What is PM2.5 and Why Do I Itch?

 

PM refers to particulate matter that hangs in the air creating haze and off-color sunshine.  The 2.5 refers to the size of these particles, which is 2.5 microns or less, which are produced by vehicle exhaust, burning fuels (wood, oil, coal), and wildfires. They are easily carried over long distances. As you can well imagine, such tiny particles can pass deep into lungs and through blood vessel walls into the bloodstream thus increasing risk for heart and lung disease. Several thousand of the smaller particles could fit on the period at the end of this sentence. What came as a surprise to me as I investigated this hazardous air-borne matter was its effect on the skin.

 “These pollutants often contain chemical compounds that act like keys, allowing them to slip past the skin’s outer barrier and penetrate into cells, where they can disrupt gene transcription, trigger oxidative stress or cause inflammation.” 

 Past studies have found a link between atopic dermatitis (AD, aka eczema) and air pollution in cities with high background levels of PM2.5 from cars and industry.  The latest study, published in April of this year in JAMA Dermatology, was conducted by researchers in San Francisco as they perused medical records from November, 2018.  At that time, a serious wildfire nearby (Camp Fire), while extinguished in about two weeks, caused a notable increase in the number of clinic visits for itching and new rashes in both pediatric and adult populations. The authors of the study concluded that even short-term exposure to high PM2.5 environmental particulate matter is associated with increased skin woes, and the majority of new patients scratching n’ rashing had no history of dermal disorders.

 Ugh, walked this morning through the PM2.5 haze, and now I’m itching all over! Little red itchy bumps on the forearm; PM2.5 or creepy little noseeums (a catch-all name for 5,000 species of tiny biting flies)?

“There’s always a little bit of tension around

these issues of, well, is the drug going

to work, or not.”

Dr. Robert Shafer, Stanford infectious disease specialist

 

Good news from a phase 2 investigation pitting Molnupiravir (an oral antiviral agent still in clinical trials) against SARS-CoV-2.  After years of testing this-a-vir and that-a-vir in various labs, Molnupiravir and Remdesivir proved most likely to succeed.  Here’s the background story followed by the test results.

RNA viruses rely on their RNA-dependent polymerase (RdRP)* to stitch together  viral messenger RNA.  The sequenced mRNA in turn produces various proteins used for the production of new virions as the invading virus overtakes host cells. What’s needed for halting viral reproduction is a reliable RdRp inhibitor. Many those-a-virs created in labs have been tested against SARS-CoV-2. A successful compound will plop itself into the developing viral sequence causing mutations in the proteins and…hurray! no new offspring created. Remdesivir showed strong inhibition in lab and animal trials, and was subsequently approved for treatment in patients. Unfortunately, while it works well in toning down the severity of the illness thus speeding recovery, it requires IV infusion in a hospital setting and doesn’t reduce deaths in difficult cases. 

There are currently 246 antivirals in development. Creating antiviral meds is rather tricky, the difficulty being how to stop propagation of more virions produced within the host cell without killing the cell itself. Merck’s Molnupiravir, originally developed by Emory University then bought by Ridgeback Bio that sold it to Merck, originally targeted Influenza for Phase 1 animal trials. The drug proved to be effective at curbing flu infections in mice, guinea pigs, ferrets and human-airway organoids (human cells grown in petri dishes into viable tissues).. 

But then along came March, 2020 and the onset of SARS-CoV-2 which completely changed their plans. A successful test with ferrets proved that Molnupiravir blocked both developing cases as well as ferret to ferret transition. They went on to a Phase 2 safety trial with 202 outpatients with early symptoms of SARS-CoV-2. Those who received 400 or 800 mg. daily were completely free of virus by Day 5. Only 11.1% of the placebo group had similar clearance. Phase 2/3 testing is underway with results expected in September.

Here’s hoping!!

 

Oops, forgot to include the illustration that goes with yesterday's post.

 

I spend hours on the internet reading various e-magazines, often going down a path of interest leading me far from my goal—namely getting a thought-provoking post to you more or less weekly.  Yesterday, I found this study in the journal ‘Brain Communications’ about how near-death experiences (NDE) in humans may have an evolutionary origin; it’s a definite read and share investigation.  Let’s start with thanatosis (feigned death or ‘playing possum’) as it occurs in animals under attack by predators. 

An artist created the above cartoon from a real-life video involving an impala who goes limp after being caught by a cheetah who then is bullied by a hyena thus allowing the impala to make a get-away.  If you would like to see the actual dramatic footage from Africa, check out: https://www.youtube.com/watch?v=JqlGjX1MtVg.  After that, google ‘thanatosis’ or ‘thanatosis in insects’ to see an enormous array of animals, and insects, many on their backs with feet in the air, feigning death when threatened by those higher on the food chain. Another interesting link is found at https://www.thoughtco.com/why-some-animals-play-dead-373909.

 The authors of this study define NDEs as “unique conscious, self-related emotional, spiritual and mystical unexplained experiences occurring in life-threatening situations or situations that may feel life-threatening, including cardiac arrests, traffic accidents, physical assaults and drug abuse.”

They searched for examples of encounters between humans and big animals including sharks, and heard or read testimonials from survivors of mass executions, genocide, or terrorists attacks for examples of thanatosis or NDEs. After compiling their data, they concluded that thanatosis occurs across a wide range of creatures from arthropods to humans, and that playing dead or going into an NDE sort of dream or trance was definitely associated with survival.  See below for an archived account of a human/lion interaction in the 19^th century, and a few other such stories are included in the material in “Brain Communications”.

 You can skim or read the entire study material at https://academic.oup.com/braincomms/article/3/3/fcab132/6307709 .  Next newsletter I will include the physiology that accompanies human and probably other animal species when flight is not an option but feigning death or entering a dreamlike state may be a life saver. And the NDEs associated with “out-of-body experiences, feeling one with the universe, feeling peace and acceptance, sometimes even joy, and visual and auditory hallucinations, including seeing bright lights, being in a tunnel and meeting spirits or ancestors” can become a life-changing memory.

 Interested in reading the entire study?  Visit: https://academic.oup.com/braincomms/article/3/3/fcab132/6307709.

Thanks for reading, double thanks for feedback!

DenverDoc

______

 

The Peanut Butter Smell Test

There’s been a lot of talk about anosmia or loss of smell as a side effect of COVID.  But anosmia in older persons, occurring without other known causes such as polyps in the nose or chronic sinusitis, may be a sign of developing Alzheimer’s dementia (AD). 

A study conducted in 2013 found that patients with early signs of AD exhibited a significant loss of sense of smell, specifically on the left side of their nose. This simple test, looking for a left/right discrepancy in identifying peanut butter odor, was touted to be a simple, no-cost detector for AD.  After reading this, I admit I high-tailed it into the kitchen to sniff a bit of PB no J.  Ah, thank heavens, peanut butter fumes equally yummy on both sides.

Years later, a group of researchers from the U.S. and Columbia decided to retest volunteers with AD.  While partial or complete loss of smell continues to be a possible symptom of developing AD, the scientists found no disparity in bilateral odor detection in one group of 20 exposed to 20 different aromas.  This group had the opposite nasal opening taped as opposed to the other group of 15 in which one side was squashed by the person’s finger while testing the contralateral side.  The researchers concluded that pushing on one nostril variably distorted smell detection on the other side.  Bottom line:  there is no evidence of a left vs right-sided smell disparity.      

 Shrinkflation defined

My favorite brand of tea just lost 5 oz. and actually went UP in price $0.14!

 For those of you interested in an EmailNewsletter in which I not only write about health issues including COVID, I also include excerpts from books I read, magazines, and the internet.  If you care to subscribe, please send your email address to me at Denverdoconline@gmail.com.  There is no fee, and if you are not enjoying it, you can always reply to the newsletter with Unsubscribe in the subject space.

Thanks always for visiting the blog,

DenverDoc

 

Shower placebo

 

“Despite my largely sedentary lifestyle,

A shower is the perfect way to scrub off

All the COVID-19 fear that has landed on

Me during the day.”

                              Brittany

 

Doomscrolling nocebo

 

“What doomscrolling does is rob future-you

Of the energy you need to really focus on

Important things.”

                              Karen Ho, the ‘Doomscroll Reminder Lady”

See below for information on placebos and nocebos.

 

 

Nocebo

You’ve certainly heard of placebo which translates from Latin as “I shall please.”  Placebo effects come from a feeling that whatever treatment being offered will have positive outcomes.  An upbeat promise in the default mode network (1) translates chemically into a positive mood through release of brain-produced uplifting chemicals such as dopamine, oxytocin, and vasopressin.

Nocebo, on the other hand, is the polar opposite of placebo, also comes from Latin translated as “I shall harm.”  Fear, anxiety, or exaggerated negative expectations as in ‘I will have a horrible reaction to this shot’ facilitate release of ‘fight or flight’ hormones such as cortisol which amplify unpleasant side effects. While thinking in a placebo/nocebo sort of way won’t heal broken bones or cause disease, there are ample research findings verifying that placebos improve while nocebos block satisfying clinical outcomes.

If you are still uncomfortable with these novel vaccines funded by Operation Warp Speed and approved by the FDA in a mere fraction of the time generally allotted for new vaccines, check out the links (2) and (3) below for feel-good placebo thoughts.

1. Remember that?  It’s the part of our brain that easily wanders and obsesses over things negative or positive in the past, present, or possible future.

2. https://jamanetwork.com/journals/jama/fullarticle/2770681?guestAccessKey=febb71d3-678b-46bb-a1bc-a10453343a3a&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jama&utm_content=olf&utm_term=021521

3. https://.com/journals/jama/fullarticle/2776658?guestAccessKey=7f512986-192e-4b8e-b900-b6733a3dc298&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jama&utm_content=olf&utm_term=021521

 

Do nine gin-soaked raisins a day keep arthritis pain away?  And what about COVID, could tipsy raisins be a decent anti-inflammatory medicine for the infected?  At least one woman recently vouched for that.

Reading about this raisin product is intriguing, particularly on drunkenraisins.com.  This company’s website promotes their “21^st century recipe” as opposed to the longstanding homemade variety.  The latter involves store-bought golden raisins soaked in any old gin for nine days, then eaten each morning, 9-at-a-time. DrunkenRaisins, however, uses a “Choice Jumbo Golden Raisin”, adds a ‘correct’ juniper berry influenced gin, then marinates the dried fruit in a sealed container with honey and imported cinnamon bark oil.  Each batch takes 10-14 days to finish ‘giving birth to the magic of one of the best anti-inflammatory foods available.”

My mouth is watering, and I don’t even really care for gin.  This goodbye to aching joints habit dates back 100 years.  Now is this placebo or an actual non-steroidal anti-inflammatory drug that needs no rx?  Placebo or not, it could very well be a very pleasant way to dial down arthritic pain.

Perhaps you’ve heard of Lucia DeClerck; she’s recently made headline news.  On her 105^th birthday in January, she was diagnosed with COVID, one day after getting her second Pfizer vaccine.  She isolated for 2 weeks, had very few symptoms, missed her chats with her friends, then went back to her room in a New Jersey nursing home, all the while never missing a single morning dose of her nine golden raisins which she’s been taking for decades.

Was it the vaccine? Prayer and no junk food which she practices daily?  The raisins?  Doesn’t really matter does it…vaccines 1 &2 with rising protection, anti-inflammatory juniper berry phenols toning down an overactive immune system, and/or belief in raisins and religion.  There you have it, whatever ‘it’ is.

Interested?  There are drunken raisin recipes all over the internet, or call DrunkenRaisins.  They’ll ship a super fresh batch to you within 2 to 3 days. 

Thanks for stopping in,

DenverDoc

 

French Press vs Drip Coffee

“My answer now is that French press

coffee is a bit bad for you.”

Nathan Crane

I’ve always favored drips, in coffee makers that is, and my Mr. Coffee is still going strong after 7 years of daily use.  I’ve enjoyed French Press coffee as well, but here’s the problem.  Drip design uses paper filters whereas French Press uses metal filtration.  The paper baskets or cones not only catch the grounds but also cafestol and kahweol, just 2 among hundreds of plant-based chemical compounds found in your morning cup.  These diterpenes, which go right through that French metal filter, can raise your cholesterol level.

On the other hand, look up cafestol on pubmed.gov (1); you’ll find this coffee component has a lot of good things going for it.  These benefits include anti-inflammation, neuroprotection, and anti-cancer effects.  Maybe a mix of a little French Press and a cup or two of drip is our best bet.  And the latest coffee consumption news from Dr. David Kao, medical director of the Colorado Center for Personalized Medicine, is drink 2 or more cups daily—black, no additives—for a 30% drop in risk of heart failure. (2)

 

1. https://voltagecoffee.com/is-french-press-coffee-bad-for-you/

2. http://lite.cnn.com/en/article/h_619a9bdedd9e9078be2031701a3a474b

­­­_____

 

“This dulled, useless state of mind – epitomized by

the act of going into a room and then forgetting

why we are there is so boring, so lifeless…

One powerful factor could be the fact

that everything is so samey.

Moya Sarner, free-lance journalist

 

Dear Friends,

 

More than a few of us have compared this past year to the movie “Ground Hog Day”.  I rather prefer Ms. Sarner’s take on our daily lives, namely they’re all just so samey.  Having trouble remembering words or remembering what you did this morning much less last week?  You may be suffering from brain fog. Ditch the samey for new and different.  A switch of venue or even company for coffee just might switch your cognition back on. Here’s one explanation why.

 Sarner contacted two neuroscientists to discuss the origins and solutions of this cognitive loss. (1) In short, they replied that the human brain evolved in such a way as to sharpen focus on novel events in the environment.  This was, of course, essential during the hunt-and-gather days when humans were as likely to be prey as predators.  We continue to rely on instantaneous notation of possible danger even before it comes into our conscious mind, say a car moving into our path, the smell of smoke, or a stranger approaching, all of which lead to a necessary brain alertness.  On the lighter side, new places, unexpected events, unusual sounds, or beautiful scenery also catches our attention and highlights our memories. 

 I will never forget where I was last Sunday, sitting mid-afternoon at the Irish Snug on Colfax listening to a huge tableful of musicians playing guitars, mandolins, accordions and one maestro on the double bass cello.  I got a bit teary-eyed in a happy sort of way, relieved to be back in the world of people and music, meeting new people and enjoying music I’d never heard.  And (placebo? brain re-engagement?) I really do feel less scrambled.

 Best wishes as the new normal emerges,

 Denver Doc

 https://www.theguardian.com/lifeandstyle/2021/apr/14/brain-fog-how-trauma-uncertainty-and-isolation-have-affected-our-minds-and-memory

____

 

 

Writer’s Block

                                    Writing is easy.

All you do is stare at

A blank sheet of paper until

Drops of blood form on

Your forehead.

Gene Fowler

 

I just hit a writer’s block as a fair chunk of unsaved brilliant writing disappeared when I rested my wrists on my laptop.  But that particular problem is not included in the “Changing Minds” authors’ list of reasons for sitting and staring at that virtual sheet of white paper.  They mentioned procrastination, perfectionism, fear of criticism, or—just plain old Eeyore’s explanation—"what’s the use”. 

They cite the sagging of motivation and energy in older writers, simply “lacking the stamina for the sustained cognitive effort that writing requires.” Reminds me of how I used to zip a health newsletter out without fail every week when I was twenty-some years younger.  Phillip Roth, when asked if he missed writing as he aged, replied, “I was by this time [about age 77] no longer in possession of the mental vitality or the verbal energy or the physical fitness needed to mount and sustain a large creative attack of any duration on a complex structure as demanding as a novel.  Not everyone can be fruitful forever.” (But he was certainly still able to spit out a complex sentence!)

Speaking of complexity of language, author Iris Murdoch had an unfortunate condition that her final book was called “a mess” by the NYT reviewer, “Strewn with imprecisions and blatant redundancies…pet words [scattered] like so many nails in the reader’s road.”  Not yet diagnosed with dementia, she was already struggling with cognitive impairment, and was diagnosed with Alzheimer’s disease two years before her death at 79.

When machine-readable texts and sophisticated linguistic analysis tools became available, researchers began analyzing the works of various authors, including Murdoch and other writers known to have developed dementia.  Vocabulary size notably shrank in those presumed to have or diagnosed with dementia as compared to nonimpaired authors whose word usage either stayed stable or increased over their careers.

Have you read “Aging with Grace:  What the Nun Study Teaches Us About Leading Longer, Healthier, and More Meaningful Lives”?  I strongly recommend it.

 

 

 

Is it advancing age or the lack of everyday conversations with multiple people?  What, I ask myself almost daily, is wrong with my word-finding ability?  I have encouraged me (in that 2^nd person sort of judgmental voice) to think a moment before I just point to the object or replace the unfound word with ‘thing’ or ‘stuff’.  Pausing then brings on other speech disfluencies wherein the use of filler words like ‘uh’ or ‘um’, or whole word repetitions such as ‘we need…we need’, or interjections like ‘like’ disrupt not only one’s flow of speech but also one’s thinking process.   

Psychologists call such lapses tip-of-the-tongue (TOT) states and emphasize that these TOTs do not necessarily indicate impending dementia. That’s good news, but what does it indicate?  Chances are good that those of us who are seniors haven’t lost the concept of that which we cannot name.  The authors of a book on aging and language (1) call these aggravating TOT states ‘a glass half empty or a glass half full.’  These failed retrievals could be weakened neural connections in a tired old brain, or they might indicate such a plethora of stored words from all those years of speaking and reading that it becomes difficult to find the right word in short order. 

A search on PubMed suggests multiple hypotheses about why seniors have more TOTs than juniors.  I choose to go with the word-laden brain hypothesis, allowing us elders to deliver astounding explanations of meaning even if the word in question remains elusive. 

But here’s an inscrutable cognitive glitch—yesterday I made one entry in my journal, ‘GNL 18,19’.  I have absolutely no idea what that means.

DenverDoc

1. “Changing Minds:  How Aging Affects Language and How Language Affects Aging,” authors Roger Kreuz and Richard Roberts

 

Nootropes

 

Nootropes refer to drugs, supplements, herbs, etc. that are believed to improve cognitive functions.  Sometimes a lost word is not just a word-finding problem (as mentioned in a previous newsletter) but an actual aging-related loss of normal brain functioning.

 

I personally take four of them daily:  bacopa monnieri, caffeine (in coffee form), choline, and creatine.  The problem, as always with supplements, is there’s no way to know whether or not they actually made a difference.  Perhaps healthy living and no nootropes at all would have sufficed.  There are many lists available on the internet touting the benefits of various brain boosters.  Here’s a list that explains 14 possible nootrope choices(1).

 

I recommended bacopa monnieri to a good friend.  Here’s her text:

I started bacopa today.

The pills are creepy and black but I feel good!

Except I couldn’t remember the word bacopa so I guess it’s not helping that much.

 

1.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746283/

 

All the understated ways that people are

Saying I love you, I miss you,

I’m doing my very best,

Don’t worry about us.

Miki Meek, NPR

 

I’ve read that concentrating on that which you wish to dream while sleeping will deliver contents as requested.  Wishing my Mom to appear got me nowhere, but I wasn’t surprised about that as I carry her around with me most days. The best I could muster from Dad was a nighttime sequence wherein he was on a downward moving walkway carrying him fast and farther away despite my shouts to step off of it…come back! He was hard of hearing in life and rather spacey at the end, so who knows.

 

About a month ago, I came across a recently released book now translated into English titled “The Phone Booth at the Edge of the World”. The Italian author, Laura Imai Messina, earned a PhD from Tokyo University of Foreign Studies and lives in Japan with her husband and children. This novel was based on the actual Japanese Wind Phone in Otsuchi, a seaside town decimated by the March, 2011 earthquake and tsunami.  At least 19,000 people perished in the disaster.

 

Itaru Sasaki created the booth in his garden in 2010 when his cousin died.  After the 2011 tragedy, he opened it up to the public.  Tens of thousands of people have since visited the booth with its disconnected phone that allows those who lost loved ones, for whatever reason, to pour out their feelings through the phone and into the wind.  That’s so much better than wishing for cameo dream appearances!

 

I just finished the book, an excellent love story filled with loss and hope and beautifully written. I’d also recommend “Ghosts of the Tsunami: death and life in Japan’s disaster zone.” 

 

 

Too Much Sitting

Yes, I understand that too much sitting may even outdo smoking as a health hazard. Stand or move around during the day, and poof! you have a lower risk of early death than if you sit without stirring at a desk or on a couch. But this little downside to the backside from prolonged sitting, again from “The Week” magazine, made me smile.

The American Society of Plastic Surgeons said there was a 22 percent

increase in butt implants in 2020, perhaps because lots of sitting leads

to “general flattening.”

 

Not flattering!

 

Liposomal vitamin C

Somewhere along our evolutionary line, our primate ancestors lost the ability to manufacture vitamin C also known as ascorbic acid.  Scientists theorize that self-made vitamin C was no longer necessary for most primates due to the high intake of the vitamin through daily intake of fruits and vegetation.  We therefore must rely on dietary or supplemental C.  Unfortunately, one of the problems with the powders, tablets, and capsules of ascorbic acid is that very little of it is absorbed into the bloodstream.  Taking higher doses assures that most of the vitamin C stays in the gut and is eliminated through the GI tract.

Liposomal vitamin C is the same ingredient packaged in a delivery system that assures most of the active C is absorbed.  Liposomes are microscopic bubbles; their outer coating is a lipid layer that allows easy entrance through the intestinal lining just like dietary fats.  In addition, liposomal C does not raise oxalate levels in the blood thus eliminating the increased risk of kidney stones.

Rather than further explain the benefits of liposomal C, I’d recommend you check out:

https://www.reviewscout.org/top-5-vitamin-c/

 

Developing… not on the market yet

A recently-tested new topical goo for atopic dermatitis (AD) suggests that a combination of cannabidiol (CBD) and aspartame applied regularly to the itchy, inflamed, scaley skin of AD alleviates or clears all those symptoms in a satisfying sort of way.  The trial included 57 people who were randomized to control group, CBD cream alone, or the new combo.  Researchers used the ISGA score (investigator’s static global score) to record baseline symptom assessment compared to change after 2 weeks of use. ISGA scores range from 0 (no trouble at all) to 4 (a hot mess of skin misery).  After 14 days, 50% of the group receiving CBD/aspartame scored 0-1, down 2-3 points from the start of the trial whereas the CBD and control group participants scored the satisfying ISGA 0-1 in just 20% and 15% respectively.

CBD-enriched creams have proven success in multiple dermatological problems including AD, acne, psoriasis, skin cancer, pruritus, and pain.  But who thought aspartame was an effective dermal soother? 

Aspartame apparently has analgesic functions that are similar to those of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. A rodent trial in 2015 exposed the mice to topical 2, 4-dinitrofluorobenzene thus creating the mousy version of AD. Sucrose in the mice’s drinking water did nothing to soothe the itch and inflammation whereas drinking aspartame in water inhibited ear swelling and skin eruptions.  Please note, the International Sweeteners Association does not recommend adding aspartame to your drinking water based on other not-so-successful animal studies.