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Mehlman Qbanks: https://qbanks.mehlmanmedical.com/IG: https://www.instagram.com/mehlman_medical/Main Website: https://mehlmanmedical.com/
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Join Our 8 Week Root Cause Reset Masterclass Starts June 4 -->DianeKazer.com/RCR 50% Off Dr Judy Morgan's Books --> DrJudyMorgan.com Code: CHI50 10% Off Dr Judy Morgan's Supplements -->DrJudyMorgan.com Code DK10 Join Our Elite VIP Tribe --> DianeKazer.com/VIP Apply To Become A Patient --> DianeKazer.com/PATIENT If you've ever trusted your vet… followed the protocol… done "everything right" for your pet… …and still felt like something was off, then this episode is for you. I'm going live today on our CHI Podcast with holistic veterinarian, Dr. Judy Morgan and we are getting controversial… Not surface-level… not sugar-coated… but the conversations most pet owners aren't having (and honestly… most vets aren't either). Here's what we're diving into: ✨ Immuno-suppressants…what are they and why they leave your pet with virtually zero immune defense ✨ The truth about ticks… and those "tick boxes" mysteriously popping up all over the US ✨ Parasite protocols + Heartworm medications — the harm they actually do inside your furry friend's body ✨ The dangers of mRNA vaccines in pets ✨ Biopsies, c@nc$r and lipomas — when intervention may spread what you're trying to stop I'm not here to scare you. I'm here to aware you so you can embody your power as a pet owner. Because your dog or cat doesn't get to ask for a second opinion… you are their advocate. And when you innerstand what's really going on — you can make decisions from clarity, not pressure. If you've ever questioned: "Is this really the best option for my pet?" You'll want to hear this.
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References Clin Exp Rheumatol . 2019 Sep-Oct;37(5):715-722Front Neurol. 2024 Jul 3;15:1396520. Glia. 2021 Jan 2;69(5):1216–1240Guerra, DJ.2026. Unpublished LecturesMozart, WA. 1786. Symphony 38 in D Major." Prague". K. 504https://music.youtube.com/watch?v=tLinpqckLGw&si=oKPtpiJJDEuoEHjBBalin, M. 1966. Coming Back to Me Jefferson Airplanehttps://open.spotify.com/track/0TBntp6t4oS6UXjxikO5n7?si=20e475b0642c433b
ReferencesCereb Cortex. 2023 Sep 16;33(21):10750–10760.J of Pineal Research 2018. Vol65. Issue 4. November.E12525Guerra, DJ.2026. Unpublished LecturesAllman, G. 1969.Whipping Post" Allman Brothers Live at the Fillmore .https://music.youtube.com/watch?v=gZRdZhfhqhw&si=tX-mHJom9v_BpLSYMozart, WA. 1783-91 Horn Concerti I-IV.https://music.youtube.com/playlist?list=OLAK5uy_mUVuXqYj7Ghb4jkkNzjKUqCkr1u3tPSIc&si=iUY-Qvu6aIobGpIr
Following the Healthy Brick Road, Interview with CMS Admin Dr. Oz | TRIGGERED Ep.333 Live from Rumble Studio For advertising inquiries please email sponsorships@rumble.com --- Immuno 150 - order online at http://Immuno150.com or call toll free 888-316-2224. --- Visit http://DonJrGold.com today to claim your free 2026 Gold & Silver Kit. --- Call 877-80-INVEST — that's 877-80-INVEST or log onto www.InvestYrefy.com
SAL RUSSO from NYC joins the show to highlight how Immuno 150 helped him correct his vision and avoid cataract surgery. IMMUNO 150 was formulated to strengthen immune systems and correct many abnormalities. Its 70 plant-derived colloidal minerals are the key to its success.Blended with 80 carefully selected, premium nutrients, it's one of the finest supplements available.“The human body needs 60 minerals to avoid disease”– Dr. Linus Pauling, Two-time Nobel Prize Winnerwebsite: www.immuno150.com888.316.2224
ReferencesBritish Journal of Anaesthesia,2002. 89, 739-746ssue 5p739-746 NovemberFront Immunol. 2023 Jan 5;13:1066599Front Immunol. 2024 Sep 23;15:1401962. Guerra, DJ 2026. Unpublished LecturesBach, JS. 1717.. Violin Partita. Ciaccona. No.2. BWV.1004.https://music.youtube.com/watch?v=ai8NiHI1-eo&si=ZoB5YewTA9AMN5UzParsons, G. 1968.Hickory Wind. Byrdshttps://open.spotify.com/track/3YBTxokhuaszeWCOXC7FQn?si=04740ef540b64bb0Parsons, G. 1965.Brass Buttons. Pocohttps://open.spotify.com/track/6Bijmp2RULR8SgmpqRe7tx?si=cffa81c0cbd64fdeMcQuinn & Parsons 1971.Pale Blue Byrds.https://open.spotify.com/track/46D9uj48T6E8xlSKLv4cEU?si=f52ac2da25fd4eb2
ReferencesScience.2019 Dec 6;366(6470):1259–1263Metab Brain Dis. 2025 Jan 24;40(1):111. Nature 2024 volume 628, pages 154–161Cell Stem Cell. 2022 Aug4;29(8):1197–1212.Transl Neurodegener.2024 Jul 30;13:38Guerra, DJ.2026.Unpublished Lectures.Camp. H. Pride of Man, 1968, Quicksilver Messenger Servicehttps://music.youtube.com/playlist?list=OLAK5uy_nLnEKjG3esjS9BODPxsViBFVi71tHUVCg&si=TUhAYmWREgvaVEZcBalin/Kaukonen/Slick/Cassady/Kantner.1969.Volunteers. lp.Jefferson Airplanehttps://music.youtube.com/playlist?list=OLAK5uy_mDXwNUaUAaHTf8GcmBZcalldqwdt0I-QI&si=yjkxMUNRqdywR-W5
ReferencesNature 2024 volume 628, pages 154–161Cell Stem Cell. 2022 Aug4;29(8):1197–1212.Transl Neurodegener.2024 Jul 30;13:38Guerra, Dj.2026 Unpublished LecturesSchubert, F piano Sonatas 959 and 960https://music.youtube.com/playlist?list=OLAK5uy_nfQQU2ubL5bfBrqFNPebxFMydXv13sbMA&si=0ycKMbi8hjulstIN
ReferencesProc Natl Acad Sci U S A. 2025 Sep8;122(37):e2516103122J of Neurochemistry. 2019. 151, Issue6 December: 676-688Neuron. 2024 Dec 23;113(4):554–571.e14Guerra, Dj.2026. Unpublished LecturesTownsend, P. 1971. Behind Blue Eyes The Whohttps://music.youtube.com/watch?v=wOGWrbIYPqY&si=LPpO6q9M__juQ3FrClapton, E., Whitlock, B. 1970. Bell Bottom Blues. Derek & the Dominoeshttps://music.youtube.com/watch?v=UcYlWEddjYo&si=-Svqmo3QL2SswLPu
ReferencesGuerra,Pre DJ.2026 Unpublished LecturesFront. Immunol. 2016Sec. T Cell Biology Volume 7 - 30 MarchTranslational Neurodegeneration 2024.Volume 13, article number 10Biber, H. 1676 Violin Sonatashttps://music.youtube.com/watch?v=ZE3OGrusXSY&si=DJlIhY8CihrpNzkw
ReferencesFront Pharmacol. 2022 Oct 28;13:1012013Redox Biology2021 Volume47, November, 102165Front.Immunol.2016 30 March Sec. T Cell Biology Volume 7 International Immunopharmacology2023.Volume 125, Part B, December111166Guerra, DJ. 2026. Unpublished LecturesMozart, WA.1775. Violin Concerto III.in G Major. K.216https://music.youtube.com/watch?v=IhQAtkXOK6o&si=1YcKlHdcomP3aRMQSimon, P. 1966. April Come She Will. S&G. SoS..lphttps://music.youtube.com/watch?v=6NWjRmfnmIk&si=aurPqaky4qJlUP-QHarrison, G.1969. Here Comes the Sun. Beatles Abbey Road.lphttps://music.youtube.com/watch?v=xUNqsfFUwhY&si=YrBxj8sITFZim4AM
ReferencesGuerra, DJ. Unpublished LecturesMozart, WA. 1786. Le Nozze di Figaro. K.492. Overturehttps://music.youtube.com/watch?v=pb1tlh9xn38&si=TJ34fcY86DMcVddeLennon/McCartney. 1966. Got to get You into My Life: Revolver lp.https://music.youtube.com/watch?v=r95-7zfgtLw&si=5SnrpxA1j2YFXIzjHunter/Garcia.1970. Brokedown Palace. American Beauty lphttps://music.youtube.com/watch?v=-9HepG1Z4fI&si=7ui43FuZWIm5cNRx
Eric talks with Elmer Heinrich about his life story and mission of educating the public about the importance of daily mineral intake. They breakdown a key to longevity and an active lifestyle. See omnystudio.com/listener for privacy information.
Live from Rumble Studio For advertising inquiries please email sponsorships@rumble.com --- Immuno 150 - order online at http://Immuno150.com or call toll free 888-316-2224. --- Text my name DONJR to the number 989898 to receive your free infokit on gold. There's no obligation, just useful information.
FEATURING MR. H of IMMUNO 150.IMMUNO 150 was formulated to strengthen immune systems and correct many abnormalities. Its 70 plant-derived colloidal minerals are the key to its success.Blended with 80 carefully selected, premium nutrients, it's one of the finest supplements available.“The human body needs 60 minerals to avoid disease”– Dr. Linus Pauling, Two-time Nobel Prize Winner
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Send us a textDr. Andrew Holman, MD is Co-Founder & Chief Executive Officer of Inmedix ( https://inmedix.com/ ), a medical diagnostics company pioneering the field of stress biology through its FDA-cleared CloudHRV® platform. Inmedix brings cloud-based clinical diagnostics and immuno-autonomics to medicine to improve outcomes in autoimmune diseases and beyond.Dr. Holman is the founding rheumatologist at Pacific Rheumatology Associates Inc PS, Director of Research at Pacific Rheumatology Research Inc., a former President of the Northwest Rheumatism Society (2005) and a Clinical Associate Professor of Medicine at the University of Washington.Dr. Holman has 25 year clinical (and 19 year rheumatology) research career experience with 16 lead author published papers, and 25 lead author published abstracts. For Inmedix, he has designed, completed and published 15 clinical studies, including FDA negotiations, involving nearly 1500 patients.Dr. Holman's research highlights include, but are not limited to, studying the use of dopamine agonists as a treatment of fibromyalgia, exploring the impact of hypermobility syndromes, evaluating innovative autonomic nervous system (ANS) analysis with 5-min heart rate variability (HRV) in patients with rheumatoid arthritis and other autoimmune diseases, and broadening understanding of pain in patients with PC3 (positional cervical cord compression) using dynamic flexion-extension, cervical magnetic resonance imaging (dMRI). Dr. Holman has his Doctor of Medicine (M.D.), Medicine from University of Missouri-Columbia and did his Rheumatology Fellowship at the University of Washington - School of Medicine.#AndrewHolman #Inmedix #CloudHRV #ClinicalDiagnostics #ImmunoAutonomics #AutoimmuneDiseases #StressBiology #Rheumatology #Fibromyalgia #RheumatoidArthritis #HeartRateVariability #HRV #STEM #Innovation #Science #Technology #Research #ProgressPotentialAndPossibilities #IraPastor #Podcast #Podcaster #Podcasting #ViralPodcastSupport the show
FEATURING MR. H of IMMUNO 150.IMMUNO 150 was formulated to strengthen immune systems and correct many abnormalities. Its 70 plant-derived colloidal minerals are the key to its success.Blended with 80 carefully selected, premium nutrients, it's one of the finest supplements available.“The human body needs 60 minerals to avoid disease”– Dr. Linus Pauling, Two-time Nobel Prize Winnervisit immuno150.com
3798 – December 17, 2025 – Beth Takes a Day Off – Larry Meets Mr. H – Today’s show is sponsored by Mr. H and Immuno 150. Larry reads (with ChatGPT’s help) “The National Security Strategy” so you don’t have to. Things that stood out: #1 – The absolute “America First” policy of it. #2 – The U.S. Military will ... The post Beth Takes a Day Off – Larry Meets Mr. H appeared first on CSC Talk Radio.
Mehlman Qbanks: https://qbanks.mehlmanmedical.com/IG: https://www.instagram.com/mehlman_medical/Telegram: https://mehlmanmedical.com/subscribe/
Dans ce numéro du Journal des biotechs, Frédéric Gomez, analyste chez Pharmium Securities, revient sur un dossier dont il avait déjà parlé il y a un an : Galderma. Il explique également les ressorts de l'augmentation de capital de Transgene et se demande si Cosmo Pharmaceutical aurait enfin trouvé une solution... à la calvitie.L'entretien est consacré à Marc Le Bozec. Le directeur général par intérim d'OSE revient sur la crise de gouvernance récente, définit la stratégie de la biotech et livre les grands axes de la feuille de route envisagée. Hébergé par Audion. Visitez https://www.audion.fm/fr/privacy-policy pour plus d'informations.
FEATURING MR. H of IMMUNO 150.IMMUNO 150 was formulated to strengthen immune systems and correct many abnormalities. Its 70 plant-derived colloidal minerals are the key to its success.Blended with 80 carefully selected, premium nutrients, it's one of the finest supplements available.“The human body needs 60 minerals to avoid disease”– Dr. Linus Pauling, Two-time Nobel Prize Winnervisit immuno150.com
Mehlman Qbanks: https://qbanks.mehlmanmedical.com/IG: https://www.instagram.com/mehlman_medical/Telegram: https://mehlmanmedical.com/subscribe/
On this episode Lara and Vyanka talk to Prof Greg Delgoff from the University of Pittsburgh all about immuno-metabolism in cancer and emerging treatments. This is ImmunoTea: Your Immunology Podcast, presented by Dr Lara Dungan and Dr Vyanka Redenbaugh. This is the show where we tell you all about the most exciting research going on in the world of immunology. So grab a cup of tea, sit down and relax and we'll fill you in. Contact us at ImmunoTeaPodcast@gmail.com or @ImmunoTea on twitter. Hosted on Acast. See acast.com/privacy for more information.
IMMUNO 150 was formulated to strengthen immune systems and correct many abnormalities. Its 70 plant-derived colloidal minerals are the key to its success.Blended with 80 carefully selected, premium nutrients, it's one of the finest supplements available.“The human body needs 60 minerals to avoid disease”– Dr. Linus Pauling, Two-time Nobel Prize Winnervisit immuno150.com
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Exceptional Health Products is a division of Liquid Assets, Inc. that was incorporated in the state of Oklahoma in 1983. The principals are Mr. Elmer Heinrich and his wife Shirley. Mr. Heinrich, (more commonly known as Mr. H) is the company President and CEO. Liquid Assets opened it first plant minerals mine in Utah in 1984 and since then, has sold it's SenTraMin minerals in 27 countries. These minerals are the base of the company's fabulous nutritional product called Immuno 150. Mr. H has owned and operated successful companies in seven countries. The Heinrich foundation is basically the parent of all entities beginning with S and H Drilling, The Hotsy Corporation, Robo Car Wash Company, Rockett Water filters, The Rockland Corporation, The Rockland Mineral mine, Hospital Santa Monica in Mexico, and now Exceptional Health Products.The company has been blessed to have been able to work with its chemist's and many mineral users, over an extended period, to formulate a combination of various nutritional constituents with its 70 plant minerals that are scientifically comingled, in Immuno 150, to be compatible with the human digestive system for total assimilation. Based on 40 years of experience in the plant minerals business, serving millions of people, the principles of Exceptional Health Products are convinced The World is Sick due to a lack of minerals in food.www.immuno150.com
In this episode our guest is Dr. Ebru Karpuzoglu—a doctor of molecular medicine and immunology, and founder of the award-winning skincare line AveSeena. Dr. Karpuzoglu shares her scientific insights into inflammaging, a hidden root cause of aging and chronic skin issues, and how maintaining the skin's microbiome and immune balance is essential for radiant, healthy skin. Learn how AveSeena merges science and self-care, why it's trusted by scientists and skincare lovers alike, and how your skin's health goes far beyond the surface.
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Exceptional Health Products is a division of Liquid Assets, Inc. that was incorporated in the state of Oklahoma in 1983. The principals are Mr. Elmer Heinrich and his wife Shirley. Mr. Heinrich, (more commonly known as Mr. H) is the company President and CEO. Liquid Assets opened it first plant minerals mine in Utah in 1984 and since then, has sold it's SenTraMin minerals in 27 countries. These minerals are the base of the company's fabulous nutritional product called Immuno 150. Mr. H has owned and operated successful companies in seven countries. The Heinrich foundation is basically the parent of all entities beginning with S and H Drilling, The Hotsy Corporation, Robo Car Wash Company, Rockett Water filters, The Rockland Corporation, The Rockland Mineral mine, Hospital Santa Monica in Mexico, and now Exceptional Health Products.The company has been blessed to have been able to work with its chemist's and many mineral users, over an extended period, to formulate a combination of various nutritional constituents with its 70 plant minerals that are scientifically comingled, in Immuno 150, to be compatible with the human digestive system for total assimilation. Based on 40 years of experience in the plant minerals business, serving millions of people, the principles of Exceptional Health Products are convinced The World is Sick due to a lack of minerals in food.www.immuno150.com
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Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in the Pharma and Biotech world.Jefferies predicts an increase in small tuck-in deals in the biotech industry as companies face challenges accessing capital. Companies and industry groups are offering solutions to mitigate the impact of Trump tariffs on rare disease, cell, and gene therapy. Pitchbook suggests a shift towards more sustainable investing in biotech VC firms. Gilead is gearing up to challenge J&J in the $20 billion multiple myeloma CAR-T market. PTP's generative AI is revolutionizing data summaries for biotech QC workflows. Sanofi recently acquired Blueprint for $9.5 billion, while BMS has committed up to $11 billion with Biontech. Lilly has signed a deal worth up to $870 million, and Regeneron is investing nearly $2 billion in a Chinese obesity drug. Merck's CEO is emphasizing diversity in operations following the defeat of an anti-DEI measure. Immuno-oncology drugs Keytruda and Opdivo may face scrutiny in the near future.In other news, Vigil Neuroscience's Trem2 antibody for a rare brain disease failed in a Phase II trial shortly after Sanofi's acquisition of the company. Analysts believe the results were not surprising and should not impact the deal. Lilly has signed a deal worth up to $870 million to develop a long-acting GLP-1 obesity drug, while the FDA is committed to making rare disease drugs available at the first sign of promise. Pharma tuck-in deals are increasing after a slow first quarter for small biotechs. BioAgc Biologics will be attending Bio International in Boston to discuss their global drug production capabilities.Stay tuned for more updates on investing in research, welcoming global talent, the biotech VC cycle, Gilead's challenge to J&J in the multiple myeloma CAR-T market, and much more. Upcoming events and job listings in the pharmaceutical industry are also featured in our newsletter.Thank you for tuning in to Pharma and Biotech daily.
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SHOW NOTESWhat impact does surgery have on the body?Intentional trauma Physiological response Psychosocial impact StressWhen we think about surgery, it's essential to understand that it triggers a significant reaction in the body known as the 'stress response.' This response is a complex interplay of hormonal and metabolic changes directly linked to the degree of tissue damage during surgery. It can intensify if there are any complications after the operation. Let's break it down: The whole process starts when the hypothalamic-pituitary-adrenal axis, or HPA axis, kicks into gear. This leads to a surge in hormones like cortisol, growth hormone, glucagon and catecholamines. These hormones are important because they help the body cope with stress by boosting energy availability and adjusting other bodily functions.Ebb phase (0-48hrs)Increased catabolism of stored glycogen (glycogenolysis)Suppression of insulin secretion → transient hyperglycemiaIncreased catecholamines, cortisol, and inflammatory cytokines (IL-6, TNF-α)Flow phase (3-10 days)Hypermetabolism (increased BMR)Increased protein catabolism → muscle breakdown (to provide amino acids for tissue repair and immune function)Increased lipolysis (fat breakdown) for energySustained insulin resistance → continued hyperglycemiaEnhanced GNG Pro-inflammatory response → increased cytokines and acute-phase protein productionIn the initial stages after surgery, the body releases a wave of pro-inflammatory cytokines. These cytokines jumpstart the healing process by promoting inflammation, which is important for healing surgical wounds. However, to keep this inflammation from going overboard, the body soon follows up with anti-inflammatory cytokines.These inflammatory processes have widespread effects across the body. For example, they can influence how the hypothalamus regulates body temperature or how the liver produces certain proteins that help fight infection and aid in wound healing.But here's where it gets even more interesting: other hormones like glucagon, cortisol, and adrenaline also play a role in modulating these responses. They can affect everything from your blood sugar levels to how your cardiovascular system handles the stress.So, why is all this important? Well, by understanding and managing these responses effectively, we can significantly improve how patients recover from surgery. It's all about helping the body maintain balance during a time when it's incredibly vulnerableDisruption of Metabolic Homeostasis: Surgery often disrupts the body's normal metabolic balance, notably through insulin resistance, where cells fail to respond effectively to insulin, leading to 'diabetes of the injury.' Insulin Resistance and Hyperglycemia: Insulin resistance can cause high blood sugar levels, significantly increasing the risk of surgical complications and mortality. Post-surgery, the body may enter a catabolic state, breaking down muscle instead of fat, which impairs wound healing, weakens the immune system, and reduces muscle strength. Increased Risks for Vulnerable Groups: Elderly, diabetics, and cancer patients are particularly at risk due to their compromised metabolic and inflammatory states. These groups have less physiological reserve, leading to pronounced catabolic states and increased risk of severe post-operative complications. Impact on Recovery and Outcomes: The metabolic chaos from insulin resistance to protein loss not only delays recovery but also exacerbates risks of infection and other complications. Effective management of these changes is crucial for improving surgical outcomes and ensuring that patients thrive post-surgery.ERAS helps to mitigate these by Surgery isn't just about the physical repair or removal of tissue; it triggers a cascade of stress responses in the body that can complicate recovery. These include everything from the psychological impacts of anxiety and the physiological effects of fasting to direct tissue damage and the systemic reactions to it, such as fluid shifts and hormonal imbalances.Key Components of ERAS:Comprehensive Care: ERAS isn't just a single technique but a suite of practices designed to address every aspect of the patient's journey — before, during, and after surgery. This approach aims to minimise the stress responses by controlling pain, reducing fasting times, optimising fluid management, and promoting early mobility.Minimising Fasting: One traditional practice that ERAS revises significantly is the preoperative fasting rule. Old guidelines that required fasting from midnight before surgery are now replaced with more lenient, evidence-based practices that allow intake of clear fluids up to two hours and solids up to six hours before surgery. This change helps maintain normal blood glucose levels, reduces stress, and decreases the body's shift into a catabolic (muscle-degrading) state.Nutritional Optimisation: ERAS protocols emphasise the importance of not entering surgery in a depleted state. By allowing a carbohydrate-rich drink shortly before surgery, patients are better hydrated and less anxious, which in turn reduces insulin resistance and preserves muscle mass — critical factors in speeding up recovery post-surgery. Post-operatively, oral nutrition may be delayed by the medical team until bowel function returns, typically taking close to a week. This delay is stated to reduce postoperative complications such as abdominal distension and nausea/vomiting.For the first several days post surgery fluids of limited nutritional value such as water are provided to patient until tolerance is established leading to insufficient nutrition intake during this time increasing the risk of malnutrition. The ERAS protocol promotes early oral intake within 24 hours post surgery departing from traditional fasting practices. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Therefore addressing malnutrition is a key component of the ERAS protocol.Immune-Enhancing Diets: Post-surgery nutrition is just as crucial. ERAS encourages diets rich in nutrients that bolster the immune system and enhance wound healing. This includes omega-3 fatty acids, which help modulate the inflammatory response; arginine, which supports protein synthesis and tissue growth; glutamine, which is vital for cellular health and recovery; and nucleotides, which are essential for rapid cell division and immune function .Immuno-nutrition is a specialised medical nutrition therapy that has been shown to adjust the body's inflammatory response: It incorporates specific nutrients like omega-3 fatty acids, arginine, polyunsaturated fatty acids, and nucleotides. It's typically recommended starting 5-7 days before surgery and continuing post-operatively for over 7 days or until oral intake meets at least 60% of the patient's nutritional requirements.How can we use this info to optimize surgical outcomes?Patient education Early nutrition pre and post surgery - Minimise fasting time What is ERAS? How does it differ from traditional care/practice?Introduced by Henrik Kehlet in 1997, the Enhanced Recovery After Surgery (ERAS) protocol has revolutionised surgical practices by optimising perioperative care. A key aspect of ERAS is its interdisciplinary approach, involving healthcare professionals from various specialties to minimise surgical stress and facilitate recovery. What is malnutrition?Malnutrition, is defined as an involuntary reduction in body weight, muscle mass and physical capabilities, affects up to 65% of surgical patients and can worsen during hospital stays. Enhancing nutritional status and promoting functional nutrition therapy is essential, even forpatients without evident malnutrition, particularly when prolonged perioperative oral intake challenges arise. Addressing malnutrition is essential for preventing surgical complications, prolongedhospital stays and higher healthcare costs. What are the benefits of ERAS for the patient?It has been shown that the key physiological benefits include:-enhances the body's anabolic processes-promotes wound healing, which is critical for patient recovery.-Reduces the risk of nutritional depletion-Minimises insulin resistance, a common issue post-surgery, allowing for better blood sugar control and improved metabolic function.-Reduce protein catabolism-And lowers the risk of pressure injuries, which can develop due to extended immobility after surgery.What are the benefits of ERAS from a healthcare perspective? From a healthcare perspective, ERAS has been shown to-shorter length of hospital stay for patients,-Lower risk of ICU transfer rates-reduce readmission rates-And all of these improvements lead to lower healthcare costs, not just for the hospital but for the overall healthcare system, as fewer complications and shorter stays reduce the financial strain.Step 1: Screen & StrengthenIf you've lost any weight unintentionally in the lead up to surgery, or been eating poorly because of a reduced appetite, you may be at risk of malnutrition and it's really important to address this prior to surgery. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Addressing malnutrition is a key component of the ERAS protocol and why it's effective in improving surgical outcomes for patients.Book an appointment with a dietitian who can guide you on appropriate dietary changes to minimise muscle loss, build you up and optimise nutritional status and stores pre-op. A well-nourished body tolerates surgery better, heals faster, has a stronger immune system to fight infection, and experiences fewer complications.Step 2: Consider Immunonutrition If you're planned for major surgery, especially certain cancer and abdominal surgeries, consider the use of an immunonutrition supplement in the 5-7 days pre op. These are the supplements loaded with arginine, n3s, glutamine and nucleotides to support the immune system and reduce inflammatory responses, potentially leading to fewer infections and better recovery.Step 3: Build Your Strength & Energy Stores prior to surgery Carb load with food in the days leading up to surgery - think that big bowl of pasta a footy player would have the night before the grand final. ERAS protocols have significantly reduced or eliminated long periods of "nil by mouth" (NBM) before surgery.Ask your surgical team exactly when you need to stop eating solid food – it might be much later than you think, often around 6 hours before surgery for a light meal. For clear fluids, it could be as little as 2 hours before!We'll make the most of every second to prevent unnecessary dehydration, hunger, anxiety, and preserve your body's energyStep 4: The Pre-Surgery Carb Load using clear fluidsMany ERAS protocols include a special carbohydrate-rich drink taken a few hours before surgery. Your hospital may provide this, but if they don't, we can organise orders for you or point you in the right direction. It's usually a clear, sweet drink. Think of it as topping off your fuel tank right before the 'race'."These have been shown to reduce post-operative insulin resistance (which can slow healing), help maintain muscle strength, can reduce nausea, and improve overall wellbeing. It basically tells your body it's in a 'fed' state, not a 'starvation' state, heading into surgery.This is best done with tailor made medical nutrition drinks as they come prepped with the correct doses of maltodextrin-polymer carbs and a lower osmolality than other solutions, which essentially means they gentler on your gut and better for gastric emptying so they don't linger in your gut during surgery. Always follow surgical instructions, but ideally we're aiming for 100 grams of carbohydrate the night before surgery and about 50 grams of carbohydrate in clear fluids approximately 2 hours before anesthesia. This might look like 4 x 200ml drinks the night before, and 2 the morning of surgery If you can't access these drinks, apple or cranberry juice are reasonable replacements. Drop us an email or message or give us a call if you'd like advice on where to get pre-op and immunonutrition supplement drinks. Then we move on to post op and Step 5 which is aiming to eat early. ERAS encourages starting to eat and drink as soon as it's safe after surgery – often within hours, not days!As soon as your team says it's okay, try sipping water, then progress to other clear fluids, and then light foods as tolerated. Even small, frequent amounts help. This helps to stimulates your gut to start working again, reducing the risk of ileus – a slow, sleepy bowel, provides energy for healing, and can help you feel more normal, faster.If you haven't been told you can eat or drink, keep asking the question! You are your best advocate! Another tip that can help here is step 6: Chew GumIf your team allows it, start chewing sugar-free gum several times a day once you're able. It sounds simple, but it can be surprisingly helpful in mimicking eating even when you're not allowed to, and can stimulate your digestive system to return to usual function sooner and reduce the risk of ileus.Step 7 is to Nourish to Heal This is where we bring in our good friend protein to optimise tissue repair and recovery Include protein rich food at each meal, and chat to us if you're finding this difficult because there are plenty of hacks if you're not feeling up to chicken breast and steak! And finally step 8 is to Listen to Your BodyWhile ERAS encourages early eating, we always want you to be tuned in to your body's cues and speaking up to your medical team and us if something doesn't feel right. There are plenty of interventions that can be used to keep you comfortable while still optimising your nutrition to get the best outcomes from surgery. Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Hübner, M., Klek, S., et al. (2021). ESPEN practical guideline: Clinical nutrition in surgery. Clinical Nutrition, 40(7), 4745-4761.Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Laviano, A., Ljungqvist, O., et al. (2017). ESPEN guideline: Clinical nutrition in surgery. Clinical Nutrition, 36(3), 623-650.Gustafsson, U. O., Scott, M. J., Schwenk, W., Demartines, N., Roulin, D., Francis, N., et al. (2019). Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018. Clinical Nutrition, 38(2), 576-586. (Note: The ERAS® Society website, erassociety.org, is the primary source for the most current and comprehensive suite of procedure-specific guidelines.)Ljungqvist, O., Scott, M., & Fearon, K. C. (2017). Enhanced Recovery After Surgery: A review. JAMA Surgery, 152(3), 292-298.Thiele, R. H., Raghunathan, K., Brudney, C. S., Campos, S., Candiotti, K., Chaves, S., et al. (2016). American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management in adults. Perioperative Medicine, 5, 26. (Note: This is an example of ASER/POQI consensus; look for other relevant POQI statements on specific surgical procedures and their nutritional components.)Soon, K., Levy, G. M., Cusack, L. A., Varma, S., & Nicholson, G. A. (2020). The effect of preoperative carbohydrate loading on patient outcomes in elective surgery: A systematic review and meta-analysis. Systematic Reviews, 9(1), 254.Lewis, S. J., Egger, M., Sylvester, P. A., & Thomas, S. (2001). Early enteral feeding versus "nil by mouth" after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ, 323(7316), 773-776.Osland, E. J., Hossain, M. A., Khan, S., & Memon, M. A. (2014). Effect of timing of oral feeding on patient outcomes after elective colorectal surgery: A systematic review and meta-analysis. Journal of Gastrointestinal Surgery, 18(5), 1039-1051.Braga, M., Gianotti, L., Nespoli, L., Radaelli, G., & Di Carlo, V. (2002). Nutritional approach in malnourished surgical patients: a prospective randomized study. Archives of Surgery, 137(2), 174-180.Marimuthu, K., Varadhan, K. K., Ljungqvist, O., & Lobo, D. N. (2012). A meta-analysis of the effect of combinations of enhanced recovery after surgery (ERAS) interventions on postoperative outcomes. Annals of Surgery, 255(4), 640-649.
In today's episode, we spoke with Shubham Pant, MD, MBBS, and Professor Timothy Elliott, about ongoing research with cancer vaccines. Dr Pant is a professor in the Department of Gastrointestinal Medical Oncology in the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center in Houston. Dr Elliott is the Kidani Professor of Immuno-oncology in the Nuffield Department of Medicine at the University of Oxford in the United Kingdom. In our exclusive interview, Pant and Elliott discussed the current landscape of vaccines for cancer treatment, ongoing research seeking to extend the benefits of vaccines as cancer management and prevention strategies, and what the future may hold.
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YOU HAVE TO LISTEN TO THIS FEATURE with Mr. H from Liquid Assets. They are the makers of an amazing product called IMMUNO 150. This isn't us selling you. This is us informing you and putting our reputation behind a product that has made us feel so much better!No more colds! Quick recovery. You wake up and whatever pain you might have had - it's gone! Or you're much better! OVERNIGHT! Also, there are stories that you might think a miracle was involved but no - unhealthy people have fully recovered from various diseases including cancers - just from taking IMMUNO 150. Click hear to visit their site. IMMUNO150.COM
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YOU HAVE TO LISTEN TO THIS FEATURE with Mr. H from Liquid Assets. They are the makers of an amazing product called IMMUNO 150. This isn't us selling you. This is us informing you and putting our reputation behind a product that has made us feel so much better!No more colds! Quick recovery. You wake up and whatever pain you might have had - it's gone! Or you're much better! OVERNIGHT! Also, there are stories that you might think a miracle was involved but no - unhealthy people have fully recovered from various diseases including cancers - just from taking IMMUNO 150. Click hear to visit their site. IMMUNO150.COM
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