geoffrey modest medical blogs

  3 articles were published recently that may shed some light into the enigma of “long covid”, now morphing into PACS, or Post-acute Covid-19 syndrome. the whole issue of PACS is quite unclear. These symptoms can occur in small or large percentages of those with Covid (varies a lot in the studies), frequently happen in those who have mild symptoms or even are asymptomatic, can start early in the covid course or after a several month delay, can happen in quite healthy young people with no particular comorbidities, can vary from mildly disabling (a bit of fatigue, hair falling out, small changes in smell/taste) to being pretty devastating (unable to function because of fatigue, brain fog, profound changes in taste making it hard to eat, even severe neuromuscular problems).   Will do one article today (too long for others), with follow-up blog on 2 others.       The potential role of the GI microbiome in PACS/long covid (see  covid long covid gut microbio...

this is the second of two blogs on the microbiome, inspired by a recent review that highlighted several other health-related data besides the non-caloric artificial sweeteners (see  microbiome review nejm2016 in dropbox, or Lynch SV. N Engl J Med 2016;375:2369).  Details: ​ -- the microbiome is huge, with 9.9 million microbial genes represented, as found from studying 1200 people in the US, China, and Europe. And it has >1000 species of microbes -- Although the microbiome was previously felt to develop after birth, bacteria are found in the placentas of healthy mothers, in the amniotic fluid of preterm infants, and in meconium. And, the mode of infant delivery does influence postnatal microbial exposure: intravaginal delivery does seem to confer an infant microbiome taxonomically similar to the maternal gut and vaginally microbiota. Also the infant microbiome does become more similar to the adult one with the cessation of breast-feed...