Podcasts about crp

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Best podcasts about crp

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Latest podcast episodes about crp

Habitat University
S2 E1 - Habitat Management: Private Lands in Private Hands

Habitat University

Play Episode Listen Later Jan 7, 2022 44:20


There is A LOT of private land in the U.S. and that means there are A LOT of challenges and opportunities for wildlife habitat conservation there! This season, Adam and Jarred will be joining guests from across the country to admire these challenges and opportunities thoroughly. In this first episode of Season 2 of Habitat University, they set the stage for the season and discuss what some of these challenges and opportunities will look like and how they'll be exploring them in the episodes to come!     Help us improve the podcast by taking this Habitat University Listener Feedback Survey: https://purdue.ca1.qualtrics.com/jfe/form/SV_5oteinFuEzFCDmm   Resources and references mentioned in the episode:   Morgan et al. (2019) study that reports area of private land and numbers of private lands wildlife biologists in each state. Morgan, J. J., Rhoden, C. M., White, B., & Riley, S. P. (2019). A state assessment of private lands wildlife conservation in the United States. Wildlife Society Bulletin, 43(3), 328-337. doi:https://doi.org/10.1002/wsb.997   Overview of private lands wildlife conservation in the U.S. with reference to the 71% private land ownership statistic. Burger, L. W., Evans, K. O., McConnell, M. D., & Burger, L. M. (2019). Private lands conservation: A vision for the future. Wildlife Society Bulletin, 43(3), 398-407. doi:10.1002/wsb.1001   National Woodland Owner Survey from the U.S. Forest service with information on family forest ownership: https://www.fia.fs.fed.us/nwos/ The dashboard shows customized information for each state, including those shared in the episode: https://ffrc.shinyapps.io/NWOSdashboard/     Report on landownership statistics in Iowa. Zhang, W. A. Plastina, and W. Sawadgo. 2018. Iowa Farmland Ownership and Tenure Survey 1982-2017: A Thirty-five Year Perspective, Iowa State University Extension and Outreach, FM 1893. https://store.extension.iastate.edu/product/6492   Macaulay study that shows the impact of wildlife associated recreation on private lands management in the U.S. Macaulay, L. (2016). The role of wildlife-associated recreation in private land use and conservation: Providing the missing baseline. Land Use Policy, 58, 218-233. doi:https://doi.org/10.1016/j.landusepol.2016.06.024   USFWS Report showing the impacts of CRP on private lands in the northern US on breeding duck production. Drum, R. G., Loesch, C. R., Carrlson, K. M., Doherty, K. E., & Fedy, B. C. (2015). Assessing the biological benefits of the USDA-Conservation Reserve Program (CRP) for waterfowl and grassland passerines in the Prairie Pothole Region of the United States: Spatial analyses for targeting CRP to maximize benefits for migratory birds. Final Report for USDA–FSA Agreement. https://www.fsa.usda.gov/Assets/USDA-FSA-Public/usdafiles/EPAS/PDF/drumetal2015_crp_prr_final.pdf

Hradec Králové
Radioporadna: Diagnostických samotestů je v lékárnách spousta, vyznáte se v nich? Výsledek ale musí potvrdit lékař

Hradec Králové

Play Episode Listen Later Dec 28, 2021 14:34


V našich lékárnách je k dispozici volně ke koupi nepřeberné množství nejrůznějších diagnostických testů. Testy plodnosti, těhotenské testy, testy na alkohol a na drogy, testy na cukrovku, CRP testy či v neposlední řadě i Covid-19 antigenní testy a testy na protilátky. Vyznáte se v nich? Poradíme vám.

PsicoTalk
EP29: Encerrar para começar: o que nós conseguimos fazer importa!

PsicoTalk

Play Episode Listen Later Dec 26, 2021 38:55


Neste episódio, os psicólogos Ilailson Rocha (@ilailsonrocha - CRP 03/23791) e Dandara Palhano (@dandarapalhano - CRP 13/7379) encerram o ano de 2021 num diálogo sobre comportamentos, anseios e sentimentos acerca dos nossos feitos, planos, metas e sonhos. Planejar é bom, reconhecer é ainda melhor.

The Keto Kamp Podcast With Ben Azadi
Tara Garrison | Short-Term Keto: How to FOLLOW A KETO LIFESTYLE THE RIGHT WAY KKP: 353

The Keto Kamp Podcast With Ben Azadi

Play Episode Listen Later Dec 24, 2021 69:00


Today, I am blessed to have here with me Tara Garrison. She is the founder of HIGHER, a Health & Life Coaching company that offers training, nutrition, mindset and biohacking coaching. She has helped many celebrities, professional athletes, and top executives optimize their health. Tara is the creator of the popular Keto In & Out System and author of Short-Term Keto, in which she teaches how to “Do Keto. Not Forever” to optimize metabolism, brain power, athletic performance and physique. She is the host of the Inside Out Health Podcast, a mom of 4, avid weightlifter, Boston Marathoner and lover of nature. The link to get the Top 100 Keto Recipes eBook free is shorttermketo.com In this episode, Tara talks about her health journey and why she finally decided to honor what was best for her unapologetically. We talk about how making significant changes can be uncomfortable, but Tara wants you to remember that discomfort is only temporary. Tara explains why you need to align with your truth. Plus, we chat about the reasons why you don't want to be in ketosis your entire life. Tune in as we dive into the importance of salt, ditching your carbophobia, and how to start implementing carbs back into your lifestyle. Free 7 Day Keto Challenge: http://www.ketokampchallenge.com 90 Day Detox Program: http://www.ketokampdetox.com Order Keto Flex: http://www.ketoflexbook.com -------------------------------------------------------- / / E P I S O D E   S P ON S O R S  PureForm Omega Plant Based Oils (Best Alternative to Fish Oil): http://www.purelifescience.com Use ben4 for $4.00 off. Paleo Valley beef sticks, apple cider vinegar complex, organ meat complex & more. Use the coupon code KETOKAMP15 over at https://paleovalley.com/ to receive 15% off your entire order. Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list.  [01:10] How Tara Started Unapologetically Honoring What Was Best For Her Weight has been an issue for Tara since the third grade.  Being a stay-at-home mom was definitely not aligned with Tara's personality. She felt sad and depressed as a stay-at-home mom.  Tara started weightlifting because the gym by her house only had weights and treadmills.  After lifting weights for eight months, Tara looked exactly the same. So, she decided to switch her nutrition – she went from 40% body fat to 11% body fat.  Then, Tara found keto. She felt healthy in both her mind and her body.    [11:20] The Discomfort That You Have To Go Through Is Temporary The life of your dreams is a life of alignment with yourself and your authentic self. Exercising and diet is a temporary stressor.  You aren't going to be stressed forever.  The actions required for you to gain muscle is going to suck. However, your body is excellent at retaining muscle. So, the discomfort is temporary.  How you see yourself matters way more than how everyone else sees you.    [17:30] Why You Need To Align With Your Truth Most people know that they need to stop exercising and sleep more. If you have hypothyroidism, you're super inflamed, your CRP is off the charts, and you're exhausted, then yes, you need to sleep more! Training is inflammatory, and if you're already inflamed, there will be problems.  You already know what you need to do; listen to your body. Trust your feelings.    [21:15] Why You Don't Want To Be In Ketosis For Your Entire Life If you love being in ketosis, you can stay in it for as long as you want.  If keto doesn't feel as good as it used to, then you may want to switch things up.  Keto impacts our neurotransmitters and our mental health. When you eat a diet that is mostly fat and protein, your body will favor dopamine production.  When you eat a diet that's mostly carbs and protein, you will favor serotonin production.  If you're not eating carbs, you're not going to favor serotonin production as much.  One of the reasons you should carb cycle is to improve your emotions and mood.    [31:20] Guess What? Insulin Isn't The Enemy!  If you don't have high blood sugar, then insulin isn't the enemy. Insulin is an energy shuttling hormone. It takes glucose and places it in our bodies.  We can store anywhere from 350 up to 800 grams of carbohydrates in our liver and muscles.  Athletes can eat a lot of carbohydrates and not be obese because of the energy they are using.  If you aren't exercising, your body will store carbohydrates as fat storage.    [36:00] Tara Always Trains When She Is Fasted – Here's Why Tara always trains fasted; it's great for your metabolism. If you are healthy, you should be able to train fasted in the morning. If you can't train fasted, then you have some work to do with your blood sugar regulation.  Tara will thrive off of adrenaline during a fasted workout. Eating will bring your adrenaline down.    [39:20] Adrenals and Salt: The Importance of Sodium On Keto If you don't have enough salt on keto, your kidneys will excrete aldosterone, and then you'll start to have high adrenaline and high cortisol long-term. Rushing women syndrome is a hallmark of adrenal stress.  If you're not okay with sitting still and being calm, then you have adrenal stress.  Also, if you feel overwhelmed, then you have adrenal fatigue.  So, make sure to monitor your salt intake.    [43:55] Are You Scared of Carbs? How To Address Carbophobia  We have to foster a healthy mindset around the fact that you're not eating carbs when you're doing keto. Carbs are not going to kill you.  China has an obesity rate of 5 to 6%, they eat more rice than any other country in the world.  In America, we have a 42.4% obesity rate. It's not just carbs that are making you fat.  Carbohydrates are not inherently bad for us. It's what happened to our metabolism from sitting all day, overconsumption, and processed foods.    [50:20] When You Should Start Implementing Carbohydrates   During keto, if you don't feel that great anymore, it's time to start eating carbs again.  If you're working out more, you can start using carbohydrates to fuel your body and workouts.  If you're not sleeping well and have diarrhea, you should introduce carbohydrates again. Being moody is also a sign that you need to add carbohydrates.    AND MUCH MORE!   Resources from this episode:  Check out Tara's Website: https://www.taragarrison.com/ Inside Out Health Podcast: https://podcasts.apple.com/us/podcast/inside-out-health-with-coach-tara-garrison/id1468368093 Follow Tara Garrison  Instagram: https://www.instagram.com/coachtaragarrison/ Facebook: https://www.facebook.com/taragarrisonpersonal Twitter: https://twitter.com/coachtarag TikTok: https://www.tiktok.com/@coachtaragarrison Get Short-Term Keto: A 4-Week Plan to Find Your Unique Carb Threshold: https://www.amazon.com/Short-Term-Keto-28-Day-Unique-Threshold/dp/1628604409/benazadi-20 Upgraded Formulas (code ketokamp): https://www.upgradedformulas.com/products/hair-kit-test Join the Keto Kamp Academy: https://ketokampacademy.com/7-day-trial-a Watch Keto Kamp on YouTube: https://www.youtube.com/channel/UCUh_MOM621MvpW_HLtfkLyQ Free 7 Day Keto Challenge: http://www.ketokampchallenge.com Order Keto Flex: http://www.ketoflexbook.com -------------------------------------------------------- / / E P I S O D E   S P ON S O R S  PureForm Omega Plant Based Oils (Best Alternative to Fish Oil): http://www.purelifescience.com Use ben4 for $4.00 off. Paleo Valley beef sticks, apple cider vinegar complex, organ meat complex & more. Use the coupon code KETOKAMP15 over at https://paleovalley.com/ to receive 15% off your entire order. Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list.  *Some Links Are Affiliates* // F O L L O W ▸ instagram | @thebenazadi | http://bit.ly/2B1NXKW ▸ facebook | /thebenazadi | http://bit.ly/2BVvvW6 ▸ twitter | @thebenazadi http://bit.ly/2USE0so ▸clubhouse | @thebenazadi Disclaimer: This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Ben Azadi disclaim responsibility from any possible adverse effects from the use of information contained herein. Opinions of guests are their own, and this podcast does not accept responsibility of statements made by guests. This podcast does not make any representations or warranties about guests qualifications or credibility. Individuals on this podcast may have a direct or non-direct interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.

Nine Finger Chronicles - Sportsmen's Nation

On this episode of the Nine Finger Chronicles, Dan talks with returning guest Clinton Fawcett about buying a new property and his short and long term habitat goals. Clinton talks about how the opportunity to buy this piece of property fell in his lap and with it being at a great price and close to his home, it was a no brainer. The guys quickly get in to a discussion about the current state of the property and what the deer movement on this piece looks like. Clinton  breaks down how cattle will continue to be a factor, his long term goal of creating a pond, plating CRP, and over time removing rotating crops to replace with food plots specific for deer. This is an excellent episode for those who are new to owning property and what habitat goals couple look like. Nine Finger Chronicle is Powered by Simplecast

Sportsmen's Nation - Whitetail Hunting
N.F.C. - New Property New Goals

Sportsmen's Nation - Whitetail Hunting

Play Episode Listen Later Dec 24, 2021 59:04


On this episode of the Nine Finger Chronicles, Dan talks with returning guest Clinton Fawcett about buying a new property and his short and long term habitat goals. Clinton talks about how the opportunity to buy this piece of property fell in his lap and with it being at a great price and close to his home, it was a no brainer. The guys quickly get in to a discussion about the current state of the property and what the deer movement on this piece looks like. Clinton  breaks down how cattle will continue to be a factor, his long term goal of creating a pond, plating CRP, and over time removing rotating crops to replace with food plots specific for deer. This is an excellent episode for those who are new to owning property and what habitat goals couple look like. Nine Finger Chronicle is Powered by Simplecast

Eagle's Eye View: Your Weekly CV Update From ACC.org
Eagle's Eye View: Your Weekly CV Update From ACC.org (Week of Dec. 22)

Eagle's Eye View: Your Weekly CV Update From ACC.org

Play Episode Listen Later Dec 22, 2021 8:17


This week's View looks at differences in results of the REDUCE-IT (Reduction of Cardiovascular Events With Icosapent Ethyl-Intervention Trial) and STRENGTH (Long-Term Outcomes Study to Assess Statin Residual Risk With Epanova in High Cardiovascular Risk Patients With Hypertriglyceridemia) trials and if they can be explained by the active and comparator oils on lipid traits and C-reactive protein (CRP). Dr. Eagle also examines whether traditional CV risk factors are associated with incident ASCVD among those with absent coronary calcium. And finally, Dr. Eagle looks at driving restrictions in those receiving a secondary prevention ICD.

For The Love of Truth's Podcast
28 signs your body needs more magnesium

For The Love of Truth's Podcast

Play Episode Listen Later Dec 22, 2021 2:49


#Adrian #magnesiumOil #WhatAreTheSymptomsOfMagnesiumDeficiencyWhat are the symptoms of magnesium deficiency in humans?80+ % of people are short of magnesium.   This video lists 28 signs you need magnesium / have magnesium deficiency. There are many magnesium benefits. The fastest way I know of to get your magnesium levels up is with magnesium chloride oil applied topically.  I apply it liberally all over after showering and drying. You cannot ingest large quantities of magnesium because it is a laxative.My other magnesium videos:https://www.youtube.com/playlist?list=PLHfgyyQrAM7j_ZVsJZVitbt_rfyH_OjkaMy playlist for all mental and physical health and wellbeing videos.:https://www.youtube.com/playlist?list=PLHfgyyQrAM7ibUYoYd57agWjpbjDHDEgRI have written a book about health. You can read more about it here:http://alternativeprinciplesforhealth.infoFrom my book:Magnesium- a key to unlock many locksGetting my magnesium levels back up has been the single most effective thing of solving a variety of health issues I was having.  In fact of everyone I know who was having a variety of health issues getting enough magnesium into their systems has transformed things.  Make sure you read up on this, understand why it is SO important, and then take action right now.There is plenty of information about cancer patients being low on magnesium –  this is referred to as hypo-magnesia.Magnesium is VITAL for cellular health.  It is worth reading up on this amazing mineral and then making sure you have enough available to you. I have read that to 1300 enzyme reactions rely on it, and I have read that is 325 reactions.  Whatever the number this one mineral is absolutely critical to life and yet it is largely ignored by the allopathic medical profession.  Well, they would, it is cheap, easily available and cannot be patented. Research indicates that up to 80% of people are magnesium deficient.Start immediately with magnesium oil (magnesium chloride and water 50/50) applied to your skin. You don't have to buy it ready mixed, buy a big bag on eBay and dilute it with filtered water and save yourself a fortune.  Soak yourself in it every day.  This is the fastest way to replenish your magnesium levels.  Even with this, it could take  3-4 months or longer to get levels back up to normal levels.  (If you have problems with kidney function take some medical advice from someone who really understands magnesium properly.)  You should pay attention to getting plenty of vitamins B6 and D.I have read in many places it can help in cases like ADHD and autismHere is a list of some of the common symptoms that are results of low magnesium levels.  It is not a complete list.  I have marked a ** next to each that I had that has now gone away)• Muscle cramps or twitches **• Insomnia• Irritability• Sensitivity to loud noises **• Anxiety **• Autism• ADD• Palpitations **• Angina• Constipation• Anal spasms **• Headaches **• Migraines **• Fibromyalgia• Chronic fatigue• Asthma• Kidney stones• Diabetes• Obesity• Osteoporosis• High blood pressure• PMS• Menstrual cramps• Irritable bladder• Irritable bowel syndrome• Reflux• Trouble swallowing **Magnesium deficiency has even has been linked to inflammation in the body and higher CRP levels.Support the show (https://www.patreon.com/adrianr)

For The Love of Truth's Podcast
Magnesium benefits for women and men | Magnesium chloride oil | Adrian

For The Love of Truth's Podcast

Play Episode Listen Later Dec 22, 2021 13:29


#Adrian #magnesiumBenefitsForWomen #MagnesiumChlorideMagnesium benefits for women and men. This is my story of what happened to me using magnesium oil everyday for 3+ years, and why I decided I had to do that. Nearly all of us are short on magnesium.  Magnesium is critical and offers major wide ranging benefits for men and women. I still apply magnesium chloride oil everyday - it has helped alleviate many problems for me and I feel so much better for it. In this video I explain why I do it and how it has changed my health for the better. Including no more headaches or  migraines, now I know I know how to stop cramps. It is also good for pain relief.My book:I have written a book on health and well-being. Nothing mainstream in here, just things I've observed and worked out that have helped me and others who have used the ideas.You can read more about it here:http://alternativeprinciplesforhealth.info/--DMSO:https://www.youtube.com/playlist?list=PLHfgyyQrAM7h38eBvAQbZTy38dN_zdGfMMagnesium and Magnesium Chloride Oil:https://www.youtube.com/playlist?list=PLHfgyyQrAM7j_ZVsJZVitbt_rfyH_OjkaExcerpt From my book:Magnesium- a key to unlock many locksMagnesium is VITAL for cellular health.  It is worth reading up on this amazing mineral and then making sure you have enough available to you. I have read that to 1300 enzyme reactions rely on it, and I have read that is 325 reactions.  Whatever the number this one mineral is absolutely critical to life and yet it is largely ignored by the allopathic medical profession.  Well, they would, it is cheap, easily available and cannot be patented. Research indicates that up to 80% of people are magnesium deficient.Start immediately with magnesium oil (magnesium chloride and water 50/50) applied to your skin. You don't have to buy it ready mixed, buy a big bag on eBay and dilute it with filtered water and save yourself a fortune.  Soak yourself in it every day.  This is the fastest way to replenish your magnesium levels.  Even with this, it could take  3-4 months or longer to get levels back up to normal levels.  (If you have problems with kidney function take some medical advice from someone who really understands magnesium properly.)  You should pay attention to getting plenty of vitamins B6 and D.I have read in many places it can help in cases like ADHD and autismHere is a list of some of the common symptoms that are results of low magnesium levels.  It is not a complete list.  I have marked a ** next to each that I had that has now gone away)• Muscle cramps or twitches **• Insomnia• Irritability• Sensitivity to loud noises **• Anxiety **• Autism• ADD• Palpitations **• Angina• Constipation• Anal spasms **• Headaches **• Migraines **• Fibromyalgia• Chronic fatigue• Asthma• Kidney stones• Diabetes• Obesity• Osteoporosis• High blood pressure• PMS• Menstrual cramps• Irritable bladder• Irritable bowel syndrome• Reflux **• Trouble swallowing **Magnesium deficiency has even has been linked to inflammation in the body and higher CRP levels.Some start points for you with magnesium chloride:http://www.westonaprice.org/health-topics/abcs-of-nutrition/magnificent-magnesium/ http://www.health-science-spirit.com/magnesiumchloride.htmlhttp://drsircus.com/medicine/magnesium/inflammation-and-systemic-stressMAGNESIUM DEFICIENCY IN THE PATHOGENESIS OF DISEASEEarly Roots of Cardiovascular, Skeletal and Renal Abnormalitieshttp://www.mgwater.com/Seelig/Magnesium-Deficiency-in-the-Pathogenesis-of-Disease/chapter1.shtmlSupport the show (https://www.patreon.com/adrianr)

Autism Stories
Autism Stories: Ben Breaux

Autism Stories

Play Episode Listen Later Dec 20, 2021 13:34


"When looking for a communication partner, I need to see if I connect with them, and I can tell if I will connect with them almost instantly, because I need to trust them with so many important aspects of my life. They become more than just a CRP; they become my family. They need to be patient, but also push me to do the most I can do," says Ben Breaux. Ben joins this episode of Autism Stories to talk discuss what making a good communication regulation partner, why he decided to take the homeschool route, and what he plans to study in college. To learn more about Ben visit https://www.facebook.com/benbreauxautisticspeakshismind/ Be updated on the latest Autism Stories episode by subscribing on your favorite podcast listening platform. If you could give us a positive rating and review on your favorite listening platform we would really appreciate that. If you want to reduce your overwhelm and help get your needs met and desires fulfilled then book a free zoom call now with Autism Personal Coach https://calendly.com/autimspersonalcoach/60min. If you are not comfortable with video then we can turn your video off for the call. If you would be interested in being interviewed on Autism Stories or would like to be a sponsor send an email to doug.blecher@autismpersonalcoach.com.

Naturally Nourished
Episode 270: Functional Approaches to IBD

Naturally Nourished

Play Episode Listen Later Dec 13, 2021 69:51


Are you or a loved one dealing with inflammatory bowel disease? Want to know how you can reduce inflammation and get IBD into remission? Looking for natural solutions for Crohn's or Ulcerative Colitis? Tune in to hear us cover the symptoms, diagnosis, and root causes of IBD in this informative episode.    In this episode, we compare conventional approaches to IBD with a functional medicine approach using the Remove, Restore, Repair framework. Learn about essential tools for remission, our favorite therapeutic foods and supplements, and how the microbiome plays an important role.    Patreon.com/alimillerRD Past Episodes on Gut HealthEpisode 24: Leaky Gut Episode 60: Dysbiosis and the microbiome Episode 87: The Gut Brain Axis Episode 93: Getting Autoimmune Disease Into Remission Episode 105: Perfecting Your Poop Episode 127: In Defense of Vegetables Episode 131: Candida & SIBO Deep Dive Episode 137: All About the Gut Episode 174: The Dysbiosis Disease Connection and Ali's Cleanse Episode 198: So You're On an Antibiotic Episode 230: Dysbiosis through Disconnection Episode 254: Picking the Right Probiotic Defining Inflammatory Bowel DiseaseCrohn's vs. Ulcerative Colitis Symptoms DiagnosisCBC, CRP, Sed Rate, Calprotectin Conventional Treatment of IBD Functional Approaches to IBDMRT Food Sensitivity Panel Stool TestCalprotectin, Lactoferrin, Lysozyme  SCD Diet Low FODMAPs Diet Drivers of IBD FlaresStressCalm and Clear Adaptogen Boost GabaCalm Relax and Regulate Gluten Exposure & Inflammatory FoodsDigestaid Grassfed Whey Protein Role of the MicrobiomeTargeted Strength Probiotic Rebuild Spectrum Probiotic Beat the Bloat  GI Reset Clinical effects and gut microbiota changes of using probiotics, prebiotics or synbiotics in inflammatory bowel disease: a systematic review and meta-analysis Supporting Gut Lining IntegrityGI Lining Support 2-3 scoops/dayRandomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis The Role of Dietary Nutrients in Inflammatory Bowel Disease Collagen & Gelatin use code ALIMILLERRD Bone Broth Fasting Reducing InflammationSuper Turmeric 3-4/dayCurcumin has bright prospects for the treatment of inflammatory bowel disease EPA DHA Extra 2-3/dayEffect of an Enteric-Coated Fish-Oil Preparation on Relapses in Crohn's Disease CBD Santa Cruz Medicinals use code ALIMILLERRD Foria CBD Suppositories use code ALIMILLERRDAn overview of cannabis based treatment in Crohn's disease Vitamin D Balanced Blend Gut Rehab Bundle   This episode is also sponsored by FOND Bone Broth Tonics, Your Sous Chef in a Jar. FOND is slow simmered and lovingly tended from simmer to seal. They partner with organic farms and hand-pick and pair ingredients to optimize absorption and taste. Use code ALIMILLERRD to save at fondbonebroth.com. 

The Gary Null Show
The Gary Null Show - 12.09.21

The Gary Null Show

Play Episode Listen Later Dec 9, 2021 55:56


Compounds in leafy green vegetables could help prevent cognitive decline Rush University Medical Center, December 2, 2021.  Rush University Medical Center analyzed data from 960 participants between the ages of 58 and 99 years in the Rush Memory and Aging Project. Individuals whose intake of leafy green vegetables including spinach, kale/collards/greens, and lettuce, was among the top 20% of subjects at a median of 1.3 servings per day had a rate of cognitive decline over follow-up that was significantly slower than that of subjects' whose intake was among the lowest 20% at 0.1 servings per day. The authors compared the difference to that of someone 11 years younger. When individual nutrients contained in leafy vegetables were analyzed, having an intake among the top 20% of intake of phylloquinone (vitamin K1), lutein, folate, alpha-tocopherol (vitamin E), nitrate and kaempferol were each associated with slower cognitive decline in comparison with an intake that was among the lowest fifth. The authors concluded that “Consumption of approximately 1 serving per day of green leafy vegetables and foods rich in phylloquinone, lutein, nitrate, folate, alpha-tocopherol, and kaempferol may help to slow cognitive decline with aging.” (NEXT) Keto diet may not work for women University of California at Riverside, December 8, 2021 Scientists from UC Riverside are studying how the popular keto and intermittent fasting diets work on a molecular level, and whether both sexes benefit from them equally. The idea behind the keto diet is that low levels of carbohydrates and very high levels of fat and protein will force the body to use fat as fuel, resulting in weight loss. Legions of people swear by it, and innumerable companies produce foods designed for those people. Intermittent fasting operates on a similar principle, restricting eating to a small window of time during the day. During the hours without food, the body exhausts its stores of sugar and switches to burning fat. The fat gets converted to ketone bodies that the brain can use as fuel. (NEXT) Better exercise performance and increased intake of nutrients that support healthy inflammation linked to reduced inflammaging in older adults Collegium Medicum University of Zielona Gora (Poland), December 1 2021. Research reported in Nutrients revealed an association between decreased indicators of chronic inflammation and greater intake of nutrients that help maintain inflammation at a healthy level combined with better walking performance in an older population. The study included 60 men and women aged 65 and older. Dietary recall responses were evaluated to determine the intake of the anti-inflammatory vitamins A, C, D and E and beta-carotene, as well as fatty acids omega 3 (which has shown anti-inflammatory effects) and omega 6 (associated with inflammation when intake is high). Physical performance was evaluated using six-minute walk tests. Blood samples were analyzed for the inflammation markers serum C-reactive protein (CRP), interleukins 1beta, 6, 8 and 13, tumor necrosis factor-alpha (TNFα) and circulating free DNA, and the anti-inflammatory cytokine interleukin 10. (NEXT) Microplastics found to be harmful to human cells, new study shows University of York (UK), December 8, 2021 High levels of ingested microplastics in the human body have the potential to have harmful effects, a new study reveals. This is the first-time scientists have attempted to quantify the effects of the levels of microplastics on human cells using a statistical analysis of the available published studies. “What we have found is that in toxicology tests, we are seeing reactions including cell death and allergic reactions as potential effects of ingesting or inhaling high levels of microplastics.” These studies focused on microplastic contamination of drinking water, seafood and table salt and revealed high levels of human exposure to microplastics from consuming these. (NEXT) A handful of nuts a day reduces major disease risk: Review Imperial College of London, December 5, 2021 Eating at least 20 grams of nuts a day could cut the chances of dying from respiratory disease by about a half and diabetes by nearly 40%, researchers say. The study, which establishes the benefits of nut consumption on cardiovascular conditions, also found convincing data of the food's effect on other diseases. “We found a consistent reduction in risk across many different diseases,” said study co-author Dr Dagfinn Aune from Imperial College London's school of public health. (NEXT) Pandemic worriers shown to have impaired general cognitive abilities McGill University (Quebec), December 5, 2021 A new study finds the pandemic may have also impaired people's cognitive abilities and altered risk perception, at a time when making the right health choices is critically important. Scientists at McGill University and The Neuro (Montreal Neurological Institute-Hospital) surveyed more than 1,500 Americans online from April to June, 2020. Participants were asked to rate their level of worry about the COVID-19 pandemic and complete a battery of psychological tests to measure their basic cognitive abilities like processing and maintaining information in mind.

FarmBits
Episode 055: Precision Conservation Conversation

FarmBits

Play Episode Listen Later Dec 9, 2021


Precision conservation is an emerging technique in digital agriculture that uses spatial data to inform decisions about where to implement conservation practices and potentially which conservation practices would be most beneficial. Dr. Andrew "Andy" Little, Assistant Professor and Landscape and Habitat Management Extension Specialist, joins this FarmBits episode to provide an overview of precision conservation and discuss the work that he and his lab team are doing to further conservation practices using digital agriculture. Andy tells us a little bit about his background, describes how digital tools are changing the way that conservation practices may be implemented, and overviews the programs and projects that producers can get involved in if they're interested in conservation. Conservation practices are expected to be an important part of sustainable agriculture moving forward so this episode is well worth the listen. AWESM Lab Information: Website: https://wildlifeecologylab.unl.edu/ Twitter: https://twitter.com/AWESMLab Precision Conservation: https://wildlifeecologylab.unl.edu/precision-conservation Coffee and Conservation: https://wildlifeecologylab.unl.edu/coffee-and-conservation Dr. Andrew Little's Contact Information: E-Mail: alittle6@unl.edu LinkedIn: https://www.linkedin.com/in/andrewlittle1480/ Twitter: https://twitter.com/DrAndrewLittle FarmBits Contact Information: Website: https://on-farm-research.unl.edu/farmbits E-Mail: farmbits@unl.edu Twitter: https://twitter.com/NEDigitalAg Jackson's Twitter: https://twitter.com/jstansell87 Jackson's LinkedIn: https://www.linkedin.com/in/jacksonstansell/ Jose's Twitter: https://twitter.com/josegcesario Jose's LinkedIn: https://www.linkedin.com/in/jose-guilherme-cesario-pereira-pinto/ Opinions expressed by the hosts and guests on this podcast are solely their own, and do not reflect the views of Nebraska Extension or the University of Nebraska - Lincoln.

The Crash Rabbit Pod
All Rise, Magical Sugar Rabbits vs. 1toMillion, and TJPW's 2021 - CRP 28

The Crash Rabbit Pod

Play Episode Listen Later Dec 5, 2021 171:15


As 2021 draws to a close, Robbie & Ty are back on the CRP for the final episode of the year (and maybe for a while). They cover 2 different main events, Pom being Pom, along with the full show of All Rise. They also take a look back of TJPW in 2021, recapping the year with the promotion's new faces, title reigns, and big matches. Finally, they close the podcast for the year by discussing their favorite moments and hopes for 2022. Follow the Podcast on Twitter: https://twitter.com/crashrabbitpod?lang=en (We don't know if this is the end, but just in case it is: Thank you for listening!)

9 Lives Magazine - Photographie & Art Visuel
Rencontre avec Audrey Hoareau à l'occasion de son installation au CRP/

9 Lives Magazine - Photographie & Art Visuel

Play Episode Listen Later Dec 4, 2021 16:07


À la rentrée dernière, la commissaire d'exposition Audrey Hoareau, succédait à Muriel Enjalran, à la tête du CRP/Centre régional de la Photographie Hauts-de-France à Douchy-les-Mines. Nous avons rencontré la nouvelle directrice qui inaugurera sa toute première exposition en janvier 2022 avec "Tsavt Tanem", un travail sur les racines arméniennes de l'artiste photographe Camille Levêque. Une année importante pour le centre, puisqu'il célèbrera ses 40 ans d'existence. Cet entretien est donc pour nous l'occasion de recueillir ses premières impressions sur sa prise de fonction et d'aborder également l'exposition « Tout doit disparaître » de la collection de Jean-Marie Donat, qui ouvre ses portes le week-end prochain au CENTQUATRE à Paris, un événement organisé en partenariat avec le CRP/.

The Duran Podcast
On the brink of Great Power Conflict. How did we get to this point? [Part 2]

The Duran Podcast

Play Episode Listen Later Nov 30, 2021 55:31


On the brink of Great Power Conflict. How did we get to this point? [Part 2] The Duran: Episode 1153 Subscribe to CRP: https://www.youtube.com/CoachRedPill CRP on Patreon channel: https://www.patreon.com/CoachRedPill CRP on Telegram: https://t.me/realCRP #Russia #Ukraine #Putin #TheDuran

Recovery Radio
Collegiate Recovery vs. Winter Break

Recovery Radio

Play Episode Listen Later Nov 30, 2021 36:28


For college-aged students, the stresses of end-of-semester projects, finals, and going home for winter break can be difficult. It can be especially distressing to students in recovery. To raise awareness around holiday parties, binge drinking, and how to make a gameplan with family, Michael interviews Dr. Jaime Garza at the University of Alabama, a powerhouse in the SEC athletic conference and in the world of collegiate recovery programs. Dr. Garza serves as the Coordinator of Collegiate Recovery and Intervention Services (CRIS) at the university and has worked in substance use disorder treatment since 2005. He has been heavily involved in the creation and development of several nationally-recognized collegiate recovery programs and, along with his team, has successfully made higher education accessible to individuals with personal life struggles. To learn more, visit https://cris.sa.ua.edu/ or check out @bamarecovery on Facebook and Instagram. If you are concerned about a loved one drinking too much or who is addicted to drugs, get in touch with a recovery specialist 24/7 at Landmark Recovery. Call 888-448-0302 and find a treatment center near you: https://landmarkrecovery.com/locations/find-a-landmark-near-you/ SHOW NOTES: [3:53] An introduction to collegiate recovery programs (CRP). Jaime shares how he began working in the field. [6:13] A brief history of collegiate recovery programs. [9:56] Importance of students engaging in a CRP on campus, especially prior to the holidays. [15:10] CRPs as on-campus, outpatient treatment programs and educational systems of preventative care and awareness. [17:14] Binge drinking, holiday parties, and having a family game plan over winter break. [24:08] How to address excessive drinking or drugging. [26:50] How to find more information about Collegiate Recovery Programs. Also, the #1 thing to know when asking for information? It's completely confidential and will not negatively affect you/your student's academic career.

The Duran Podcast
[Part 1] Summit for Democracy. Russia-China & history behind Ukraine-Taiwan

The Duran Podcast

Play Episode Listen Later Nov 29, 2021 57:22


[Part 1] Summit for Democracy. Russia-China & history behind Ukraine-Taiwan The Duran: Episode 1153 Subscribe to CRP: https://www.youtube.com/CoachRedPill CRP on Patreon channel: https://www.patreon.com/CoachRedPill CRP on Telegram: https://t.me/realCRP

Confessions of a Disney Cast Member
169. Discussionist 7: Food, Glorious Food (Chicken Nuggets and Mickey Waffles Only)

Confessions of a Disney Cast Member

Play Episode Listen Later Nov 20, 2021 69:13


n this week's discussion episode of Confessions of a Disney Cast Member, we are joined by CRP alumni Kadie, where we talk all things Disney food. Follow Kadie's food Instagram @ne.eats.and.more This podcast is not affiliated by The Walt Disney Company. Just cast members who love celebrating other cast members and reminiscing.  Follow Us on Instagram: @TheDisneyConfessionist @ne.eats.and.more

The Cabral Concept
2115: Detox Protocols Order, Vasomotor Rhinitis, Tight Jaw, Chronic Pelvic Pain, Diverticulitis, Taking Herbs on Fast (HouseCall)

The Cabral Concept

Play Episode Listen Later Nov 20, 2021 27:04


Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions:  Andrea: I had a question for you based on the health plan you provided me back on 4/7. after completing my metals test. Before I could follow-out this plan of detoxes/metals detox, I had lots of abnormal symptoms begin so I had to see my functional medicine doctor. She performed multiple additional tests and long story short, I was recently diagnosed with SIBO, colon bacteria overgrowth, +e-coli, low sIgA, chronic UTIs, and inflammation/elevated CRP. So in addition to the supplements I normally take, I am now also taking the supplements/herbs (attached) for 3 months. Then the plan would be to complete a general detox and metals detox. The problem is we are trying to get pregnant as soon as we are able to (after this 3 month SIBO treatment plan). So in order to also complete a detox and metals detox, I was curious if I'd be able to complete Dr Calbral's general and metals detox while I am taking the attached supplements? Or must I wait til I'm done with these before starting the detoxes? I noticed the metals detox is 6 weeks and wasn't sure if there is a shorter version of this too? Thanks! Katie: Hi Dr. Cabral! What can you share about vasomotor rhinitis? My allergy doctor believes I have it as my normal allergy symptoms have gotten so much better after many protocols, but I still suffer from one odd symptom - the feeling that my nostrils are inflamed and small, making it hard to get air in through my nose. I frequently end up taking sharp sniffs to get enough air through my nose. There are no other symptoms of this aside from occasional throat (and then chest) pain from being so tense trying to get air in. What can I do to overcome this naturally? Thanks for all you do! Jessi: Hi. Thank you for all that you do, Im new to the podcast, I had one issue (im not 100% sure you answered already i tried to look it up on past podcast, but wasn't able to find anything. My question is of 2 1.) I think every night or a lot of nights I wake up with a tight jaw, I once woke up at 3am and i noticed I had my jaw Clenched, not sure why or if its even a health issue, or mental. 2.) Ever since i can remember I've always only had one nostril working. some times it switches, mostly is my right nostril that gets stuffed or can't breath through it. If you can shed some light on this id appreciate it. Maggie: Hi Dr. Cabral. I am a huge fan of your podcasts and try to follow your advice as much as I can. I have struggled with chronic pelvic pain and inflammation in my lower abdomen for about 9 years. I have had ultrasounds, a CT scan, a cystoscopy, physical therapy, botox injections, antidepressants, was put back on birth control in case it was endometriosis, you name it, I have done it. The pain/inflammation started while I was on a course of metronidazole. Ever since then, I have had recurring yeast infections, white coating on the tongue, depression/anxiety worsened, brain fog and just overall feeling more fatigued and feeling like my immune system isn't as strong as it was pre-pain. After listening to your podcasts I thought it made sense that candida would be the culprit so I am currently on week 5 of the CBO protocol. I have noticed a change in my brain fog, yeast infections, and overall mood, but have had no changes to the constant dull ache and inflammation in my lower abdomen. Do you think that this could possibly be caused by something else? The pain is worse if I worked out recently or tends to be worse at night. I stopped smoking weed as that would make the pain worse, maybe from the change in blood pressure, not sure? Any advice is much appreciated. Thank you so much! James: Hi Doctor Cabral I been diocese diverticulitis and had acute attacked many times over the past 15 years. I have been told to get the operation. I take antibiotics when this happens and know that is also not good for me. However it now is two years since my last attack. I am 65 years old and concerned I may need the operation in later years. How can I prevent it from happening and can I cure it with diet ? I take your supplements especially probiotics. What would you recommend? Trying to avoid an operation and trying to cure it. Alex: Hi Dr. Cabral! I am so thankful for all of the content and energy that you have pushed out for everyone. My question is on shilajit. When you take shilajit, does it break a fast. Thanks again. Alex   Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!  - - - Show Notes & Resources: http://StephenCabral.com/2115 - - - Get Your Question Answered: http://StephenCabral.com/askcabral   - - - Dr. Cabral's New Book, The Rain Barrel Effect https://amzn.to/2H0W7Ge - - - Join the Community & Get Your Questions Answered: http://CabralSupportGroup.com - - -  Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Stress, Sleep & Hormones Test (Run your adrenal & hormone levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - > View all Functional Medicine lab tests (View all Functional Medicine lab tests you can do right at home for you and your family)

The Crash Rabbit Pod
An Update on the Future, Rika hates Mahiro, and the next Championship Challengers - CRP 27

The Crash Rabbit Pod

Play Episode Listen Later Nov 19, 2021 97:00


Post-Wrestle Princess II, Robbie & Ty return to the CRP to talk TJPW's late October and early November shows. They talk the adventures of Paminchu, a one-sided relationship, the next Princess of Princess and International Princess Title defenses set for All Rise, + more! They also discuss the future of the CRP at the end of 2021 and in 2022. Follow the Podcast on Twitter: https://twitter.com/crashrabbitpod?lang=en

Rio Bravo qWeek
Episode 75 - Multisystem Inflammatory Syndrome

Rio Bravo qWeek

Play Episode Listen Later Nov 19, 2021 36:15


Episode 75: Multisystem Inflammatory Syndrome in Children (MIS-C).  Dr Schlaerth explains the signs, symptoms, and basic management of MIS-C. Lam explain the role of anti-obesity medications in weight management. Introduction: The Role of Drugs in Weight Loss Management    By Lam Chau, MS3, Ross University School of Medicine     Today about 70% of adult Americans are overweight or obese. Obesity is associated with increased risk of heart disease, stroke, and diabetes, among many other diseases. Studies have shown losing 5-10% of your body weight can substantially reduce your risk of cardiovascular disease.  Traditional belief is that weight loss can only be attributed to diet and exercise. While there are certainly elements of truth to that statement, medication is a safe and proven method for weight management that is often overlooked. The fact of the matter is that weight loss is an ongoing field of study with constant new research and innovations.  In June of this year, a medication named Wegovy was approved for weight loss management by the FDA. This drug is indicated for chronic weight management in patients with a BMI of 27 or greater with an accompanying weight-related ailment or in a patient with a BMI of 30 or greater. Rachel Batterham, PhD, of the Centre for Obesity Research at University College London, shared: "The findings of this study represent a major breakthrough for improving the health of people with obesity. No other drug has come close to producing this level of weight loss — this really is a game changer.” Despite breakthroughs like these, the use of medication for weight loss is still relatively low. Dr. Erin Bohula, a cardiologist and assistant professor at Harvard Medical School, believes “there are probably a few reasons for this, including cost, if not covered by insurance, and a perception these agents are not safe in light of the history with weight loss agents.” A study from 2019 examined the medical records from eight geographically dispersed healthcare organizations. They found that out of 2.2 million patients who were eligible for weight loss medication, only 1.3% filled at least 1 prescription. Weight loss is a dynamic process with many different variables. While it may not necessarily be for everyone, medication can help tremendously and is an option you should consider if you are interested in weight loss[1,2]. This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home.  ___________________________Multisystem Inflammatory Syndrome in Children (MIS-C).   By Katherine Schlaerth, MD, and Hector Arreaza, MD. History and epidemiologyMost children who get COVID-19 have either no symptoms or very mild symptoms. However, about 18 months ago, a new pediatric complication of COVID-19, possibly postinfectious, was described.  The eight children who were initially described had a clinical presentation which was similar to either Kawasaki Disease or perhaps toxic shock syndrome, and since these children had signs of a hyperinflammatory state coupled with shock, the new syndrome was named Multisystem Inflammatory Syndrome in Children, or MIS-C for short. By midsummer of 2021, the United States had about two thousand cases and 30 deaths in children under 21.  Other name for this condition is Pediatric Hyperinflammatory Shock. DiagnosisWhat are the criteria for a diagnosis of Multisystem Inflammatory Syndrome? They include:Age below 21Fever above 100.4 degrees Fahrenheit or 38 degrees centigrade for 24 hours (a subjective fever for more than 24 hours counts too). Laboratory evidence of inflammation which should include at least two of the following tests: elevated CRP, elevated ESR, elevated fibrinogen level, procalcitonin, D-dimer, ferritin, lactic acid dehydrogenase (LDH), interleukin-6, and neutrophil counts, low lymphocyte count and low albumin.Severe disease necessitating hospitalization with multisystem organs affected. The systems affected include cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic, and neurologic (at least three systems need to be involved). No creditable other diagnosis. Other symptoms include:GI complaints (diarrhea, vomiting, abdominal pain)Skin rashConjunctivitisHeadacheLethargyConfusionRespiratory distressSore throatMyalgiasSwollen hands/feetLymphadenopathyCardiac signs and symptoms include troponin/BNP elevation and arrhythmia. Findings on ECHO may include depressed LVEF, coronary artery abnormalities, including dilation or aneurysm, mitral regurgitation, and pericardial effusion. There also must be a positive test for SARS-CoV-2 and this test can be either a reverse transcriptase polymerase chain reaction (RT-PCR), serologic, or antigen testing. Exposure to someone who has had or is suspected of having had COVID-19 within the last 4 weeks also counts.  Patients with MIS-C may have predominately gastrointestinal symptoms, mucocutaneous findings, and may be hypotensive or “shocky” on presentation. Up to 80% require ICU admission. Thrombocytopenia and /or elevated transaminase levels can also be seen.  MIS-C vs Kawasaki DiseaseThe big issue in diagnosing MIS-C is the overlap with Kawasaki's disease and with toxic shock syndrome. Patients with Kawasaki Disease in their second week of illness often will have thrombosis, not thrombocytopenia. Whereas MIS-C usually affects school age children or adolescents, Kawasaki Disease is more commonly a problem in younger children, who have an average age of 2 years.  Kawasaki Disease is also more common in Asian children and MIS-C disproportionately seems to affect Black and Hispanic children.  Obesity seems to be another risk factor for MIS-C.  Kawasaki's Disease also has different cardiac manifestations from MIS-C. Coronary artery dilatation is common in Kawasaki's disease and left ventricular dysfunction in MIS-C, although sometimes coronary artery dilatation and rarely aneurisms can be noted on echocardiogram in putative MIS-C, which is why differentiation from Kawasaki's Disease is an issue.  PathophysiologyThe cause of MIS-C is probably postinfectious immune dysregulation. Only a minority of MIS-C patients are identified as having COVID-19 by RT-PCR, but most have positive tests for immunoglobulin G.  Statistically, there is a lag of 4-6 weeks between peak community cases of COVID-19 and the time at which children present with MIS-C.   Although research is being done on MIS-C, and theories abound about etiology, there is no clear-cut answer to why some children get MIS-C and the vast majority do not. In a review of the literature on MIS-C using literature from December 2019 through May 2020, gastrointestinal symptoms such as diarrhea, and abdominal pain were 4-5 times more common than cough and respiratory distress.  There was a slight preponderance of male patients and mean age was 8 ½ years. ICU admission was common and 2/3 required inotropic support, over ¼ needed respiratory help with extracorporeal membrane oxygenation warranted in 31 children. The death rate was 1.5 % of these very sick children treated in hospital.  In another smaller study, 80% had mild, but 44% had moderate to severe EKG abnormalities including coronary involvement. The good news was that coronary arteries were normal in all children after a month, and at 4-9 months, only 2-4% had mild heart abnormalities. Unfortunately, mechanisms of MIS-C as well as universal treatment is still being worked out. Published articles may be delayed due to time constraints in publishing. Other immunologic interventions do not have sufficient data. TreatmentWhat about the treatment of children diagnosed with MIS-C?Usually, a variety of specialists become involved initially. These can include pediatric rheumatology, infectious disease, cardiology, and hematology. If children with MIS-C meet criteria for complete or incomplete Kawasaki disease as well, regardless of COVID-19 testing results, IVIG and aspirin are reasonable.  Corticosteroid use must be individualized, and if used it may require a taper.  An echocardiogram can be done initially looking for coronary aneurisms and repeated in a week.  In severe cases, shock may be a presenting factor needing urgent attention. Generally, the treatments used are decided by the aforementioned consults and may consist of immunomodulating therapy, including possibly IVIG (2g/kg), and/or corticosteroids methylprednisolone (30mg/kg).  AntiviralsThe role of antiviral therapy is unclear and remdesivir should be reserved for children with acute COVID-19.  COVID-19 vaccination-associated myocarditisAnother entity which needs further evaluation is COVID-19 vaccination-associated myocarditis in adolescents. This problem is more common in young males and may occur after the administration of mRNA based COVID-19 vaccines. The presentation occurs within 2 weeks of COVID-19 vaccination, and clinical presentation can include chest pressure, abnormal biomarkers (elevated troponins), and cardiac imaging findings. It is unknown if subclinical cases occur.  COVID-19 infection in children, while usually benign, has the potential to become serious, and the association between some mRNA vaccines and the occurrence of myocarditis has yet to be thoroughly studied. We look forward to more and better data to guide the care of children and young adults in these spheres. The risk of having myocarditis is still higher with the actual COVID-19 than the COVID-19 vaccine. The incidence of myocarditis after BioNtech/Pfizer vaccine was 2.13 cases per 100,000 persons in a large study done in a large health care organization in Israel where more than 2 million people were vaccinated (that represents 0.00213%). Another US study showed that there were 77 cases per million doses of vaccines in young male, in contrast, there were 450 cases of myocarditis per million COVID-19 cases in the same age group.____________________________Conclusion: Now we conclude our episode number 74 “Multisystem Inflammatory Syndrome in Children.” Dr. Schlaerth explained that MIS-C is a work in progress in terms of pathophysiology, diagnosis, treatment, and prognosis. MIS-C and Kawasaki Disease are very similar, but, for example, GI symptoms, cardiac dysfunction, shock and multisystem dysfunction are more prominent in MIS-C than Kawasaki Disease. Whereas coronary artery aneurysms are more common in Kawasaki disease than MIS-C. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Katherine Schlaerth, and Lam Chau. Audio edition: Suraj Amrutia. See you next week! _____________________References:FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014, June 04, 2021, U.S. Food and Drug Administration (FDA), https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014. Saxon DR, Iwamoto SJ, Mettenbrink CJ, et al. Antiobesity Medication Use in 2.2 Million Adults Across Eight Large Health Care Organizations: 2009-2015. Obesity (Silver Spring). 2019;27(12):1975-1981. doi:10.1002/oby.22581. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6868321/.  Carroll, Linda, Weight-loss pills can help. So why don't more people use them? NBC News Health Care, September 2, 2018.  https://www.nbcnews.com/health/health-care/weight-loss-pills-can-help-so-why-don-t-more-n905211 World Health Organization, WHO recommends groundbreaking malaria vaccine for children at risk, October 6, 2021. https://www.who.int/news/item/06-10-2021-who-recommends-groundbreaking-malaria-vaccine-for-children-at-risk Lee, Min-Sheng et. al, Similarities and Differences Between COVID-19-Related Multisystem Inflammatory Syndrome in Children and Kawasaki Disease, Front. Pediatr., 18 June 2021, https://doi.org/10.3389/fped.2021.640118.  Gail F. Shust, Vijaya L. Soma, Philip Kahn and Adam J. Ratner, Pediatrics in Review July 2021, 42 (7) 399-401; DOI: https://doi.org/10.1542/pir.2020-004770. Jain SS, Steele JM, Fonseca B, et al. COVID-19 vaccination-associated myocarditis in adolescents. Pediatrics. 2021; doi:10.1542/peds.2021-053427.  https://pediatrics.aappublications.org/content/pediatrics/early/2021/08/12/peds.2021-053427.full.pdf.  Wilson, Clare, Myocarditis is more common after covid-19 infection than vaccination,  New Scientist, 4 August 2021, https://www.newscientist.com/article/mg25133462-800-myocarditis-is-more-common-after-covid-19-infection-than-vaccination/#ixzz79JPn2E47. Son, Mary Beth F, MD, and Kevin Friedman, MD, COVID-19: Multisystem inflammatory syndrome in children (MIS-C) clinical features, evaluation, and diagnosis, Up to Date, September 2021, https://www.uptodate.com/contents/covid-19-multisystem-inflammatory-syndrome-in-children-mis-c-clinical-features-evaluation-and-diagnosis?search=kawasaki%20vs%20misc&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1  

Stroke Alert
Stroke Alert November 2021

Stroke Alert

Play Episode Listen Later Nov 18, 2021 28:22


On Episode 10 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the November 2021 issue of Stroke: “Biomarkers of Coagulation and Inflammation in COVID-19–Associated Ischemic Stroke” and “Treatment-Associated Stroke in Patients Undergoing Endovascular Therapy in the ARUBA Trial.” She also interviews Dr. S. Claiborne Johnston about “Ischemic Benefit and Hemorrhage Risk of Ticagrelor-Aspirin Versus Aspirin in Patients With Acute Ischemic Stroke or Transient Ischemic Attack.” Dr. Negar Asdaghi: 1) What is the net ischemic benefit derived from combination of ticagrelor and aspirin treatment in patients with mild ischemic stroke or transient ischemic attack? 2) Is the ischemic stroke in patients hospitalized with COVID-19 associated with the rise in biomarkers of inflammation and coagulopathy? 3) What are the characteristics associated with periprocedural stroke in patients treated endovascularly for an unruptured AVM? We'll discuss these topics and much more at today's podcast. Stay with us. Dr. Negar Asdaghi:                        Welcome back to the Stroke Alert Podcast. My name is Negar Asdaghi. I'm an Associate Professor of Neurology at the University of Miami Miller School of Medicine and your host for the monthly Stroke Alert Podcast. For the November 2021 issue of Stroke, we have a large selection of topics, from peanut consumption reducing the risk of ischemic stroke, and the decline in the rate of progression of coronary atherosclerosis in patients on a Mediterranean diet, to how the efficacy of endovascular thrombectomy diminishes in patients with more pervious thrombus composition, which I encourage you to review in addition to our podcast today. Dr. Negar Asdaghi:                        Later in the podcast, I have the distinct honor of interviewing Dr. Claiborne Johnston from Dell Medical School at UT Austin on his latest work with data from the THALES trial to clarify the net ischemic benefits derived from a combination of ticagrelor and aspirin therapy in comparison with the risks of hemorrhage associated with this treatment in patients with mild and moderate stroke and TIA. But first with these two articles. Dr. Negar Asdaghi:                        COVID-19–associated ischemic stroke, or CAIS, is a new term that, unfortunately, stroke physicians need to be familiar with. While acute ischemic stroke can occur in parallel from, say, traditional causes of stroke in patients infected with coronavirus, ischemic stroke and other thrombotic events, such as myocardial infarction, pulmonary embolism, deep vein thrombosis, and acute limb thrombosis, can occur in the setting of overt hyperinflammation and subsequent coagulopathy that is observed in patients hospitalized with severe COVID-19 illness. Dr. Negar Asdaghi:                        Elevated D-dimer, although quite non-specific, has emerged as a marker of COVID-19–associated coagulopathy, but whether an elevated D-dimer in isolation or in combination with various other inflammatory and coagulation markers is associated with development of acute in-hospital ischemic stroke in those hospitalized with COVID is not known. Dr. Negar Asdaghi:                        So, in the current issue of the journal, in the article titled "Biomarkers of Coagulation and Inflammation in COVID-19–Associated Ischemic Stroke,” Dr. Charles Esenwa from the Department of Neurology at Montefiore Medical Center and colleagues did an interesting analysis of over 5,000 patients with COVID-19 who were admitted to one of the Montefiore Health System hospitals between March 1, 2020 and May 8, 2020. This was a retrospective analysis, so they had to work with the available biomarkers for each patient and use a machine learning cluster analysis of these biomarkers to divide the patients basically based on five biomarkers to four clusters. Dr. Negar Asdaghi:                        The following five biomarkers were chosen by this machine learning cluster analysis. These included CRP, D-dimer, LDH, white BC, and PTT. So, they had to come up with some arbitrary rules to exclude biomarkers that were either missing in over 30% of their population, and they also excluded those patients that were hospitalized for a long period of time, and they chose a 30-day hospitalization and over. And they also only used the first reading for each biomarker. Again, these were arbitrary rules that were set forth by the authors, and they found some alarming findings. When they clustered patients based on similarities in these biomarkers, they came up with predicted models for combined thrombotic events and acute ischemic stroke. Dr. Negar Asdaghi:                        For example, in the cluster where the patients had the highest mean values for CRP, D-dimer, LDH, and white BC, and a relatively low PTT, these patients had the highest prevalence of acute ischemic stroke. They had the highest prevalence of in-hospital strokes and severe strokes and highest percentage of total thrombotic events. In contrast, the cluster with the lowest mean of all of these five biomarkers had no cases of in-hospital acute ischemic strokes; they had the lowest prevalence of composite, all thrombotic events, and patients had the least severe complications. Dr. Negar Asdaghi:                        So, they also tested the effects of biomarkers individually for prediction of acute ischemic stroke. And it turns out that when they used a lone marker, only D-dimer again was associated with acute ischemic stroke. Very interestingly, D-dimer was specifically elevated in those COVID-19 patients in whom the stroke was ultimately classified as cryptogenic. Dr. Negar Asdaghi:                        So, what does that mean? That means that it's more likely that a stroke had occurred in the setting of severe COVID-19 hyperinflammatory response, and less likely associated with other classical causes of stroke. Dr. Negar Asdaghi:                        So, what did we learn overall from this study? Well, hospitalized COVID-19 patients with a combination of high CRP, D-dimer, LDH, and white BC, and slight reduction in their PTT, had a 4.5-fold increase in the risk of in-hospital mortality and a fivefold increase in the risk of in-hospital stroke as compared to the COVID-19 patients with the lowest mean values for all the five biomarkers mentioned above. So, important information to keep in mind as we treat hospitalized COVID-19 patients, and we await more prospective data on this topic. Dr. Negar Asdaghi:                        Arteriovenous malformations, or AVMs, are congenital vascular lesions that are associated with long-term excess mortality and morbidity, essentially almost all related to their risk of intracerebral hemorrhage. Roughly half the patients with brain AVMs present with intracerebral hemorrhage, resulting in a first-ever hemorrhage rate of about 0.5 per 100,000 person years. Dr. Negar Asdaghi:                        Annual risk of hemorrhage is estimated at 1 to 4% for all comers with AVMs, but varies significantly, and can be as low as 0.9% in patients with unruptured, superficially located brain AVMs with superficial drainage, but may be as high as over 34% in patients with ruptured, deeply seated brain AVMs with deep venous drainage. So, treatment would entirely be dependent on the type of presentations and characteristics of each patient with an AVM. Dr. Negar Asdaghi:                        Whether unruptured AVMs should be managed clinically or treated either endovascularly or surgically is the subject of the ARUBA trial that is a randomized trial of unruptured brain AVMs. The enrollment of ARUBA was halted by the study's DSMB board, but medical management was found to be superior to treatment arm for the primary outcome of symptomatic stroke and death. Dr. Negar Asdaghi:                        Since then, there's been a lot of focus in the literature and comparison of outcomes between treated and untreated patients with unruptured AVMs, but less has been published on characteristics of patients who suffered from periprocedural stroke, an important part of the primary outcome of ARUBA. So, in the current issue of the journal, we have the study titled “Treatment-Associated Stroke in Patients Undergoing Endovascular Therapy in the ARUBA Trial.” Dr. Negar Asdaghi:                        Dr. Joshua Burks and colleagues from the Department of Neurosurgery at the University of Miami and colleagues evaluated 64 patients with unruptured AVMs enrolled in the ARUBA trial who underwent endovascular treatment as part of the trial and looked at the characteristics of those who suffered a perioperative stroke, defined as a stroke recorded at or within 48 hours of intervention, as this would represent a direct procedure-related complication rather than sequelae of, say, treated or partially treated AVM itself. Dr. Negar Asdaghi:                        All patients who initiated endovascular intervention, including attempted interventions in cases where therapy was aborted secondary to technical or anatomical limitations, were included regardless of randomization or subsequent withdrawal from the study beyond 48 hours following the intervention. So, what they found was that 16% of interventions resulted in stroke, 11% hemorrhagic, and 5% ischemic strokes. And they had no perioperative mortality, which is good news. Dr. Negar Asdaghi:                        In univariate analysis, they found many factors that were more commonly seen in patients that suffered from perioperative stroke as compared to those who did not have a stroke perioperatively. Those factors included, for instance, female sex. Over half of these patients were female. Close to half were enrolled in France. And over 40% of those who suffered a stroke in the perioperative timeframe had Spetzler-Martin grade two AVMs. Dr. Negar Asdaghi:                        When they accounted for all confounding variables, they found that endovascularly treated unruptured AVMs that are supplied by the posterior cerebral artery cortical feeders and those with Spetzler-Martin grade two and three had a higher perioperative stroke risk as compared to their counterparts without these characteristics. Interestingly, there are also significant geographical disparities in the risk of stroke in that patients treated in the United States or Germany had a significantly lower stroke risk than patients treated in other countries. Dr. Negar Asdaghi:                        So, what did we learn from this study? There are patients and lesion characteristics that increase the risk of stroke associated with endovascular treatment of unruptured AVMs. The current study suggests that AVMs with cortical arterial feeders from posterior cerebral artery and those with grade two and three Spetzler-Martin were associated with a higher risk of procedural and periprocedural stroke. Dr. Negar Asdaghi:                        And very importantly, as with every surgical intervention, the risk of a procedure is operator-dependent, as well as center-dependent. And these are important factors to keep in mind as technology evolves and more treatments become available to decide whether to keep or to refer patients with unruptured AVMs to a more experienced center. Dr. Negar Asdaghi:                        Patients with mild ischemic stroke and transient ischemic attack are at high risk of having recurrent ischemic events, especially in the immediate aftermath of their symptom onset. Early diagnosis and initiation of secondary preventive measures, such as antiplatelet or anticoagulation therapies, in the appropriate setting considerably reduce this recurrent risk. Dr. Negar Asdaghi:                        Multiple randomized trials have shown that as compared to treatment with a single antiplatelet agent, dual antiplatelet treatment is more effective in reducing the risk of stroke and other major vascular events in the TIA mild stroke population, a benefit that comes with an expected increase in the risk of hemorrhage. Dr. Negar Asdaghi:                        THALES trial is one of the latest trials to determine the efficacy of dual, which is combination of ticagrelor and aspirin, versus mono-antiplatelet therapy, that is aspirin alone, in eligible patients with non-cardioembolic acute ischemic stroke and TIA. Now, it's important to keep in mind that the primary outcome of THALES is a composite of stroke or death, which included both ischemic and hemorrhagic events. Dr. Negar Asdaghi:                        Now, it's important to understand that while in the setting of a clinical trial, combining the risks associated with dual antiplatelet therapy, which is hemorrhage, and the potential treatment benefit, that is reduction of recurrent ischemic events, is appropriate as part of the outcome selection. In routine practice, this type of primary outcome can obscure the actual trade-offs between the benefits of dual antiplatelet treatment and its inherent hemorrhagic risk. Dr. Negar Asdaghi:                        So, in this issue of the journal, in the study titled "Ischemic Benefit and Hemorrhage Risk of Ticagrelor-Aspirin Versus Aspirin in Patients With Acute Ischemic Stroke or Transient Ischemic Attack," the THALES investigators led by Dr. Claiborne Johnston sought to separate the ischemic benefits of combination of ticagrelor and aspirin therapy from its hemorrhagic risks in patients enrolled in the trial. Dr. Negar Asdaghi:                        I'm joined today by Professor Johnston to discuss the findings of this paper. Dr. Johnston absolutely needs no introduction to the stroke community and our readership. He's a Professor of Neurology at Dell Medical School at the University of Texas at Austin. He's a leader in the field of cerebrovascular disorders, has served as the primary investigator of multiple randomized trials and large prospective studies to evaluate the preventive treatment outcomes in TIA and mild stroke, and has pioneered the development and validation of predictive models for recurrent stroke in this population. He's authored over 700 peer-reviewed manuscripts, has won several awards for research and teaching, and is recognized for his leadership in the field of medicine and healthcare. Dr. Negar Asdaghi:                        Good morning, Clay. We're delighted that you could join us on the podcast. Dr. S. Claiborne Johnston:           Well, thank you. It's wonderful to be here. Thank you for having me. Dr. Negar Asdaghi:                        Thank you. So, THALES is an exciting new addition to the most recent trials of dual antiplatelet therapy that studied mostly the role of clopidogrel and aspirin combination therapy. Can you please start us off by telling us why did we need a new trial in a very similar patient population? Dr. S. Claiborne Johnston:           Well, the primary reason was, yes, clopidogrel works in combination with aspirin in the setting, but clopidogrel is actually a prodrug. It requires conversion in the liver to its active form. And polymorphisms in CYP2C19 and Cyt P450 pathways are really common and associated with an inability or limited ability to convert that prodrug into its active form. So, there are a number of people who may not benefit much, if at all, from clopidogrel. So, it's kind of surprising that it works as well as it does. Dr. S. Claiborne Johnston:           Ticagrelor doesn't have that problem. It's not a prodrug. It acts directly on the P2Y12 inhibitor. And so, the hope was that we would have a more consistent and pronounced effect on risk reduction in patients after TIA and mild to moderate strokes. Dr. Negar Asdaghi:                        Primary efficacy outcome in THALES was different from the primary efficacy outcome chosen for the POINT trial, that was major ischemic events and death from ischemic vascular events, and that of the CHANCE trial, that was a combination of ischemic and hemorrhagic strokes in 90 days. Can you please tell us about the thought process behind choosing this particular primary efficacy outcome in THALES? Dr. S. Claiborne Johnston:           Yeah, so this was encouraged by the regulatory authorities. And so the primary efficacy outcome in THALES is all stroke, hemorrhagic and ischemic, and all death, hemorrhagic and ischemic. And we teased apart just the ischemic etiologies in POINT. Dr. S. Claiborne Johnston:           The rationale was that we were including all the major outcomes that the drug could impact. The problem is that people forget that it includes hemorrhagic events, and then they weigh that efficacy outcome against the safety outcome. And so there's confusion. There's sort of double-counting of safety elements in doing that comparison. Dr. Negar Asdaghi:                        Okay, great. And now, before we hear about how you disentangled the two safety and efficacy outcomes, can you please remind our listeners about the primary results of THALES, which was published obviously a few months ago? Dr. S. Claiborne Johnston:           Yeah, sure. So, it showed that the combination of ticagrelor and aspirin works. It reduced the stroke and death by about 17% over the 30-day period of treatment. So robust effect. There were some increased hemorrhages, and looking at severe hemorrhage as defined by the GUSTO definition, there was almost a fourfold increase, but it was tiny in absolute terms of 0.4% increase. Dr. Negar Asdaghi:                        Okay. So, now it's very important, as you mentioned, this disentangling of recurrent ischemic, again, safety from efficacy outcomes. Your current study that is published in the November issue of Stroke clarified these results. And we're excited to hear about those results. Dr. S. Claiborne Johnston:           That's right. So, there were two problems with the way people have interpreted the results of the THALES trial. One is this entanglement of safety events and both efficacy outcome and the safety outcome. The other was the use of relative risks as opposed to absolute risks, because a high relative risk for a rare event is less important than a small relative risk for a more difference between more common events. And so we wanted to deal with both of those issues. Dr. S. Claiborne Johnston:           So, we defined new outcomes that were not entangled. So, we defined major ischemic events, similar to what we had done in POINT, and then we defined major hemorrhage as being basically irreversible hemorrhage, and compared outcomes in the two groups. And what we found was that when we did it that way, for every 1,000 patients treated, we avoided 12 major ischemic events and produced three major hemorrhages. So, about a four-to-one ratio of ischemic benefit to hemorrhage risk. And that was true at various cutpoints for disability. Dr. S. Claiborne Johnston:           So, if we said, "Okay, yes, you had an event, and are you disabled at last follow-up at 30 days?" Then if we said that, there was also a four-to-one difference in disabling events, ischemic versus hemorrhagic. And if we said a two or greater, so moderate disability or worse, it was the same ratio, four-to-one. Dr. Negar Asdaghi:                        Okay, so four-to-one ratio of benefit. That's an important number to keep in mind. Also reassuring to see that this net clinical benefit or net clinical impact of the combination of therapy was practically the same across all the pre-specified subgroups in the trial. Were you at all surprised by the subgroup analysis? Dr. S. Claiborne Johnston:           Well you know if you do enough subgroup analyses, you're going to find differences, right? And thankfully, we have the looking at interaction terms to keep us honest, but even so, you look at 20 and you're going to have some significant interaction terms, as well. But yeah, it was reassuring that the effects were so consistent across groups. Dr. S. Claiborne Johnston:           I think there's been a tendency to over-interpret results from subgroup analyses. We don't have any evidence to suggest that we should be doing that here. I'm sure we can pick out groups that do better, and we've done that actually. The group with atherosclerosis does particularly well, but is that a chance event or is that real? I think we just have to be super-cautious about subgroup analyses. Dr. Negar Asdaghi:                        So, absolutely. One of the subgroups that I'm personally very interested in is just the time subgroup. So, all of the patients in THALES were enrolled within the first 24 hours, and the subgroup analysis did not show that there were any differences in terms of the net benefit between those that were enrolled earlier, within the first 12 hours, and those that were enrolled later, between 12 and 24 hours. But in routine clinical practice, we often see patients with TIA and mild stroke actually presented to us later than that timeframe entirely. Should we be giving them dual antiplatelet treatment? Dr. S. Claiborne Johnston:           That's a great question. So, we did an analysis in POINT where we modeled out, would we still have an important significant net benefit if we had started the trial later? And we didn't start the trial later, right? So, this was just pretending like anybody who had an event early on was not in the study in starting at a later timepoint and modeling that out. And basically what we found was that for out to three days, there was still a benefit. And, in fact, if you look at that data and look at those tables, you could even say, even out to five days. Dr. S. Claiborne Johnston:           I would say it's not unreasonable to do that given that the risks are so small and they're going to be even later with later treatment. But I would say, too, that even though we're not seeing greater impact within that first 24 hours versus 12 to 24, it just makes sense with event rates being as great as they are early on that if you don't treat with a preventive medication before an event occurs, it doesn't work. So, it just makes sense that as much as possible we ought to treat people as early as possible after their events. Dr. Negar Asdaghi:                        Very important findings and things to keep in mind. I want to ask you about the top two takeaway messages from the study. Dr. S. Claiborne Johnston:           One is that there's a favorable benefit-to-risk ratio for ticagrelor/aspirin in mild to moderate actually ischemic stroke and high-risk TIA from THALES. So that would be number one. Dr. S. Claiborne Johnston:           And then number two is watch your endpoints carefully. Think carefully, too, about whether balancing safety to efficacy events really makes sense and also whether focusing on relative risks really makes sense. I would encourage us, even though our journals tend to push us towards relative risks and we're more familiar with those, I'd encourage us to get more comfortable with using absolute risks in the way we look at data, but also in the way we talk to patients about their impact. Dr. Negar Asdaghi:                        Fair enough. I remember a few years ago, you visited us here at the University of Miami to deliver the annual Cerebrovascular Scheinberg Lecture. And you had mentioned that the idea of dual antiplatelet therapy treatment of patients with TIA mild stroke had come to you many years back when you were still in training, but it took many years for that idea to turn into reality, into randomized trials, and now translated into clinical practice. Dr. Negar Asdaghi:                        At the time, if you recall, this was right before you went to Europe to present the primary results of POINT at the European conference. And the trial results were not publicly available, so you were sworn to secrecy. You couldn't tell us about the results. It's been a few years since then. You've already completed yet another trial on this topic. Can I ask what's next for you and your team as it pertains to acute treatment of patients with TIA and mild stroke? Dr. S. Claiborne Johnston:           Well, there are a few things. So, CHANCE-2 is a really interesting trial. My role in that was peripheral, just really advisory, but it's an exciting trial. So, basically it's looking at people with those CYP2C19 polymorphisms that I mentioned before, people who don't rapidly and readily convert clopidogrel to its active form, and randomizing them to clopidogrel versus ticagrelor. Dr. S. Claiborne Johnston:           So, it's going to give us some head-to-head data on the two drugs and the people who may benefit the most from ticagrelor. And that is complete, and that will be published in the next few months. So, I that's going to be an important trial in people's thinking about how best to approach these patients. Dr. S. Claiborne Johnston:           The second is, you know, we're not done. We still have a 5% risk of events, even in those three dual antiplatelet therapy. And so we need more agents. And we need to think about secondary prevention extending to other groups as well, just as you said, longer periods of time, more severe strokes, people after thrombolysis/thrombectomy. Those are big groups of patients at extreme risk for secondary events, and we have no agents and no data right now. Dr. S. Claiborne Johnston:           I would be concerned about dual antiplatelet therapy in those patients, just given what we've seen about the risks of hemorrhage in the existing groups, which are again manageable and shouldn't change people's decision about treatment. But for the groups I just mentioned, risks of hemorrhage start to get greater. And so one worries about whether dual antiplatelet therapy's the right thing or whether other agents make more sense. So, yeah, we're interested in looking at other agents, some novel, for those other indications as well. Dr. Negar Asdaghi:                        Professor Johnston, thank you for your time, and we look forward to covering more of your research in the future. Dr. S. Claiborne Johnston:           Well, thank you. It's been a pleasure. Dr. Negar Asdaghi:                        Thank you. Dr. Negar Asdaghi:                        And this concludes our podcast for the November 2021 issue of Stroke. Please be sure to check out the November table of contents for a full list of publications, including two important topical review articles, one on thrombus composition after thrombectomy, and one on pearls and pitfalls of perfusion imaging in acute ischemic stroke, as advanced neuroimaging continues to play a critical role in decision-making for acute stroke therapies. Dr. Negar Asdaghi:                        Now, speaking of advanced neuroimaging and the immense role that neuroimaging plays in our day-to-day practice, let's take a moment as we end our November podcast to remember how the concept of medical imaging first began over 120 years ago with the discovery of X-ray by German professor of physics Wilhelm Röntgen. Dr. Negar Asdaghi:                        On Friday, November 8, 1895, while experimenting with electricity, Röntgen accidentally discovered a new kind of rays that he referred to as X-rays. He soon realized that X-rays were capable of passing through most substances, including the soft tissues of the body, but left bones and metals visible. Dr. Negar Asdaghi:                        One of his earliest photographic plates of his experiments was a film of his wife Bertha's hand with her wedding ring clearly visible. This was the first time that the inside of human body was seen without performing surgery. Dr. Negar Asdaghi:                        From Röntgen's first X-ray image to the advanced neuroimaging that we review today on our portable devices, I can't help but wonder, what will your accidental discovery on a Friday fall afternoon in November do to advance the field of science and stroke 100 years from now, as we continue to stay alert with Stroke Alert. Dr. Negar Asdaghi:                        This program is copyright of the American Heart Association, 2021. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, visit AHAjournals.org.

Fleischzeit - Carnivore and more
Ein Leben ohne Dickdarm - Svens Erfolgsgeschichte: Krankheitsgeschichte, Verdauung ohne Darm, Morbus Crohn, Ernährung im Krankenhaus, Männerbrüste durch Pflanzenöle, Carnivore Diet uvm.

Fleischzeit - Carnivore and more

Play Episode Listen Later Nov 14, 2021 64:29


„So gut wie mit Carnivore habe ich mich seit 15 Jahren nicht mehr gefühlt!“Sven hat Morbus Crohn, seit er denken kann. Antibiotika gegen Darmerkrankungen erhielt er sehr häufig. Mit 17 bekam er die Diagnosen Essstörung, Schulangst und Bulimie, weil er angab, häufig zu erbrechen. Eine Magen-Darm-Spiegelung brachte dann aber die Wahrheit ans Licht. Um das Jahr 2000 hatte er seine erste OP am Darmtrakt. Aufgrund einer Entzündung wurden 20 cm herausgeschnitten. 10 Jahre später nach einer kohlenhydratreichen Ernährung mit vielen Süßigkeiten und auch dem Versuch der vegetarischen Ernährung stand die zweite OP an. Eine Stenose, also Engstelle hatte sich aufgrund der Entzündung mit einem Öffnungsdurchmesser von gerade mal 2 bis 3 mm gebildet. Das führte zu starken Krämpfen und auch Durchfällen alle 30 Minuten. Er ist sich sicher, dass auch der Stress die Symptome verstärkt hat. Vor seiner dritten OP war er bereits zur ketogenen Ernährung gekommen und es ging ihm damit auch schon viel besser. Jetzt mussten aber wieder Engstellen, die auch von den Narben entstanden waren entfernt werden. Außerdem hatten sich im Dickdarm viele Fisteln gebildet, die lebensgefährlich waren. Deshalb erhielt er schließlich einen künstlichen Darmausgang. Der Dickdarm ist im Körper geblieben, aber wurde stillgelegt. Der Dünndarm wurde durch die Bauchdecke ausgeleitet. Immer noch teilweise Durchfälle. Man verliert immer 3 l Flüssigkeit, weil der Dickdarm nicht mehr zum Resorbieren der Verdauungssäfte da ist. Deshalb benötigt er auch viele zusätzliche Elektrolyte.Sven ernährt sich nicht nur Carnivore, aber wenn er sich rein Carnivore, also nur von Fleisch und Fett ernährt, tut ihm das am besten. Mit Gemüse ist sein Ausgang sehr viel flüssiger. Er hat mehr Energie durch Carnivore. Mais kommt raus, wie er ihn isst. Broccoli, Blumenkohl, Pilze, Hülsenfrüchte auch. Man kann die Gemüsesorten dann im Beutel erkennen. Pilze werden gar nicht verdaut. Hülsenfrüchte kommen so, wie er sie gebissen hat, wieder raus. Bei Eiern, Fleisch und Fett kommt am wenigsten im Beutel raus. Bei rohem Fleisch gar nichts. Durch Milchprodukte entstehen eher Durchfälle. Rohe Eier werden auch komplett verdaut. Als Supplement ist für ihn 30 g Fischöl aufgrund der Omega-3-Fettsäuren sehr wichtig. Sein Entzündungswert, also CRP-Wert, lag bei 300. Jetzt im April, zwei Jahre später hatte er einen CRP-Wert von 7. Laut Aussage der Ärzte ist es ein Wunder, dass er das nicht ohne Cortison geschafft hat. Er möchte kein Cortison mehr nehmen, denn durch die früheren Cortisoneinnahmen hat er bereits eine sehr starke Osteoporose bekommen. Seine Ketonwerte liegen immer etwas über 2. Kokosöl führte bei ihm zu einem Juckreiz. Leinöl durch die Phytoöstrogene zu einer unschönen Veränderung des Körperbaus. Seit gespannt auf das unheimlich interessante Interview mit Sven, das uns eine Erfahrungswelt öffnet zu unserem Verdauungssystem, die wir alle nicht erfassen können. Außerdem zeigt uns Svens Erkrankung, wie falsch geleitet unsere Ernährungsratschläge mit vielen Ballaststoffen und viel Getreide sind.Fleischzeit ist der erste deutschsprachige Podcast rund um die carnivore Ernährung. Hier erfahrt ihr Tipps zur Umsetzung des carnivoren Lifestyles, wissenschaftliche Hintergründe zur Heilsamkeit sowie ökologische und ethische Informationen zum Fleischkonsum.Andrea Sabine Siemoneit und Dave Niedermayr berichten nach zwei Jahren carnivorer Ernährung über ihre Erfahrungen und Erkenntnisse. Außerdem interviewen sie andere Carnivoren.Ihr findet uns auf Instagram unter:@fleischzeitpodcast, @fastencoachdave, @carnitarierinAndreas Website, wo ihr auch Das Handbuch der Carnivoren Ernährung erwerben sowie den Link zum Coaching finden könnt: www.carnitarier.deZur Salzmische von Dave oder zu seinen Coaching beim Fasten oder bei Carnivore kontaktiert ihr ihn unter dave@salzmische.de oder unter der Telefonnummer +49 1515 9454596.Haftungsausschluss:Alle Inhalte im Podcast werden von uns mit größter Sorgfalt recherchiert und publiziert. Dennoch übernehmen wir keine Haftung für die Richtigkeit, Vollständigkeit oder Aktualität der Informationen. Sie stellen unsere persönliche subjektive Meinung dar und ersetzen auch keine medizinische Diagnose oder ärztliche Beratung. Dasselbe gilt für unsere Gäste. Konsultieren Sie bei Fragen oder Beschwerden immer Ihren behandelnden Arzt.

The Whole View
Episode 482: Natural Pain Management Strategies

The Whole View

Play Episode Listen Later Nov 12, 2021 70:29


This week, Stacy and Dr. Sarah break down Sarah's top 3 natural strategies for pain management and how each can be used in addition to or even in place of a prescribed pain plan. Links to any products and articles discussed in the episode here on Monday! This week's listener question: Hi Dr. Sarah and Stacy. My question is - how to begin the AIP without NSAIDs? I understand why removing them is critical - to recognize what foods and lifestyle components may drive inflammation. However, osteoarthritis is in both knees with the right one being bone on bone and in the cervical area, again with the right side being worse.  Generally, I use aleve for pain and if I don't have to travel or go in the office, I either don't use it or use one instead. But with job sites reopening, I have had to use them more frequently and I have a bit of travel for my job. Oh, I'll also mention that at one point, my CRP level was 41 and at last test a couple of years ago, it was down to 19. So I'm open to any suggestions on how to better manage the health challenges so I can begin AIP properly. Thanks so much! I take supplements including vitamins c and d, both of which are to reduce C-reactive protein. I strive for 8 hours of sleep though it's mostly interrupted and have year round allergies for which I currently receive allergy shots. I also manage PCOS and osteoarthritis.  - Nicole Don't forget to subscribe to this channel and visit realeverything.com and thepaleomom.com!  If you haven't yet unlocked our bonus content, checkout Patreon for exclusive behind-the-scenes content and how Stacy and Sarah really feel about the topics they discuss. Your subscription goes to support this show and gets you direct access to submit your questions! We also want to give a big thank you to this week's sponsors! ThirdLove | 20% off Storyworth | $10 off your first order Raycon | 20% off Public Goods | $15 off your first order Learn more about your ad-choices at https://www.iheartpodcastnetwork.com

Edible-Alpha® Podcast
How Eco Practices Can Boost Farm Revenues

Edible-Alpha® Podcast

Play Episode Listen Later Nov 11, 2021 67:15


In Edible-Alpha® podcast #100, we bring back FFI founder Tera Johnson, who is now CEO of Iroquois Valley Farmland REIT, an organic farmland finance company. She was the featured presenter for our October 26 “Enhancing Farm Revenues with Conservation Practices & Ecosystem Services” webinar, which forms the basis of this podcast. Tera defines ecosystem services on-farm conservation practices and structural improvements that farmers can get at least partially reimbursed or credited for. Examples include converting cropland to CRP, planting riparian buffers to protect waterways, acquiring high tunnels for controlled growing, or leasing space for solar arrays. Farmers can sometimes stack these practices, purposing the same piece of land for multiple benefits and credits. The USDA's Natural Resources Conservation Service (NRCS) has a thick catalog of programs and initiatives for farmers, and the financial kickbacks can be significant. However, the options can be tricky to wade through and understand which would make sense on an individual farm. Some USDA offices provide excellent assistance, but this isn't always the case. Some conservation practices, such as nutrient mitigation, are gaining traction with other sectors as well. More county and municipal governments and sewage districts are incentivizing farmers to keep phosphorus and other nutrients on-farm and out of waterways. Farmer incentives for solar installation are gaining steam, too, especially in the expansive, sunny West. The financial benefits of these programs for farmers can be significant. However, the reimbursement process may be complex and drawn out. Sometimes farmers must foot the bill upfront, or their exact earnings may be outcome dependent, such as solar- or wind-power generation. Next, Tera and Andy discuss carbon sequestration, a key tenet of regenerative ag—and a hot topic lately, with more and more stakeholders incentivizing farmers to capture carbon in the soil. But, as Tera notes, we're in the Stone Age of this market, so it's kind of a Wild West, lacking universal measurement or impact standards. Many farmers are receiving offers from carbon credit buyers, but don't know who to trust. And whether organic and regenerative farmers who've been sequestering carbon for years are being justifiably recognized or compensated for their efforts is still murky. Tera says these kinks should all get ironed out eventually, as this is clearly the future of ag. Webinar participant Marie Raboin, who works in phosphorous crediting and adaptive management in Dane County, Wisconsin, while also running Brix Cider, adds important context to the discussion: Even though science shows many conservation practices work, farmers aren't always eager adopters. This requires them to think very differently about their farm, and they need to feel like they can trust the people and organizations propositioning them. Marie says farm businesses work very differently than most, and outside parties must respect their culture, language and way of doing things. Despite the complexities and yet-to-be-worked-out aspects of ecosystem services and conservation practices, both Tera and FFI strongly believe they are well worth farmers exploring for their many environmental and economic benefits.

ASCO Guidelines Podcast Series
Musculoskeletal Toxicities: Management of irAEs Guideline (Part 7)

ASCO Guidelines Podcast Series

Play Episode Listen Later Nov 8, 2021 10:20


An interview with Dr. Maria Suarez-Almazor from MD Anderson Cancer Center, author on “Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update.” She reviews identification, evaluation & management of musculoskeletal toxicities in patients receiving ICPis, including inflammatory arthritis, myositis & polymyalgia-like syndrome in Part 7 of this 13-part series. For more information visit www.asco.org/supportive-care-guidelines   TRANSCRIPT [MUSIC PLAYING] SPEAKER: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care, and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. BRITTANY HARVEY: Hello and welcome to the ASCO Guidelines podcast series brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all the shows, including this one, at ASCO.org/podcasts. My name is Brittany Harvey, and today, we're continuing our series on the management of immune-related adverse events. I am joined by Dr. Maria Suarez-Almazor from the University of Texas M.D. Anderson Cancer Center in Houston, Texas, author on Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update and Management of Immune-Related Adverse Events in Patients Treated with Chimeric Antigen Receptor T-Cell Therapy: ASCO Guideline. And today, we're focusing on musculoskeletal toxicities in patients treated with immune checkpoint inhibitor therapy. Thank you for being here, Dr. Suarez-Almazor. MARIA SUAREZ-ALMAZOR: Thank you. BRITTANY HARVEY: First I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The full conflict of interest information for the guideline panel is available online with the publication of the guidelines in the Journal of Clinical Oncology. Dr. Suarez-Almazor, do you have any relevant disclosures that are directly related to these guidelines? MARIA SUAREZ-ALMAZOR: Thank you, Brittany. I don't have any disclosures directly related to the guidelines. BRITTANY HARVEY: Thanks very much. Then getting into the content of this, what are the immune-related musculoskeletal toxicities addressed in this guideline? MARIA SUAREZ-ALMAZOR: There are three major musculoskeletal syndromes covered in this guideline-- inflammatory arthritis, myositis, and polymyalgia rheumatica. BRITTANY HARVEY: Great. Then let's start with that first one that you mentioned. So what are the key recommendations for identification, evaluation, and management of inflammatory arthritis? MARIA SUAREZ-ALMAZOR: The diagnosis of inflammatory arthritis is primarily based on a thorough joint exam to detect the presence of synovitis and how many joints and what joints are actually involved. For this reason, we recommend early referral to a rheumatologist. From a diagnostic perspective, we recommend testing for antinuclear antibodies or ANA, rheumatoid factor, and cyclic citrullinated peptide antibodies or anti-CCP. These are only positive in 10% to 20% of patients but may be indicative of a more persistent disease. As inflammatory arthritis does not have any specific biochemical parameters for follow up, we use inflammatory markers such as sed rate and CRP in conjunction with the clinical exam as indicators of disease activity. For grades 1 and 2, we recommend treatment with nonsteroidal anti-inflammatory drugs or NSAIDs, or low-dose steroids up to 20 milligrams of oral prednisone or equivalent. If there is involvement of only one or two joints, local treatment with steroid injections can be indicated. For grade 3 and higher, the dose of steroids can be increased up to 0.5 to 1 milligram per kilogram of body weight. And if there is no improvement within two weeks or if the steroids cannot be satisfactorily tapered, we recommend early initiation of a disease-modifying antirheumatic drug or a DMARD, such as methotrexate, hydroxychloroquine, or sulfasalazine. We need to understand though that these may take up to two or three months to be effective. Alternatively, we can use biologic agents which have a faster onset of action. Recommended agents include tumor necrosis factor or interleukin 6 receptor inhibitors. In severe cases, immune checkpoint inhibitors may need to be permanently discontinued. But the overall goal is to try to continue therapy while we treat the adverse event. BRITTANY HARVEY: Understood. Appreciate your reviewing that information for inflammatory arthritis. Following that, what are the key recommendations for identification, evaluation, and management of myositis? MARIA SUAREZ-ALMAZOR: Well, myositis is really the most serious of the musculoskeletal toxicities. And it can be life threatening, especially when it's associated with myocarditis and with myasthenia gravis features. It usually presents with proximal weakness of the upper and lower extremities and sometimes with myalgia and even rhabdomyolysis. It usually is very acute in its presentation. Specific testing includes muscle enzymes, creatine kinase and aldolase, and electromyography and muscle biopsy if the diagnosis is uncertain. MRI can be useful as it can show muscle inflammation. And it can also assist in identifying a location for a biopsy if needed. Consultation with rheumatology and neurology should be requested early on. We also recommend that all patients undergo testing of cardiac enzymes such as troponin. And if elevated, a cardiology consultation should be placed right away and further testing performed. For grades 1 and 2, if patient has symptoms, treatment with corticosteroids are 0.5 to 1 milligram per kilogram should be initiated. For patients with grade 3 or 4, checkpoint inhibitors should be discontinued and the patient should be hospitalized. Corticosteroids should be initiated at a dose of 1 milligram per kilogram of prednisone or equivalent. And patients with severe compromise may need intravenous corticosteroid doses at higher doses of 1 or 2 milligrams per kilogram or even higher. For severe disease or if there is myocarditis or concomitant myasthenia gravis, we can consider plasmapheresis. IVIG can also be used, but it has a slower onset of action. And it is important to remember that plasmapheresis can remove immunoglobulins. So if it is to be used, the IVIG should be administered after the plasmapheresis is completed. There are other immunosuppressant therapies such as biologic agents that can also be considered. And sometimes for maintenance, oral immunosuppressants such as azathioprine, methotrexate, or mycophenolate mofetil can also be considered. Patients with severe disease may need to permanently discontinue the checkpoint therapy. BRITTANY HARVEY: OK, those details are helpful for clinicians. So then, for the last category, addressed in this guideline that you mentioned, what are the key recommendations for identification, evaluation, and management of polymyalgia-like syndrome. MARIA SUAREZ-ALMAZOR: Polymyalgia rheumatica syndromes present with marked pain and stiffness of the muscles in the shoulder and hip girdles. But some patients can also present with concomitant inflammatory arthritis. The workup is very similar to that of arthritis. In these patients, it is very important though to obtain a creatine kinase so that the muscle enzyme to be certain that the myalgia is not from myositis, as a treatment would be very different. Although very rare, polymyalgia, in some instances can be associated with giant cell arteritis which, if present, would require more aggressive treatment. For this reason, it is important to ask the patient about symptoms such as headache, visual disturbances, or jaw claudication. The management of polymyalgia-like immune adverse events alone, without any associated vasculitis, is very similar to that of arthritis. So we would use NSAIDs and low-dose steroids for grade 1 and 2. Higher doses of steroids and disease modifying agents, including biologics, might be needed for grades 3 and 4. But overall, very similar management as that of inflammatory arthritis. BRITTANY HARVEY: Great. Thanks for reviewing all of those recommendations for those three different categories. So then, in your view, Dr. Suarez-Almazor, how will these recommendations for the management of musculoskeletal toxicities impact both clinicians and patients? MARIA SUAREZ-ALMAZOR: Thank you, Brittany. For the most common rheumatologic adverse events, such as arthralgia, inflammatory arthritis, or polymyalgia-like syndromes, because they are not life threatening, we may not be as worried. But we need to recognize that they can greatly impair quality of life. So we really hope that these recommendations can assist patients and clinicians in the early recognition of symptoms and also in initiating prompt treatment so our goal to be able to continue checkpoint inhibitor therapy can be achieved by controlling the symptoms that really impair quality of life. Myositis is a much more serious adverse event that can lead to death. Patients may not be able to restart immune checkpoint inhibitor therapy again after they develop myositis. So we hope that these recommendations do highlight the need for very prompt diagnosis, consultation with specialists, and very aggressive treatment early on to control and manage these devastating, life-threatening adverse event. BRITTANY HARVEY: Definitely. Early recognition, treatment, and improved quality of life are key. So I want to thank you for your work on these guidelines and for taking the time to speak with me today, Dr. Suarez-Almazor. MARIA SUAREZ-ALMAZOR: Thank you, Brittany. BRITTANY HARVEY: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast series. Stay tuned for additional episodes on the management of immune-related adverse events. To read the full guideline, go to www.ASCO.org/supportive-care-guidelines.  You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in iTunes or the Google Play store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. [MUSIC PLAYING]

Growing Harvest Ag Network
Mid-morning Ag News, November 3, 2021: Expert offers advice on feeding lower quality forages

Growing Harvest Ag Network

Play Episode Listen Later Nov 3, 2021 2:27


After this year's drought, many cattle producers are heading into the winter feeding season with lower-quality hay supplies - like CRP hay or corn stover. NDSU Extension Specialist Janna Block says producers need to be honest with themselves about their feed quality -- because there are consequences for pregnant cow conditions this winter, and calf health for next season. See omnystudio.com/listener for privacy information.

ASCO Guidelines Podcast Series
CAR-T Cell Therapy: Management of irAEs Guideline (Part 2)

ASCO Guidelines Podcast Series

Play Episode Listen Later Nov 1, 2021 30:13


An interview with Dr. Bianca Santomasso from Memorial Sloan Kettering Cancer Center and Dr. Monalisa Ghosh from the University of Michigan Health System, authors on “Management of Immune-Related Adverse Events in Patients Treated With Chimeric Antigen Receptor T-Cell Therapy: ASCO Guideline.” They discuss recommendations for management of irAEs in patients treated with CAR T-Cell Therapy in Part 2 of this 13-part series. For more information visit www.asco.org/supportive-care-guidelines   TRANSCRIPT [MUSIC PLAYING] SPEAKER: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. [MUSIC PLAYING]   BRITTANY HARVEY: Hello, and welcome to the ASCO Guidelines podcast series brought to you by the ASCO Podcast Network. A collection of nine programs covering a range of educational and scientific content, and offering enriching insight into the world of cancer care. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today we're continuing our series on the management of immune-related adverse events. ASCO has developed two guidelines for the management of immune-related adverse events-- one for patients treated with immune checkpoint inhibitor therapy and a second for patients treated with CAR T-cell therapy. In our last episode, you heard an overview of the Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update. Today, we'll be focusing on the Management of Immune-Related Adverse Events in Patients Treated with Chimeric Antigen Receptor T-Cell Therapy: ASCO Guideline, and we'll have authors join us for future episodes to discuss the key recommendations for organ-specific management for patients treated with immune checkpoint inhibitor therapy. Today, I am joined by Dr. Monalisa Ghosh, from the University of Michigan Health System in Ann Arbor, Michigan and Dr. Bianca Santomasso from Memorial Sloan Kettering Cancer Center in New York, New York, authors on both Management of Immune-Related Adverse Events in Patients Treated with Chimeric Antigen Receptor T-Cell Therapy: ASCO Guideline and Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update. Thank you both for being here, Dr. Ghosh and Dr. Santomasso. In addition, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest policy is followed for each guideline. The full Conflict of Interest information for this guideline panel is available online with the publication of the guidelines in the Journal of Clinical Oncology. Dr. Ghosh, do you have any relevant disclosures that are directly related to this guideline? MONALISA GHOSH: No. I do not have any relevant disclosures. BRITTANY HARVEY: Thank you. And, Dr. Santomasso, do you have any relevant disclosures that are directly related to this guideline? BIANCA SANTOMASSO: Yes. I'd like to disclose that I've served as a paid consultant for Celgene, Janssen Pharmaceutical, and Legend Biotech for advising them on the topics of CAR T-cell therapy side effects. BRITTANY HARVEY: Thank you. Then, getting into these immune-related adverse events-- first, Dr. Ghosh, can you give us an overview of the scope and purpose of this guideline? MONALISA GHOSH: Sure. The purpose of this guideline is to offer expert guidance and recommendations on the management of immune-related adverse events in patients treated with chimeric antigen receptor or CAR T-cell therapy. This guideline offers guidance on the diagnosis, evaluation, and management of the most common toxicities of CAR T-cell therapy, which includes Cytokine Release Syndrome-- or CRS-- and immune effector associated neurologic syndrome-- or ICANS. As well as other potential, but less common toxicities, such as Hemophagocytic Lymphohistiocytosis-- or HLH-- B-cell aplasia, prolonged and recurrent cytopenias, Disseminated Intravascular Coagulation-- or DIC-- and infections. BRITTANY HARVEY: Great. Thank you. Then, Dr. Santomasso-- looking at this guideline, there's a few overarching recommendations. So, what are those general recommendations for the management of immune-related adverse events in patients receiving CAR T-cell therapy? BIANCA SANTOMASSO: Yes. The overarching recommendations are, really, first to recognize that these side effects exist. And that, as such, it's important to recognize that patients who develop these toxicities or side effects after CAR T-cell therapy need to be evaluated, or managed in, or transferred to a specialty center that has experience with the management of these toxicities. They're new toxicities. This is a new therapy. And patients are increasingly going to be managed in, or treated in, the outpatient setting, and, as such, they need to remain within a short distance of the treating center for about four to eight weeks post-therapy, and they should then return to their treating center upon experiencing any toxicities. Finally, as its flu season and infection season, it is recommended that inactivated influenza and COVID-19 vaccination be performed on patients and also family members as well. And any patient who does have an active infection, the CAR T-cell infusion should be delayed until that infection has been successfully treated or controlled. I often make a final point, which is that the immunogenicity of and efficacy of COVID-19 vaccines is uncertain in these patients with these agents, but the potential benefits outweigh the risks and uncertainties for most patients. BRITTANY HARVEY: Thank you. Those are important points for patients and treating clinicians. So then, Dr. Ghosh-- as you mentioned, this guideline addresses the seven most common CAR-T-related toxicities, and I'd like to review the key recommendations for each of those. So let's start with, what are the key recommendations for identification, evaluation, and management of cytokine-release syndrome? MONALISA GHOSH: Well, Cytokine Release Syndrome is one of the two major toxicities that occur immediately or within a short time period after infusion of CAR T-cells. We have defined Cytokine Release Syndrome, or CRS, as an immune-mediated phenomenon that's characterized by various symptoms that are indicative of immune activation and inflammation. And patients may experience signs and symptoms that could include fever, hypotension, hypoxia, tachycardia, shortness of breath, rash, nausea, headache, and various other symptoms that are a little less common. These symptoms are caused primarily by the release of cytokines. Cytokines are the messengers of the immune system, and most of them are released by bystander immune and non-immune cells. We know that the onset of Cytokine Release Syndrome is variable depending on the CAR T-cell product that's used, as well as the patient population that's treated. But it generally occurs anywhere from two to seven days after infusion of CAR T-cells, and in some rare cases can occur even a little bit later. A standard grading system has been developed and grade CRS, or Cytokine Release Syndrome, based on three parameters-- fever, hypotension, or low blood pressure; and hypoxia or low oxygen levels. CRS is primarily managed with IL-6 antagonists because IL-6 is an inflammatory cytokine that has been shown to mediate a lot of the systemic effects that we see from Cytokine Release Syndrome. And one of the treatments is the monoclonal antibody tocilizumab, which acts against-- or blocks-- the IL-6 receptor. CRS that is refractory to tocilizumab is generally treated with steroids. Then there's limited experience with additional therapies, especially in the setting of CRS, that does not respond to tocilizumab or steroids. There are other anti IL-6 therapies available. For example, siltuximab, which binds to IL-6 itself rather than the IL-6 receptor. However, there have been no direct comparative studies of these agents. Anakinra, which is also an IL-1 receptor antagonist has also been shown to mitigate CRS in some CAR T-cell recipients that have high grade CRS. BRITTANY HARVEY: OK. Thank you for reviewing those management strategies. So, following that-- Dr. Santomasso, what are key recommendations for identification, evaluation, and management of immune effector cell-associated neurotoxicity syndrome? BIANCA SANTOMASSO: Sure. Immune Effector Cell-associated Neurotoxicity Syndrome-- also known as ICANS-- is the second most frequent severe toxicity that can be seen after CAR T-cell therapy. So, what is ICANS? These are transient neurological symptoms that occur in the days after infusion, most commonly with CD19 CAR T-cell therapy. And the clinical manifestations of ICANS include encephalopathy, which is confusion, behavioral changes, expressive aphasia, or other language disturbance, change in handwriting or other fine motor impairment or weakness, and tremor and headache can also be seen. In more severe cases, patients can become obtunded with a depressed level of consciousness or even develop seizures, and they may require a higher level of ICU care, such as intubation for airway protection. And in very rare cases, malignant cerebral edema may develop, which may be fatal. ICANS can occur at the same time as Cytokine Release Syndrome, or can also occur several days after or shortly after CRS resolves, so it's important to have a high index of suspicion even after Cytokine Release Syndrome has resolved, but typically the side effects are self-limited and occur within the one month after infusion. Most symptoms lasts between 5 and 17 days, and the time of onset duration and severity of ICANS may really vary depending on the CAR T-cell product used or the disease state of the patient. So, what do I mean by that? Patients with high disease burden seem to be at increased risk for severe ICANS, so kind of knowing the disease that the patient has and the burden of disease is important. And then also there may be product-specific differences as well, so reviewing the product label is important as well because each may have its own risk evaluation and mitigation strategies that inform both the duration and the frequency of monitoring for ICANS after infusion. For evaluation of ICANS, we recommend, again, the ASTCT ICANS grading system. These allow for monitoring of several different aspects of neurologic function in these patients. Mental status changes are really what define the onset of ICANS. So for CRS, it's fever; for ICANS, it's mental status changes. And the severity of the mental status change can be determined by a standardized score known as the ICE score, which stands for Immune Effector Cell-associated Encephalopathy score. This is a simple 10-point scoring metric where points are assigned for orientation to year, month, city, hospital, ability to name three objects, ability to follow simple commands, write a standard sentence, and count backwards from 100 by tens. And for children younger than age 12 or those with developmental delay, The Cornell Assessment of Pediatric Delirium, also known as the CAPD, can be used in placement of the ICE assessment. Prior to CAR infusion, patients should be evaluated, including with an ICE score, for their baseline neurologic status. And what's nice is that this ICE assessment can be used as a daily screen after CAR infusion for the onset of ICANS during at-risk period. Then, other than the ICE score, there are four other neurologic domains that contribute to ICANS grading, and that's level of consciousness, seizures, severe motor weakness, and signs and symptoms of elevated intracranial pressure or cerebral edema, and patients are graded according to the most severe symptom in any of the five domains. So for patients who develop ICANS, it's recommended that they have workup, including blood work, CRP, CBC, comprehensive metabolic panel, fibrinogen, and coagulation tests. Neuroimaging with a non-contrast CT of the brain should be done and considering MRI of the brain in patients who are stable enough. In addition, electroencephalogram and lumbar puncture should be considered. And the electroencephalogram is really to rule out subclinical seizures, and the lumbar puncture is to assess the opening pressure-- or the pressure within the central nervous system-- and also to send studies to rule out infection. And again, these all have to be considered on an individual case by case basis, but are things to keep in mind. So for treatment of ICANS, the mainstay of treatment is, really, supportive care and corticosteroids. Tocilizumab, while it seems to rapidly resolve Cytokine Release Syndrome and most symptoms, actually does not resolve ICANS and may worsen it, so steroids are really typically used. The typical steroid is dexamethasone at a dose of 10 milligrams, and the interval really depends on the grade of the ICANS. Because of the possibility that tocilizumab may worsen neurotoxicity, ICANS really takes precedence over low grade CRS when the two occur simultaneously. And patients who don't show improvement within 24 hours after starting steroids or other supportive measures should have CSF evaluation and neuroimaging. Often treatment of seizures-- many patients are put on Keppra and levetiracetam or other anti-seizure medicine if they develop ICANS, and patients with grade 3 or greater ICANS may need an ICU level of care and escalation of steroid doses. The steroids are continued until ICANS improves to grade 1 and then tapered as clinically appropriate. And the most important thing to remember is that ICANS just needs to be monitored very closely as patients may worsen as some steroids are tapered. They also may improve rapidly after steroids are started, so steroids should be tapered quickly as patients improve. And, again, as with CRS, there's limited experience with other agents, such as Anakinra and siltuximab, but those could be considered in severe or refractory cases. BRITTANY HARVEY: Understood. I appreciate you going through when and how clinicians should screen for ICANS and those key management points. So, in addition to that-- Dr. Ghosh, what are the key recommendations regarding cytopenias? MONALISA GHOSH: So cytopenias can occur post-CAR T-cell infusion, and they can occur either in the early phase or in the later phase after CAR T-cell infusion. Meaning that they can occur early within the first few days to weeks post-CAR T-cell therapy or could even occur months to years later. These cytopenias include anemia, thrombocytopenia, leukopenia, neutropenia. Many patients may present with fatigue, weakness, shortness of breath, lightheadedness, frequent infections, fevers, bruising, and bleeding, and the symptoms usually are consistent with how they would present otherwise with anemia, thrombocytopenia, or neutropenia. Acute cytopenias within three months of CAR T-cell therapy are more common. This is due to usually the lymphodepleting chemotherapy that is administered prior to CAR T-cell therapy. Most patients receive a combination of fludarabine and cyclophosphamide prior to CAR T-cell infusion, or they may receive another agent, such as bendamustine. Most patients also come into CAR T-cell therapy with low lymphocyte counts from previous therapies. Early cytopenias, as I mentioned, are generally due to lymphodepleting chemotherapy or other recent therapies. There also could be an immune-mediated process due to the CAR T-cells. Usually prolonged cytopenias which occur beyond three months post-CAR T-cell infusion can be seen in a small number of patients. And the mechanism of prolonged cytopenias is really unclear at this time, but likely multifactorial. Most recipients of CAR T-cells who have prolonged cytopenias beyond three months post-CAR T-cell infusion should have a standard workup to rule out other common causes, such as vitamin or nutritional deficiencies. They should also have testing such as bone marrow biopsy and scans to rule out relapse disease-- relapse lymphoma or leukemia, for instance, that could be causing these cytopenias. Other examples would be myelodysplastic syndrome or other bone marrow failure syndromes. So cytopenias are generally managed with supportive care including growth factor and transfusion support. This applies to both cytopenias in the early period post-CAR T-cell therapy or more delayed prolonged cytopenias. In patients who have prolonged cytopenias of unclear cause that could be immune-mediated, other interventions such as high dose IVIG or even steroids could be considered depending on the situation. For those that have cytopenias in the first few months post-CAR T-cell therapy, generally they are monitored and treated with supportive care, and these cytopenias eventually resolve in the majority of patients. BRITTANY HARVEY: Great. Those are important considerations. Then, Dr. Santomasso, what are the key recommendations regarding Hemophagocytic Lymphohistiocytosis? BIANCA SANTOMASSO: The major recommendations for the identification, evaluation, and management of Hemophagocytic Lymphohistiocytosis, or HLH-- this is also known as macrophage activation syndrome. First, let's just start by saying that this is a dysfunctional immune response, and it's basically characterized by macrophages which are revved up and hyperactive and also possibly lymphocytes as well. There are high levels of pro-inflammatory cytokines during this state and tissue infiltration, and hemophagocytosis, and organ damage. This can occur outside of the context of CAR T-cell therapy, either as a primary HLH or secondary HLH that can be either triggered by infections, or autoimmune disease, or cancer-- especially hematological malignancies, but HLH has also been observed as a rare complication of CAR T-cell therapy. And outside of the setting of CAR T-cell therapy, HLH is defined by fever, cytopenias, hyperferritinemia-- or high ferritin level-- as well as bone marrow hemophagocytosis. And what's interesting is that this is very similar to what's seen during Cytokine Release Syndrome, and that can make it difficult for patients who have moderate to severe CRS to distinguish that from HLH. The laboratory results may be very similar. So the key to recognizing HLH is really to have it on your differential even though it occurs rarely after CAR T-cell therapy. It may occur with slightly different timing and may require more aggressive treatment. The lab alterations can include, again, as I mentioned, these elevated levels of several cytokines, such as interferon gamma. We can't normally send those in the hospital or the clinic, but sometimes soluble IL-2 receptor alpha can be sent and serum ferritin can be sent, and that's an especially useful marker. There have been diagnostic criteria for CAR T-cell-induced HLH that have been proposed, and these conclude very high ferritin levels-- over 10,000-- and at least two organ toxicities that are at least grade 3, such as transaminitis, increased bilirubin, renal insufficiency or oliguria, or a pulmonary edema, or evidence of hemophagocytosis in bone marrow or organs. Unlike other forms of HLH that occur outside of the context of CAR T-cell therapy, the patients may not have hepatosplenomegaly, lymphadenopathy, or overt evidence of hemophagocytosis. So just because a patient may not show those yet doesn't mean that HLH shouldn't be considered. If we see patients that have a persistent fever without an identified infection source or worsening fever, we basically should be considering HLH and doing the appropriate workup and treatment. Patients with HLH often have low fibrinogen, high triglycerides, and also cytopenias as well. The treatment-- just as there's an overlap kind of in the signs and symptoms, the treatment and the clinical management overlaps as well with CRS, so tocilizumab is typically administered. But corticosteroids should really be added for these patients, especially if there's clinical worsening or grade 3 or greater organ toxicity. And if there's insufficient response after 48 hours of corticosteroid therapy plus tocilizumab, many centers consider adding another medication such as Anakinra. I'll finally make a comment that, outside of the context of CAR T-cell therapy, HLH is sometimes treated with cytotoxic chemotherapy, such as etoposide. This approach generally is not used as a first line for patients undergoing CAR T-cell therapy due to etopiside's documented toxicity to T lymphocytes. And generally, the corticosteroids, plus the anti IL-6 agent, plus Anakinra is considered the first line of management. BRITTANY HARVEY: Got it. That's an important note on the management of HLH, and a great note on distinguishing CRS and HLH. So in addition, Dr. Ghosh-- what are the recommendations for management of B-cell aplasia? MONALISA GHOSH: B-cell aplasia, it's a disorder that's caused by low numbers or absent B-cells. And this is particularly relevant to CD19 directed CAR T-cell therapy, which is what most of the CAR T-cell therapies that are available right now target. They target CD19, and CD19 is present on normal as well as malignant B-cells. So most patients who receive anti-CD19 CAR T-cell therapy will develop B-cell aplasia at some point, and B-cell aplasia may be temporary or prolonged. It usually does, on one hand, indicate ongoing activity of the CD19 CAR T-cells and can be used as a surrogate marker. And increase in CD19 CAR T-cells could, in some patients, signal impending relapse, or dysfunction, or absence of activity of CD19 CAR T-cells. B-cell aplasia in CAR T-cell recipients is really due to, as I mentioned, an on-target, off-tumor effect. It can be prolonged and there is variability in rates of prolonged B-cell aplasia. The most significant consequence of B-cell aplasia is that it can lead to low immunoglobulin production. And immunoglobulin production is a very important part of the immune response by providing antibody-mediated immunity, so patients may present with frequent infections and low immunoglobulin levels. For most CAR T-cell recipients, this can be managed with infusions of Intravenous Immunoglobulins-- IVIG. However, the presence of B-cell aplasia can also present other challenges-- especially during this current pandemic, as Dr. Santomasso alluded to earlier, that it is unclear if patients will be able to mount a sufficient enough antibody response to the COVID-19 vaccines available since they cannot produce significant amounts of antibodies. This is an active area of research. However, we do advise that all CAR T-cell recipients do get the COVID vaccine and also other seasonal vaccines, such as the influenza vaccine. So it remains to be seen. We need some more long-term follow-up studies on how many people who receive CD19-directed CAR T-cell therapy will have prolonged B-cell aplasia and what the consequences will be. At this time, it is suggested that patients have their IgG levels monitored and-- if possible-- their actual B-cell numbers monitored. And if their IgG levels drop below a certain number, then they may receive IVIG infusions intermittently. We recommend in this guideline using 400 as a possible cutoff for IgG levels prior to administering IVIG. However, if patients have higher IgG levels and they have recurrent or life threatening infections, infusion of IVIG is recommended as a consideration to help boost the antibody response. BRITTANY HARVEY: OK. As you mentioned, those challenges are particularly relevant now. So then, Dr. Santomasso, what are the key recommendations regarding Disseminated Intravascular Coagulation? BIANCA SANTOMASSO: Disseminated Intravascular Coagulation is a disorder that's characterized by systemic pathological activation of blood clotting mechanisms, which results in both clot formation throughout the body and also bleeding. There's an increased risk of hemorrhage as the body is depleted of platelets and other coagulation factors. So it's basically important for clinicians to be aware that DIC-- or Disseminated Intravascular Coagulation-- can occur after CAR T-cell therapy, and it can occur either with or without concurrent Cytokine Release Syndrome. The treatment is primarily supportive care and replacing the factors, such as fibrinogen-- based on the levels-- and also replacing factors based on partial thromboplastin time and bleeding occurrences. But corticosteroids and IL-6 antagonist therapy can be used if there is concurrent CRS or in the setting of severe bleeding complications. There is limited evidence for other interventions. BRITTANY HARVEY: Great. Appreciate you reviewing those. So then, the last category of toxicity addressed in this guideline-- Dr. Ghosh, what are the key recommendations for identification, evaluation, and management of infections? MONALISA GHOSH: So a variety of infections can be seen after CAR T-cell therapy. And there are many factors that can lead to infection after CAR T-cell therapy including the presence of cytokines, such as neutropenia or leukopenia and B-cell aplasia that we earlier discussed-- leading to low immunoglobulin production and protection. As well as the increased risk of infection due to use of high-dose steroids to treat CAR T-cell-related toxicities, such as ICANS or CRS. Early after the infusion of CAR T-cell therapy-- that is, within three months-- patients often develop neutropenia due to lymphodepleting chemotherapy and/or the CAR T-cells themselves. And these patients are particularly susceptible to infection, so most of the infections that occur early on tend to be bacterial infections, and a few fungal infections have been observed as well. Patients who receive high-dose steroids for high grade CRS or ICANS have been shown to have increased serious infectious complications including bacterial infections, fungal infections, as well as viral reactivations. Infectious complications that occur later are often due to hypogammaglobulinemia due to B-cell aplasia and reduced production of immunoglobulins. And treatment is typically directed at the infectious source, as it would be even if these patients did not have CAR T-cell therapy. There are some prophylactic antimicrobials that are recommended for CAR T-cell recipients who have prolonged cytopenias. Especially those with prolonged neutropenia should be on some sort of bacterial and/or fungal prophylactic antimicrobials. Patients should also be monitored for hypogammaglobulinemia long term and should receive intravenous immunoglobulins as needed. As we have mentioned a couple of times already, being very aware that these patients are also more susceptible to seasonal infection, such as influenza, is important, and so vaccinations are very important for this patient population. Vaccinating against influenza and vaccinating against COVID-19. BRITTANY HARVEY: Thank you both for reviewing those key points for the most common CAR T-related toxicities. So, just to wrap us up-- Dr. Santomasso-- in your view, how will this guideline impact both clinicians and patients? BIANCA SANTOMASSO: Well, I think we've seen now that cell therapy is really one of the major advances in cancer treatment in the past decade. And I think it's reasonable to expect more of these cell therapies to be developed, and we'll hopefully see their use extend beyond very specialized centers. But CAR T-cell therapy side effects are manageable if they're recognized, so I think this guideline helps that, and they're reversible with proper supportive care. They can be serious and they require close vigilance and prompt treatment. But, again, we believe this guideline and recommendations will help members of clinical teams with both the recognition and management of all of these toxicities, and that will help patients by increasing their safety. BRITTANY HARVEY: Great. That's important to note that these toxicities can be severe, but are also manageable. So I want to thank you both for your work on these guidelines and for taking the time to speak with me today, Dr. Santomasso and Dr. Ghosh. BIANCA SANTOMASSO: Our pleasure. MONALISA GHOSH: Absolutely. It was my pleasure. BRITTANY HARVEY: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast series. Stay tuned for additional episodes on the management of immune-related adverse events in patients treated with immune checkpoint inhibitors. To read the full guidelines, go to www.asco.org/supportive care guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in iTunes or the Google Play store. If you have enjoyed what you've heard today, please rate and review the podcast, and be sure to subscribe so you never miss an episode. [MUSIC PLAYING]

Naturally Nourished
Episode 262: The Keto-Immune Connection and Natural Immunity Updates

Naturally Nourished

Play Episode Listen Later Oct 18, 2021 64:23


Did you know that a ketogenic diet can support immune health? Beyond its tried and true benefits of weight loss, fertility, and enhanced neurological health, keto has multiple mechanisms that reduce inflammation in the body. In fact, keto can reduce certain inflammatory chemicals including inflammasomes, it can enhance cell membrane health and can even reduce CRP by 35-40%. What's more, there is a direct relationship between ketones and T Cell function including enhanced production and specificity of these long term players of the immune system.    In this episode, we unpack the many benefits of the ketogenic diet on the immune system and get into the nitty gritty research of how a ketogenic diet can be used as a clinical tool for restoring and maintaining metabolic and immune health. We also unpack the taboo topic of n@tural immunitee (did you know it is a banned hashtag?!) Learn how to rev up your immune system using keto along with targeted supplementation and how you can make your terrain resilient to whatever viru$ comes our way next!   Also in this episode:  Next Level Keto - starts 10/27 Women's Wellness Workshop 12/4 - Tickets Available Soon! Become a Client Ali Miller RD Patreon Benefits of KetoEpisode 99: Ketosis as Medicine Episode 121: Keto and Women's hormones 101  Comparison of low fat and low carbohydrate diets on circulating fatty acid composition and markers of inflammation Limited effect of dietary saturated fat on plasma saturated fat in the context of a low carbohydrate diet The relation between insulin sensitivity and the fatty-acid composition of skeletal-muscle phospholipids Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study The Keto Immune Connection & T Cell ImmunityThe ketone metabolite β-hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease Very‐low‐carbohydrate diet enhances human T‐cell immunity through immunometabolic reprogramming | EMBO Molecular Medicine Where to Start?12 Week Food as Medicine Ketosis Program Next Level Keto Vitamin D Balanced Blend Bio-C Plus Cellular Antiox Multidefense Restore Baseline Probiotic Episode 257: Immune Health Q&A Episode 253: Vitamin D Episode 255: Vitamin C Natural ImmunityPersistence of neutralizing antibodies a year after SARS‐CoV‐2 infection in humans Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections   Love the Naturally Nourished Podcast? Consider supporting us through Patreon with tiers from $3 to $25 and perks including exclusive monthly Q&A's, monthly research releases and rants, program and supplement discounts and more! 

The Doctor Is In Podcast
701. New Alzheimer's Study

The Doctor Is In Podcast

Play Episode Listen Later Oct 18, 2021 28:35


Dr. Martin shares a 12 week study that's showing inflammation was reduced by 30% when taking probiotics. A really interesting study that used C-reactive protein (CRP) testing to determine inflammation levels in participants. Inflammation damages blood vessels primarily, but it also affects the brain. More studies are referencing the gut-brain axis and the importance of having healthy bacteria – why everyone needs to be taking probiotics! In today's episode, Dr. Martin also goes over 10 things to keep doing if you want to get Alzheimer's. Nobody wants to get Alzheimer's, but if you keep doing these things, your risk goes up dramatically!  

The Crash Rabbit Pod
Wrestle Princess II - CRP 26

The Crash Rabbit Pod

Play Episode Listen Later Oct 16, 2021 122:58


Robbie & Ty are back on the CRP to discuss TJPW's biggest show of the year: Wrestle Princess II. They talk feelings going into the show, Yuki Arai meeting Aja Kong, the emotional bond between the Magical Sugar Rabbits, and a very noteworthy main event. Follow the Podcast on Twitter: https://twitter.com/crashrabbitpod?lang=en

National Wildlife Federation Outdoors
Take Action with Howard Vincent, President & CEO of Pheasants Forever & Quail Forever.

National Wildlife Federation Outdoors

Play Episode Listen Later Oct 15, 2021 67:19


For this episode we sit down with the President and CEO of Pheasants Forever and Quail Forever, Howard Vincent. We talk pheasant and quail season outlooks and the issues the birds are facing, then we move on to several conservation topics including the upcoming Farm bill and the Conservation Reserve Program – what it does, it's benefits and why it's so important for conservation.  We also cover the recently formed grasslands sporting coalition and their hopes and dreams for restoring America's grasslands. We touch on the Recovering America's Wildlife Act, climate change impacts on wildlife, and why it's so critical average sportsmen and women engage in conservation. Links: https://www.quailforever.org/; https://www.pheasantsforever.org/ ; https://www.actfrograsslands.org   Show notes: 1:05 - Howard Vincent introduction. 3:00 - What has Howard been doing outside recently? 5:05 - General outlook on on this year. How are the pheasants and quail doing overall? 7:54 - What is the state of pheasants and quail? What is the conservation outlook? 13:14 - The Farm Bill 101 and CRP. What they do, what they are designed to do and why we need them. 15:40 - What does a typical CRP acre look like? 20:40 - Precision agriculture.  23:20 - Unpacking the new Farm Bill.  39:50 - A message from our partner podcast, Artemis Sportswomen. 42:10 - The Grasslands Act. What it is and what it's designed to do. 47:34 - How an average Joe/Jane get engaged in the Grasslands Act?  70% of grasslands are gone. The time to act is NOW. 54:27 - Recovering America's Wildlife Act and its importance for the sporting community.  1:02:45 - Closing statement from Howard Vincent. Get fired up! Your voice makes a difference!

Confessions of a Disney Cast Member
160. Discussionist 3: Not So Scary VS Horror Nights

Confessions of a Disney Cast Member

Play Episode Listen Later Oct 14, 2021 74:30


In this week's discussion episode of Confessions of a Disney Cast Member, I am joined by CRP alumni, Cameron Brown, where will be discussing the best and worse of Mickey's Not So Scary Halloween Party and Halloween Horror Nights. Join us every Friday for a new topic where we discuss the past, present and future of all things Disney. This podcast is not affiliated by The Walt Disney Company. Just cast members who love celebrating other cast members and reminiscing.  Follow Us on Instagram: @TheDisneyConfessionist @beingcameron

The Gary Null Show
The Gary Null Show - 10.08.21

The Gary Null Show

Play Episode Listen Later Oct 8, 2021 59:38


Raspberries, ellagic acid reveal benefits in two studies Oregon State University, October 1, 2021.    Articles that appeared recently in the Journal of Berry Research report that raspberries and compounds present in the fruit could help support healthy body mass and motor function, including balance, coordination and strength.   In one study, Neil Shay and colleagues at Oregon State University fed mice a high fat, high sugar diet plus one of the following: raspberry juice concentrate, raspberry puree concentrate, raspberry fruit powder, raspberry seed extract, ellagic acid (a polyphenol that occurs in a relatively high amount in raspberries), raspberry ketone, or a combination of raspberry ketone and ellagic acid. Additional groups of animals received a high fat, high sugar diet alone or a low fat diet.   While mice that received the high fat and sugar diet alone experienced a significant increase in body mass, the addition of raspberry juice concentrate, raspberry puree concentrate or ellagic acid plus raspberry ketone helped prevent this effect. Of note, mice that received raspberry juice concentrate experienced gains similar to those of animals given a low fat diet. "We hope that the findings from this study can help guide the design of future clinical trials," Dr Shay stated.   In another study, Barbara Shukitt-Hale, PhD, and her associates at Tufts University's Human Nutrition Research Center on Aging gave 19 month old rats a control diet or a diet enhanced with raspberry extract for 11 weeks. Psychomotor behavior was assessed during week 7 and cognitive testing was conducted during weeks 9-10.   Animals that received raspberry performed better on psychomotor coordination and balance, and had better muscle tone, strength and stamina than those that received a control diet. "These results may have important implications for healthy aging," stated Dr Shukitt-Hale. "While further research in humans is necessary, animal model studies are helpful in identifying deficits associated with normal aging."       Massage doesn't just make muscles feel better, it makes them heal faster and stronger Harvard University, October 6, 2021 Massage has been used to treat sore, injured muscles for more than 3,000 years, and today many athletes swear by massage guns to rehabilitate their bodies. But other than making people feel good, do these "mechanotherapies" actually improve healing after severe injury? According to a new study from researchers at Harvard's Wyss Institute for Biologically Inspired Engineering and John A. Paulson School of Engineering and Applied Sciences (SEAS), the answer is "yes." Using a custom-designed robotic system to deliver consistent and tunable compressive forces to mice's leg muscles, the team found that this mechanical loading (ML) rapidly clears immune cells called neutrophils out of severely injured muscle tissue. This process also removed inflammatory cytokinesreleased by neutrophils from the muscles, enhancing the process of muscle fiber regeneration. The research is published in Science Translational Medicine. "Lots of people have been trying to study the beneficial effects of massage and other mechanotherapies on the body, but up to this point it hadn't been done in a systematic, reproducible way. Our work shows a very clear connection between mechanical stimulation and immune function. This has promise for regenerating a wide variety of tissues including bone, tendon, hair, and skin, and can also be used in patients with diseases that prevent the use of drug-based interventions," said first author Bo Ri Seo, Ph.D., who is a Postdoctoral Fellow in the lab of Core Faculty member Dave Mooney, Ph.D. at the Wyss Institute and SEAS. Seo and her coauthors started exploring the effects of mechanotherapy on injured tissues in mice several years ago, and found that it doubled the rate of muscle regeneration and reduced tissue scarring over the course of two weeks. Excited by the idea that mechanical stimulation alone can foster regeneration and enhance muscle function, the team decided to probe more deeply into exactly how that process worked in the body, and to figure out what parameters would maximize healing. They teamed up with soft robotics experts in the Harvard Biodesign Lab, led by Wyss Associate Faculty member Conor Walsh, Ph.D., to create a small device that used sensors and actuators to monitor and control the force applied to the limb of a mouse. " The device we created allows us to precisely control parameters like the amount and frequency of force applied, enabling a much more systematic approach to understanding tissue healing than would be possible with a manual approach," said co-second author Christopher Payne, Ph.D., a former Postdoctoral Fellow at the Wyss Institute and the Harvard Biodesign Lab who is now a Robotics Engineer at Viam, Inc.  Once the device was ready, the team experimented with applying force to mice's leg muscles via a soft silicone tip and used ultrasound to get a look at what happened to the tissue in response. They observed that the muscles experienced a strain of between 10-40%, confirming that the tissues were experiencing mechanical force. They also used those ultrasound imaging data to develop and validate a computational model that could predict the amount of tissue strain under different loading forces. They then applied consistent, repeated force to injured muscles for 14 days. While both treated and untreated muscles displayed a reduction in the amount of damaged muscle fibers, the reduction was more pronounced and the cross-sectional area of the fibers was larger in the treated muscle, indicating that treatment had led to greater repair and strength recovery. The greater the force applied during treatment, the stronger the injured muscles became, confirming that mechanotherapy improves muscle recovery after injury. But how? Evicting neutrophils to enhance regeneration To answer that question, the scientists performed a detailed biological assessment, analyzing a wide range of inflammation-related factors called cytokines and chemokines in untreated vs. treated muscles. A subset of cytokines was dramatically lower in treated muscles after three days of mechanotherapy, and these cytokines are associated with the movement of immune cells called neutrophils, which play many roles in the inflammation process. Treated muscles also had fewer neutrophils in their tissue than untreated muscles, suggesting that the reduction in cytokines that attract them had caused the decrease in neutrophil infiltration. The team had a hunch that the force applied to the muscle by the mechanotherapy effectively squeezed the neutrophils and cytokines out of the injured tissue. They confirmed this theory by injecting fluorescent molecules into the muscles and observing that the movement of the molecules was more significant with force application, supporting the idea that it helped to flush out the muscle tissue. To pick apart what effect the neutrophils and their associated cytokines have on regenerating muscle fibers, the scientists performed in vitro studies in which they grew muscle progenitor cells (MPCs) in a medium in which neutrophils had previously been grown. They found that the number of MPCs increased, but the rate at which they differentiated (developed into other cell types) decreased, suggesting that neutrophil-secreted factors stimulate the growth of muscle cells, but the prolonged presence of those factors impairs the production of new muscle fibers. "Neutrophils are known to kill and clear out pathogens and damaged tissue, but in this study we identified their direct impacts on muscle progenitor cell behaviors," said co-second author Stephanie McNamara, a former Post-Graduate Fellow at the Wyss Institute who is now an M.D.-Ph.D. student at Harvard Medical School (HMS). "While the inflammatory response is important for regeneration in the initial stages of healing, it is equally important that inflammation is quickly resolved to enable the regenerative processes to run its full course." Seo and her colleagues then turned back to their in vivo model and analyzed the types of muscle fibers in the treated vs. untreated mice 14 days after injury. They found that type IIX fibers were prevalent in healthy muscle and treated muscle, but untreated injured muscle contained smaller numbers of type IIX fibers and increased numbers of type IIA fibers. This difference explained the enlarged fiber size and greater force production of treated muscles, as IIX fibers produce more force than IIA fibers. Finally, the team homed in on the optimal amount of time for neutrophil presence in injured muscle by depleting neutrophils in the mice on the third day after injury. The treated mice's muscles showed larger fiber size and greater strength recovery than those in untreated mice, confirming that while neutrophils are necessary in the earliest stages of injury recovery, getting them out of the injury site early leads to improved muscle regeneration. "These findings are remarkable because they indicate that we can influence the function of the body's immune system in a drug-free, non-invasive way," said Walsh, who is also the Paul A. Maeder Professor of Engineering and Applied Science at SEAS and whose group is experienced in developing wearable technology for diagnosing and treating disease. "This provides great motivation for the development of external, mechanical interventions to help accelerate and improve muscle and tissue healing that have the potential to be rapidly translated to the clinic." The team is continuing to investigate this line of research with multiple projects in the lab. They plan to validate this mechanotherpeutic approach in larger animals, with the goal of being able to test its efficacy on humans. They also hope to test it on different types of injuries, age-related muscle loss, and muscle performance enhancement. "The fields of mechanotherapy and immunotherapy rarely interact with each other, but this work is a testament to how crucial it is to consider both physical and biological elements when studying and working to improve human health," said Mooney, who is the corresponding author of the paper and the Robert P. Pinkas Family Professor of Bioengineering at SEAS. "The idea that mechanics influence cell and tissue function was ridiculed until the last few decades, and while scientists have made great strides in establishing acceptance of this fact, we still know very little about how that process actually works at the organ level. This research has revealed a previously unknown type of interplay between mechanobiology and immunology that is critical for muscle tissue healing, in addition to describing a new form of mechanotherapy that potentially could be as potent as chemical or gene therapies, but much simpler and less invasive," said Wyss Founding Director Don Ingber, M.D., Ph.D., who is also the Judah Folkman Professor of Vascular Biology at (HMS) and the Vascular Biology Program at Boston Children's Hospital, as well as Professor of Bioengineering at SEAS.   Vitamin E could help protect older men from pneumonia University of Helsinki (Finland), October 7 2021.    An article that appeared in Clinical Interventions in Aging reported a protective role for vitamin E against pneumonia in older men.   For the current investigation, Dr Harri Hemilä of the University of Helsinki, Finland analyzed data from the Alpha-Tocopherol Beta-Carotene (ATBC) Cancer Prevention Study conducted in Finland. The trial included 29,133 men between the ages of 50 to 69 years who smoked at least five cigarettes daily upon enrollment. Participants received alpha tocopherol (vitamin E), beta carotene, both supplements, or a placebo for five to eight years.   The current study was limited to 7,469 ATBC participants who started smoking at age 21 or older. Among this group, supplementation with vitamin E was associated with a 35% lower risk of developing pneumonia in comparison with those who did not receive the vitamin.  Light smokers who engaged in leisure time exercise had a 69% lower risk compared with unsupplemented members of this subgroup. The risk in this subgroup of developing pneumonia by age 74 was 12.9%.   Among the one-third of the current study's population who quit smoking for a median period of two years, there was a 72% lower risk of pneumonia in association with vitamin E supplementation. In this group, exercisers who received vitamin E experienced an 81% lower pneumonia risk.   Dr Hemilä observed that the benefit for vitamin E in this study was strongest for older subjects—a group at higher risk of pneumonia.   "The current analysis of individual-level data suggests that trials on vitamin E and pneumonia on nonsmoking elderly males are warranted," he concluded.       Toxic fatty acids to blame for brain cell death after injury New York University, October 7, 2021 Cells that normally nourish healthy brain cells called neurons release toxic fatty acids after neurons are damaged, a new study in rodents shows. This phenomenon is likely the driving factor behind most, if not all, diseases that affect brain function, as well as the natural breakdown of brain cells seen in aging, researchers say. Previous research has pointed to astrocytes—a star-shaped glial cell of the central nervous system—as the culprits behind cell death seen in Parkinson's disease and dementia, among other neurodegenerative diseases. While many experts believed that these cells released a neuron-killing molecule to "clear away" damaged brain cells, the identity of this toxin has until now remained a mystery. Led by researchers at NYU Grossman School of Medicine, the new investigation provides what they say is the first evidence that tissue damage prompts astrocytes to produce two kinds of fats, long-chain saturated free fatty acids and phosphatidylcholines. These fats then trigger cell death in damaged neurons, the electrically active cells that send messages throughout nerve tissue. Publishing Oct. 6 in the journal Nature, the study also showed that when researchers blocked fatty acid formation in mice, 75 percent of neurons survived compared with 10 percent when the fatty acids were allowed to form. The researchers' earlier work showed that brain cells continued to function when shielded from astrocyte attacks.  "Our findings show that the toxic fatty acids produced by astrocytes play a critical role in brain cell death and provide a promising new target for treating, and perhaps even preventing, many neurodegenerative diseases," says study co-senior author Shane Liddelow, Ph.D. Liddelow, an assistant professor in the Department of Neuroscience and Physiology at NYU Langone Health, adds that targeting these fats instead of the cells that produce them may be a safer approach to treating neurodegenerative diseasesbecause astrocytes feed nerve cells and clear away their waste. Stopping them from working altogether could interfere with healthy brain function. Although it remains unclear why astrocytes produce these toxins, it is possible they evolved to destroy damaged cells before they can harm their neighbors, says Liddelow. He notes that while healthy cells are not harmed by the toxins, neurons become susceptible to the damaging effects when they are injured, mutated, or infected by prions, the contagious, misfolded proteins that play a major role in mad cow disease and similar illnesses. Perhaps in chronic diseases like dementia, this otherwise helpful process goes off track and becomes a problem, the study authors say. For the investigation, researchers analyzed the molecules released by astrocytes collected from rodents. They also genetically engineered some groups of mice to prevent the normal production of the toxic fats and looked to see whether neuron death occurred after an acute injury. "Our results provide what is likely the most detailed molecular map to date of how tissue damage leads to brain cell death, enabling researchers to better understand why neurons die in all kinds of diseases," says Liddelow, also an assistant professor in the Department of Ophthalmology at NYU Langone. Liddelow cautions that while the findings are promising, the genetic techniques used to block the enzyme that produces toxic fatty acids in mice are not ready for use in humans. As a result, the researchers next plan is to explore safe and effective ways to interfere with the release of the toxins in human patients. Liddelow and his colleagues had previously shown these neurotoxic astrocytes in the brains of patients with Parkinson's, Huntington's disease, and multiple sclerosis, among other diseases.   Clinical trial for nicotinamide riboside: Vitamin safely boosts levels of important cell metabolite linked to multiple health benefits University of Iowa Health Care, October 3, 2021   In the first controlled clinical trial of nicotinamide riboside (NR), a newly discovered form of Vitamin B3, researchers have shown that the compound is safe for humans and increases levels of a cell metabolite that is critical for cellular energy production and protection against stress and DNA damage.   Studies in mice have shown that boosting the levels of this cell metabolite -- known as NAD+ -- can produce multiple health benefits, including resistance to weight gain, improved control of blood sugar and cholesterol, reduced nerve damage, and longer lifespan. Levels of NAD+ diminish with age, and it has been suggested that loss of this metabolite may play a role in age-related health decline.   These findings in animal studies have spurred people to take commercially available NR supplements designed to boost NAD+. However, these over-the-counter supplements have not undergone clinical trials to see if they work in people.   The new research, reported in the journal Nature Communications, was led by Charles Brenner, PhD, professor and Roy J. Carver Chair of Biochemistry at the University of Iowa Carver College of Medicine in collaboration with colleagues at Queens University Belfast and ChromaDex Corp. (NASDAQ: CDXC), which supplied the NR used in the trial. Brenner is a consultant for ChromaDex. He also is co-founder and Chief Scientific Adviser of ProHealthspan, which sells NR supplements under the trade name Tru NIAGEN®.   The human trial involved six men and six women, all healthy. Each participant received single oral doses of 100 mg, 300 mg, or 1,000 mg of NR in a different sequence with a seven-day gap between doses. After each dose, blood and urine samples were collected and analyzed by Brenner's lab to measure various NAD+ metabolites in a process called metabolomics. The trial showed that the NR vitamin increased NAD+ metabolism by amounts directly related to the dose, and there were no serious side effects with any of the doses.   "This trial shows that oral NR safely boosts human NAD+ metabolism," Brenner says. "We are excited because everything we are learning from animal systems indicates that the effectiveness of NR depends on preserving and/or boosting NAD+ and related compounds in the face of metabolic stresses. Because the levels of supplementation in mice that produce beneficial effects are achievable in people, it appears than health benefits of NR will be translatable to humans safely."   The next step will be to study the effect of longer duration NR supplementation on NAD+ metabolism in healthy adults, but Brenner also has plans to test the effects of NR in people with diseases and health conditions, including elevated cholesterol, obesity and diabetes, and people at risk for chemotherapeutic peripheral neuropathy.   Prior to the formal clinical trial, Brenner conducted a pilot human study -- on himself. In 2004, he had discovered that NR is a natural product found in milk and that there is pathway to convert NR to NAD+ in people. More than a decade of research on NR metabolic pathways and health effects in mice and rats had convinced him that NR supplementation had real promise to improve human health and wellness. After consulting with UI's institutional review board, he conducted an experiment in which he took 1 gram of NR once a day for seven days, and his team analyzed blood and urine samples using mass spectrometry. The experiment showed that Brenner's blood NAD+ increased by about 2.7 times. In addition, though he reported immediate sensitivity to flushing with the related compound niacin, he did not experience any side effects taking NR.   The biggest surprise from his metabolomic analysis was an increase in a metabolite called NAAD, which was multiplied by 45 times, from trace levels to amounts in the micromolar range that were easily detectable.   "While this was unexpected, I thought it might be useful," Brenner says. "NAD+ is an abundant metabolite and it is sometimes hard to see the needle move on levels of abundant metabolites. But when you can look at a low-abundance metabolite that goes from undetectable to easily detectable, there is a great signal to noise ratio, meaning that NAAD levels could be a useful biomarker for tracking increases in NAD+ in human trials."   Brenner notes this was a case of bidirectional translational science; having learned something from the initial human experiment, his team was able to return to laboratory mice to explore the unexpected NAAD finding in more detail.   Brenner's mouse study showed that NAAD is formed from NR and confirmed that NAAD levels are a strong biomarker for increased NAD+ metabolism. The experiments also revealed more detail about NAD+ metabolic pathways.   In particular, the researchers compared the ability of all three NAD+ precursor vitamins -- NR, niacin, and nicotinamide -- to boost NAD+ metabolism and stimulate the activity of certain enzymes, which have been linked to longevity and healthbenefits. The study showed for the first time that oral NR is superior to nicotinamide, which is better than niacin in terms of the total amount of NAD+ produced at an equivalent dose. NR was also the best of the three in stimulating the activity of sirtuin enzymes. However, in this case, NR was the best at stimulating sirtuin-like activities, followed by niacin, followed by nicotinamide.   The information from the mouse study subsequently helped Brenner's team design the formal clinical trial. In addition to showing that NR boosts NAD+ in humans without adverse effects, the trial confirmed that NAAD is a highly sensitive biomarker of NAD+ supplementation in people.   "Now that we have demonstrated safety in this small clinical trial, we are in a position to find out if the health benefits that we have seen in animals can be reproduced in people," says Brenner, who also is co-director of the Obesity Research and Education Initiative, professor of internal medicine, and a member of the Fraternal Order of Eagles Diabetes Research Center at the UI.   Protecting the ozone layer is delivering vast health benefits Montreal Protocol will spare Americans from 443 million skin cancer cases National Center for Atmospheric Research, October 7, 2021 An international agreement to protect the ozone layer is expected to prevent 443 million cases of skin cancer and 63 million cataract cases for people born in the United States through the end of this century, according to new research. The research team, by scientists at the National Center for Atmospheric Research (NCAR), ICF Consulting, and U.S. Environmental Protection Agency (EPA), focused on the far-reaching impacts of a landmark 1987 treaty known as the Montreal Protocol and later amendments that substantially strengthened it. The agreement phased out the use of chemicals such as chlorofluorocarbons (CFCs) that destroy ozone in the stratosphere. Stratospheric ozone shields the planet from harmful levels of the Sun's ultraviolet (UV) radiation, protecting life on Earth. To measure the long-term effects of the Montreal Protocol, the scientists developed a computer modeling approach that enabled them to look to both the past and the future by simulating the treaty's impact on Americans born between 1890 and 2100. The modeling revealed the treaty's effect on stratospheric ozone, the associated reductions in ultraviolet radiation, and the resulting health benefits.  In addition to the number of skin cancer and cataract cases that were avoided, the study also showed that the treaty, as most recently amended, will prevent approximately 2.3 million skin cancer deaths in the U.S. “It's very encouraging,” said NCAR scientist Julia Lee-Taylor, a co-author of the study. “It shows that, given the will, the nations of the world can come together to solve global environmental problems.” The study, funded by the EPA, was published in ACS Earth and Space Chemistry. NCAR is sponsored by the National Science Foundation. Mounting concerns over the ozone layer Scientists in the 1970s began highlighting the threat to the ozone layer when they found that CFCs, used as refrigerants and in other applications, release chlorine atoms in the stratosphere that set off chemical reactions that destroy ozone. Concerns mounted the following decade with the discovery of an Antarctic ozone hole. The loss of stratospheric ozone would be catastrophic, as high levels of UV radiation have been linked to certain types of skin cancer, cataracts, and immunological disorders. The ozone layer also protects terrestrial and aquatic ecosystems, as well as agriculture. Policy makers responded to the threat with the 1987 Montreal Protocol on Substances that Deplete the Ozone Layer, in which nations agreed to curtail the use of certain ozone-destroying substances. Subsequent amendments strengthened the treaty by expanding the list of ozone-destroying substances (such as halons and hydrochlorofluorocarbons, or HCFCs) and accelerating the timeline for phasing out their use. The amendments were based on Input from the scientific community, including a number of NCAR scientists, that were summarized in quadrennial Ozone Assessment reports. To quantify the impacts of the treaty, the research team built a model known as the Atmospheric and Health Effects Framework. This model, which draws on various data sources about ozone, public health, and population demographics, consists of five computational steps. These simulate past and future emissions of ozone-destroying substances, the impacts of those substances on stratospheric ozone, the resulting changes in ground-level UV radiation, the U.S. population's exposure to UV radiation, and the incidence and mortality of health effects resulting from the exposure. The results showed UV radiation levels returning to 1980 levels by the mid-2040s under the amended treaty. In contrast, UV levels would have continued to increase throughout this century if the treaty had not been amended, and they would have soared far higher without any treaty at all.  Even with the amendments, the simulations show excess cases of cataracts and various types of skin cancer beginning to occur with the onset of ozone depletion and peaking decades later as the population exposed to the highest UV levels ages. Those born between 1900 and 2040 experience heightened cases of skin cancer and cataracts, with the worst health outcomes affecting those born between about 1950 and 2000. However, the health impacts would have been far more severe without the treaty, with cases of skin cancer and cataracts rising at an increasingly rapid rate through the century.  “We peeled away from disaster,” Lee-Taylor said. “What is eye popping is what would have happened by the end of this century if not for the Montreal Protocol. By 2080, the amount of UV has tripled. After that, our calculations for the health impacts start to break down because we're getting so far into conditions that have never been seen before.” The research team also found that more than half the treaty's health benefits could be traced to the later amendments rather than the original 1987 Montreal Protocol. Overall, the treaty prevented more than 99% of potential health impacts that would have otherwise occurred from ozone destruction. This showed the importance of the treaty's flexibility in adjusting to evolving scientific knowledge, the authors said. The researchers focused on the U.S. because of ready access to health data and population projections. Lee-Taylor said that the specific health outcomes in other countries may vary, but the overall trends would be similar. “The treaty had broad global benefits,” she said.     What is Boron? The trace mineral boron provides profound anti-cancer effects, in addition to maintaining stronger bones. Life Extension, September 2021 Boron is a trace mineral found in the earth's crust and in water. Its importance in human health has been underestimated. Boron has been shown to have actions against specific types of malignancies, such as: Cervical cancer: The country Turkey has an extremely low incidence of cervical cancer, and scientists partially attribute this to its boron-rich soil.1 When comparing women who live in boron-rich regions versus boron-poor regions of Turkey, not a single woman living in the boron-rich regions had any indication of cervical cancer.2(The mean dietary intake of boron for women in this group was 8.41 mg/day.)  Boron interferes with the life cycle of the human papillomavirus (HPV), which is a contributing factor in approximately 95% of all cervical cancers.1  Considering that HPV viruses are increasingly implicated in head and neck cancers,3,4 supplementation with this ultra-low-cost mineral could have significant benefits in protecting against this malignancy that is increasing in prevalence. Lung cancer: A study conducted at the University of Texas MD Anderson Cancer Center between 1995 and 2005 found that increased boron intake was associated with a lower risk of lung cancer in postmenopausal women who were taking hormone replacement therapy. Prostate cancer: Studies point to boron's ability to inhibit the growth and spread of prostate cancer cells.  In one study, when mice were exposed to boric acid, their tumors shrank by as much as 38%.6 One analysis found that increased dietary boron intake was associated with a decreased risk of prostate cancer.7 Several human and animal studies have confirmed the important connection between boron and bone health. Boron prevents calcium loss,8 while also alleviating the bone problems associated with magnesium and vitamin D deficiency.9 All of these nutrients help maintain bone density. A study in female rats revealed the harmful effects a deficiency in boron has on bones, including:10 Decreased bone volume fraction, a measure of bone strength, Decreased thickness of the bone's spongy inner layer, and Decreased maximum force needed to break the femur. And in a study of post-menopausal women, supplementation with3 mg of boron per day prevented calcium loss and bone demineralization by reducing urinary excretion of both calcium and magnesium.8 In addition to its bone and anti-cancer benefits, there are nine additional reasons boron is an important trace mineral vital for health and longevity. It has been shown to:1 Greatly improve wound healing, Beneficially impact the body's use of estrogen, testosterone, and vitamin D, Boost magnesium absorption, Reduce levels of inflammatory biomarkers, such as high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor α (TNF-α), Raise levels of antioxidant enzymes, such as superoxide dismutase (SOD), catalase, and glutathione peroxidase, Protect against pesticide-induced oxidative stress and heavy-metal toxicity, Improve the brain's electrical activity, which may explain its benefits for cognitive performance, and short-term memory in the elderly, Influence the formation and activity of key biomolecules, such as S-adenosyl methionine (SAM-e) and nicotinamide adenine dinucleotide (NAD+), and Potentially help ameliorate the adverse effects of traditional chemotherapeutic agents. Because the amount of boron varies in the soil, based on geographical location, obtaining enough boron through diet alone can be difficult. Supplementing with low-cost boron is an effective way to maintain adequate levels of this overlooked micronutrient.

Healthed Australia
Iron deficiency in patients with comorbidities

Healthed Australia

Play Episode Listen Later Oct 7, 2021 49:23


Oral iron absorption in patients with chronic inflammatory conditions is very poor Oncology patients are often iron deficient, but seldom treated Heart failure patients will benefit greatly from IV iron if deficient Diagnosing functional iron deficiency without anaemia is easy: normal CRP, ferritin 100 and a transferrin saturation

Confessions of a Disney Cast Member
158. Discussionist 2: UK (Pav) Hun?

Confessions of a Disney Cast Member

Play Episode Listen Later Oct 7, 2021 73:35


In this week's discussion episode of Confessions of a Disney Cast Member, we will be chatting in-depth about our experiences applying for the CRP, giving you all of the advice you need to know, along with a dive into the history of world showcase and the UK pavilion. Join us every Friday for a new topic where we discuss the past, present and future of all things Disney. This podcast is not affiliated by The Walt Disney Company. Just cast members who love celebrating other cast members and reminiscing. Follow Us on Instagram: @TheDisneyConfessionist

Beyond Labels and Limitations
Episode 65: LGMD Awareness Day, Physical Struggles and Blood Work

Beyond Labels and Limitations

Play Episode Listen Later Sep 29, 2021 18:41


On episode 65 of Beyond Labels & Limitations, John Graybill talks about the LGMD Awareness Day which is every September 30th. This day is important in spreading awareness about LGMD. Go to LGMD Awareness Foundation to learn more about LGMD. John also shares some physical struggles he's had over the past week and his upcoming blood work. There are 3 tests he asks for and they are: CPK, Vit D., cCRP or CRP. _______________________________ Connect with John: Visit the Website Subscribe on YouTube Email: BLLjenjohn@gmail.com ________________________________ "Desire to Inspire" TKG  

The Lucas Rockwood Show
483: Happy Gut, Happy Brain with Jimmy St. Louis

The Lucas Rockwood Show

Play Episode Listen Later Sep 29, 2021 42:52


Did you receive a CRP (C-reactive protein) test during your last blood test? Since recent research correlates systemic inflammation with dozens of diseases and illnesses, cooling this internal flame has become a major focus in preventative medicine. On this week's podcast, we'll speak about the low-grade, chronic inflammation that many of us struggle with unknowingly due to gut dysbiosis. In an ideal world, we eat a meal, digest and absorb its nutrients. In the real world, many of us eat foods that create a fight response internally as your body treats the offending foods like an invasive threat.  Listen & Learn How your gut bacteria form a “soil” like environment for digestion Why modern foods and lifestyles leave many of us imbalanced How to find motivation later in life to make changes  The power and speed of diet and lifestyle changes Resources & Links: Jimmy's Site ABOUT OUR GUEST Jimmy is the founder of the Cognitive Health Institute which focuses on gut health to reduce inflammation, thus lowering the likelihood, as well as the symptoms of autoimmune diseases, and neurodegenerative diseases. Jimmy played football professionally for the NFL's Tennessee Titans as a tight end and most recently was a member of the 2016 United States Rowing Team. His accomplishments include four national medals as well as a third-place finish in the 2016 Olympic trials. Nutritional Tip of the Week: Carbohydrates Like the Show? Leave us a Review on iTunes

Get Your Life Back in Rhythm
Is Fish Oil Still Good for the Heart and Longevity?

Get Your Life Back in Rhythm

Play Episode Listen Later Sep 24, 2021 19:02


Is Fish Oil Still Good for the Heart and Longevity? Is fish oil still good for the heart? Ten or 20 years ago I would have said most definitely for the heart and possibly for longevity. Now, I'm not so sure. But before we jump into this article, let me share with you 6 reasons why I have taken fish oil in the past. Six Reasons Why I've Taken Fish Oil 1. Fish Oil May Lower Blood Pressure 1-2 Points Studies show that fish oil may have a slight blood pressure-lowering effect in the range of 1-2 mmHg. And as my long-time readers know, the goal blood pressure to prevent heart disease and to optimize for longevity seems to be about 110/70 mmHg. To put this blood pressure-lowering effect of fish oil into perspective, you could get this same 1-2 mmHg blood pressure reduction from losing just 2-4 pounds. 2. Fish Oil Lowers Triglycerides High levels of triglycerides in the blood can cause all sorts of damage to your vascular system. And fish oil has long been proven to lower triglycerides. However, whatever benefit you may gain in triglyceride-lowering from fish oil, simply eliminating all added sugars and flour may lower your triglycerides even more! 3. Fish Oil May Keep Inflammation Levels Lower Once again, long-term readers know that keeping inflammation levels low may be the secret to avoiding cardiovascular disease, including atrial fibrillation, and optimizing for longevity. And science suggests that fish oil may help to reduce inflammation levels. As my personal goal is to have a C-reactive protein (CRP) lab value of zero despite having a history of an autoimmune condition, this provided an additional reason for me to take fish oil. For those not familiar with the CRP blood test, a CRP reading of zero indicates no significant inflammation going on anywhere in the body. 4. Fish Oil May Promote Longevity Although the data is weak, some studies report a longevity benefit from fish oil. For example, in this study, fish oil helps to prevent the telomere shortening that comes with aging. While many studies report that higher blood levels of omega-3's are associated with an increased lifespan, it isn't clear to me if this is from fish oil or from eating real fish. 5. Fish Oil May Help with Weight Loss Once again, the data here is weak but yes, there are studies reporting that fish oil helps with weight loss. Indeed, some studies report that fish oil may reduce hunger and enhance metabolism. As one who has struggled to keep my weight in check, I was eager for any help I could get. Sadly, I didn't notice any reduction in my hunger or an increased calorie burn with fish oil. 6. Fish Oil May Help with Dry Eyes and Dry Skin Yes, fish oil has been shown to help with dry eyes and dry skin. And given that I live in the very dry state of Utah, my hope was that fish oil would help me better tolerate contact lenses and help to moisturize my skin. But with many of the other possible fish oil benefits, it didn't really seem to help my dry eyes or my dry skin. Fish Oil Doesn't Seem to Prevent Heart Disease and Cancer With all of the above reasons to take fish oil, one would hope that fish oil prevents heart disease and cancer. So in the biggest and most rigorous study to date, the recently completed VITAL Trial randomized nearly 26,000 patients to approximately 1 gram/day of fish oil or placebo for over 5 years. Sadly, faithfully taking fish oil for over 5 years didn't prevent heart disease nor did it prevent cancer. Fish Oil May Increase Your Risk of Atrial Fibrillation While fish oil didn't seem to impact heart disease risk, a just-published sub-study of the VITAL Trial showed a non-statistical trend toward an increased risk of atrial fibrillation from taking 1 gram/day of fish oil. To put this finding in perspective, a study using 2 grams/day of fish oil also showed a non-statistically significant increased risk of atrial fibrillation. And at the high dose of 4 grams/day of fish oil,

Habitat University
Episode 12 - Habitat Management: Reflections from a College Classroom

Habitat University

Play Episode Listen Later Sep 14, 2021 52:30


Adam and Jarred are joined in this episode by award-winning instructor, Dr. Liz Flaherty, to chat about teaching undergraduate students all about habitat management. Dr. Flaherty is an Associate Professor of Wildlife Ecology & Habitat Management at Purdue University. Take a listen to learn about the insights you can take from a college classroom and apply on your own property. Help us improve the podcast by taking this Habitat University Listener Feedback Survey: https://purdue.ca1.qualtrics.com/jfe/form/SV_5oteinFuEzFCDmm Dr. Liz Flaherty - https://ag.purdue.edu/fnr/Pages/profile.aspx?strAlias=eflaher The research Jarred mentioned about the value of CRP fields based on their distance from bobwhite populations. Private land conservation has landscape-scale benefits for wildlife in agroecosystems - https://besjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/1365-2664.13136

On The Wing Podcast
PODCAST EP. 133: North American Grasslands Conservation Act

On The Wing Podcast

Play Episode Listen Later Sep 8, 2021 66:20


This week, ten organizations have joined forces to unveil a vision for new grasslands conservation legislation modeled upon the successful North American Wetlands Conservation Act (NAWCA). Host Bob St.Pierre leads a discussion with the presidents & chief executive officers of three of those partner groups. Through this important conversation, Pheasants Forever and Quail Forever's Howard Vincent, Backcountry Hunters & Anglers' Land Tawney, and National Wildlife Federation's Collin O'Mara demonstrate an obvious chemistry that has created a bond of friendship resulting in a powerful collaborative vision for grasslands conservation. Episode Highlights: • NWF's O'Mara details the history behind the concept and provides an “inside the beltway” sneak peek for how the idea will move into actual legislation. • PF & QF's Vincent explains how this voluntary private lands grasslands and sagebrush tool would complement the Farm Bill, CRP, and the conservation efforts of USDA by living at the Department of the Interior under the NAWCA model. • BHA's Tawney extolls the virtues of polite persistence in his call upon hunters and anglers to take action in support of this important grasslands conservation concept. Learn more about the North American Grasslands Conservation Act at www.ActForGrasslands.org Partners include:  Pheasants Forever  Quail Forever  National Wildlife Federation  Backcountry Hunters & Anglers  The Theodore Roosevelt Conservation Partnership  North American Grouse Partnership  World Wildlife Fund  National Deer Association  Izaak Walton League of America  Land Trust Alliance  Wildlife Mississippi

The Gary Null Show
The Gary Null Show - 09.07.21

The Gary Null Show

Play Episode Listen Later Sep 7, 2021 59:21


Pomegranate peel has protective effects against enteropathogenic bacteria US Department of Agriculture, August 31, 2021 A recent study by the U.S. Department of Agriculture revealed that pomegranate peel extract contains bioactive compounds that have potential antibacterial activity. The study's findings were published in the journal Nutrition Research. Pomegranate fruit peel is considered an agricultural waste product. However, it is a rich source of polyphenols like punicalins, punicalagins and ellagic acids. Earlier studies have shown that products derived from pomegranates have health benefits, including antibacterial activity, in vitro. There is limited evidence, however, of their antibacterial activity in vivo. For this study, researchers sought to determine the antibacterial properties of pomegranate peel extract in vivo. In particular, they focused on the punicalin, punicalagin and ellagic acid present in the peel extract. The researchers infected C3H/He mice with the bacterial pathogen Citrobacter rodentium, a bacterium that mimics the enteropathogenic bacterium, Escherichia coli. Prior to infection, the mice were orally treated with water or pomegranate peel extract. Twelve days after infection, the researchers examined C. rodentium colonization of the colon and spleen, as well as changes in tissue and gene expression. Fecal excretions were also analyzed for C. rodentium. The results revealed that the pomegranate peel extract reduced weight loss and mortality induced by C. rodentium infection. The extract also reduced C. rodentium colonization of the spleen. Additionally, pomegranate peel extract decreased the extent of damage in the colon caused by C. rodentium infection. In sum, pomegranate fruit peel extract contains bioactive compounds that can help reduce the severity of C. rodentium infection in vivo.   Vitamin D may protect against young-onset colorectal cancer Dana-Farber Cancer Institute and Harvard  School of Public Health, September 1, 2021 Consuming higher amounts of Vitamin D - mainly from dietary sources - may help protect against developing young-onset colorectal cancer or precancerous colon polyps, according to the first study to show such an association. The study, recently published online in the journal Gastroenterology, by scientists from Dana-Farber Cancer Institute, the Harvard T.H. Chan School of Public Health, and other institutions, could potentially lead to recommendations for higher vitamin D intake as an inexpensive complement to screening tests as a colorectal cancer prevention strategy for adults younger than age 50. While the overall incidence of colorectal cancer has been declining, cases have been increasing in younger adults - a worrisome trend that has yet to be explained. The authors of the study, including senior co-authors Kimmie Ng, MD, MPH, of Dana-Farber, and Edward Giovannucci, MD, DSc., of the T.H. Chan School, noted that vitamin D intake from food sources such as fish, mushrooms, eggs, and milk has decreased in the past several decades. There is growing evidence of an association between vitamin D and risk of colorectal cancer mortality. However, prior to the current study, no research has examined whether total vitamin D intake is associated with the risk of young-onset colorectal cancer. “Vitamin D has known activity against colorectal cancer in laboratory studies. Because vitamin D deficiency has been steadily increasing over the past few years, we wondered whether this could be contributing to the rising rates of colorectal cancer in young individuals,” said Ng, director of the Young-Onset Colorectal Cancer Center at Dana-Farber. “We found that total vitamin D intake of 300 IU per day or more - roughly equivalent to three 8-oz. glasses of milk - was associated with an approximately 50% lower risk of developing young-onset colorectal cancer.” The results of the study were obtained by calculating the total vitamin D intake - both from dietary sources and supplements - of 94,205 women participating in the Nurses' Health Study II (NHS II). This study is a prospective cohort study of nurses aged 25 to 42 years that began in 1989. The women are followed every two years by questionnaires on demographics, diet and lifestyle factors, and medical and other health-related information. The researchers focused on a primary endpoint - young-onset colorectal cancer, diagnosed before 50 years of age. They also asked on a follow-up questionnaire whether they had had a colonoscopy or sigmoidoscopy where colorectal polyps (which may be precursors to colorectal cancer) were found. During the period from 1991 to 2015 the researchers documented 111 cases of young-onset colorectal cancer and 3,317 colorectal polyps. Analysis showed that higher total vitamin D intake was associated with a significantly reduced risk of early-onset colorectal cancer. The same link was found between higher vitamin D intake and risk of colon polyps detected before age 50. The association was stronger for dietary vitamin D - principally from dairy products - than from vitamin D supplements. The study authors said that finding could be due to chance or to unknown factors that are not yet understood. Interestingly, the researchers didn't find a significant association between total vitamin D intake and risk of colorectal cancer diagnosed after age 50. The findings were not able to explain this inconsistency, and the scientists said further research in a larger sample is necessary to determine if the protective effect of vitamin D is actually stronger in young-onset colorectal cancer. In any case, the investigators concluded that higher total vitamin D intake is associated with decreased risks of young-onset colorectal cancer and precursors (polyps). “Our results further support that vitamin D may be important in younger adults for health and possibly colorectal cancer prevention,” said Ng. “It is critical to understand the risk factors that are associated with young-onset colorectal cancer so that we can make informed recommendations about diet and lifestyle, as well as identify high risk individuals to target for earlier screening.”     Choosing personal exercise goals, then tackling them immediately is key to sustaining change University of Pennsylvania, September 1, 2021 When people set their own exercise goals – and then pursue them immediately – it's more likely to result in lasting positive changes, according to a new study at the Perelman School of Medicine at the University of Pennsylvania. The results of this research are especially important because they were found among an underserved population that is at particularly high risk of having or developing heart conditions. The study was published in JAMA Cardiology. “Most behavior change programs involve goal-setting, but the best way to design that process is unknown,” said lead author Mitesh Patel, MD, MBA, an associate professor of Medicine at Penn and vice president for Clinical Transformation at Ascension. “Our clinical trial demonstrated that physical activity increased the most when patients chose their goals rather than being assigned them, and when the goals started immediately rather than starting lower and gradually increasing over time. These findings are particularly important because the patients were from lower-income neighborhoods and may face a number of challenges in achieving health goals.” This study consisted of 500 patients from low-income neighborhoods, mainly in West Philadelphia but also elsewhere in and outside of the city. Participants either had a cardiovascular disease or were assessed to have a near-10 percent risk of developing one within a decade. These high-risk patients stood to greatly gain from increased physical activity. Patel's previous work at the Penn Medicine Nudge Unit often focused on the use of gamification, a concept used to create behavioral change by turning it into a game. The work usually tested whether playing a game attached to physical activity goals could make significant increases against not playing a game, or between different versions of a game. As with past studies, every participant was given a wearable step tracker that recorded their daily step counts through Penn's Way to Health platform. But what set this study apart from many of its predecessors was that the main outcomes of the research were less about participation in the games themselves and more about how goals were established, as well as when participants were encouraged to pursue them. Once every participant got their wearable step counter, they were given a week or two to get used to it. This time period also functioned as a baseline-setting period for everyone's pre-intervention daily step count. After that, participants were randomly assigned to the control group, which didn't have step goals or games attached, or one of the gaming groups with goals. Those in the gamified group also went through two other sets of random assignments. One determined whether they'd have input on their step goal, or whether they'd just be assigned a standard one. The second decided whether each participant would immediately start working toward their goals (for the entire 16-week intervention), or whether they'd ramp up to it, with minor increases in goals, until the full goals kicked in at week nine. After analyzing the results, the researchers saw that the only group of participants who achieved significant increases in activity were those who chose their own goals and started immediately. They had the highest average increase in their steps compared to the group with no goals, roughly 1,384 steps per day. And, in addition to raw step counts, the study also measured periods of sustained, high activity, amounting to an average increase of 4.1 minutes daily. Comparatively, those who were assigned their goals or had full goals delayed for half the intervention only increased their daily steps above the control group's average by between 500 and 600 steps. “Individuals who select their own goals are more likely to be intrinsically motivated to follow through on them,” said Kevin Volpp, MD, PhD, director of the Center for Health Incentives and Behavioral Economics. “They feel like the goal is theirs and this likely enables greater engagement.” The study didn't end when the researchers turned the games off. Participants kept their activity trackers, and in the eight weeks following the intervention, the group that chose their goals and started immediately kept up their progress. In fact, they achieved almost the exact same average in steps – just three less than during the active games. “It is exciting to see that the group that increased their activity levels by the most steps maintained those levels during follow-up,” Patel said. “This indicates that gamification with self-chosen and immediate goals helped these patients form a new habit.” Many programs, whether offered through work or by health insurance companies, offer incentives for boosts in physical activity. But these goals are often fairly static and assigned based on round numbers. Patel, Volpp, and colleagues believe this research suggests that adjusting goal setting in these programs can have a significant impact. And if these adjustments lead to gains among people with lower incomes, whom cardiovascular disease kill at 76 percent higher rates, that could be particularly important.           “Goal-setting is a fundamental element of almost every physical activity program, whether through a smartphone app or in a workplace wellness program,” Volpp said. “Our findings reveal a simple approach that could be used to improve the impact of these programs and the health of their patients.”   Comparing seniors who relocate long-distance shows that where you live affects your longevity Massachusetts Institute of Technology, September 1, 2021 Would you like to live longer? It turns out that where you live, not just how you live, can make a big difference. That's the finding of an innovative study co-authored by an MIT economist, which examines senior citizens across the U.S. and concludes that some locations enhance longevity more than others, potentially for multiple reasons. The results show that when a 65-year-old moves from a metro area in the 10th percentile, in terms of how much those areas enhance longevity, to a metro area the 90th percentile, it increases that person's life expectancy by 1.1 years. That is a notable boost, given that mean life expectancy for 65-year-olds in the U.S. is 83.3 years. "There's a substantively important causal effect of where you live as an elderly adult on mortality and life expectancy across the United States," says Amy Finkelstein, a professor in MIT's Department of Economics and co-author of a newly published paper detailing the findings. Researchers have long observed significant regional variation in life expectancy in the U.S., and often attributed it to "health capital"—tendencies toward obesity, smoking, and related behavioral factors in the regional populations. But by analyzing the impact of moving, the current study can isolate and quantify the effect that the location itself has on residents. As such, the research delivers important new information about large-scale drivers of U.S. health outcomes—and raises the question of what it is about different places that affects the elderly's life expectancy. One clear possibility is the nature of available medical care. Other possible drivers of longevity include climate, pollution, crime, traffic safety, and more. "We wanted to separate out the role of people's prior experiences and behaviors—or health capital—from the role of place or environment," Finkelstein says. The paper, "Place-Based Drivers of Mortality: Evidence of Migration," is published in the August issue of the American Economic Review. The co-authors are Finkelstein, the John and Jennie S. MacDonald Professor of Economics at MIT, and Matthew Gentzkow and Heidi Williams, who are both professors of economics at Stanford University. To conduct the study, Finkelstein, Gentzkow, and Williams analyzed Medicare records from 1999 to 2014, focusing on U.S. residents between the ages of 65 and 99. Ultimately the research team studied 6.3 million Medicare beneficiaries. About 2 million of those moved from one U.S. "commuting zone" to another, and the rest were a random 10 percent sample of people who had not moved over the 15-year study period. (The U.S. Census Bureau defines about 700 commuting zones nationally.) A central element of the study involves seeing how different people who were originally from the same locations fared when moving to different destinations. In effect, says Finkelstein, "The idea is to take two elderly people from a given origin, say, Boston. One moves to low-mortality Minneapolis, one moves to high-mortality Houston. We then compare thow long each lives after they move." Different people have different health profiles before they move, of course. But Medicare records include detailed claims data, so the researchers applied records of 27 different illnesses and conditions—ranging from lung cancer and diabetes to depression—to a standard mortality risk model, to categorize the overall health of seniors when they move. Using these "very, very rich pre-move measures of their health," Finkelstein notes, the researchers tried to account for pre-existing health levels of seniors from the same location who moved to different places. Still, even assessing people by 27 measures does not completely describe their health, so Finkelstein, Gentzkow, and Williams also estimated what fraction of people's health conditions they had not observed—essentially by calibrating the observed health of seniors against health capital levels in places they were moving from. They then consider how observed health varies across individuals from the same location moving to different destinations and, assuming that differences in unobserved health—such as physical mobility—vary in the same way as observed differences in health, they adjust their estimates accordingly. All told, the study found that many urban areas on the East and West Coasts—including New York City, San Francisco, and Miami—have positive effects on longevity for seniors moving there. Some Midwestern metro areas, including Chicago, also score well. By contrast, a large swath of the deep South has negative effects on longevity for seniors moving there, including much of Alabama, Arkansas, Louisiana, and northern Florida. Much of the Southwest, including parts of Texas, Oklahoma, New Mexico, and Arizona, fares similarly poorly. The scholars also estimate that health capital accounts for about 70 percent of the difference in longevity across areas of the U.S., and that location effects account for about 15 percent of the variation. "Yes, health capital is important, but yes, place effects also matter," Finkelstein says. Other leading experts in health economics say they are impressed by the study. Jonathan Skinner, the James O. Freeman Presidential Professor of Economics, Emeritus, at Dartmouth College, says the scholars "have provided a critical insight" into the question of place effects "by considering older people who move from one place to another, thus allowing the researchers to cleanly identify the pure effect of the new location on individual health—an effect that is often different from the health of long-term residents. This is an important study that will surely be cited and will influence health policy in coming years." The Charlotte Effect: What makes a difference? Indeed, the significance of place effects on life expectancy is also evident in another pattern the study found. Some locations—such as Charlotte, North Carolina—have a positive effect on longevity but still have low overall life expectancy, while other places—such as Santa Fe New Mexico—have high overall life expectancy, but a below-average effect on the longevity of seniors who move there. Again, the life expectancy of an area's population is not the same thing as that location's effect on longevity. In places where, say, smoking is highly prevalent, population-wide longevity might be subpar, but other factors might make it a place where people of average health will live longer. The question is why. "Our [hard] evidence is about the role of place," Finkelstein says, while noting that the next logical step in this vein of research is to look for the specific factors at work. "We know something about Charlotte, North Carolina, makes a difference, but we don't yet know what." With that in mind, Finkelstein, Gentzkow, and Williams, along with other colleagues, are working on a pair of new studies about health care practices to see what impact place-based differences may have; one study focuses on doctors, and the other looks at the prescription opioid epidemic. In the background of this research is a high-profile academic and policy discussion about the impact of health care utilization. One perspective, associated with the Dartmouth Atlas of Health Care project, suggests that the large regional differences in health care use it has documented have little impact on mortality. But the current study, by quantifying the variable impact of place, suggest there may be, in turn, a bigger differential impact in health care utilization yet to be identified. For her part, Finkelstein says she would welcome further studies digging into health care use or any other factor that might explain why different places have different effects on life expectancy; the key is uncovering more hard evidence, wherever it leads. "Differences in health care across places are large and potentially important," Finkelstein says. "But there are also differences in pollution, weather, [and] other aspects. … What we need to do now is get inside the black box of 'the place' and figure out what it is about them that matters for longevity."   Gut bacteria influence brain development Researchers discover biomarkers that indicate early brain injury in extreme premature infants University of Vienna (Austria), September 3, 2021 The early development of the gut, the brain and the immune system are closely interrelated. Researchers refer to this as the gut-immune-brain axis. Bacteria in the gut cooperate with the immune system, which in turn monitors gut microbes and develops appropriate responses to them. In addition, the gut is in contact with the brain via the vagus nerve as well as via the immune system. "We investigated the role this axis plays in the brain development of extreme preterm infants," says the first author of the study, David Seki. "The microorganisms of the gut microbiome - which is a vital collection of hundreds of species of bacteria, fungi, viruses and other microbes - are in equilibrium in healthy people. However, especially in premature babies, whose immune system and microbiome have not been able to develop fully, shifts are quite likely to occur. These shifts may result in negative effects on the brain," explains the microbiologist and immunologist. Patterns in the microbiome provide clues to brain damage "In fact, we have been able to identify certain patterns in the microbiome and immune response that are clearly linked to the progression and severity of brain injury," adds David Berry, microbiologist and head of the research group at the Centre for Microbiology and Environmental Systems Science (CMESS) at the University of Vienna as well as Operational Director of the Joint Microbiome Facility of the Medical University of Vienna and University of Vienna. "Crucially, such patterns often show up prior to changes in the brain. This suggests a critical time window during which brain damage of extremely premature infants may be prevented from worsening or even avoided." Comprehensive study of the development of extremely premature infants Starting points for the development of appropriate therapies are provided by the biomarkers that the interdisciplinary team was able to identify. "Our data show that excessive growth of the bacterium Klebsiella and the associated elevated γδ-T-cell levels can apparently exacerbate brain damage," explains Lukas Wisgrill, Neonatologist from the Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics at the Department of Pediatric and Adolescent Medicine at the Medical University of Vienna. "We were able to track down these patterns because, for a very specific group of newborns, for the first time we explored in detail how the gut microbiome, the immune system and the brain develop and how they interact in this process," he adds. The study monitored a total of 60 premature infants, born before 28 weeks gestation and weighing less than 1 kilogram, for several weeks or even months. Using state-of-the-art methods - the team examined the microbiome using 16S rRNA gene sequencing, among other methods - the researchers analysed blood and stool samples, brain wave recordings (e.g. aEEG) and MRI images of the infants' brains. Research continues with two studies The study, which is an inter-university clusterproject under the joint leadership by Angelika Berger (Medical University of Vienna) and David Berry (University of Vienna), is the starting point for a research project that will investigate the microbiome and its significance for the neurological development of prematurely born children even more thoroughly. In addition, the researchers will continue to follow the children of the initial study. "How the children's motoric and cognitive skills develop only becomes apparent over several years," explains Angelika Berger. "We aim to understand how this very early development of the gut-immune-brain axis plays out in the long term. " The most important cooperation partners for the project are already on board: "The children's parents have supported us in the study with great interest and openness," says David Seki. "Ultimately, this is the only reason we were able to gain these important insights. We are very grateful for that."     Amino acid supplements may boost vascular endothelial function in older adults: Study University of Alabama, August 28, 2021 A combination of HMB (a metabolite of leucine), glutamine and arginine may improve vascular function and blood flow in older people, says a new study. Scientists from the University of Alabama report that a supplement containing HMB (beta-hydroxy-beta-methylbutyrate), glutamine and arginine (Juven by Abbott Nutrition) increased flow-mediated dilation (FMD - a measure of blood flow and vascular health) by 27%, whereas no changes were observed in the placebo group. However, the researchers did not observe any changes to markers of inflammation, including high-sensitivity C-reactive protein (hsCRP) and tumor necrosis factor-alpha (TNF-alpha) “Our results indicate that 6 months of dietary supplementation with HMB, glutamine and arginine had a positive impact on vascular endothelial function in older adults,” wrote the researchers, led by Dr Amy Ellis in the European Journal of Clinical Nutrition . “These results are clinically relevant because reduced endothelial-dependent vasodilation is a known risk factor for cardiovascular diseases. “Further investigation is warranted to elucidate mechanisms and confirm benefits of foods rich in these amino acids on cardiovascular outcomes.” The study supported financially by the National Center for Complementary and Alternative Medicine. Study details Dr Ellis and her co-workers recrtuited 31 community-dwelling men and women aged between 65 and 87 to participate in their randomized, placebo-controlled trial. The participants were randomly assigned to one of two groups: The first group received the active supplements providing 3 g HMB, 14 g glutamine and 14 g arginine per day; while the second group received a placebo. After six months of intervention, the researchers found that FMD increased in the HMB + glutamine + arginine group, but no such increases were observed in the placebo group. While no changes in CRP or TNF-alpha levels were observed in the active supplement group, a trend towards an increase in CRP levels was observed in the placebo group, but this did not reach statistical significance, they noted. “Although no previous studies have examined this combination of amino acids on vascular function, we hypothesized that the active ingredients of the supplement would act synergistically to improve endothelial function by reducing oxidative stress and inflammation,” wrote the researchers. “However, although we observed a trend for increasing hsCRP among the placebo group (P=0.059), no significant changes in hsCRP or TNF-alpha were observed for either group. “Possibly, the effects of the supplement on reducing oxidative stress and inflammation were subclinical, or the high variability in these biomarkers, particularly hsCRP, among our small sample could have precluded visible differences.” The researchers also noted that an alternate mechanism may also be responsible, adding that arginine is a precursor of the potent vasodilator nitric oxide “Although investigation of this mechanism was beyond the scope of this study, it is feasible that the arginine in the supplement improved endothelial-dependent vasodilation by providing additional substrate for nitric oxide synthesis,” they added.     Moderate coffee drinking associated with lower risk of mortality during 11-year median follow-up Semmelweis University (Bulgaria), September 1 2021.  Research presented at ESC (European Society of Cardiology) Congress 2021 revealed a lower risk of dying from any cause during an 11-year median period among light to moderate coffee drinkers in comparison with men and women who had no intake. The study included 468,629 UK Biobank participants of an average age of 56.2 years who had no indications of heart disease upon enrollment. Coffee intake was classified as none, light to moderate at 0.5 to 3 cups per day or high at over 3 cups per day. A subgroup of participants underwent magnetic resonance imaging (MRI) of the heart to assess cardiac structure and function.  Light to moderate coffee intake during the follow-up period was associated with a 12% decrease in the risk of dying from any cause, a 17% lower risk of cardiovascular mortality and a 21% reduction in the incidence of stroke in comparison with the risks associated with not drinking coffee.  “The imaging analysis indicated that, compared with participants who did not drink coffee regularly, daily consumers had healthier sized and better functioning hearts,” reported study author Judit Simon, of Semmelweis University in Budapest. “This was consistent with reversing the detrimental effects of aging on the heart.” “To our knowledge, this is the largest study to systematically assess the cardiovascular effects of regular coffee consumption in a population without diagnosed heart disease,” she announced. “Our results suggest that regular coffee consumption is safe, as even high daily intake was not associated with adverse cardiovascular outcomes and all-cause mortality after a follow-up of 10 to 15 years. Moreover, 0.5 to 3 cups of coffee per day was independently associated with lower risks of stroke, death from cardiovascular disease, and death from any cause.”

SuperFeast Podcast
#131 How To Turn Your Immune System On with Dan Sipple

SuperFeast Podcast

Play Episode Listen Later Aug 31, 2021 74:04


We've been receiving loads of emails from our SuperFeast community wanting to know what they can do to turn their immune system on and keep it fortified. Recently Mason caught up with our favourite functional Naturopath, Dan Sipple, to discuss go-to herbs, minerals, foods, and lifestyle practices to increase the body's immunological capacity. Embodying health sovereignty in a time of COVID has become quite a contentious topic; Who would have thought that trusting the body's immune system could become so politicised? Regardless of how you sit with the whole vaccinated/unvaccinated approach to the virus, bolstering the immune system is something (hopefully) most of us can agree is essential. People are now thinking about their immune system in ways they never have before, and we are here to offer guidance in any way we can.    Imagine a society where mainstream consensus was to value and trust the body's natural immune system over pharmaceutical drugs. Imagine a world where superior herbs and medicinal mushrooms were mandated, subsidised, and heavily endorsed to keep us all thriving and truly living our best lives. To quote John Lenon 'imagine all the people living life in peace' (instead of fear); We are here for this vision. Tune in to hear Mason and Dan explore all the ways they would reinforce and support people's immune systems if they were to (hypothetically speaking) dictate all members of society take part in an Immune MAXzine. Where empowered sovereign health is the goal, and we live with reverence for Mother Nature's unassailable healing intelligence. This episode is packed full (and I mean full) of expert knowledge to have you feeling equipped and in an embodied state of health. We're advocating less divisiveness, more connection, and holistic health for everyone. Don't miss it.   "The amount of experiential clinical data that we have is overwhelming, and it's so overwhelmingly effective. If we really wanted to protect the population, Astragalus would be rolled out and would become a national treasure. Perhaps we could find an Australian-based tonic herb that works similarly? At the moment we don't know because the herbal tradition in Australia has a very different approach and was documented in a very different way. At the same time, we could be on the hunt for the adaptogens within the Australian system".   - Mason Taylor     Mason and Dan discuss:   What is immunity?  Microbiome analyses. The skins microbiome. Strengthening the Wei Qi shield. Colostrum for the immune system. Herbs for long-term immune regulation. Dietary applications for the immune system. Medicinal mushrooms for the immune system. Arming the immune system in acute situations. Astragalus for lung, spleen, and surface immunity. The effects of stress and sleep on the immune system. How the immune system is influenced by the microbiome. What causes the immune system to become dysregulated? Lifestyle practices to increase your immunological capacity.    Who is Dan Sipple?   Naturopath Dan Sipple believes that establishing optimum bulletproof health is best achieved through a pro-active, functional, holistic approach that allows one to truly thrive. His approach utilises cutting-edge evidence-based medicine applied through modalities such as herbal nutrition & medicine, with a strong focus on environmental health and longevity. Dan specialises in the areas of Immune / Gastrointestinal / Hormonal health and utilise functional diagnostic labs such as uBiome, Nutripath, Laverty, and Clinipath Pathology to assist in locating the imbalances contributing to the patient's condition. From here, he aims to create an individualised protocol designed to address root dysfunction and create bulletproof health.   CLICK HERE TO LISTEN ON APPLE PODCAST    Resources: Dan Website Dan Instagram Gut Health Podcast 1 Gut Health Podcast 2   Q: How Can I Support The SuperFeast Podcast? A: Tell all your friends and family and share online! We'd also love it if you could subscribe and review this podcast on iTunes. Or  check us out on Stitcher :)! Plus  we're on Spotify!   Check Out The Transcript Here:   Mason Taylor: (00:04) Hey man, welcome back.   Dan Sipple: (00:06) Thanks buddy. Good to be here.   Mason Taylor: (00:08) Yeah, good to be looking at your face digitally. Yeah, I think it's been a while since we've had a catch up. We've definitely talked about immunity before but there's just been a little tweak in the consciousness lately where all of a sudden collectively with what's going on in the world with COVID everyone's thinking about immunity much more than they ever have I feel on a collective nature and then there's a number of people that are allowing themselves because immunity is like a... You can't separate the immune system from the rest of the body and I feel like there's panic when people think about their immune system being something that's strong enough or not strong enough with or without natural medicine, with or without a vaccine so on and so forth.   Mason Taylor: (00:56) I feel like there's a really nice moving away into more of a perception of what immunity is and then the word immunity can kind of fall away and people can connect to the whole nature of their system and how there is the body's capacity to protect itself with efficacy based on your personal constitution. I guess there's just a real... There's a variance there in terms of if you want your immune system to be strong you're in a more reductionist... Having a reductionist kind of like vitamin and nutrient and mineral supplementation which can be super beneficial and goes from vaccines, drugs to isolates and those kinds of things to real hard core intentionalized personalization lifestyle based immunity and then eventually the body's capacity to stay in harmony and flow and stay protected. Then the capacity for... It's like a family fire as well. You're stoking the fire of your own capacity for your genome to stay really healthy and expressed and I don't even like the word healthy in that context because it implies unhealthy and-   Dan Sipple: (02:05) Yeah, I agree.   Mason Taylor: (02:06) I guess I'm really stoked to jump in with you. I don't know where we're going to go just exploring. We've got a lot of people asking what they can do for their immune system during this time, got a lot of people saying get on the zinc and vitamin C and D's and all that kind of stuff. Want to jump into that with you and then a lot of people are asking what they can do if they're not going to get vaccinated, a lot of people saying I'm getting vaccinated. What can I do in conjunction with it and I don't think that's probably our place to really talk to too much rather than just generally talking about health and immunity but I think it's relevant no matter where you are on the spectrum. Got a very wide community listening and definitely want to be inclusive in this context when we're talking about immunity but yeah, how are you feeling about it all? What's happening clinically for you? What are people worried about? What are they asking for and do you see an evolution in the way people are relating to their immune system and their capacity to protect themselves from last year to this year?   Dan Sipple: (03:06) Yeah, great question. I definitely am seeing it sort of in nearly every discussion and every consultation now. I think if there's anything good that's coming out of it is that people are thinking about their immune systems in a way they probably haven't been aware of before and so hopefully today we can just sort of dive into the different arms of immunity and discuss how different botanicals and nutrients and probiotics and dietary applications work to influence the immune system at large. Obviously full disclosure, I'm not an immunologist, I'm not a virologist, I'm a naturopath so I have a, I suppose a limited understanding but I'm I'm also super, super passionate about the immune system in general but yeah, it definitely does come up more and more as time goes on with the pandemic and everything and what everyone's going through. I think a conversation needs to be extended out into those areas because it is getting attention in terms of the zinc, the vitamin D. It would be good if it had more attention. I still think we need to push for a light on those areas because I'm still aware of different media releases and different practitioners and everything that are telling people you can't do anything for your immune system.   Dan Sipple: (04:26) It's static which is complete nonsense as far as I'm concerned because we've got good clinical data, lots of research, a test tube and animal studies and human studies to say how different nutrients and botanical extracts influence what blood cell for example influence [crosstalk 00:04:45]-   Mason Taylor: (04:44) Those people, the science is so clear on that. You can get a white blood analysis before and after taking mushrooms and see the activity and do that with a plethora of other things. You have a sauna behind you, you know? It's been clinically proven of how capacitated the immune system becomes and whether that's from directly on the immune system itself or because the nervous system is effective and it's able to go into a rest and digest place and then therefore have more efficacy. It doesn't matter. Those people have been compromised. I think we know that now.   Dan Sipple: (05:15) And people see through it too, which is good. Again, if there's anything that's good that's coming out of it people that are sitting on the fence or confused, even if you're on the side of you are going to go with the vaccination and that sort of [inaudible 00:05:33], cool. That's fine. If you're interested at the same time in what builds a healthy, strong immune system, fantastic. If you're not looking through that lens too then you damn sure want to be looking at those strategies with regards to how to regulate and boost your immune system too in my opinion.   Mason Taylor: (05:52) Yeah.   Dan Sipple: (05:53) Yeah, like I said it's just disappointing I suppose that still not one campaign, still not one release, any sort of attention on that side of medicine, I've heard nothing so far.   Mason Taylor: (06:07) Let's just do a... We kind of all know, I think i have nausea, we know why that is. We know how reductionist it is, we know the system is for all that it's good for, it's completely, it's a machine and the machine has a lack of capacity for the natural and for nuance and also for anything long term. This is what spurred me on getting in touch with you to do this one today. I was just thinking about just in let's go down the rabbit hole and into the imagination that there was a task force that was brought on and it was like, "Look, okay we're going to do what we do best in [inaudible 00:06:54] and look for the reactionary one size fits all, force everyone to do this thing so we can get back which is the vaccine which is fine but we want this task force to be looking at the long term integrity of the health of our population and so one thing that I've kind of thought I don't know how people can still be slinging stones at anyone that says, "Well why don't we have a mass roll out of like mushrooms and vitamin C and all these... The subsidisation of all these things?"   Mason Taylor: (07:26) It's too much of a complex thing for them to comprehend. It's not just a drug for everybody, it's like there's nuance and it's something that they have to do continuously not just think take once and think that you're going to be all hunky dorie although that's obviously not going to be the case going forward. We can see that now.   Dan Sipple: (07:45) That's the western mentality right there, isn't it? The pill for an ill. It's not a long term strategy unlike the more naturopathic philosophy which I suppose is more lifestyle based than long term.   Mason Taylor: (08:00) What would you say... I constantly think the thing that makes sense the most for me and if there was a task force brought in we've talked a lot about the microbiome. We don't have to go into the nuance here but if all of a sudden there was free testing offered for every single person within the population to go and get your microbiome analysed and get a full panel and free analysis. You can get digital analysis now and start training up naturopaths and naturopathic students on how to read this and give generic feedback and create databases for generic feedback. You can just look up you're out of range on this strain of bacteria, that needs to go down. This needs to go up and this is the way you do it and we're going to subsidise your prebiotics in order to get there.   Dan Sipple: (08:45) That would be nice, wouldn't it?   Mason Taylor: (08:49) Well, it's actually where you go, "These people are incompetent or sinister." Where you know that the data's very clear now. We know that one of the problems with passing on infection, whether it's influenza or whether it's COVID, we know part of it is that your immune system's not actually able to keep the infection under control and not able to manage its levels of inflammation.   Dan Sipple: (09:10) Correct.   Mason Taylor: (09:11) I'm definitely glad... I'm just a fan of looking at all this guys. I'm not saying black and white, I think it's fun, I think it's fun thinking about this. You naturally know that if you're able to manage those pathways and bring some greater intelligence to the body across the population, then you're going to get on top of this and at the beginning we knew that this was going to be long term and we knew it was because I was saying only when we get vaccination in place, blah, blah, blah. At the same time, you could go, "All right, let's hit some goals. Let's see. We know the data says that if these strains are elevated within the gut and you look at you can see across the population that those that we have chronically high amount of this, you'd be able to actually enlighten us to which strains they would be, say the type that lives off animal protein, excessive amounts of animal protein. You can have greater inflammation, you're going to have less tight junctures within the gut and therefore you know clinically that you're going to be more prone to viral infection.   Mason Taylor: (10:09) You went, "Let's set some goals across the population and protect the microbial diversity within the population. Let's make sure that we up the indigenous microbes within the gut and you can also start supporting local... If they were actually wanting to localise our industry and not take it global, at that point you can start funnelling research into the particular compounds that we have off this land say and start localising the production of prebiotics, soil based prebiotic on the probiotic supplementation and all those that's clinically correct and then get everyone a free three month, every three months, free test. They can opt in or opt out and they can just get dropped that test, get it sent and they can see real time how they're moving in the direction where they're the foundation of their immune system, their gut is actually able to handle itself better and there would be legitimate... I think they could do studies as well but they would be legitimate logic there that we are going to stop the spread of anything virulent going through the community and the population if we did that.   Dan Sipple: (11:16) That would be fantastic. We all know I think it's tricky to come out and say this I suppose but we all know that it's not really about health at the end of the day because if it was it'd be more drastic measures put in place to stop the sale of alcohol and fast food and exercise would be mandatory and blah, blah, blah, blah, blah, blah. Yeah, in an ideal society that'd be great if they would subsidise those sorts of things. I think in addition to that panel's zinc status, like vitamin D status, like inflammatory markers above and beyond CRP and ESI which is what you get on a standard blood test if your doctor's willing to even look that far. Yeah, that's what I suppose what we more I guess integrative and naturopathic practitioners are more interested in those nuances with people's immune system and their integrity because it's not just about one type of blood cell or an antibody, you know? There's a lot of talk about antibodies at the moment because of the vaccination discussion.   Dan Sipple: (12:18) Yeah, cool. What about natural killer cells? What about macro fighters? What about nutrifils? What about the microbiome? All of those things... What about sleep? What about stress? It's like how long's a piece of string? We know the immune system is a lot more complicated and complex above and beyond just B cells and antibodies.   Mason Taylor: (12:35) Yeah. I had a couple of skits yet to get around to and I probably won't... Actually doing at the moment. I don't have time to do the skits unfortunately. I'll be good at my real job first and then eventually I will have my comedy career but just like the gag just being a security guard sitting in front of a pub and asking for a live blood analysis before you come in so we know you've actually taken your, what I call the immune maxine. Can you imagine? You imagine you're in charge of government. You go and find all these beautiful providers and you go and create this product that's full of... Or we can go into it, you know? I'm thinking full of mushrooms. We can go into sources of zinc and vitamin D. I'd love to do that with you but I've got the prebiotics in there, you got your colostrum in there so that when you can get that live blood analysis you can see where the... You can't discriminate against people that are immune compromised. They can of course go get tested and they can show that they are exempt from doing such thing.   Mason Taylor: (13:44) Prove. Prove you've got the immunological capacity to handle a strain, be adaptive enough to handle infection and not pass it on. Not allow your system to get to the point where you can get hoodwinked by very intelligent virus very quickly which we know happens with the flu every single year. I feel kind of silly because I used to walk around looking at airports and national airports just going... You read enough of Stephen Buhna, you look enough at virology and bacterial infection, you go, "Our ancestors are just hopping and skipping through the plane and I was thinking... This is five years ago I remember having this thought really strong. We should have some parameters around people just travelling all over the world and just coughing and spluttering and like I used to put my jumper up as I'm getting into the airport. I'm the one putting it up over my nose and over my mouth and now here we are it's swung so far the other way I'm thinking with none of the actual understanding of what these things are and what viruses are and don't know if anyone actually understands what this virus is looking at those from where it came from.   Mason Taylor: (15:00) It's not just an everyday jump from animal to human transmission which is easily traceable but it's nonetheless it's a stupid approach as we know looking at antibiotic... Sole antibiotic treatments is, it's a stupid way to go try and kill bacteria, kill the ancestors. As Buhna says, they're too smart. You're not going to do it. You're not going to beat them. Just give up. Just say we're looking at this immune maxine that everyone's going to be offered and given. We'll look at the one that's really acute. We want everyone's immune system not necessarily stimulated but in a short term kind of reactionary sense we want them all armed. What are you going in there?   Dan Sipple: (15:51) Look, echinacea comes to mind straightaway. I think any naturopath I would think agree with that, that if there's any really good clinical efficacy with echinacea and it can be used long term too by the way but when it is early days initial infection, very short term, very acute high doses and not the echinacea by the way that you get from the chemist. We're talking obviously practitioner grade liquid one in one, one in two echinacea root. That is where it would shine. I'd probably be going in there with transfer factors, colostrum, a whopping big dose of vitamin C.   Mason Taylor: (16:30) The colostrum's a huge one. I remember that paper that Daniel [Vitalis 00:16:35] used to talk about with the flu and the colostrum was three times more effective? It was a really decent-   Dan Sipple: (16:41) Yeah, he's still quite big into colostrum. I haven't looked into his stuff for years and looked into it the other day in his range and there was the fine pollens and the deer antlers and this massive big-   Mason Taylor: (16:53) Bag of colostrum.   Dan Sipple: (16:54) Yeah.   Mason Taylor: (16:55) I mean, if it was three times more effective than the flu vaccine at stopping the infection and the transmission of infection, I mean isn't that worth looking at? That's where it gets silly, you know? Just do both.   Dan Sipple: (17:07) Oh, 100%.   Mason Taylor: (17:09) Just do both. I'm so over it. Do you remember years ago we did that tour... Years ago when no jab no pay came in and I felt it. I've a lot of friends and single mothers who were just forced into a corner and now were going to have their money taken away unless their kids get jabbed. For better or worse. I'm not saying I'd agree or disagree although I do disagree at that kind of level of coercion and no nuance. I remember I just wrote I think in a blog or something like that, I was like, "Look, what about that and?" Why not that and-   Dan Sipple: (17:44) Well it's just a conversation, isn't it?   Mason Taylor: (17:47) And reishi mushroom and colostrum. Then do you remember when I did that tour as like four years ago now we did that tour and nothing about vaccines at all but the whole pro vaccine mob of The Telegraph, Sydney Morning Herald, they kind of just started writing hit pieces and they wrote one on me and they were saying this guy Mason Taylor thinks that these people should be taking reishi mushroom instead of vaccinating," which of course they're so programmed and they're just mobsters who get told who to go after and that's what they did. They called us at 5:00 in the morning trying to catch us off guard because they're awful people pretending to be a journalist. They just write these hit pieces without actually looking at any of the nuance and just like why is it an unreasonable thing to say as many people are saying right now go get the vaccine but then do all these other things as well. That gets of course the level because they don't have the capacity to hold two ideas at the same time because they lack intelligence. Not everyone. I've had lots of... I've had people on here that like really... They really enjoyed getting their vaccine but they have the capacity to realise that it's not going to do it alone.   Mason Taylor: (18:58) I think that's where I just want to preface it, that's where we're coming from so yeah, colostrum, do you want to tell everyone about the transfer factors and what the vibe is with them?   Dan Sipple: (19:09) Yeah, so look as I understand its peptides transferred from bovine or chicken sources mostly bovine from what I understand that when transferred over to human host in this case I guess does transfer the immunological weaponry and memory that the source contained so that therefore when the host is then exposed to different antigens it has a much stronger chance of dealing with it effectively but in addition to the anti pathogenic action of it, it's more also about being used long term for immune regulation and that's a big piece I think that gets overlooked too is the regulation of the immune system is what's important here because it's not just, as I said earlier about the antibodies or one type of cell. The regulation is what's missing so we kind of zoom out from the COVID discussion and just talk about the fact that in today's kind of society, in contemporary society a lot of people by and large have dysregulated immune systems. That comes back down to a whole heap of factors which we can get into but I always collectively refer that as to like antigenic load. What's someone's antigenic load like? What does that mean? Well, it means what's pissing off someone's immune system. What's causing their immune system to create havoc and inflammation and collateral damage to their own ecosystem.   Dan Sipple: (20:37) That can be dietary proteins coming through a leaky gut, that can be parasites, that can be different viruses and stealth infections. It can be weakened nutritional status. It can be stress all to my gut microbiome. That kind of yeah, that kind of conversation is where I'm at at the moment in terms of what can we also use so that when we do encounter a really gnarly infection that our immune system just doesn't absolutely blow a fuse.   Mason Taylor: (21:05) You'd be wanting to basically you're in this task, say you're in this task force and they're like, "Listen, over the next five, 10 years we want the population of all Australians to be really fortified so we can slow down the spread of this thing. You'd have to start speculating in the beginning but because the immune system's evolved you're speculating in a general way but in a way that you know is inevitably involved, yeah. You'd be wanting to test people for Epstein Barr, see if there's any stealth infection in that kind of context parasitic load. You want to be looking at their leaky gut, so on and so forth to make sure they aren't walking around with something that perhaps is symptomatic and perhaps it's asymptomatic. Just because it's asymptomatic doesn't mean it's not going to cause harm to... In this instance cause harm to everyone else because you've got stealth infections that you're not looking at. You'd want to be making sure that people have the opportunity to test for those things so that then if they did get sick their immune system had the chance to catch onto it and they wouldn't become affected themselves.   Dan Sipple: (22:05) Correct, but in doing all that this is the whole thing, that takes time, that takes resources, it takes patience, it takes more than spending seven minutes with a patient in a doctor's office, right? You can already see how nuanced it is and then when you look at it like that it's like well of course the powers that be want a quick fix, they want a quick intervention, that they can quickly roll out but it's a silly assumption to sort of present that that's going to be a long term solution because it ain't. The data's already showing that it isn't. If we model off other countries where they have high vaccination rates and yet high cases surely that's enough to kind of suggest that well, maybe the model that we have used isn't working and we've got to go back to the drawing board.   Dan Sipple: (22:52) Yeah, for me being naturopathically changed... Trained, sorry and having, full disclaimer, having gone through all this myself 10, 12 years ago even before I became a naturopath and decided to study, I discovered all this over time and I remember there was a time when I'd learn about the interleukins and the T helper cells and all of that type of thing and got super obsessed about how herbal medicine and botanicals and everything influenced that because I thought, "Well, if we can influence these different arms of immunity then we've got a chance against autoimmune disease, allergies, parasites, immune deficiency, and all those things.   Dan Sipple: (23:32) I'm still as passionate as I was then if not more. That's kind of where a lot of my work lies as a practitioner is dealing with I see all sorts of things of course but I see a lot of those people that were kind of like me, you know? Really caught in that stealth infection pattern where their immune systems just have become dysregulated. And it's not a quick fix. That's what I mean, it takes a lot of time and diligence and effort and money too. It's true, the functional testing and to get all that underway isn't easy and it's not cheap.   Mason Taylor: (24:06) And you can see it's like that not being subsidised and that not being covered-   Dan Sipple: (24:10) Exactly.   Mason Taylor: (24:11) You can see the, not to say the word but you can see the agenda behind it. If you're a smart person and you follow the science you can see the science lead you back to this place inevitably. Let's look at the maxim again. We went for starting like with colostrum and where else did you go with it?   Dan Sipple: (24:35) Yeah, I'm just thinking with the immune system getting those white blood cells primed I wouldn't so much in this scenario use the tonics. They're more for long term. I would want a quick, sharp, acute expansion and an attack of all those white cell troops so yeah, it's things like your echinacea root, your zinc, vitamin C. maitake mushroom might be a little bit more nuanced there.   Mason Taylor: (24:58) Yeah, maitake... That's what keeps coming to mind for me, turkey tail-   Dan Sipple: (25:02) Pigtail, maitake.   Mason Taylor: (25:03) That's actually another one. Yep.   Dan Sipple: (25:04) Yep. For sure. I'd keep it pretty basic in the acute. Longer term, different story. That's when I would probably expand it a bit more and zoom out.   Mason Taylor: (25:13) Okay, so we've got the immune maxim and then the maxim marathon. There's obviously going to be crossover. The way I see it, let's go a little bit into the nuance there. We keep on going on vitamin C and yeah, got to be onto vitamin C and so people are taking isolates, people are taking scorbix acid and then people are taking the lithosperic vitamin C and they're kind of good ones for the sprint, the maxim sprint when you have an outbreak and you go kind of, "All right, everyone we need you [inaudible 00:25:47]. We need to make sure you've got that echinacea in there. Maybe that's where you get the chi tonics like the astragalus. There's where I'd be coming from after having chats with my friends, my Chinese herbalist practitioner friends. They're saying you'd get astragalus always for the wei chi to put up the shield around yourself. [inaudible 00:26:10] getting in there and then they're also saying everyone should be on licorice, ginger and poreau just to augment the spleen because that just shows a major kink for this particular infection to get in and you can strengthen up that earth based system then you're going to have a much better potential to then have strong lungs metal element within the lungs and that puts up the wei chi shield so that you're less inclined to have that infection get into to begin with. Yeah so-   Dan Sipple: (26:40) Just having a thought coming through man as you're saying that back to the acute hypothetical treatment, tincture, whatever you want to call it I'm thinking along those lines too. Chinese skullcap, one of my favourites and I'd probably use that too long term because it's got a great effect on those T red cells so when you've had the initial sprint and then you want to come back and tell the troops to chill out and calm down and get back in and ready for the next one and keep them healthy, yeah Chinese skullcap all the way, probably with the astragalus, those two as the prime-   Mason Taylor: (27:14) [inaudible 00:27:14]?   Dan Sipple: (27:15) Yeah.   Mason Taylor: (27:15) Yeah, I definitely at the start of this I ordered a big bag for myself. Had never really taken it long term but when it all started going down I got onto that was the other recommendation, a good reminder. It's kind of like I've got sitting there. Got a big half a bag sitting there which I like coming out of winter it's like I'm enjoying putting it aside but for everyone in the northern hemisphere [inaudible 00:27:36] would be a good time to be getting onto those. Let's look, we've got the sprint and the marathon. I've been chatting to you a little bit about the nature of supplementation with say like vitamin C and zinc, how we can do it in a real kind of an isolated form versus what we're going to be skipping over to for the long term and the lifestyle term so we don't get stuck in isolation. Reduction isn't even when it's in the health based system so how would you differentiate the kind of the vitamin C types that were going in there?   Dan Sipple: (28:05) Yeah, so for the person whose immune system's burnt out, they've seen chronic infections before and then they come along and they hit something like this, that's... I would use it in the acute and the long term with that type of person. Same with zinc. I think if you're pretty healthy so to speak in that kind of context and we're looking at something long term that's where the fat solubles A and D I think are really good because again, it comes back to more immune regulation and strength, yeah? Vitamin A and vitamin D naturally come in cod liver oil which is always a good thing to do, five to 10 mil a day. That's usually what I sort of prescribe as far as patients go. Colostrum which I said before. I definitely would use that long term just to keep all the sort of armies of the immune system well nourished. We've got the innate side of the immune system which gets excited when it first encounters a pathogen and if that isn't capable enough to counter it, that's when it has to call on the adaptive side. That adaptive side is what houses the T cells, the B cells which contain antibodies.   Dan Sipple: (29:09) I'm doing a little series on Instagram at the moment all about T cells and that is what kind of makes up the T cell subsets so that's your TH1, TH2, these are just different armies of troops really for T cell responses, it gets quite sort of complex but it's cool to look at again how herbs influence different arms of immunity because people can also get stuck in patterns where their immune system stays skewed for whatever reason. Might be allergies and asthma and parasites can keep something called the TH2 cytokines polarised and when that happens it kind of imbalances other areas of the immune system so rather than it all being nice and even and ready to fire it can get skewed. Therefore, if that person then encounters a pathogen, they quite likely have a poorer response because that part of the immune system is deficient. You get me?   Mason Taylor: (30:03) Mm-hmm (affirmative).   Dan Sipple: (30:03) Yeah. Mushrooms are fantastic for that exact scenario by the way.   Mason Taylor: (30:09) Funny mushrooms. They're so good. I'm at this point and I don't even have to say it anymore, I've got everyone else going and saying it for me like it's just there's no point. There's no point in not being on mushrooms.   Dan Sipple: (30:20) We're not talk about white button mushrooms or psychedelic mushrooms, people.   Mason Taylor: (30:25) Chaga, turkey tail, reishi, maitake, shiitake-   Dan Sipple: (30:28) Cordyceps.   Mason Taylor: (30:30) [inaudible 00:30:30] cordyceps, lion's mane. They're all there. Yeah, that's like I think at the time we eventually were like everyone was just asking for a capsule from us. Even though we like the powder and being able to like... For me, I'm at the point just mega dosing just comes into relevance so often these days where I'm like I can just feel my body craving a heap teaspoon of chaga and then again in the afternoon. Then the capsules have made it pretty easy as well. Even though we've got to say it is a certain label dose but this is from my discretion, me going against the rules because we've got that as a listed medicine but for me I go against the rules and I'll double that and triple that regularly because you can get a sense of it and that's the beautiful thing about the mushrooms is they give you that feeling of protection within your body. You go, "Wow." You can sense the-   Dan Sipple: (31:26) It's tangible, yeah.   Mason Taylor: (31:27) Yeah, it's a tangible click up in activity and what I imagine is immunologic activity and that's why reishi's so great for people in the beginning especially in ashwagandha kind of falls into it as well because it's such a nervous system regulator that you can just drop into your body and get a sense of what you're actually feeling. That's why people get spiritual awakenings from reishi. It's not anything too woo woo, just the fact that you can get perception of your own self. You get perception of yourself and how you actually feel and how your nervous system feels, you unplug. That's the metaphorical unplugging from the matrix. You're not told how you feel, you actually, you get it. The mushrooms have got to be in there. I don't see any point in people not being on the mushrooms daily right now and it's another one like if you're actually wanting to protect people's... The cellular structure. You're actually trying to protect the treasures of the body. That would be and again, I'm biassed in that.   Mason Taylor: (32:25) There's so many things I'd be doing that that would be the first thing that would just be thrown out into the population completely subsidised a certain amount for everyone and then fully subsidised just start... The industry, that you could be creating, you're not going to... It might not work at the di dao mushrooms that I have but because there's a cap on the way that we can produce that. You can still do very decent large scale grown on wood mushrooms and you could... Again, you could be creating industry rather than destroying it right now and just what we know that's going to save so many people's immune systems.   Dan Sipple: (33:06) Oh mate, even IHCC, the shiitake extract, you know?   Mason Taylor: (33:14) You're right, that is the other one. This is where you can start going into the in that sprint. You can actually start going into the isolates that are coming out of them and isolate particular beta glucan's coming out of the mushrooms which makes sense and then when you go into marathon down the track. That's when you go back to di dao professionally full spectrum extraction.   Dan Sipple: (33:36) Yeah, and astragalus there too as you said, that'd be the... I think that's one that you do feel... It's not a mushroom but it's again like that tangible feeling, that is something that every patient says that they feel, that uplift and that chi and that's what you want if you're running that marathon and if you have a burnt out what we call T cell senescence so in other words if your T cell are exhausted and burnt out and senescent that is I've never seen anything act more specific to that. There are other herbs that can compliment it but yeah, I'm just such a fan of that herb and the research just continues to sort of come out in favour of it. I just think it's fantastic. So lucky we've got that tool.   Mason Taylor: (34:19) Yeah, that's one of the ones, the Taoists who the mushrooms are kind of spread out but astragalus was traditionally that one that was just quite available everywhere and it's like an honorary mushroom with its big blue [inaudible 00:34:30] and just its immunological adaptability. It's one of those ones in all accounts friends talking to Taoists, they say, "Yeah astragalus is the one I'll take every single day." Yeah, it does make sense and that's short term and long term. I mean you get onto that, that's why there's a reason we've said for the last I don't know, how long have I had astragalus? Like eight years? There's a reason I've said every single time we get to autumn you start smashing it. It's lung season. You start preparing your body for winter. It's the steel and it's a beautiful spleen tonic and it's a beautiful lung tonic and that's where you derive your surface immunity. That's where you derive your wei chi. Of course it makes sense to be getting onto that preventatively. Make no mistake guys, chi herbs, astragalus, the amount of data that there is on it and thousand upon thousands upon thousands of years of clinical usage, that much time of just like, the folklore behind it.   Mason Taylor: (35:33) That amount of experiential clinical data that we have is so overwhelming and it's so overwhelmingly effective, if we really wanted to protect the population that herb would be rolled out and become a national treasure. Perhaps we could find an Australian based tonic herb at the moment we don't know because we don't have a similar type of herbal tradition in Australia to the Taoist tradition. It's a very different approach and it was documented in a very different way. At the same time we could be on the hunt for like the adaptogens within the Australian system and then that does bring me to the vitamin C. I can see liposomal vitamin C, an isolate of vitamin C being used in the sort sprint just to get that spike and [inaudible 00:36:23] to see what you're using as well in that instance but for me I'm getting to the point where I feel uncomfortable using them and going to a whole fruit, whole food vitamin C, like a freeze dried cacadoo plum, freeze dried davidson plum, getting finger lime in there. Especially those Australian botanicals. I'm feeling so fantastic and then it's got all the pigments thrown in there. There's all those polyfenals going in just like feeding the bacteria.   Dan Sipple: (36:54) That's it.   Mason Taylor: (36:55) Got the natural fibres. It's how I feel about doing an isolate of a mushroom which can be good clinically. First just get the whole thing. There's all these substances in there that we haven't identified that are going to help bring greater long term efficacy. I think that's where we need to go with the vitamin C's. Get the camu camu. Freeze dried camu camu in there.   Dan Sipple: (37:15) Yes, 100%. Whole food vitamin C all the way. I think when you're out of the danger zone and if there's a useful semi long term... When by that I mean weeks, months potentially liposomal vitamin C. It's just in winter. Same as vitamin D. I've no problem with patients pumping those, couple of sprays under the tongue each day in winter and you can do it on and off in other months too but I think in those other months where your vitamin D stores are naturally going to raise you are going to be more outside, you're going to be exercising more, yada yada, I think that's... Yeah, it makes sense to sort of zoom out and use the whole plant extracts like you say because you're going to get that cross feeding with microbiome support which inevitably's going to influence the immune system at the end of the day anyway. So much from your microbiome... Sorry, so much of your immune system is influenced by your microbiome and they've shown that in rat studies where they'll compare rats the size of their spleen and thymus gland. Have I sent you this study? I don't think I have.   Dan Sipple: (38:16) They wiped out the microbiomes of these poor, poor mice, right? Compared the size of their spleen and their thymus to the groups that hadn't and it was like obviously significantly different and then they replaced the microbiome, re injected it back into these rats. Boom, spleen starts growing, thymus starts growing.   Mason Taylor: (38:39) Like a faecal transplant? How'd they inject it back in?   Dan Sipple: (38:41) Yeah, yeah. That's right. Yeah, it was a faecal transplant. This was done... Jason [Hurlac 00:38:45] put me onto this research. I think it was done a long, long time ago now but it was kind of I believe the initial sort of understanding around that time of how much gut bugs talked to the immune system. I see it man clinically. You see the patients, always one of them where at some point in their life the microbiome just gets absolutely trashed. The immune system goes down in response to it and once those bugs are gone, they're gone. Some species literally go extinct and we're what? Four or five generations now in antibiotic usage so we're already watered down, dwindled down when we start life. Like one course of antibiotics can do that let along 20 or 30 or 40 like some patients have come to me, they've got health issues by the time they're 20 or 30 or 40 and you're like, "How many antibiotic courses do you recon you've had in your life if you just had to guess?" If they're lucky it's five. Some people it's like 40. It's pretty devastating.   Mason Taylor: (39:47) Yes.   Dan Sipple: (39:47) Not to say that they don't have their use as well. There are times when antibiotics are useful.   Mason Taylor: (39:55) I mean this is again... It's like I feel you and thank you for saying that but it's also like of course. You start talking about this and I know we weren't going to even talk about this myopic approach and the vaccine going into it but at some point I think everyone needs to grow up and become a little bit more mature and remember that it's like with antibiotics. It's like you go, because you're bringing up an irresponsible usage of a drug that's saved a lot of people and you know you've had to say that little disclaimer because you know people's hearing, the cult like hearing will be there or the immature way of hearing it is going... I'm not saying you're saying this, I'm saying this.   Dan Sipple: (40:36) Oh no, yes.   Mason Taylor: (40:37) Is going to be, "Well if they've done this and they've done that how dare you badmouth something." It's the same with the vaccines. How dare you to badmouth this. It's like it's that full tribal... It's an immature way of your reacting. It's like if someone was to tell you they're taking it personally it's like rather than being in a community where you're able to actually to have some criticism based upon yourself which I'm coming from someone who doesn't like criticism at all but I've definitely appreciated and work on it, someone says to me, "It's amazing when you get really passionate and you get frustrated about things in the world but you know what? The excess of that frustration, it can be a little bit detrimental to yourself and those around you." That's like, that's the equivalent of having say, "Hey, a little bit of excess antibiotic, it's actually not that great for the people of the population and it's actually going to be really detrimental when we get these resistant bacteria and then eventually we do have these resistant viruses as we know. It's like, "How dare you? No, my frustration is done this for me and it's done that for me and how dare you question it. That's sacred to me. That's sacred. You're not allowed to touch that."   Mason Taylor: (41:42) Same thing so I mean it's a challenge for everyone listening to remember the Scott Fitzgerald quote, "The sign of true intelligence is to hold two opposing ideas in your mind at the same time and still function." If you are reacting one way or another or if you find yourself defensive, you're finding your way to seem progressive but you watch your internal dialogue, look for the gathering evidence. If you're trying to gather evidence rather than stay in a forward moving progressive, sometimes and I don't know and actually be, I don't know. You don't sit in the middle but when you are in the middle of two conversations, you're not fence sitting but you're able to handle the complex nuance within the conversation and if you can do that you can start peeking through and seeing these little sides of truth and you'd never try and just rest on one ultimate truth and I think that's what we definitely need to be doing here and I think in that sense let's go back to our maxims what are you putting in there? I know we got the 40 vegetables that we're trying to have every week as the rule for [inaudible 00:42:49]. I think it's great advice.   Dan Sipple: (42:51) Yeah.   Mason Taylor: (42:52) All different types of pigments and fibres and the appropriate amount of protein, appropriate amount of legumes. Kind of those ratios we discuss in the other podcast in order to how to get your microbial diversity up. What are those little extras? I know originally you liked Organify, red Organify to get the pigments in and get the gut kind of going up. What else are you liking in there?   Dan Sipple: (43:16) Depending on if I look at someone's microbiome and there's certain species that need nourishing that will determine if I go down that path with either red polyphenols or blue or combination.   Mason Taylor: (43:28) What about across the population if you're just speculating?   Dan Sipple: (43:30) It's more diet in that case. It's more just diversity in your diet, stop eating six vegetables per week and try and hit 40 different species, you know? I think even more zoomed out from that though unless nuance is the effect of stress and sleep on the immune system. Those, they're huge at the moment man. The patients that I'm seeing that are that torn and twisted and stressed and confused as a result of what's going on it's like that's immune deficiency right there. Stress disables immunity, period. If we're having the conversation about immune intelligence and immune capacity, it's like well we have to be talking about sleep. Are you sleeping right now or are you going to bed and scrolling through your phone and getting triggered by all this shit because most people are, right? It's not easy to just turn it off either you want to be informed regardless of which lens you're looking through. You want to know what's going on. That is a tricky thing to navigate but I have to obviously continually read or write that the importance nature time, slowing down, stress and yes, sleep on the immune system. The immune system recharges through the night.   Dan Sipple: (44:36) It's like hormones so if you're not sleeping your immune system is regardless of what... I've seen people on the best protocols. You can't fault it but stressed to the max and not sleeping and it's just like, "That stuff's not even..." it might be having some protective effect than without but it's definitely not putting you in a prime spot where your goals are sort of orientated. Again, disclaimer. That's been me in the past as well for sure.   Mason Taylor: (45:04) I mean, this is what I thought at the beginning. Imagine if immediately... I think the biggest step that they did was they took the six free mental health plans sessions from six to 10 sessions or something like that and then started educating about a little bit about like here's the helpline, here's lifeline, so on and so forth. Here's Beyond Blue. The only thing that made sense to me to go above and beyond, can you imagine if we just... I know this is full speculation and sometimes I like flying to Neverland and go, all right. We know that sleep and stress... We know we've got markers that can measure those. Something as simple as like I don't know, like an [inaudible 00:45:51] and there's apps. If you're in this technological place. I know a lot of people listening to this are like, "I don't want to be using technology, I don't want Bluetooth on me," but I'm talking about mass wide rollout. If you were put in charge of getting the help of our population up and able to handle this and stop the decimation that this is having on families, the decimation this is having on small businesses. Just the decimation this is having.   Mason Taylor: (46:17) People not appreciating the fact that, all right, cool. Some lives have been saved but what about those moments of like young families lives where we put this much stress at the beginning of what's already a stressful journey and then that completely gets them tripping over for a few years, that impacts their life forever. There's no measurement-   Dan Sipple: (46:33) As if life isn't stressful enough as it is for most families, right, financially, socially?   Mason Taylor: (46:39) I wonder if people would then go, "This is a violation of my rights," if you go, "Hi everyone, we're going to educate you on how to sleep better and we're going to... Again, we're going to subsidise and we're going to just, you know we're going to create some good internal business and create some money for smaller operators and we're going to get everyone on sleep markers and we're going to start incentivizing you to get those markers variable to you and rewarding you and stop bringing a pride in through our nation around optimising our sleep. We start by creating nonjudgement but hey everyone here's the education. Here's exactly what we know and then we're going to start allowing you to get... Reward yourself as you go along in that process and optimise your sleep. Can you imagine the insane amount of health and just how much our medical system would be alleviated long term if we did something like that?   Dan Sipple: (47:33) Oh, 100%. I remember someone saying years ago that I can't remember, it was literally like 10 years ago it was in a documentary and then some fellow was like, "Imagine if we had a crisis of health." It's just like, "Yeah." Lot of businesses are going to go down, a lot of corporations are going to lose out, you know? Yeah, it comes back to what you said at the end of the day not to get conspiratorial at all because that's not the objective of the conversation but it's like, "We know that there is an agenda."   Mason Taylor: (48:00) Yeah, of course.   Dan Sipple: (48:01) Because if there wasn't these things would be in the headlines and they would be campaigns towards bringing them to the forefront so yeah, those-   Mason Taylor: (48:10) As soon as anyone says it's too expensive we know they're full of crap now because look at how much money... How much debt we've been willing to just to go into and I'm not saying that's right or wrong. The other just those, yeah the measurements on stress. I mean, you've got the sauna behind you, we've got the capacity to go and utilise indigenous healing modalities revolving around meditation, going walkabout, connecting with nature. There could be this mass rollout of free information taking pride the same way that's like throughout China you'll se tai chi being done in the park and it's a part of their culture. This could've been an opportunity for Australian culture to go beyond just basically boozing at the pub and barbecues which I love both of them. I think they're wonderful but can you just imagine the cultivation of national pride as well as everything else. If everyone else wants to go down the medical intervention route as well that's like absolutely do it. Can you imagine though if they rolled out meditation? Started the subsidisation of [inaudible 00:49:24] practises? Can you imagine, and you can do it at home. Mass education just all of a sudden bring subsidising of the media outlets if they'd start. Give them perks if they start taking on pro bono advertising of particular elements of how to de stress the body through meditation courses.   Mason Taylor: (49:47) Getting a buddy, through yoga ninjas. Start producing fire infrared saunas here in Australia. Go get Sebastian producing the new... He's got new aurora ones that just like little domes. It's a local company, start getting those produced and start putting those in houses. Start moving them around through the community and start showing people with their little band or whatever it is with have a little Bluetooth and it's hooked up. I know then everyone will go, "I don't want my data... I don't want the government having my data of my sleep markers and my stress markers but regardless looking at a macro scheme here and it might see pie in the sky but I guess-   Dan Sipple: (50:31) Oh man. Sorry to cut you off.   Mason Taylor: (50:31) You're good.   Dan Sipple: (50:31) Even subsidising growing your own food in your own backyard, man, something so simple.   Mason Taylor: (50:39) This, we know it's a golden opportunity for if you're a huge business. We know what this would be a golden opportunity for if you were an actual human oriented and focused government. We know what it would be a huge opportunity for if you weren't selfish and stupid and you could think laterally and you weren't just a talking head and there's so many people raring up and it's dangerous. The lessons I always got from my dad... Sent my dad the samurai, just passed recently. He's like, "One thing you keep your head down long enough that you don't pop up against the grass and get your head taken off too early." Stay down and move with stealth and then pop up when it's absolutely necessary, do what you have to do and then go back down and move but it's-   Dan Sipple: (51:36) And they're making it hard to stay down.   Mason Taylor: (51:38) They're making it hard to stay down just because it's so blatant. I think for when everyone was to say what we've talked about here and I guess a lot of the point of this conversation is we've talked a little bit about immunity which also talking about a reality that worth manifesting and we're needing to do these kinds of things ourselves which we are doing. Trying to hopefully move away from the idea that it's taboo to start taking responsibility for your immune system and start doing things in conjunction to one another. Obviously it is. I said, "Why don't you guys give children and the mums if you say no jab, no pay, no welfare for single parents.   Mason Taylor: (52:20) Why wouldn't you give them reishi as well if we know that reishi mushroom has been proven to be that good to the immune system and they can't handle that level of nuance that they need to go on the attack basically." If you can't handle that level of conversation or if you're able, then well we know they can't have that level of conversation, I guess all I'm saying is we know now we're going to have to be the ones to carry that much nuance but it's also worth remembering that you don't want to be like them and find your identity based on creating opposition. I think that's what's also kind of I think going to get people being less effective and being hysterical and sticking their head up too early.   Dan Sipple: (53:06) 100%, 100%.   Mason Taylor: (53:07) What they're doing here is they're not... I know it feels threatening for a lot of people on both sides. It feels threatening to people on both sides and if you are in that state of feeling threatened, first of all you're putting everyone in danger because your immunological health is going to go down because you're stressed. First of all, stop it. Stop being selfish. The other point is there is a middle ground in order to be effective and there is no right answer in how to get in. Other people are like, "You have to get jabbed. You have to get up and come and march otherwise you consent." Do those things, by all means but I would recommend for everyone to stay within your own body. Stay within your own capacity to fuel who you are and don't fall into that finger pointing identity and that tribalism. You can still take action but-   Dan Sipple: (53:58) Doesn't have to be promoted necessarily just like in your own backyard, you know?   Mason Taylor: (54:04) This is going to be long term. This is long term stuff going on. You're going to have to start getting actioners and as you said, it's a good time to start getting into growing your own food. It's a really good time for cultivating... Appreciating the localization of your community and really start in placing a lot of value on the connections that you have made, the genuine connections that you have made, friends and family because yeah, community can be a house of cards sometimes especially when it's polarising things like this so you've got to nourish those golden relationships and not just the ones that seem ideologically driven. Yeah, I found my tribe. I found my tribe. They believe the same things I believe. It's like, "No, not that. Not that superficial connection just because you are ideologically driven. They're useful. Real genuine connection. So good for the immune system. Makes you feel safe doing that.   Dan Sipple: (55:01) Yeah, well it's also no good if everyone hangs out over this side and then the opposition all hangs out over this side, is it? That's just divisiveness and that's what we're seeing. We need to, as you said earlier hold that space for context and different lenses and that's obviously what's not happening now and I don't see any... The isolation, it crashes the immune system, right? It's like we know our kids need exposure, we know that your immune systems have to practise, they have to get exposed regularly to become educated and to stop... We can talk about the germ theory and the hygiene hypothesis and all that stuff and how that all came about with the context of autoimmunity. The immune system going awry and not recognising what's what anymore and not being able to tell the difference between a pathogen and your own tissue which we know is on the rise today. The point is-   Mason Taylor: (55:54) That's really on the rise now, isn't it?   Dan Sipple: (55:56) 100%, 100%. Yeah, there's people and again full disclaimer, this was me. I was immune deficient and autoimmune at the same time. See it all the time. What's that tell us? We've got immune dysregulation going on. Look, we're not saying we've got all the answers. That's not sort of what the conversation's about but in terms of isolation we know that causes stress, we know that's going to deplete indigenous immunity across the board.   Mason Taylor: (56:25) We also know we have leaders that can't handle any type of nuance and go and squash any type of conversation to get a multifaceted approach to what's going on here.   Dan Sipple: (56:36) Yeah.   Mason Taylor: (56:38) Without going into it with resentment because resentment is definitely going to harm you and harm your immune system and harm your liver but if you can find ways to get very excited about the fact that you're going to start... you need to be the one, regardless of what approach you're taking, you're going to need to take responsibility for-   Dan Sipple: (56:58) Responsibility, yeah.   Mason Taylor: (56:58) Yeah, being one of those people. Being part of the drive to increase the immunological capacity across the population within your community starts with you, starts with your family. Then starts with your community. I feel really good about [inaudible 00:57:12] and I imagine I'm sure you're feeling pretty good as well. I'm just realising the flag that we're waving and hoping to not be too... Oh gosh, what's the word? I don't want to be in opposition to anyone. I don't want to be inflammatory, I just I really enjoy just going and like waving the flag for personal responsibility, sovereignty, relationship with you. In this conversation relationship with the microbiome, the immune system and just give them herbs. That's the other thing, it's not simple. I've been kind of like, I don't know I've just been worried to kind of say it and we're talking about all these herbalists who are really conservative herbalists like Michael Tierra do it and even people like Stephen Buna who's quite like... He's clinical. They're both just like at the one point they're like, "Yeah, get on adaptogens." Buna's saying it specifically in relation to COVID. He's saying, "I'm sure it helps in a few of his posts but that's just where it gets to the point where it becomes very irresponsible not to be talking about these things. Oh, where's the data? It's like, "Guys, you are off your head.   Mason Taylor: (58:18) There is data emerging but you're off your head. That I'm science driven, where's the data kind of put a full stop and look at me. Look how smart I am because I'm able to ask someone for where's the data and not actually be able to think in that, I don't know in the way that life actually exists in consortium with many forces. Then yeah, sorry. I think you lack, I think you've pretty low IQ if that's your approach and you're defensive and I think you'd probably have a lot more fun in life and have a lot more connection if you've got out of that tribal way of looking and yeah, people just should be on adaptogens to get onto it and then the-   Dan Sipple: (59:00) What have you got to lose? That's the thing, it's like what have you got to lose? It's not a high risk intervention like other certain things, is it?   Mason Taylor: (59:05) I don't think so. I'm like well no, it's not. Zinc's the other one that's getting thrown around at the moment. What's the type of zinc-   Dan Sipple: (59:18) I love zinc man. It's zinc and copper balance is a big thing. I always look at that with the context of patients and immune system issues. What we typically see most of the time I'd say is more of a tilting towards a copper excess and a zinc deficiency but you can also see just a deficiency of both or people can just be normal and still have immune issues but their zinc and copper not be an issue. Zinc deficiency is probably more the common out of the two. That can come back to obviously diet, zinc lost due to certain conditions, [inaudible 00:59:53] disorder being one of them, heavy metal competition, the soils being a poor source of zinc these days, the rise of plant based diets which might have great clinical usage in some areas but yeah, when it comes to something like zinc deficiency that's something that I do often observe in people that are purely plant based. Yeah, that who

Rheuminations
Sponsored Episode: A Historical Look at Cardiovascular Risk in Rheumatoid Arthritis

Rheuminations

Play Episode Listen Later Aug 30, 2021 27:57


This podcast series is sponsored by Vectra®. Discussion does not constitute or imply endorsement of the product. In this episode, Adam J. Brown, MD, and Jon Giles, MD, explore the history of cardiovascular risk in rheumatoid arthritis from the 1950s onward, including the emergence of data surrounding inflammation and cardiovascular disease, as well as the need for therapeutics that go beyond simply treating joint pain. Intro :11 Intro of Dr. Jon Giles :22 Today's episode 1:36 How did you become interested in cardiovascular disease in rheumatology? 2:18 When did cardiovascular risk become part of the discussion about RA? 4:33 How to follow patients over time and develop a better sense of cardiovascular risk through studies. 7:23 Are there unique cardiovascular risk factors among RA patients? 10:19 CRP levels as predictive of cardiovascular events 12:09 The biology behind cytokines associated with cardiovascular risk 14:22 Are current interventions and therapeutics making a difference? 16:27 General awareness among patients and physicians of cardiovascular disease and RA 18:29 Roles and responsibilities in cardiovascular risk management 21:15 How do we screen for cardiovascular risk beyond lipid panels? 22:27 Where is the field of cardiovascular risk and RA going? 24:01 Steroids, NSAID's, and cardiovascular risk 25:43 Episode wrap up 27:04 Thanks for listening 27:49

Fundamental Health with Paul Saladino, MD
Ending the debate over seed oils, with Tucker Goodrich

Fundamental Health with Paul Saladino, MD

Play Episode Listen Later Aug 24, 2021 128:57


Tucker Goodrich is a technology executive in the financial industry who designs, runs, and debugs complex systems in high-risk environments. Areas of expertise include risk management, systems management, and cyber-security. After experiencing some personal health crises and realizing that the ‘solutions' offered by medical professionals weren't working or addressing causation he started applying the same approach in research and evaluation of data to his own health issues to determine root causes. His interests have focused on dietary and environmental drivers of chronic disease, including carbohydrate, wheat, and various classes of fats. Specifically, he's attempting to understand and popularize understanding of the mechanisms driving the diet-derived explosion in so-called chronic diseases (or diseases of civilization). He is active on twitter (@tuckergoodrich, has a blog called Yelling Stop, is an Expert Advisor for the nutrition start-up Nutrita, and has been a guest on numerous podcasts.   Time Stamps: 0:10:16 Podcast begins 0:12:16 Tucker's blog post: https://yelling-stop.blogspot.com/2021/06/thoughts-on-of-rats-and-sidney-diet.html 0:14:16 Compounds that reduce overeating 0:17:16 Dietary Linoleic Acid Elevates Endogenous 2-AG and Anandamide and Induces Obesity: https://onlinelibrary.wiley.com/doi/full/10.1038/oby.2012.38 0:23:31 Endocannabinoid signal in the gut controls dietary fat intake: https://www.pnas.org/content/108/31/12904 0:29:56 A Neural Circuit for Gut-Induced Reward: https://www.cell.com/cell/fulltext/S0092-8674(18)31110-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867418311103%3Fshowall%3Dtrue 0:35:46 CRP is a marker of oxidized linoleic acid 0:38:32 Dietary linoleic acid intake and blood inflammatory markers: a systematic review and meta-analysis of randomized controlled trials: https://pubs.rsc.org/en/content/articlelanding/2017/FO/C7FO00433H 0:43:06 Take a pill or just stop eating so many seed oils? 0:45:16 Low‐Density Lipoprotein Cholesterol Corrected for Lipoprotein(a) Cholesterol, Risk Thresholds, and Cardiovascular Events: https://www.ahajournals.org/doi/10.1161/JAHA.119.016318 0:49:46 A high linoleic acid diet increases oxidative stress in vivo and affects nitric oxide metabolism in humans: https://pubmed.ncbi.nlm.nih.gov/9844997/ 0:54:16 HNE - what is it and why is it important? 0:58:36 Where is linoleic acid even found? 1:02:46 The average amount of linoleic acid in the human diet 1:12:06 Why I don't eat bacon 1:14:46 Just because a study was conducted a long time ago, doesn't mean it should be ruled out 1:20:31 Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73): https://www.bmj.com/content/353/bmj.i1246 1:27:16 When low LDL can result in a higher risk of cardiovascular disease 1:28:31 Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis: https://www.bmj.com/content/346/bmj.e8707 1:32:16 Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study: https://pubmed.ncbi.nlm.nih.gov/9989963/ 1:40:40 The blood test you should consider getting  1:42:55 The idea of "intralipid" 1:51:00 Tucker's personal experience with weight loss and dietary changes 2:03:10 Health Characteristics of the Wayuu Indigenous People: https://academic.oup.com/milmed/article/184/7-8/e371/5481850 2:07:25 Where to find more of Tucker Goodrich   Sponsors: Blazing Bull: $150 off of a 1500 degree grill at BlazingBullGrills.com with code “CARNIVOREMD” at checkout Lets Get Checked: 20% off your order at www.TRYLGC.com/carnivoremd  White Oak Pastures: www.Whiteoakpastures.com, use code: CarnivoreMD for 10% off your first order Belcampo: www.belcampo.com use code: CarnivoreMD for 20% off your order

Healthy Human Revolution
Transforming Your Health Through Plants | Brittany Jaroudi

Healthy Human Revolution

Play Episode Listen Later Aug 17, 2021 47:52


In today's interview, I'm honored to interview Brittany Jaroudi. Growing up, Brittany was always fearful that her parents would die. She had to witness her mother go through cancer three different times, and her father had a massive heart attack that led to triple bypass surgery and, eventually, stents and a defibrillator. Her dad now has diabetes and congestive heart failure. Brittany followed the same lifestyle as her parents through her childhood, adolescence, and early adulthood, eating a standard American diet. They ate take-out and lots of meat, dairy, and oil. Her struggles with weight began when she was only 8 years old, and by the time she was in her mid-20s, her eating habits had really caught up with her. She was 185 pounds! Her doctor diagnosed her with high blood pressure (150/90) and put her on two different blood pressure medications. Brittany had high cholesterol (total cholesterol: 242). Her anxiety was through the roof, with a resting heart rate in the 90s. Brittany's hs-CRP (high-sensitivity C-reactive protein, a marker of inflammation and cardiovascular disease risk) was extremely high, and she had chest pains. She thought, “This can't be my life at 25 years old.” Brittany began researching ways to get herself out of the health crisis. She found the Forks Over Knives documentary, and it all clicked. She saw what the future would be if she stayed on her current path: heart disease, autoimmune disease, diabetes, and maybe even cancer. After watching the documentary, Brittany immediately went plant-based. She got rid of all the dairy, meat, and processed foods she had in her house. Since that day three years ago, she has lost 60 pounds; she no longer has high cholesterol (150 total); Brittany has high blood pressure (110/70); her resting heart rate is 60, and her hs-CRP is in the normal range! To connect with Brittany: Website: www.thejaroudifamily.com Youtube: www.youtube.com/thejaroudifamily

The Carnivore Yogi Podcast
All about improving your health through food & lifestyle with the Nourished Caveman

The Carnivore Yogi Podcast

Play Episode Listen Later Aug 11, 2021 70:14


This episode is sponsored by Let's Get Checked! Use my code YOGI30 to get 30% off your at home lab tests! Skip the hassle of the doctor & get to the root of what's going on from the convenience of your own home! Check your CRP - https://trylgc.com/carnivoreyogi Check your thyroid labs: https://trylgc.com/carnivorethyroid Test your A1C - https://trylgc.com/carnivoreyogiA1C - Micronutrients http://trylgc.com/CarnivoreMicronutrient - Vitamin D - http://trylgc.com/carnivorevitaminD - Cholesterol- http://trylgc.com/carnivoreyogicholesterol Vivica Menegaz is a certified whole-food nutritionist, blogger, published author and one of the leading voices advocating for a food-based approach to healing. Vivica was the first one to use the now popular expression “Keto Paleo” to describe her lifestyle and way of eating. She is the founder of the “The Healing Foods Method' – an 14 week online nutrition program where she works 1-on-1 with clients to turn their health around utilizing a therapeutic ketogenic diet for healing (keto paleo). Tracing back to her Italian origins, Vivica is a passionate cook whose love of healing food has been shared with millions through her blog, “The Nourished Caveman.” While living in Northern California, pursuing her self-sufficiency dreams and practice of nutrition, Vivica's life came to a turning point when she discovered she was pre-diabetic. The nourishing Paleo foods she had been advocating we evidently not the whole solution to modern health problems. Fueled by this discovery, Vivica dove into research and found the ketogenic diet. It was love at the first bite. Within the first couple of months, her blood glucose levels dropped, she shed excess weight, her brain fog cleared up and her energy levels skyrocketed. After a year of successful keto paleo lifestyle Vivica's own health journey took another turn as she was now diagnosed with Hashimoto's and Hypothyroidism. Again she had to rely on her studies and practical applications to resolve those challenges, and that is how she became the first holistic nutritionist to successfully utilize a ketogenic approach as the foundation to endocrine rebalancing. Vivica's therapeutic approach to food, lifestyle and supplementation, utilizes the healing power of foods and mindset, to address the incapacitating symptoms of many lifestyle-diseases that have plagued our modern lives. She has made it her mission to help others reclaim their health and quality of life. Vivica is also the author of 3 cookbooks: “The Ultimate Paleo Cookbook” 2015, together with 9 other bloggers, and “the big book of Fat Bombs” in 2016. Her latest book: “the Keto Paleo Kichen” was released in December 2017. Follow her on her website - https://thenourishedcaveman.com/about-vivica

The Duran Podcast
Great Power conflict, from possibility to high probability [Geopolitics Focus]

The Duran Podcast

Play Episode Listen Later Aug 4, 2021 97:44


Great Power conflict, from possibility to high probability [Geopolitics Focus] - Episode 5 Subscribe to CRP: https://www.youtube.com/CoachRedPill CRP on Patreon channel: https://www.patreon.com/CoachRedPill CRP on Telegram: https://t.me/realCRP

The Vance Crowe Podcast
Gina Snyder: Montana cattle ranching with a different approach

The Vance Crowe Podcast

Play Episode Listen Later Jul 19, 2021 50:17


Gina Snyder is a cattle rancher in North East Montana. Snyder's family made the decision to change how they ranch and she joins Vance Crowe to talk about what it takes to raise cattle in a cow-calf operation. Crowe and Snyder discuss buying cows at auction, raising them on ranch lands, CRP lands and water. Snyder has a clear view on the environmental value of raising cattle on grasslands.Gina Snyder's Twitter: https://twitter.com/nemtblueskyAllan Savory Ted Talk Gina referenced: https://www.youtube.com/watch?v=vpTHi7O66pIPODCAST LINKS —Vance Crowe Podcast Website: https://www.vancecrowe.com/podcastApple Podcasts: https://podcasts.apple.com/us/podcast/the-vance-crowe-podcast/id1463771076Spotify: https://open.spotify.com/show/08nGGRJCjVw2frkbtNrfLw?si=WUCu-FoyRRu9U_i-1gJZfgRSS: https://feeds.transistor.fm/the-vance-crowe-podcastYouTube Full Episodes: https://www.youtube.com/channel/UCigB7W5bX_gCinJxev9WB8w/YouTube Clips: https://www.youtube.com/channel/UCJKKb66A5_4ZcsE-rKI24ygBuy a sweatshirt, T-shirt or mugs from the podcast! Check out the Articulate Ventures Merch Store: https://teespring.com/stores/thevancecrowepodcastSubscribe to the podcast for email notifications on new episodes, invites to events and other exclusive content — http://eepurl.com/gSTfk5ABOUT THE VANCE CROWE PODCAST — Vance Crowe interviews people with an expertise that you would want to know about, but might not think to ask. He prompts his guests to think about their work in novel ways, discusses how it applies to regular people and has fun sharing stories and experiences.SUPPORT THE PODCAST —Rate the Podcast |  https://ratethispodcast.com/vcpJoin the Articulate Ventures Network | https://network.articulate.ventures/ —We are a patchwork of thinkers that want to articulate ideas in a forum where they can be respectfully challenged, improved and celebrated so that we can explore complex subjects, learn from those we disagree with and achieve our personal & professional goals.Contact Vance for a Talk | https://www.vancecrowe.com/ —Vance delivers speeches that reveal important aspects of human communication.  Audiences are entertained, engaged, and leave feeling empowered to change something about the way they are communicating.  Vance tells stories about his own experiences, discusses theories in ways that make them relatable and highlights interesting people, books, and media that the audience can learn even more from. Join the #ATCF Book Club | https://articulate.ventures/category/atcf-book-club