Did you know?
The radical mastectomy for breast cancer was standard practice for nearly 60 years before less invasive options were proven effective.
STOPs
A TOP (Suggested Termination Of Practices) is a recommendation that advocates for the discontinuation of certain medical interventions, treatments, or practices based on emerging evidence indicating that these may be ineffective, harmful, or counterproductive in the management of specific conditions.
Research feed Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Karen Pendergrass
Overview 
Research Feed Overview
A STOP (Suggested Termination Of Practice) is a recommendation that advocates for the discontinuation of certain medical interventions, treatments, or standard practices based on emerging evidence indicating that these may be ineffective, harmful, or counterproductive in the management of specific conditions. STOPs are derived from rigorous analysis and are intended to optimize patient care by eliminating practices that current research has shown to exacerbate a condition or impede recovery. This concept is particularly relevant in fields where new findings challenge traditional approaches, guiding clinicians towards more effective, evidence-based practices. Overall, as microbiome research progresses, it is expected to challenge and refine many established medical practices, leading to more holistic and integrated approaches to health and disease management.
STOP Examples
The duration before a standard medical practice is revised or discontinued varies significantly, influenced by the emergence of new evidence, societal and cultural shifts, and advancements in technology. For instance, the use of high-dose glucocorticoids in acute spinal cord injury persisted for about 20 years until research demonstrated minimal benefits and significant risks. Thalidomide’s tragic effects were recognized within just 4 years of its introduction. Antibiotics for viral infections were commonly misused for around 40 years before significant efforts were made to curb their overprescription, and the radical mastectomy for breast cancer was standard practice for nearly 60 years before less invasive options were proven effective. These timelines underscore the importance of continuous investigation and reevaluation of medical practices to ensure they align with the best available evidence and meet contemporary standards of care.
| STOP Example | Standard Practice |
|---|---|
| Glucocorticoids in Acute Spinal Cord Injury | High-dose glucocorticoids, particularly methylprednisolone, were routinely used to reduce inflammation in acute spinal cord injuries. However, subsequent research showed minimal benefits and significant risks [x], prompting revised guidelines against routine use. |
| Thalidomide for Morning Sickness | Thalidomide was widely prescribed to treat morning sickness in pregnant women. Unfortunately, it caused severe birth defects, leading to its ban and a complete overhaul of drug safety regulations to prevent similar pharmaceutical disasters. |
| Antibiotics for Viral Infections | Antibiotics were frequently prescribed to treat viral infections like colds and flu. Later, research proved antibiotics are ineffective against viruses, and their overuse led to antibiotic resistance, prompting guidelines against their use for viral conditions. |
| Radical Mastectomy for Breast Cancer | Radical mastectomy, involving extensive tissue removal, was the standard treatment for breast cancer. Later, studies showed that less invasive surgeries often have similar outcomes, leading to a shift towards more conservative surgical approaches to preserve quality of life. |
Our Novel STOPs
While our database focuses on the microbiome signature of conditions and subsequent Microbiome-targeted Interventions (MBTIs), we often encounter information that warrants a suggested termination of practice (STOP), instead. As this database progresses, more STOPs will be included along with their corresponding rationales.
| Suggested Termination Of Practice Issued | Standard Practice |
|---|---|
| Zinc Supplementation for Endometriosis | Although earlier case-control studies reported low serum zinc levels in women with endometriosis, prompting clinical use of zinc supplements, these findings likely reflect secondary effects of inflammation rather than true deficiency. Instead, routine zinc supplementation may promote disease progression rather than prevention, warranting a Suggested Termination of Practice (STOP) for zinc in endometriosis. |
| Ferrous Sulfate Supplementation for Endometriosis (in progress) | Endometriosis often results in heavy menstrual bleeding and subsequent iron-deficiency anemia. Traditionally, clinicians prescribe iron supplementation to replenish iron stores and alleviate symptoms like fatigue. However, iron is a crucial growth factor for certain bacteria implicated in the pathogenesis of endometriosis; thus, iron supplementation can potentially exacerbate inflammatory processes further. Of note, studies indicate that some specific types of iron chelation therapy, which reduces excess iron, may instead be beneficial in managing endometriosis symptoms and improving iron absorption, suggesting a paradoxical effect. |
| Zinc Oxide Supplementation (in progress) | Although the microbiome signature database for Multiple Sclerosis is not yet finished, a STOP for zinc supplementation in favor of zinc aspartate supplementation will be issued. |
| Chlorhexidine and Breast Cancer | We suggest the termination of practice for indiscriminate use of Chlorhexidine-based mouthwash due to increased Breast Cancer Risk. |
Research Feed
Exploring the link between dietary zinc intake and endometriosis risk: insights from a cross-sectional analysis of American women
October 23, 2024
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Endometriosis •
Endometriosis
Did you know?
Gut microbiota predict endometriosis better than vaginal microbiota.
STOPs •
STOPs
Did you know?
The radical mastectomy for breast cancer was standard practice for nearly 60 years before less invasive options were proven effective.
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Fruit and vegetable consumption and risk of endometriosis
January 12, 2018
/
Endometriosis •
Endometriosis
Did you know?
Gut microbiota predict endometriosis better than vaginal microbiota.
STOPs •
STOPs
Did you know?
The radical mastectomy for breast cancer was standard practice for nearly 60 years before less invasive options were proven effective.
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
Create a free account to unlock this study summary.
Microbiome Insiders can read two study summaries for any topic on Microbiome.
Molecular detection of intrauterine microbial colonization in women with endometriosis
April 1, 2024
/
Endometriosis •
Endometriosis
Did you know?
Gut microbiota predict endometriosis better than vaginal microbiota.
STOPs •
STOPs
Did you know?
The radical mastectomy for breast cancer was standard practice for nearly 60 years before less invasive options were proven effective.
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
Create a free account to unlock this study summary.
Microbiome Insiders can read two study summaries for any topic on Microbiome.
Microbiome-Targeted Interventions (MBTIs)
Microbiome Targeted Interventions (MBTIs) are cutting-edge treatments that utilize information from Microbiome Signatures to modulate the microbiome, revolutionizing medicine with unparalleled precision and impact.
STOP Advisory: Reevaluating Zinc Supplementation in Endometriosis
Excessive zinc intake may worsen endometriosis by activating estrogen receptors, disrupting immune function, and altering the microbiome. A large NHANES study found that intake above 14 mg/day significantly increases endometriosis risk. With many supplements exceeding this threshold, routine zinc supplementation may contribute to disease progression rather than prevention, prompting a Suggested Termination of Practice (STOP).
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
Zinc
Zinc is an essential trace element vital for cellular functions and microbiome health. It influences immune regulation, pathogen virulence, and disease progression in conditions like IBS and breast cancer. Pathogens exploit zinc for survival, while therapeutic zinc chelation can suppress virulence, rebalance the microbiome, and offer potential treatments for inflammatory and degenerative diseases.
Breast Cancer
Traditionally linked to genetic predispositions and environmental exposures, emerging evidence highlights the microbiome as a critical and underappreciated factor influencing breast cancer progression, immune response, and treatment outcomes.
STOP: Indiscriminate Chlorhexidine Mouthwash Use Due to Breast Cancer Risk
Microbiome findings provide mechanistic insights into how chlorhexidine (CHX) mouthwash might contribute to breast cancer and breast disease in a causal manner.
Women’s Health
Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
STOPs
A STOP (Suggested Termination Of Practices) is a recommendation that advocates for the discontinuation of certain medical interventions, treatments, or practices based on emerging evidence indicating that these may be ineffective, harmful, or counterproductive in the management of specific conditions.
Women’s Health
Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
STOPs
A STOP (Suggested Termination Of Practices) is a recommendation that advocates for the discontinuation of certain medical interventions, treatments, or practices based on emerging evidence indicating that these may be ineffective, harmful, or counterproductive in the management of specific conditions.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
STOPs
A STOP (Suggested Termination Of Practices) is a recommendation that advocates for the discontinuation of certain medical interventions, treatments, or practices based on emerging evidence indicating that these may be ineffective, harmful, or counterproductive in the management of specific conditions.