Ellen Kamhi, PhD RN, The Natural Nurse, Leaky Gut is also called Compromised Intestinal Permeability, due to loss of integrity of the tight junctions between cells in the intestinal mucosa, and is well documented in the scientific literature. See my document Role of Intestinal Permeability in the Inflammatory Process. This condition should be addressed by all health care providers.
Human nutrition, gut microbiome and immune system S'eclairer
Dr Zahida Chaudnary talks with the students about nutrition, gut microbiomes, and nutrition as we look at diseases and how your body reacts to what you eat.
Check out the slideshow by itself here.
Want an audio version? Subscribe to our Podcast on iTunes!
Want to join us for the live discussion? Check out our Social Media in the noon hour every Monday as we sit down on Google Hangout OnAir! Follow us on Twitter, Facebook, or Google+ to get updated with the link when we start!
Microbiota, leaky gut syndrome and gut-related diseasesMaurizio Salamone
Lecture on "Microbiota, Leaky gut Syndrome and gut-related disease" at the 7° International workshop on Immunonutrition "Eating for preventing" Carovigno (BA) May 1st-3th 2014
Renée Wilson, Registered Dietitian and PhD Candidate at University of Otago, New Zealand. Presented at the 1st International Symposium on Kiwifruit and Health: http://www.kiwifruitsymposium.org/presentations/diet-microbiota-and-metabolic-health/
This cross-sectional pilot study aims to determine whether or not there are any differences between the gut microbiota of people with normal glucose tolerance, pre-diabetes and type 2 diabetes.
Presentation given at Eva Perry Library about the emerging information on the microbiome. Key highlights include definition of the microbiome, affect of microbiome on health, how to maintain a healthy/balanced microbiome.
The Leaky Gut Syndrome is a rapidly growing condition
Millions of people are struggling with and don’t even know it
We might think leaky gut syndrome only affects the digestive system, but in reality it can lead to many other health conditions
Food allergies, low energy, joint pain, thyroid disease, autoimmune conditions and slow metabolism could be leaky gut symptoms
The Gut-Brain Connection: An Inside Look at DepressionAugustin Bralley
During a recent Metametrix sponsored breakfast at the IFM Symposium in Hollywood, Florida, Dr. Todd LePine gave a compelling presentation entitled The Gut-Brain Connection: An Inside Look at Depression.
Human nutrition, gut microbiome and immune system S'eclairer
Dr Zahida Chaudnary talks with the students about nutrition, gut microbiomes, and nutrition as we look at diseases and how your body reacts to what you eat.
Check out the slideshow by itself here.
Want an audio version? Subscribe to our Podcast on iTunes!
Want to join us for the live discussion? Check out our Social Media in the noon hour every Monday as we sit down on Google Hangout OnAir! Follow us on Twitter, Facebook, or Google+ to get updated with the link when we start!
Microbiota, leaky gut syndrome and gut-related diseasesMaurizio Salamone
Lecture on "Microbiota, Leaky gut Syndrome and gut-related disease" at the 7° International workshop on Immunonutrition "Eating for preventing" Carovigno (BA) May 1st-3th 2014
Renée Wilson, Registered Dietitian and PhD Candidate at University of Otago, New Zealand. Presented at the 1st International Symposium on Kiwifruit and Health: http://www.kiwifruitsymposium.org/presentations/diet-microbiota-and-metabolic-health/
This cross-sectional pilot study aims to determine whether or not there are any differences between the gut microbiota of people with normal glucose tolerance, pre-diabetes and type 2 diabetes.
Presentation given at Eva Perry Library about the emerging information on the microbiome. Key highlights include definition of the microbiome, affect of microbiome on health, how to maintain a healthy/balanced microbiome.
The Leaky Gut Syndrome is a rapidly growing condition
Millions of people are struggling with and don’t even know it
We might think leaky gut syndrome only affects the digestive system, but in reality it can lead to many other health conditions
Food allergies, low energy, joint pain, thyroid disease, autoimmune conditions and slow metabolism could be leaky gut symptoms
The Gut-Brain Connection: An Inside Look at DepressionAugustin Bralley
During a recent Metametrix sponsored breakfast at the IFM Symposium in Hollywood, Florida, Dr. Todd LePine gave a compelling presentation entitled The Gut-Brain Connection: An Inside Look at Depression.
covers Introduction.
History of probiotics.
General characteristics of probiotics.
Why are probiotics important to human health?
Some probiotics strains.
Mechanism of action
Advantages of host and type of advantages.
Classification of probiotics and examples.
Probiotics but not antibiotics, explanation with AAD.
Some probiotic food.
Probiotics and cancer.
Disadvantages of probiotics
Status of probiotics in india
India and global probiotics manufactures.
The low FODMAP diet for irritable bowel syndrome: from evidence to practice Robin Allen
At the end of this session, participants will
be able to:
– Describe the mechanisms of action and
evidence for the use of the low FODMAP diet
in patients with irritable bowel syndrome
– Be familiar with the concepts of the 3 phases
for implementing the low FODMAP diet
– Discuss ways in which the diet could be
modified to suit the needs of the individual
VHIR Seminar led by Joel Doré. Research Director. Institut National de la Recherche Agronomique (INRA). Jouy-en-Josas, France.
Abstract: The human intestinal tract harbours a complex microbial ecosystem which plays a key role in nutrition and health. Interactions between food constituents, microbes and the host organism derive from a long co-evolution that resulted in a mutualistic association.
Current investigations into the human faecal metagenome are delivering an extensive gene repertoire representative of functional potentials of the human intestinal microbiota. The most redundant genomic traits of the human intestinal microbiota are identified and thereby its functional balance. These observation point towards the existence of enterotypes, i.e. microbiota sharing specific traits but yet independent of geographic origin, age, sex etc.. It also shows a unique segregation of the human population into individuals with low versus high gene-counts. In the end, it not only gives an unprecedented view of the intestinal microbiota, but it also significantly expands our ability to look for specificities of the microbiota associated with human diseases and to ultimately validate microbial signatures of prognostic and diagnostic value in immune mediated diseases.
Metagenomics of the human intestinal tract was applied to specifically compare obese versus lean individuals as well as to explore the dynamic changes associated with a severe calory-restricted diet. Microbiota structure differs with body-mass index and a limited set of marker species may be used as diagnostic model with a >85% predictive value. Among obese subjects; the overall phenotypic characteristics are worse in individuals with low gene counts microbiota, including a worse evolution of morphometric parameters over a period of 10 years, a low grade inflammatory context also associated with insulin-resistance, and the worst response to dietary constraints in terms of weight loss or improvement of biological and inflammatory characteristics. Low gene count microbiota is also associated with less favourable conditions in inflammatory bowel disease, such as higher relapse rate in ulcerative colitis patients.
Finally, microbiota transplantation has seen a regain of interest with applications expanding from Clostridium difficile infections to immune mediated and metabolic diseases.
The human intestinal microbiota should hence be regarded as a true organ, amenable to rationally designed modulation for human health.
Assist other natural antimicrobial agents
Cardiovascular diseases
Assist the liver in the detoxification process
Bolster the immune system.
Decrease the incidence and duration of diarrhea
Enable better growth development in children.
Lower blood pressure
Have anti-carcinogenic, anti-mutagenic, and anti-allergic activities.
Help prevent osteoporosis.
Help prevent colon cancer
Improve digestion and balance cholesterol metabolism.
Increase nutritional value of foods through better digestibility and an increased absorption of
nutrients.
Manufacture lactase, which promotes intestinal lactose digestion.
Prevent and reduce intestinal tract infections
Promote a feeling of well-being.
12
covers Introduction.
History of probiotics.
General characteristics of probiotics.
Why are probiotics important to human health?
Some probiotics strains.
Mechanism of action
Advantages of host and type of advantages.
Classification of probiotics and examples.
Probiotics but not antibiotics, explanation with AAD.
Some probiotic food.
Probiotics and cancer.
Disadvantages of probiotics
Status of probiotics in india
India and global probiotics manufactures.
The low FODMAP diet for irritable bowel syndrome: from evidence to practice Robin Allen
At the end of this session, participants will
be able to:
– Describe the mechanisms of action and
evidence for the use of the low FODMAP diet
in patients with irritable bowel syndrome
– Be familiar with the concepts of the 3 phases
for implementing the low FODMAP diet
– Discuss ways in which the diet could be
modified to suit the needs of the individual
VHIR Seminar led by Joel Doré. Research Director. Institut National de la Recherche Agronomique (INRA). Jouy-en-Josas, France.
Abstract: The human intestinal tract harbours a complex microbial ecosystem which plays a key role in nutrition and health. Interactions between food constituents, microbes and the host organism derive from a long co-evolution that resulted in a mutualistic association.
Current investigations into the human faecal metagenome are delivering an extensive gene repertoire representative of functional potentials of the human intestinal microbiota. The most redundant genomic traits of the human intestinal microbiota are identified and thereby its functional balance. These observation point towards the existence of enterotypes, i.e. microbiota sharing specific traits but yet independent of geographic origin, age, sex etc.. It also shows a unique segregation of the human population into individuals with low versus high gene-counts. In the end, it not only gives an unprecedented view of the intestinal microbiota, but it also significantly expands our ability to look for specificities of the microbiota associated with human diseases and to ultimately validate microbial signatures of prognostic and diagnostic value in immune mediated diseases.
Metagenomics of the human intestinal tract was applied to specifically compare obese versus lean individuals as well as to explore the dynamic changes associated with a severe calory-restricted diet. Microbiota structure differs with body-mass index and a limited set of marker species may be used as diagnostic model with a >85% predictive value. Among obese subjects; the overall phenotypic characteristics are worse in individuals with low gene counts microbiota, including a worse evolution of morphometric parameters over a period of 10 years, a low grade inflammatory context also associated with insulin-resistance, and the worst response to dietary constraints in terms of weight loss or improvement of biological and inflammatory characteristics. Low gene count microbiota is also associated with less favourable conditions in inflammatory bowel disease, such as higher relapse rate in ulcerative colitis patients.
Finally, microbiota transplantation has seen a regain of interest with applications expanding from Clostridium difficile infections to immune mediated and metabolic diseases.
The human intestinal microbiota should hence be regarded as a true organ, amenable to rationally designed modulation for human health.
Assist other natural antimicrobial agents
Cardiovascular diseases
Assist the liver in the detoxification process
Bolster the immune system.
Decrease the incidence and duration of diarrhea
Enable better growth development in children.
Lower blood pressure
Have anti-carcinogenic, anti-mutagenic, and anti-allergic activities.
Help prevent osteoporosis.
Help prevent colon cancer
Improve digestion and balance cholesterol metabolism.
Increase nutritional value of foods through better digestibility and an increased absorption of
nutrients.
Manufacture lactase, which promotes intestinal lactose digestion.
Prevent and reduce intestinal tract infections
Promote a feeling of well-being.
12
colon drug delivery- advantage and disadvantage of colon delivery, anatomy of colon in healthy and diseased state , different approaches (conventional and new) for colon delivery, in vitro and in vivo evaluation
Research and clinical studies of the protein zonulin and the zonulin signaling pathway demonstrate the
clinical efficacy of zonulin as a biomarker of intestinal permeability. Studies also confirm that zonulin
signaling is an essential mechanism in promoting healthy immune function and tolerance at the
gastrointestinal mucosal barrier.
Ankylosing Spondylitis the gut and the bugs: an integrative approach to treat...IFSMED
Rheumatologist Dr. Alex Shikhman makes the connection between ankylosing spondylitis and the gut. Offering natural dietary supplements to help manage many of the side effects associated with the disease
this presentation is on the relationship and effect of nutrition on general and oral health
management of few cases and pictures of the same are also included
I am a professional pharmacist. These slides provide for pharmacy department students. These slides describe pathology some topics.
Such as peptic ulcer disease, Immunity etc.
Presentation about our immune system: how it works, what makes the immune system weak, and the natural ways to boost your immune system especially during the flu season.
In depth evidence based article about Natural Support for Autoimmune Disease, such as Hops, Artemisia, Sarsaparilla, Reishi, Ashwagandha and more, published in Journal of Restorative Medicine 1212:1 p47
Horticulturist Bill Barash presents information about Plant Families, describing distinguishing characteristics, examples of plants in each family, folkloric and medicinal use
Ellen Kamhi PhD RN and Eugene Zampieron ND . All health providers should be aware of the possibility of interactions between pharmaceutical agents and botanical supplements. This is an introduction to a full course on Drug Nutrient Depletions and Herb Drug Interaction. In this intro, we describe drugs that can cause depletions through a variety of biochemical mechanisms. Depletion of nutrients can lead to alterations in physiology leading to side effects, symptoms or other conditions and disease.
We also review significant herb/drug interactions, and provide a review of databases and information relating to this topic.
Homeopathy:
Homeopathic medicine is a whole medical system that originated in Europe and has been practiced in the United States since the early 19th century. Homeopathy is based on three principles: Like Cures Like, Minimum Dose, Individualized Therapy. We will cover the basic tenets of homeopathy and how to integrate homeopathic remedies for safe and effective child care.
Thyroid and Adrenal Gland Function Determine many aspects of health, wellness and overall energy. If there is a miscommunication between these and other glands, it can lead to interferences in health, such as weight gain, infertility, digestive disorders and mood disorders. The Natural Nurse, Ellen Kamhi, PhD RN explains the basic function and feedback mechanisms involved in gland communication, along with Natural Remedy Support.
Ellen Kamhi PhD, RN, AHG, AHN-BC, The Natural Nurse discusses food allergies, histamine release, leaky gut syndrome, testing for leaky gut, natural therapies and herbs for allergies, nettles, quercitin, Vitamin C
Pharmacognocy is the study of plant chemistry. In this presentation, Ellen Kamhi PhD RN, The Natural Nurse , reviews the class of plant chemical called ALKALOIDS. These include plant chemicals that can be healing, and others that are toxic. Pain relievers, such as morphine, are included in this class, as well as stimulants such as caffeine.
The quality and efficacy of Traditional Herbal Medicine can be influenced by correct collection of Raw Materials. In this presentation prepared by Dr. Eugene Zampieron, ND, we discuss collection details to assure the best quality and efficacy of traditional herbal remedies made at home. Tinctures, Extracts, Poultices, Salves and other Herbal Preparations are discussed.
The immune system is our first line of defense to keep the body safe from infections. It includes the skin, thymus,gastrointestinal lining, tonsils/adenoids, spleen, lymph nodes, bone marrow and more. We discuss natural therapies, such as herbs, food and stress reduction techniques that support the natural activities of the immune system.
Ellen Kamhi PhD RN, Research validation of the Role of Intestinal Permeability in the Inflammatory Process, also called LEAKY GUT SYNDROME, along with Studies on the use of Natural Therapies for this condition
Ellen Kamhi PhD, RN, AHG, AHN-BC discusses botanical medicine- active constituents found in indigenous healing plants, the doctrine of signatures, specific actives in common botanical medicine used for healthcare, scientific studies, and consideration of adverse effects
Conventional Medicine Suggests that Physicians Watch and Wait rather than use antibiotics for mild ear infections. Rather than do that, it makes more sense to use natural therapies WHILE you are waiting. They often help resolve the issue so more aggressive pharmaceutical agents and ear tubes can be avoided.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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LEAKY GUT Intestinal permeability
1. The Role of Compromised Intestinal Permeability
in the Inflammatory Process: Natural Interventions
Ellen Kamhi, PhD, RN, AHG, AHN-BC
www.naturalnurse.com
3. Epidemiology
1.4 million Americans have IBD, evenly split between
Crohn’s and ulcerative colitis. Males and females are
affected equally.
• Crohn’s Disease
– Incidence is highest in developed countries.
– Most commonly diagnosed in young adults (late adolescence to
third decade of life).
• Ulcerative Colitis
– Incidence is highest in developed countries.
– On average people are diagnosed in their mid-30s
– Highest in Jewish populations followed by non-Jewish white
populations.
4. Past literature: the link between intestinal
permeability and inflammation
Parke, A, Gastrointestinal disorders and rheumatic
diseases. Current Opinion in Rheumatology.1991
Feb;3(1):160-5.
“In some instances, the association between
gastrointestinal pathology and extraintestinal disease is so
strong that treatment of gastrointestinal disease cures the
patient of the extraintestinal complaints. maintenance of
the structural and immunologic barriers of the
gastrointestinal tract are vital in determining the
general health of the patient, and the associations
between the gut, arthritis, dermatitis, and autoimmune
disease are much stronger than may appear at first glance. ”
5. Current literature: the link between
intestinal permeability and inflammation
Vandenbroucke RE, et. Al. Matrix metalloproteinase 13
modulates intestinal epithelial barrier integrity in inflammatory
diseases by activating TNF.
EMBO Mol Med. 2013 May 30. doi:10.1002/emmm.201202100.
Wilcz-Villega EM, et. al. Mast Cell Tryptase Reduces Junctional
Adhesion Molecule-A (JAM-A) Expression in Intestinal Epithelial
Cells: Implications for the Mechanisms of Barrier Dysfunction in
Irritable Bowel Syndrome.
Am J Gastroenterol. 2013 Apr 16. doi: 10.1038/ajg.2013.92
6.
7. Intestinal Permeability: a vicious
cycle of inflammation
• mucosal biopsies from IBD and celiac patients
patients shows altered expression of several
critical tight junction proteins, including
upregulation of zonulin and claudin 2
• On this manner, a vicious circle is created, in which
barrier dysfunction allows further leakage of
luminal contents, thereby triggering an
immune response that in turn promotes
further breakdown of the tight junctions.
9. Tight junctions are dynamic
structures that are involved in
developmental, physiological and
pathological processes.
Tight junction dysfunction seems to
be the primary defect in
autoimmune diseases.
10. ADHESION MOLECULES
Zonulins, Occludin, Claudins
• Modulate movement of fluid,
macromolecules and leukocytes from
the blood stream to the intestinal
lumen, and vice versa
• Protect the epithelial cells of the
intestine against colonization by
microorganisms
11. Adhesion Molecules
• Zonulin: protein that participates in tight
junctions between cells of the wall of the
digestive tract. Discovered in 2000 as the target
of zonula occludens toxin, secreted by cholera
pathogen Vibrio cholerae,[1] it has been
implicated in the pathogenesis of coeliac
disease[2] and diabetes mellitus type 1.[3]
• ^ Wang, W; Uzzau, S; Goldblum, SE; Fasano, A (2000). "Human zonulin, a potential
modulator of intestinal tight junctions". Journal of Cell Science 113 (24): 4435–40.
PMID 11082037.
• ^ Thomas, KE; Sapone, A; Fasano, A; Vogel, SN (2006). "Gliadin stimulation of
murine macrophage inflammatory gene expression and intestinal permeability are
MyD88-dependent: role of the innate immune response in Celiac disease". Journal of
immunology (Baltimore, Md. : 1950) 176 (4): 2512–21. PMID 16456012.
• ^ Sapone, A; De Magistris, L; Pietzak, M; Clemente, MG; Tripathi, A; Cucca, F;
Lampis, R; Kryszak, D et al. (2006). "Zonulin upregulation is associated with
increased gut permeability in subjects with type 1 diabetes and their relatives".
Diabetes 55 (5): 1443–9. DOI:10.2337/db05-1593. PMID 16644703.
13. Intestinal fortitude….
• The strength of the intestines depends on the
effectiveness of the matrix that keeps its
framework intact.
• In a healthy intestine, few unwanted molecules
can penetrate the cell membranes of the small
or large intestine, or escape between intestinal-wall
cells because of the tight seal created by
the intracellular “glue” which forms a barrier.
14. GALT
• The Gastrointestinal lining contains most
of the immune cells in the body (Gut
Associated Lymphoid Tissue (GALT)
• It engages in a continuous fight with
potentially pathogenic bacteria, fungi,
parasites, lectins, allergens, while leaving
symbiotic bacteria unscathed.
16. Periodontal disease is really a
Periodontal infection
Science is showing that the gums are a
major entry point for microorganisms to
invade the rest of the body.
Candida
Helicobacter
Pylori
17. • . The small and large
intestines measured
together and laid flat
equal about 25 feet in
length.
• The total surface area
of villi and microvilli in
the intestines that is
capable of absorbing
nutrients is about the
size of a tennis court.
27. ROME III Criteria (2006)
The Rome III criteria system was developed to classify the
functional gastrointestinal disorders based on clinical symptoms.
Each disorder has its own set of criteria.
For example, the Rome III criteria for
irritable bowel syndrome (IBS) :
Symptoms of recurrent abdominal pain or discomfort and a marked
change in bowel habit for at least six months, with symptoms
experienced on at least three days of at least three months.
Two or more of the following must apply:
Pain is relieved by a bowel movement
Onset of pain is related to a change in frequency of stool
Onset of pain is related to a change in the appearance of stool.
28. Intestinal Permeability
• Measurement of urinary clearance post
challenge drink.
– Lactulose
– Mannitol
– Lactulose/Mannitol Ratio
31. Permeability can occur between
juntions or transcellularly
• Altered permeability
between tight
junctions
• {tested with
Lactulose, a dimer }
• Altered permeability
transcellularly (thru
the cell)
• {Use Mannitol, a
monosaccharide}
34. • Once tight junctions are compromised bacterial
toxins, xenobiotics and food antigens enter the
circulation
• These stimulate the immune system , which
attempts to remove them from circulation, thus
forming ANTIGEN-ANTIBODY/CIRCULATING
IMMUNE COMPLEXES which trigger additional
inflammation.
• The heightened activation of inflammatory
cascades results in further production of
proinflammatory cytokines TNF-alpha, IL-6 and
IL-1B
• As immune complexes are deposited in
Connective tissue, activation of the complement
and alternate complement pathway
35.
36. Food Sensitivities
“IgG-mediated immunologic adverse
reactions to foods”
Food allergies cause the immune
system to synthesize and release
reactive chemical agents including:
– Cytokines and lymphokines
– Interferon
– IgG antibodies
37. Associate Conditions
•Celiac Disease
•IBD
•IBS
•Food Allergy
•Atopic Dermatitis, Eczema
•Ankylosing Spondylitis
•Inflammatory Joint Disease
•Rheumatoid Arthritis
Fasano A. Surprises from Celiac Disease. Scientific American 2009(Aug):54-61.
Associated Conditions
38. OBJECTIVE III
Incorporating low risk- high efficacy
evidence based natural interventions
in patient protocols
39. ••
Treatment Protocol
••4R program
• Dr Jeff Bland
• Remove
• Replace
• Reinoculate
• Repair
41. Gluten Free Diet
Vazquez-Roque MI , et. Al. Gastroenterology.
2013 Jan 25. pii: S0016-5085(13)00135-2.
A Controlled Trial of Gluten-Free Diet in Patients with
Irritable Bowel Syndrome-Diarrhea: Effects on
Bowel Frequency and Intestinal Function.
CONCLUSION:: Gluten alters bowel barrier functions
in patients with IBS-D, particularly in HLA-DQ2/8-
positive patients. These findings reveal a reversible
mechanism for the disorder.
42. Gluten Free Diet
• A gluten free diet reduced diarrhea in
patients with IBS
• There was a measurable increase
in intestinal permeability in those eating
gluten.
• Gluten caused an increased production of
inflammatory markers
• Worse in patients who had positive gene
markers for gluten sensitivity.
http://www.glutenfreesociety.org/gluten-free-society-blog/ibs-reversable-on-a-gluten-free-diet/
44. Probiotics to Reinoculate
Friendly Microbiota
Acidophilus, Bifidus and other beneficial species
can be given orally to help re-establish healthy
gut flora.
J Neurogastroenterol Motil. 2011 Jul;17(3):252-66. doi:
10.5056/jnm.2011.17.3.252. Irritable bowel syndrome, gut
microbiota and probiotics. Lee BJ, Bak YT.
45. Normal Flora & Probiotics
Decrease Inflammation
• Bennet JD, Brinkman M. Treatment of
ulcerative colitis by implantation of normal
colonic flora. Lancet 1989;1:164.
• Borody TJ et al. Treatment of ulcerative
colitis using fecal bacteriotherapy. J Clin
Gastroenterol. 2003; 37(1):42-47.
• Gionchietti P et al. Prophylaxis of pouchitis
onset with probiotic therapy.
Gastroenterology. 2003;124:1202-1209.
46. Repair
GLUTAMINE - most abundant amino acid
involved in more metabolic processes than
any other amino acid.
Directly used by cells lining the intestines to
rebuild villi. Also used by white blood
cells, supporting immune function.