team.Something to take into consideration, if the patient is hemodynamically stable it is highly recommended to delay empirical antibiotic treatment 48-72 hours until a bone biopsy is obtained.  The reason is that with percutaneous biopsy ideally done before the initiation of antibiotic treatment, “the microbiological yield will be higher”.We'll have a better idea of what particular bugs are causing the problem and guide the treatment appropriately. The choice of antibiotic therapy is strongly determined by susceptibilities results.  The antibiotic given will be narrowed down only for the targeted susceptible organisms.  In the absence of such information, or when a hospitalized patient presents with an increased risk for MRSA infection, empiric antibiotic coverage is then administered while awaiting culture results. It should be broad-spectrum antibiotics and include coverage for MRSA, broad gram-negative and anaerobic bacteria.  For example, vancomycin plus piperacillin-tazobactam, or with broad-spectrum cephalosporin plus clindamycin.  Treatment will typically be given for 4 to 6 weeks.The duration between 4-6 weeks is important for complete healing, but a small study with a small sample showed that an even shorter duration of 3 weeks may be effective, but more research is needed. In certain situations, surgery is necessary to preserve viable tissue and prevent recurrent infection, especially when there are deep abscesses, necrosis, or gangrene, amputation or debridement is deemed appropriate. If the infected bone is completely removed, patients may need a shorter course of antibiotics, even a few days only. Amputation can be very distressing, especially when we need to remove large pieces of infected bone, for example, a below-the-knee amputation. We need to be sensitive to the patient's feelings and make a shared decision about the best treatment for them.In patients with diabetes, additional care must be taken seriously, patient education about the need for compliance with treatment recommendations, with careful wound care, and good glycemic control are all beneficial for the healing and recovery process. Because this is a very common problem in the clinic and at the hospital, we must keep our eyes wide open and carefully assess patients with suspected osteomyelitis to detect it promptly and start appropriate treatment. Adequate and timely treatment is linked to fewer complications and better outcomes._________________________Conclusion: Now we conclude episode number 173, “Acute Osteomyelitis.” Future Dr. Tran explained the pathophysiology, diagnosis, and management of osteomyelitis. A bone biopsy is the ideal method of diagnosis. Delaying antibiotic treatment a few days until you get a biopsy is allowed if the patient is stable, but if the patient is unstable, antibiotics must be started promptly. Dr. Arreaza mentioned the implications of amputation and that we must discuss this treatment empathically with our patients. This week we thank Hector Arreaza and Di Tran. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Bury DC, Rogers TS, Dickman MM. Osteomyelitis: Diagnosis and Treatment. Am Fam Physician. 2021 Oct 1;104(4):395-402. PMID: 34652112.Cunha BA. Osteomyelitis in elderly patients. Clin Infect Dis. 2002 Aug 1;35(3):287-93. doi: 10.1086/341417. Epub 2002 Jul 11. PMID: 12115094.Fritz JM, McDonald JR. Osteomyelitis: approach to diagnosis and treatment. Phys Sportsmed. 2008 Dec;36(1):nihpa116823. doi: 10.3810/psm.2008.12.11. PMID: 19652694; PMCID: PMC2696389.Hatzenbuehler J, Pulling TJ. Diagnosis and management of osteomyelitis. Am Fam Physician. 2011 Nov 1;84(9):1027-33. PMID: 22046943.Hofstee MI, Muthukrishnan G, Atkins GJ, Riool M, Thompson K, Morgenstern M, Stoddart MJ, Richards RG, Zaat SAJ, Moriarty TF. Current Concepts of Osteomyelitis: From Pathologic Mechanisms to Advanced Research Methods. Am J Pathol. 2020 Jun;190(6):1151-1163. doi: 10.1016/j.ajpath.2020.02.007. Epub 2020 Mar 16. PMID: 32194053.Momodu II, Savaliya V. Osteomyelitis. [Updated 2023 May 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532250/Royalty-free music used for this episode: Trap Chiller by Gushito, downloaded on Nov 06, 2023, from https://www.videvo.net 

First up this week, guest host Kevin McLean talks to freelance writer Andrew Zaleski about recent advancements in the world of synthetic blood. They discuss some of the failed attempts over the past century that led many to abandon the cause altogether, and a promising new option in the works called ErythroMer that is both shelf stable and can work on any blood type.   Next on the episode, producer Zakiya Whatley talks to Aaron Weimann from the University of Cambridge about the evolutionary history of the deadly bacterial pathogen Pseudomonas aeruginosa. They discuss how more than a century's worth of samples from all over the world contributed to new insights on the emergence and expansion of the pathogen known for its ability to develop antimicrobial resistance.   This week's episode was produced with help from Podigy.   About the Science Podcast   Authors: Kevin McLean, Andrew Zaleski, Zakiya Whatley   Episode Page: https://www.science.org/doi/10.1126/science.z1jhbqi   About the Science Podcast: https://www.science.org/content/page/about-science-podcast   [Image: Matt Roth, Music: Jeffrey Cook and Nguyen Khoi Nguyen] Learn more about your ad choices. Visit megaphone.fm/adchoices

My Results With GI Mapping: Addressing Digestive Issues and Food Allergies Click Here for a FREE 15 min Zoom Consultation With Brad: Over 40 Fitness Hacks Facebook Group Step By Step Podcasting Link! Descript Editing Software Link! www.Over40FitnessHacks.com In this episode of Over 40 Fitness Hacks, host Brad Williams discusses his recent experience with a GI mapping test. After suffering from a severe stomach flu that led to unexpected food allergies to chicken and eggs, Brad pursued a GI mapping test recommended by his DPC (Direct Primary Care) doctor to investigate ongoing digestive issues. Brad explains how the GI mapping test works, involving a stool sample analyzed for various bacteria levels, both good and bad. His results indicated an overgrowth of H. pylori, along with other bacteria like Morganella, Pseudomonas, and Streptococcus, though not at dangerous levels. His test also showed a low score in digestive enzymes, indicating poor nutrient absorption, and a high immune response marker due to the H. pylori infection. Given the options of antibiotics or a supplement regimen to address these issues, Brad chose the supplement route to avoid disrupting his gut microbiome further. He plans to retest in two months using a breath test for H. pylori and will journal his progress. Brad emphasizes the importance of seeking multiple medical opinions and exploring both traditional and holistic approaches to health. He concludes by expressing optimism about future advancements in the fitness and health industry, driven by AI technology, and offers a free 15-minute consultation for listeners. He plans to update listeners on his progress in a future episode. If you're interested in online personal training or being a guest on my podcast, "Over 40 Fitness Hacks," you can reach me at brad@over40fitnesshacks.com or visit my website at: www.Over40FitnessHacks.com Additionally, check out my Yelp reviews for my local business, Evolve Gym in Huntington Beach, at https://bit.ly/3GCKRzV

   Join us on War Docs as we welcome Army Physician MAJ Mary Ford, an infectious disease specialist and lead author of the acclaimed Military Medicine Journal's article of the year: Clinical Characteristics and Resistance Patterns of Pseudomonas aeruginosa Isolated From Combat Casualties https://pubmed.ncbi.nlm.nih.gov/34196358/    Listen in as MAJ Ford shares the impactful findings of her team's research on Pseudomonas aeruginosa in combat casualties, a topic of paramount importance to military health. Her personal journey into the infectious disease field, spurred by early curiosities and familial influences, and the progression of her military career make for a captivating story of dedication and passion.       In this engaging conversation, we also tackle the critical subject of infection prevention and antimicrobial stewardship in the face of combat trauma. Hear about the vital role of simple measures, like hand hygiene, in combating infections, especially those caused by the antibiotic-resistant Pseudomonas aeruginosa. Discover how MAJ Ford's team utilized the Trauma Infectious Disease Outcomes Study to uncover that approximately 6% of combat trauma patients developed Pseudomonas infections. The implications of these findings are vast, offering significant advancements for clinical outcomes and infection control in military medical settings. Tune in for a deep understanding of how such research continues to shape practices and policies within the Department of Defense.   Chapters: (00:02) Infectious Disease in the Military (07:12) Combat Trauma Infections and Pseudomonas   Chapter Summaries: (00:02) Infectious Disease in the Military  MAJ Mary Ford's research on Pseudomonas aeruginosa in combat casualties and its impact on military health, her personal journey into infectious disease, and the enduring need for ongoing research in the Department of Defense.   (07:12) Combat Trauma Infections and Pseudomonas   Infection prevention and antimicrobial stewardship are crucial in controlling Pseudomonas infections in combat trauma patients.   Take Home Messages: In the context of military medicine, the issue of infections following combat trauma is a significant concern, with Pseudomonas aeruginosa identified as a noteworthy pathogen due to its prevalence in prolonged hospital stays and its intrinsic antibiotic resistance mechanisms. Infection prevention and antimicrobial stewardship are critical components in the management of combat trauma infections. Basic practices such as hand hygiene play a pivotal role in controlling the spread of infections and can have substantial impacts on patient outcomes. Research conducted through the Trauma Infectious Disease Outcomes Study (T-DOS) has revealed that about 6% of combat trauma patients develop Pseudomonas infections, which underscores the importance of understanding and addressing these infections to improve clinical practices and infection control protocols. Combat trauma patients with Pseudomonas infections often experience lengthy hospital stays and intensive care unit admissions, highlighting the need for robust infection prevention strategies in military healthcare settings to reduce the burden of these nosocomial infections. The fight against infections like Pseudomonas aeruginosa in military medicine is an ongoing challenge that requires continuous research and evidence-based practices to ensure the health and readiness of military personnel. Basic infection control measures remain foundational in mitigating infectious threats.   Episode Keywords:  Military Medicine, Infectious Disease, Pseudomonas aeruginosa, Combat Trauma, Antimicrobial Stewardship, Research, Clinical Practices, Infection Control, Military Health, Nosocomial Pathogen, Antibiotic Resistance, Retrospective Analysis, Prospectively Collected Data, Trauma Infectious Disease Outcomes Study, Clinical Outcomes, Infection Prevention, Military Medical Environments Hashtags: #wardocs #military #medicine #podcast #MilMed #MedEd #MilitaryMedicine, #PseudomonasAeruginosa, #CombatInfections, #InfectiousDiseases, #AntimicrobialStewardship, #WarDocsPodcast, #MilitaryHealthcare, #TraumaInfections, #InfectionPrevention, #ClinicalResearch   Honoring the Legacy and Preserving the History of Military Medicine   The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation.   Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast   Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm   WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you.   WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield, demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast  

TWiV rebuts a recent opinion piece which falsely claims that the COVID-19 pandemic began in a lab (it began in Nature), followed by a discussion of Paride bacteriophage, which has the unsual property of being able to kill dormant, antibiotic-tolerant cells by direct lytic replication. Hosts: Vincent Racaniello, Alan Dove, Rich Condit, Brianne Barker, and Jolene Ramsey Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode MicrobeTV Discord Server 2024 International HBV Meeting Register for ASV Annual Meeting SARS-CoV-2 origin discussions previously on TWiV: TWiV 1019: Eddie Holmes on SARS-CoV-2 origins TWiV 1017: From Nature, not a lab TWiV 995: Viral origin stories TWiV 940: Eddie Holmes in on viral origins TWiV 876: Spillover market with Michael Worobey TWiV 762: SARS-CoV-2 origins with Robert Garry TWiV 760: SARS-CoV-2 origins with Peter Daszak, Thea Kølsen Fischer, Marion Koopmans TWiV 774: Kristian Andersen, Robert Garry, and the deleted SARS-CoV-2 sequences Why the Pandemic Probably Started in a Lab, in 5 Key Points (NY Times) Phage Paride kills dormant, antibiotic-tolerant cells of Pseudomonas aeruginosa (Nat Comm) Interview with Enea Maffei (Spotify) Timestamps by Jolene. Thanks! Weekly Picks Brianne – How to build a nuclear warning for 10,000 years' time Rich – Doctor My Eyes | Jackson Browne Alan – WHO Health for All Film Festival winners Jolene – El enemigo de mi enemigo es mi amigo Vincent – A Population Dotmap of New York City and Race and Ethnicity in New York City Listener Picks David – The greatest clock (and map) ever made Peter – The Mouse as a Microscope Intro music is by Ronald Jenkees Send your virology questions and comments to twiv@microbe.tv

Klebsiella, Streptococcus, Pseudomonas, oh my! Have you been told that your gut symptoms are related to these opportunistic pathogens based on popular stool testing? Has your provider suggested antibiotics or herbal antimicrobials for these bugs? If so, then this episode is for you! Join the gals as they discuss the best strategies to address these opportunistic bugs and bring back balance to your microbiome. 

On episode #48 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the weeks of 1/31 – 2/13/24. Hosts: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, RSS, email Become a patron of Puscast! Links for this episode Viral Infectious attenuated tetravalent Butanatan-Dengue vaccine (NEJM) Kids with severe disease following first and second dengue virus infection (Nature) Oropouche fever outbreak in Latin America (Lancet Infectious Diseases) CMV mRNA vaccine knocks out gB/MF59 vaccine (JID) Acyuclovir-resistant mucocutaneous HSV in immunocompromised patients (OFID) Bacterial Dalbavancin for vertebral osteomyelitis (OFID) Severe vibrio vulnificus infections (MMWR) Demystifying UTIs in the era of antibiotic resistance (PLoS Pathogens) Syphilis testing recommendations (MMWR) Doxycycline vs azithromycin for scrub typhus (BMC Infectious Diseases) REALLY drug resistant Pseudomonas aeruginosa outbreak(CID) Fungal SUBA or conventional itraconazole for treatment of endemic mycoses (OFID) Fluconazole resistant Candida (CDC) Are you in the hospital too long after being treated with echinocandin for your Candidemia or invasive Candidiasis (OFID) Nasopharyngeal swab or lower respiratory tract specimen for Pneumocystis jirovecii diagnosis (OFID) Global guideline for cryptococcosis diagnosis and management (Lancet Infectious Disease) Parasitic Toxoplasma IgG positivity associates with increase mortality (AJTMH) Miscellaneous How well did infectious diseases fellows match (JID) Back to the future of the physician-scientist in infectious diseases (JID) Full or not infectious disease training (JID) Music is by Ronald Jenkees