EP 61: First Artificial Heart Transplant & Lab Leak Hypothesis

EP 61: First Artificial Heart Transplant & Lab Leak Hypothesis

First Artificial Heart Transplant 

A surgical team at Duke University Hospital, led by Drs. Jacob Schroder and Carmelo Milano, successfully implanted a new-generation artificial heart in a 39-year-old man with heart failure, becoming the first center in North America to perform the procedure.

For the first time, a U.S. patient received an Aeson total artificial heart device implant. The device was created in 2008, initially approved in Europe in 2012, was the first total artificial heart to receive FDA approval. In July of 2021, the company also made its 1st sale in Europe. The company did have trial setbacks before, in 2014 their first transplanted patient died 75 days after the operation.

The operation lasted more than eight hours as part of a clinical trial at Duke University Hospital—beginning just after midnight and ending around 8:30 a.m.— The surgery team placed the Aeson total artificial heart created by a French medical technology company called Carmat.

Carmat designer and developer are aiming to provide a therapeutic alternative for people suffering from end-stage biventricular heart failure, today announced the first implant of its Aeson bioprosthetic artificial heart in a commercial setting. The surgeons said the biggest problem is fitting the device into the heart, which will limit the first generation of applicability like for small patients.

Heart Failure 

Heart Failure occurs when the heart can no longer carry out its essential function as a “blood pump” to provide a sufficient cardiac output to satisfy the metabolic needs. It primarily affects the left chamber of the heart, then the right chamber leading to biventricular heart failure. At this stage, vital organs such as the brain, liver, and kidneys do not receive enough nutrients and oxygen to function properly. 

Heart failure is a global pandemic affecting at least 26 million people and is increasing in prevalence. Despite significant advances in therapies and prevention, approximately 5% of this population have terminal heart failure, described as end-stage heart failure, refractory to current medical treatment.

As heart failure is a progressive disease, the prognosis is poor: less than 50% survival five years after diagnosis.

The device consists of two ventricular chambers and four biological valves ensuring that the prosthetic not only resembles the human heart but also functions like one.

The heartbeat is created by an actuator fluid that the patient carries in the bag outside the body and the heart is pumped using micropumps in response to the patient’s needs as determined by the sensors and microprocessors on the heart itself. Two outlets connect the artificial heart to the aorta, which is a major artery in the body, as well as the pulmonary artery that carries blood to the lungs to oxygenate it. 

As part of efforts to lead a near-normal life, the recipient will have to carry around almost a nine-pound (four kgs) bag that consists of a controller and two chargeable battery packs that work for approximately four hours, before requiring recharging.

The device currently has been approved for use in Europe for bridge patients who are diagnosed with Bi-ventricular failure and need a heart transplant in the next 180 days. 

https://www.youtube.com/watch?time_continue=46&v=xdcLKTpxr2g&feature=emb_logo

Full Youtube video on Dukes Surgeons and the implant 

https://www.youtube.com/watch?v=GAI22Y6ksjo&t=1139s

https://www.carmatsa.com/en/our_product/

 

Lab Leak Hypothesis 

The Lab Leak theory of COVID-19 Origins. Back in May, a group of scientists – shifted the debate about the origins of COVID-19, they published a letter in the journal of science saying the lab-leak theory needs to be taken more seriously by the scientific community.

Due to the previous administration and other political influencers, it was denounced as an anti-Chinese and anti-science conspiracy by almost all scientists as well as by most of the media: only right-wing outlets covered it at the time.

A few weeks ago, Anthony Fauci, Biden’s chief medical adviser, asked Chinese officials to release the hospital records of WIV staff members. Others have asked for blood samples from WIV staff members, and access to WIV bat and virus samples, laboratory notebooks, and hard drives. 

Email to Fauci from Kristain Anderson, one of the fiercest public critics of the lab leak theory and its proponents, discussed with Fauci in February 2020 if SARS-CoV2 was “engineered“:

“The unusual features of the virus make up a really small part of the genome (<0.1%) so one has to look really closely at all the sequences to see that some of the features (potentially) look engineered.

“We have a good team lined up to look very critically at this, so we should know much more at the end of the weekend. I should mention that after discussions earlier today, Eddie, Bob, Mike, and myself all find the genome inconsistent with expectations from evolutionary theory“

A virus that came from nowhere 

A zoonotic origin of COVID-19, i.e directly from bats or via another intermediate animal host, is scientifically the most logical theory. Problem is, that despite all these investigations, no clues in this regard were found. The virus appeared as if from nowhere, already perfectly adapted to humans, sometime in November 2019.

All searches of Wuhan’s “wet markets” where live animals poached from the wild are sold, delivered exactly nothing. No animal host, no traces of SARS-CoV2 antibodies anywhere in the blood, animal or human, prior to November/December 2019.

Wall Street Journal cited US intelligence sources: “Three researchers from China’s Wuhan Institute of Virology became sick enough in November 2019 that they sought hospital care, according to a previously undisclosed U.S. intelligence report”

Conflict of interest 

In early 2021 WHO deployed a team to China in early 2021, led by Peter Daszak, a British zoologist. Daszak had a conflict of interest about the size of a planet: his EcoHealth Alliance was for years channeling almost 40 million US funding money from NIH and Pentagon to the Wuhan Institute of Virology (WIV) for the purpose of coronavirus research.

In 2019, the Daszaks team and Wuhans lab of virology (WIV) began conducting gain of function research. The gain of function research, where naturally occurring coronaviruses were manipulated in the lab to make them more pathogenic for humans, the idea is to develop a universal coronavirus vaccine. WIV was doing viral experiments like state-of-the-art genetic manipulation and virus passaging in human cell culture or in genetically manipulated (“humanized”) mice, all to make the coronaviruses more pathogenic to humans.

Beijing is seeking to counter the hypothesis

Earlier in the pandemic, the Chinese government flouted the pangolin theory, claiming to have found SARS-CoV2 antibodies in poached pangolins sold on Chinese markets. Alina Chan and her colleague proved that research was badly drawn at best: the exact same pangolin virus genome was published by various papers as independent isolations.

Per published paper: “To our knowledge, all of the published pangolin CoV genome sequences that share a nearly identical Spike receptor binding domain with SARS-CoV-2 originate from this single batch of smuggled pangolins. This raises the question of whether pangolins are truly reservoirs.”

Call it a tale of two laboratories: the Fort Detrick Research Institute of Infectious Diseases in the US, the Wuhan Institute of Virology in China, and a competing narrative about the origins of Covid-19.

In August 2019, Fort Detrick’s BSL-4, or top security, lab was shut down by the US Centres for Disease Control and Prevention for safety violations related to the disposal of dangerous materials. It was reopened in April 2020, but the closure became the main topic in China’s tightly controlled domestic information environment.

The hashtag for Fort Detrick’s Chinese name has over 270 million hits on Weibo, a Twitter-like platform, usually on themes of the US hiding bioweapons and researching deadly viruses.

From Global times in China “Combining more than 8,000 pieces of news reports related to the lab-leak theory, the Global Times found that as many as 60 percent of the coverage was from the US alone.”

Human Mistake

By 2010, researchers published it as fact: “The most famous case of a released laboratory strain is the re-emergent H1N1 influenza-A virus which was first observed in China in May of 1977 and in Russia shortly thereafter.” The virus may have escaped from a lab attempting to prepare an attenuated H1N1 vaccine in response to the U.S. swine flu pandemic alert. The virus reappeared after a 20-year absence. Genetic analysis indicated that this strain was missing decades of nucleotide sequence evolution, suggesting an accidental release of a frozen laboratory strain into the general population. 

What’s next for lab-leak investigations

The Chinese government rejected the World Health Organisation’s plan for the second phase of investigation into the origins.

https://www.scmp.com/news/china/diplomacy/article/3141823/china-pushing-its-own-coronavirus-lab-leak-theory-latest

https://www.biorxiv.org/content/10.1101/2020.07.07.184374v1

https://www.wsj.com/articles/intelligence-on-sick-staff-at-wuhan-lab-fuels-debate-on-covid-19-origin-11621796228

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0011184

 

EP 124: Why People Become Nurses

EP 124: Why People Become Nurses

Benefits of Becoming a Nurse

There are many reasons to become a nurse, from good pay to job satisfaction. A career in nursing is an unselfish one, to say the least. Nursing allows for a wide variety of opportunities inside and outside of work. Growth opportunities through education combined will allow flexible hours to pursue multiple ventures. 

5 Reasons to Become a Nurse

  1. Competitive compensation in a growing industry

The healthcare field is always growing and changing. The beauty of it is that it will forever be growing because we always want to improve our health as a species. We want to live longer,  more efficiently combat disease, and improve our well-being. That is why most careers in the healthcare industry are safe and consistent careers. It is a forever evolving industry, some jobs will be weeded out but new ones will always arise. 

Medical professionals are in high demand to care for an aging population that is increasingly aware of the importance of preventative healthcare. The increased need and awareness have made registered nurses one of the top five occupations expected to add jobs from 2019-2029.* As a result, job opportunities in this sector have never been greater!

https://www.bls.gov/newsroom/2019_jobs-and-careers 

The Bureau of Labor and Statistics estimates that the employment of registered nurses is projected to grow 7 percent from 2019 to 2029, faster than the average for all occupations. Growth will occur for a number of reasons, including an increased emphasis on preventive care; increasing rates of chronic conditions, such as diabetes and obesity; and demand for healthcare services from the baby-boom population, as this group leads longer and more active lives.

https://www.bls.gov/ooh/healthcare/registered-nurses.htm 

  1. A job that makes a difference

Nurses are often looked at as the “rock star” profession of healthcare. They’re always there for you, night and day with a warm smile on their face to comfort you when life might be rough. Nurses dispense comfort, compassion, and caring without even being asked. It’s true that Nurses do more than give medicine or treat wounds they care about patients by helping them improve not only their acute hospital outcomes but their lives. 

Every day as nurses we get to leave our mark on someone’s life by providing them with that extra little bit of love and understanding when they need it most.

There are not many careers with the potential to change or save a life every day. As a nurse, you will constantly have new patients with different interactions. It is an interesting career because there is always an equal opportunity to teach and to learn. 

Most surveyed nurses (81%) reported satisfaction with their career choices, according to a 2019 survey conducted by AMN Healthcare and The Center for Advancement of Healthcare Professionals. According to a 2018 survey of nurses by Medscape, 94% of registered nurses answered “yes” when asked whether they were glad they became a nurse or advanced practice nurse. 

https://www.purdueglobal.edu/blog/nursing/10-reasons-become-nurse/ 

  1. Active and exciting work

If you’re the type of person who likes to be on their feet all day, then nursing might just be for you. Unlike many desk jobs where employees sit at a computer screen staring aimlessly into space until they get bored and go watch cat videos on YouTube, nurses are always busy doing something—even if that thing is not as fun or exciting as other tasks. True, there will often come parts in your job which may seem mundane but don’t let them discourage you–because with every task comes an opportunity to learn new things!

Nurses are the backbone of healthcare. From meeting new patients to dealing with various health concerns, nurses tackle a different challenge every time they step into work. For many nurses, this can feel like an adrenaline rush as their day is full of surprises and mystery! That’s why most embrace these challenges that come with being in such a demanding profession according to AMN Healthcare’s nursing survey. 

  1. Flexible schedule and variety of specialties

It doesn’t matter when you’re a nurse, as long as you have the right shift for your needs. You can work evenings if mornings don’t agree with your sleep schedule or take on longer shifts over fewer days so that family time is yours to spend in large chunks. Or stick to what feels more traditional and find someplace where they give their employees regular schedules without too many changes.

While there are nursing jobs out there that fit the normal eight-hour day, five days per week, the average workday for nurses in long-term health facilities or hospitals is twelve-hour shifts, three days per week. Nursing offers a unique benefit that most professional careers don’t: job flexibility. Depending on where you choose to work as a nurse, oftentimes, you have a say when it comes to working full-time, part-time, or on-call.

https://absn.madonna.edu/blog/6-reasons-why-become-a-nurse/ 

Flexibility in location is another perk of becoming a nurse. Nurses can work anywhere from traditional locations, such as hospitals and doctor’s offices to less-obvious ones like home health care or schools. And some nurses even choose an exciting career as a flight nurse!

If you’re ready to get away from home but not too far away; if you crave variety while still being near friends and family – then I have just what you need: Meet “travel nurses” who literally live out fantasies by moving between hospitals around America due lack of staffing needs at each location. This high in-demand job oftentimes offers lucrative paychecks. 

Bedside nurses serve on the frontlines of direct patient care. You can find them working in settings such as nursing homes, hospitals, and long-term care facilities. As a bedside nurse with a BSN degree, you can pursue certification in the following specific areas of practice:

  • Emergency care: this nurse cares for patients who require urgent treatment.
  • Oncology and hematology care: this nurse cares for patients who have (or are at risk for) cancer or blood diseases or blood disorders.
  • Transplant care: this nurse cares for patients donating or receiving an organ.
  • Pediatric care: this nurse cares for primarily children and patients under the age of 18.
  • Labor and delivery care: this nurse cares for women and babies at all stages of childbirth.
  • Nephrology care: this nurse cares for patients with kidney disease or abnormal kidney function.

Another benefit of earning a BSN degree? You’re not pigeonholed into working inside of the hospital. You can choose to apply your skills and knowledge beyond the bedside, in settings such as:

  • Airplanes
  • Correctional facilities
  • Courts of law
  • Health insurance companies
  • Medical disaster teams
  • Laboratories

Alternative nursing careers can also be those that don’t involve direct patient care at all. These job titles, which often require educational training outside of a BSN, include:

  • Legal nurse consultant: this nurse works as a medical expert in legal cases.
  • Nurse attorney: this nurse represents medical professionals in the courtroom.
  • Nurse writer: this nurse writes educational materials, articles, blogs, and even Hollywood scripts.
  • Nurse entrepreneur: this nurse owns his or her own healthcare business venture.
  • Informatics nurse: this nurse develops communication and information technologies.

https://absn.madonna.edu/blog/6-reasons-why-become-a-nurse/ 

  1. Professional developmental opportunities 

You can explore a variety of careers by earning your Bachelor’s degree in Nursing. The BSN opens the door to new, exciting roles with higher salaries and more opportunities for career growth than ever before! 

The power of education cannot be overstated–the higher your level of certification, the greater potential there is for opportunity within your profession. When seeking out further specialization after earning a Bachelor’s degree from one school system (a “BS”), many nurses opt instead to earn their Master’s Degree in Nursing (MSN) from another institution (“MS”). This postgraduate coursework provides them with valuable skills which can then translate into careers like:

  • Nurse practitioner: this nurse has similar responsibilities to that of a doctor. However, it’s important to note that every state has different rules that determine the scope of practice for nurse practitioners.
  • Clinical nurse specialist: this nurse brings leadership to practice settings.
  • Nurse anesthetist: this nurse delivers anesthesia to patients.
  • Clinical Nurse Manager: this nurse supervises the nursing staff.

Advances in technology are allowing nurses to use data analysis for the purposes of treatment and care. It would be very surprised if this new field didn’t lead to a whole new career path, but informatics has already created one that is accessible now through nursing programs across America. Informatics deals with measuring all sorts of things related to healthcare including how it can help diagnose patients’ conditions or provide them access to tailored treatments at their bedside when they need it most. Nurses who specialize in data analysis will become leaders as we forge into our future where there’s no telling what kind of medical advances could happen next!

Becoming a nurse has many positives. It is credited with being part of an ever-evolving industry, healthcare. Career stability and high incomes are nice benefits to have in a career. Nursing also brings in respect and ample room for growth through education and clinical skills. Due to its flexible schedules and varying specialties, nursing is a great career path for many. 

EP 122: Day Shift Expectation vs Reality

EP 122: Day Shift Expectation vs Reality

Nurses working dayshift expectations vs reality

As a nurse, depending on your shift, your workflow and experience as a nurse is going to differ. We have worked both shifts, mainly 4 years on nights but today we are going to share our experience to share the expectations vs reality of working day shift as a nurse

Your nursing shifts start at 5 am

As a dayshift nurse, you have to get up as early as 5 am to eat, pack your lunch, and beat the morning traffic. This is the part that most nurses dread. The Day shifts typically range from about 6:45 in the morning until a little around 7:30 at night.

Are you someone who constantly stays up late? Or are you the type of person who prefers a regular bedtime and enjoying the sunrise? If the answer is no, then you might have a hard time dealing with early nursing shifts.

Getting your butt up at 5 am to get ready for work definitely isn’t fun. But you’ll get used to it. After all, that’s why coffee was invented (for dayshift nurses).

The best benefit to working the day shift is having a consistent schedule that your body loves. Working the day shift also gives you the benefit of lining up with the rest of the world’s schedules.

Dayshift is hands-on

If you’re looking for opportunities to practice your hands-on skills, the day shift is ideal as it has more procedures. If you love starting IVs, ambulating, assisting in procedures, you will enjoy working days, as nights typically see procedures during emergencies.

The noisiness on dayshift

During dayshift the noisiness is consistent. There are patients, alarms, phones, family, call lights, food trays, consults, nursing rounds, procedures, tests, etc.

The dayshift nursing environment is constantly noisy, so if you love organized chaos and are constantly connected to your work environment, dayshift is for you.

Nursing support on dayshift

Dayshift nursing is really busy but with days this means there are more people to pick up all the extra work. There are always patients to take care of with constant order changes throughout the day, consults to follow-up with to figure out the plan of care, etc. You will never feel alone as a dayshift nurse because you will constantly have nursing support such as nursing leadership (charge nurse), nursing staff, and coworkers.

The plan of care

As a dayshift nurse, you’re the primary team member when It comes to total care.

As the primary nurse, you are not only responsible for the direct care of a patient, but also taking part in providing indirect nursing care for other patients as well. During the day the entire hospital team is there; Doctors, residents, consults, Physical therapy, occupational therapy, respiratory therapy, dietary, social worker, case management &, etc.

If you adapt easily to quick changes in plans and are flexible to other people needing access to your patient, the day shift might be for you. If you don’t enjoy this type of commotion, stick to the night shift; it’s much more controllable in this area.

Charting during dayshift

Charting nursing care during dayshift can be a challenge as well. With the constant stream of nursing activity and interruptions, charting nursing care can become tricky. Day shifters chart at random times throughout the day, but have more patient face-to-face contact and charting

Dayshift nursing is fast-paced. You will get used to charts quickly on your dayshift. If you love reading up on your patients and do some digging to perform better care, consider working nights.

PO supplementation on day shift for nurses

Are you someone who cannot go without food or drinking? With the entire team being at the hospital, this includes management, which never allows any food or drinks at the nurse’s station.

During nights, the opportunities to sit down and eat more often and you can enjoy your meal. Most hospitals don’t have a 24/7 cafeteria, which can be tough for those without outside meal plans.

Friendships on days

Both day and night present an opportunity to engage with and get to know your coworkers. Nightshift is a lot easier going and to get along with.

Night nurses are typically quiet and reserved; day shift nurses have the opposite demeanor: they are talkative and engaging in conversation. Both dayshift nurse and night shift nursing have their own unique perks

Concluding thoughts

If you’re looking to get ahead in your nursing career, it’s important that you have a good understanding of the nursing shifts and responsibilities. Both nursing shifts offer different nursing opportunities and nursing challenges.

Working dayshift nursing can be very taxing on your schedule if you have a family or children to take care of. It is constantly noisy, fast-paced, and not the most relaxing nursing shift at all. If you are really dedicated to your nursing career, both shifts will be equally challenging.

 

EP 60: Methadone and Mental Health

EP 60: Methadone and Mental Health

Methadone and Mental Health

We live in a society where a solution is often some kind of drug. Let that be for weight loss, muscle gain, cognitive performance, and even drug addiction. People want a quick and easy fix so that is what is provided to them, unfortunately, this does not solve the root cause of certain ongoing issues. The “take a pill for this” method does not work in every situation but that is what the consumer wants, so that is what they received.  

What is Methadone?

Methadone was developed in Germany around 1937 and 1939 by Gustav Ehrhart and Max Bockmühl. 

Heroin and fentanyl are opiates that affect our brain’s reward center by releasing dopamine. When these receptors are activated, they stimulate the release of neurotransmitters that regulate pain, hormone production, and feelings of well-being throughout the body. With this in mind, heroin binds to mu-opioid receptor (MORs) which stimulates a reinforcing behavior cycle on drugs; meaning users will continually use more for their desired effects–until withdrawal symptoms start taking over where we may feel physical or mental distress until we can get another hit

  • Mu receptors play an effect on analgesia, smooth muscle tone, sedation, mood alteration, and n/v.

Methadone acts by binding to the µ-opioid receptor, but also has some affinity for the NMDA receptor.

  • mu-opioid receptors are a key molecular switch triggering brain reward systems and potentially initiating addictive behaviors.
  • This receptor, therefore, mediates therapeutic (analgesia) and addictive activities of morphine, suggesting that further development of morphine-like compounds may necessarily lead to addictive analgesics.

Methadone is a synthetic opiate that is used to treat drug addiction. Methadone binds to the same brain receptors as heroin and morphine, but methadone blocks the euphoric high caused by heroin or morphine. It has a long half-life, lasting 24 – 36 hours, making it an ideal detox agent for ongoing treatment. Methadone also decreases cravings for drugs and helps addicts stop using illegal drugs. However, in higher doses methadone can exhibit opiate-like effects, creating a state of euphoria, sedation, respiratory depression, and relaxation for users.

Methadone is the most common drug for treating heroin addicts worldwide. It has been used as a treatment since it was first discovered in Germany during WWII, and now doctors are starting to use methadone more than ever before due to its effectiveness and safety. Methadone allows people with addictions time to recover from their addiction while they assimilate back into society by working or going through school instead of being high all day every day like when using other drugs such as heroin- which can have harmful effects on one’s body if abused over long periods of time (such as liver damage). For optimal results, patients should also participate in counseling sessions where they will talk about how life affects them so that together these professionals can help the addict find ways out.

https://psychiatry.uams.edu/clinical-care/cast/what-is-methadone/

https://www.drugabuse.gov/publications/research-reports/heroin/effects-of-heroin-on-body 

The lowest GoodRx price for the most common version of methadone is around $10.26, 75% off the average retail price of $41.30.

Methadone administration

A relatively low dose of methadone (eg, <30 mg per day) can lessen acute withdrawal but is often not effective in suppressing craving and blocking the effects of other opioids. Though a few patients respond to a maintenance dose of 30–60 mg per day, most patients fare better if their initial 30–40 mg per day dose is gradually raised to a maintenance level of 60–120 mg per day, which typically creates sufficient tolerance to minimize a euphoric response if patients self-administer additional opioids. 

https://www.asam.org/docs/default-source/practice-support/guidelines-and-consensus-docs/asam-national-practice-guideline-supplement.pdf 

Is Methadone a good solution for opioid addiction?

Methadone is a highly addictive synthetic opiate, more addictive than Heroin and harder to withdraw from. The National Treatment Agency for Substance Misuse (NTA) recognizes that addicts have been parked on methadone for too long, and now promotes abstinence as the treatment goal, with time limits on the duration of methadone maintenance.

https://www.theguardian.com/society/2012/jan/10/why-methadone-drugs-dont-work 

While methadone may help reduce cravings for heroin and other dangerous narcotics, it still leaves the individual dependent on an opiate drug. Despite this, methadone use can keep addicted people safer and out of the justice system as they begin recovery.

  • Deaths from opioids (including semisynthetic opioids, natural opioids, and methadone) have increased more than 300% in the last 20 years.
  • Methadone is responsible for nearly one in four opioid-related deaths.

Study

Methadone Prescribing and Overdose and the Association with Medicaid Preferred Drug List Policies — United States, 2007–2014

  • Methadone accounted for approximately 1% of all opioids prescribed for pain but accounted for approximately 23% of all prescription opioid deaths in 2014. State drug management practices and reimbursement policies can affect methadone prescribing practices and, in turn, might reduce methadone overdose rates within a state.
  • https://www.cdc.gov/mmwr/volumes/66/wr/mm6612a2.htm 

More than 70,000 Americans died from a drug-involved overdose in 2019, including illicit drugs and prescription opioids. 

In response to the escalating number of deaths related to the improper use of the prescription drug, methadone, the Illinois Department of Human Services’ (IDHS) Division of Alcoholism and Substance Abuse is urging Illinois consumers, health care professionals and the opiate treatment clinics to be well informed on the safe use of methadone.

https://www.dhs.state.il.us/page.aspx?item=46054 

Mental health

For some people, the feelings of anxiety and depression that emerged during this pandemic will resolve as routines resume. But others who face new or worse mental health issues may not be so lucky–a number which could very well become quite large given the magnitude of despair and disruption caused by a virus, unlike anything we have ever seen before in our lifetime. This burden would undoubtedly put an even greater strain on already strained systems for treating these conditions if they were to come into contact with one another down the road.

  • Young adults have experienced a number of pandemic-related consequences, such as closures of universities and loss of income, that may contribute to poor mental health. During the pandemic, a larger than average share of young adults (ages 18-24) report symptoms of anxiety and/or depressive disorder (56%). Compared to all adults, young adults are more likely to report substance use (25% vs. 13%) and suicidal thoughts (26% vs. 11%). Prior to the pandemic, young adults were already at high risk of poor mental health and substance use disorder, though many did not receive treatment.
  • Research from prior economic downturns shows that job loss is associated with increased depression, anxiety, distress, and low self-esteem and may lead to higher rates of substance use disorder and suicide. During the pandemic, adults in households with job loss or lower incomes report higher rates of symptoms of mental illness than those with a job or income loss (53% vs. 32%).
  • Research during the pandemic points to concerns around poor mental health and well-being for children and their parents, particularly mothers, as many are experiencing challenges with school closures and lack of childcare. Women with children are more likely to report symptoms of anxiety and/or depressive disorder than men with children (49% vs. 40%). In general, both prior to, and during, the pandemic, women have reported higher rates of anxiety and depression compared to men.
  • https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/ 

Drug overdose deaths spiked dramatically during the COVID-19 pandemic. According to the Centers for Disease Control and Prevention (CDC), nationwide a record 93,000 people died from a drug overdose in 2020, a 29% increase over the previous year. The state of Illinois saw more than a 27% increase in deaths, while Michigan recorded a 16% increase.

While the numbers may be shocking, for some they weren’t surprising.

https://newsroom.osfhealthcare.org/covid-19-fallout-a-spike-in-drug-deaths/ 

EP 59: Eggs and Salmonella

EP 59: Eggs and Salmonella

Eggs and Salmonella

There has been a debate going on for years about, should eggs be refrigerated. For those of you that don’t know, the US is one of the only countries that keeps eggs in a fridge. It is not a choice whether you should keep your eggs in the fridge, it is the law. The US Department of Agriculture requires eggs to be refrigerated. Should we refrigerate our eggs?

Why do some countries refrigerate their eggs?

In America, food safety officials emphasize that once eggs have been refrigerated, it is critical they remain that way. A cool egg at room temperature can sweat, facilitating the growth of bacteria that could enter the egg through its porous shell. This bacteria is usually salmonella. This is because eggs undergo a different process before they hit the shelves in the US. The reason we need to keep our eggs in the fridge is that the eggs undergo a specific cleaning process before you are able to buy them. 

“The U.S. Department of Agriculture (USDA) determined that the best way to fight Salmonella contamination is by sanitizing the eggs before they reach the consumer. The washing process removes contaminants, but it also removes the natural coating of the egg, leaving the shell porous. On U.S. commercial egg farms, it is required that eggs are thoroughly washed and immediately refrigerated before they leave the farm and during transportation to the grocery store”. 

By 1970, the U.S. had perfected an egg washing system that was easy, effective, and produced clean eggs. There was one catch, after washing the eggs had to be refrigerated. The trade-off for clean, spotless, and bacteria-free eggs is that washing also removes a thin, filmy, protective outer layer called the cuticle. This cuticle is a semi-permeable layer that keeps bacteria out of an egg while letting oxygen circulate. Without this layer the egg becomes more permeable, allowing different types of bacteria to enter the egg. That is why eggs are handled differently in the US. without the cuticle, eggs need to be kept cold to discourage bacterial growth. This process also extends the shelf life of eggs by about 2 weeks, totaling about 40 days. Remember once the egg is washed, it has to be refrigerated. 

https://eggsafety.org/us-refrigerate-eggs-countries-dont/

https://www.organicvalley.coop/blog/why-does-us-refrigerate-eggs/

Different Types of Eggs

Standard White Eggs

These eggs come from white hens that are typically raised in conventional housing systems.  Conventional housing has been the standard for decades, but the Alberta egg industry has begun to transition away from conventional housing systems.

Standard Brown Eggs

These eggs come from brown hens that are typically raised in conventional housing systems.  Conventional housing has been the standard for decades, but the Alberta egg industry has begun to transition away from conventional housing systems.

Furnished / Enriched / Nest-Laid Eggs

These eggs come from hens that are raised in furnished housing systems.  Furnished housing provides more space (both floor space and height) for the hens to move around, while also providing a variety of enrichment, which allows the hens to express more natural behaviors.  Enrichments include nesting boxes, perches, scratch pads, and dust baths.

Free-Run Eggs

These eggs come from hens that are raised in free-run (barn or aviary) housing systems.  Free-run systems allow the hens to roam freely within an enclosed barn, while also providing a variety of enrichments such as nesting boxes and perches. 

Free-Range Eggs

These eggs come from hens that are raised in free-run (barn or aviary) housing systems, which also provide access to outdoor runs (when weather permits).

Organic Eggs

These eggs come from hens that are raised in free-range housing systems.  The hens are only provided feed that has been certified organic, which means that it only contains ingredients that were grown without pesticides, herbicides, or commercial fertilizer.  Look for a certified organic symbol on the egg carton.

Omega-3 Eggs

These eggs come from hens that were provided feed containing extra flax (up to 10-20%).  As a result, the eggs laid by these hens contain more Omega-3 fatty acids.

Vitamin-Enhanced Eggs

These eggs come from hens that were provided feed that was nutritionally enhanced to include higher levels of certain vitamins (ie: Vitamin D or Vitamin E).  As a result, the eggs laid by these hens contain corresponding higher amounts of the particular vitamin(s). 

Vegetarian Eggs

These eggs come from hens that were provided feed containing only plant-based ingredients.

Processed Eggs

Liquid, frozen and dried egg products come from eggs that were broken by special egg breaking machines, and then pasteurized.  They often contain added ingredients (ie: preservatives, flavoring, or coloring) and this process allows for special formulations (ie: egg whites only).

https://eggs.ab.ca/eggs/types-of-eggs/

Maintaining egg freshness

It’s a bit disturbing to know that some eggs end up sitting on a shelf somewhere for up to six weeks before you buy them.

The Float Test

  • If you put an egg in a bowl of water and it sinks to the bottom and lays on its side, then it is as fresh.
  • If it sinks but stands on its end, then it is still good to eat but getting older. 
  • If it floats to the top of the water, do not eat it it’s an old egg.

Other Ways to Tell If an Egg Is Fresh

  • If the shell seems unusually thick, then it is fresh.
  • If the yolk stands really tall after you’ve cracked the egg, it is fresh.
  • If the yolk has wrinkles or dissolves into a puddle when you crack it open, then it is an old egg.

https://eggs.ab.ca/eggs/types-of-eggs/

Should you eat eggs every day?

Science says that up to 3 whole eggs per day are perfectly safe for healthy people. A single medium-sized egg contains 186 mg of cholesterol, which is 62% of the recommended daily intake (RDI).

Salmonella

The case for washing before buying

Studies have shown that washing eggs before reaching shelves prevent Salmonella from entering the inside of the egg.

Study 1

Took a look at hundreds of eggs and experimented with the if a washing technique is used to clean the eggs before reaching consumers there would be less salmonella. Its results showed that:  

  • When undertaken according to a strictly controlled set of best practice conditions, washing eggs that have been contaminated with Salmonella before cuticle hardening does not lead to contamination of contents with these pathogens.
  • Careful temperature regulation has to be used to inhibit salmonella entrance into the egg.
  • https://pubmed.ncbi.nlm.nih.gov/14717344/ 

Study 2

Another study looked at if washing eggs have a greater effect on salmonella than non-washed eggs. They concluded that:

  • The penetration of bacteria across the eggshell is dependent on the survival of bacteria on the eggshell surface and egg storage conditions. Results from this study indicated that there was no significant difference in the survival rate of S. Typhimurium on the eggshell surface of washed and unwashed eggs.
  • Found that S. Typhimurium strain 2 penetration was significantly higher in washed eggs than unwashed eggs.
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951326/

Study 3

Meta-analysis of whether washing eggs had any statistical effect on salmonella.

  • As this literature review shows, the master key to reduce the likelihood of getting ill from Salmonella in eggs from the point of the consumer is to buy Salmonella-free eggs.
  • The large majority of consumers do not have access to eggs with this guaranteed Salmonella-free status. When purchasing/collecting and using these eggs in cooked dishes, three practices will together reduce Salmonella to acceptable numbers: (1) washing hands after touching dirty eggs or egg contents to avoid ingestion of spilled raw eggs, (2) assuring a proper control of cooking time and temperature, monitored by reliable methods, and (3) cleaning of surface that has been in contact with dirty eggshells or egg containments.
  • https://onlinelibrary.wiley.com/doi/full/10.1111/1541-4337.12753 

What is salmonella

Salmonella is a bacterial infection that usually affects the intestinal tract. Salmonella lives in human and animal intestines and are shed through feces. 

People are usually affected through contaminated food or water, usually through uncooked meats, poultry, eggs, and egg products. 

CDC estimates Salmonella bacteria cause about 1.35 million infections, 26,500 hospitalizations, and 420 deaths in the United States every year. Food is the source of most of these illnesses.

https://www.cdc.gov/salmonella/index.html 

Symptoms

Signs and symptoms can last anywhere from 2 to 10 days. Onset of symptoms can be anywhere from 6 hours to 6 days. Commonly associated with the stomach flu

  • Nausea
  • Vomiting
  • Abdominal cramps
  • Diarrhea
  • Fever
  • Chills
  • Headache
  • Blood in the stool

Prevention

  • Wash your hands
  • Proper raw meat and poultry handling
  • Proper food storage
  • Clean your cutting board

https://www.mayoclinic.org/diseases-conditions/salmonella/symptoms-causes/syc-20355329