8-month-old deaf toddler Jonathan reacts to the activation of his cochlear implant.
Friday, May 28, 2010
Tuesday, May 11, 2010
Snakebites About to Get a Lot More Deadly
The cure for North American coral snake bite is about to disappear. Why an unprofitable anti-venom may end up costing lives.
By Glenn Derene
As venomous snakes go, the coral snake is a clumsy biter. Unlike pit vipers such as rattlesnakes and cottonmouths, which have gruesomely efficient fangs that articulate forward during a strike and inject venom like hypodermic needles, the brightly colored coral snake has small, rear-facing fangs that guide venom into a wound. This process doesn't always work well--experts estimate that 25 percent of coral snake envenomations are dry bites--which is perhaps why the coral is so unaggressive. The snake is found throughout Florida, as well as in parts of Alabama, South Carolina, Louisiana, Texas and Arizona, but there are generally only about 100 or so bites each year.
What the coral lacks in belligerence, it makes up for in neurotoxicity. Unlike bites from pit vipers, which cause immense pain and swelling at the wound site, coral snake victims usually report little pain after being bitten. But the effects begin to show within hours, with symptoms such as tingling sensations in the extremities, dysarthria (slurred speech) and ptosis (droopy eyelids). Then a victim's lungs shut down. "The venom acts as a neuromuscular blockade to the lungs," University of Florida professor of medicine Craig Kitchens says. "Without antivenom, you need artificial respiration or you die."
Unfortunately, after Oct. 31 of this year, there may be no commercially available antivenom (antivenin) left. That's the expiration date on existing vials of Micrurus fulvius, the only antivenom approved by the Food and Drug Administration for coral snake bites. Produced by Wyeth, now owned by Pfizer, the antivenom was approved for sale in 1967, in a time of less stringent regulation.
Wyeth kept up production of coral snake antivenom for almost 40 years. But given the rarity of coral snake bites, it was hardly a profit center, and the company shut down the factory that made the antivenom in 2003. Wyeth worked with the FDA to produce a five-year supply of the medicine to provide a stopgap while other options were pursued. After that period, the FDA extended the expiration date on existing stock from 2008 to 2009, and then again from 2009 to 2010. But as of press time, no new manufacturer has stepped forward.
Antivenom shortages are a surprisingly common occurrence. The entire state of Arizona ran out of antivenom for scorpion stings after Marilyn Bloom, an envenomation specialist at Arizona State University, retired in 1999. Bloom had been single-handedly making all the scorpion antivenom for state hospitals. Recently, Merck & Co, the only FDA-licensed producer of black widow antivenom, has cut back distribution because of a production shortage of the drug. In a 2007 report, the World Health Organization listed worldwide envenomations as a "neglected public health issue."
New scorpion and black widow antivenoms are currently in the pipeline, thanks to efforts by several poison-control associations to speed foreign drugs into the market through FDA research programs. There is also a coral snake antivenom produced by Mexican drug manufacturer Instituto Bioclon that researchers believe could be even more effective and safe than the outgoing Wyeth product. But that drug, Coralmyn, is not currently licensed for sale by the FDA. The tests required for licensing would cost millions of dollars, and for such a rare treatment (there are 15 times as many scorpion stings per year as coral snake bites), it could take decades for Bioclon to make its money back.
Envenomation experts express exasperation and disbelief at the situation. "It's ridiculous that we're losing a technology that we already have," says Joe Pittman, a snakebite treatment specialist at the Florida Poison Information Center in Tampa. "It's even more ludicrous that we have a product that's available, and we have to jump through so many hoops to get it approved." In July 2009, an FDA advisory board determined that Coralmyn qualified for an accelerated approval process, but there is still no one with the estimated $3 million to $5 million to pay for the required studies.
"Nobody in this situation is being a bad actor," says Eric Lavonas of the Rocky Mountain Poison and Drug Center. "We just don't have a system set up to deal with it." With no adequate replacement for coral snake antivenom, hospitals are likely to appeal to local zoos, many of which maintain small stocks for their staff. But zoos are under no obligation to provide the medicine.
If and when shortages do occur, many hospitals will have no other option but to intubate coral snake bite victims on ventilators for weeks until the effects of the toxin wear off--potentially costing hundreds of thousands of dollars per bite. "It's probably going to end up costing us far more not to deal with this than to deal with it," Lavonas says, "both in human suffering, and in dollars and cents."
By Glenn Derene
As venomous snakes go, the coral snake is a clumsy biter. Unlike pit vipers such as rattlesnakes and cottonmouths, which have gruesomely efficient fangs that articulate forward during a strike and inject venom like hypodermic needles, the brightly colored coral snake has small, rear-facing fangs that guide venom into a wound. This process doesn't always work well--experts estimate that 25 percent of coral snake envenomations are dry bites--which is perhaps why the coral is so unaggressive. The snake is found throughout Florida, as well as in parts of Alabama, South Carolina, Louisiana, Texas and Arizona, but there are generally only about 100 or so bites each year.
What the coral lacks in belligerence, it makes up for in neurotoxicity. Unlike bites from pit vipers, which cause immense pain and swelling at the wound site, coral snake victims usually report little pain after being bitten. But the effects begin to show within hours, with symptoms such as tingling sensations in the extremities, dysarthria (slurred speech) and ptosis (droopy eyelids). Then a victim's lungs shut down. "The venom acts as a neuromuscular blockade to the lungs," University of Florida professor of medicine Craig Kitchens says. "Without antivenom, you need artificial respiration or you die."
Unfortunately, after Oct. 31 of this year, there may be no commercially available antivenom (antivenin) left. That's the expiration date on existing vials of Micrurus fulvius, the only antivenom approved by the Food and Drug Administration for coral snake bites. Produced by Wyeth, now owned by Pfizer, the antivenom was approved for sale in 1967, in a time of less stringent regulation.
Wyeth kept up production of coral snake antivenom for almost 40 years. But given the rarity of coral snake bites, it was hardly a profit center, and the company shut down the factory that made the antivenom in 2003. Wyeth worked with the FDA to produce a five-year supply of the medicine to provide a stopgap while other options were pursued. After that period, the FDA extended the expiration date on existing stock from 2008 to 2009, and then again from 2009 to 2010. But as of press time, no new manufacturer has stepped forward.
Antivenom shortages are a surprisingly common occurrence. The entire state of Arizona ran out of antivenom for scorpion stings after Marilyn Bloom, an envenomation specialist at Arizona State University, retired in 1999. Bloom had been single-handedly making all the scorpion antivenom for state hospitals. Recently, Merck & Co, the only FDA-licensed producer of black widow antivenom, has cut back distribution because of a production shortage of the drug. In a 2007 report, the World Health Organization listed worldwide envenomations as a "neglected public health issue."
New scorpion and black widow antivenoms are currently in the pipeline, thanks to efforts by several poison-control associations to speed foreign drugs into the market through FDA research programs. There is also a coral snake antivenom produced by Mexican drug manufacturer Instituto Bioclon that researchers believe could be even more effective and safe than the outgoing Wyeth product. But that drug, Coralmyn, is not currently licensed for sale by the FDA. The tests required for licensing would cost millions of dollars, and for such a rare treatment (there are 15 times as many scorpion stings per year as coral snake bites), it could take decades for Bioclon to make its money back.
Envenomation experts express exasperation and disbelief at the situation. "It's ridiculous that we're losing a technology that we already have," says Joe Pittman, a snakebite treatment specialist at the Florida Poison Information Center in Tampa. "It's even more ludicrous that we have a product that's available, and we have to jump through so many hoops to get it approved." In July 2009, an FDA advisory board determined that Coralmyn qualified for an accelerated approval process, but there is still no one with the estimated $3 million to $5 million to pay for the required studies.
"Nobody in this situation is being a bad actor," says Eric Lavonas of the Rocky Mountain Poison and Drug Center. "We just don't have a system set up to deal with it." With no adequate replacement for coral snake antivenom, hospitals are likely to appeal to local zoos, many of which maintain small stocks for their staff. But zoos are under no obligation to provide the medicine.
If and when shortages do occur, many hospitals will have no other option but to intubate coral snake bite victims on ventilators for weeks until the effects of the toxin wear off--potentially costing hundreds of thousands of dollars per bite. "It's probably going to end up costing us far more not to deal with this than to deal with it," Lavonas says, "both in human suffering, and in dollars and cents."
Tuesday, April 6, 2010
Parkinson's patient's cycling ability stuns doctors
BY GINA KOLATA
NEW YORK TIMES
Monday, Apr. 05 2010
Dr. Bastiaan R. Bloem of the Radboud University Nijmegen Medical Center in the
Netherlands thought he had seen it all in his years of caring for patients with
Parkinson's disease. But the 58-year-old man who came to see him recently was a
total surprise.
The man had had Parkinson's disease for 10 years, and it had progressed until
he was severely affected. Parkinson's, a neurological disorder in which some of
the brain cells that control movement die, had made him unable to walk. He
trembled and could walk only a few steps before falling. He froze in place, his
feet feeling as if they were bolted to the floor.
But the man told Bloem something amazing: He said he was a regular exerciser —
a cyclist, in fact — something that should not be possible for patients at his
stage of the disease, Bloem thought.
"He said, 'Just yesterday I rode my bicycle for 10 kilometers' — six miles,"
Bloem said. "He said he rides his bicycle for miles and miles every day.
"I said, 'This cannot be,'" Bloem, a professor of neurology and medical
director of the hospital's Parkinson's Center, recalled in a telephone
interview. "This man has end-stage Parkinson's disease. He is unable to walk."
But the man was eager to demonstrate, so Bloem took him outside where a nurse's
bike was parked.
"We helped him mount the bike, gave him a little push, and he was gone," Bloem
said. He rode, even making a U-turn, and was in perfect control, all his
Parkinson's symptoms gone.
Yet the moment the man got off the bike, his symptoms returned. He froze
immediately, unable to take a step.
Bloem made a video and photos of the man trying to walk and then riding his
bike. The photos appear in the April 1 issue of The New England Journal of
Medicine.
After seeing that man, Bloem asked 20 other severely affected patients about
riding a bike. It turned out that all could do it, though it is not clear why.
Bloem and other Parkinson's specialists were amazed. People with Parkinson's
disease can often dance, run, walk smoothly and do complex movements for a few
minutes if they are given appropriate signals — emotional or visual cues. There
are famous examples, such as a group of Parkinson's patients who were caught in
a fire and managed to run down steps and escape, only to freeze in place when
they got outside.
But this effect, known as the kinesia paradox, does not last long. Riding for
miles and miles is very different from walking for a few minutes. And until
now, Bloem said, it was not known that patients with Parkinson's could ride
bikes.
He said bicycling offers patients an opportunity to be symptom-free while they
are riding, to look and feel normal, and to get some real cardiovascular
exercise.
Bloem said he hoped that perhaps regular exercise might slow the progress of
Parkinson's disease. It does in rats, he said.
NEW YORK TIMES
Monday, Apr. 05 2010
Dr. Bastiaan R. Bloem of the Radboud University Nijmegen Medical Center in the
Netherlands thought he had seen it all in his years of caring for patients with
Parkinson's disease. But the 58-year-old man who came to see him recently was a
total surprise.
The man had had Parkinson's disease for 10 years, and it had progressed until
he was severely affected. Parkinson's, a neurological disorder in which some of
the brain cells that control movement die, had made him unable to walk. He
trembled and could walk only a few steps before falling. He froze in place, his
feet feeling as if they were bolted to the floor.
But the man told Bloem something amazing: He said he was a regular exerciser —
a cyclist, in fact — something that should not be possible for patients at his
stage of the disease, Bloem thought.
"He said, 'Just yesterday I rode my bicycle for 10 kilometers' — six miles,"
Bloem said. "He said he rides his bicycle for miles and miles every day.
"I said, 'This cannot be,'" Bloem, a professor of neurology and medical
director of the hospital's Parkinson's Center, recalled in a telephone
interview. "This man has end-stage Parkinson's disease. He is unable to walk."
But the man was eager to demonstrate, so Bloem took him outside where a nurse's
bike was parked.
"We helped him mount the bike, gave him a little push, and he was gone," Bloem
said. He rode, even making a U-turn, and was in perfect control, all his
Parkinson's symptoms gone.
Yet the moment the man got off the bike, his symptoms returned. He froze
immediately, unable to take a step.
Bloem made a video and photos of the man trying to walk and then riding his
bike. The photos appear in the April 1 issue of The New England Journal of
Medicine.
After seeing that man, Bloem asked 20 other severely affected patients about
riding a bike. It turned out that all could do it, though it is not clear why.
Bloem and other Parkinson's specialists were amazed. People with Parkinson's
disease can often dance, run, walk smoothly and do complex movements for a few
minutes if they are given appropriate signals — emotional or visual cues. There
are famous examples, such as a group of Parkinson's patients who were caught in
a fire and managed to run down steps and escape, only to freeze in place when
they got outside.
But this effect, known as the kinesia paradox, does not last long. Riding for
miles and miles is very different from walking for a few minutes. And until
now, Bloem said, it was not known that patients with Parkinson's could ride
bikes.
He said bicycling offers patients an opportunity to be symptom-free while they
are riding, to look and feel normal, and to get some real cardiovascular
exercise.
Bloem said he hoped that perhaps regular exercise might slow the progress of
Parkinson's disease. It does in rats, he said.
Friday, April 2, 2010
A finch's decoded genome might help us with speech
By Kim McGuire
ST. LOUIS POST-DISPATCH
03/31/2010
When we hear a song for the first time, it often seems like it goes in one ear and out the other, sometimes only few catchy words from a chorus leaving much of an impression.
bullet Hear the sounds of the zebra finch
But when the Australian zebra finch hears its father sing for the first time, those simple melodies activate large, complex gene networks in the bird’s brain, according to new research by an international team of scientists that includes researchers from Washington University and the University of Illinois at Urbana-Champaign.
The findings, published today in the journal Nature, reveal how the team successfully decoded the genome of the zebra finch, only the second bird to have its genetic code completely mapped.
The project provides new insights that will help scientists understand how humans learn language and may someday provide insights into diseases like autism that can inhibit speech, team members say.
"Now we can look deep into the genome, not just at the genes involved in vocal learning, but that the complex ways in which they are regulated," said Richard K. Wilson, the research’s senior author and director of Washington University’s Genome Center. "This information provides clues to how vocal learning occurs at the most basic molecular level in birds and people."
Past research has shown that hundreds of genes light up in the finch’s brain as the bird learns a new song.
The new research show that significantly more genes — about 800 total — are activated by the act of singing.
The team selected the zebra finch for study because songbirds are among few animals that learn how to sing — just like humans. As young birds, the finch "babbles" but eventually learns how to imitate its father.
In contrast, a chicken, the other bird to have its genome sequenced, instinctively knows how cluck. It is not a form of communication learned from other birds.
"There is a functional development parallel between the way a bird learns to sing and a human learns to speak," said David Clayton, a neuroscience professor at the University of Illinois and leader of the group that proposed the genome sequencing project. "The avian brain is quite different in a superficial detail from the mammalian brain or the human brain, but some striking parallels have emerged."
Wes Warren, lead author and genetics professor at Washington University, explained that the zebra finch proved to be the model study organism because they learn to sing in a predictable way over a relatively short span of time and many of their genes are conserved in humans.
Now, scientists can conduct future studies to identify a core set of genes in the finch’s brain and see if any of these are disrupted in people with speech disorders caused stuttering, or stroke and by diseases like autism and Parkinson’s, Warren said.
"It’s just amazing to know that when the finch hears a song, there’s always a gene that corresponds in the brain," he said. "Clearly, that’s going to be even more complex in humans."
Warren said as more animals have their genes sequenced, scientists will be able to draw more comparisons that might yield insight into human development.
Next up for some of the Washington University scientists who participated in the finch project is the sequencing of the parrot genome, which is slated for completion sometime later this year.
ST. LOUIS POST-DISPATCH
03/31/2010
When we hear a song for the first time, it often seems like it goes in one ear and out the other, sometimes only few catchy words from a chorus leaving much of an impression.
bullet Hear the sounds of the zebra finch
But when the Australian zebra finch hears its father sing for the first time, those simple melodies activate large, complex gene networks in the bird’s brain, according to new research by an international team of scientists that includes researchers from Washington University and the University of Illinois at Urbana-Champaign.
The findings, published today in the journal Nature, reveal how the team successfully decoded the genome of the zebra finch, only the second bird to have its genetic code completely mapped.
The project provides new insights that will help scientists understand how humans learn language and may someday provide insights into diseases like autism that can inhibit speech, team members say.
"Now we can look deep into the genome, not just at the genes involved in vocal learning, but that the complex ways in which they are regulated," said Richard K. Wilson, the research’s senior author and director of Washington University’s Genome Center. "This information provides clues to how vocal learning occurs at the most basic molecular level in birds and people."
Past research has shown that hundreds of genes light up in the finch’s brain as the bird learns a new song.
The new research show that significantly more genes — about 800 total — are activated by the act of singing.
The team selected the zebra finch for study because songbirds are among few animals that learn how to sing — just like humans. As young birds, the finch "babbles" but eventually learns how to imitate its father.
In contrast, a chicken, the other bird to have its genome sequenced, instinctively knows how cluck. It is not a form of communication learned from other birds.
"There is a functional development parallel between the way a bird learns to sing and a human learns to speak," said David Clayton, a neuroscience professor at the University of Illinois and leader of the group that proposed the genome sequencing project. "The avian brain is quite different in a superficial detail from the mammalian brain or the human brain, but some striking parallels have emerged."
Wes Warren, lead author and genetics professor at Washington University, explained that the zebra finch proved to be the model study organism because they learn to sing in a predictable way over a relatively short span of time and many of their genes are conserved in humans.
Now, scientists can conduct future studies to identify a core set of genes in the finch’s brain and see if any of these are disrupted in people with speech disorders caused stuttering, or stroke and by diseases like autism and Parkinson’s, Warren said.
"It’s just amazing to know that when the finch hears a song, there’s always a gene that corresponds in the brain," he said. "Clearly, that’s going to be even more complex in humans."
Warren said as more animals have their genes sequenced, scientists will be able to draw more comparisons that might yield insight into human development.
Next up for some of the Washington University scientists who participated in the finch project is the sequencing of the parrot genome, which is slated for completion sometime later this year.
Sunday, March 28, 2010
Sex-Crazed Bugs Unleashed in Israel
One of the great challenges of modern agriculture is how to use technology to mass produce crops while sparing consumers from the harmful chemicals and byproducts of the agricultural process. Though meant to kill harmful insects, pesticides carry a very serious risk to the environment.
While studies have shown that mankind is developing cancer and other diseases at a higher rate due to exposure to pesticides, the crop-killing vermin are only becoming more immune to its effects. At the Hebrew University of Jerusalem, researchers have discovered a way to safely eliminate insects without the need for harmful chemicals.
Professor Boaz Yuval at the university’s Robert H. Smith Faculty of Food, Agriculture and the Environment believes that sex is the key.
If you can sterilize male insects before they copulate with females, these females will be unable to lay eggs. The problem, however, is that males who are sterilized also lose their sex drive, leaving the females to mate with male insects who are not sterilized.
Researchers at the Hebrew University of Jerusalem have created a special, high protein, bacteria-enhanced “breakfast of champions” to sterilize males. By greatly increasing their sex drive and sexual performance, females spend all of their time with these Casanova sex-crazed males and never are able to lay eggs of their own.
While original applications of this research will be for plant and animal pests, many are looking to see how this work can be applied to stop the spread of organisms carrying human diseases.
While studies have shown that mankind is developing cancer and other diseases at a higher rate due to exposure to pesticides, the crop-killing vermin are only becoming more immune to its effects. At the Hebrew University of Jerusalem, researchers have discovered a way to safely eliminate insects without the need for harmful chemicals.
Professor Boaz Yuval at the university’s Robert H. Smith Faculty of Food, Agriculture and the Environment believes that sex is the key.
If you can sterilize male insects before they copulate with females, these females will be unable to lay eggs. The problem, however, is that males who are sterilized also lose their sex drive, leaving the females to mate with male insects who are not sterilized.
Researchers at the Hebrew University of Jerusalem have created a special, high protein, bacteria-enhanced “breakfast of champions” to sterilize males. By greatly increasing their sex drive and sexual performance, females spend all of their time with these Casanova sex-crazed males and never are able to lay eggs of their own.
While original applications of this research will be for plant and animal pests, many are looking to see how this work can be applied to stop the spread of organisms carrying human diseases.
Eye Spy Israeli Nanotechnology
The Wall Street Journal’s MarketWatch website reports that Nano Retina, based in Herzliya, has developed a system of retinal implants to help people suffering from macular degeneration, complications of diabetes, and other diseases that affect vision.
Without getting all technical, the Bio-Retina would be implanted into the eye and actually glued over one’s natural but damaged retina. As light enters the eye, the Bio-Retina converts it into tiny electrical impulses and sends them off to the brain, essentially functioning just as a normal, healthy retina would. Best part? The procedure takes about half an hour. Heck, that’s faster than most dentist visits.
Unsurprisingly, Nano Retina’s innovative chief executive Ra’anan Gefen comes from a background of technology development in Israel’s military. Nano Retina isn’t a one-man show, though. The company is a joint venture of Rainbow Medical, also of Herzliya, and Zyvex Labs of Texas. (And, to be fair, we should mention that U.S.-based Second Sight Medical Products is also working on its own solution.)
Will bionic eyes become standard fare? Will macular degeneration become a thing of the past? Will the carrot industry survive? Only time will tell.
Without getting all technical, the Bio-Retina would be implanted into the eye and actually glued over one’s natural but damaged retina. As light enters the eye, the Bio-Retina converts it into tiny electrical impulses and sends them off to the brain, essentially functioning just as a normal, healthy retina would. Best part? The procedure takes about half an hour. Heck, that’s faster than most dentist visits.
Unsurprisingly, Nano Retina’s innovative chief executive Ra’anan Gefen comes from a background of technology development in Israel’s military. Nano Retina isn’t a one-man show, though. The company is a joint venture of Rainbow Medical, also of Herzliya, and Zyvex Labs of Texas. (And, to be fair, we should mention that U.S.-based Second Sight Medical Products is also working on its own solution.)
Will bionic eyes become standard fare? Will macular degeneration become a thing of the past? Will the carrot industry survive? Only time will tell.
Thursday, March 11, 2010
The Truth About Urine
The Truth About Urine
What do urine color and odor changes mean? How often should you 'go'? Find out.
By Stephanie Watson
WebMD FeatureReviewed by Louise Chang, MD
March 11, 2010
Urine isn't something most people talk about. We barely give it more than a passing glance as it swirls out of sight down the toilet bowl. Yet changes in the urine – its color, odor, and consistency – can provide important clues about the status of your body. Your urine can reveal what you've been eating, how much you've been drinking, and what diseases you have.
"Urine and urinalysis have, for hundreds of years, been one of the ways physicians have looked at health," says Tomas Griebling, MD, MPH, vice chair of the urology department at the University of Kansas.
"From a historical view, urinalysis was one of the original windows into what's happening in the body," Griebling says. That's because many of the substances circulating in your body, including bacteria, yeast, excess protein and sugar, eventually make their way into the urine.
Urine is an important part of the body's disposal process. Its job is to remove the extra water and water-soluble wastes the kidneys filter out of the blood. "The urine is there primarily to get rid of toxins or things that would otherwise build up in the body that would be bad for the body," says Anthony Smith, MD, professor and chief of urology at the University of New Mexico.
When you notice that your urine has changed color, or there's a strange odor wafting up from the toilet, the cause might be something as harmless as what you had for dinner (which could have included beets or asparagus). It also might be a sign of a more serious condition, such as an infection or cancer.
Before you flush, here are a few urine changes to look out for, and what they might be saying about your health.
Color Changes
Urine gets its yellow color from a pigment called urochrome. That color normally varies from pale yellow to deep amber, depending on the concentration of the urine. Darker urine is usually a sign that you're not drinking enough fluid. "Your body needs a certain amount of fluid to function, so the body will hold on to fluid and the urine will become very strong and concentrated. When that happens, it will turn a darker color," Griebling says.
The opposite is also true. If your urine is very pale, it means that you're either drinking a lot of fluid, or you're taking a diuretic -- a drug that forces the body to get rid of excess water.
Urine can turn a rainbow of colors, and an unusual hue isn't necessarily cause for alarm. Certain medications can turn the urine fluorescent green or blue, carrots can tint it orange, vitamins can give it a yellow hue, and an inherited disease called porphyria can shade it the color of port wine.
Seeing red is typically a sign that there is blood in the urine, but before you panic, know that a little blood can produce a dramatic color change. "What I always tell patients is it takes one drop of blood to turn a toilet bowl red," Smith says.
That said, just a little blood in the urine can be a sign of something serious, like an infection or cancer, and it warrants a visit to your doctor or urologist. If you're seeing blood and your urine is also cloudy, there's a good chance you've picked up an infection, Smith says.
Odor Changes
Urine normally doesn't have a very strong smell. If you get a whiff of something particularly pungent, you could have an infection or urinary stones, which can create an ammonia-like odor. Diabetics might notice that their urine smells sweet, because of excess sugar. In the past, doctors would actually taste urine for this sweetness to diagnose diabetes.
Some foods can also change urine odor. Asparagus is among the most notorious. What people are smelling when they eat asparagus is the breakdown of a sulfur compound called methyl mercaptan (the same compound found in garlic and skunk secretions). If you catch a whiff of something after eating a plate of asparagus, it means that you've inherited the gene for the enzyme that breaks down mercaptan. Not everyone has this enzyme and, therefore, not everyone can smell it.
How Often Do You Need to Go?
How often you need to go can be as important an indicator of your health as the color or smell of your urine. Most people take bathroom breaks about six to eight times a day, but you might go more or less depending on how much fluid you drink. If you're constantly feeling the urge to go and it's not because you're not drinking extra fluid, causes can include:
Overactive bladder -- involuntary contractions of the bladder muscle
Urinary tract infection
Interstitial cystitis -- a condition that causes the bladder wall to become inflamed and irritated
Benign prostate enlargement -- growth of the prostate that causes it to squeeze the urethra and block the normal flow of urine out of the body
Neurological diseases, including stroke and Parkinson's disease
Diabetes
The opposite problem -- not going to the bathroom enough -- can occur when there is a blockage or infection. Or, it can be the result of bad bathroom habits. Some people -- especially teachers, surgeons, and anyone else who doesn't have time for regular bathroom breaks throughout the day -- tend to hold it in.
Delaying urination can be problematic, says Smith, who compares the bladder to a Slinky: It stretches and then contracts repeatedly, but eventually it can stretch too much to bounce back. "The bladder can develop a chronic overdistension…a chronic emptying problem," he says.
Developing Healthy Bathroom Habits
Take good care of your bladder, and it will thank you by helping you urinate regularly. To avoid having to make too many bathroom visits, stay hydrated, but not overhydrated. Drink whenever you're thirsty, but don't feel as though you have to adhere to the eight-glasses-a-day recommendation (unless you have kidney or bladder stones, in which case you'll need to increase your fluid intake).
If you're getting up during the night to use the bathroom, stop drinking three to four hours before bedtime. Limit caffeine, which can irritate the lining of the bladder. Also watch your intake of alcohol, which can have similar effects.
Finally, don't hold it in. As soon as you feel the urge to go, excuse yourself from whatever you're doing and find a bathroom.
What do urine color and odor changes mean? How often should you 'go'? Find out.
By Stephanie Watson
WebMD FeatureReviewed by Louise Chang, MD
March 11, 2010
Urine isn't something most people talk about. We barely give it more than a passing glance as it swirls out of sight down the toilet bowl. Yet changes in the urine – its color, odor, and consistency – can provide important clues about the status of your body. Your urine can reveal what you've been eating, how much you've been drinking, and what diseases you have.
"Urine and urinalysis have, for hundreds of years, been one of the ways physicians have looked at health," says Tomas Griebling, MD, MPH, vice chair of the urology department at the University of Kansas.
"From a historical view, urinalysis was one of the original windows into what's happening in the body," Griebling says. That's because many of the substances circulating in your body, including bacteria, yeast, excess protein and sugar, eventually make their way into the urine.
Urine is an important part of the body's disposal process. Its job is to remove the extra water and water-soluble wastes the kidneys filter out of the blood. "The urine is there primarily to get rid of toxins or things that would otherwise build up in the body that would be bad for the body," says Anthony Smith, MD, professor and chief of urology at the University of New Mexico.
When you notice that your urine has changed color, or there's a strange odor wafting up from the toilet, the cause might be something as harmless as what you had for dinner (which could have included beets or asparagus). It also might be a sign of a more serious condition, such as an infection or cancer.
Before you flush, here are a few urine changes to look out for, and what they might be saying about your health.
Color Changes
Urine gets its yellow color from a pigment called urochrome. That color normally varies from pale yellow to deep amber, depending on the concentration of the urine. Darker urine is usually a sign that you're not drinking enough fluid. "Your body needs a certain amount of fluid to function, so the body will hold on to fluid and the urine will become very strong and concentrated. When that happens, it will turn a darker color," Griebling says.
The opposite is also true. If your urine is very pale, it means that you're either drinking a lot of fluid, or you're taking a diuretic -- a drug that forces the body to get rid of excess water.
Urine can turn a rainbow of colors, and an unusual hue isn't necessarily cause for alarm. Certain medications can turn the urine fluorescent green or blue, carrots can tint it orange, vitamins can give it a yellow hue, and an inherited disease called porphyria can shade it the color of port wine.
Seeing red is typically a sign that there is blood in the urine, but before you panic, know that a little blood can produce a dramatic color change. "What I always tell patients is it takes one drop of blood to turn a toilet bowl red," Smith says.
That said, just a little blood in the urine can be a sign of something serious, like an infection or cancer, and it warrants a visit to your doctor or urologist. If you're seeing blood and your urine is also cloudy, there's a good chance you've picked up an infection, Smith says.
Odor Changes
Urine normally doesn't have a very strong smell. If you get a whiff of something particularly pungent, you could have an infection or urinary stones, which can create an ammonia-like odor. Diabetics might notice that their urine smells sweet, because of excess sugar. In the past, doctors would actually taste urine for this sweetness to diagnose diabetes.
Some foods can also change urine odor. Asparagus is among the most notorious. What people are smelling when they eat asparagus is the breakdown of a sulfur compound called methyl mercaptan (the same compound found in garlic and skunk secretions). If you catch a whiff of something after eating a plate of asparagus, it means that you've inherited the gene for the enzyme that breaks down mercaptan. Not everyone has this enzyme and, therefore, not everyone can smell it.
How Often Do You Need to Go?
How often you need to go can be as important an indicator of your health as the color or smell of your urine. Most people take bathroom breaks about six to eight times a day, but you might go more or less depending on how much fluid you drink. If you're constantly feeling the urge to go and it's not because you're not drinking extra fluid, causes can include:
Overactive bladder -- involuntary contractions of the bladder muscle
Urinary tract infection
Interstitial cystitis -- a condition that causes the bladder wall to become inflamed and irritated
Benign prostate enlargement -- growth of the prostate that causes it to squeeze the urethra and block the normal flow of urine out of the body
Neurological diseases, including stroke and Parkinson's disease
Diabetes
The opposite problem -- not going to the bathroom enough -- can occur when there is a blockage or infection. Or, it can be the result of bad bathroom habits. Some people -- especially teachers, surgeons, and anyone else who doesn't have time for regular bathroom breaks throughout the day -- tend to hold it in.
Delaying urination can be problematic, says Smith, who compares the bladder to a Slinky: It stretches and then contracts repeatedly, but eventually it can stretch too much to bounce back. "The bladder can develop a chronic overdistension…a chronic emptying problem," he says.
Developing Healthy Bathroom Habits
Take good care of your bladder, and it will thank you by helping you urinate regularly. To avoid having to make too many bathroom visits, stay hydrated, but not overhydrated. Drink whenever you're thirsty, but don't feel as though you have to adhere to the eight-glasses-a-day recommendation (unless you have kidney or bladder stones, in which case you'll need to increase your fluid intake).
If you're getting up during the night to use the bathroom, stop drinking three to four hours before bedtime. Limit caffeine, which can irritate the lining of the bladder. Also watch your intake of alcohol, which can have similar effects.
Finally, don't hold it in. As soon as you feel the urge to go, excuse yourself from whatever you're doing and find a bathroom.
Subscribe to:
Posts (Atom)