Tag Archives: literature review

Dr. M’s SPA Newsletter Volume 15 Issue 32 – Year in Review: 2025

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The Year in Review – 2025

Articles and Points of Interest:

1) Microplastics in the Brain – From Science Advances: “Human health is being threatened by environmental microplastic (MP) pollution. MPs were detected in the bloodstream and multiple tissues of humans, disrupting the regular physiological processes of organs. Nanoscale plastics can breach the blood-brain barrier, leading to neurotoxic effects. How MPs cause brain functional irregularities remains unclear. This work uses high-depth imaging techniques to investigate the MPs within the brain in vivo. We show that circulating MPs are phagocytosed and lead these cells to obstruction in the capillaries of the brain cortex. These blockages as thrombus formation cause reduced blood flow and neurological abnormalities in mice. Our data reveal a mechanism by which MPs disrupt tissue function indirectly through regulation of cell obstruction and interference with local blood circulation, rather than direct tissue penetration. This revelation offers a lens through which to comprehend the toxicological implications of MPs that invade the bloodstream.” (Huang et. al. 2025)

2) From Nature Medicine: “Brain insulin responsiveness is linked to long-term weight gain and unhealthy body fat distribution. Here we show that short-term overeating with calorie-rich sweet and fatty foods triggers liver fat accumulation and disrupted brain insulin action that outlasted the time-frame of its consumption in healthy weight men. Hence, brain response to insulin can adapt to short-term changes in diet before weight gain and may facilitate the development of obesity and associated diseases.” (Pullman et. al. 2025)….

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 31 – Poly Vagal Theory, Stephen Porges, PhD

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I think that this is an important time to pause and relook at Polyvagal Theory before continuing with Beyond Behaviors.

Polyvagal Theory: Current Status, Clinical Applications, and Future Directions (Porges, S. 2025)

“Social behavior and the capacity to manage challenge are dependent on the neural regulation of physiological state.” S. Porges


When I dove into Stephen Porges’s 2025 review of the Polyvagal Theory (PVT), I felt like I’d stepped into a crossroads where neurobiology, clinical practice, trauma science, and human experience collide. This paper isn’t merely a summary of three decades of work (all of which I have read); it’s a spirited defense of a paradigm that’s been both celebrated (by me) and contested (by others). What follows is an honest appraisal of what the article teaches us, where it sparks real insight, and where it may fall short, especially through the lens of evidence-based medicine and developmental neurophysiology. (I also went deeper into his 2022 paper in Frontiers in Integrative Neuroscience for the biophysiology of the ANS)

At its heart, the article argues that the autonomic nervous system (ANS), through a set of hierarchically organized circuits centered on the vagus nerve, is not just a background player in stress and homeostasis, but a core regulator of social engagement, physiological flexibility, and behavior. Dr. Porges situates his theory as an alternative and expansion to classical views that treat sympathetic (fight/flight) and parasympathetic (rest/digest) branches as functional opposites. Instead, he proposes a three-component hierarchy: the ventral vagal complex (VVC) supporting social engagement, a mobilization circuit mediated by the sympathetic nervous system or fight or flight state, and a dorsal vagal circuit that facilitates shutdown or immobilization under extreme threat…..

Enjoy,
Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 25 – Tough Conversations

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Speaking Truth in Love: The Weight of Avoidance in Pediatric Metabolic Health

After completing the second round of our Asthma and Obesity Metabolic Pilot Program at Salisbury Pediatrics, I left the clinic reflecting deeply on what I witnessed. It crystallized a truth that is uncomfortable but undeniable: the greatest health threats to our children today are not infectious or accidental, they are metabolic. Diseases once reserved for adulthood: insulin resistance, fatty liver, hypertension, early vascular aging are now appearing in children who should be free to run, play, and thrive.

In modern society, conversations about weight and metabolic dysfunction have become relatively taboo. This is not to say that children of normal or low weight are immune; they, too, can be at risk. However, the excess-weight group carries the highest statistical burden. Too often, clinicians hesitate to speak truth to families for fear of offending, shaming, or overstepping. In doing so, we risk silence becoming complicity and allowing preventable disease to take root in the very children we are charged to protect.

Much of this epidemic is not born of individual failure but of systemic neglect. Government-funded, poor-quality school meals, cheap processed foods, and relentless marketing of sugar and refined carbohydrates have built an environment where metabolic injury is almost inevitable. When a child’s daily fuel is engineered for shelf life instead of cell life, the outcome is not accidental, it is predictable. Our pilot program lab results are a painful window into that truth…. and a literature review on eczema and anaphylaxis.

Enjoy Dr. M

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 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 3

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Literature Review

1) Microplastics in the Brain – From Science Advances: “Human health is being threatened by environmental microplastic (MP) pollution. MPs were detected in the bloodstream and multiple tissues of humans, disrupting the regular physiological processes of organs. Nanoscale plastics can breach the blood-brain barrier, leading to neurotoxic effects. How MPs cause brain functional irregularities remains unclear. This work uses high-depth imaging techniques to investigate the MPs within the brain in vivo. We show that circulating MPs are phagocytosed and lead these cells to obstruction in the capillaries of the brain cortex. These blockages as thrombus formation cause reduced blood flow and neurological abnormalities in mice. Our data reveal a mechanism by which MPs disrupt tissue function indirectly through regulation of cell obstruction and interference with local blood circulation, rather than direct tissue penetration. This revelation offers a lens through which to comprehend the toxicological implications of MPs that invade the bloodstream.” (Huang et. al. 2025)

This weeks podcast is a direct look at the world of toxicology and the human consequences of exposure over time. Microplastics are the new and next trouble maker on the planet. This study raises the concern that micro and nano plastics can and do enter the brain and will disrupt and thus alter brain physiological processes. More time to answer the true risk reality. Not good. and more….Plus a letter about MAHA from Dr. Jeffrey Bland, a serious take on preventative medicine as opposed to disease pharmaceutical centric medicine.

Dr. M

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