Uplifting Updates

During these uncertain and challenging times, we can all use some good news. On that note, it gives me great pleasure to share with you that scientists have confirmed that it is extremely rare for mothers to transmit SARS-CoV-2 virus (heretofore referred to by it’s colloquial name, covid-19) to their newborns…and why.

Researchers at the National Institutes of Health led by Dr. Roberto Romero reported on July 14, 2020, that the placenta lacks certain molecules used by the virus to cause the infection. To quickly recap biology 101, our genetic code and all important instructions which determine our traits are contained within our DNA, located in the nucleus of the cell. Messenger RNA, or mRNA, is a type of RNA which carries the information contained within the DNA to a different part of the cell, the ribosome, which is made of a different RNA called rRNA (ribosomal RNA). The ribosome translates the genetic code, or message, contained within the mRNA into proteins. Proteins are a crucial macromolecule necessary for function and survival, and many of them serve as enzymes, catalysts of chemical reactions which allow processes to operate smoothly as they should.

So what does all of this have to do with newborns and covid-19? The ACE2 receptor is the primary receptor on the cell surface used by covid-19 to cause infection. However, unlike adult cells, the membrane of the placenta (which houses the developing fetus) contains only a minute amount of the mRNA molecule which manufactures ACE2 receptors. Little to no mRNA means no receptors for the virus to mess with or wreak havoc upon. Furthermore, the placenta lacks (or contains only trace amounts of) a different kind of mRNA, the one that produces an enzyme called TMPRSS2. This is the enzyme the covid-19 uses to infiltrate cells. No enzyme, no entry, no infection.

In other good news, Moderna, a biotech company working on developing a vaccine, shared exciting news earlier this week. They reported that all 45 participants in Phase 1 of their drug trial produced antibodies in response to treatment. Phase 3 of the trial is due to begin later this month with 30,000 participants.  

While there are still many unknowns about this disease and much yet to be explored and tackled, including a vaccine, it is nice to report a modicum of good news. I hope to have the ability to continue sharing positive developments in the ensuing weeks and months. Until then, please maintain proper handwashing, wear a mask (not a chin guard), and stay safe.  

When Your U.T.I. Refuses to Die

U.T.I.s are getting harder to treat which is understandably driving people mad!

Not all infections are created equal, especially when it comes to those that affect the genitourinary system.

Matt Richtel explores this phenomenon in his recent article in The New York Times (July 13, 2019, link to article). More and more women have recently discovered the hard way that the same Bactrim and nitrofurantoin which cured urinary tract infections (U.T.I.s) in their twenties are no longer helping them in their forties. This previously successful course of antibiotics is failing due to the development of resistance towards the medications.

Doctors refer to these as drug resistant U.T.I.s., and they have the New York City Department of Health working overtime to better understand the nature of these infections. According to the department, approximately one third of U.T.I.s caused by E. coli (the leading cause of the infection) were found to be resistant to Bactrim. Ampicillin is also not as powerful as it used to be. Continued usage of ineffective medication results in treatment delay and proliferation of the infection. More women require hospitalization than in years prior, especially if the infection spreads to the kidneys, and utilization of intravenous antibiotics is also on the rise. U.T.I.s can be especially dangerous, even fatal, within the geriatric community. In 2002, the Centers for Disease Control and Prevention (CDC) estimated that approximately 13,000 people died annually from hospital acquired U.T.I.s.

Researchers have proposed both a short term and long term solution to this problem. The short term goal is to develop inexpensive and rapid diagnostic testing, particularly urine cultures, that would enable doctors to prescribe the proper antibiotic to kill the particular strain in question from the get-go. The long term goal involves creating a medical paradigm shift towards reduced utilization of antibiotics and only prescribing them when truly medically necessary. The more careful we are about selectively using antibiotics, the less resistance we will develop towards them.

Until that happens, I encourage you to be your own biggest advocate. You know your body better than any doctor you will ever visit, and if the medication you have been prescribed is not relieving your symptoms, please request a urine culture from your urologist.

In addition, recurrent U.T.I.s may result in overactivity of the pelvic floor muscles. This may manifest as urinary frequency, incomplete emptying of the bladder, bowel dysfunction, and/or pain during vaginal penetration. Pelvic floor physical therapy is a proven conservative treatment approach to address these symptoms. If you or someone you know stands to benefit from these services, please reach out to us at Revitalize Physical Therapy. We would love to have the opportunity to help you!