A Single Sneeze Can Spread Throughout Entire Building

MIT researchers using high-speed cameras and applying fluid dynamics have discovered that although ejected droplets from a sneeze typically fall to the ground, the "cloud" of moisture from a single sneeze actually floats and can enter ventilation ducts and can potentially spread throughout an entire building or airplane. Watch video below.

These findings have profound implications as to how infections may travel within buildings and other contained structures like cruise ships and airplanes.

So although most people cover their mouths when sneezing in public, it also needs to happen in private even when there's nobody around. Of course, more study is needed to see if the sneeze "cloud" is even minimized with mouth-covering.

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Flushing Ears with Cold Water Can Treat Somatoparaphrenia

Somatoparaphrenia is a condition whereby a person denies that a limb or an entire side of the body belongs to them, even if provided with irrefutable proof. This condition usually is accompanied by left-sided paralysis and anosognosia (denial or lack of awareness) of the paralysis often due to a parietal stroke.

What is interesting is that flushing the left ear with cold water (caloric vestibular stimulation) can temporarily treat/resolve somatoparaphrenia. Specifically, the protocol is flushing into the left ear canal 60cc of cold water (20 degrees Celsius) for one minute. During the stimulation, the patient is laid down and head tilted forward 30 degrees. If properly done, clear horizontal nystagmus with leftward slow phase can be seen for about 3 minutes.

Normally, flushing the ear in this manner is routinely performed as part of balance testing (ENG) to determine whether a person's dizziness is due to an inner ear problem or not.

In any case, how does vestibular stimulation help with somatoparaphrenia? I don't quite understand it myself, but according to one reference:

"vestibular input takes part in building up and updating the representation of egocentric space." [link]

Whatever that means...

References:
Can vestibular caloric stimulation be used to treat apotemnophilia? Med Hypotheses. 2007;69(2):250-2. Epub 2007 Feb 9.

Partial Remission of Hemiplegia and Somatoparaphrenia Through Vestibular Stimulation in a Case of Unilateral Neglect. Cortex Volume 28, Issue 2, June 1992, Pages 203–208

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Does Drinking Alkaline Water Help With Reflux?

Image by WJ Pilsak from Wikipedia

Treatment in some reflux-sufferers may require addressing not just the acid in reflux, but also the pepsin. In one tantalizing research paper, alkaline water (pH 8.8) was found to instantly and permanently inactivate pepsin in vitro (ie, in a test tube). Pepsin is a stomach enzyme that can cause inflammation and mucosal damage when in the throat area. This peptic enzyme can be deposited outside the stomach due to laryngopharyngeal reflux (LPR) and can cause symptoms of globus, burning, hoarseness, chronic cough, chronic throat clearing, etc.

With pepsin triggered symptoms, treatment to resolve can become exceedingly frustrating given standard treatment with zantac, prilosec, and other "reflux" medications do not work as well. Furthermore, human pepsin remains stable at pH 7.4 and can be repetitively reactivated by acid from any source (ie, orange juice).

BUT... keep in mind that test tube results in this research may not necessarily translate to actual improvement in humans. However, drinking a small amount of alkaline water a few times a day (just enough to coat the throat) can't hurt.

Keep in mind that most tap and bottled waters (typically pH 6.7 to 7.4) would not be expected to affect pepsin stability.

I should also mention that drinking alkaline water will not do much to help acid reflux as the alkaline water will only briefly neutralize any acid and is ineffective for long-duration acid suppression. For those suffering from acid reflux, stick with the traditional reflux medications which work extremely well.

Reference:
Potential benefits of pH 8.8 alkaline drinking water as an adjunct in the treatment of reflux disease. Ann Otol Rhinol Laryngol. 2012 Jul;121(7):431-4.

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Mal de Debarquement Syndrome - Rare Cause of Dizziness

The BBC recently printed a story describing a rare condition called mal de debarquement which causes dizziness, typically after a boat cruise, though can occur with airplane flights and even a long drive in a car with switchbacks (going up/down a mountain).

Two signs that a patient has mal de debarquement are if they feel a rocking sensation for weeks or months starting AFTER a cruise and two, if they're much better when in motion like vigorous exercise, but feel much worse when staying still.

Read the story here.

Unfortunately, no great treatment for this condition beyond displacement type exercises (walking, running, bicycling... but NOT on a treadmill or stationary bike).

This condition was also in an article by the Washington Post in 2010.

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Why Did Hair Turn Green for Residents of a Certain Town?

In 2011, in a certain township called Anderslov in Sweden, formerly blonde residents' hair mysteriously started turning green.

Was it a biological problem? Was it a disease? Was it contagious?

Nope...

Actually, suspicion initially was towards the drinking water and in particular, the copper levels since copper is known to dye things green via a complex oxidation process.

When copper oxidizes, it forms minerals that are green (and/or blue) including:

brochantite (hydrated copper sulfate) Cu4SO4(OH)6
malachite (hydrated copper carbonate) Cu2CO3(OH)3
azurite (hydrated copper carbonate) Cu3(CO3)2(OH)2

This action is known as verdigris... it is also why if you look at the Statue of Liberty, she appears greenish:

It is also why cheap copper jewelry when worn against the skin will turn it green.

However, confounded researchers found normal levels of copper in the water going into the homes.

BUT... water tested first thing in the morning inside the homes was found to contain copper levels 5-10x normal.

What scientists discovered was that the ultimate culprit was a combination of living in a new home and hot showers.

During the night, sitting hot water reacted with copper from the pipes and water heater causing levels of copper and associated minerals in the water to build up. This problem was most severe in new homes where the pipes lacked special coating. So, when residents of affected new homes took a hot shower in the morning, the copper in the water turned their hair green.

In order to avoid green hair, cold water needed to be used to wash the hair... or move to an older home which contained pipes that didn't leach copper in hot water.

What is this special coating that prevents copper from causing green problems? It is a polymer that is applied during manufacturing and includes acrylic, epoxy, polyurethane, cellulose, silicone, or vinyl depending on the copper's ultimate use.

Of note, this research on green hair won the 2012 Ig Nobel Prize for chemistry.

Sources:
'Nerdy' Swede wins faux- Nobel for green-hair find. The Local 9/21/12

'New homes' turn Swedes' hair green. The Local 12/17/11

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To Ear Plug or Not to Ear Plug

Seems like a fairly simple question... but oh what controversy it stirs up when regarding a patient with ear tubes who wants to go swimming.

There are two schools of thought...

1) Based on evidence and research, no need to wear ear plugs... ever.

The argument... Well, here's the research:

• A meta-analysis of swimming and water precautions.
• Water precautions and tympanostomy tubes: a randomized, controlled trial.
• A meta-analysis of swimming and water precautions.
• The effect of water exposure after tympanostomy tube insertion. 

 2) Based on personal experience, ear plugs should be worn.

The argument:

When there's a tube present through the eardrum, any water that gets into the ear canal can potentially go through the tube and into the middle ear space and cause an infection (otitis media). The middle ear space should remain sterile, but if the water is contaminated with germs, this sterile space becomes violated.

Remember, germs found in swimming pools, lakes, rivers, and oceans can be quite funky to say the least. Think of all the birds and animals that go potty in such bodies of water (let alone humans). Read more about poop in swimming pools.

Furthermore, there is a type of ear infection called Swimmer's Ear (otitis externa) which is an infection of the skin lining the ear canal. If swimming can cause Swimmer's Ear, than by golly, it certainly can cause middle ear infections as well.

Also, if swimming can cause life-threatening brain eating amoebic infections (amoeba travels into the nose and up into the brain), than by golly, such water getting into the ear can certainly cause ear infections.

Though research does not necessarily bear this argument out, many ENTs have noted from personal experience that it is not uncommon that a patient with ear tubes presents with a draining ear infection within a few days of swimming.

Given water precautions take minimal effort and costs little ($10 ear plugs or swim cap or ear bands... see below), it seems worth it to play it on safe side.

Conclusion?

What do I typically recommend? Ear plugs when swimming, but not necessary when taking a bath (given tap water is theoretically clean).

Many will disagree depending on who you ask, but that's my personal opinion.

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Amoeba Deaths from Neti-Pot Use and How to Minimize Risk

In the past few weeks, there have been numerous stories about the 2nd death in Louisiana from Neti-Pot use leading to an amoeba infection of the brain. The culprit organism Naegleria fowleri causes a life-threatening encephalitis after passing thru the nose and up into the brain where the organism eats neurons for food.

As such, recommendations have been issued to use water as instructed with the Neti-Pot packaging... water should be boiled, distilled, or filtered.

However, before the millions of people who may have elected to simply use tap-water change their daily routine, consider that more commonly, swimming in warm lakes or rivers causes 2-3 amoeba related deaths per year... and swimming in and of itself leads to thousands of drownings per year. So far, there have been only TWO amoeba-related deaths linked with Neti-Pot usage that we know of so far.

In any case, lets talk about boiled, distilled, or filtered water and what a Neti-Pot user can do to keep their daily routine simple. After all, it is so simple to simply fill the container with running tap-water. The additional step to keep things safe can become annoying.

Boiled Water: Naegleria fowleri can not survive in temperatures above 47°C. As such, by boiling water, you guarantee death if any are present in the water. Typically, boil for for 3-5 minutes and cool to lukewarm before storage.

Save time by boiling a large amount of water and storing in 1+ gallon containers for daily use.

Distilled Water: By definition, distillation involves boiling the water and then condensing the steam into a clean container. It's a slow process, but it not only kills any micro-organisms much like simple boiling does, but also removes any inorganic "impurities" that may be harmful like mercury as well as beneficial minerals including calcium, magnesium, and sodium. Distillation does not discriminate.

It is not feasible for most individuals to set up a home water distillation process just so they can use the Neti-Pot. Though can get expensive over the years, save time by purchasing large volumes of distilled water to have at home. But, there are portable water distilling machines you can purchase as well.

 

Filtered Water: Water that is filtered is cleaned by means of a fine physical barrier, a chemical process or a biological process. In most homes, filtered water is almost universally achieved by a physical barrier. There are numerous vendors out there that sell devices to filter the water including Pur Water and Brita.

Alternative filters should contain pores at least 1 micron in size or smaller.

Save time by purchasing a faucet attachment that automatically filters water into your Neti-Pot when you need it.

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