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Dennis OConnor

Lotus | TCM (Traditional Chinese Medicine) Resources for COVID-19 - 0 views

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    Recommended by Erin Raskin John Chen, PhD, Pharm D, OMD, LAc is a very knowledgeable and generous man.
Dennis OConnor

Help Hope Live v1.0 - Honor Kabir Kadre - Video - 1 views

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    Kabir speaks from the heart. Big Love.
Dennis OConnor

Donate to Southwest Catastrophic Injury Fund in honor of Kabir Kadre - 2 views

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    "Thank you for visiting! As you likely know, my name is Kabir Kadre, and I am partnering here with Help Hope Live, a registered 501(c)(3) nonprofit, in part because they provide both tax deductibility and fiscal accountability to those who wish to support the medical costs of my life with Spinal Cord Injury and the resulting quadriplegia and paralysis. Thanks to their efforts, and with your generous support, I am able to offset my substantial medical costs and focus on giving what I can to the world through the gift of my life."
Dennis OConnor

Substantial undocumented infection facilitates the rapid dissemination of novel coronav... - 0 views

  • AbstractEstimation of the prevalence and contagiousness of undocumented novel coronavirus (SARS-CoV2) infections is critical for understanding the overall prevalence and pandemic potential of this disease. Here we use observations of reported infection within China, in conjunction with mobility data, a networked dynamic metapopulation model and Bayesian inference, to infer critical epidemiological characteristics associated with SARS-CoV2, including the fraction of undocumented infections and their contagiousness. We estimate 86% of all infections were undocumented (95% CI: [82%–90%]) prior to 23 January 2020 travel restrictions. Per person, the transmission rate of undocumented infections was 55% of documented infections ([46%–62%]), yet, due to their greater numbers, undocumented infections were the infection source for 79% of documented cases. These findings explain the rapid geographic spread of SARS-CoV2 and indicate containment of this virus will be particularly challenging.
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    Recommended by Jessica Block
Dennis OConnor

CDC - Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiec... - 0 views

  • This document recommends practices for extended use and limited reuse of NIOSH-certified N95 filtering facepiece respirators (commonly called “N95 respirators”). The recommendations are intended for use by professionals who manage respiratory protection programs in healthcare institutions to protect health care workers from job-related risks of exposure to infectious respiratory illnesses.
  • Minimize the number of individuals who need to use respiratory protection through the preferential use of engineering and administrative controls;
  • Use alternatives to N95 respirators (e.g., other classes of filtering facepiece respirators, elastomeric half-mask and full facepiece air purifying respirators, powered air purifying respirators) where feasible;
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  • mplement practices allowing extended use and/or limited reuse of N95 respirators, when acceptable; and
  • Prioritize the use of N95 respirators for those personnel at the highest risk of contracting or experiencing complications of infection.
  • Respirator Reuse Recommendations
  • There is no way of determining the maximum possible number of safe reuses for an N95 respirator as a generic number to be applied in all cases. Safe N95 reuse is affected by a number of variables that impact respirator function and contamination over time.
  • Risks of Extended Use and Reuse of Respirators
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    Recommended by Jessica Block
Dennis OConnor

Up-to-Date Coronavirus (SARS-CoV-2 / COVID-19) Information - Peter Attia MD - 0 views

  • Currently, my entire clinical and research team are working on trying to make sense of the SARS-CoV-2 / COVID-19 pandemic.
  • We’re constantly in contact with leading experts and doctors working on this issue around the world,
  • We will tell you what we know, when we know it, and what we don’t know.
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  • Information will continue to be passed through podcasts, patient memos, and videos.
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    Recommended by Vicky Newman & Erin Raskin
Dennis OConnor

How to Protect Yourself from COVID-19: Supporting Your Immune System When You May Need ... - 0 views

  • How Can I Protect Myself, My Family, and My Community
  • How to Avoid Infection with COVID-19 
  • How to Support Your Immune System: Remember, Let Food Be Your Medicine! 
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  • How to Supplement for Immune Function 
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    Recommended by Erin Raskin, DACM, L.Ac
Dennis OConnor

Exporting Your Data with Oura on the Web - Oura Help - 0 views

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    Here is how you login to Oura to see your data: https://cloud.ouraring.com/account/login
Dennis OConnor

This Is How We Beat the Coronavirus - The Atlantic - 1 views

  • We’re closing schools and businesses and committing to social (really, physical) distancing. But as the sobering charts from the analysis show, this isn’t enough.
  • Asian countries have engaged in suppression; we are only engaging in mitigation.
  • At the moment, we can’t even test everyone who is sick.
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  • Testing will allow us to isolate the infected so they can’t infect others. We need to be vigilant, and willing to quarantine people with absolute diligence.
  • To achieve this, we need to test many, many people, even those without symptoms.
  • Our primary approach is social distancing—asking people to stay away from one another.
  • Our efforts are good, temporizing measures.
  • Social distancing cannot prevent these infections, as they’ve already happened. Therefore, things will appear to get worse for some time, even if what we’re doing is making things better in the long run.
  • buried in the Imperial College report is reason for optimism. The analysis finds that in the do-nothing scenario, many people die and die quickly. With serious mitigation, though, many of the measures we’re taking now slow things down. By the summer, the report calculates, the number of people who become sick will eventually reduce to a trickle.
  • We can create a third path. We can decide to meet this challenge head-on. It is absolutely within our capacity to do so. We could develop tests that are fast, reliable, and ubiquitous. If we screen everyone, and do so regularly, we can let most people return to a more normal life. We can reopen schools and places where people gather. If we can be assured that the people who congregate aren’t infectious, they can socialize.
  • We can build health-care facilities that do rapid screening and care for people who are infected, apart from those who are not.
  • We can even commit to housing infected people apart from their healthy family members, to prevent transmission in households.
  • We will need to massively strengthen our medical infrastructure. We will need to build ventilators and add hospital beds. We will need to train and redistribute physicians, nurses, and respiratory therapists to where they are most needed. We will need to focus our factories on turning out the protective equipment—masks, gloves, gowns, and so forth—to ensure we keep our health-care workforce safe.
  • most importantly, we need to pour vast sums of intellectual and financial resources into developing a vaccine that would finally bring this nightmare to a close
  • If we commit to social distancing, however, at some point in the next few months the rate of spread will slow. We’ll be able to catch our breath. We’ll be able to ease restrictions, as some early hit countries are doing. We can move toward some semblance of normalcy.
  • The temptation then will be to think we have made it past the worst. We cannot give in to that temptation. That will be the time to redouble our efforts. We will need to prepare for the coming storm. We’ll need to build up our stockpiles, create strategies, and get ready.
  • We need to keep time on the clock, time to find a treatment or a vaccine.
  • We all have a choice to make. We can look at the coming fire and let it burn. We can hunker down, and hope to wait it out—or we can work together to get through it with as little damage as possible.
Dennis OConnor

In the Footsteps of Thich Nhat Hanh Online Summit - 0 views

  • Cultivate joy and transform suffering with wisdom from leading teachers in the Plum Village tradition of mindfulness, compassion, and peace.
  • Discover the beauty and brilliance of Thich Nhat Hanh’s wisdom with guidance from some of those who know him best. Join 9 incredible teachers from his lineage as they offer intimate insights inspired by his most powerful teachings.
  • “We have more possibilities available in each moment than we realize.”~ Thich Nhat Hanh
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    Recommended by Erin Raskin: Free Online Event - March 25-26, 2020
Dennis OConnor

First U.S. Company Announces an Upcoming Home COVID-19 Test | Time - 0 views

  • Food and Drug Administration allowed certified labs, including commercial lab testing companies, to develop and distribute COVID-19 tests on Feb. 29.
  • People can order the Everlywell COVID-19 test on the company’s website, after first answering questions about their basic health, symptoms and risk factors for the coronavirus disease. A doctor still needs to prescribe the test, so telemedicine doctors from PWNHealth, a national network of physicians who prescribe diagnostic tests, then reviews these answers to determine if a person qualifies for testing, based on criteria established by the Centers for Disease Control and Prevention.
  • Currently, because COVID-19 tests are not plentiful in the U.S., doctors are trying to rule out other respiratory diseases like flu first, and only ordering tests for people with symptoms who also have other risk factors for infection, such as being in close contact with others who have been diagnosed.
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  • If the telemedicine doctor decides to prescribe an Everlywell COVID-19 test, the company says it will send the $135 test kit in two days (customers can pay $30 more to receive the kit overnight).
  • As with many of the commercially available tests, this one extracts SARS-CoV-2, the virus behind COVID-19, from the sample and then probes for specific genetic signatures of the virus.
  • If the test is positive, the company also provides a full telemedicine consultation with one of around 200 physicians that is included in the cost of the test.
  • Everlywell says it is ready to ship 30,000 COVID-19 tests, and plans to expand the number of labs processing the sample
  • kits will depend on the availability of swabs for collecting samples
  • global shortage of swabs for any lab performing the test.
  • We’re working hard to ramp up weekly capacity to test 250,000 Americans,” says Cheek
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    DeAunne Denmark, M.D. Phd - I was just reading about this last night. Dr forum blowing up about it. It could be a gigantic win for EverlyWell (and at-home D-T-C Direct-to-Consumer) if they do it right. But *must* do it right, e.g. including transparency re: methods, interfacing with HCP/EMRs, etc. The big issue may be collection variability, not unlike the microbiome. Nasal swab not trivial, more talk now about collection variability possibly accounting for a large proportion of "negs" turning positive. Hate to see a lot of false confidence running around at large infecting others.
Dennis OConnor

The Coming Influenza Pandemic: Lessons From the Past for the Future | The Journal of th... - 0 views

  • in the case of a true pandemic, hospital capacity may well be overwhelmed, and healthcare workers may themselves become ill. 
  • However, the lessons learned within the osteopathic medical profession as a result of the 1917-1918 pandemic could prove useful once again if (or when) a new influenza pandemic occurs.
  • Time to roll up sleeves, vaccinate patients, and hone osteopathic manipulative skills
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  • Obviously, the data collected shortly after the 1917-1918 pandemic must be treated cautiously.
  • In 1918, C.P. McConnell, DO,11 reported that the most effective treatment during the influenza pandemic was begun early in the onset of symptoms (within the first 24 hours) and consisted of carefully applied muscular relaxation and, most importantly, relaxation of the deep and extensive contractions of the deep spinal musculature and mobilization of the spine. These treatments would be repeated two or three times early in the course of the infection, along with traditional supportive measures such as hydration. During later influenza epidemics, such as the 1928-1929 and the 1936-1937 outbreaks, various lymphatic pump treatments and more attention to the cervical and upper thoracic regions were added to this recommended treatment protocol.12 These treatments, individualized to each patient's needs, were apparently the most commonly applied osteopathic medical procedures during the epidemics. 
  • action of these treatments were to diminish somatic inputs from contracted muscles
  • that had further stimulated the already overactive sympathetic system
  • hyperreactivity exacerbated the counterproductive and deadly immune respons
  • OMT) likely enhanced lymphatic drainage and encouraged appropriate immune response
  • we have no controlled data on the effects of OMT on the pandemic influenza
  • Noll et al13 demonstrated that OMT given to elderly patients with pneumonia decreases medication use and hospital stay
  • Whatever the mechanism, these beneficial outcomes have taught us a great deal about how the osteopathic medical profession might handle a coming pandemic.
  • treatments used back then can be used again and do not require patient hospitalization
  • methods can also be taught to family members
  • do not rely on the availability of potent, expensive, and often harmful (especially when one is in a weakened condition) medications.
  • treatments can be delivered by osteopathic medical students under the direction of a physician—a measure that would add significantly to the pool of trained healthcare providers available to assist the public in such an emergency.
  • OMT is meant to improve function, enabling the body itself to better
Dennis OConnor

Free Live Practice Sessions - UCSD Center for Mindfulness - 0 views

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    "Due to the current situation with the coronavirus (COVID-19) evolving rapidly across the United States, our Center, The Sanford Institute, and the Compassion Institute  will work together to provide daily streams and recordings of mindfulness and compassion sessions to provide resources and online support to those affected."
Dennis OConnor

What Went Wrong with Coronavirus Testing in the U.S. | The New Yorker - 0 views

  • n February 5th, sixteen days after a Seattle resident who had visited relatives in Wuhan, China, was diagnosed as having the first confirmed case of COVID-19 in the United States, the Centers for Disease Control, in Atlanta, began sending diagnostic tests to a network of about a hundred state, city, and county public-health laboratories⁠. Up to that point, all testing for COVID-19 in the U.S. had been done at the C.D.C.; of some five hundred suspected cases⁠ tested at the Centers, twelve had confirmed positive. The new test kits would allow about fifty thousand patients to be tested, and they would also make testing much faster, as patient specimens would no longer have to be sent to Atlanta to be evaluated.
  • Before a state or local lab could use the C.D.C.-developed tests on actual patients
  • verification
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  • larger number, about thirty-six of them, received inconclusive⁠ results from one of the reagents.
  • Another five,
  • had problems with two reagents
  • On February 8th
  • e cascading effects that they’ve had on the country’s COVID-19 preparations suggest a much larger problem with the way the United States has structured its pandemic response.
  • the verification problems were “part of the normal procedures⁠.” In the meantime, she said, until new reagents could be manufactured, all COVID-19 testing in the United States would continue to take place exclusively at the C.D.C⁠.
  • The public-health-laboratory network was never intended to provide widespread testing in the event of a pandemic.
  • the three-week delay caused by the C.D.C.’s failure to get working test kits into the hands of the public-health labs came at a crucial time.
  • The void created by the C.D.C.’s faulty tests made it impossible for public-health authorities to get an accurate picture of how far and how fast the disease was spreadin
  • In hotspots like Seattle, and probably elsewhere, COVID-19 spread undetected for several weeks, which in turn only multiplied the need for more tests.
  • The problem was that containment was not done very well.
  • we’re looking at exponential growth, and we need to figure out how to meet an exponential demand.”
  • Yet flexibility was not what Jerome and his lab found when they tried to get an E.U.A. for their COVID-19 test.
  • problem was exacerbated by a President who has simultaneously underplayed the severity of the outbreak and overpromised the means available to fight it
  • problems with COVID-19 testing in the United States have obscured
  • several labs reported their problems to the C.D.C. In a briefing a few days later,
  • Chinese scientists uploaded a copy of the virus’s genome to an online repository⁠, and virologists around the world set to work to develop diagnostic tests for the new disease
  • January 21st, a team in Berlin, led by Christian Drosten, one of the scientists who discovered the original SARS virus, in 2003, submitted the first paper to describe a protocol for testing for SARS-CoV-2.
  • That protocol would form the basis for a test disseminated, early on, by the World Health Organization
  • That same day, Messonnier announced that the C.D.C. had finalized its own test⁠, which it used to confirm the first known case of COVID-19 in the U.S.
  • The U.W. virology lab
  • started, probably in earnest in mid-January, to prepare what we call a laboratory-developed test,⁠
  • It took a team at the lab, working under the direction of Alex Greninger, about two weeks to develop a working version
  • But, as soon as Alex Azar, the Secretary of Health and Human Services, declared a public-health emergency, on February 4th, a new regulatory regime took effect. From that point on, any lab that wanted to conduct its own tests for the new coronavirus would first need to secure something called an Emergency Use Authorization from the F.D.A.
  • This shift in the regulations sounds perverse, since it restricts the use of new tests at precisely the moment they’re most needed.
  • E.U.A. process is supremely flexible.
  • triumph of modern medical science
  • hen there’s a big emergency and we feel like we should really do something, it gets hard. It’s a little frustrating. We’ve got a lot of scientists and doctors and laboratory personnel who are incredibly good at making assays. What we’re not so good at is figuring out all the forms and working with the bureaucracy of the federal government.”
  • At one point, he was very frustrated because he’d e-mailed them what we were doing so they could review it,”
  • Here we are in this SARS-CoV-2 crisis, and you have to send them something through the United States Postal Service. It’s just shocking.
  • Despite these difficulties, Jerome said, the F.D.A. ultimately proved responsive to the lab’s entreaties. “They had good and substantive feedback that made our testing better, and the response time was typically just a couple of days.”
  • believe it was, February 29th,” he said. “And then we got a specimen from one of the people who were the two original cases in Washington
  • The E.U.A. regulations, however, prohibited the lab from reporting the results to the doctors who had ordered the tests for their patients.
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    "Sharfstein, too, thinks that it's fair to criticize the federal government for not recognizing that its pandemic plans had a single point of failure. The C.D.C. quickly developed a working test, and it was understandable, at some level, that people at the Centers thought that fixing the faulty reagents for the public-health labs would be faster than shifting to an entirely different protocol. Nevertheless, Sharfstein said, "Why are we relying only on the C.D.C.? What the F.D.A. could have done, and eventually did do, is say, 'You can use other approaches.' " Even so, he said, "I don't think it's quite fair to totally blame the F.D.A. for this. The F.D.A. can design an approach to support the public-health strategy, but someone has to tell F.D.A. the public-health goal." The delay in clearly establishing those goals, he said, shows why the decision to shut down the N.S.C. directorate was so consequential. "People talk about, like, why does it matter that they closed the White House office on pandemic preparedness? This is one reason.""
Dennis OConnor

Advice from Dr. Mimi Guarneri - Integrative Medicine - 1 views

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    "Thankfully, there are many things we can do as individuals and communities that may be helpful. It is important to remain calm and think clearly. Remember that our positive attitudes go a long way in protecting health, enriching our daily lives, and supporting the ones we love. Here is a list of things one can do at home to help in these uncertain times:"
Dennis OConnor

Don't "Flatten the Curve," stop it! - Joscha Bach - Medium - 1 views

  • What all these diagrams have in common:
  • They have no numbers on the axes.
  • They don’t give you an idea how many cases it takes to overwhelm the medical system, and over how many days the epidemic will play out.
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  • They suggest that currently, the medical system can deal with a large fraction (like maybe 2/3, 1/2 or 1/3) of the cases, but if we implement some mitigation measures, we can get the infections per day down to a level we can deal with.
  • They mean to tell you that we can get away without severe lockdowns as we are currently observing them in China and Italy.
  • nstead, we let the infection burn through the entire population, until we have herd immunity (at 40% to 70%), and just space out the infections over a longer timespan.
  • The Curve Is a Lie
  • suggestions are dangerously wrong, and if implemented, will lead to incredible suffering and hardship.
  • Let’s try to understand this by putting some numbers on the axes.
  • California has only 1.8.
  • The US has about 924,100 hospital beds (2.8 per 1000 people)
  • Germany have 8
  • South Korea has 12
  • Based on Chinese data, we can estimate that about 20% of COVID-19 cases are severe and require hospitalization
  • many severe cases will survive if they can be adequately provided for at home
  • oxygen, IVs and isolation
  • mportant is the number of ICU beds
  • by some estimates can be stretched to about a 100,000, and of which about 30,000 may be available
  • About 6% of all cases need a ventilator
  • if hospitals put all existing ventilators to use, we have 160,000 of them
  • CDC has a strategic stockpile of 8900 ventilators
  • number of ventilators as a proximate limit on the medical resources, it means we can take care of up to 170,000 critically ill patients at the same time.
  • Without containment, the virus becomes endemic
  • Let’s assume that 55% of the US population (the middle ground) get infected between March and December, and we are looking at 180 million people.
  • Of the 180 million, 80% will be regarded as “mild” cases.
  • About 20% will develop a severe case and need medical support to survive.
  • Severe cases tend to take about 3–6 weeks to recover
  • 6% may need intubation and/or ventilation
  • Once a person is on the ventilator, it often takes about 4 weeks for them to get out of intensive care again.
  • The “flattening the curve” idea suggests that if we wash our hands and stay at home while being sick aggressively enough, we won’t have to stop the virus from becoming endemic and infecting 40% to 70% of all people, but we can slow the spread of the infection so much that out medical system can deal with the case load. This is how our normally distributed curve looks like when it contains 10.8 million patients, of which no more than 170,000 are ill at the same time:
  • Dampening the infection rate of COVID-19 to a level that is compatible with our medical system means that we would have to spread the epidemic over more than a decade!
  • confident that we will have found effective treatments until the
  • reducing the infectivity of the new corona virus to a manageable level is simply not going to be possible by mitigation, it will require containment.
  • My back-of-the-envelope calculation is not a proper simulation, or a good model of what’s going on either. Don’t cite it as such!
  • the point of my argument is not that we are doomed, or that 6% of our population has to die, but that we must understand that containment is unavoidable, and should not be postponed, because later containment is going to be less effective and more expensive, and leads to additional deaths.
  • Containment works
  • China has demonstrated to us that containment works
  • lockdown of Wuhan did not lead to starvation or riots
  • made it possible to focus more medical resources on the region that needed it most
  • implemented effective containment measures as soon as the first cases emerged.
  • South Korea was tracking its first 30 cases very well, until patient 31 infected over 1000 others on a church congregation.
  • For some reason, Western countries refused to learn the lesson.
  • The US, UK and Germany are not yet at this point: they try to “flatten the curve” by implementing ineffective or half hearted measures that are only meant to slow down the spread of the disease
  • instead of containing it.
  • some countries will stomp out the virus and others will no
  • few months from now
  • almost all travel from red zones into green zones will come to a hal
  • world will turn into red zones and green zones
  • Flattening the curve is not an option for the United States, for the UK or Germany. Don’t tell your friends to flatten the curve. Let’s start containment and stop the curve.
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    "Flattening the curve is not an option for the United States, for the UK or Germany. Don't tell your friends to flatten the curve. Let's start containment and stop the curve." Strong article with data visualizations from a Phd working out of MIT/Harvard.
Dennis OConnor

Is Your Story Making You Sick? - 1 views

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    "shows how people can rewrite the toxic stories they tell themselves. The film reveals how individuals battling addiction, trauma, and depression can change their stories and transcend their pain."
Dennis OConnor

Home - NORD (National Organization for Rare Disorders) - 0 views

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    ""This year, patients, families, caregivers, medical professionals, NORD staff and other stakeholders participated in over 25 Rare Disease Day advocacy events in 23 states.""
Dennis OConnor

Chasing My Cure: Dr. David Fajgenbaum Lessons from his Rare Disease and On Finding Cure... - 0 views

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    "David Fajgenbaum, MD, MBA, MSc, is the co-founder and Executive Director of the Castleman Disease Collaborative Network (CDCN) and one of the youngest individuals to be appointed to the faculty at Penn Medicine, where he is an Assistant Professor of Medicine in Translational Medicine & Human Genetics, Founding Director of the Center for Study & Treatment of Castleman & inflammatory Lymphadenopathies (CSTL). An NIH-funded physician-scientist, he has dedicated his life to discovering new treatments and cures for deadly disorders like idiopathic multicentric Castleman disease (iMCD), which he was diagnosed with during medical school. As common as ALS and more deadly than lymphoma, iMCD involves the immune system attacking and shutting down the body's vital organs such as the liver, kidneys, bone marrow, and heart. After spending months hospitalized in critical condition, having his last rites read, and having four deadly relapses, he is now in his longest remission ever thanks to a treatment that he identified in the lab."
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