literature review

Dr. M’s SPA Newsletter Volume 15 Issue 16

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A Rooted Approach to Modern Medicine: The Vision Forward

My emerging and chronically iterating philosophy of medicine is a rising structural entity rooted between ancient healing wisdom and modern scientific insight. It is layered with root cause immunometabolomic thinking and built upon anthropological foundations. As a pediatrician, educator, and onion peeling thinker, I believe that a medical approach grounded in compassion, prevention, and the pursuit of root causes is the way forward. Medicine is not just about treating disease but about reshaping the very terrain in which illness arises. This can and must start with our women and children.

At the heart of this vision is a belief in the power of systems biology and our deep interconnectedness. The human body cannot be understood or healed through isolated parts or siloed provider experiences. We must move beyond symptom suppression and toward an understanding of the why behind disease. Why does a child struggle with allergies, ADHD, or autoimmune illness? What factors in the environment, diet, stress response, or microbial ecosystem have altered their trajectory? Why are the governmental and NGO leaders not guiding us towards a benevolent goal of whole child health? These are the questions that shape and guide our practice….and a literature review.

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 15

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Systemic Maternal Inflammation and Neurodevelopment: The Role of IL-6 and IFN-γ in Autism Spectrum Disorder

I just returned from Estes Park, Colorado where I presented a lecture on the Growing Brain/Mind – a tour through the underpinnings of childhood neurological changes that we call Autism. The timing is perfect for this article to be written.

In an era when chronic disease in children is rising at an unprecedented pace, the search for root causes must include an honest inquiry into the conditions present during fetal development. The review article by Majerczyk and colleagues, Systemic Maternal Inflammation Promotes ASD via IL-6 and IFN-γ, brings forward a critical piece in this puzzle that I began to explore a few years ago when writing a book. It connects the dots between maternal immune dysregulation and long-term neurodevelopmental outcomes, specifically autism spectrum disorder (ASD). Through a synthesis of clinical data and animal research, the authors make a compelling case for the centrality of two inflammatory messengers, interleukin-6 (IL-6) and interferon-gamma (IFN-γ), in shaping fetal brain development during gestational stress. The key words here being GESTATIONAL STRESS, the recurring scientific theme for ASD development, not vaccines… and some literature reviews.

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 13

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Literature Review

1) An exciting phase three trial with the CETP inhibitor Obicetrapib has shown serious promise for ASCVD and Alzheimer’s Disease (AD). “In BROADWAY, a pre-specified AD sub-study was designed to assess plasma AD biomarkers in patients enrolled in the BROADWAY trial and evaluated the effects of longer duration of therapy (12 months) with a prespecified population of ApoE3/4 or 4/4 carriers. The sub-study included 1727 patients, including 367 ApoE4 carriers. The primary outcome measure was p-tau217 absolute and percent change over 12 months. Additional outcome measures included neurofilament light chain (“NFL”), glial fibrillary acidic protein (“GFAP”), p-tau181, and Aβ42/40 ratio absolute and percent change over 12 months. NewAmsterdam observed statistically significant lower absolute changes in p-tau217 compared to placebo over 12 months in both the full ITT population (p<0.002) and in ApoE4 carriers (p=0.0215).” (NAMS)

Obicetrapib has shown significant LDL and Lp(a) lowering effects as well in early trials. I will be watching this discovery closely as it may be a game changer for these diseases. “In the BROADWAY trial, more than 2,500 participants with established heart disease or genetic high cholesterol were given either Obicetrapib or a placebo, in addition to their regular cholesterol medications. After 12 weeks, those on Obicetrapib had dropped their LDL cholesterol by 32.6 per cent and Lp(a) by 33.5 per cent on average – many achieved guideline-recommended targets for the first time.” (Sci Tech Daily) The drop in Lp(a) is the profound result as this is a massive risk factor for ASCVD and to date is not moveable by statins and most used meds.

2) GLP1 drugs and risk for macular degeneration?… and more

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 11

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Heat Exhaustion Prevention and Awareness

It is that time of year in many parts of the country. Planning ahead of an event or extended time out in the heat is very important especially as we age or while pregnant.

Summer break does not end the competitive athletics. Kids of all ages are playing sports during the heat of the day all over the country this summer. This time of year poses a major risk of overheating for children and adolescents engaged in aggressive aerobic outdoor exercise. It is prudent to try to have vigorous workouts during the early morning hours preferably or later in the evening for the older kids who get to bed later by nature.

In our clinic, we have had admissions to the hospital for heat exhaustion and muscle breakdown known as rhabdomyolyisis. For example, a young man was practicing on the football field and overheated due to a combination of under hydration and excessive ambient temperature. Symptoms included excessive sweating, rapid pulse, muscle pain, nausea, vomiting and dizziness… and a literature review.

Enjoy, Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 7

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Let’s dive into articles that have been critical to understanding type 2 diabetes and Insulin Resistance: the Ominous Octet and now the Egregious Eleven from the BMC Medicine paper and the 2009 Diabetes paper by Dr. Ralph DeFronzo. Peter Attia recently interviewed Dr. Defronzo and I am on listen #3 because it is so good and yet incredibly complicated. This piece is a compilation of that interview and reviewing Dr. DeFronzo’s papers.

“…all too often, the risk factors for these disorders are not addressed promptly in clinical practice, leading to irreversible pathologic progression… Traditional approaches to treatment involving sequential therapy, in which agents are added only after one has failed, contribute to clinical inertia and often prevent goal attainment, leading to adverse outcomes…. in turn contributing to increased morbidity and mortality. In contrast, early diagnosis and prompt, intensive intervention, often with initial combination therapy, leads to faster goal attainment and improved outcomes for at-risk patients.” (Handelsman et al. 2023)(Schwartz et. al. 2024)

…literature review.

Enjoy,

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 6

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This is such an important topic to cover, even for a pediatrician. Dementia!

This problem is slated to exponentially worsen in the coming decades. And it starts at birth!

​In the intricate landscape of Alzheimer’s disease (AD), emerging research underscores a pivotal yet under explored facet for the why?, the brain’s energy immunometabolism. A recent study by Patel et al., titled “Global Energy Metabolism Deficit in Alzheimer Disease Brain,” delves into this domain, revealing significant metabolic disruptions that may illuminate novel upstream causes and possible therapies.

​ For the better part of the last few decades, all AD research centered on the amyloid and tau plaques as the causative problem. However, billions of dollars and many drugs later, this hypothesis has crashed and burned. Failed therapies coupled to the skyrocketing volume of AD patients in the US over the next few decades will burden the US healthcare system and families alike. Folks, we need better answers and therapies rapidly. Thus, I have been following this information on and off over the years looking for answers. Last month, Dr. David Perlmutter gave an excellent lecture on microglial cells in the brain and their impact on AD and neurocognition in general. One paper that he cited was the Patel paper. Let’s look at it.

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 5

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Picture this, a tiny, 30 nm, relentless RNA virus named norovirus slips into your life, uninvited, and turns your gut into a battlefield. It’s not the flu. Forget that “stomach flu” misnomer. It’s a Caliciviridae family member, a nonenveloped, single-stranded RNA ninja that thrives in making chaos. As a pediatrician, I’ve seen it wreak havoc in kids and parents alike, and it’s a master of surprise.

It just played Risk in my GI tract last week. Not Fun!

Let’s unpack how it infects, spreads, and toys with us humans, straight from the AAP’s Red Book (2024) and other research. Norovirus causes an estimated 1 in 15 US residents to become ill each year as well as 71,000 hospitalizations and 800 deaths annually, predominantly among young children and the elderly.

Norovirus doesn’t knock, more so it sneaks in, needing under 100 viral particles to ignite trouble. You’re sipping contaminated water, munching an oyster from a shady bay, or your toddler’s unwashed hands after a playdate deliver the payload. It’s mostly fecal-oral, stool to mouth via food, water, or surfaces. But don’t sleep on aerosolized vomit. One hurl in a crowded daycare, and airborne particles linger, landing on toys, doorknobs, you name it for days. Did I say lingering! Smart viral spread!

Gorilla warfare is on!

Dr. M

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