She reportedly received an embolization for a “benign” condition and will be hospitalized through the end of the week. Some thoughts on this development:

Embolizations are most commonly done through one of the main femoral or groin arteries and it does not require a large incision. Typically a large bore needle with a sheath is placed into the artery by an interventional radiologist and then under flouroscopy an embolization catheter is threaded up towards in the aorta until the renal or kidney artery is reached. The catheter can then be threaded into the renal artery to the area of concern in the kidney.

After the catheter is placed correctly, a coil or foam is placed into the artery blocking the artery and “killing the tissue” beyond the blockage. Sometimes a dye is injected into the body’s arterial system to confirm that dye does not reach beyond the blockage. The catheter and sheath are then removed, with the small hole in the artery closed using a device specially designed to place a suture around the arterial puncture site.

Embolizing tissue in a solid organ is done very commonly by interventional radiologists, most usually to choke off blood supply to a tumor or cancer. However, it is not usually the first procedure done when a cancer that can be removed surgically is present, as are most kidney cancers. It can be done to “kill tissue” that is forming a cyst.

Generally embolizations for a small amount of benign tissue or a small cyst would not require a post-op stay of 3-4 days. The treating team in this case will likely be checking her kidney function using creatinine and BUN (blood urea nitrogen) and will be watching the puncture site to detect any development of pseudoaneurysm.

However, there is much that is left out of today’s report that would be helpful to know to fully ascertain the condition and care Mrs. Trump has received.

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Dr. Jerome Adams

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Multiple sources today are reporting that he was under continuing care of a physician who recommended that he stop flying as a commercial airline pilot for Lufthansa controlled Germanwings air service.

Lubitz seems to be a well-liked, non-controversial young man from a stable upbringing who by all accounts loved being a pilot.

What could have caused him to fly his airliner with another 149 people aboard to their certain annihilation into a French mountainside? One wonders what medical condition would cause a professional pilot to do this?

Lyme disease is a possibility. Sadly, this tick borne illness is endemic in Germany. Once infected with the Borrelia microbe it can be very difficult to eradicate. It can cause a myriad of symptoms and up to 25% of those infected either present or manifest significant psychiatric symptoms.

These mental illness problems include depression and erratic behavior up to frank psychotic symptoms.

It appears that Andreas Lubitz had a medical condition of some sort in 2009 that delayed his pilot training. After treatment, he was cleared to begin his professional flying career.

Lyme disease, like its spirochetal cousin syphilis many decades earlier, is known by medical professionals as the great imitator. It can cause many different disease symptoms, is difficult to diagnose, and a very difficult infection to eradicate.

It has felled many healthy young German adults who are chronically ill with a relapsing, remitting pattern of symptoms, including psychiatric maladies.

Clearly, there was something terribly wrong with Andreas Lubitz and there had been for many years. His doctors were trying to get him out of the cockpit. Tragically for the 149 lost souls, it was too late.

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He recently published a report in Hernia that suggested folding the top third of the mesh back onto the middle third to reduce the number of microgrips attaching directly to the skin.

This still allows for microgrips to attach to tissue of the pubic bone and inguinal ligament in the most immediate area of the hernia space.

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It is a normally occurring bacteria in the intestines, bile ducts, and genitourinary system. However, when there is local overgrowth due to other flora being suppressed (especially by cephalosporins) it causes clinically important urinary and biliary tract infections.

Interestingly, Enterococcus faecalis has an outer capsule that prevents it from being degraded by bile salts.

Of particular worry is the ability of Enterococcus faecalis to enter the bloodstrean and colonize heart valves in subacute bacterial endocarditis.

There is a heightened risk of subacute bacterial endocarditis in heart valves that have previously been damaged by Group A streptococcus such as in rheumatic fever.

All strains of E. faecalis are resistant to cephalosporins and there are now some strains resistant to vancomycin.

The diagnosis is made by culturing in 40% bile and 6.5% sodium chloride solution.

Treatment most commonly is ampicillin or vancomycin if no resistance is present and an aminoglycoside

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Patrick Schloss, Ph.D, and colleagues analyzed the microbiome of stool samples from 30 healthy volunteers, 30 patients with known colon adenomas, and 30 with known colorectal cancer.

The researchers determined that several microbial gene sequences, when absent, were highly suggestive of the presence of either adenomas or colorectal cancer. The sensitivity for both conditions was 90% with the specificity of the gene sequence absence being 80% and 83% respectively.

In addition, the absence of four specific gene sequences in the microbial environment in the guy allowed better distinction between adenoma and colorectal cancer than did fecal occult blood testing.

This study builds on previous research that showed that patients with an overgrowth of some bacterial species such as Fusobacterium and Bacteroides fragilis is associated with increased risk of colorectal cancer.

Likely important protective bacteria that are missing in colons with colorectal cancer are Clostridium, Bacteroides, and Lachnospiraceae.

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The antibiotic, dubbed teixobactin, is still in clinical trials with animals.

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Depending on cell type, each cell has a different sensitivity. In descending order of radiation sensitivity these cells are:

tumor cells
endothelium
fibroblasts
muscle
nerve cells

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