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Maximilian Sauer, ETH Zürich
Maximilian Sauer, ETH Zürich

Tiny Hooks Keep UTI Bacteria From Being Flushed Out When You Pee

Maximilian Sauer, ETH Zürich
Maximilian Sauer, ETH Zürich

Urinary tract infections (UTIs) are typically treated with antibiotics, but according to New Scientist, new information about how the bacteria work could lead to a different method of dealing with the infections. The study, conducted by researchers from the University of Basel and the ETH Zurich, was recently published in Nature Communications.

UTIs are caused when bacteria from the large intestine, like E. coli, travel up the urinary tract. While cranberry juice can help ease symptoms and even prevent infections, taking antibiotics has been the main cure. But we may be approaching these infections the wrong way.

The researchers found that in E. coli infections, the bacteria have a protein called FimH, located at the ends of hair-like appendages. FimH has a "catch-bond mechanism" that hooks onto the sugar molecules on the surface of cells in the urinary tract. When the infected person urinates, the hooks stop the bacteria from exiting the body.

"The protein FimH is composed of two parts, of which the second non-sugar binding part regulates how tightly the first part binds to the sugar molecule," Timm Maier of the University of Basel said in a press statement. “When the force of the urine stream pulls apart the two protein domains, the sugar binding site snaps shut. However, when the tensile force subsides, the binding pocket reopens. Now the bacteria can detach and swim upstream to the urethra.”

According to the researchers, identifying the protein and how it works could lead to a new approach for treatment. If the catch-bond mechanism can be disengaged so that the bacteria can be peed out, then it becomes less important to kill the bacteria with antibiotics. Fewer antibiotics means that the bacteria are less likely to become resistant. New Scientist reports that the researchers behind the study are already testing new FimH-blocking drugs in animals.

[h/t New Scientist]

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Medicine
The 98.6℉ Myth: Why Everything You Think You Know About Body Temperature Is a Lie
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When you were kid, you probably knew that to score a magical sick day home from school, you needed to have a fever. When the thermometer came out of your mouth, it had to read higher than 98.6℉—the long-accepted "normal" human body temperature. (If you wanted to really seal the deal, you may have hoped to hit 100℉.) Since then, you may have used a temperature above 98.6℉ as a metric to work from home (or call out sick entirely).

But here's the thing: The average body temperature isn't actually 98.6℉—a fact that we've known for more than 25 years. The myth originated in the 19th century with a single doctor, and despite evidence to the contrary, it's persisted ever since.

THE GIANT—AND FAULTY—ARMPIT THERMOMETER

In 1851, Carl Wunderlich, the director of the hospital at Leipzig University, began going from room to room with a comically large thermometer in tow. He wanted to understand how body temperature is affected by different diseases, so in each room, he would hold the foot-long device in patients' armpits for a full 20 minutes, waiting for a temperature to register. Once it did, he'd note the temperature on the patient's chart (Wunderlich is thought to be the first physician to do so). He and his staff did this for years, repeatedly taking the temperatures of some 25,000 patients and logging them on their charts, until he had millions of readings. In 1868, he finally published this data in Das Verhalten der Eigenwarme in Krankheiten (On the Temperature in Diseases: A Manual of Medical Thermometry). He concluded that the average human body temperature was 98.6℉, underscoring the idea that fever is a symptom of illness, not a cause.

No one questioned Wunderlich's methods, or his average, for about 140 years. Then, in the early 1990s, internist Philip Mackowiak—a professor of medicine at the University of Maryland, a medical historian, and, apparently, a clinical thermometer junkie—saw one of the physician's instruments at the Mutter Museum in Philadelphia. He told the Freakonomics podcast that he'd always had doubts about the 98.6℉ standard. "I am by nature a skeptic," he said. "And it occurred to me very early in my career that this idea that 98.6 was normal, and then if you didn't have a temperature of 98.6, you were somehow abnormal, just didn't sit right."

Getting his hands on Wunderlich's thermometer—which the museum let him borrow—only deepened his doubts. The huge thermometer was unwieldy and non-registering, meaning, Mackowiak explained, "that it has to be read while it's in place." Not only that, but Wunderlich had used the device to measure temperatures in the armpit, which is less reliable than temperatures taken in the mouth or rectum. The instrument itself also wasn't terribly precise: It measured up to 2 degrees Centigrade higher than both ancient and modern instruments.

In 1992, Mackowiak decided to test Wunderlich's average. Using normal-sized oral thermometers and a group of volunteers, he determined that the average human body temperature actually hovers around 98.2℉. Mackowiak found that body temperature tends to vary over the course of the day, with its lowest point around 6 a.m. and its highest in the early evening. Body temperature can also fluctuate monthly (with the menstrual cycle) and over a lifetime (declining decade by decade with age), and may even be differentially linked to sex and race assignments. He concluded that normal body temperature is so unique to each person that it's almost like a fingerprint and, given that wide variation, not actually a very reliable indicator of illness.

As a result of his study, Mackowiak proposed raising the threshold for fever to 98.9℉ for temperatures taken in the morning (and 99.9℉ at other times). While it's a relatively minor change in terms of actual degrees, this fever threshold is actually lower than the CDC's, which is a temperature of 100.4℉ or higher.

There are potential real-life consequences in this gap, for everyone from students (who'd have to attend school with what would be considered a low-grade fever by Wunderlich's 98.6℉ standard) to employers and daycares (who use temperature to set attendance policies). What's more, anyone who is actually sick but ignores a low-grade fever—one that meets Mackowiak's threshold but still falls under the CDC's—could pose a risk to people with compromised immune systems trying to avoid unnecessary exposure to illness in public places.

THE BALANCING POINT

There's a reason the average trends near 98℉ instead of 92℉ or 106℉. As endotherms, mammals expend a great deal of energy maintaining body temperature when compared with cold-blooded creatures. To find and conserve a just-right body temperature, central nervous system sensors gather data (too warm? too cold? just right, Goldilocks?) and send that information to the pebble-sized hypothalamus near the base of the brain. There, the data is converted into action: releasing sweat and widening the blood vessels if too warm; raising metabolism, constricting the blood vessels, and inducing shivering if too cold.

According to a study by Aviv Bergman and Arturo Casadevall in the journal mBio, the precise balancing point for ideal body temperature is the sweet spot where the metabolic cost for all this thermoregulation balances with the evolutionary advantage of warding off fungal disease. (While warm-blooded animals are prone to bacterial or viral infections, they rarely experience fungal infections because most fungi can't withstand temperatures above 86℉. Cold-blooded animals, on the other hand, are prone to all three.) For Bergman and Casadevall, this benefit even explains what tipped Darwin's scales in favor of mammals, allowing them to edge out other vertebrates for dominance after the Cretaceous-Tertiary mass extinction wiped out the dinosaurs.

Of course, rules call for exceptions, and the one place where human body temperature demonstrates sustained elevation is outer space. Astronauts on prolonged missions clock significantly higher average body temperatures than they do when terrestrial—even up to 104℉. This so-called "space fever" is probably a product of some combination of radiation exposure, psychological stress, and immune response to weightlessness. Researchers believe this phenomenon could yield crucial information about thermoregulation—and may even offer insight into how humans might adapt to climate change.

WHY THE MYTH PERSISTS

It's been 26 years since Mackowiak's study, yet the newer data has not taken hold among medical professionals or the public. What gives?

Mackowiak tells Mental Floss that he finds it a bit mystifying that the myth persists, especially since many people, when pressed, know that the so-called "average" temperature varies. Part of the problem may be psychological: We cling to beliefs despite evidence to the contrary—a phenomenon called belief perseverance [PDF]. It's a significant force upholding a surprising number of medical myths. The idea humans should drink eight glasses of water a day? Not science. Sugar causes hyperactive behavior? Nope. Reading in dim light harms eyesight? Not really.

Unlearning persistent myths—especially ones loaded with the weight of medical authority—is difficult. "Deep down, under it all," Mackowiak says, "people want simple answers for things."

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The Body
11 Facts About Fingernails
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Whether there's dirt beneath them or polish atop them, your fingernails serve more than just decorative purposes: They help keep your fingertips safe and have a multitude of special functions that even your doctor might not be aware of. “The nails occupy a unique space within dermatology and medicine in general, particularly because they are such a niche area about which few people have expertise,” Evan Rieder, assistant professor in the Ronald O. Perelman Department of Dermatology at NYU Langone Health, tells Mental Floss.

1. FINGERNAILS HAVE FOUR MAIN PARTS.

Along with skin and hair, nails are part of the body's integumentary system, whose main function is to protect your body from damage and infection. Fingernails have four basic structures: the matrix, the nail plate, the nail bed, and the skin around the nail (including the cuticle).

Fingernail cells grow continuously from a little pocket at the root of the nail bed called the matrix. The pale, crescent-shaped lunula—derived from Latin for "little moon"—on the nail itself is the visible portion of the matrix. If the lunula is injured, the  nail won't grow normally (a scarred lunula can result in a split nail), and changes in the lunula's appearance can also be signs of a systemic disease.

Fingernail cells are made of a protein called keratin (same as your hair). As the keratin cells push out of the matrix, they become hard, flat and compact, eventually forming the hard surface of the nail known as the nail plate. Beneath that is the nail bed, which almost never sees the light of day except when there's an injury or disease.

Surrounding the matrix is the cuticle, the semi-circle of skin that has a tendency to peel away from the nail. The skin just underneath the distal end of the fingernail is called the hyponychium, and if you've ever trimmed your nails too short, you know this skin can be slightly more sensitive than the rest of the fingertip.

2. THEY GROW AT A RATE OF 0.1 MILLIMETERS A DAY ...

That's about 3 to 4 millimeters per month. But they don't always grow at the same speed: Fingernails grow more quickly during the day and in summer (this may be related to exposure to sunlight, which produces more nail-nourishing vitamin D). Nails on your bigger fingers also grow faster, and men's grow faster than women's. The pinky fingernail grows the slowest of all the fingernails. According to the American Academy of Dermatology, if you lose a fingernail due to injury, it can take up to six months to grow back (while a toenail could take as much as a year and a half).

3. ... BUT NOT AFTER YOU'RE DEAD.

You've probably heard that your fingernails keep growing after death. The truth is, they don't, according to the medical journal BMJ. What's actually happening is that the skin around the base of the fingernails retracts because the body is no longer pumping fluids into the tissues, and that creates a kind of optical illusion that makes the nails appear longer.

4. ITS ESTIMATED THAT 20 TO 30 PERCENT OF PEOPLE BITE THEIR NAILS.

Scientists say it's still unclear why, but they suspect nail-biters do it because they're bored, frustrated, concentrating, or because it just feels comforting (and anxiety doesn't seem to play a big role). Perfectionists who don't like to be idle are very likely to have the habit. Biters expose themselves to the dangerous crud that collects underneath the nail: The hyponychium attracts bacteria, including E. coli, and ingesting that through nail-biting can lead to gastrointestinal problems down the line. Biting can also damage teeth and jaws.

5. HUMAN FINGERNAILS ARE BASICALLY FLAT CLAWS.

Our primate ancestors had claws—which, like nails, are made of keratin. As human ancestors began using tools some 2.5 million years ago (or even earlier), evolutionary researchers believe that curved claws became a nuisance. To clutch and strike stone tools, our fingertips may have broadened, causing the claws to evolve into fingernails.

6. THE NAIL ACTUALLY MAKES YOUR FINGERTIP MORE SENSITIVE.

While the fingernail may be tough enough to protect tender flesh, it also has the paradoxical effect of increasing the sensitivity of the finger. It acts as a counterforce when the fingertip touches an object. "The finger is a particularly sensitive area because of very high density of nerve fibers," Rieder says.

7. FINGERNAILS CAN REVEAL LUNG, HEART, AND LIVER DISEASES.

"One of the most interesting facts about fingernails is that they are often a marker for disease within the body," Rieder says. Nail clubbing—an overcurvature of the nail plate and thickening of the skin around the nails—is a particularly significant sign of underlying illness, such as lung or heart disease, liver disease, or inflammatory bowel disease. Two-toned nails—whitish from the cuticle to the nail's midpoint and pink, brown, or reddish in the distal half—can be a sign of kidney and liver disease. Nails that are two-thirds whitish to one-third normal can also be a sign of liver disease. However, little white marks on your nails, known as milk spots (or punctate leukonychia) are just the remnants of any kind of trauma to the nail, from slamming it in a door to chewing on it too fervently.

8. YOU CAN GET A COMMON SKIN DISEASE ON YOUR NAILS.

Psoriasis is "typically thought of as a skin disease, but is actually a skin, joint, and nail disease, and when severe, a marker of cardiovascular risk," Rieder says. Psoriatic fingernails may have orange patches called oil spots, red lines known as splinter hemorrhages, lifting of the edges of the nails, and pits, "which look like a thumb tack was repeatedly and haphazardly pushed into the nails," he says.

Doctors often prescribe topical or injected corticosteroids to treat psoriatic nails, but using lasers is an emerging and potentially more cost-effective technique. Rieder relies on a pulsed dye laser, which uses an organic dye mixed with a solvent as the medium to treat nail psoriasis, "which can be both medically and aesthetically bothersome," he says. This laser is able to penetrate through the hard nail plate with minimal discomfort and "to treat targets of interest, in the case of psoriasis, blood vessels, and hyperactive skin," Rieder says.

9. ANCIENT CULTURES DISPLAYED SOCIAL STATUS WITH NAIL ART.

Painting and other forms of decorating nails have a history of offering social and aesthetic cues through variations in nail color, shape, and length, Rieder says. In fact, he adds, in some cultures ornate and well-decorated fingernails "serve as a proxy for social status."

Five thousand years ago in China, men and women of the Ming Dynasty aristocracy grew their nails long and covered them with golden nail guards or bright home-made polishes. The long nails allegedly announced to the world their social rank and their freedom from performing menial labor.

10. A FORMER BEAUTICIAN HELD THE WORLD RECORD FOR THE LONGEST NAILS.

Lee Redmond of Utah started growing her nails in 1979 and kept at it until she held the world record for "longest fingernails on a pair of hands ever (female)" in 2008. Her right thumbnail was 2 feet, 11 inches and the collective length of all her nails was 28 feet, 4 inches. She also applied nail hardener daily and painted them a reflective gold. Unfortunately, she broke her nails in a 2009 car accident and has no plans to regrow them.

11. THE FIRST NAIL CLIPPERS WERE PATENTED IN 1875.

Today, biters don't have to use their teeth to trim their nails. While the earliest tools for cutting nails were most likely sharp rocks, sand, and knives, the purpose-built nail clipper—though it might be more accurately called a circular nail file—was designed by a Boston, Massachusetts inventor named Valentine Fogerty and patented in 1875. The nail clippers we know today were the design of inventors Eugene Heim and Oelestin Matz, who were granted their patent for a clamp-style fingernail clipper in 1881.

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