Podcasts about lung institute

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Play Episode Listen Later Jul 22, 2021 7:21

Dr. Steven Gundry is an author, medical researcher and former cardiac surgeon whose mission is to improve people's health, happiness and longevity through nutrition. He is the director and founder of the International Heart & Lung Institute as well as the Center for Restorative Medicine in California. The post 806: Why Coffee Is Good For Your Health With Dr. Steven Gundry, The Energy Paradox [K-Cup DoubleShot] appeared first on Time4Coffee.

804: Why to Believe in Magic With Dr. Steven Gundry, The Energy Paradox [K-Cup TripleShot]

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Play Episode Listen Later Jul 20, 2021 14:03

Dr. Steven Gundry is an author, medical researcher and former cardiac surgeon whose mission is to improve people's health, happiness and longevity through nutrition. He is the director and founder of the International Heart & Lung Institute as well as the Center for Restorative Medicine in California. The post 804: Why to Believe in Magic With Dr. Steven Gundry, The Energy Paradox [K-Cup TripleShot] appeared first on Time4Coffee.

802: What It's Like Going From Successful Heart Surgeon to Nutrition Guru With Dr. Steven Gundry, The Energy Paradox [Main T4C Episode]

Play Episode Listen Later Jul 19, 2021 36:36

Dr. Steven Gundry is an author, medical researcher and former cardiac surgeon whose mission is to improve people's health, happiness and longevity through nutrition. He is the director and founder of the International Heart & Lung Institute as well as the Center for Restorative Medicine in California. The post 802: What It's Like Going From Successful Heart Surgeon to Nutrition Guru With Dr. Steven Gundry, The Energy Paradox [Main T4C Episode] appeared first on Time4Coffee.

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803: Why You Need to Listen to Your Gut With Dr. Steven Gundry, The Energy Paradox [K-Cup DoubleShot]

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Play Episode Listen Later Jul 19, 2021 9:09

Dr. Steven Gundry is an author, medical researcher and former cardiac surgeon whose mission is to improve people's health, happiness and longevity through nutrition. He is the director and founder of the International Heart & Lung Institute as well as the Center for Restorative Medicine in California. The post 803: Why You Need to Listen to Your Gut With Dr. Steven Gundry, The Energy Paradox [K-Cup DoubleShot] appeared first on Time4Coffee.

Journal Editorial - Can we turn heart failure into heart success by studying myocardial remission?

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Play Episode Listen Later Jun 21, 2021 15:30

With Thomas Luescher, Senior Editor EHJ and Brian Halliday, National Heart and Lung Institute, London - UK Link to paper Link to editorial

Medach On Air #13 | Медицинская наука

Medach podcast

Play Episode Listen Later Jun 10, 2021 120:32

С древнейших времен медицина представляла из себя исследовательскую специальность. От простейших вещей в виде анатомии до исследования сложнейших взаимоотношений между органами системами. Все требовало исследования, доказательств механизма работы, и чем дальше, тем сложнее стало сочетать практическую деятельность с работой ученого и наоборот. Кто-то из «полей» ушел с головой в науку, кто-то в ней разочаровался или, достигнув определённых высот, успешно вернулся обратно к практической медицине, а кто-то не менее успешно сочетает эти две ипостаси. В этом выпуске Василий Купрейчик, доктор Тэо, Антон Лобода и Чумной Доктор обсудят науку в медицине: туда и обратно. В гостях у нас будет Даниил Мунблит, PhD, профессор кафедры педиатрии и детских инфекционных болезней Сеченовского Университета и Honorary Senior Lecturer, National Heart and Lung Institute, Imperial College London.

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Journal Editorial - Silent brain infarcts and early cognitive outcomes after transcatheter aortic valve implantation: a systematic review and meta-analysis

Play Episode Listen Later May 24, 2021 10:44

With Thomas Luescher, Senior Editor EHJ and Brian Halliday, National Heart and Lung Institute, London - UK Link to EHJ paper

Journal Editorial - Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes

Play Episode Listen Later May 10, 2021 8:31

With Thomas Luescher and Brian Halliday, National Heart and Lung Institute, London - UK Link to EHJ paper

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Pre-Screen to Intervene: A Proactive Approach to Firefighter Health and Survival

Rapid Fire

Play Episode Listen Later May 3, 2021 41:28 Transcription Available

Understand how preventative measures and regular monitoring can help reduce occupational health concerns like cancer and cardiovascular disease with Todd LeDuc, Chief Strategy Officer of LifeScan Wellness Centers, and Rob Brown, Physicians Assistant and founder of the New York Firefighters Heart & Lung Institute, who are helping firefighters gain access to regular health check-ups and spread awareness about early detection. WHAT YOU CAN EXPECT TO LEARN:Why You Should Schedule Regular Monitoring of Your HealthHow to Take Precaution Even When You're Asymptomatic Why It's Important for Doctors to Translate Science to Firefighter Speak The Importance of an Annual Preventative ExamHow COVID-19 Can Have an Impact on Your Cardiovascular HealthHow to Access Preventative Monitoring ResourcesABOUT OUR GUESTS:Todd J. LeDuc, MS, CFO, FIFirE, retired after nearly 30 years as an Assistant Fire Chief of Broward County, Florida, an internationally accredited career metro department. He serves as a Chief Strategy Officer for LifeScan Wellness Centers, a national provider of comprehensive physicals and early detection exams. For over a decade, he has served as a member of the International Association of Fire Chief's Safety, Health & Survival Section and is currently the Secretary of that section. LeDuc is also the editor of Surviving the Fire Service (Fire Engineering Books) and serves on numerous advisory boards and publications. Rob Brown began his fire service career in 1992 with the Glenwood Fire Department in Long Island, NY. He currently serves as a Lieutenant with the New York City Fire Department and has been an active member since 1996. FDNY Lieutenant Rob Brown, who is also a Physicians Assistant, and the founder of the New York Firefighters Heart & Lung Institute, has also previously written for Firehouse Magazine, WNYF Magazine, and continues to speak about firefighter health & safety issues on a national level. ABOUT THE HOST:Battalion Chief Keys completed a total of 31 years of service, beginning as a firefighter for a high volume station in the Bronx. As a Captain and Lieutenant, he served various municipalities including Midtown Manhattan, until settling into East New York Brooklyn, where he became Battalion Chief. Within his new role he took charge of Research and Development where he learned how new innovations are tested and introduced to the fire service.Learn more about Fire-Dex products and services by visiting, www.firedex.comJoin the Conversation by Following Us at:Facebook: https://www.facebook.com/FireDexTwitter: https://twitter.com/firedexInstagram: https://www.instagram.com/firedexgear/

Journal Editorial - Predicted benefit of an implantable cardioverter-defibrillator: the MADIT-ICD benefit score

Play Episode Listen Later Apr 12, 2021 10:38

With Thomas Luescher, Senior Editor EHJ and Brian Halliday, National Heart and Lung Institute, London - UK Link to EHJ paper

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Journal Editorial - Less dementia after catheter ablation for atrial fibrillation: a nationwide cohort study

Play Episode Listen Later Dec 28, 2020 7:36

With Thomas Luescher, Senior Editor EHJ and Brian Halliday, National Heart and Lung Institute, London - UK Link to EHJ paper

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Journal Editorial - The sooner, the better: anti-inflammation in acute myocardial infarction

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Play Episode Listen Later Dec 14, 2020 9:37

With Thomas Luescher, Senior Editor EHJ and Brian Halliday, National Heart and Lung Institute, London - UK Link to EHJ paper Link to EHJ editorial

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Dr. Steven Gundry, Nutrition, Aging and Longevity

The Nelda Podcast

Play Episode Listen Later Oct 20, 2020 48:33

Although he's authored over 300 articles and book chapters on cardiac surgery and created innovative cardiac surgical devices, Dr. Steven Gundry now directs all of his energies at the edge of a different kind of table—the dining table. He went from being a top cardiac surgeon to being a researcher and best-selling author focusing on cutting-edge human nutrition. His research has reaped major nutritional breakthroughs impacting high cholesterol, heart disease, and high blood pressure. His career shift came after seeing the dramatic effects of dietary changes among his own surgical patients. It was an epiphany. As Director and Founder of the International Heart & Lung Institute and the Center for Restorative Medicine in California, Gundry helps patients learn how to take control of their weight, health, and energy by following his simple nutritional program. His years of research have revealed what nutrients are deficient in the American diet and which “staple foods” are harming human health. His discoveries also have uncovered the complex relationship between gut health and overall health. Gundry explains, “Within our gut, there are a hundred trillion bacteria, probably 500 trillion viruses, and a bunch of fungi. This gut biome is a complex ecosystem, more complex than any tropical rainforest and it has a symbiotic relationship with us, its hosts.” Dr. Gundry's nutritional philosophy has gained a national audience with the publication of his best-selling books, The Longevity Paradox, The Plant Paradox, The Plant Paradox Cookbook, The Plant Paradox Quick and Easy, and Dr. Gundry's Diet Evolution. The results of his programs have been impressive. According to his research data analysis, participants have not only had improvements to cardiac health and weight, but also dramatic health benefits such as eliminating chronic autoimmune disease or migraines. They have even been shown to grow biologically younger. It's a fountain of youth you'll want to hear about in my interview with nutritional trailblazer and gut biome expert Dr. Steven Gundry.

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Enfermedad de la válvula mitral

Revista MSP

Play Episode Listen Later Oct 19, 2020 27:36

#CanalMSP | En muchos casos la reparación de la #VálvulaMitral podría ser de mayor beneficio para el paciente que el reemplazo. Conéctese con el director del Hispanic Valve Center del Bayamon Heart and Lung Institute. ¡No se lo pierdan! Ingrese al #ForoCardiológicoddMSP aquí https://bit.ly/313l52L #ExclusivoMPS - - - Ver esta entrevista en Youtube: https://youtu.be/ZfDRBp1ExO8 - - - Visite nuestro sitio especializado: bit.ly/2Qbn67F - - - Visite nuestro portal de noticias: medicinaysaludpublica.com/ - - - Síguenos en Facebook: www.facebook.com/revistamsp/

Circulation October 13, 2020 Issue

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Play Episode Listen Later Oct 12, 2020 23:12

This week’s episode includes author Mark Chan, editorialist Thomas Wang, and Associate Editor Wendy Post as they discuss the prioritization of candidates of post-myocardial infarction heart failure using plasma proteomics and single-cell transcriptomics. TRANSCRIPT BELOW: Dr Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Dr Greg Hundley: And I'm Greg Hundley, associate editor, director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Well, Carolyn, this week's feature, really interesting, involving proteomics and single-cell transcriptomics, trying to identify how we could prioritize individuals after they've sustained myocardial infarction as to whether or not they'll develop heart failure. Lots to go over in that feature. But before we get to that, how about we grab a cup of coffee and start in with some of the other interesting papers in this issue? Dr Carolyn Lam: Absolutely. I've got my coffee and I have to tell you though, I am so excited about this feature, it comes from Singapore, but my first paper too is about transcriptomic profiling. But Greg, I have to ask you first, have you heard of the cardiac cellulome? Dr Greg Hundley: Oh my goodness, Carolyn. So you're starting the reverse-quiz strategy to help me. I have not heard of the cellulome. Help enlighten me. Dr Carolyn Lam: I just love that word. We've heard of all kinds of other omes, but this cellulome is something I've learned through today's paper. So the authors today who are Alexander Pinto from Baker Heart and Diabetes Institute and colleagues, they developed a novel cardiac single-cell transcriptomic strategy to characterize the cardiac cellulome. And that refers to the network of cells that forms the heart. The method was utilized to profile the cardiac cellular ecosystem in response to two weeks of angiotensin II as a pro-fibrotic stimulus. So what did they find? Well, they identified two previously undescribed cardiac fibroblasts populations that are the key drivers of fibrosis. Their names were Fibroblast-Cilp and Fibroblast-THBS4. Now, these do not correspond to smooth muscle actin-expressing myofibroblasts, which have been widely viewed as the primary drivers of fibrosis. So this is really novel. The cardiac cellular landscape was sexually dimorphic at the cell abundance and gene expression level, including cellular responses to angiotensin II induced tissue remodeling. So these data really provide insights into the cellular and molecular mechanisms that promote pathologic remodeling in the mammalian heart, and really highlight that early transcriptional changes precede chronic cardiac fibrosis. Dr Greg Hundley: Very nice, Carolyn. Well, let me switch to the clinical realm. And my first paper comes from Professor Holger Thiele from the Heart Center Leipzig at the University of Leipzig, and it's involving general versus local anesthesia with conscious sedation for patients undergoing TAVI procedures. So the study comes from the SOLVE-TAVI study, and it's a multi-center open-label 2x2 factorial randomized trial of 447 patients with aortic stenosis undergoing transfemoral TAVR, comparing conscious sedation versus general anesthesia. And the primary efficacy endpoint was powered for equivalence, and consisted of the composite of all-cause mortality, stroke, myocardial infarction, infection requiring antibiotic treatments, and acute kidney injury at 30 days. Dr Carolyn Lam: Wow, Greg, as I understand it, about half of patients today receive TAVI or TAVR with conscious sedation. So it's really an important question. So what did they find? Dr Greg Hundley: You're exactly right. So the composite end point occurred in 27% of the conscious sedation patients and 26% of the general anesthesia patients. Really equivalent. And this held true for each of those composite endpoints. In addition, there was a lower need for inotropes or vasopressors with conscious sedation, versus general anesthesia. Thus, these findings suggest that conscious sedation can safely be used for patients undergoing TAVR procedures. Dr Carolyn Lam: Very important clinical one, Greg. Well, I've got a clinical paper for you too. And this one, trying to answer the question, what's the optimal duration of dual anti-platelet therapy, or DAPT, after PCI with drug-eluting stents. A very familiar, perhaps, an important question. So these authors, led by Dr Deepak Bhatt from Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, performed a systematic review and network meta-analysis of 24 randomized controlled trials comparing short-term DAPT, or less than six months, followed by aspirin or P2Y12 inhibitor monotherapy, versus mid-term DAPT, which was six months, versus 12 months DAPT, as well as an extended-term DAPT, which was more than a year after PCI with a drug-eluting stent. Dr Greg Hundley: So Dr Carolyn, three groups, what did they find? Dr Carolyn Lam: Compared to 12 months DAPT, short-term DAPT followed by P2Y12 inhibitor monotherapy reduced major bleeding after PCI with a drug-eluting stent, whereas extended-term DAPT reduce myocardial infarction at the expense of more bleeding events. Overall, the extended-term DAPT was associated with a higher risk of major bleeding compared with all other DAPT groups, except in patients with acute coronary syndrome. Dr Greg Hundley: So extended, more bleeding complications. So take me home on this, Carolyn, what is the final message here? Dr Carolyn Lam: Here's the message. Compared with 12-month DAPT, the net clinical benefit appears to favor short-term DAPT followed by P2Y12 inhibitor monotherapy instead of aspirin in select patients. Although, extended term DAPT has a role for patients who have a low bleeding risk, but a higher ischemic risk, such as those with acute coronary syndrome, thus a personalized approach appears to be warranted. Dr Greg Hundley: Very good. Well, I'm going to turn back to the world of basic science and discuss a paper related to pulmonary hypertension. And it comes from Dr Sébastien Bonnet from the University Laval. So Carolyn, the subcellular mechanisms that govern the transition from a compensated to a de-compensated right ventricle in patients with pulmonary hypertension remain poorly understood, and as a consequence, there are no clinically established treatments for RV failure and a paucity of clinically useful biomarkers. So this study investigated the long non-encoding RNAs, powerful regulators of cardiac development disease, in relation to adverse RV remodeling in pulmonary artery hypertension. Dr Carolyn Lam: So these LNK RNAs, I think that's what they're called, right? Long non-coding RNAs, what did they find? Dr Greg Hundley: This was another one of our really nice translational articles, because they combined results from both animals and human subjects. The authors demonstrated that the long non-coding RNA H19 is upregulated in decompensated right ventricles due to pulmonary hypertension, and the finding correlated with RV hypertrophy and fibrosis. Now, similar findings were observed in monocrotaline and pulmonary artery banded rats. The authors found that silencing H19 limits pathological RV hypertrophy, fibrosis, and capillary rarefaction, thus preserving RV function in those two models of pulmonary hypertension, both the monocrotaline and the pulmonary artery banded rats, without effecting pulmonary vascular remodeling. And finally, Carolyn, the authors found that circulating H19 levels in plasma of patients, discriminate pulmonary arterial hypertension patients from controls correlated with RV function and predicted long-term survival in two independent idiopathic pulmonary artery hypertension cohorts. Moreover, H19 levels delineated subgroups of patients with differential prognosis, when combined with NT-proBNP levels or the risk score proposed by both the Reveal and the 2015 European Pulmonary Hypertension Guidelines. So, in summary, these authors findings identify H19 as a potentially new therapeutic target to impede the development of maladaptive RV remodeling, and thus a promising biomarker as well of pulmonary arterial hypertension severity and prognosis. Dr Carolyn Lam: Oh, Greg, I love that. Not just the paper, but the way you explained it. Thanks so much. Well, let's dip into what else there is in today's issue, shall we? First, there's Global Rounds by Dr Yacoub entitled, Towards Meeting the Challenges of Improving Cardiovascular Health in Egypt. There's a research letter by Dr Cheng on imaging the sarcoplasmic reticulum calcium signaling in intact cardiac myocytes. There's another Research Letter by Dr Angiolillo on the pharmacodynamic and pharmacokinetic effects of a low maintenance dose ticagrelor regimen, versus standard dose clopidogrel, in patients with diabetes without prior major cardiovascular events, undergoing elective PCI. And this is the OPTIMUS-6 study. There's an On my Mind paper by Dr Santos on coronary artery calcification and familial hypercholesterolemia, and an ECG Challenge by Dr Liu, which is not your uncommon electrocardiographic findings, and really looking at Q waves with post-QRS deflections. I'll let you take a look. Dr Greg Hundley: Oh, wow, Carolyn. This issue is just jammed with really nice articles. I've got a research letter entitled, Long-Term Outcomes After Infective Endocarditis, Following Transcatheter Aortic Valve Replacement, and it's from Dr Josep Rodés-Cabau from Quebec Heart and Lung Institute. And then finally, a nice exchange of letters by Drs Rozenbaum, Kemner, and Parasuraman regarding the article Cost-Effectiveness of Tafamidis Therapy for Transthyretin Amyloid Cardiomyopathy, and there's a very nice response by Dr Kazi. Now we get to proceed on to that feature article. Dr Carolyn Lam: Yay! Let's go, Greg. Dr Greg Hundley: Well listeners, we are to our feature discussion. And today we have Dr Mark Chan from the National University of Singapore, our own associate editor, Dr Wendy Post from Johns Hopkins, and Dr Thomas Wang from the University of Texas Southwestern Medical Center. Well, Mark, we'll start with you. Could you explain to us some of your thinking behind how you formulated this study and what was the hypothesis that you wanted to address? Dr Mark Chan: The background, really, was to try to prioritize protein candidates in post myocardial infarction heart failure. We do know that there are several hundred candidates out there in the literature, but really, what we wanted to do was to try to enrich and select out what we thought would be the most biologically relevant proteins. And really, the hypothesis was that, by combining two very powerful unbiased discovery tools that have been developed in the last few years, we would be able to achieve this goal. The two tools, I think, Tommy would be very familiar with, because he's used plasma proteomics as well in a lot of his work. That's one of the unbiased discovery tools that we used. Measuring 1300 proteins in blast mine. Second two was a single-cell transcriptomics where we're able to look at RNA sequences, genome RNA sequences, at the individual cell level. So we first started off with cohorts of patients with acute myocardial infarction that were followed up for about five years for heart failure events, and we obtained plasma from these patients at about 30 days after myocardial infarction. So with the initial plasma proteomics, and found more than 200 candidates, actually very similar to what we actually see in the literature in terms of protein candidates predicting heart failure, in particular, post-MI heart failure. We then thought that what we really want to do is prioritize the most important proteins, and that's when we went onto single-cell transcriptomics. And we found a total of 83 protein candidates, which were directionally similar across the human plasma proteomics and the single-cell transcriptomic data across different models of ischemic heart failure. And six candidates are the ones that we are hoping to discuss a bit more about, the top six candidates, today, which I'm sure you'll ask me about very soon. Dr Greg Hundley: You've really led us into the next question. Tell us a little bit about the six candidates. Dr Mark Chan: The top six candidates to all of us are really familiar with NT-proB natriuretic peptide that's been around for decades, cardiac troponin, that's the second well-known, well-established candidate, and four other candidates that seem to be really emerging as potential targets in heart failure and ischemic cardiomyopathy. Angiopoietin-2, thrombospondin-2, latent-transforming growth factor binding protein 4, and a less commonly investigated protein, FSLT3, or follistatin-like related protein 2. The two candidates that are particularly interesting to me are angiopoietin-2 and thrombospondin-2 , and looking at a lot of Tommy Wang's work as well, we can see that these two candidates looking to be important future targets for biomarker discovery, validation, and maybe, potentially, druggable candidates to manage patients with post-MI heart failure and ischemic cardiomyopathy. Dr Greg Hundley: Wendy, coming to you as an associate editor and really an expert in genetic epidemiology, what intrigued you about this article? Especially I heard Mark discuss differentially expressed genetics and transcriptomics. What brought you to this article and what increased its relevance to you? Dr Wendy Post: We were very intrigued by both the importance of the problem that was being addressed, in that ischemic cardiomyopathy is a very common and major challenge that we all encounter as cardiologists, but also the unique approach that was used to handle a large amount of data. So with the plasma proteomic approach, which Mark described as the first step, you take thousands of data points and try to narrow it down, which he did, but still needed to narrow it down even more. And then use a complimentary, but different, approach to try to understand which of these hits, so to speak, maybe the ones that are important. And so using the single-cell transcriptomic approach, was able to narrow down to these six candidates. And then it was very reassuring that two of the six were what we would have hypothesized. So if you didn't find those, we'd worry that maybe something was wrong with your approach. So on the one hand, you'd say, "Well, we already knew that. So what are you telling us?" But it actually was proof, so to speak, that your approach was working, and that these other four novel candidates might turn out to be the next BNP. So that was really a few of the things that intrigued us about this paper. Dr Greg Hundley: So Tommy, as a practicing clinical cardiologist, and then also, really, as a clinician researcher, what do you see as relevant with Mark's work and also Wendy's description here for all of us that are seeing patients that has sustained myocardial infarction? Dr Thomas Wang: I think as Mark and Wendy have both nicely summarized, but I'll revisit, they're really two areas in which knowledge of these biomarkers could impact patient care down the road. One is an informative set of biomarkers to tell us which among the large number of patients with myocardial infarction might be destined to develop heart failure so that we can, as clinicians, ramp up our therapies, increase our vigilance, increase our monitoring, so that we might be able to intervene on that at a very early stage, or even before the heart failures develop. The second, which is potentially even more exciting, is the possibility that some of these biomarkers might be so informative of pathways leading to heart failure, that we could actually directly intervene on the pathways that are reflected by these biomarkers. So in other words, biomarkers would tell us not just biology, but about therapeutically effective strategies. And I think, as Mark has nicely emphasized, there are scores, if not hundreds, of biomarkers that have been looked at in this context, and there's no amount of resource in the world that allows investigators to pursue, in prospective clinical studies or experimental studies, all of these biomarkers. And so the real value of their study is to illustrate an approach for winnowing down this large number of biomarkers down to a smaller set, a much smaller set, that seem really worth pursuing in further study. Dr Greg Hundley: Well, with that lead in, Tommy and Mark and Wendy, maybe start with you, Mark, what do you see as the next step and this area of research moving forward? Dr Mark Chan: I think I need to sound a word of caution first with respect to the study itself. It is, at the end of the day, still a very descriptive study. Heavy in bioinformatic elucidation of targets. So careful mechanistic validation and further understanding of these highly prioritized targets will still be important. In terms of how we can potentially get these results closer to the post-MI heart failure patients, closer to the bedside, one concept that I think it's becoming increasingly apparent is that a lot of these bioactive proteins in circulating plasma are likely a part of the secretome. Part of what we call exosomes or micro-bubbles that are secreted by cells. And we do see the origin big cells in the single-cell studies as part of this paper. We do get an idea. A lot of these cells really are within the extracellular matrix, which is the substrate in which your cardiomyocytes are embedded. We think that enriching the plasma for the exosome fraction, which one of my colleagues is now working on, could be the best way to derive a more powerful tool for prognostication. To really determine with a high level of specificity, not just sensitivity, but highly specific to determine which patients end up with post-myocardial infarction heart failure. So enriching plasma for exosomes and potentially looking at the proteins within these exosomes, we've already started work on that. And so far, the results, compared to the proteins just measured in free plasma, seem to predict heart failure events a lot better when we come down to the exosome fraction. The other project, this is using exosomes to treat post-MI large animal models. So we have injected mesenchymal cell stem cell derived exosomes, and we've shown that they can reduce infarct size in large animal models, and also prevent some of the hemodynamic complications that result in heart failure. But really, trying to find which are the proteins actually are meaningfully preventing heart failure and reducing infarct size, I think that is also going to be part of the next steps. Dr Greg Hundley: Mark, thank you for that summary. Tommy, do you have anything to add to that? Dr Thomas Wang: I certainly agree with all that's been said. I would also emphasize that understanding the biology of some of these newer biomarkers and how they might link heart failure or active MI is going to be really important when we consider potential clinical applications. And so, further along the experimental line, I think animal models, mouse models, and other types of models, being which the biology and pathways we would manipulate it so that we can see whether these biomarkers truly do reflect etiologic pathways in heart failure would be valuable. Dr Greg Hundley: Thank you, Tommy. Well, listeners, we've had a great presentation from Dr Mark Chan, an excellent review by both Wendy Post and Tommy Wang, emphasizing how we are discovering new protein biomarkers using plasma proteomics for identification of those that may develop heart failure after myocardial infarction. And more to come in this area. We feel very privileged to have the opportunity to work with bright young investigators like this and present this work in Circulation For both Carolyn and myself, we wish you a great week and look forward to catching you next week on the Run. This program is copyright American Heart Association, 2020.

51. The "Healthy Foods" You Should Absolutely Not Eat | Dr. Steven Gundry

Growth Minds

Play Episode Listen Later Sep 16, 2020 58:14

Dr. Steven Gundry is a cardiothoracic and heart surgeon, founder of the International Heart & Lung Institute, and a New York Times Bestselling Author of the Plant Paradox, Longevity Paradox, and the upcoming Energy Paradox. In our in-depth conversation about health, diet, and longevity, we go into: Why Dr. Steven Gundry eats only once a day, and what he eats What 3 ingredients he would use if people ate only one meals to maximize energy and longevity The importance of our gut health (and new research that shares how it impacts our mood, emotions, and decisions) Healthy foods that you must avoid (that we've been taught were healthy) What all blue zone cities (that have longest life expectancy) have in common in terms of their diet and lifestyles The one vitamin that we all need at least 5x more of and more With love, Sean Subscribe to the podcast: https://podcasts.apple.com/us/podcast/growth-minds/id1482999379 Subscribe on YouTube: https://www.youtube.com/channel/UCagEMDM-X90JiwX3d8jelIg Learn more about Dr. Steven Gundry: Website: https://drgundry.com/ Instagram: https://www.instagram.com/drstevengundry/ Twitter: https://www.facebook.com/DrStevenGundry/ Pre-order The Energy Paradox: https://amzn.to/2ZGbdLY

Time to Reconsider What You’ve Been Told About Aging (Minisode #7)

Dhru Purohit Show

Play Episode Listen Later Aug 24, 2020 19:19

When you think of aging, what comes to mind? Do you view it as a positive rite of passage or a negative phenomenon that must simply be endured? You might assume that you’re destined for the latter, but it doesn’t have to be that way. You can be an active participant in your own aging process. Your habits and your environment have a lot of influence on your longevity, and how you’ll feel in your later years.In this mini-episode, Dhru speaks with Dr. Mary Pardee, Dave Asprey, and Dr. Steven Gundry about the difference between healthspan and lifespan, the pillars of aging, and the key components of the Mediterranean diet that support longevity. Dr. Mary Pardee is a naturopathic medical doctor and a certified Functional Medicine doctor who specializes in integrative gastroenterology and hormone balancing. She is the founder of modrn med, a telemedicine and virtual wellness company that provides medical and health services to clients across the world. Dave Asprey is the Founder & CEO of Bulletproof 360, creator of the global phenomenon Bulletproof Coffee, a two-time New York Times bestselling author, the host of the Webby award-winning podcast Bulletproof Radio, serial entrepreneur and global change agent. Dave has dedicated over two decades of his life identifying and working with world-renowned doctors, scientists, luminaries of human existence, and innovators to uncover the most advanced methods for enhancing mental and physical performance. Dave’s discoveries and the companies he has founded offer tools that enable people the opportunity to take control of body, mind and biology—elevating human performance far beyond what we ever dreamed possible. Dr. Steven Gundry is a renowned heart surgeon, three-time New York Times bestselling author, and medical researcher. He is the author of: Diet Evolution, The Plant Paradox, The Plant Paradox Cookbook, The Plant Paradox 30 and, The Longevity Paradox: How To Die Young at a Ripe Old Age. Dr. Gundry is the leading expert on the lectin-free diet as the key to reversing disease and boosting longevity. He is the director of the International Heart and Lung Institute in Palm Springs, California, and the founder/director of The Center for Restorative Medicine in Palm Springs and Santa Barbara where he treats patients, seven days a week. And he's the co-founder of his own supplement and health food line, GundryMD, and the host of the weekly Dr. Gundry Podcast.Find Dhru’s full-length conversation with Dr. Mary Pardee here: https://broken-brain.lnk.to/DrMaryPardee/Find Dhru’s full-length conversation with Dave Asprey here: https://broken-brain.lnk.to/DaveAsprey/Find Dhru’s full-length conversation with Dr. Steven Gundry here: https://broken-brain.lnk.to/DrStevenGundry/For more on Dhru Purohit, be sure to follow him on Instagram @dhrupurohit, on Facebook @dhruxpurohit, on Twitter @dhrupurohit, and on YouTube @dhrupurohit. You can also text Dhru at (302) 200-5643 or click here https://my.community.com/dhrupurohit.Interested in joining Dhru’s Broken Brain Podcast Facebook Community? Submit your request to join here: https://www.facebook.com/groups/2819627591487473/. See acast.com/privacy for privacy and opt-out information.

Ep.32 Jenna Macciochi: Immune response, COVID-19 and what's within our power

The Health Scientist Podcast

Play Episode Listen Later Apr 22, 2020 59:36

Jenna completed her BSc in Immunology at the University of Glasgow in 2002 followed by a PhD in the National Heart and Lung Institute at Imperial College London. She has held positions in infectious disease at The London School of Hygiene & Tropical Medicine as well as working in both Biotech specialising in clinical retraining of immunological tolerance using oral immunotherapy and in Pharma looking at management of inflammation using dietary fibre and metabolic endotoxemia. Jenna is currently a lecturer at the University of Sussex where she chairs the Board of Study for various degrees in the biomedical arena. Jenna's Instagram Jennas Website Jenna's Book "Immunity: The Science of Staying Well" Jenna's Twitter In this episode we cover: The coincidental timing of Jenna's book release with the current COVID-19 situation Jenna's extensive background in immunology What is the immune system, what different parts make it up and how does it work to protect us? What are some of the factors that make COVID-19 so effective at spreading? What are cytokines and how are they involved in the "cytokine storm", characteristic of serious cases of COVID-19? They way our own immune system can be responsible for some of damage caused during an infection Why do some people get more serious cases of COVID-19 than others? How can nutrition affect the way viruses behave in our bodies? The difference between taking supplements to fix a genuine deficiency and taking more than you need. More isn't always better. What's the role of oxidative stress in our immune response? Is "boosting" our immune system possible with diet/supplements or is it even something we would want to do? The massive amount of misinformation, circulating right now about nutrition and immunity and the role the media plays What role do macronutrients and energy metabolism play in the immune response? The importance of eating in energy balance. Metabolic reprogramming, the Warburg Effect and glucose use in immune cells. The research around and potential role of fasting and ketosis in immuno-modulation. How does exercise effect immunity. Can you do too much? The role of resistance exercise and muscle mass in maintaining our thymus gland and immune function Cumulative stress from multiple sources and how it can affect immunity How can the microbiome and gut-health play a part in our immune response Other lifestyle factors that we can manage to help with immunity

[PODCAST] BYWG Best Of….The Plant Paradox – Healthy Foods That Cause Disease and Weight Gain

Beyond Your Wildest Genes

Play Episode Listen Later Feb 15, 2020 47:23

[PODCAST] BYWG Best Of...The Plant Paradox - Healthy Foods That Cause Disease and Weight Gain Dr. Steven Gundry is a renowned cardiologist, New York Times best-selling author, and medical researcher. During his 40-year career in medicine, he has performed over 10,000 heart surgeries and developed life-saving medical technology. In 2008, his book, “Dr. Gundry’s Diet Evolution,” revealed a new career shift—helping patients to heal themselves and avoid surgery through diet. In April, his second book, "The Plant Paradox", published by Harpers Wave, hit bookstores. It’s now a New York Times bestseller. The book outlines a 90-day plan for some of the world's most pressing health issues, from obesity to heart disease. Gundry MD, founded by Dr. Gundry in 2016, is a wellness blog, YouTube channel and supplement company to help equip people with powerful tools in reclaiming their health. He practices medicine at his Center for Restorative Medicine and International Heart & Lung Institute in Palm Springs and Santa Barbara, CA. For more information about Dr. Gundry, see his website www.drgundry.com Check Out Steven's Book on Amazon Link: http://amzn.to/2Bbh4tr TALKING POINTS AUTOIMMUNE DISEASE: CLICK HERE LECTINS: CLICK HERE GLUTEN: CLICK HERE WHEAT GERM AGGLUTININ: CLICK HERE BYWG BOOK OF THE MONTH Our BYWG Book of the Month is simply incredible and in our estimation a book everyone needs to read. Cancer and the New Biology of Water by author Dr. Thomas Cowan should be on your super shortlist. Dr. Cowan has been on our podcast twice; once to talk about Dr. Cowan’s Garden his nutrient-dense nutrient diverse vegetable powders and most recently on November 11, 2019 to discuss his newest book. The link to purchase the book will be in our weekly newsletter and on social media posted and sent throughout the entire month. Book purchase link: CLICK HERE Dr. Cowan’s Garden Powders link: CLICK HERE BYWG PRODUCT OF THE MONTH Our BYWG Product of the Month is the Joovv Red Light Therapy Device. Photobiomodulation has been shown to assist with pain and inflammation relief, fitness, training, and muscle recovery, and hormone regulation to highlight a few of its near countless benefits. As I mentioned I own a Joovv Mini and Joovv Go and use them every single day. My skin has never looked better and I am certainly recovering from my workouts quicker. On October 8th, 2018 I interviewed the co-owner, Scott Nelson. I highly encourage you to listen in to learn about all the benefits of Red Light Therapy. Website link: CLICK HERE Purchase Joov: CLICK HERE BYWG SUPPLEMENT OF THE MONTH Our BYWG Supplement of the Month for February 2020 is Vitamin D3 Boost. It is pretty mainstream now how important Vit. D3 is to your overall health and wellness. What is not mainstream is the nutritional facts that Vitamin D3 needs a few other co-factors and Vitamins and Minerals to enhance its effectiveness. Recognizing this we set out to formulate the gold standard for Vitamin D3 supplements. Vitamin D3 Boost has the most active form of Vitamin D as well as Vitamin K2 and Magnesium with a little bit of MCT oil to enhance the absorption of these fat-soluble vitamins. This is truly a world-class Vitamin D3 formulation. You can check out the spec sheet and research articles on the website: CLICK HERE The 10% discount code for the month of February is vitd10. (yes it is case sensitive) You can purchase Vitamin D3 Boost: CLICK HERE Be Awesome and Never Unawesome

Conversations with the Pioneers of Oncology: Dr. Vince DeVita

Cancer Stories: The Art of Oncology

Play Episode Listen Later Jan 24, 2020 37:08

Dr. Hayes interviews Dr. DeVita about his role as Director of NCI and his time with CHOP and MOPP. TRANSCRIPT [MUSIC PLAYING] 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] Welcome to JCO's Cancer Stories, The Art of Oncology, 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 role of cancer care. You can find all of the shows, including this one, at podcast.asco.org. Welcome to Cancer Stories. I'm Dr. Daniel Hayes. I'm a medical oncologist and a translational researcher at the University of Michigan Rogel Cancer Center. And I'm the past president of ASCO. I'm really privileged to be your host for a series of podcast interviews with the founders of our field. In this series of podcasts, I hope to bring appreciation of the courage and the vision and most importantly the scientific background among the leaders who founded our field of clinical cancer care over the last 70 years. I hope by understanding the background of how we got to what we now considered normal in oncology, we can all work together towards a better future for our patients and their families during and after cancer treatment. Today, my guest on this podcast is Dr. Vincent T. DeVita, best known as Vince. Dr. DeVita is generally considered one of the so-called Gang of Five, including Doctors Canellos, Young, Chabner, and Schein, who I've been trying to get on for this podcast in the future, all at the NCI, and who brought many of the concepts we now accept as standard into the clinic in the 1960s and '70s. Dr. DeVita is currently a Professor of Medicine and Epidemiology and Public Health at the Yale School of Medicine. I think it's also fair to say, Dr. DeVita was instrumental in the passage of the 1971 National Cancer Act. And I want to hear more about that as we get into this. He was director of the NCI and the National Cancer Program from 1980 to 1988 and then moved to Memorial Sloan Kettering Cancer Center as Physician in Chief and subsequently became the Director of the Yale Cancer Center in 1993. Among his many honors-- and I don't have time to go through them all-- but he has served as President of the American Cancer Society. And I think most dear to me, he was President of ASCO in 1977 and 1978. Dr. DeVita, welcome to our program. Nice to be here, Dan. I've done a little background. I know you grew up in the Bronx. And I know you went to William and Mary for undergrad and George Washington Medical School. And I also read what I didn't know, which is that you did your internship and residency at the University of Michigan. We're recording this just before the NCAA basketball tourney. And I have to say, go blue. We're all excited here in Ann Arbor about our basketball team. [LAUGHTER] What I'm really interested in is, were your parents physicians? Or what made you choose medicine out of the Bronx? Well, no, my father was a banker. And my mother was an interior decorator. So it was kind of a funny mix. But I think it's kind of peculiar. I was growing up, and my mother-- I tell this story in my book. My mother was kind of frightened by the fact that I really, as a seven- or eight-year-old kid, really thought the guy who delivered the ice-- in those days, we had ice boxes-- was terrific. And I wanted to be like Nunzi the iceman. And she panicked and said, no, no. You're going to be a doctor. And every time someone asked me what I was going to be, I just said I was going to be a doctor. And when I went to school, I decided I'd be a doctor. It was sort of Mama driving me in that direction. So you had a choice of being an iceman or a doctor [LAUGHS]. Right. I like-- I mean, biology was always a favorite subject of mine. So it was a good fit. And tell me about how you ended up going to the NIH and choosing oncology. Was that serendipitous? I talked to Bob Young the other day. And he said, fundamentally, he hadn't planned to be an oncologist and got to the NIH and liked it. Was that your role, or did you know you wanted to do cancer from the start? No, I was going to be a cardiologist. In fact, when I was a first-year resident, I did cardiac catheterizations and was a co-author on a paper that for a long time was well-cited in the field. So I applied to both the Heart and Lung Institute and the Cancer Institute. And those are very competitive positions. And I had an interview with Robert Berliner, which didn't go well [LAUGHS]. So I didn't get invited to the Heart Institute. And I went to the Cancer Institute. And when I walked in, Dr. David Rall was the chief of the pharmacology branch. And I asked him if I could work on the pharmacology of digoxin. And he, wise person that he was, said, sure. Go ahead if that's what you want to do. And I was surrounded by people who were working on anti-cancer drugs. And I actually became fascinated with them. And it was only a few months, because I was also on the wards at the time, that I said, oncology is the way to go. It was an exciting new field. It was kind of a funny field in those days. But I found it exciting, so I switched. So just to give you a plug here, I think many of us know that you wrote a book, The Death of Cancer, published a couple of years ago, co-written with your daughter Elizabeth by the way. But in it, you described a number of things. And one of those that I loved were your stories about Gordon Zubrod. And I trained with Dr. Frei at the Dana-Farber. He always had great things to say about Dr. Zubrod. And I wonder if you could tell the folks listening in who he was-- I think most people don't even know that-- and the impact he had on our field. Yeah, I used to call him the great umbrella. The field was very controversial at the time. And so the people who were doing things like saying, I'm going to try to cure this cancer-- leukemia in Frei's case and Hodgkin's in our case-- were considered just a little bit this side of insane. He was somebody who was distinguished. Now, Frei had-- Zubrod had been at St. Louis as a professor and also at Johns Hopkins. And he was a very distinguished-looking man and a very polite, careful man. And so he used to provide sort of the umbrella for all of us, so that [INAUDIBLE] he'd take the heat. And we could go on and do our work. So he was-- he did enormous number of things. I mean, the whole clinical trial structure was established by Gordon Zubrod. The phase I, II, III trials was all done in a paper by Gordon Zubrod in the late 1950s. So I think he was just a guy who had foresight and was a great leader. I ultimately took his job. He got tired of bucking the bureaucracy and retired and went to Florida as the director of their cancer center there. So I got to know him pretty well. And like Frei, I have great admiration with him. I mean, it's interesting how we take phase I, II, and III for granted. And when he came in, and not too long before you came in, those things weren't-- nobody really knew how to do this stuff. Doctors Frei and Freireich were already at the NCI when you got there, correct? Yes, indeed. Yeah, they were. Yeah. And so they must have been inspirational. They were, and especially Freireich. Freireich was always on the wards. And Tom didn't come over to the wards very much. He was sort of the direct-- he was chief of medicine. And Freireich was the chief of the leukemia service. So we saw Freireich all the time. Tom came over once in a while. And Jay was a super doctor. And it was very hard to stay ahead of him. You'd get an x-ray on a patient. And he'd call you up 20 minutes later and tell you what it was. He was already down looking at it. So you had to stay on your toes with Jay. And of course he was, as everybody knows-- Jay-- he was a bold guy, who-- I mean, he looked like he could walk through a wall. So he frightened a lot of people. But he was an inspiration. So I'm always grateful for what Jay Freireich taught me. There's a great story in your book, that Dr. Frei has told me as well, about the first platelet transfusion at the NCI. Can you elaborate on that? I think most folks don't know about that story. Platelet transfusion was, again, one of those radical departures. But Freireich reasoned that we were losing more people from bleeding than we were from leukemia. So he worked out a way of plasma pheresing people and collecting platelets. And we didn't have a lot of the expertise we have now. And they came in quart bags. I mean, they were plasma bags that were huge. And we were treating little kids. So they were-- throwing them into heart failure was a problem. So it was pretty radical. And he was told to stop doing it by the clinical director at that time. And in fact, he was told that if he didn't stop doing it, he was going to be fired. And he told me-- he said, I went back to my office, sat down, and thought about it. And I decided I didn't want to work at a place where I couldn't do that. So I just kept on doing it. And the person who said he was going to fire him never did. But that was Jay Freireich. [LAUGHS] He believed so strongly in it. And when I went to Yale right after I left the Cancer Institute-- I finished my residency up there. And I told them-- when I saw leukemia patients who were bleeding-- and I said, what you should do is platelet transfusions. And they said, they don't work. And I said, I used them. And I saw them work. So I think we're losing patients unnecessarily. It was just very controversial. So eventually I left the program. I was going to take a residency and then a fellowship in hematology there. And I decided to go back to the Cancer Institute where these adventurous things were going on. Times are different now, of course. Dr. Frei once told me a story that he-- you may have been with him-- that he was making rounds in the clinical center. And in those days, apparently, the adults and the kids were in the same ward. And there was a child with essentially no white cells, who'd been induced for leukemia, and a man next to him with CML. And so-- and actually, when Dr. Frei told me this, I kind of said, I don't think I want to hear this story, because he said, well, you know, the kid didn't have any white cells. And the guy next to him had way too many white cells. So [LAUGHS] I said, tell me you didn't do this. He said, yeah, we took platelets out from the guy and gave them to the kid. And the kid got better for a while. It was really exciting. I thought, boy, you don't see that anymore. Yeah, I mean, it was a very reasonable thing to do, because the white cells in a chronic myelogenous leukemia patient work very well in terms of fighting infection. Yeah. So there was no reason. And the kids, otherwise, wouldn't survive. And so, yeah, I was there when we got these-- we gave these. I mean, they weren't easy to give, because they stuck in the lungs. And we didn't have HLA matching at the time. So they were-- a lot of them were mismatched. But for a while, they were effective. And then we went to collecting white cells from normal people. But the white cells had not worked as well as platelets had worked. Platelets have been a lifesaver. Now it's a couple of hundred million dollar business each year now. So it's routinely done, as many things that Jay started are routinely done now. Of the many things for which you are credited, I think it's the use of combination chemotherapy for Hodgkin's and then subsequently non-Hodgkin's that is one of your lasting legacies. There must have been a lot of drama around doing that. I mean, I think we all just assume you're going to start protocol. You write the protocol. You get funding for it. And you go forward. But can you give us some stories about sitting around at night and thinking about how to do this? Or how did you choose those drugs and why and how to give them and the obstacles that were involved? Yeah, actually, it was a very complicated process. And we didn't have the information we have now. What we had was-- I was doing this with Jack Moxley, who left active medicine and became a dean after he left the Cancer Institute. But we're still in touch. And Jack was working with [? Sy ?] [? Perry ?] using the new isotope, tritiated thymidine, looking at the bone marrow of CML patients and also of mice. And I was doing the same thing with the leukemia 1210, which was a model that we used for chemotherapy all the time. And what we were trying to do was figure out the kinetics of human versus mouse marrow, so we could develop schedules that humans would survive. We quickly found out that you can't use the mouse as a model, because their blood cells went through a kinetic phase about half the length of humans. So you had to schedule in a different way. So we worked that out. And then we looked at very simple-- something that people really ignored is that when you give a chemotherapy agent that is toxic to the marrow, you don't get abnormal blood counts right away. For a week, you'll have a normal white cell. And then on day seven or eight, it begins to fall, because the storage compartment in the marrow works well for about a week. And then there's no replenishment. And the white count falls. So between the two, looking at the marrow and looking at the white cells in the periphery, we came up with a schedule for MOPP. And then the other things were simple. We just decided that you'd have to have three or four drugs that worked by themselves. There had been people doing combination chemotherapy before-- Tom Hall in Boston and [? Alan ?] [INAUDIBLE] at Yale. And their rationale was they're looking at a sequential biochemical blockade. But they ignored whether the drugs actually worked against the tumor, assuming that if you gave them together, that the biochemical blockade would dominate. And it didn't work. In fact, it was very discouraging. But we decided the way to do it was take drugs that had some activity in the disease and use them together and use them in full doses in the schedules that we worked out because of the prior work I was telling you about. So it took a while to put that together. And then Jack Moxley and I used to do this at a bar in Georgetown called the Lehigh Grill, where we used to-- my cardiology desire-- I used to go to Georgetown where there was a wonderful cardiologist Proctor Harvey, who used to hold Thursday night sessions. You had an auditorium that was wired. So you could hear heart sounds. And after that, we'd go to the Lehigh Grill. And we sort of put together the protocol. When we presented it to Tom, he thought it was a good idea. But the other people around him thought it was insane and really tried to stop it. Tom Frei? Yeah. Tom Frei, yeah, yeah. Well, Tom was supportive. Yeah, Emil Frei was his real name. But everybody called him Tom. Yeah, he was supportive. But the people around him and my immediate boss was very much against it, because he thought it would interfere with the protocol that they were doing and so forth. So Tom worked out a solution worthy of Solomon. He said, OK, we could do-- the magic number for phase I trials in those days was 14. If you got nothing in 14 patients, then you didn't go any further. So we could do 14 patients with the first protocol, which was called MOMP-- M-O-M-P. And we had to do the workups ourselves. We couldn't use other colleagues to work up the patients. And we had to go get the patients ourselves. So Jack Moxley and I did all those things. And the results were very encouraging. And then Jack left. And I sat down and decided that we'd put procarbazine. I was working on procarbazine. It was then called [INAUDIBLE]. And I was working on it and doing the pharmacology in the phase I study with it in Hodgkin's disease. It was a promising candidate. So we put it in. And that became MOPP. Also in those days, six weeks of therapy was it. They didn't get more than six weeks. We reasoned that the marrow problems would be acute. But you'd have to give it probably for a long period of time to affect the tumor. So we gave it for at least six months or to a complete remission plus two months. And we assumed that there were cells left after we couldn't see them. So it was a lot of good thinking that went into it that turned out to be correct, because most of the-- since then, a lot of protocols follow the same sort of routine. And it really works for a lot of cancers. But it was controversial. I went to the AACR meeting. This was before ASCO. And I presented it as an abstract. And David Karnofsky, who was sort of a god at that time at Memorial Sloan Kettering, just tore me apart. And what was I doing using the term complete remission for a solid tumor. He said, that was a term that was used in leukemia. Now, I didn't say it. But I'm thinking, the reason you use them is you can get complete remission. So we had complete remissions. And I was kind of shaking with the microphone in my hand at the time. So it was a scary but it was a good experience. I have to say-- So it just gives you an idea that people were not receptive [INAUDIBLE]. Those of us who are junior to you can't imagine that you were intimidated by somebody else [LAUGHS]. Well, I was a youngster, then. I was-- Jack Moxley and I, I would say, thinking back, we were cocky. But the big guys in the field could scare me. And Zubrod was a-- I mean, Karnofsky was a big guy in the field. Yeah. He just had a hard time getting out of the leukemia mind frame. And so of course, we've used complete remission since then in any kind of solid tumor where you can get one. In your book, you have a great quote that you presented somewhere. And Dr. Frei was there. And Wayne Rundles was there. Wayne, of course, has been at Duke for 100 years. And he said, do your patients speak with you after you're done? Well, Wayne Rundles-- when he first saw the MOPP protocol, Wayne Rundles said, that's nonsense. He said, I get the same thing with nitrogen mustard by myself. Well, nobody had ever got that with nitrogen mustard. So we actually had to set up a controlled trial and do it and prove that MOPP was better. So when I presented it when we were first starting it-- at a meeting. Tom had arranged this meeting with all the bigwigs in the field. And when I presented it at that, everybody was sort of quiet. And then Wayne Rundles raised his hand. He looked pale. He raised his hand and said to me, Dr. DeVita, do your patients speak to you after you do this? [LAUGHS] So he-- a few years later when we were obviously getting good results, he invited me to grand rounds. And by then, we were good friends. And I was up on the podium. And after I gave the talk, he was sitting down below smiling at me. And I said, Dr. Rundles, if you remember, you asked me if your patients speak to you when you do this. And I can tell you that they do for a lot longer. So it was fun. But it was fun. He was a good friend by then. And I had great respect for him. Actually, he was a very nice man. He was. When did you start thinking that you had a success? Was it during those first 13 patients or 14 patients that you treated? I mean, was it obvious right away, or did you start [INAUDIBLE]-- Well, it was obvious-- --you were in the wrong place? We put-- no. We thought it pretty early, because we were worried. We put patients in reverse isolation. Nobody knew whether you were going to kill them if you gave them all these drugs together. And it turned out the first surprise was, yeah, they had the usual toxicity. But it really wasn't that bad. So it was doable. And the second was-- we had a small number. But we had-- something like 80% of the patients went into a complete remission. And I think nobody had seen that. Now, the question was, how long were they going to last? So we were optimistic. And when we put patients on it, there was no cure for them at that time. And we said, we're optimistic that this is going to be something that will last. But we don't know. And then by three years, it looked pretty good. And I think I presented the first abstract four years after we started. And by that time, we had relapse-free survival curves. And again, nobody before that time had presented relapse-free survival curves in any of the lymphomas. So by then, by four years, I think we felt we had probably cured some patients with the disease. I asked Bob Young this same question. Did you feel a sense of history at the time, that this was really historical? Or did that come later when you looked backwards? I think what people don't realize about those days is neither Freireich nor ourselves were treating leukemia and Hodgkin's disease. In other words, we weren't out to develop a treatment for those diseases. We were out to prove you could cure cancer with drugs, because nobody believed it. If you said that, they really thought you had gone balmy. So we were out to look-- so we knew if we could do it, it would be historic. So we were excited when we looked like maybe it was going to happen. By that time, when we had first reported it, the VAMP program that Freireich did, which was an historic program-- he only had 17 patients. And they actually never published a paper on VAMP. And I asked Jay why they never did that. And he said because he didn't think they would accept it anywhere. So but by that time, they were getting about a 50% complete remission rate going four or five years. And they were thinking they're curing leukemia. And we were getting 80% complete remission rates. So I think everybody felt that we were going to prove that you could cure cancer with the drugs. And we did. So yes, in a sense, we set out to do something that would be historic. And so when it happened, I think, it is. It was a sort of a door opener for medical oncology in Hodgkin's disease. I'd like to turn now for just a minute to your role in politics. You were pretty instrumental, I think, when the National Cancer Act was signed in 1971. And that also sounds like a TV drama to me. It sounds like-- and I know this anyway, but in reading your book, it was not clear that was going to get through. Can you give us some of the playground behind that and Mary Lasker's role and how that happened? Well, Mary Lasker played a big role. The MOPP program actually played a big role, because Mary Lasker was sort of working in the background. Cancer was always a cause for her. But when we did the MOPP program, there was a guy named Luke Quinn, who she had hired to be a lobbyist, who was sort of hidden in the American Cancer Society so they wouldn't realize it was Mary Laskers' lobbyist. And he was referred to me by Sidney Farber. And I didn't want to take him at first, because he was diagnosed as having gall bladder cancer. And I said to them, you know-- I said to Sidney Farber, I don't really treat patients with gall bladder cancer. And there was silence on the phone. And he said, (SOMBER, COMMANDING VOICE) you will take this patient. [LAUGHS] So I took the patient. And when I examined him, when he came down and I examined him, he had adenopathy in both axillae. And gall bladder cancer just doesn't do that. So I had to do another biopsy. He was not a pleasant guy. So it was not easy to do these things. I had to get another biopsy. And it turned out that my pathologist at the time, Costan Berard, when he compared the biopsy, he said, it's a lymphoma, clearly. It was a diffuse, large cell lymphoma. What they had done is, because Claude Welch did the surgery-- a very famous abdominal surgeon-- and he said it was gall bladder cancer, that the pathologist sort of assumed it was. And it was a compression artifact. Long story short, he went into remission. And Mary Lasker went gaga. Wait a minute. We got something here. And that was what pushed her to get her friend, Senator Ralph Yarborough, to put up a committee on cancer to come up with the Cancer Act. And-- So it must have been quite a day when President Nixon signed that. Yeah, well, it was-- I wasn't at the signing. I wasn't high enough up in the chain to be invited to the signing. But yeah, I have all the photos of him signing it. And later when I met him-- I have a picture in the book of he and I shaking hands and him looking like he's having a roaring laugh. People ask me what I said that was funny. And I have no idea. But when I asked him, I said what is your greatest achievement as a president? He said two-- opening up China and signing the Cancer Act. So he was-- Really? Yeah, so I think he was proud that he did that. That's a great story. Actually, the other story I had not heard, but read in your book-- I'd like you to tell me about your lunch with Mr. Featherstone. [LAUGHS] Featherstone Reid, his name was. Well, this was a very-- this was a regular occurrence. Mary Lasker, when she came to town, would stay with Deeda Blair, Mrs. William McCormick Blair, who was a Washington socialite and had a lovely house on Foxhall Road. And they would have lunches and dinners. And they always arranged it so that people-- the scientists sat next to somebody with influence. And this is how they influenced the Congress to put more money into the cancer program. So one time, I got a call in the morning from Deeda Blair, saying, I'm having a lunch. We'd like to have you there. And I said, gee, I-- it's too short notice. I can't do it. And she said, well, Mary really wants you to be there. Mary was hard to say no to. So I rearranged my schedule, drove down to Deeda's house. And there was a big black limo sitting in the front of the house. I went in, and they introduced me to Featherstone Reid. I had no idea who he was. And every time Mary would say, we want more money for research with leukemias and lymphomas. Vince, tell him about what's going on. And I would tell him about. At the end of the lunch, he left. And Mary and I sat down on the couch to have a cup of coffee. And I said, Mary, who is Featherstone Reid? And she said, he's Warren Magnuson's driver. And when she saw the shock on my face-- Senator Warren Magnuson was the chairman of the appropriations committee of the Senate. When she saw the shock on my face, she said, wait a minute. When Mrs. Maggie-- he takes Mrs. Maggie shopping during the day. And Mrs. Maggie-- he fills her with all this information we're giving him. And then Mrs. Maggie is the last person to put her head down on the pillow next to Warren Magnuson. This is the way she worked. She would take someone like Magnuson, who was a good friend, but she would surround him with extraneous people who would say the same thing. So it was sort of like subliminal stimulation for him. He was always hearing these positive things. And then he supported the program. She was a piece of work. I never got to meet her. But it sounds like she was a force of nature. She was. And of course, the Lasker Award is now named for her and her husband and sort of the American Nobel Prize. She's had such [INAUDIBLE]. Yeah, and our crew won it in 1972-- Frei, Freireich, myself, and other people for other things. So I'm very fond of Mary Lasker, obviously. It's just a wonderful story. And I got to know her pretty well, so. I have one other question. And I'm not sure you'll want-- if you don't want to go off on it, we can edit it out. But in your book, you talked about Howard Skipper and Frank Schabel. And Dr. Frei used to talk about them all the time. And I think it's worthwhile to bring them into the history of what we do. Did you actually work with them or collaborate with them, or just base some of your ideas on what they had in mind? When I was starting at the Cancer Institute, I thought Schabel worked at the Cancer Institute-- I mean, Skipper worked at the Cancer Institute, because I would be working in the lab. I was doing the tritiated thymidine studies on L1210 mice. And he would be looking over my shoulder. He was doing the similar studies, but he was just doing it with cell counts in the abdomen of the mice. And he thought that was good enough. And he was there at a weekly meeting we had, which George Canellos named the Society of Jabbering Idiots. It was a great, great meeting, actually. [LAUGHS] And he was there all the time. And my view and Tom's view differ a little bit on Skipper. I think he was a real driving force, that he did the studies in mice that we were doing in the clinic with people. And he actually-- in 1964, he wrote a paper showing that you could cure L1210 leukemia. It was the first example of curing a mouse with leukemia. And I think-- so it was sort of a feedback mechanism between the Cancer Institute and the Southern Research Institute. So and he did-- he used to do these booklets. And I think he published hundreds of these booklets. Some of them, we convinced him to actually publish as papers. But I have the collection. There may be 100 booklets he wrote. And he would take a concept that we were working on and then work through it in mice. It was very, very important. And he was a wonderful person. His only problem was he smoked like a chimney. But he was-- I liked Frank and Howard. Yeah, Dr. Frei had the entire set of monographs on his bookshelf in his office and would encourage us to come in and borrow them and read them and come back. And frankly, he basically predicted what you've done with combination therapy. He predicted adjuvant therapy working. There were just a number of things he saw in these mice that we've gone on to apply in the clinic. It's pretty remarkable, I think, so. Yeah, I mean, it's not only he predicted it. But he actually showed the concept worked in mice. So as we know, mice and human are very different [INAUDIBLE]. There was a guy in Boston, Stuart Schlossman, a very fine scientist. And he didn't like mouse models. And when asked what he would do when he saw a tumor-bearing mouse, he would say, I would step on it, because he didn't believe mouse models. And but Frank and Howard did experiments and made allowances for the difference between humans and mice. So it was always good to know. I mean, I have the summary he wrote on Hodgkin's disease after he saw the MOPP program. So I think they're very instructive booklets. So I kept them. Like Tom, I think that we sort of live by them. Well, thanks for discussing them. I think our listeners need to remember these two guys. They were great. We're running out of time. I've really just touched the surface of what you've done and contributed to the field. And the people you've trained is sort of a who's who of oncology, frankly. But at the end of the day, what's your-- I'll ask you the same question you asked President Nixon. And that is, what is your legacy? What do you want people to remember that Vince DeVita did? I get asked that question a lot. And I don't have one thing that I can say. I mean, I've been lucky in my career that I've had a chance to do many things. Being the Director of the Cancer Institute was wonderful. You could sit on top of the whole field and just sort of scan it and see what's going on. And it was very important, because you've become the spokesman of practicing physicians at the same time. MOPP, of course, was important. Putting out the first comprehensive textbook in the field and watching it-- we just came out with the 11th edition-- is also very exciting. So there-- we were the first to successfully treat Pneumocystis carinii pneumonia. And we reported it in a paper in the New England Journal. I mean, there were a lot of things. I'm best known, I think, for MOPP, probably, and the principles of MOP, which I'm very proud of. But there's so many that I have a hard time. I like opera. And people ask me, what's my favorite opera? And I usually say, it's the one I just saw. It's very hard for me to pick one opera. There's so many that I like. So I'm not dodging it. But I just never can say, well, it's this. That's very fair. Frankly, I think, without your contributions, I probably wouldn't be sitting here doing what I do. And I think there are thousands of us who would say that. So we're-- Well, that's very flattering. Well, not only are we appreciative, more importantly, there are a lot of people who are alive who wouldn't have been without what you and your colleagues did at the NCI that so many years ago, so-- [INTERPOSING VOICES] I was involved in the training of 93 medical oncologist. At one time, something like 40% of all the [INAUDIBLE] directors were our graduates. So they have gotten around. And that was good for the field. They went out with the same principles we were developing at the Cancer Institute, so that's very gratifying. Have you kept in touch with any of the patients that you're treated back at the NCI? I talked to Saul Rosenberg. And he told me he still sees people that he treated 30 or 40 years ago when he first moved to Stanford. We're writing a paper on the 45-year follow-up of the first 188 patients. Again, nobody has 45-year follow-ups. And we called every one of the survivors. And there's something like 60% or so of the complete remissions are alive. So I talked to some of them. But we had a nurse talk to a lot of them. And I got messages from them after the call. And some of them still contact me, after sort of an anniversary of their treatment. So yeah, I've kept up with them. The gratifying thing is most of them are suffering from the same illness as most people who are getting into their 70s or some of them 80s. They have hip problems and so on and prostate cancer. But there doesn't seem to be any really major increase in anything in these long survivors. Now, mind you, these were patients who got MOPP as their only treatment. And so when you see second tumors in these kinds of patients, it's usually patients who got radiation therapy plus MOPP. So these patients who are 45 years had just got MOPP. And they seem to be perfectly fine. That's remarkable. I love your comment that they are getting the same illness as the rest of us get as they get older. That's great. Yeah, we don't cure bad hips and bad knees and-- Yeah, we can't cure old age. When I was at the Dana-Farber, I had a patient who had been one of Sydney Farbor's original patients from the early '50s. And by this time he was obviously an adult. He was older than I was. And he was fine, as you've said. Although he said Dr. Farber kept treating him and treating him and treating him. And then finally, when Dr. Farber passed away, someone else picked up his chair. And they said, why are you still getting this? And they stopped it. Yeah. So he got a lot of treatment. I had one of Freireich's VAMP patients. She was a girl in her early teens. And she was a wildcat. But she had had something else, and it failed. And she was one of the first patients on VAMP. And she went into remission. And she stayed in remission. And I followed her for many years. She went to college. She got married. She had children. She brought her children in to see me. And last time I had any follow-up with her, she was in her 60s. And she was one of the really first long survivors of that particular program. So it's really neat to see these patients. And it's not rare for me to go to a meeting and have people walk up to me and say they got MOPP 25 years ago. Someone else gave it to them. And they're alive and well. So that's one of the great gifts of having a chance to do this kind of work. What a privilege. Well, I think we need to end. Again, I want to thank you for being on with us today and filling us in with some of these stories. Had really good feedback for my podcast series. And it's because of the people I've had on it. So thank you very much for all you've done. It's really good talking to you. And I look forward to listening to all your podcasts. [MUSIC PLAYING] Until next time, thank you for listening to this JCO's Cancer Stories, The Art of Oncology podcast. If you enjoyed what you heard today, don't forget to give us a rating or review on Apple Podcast or wherever you listen. While you're there, be sure to subscribe so you never miss an episode. JCO's Cancer Stories, The Art of Oncology podcast is just one of ASCO's many podcasts. You can find all the shows at podcast.asco.org. [MUSIC PLAYING]

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Current Trends in Coronary Artery Bypass Surgery

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Play Episode Listen Later Jan 23, 2020

Written by: David ColeCoronary bypass surgery is a very common type of heart surgery. Dr. Charles Klodell, Cardiothoracic Surgeon at Florida Heart and Lung Institute, discusses when this treatment is necessary and how it works.

Current Trends in Coronary Artery Bypass Surgery

surgery heart disease heart health bypass arteries current trends coronary coronary artery disease lung institute

Play Episode Listen Later Jan 23, 2020

Coronary bypass surgery is a very common type of heart surgery. Dr. Charles Klodell, Cardiothoracic Surgeon at Florida Heart and Lung Institute, discusses when this treatment is necessary and how it works.

What Happens When Heart Valves Don't Function Properly

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Play Episode Listen Later Jan 16, 2020

Written by: David ColeYour heart keeps your blood pumping, but malfunctioning heart valves can cause other problems. Dr. Charles Klodell, Cardiothoracic Surgeon at Florida Heart and Lung Institute, discusses how heart valves can malfunction.

What Happens When Heart Valves Don't Function Properly

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Play Episode Listen Later Jan 16, 2020

Your heart keeps your blood pumping, but malfunctioning heart valves can cause other problems. Dr. Charles Klodell, Cardiothoracic Surgeon at Florida Heart and Lung Institute, discusses how heart valves can malfunction.

Latest Treatment for Hyperhidrosis

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Play Episode Listen Later Jan 9, 2020

Written by: David ColeExcessive sweating may be embarrassing, but it could be a warning sign for other issues. Dr. Charles Klodell, Cardiothoracic Surgeon at Florida Heart and Lung Institute, discusses the latest treatment available for hyperhidrosis.

Latest Treatment for Hyperhidrosis

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Play Episode Listen Later Jan 9, 2020

Excessive sweating may be embarrassing, but it could be a warning sign for other issues. Dr. Charles Klodell, Cardiothoracic Surgeon at Florida Heart and Lung Institute, discusses the latest treatment available for hyperhidrosis.

Landmark Transcatheter Mitral Valve Replacement Pivotal Trial

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Play Episode Listen Later Jan 2, 2020

Written by: David ColeSerious heart conditions requiring surgery can be frightening. Dr. Charles Klodell, Cardiothoracic Surgeon at Florida Heart and Lung Institute, discusses the landmark transcatheter mitral valve replacement pivotal trial and how it works.

Landmark Transcatheter Mitral Valve Replacement Pivotal Trial

trial replacement valve heart disease landmark pivotal heart health mitral transcatheter lung institute

Play Episode Listen Later Jan 2, 2020

Serious heart conditions requiring surgery can be frightening. Dr. Charles Klodell, Cardiothoracic Surgeon at Florida Heart and Lung Institute, discusses the landmark transcatheter mitral valve replacement pivotal trial and how it works.

Blood Conservation in Cardiac Surgery

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Play Episode Listen Later Dec 31, 2019

Written by: David ColeMajor surgeries result in some blood loss, but techniques are in place to conserve blood. Dr. Charles Klodell, Cardiothoracic Surgeon at Florida Heart and Lung Institute, discusses blood conservation in cardiac surgery.

Blood Conservation in Cardiac Surgery

blood conservation heart disease heart health cardiovascular diseases cardiac surgery lung institute

Play Episode Listen Later Dec 31, 2019

Major surgeries result in some blood loss, but techniques are in place to conserve blood. Dr. Charles Klodell, Cardiothoracic Surgeon at Florida Heart and Lung Institute, discusses blood conservation in cardiac surgery.

Longevity, Lectins, and LPS with Dr. Steven Gundry

Decoding Superhuman

Play Episode Listen Later Dec 9, 2019 50:02

International bestselling author Dr. Steven Gundry joins the show to talk about all things lectins: how to test, why we should avoid lectins, and why there are certain types of lectins that are worse than others. In addition, we talk about the carnivore diet, peptides, and alcohol.Who is Dr. Steven Gundry? Dr. Steven Gundry is a renowned heart surgeon, celebrity doctor, medical researcher and a New York Times best-selling author. Dr. Gundry worked in medicine for over 40 years. He’s probably best known for the work as a cardiothoracic surgeon and heart surgeon… but today his focus is on something very different:In 2002 Gundry abandoned his career as a cardiothoracic surgeon to establish The Center for Restorative Medicine, claiming to have discovered some unconventional truths about human nutrition. He has since authored two books focused on food-based health interventions, recommending a plant-based diet. You might have read his books, “The Plant Paradox: The Hidden Dangers in “Healthy” Food That Cause Disease and Weight Gain” and he’s now tackling gut health and many of the myths surrounding healthy aging in “The Longevity Paradox: How to Die Young at a Ripe Old Age.”He’s a leading expert on the lectin-free diet and believes we have the ability to heal ourselves through nutrition when certain dietary obstacles are removed. Dr. Gundry’s mission is to improve people’s health, happiness, and longevity by making simple changes to the human diet. He’s the Director and Founder of the International Heart & Lung Institute as well as the Center for Restorative Medicine in Palm Springs and Santa Barbara, CA. Every day at these offices, Dr. Gundry helps patients learn how to take control of their weight, health, and energy by using his surprisingly simple diet advice.Highlights[2:57] Dr. Gundry explains what is the holobiome[5:34] Discussing what are lectins[15:04] The types of food that should be avoided[20:54] Testing for lectin sensitivity[27:31] Theories for coronary artery disease and cardiovascular disease[31:36] Genetics predisposition to lectin sensitivity[38:51] Carnivore diet for people with autoimmune conditions[43:18] Glyphosate in wineResourcesThe Plant Paradox Quick and Easy: The 30-Day Plan to Lose Weight, Feel Great, and Live Lectin-FreeThe Plant Paradox Family Cookbook: 80 One-Pot Recipes to Nourish Your Family Using Your Instant Pot, Slow Cooker, or Sheet PanThe Longevity Paradox: How to Die Young at a Ripe Old AgeDr. Gundry's Diet Evolution: Turn Off the Genes That Are Killing You and Your WaistlineThe End of Alzheimer's by Dale BredesenElevated Adiponectin And Tnf-alpha Levels Are Markers For Gluten And Lectin SensitivityOur sponsor today is CAR.O.L You don’t have time for that 45 minute jog.You need something fast, efficient, and leaves you wanting more. My favorite tool for this is the CAR.O.L. She is a life-changing bike, that provides you all the endurance you need into two 20 second bursts. Yes, you read that right. That’s 40 seconds of max-effort, including the warm up and cool downs, you get a kick-ass workout in 8 minutes and 40 seconds. The CAR.O.L is a resistance bike powered by artificial intelligence, which personalizes and optimizes the resistance, so you hit your maximum intensity levels and maximize glycogen depletion every single time. The proof is really in the pudding. CAR.O.L’s effectiveness was independently verified by the American Council on Exercise. I gave the CAR.O.L bike spin at Health Optimization Summit in London this year, and she kicked my ass so much that I had to get one. Check out CAR.O.L at carolfitai.com If you have limited time and want a kick ass workout, which basically everyone that listens to this show does, use the code DECODING150 for a big discount, head over to CarolfitAI.com to secure yours.Continue Your High Performance Journey with Dr. Steven GundryWebsiteSupplement LineFacebookInstagramTwitterThe Dr. Gundry PodcastDisclaimer This information is being provided to you for educational and informational purposes only. This is being provided as a self-help tool to help you understand your genetics, biodata and other information to enhance your performance. It is not medical or psychological advice. Virtuosity LLC, or Decoding Superhuman, is not a doctor. Virtuosity LLC is not treating, preventing, healing, or diagnosing disease. This information is to be used at your own risk based on your own judgment. For the full Disclaimer, please go to (Decodingsuperhuman.com/disclaimer). See acast.com/privacy for privacy and opt-out information.

Ep 2. Living With IPF

Raremark Voices

Play Episode Listen Later Nov 28, 2019 18:15

In this series, we invite extraordinary people living with a rare condition and industry experts to talk about their experience and hopes for the future. In our second episode of Raremark Voices, we talk with British Lung Foundation Chair in Respiratory Research & NIH Research Clinician Scientist Toby Maher, and patient advocate and founder of the advocacy group PF Warriors, Bill Vick. Our guests: Toby Maher Professor Toby Maher qualified at Southampton Medical School and trained in respiratory medicine at the Royal Brompton Hospital, the Transplant Unit at Harefield Hospital and at St Mary’s Hospital, Paddington. During his training, he gained an MSc in respiratory medicine from Imperial College London. In 2005, Professor Maher was awarded a Wellcome Trust Clinical Research Fellowship, enabling him to study the molecular mechanisms involved in the development of idiopathic pulmonary fibrosis. Professor Maher is a consultant respiratory physician and continues to see patients every week. He is also an honorary senior lecturer at the National Heart and Lung Institute, Imperial College London, and honorary senior research associate at University College London, as well as the British Lung Foundation Chair in Respiratory Research and Professor of Interstitial Lung Disease at Imperial College London. Bill Vick Bill was training for a triathlon at the age of 72 when he was diagnosed with IPF. His doctor told him he had two years to live. Now at the age of 81, Bill has more than beaten the odds and taken on the mission of helping others to do the Bill is the founder of PF Warriors, a volunteer group of pulmonary fibrosis (PF) patients, families and medical professionals helping each other in living with PF. PF Warriors has now grown to be the world's largest community of people dealing with PF. Bill's aim is to first raise awareness in both the medical community and the general population; and secondly, to inspire other patients to live and live a full life with PF.

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Inauguración del Heart and Lung Institute del Bayamón Medical Center

Revista MSP

Play Episode Listen Later Oct 18, 2019 41:16

Hoy la revista MSP se complace compartir la inauguración del Heart and Lung Institute del Bayamón Medical Center, esta instalación proveerá, recursos, equipos especializados y procedimientos, que hasta ahora muchos pacientes tenían que procurar fuera de Puerto Rico. Entrevistas exclusivas con el licenciado Rosado y los doctores Del Río, y Santiago. ¡NO SE LO PIERDA! - - - Bayamón Medical Center: http://www.bayamon-medical.com/ - - - Visite nuestro sitio web: https://medicinaysaludpublica.com/ - - - Síguenos en Facebook: https://www.facebook.com/revistamsp/ - - - Todo sobre la salud del corazón: https://saludycardiologia.com/

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What Symptoms are Most Common for People Who Have Issues With Their Heart Valves?

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Play Episode Listen Later Aug 4, 2019

Written by: David ColeHeart valves can trigger particular symptoms. Dr. Jeffery Snyder, cardiothoracic surgeon at Florida Heart and Lung Institute, discusses these symptoms.

What Symptoms are Most Common for People Who Have Issues With Their Heart Valves?

heart symptoms heart health valves heart valve lung institute

Play Episode Listen Later Aug 4, 2019

Heart valves can trigger particular symptoms. Dr. Jeffery Snyder, cardiothoracic surgeon at Florida Heart and Lung Institute, discusses these symptoms.

How to Die Young at a Ripe Old Age: The Longevity Paradox & The 7 Deadly Myths Of Aging

Ben Greenfield Life

Play Episode Listen Later Apr 18, 2019 82:01

My guest on today's podcast and former guest on my show "", Dr. Steven Gundry proposes in his new book "", that the “diseases of aging” we most fear are not simply a function of age; but rather, they are a byproduct of the way we have lived over the decades. In The Longevity Paradox, he maps out a new approach to aging well—one that is based on supporting the health of the “oldest” parts of us: the microorganisms that live within our bodies. He believes that - from diseases like cancer and Alzheimer’s to common ailments like arthritis to our weight and the appearance of our skin, these bugs are in the driver’s seat, controlling our quality of life as we age. Dr. Gundry is a cum laude graduate of Yale University with special honors in Human Biological and Social Evolution. After graduating Alpha Omega Alpha from the Medical College of Georgia School of Medicine, Dr. Gundry completed residencies in General Surgery and Thoracic Surgery at the University of Michigan and served as a Clinical Associate at the National Institutes of Health. There, he invented devices that reverse the cell death seen in acute heart attacks; variations of these devices subsequently became the Gundry™ Retrograde Cardioplegia Cannula. It has become the world’s most widely used device of its kind to protect the heart from damage during open-heart surgery. After completing a fellowship in congenital heart surgery at The Hospital for Sick Children, Great Ormond Street, in London, Dr. Gundry was recruited as Professor and Chairman of Cardiothoracic Surgery at Loma Linda University Medical Center. There, he and his partner, Leonard Bailey, pioneered infant and pediatric heart transplantation. Together, they have performed more such transplants than any other surgeons in the world. During his tenure at Loma Linda, Dr. Gundry pioneered the field of xenotransplantation, the study of how the genes of one species react to the transplanted heart of a foreign species. He was one of the original twenty investigators of the first FDA-approved implantable left ventricular assist device (a kind of artificial heart). Dr. Gundry is also the inventor of the Gundry Ministernomy, the widely used minimally invasive approach to aortic- or mitral-valve repair, the Gundry Lateral Tunnel, a “living” tissue that can rebuild parts of the heart in children with severe congenital heart malformations; and the Skoosh™ venous cannula, the most widely used cannula in minimally invasive heart operations. One of the fathers of robotic surgery, as a consultant to Computer Motion (now ), Dr. Gundry received early FDA approval to use robotic-assisted minimally invasive surgery for coronary artery-bypass and mitral-valve operations. He holds patents on devices for connecting blood vessels and coronary artery bypasses without sutures, as well as for repairing the mitral valve without the need for sutures or a heart-lung machine. He has served on the Board of Directors of the American Society of Artificial Internal Organs (ASIAO), and was a founding board member and treasurer of the International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS). He recently completed two successive elected terms as President of the Board of Directors of the American Heart Association, Desert Division. Dr. Gundry has been elected a Fellow of the American College of Surgeons, the American College of Cardiology, the American Surgical Association, the American Academy of Pediatrics, and the College of Chest Physicians. He is a member of numerous other surgical and medical societies. He is also the author of more than three hundred articles, chapters, and abstracts in peer-reviewed journals on surgical, immunology, genetic, nutrition, and lipid investigations. He has operated in more than thirty countries, including charitable missions to China, India, and Zimbabwe. Inspired by the stunning reversal of coronary artery disease in an “inoperable” patient, using a combination of dietary changes and nutriceutical supplements, in 2001, Dr. Gundry changed the path of his career. An obese, chronic “diet” failure himself, he adapted his undergraduate Yale University thesis to design a diet based on evolutionary genetic coding, which enabled him to reverse his own medical problems. In the process, he effortlessly lost 70 pounds. The equally astonishing results from following what he came to call Diet Evolution in several of his staff led Dr. Gundry to accept a position in Palm Springs where he could devote his efforts to disease reversal. No longer satisfied with repairing the damage of chronic diseases, since 2002, Dr. Gundry founded and has served as Medical Director of The International Heart and Lung Institute in Palm Springs, California, which serves patients referred from across the nation. He is also Founder and Director of The Center for Restorative Medicine, part of the Institute. Its mission is to prevent and reverse the chronic diseases of “ageing” with diet and nutriceutical interventions, using surgical intervention for heart and vascular disease as a last resort. During our discussion, you'll discover: -The myth of the Mediterranean Diet promoting longevity...11:20 "Blue Zones" is a term coined by a journalist named Dan Bruckner Dr. Gundry has spent most of his life living in a Blue Zone (Loma Linda, CA) Doesn't disagree with the premise you should follow the Mediterranean Diet, but there's more to it... "The only purpose of food is to get olive oil in your mouth" The key to the Mediterranean Diet is not whole grains and beans Book: Residents of Acciaroli, Italy do not eat pasta or bread, but love lentil beans Millet, sorgum, teft do not have a hull (where most of the defense mechanisms of the plant are located) Unprocessed barley: People live a long time in spite of it, not because of it Influence of the Greek Orthodox church on the Mediterranean Diet Fasting and abstaining from animal products are observed during Lent -The missing link in the Mediterranean Diet regarding longevity...20:45 , a compound that is deleterious to the surface of blood vessels Cleveland Clinic invented a test to detect TMAO Recognized low incidence of coronary artery disease in spite of animal product consumption Present in most olive oils, balsamic vinegars and red wines A structural analog of choline Not all TMAO is created equal The ideal Mediterranean Diet (Hint: Olive Garden got it wrong) Rich in polyphenols, olive oil and red wine More fish and eggs than meat Some type of fasting component You can mitigate a bad diet with a fast or fasting mimicking diet for 5 consecutive days Done on a quarterly basis The Carnivore Diet is a fad, fancy name for the Atkins Diet -The carbohydrate Okinawans consume that staves off inflammation and high blood sugar...27:40 ~85% of the traditional Okinawan diet is a blue or purple sweet potato 5-6% of the diet white rice (no brown rice) Remaining soy-based products and pig fat Taro and sweet potatoes are resistance starches "The more we eat for our gut microbiome, the more our gut microbiome will take care of us." Nigerians carry the highest percentage of APO E-4 gene of any people on earth Their starch is melon Very low rate of Alzheimers -Dr. Gundry's thoughts on roughage and fiber intake...35:14 went on a mission to Africa to operate on colon cancer Realized no one had colon cancer Studied their stools Eating huge amount of tubers (yams) and millet Didn't realize there was a difference between soluble and insoluble fiber Advocated for eating whole grains Ended up dying of colon cancer Lives in tunnels in sub-saharan Africa Lives 30x longer than other rats Gut microbiome is identical of healthy 105 year old humans Eats tubers, roots and fungi -The myth of the efficacy of animal protein for longevity...42:45 US Dept of Agriculture sells agricultural products (owns the food pyramid) Vegans live the longest The more animal protein consumed, the less the longevity You can mitigate meat intake with a vegan fast or fasting mimicking diet for 5 days consecutively Methionine/glycine ratio People who are primarily carnivorous do not historically have the highest longevity -The myth of growth hormones...49:20 Loranz people of Ecuador do not have cancer or diabetes When block IGF-1 receptor in mice, live 40% longer When give growth hormones, abolishes effect of calorie restriction Supplement with quercetin -The myth of iron intake for longevity...55:05 Iron is one of the deadliest substances Iron is dangerous for mitochondrial function Regular blood donors have longer life spans than non-donors Endurance training helps reduce iron levels Ferritin and GGT are musts for a blood test to track "internal rust" Ferritin is a great marker for inflammation Elevated level indicates potential auto-immune disease -The myth of metabolic rate...59:50 Age is akin to rate of energy consumption Carnivores run higher temperatures than herbivores; breakdown of protein generates a lot of heat Sweet spot between fitness and low metabolism: Hibernating animals can live 2-3x longer than non-hibernating animals due to reduced metabolic rate There are periods we should have less energy expenditure than others We live in constant summer, regardless of where we live in the world -The myth of saturated fat...1:05:15 Dr. Ancel Keys published the Said saturated fat was related to coronary heart disease He did not say plant fats were bad for you (although it was implied) Retired near Acciorili and ate large amounts of olive oil Did not make the connection between animal fat and animal protein 30% of people carry APO E 4 gene Saturated fats in coconut oil, cheese increase LDL's in these people Mucus absorbs lectins; is essential for gut health in older age -Why milk does not in fact do the body good... Most milk in the US is casein a1 milk, from holstein cows Cow milk is designed to make baby cows grow quickly (lots of IGF1) Humans are designed to grow slowly (low amounts of IGF1) Adolescents who grow quickly have higher chance of cancer in 10-20 years We're the only animal that drinks another animal's milk Ben's kids drink goat and camel milk -And much more... Resources from this episode: -Book: -Book: -Book: -Book: - - - on the growing epidemic of loneliness and relationships/longevity. - - - - - - Episode Sponsors: -: My personal playground for new supplement formulations. Ben Greenfield Fitness listeners receive a 10% discount off your entire order when you use discount code: BGF10. -: A new take on an ancient secret: Pain-soothing herbs, incredible antioxidants, and phytonutrients all in one delicious, soothing “Golden Milk” nighttime tea! Receive a 20% discount on your entire order when you use discount code: BENG20. -: You can be sure that I researched all the saunas before I bought mine and Clearlight was the one that stood out from all the rest because of their EMF and ELF Shielding and their Lifetime Warranty. Use discount code: BENGREENFIELD to get $500 off your sauna and a free bonus gift! -: As your qualified candidates roll in, we make it easy to screen & rate them, allowing you to make the best hiring decisions for your business. Try it for free when you use ! Do you have questions, thoughts or feedback for Dr. Gundry or me? Leave your comments below and one of us will reply!

director university california founders health president china college pain professor africa michigan italy rich board influence medicine eating institute hospitals myths diet receive alzheimer's disease vegan fellow fda regular paradoxes agriculture endurance deadly ecuador longevity retired cows lives gut nigerians mediterranean national institutes yale university remaining zimbabwe surgeons ended american academy eats palm springs medical director american society american colleges pediatrics supplement elevated international society american heart association emf realized cardiology cleveland clinic saturated blue zones ldl carnivore diet taro studied medical college mediterranean diet millet ben greenfield die young mucus igf carnivores us dept gundry general surgery sick children unprocessed greek orthodox loma linda georgia school apoe okinawan ferritin alpha omega alpha ancel keys clearlight hibernating cardiothoracic surgery thoracic surgery social evolution tmao ben greenfield fitness ggt restorative medicine golden milk lifetime warranty okinawans chest physicians leonard bailey lung institute methionine great ormond street clinical associate ripe old age diet evolution american surgical association

208: Dr. Steven Gundry | Reverse Chronic Disease With Nutrition & Health

Humans 2.0 Archive

Play Episode Listen Later Mar 26, 2019 46:02

NYT Bestselling author of The Plant Paradox: The Hidden Dangers in "Healthy" Foods That Cause Disease & The Longevity Paradox: How to Die Young At a Ripe Old Age. STEVEN R. GUNDRY, M.D., F.A.C.S., F.A.C.C., is a cum laude graduate of Yale University with special honors in Human Biological and Social Evolution. After graduating Alpha Omega Alpha from the Medical College of Georgia School of Medicine, Dr. Gundry completed residencies in General Surgery and Thoracic Surgery at the University of Michigan and served as a Clinical Associate at the National Institutes of Health. There, he invented devices that reverse the cell death seen in acute heart attacks; variations of these devices subsequently became the Gundry™ Retrograde Cardioplegia Cannula. It has become the world's most widely used device of its kind to protect the heart from damage during open-heart surgery. After completing a fellowship in congenital heart surgery at The Hospital for Sick Children, Great Ormond Street, in London, Dr. Gundry was recruited as Professor and Chairman of Cardiothoracic Surgery at Loma Linda University Medical Center. There, he and his partner, Leonard Bailey, pioneered infant and pediatric heart transplantation. Together, they have performed more such transplants than any other surgeons in the world. During his tenure at Loma Linda, Dr. Gundry pioneered the field of xenotransplantation, the study of how the genes of one species react to the transplanted heart of a foreign species. He was one of the original twenty investigators of the first FDA-approved implantable left ventricular assist device (a kind of artificial heart). Dr. Gundry is also the inventor of the Gundry Ministernomy, the widely used minimally invasive approach to aortic- or mitral-valve repair, the Gundry Lateral Tunnel, a "living" tissue that can rebuild parts of the heart in children with severe congenital heart malformations; and the Skoosh™ venous cannula, the most widely used cannula in minimally invasive heart operations. One of the fathers of robotic surgery, as a consultant to Computer Motion (now Intuitive Surgical), Dr. Gundry received early FDA approval to use robotic-assisted minimally invasive surgery for coronary artery-bypass and mitral-valve operations. He holds patents on devices for connecting blood vessels and coronary artery bypasses without sutures, as well as for repairing the mitral valve without the need for sutures or a heart-lung machine. He has served on the Board of Directors of the American Society of Artificial Internal Organs (ASIAO), and was a founding board member and treasurer of the International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS). He recently completed two successive elected terms as President of the Board of Directors of the American Heart Association, Desert Division.Dr. Gundry has been elected a Fellow of the American College of Surgeons, the American College of Cardiology, the American Surgical Association, the American Academy of Pediatrics, and the College of Chest Physicians. He is a member of numerous other surgical and medical societies. He is also the author of more than three hundred articles, chapters, and abstracts in peer-reviewed journals on surgical, immunology, genetic, nutrition, and lipid investigations. He has operated in more than thirty countries, including charitable missions to China, India, and Zimbabwe.Inspired by the stunning reversal of coronary artery disease in an "inoperable" patient, using a combination of dietary changes and nutriceutical supplements, in 2001, Dr. Gundry changed the path of his career. An obese, chronic "diet" failure himself, he adapted his undergraduate Yale University thesis to design a diet based on evolutionary genetic coding, which enabled him to reverse his own medical problems. In the process, he effortlessly lost 70 pounds. The equally astonishing results from following what he came to call Diet Evolution in several of his staff led Dr. Gundry to accept a position in Palm Springs where he could devote his efforts to disease reversal. No longer satisfied with repairing the damage of chronic diseases, since 2002, Dr. Gundry founded and has served as Medical Director of The International Heart and Lung Institute in Palm Springs, California, which serves patients referred from across the nation. He is also Founder and Director of The Center for Restorative Medicine, part of the Institute. Its mission is to prevent and reverse the chronic diseases of "ageing" with diet and nutriceutical interventions, using surgical intervention for heart and vascular disease as a last resort. Dr. Gundry lives with his wife, Penny and their four dogs, George, Bella, Black Pearl, and Fanny Foo Foo in Palm Springs and Montecito, California. His two grown daughters live nearby.Please do NOT hesitate to reach out to me on LinkedIn, Instagram, or via email mark@vudream.comLinkedIn - https://www.linkedin.com/in/mark-metry/Instagram - https://www.instagram.com/markmetry/Twitter - https://twitter.com/markymetryMedium - https://medium.com/@markymetryFacebook - https://www.facebook.com/Humans.2.0.PodcastMark Metry - https://www.markmetry.com/Humans 2.0 Twitter - https://twitter.com/Humans2Podcast

director university california founders health president china college young professor food michigan board focus medicine institute nutrition hospitals humans disease animals productivity plant meat fellow fda paradoxes reverse longevity illness gut chronic national institutes yale university zimbabwe surgeons american academy palm springs medical director american society american colleges pediatrics microbiome bacteria international society epigenetics american heart association cardiology chronic disease black pearl nyt bestselling medical college gundry general surgery sick children montecito loma linda georgia school alpha omega alpha intuitive surgical cardiothoracic surgery thoracic surgery social evolution lectin restorative medicine chest physicians lung institute leonard bailey great ormond street clinical associate ripe old age steven r gundry diet evolution american surgical association

208: Dr. Steven Gundry | Reverse Chronic Disease With Nutrition & Health

Humans 2.0 | Mind Upgrade

Play Episode Listen Later Mar 26, 2019 46:02

Cardiogenic shock, the poor relation of septic shock – are we missing a trick? - Susanna Price

Intensive Care Society Podcast

Play Episode Listen Later Dec 27, 2018 19:35

Dr Susanna Price trained in both cardiology and intensive care medicine in the UK, and completed a fellowship at the Thorax center with Jos Roelandt. She was awarded a PhD from Imperial College London, and following completion of her training was awarded the two-year BHF Jill Dando GUCH Fellowship in order to train further in critical care and imaging in congenital heart disease. She is a consultant at the Royal Brompton Hospital where she is Clinical Lead for Critical Care, Honorary Senior Lecturer at National Heart & Lung Institute, Imperial College London. Dr Price is President-elect of the European Society of Cardiology (ESC) Acute Cardiovascular Care Association, and sits on numerous committees including the ESC Education Committee, ESC Press & Media Committee, ALS subcommittee of the RCUK and SCCM US guideline committee. She is an Associate Editor of the European Heart Journal of Acute Cardiovascular Care, and an invited reviewer for a number of other journals. She has been a member of a number of Task Forces relating to international guidelines including VA-ECMO, acute cardiovascular care, the management of cardiovascular diseases including valvular disease, endocarditis, non-cardiac surgery, pulmonary hypertension, pericardial disease, cardiovascular disease in pregnancy and grown-up congenital heart disease. Dr Price has authored numerous papers and book chapters on cardiology, echocardiography and intensive care, and lectures regularly globally

Adventures in Entrepreneurship with Germain Boer: Episode 253 of The Action Catalyst Podcast

The Action Catalyst

Play Episode Listen Later Sep 26, 2018 48:54

Germain Böer is an innovator in all that he does. His courses use technology and creative assignments that challenge students to think, and feature speakers who have created unusual companies. He also conducts experiential learning programs that transform students into self-driven entrepreneurs. After working for Arthur Andersen & Co., the Institute of Management Accountants., and two universities, Prof. Böer joined The Owen School in 1977 as a professor of management accounting, Since that time, he has initiated numerous entrepreneurship activities at Owen, including an annual entrepreneurship conference; student sessions with venture capitalists; and a new course, “Adventures in Entrepreneurship,” in which Owen students learn how to start a new venture by working directly with entrepreneurs. Prof. Böer also instituted a program that connected students holding graduate degrees in biology with local biotech companies so the students could learn about the business side of the industry while earning an MBA. He currently serves as an advisor to startup companies in the Nashville area and is a member of the editorial boards of Journal of Accounting and Public Policy, and Strategic Finance. He has provided consulting services for companies such as Chase Manhattan Bank, the National Heart and Lung Institute, General Electric, and Magnatek. Prof. Böer is the past recipient of two Owen teaching awards and in 1999 he was presented with the Most Outstanding Teacher Award by the graduating Executive MBA class. In 2003, the Tennessee District Office of the U.S.Small Business Administration named him Small Business Research Advocate of the Year. In addition to his academic service, Prof. Boer served as Interim Dean of the Owen School in 1986-87. Show Highlights: There's not one kind of person that's going to be a great entrepreneur. It takes all different kinds.Successful entrepreneurs have similar characteristics, such as attitude. How you look at the world.Entrepreneurs don't see problems. They see opportunities.A good entrepreneur has to be persistent because there are ups and downs.What you start with is not where you're going to end up.At the beginning, be real, real stingy.Write thank you notes to people; nobody does that anymore.Serial entrepreneurs start gathering investors long before they actually need the money. Germain's closing thoughts: Everybody has limitations. I've heard people say, “When I'm having a meeting with the top managers, I want to be the dumbest guy in the room.” And that's doesn't sound too smart, but it's actually very smart. Surround yourself with the right people as your company grows. You want to have a team that when you're not there, everything goes as it should. The Action Catalyst is a weekly podcast hosted by Dan Moore, President of Southwestern Advantage, the oldest direct-sales company in America, and Partner with Southwestern Consulting. With more than 45 years in sales leadership and marketing management, Dan has a wealth of knowledge to share on how to make better use of time to achieve life, sales, and other business goals. Each week, he interviews some of the nation's top thought leaders and experts, sharing meaningful tips and advice. Subscribe on iTunes and please leave a rating and review!

Circulation September 4, 2018 Issue

The Accad and Koka Report

Play Episode Listen Later Sep 4, 2018 21:44

Dr Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Current guidelines recommend measurement of one of the cardiac specific isoforms of cardiac troponin complex. However, what's the utility of combining measurements of troponins I and T in the early diagnosis of acute myocardial infarction? Well, you have to wait for our upcoming feature discussion, but it's coming right up after these summaries. The first original paper this week sheds light on the genetic basis and mechanisms of bicuspid aortic valve, the most common congenital heart defect in the population. We know that bicuspid aortic valve is an autosomal dominant trait with variable expression and incomplete penetrants suggestive of genetic and environmental modifiers. In the current study, first author Dr Gharibeh, corresponding author Dr Nemer from University of Ottawa, and authors of the Bicuspid Aortic Valve Consortium assessed cardiac structure and function in mice, lacking a GATA6 allele. They found that GATA6 heterozygous mice had a highly penetrant type of bicuspid aortic valve with right and left leaflet fusion, which is the most frequent type found in humans. GATA6 transcript levels were lower in human bicuspid aortic valve as compared to normal tricuspid valves. Mechanistically, GATA6 haploinsufficiency disrupted valve remodeling and extracellular matrix composition through dysregulation of the importance in the molecules including matrix metalloproteinase nine. Cell-specific inactivation of GATA6 reveal that an essential rule for GATA6 in secondary heart field myocytes. Thus, the study identifies a new cellular and molecular mechanism underlying bicuspid aortic valve. In the field of cardiac regeneration, c-Kit positive adult progenitor cells were initially reported to produce new cardiomyocytes in the heart. However, more recent genetic evidence suggests that such events are exceedingly rare. Today's paper provides insights into this discrepancy and it is from first author Dr Maliken, corresponding author, Dr Molkentin from Howard Hughes Medical Institute Cincinnati Children's Hospital Medical Center. The authors took a novel approach of deleting the necessary cardiogenic transcription factors, GATA4 and GATA6, from c-Kit expressing cardiac progenitor cells to determine whether true de novo cardiomyocyte formation would occur. They found that deletion of the necessary cardiogenic transcription factors, GATA4 and GATA6, from these c-Kit+ cardiac progenitor cells remarkably resulted in greater apparent cardiomyocyte derivation from the c-Kit+ cells. Deletion of GATA4 from c-Kit–derived endothelial progenitors altered the integrity of the endothelial cell network in the heart, resulting in greater c-Kit+–derived leukocytes entering the heart and fusing with cardiomyocytes. Thus, they demonstrated a new role for GATA4 in endothelial differentiation, specifically showing for the first time that GATA4 is essential for vascular development by the c-Kit lineage. The study shows that leukocyte to cardiomyocyte fusion is the primary basis for path lineage tracing results, incorrectly suggesting that c-Kit+ cardiac progenitor cells generated de novo cardiomyocytes in the heart. Lecithin–cholesterol acyltransferase, or LCAT, is the sole enzyme that esterifies cholesterol in the plasma. Its role in the supposed protection from atherogenesis remains unclear, because mutations in LCAT can cause more or less carotid atherosclerosis. Addressing this conundrum, co-first authors Drs. Oldoni and Baldassarre, co-corresponding authors Dr Kuivenhoven from University Medical Center Groningen, Dr Holleboom from Academic Medical Center Amsterdam, and Dr Calabresi from University of Milano in Italy hypothesized that genetic mutations causing complete LCAT deficiency versus partial LCAT deficiency would be differentially associated with carotid atherosclerosis in carriers of LCAT mutations. To study this, they looked at 74 heterozygotes for LCAT mutations who are recruited from Italy and the Netherlands and who were assigned to complete versus partial LCAT deficiency. These were also compared to 280 controls. Using carotid intima-media thickness as a measure of atherosclerosis, the authors demonstrated that carriers of LCAT mutations leading to complete LCAT deficiency exhibited less carotid atherosclerosis, indicating a reduced risk of cardiovascular disease. By contrast, however, carriers of LCAT mutations leading to partial LCAT deficiency showed marginally more atherosclerosis. The association of mutations in LCAT with subclinical atherosclerosis appeared to be related to the capacity of LCAT to esterify cholesterol on apoB-containing lipoproteins since the abnormal LCAT present in the partial deficiency was only active on this class of lipoproteins. These important findings bear relevance for pharmaceutical strategists that target LCAT. After a bioprosthesis aortic valve replacement, what is the incidence, correlates, and outcomes of hemodynamic valve deterioration? First author Dr Salaun, corresponding author Dr Pibarot from Quebec Heart and Lung Institute and their colleagues studied 1,387 patients who underwent bioprosthetic aortic valve replacement and found that hemodynamic valve deterioration identified by Doppler echocardiography occurred in one-third of patients and was associated with a 2.2-fold higher adjusted mortality. Diabetes and renal insufficiency were associated with early hemodynamic valve deterioration whereas female sex warfarin use and stented bioprosthetic valve versus the stentless ones were associated with late hemodynamic valve deterioration. These findings suggest that following bioprosthetic valve replacement, a systematic echocardiographic follow-up may be considered to ensure adequate detection and quantitation of hemodynamic valve deterioration. That wraps up on the summaries this week. Now for our feature discussion. We are recognizing the critical role that cardiac troponins play for the early diagnosis of acute myocardial infarction. We also know that there are different isoforms of cardiac troponins, the cardiac troponins T and I. Now, have you ever considered combining the two? How does that help the early diagnosis of acute myocardial infarction? Well, I am delighted to have with us the corresponding author of our feature paper today, Dr Christian Mueller from University Hospital Basel in Switzerland, a very familiar voice on this podcast. Welcome, Christian, and thank you so much for publishing yet another wonderful paper with us. Dr Christian Mueller: Thank you very much for highlighting this important work and allowing me to comment on it in the podcast. Dr Carolyn Lam: Christian, first of all, could you paint the background to help us understand what's the difference between the two isoforms, I mean, in terms of diurnal variation, the way that they may be released earlier or later, the way they may or may not be impacted by comorbidities like renal dysfunction or hemolysis? Could you help us understand why there may be rational to combine the two in looking at their impact on the diagnosis of acute myocardial infarction? Dr Christian Mueller: The measurement of cardiac troponin as a structural protein unique to the heart clear is a central piece in our early diagnosis of acute myocardial infarction, so both for the early rule out in patients who present with chest pain and are finally found to have more benign disease as well as the early ruling. In general, I think it's important to highlight that there are two isoforms exactly as you have mentioned, so there is cardiac troponin T and cardiac troponin I. So these two proteins are cardiac specific and are used in the diagnosis of acute myocardial infarction. Now with the development of high-sensitivity methods or measurements of both cardiac troponin T and cardiac troponin I concentrations, we have been able to get a little bit of a better understanding of in fact differences in the pathophysiology as well as analytical details between cardiac troponin T and I. Before I start highlighting the differences, I think it's important, I mean, both signals show a very strong correlation, so still very, very similar to each other. However, the small differences that have begun to emerge kind of allow to suggest that possible we could use them together as two pieces of information in the diagnosis. So, what are the differences? First, exactly as you have highlighted, that if in fact that diurnal rhythm with cardiac troponin T, which means that cardiac troponin T concentrations are higher in the morning hours as compared to the evening, we still have no clue why that's the case, but it's a relevant difference about 25% and it has been shown in two cohorts and a group from Maastricht who was the first one highlighting this. This rhythm has not been found for cardiac troponin I. The second difference is that, again, probably understood in many, many population studies cardiac troponin T concentrations are even stronger predictors of death as compared to cardiac troponin I concentration. Then the third difference it seems that if we measure it with high-sensitivity assays, for example high sensitivity, it seems to rise or if you released from injured cardiomyocytes even slightly earlier as compared to T and possibly even less injuries necessary to release I as compared to T. Then you mentioned renal function. Cardiac troponin T concentration shows slightly higher correlation with renal function as compared to I. Also, other pre-analytical issues, hemolysis seems to affect T and I concentration in a different way. So a lot of small tiny differences that have emerged and that underlie the hypothesis that possibly by combining the two signals we could be even more accurate in the diagnosis rather than relying on one on its own. Dr Carolyn Lam: That's good. That really sets up the rational very well. I think in and of itself is a learning lesson, because I think most clinicians sort of take the two equivalently. So could you tell us what you found? Dr Christian Mueller: I would like to of course thank the fantastic team that has allowed us to generate this data. It's a collaboration between the APACE investigators, the ADAPT investigators and experts in clinical chemistry from Maastricht University and Noreen Fandalin and Karen Villa of the first office. So we used two large diagnostic studies, APACE and ADAPT. We measured high-sensitivity cardiac troponin T and I and both of them and compared the diagnostic performance as compared to the final adjudicated diagnosis by two independent cardiologists who, of course, had all information, cardiac imaging and whatever you need to adjudicate. So, what we found is that in general if you look at diagnostic accuracy, overall is quantified by the area under the curve. Combining the two signals did not consistently increase overall diagnostic accuracy as compared to the individual isoforms. However, we were able to document some improvement for the rule out for the very early rule out of acute myocardial infarction. So the concept that is extremely attractive of course from a medical as well as from an economic perspective is to rule out the presence of acute myocardial infarction with a single blood draw. So, we can do this if we assess the ECG. The ECG doesn't show relevant changes. Then if the troponin concentration measured with a high-sensitivity assay is very low, then the likelihood that the patient would have an acute myocardial infarction again is extremely low or in scientific term sort of a negative predictive value approach is 99 to 100%. By combining very low concentration for high-sensitivity T and very low concentration for I, we were able to increase the efficacy of the early rule out and that seemed to be the most likely possible clinical utility of combining the two signals. Dr Carolyn Lam: Even that so-called neutral findings are very important. It's an important question to ask and important answer to get. Could you give us an idea for the rule-out part? How much do we gain? How much exactly do we gain by using both assays instead of just one? Dr Christian Mueller: So, the efficacy of the early rule-out depends to some extent on the assay used and the cut off applied. So the current you see algorithm uses cut-off that has been shown to be very safe. However, they are regarding their efficacy not very high. So the current you see recommended cut-offs and approach, allows the rule-out only in about perhaps 10 or 15% of patients. That number can be significantly increased, likely doubled or perhaps even increased threefold by using the combination approach. So this has been consistently showed both in the derivation and the validation cohort. Dr Carolyn Lam: Yeah. Do you think this is ready for prime time? I noticed a very balanced discussion actually calling for future studies, but perhaps you could state it better now. Dr Christian Mueller: The main limitation regarding prime time is the fact that currently manufacturers either of a high-sensitivity TSA or of a high-sensitivity high method, which means that the vast majority of hospitals at this point in time do only have one method available. It would require quite substantial investment in both hardware as well as changing of the logistics in the lab to implement measurement of both assays. So I think it's likely feasible, but it would be associated with relevant investment from a hospital perspective. In addition, I mean, also the rule-out approaches that use of only one assay also there are studies ongoing in trying to further increase the efficacy of the single marker approach. So I think it's the best tool marker strategy that we were able to come up with recently, because many of the other biomarkers that we had tested really didn't work out. Still, as you mentioned, I think it's also important to be very, very honest that it will be difficult to implement tomorrow in most institutions. Dr Carolyn Lam: Yeah, and perhaps a little bit more work needs to be done to sort first identify perhaps special situations where these may be particularly helpful. I supposed like you just said when we're thinking of the ESCs to review one-hour type algorithm, who knows maybe we should be having that extra insurance of the second test in those that test it negative in the first or something like that. Do you plan further work? I always ask you because you're always in the forefront of these things and we just love touching your work. Dr Christian Mueller: We have several additional analyses ongoing. Again, I think the main part is for just to go ... I go back from a clinical perspective. So I think for many hospitals that are using T at the moment, it's important to have I available for certain situations. So for example if you have a patient in whom you have evidence of chronic skeletal muscle disease, most of these disorders are rare but some of them have been shown to be associated with increasingly highly troponin T that do not seemed to be related for cardiac diseases but from skeletal muscle. This is rare but if you have a patient with that kind of history, then the dual mark measurement is I think mandatory. The same applies to iso that the other reasons to have false positive results for iso whenever you are ... If your hospital is using I, you should have the T method also available because once in a while you will identify patients in whom you have an I result that doesn't really match the clinical setting, then it's so easy and often so helpful to get the T result to decide on the most appropriate measurement of patient. For which patients are kind of a standard that measures T and I would be justified, I think that's something to tease out in future study. I think that the rational is there and likely it will depend also on kind of which T or which I method we might use in the future. So at the moment, we have one method for high-sensitivity T, but there are several other methods in development and kind of applying for FDA approval for high-sensitivity I and possibly combination of these might be even more beneficial regarding the single measurements and I think that has to be teased out in future studies. Dr Carolyn Lam: Exactly, but what great insights for us to consider as clinicians now for specific cases where we may consider find those if we have those in our institutions. At the end of the day, I supposed cost-effectiveness analysis will need to be done. Agree? Dr Christian Mueller: Absolutely, absolutely. The good thing about troponin, it's extremely inexpensive. So as compared to most of the new fancy biomarkers that are usually, rather prices of troponin is a routine marker. It's inexpensive. It's there for very likely that if we are able to document some clinical value that also the cost-effectiveness study that's definitely unnecessary will show also some economic benefit. Dr Carolyn Lam: Oh, Christian, thank you for publishing yet another impactful and clinically relevant paper with us here in Circulation. I mean, it's exactly the kinds of papers that we really treasure here, because they directly inform clinicians and open our eyes to actually things that we should be considering in our everyday practice. Clod I ask you maybe cheekily to share about your experience with publishing at Circulation? Someone like you will be the best person to tell the world what it's like. Dr Christian Mueller: Oh, of course. I mean, for us as a research group and for me as a researcher, it's fantastic. It's perfect to have some of our work published in Circulation that has fantastic impact factor, fantastic readership and ensures that the research catch the attention that's fantastic. Also, I think for us as a research group, the recognition of being able to publish in Circulation is outstanding and it helps us continue in the research group that we do. The comments made to large extent also by the editors. Also, on this manuscript, I think we're incredibly insightful and definitely had a major contribution to the final product to make it as attractive and also as balanced and insightful I think as it is at this point in time. Dr Carolyn Lam: Thank you so much for providing that feedback, because it is our aim, explicit aim to put a partner authors in getting the best of the manuscript and working really closely with you. So thank you once again, Christian, for your time today. Audience, I know you've heard many times from this favorite person that we have on our podcast. Do share this podcast with all your colleagues and don't forget to tune in again next week.

university italy current run netherlands addressing singapore switzerland audience fda diabetes ottawa adapt drs milano tsa cardiac circulation maastricht ecg doppler deletion maastricht university apob nemer calabresi lung institute duke national university escs lecithin carolyn lam university medical center groningen

Ep. 2 Francis and Accad on EBM

Play Episode Listen Later Apr 22, 2018 57:46

We have a fun chat with Professor Darrel Francis, from Imperial College in London and the UK’s National Heart and Lung Institute. Dr. Francis takes the “pro” side and Michel the “con” side in regards to evidence-based medicine. GUEST: Darrel Francis’ https://twitter.com/ProfDFrancis?lang=en (Twitter handle) and https://www.imperial.ac.uk/people/d.francis (website) WATCH ON YOUTUBE: https://youtu.be/mpckHx2i61Q (Watch the episode) on our YouTube channel Support this podcast

uk imperial college national heart lung institute accad

202: Dr. Steven Gundry - The Plant Paradox • What Are Lectins? • Fruit Might As Well Be Candy

The Ultimate Health Podcast

Play Episode Listen Later Dec 5, 2017 55:22

Dr. Steven Gundry has worked in medicine for over 40 years and is probably best known for my work as a cardiologist and heart surgeon. He now teaches people how to avoid surgery by using his unique vision of human nutrition. Dr. Gundry is the director of the International Heart and Lung Institute and he's the founder and director of the Center for Restorative Medicine. Dr. Gundry is the author of two books and over three hundred articles published in peer-reviewed journals. His latest book is titled The Plant Paradox and is the focus of today's show. In this episode, we discuss: Dr. Gundry was eating "healthy" and exercising daily but his health was falling apart The war that goes on between plants and animals What are lectins? Lectins are one of fundamental causes of autoimmune disease Reversing vitiligo by following The Plant Paradox program Quinoa, squash, cucumbers, and pumpkin aren't healthy foods The microbiome-immune system connection Lectins are found primarily in the peels and seeds Half the world's production of Tums (calcium carbonate) is mixed into cattle food so they keep eating Pressure cookers destroy all lectins minus gluten Stop eating brown rice Should you keep some gluten in your diet? Are grains & beans making you gain weight? Lectins can appear in the flesh of animals Animal protein ages us Why wild seafood gets two thumbs up Shrimp and crabs are not bottom feeders Fruit might as well be candy You weren't designed to eat grains, beans, nightshades, peanuts, cashews, and chia seeds Show sponsors: Sunwarrior

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The Plant Paradox: Are Lectins Really That Harmful Or Is Dr. Steven Gundry Wrong?

Ben Greenfield Life

Play Episode Listen Later Sep 2, 2017 61:57

https://bengreenfieldfitness.com/gundry Grains of all kinds, especially whole grain wheat. Corn. Tomatoes. Potatoes. Beans and legumes, particularly soy. Just about all nuts, especially cashews and peanuts. Zucchini, bell peppers, eggplant and pickles. And yes, even our dear friend the avocado. Each of these foods has one thing in common - a food component that today's podcast guest, , claims may responsible for some of the world's most pressing health issues, from obesity to heart disease. In Dr. Gundry's new book , he highlights exactly what that foood component is. Dr. Gundry is a renowned cardiologist, New York Times best-selling author and medical researcher. During his 40-year career in medicine, he has performed over 10,000 heart surgeries and developed multiple life-saving medical technologies, including patenting nine cardiac surgery devices. He is a cum laude graduate of Yale University with special honors in Human Biological and Social Evolution. After graduating Alpha Omega Alpha from the Medical College of Georgia School of Medicine, Dr. Gundry completed residencies in General Surgery and Thoracic Surgery at the University of Michigan and served as a Clinical Associate at the National Institutes of Health. There, he invented devices that reverse the cell death seen in acute heart attacks; variations of these devices subsequently became the Gundry™ Retrograde Cardioplegia Cannula. It has become the world’s most widely used device of its kind to protect the heart from damage during open-heart surgery. After completing a fellowship in congenital heart surgery at The Hospital for Sick Children, Great Ormond Street, in London, Dr. Gundry was recruited as Professor and Chairman of Cardiothoracic Surgery at Loma Linda University Medical Center. There, he and his partner, Leonard Bailey, pioneered infant and pediatric heart transplantation. Together, they have performed more such transplants than any other surgeons in the world. During his tenure at Loma Linda, Dr. Gundry pioneered the field of xenotransplantation, the study of how the genes of one species react to the transplanted heart of a foreign species. He was one of the original twenty investigators of the first FDA-approved implantable left ventricular assist device (a kind of artificial heart). Dr. Gundry is also the inventor of the Gundry Ministernomy, the widely used minimally invasive approach to aortic- or mitral-valve repair, the Gundry Lateral Tunnel, a “living” tissue that can rebuild parts of the heart in children with severe congenital heart malformations; and the Skoosh™ venous cannula, the most widely used cannula in minimally invasive heart operations. One of the fathers of robotic surgery, as a consultant to Computer Motion (now Intuitive Surgical), Dr. Gundry received early FDA approval to use robotic-assisted minimally invasive surgery for coronary artery-bypass and mitral-valve operations. He holds patents on devices for connecting blood vessels and coronary artery bypasses without sutures, as well as for repairing the mitral valve without the need for sutures or a heart-lung machine. He has served on the Board of Directors of the American Society of Artificial Internal Organs (ASIAO), and was a founding board member and treasurer of the International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS). He recently completed two successive elected terms as President of the Board of Directors of the American Heart Association, Desert Division. Dr. Gundry has been elected a Fellow of the American College of Surgeons, the American College of Cardiology, the American Surgical Association, the American Academy of Pediatrics, and the College of Chest Physicians. He is a member of numerous other surgical and medical societies. He is also the author of more than three hundred articles, chapters, and abstracts in peer-reviewed journals on surgical, immunology, genetic, nutrition, and lipid investigations. He has operated in more than thirty countries, including charitable missions to China, India, and Zimbabwe. Inspired by the stunning reversal of coronary artery disease in an “inoperable” patient, using a combination of dietary changes and nutriceutical supplements, in 2001, Dr. Gundry changed the path of his career. An obese, chronic “diet” failure himself, he adapted his undergraduate Yale University thesis to design a diet based on evolutionary genetic coding, which enabled him to reverse his own medical problems. In the process, he effortlessly lost 70 pounds. The equally astonishing results from following what he came to call Diet Evolution in several of his staff led Dr. Gundry to accept a position in Palm Springs where he could devote his efforts to disease reversal. No longer satisfied with repairing the damage of chronic diseases, since 2002, Dr. Gundry founded and has served as Medical Director of The International Heart and Lung Institute in Palm Springs, California, which serves patients referred from across the nation. He is also Founder and Director of The Center for Restorative Medicine, part of the Institute. Its mission is to prevent and reverse the chronic diseases of “ageing” with diet and nutriceutical interventions, using surgical intervention for heart and vascular disease as a last resort. During today's discussion with Dr. Gundry, you'll discover: -What exactly a lectin is, and why plants have them...[6:56] -What happens to the gut upon consumption of lectins, and whether there's any research behind it...[9:25 ] -The common (and uncommon) sources of lectins that most people eat...[20:35] -How a lectin is different than gluten...[21:35 & 30:10] -Whether our ancestors ate plants and lectins...[31:10 & 44:50] -Why Steven is such a fan of eating fruit that’s in season, or fruit that is unripened...[36:45] -Why Steven thinks it is that so many of the Blue Zones in Dan Buettner's longevity book had a propensity for eating legumes, yet still lived long...[48:45] -Simple hacks you can use to reduce lectins in common foods like tomatoes, peppers, potatoes, apple, rice, etc...[39:55, 43:25 & 55:50] -And much more! Resources from this episode: Show Sponsors: -Atrantil - Go to and use the code Ben for 15% off. -Rover - The nation's largest network of 5-star pet-sitters. Go to and use promo code "BEN" to get $25 off. -HealthIQ - To learn more about life insurance for physically active people and get a free quote, go to . -Qualia - Go to to fine tune your brain for cognitive fitness. Do you have questions, thoughts or feedback for Dr. Gundry or me? Leave your comments at and one of us will reply!

director university california founders health president china college new york times professor michigan simple board medicine institute hospitals plant fellow fda paradoxes national institutes corn yale university zimbabwe surgeons beans american academy palm springs medical director american society american colleges tomatoes pediatrics potatoes harmful international society american heart association cardiology grains blue zones medical college zucchini dan buettner gundry general surgery sick children qualia loma linda georgia school plant paradox lectins alpha omega alpha intuitive surgical cardiothoracic surgery thoracic surgery social evolution restorative medicine chest physicians lung institute leonard bailey great ormond street clinical associate diet evolution american surgical association

Circulation August 15, 2017 Issue

health blood sleep heart national institutes human services us department good night's sleep lung institute

Play Episode Listen Later Aug 14, 2017 18:46

Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr. Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Our podcast today highlights an important perspective piece on charting a future together and turning discovery science into cardiovascular health. You don't want to miss this, coming up right after these summaries. The first original paper tells us about the importance of changes in exercise capacity following transcatheter aortic valve replacement or TAVR. First author, Dr. Altisent, corresponding author, Dr. Rodés-Cabau, and colleagues from Quebec Heart and Lung Institute in Canada studied a total of 305 patients undergoing TAVR with baseline and six month followup exercise capacity assessments by six minute walk tests. They found that close to one-third of patients undergoing TAVR failed to improve their exercise capacity despite an optimal hemodynamic result post-procedure. Factors associated with a lesser exercise capacity improvement included patient characteristics such as older age, female sex, non-cardiac comorbidities, such as chronic obstructive lung disease, peripheral artery disease and bleeding episodes resulting in reduced hemoglobin levels. Importantly, the absence of an improvement in physical performance at six months post-TAVR was an independent predictor of mortality and adverse cardiovascular outcomes during the ensuing four years and particularly among patients with a greater impairment of exercise capacity pre-TAVR. Thus, implementing exercise capacity assessment pre and post-TAVR may help to improve patient risk stratification and augment the accuracy of the prognostic information given to patients, helping to identify those requiring more intensive followup assessment. The next study provides mechanistic insights into the adverse health outcomes associated with particulate matter exposure in the air. First author, Dr. Lee, corresponding author, Dr. Kahn, from Fudan University in Shanghai, China and colleagues conducted a randomized double-blind crossover trial in 55 healthy college students in Shanghai. Real and sham air purifiers were placed in participant's dormitories in random orders for nine days with a 12 day washout period. Serum metabolites were quantified using gas chromatography mass spec and ultra-high performance liquid chromatography mass spec. They found that higher particulate matter exposure led to a significant increase in cortisol, cortisone, epinephrine and norepinephrine. Between treatment, differences were also observed for glucose, amino acids, fatty acids and lipids. They also found that higher blood pressure, hormones, insulin resistance and biomarkers of oxidative stress and inflammation were present among individuals with higher exposure to particulate matter. Thus, this study showed that activation of the hypothalamus-pituitary-adrenal and sympathetic-adrenal medullary axis may contribute to the adverse cardiovascular and metabolic effects of particulate matter exposure in the air. In China, indoor air purification may be a practical way to reduce personal exposure to particulate matter. The next study shows that N-acetylcysteine may be new effective thrombolytic treatment. First author, Dr. Lizarrondo, corresponding author, Dr. Gauberti and colleagues from Inserm, France hypothesized that N-acetylcysteine might cleave the von Willebrand factor multimers inside occlusive thrombi, thereby leading to their disillusion and arterial recanalization. To test this hypothesis, the authors used experimental models of thrombotic stroke induced by either intra-arterial thrombin injection or ferric chloride application followed by measurement of cerebral blood flow using a combination of Laser Doppler Flowmetry and magnetic resonance imaging. They showed that intravenous and acetylcysteine administration promoted lysis of arterial thrombi that were resistant to conventional approaches such as recombinant TPA, direct thrombin inhibitors and anti-platelet treatments. Furthermore, through in vitro and in vivo experiments, they provided evidence that the molecular target underlying the thrombolytic effects of N-acetylcysteine were principally the von Willebrand factor that crosslinked platelets in arterial thrombi. Co-administration of N-acetylcysteine and a non-peptidic GP2B3A inhibitor further improved its thrombolytic efficacy essentially by accelerating thrombus disillusion and preventing rethrombosis. In a new large vessel thromboembolic stroke model in mice, this co-treatment significantly improved ischemic lesion size and neurological outcomes. Importantly, N-acetylcysteine did not worsen hemorrhagic stroke outcome suggesting that exerted thrombolytic effects without significantly impairing normal hemostasis. Thus, in summary, N-acetylcysteine was shown to be an effective and safe alternative to currently available anti-thrombotic agents to restore vessel patency after arterial occlusion. The clinical implications of the study are wide reaching considering the very wide availability, low cost and apparent safety of N-acetylcysteine. This is discussed in an accompanying editorial by Dr. Lillicrap from Queens University, Kingston, Canada. The final study identifies a novel mechanism for regulation of cardiac fibrosis that revolves around plasminogen activator inhibitor type 1 or PAI-1. First, author, Dr. Flevaris, corresponding author, Dr. Vaughan and colleagues of Northwestern University, Feinberg School of Medicine in Chicago, Illinois showed that cardiac fibrosis was detected by late gadolinium enhancement cardiac MRI in two otherwise healthy humans with complete PAI-1 deficiency due to a homozygous frameshift mutation in serpene 1. They further performed a series of mouse experiments to show that treatment of young PAI-1 deficient mice with angiotensin 2 induced extensive hypertrophy and fibrotic cardiomyopathy. Ventricular myocytes were found to be the important source of cardiac transforming growth factor beta or TGF beta and PAI-1 regulated TGF beta synthesis by cardiomyocytes in vitro as well as in vivo during cardiac injury. PAI-1 deficiency significantly enhanced multiple TGF beta signaling elements and transcriptional targets. Thus, in summary, this study show that PAI-1 is an essential repressor or cardiac fibrosis and access a molecular switch that controls the cardiac TGF beta access and its early transcriptional effects that lead to myocardial fibrosis. Modulation of the cardiomyocytes TGF beta access represents a unique therapeutic strategy that may abrogate fibrotic signaling and cardiac fibrosis. Well, that wraps it up for your summaries. Now for our featured discussion. We are incredibly privileged today to have the director of the National Heart, Lung and Blood Institute, Dr. Gary Gibbonss with us on the podcast, as he talks about his perspective piece entitled "Charting Our Future Together: Turning Discovery Science into Cardiovascular Health." Also, joining me today is our editor in chief, Dr. Joseph Hill from UT Southwestern. Joe, I know you share my incredible excitement and enthusiasm at having Dr. Gibbonss on this podcast with us. Maybe could I invite you to say a few words to frame just how important this perspective piece is for Circulation? Dr. Joseph Hill: We all know that cardiovascular medicine and science are evolving at an unprecedented pace. The challenges we face are evolving and yet the opportunities and the tools and the resources at our disposal are unprecedented in their scope and vision. We're very pleased that Gary has provided strong leadership at NHLBI now for several years and has laid out in this perspective piece here where he thinks the next steps are specifically around this strategic vision that focuses on precision medicine and data science. I would love to hear Gary provide additional perspective on that vision. Dr. Gary Gibbons: Well, thank you, Joe. As the director of NHLBI, clearly we're public servants and we're accountable stewards of the nation's investment in heart, lung and blood and sleep disorders. This piece gave us an opportunity to outline some of the opportunities that lay ahead in a strategic visioning process. First, I should note that a key part of the legacy of the NHLBI is to make strategic investment with enduring principles in mind to really support investigator initiated discovery science as really the core foundational element of our research portfolio, as well as to maintain a balance portfolio to really expands to spectrum of basic translation clinical population and implementation science. In this piece, we particularly want to highlight our strategic visioning process in which we encourage the broad input of the NHLBI community that actually included over 4,000 participants in this process from every state in the country. Indeed, 42 countries around the world to provide the most compelling questions and critical challenges that the field faces around strategic goals of understanding normal human biology, reducing disease, accelerating translation and preparing a biomedical workforce and resources for the discovery science of the 21st century. Out of that strategic vision, we focus in on two elements that emerged that relate it to precision medicine and data science for this piece and really that was the central core of what we wanted to share with the Circulation readership about how these two areas we think are going to be transformative in the years ahead. Dr. Carolyn Lam: Dr. Gibbons, you know, when the term precision medicine is used, sometimes it's a bit fuzzy I think in the minds of a lot of people. Could you maybe give a few examples or perhaps a specific idea that comes to mind? Dr. Gary Gibbons: You're right. There's often a lot said about it than probably a bit of hype about it. In some ways you could see this as a legacy of cardiovascular medicine and science. It could be argued that the definition of cardiovascular risk factors that came out of the Framingham Heart Study many years ago was the first sort of forerunner of precision medicine. It helped us indeed define those individuals who are at the greatest risk of having a heart attack and that to this day has played a role in directing targeted preventive treatments of the highest risk individuals in order to prevent heart attacks. That has continued to evolve. I think what's new now is that we have, as Dr. Hill mentioned, new modalities of both imaging and analytics of computational science, as well as novel biomarkers and genetic markers that can help us be even more precise in that risk assessment. That's really I think the greater opportunity to further subcategorize patient populations to get the right drug to the right patient at the right time with a more strategic treatment approach. Dr. Joseph Hill: Gary, that's very exciting. I think your vision is absolutely compelling. I like how you categorize the NHLBI as a catalyst for the future. I'd like to think that the Biomedical Journals, the AHA Portfolio of Journals and Circulation are also catalysts that will partner with NHLBI and other entities to chart the course for the future. That again the challenges that we face now are different than they were back in the era when Framingham first got started after World War II. The tools that we have are also evolving rapidly and certainly our perspective from Circulation is that we are stewards of helping chart that course, helping identify and bring forth the best science around the world. In many ways we look to you as a partner. Dr. Gary Gibbons: Oh, absolutely. The NHLBI really can't fulfill our mission of turning discovery science into the health of the nation and indeed around the world without a circle of partners and that certainly includes the platforms of disseminating new knowledge like Circulation, as well as partner organizations such as American Heart Association. We definitely appreciate the value that your organ brings to really enhancing our efforts to not only take discovery science, but make that knowledge available to practitioners and researchers and patients. I think a key part of the 21st century is how we not only can discover and generate new knowledge, but how we can facilitate that movement of data to knowledge and from knowledge to action that actually enhances the lives of patients in the real world context. Again I believe your journal plays an important role in helping to do that. Dr. Carolyn Lam: You both mentioned critical challenges that we're facing and will face. The Chinese for these challenges or crisis, the word is actually wéijī. Okay? Wéi is actually meaning danger, whereas jī is for jīhuey which is opportunity. In every challenge, there's always this new opportunity and I just really would like to ask what are the greatest challenge and perhaps the greatest opportunity? Dr. Gary Gibbons: I think the challenge that we probably face is the emerging epidemic of non-communicable diseases typically cardiovascular disease throughout the world. Not only in the most industrialized nations, but indeed mainly the developing nations. This will quickly surpass communicable infectious diseases as the major burden and causes of mortality worldwide. We're dealing with a global challenge. Increasingly, we recognize that scientific discovery and analysis is often siloed in various packets. Our vision for the future is really to promote the creation of a global reach of what we're calling a Data Commons. That is that a disease has no borders. Science should not be limited to national states. It is part of the commonwealth if you will of information and knowledge that really should transcend national borders. We say this is a global community of data and information and knowledge exchange and collaboration. As part of this global community, it's that we think this diverse and inclusive approach will be critical to the best minds and best practitioners of the world learning from each other and contributing to this commonwealth of knowledge. We're excited because the opportunity on the other side of that challenge is that it's an unprecedented capability of power to communicate now. We I think are communicating with you from Singapore and we're in a digital age in which this notion of communication and knowledge exchange should be more fast than it's ever been before. Indeed, we can create computer platforms that are similar to what exist for a Facebook or a Google that are global in scope. The vision is really to say what would happen if we could turn that toward biomedicine and make biomedicine part of this data science such that we have global contributions to our understanding, knowledge exchange and really create that sort of global sandbox if you will of knowledge exchange and discovery. That's part of this notion of creating a Data Commons and really advancing data science as an element of a strategic vision. As we move forward with precision medicine and data science, our most sacrosanct stewardship is for the next generations. A critical element is to ensure that we're providing them with the tools and training to really lead the charge of advancing these exciting areas of science and that indeed will be a global enterprise. Dr. Joseph Hill: That's very exciting, Gary. I take my hat off to you for the leadership that you have maintained at the NHLBI during these times that are once very challenging and at the same time exhilarating. I look forward to working with you through our journal and partnering with you to bring to fruition much of what you had laid out in your vision. Dr. Gary Gibbons: Thank you, Joe. We look forward to our ongoing partnership. Dr. Carolyn Lam: Thank you, listeners, for joining us today. Do join us again next week.

Pod #250: EFT For A Good Night's Sleep

Tapping Q & A Podcast

Play Episode Listen Later Dec 21, 2016 11:47

On some level we know that getting a good night’s sleep is important. I know the quality of my sleep impacts how I handle each day. But did you know: Sleep plays a vital role in good health and well-being throughout your life. Getting enough quality sleep at the right times can help protect your mental health, physical health, quality of life, and safety. The way you feel while you're awake depends in part on what happens while you're sleeping. During sleep, your body is working to support healthy brain function and maintain your physical health. In children and teens, sleep also helps support growth and development. The damage from sleep deficiency can occur in an instant (such as a car crash), or it can harm you over time. For example, ongoing sleep deficiency can raise your risk for some chronic health problems. It also can affect how well you think, react, work, learn, and get along with others. That is a direct quote from Heart, Blood, and Lung Institute at the National Institute of Health which is run by the US Department of Health and Human Services. Here is an updated version of the tapping I do before I go to bed to ensure a good night’s sleep. I have included both an audio and text version of the script (below).

Circulation December 6, 2016 Issue