Medical Articles by Dr. Ray

Dec

2022

Certain Probiotics Are not as Harmless as Thought

By Ray Schilling | diet, Mortality, Nutrition

Recently a medical publication stated that certain probiotics are not as harmless as thought. Researchers presented their findings at the American College of Chest Physicians 2022 Annual Meeting. 23,533 ICU admissions to a number of hospitals in Colorado over a 5-year period were the data base for this study. There was a clear relationship between taking probiotic powder and the fact that some of these gut bacteria make their way into the blood stream. This condition has the name of bacteremia. Although bacteremia is uncommon (only 0.37%), the mortality rate for those who developed probiotic-related bacteremia was 25.6%. This is about twofold greater than the 13.5% mortality rate of controls who did not take probiotics. The risk ratio was 2.23-fold higher for ICU patients who ingested probiotics versus those who did not. What killed the patients who took probiotics were the gut bacteria that entered into their blood stream.

Discussion of “certain probiotics are not as harmless as thought”

Physicians often recommend probiotics as tools to improve the gut bacterial flora. Unfortunately, there is a lack of research in this area. There is no hard evidence that probiotics are beneficial for irritable bowel syndrome or ulcerative colitis. There is also no hard evidence that a previously deranged bowel flora would transition into a healthy bowel flora. On the other hand, we also know that fermented vegetable products like kimchi or sauerkraut also have beneficial bacteria in them that can support your bowel flora. One of the problems is the concentration of probiotic supplements. They come in 80 billion, 100 billion and higher bacteria counts per capsule. It is possible that some of these bacteria find their way through cracks in the lining of the bowel into the blood stream.

Patients outside the ICU setting

ICU patients are vulnerable and often have immune deficiencies. It may be that in regular patients outside the ICU probiotics may not be that problematical. But nobody knows for sure as there are no studies available that support this. The practice of recommending probiotics over sauerkraut and kimchi is simply based on hearsay.

Risk assessment necessary

Once probiotic bacteria are in the blood, they can freely travel through the circulatory system into the rest of the body. This is how septicemia develops. This is a dangerous condition, which does not always respond to antibiotics. It is because of this why there is such a high mortality rate as I mentioned above.

As mentioned, there is a lack of good evidence for the beneficial effects of probiotics. However, there is a risk of bacteremia in ICU patients. This warrants a risk assessment whether or not we should supplement our food intake with probiotic supplements or not. Fermented vegetable products like kimchi or sauerkraut are not as highly concentrated as probiotic capsules. Nevertheless, they are useful supplements that you can mix into salads or use as a side dish to your main meal. Until the time that more evidence is available about probiotics it is best to not take probiotics. Replace it with kimchi and sauerkraut.

Fermented foods versus probiotics

Fermented foods like sauerkraut and kimchi can help the gut balance its bacteria. But there are other fermented foods that can help your gut: yoghurt and kefir, which is a fermented probiotic milk drink. Other fermented foods are tempeh, miso, kombucha and pickles. The good bacteria outnumber the bad bacteria when you consume fermented foods regularly. Kimchi does not only provide healthy gut digestion, but it also prevents the formation of toxins from unhealthy gut bacteria. These toxins can damage the kidneys. So, kimchi prevents kidney damage.

Sauerkraut and kimchi are fermented foods that have been consumed for hundreds of years. They provide nutrients, vitamins and minerals along with plenty of fiber and probiotic bacteria to support the gut. I consider kimchi and sauerkraut the better probiotic than probiotic pills, which likely are too concentrated.

Certain Probiotics Are not as Harmless as Thought

Conclusion

Recently a publication reported about 23,533 ICU admissions to various hospitals in Colorado over a 5-year period. These patients took daily probiotics. There was a clear relationship between taking probiotic powder and the fact that some of these gut bacteria made their way into the blood stream. Unfortunately, there was a mortality risk of 25.6% for probiotic-related bacteremia. Controls not taking probiotics had a much lower mortality rate of 13.5%. The investigators concluded that a literature search failed to support beneficial effects of the probiotic powder. The evidence was rather weak and did not justify the risk of probiotic-bacteremia. In contrast, natural probiotics in the form of fermented foods like kimchi and sauerkraut have been around for centuries and are known to be safe. I see no reason why we should take a risk with probiotic pills when there are many alternative fermented foods.

Dec

2022

Mast Cell Activation Syndrome

By Ray Schilling | alcohol, Allergies, anaphylactic reaction, diet, immune system, Inflammation

Mast cell activation syndrome (MCAS) also goes by the name of systemic macrocytosis. That is to say it is a syndrome where mast cells are multiplying abundantly and secreting the inflammatory substances histamine, leukotrienes and cytokines. Certainly, people who suffer from MCAS can get severe anaphylactic reactions, but an epinephrine injection can often stop this. Indeed, the physician must look for potential triggering factors like alcohol, spicy foods, exercise, insect stings, possible heavy metal accumulation or certain medications. In some cases heavy metal accumulation could also be a factor that triggers mast cells to release histamine. In these cases a series of 20 chelation therapy sessions would be stabilizing.

Symptoms of mast cell activation syndrome

When there is skin involvement in patients with mast cell activation syndrome, they get flushing, itching and skin rashes.
With gastrointestinal involvement patients experience nausea and vomiting, bloating, abdominal pain, diarrhea and reflux (GERD).
Patients with neurological symptoms develop brain fog, headaches, cognitive problems, tremors and anxiety/depression.
When MCAS affects your endocrine glands, you may develop bone pain, bone lesions or weak bones.
Patients where the heart is affected may be fainting, their blood pressure may fluctuate between with high or low readings and they may experience heart palpitations.
When your respiratory system is affected, your lungs may be wheezing and you may develop nasal congestion.
More symptoms
The most dangerous symptom is anaphylaxis. This is a life-threatening allergic reaction where your air way entry could close off.
Any of these symptoms can get triggered by heat, cold or temperature changes. Stress, friction, insect bites or stings can also trigger a reaction. Additional factors can be environmental odors or perfumes, certain foods or medicine, alcohol and contrast dyes.

Diagnosis of mast cell activation syndrome

The most appropriate specialist to see is an allergist or immunologist. Other specialists could be a dermatologist, gastroenterologist, hematologist or endocrinologist. You will need blood tests like a serum tryptase level, which is a marker for mast cell burden. It is best to get a baseline tryptase level and also get a tryptase level after a mast cell reaction. In addition, you need a 24-hour urine collection for a number of mast cell activators. Depending on where your mast cell activation syndrome is located you need a skin or bone marrow biopsy.

More possible tests

The physician may decide to do an endoscopy or colonoscopy of the gastrointestinal tract. The pathologist can do several staining procedures with biopsy material to specifically look at mast cells. If there is a strong family history of mast cell activation syndrome the physician may decide to do genetic tests. In order to assess mast cell damage, your doctor may order a bone density test and bone scans including CT scans of the abdomen and chest.

Treatment of mast cell activation syndrome

The treatment of mast cell activation syndrome consists of a combination of multiple steps. First, if there is a life-threatening anaphylactic reaction, the patient applies an epinephrine injection. The physician taught the patient earlier how to do an epinephrine injection. This stops the sudden, rapid release of mediators from mast cells. After the epinephrine injection the patient needs transport to the nearest ER of a hospital for follow-up care. It is important that any patient with this syndrome should carry injectable epinephrine( an Epi-Pen) at all times.The purpose of treatment against mast cell activation syndrome is to block reactivity of mast cells or to stop the effects of mast cell mediators.

A number of medications are available to do this.

H1 and H2 antihistamines. The difference between these two is explained here.
Mast cell stabilizers (cromolyn sodium, ketotifen). For more on ketotifen follow this link.
Leukotriene inhibitors such as montelukast. You can find more info on leukotriene modifiers here.
Aspirin (under direct physician’s supervision)
Aggressive mast cell disease may require treatment with chemotherapy.

You can lower your risk of getting mast cell activation syndrome by watching your diet. Here is a list of the foods that will protect you:

Mast Cell Activation Syndrome

Conclusion

Mast cell activation syndrome is a complex disease entity. Often there are several factors that contribute to this. Conventional medicine still cannot offer a treatment modality that will cure this condition, the only possibility is to control it. The physician must therefore use a combination of treatment modalities in order to help the patient with this condition. In cases of heavy metal accumulation several treatments with chelation therapy are beneficial. With an acute anaphylactic reaction, the

Mast Cell Activation Syndrome applies an epinephrine injection, which will stabilize the condition. But the patient should now follow this up with a series of blood tests in the emergency department of a hospital.

Treating mast cell hyperactivity

The purpose of treating mast cell activation syndrome is to block reactivity of mast cells or to stop the effects of mast cell mediators. H1 and H2 antihistamines help for gastrointestinal hyperactivity. Cromolyn sodium and ketotifen are mast cell stabilizers. Leukotriene inhibitors such as montelukast help to stabilize the mast cells to not secrete cytokines, which cause inflammation. Aggressive mast cell disease may require chemotherapy treatment, similar to what is needed to treat cancer.

The purpose of treatment is to help the patient control the mast cell hyperactivity. At this time medical science does not have all the answers. Unfortunately, at this point conventional medicine has no cure for this syndrome, but it can be managed with a lot of attention to the symptoms.

Dec

2022

The Bubonic Plague Still Affects some People today

By Ray Schilling | antibiotics, autoimmune disease, Infectious Disease

Although the plague is of historic significance, it still is around and the Bubonic plague still affects some people today. In the Middle Ages the world population experienced a reduction from 475 million to 350–375 million between 1346 and 1353. This pandemic relied on fleas on ground rodents, which showed infection with the bacterium Yersinia pestis. Flea bites transmitted the plague bacteria to humans. Nowadays we have effective antibiotics against the plague. Doxycycline is the antibiotic of choice against this bacterium. But in the Middle Ages no antibiotic was available. Those who had a certain variant of the immune system survived, while others who did not have this perished.

Study from nature showing changes of the immune system due to the Bubonic plague

An international research article involving scientists from Canada, the US and France was published in the medical journal nature. Nature published this on Oct. 19, 2022. The title was:” Evolution of immune genes is associated with the Black Death “. The scientists worked with a hypothesis that the human immune genome underwent a shift after the plague in those who survived. They tested their hypothesis by doing DNA analyses in corpses from before, during and after the Black Death. Specifically, more than 300 skeletons came from London/England, where the plague hit hard. 198 samples came from 5 different locations in Denmark. Researchers extracted DNA from the roots of the teeth. They checked for the individual’s’ DNA and for the presence or absence of the bacterium Yersinia pestis. CNN summarized this here.

Results of the study

Hendrik Poinar is a professor of anthropology at McMaster University in Hamilton and coauthor of this study. He said: “It’s a long process, but in the end you have the sequence of those genes for those people from before, during and after the plague and you can ask: Do the genes one population carried look different than the ones another population carried?” There was one particular gene, ERAP2 that had a strong association with the plague. The London study showed that 40% of individuals had an ERAP2 variant protective of the plague prior to the plague. After the plague 50% of the individuals had this variant.

Denmark data

In Denmark prior to the plague 45% of the population carried the variant of ERAP2, while 70% of the population buried after the plague carried this variant. The researchers did in vitro experiments with cultured cells. They could show that macrophages, which are immune cells that initiate immune responses, kill Yersinia pestis bacteria better when the ERAP2 variants are present in comparison to when they are not.

The downside of immunity

The downside of the ERAP2 variant is that researchers linked it to a greater susceptibility to autoimmune disorders. Diseases like Crohn’s disease, rheumatoid arthritis and systemic lupus belong into this category. Luis Barreiro is a professor of genetic medicine at University of Chicago and a coauthor of the study. He said: “This suggests that populations that survived the Black Death paid a price, which is to have an immune system that increases our susceptibility to react against ourselves.” He mentioned further:” It is unlikely that Covid-19 outbreak would shape our immune system in a similar way — largely because the disease predominantly kills people after their reproductive age, meaning it’s unlikely genes that confer protection would be passed on to the next generation.”

The Bubonic Plague Still Affects some People today

Conclusion

A publication in October of 2022 examined 300 skeletons from London, England where the plague hit severely between 1346 and 1353. The study also examined skeletons from Denmark. In both locations the scientists timed the samples before, during and after the pandemic. They found a genetic variant of the immune system by the name of ERAP 2, which changed in the population before and after the plague. The London study showed that 40% of individuals had an ERAP2 variant protective of the plague prior to the plague. After the plague 50% of the individuals had this variant. In Denmark 45% of the population carried the variant of ERAP2, before the plague while 70% of the population buried after the plague carried this variant. In vitro studies showed that macrophages were more aggressive as a result of sensitization of the immune system from an increase of the ERAP2 variant.

Autoimmune diseases

The increase of the ERAP2 variants stimulates the immune system. The researchers determined with in vitro studies that the Yersinia pestis bacterium stimulate macrophages. The downside of the ERAP2 variant is that researchers linked it to a greater susceptibility to autoimmune disorders. Diseases like Crohn’s disease, rheumatoid arthritis and systemic lupus belong into this category. Professor Luis Barreiro from the University of Chicago said:” It is unlikely that Covid-19 outbreak would shape our immune system in a similar way — largely because the disease predominantly kills people after their reproductive age, meaning it’s unlikely genes that confer protection would be passed on to the next generation.”

Nov

2022

Lack of Sleep Harms the Immune System and Causes Inflammation

By Ray Schilling | Cardiovascular disease, depression, Diabetes, Heart Disease, Inflammation, Insomnia, sleep, Sleep apnea

A research group from Boston, MA and New York, NY found that a lack of sleep harms the immune system and causes inflammation. This was summarized in this CNN article.

Specifically, they first conducted experiments with a mouse model. They studied the effects of sleep disruption and sleep deprivation and could later confirm identical changes in man. The observation was that a lack of sleep caused the hematopoietic cells in the bone marrow to proliferate, but the cell diversity was less than in people with normal sleep patterns. The same pattern of bone marrow proliferation was present in mice. This research was published Sept. 21, 2022 in the Journal of Experimental Medicine.

Chronic sleep deficit

A chronic sleep deficit caused chronic inflammation and eventually autoimmune diseases. Again, this was a pattern present in both the mouse model and in humans. Next the researchers observed what happened with sleep recovery. In the past it was assumed that with sleep recovery all of the physical changes from sleep deprivation would disappear. However, the opposite was true: both in mice and in humans the bone marrow stimulation and the lack of cell diversity persisted.

In the mouse model the researchers could show that there were permanent epigenetic changes, which were caused by sleep deprivation. The same is true with humans, but this is more difficult to show than in the mouse model. The researchers came to the conclusion that sleep deprivation stimulates bone marrow maturation, but restricts the clonal differentiation. In doing so the body initiates inflammation, which becomes chronic even with sleep restoration.

Human sleep studies

There were 14 volunteers that were the test subjects. One group was the normal sleep control. The other group underwent chronic sleep deprivation. Each group did this for 6 weeks. There was a 4-to-6-week washout period. Following this the previous normal sleep group started a 6-week sleep deprivation program. On the other hand, the prior sleep-deprived group switched to 6 weeks of normal sleep. All of the participants had daily late afternoon blood tests.

There are many sleep disruptions, which cause a sleep deficit

In modern life sleep gets disrupted in many ways. There can be sleep fragmentation, sleep restriction, jet lag, obstructive sleep apnea (OSA), and insomnia.

People with these conditions often oscillate between these various types. They may have a few days of normal sleep, but then have sleep deprivation again for a few days. Every time they have sleep deprivation the bone marrow enhances hematopoietic activity. Normally there is a high leukocyte number in the blood at the end of the day and in the morning a lower leukocyte count. But with sleep deprivation there is a high monocyte count in the blood that stays high even when subjects switch back to a normal sleep pattern.

Epigenetic effect of sleep deprivation on bone marrow cells

The authors found that sleep deprivation affects the genetic control of hematopoietic cells in the bone marrow. They called this the epigenetic effect of sleep deprivation. This is responsible for the evening leukocyte response, the monocytosis and the tendency for autoimmune diseases. They summed this up by saying: “Our findings support the hypothesis that periods of poor sleep, even if followed by sleep recovery, have sustained consequences on immunological health.”

Lack of sleep harms the immune system and causes inflammation says the literature

There is ample evidence that a lack of sleep causes cardiovascular disease, diabetes, depression and more frequent infections. Healthy sleep is important when you want to age well without complications. But enough sleep is also necessary to prevent obesity, diabetes and cardiovascular disease. Experts consider getting enough high-quality sleep as essential as a balanced diet and regular exercise.

Lack of Sleep Harms Immune System and Causes Inflammation

Conclusion

So far, most researchers believed that when you miss some sleep for a few nights that a afternoon nap or a few nights of longer sleep would compensate for the sleep deficit with no sequelae. Think again, because new research from a group in Boston, MA and New York, NY found that lack of sleep harms the immune system and causes inflammation permanently. Sleep deprivation stimulates the bone marrow cells to multiply and causing proliferation of monocytes, called monocytosis as well. Despite afternoon naps and recovery sleep this condition remains and can lead to autoimmune diseases. All this was unknown up to now. Our bone marrow cells need regular sleep hours to stay diversified and to optimally fight infections in the body. This prevents autoimmune diseases and keeps our defenses against viral diseases strong.

Nov

2022

Poetry Helps Anxiety and Depression

By Ray Schilling | Anxiety, depression, Pain

Recently CNN published an article that stated that poetry helps anxiety and depression. Notably, poetry helps to cope with loss, fear, a marital break-up and helps during loneliness like a quarantine for Covid-19. Certainly, it is because of this that two authors, David Haosen Xiang and Alisha Moon Yi wrote this 2020 review about poetry’s healing power throughout the pandemic. It is important to realize that they conducted poetry classes at Harvard Medical School and Harvard College. In doing this they observed various health benefits from writing, reading and listening to poetry. Indeed, they saw that poetry combatted stress and depression and reduced postsurgical pain. In addition, poetry improved mood, work performance and memory.

Poetry helped hospitalized children

Another key point, a 2021 study involving 44 hospitalized children measured the effects of poetry on fear, sadness, anger, worry and fatigue. By all means, all of these parameters were reduced when the children were reading, writing or listening to poetry. However, one exception was pain in this group of children, which was unaffected by poetry.

Details of the statistical results

To clarify, here are the results of this study in more detail. A statistically significant reduction of symptoms requires a p value of 5% or less. The 44 hospitalized children had a fear reduction with a p value of 2.1%. Exposure to poetry reduced sadness with a p value of 0.4%, anger with 3.9%, worry with 4.1%, and fatigue with 0.1%. As indicated already the only exception was pain reduction, which had a p value of 9.1% meaning that it was not statistically significant. Poetry has the ability to provide comfort and boost your mood when you are exposed to stress, trauma and grief.

Emotional responses elicited by hearing poetry

Poetry can also elicit peak emotional responses. In a study from 2017, researchers examined psychophysiological responses of 27 people. They measured how many people experienced chills or goosebumps when they listened to poetry read aloud. The researchers concluded that physical responses are connect to the rewards-sensing area of the brain.

Pleasure inducing activities can stimulate the reward areas of the brain

The pleasure center consists of the nucleus accumbens, the amygdala and the hippocampus. Together they contain dopamine neurons that communicate with the grey matter nerve cells in the prefrontal cortex. I have discussed this elsewhere in more detail. A pleasurable meal, sex, winning a video game, listening to music, earning money and reading a funny cartoon can all cause dopamine release that the person perceives as pleasure. But so can drugs, smoking cigarettes, drinking alcohol and taking street drugs.

Dr. Amen’s SPECT scans

Dr. Amen is a psychiatrist who specializes in SPECT scan technology. SPECT stands for Single Photon Emission Computerized Tomography. This is summarized in this review. Briefly, a SPECT scan shows where most of the blood flow occurs in the brain. People who abuse drugs or nicotine develop areas that have a lack of perfusion. It looks like holes in the brain as depicted under point 5 of the above link, which can create abnormal thinking patterns. Fortunately, with drug rehabilitation the brain pattern can normalize again.

Discussion of why poetry helps anxiety and depression

It is the excitement of the pleasure centers in the brain that relieves anxiety and depression. It seems to not matter whether we listen to poetry read aloud, read it or create it. But a pleasurable meal, sex, winning a video game, listening to music, earning money and reading a funny cartoon can also release dopamine in the pleasure centres of our brain. Repeated stimulation of the pleasure centers from exposure to poetry seems to be what gives us relief from anxiety and depression.

Xiang and Yi who observed students writing, reading and listening to poetry at Harvard Medical School and Harvard College said: “Whether it is coping with pain, dealing with stressful situations, or coming to terms with uncertainty, poetry can benefit a patient’s well-being, confidence, emotional stability, and quality of life.”

Poetry Helps Anxiety and Depression

Conclusion

Newer research showed that poetry helps anxiety and depression. This is true in university and college students as well as in hospitalized children. One study concluded that poetry seems to activate the rewards-sensing area of the brain. Other studies showed that it is the nucleus accumbens, the amygdala and the hippocampus, which form the pleasure centers in the brain. The psychiatrist Dr. Daniel Amen did detailed studies with SPECT scans where brain changes are made visible. Brain SPECT scans have a similar appearance in people exposed to writing, reading and listening to poetry as people who had a pleasurable meal, sex, were winning a video game, listening to music, earning money or reading a funny cartoon. The common denominator is the release of dopamine from the pleasure centres of the brain.

Oct

2022

Overcoming Grief after a Loss

By Ray Schilling | Anxiety, depression, Mental Health, stress

This article is about overcoming grief after a loss. During the Covid epidemic many people died, which caused a lot of grief among their loved ones. Unresolved grief can cause anxiety and depression. Whenever you have lost a loved one, counseling can help you to continue the grieving process.

Claire Bidwell Smith is an author of several books and has a master’s degree of clinical psychology from Antioch University in Los Angeles. She published the book “Anxiety-the missing stage of grief” (Hachette Books, 2018). In it she explores the stages of grief and notices that anxiety is very much part of the grieving process. However, this point is often overlooked by mainstream psychologists. Claire Bidwell Smith offers strategies to deal with the loss of a loved one and overcome the anxieties that people often feel as well. Here is a write-up from CNN where Claire Bidwell Smith was interviewed.

Anxiety is a powerful emotion

Anxiety can be very powerful, but it is often mistaken for a physical problem. As a result, people present at the emergency room of a hospital for various symptoms of pain and a myriad of other complaints. After expensive tests the doctor finds no physical abnormality and the diagnosis is anxiety or panic attack. Smith said that 70% of her referrals went to the hospital first and were diagnosed as panic attacks. Patients have a hard time to understand that their anxiety is a direct result of their grieving process.

Relationship between grief and anxiety

CNN asked Smith how grief and anxiety are related. She answered that a sudden death from an infection like Covid makes you realize that we are not safe and are not in control. Everything in your life changes and emotional upheaval is much bigger than ever imagined. Grief, which consists of emotions that accompany a loss of life can force you to kneel down emotionally speaking. This process feeds anxiety. People who grieve the loss of a loved one get anxious about their own health and about the safety of other loved ones. They may not even realize that what they are experiencing is anxiety or that this is related to the grieving process.

Anxiety

Anxiety is a condition that presents with fears and worries. This can present with many different body symptoms. The patient may experience chest pains and think it is a heart attack. But tests are normal and the physician calls it anxiety. Similarly, anxiety can present as stomach aches, headaches or insomnia.

What coping strategies are available?

There are many support groups to help people with anxiety; in addition, grief therapists can help with individual counseling. It may be difficult to motivate the patient to make use of these services. Since Covid you can have access to virtual anxiety support services. It is important that people seek counseling support, as otherwise they get stuck in their anger or guilt. Unfortunately, many people give up and end up in substance abuse. They develop relationship problems and get into trouble at work or in school. So, not seeking support only backfires. Get yourself on a waiting list for a counselor! Work through your grief and you will feel better.

What is your advice to people who resist a formal mental health treatment?

Smith mentioned that there are a lot of self-guided online courses. Also, reading books and articles about grieving are useful, because you get on with your grieving process. Social media is another source for information about the grieving process. It helps you to understand what other people with the same problem experienced and how they overcame it. Having said this, people can develop a full-blown anxiety disorder or clinical depression. In this case they require an assessment by a psychiatrist.

What is the role of meditation and mindfulness in healing anxiety?

Smith pointed out that when we grieve and when we are anxious, we spend time in the past or we worry about the future. Meditation and mindfulness bring our awareness to the present moment. Meditation helps us to focus on our own thoughts. It helps us also to detach from negative thoughts or irrational fears.

Imagination as another powerful tool

Smith explained as an example that she was not there when her mother died in the hospital. When she is overcome by negative emotions regarding this memory, she envisions herself crawling into the hospital bed with her dying mother, holding her and saying good bye to her. Smith admitted that it took her about 5 years before she was ready to do these imagination experiments. By using this imagining tool your present focus is on the now away from negative emotions of the past or fears what the future may hold.

Stories help to reduce grief

How we handled a painful story from the past determines how it influences our daily thinking. Often people do not know how to handle such a story and they tend to suppress it. But psychologists found that it is much healthier to deal with these stories and reframe them. When people find a way how to explore their story, they can reframe it and remove the negative feelings that had an association with it in the past. Healing comes from therapy, from counseling, online grief forums and support groups. There are also grief writing classes where you can rewrite your story experiencing how the past memories become less powerful and the future is brighter.

Stay connected with your lost loved one

It used to be taught that the best therapy would be to “letting go and moving on”. But now psychologists think it is better to move forward with the person you have lost. Specifically, what this means is that it is OK to have an inner talk with the person you lost. Smith added: “For example, pondering: What advice would my dad give me about this job offer? What would my mom think of my new boyfriend?”

The crux of grief work is making meaning out of loss

CNN asked Claire Bidwell Smith whether she quoted Hope Edelman who authored the book “The After Grief”. Hope Edelman said in this book that the “crux of grief work is making meaning out of loss”. Smith’s reply was that this stage develops naturally. But she cautioned that guilt, regret and anger are standing in the way of our ability to make meaning. They have to be dealt with first. This is why counseling, grief work and overcoming guilt and anger are so important.

Overcoming Grief after a Loss

Conclusion

When we lose a loved one or lose our job, we experience a grief reaction. There are powerful negative feelings like anger, guilt and other feelings that make it difficult to overcome our grief. Claire Bidwell Smith is an author of several books and has a master’s degree of clinical psychology from Antioch University in Los Angeles. She was interviewed by CNN regarding her work and her latest book “Anxiety-the missing stage of grief” (Hachette Books, 2018).

Anxiety is an important aspect of grieving

In the interview she explained that anxiety is an important aspect of grieving. But many people go to the emergency room of a hospital, because they think the symptoms, they feel are physical. It is the emergency physician who tells them after several tests that they have anxiety and they need to seek a counselor. After a few months of counseling grieving persons usually feel a lot better. They are now accepting what happened in the past and hope for a better future.

Oct

2022

Plant-Based Meat Alternatives are Healthier

By Ray Schilling | Cancer, Cardiovascular disease, diet, food, Health, Nutrition, Obesity, Weight loss

A recent study showed that plant-based meat alternatives are healthier than the original meat dishes. This spread into various health websites on the Internet. One example is this one.

Some statistics about plant-based meat alternatives

Plant-based meat alternatives came to the market in the 1960’s. At that time, they consisted mainly of soy. Later textured vegetable protein joined soy products. Today they consist of pea protein, soy, potato, oils, various binders and flavorings to mimic the texture and flavor of meat.

The global plant-based meat market was about 5 billion USD last year. It is projected to increase by 19% from 2022 to 2030. The plant-based dairy alternatives market totaled 11 billion in 2020. The estimate is that this will grow to 32 billion in 2031.

How healthy are plant-based substitutes?

In the center of this discussion is the publication of Christopher J. Bryant from the Bath University in England. This publication reviewed 43 studies regarding plant-based substitutes regarding healthiness and environmental sustainability. In the following I am discussing the findings, particularly about health benefit of plant-based foods versus meat-based foods.

Problems with our current food consumption

There are several problems with human diseases that are transmitted from wildlife. HIV arouse from hunting of non-human primates. Rabies was transmitted in South America by vampire bats from cattle to humans. Early cases of severe acute respiratory syndrome (SARS) came from contact with wild life. Finally, bats transmitted the SARS coronavirus-like virus from wild animals and live animal markets to humans. Subsequently human to human transmission caused the spread of Covid all around the world as a pandemic.

Use of antibiotics in feedlots

In order to control diseases in closely kept animal feedlots farmers feed the livestock antibiotics. This helps to contain infections, but it also poses a grave problem to humans as antibiotics become more and more resistant. Superbugs developed this way. 18% of meat imported from China was contaminated with Salmonella. 88% of those exposed to contaminated meat were resistant to at least one antibiotic. But 58% were resistant to multiple antibiotics.

A Harvard study from Boston showed in 2020 that red meat and processed red meat consumption caused 15% more heart attacks compared to those who substituted the protein source with plant-based foods. The same study also noted that the heart attack rates were about 15% less for subjects who substituted meat with plant products in comparison to meat eaters.

Other results of the study

Several of the reviewed studies compared the nutritional profile of plant-based meat with the animal-based counterparts. Plant-based meat was significantly lower in saturated fat, and protein. However, they were significantly higher in fibre and salt. 40% of meat products were classified as ‘less healthy’. In comparison to that investigators assessed that only 14% of plant-based meat was ‘less healthy’. When saturated fat, sodium, sugar, and overall calorie content were tabulated, plant-based meat products compared favorably to meat. But salt content was often too high in plant-derived foods.

Plant-based burgers were much healthier than conventional beef-burgers, as they contained no cholesterol, less trans-fatty acids and less saturated fat. Vegetable-based food that contains pea protein is particularly valuable with regard to a high protein content.

Criticism of plant-based meat alternatives

At the present time many plant-based meat products have too much sugar and salt in it, but lack iron and vitamin B12. Various authors suggested that the food industry should add iron and vitamin B12 to their products and reduce the sugar and salt content.

Muscle synthesis

Mycoprotein is the active biochemical that builds up the protein of the muscle mass in man. Non-animal-derived dietary protein contains ample amounts of mycoprotein according to this publication. These authors investigated the ingestion of mycoprotein in a dose-response manner. They also measured insulin levels for 4 hours after ingestion of plant-derived mycoprotein. Insulin levels remain higher than normal for a sustained period.

Weight loss

A 2017 study showed that 40 grams of mycoprotein, which is the equivalent of 18 grams of protein was sufficient to lead to a robust muscle synthetic response. 60 g of mycoprotein (27 g protein) provided an optimal response regarding muscle synthesis. Gram for gram milk protein and mycoprotein were equivalent in amino acid bioavailability. Several studies examined weight loss following mycoprotein meals. One study found in overweight patients that chicken protein consumption was higher in comparison to consumption of plant mycoprotein. The mycoprotein consuming group chose to eat 10% less calories than the chicken control group.

Greenhouse gas emissions and other factors

The publication cited above also included a lot of findings regarding how plant-derived food saves greenhouse gas emissions and other facts. For instance, the pork supply chain requires 3.3-times more fertilizer and 1.6-times more pesticides than the production of plant-derived food. What this means is that plant-derived foods are more environmentally sustainable than animal products.

Plant-Based Meat Alternatives are Healthier

Conclusion

Plant-derived foods have improved in the past few decades. Pea-derived plant products are now equivalent in terms of protein content to milk and meat. By eating more plant-derived food people consume less meat, which helps the environment, but also benefits the person who eats it. We know that with the consumption of a certain amount of plant-derived food less people develop cardiovascular disease, diabetes and cancer. 40 grams of mycoprotein, which is the equivalent of 18 grams of protein was sufficient to lead to a robust muscle synthetic response.

Consumer beware

It is important to realize that not all is well with the list of “fake meat” and other highly processed plant-based products. Consumers must read the list of ingredients. If a product contains a laundry list of ingredients that not even an adult can pronounce and understand, it is very likely a highly processed food product that only pretends to be good for you. Should the sodium content be too high, steer away from it. High sugar content means that you put it back in the shelf. All in all, eating more plant-derived foods makes you healthier and improves the environment at the same time. But it is up to us to be discriminating colourful advertising from a nutritionally sound product.

Sep

2022

When is Someone at Risk for Suicide?

By Ray Schilling | Anxiety, depression, Drugs, Mental Health, suicide

We are asking ourselves: When is someone at risk for suicide? This year’s National Suicide Week was from Sept. 4 through 10, 2022. Every day of each year it is important to be aware of signs and symptoms of impending suicide. However, the purpose of the yearly National Suicide Week is to really bring it to everyone’s attention how common deaths by suicides are. We all can contribute to improve the situation by increasing our awareness.

Some suicide statistics

In the US alone nearly 46,000 persons died by suicide in 2020. This means that there is one death by suicide every 11 minutes. In 2020 nearly 800,000 died by suicide worldwide. About 1.2 million attempted it. The hope is that the public will learn through education to recognize the signs of an impending suicide. This way the suicidal person can get counselling and hopefully not commit suicide.

Abnormal behaviors to watch out for

People who are getting suicidal may practice with guns, overdosing with pills or handle potentially lethal items. Other behavioral red flags could be giving away cherished items. The suicidal person may sleep too much or not enough. Isolation or withdrawal may be another pointer in a previously sociable person that he or she is becoming suicidal. Revenge thinking, reckless driving, agitation can all be pointers as well that the person is preparing for suicide. Justin Baker is the clinical director of The Suicide and Trauma Reduction Initiative for Veterans at The Ohio State University Wexner Medical Center. He said: ”A lot of times people need to kind of work up to that actual making an attempt because it’s a biologic thing you have to go against, your own survival”.

Watch what people say

When people become suicidal their words often indicate what they want to do. It is a warning sign, if someone is talking about wanting to die, by suicide or otherwise. Some people state that they feel like they have no reason to live. This is an alarm signal that they may be suicidal. Some people say that they feel like they are a burden for the people living around them. Other problematic statements are: “You don’t need me for this anymore” or “I feel like it’d be better if I just wasn’t here.” Someone uttering statements like these should get counseling. This allows them to vent their feelings and to reassess their situation.

Suicide risk factors

Hopelessness: People may express that they feel the future won’t be any better. Or they do not see a way out of the pain that they are in.

Obsession with death and dying: Some people ruminate about dying and they develop a plan what they may want to do to themselves.

Extreme mood swings: When somebody who usually is depressed and stressed behaves calm or cheery, this is an alarm sign that the person may be suicidal. They may have struggled with their decision to kill themselves, but when they accepted that this is what they want to do it calms their mind.

Past trauma: Abuse, trauma and neglect in the past are risk factors for suicide in the future.

Drug abuse: substance abuse predisposes a person towards being suicidal later on in life.

More suicide risk factors

Severe chronic illness with chronic pain: when a person has a chronic illness, and it is difficult to treat, people lose hope and they feel trapped. At this point suicide appears to be an option.

Mental disorders: people with schizophrenia, anxiety, depression or personality disorders are at a higher risk to turn suicidal. This is particularly so when they did not receive treatment and their mental condition deteriorates.

Family history, other factors and teen suicides

Family history of suicide: when there is a family history of suicide or a personal history of failed attempt of suicides the risk of suicide is much bigger than in the general population.

Other factors: There are many more factors that all can have a bearing on the risk for suicide. Financial loss and loss of a job are examples, but also prolonged stress from bullying or harassment. Divorce, breakup of a relationship, insufficient social support and many other negative emotions can contribute to a risk for suicide as well. A lot depends on the emotional make-up and the resilience of a person.

Teens: Teens are particularly vulnerable to commit suicide. It is important to listen to the teen in trouble and to arrange for counseling and support. More on teen suicide here.

What to do when faced with a person who contemplates suicide?

There are several crisis phones that are important to remember. In 2019 congress in the US has proposed to establish crisis lines with a simple 3-digit number: 988. But not all states have this number activated yet. The national crisis line in the US is: 1-800-273-TALK (1-800-273-8255).

In Canada the crisis hotline is: 1-833-456-4566.

There are counselors who have experience in listening to people in distress and talk to them.

When a person wants to commit suicide call 911. Sometimes a person in mental distress needs to be hospitalized and treated by a psychiatrist. Some people may benefit from electroconvulsive therapy, others from antidepressants. Cognitive therapy and behavioral therapy have a place as well in treating depressed patients. Close follow-up is important to prevent a relapse.

When is Someone at Risk for Suicide?

Conclusion

This year’s National Suicide Week was from Sept. 4 through 10, 2022. In the US alone nearly 46,000 persons died by suicide in 2020, nearly 800,000 died by suicide worldwide. It is important to recognize the signs of impending suicide. There are several high-risk factors that point to impending suicide, such as hopelessness, obsession with death and dying and extreme mood swings. There are certain constellations that are associated with a high risk for suicide: a history of a mental disorder, a break-up of a relationship, a severe illness with chronic pain and others. It is important to get the person at risk to a counselor or psychiatrist.

Treatment intervention for suicidal person

By talking it out, the pain of suffering gets eased. If there is an underlying depression it can be treated with various treatment modalities. Cognitive behavior therapy may help to change the negative thought patterns. It is important to intervene early. Close follow-up to prevent a relapse is also important.

Aug

2022

Ultra-Processed Food and Dementia

By Ray Schilling | Alzheimer’s disease, Dementia, diet, exercise, Fitness, food, Nutrition, sugar

Researchers are more and more concerned about an association between ultra-processed food and dementia. A new study found that when you consume more than 20% of you daily food intake as processed food, you can start developing cognitive decline. Eating just 2 cookies per day, which have about 100 calories, will lead to cognitive decline.

What is processed food?

Foods such as instant noodles, hot dogs and ice cream are not healthy. There is too much salt, sugar and unhealthy fat in them that undermine your health. If you consider breakfast granola as “healthy”, you’d better take a look at the ingredients: sugar is one of them! Frozen meals, sugary drinks, take-out pizzas, deep-fried chicken and French fries also belong to unhealthy foods. Unless you buy fresh ingredients and make your own Mediterranean-style meals, you will struggle staying healthy. Processed foods lead to weight gain, which is difficult to shed unless you give up processed food.

Processed food often contains flavorings, colorings or other additives. White bread and bakery products, fried snacks, crackers, cookies, ice cream, candy, cream cheese and processed cheese, soda and frozen meals fall into this category.

Conference in San Diego

At the 2022 Alzheimer’s Association International Conference in San Diego researchers revealed the results of a Brazilian study. 10,000 Brazilians were followed with dietary habits and intermittent cognitive tests for up to 10 years. In the beginning none of the participants had a cognitive deficit. The average age at the time of the beginning of the study was 51 years. When you eat more than 20 % ultra-processed food of your total calorie intake every day, cognitive decline is showing up on the cognitive tests. Specifically, patients who consumed more than 20% calories from ultra-processed food developed 28% faster decline in cognitive tests. They also developed 25% faster decline in executive functioning.

Comment from a co author

Co Author Dr. Claudia Suemoto, an assistant professor in the division of geriatrics at the University of São Paulo Medical School stated: “In Brazil, ultra-processed foods make up 25% to 30% of total calorie intake. We have McDonald’s, Burger King and we eat a lot of chocolate and white bread. It’s not very different, unfortunately, from many other Western countries”. She went on to say: “58% of the calories consumed by United States citizens, 56.8% of the calories consumed by British citizens, and 48% of the calories consumed by Canadians come from ultra-processed foods”. She expressed her concern that these statistics show that many more seniors than now will develop Alzheimer’s disease. In the Brazilian study researchers followed their subjects for up to 10 years. After decades of exposure to ultra-processed food the numbers of people with cognitive deficits and Alzheimer’s disease will be much higher.

Other means to prevent cognitive decline

A study showed that regular aerobic exercises (running, treadmill, walking) or stretching, balancing and range of motion exercises both prevented cognitive decline. The best is to build some form of exercise into your daily routine. This is particularly important for people who have desk jobs.

What are healthy foods to eat?

We need to eat more vegetables, fruit and cut out sugar, omit too many starchy foods, salt and unhealthy fats. So, how does that work? In the following I am giving examples of a healthy breakfast, lunch and dinner.

Breakfast

Start the day with fresh fruit, a bowl of rolled oats with milk or a milk alternative. Add a few almonds or chopped nuts or ground flaxseed. You could add raspberries, blackberries, strawberries or blueberries.

If you want a breakfast with egg, try an omelet with eggs or egg white with mushrooms, onions and chopped greens! No, it does not always have to be kale! Enjoy arugula or spinach. Add some salsa on the side.

For those who hate to prepare breakfast, take it easy: put 1/2 a banana, a cup of berries, 1 tablespoon almond butter and 3/4 cup of low-fat yoghurt into the blender. Blend at high speed. This takes less than 2 minutes. Enjoy! It does not get much easier than that.

Lunch

Assemble some mixed salad greens, 1 sliced tomato, 1 cup of sliced cucumber, half a sliced avocado and 1/2 shredded carrot on a plate or in a bowl. Add 2 slices of cheese or 2 tablespoons of crumbled feta cheese. Add one boiled and sliced egg or alternatively 4 slices of chicken breast. Make a dressing of 2 tablespoons of olive oil and 1 tablespoon of balsamic vinegar. You can prepare this easy lunch the evening before and take it to work.

If you want a warm lunch, cook a simple Italian-style vegetable soup. Sprinkle it with a tablespoon of grated parmigiano cheese and serve it with a slice of whole-grain bread. A vegetable chili is a good choice for a colder day. Have some fresh fruit for dessert.

Dinner

Make vegetables the main event. Do not have a huge steak with an afterthought of vegetables, but build a tasty meal around vegetables with a protein of your choice: lean meats, such as chicken breast, enjoy fish or other seafood or experiment with other protein sources, such as tofu. The latter works well in an Asian-style vegetable stir-fry. And otherwise: breaded and deep-fried chicken or battered fish are not healthy choices, even if you prepare the meal at home! Forget the breading and dip the meat into a tasty marinade instead! If you want to have a quick dessert, make a colorful fruit salad with a dollop of yoghurt on top. For all those who drool over a decadent dessert in a restaurant, go ahead and order that Tiramisu and share it with others of your party. But it should be an exception rather than a regular treat.

Ultra-Processed Food and Dementia

Conclusion

Researchers are more and more concerned about an association between ultra-processed food and dementia. A new study found that when you consume more than 20% of you daily food intake as processed food, you start developing cognitive decline. Eating just 2 cookies per day, which have about 100 calories, will lead to cognitive decline. It is fairly easy to cut out junk foods from your diet and to adopt healthy eating ha its.

Meal suggestions

Start the day with fresh fruit, a bowl of rolled oats with milk or milk alternative. Add a few almonds or chopped nuts or ground flaxseed. You could add raspberries, blackberries, strawberries blueberries. I sweeten everything with stevia extract and avoid sugar completely. For lunch you could have mixed salad greens with 2 slices of cheese or 2 tablespoons of crumbled feta cheese. Add one boiled and sliced egg or alternatively 4 slices of chicken breast. For dinner make vegetables the main event. Do not have a huge steak with an afterthought of vegetables, but build a tasty meal around vegetables with a protein of your choice: lean meats, such as chicken breast, enjoy fish or other seafood or experiment with other protein sources, such as tofu.

Final remark

You see, it is fairly easy to avoid ultra-processed foods that lead to cognitive decline. It involves a critical look at your current eating habits and very likely some cleaning-out of less than desirable foods from your pantry.

Aug

2022

New Immunotherapy Approach against Cancer

By Ray Schilling | Cancer, immune system

A recent publication reported about a new immunotherapy approach against cancer. The model it dealt with was a very vicious brain cancer with the name glioblastoma. The results of this research were subsequently transferred to another vicious cancer, osteosarcoma, which is a form of bone cancer with a very poor prognosis. Researchers have to do further clinical experiments to establish this new immunotherapy in osteosarcoma patients. Physicians completed the following experiments and clinical studies.

Oncolytic virus Delta-24-RGD can lead to remission in glioblastoma patients

Researchers at the University of Navarra, Pamplona, Spain together with The University of Texas MD Anderson Cancer Center in the US investigated glioblastoma patients. They found that treatment of glioblastoma patients with oncolytic viruses Delta-24-RGD led to a greater than 3-year remission in 20% of cases. Normally, patients with a glioblastoma survive only 9 months on average. 12% had a greater than 95% reduction in the size of the tumor. This was a phase 1 clinical study with 37 patients who had recurrent malignant glioblastoma. The authors said: “Oncolytic adenoviruses are attractive therapeutic agents because they can kill tumor stem cells and induce cell death by several mechanisms, including direct lysis, expression of toxic proteins, induction of cytokines, and T-cell–mediated immunity.” The particular oncogenic virus that the researchers used was an adenovirus Delta-24-RGD.

Transferring glioblastoma results to a cure for osteosarcoma

The same researchers wanted to see whether the cure rates of treating patients with glioblastoma was transferable to other cancer patients. In particular they were interested in patients with osteosarcoma, which is a similarly vicious cancer. Advanced osteosarcoma has a survival rate of 27% after 5 years. The researchers first did experiments with a human osteosarcoma cell line in tissue culture and at the same time a murine osteosarcoma cell line. Later they tested the action of oncolytic viruses Delta-24-RGD in a mouse model.

Experiments with osteosarcoma cells in tissue culture

The advantage of such experiments is that you can control all the parameters easily in a Petri dish. But critics say that this is far removed from osteosarcoma behavior in humans. Researchers found that the oncolytic virus Delta-24-RGD killed many osteosarcoma cells in vitro. They also were able to insert a new gene into the oncolytic virus, which was equally effective in killing osteosarcoma cells. They called this virus Delta-24-ACT.

Curing osteosarcoma in a mouse model

Next the researchers tested effectiveness of the oncolytic viruses, Delta-24-ACT and Delta-24-RDG in mice. They injected osteosarcoma cells from tissue culture into the tibia of mice. Tumor growth was subsequently measured. The experimental groups were given two oncolytic virus infections, the control group did not. On day 10 and 18 the researchers could see that controls had faster growing tumors compared to the experimental groups. The experimental groups had less tumor side effects. And the experimental mice survived longer than the controls. Further research showed that the oncolytic viruses produced a 4-1BBL protein, which stimulated the animals’ immune system to fight the osteosarcoma.

New immunotherapy approach against cancer: Effector T cells

Researchers could prove that in mice treated with oncolytic viruses it was the special protein (4-1BBL) that stimulated T lymphocytes to become killer T cells. They in turn attacked the osteosarcoma cells.

New immunotherapy approach against cancer: The need for human research

Doing research in humans is more complicated than in a mouse model. But in order to improve survival rates in patients with osteosarcoma human research is absolutely essential. However, research is complex and the effects of oncolytic viruses is only in the 20% range with regard to increasing survival. This requires more research. It may be that instead of oncolytic viruses a stimulatory protein would arm T cells to become killer T cells that fight the cancer.

New Immunotherapy Approach against Cancer

Conclusion

Glioblastoma patients had a better survival after treatment with oncolytic viruses Delta-24-RGD. Researchers translated this type of research to another cancer, osteosarcoma. This also has a poor prognosis, Researchers did experiments in tissue culture and in a mouse model. They were able to show that oncolytic viruses produced a 4-1BBL protein, which stimulated the animals’ immune system to fight the osteosarcoma. Specifically, the protein armed T lymphocytes and turned them into killer T lymphocytes. These destroyed osteosarcoma cells in tissue culture or in the mouse model. It is encouraging to see positive results in a laboratory setting of a tissue culture. The step further in an animal experiment is also a positive achievement. More research will improve the cure rates of osteosarcoma. The effective treatment of osteosarcoma in humans is still far away! The next step is human research that shows improvements in patients’ survival rates.

Discussion of “certain probiotics are not as harmless as thought”

Patients outside the ICU setting

Risk assessment necessary

Fermented foods versus probiotics

Conclusion

Symptoms of mast cell activation syndrome

Diagnosis of mast cell activation syndrome

More possible tests

Treatment of mast cell activation syndrome

Conclusion

Treating mast cell hyperactivity

Study from nature showing changes of the immune system due to the Bubonic plague

Results of the study

Denmark data

The downside of immunity

Conclusion

Autoimmune diseases

Chronic sleep deficit

Human sleep studies

There are many sleep disruptions, which cause a sleep deficit

Epigenetic effect of sleep deprivation on bone marrow cells

Lack of sleep harms the immune system and causes inflammation says the literature

Conclusion

Poetry helped hospitalized children

Details of the statistical results

Emotional responses elicited by hearing poetry

Pleasure inducing activities can stimulate the reward areas of the brain

Dr. Amen’s SPECT scans

Discussion of why poetry helps anxiety and depression

Conclusion

Anxiety is a powerful emotion

Relationship between grief and anxiety

Anxiety

What coping strategies are available?

What is your advice to people who resist a formal mental health treatment?

What is the role of meditation and mindfulness in healing anxiety?

Imagination as another powerful tool

Stories help to reduce grief

Stay connected with your lost loved one

The crux of grief work is making meaning out of loss

Conclusion

Anxiety is an important aspect of grieving

How healthy are plant-based substitutes?

Problems with our current food consumption

Use of antibiotics in feedlots

Other results of the study

Criticism of plant-based meat alternatives

Muscle synthesis

Weight loss

Greenhouse gas emissions and other factors

Conclusion

Consumer beware

Some suicide statistics

Abnormal behaviors to watch out for

Watch what people say

Suicide risk factors

More suicide risk factors

Family history, other factors and teen suicides

What to do when faced with a person who contemplates suicide?

Conclusion

Treatment intervention for suicidal person

What is processed food?

Conference in San Diego

Comment from a co author

Other means to prevent cognitive decline

What are healthy foods to eat?

Breakfast

Lunch

Dinner

Conclusion

Meal suggestions

Final remark

Oncolytic virus Delta-24-RGD can lead to remission in glioblastoma patients

Transferring glioblastoma results to a cure for osteosarcoma

Experiments with osteosarcoma cells in tissue culture

Curing osteosarcoma in a mouse model

New immunotherapy approach against cancer: Effector T cells

New immunotherapy approach against cancer: The need for human research

Conclusion

A Survivor’s Guide to Successful Aging