Monthly Archives: August 2022

Tucker says self-care plus traditional and alternative medicine which is the foundation of biohacking can work wonders radial and focused shockwave therapy, deep heat from TECAR, laser light therapy and peripheral electro magnetic frequency (PEMF), along with certain supplements, herbs, better sleep, topicals, mindfulness breathing and guided movements.

Dr. Tucker is in a unique position. He has been in practice for over 40 years and met a lot of smart people. He uses the experience of his colleagues and their collective knowledge plus the current science from around the world. He has cultivated relations with other doctors and has small group weekly zoom calls where medical doctors, chiropractors, physical therapists, podiatrists, nutritionists, and the lay public share information about their preferences and what is working and what is sham.

Tucker has helped popularize TECAR Ask Me Anything (AMA), Shockwave AMA, Doctor of Chiropractic (DC) and Physical Therapy (PT) AMA and Kinotek AMA. These on-going zoom calls with regular practitioners, educators, integrative medicine specialists, University and Hospital based medicine practitioners are using and looking at new and innovative methods and technologies like TECAR and focused shockwave. We like to share the benefits of non-invasive procedures that help athletes recover faster, and help regular people deal with chronic pain. We see difficult cases of pain heal better and faster using combination therapies like shockwave, Winback TECAR therapy and laser light therapy especially for patients with neuropathy and osteoarthritis.

Dr. Tucker treating with Winback

These doctors recognize that extensive studies have been done but cannot keep up with all the formation. Doctors get together and talk about everything from sports medicine, injuries, and best approaches to neuropathy, dementia and arthritis. In the Ask Me Anything format we share what we find works out in our practices for patient lives in real time. We talk about everything from products that claim to increase longevity, increase sexual vigor, costs of care, and how to optimize your body.

How do you know what works and what doesnt when it comes to Biohacking alternative medicine? Google search is easy but takes a lot of time to sort through. Biohackers are looking for well-done, independent studies on herbs, acupuncture, hypnosis, hyperbaric oxygen, etc. to guide them. Doctors banding together with the purpose of sharing experience, encouraging in-office research, education, and new evidence on alternative medicine, are gathering information to give to their patients. This practice takes solid science and natural experience behind them into Biohacking.

Here, are six alternative neuropathy practices that are among the most promising:

To visit Dr. Tucker, go to: https://www.drjeffreytucker.com/

Read more about Dr. Tucker and his work with laser treatment HERE.

Excerpt from:

6 Alternative Medicine Tips for Neuropathy with Dr. Jeffrey Tucker - LATF USA

A primary care clinic start-up is differentiating itself by being the first primary care group staffed only by nurse practitioners (NPs).

Minneapolis-based The Good Clinic chain is designed to emphasize patient engagement, continuity of care, and an emphasis on wellness and convenience through a unique nurse practitioner-driven model, says Larry Diamond, CEO of Mitesco Inc., which operates The Good Clinic brand.

More than half of U.S. states26 states, Washington, D.C., and two U.S. territorieshave granted patients full and direct access to care by NPs in adopting Full Practice Authority (FPA), according to the American Association of Nurse Practitioners (AANP).

FPA is the authorization of NPs to evaluate patients, diagnose, order, and interpret diagnostic tests, and initiate and manage treatments under the exclusive licensure authority of the state board of nursing. This regulatory framework eliminates requirements for NPs to hold a state-mandated contract with a physician as a condition of state licensure and to provide patient care.

The Good Clinics NP model evolved from the shrinking volume of primary care practices in the United States, which in turn, occurred because of low reimbursement rates to primary care physicians, Diamond says.

Whats happened over time is because reimbursements are low, physicians graduating from medical school with these huge student loan bills can't afford, even if they wanted to, to go into primary care, and so the number of new docs coming out of medical school who want to go into primary care has been waning, he says.

The AMA (American Medical Association) says there's a shortage of about 25,000 to 35,000 primary care providers, which is one of the reasons why all of these urgent care centers have popped up, because in America today, it's typically two to five weeks waitlist to get in to see your primary care provider for just a normal visit, a physical, or just a follow-up, Diamond says. So, America learned, Oh, if I have an earache, a sore throat, or a cut, let me run over to the urgent care clinic, and the challenge there is that we stopped providing care and just started fixing problems.

But the prevalence of chronic diseases requires that healthcare do more than simply fix problems, he says.

Diabetes is at an all-time high, and pulmonary issues, well, they all start somewhere and it's typically because they're not addressed earlier in their disease process, he says. And the government finally has recognized that if you focus on prevention, you can avoid a lot of the costs associated with people developing chronic illnesses, and then deteriorating with them, where it always costs more to address a problem later in its cycle.

Nursing is better aligned to primary care from a philosophy perspective than medicine, Diamond says. Nursing is about working with a patient over time, to help them overcome some of the challenges that they're experiencing, where medicine has evolved to be much more about one and done. Let me do something and solve the problem, Diamond says. And with chronic illness in America, it's not typically a one and done type of solution.

Good Clinics began when the physicians that started MinuteClinic, which has since been sold to CVS, added Diamond to their team to create a primary care model that was whole-person focusedone that considered physical health, behavioral health, stressors, and how they use the healthcare system.

The concept is about, How do I take care of a person soup to nuts? [by] considering complementary and alternative medicine or whatever the person is interested inyoga, meditation, supplements, vitamins, standard medicineand to have a relationship where we co-develop a wellness plan with that person.

For example, the adolescent population has been struggling with depression and anxiety after COVID and are frequently prescribed antidepressants by behavioral health services.

No. 1, theyre not looking at their physical health to understand How is their nutrition? because nutrition in adolescents really is the start point of how you feel mentally, behaviorally. We were finding thyroids that are not operating at the levels they should be, and we're finding that their vitamin D and vitamin B levels are not the adequate level, Diamond says. Nutrition is the first starting place when you're trying to address behavioral health issues, and unfortunately, so many of the behavioral health services operate in isolation of primary care.

The companys first clinic opened in February 2021, and by the end of the year it had six clinics operating around Minneapolis. This year, it expects to open an additional 12 clinics in Minnesota, Colorado, and Arizona and by next year 50 clinics are expected to be in operation in states where NPs can freely practice at the top of their license.

And though NPs have FPA in slightly more than half of U.S. states, that doesnt preclude The Good Clinic from expanding into states where NPs dont have FPA, Diamond says.

Nurse practitioners pretty much in every state have the ability to practice; what changes as you go state to state is they often have to practice under the tutelage, from a quality control perspective, of a physician, he says. There are different levelsa physician [may have to] review chart review or they may have to sit in on a certain number of patient visits with a particular nurse practitioner. So, you can operate our model in all 50 states; it just becomes a little bit more expensive.

Georgia and Texas, for example, have the highest level of quality assurance, and Florida requires a physician to sit in on all medical exams. But that wont prohibit The Good Clinic from expanding into those states.

It just lowers it on the list, Diamond says, as to where were going to want to start.

Carol Davisis the Nursing Editor at HealthLeaders, an HCPro brand.

See original here:

'The Good Clinic' is the First Primary Care Group Staffed Solely by Nurse Practitioners - HealthLeaders Media

The majority of people who contract COVID-19 don't need to seek treatment and can typically battle the infection on their own. That's not always the case, however, especially for those who are high risk and have certain health conditions.

In an effort to prevent hospitalization and severe illness, multiple options are available, including antiviral pills and intravenous treatments. The criteria vary widely for each, and depending on your situation, one option may be recommended over the other.

Those seeking treatment are advised by the Centers for Disease Control and Prevention to reach out to their health care provider, even if only experiencing minor symptoms.

As the BA.5 subvariant continues to circulate and more cases occur, here's what to know about the treatment options, including eligibility and possible side effects.

The latest treatment to garner widespread attention, Paxlovid is an oral antiviral pill that stops viruses from replicating inside the bodys cells and is meant for those currently infected with COVID-19. Paxlovid is available to people ages 12 and up who weigh at least 88 pounds, who have a positive COVID-19 test result, are showing symptoms and are at high risk for developing severe COVID-19, according to an article from Yale Medicine.

In older people and other high-risk patients, the drug was shown to reduce the chances of hospitalization or death from COVID-19. The pills work best if taken within five days from when symptoms begin.

Research suggests that a minority of those prescribed Paxlovid do experience a rebound case of the virus, such as what happened to President Joe Biden. In those instances, symptoms recurred four or five days after completing the treatment. The CDC in June said a brief return of symptoms may be a natural part of a COVID infection, and not related to Paxlovid. No additional treatment is needed for those who experience a rebound, according to health officials.

The drug has been shown to reduce the risk of hospitalization in non-hospitalized patients by 87% when given as a three-day course, according to a study from the New England Journal of Medicine.

Paxlovid does interact with many different medications, including blood thinners and cholesterol pills, so make sure your doctor is aware of your current medication list before discussing treatment.

Also known by the brand name Lageviro, Molnupiravir is recommended for people age 18 and up who are at high risk for hospitalization and death from COVID-19. However, it should only be used when Paxlovid, Bebtelovimab and Remdesivir aren't available, as its efficacy was determined to be lower than originally reported.

The medication must be taken as soon as possible, within five days of symptom onset, according to Yale Medicine. Merck, the company behind the drug, initially reported the efficacy as 50%, but later adjusted it to 30%.

Those prescribed the medication should take four capsules every 12 hours for five days.

Molnupiravir is not recommended during pregnancy, since it has not been studied in pregnant women and has shown potential harm duringin vitrostudies. While the medication is still being studied and all of the risks may not be known, the most common side effects are diarrhea, nausea and dizziness.

The first drug approved to treat COVID-19 in late 2020, Remdesivir is the only antiviral treatment to receive full Food and Drug Administration approval - at least so far. Other treatments, including Paxlovid and Molnupiravir, are available under Emergency Use Authorization through the FDA.

Approved for both children and adults, Remdesivir is administered intravenously or through injection and must be given in a health care setting.

To receive the treatment, infants and children must be at least 28 days old, weigh over 6.5 pounds and be either hospitalized or at high risk for severe illness.

While nausea is the most common side effect, hypersensitivity, including infusion-related and anaphylactic reactions, have occurred following treatment in some instances, according to Yale Medicine. Given both in an outpatient and hospital setting, the drug inserts itself into new viral genes to block replication of the virus, shortening the time it takes seriously ill patients to recover.

While data has shown not all monoclonal antibody treatments have worked against all COVID-19 variants, some have been deemed effective in combating the omicron strain.

Bebtelovimab, which was authorized in February, is available for adults and children ages 12 and up who weigh at least 88 pounds and are at high-risk for developing severe COVID-19. An intravenous injection is given for at least 30 seconds, according to health officials, which stated the drug must be given within seven days of symptom onset.

Considered to be an alternative treatment by the National Institutes of Health, it should only be used in cases where Paxlovid or Remdesivir aren't available or appropriate.

Another monoclonal antibody, Evusheld, serves a different purpose.

Unlike the aforementioned treatments, it serves to keep immunocompromised people who don't respond to vaccination from getting sick, according to Yale Medicine. Available to anyone 12 years and older and 88 pounds, the drug shouldn't be given to those with an active infection or anyone who was recently exposed.

Doses will be given in the buttocks, during two separate injections, one after another, with repeat doses every six months. Hypersensitivity, bruising, swelling, pain and soreness at the injection site are possible after the shot is given.

More:

What Medicine Can You Take for COVID? Paxlovid, Remdesivir and Other Treatment Options - NBC Chicago

Cincinnati, OH Regenerative medicine gives hope to patients living with musculoskeletal pain in Cincinnati. Compared to traditional treatments that rely on medication or surgery, regenerative therapies harness the bodys ability to heal and repair itself, allowing patients to recover quicker. QC Kinetix (Eastgate) is an advanced regenerative orthopedics clinic providing natural customized treatment plans. The team of qualified medical providers proactively supports tissue repair by delivering critical nutrients to the injury site, improving circulation, and removing inflammatory compounds.

Whether a patient is a professional athlete, weekend warrior, or nature enthusiast, their performance depends on their mobility. Active participation in the field, gym, or hikes leaves little time for pain, inflammation, or physician visits. The regenerative clinics team is just as passionate about patients performance. They create a treatment strategy that eases pain/inflammation, gives the body a chance to trigger the healing process, and helps maintain their posture/form. The non-surgical therapies relieve pain from a torn rotator cuff, golfers elbow, tennis elbow, shoulder pain, wrist pain, ankle pain, torn Achilles tendon, and tendon/ligament tears.

Regenerative medicine techniques work best as part of a recovery routine that includes rest, physical therapy, and bracing. By combining regenerative medicine approaches with traditional sports injury treatments, patients experience strengthening tendons, ligaments, and connective tissues. Alongside sports-related injuries, QC Kinetix (Eastgate) treats patients with musculoskeletal pain resulting from trauma, falls, poor posture, lifestyle choices, repetitive/jerking movements, or muscle overuse.

The clinics regenerative therapies are popular for joint pain relief and management of soft tissue injuries. By stimulating the bodys natural healing response, the team eliminates the need for pain medication, anti-inflammatories, therapeutic massages, or extensive physical therapy. Their treatment techniques are also an excellent alternative where other traditional orthopedic treatments or costly surgical procedures have failed.

Many patients discovered QC Kinetix (Eastgate) while searching for natural knee pain treatments. The team creates plans that address bone-on-bone osteoarthritis, decreased range of motion, chronic knee pain, knee cracking/popping, torn meniscus, and torn ACL. The clinics natural regenerative techniques help knee joints heal and repair without knee replacement surgery, arthroscopic surgery, steroids, physical therapy, or extended recovery time.

When joint tissues become irritated, inflamed, or worn down over time, a patients immune cells react by destroying the cartilage. The result is chronic arthritis pain in the shoulders, hips, ankles, wrists, elbows, low back, feet, hands, and knees. While medicine, physical therapy, and surgical procedures decrease inflammation in joints, they dont slow down the progression of the disease. However, biologic therapies provide long-term relief by using the bodys existing healing mechanisms to improve pain. The providers include a variety of treatment methods after performing a comprehensive examination of a patients condition and health history. Check out their website to learn more about regenerative medicine Cincinnati.

Call (513) 847-0019 to request a consultation or learn more about regenerative medicine. QC Kinetix (Eastgate) is located at 4357 Ferguson Dr, Bldg 3, Suite 210, Cincinnati, OH, 45245, US.

Media Contact

Company NameQC Kinetix (Eastgate)Contact NameScott HootsPhone(513) 847-0019Address4357 Ferguson Dr, Bldg 3, Suite 210CityCincinnatiStateOHPostal Code45245CountryUnited StatesWebsitehttps://qckinetix.com/cincinnati/eastgate/

Original post:

QC Kinetix (Eastgate), a Regenerative Medicine Clinic in Cincinnati, offers Alternative Treatments to Surgery for Chronic Pain and Sports Injuries -...

If you're experiencing discomfort in your anal area, one of the first things that come to mind for many of us is hemorrhoids.

That's the big misnomer.

"Hemorrhoids are the great scapegoats for all sorts of anal issues and discomfort," says Sean Langenfeld, MD, Nebraska Medicine colon and rectal surgeon. "Because of their location, it's very difficult for most people to know what's going on with their anus so they assume it's hemorrhoid. Less than 50% of people who complain of hemorrhoids actually have hemorrhoids that cause symptoms. More often, they have other diagnoses ranging from small issues such as pruritus ani (anal itching), anal warts, or anal fissures to large issues such as abscesses, fistulas and cancers."

Derrick Eichele, MD, Nebraska Medicine gastroenterologist, agrees, and adds, "If you do experience new onset bleeding, it's better to get it checked early with your primary care doctor than to wait. This will allow us to rule out other alternative competing diagnoses and get you the appropriate treatment."

Hemorrhoids are vascular cushions that live inside the anal canal. They are a part of normal human anatomy. Everyone is born with three of them. These internal hemorrhoids help keep the anus closed at rest, which helps with continence. Hemorrhoids can become uncomfortable when they are swollen and inflamed. Common causes include constipation and straining, prolonged sitting on the toilet, pregnancy and strenuous exercise.

Hemorrhoids fall into two categories.

Internal hemorrhoids are the most common type. Despite commonly-held beliefs, hemorrhoids are not usually painful. They can cause painless, bright red bleeding and may bulge outside the anal opening, also known as prolapse, during bowel movements. If they get large enough, patients may see or feel a soft, pink bulge of tissue prolapsing out of their anus. This tissue goes back inside on its own, but sometimes it needs to be pushed back in.

An external hemorrhoid is a soft cushion of skin-covered vascular tissue that lives just outside the anal opening. Severe straining and strenuous exercise can cause these tiny vessels to rupture, which is similar to a blood blister. The ruptured or thrombosed hemorrhoid can grow under the skin and become firm and painful. It is usually dark blue in color and often ruptures producing small dark blood clots.

While thrombosed hemorrhoids are very painful, they are not dangerous to your health and improve over time similar to a skin bruise. If the pain is severe, they can often be removed in the office by a colorectal surgeon.

If you suspect you may have hemorrhoids, Dr. Langenfeld suggests making the following lifestyle changes that can help relieve your symptoms usually within two to seven days:

"In many cases, a suspected case of hemorrhoids ends up being a different issue," notes Dr. Langenfeld. "If the anal symptoms do not get better in a short period of time, a visit with your doctor can help determine if another issue exists. People who are searching hemorrhoids on the Internet should try to find a reliable online resource, such as the American Society of Colon & Rectal Surgeons website. They should also be searching anal fissure since this is a much more common cause of anal complaints."

Anal itching (pruritus ani) itching near the anal opening due to irritation to the skin in the area.

Anal warts caused by the human papilloma virus (HPV), anal warts are caused from direct sexual contact with an infected person.

Anal abscess an infected cavity of puss near the anal opening usually caused by an infection of one of the anal glands usually inside the anal opening.

Anal fissure a tear in the skin just inside the anal opening usually caused by trauma to the anal canal such as a large, hard bowel movement.

Anal fistula a small tunnel connecting a previously infected anal gland with the skin outside the anal opening usually caused by a previous anal abscess.

"Hemorrhoids are not dangerous and typically don't turn into more severe problems, but they can be distressing and uncomfortable," says Dr. Langenfeld. "The important thing is to rule out other causes if they do not go away on their own within one to two weeks after trying some simple lifestyle changes."

If you continue to have rectal bleeding, depending on your age and risk factors, your doctor may recommend a colonoscopy to rule out other possible sources of blood loss, says Dr. Langenfeld.

"Your primary care doctor can determine your diagnosis and help you implement lifestyle changes to alleviate your symptoms," says Dr. Langenfeld. "If symptoms linger, your primary care doctor may refer you to a gastroenterologist or colorectal surgeon for treatment."

Hemorrhoids that cause moderate or severe symptoms may require surgery. "The most common office procedure for hemorrhoids is rubber band ligation.

"Rubber band ligation is a safe, effective and pain-free procedure that can be performed in your doctor's office that involves placing a rubber ligature tightly around the internal hemorrhoid to cut off the blood supply," explains Dr. Langenfeld. "This will cause the hemorrhoid to shrink and eventually slough off over one to two weeks."A severe thrombosed hemorrhoid may require excision, which can often be performed in your doctor's office. This involves making a small incision to drain the clot and usually brings significant relief, notes Dr. Langenfeld.

Need an evaluation?Suspect you may have hemorrhoids or another type of anal issue? Call 800.922.000 to schedule an appointment with one of our doctors.

Read the original post:

What causes hemorrhoids, and when should you see a doctor? - Nebraska Medicine

Bengaluru:About three and a half years ago, Joseph,suffering from severe alcohol-associated hepatitis (SAH) as well as lung tuberculosis, was lying in a semi-coma at Rajagiri Hospital in Aluva, Kerala. The 65-year-olds liver was deteriorating rapidly.

Over the course of his hospitalisation, he attended his daughters engagement ceremony chaperoned by medical attendants. However, he worried that he would not live to see her wedding.

He couldnt get the recommended treatment of steroids for his liver due to his TB. He was told that a liver transplant was the only procedure that could save him, but since he was also suffering from SAH, to prevent the risk of a relapse, he needed to go through a mandated sobriety period of six months before surgery.

But Joseph did not have the luxury of time. That is when he was offered an unusual option Faecal Microbiota Transplantation, or stool transplant.

It is what it sounds like. Faecal Microbiota Transplantation (FMT), also called bacteriotherapy, is a procedure where human stool with good bacteria from a healthy, screened donor is transplanted into the intestine of the recipient patient through the mouth, nose, or via an enema.

The procedure restores the gut bacteria the beneficial bacteria that line our intestines improving gut and colon health. It has been experimentally most commonly used to treat irritable bowel syndrome and other gastrointestinal disorders.

At Rajagiri,FMT has been adopted by hepatologists (liver specialists), owing to therelevance of the gut microbiome (beneficial bacteria in the intestines) in liver disease.

We thought it was strange, but they told us its a lifesaving treatment, Josephs daughter Shervia, 29, told ThePrint. Even if experimental, it was his last chance at life.

Josephs family gave their consent and the treatment began in early 2019. A faecal material suspension liquid mixed with undissolved solid matter was created from a donors stool and directly poured into a tube going into Josephs nose and to the small intestine. He was given an infusion of 100 ml for seven to eight days.

He started responding and improving almost immediately, said Shervia.

A month later, Joseph was dischargedto everyones surprise and relief, much aheadof Shervias wedding.

I had no problem. The experience was good. It is because of the treatment that I was able to attend my daughters wedding. Before the procedure, doctors had said they would not be able to allow me to attend. But today I am fine, and Im also able to drive normally, said Joseph, who has been disease-free for over three years.

Shervia said she would recommend FMT to anyone for whom liver transplant isnt an option, as it is inexpensive, easy, and efficient.

FMT procedures havebeen gaining clinical relevance since early studies in the 1950s, andthe method hasproven to be consistently and highly successful in treating gastrointestinalbacterial infections that dont respond to antibiotics.

It has been adopted in several hospitals around the world as an experimental treatment. Its usage is increasing with growing evidence that gut bacteria imbalance contributes to a host of conditions, including allergies andasthma,cancer, andliver disease.

While a handful of hospitals in India have used it, Rajagiri in Kerala is the only institute in the world to have consistently performed FMT on a case-by-case basis for severe SAH cases.

Also read: Where did Earths early life forms get oxygen? Scientists finally have some answers

The FMT programme at Rajagiri Hospital is headed by hepatologist Dr Cyriac Abby Philips, senior consultant and clinical scientist at The Liver Institute there.

Dr Philips, also an expert member of the Centre of Excellence in Microbiome Studies, an upcoming scientific programme beingdevelopedby the Government of Kerala,had performed hisfirst FMT in 2014 as part of his hepatology training and thesis work at the Institute of Liver and Biliary Sciences in New Delhi.

When identifying topics for his thesis, Dr Philips, speaking to ThePrint, said he came across many rigorous papers that showed intestinal microbes playing a role in the cause and progress of several liver diseases, especially alcohol-related ones.

Since FMT was already a recommended treatment for the drug-resistantClostridioides difficileinfection (CDI), Philips sought to conduct the first human pilot trial for treating SAH patients, who didnt have alternative therapies available to them, with FMT.

As part of my thesis, I started the worlds first stool transplant protocol for the sickest group of [SAH] patients in 2014, at the time equipped with our kitchen blender, donated by my wife Teena, for homogenising fresh stool in my makeshift, dingy storage room cum FMT Lab at the lowest ground level at my institute. And it paid off, he said.

We found that close to 85 per cent patients on FMT survived one year, compared to 33 per cent on non-FMT standard care in our study, he added.

Consequently, FMT has saved the lives of many liver patients at Rajagiri.

One such person is 37-year-old Deepesh. He had been suffering from liver cirrhosis in 2018, undergoing treatment in Coimbatore. He was extremely weak, had shaky legs and couldnt even eat. His urine was discoloured, indicating damage. His doctors, too, recommended Rajagiris FMT treatment.

We trusted the doctor [at Rajagiri]. Everybody knows he is an expert, he said to ThePrint.

Deepesh underwent the same transplant procedure through his nose for eight days. Since his recovery, he has felt different.

After the treatment I had no problems I had energy again and regained my appetite, he said. Deepesh continues to be in good health.

Liver disease isnt the only disorder to be cured by FMT. In fact, it is more widely adopted for gastrointestinal disorders, such as irritable bowel syndrome and more.

The very first FMT procedure conducted in India in a clinical setting on a patient was performed by Dr Avnish Seth, gastroenterologist and hepatologist currently with the Manipal Hospital in Dwarka, Delhi, in 2014.

At the time, he performed theprocedure at Fortis Memorial Research Institute in Gurugram on a patient with ulcerative colitis, caused by CDI in a patient who had undergone heart surgery as well.

The 44-year-old male patient was on ventilator support and had reduced kidney function, so the procedure was performed thrice via colonoscopy.

The patient improved rapidly without steroids and antibiotics, and Seth has continued to perform FMT procedures.

Dayanand Medical College in Ludhiana also performs FMT procedures under Dr Ajit Sood for ulcerative colitis and Crohns Disease, both forms of inflammatory bowel disease (IBD).

ThePrint reached Dr Sood and Dr Seth by email, but did not receive a response.

Also read: 66-year-old U.S. man is the fifth in the list, but the oldest patient to be cured of HIV

The infusion of stool through a feeding tube sounds repulsive, but its far from it, assures Dr Philips.

A healthy donor is carefully selected and screened, especially for bacterial CDI, which is commonly driven by antibiotic use. Up to 100 grams of fresh stool is diluted with saline, milk, or water, and blended. This suspension is then administered through a feeding tube down the mouth or nose to the small intestine, or through a colonoscope as enema.

The stool suspension is given at the bedside and the whole process is over within 10 minutes. Since it is given deep into the small intestine, the chance of regurgitation and gaseousness from the procedure does not exist, said Dr Philips, who regularly performs the procedure for SAH and other liver diseases.

He further said that none of the patients complain of smell or distaste after the procedure because they are made to sit up for an hour post-procedure and also given medication to propel the suspension.

Dr Philips teams work has shown the benefit of FMT for a range of conditions, including alcohol addiction, antibiotic resistance, and drug-inducedliver injury.

They have also, according to Dr Philips, performed the first, largest and longest follow-up study on FMT in alcohol-associated hepatitis, and were able to show the change from bad bacterial profile to a good one starkly.

Dr Avnish Seths long-term follow-up study for ulcerative colitis had patients get periodic FMT treatments for maintenance and rescue, demonstrating successover five years.

Stool transplant was first documented in 4th century China by physician Ge Hong, and subsequently by physician Li Shizhen in the 16th century, who had their patients drinkyellow soupto treat stomach disorders. The firstpaperto be published in modern medicine for FMT in humans was in 1958.

The treatment has also been widely adopted by veterinariansand is also naturally exhibited in the wild by animals, many of whom often consume faeces of their own or other species.

The reason Joseph, Deepesh and many others have benefited from FMT is the enhanced clinical understanding of the gut microbiome, or the combined ecosystem of bacteria, fungi, and other microbes that inhabit our body, which help regulate our health and immune systems.

Also called the gut flora or microbiota, it plays a key role in digestion and healthy functioning of intestines. Disruption in the gut microbiome is believed to contribute to elevated blood sugar and cholesterol levels, fluctuations in weight, diabetes, inflammatory bowel disease, and other illnesses includingcancer.

It affects even the brain and nervous system, due to the two-way biochemical signaling mechanism called thegut-brain axis, which causes molecules produced in the intestine to affect the brain. Thus, the gut microbiome is thought to play a major role in cognition and mental health as well.

Trialsstudyingirritable bowel syndrome (IBS) have also shown that patients who had been clinically diagnosed with depression saw a remarkable improvement in their mental health after FMT.

Gut floras health is influenced by lifestyle habits and nutrition, and by diseases and antibiotics. Its disruption is exacerbated by antibiotic use and can manifest as an upset stomach of various kinds, bloating, flatulence, andevenincreased anxiety and depression.

In non-diseased people, it can be typically fixed by cutting down sugar and meat, increasing fermented and prebiotic foods, and exercising. But those with severe disease where the gut bacteria are also involved, like liver cirrhosis and SAH, undergo a more brute-force version through FMT.

When the stool transplant occurs, it regularly floods the small intestine with healthy gut flora. This likely causes the unhealthy bacteria to get displaced over the next few days and die out because the good bacteria compete for the same resources in the intestine.

It is alsolikelythat filtrates from the healthy stool, such as bacteriophages and enzymes, are the drivers of FMTs efficacy.

While FMT has been wildly successful, with the first randomised controlledtrialfor CDI treatment even stopping early due to its overwhelming positive results, it is still in the experimental stage and has extremely strict clinicalprotocols.

If performed without thorough screening, there is risk of transferring infections from donor torecipient. Adverse events in trials havedocumented mild and short-lived gastrointestinal distress that get resolved by themselves by the time the treatment is finished, but irritable bowel syndrome has been exacerbated in some.

One person in the USdiedin 2019 after receiving FMT containing a drug-resistant bacteria, whichalsoinfected one other person who received the same donors sample in pillsfrom a different batch.

The role of FMT as a therapeutic option for SAH is still in its fetal stages, warned Dr Philips. Currently, FMT must only be done within research protocols and possibly on a case-by-case basis for those interested in it after informed consent.

We need rigorous, high-quality randomised controlled trials and validation and repeatable outcomes from those trials for us to include FMT as a therapeutic option in routine clinical practice, he added.

(Edited by Zinnia Ray Chaudhuri)

Also read: Yale researchers make hearts of pigs beat again hours after death. Its a big deal

More here:

Poop has its uses too. Faecal transplants are the new treatment for cancer, liver disease - ThePrint

Cancer-associated thromboembolism (CAT) is a common yet serious condition that occurs due to the physiological changes brought about by malignancy. The two conditions that are the most prevalent are deep vein thrombosis (DVT) and pulmonary embolism (PE). Anticoagulation is the standard of care for these thrombotic problems, however, in the event these medications are contraindicated, other treatment modalities may be needed. One common example is in the setting of an active bleed, such as gastrointestinal (GI) cancer. A treatment that has been used more frequently in recent years is the inferior vena cava (IVC) filter. These can be placed to provide a physical barrier to prevent a thrombus from moving through the circulation and potentially embolizing critical organs. An advantage of these devices is that they can be placed and removed when the use of pharmacological agents is better indicated. This report is a good example of a situation where an active GI malignancy created a hypercoagulable state leading to multiple thromboembolisms. An IVC filter was placed in the perioperative setting to prevent further thrombus migration while the primary malignancy was cured with a hemicolectomy.

Cancer-associated thromboembolism (CAT) is a common medical phenomenon; 20% of all thrombotic events occur in patients with neoplastic processes and they are the second leading cause of death in this population [1]. Deep vein thrombosis (DVT) is clotting that forms in the distal veins, and they have the potential to migrate to other locations which can have grave consequences. Pulmonary embolism (PE) is the most common and potentially life-threatening thromboembolism that is seen at a rate four times higher in patients with cancer than without [2]. Thrombotic events have an increased rate of incidence because of the bodys hypercoagulable state induced by neoplastic disease processes. Tissue factor (TF) and other cellular products are released into the circulation. They create inflammatory conditionsand promote platelet adhesion as well asthrombin formation [3].

Treatment of CAT, in the setting of a DVT or PE is widely discussed in the literature, with chemical anticoagulation as the mainstay of treatment. Common pharmacologic agents include low-molecular-weight heparin (LMWH), warfarin, and more recently the use of direct oral anticoagulants [1]. The task of treating a CAT becomes more difficult in the setting of an active gastrointestinal (GI) bleed from malignancy. These lesions typically result in slow blood loss, which can lead to symptomatic anemia, and may require transfusions of packed red blood cells. In such cases, it may be inappropriate to use standard anticoagulation medication, as it can further exacerbate an active bleed.

Another treatment option available is the use of an inferior vena cava (IVC) filter. These devices are typically used in the perioperative setting where a patient is at high risk for thromboembolism, and when standard anticoagulation is contraindicated or must be stopped. In these scenarios, retrievable filters are generally used and should be removed once anticoagulation is started or restarted. Ideally, they should be removed within 30 days to decrease the risk of recurrent DVT or IVC filter thrombus formation [4]. This report highlights the appropriate use of a perioperative IVC filter in a 59-year-old African American male with a GI malignancy complicated by symptomatic anemia and multiple CATs.

A 59-year-old African American male presented to the emergency department with a five-day history of right calf swelling and pain, as well as left calf pain. The patient has a significant medical history of hypertension, prediabetes, and iron deficient anemia, which resulted in hospitalization. Three months prior, he was diagnosed with a stage IIA adenocarcinoma of the cecum, and a stage IA2 primary, epidermal growth factor receptor (EGFR) positive non-small cell lung cancer of the right lower lobe(Figures 1-2). Before presenting to the emergency department, he was seen in a walk-in clinic with the current symptoms where bilateral lower extremity venous duplex ultrasound was conducted. Results of this exam demonstrated a right-sided, acute DVT from the mid femoral vein down through the distal right peroneal veins and a partially occlusive thrombus in the right posterior tibial veins. There was also a non-occlusive acute DVT on the left lower extremity extending from the left popliteal vein down through the distal posterior tibial and peroneal veins. Finally, it revealed superficial thrombophlebitis of the small saphenous vein. Upon discovery of these findings, the patient was transported to the emergency department for further evaluation and management.

Initial vital signs in the emergency department showed a blood pressure of 151/94, pulse of 101, temperature of 100.2F, respiration rate of 19, and oxygen saturation of 99% on room air. Initial physical exam demonstrated swelling in the right lower extremity, tenderness to palpation bilaterally behind the knee, and the skin was warm to the touch. Bilateral digital clubbing was also noted. Review of symptoms was positive for a 20-pound weight loss in the last three months and was negative for chest pain, shortness of breath, dizziness, syncope, dark or bloody stools, bleeding, or craving ice. Initial lab studies were significant for hemoglobin of 5.8 and hematocrit of 21.5%; platelets were 470,000and a stool guaiac test waspositive.

Since his presenting conditions had a high suspicion of PE, a helical CT study was conducted. Results showed filling defects within the lobar branches of the right middle and lower lobes. Additional filling defects were identified within segmental and subsegmental branches of the right upper, middle, and lower lobes, as well as in the left lower lobe. Upon these findings in the emergency department, he was admitted to the internal medicine unit for further evaluation and management.

On the floor, he was given 2 units of packed red blood cells given the severe symptomatic anemia; he was started on a porcine heparin drip following hospital protocol at 20 units/kg/hr to treat the thromboembolisms. Hematology/oncology was consulted for further recommendations regarding anticoagulation in the setting of chronic slow lower GI bleed, and current bilateral DVTs, and PE. In addition, colorectal surgery was contacted because he was scheduled to undergo a right hemicolectomy the following day.

Following transfusion, his hemoglobin levels increased to 8.2 and remained stable for the remainder of the hospital admission. Hematology and oncology recommended the placement of a retrievable IVC filter to be used in the acute perioperative setting. Colorectal surgery consultation resulted in the planned right hemicolectomy being postponed until successful placement of the IVC filter. Four days after admission, with the help of fluoroscopic and sonographic guidance, an OptionElite (Argon Medical Devices, Plano, TX,USA)IVC filter was placed infrarenal without complications(Figure 3).

On day seven of admission, the surgery team evaluated the patient and decided to move forward with the previously postponed procedure. They initiated bowel preparation and started the patient on a clear liquid diet which then transitioned to a 'no diet' at midnight with the maintenance of IV fluids prior to the operation. They also recommended pausing the porcine heparin drip for six hours leading up to surgery to avoid any excessive bleeding. The following day, a laparoscopic right hemicolectomy with intracorporeal ileocolonic anastomosis was successfully performed without any immediate postoperative complications. On the days following the procedure, the patient was able to eat a normal healthy diet and have bowel movements regularly and without pain or bleeding. One month following the initial hospitalization, he returned to have the IVC filter removed, which was accomplished without complication. At that time, he was followed by pulmonology and thoracic surgery to address plans for future procedures to address the lung adenocarcinoma.

CAT is an acute medical emergency superimposed on a chronic condition. While they are not uncommon, the sequelae can be devastating. This unique hypercoagulable environment is made possible due to an imbalance in hemostatic mechanisms that lead to an increase in thrombus formation and a decrease in lysis. The specific pathophysiological cause is complex and is induced when tumor cells express TF, pro-coagulant proteins, and metalloproteases. These products, in turn, activate endothelial cells, platelets, and leukocytes. Activated leukocytes produce and release other substances such as soluble and contact factors which lead to increased platelet adhesion and thrombin activation [3]. TF plays a role in the coagulation cascade by binding to factors VII and VIIa after injury to blood vessels. Significant levels of TF do not typically circulate in the blood without vascular injury, but various neoplastic processes are known to promote the expression of TF and may lead to a hypercoagulable state and promote thrombus formation [5].

GI malignancies are notorious for causing slow bleeds that can, in time, lead to symptomatic anemia due to blood loss. In many cases, this loss may not be obvious or apparent in the stool. Instead, there may be a slow and even microscopic blood loss that can lead to symptoms of fatigue, lightheadedness, and/or syncope over time. In such events when the hemoglobin level of the patient reaches a low enough level, below 7.0, transfusion of packed red blood cellsmay be necessary. In addition to the slow, chronic blood loss that can result from a GI malignancy, the risk of CAT is also present.

Anticoagulation is the mainstay in treating CATs, however, in the setting of an active GI bleed, standard therapy might exacerbate an active bleed and make the symptoms of anemia worse. Common pharmacologic agents include the use of warfarin, heparin products, and direct oral anticoagulation. While these medications are effective in treating thromboembolisms, they come with an increased risk of bleeding. In the case presented, a porcine heparin drip was used to treat the CAT because it can be turned off quickly in the event of increased bleeding or for surgical interventions. However, to effectively prevent the recurrence of GI bleeding in these patients, the underlying malignancy must be treated. This accomplishes two important tasks. First, by treating the source of active blood loss, the patients anemia resolves naturally. Second, eliminating the malignant cells which caused the hypercoagulable state restores the natural physiology of hemostasis. In some situations, alternative treatments may need to be used as an adjunct to traditional methods.

Current guidelines from the American Heart Association (AHA), American College of Chest Physicians (ACCP), and the American College of Radiology (ACR)/Society of Interventional Radiology (SIR) recommend the use of IVC filters in patients with venous thromboembolism who have an absolute contraindication to anticoagulation, in situations where pharmacologic intervention must be stopped, or have recurrent thrombus formation despite adequate anticoagulation [4]. The introduction of retrievable filters has slightly expanded the indication for use of IVC filters to include patients with large PE who are at risk for recurrent thrombus formation and embolization, those who are not compliant with medical management, patients with limited cardiopulmonary reserve, large free-floating DVT, patients with a high risk of complications from anticoagulation, such as active bleeding, and those who have CAT [4]. Even though the indications for use of an IVC filter have been expanded in recent years, the decision to use one is taken case by case, analyzing the risks and benefits of the intervention.

The use of IVC filters is generally safe and well tolerated, however, nothing comes without risk. These risks are present during the initial placement of the filter, during the postoperative setting, and during retrieval. During the initial placement of the filters, the most common complication is due to bleeding and thrombosis formation. Less common issues can be due to improper placement, or migration, or it can be placed in the wrong location. These can lead to the filter not being able to operate properly or can lead to difficulty retrieving it when the indication is no longer present [4]. In the postoperative period, thrombosis is also possible, leading to an increased risk of developing a DVT, PE, or even renal failure if a thrombus affects the renal vasculature. Perforation of the IVC is also possible because hooks present on the filters to prevent migration may injure vessels. Filters are made of strong metallic materials; however, they can fail and send shards up the circulation to various vital organs such as the heart and lungs [2]. Finally, serious complications exist at the time of filter retrieval. During this period, it is possible to create an injury or dissection to the IVC or have a failure of the filter causing fragmentation. It is generally recommended that the filters are removed when the increased risks of CAT or another thrombus formation have passed. This is generally done within 30 days of initial implantation [4].

The art of medicine is present in a case like this because one must weigh the risks and benefits of treatment modalities when multiple conflicting problems exist. The provider must decide which problem is the most acute and attack that problem first before less acute issues can be treated. In complex disease processes like the one presented, one must take a holistic approach and make informed decisions that will benefit the patient the most. There is no standard treatment for each person because every patient and situation is different from the next. Even though there may be similarities between cases, each case is ultimately unique and may require different treatments for the disease processes involved.

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Inferior Vena Cava Filter Use in the Setting of Gastrointestinal Blood Loss, Malignancy, and Multiple Thromboembolisms: A Case Report - Cureus

Taking place at Crawfordsburn Activity Scout Centre this Sunday (August 21), Happy Fest aims to address the recent statistics concerning mental health problems within the province.

Northern Ireland is reported to have the highest prevalence of mental health issues in the UK with psychiatric morbidity 25% higher than in the UK.

The latest official figures, from the Health Survey (NI) 2019/20, report that around a fifth or 19% of the adult population aged 16 or over had a high score indicating a possible mental health problem, thats 18% of males and 21% of females. However the Covid-19 pandemic was a catalyst for change.Alternative and healing therapies have always been in Northern Ireland, but this industry is gaining momentum.Happy Fest is a first-of-its-kind event that was conceived by local entrepreneurs Ciara Daly, founder of Ciara Daly House of Make Up and Ciaran May, founder of Natural Resilience with the focus of showcasing alternative and healing businesses from Northern Ireland.Co-founder Ciara Daly, said: Alternative therapies changed my life. I was struggling with my mental health and the medication being prescribed by my doctor only helped in the short term. I was in a dark place and I knew something had to change. This is when I started exploring alternative therapies and that is when things started to change.I felt compelled to create an event that bought together practitioners who offer healing and alternative therapies where they can speak with the public who are curious about the services. Being a mother, I wanted to create an event that is family friendly.Exhibitors include hypnotherapists, reiki practitioners, reflexologists, kinesiologists, relationship, mindset and wellness coaches, breath work and plant medicine practitioners.There will also be guest speakers to share their experiences and inspiring stories. Paddy McGurgan will speak about his weight loss journey while Lisa McFarland aka Relationship Coaching NI sharing her wisdom and encouraging us to talk. Grainne McCoy will be on hand to discuss her approach to business and mindset.Happy Fest will include yoga sessions, workouts, mindset workshop, breathwork and meditation guidance, short art therapy, archery, orienteering, rock climbing, bouncy castle, face painting, live music, and food trucks.At the end of the day, co-founder and cold-water aficionado Ciaran May will invite guests to partake in a sea swim at Crawfordsburn Beach. Happy Fest co-founder Ciaran May is a mentor for men and owner of Natural Resilience Wellness Centre in Lisburn.

He explained: There is an outdated belief amongst men that anything holistic or alternative is for women only, that the best way to deal with their problems is through drink and drugs. We only need to look at the suicide rate amongst men to see that its not helping.Times are changing. People are getting back to nature, rediscovering that sense of community, the importance of connection and physical, mental, and emotional wellness. Certainly, my own life improved dramatically when I started to explore and embrace these methods and treatments.So many people have been going through huge changes these last few years, whether its in their personal or business lives and it just feels right that they can all meet and get to know each other.

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Alternative and healing businesses set to showcase in Northern Ireland - Belfast News Letter