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Dr. Jennifer Martinick

Dr Jennifer Martinick offers Non-Surgical Hair Restoration Solutions at her clinics - 0 views

www.zimbio.com/...+Martinick+Review+Non+Surgical

Dr Jennifer Martinick Hair reviews

shared by Dr. Jennifer Martinick on 10 Dec 13 - No Cached
  • Dr. Jennifer Martinick on 10 Dec 13
     
    Dr Jennifer Martinick is a highly skilled hair transplant surgeon and offers various effective hair restoration solutions. Here you can read a review on Non-Surgical Hair Restoration Solutions provided by Jennifer Martinick and her skilled team of technicians.
nucosmeticclinic

PRP Therapy - Non Surgical Hair Loss Treatment for Men and Women - 0 views

www.nuhairlosstreatments.co.uk/-surgical-hair-loss-treatments

PRP Therapy Platelet Rich Plasma Non-Surgical Hair Loss Treatment Fall Nu Cosmetic Clinic

shared by nucosmeticclinic on 21 Sep 15 - No Cached
  • nucosmeticclinic on 21 Sep 15
     
    PRP Therapy or Platelet Rich Plasma Therapy is an effective non-surgical hair loss treatment for men and women. PRP Therapy makes efficient utilization of a growth enhancing blood constituent called platelets, which when combined together with plasma, results in an unprecedented increase in the hair follicles across the treated areas.
Dr. Jennifer Martinick

Dr Jennifer Martinick Follows A Multi-Therapy Approach For Hair Restoration   - 0 views

www.briefingwire.com/...-approach-for-hair-restoration

Dr Jennifer Martinick reviews Hair

shared by Dr. Jennifer Martinick on 30 Oct 13 - No Cached
  • Dr. Jennifer Martinick on 30 Oct 13
     
    Dr Jennifer Martinick follows a multi-therapy approach to deliver remarkable hair transplant results. The clinic provides various surgical as well as non-surgical hair restoration solutions.
teremoso

Non Surgical Face Lift Hamilton Facial Rejuvenation - 4 views

This is actually an innovative beauty support that is actually distinctive throughout the market and has the prospective to improve your general wellness and help you look fresh. Microcurrent i...

Non Surgical Face Lift Hamilton

started by teremoso on 21 May 12 no follow-up yet
nucosmeticclinic

Relevant Details about Liquid Facelift or Non-Surgical Facelift in London UK - 0 views

www.nucosmeticclinic.co.uk/liquid-facelift-london-uk

facelift London liquid therapy Non-Surgical Wrinkle Treatment Anti-Wrinkle Fillers Dermal Nu Cosmetic Clinic Beauty Health Anti-Aging Skin Treatments

shared by nucosmeticclinic on 04 Nov 15 - No Cached
  • nucosmeticclinic on 04 Nov 15
     
    Liquid Facelift represent the class of cosmetic therapies that doesn't require surgical interventions which itself is a great advantage of this treatment meant to revive your facial appearance by replacing the lost volume of your cheeks.
wheelchairindia9

Tynor Hot and Cold Pack - 0 views

www.wheelchairindia.com/...Tynor-Hot-and-Cold-Pack

Tynor Hot and Cold Pack hot and cold packs hot and cold pack hot and cold pack buy online hot and cold pack india hot and cold pack therapy buy hot and cold pack tynor hot and cold pack prices

shared by wheelchairindia9 on 01 Apr 16 - No Cached
  • wheelchairindia9 on 01 Apr 16
     
    Tynor Hot and Cold Pack is a convenient device to provide hot fomentation or cold compress. Hot fomentation of the injured or inflamed area enhances the threshold of pain and thus reduces the perception of pain. It has a synergistic effect along with pain relieving drugs. Raising temperature of the injured tissue also enhances the blood profusion and the healing process. Hot fomentation has a relaxing effect. Cold compress helps in reduction of inflammation in injuries, protects by slowing the metabolic rate around the tissue, reduce oedema and bleeding. Cold compress helps in immediately lowering fever, in very high fever conditions. It can be used after an acute injury or surgical procedure. No heat or cryo burns. Requires no holding. Reusable. Easy application. Appealing aesthetics. Tynor Hot and Cold Pack Features Multi functionality Reduce swelling and odema at the site of injury. Muscles spasm and pain. Headache and minor injuries. Versatile design Can be used as either cold or hot pack. Reusable in either hot & cold condition. Temperature range - Can be used from 0 Cº to 75Cº. Longer temperature retention time. Fabric cover ensures no cryo burns or hot skin burns. Physical features Non-toxic, and biodegradable. Gel remains soft and flexible upto 0 degree. Durable, and puncture resistant. Soft, "frost free" PVC cover. Flexible conforms to the body contours. Easy to clean and maintain. Excellent workmanship. Good aesthetics. Elastic belt Holds the pack against the body, No need to hold by hand. Enhances convenience. Tynor Hot and Cold Pack Measurements
Nathan Goodyear

Association of Preoperative Testosterone Levels with Biochemical Failure in Men Undergo... - 0 views

online.liebertpub.com/...jomh.2013.0016

testosterone low T prostate cancer men male hormone hormones

shared by Nathan Goodyear on 08 Apr 14 - No Cached
  • Nathan Goodyear on 08 Apr 14
     
    Study finds that low Testosterone preoperative is associated with increased positive surgical margins and worse staging post radical prostatectomy.  Also association with a non-statistical increase in biochemical failure.
Dr. Jennifer Martinick

Dr Jennifer Martinick: A Review Of The Non-Surgical Hair Restoration Solutions Provided - 0 views

goarticles.com/...7972945

Dr Jennifer Martinick Hair reviews

shared by Dr. Jennifer Martinick on 05 Nov 13 - No Cached
  • Dr. Jennifer Martinick on 05 Nov 13
     
    Dr Jennifer Martinick Reviews the Hair Loss condition of the patients and suggests a suitable and effective hair restoration solution. Martinick Hair Restoration clinics are recognised for the excellent hair restoration solutions they provide.
spineneuro

Top VBT Surgeons of India in 2021 Using FDA-Approved Spinal Tethering Device - 0 views

www.briefingwire.com/...proved-spinal-tethering-device

vertebral body tethering top VBT surgeons of India in 2021 Vertebral Body Tethering (VBT) Surgery in India Cost of VBT Surgery India Top Hospital for VBT Surgery India

shared by spineneuro on 29 Sep 21 - No Cached
  • spineneuro on 29 Sep 21
     
    "As patients emerge as increasingly interested in non-fusion surgical alternatives for treating scoliosis whilst a back brace has not been effective, vertebral body tethering is an opportunity that preserves movement and flexibility-especially in younger patients as they continue to grow," says top VBT surgeons of India in 2021. For Enquiry Helpline Number: +91-9325887033 Email id: enquiry@spineandneurosurgeryhospitalindia.com
spineneuro

Solves Your Spine Issues With Dr. Arvind Kulkarni Laser Spine Treatment Mumbai - 0 views

www.briefingwire.com/...i-laser-spine-treatment-mumbai

Laser Spine Surgeon Dr. Arvind Kulkarni laser spine treatment in Mumbai

shared by spineneuro on 23 Feb 23 - No Cached
  • spineneuro on 23 Feb 23
     
    The best laser spine surgeon in Mumbai provides a whole program that makes use of the latest in research, generation, and treatments - from non-surgical treatments to gentle, minimally invasive surgery with an incision smaller than a postage stamp.
Nathan Goodyear

Nivolumab for previously treated unresectable metastatic anal cancer (NCI9673): a multi... - 0 views

www.ncbi.nlm.nih.gov/...PMC5809128

cancer anal cancer nivolumab immunotherapy

shared by Nathan Goodyear on 13 Jul 18 - No Cached
  • Patients received a median of six doses of nivolumab
  • four of the first 12 patients had partial responses
  • Nine (24% [95% CI 15–33]) of 37 patients achieved a response (seven partial responses and two complete responses
  • ...16 more annotations...
  • no treatment-related deaths
  • the most common adverse events were anaemia (26 [70%]), fatigue (25 [68%]), and rash
  • hypothyroidism
  • hypothyroidism
  • nivolumab-related autoimmune hypothyroidism, which resolved after a short course of corticosteroids
  • No grade 3 or 4 adverse events occurred
  • Nivolumab resulted in objective responses in 24% of patients with metastatic SCCA
  • Historically, doublet chemotherapy with cisplatin and fluorouracil has been the most common treatment for patients with metastatic SCCA
  • our results suggest that immune checkpoint blockade agents might extend overall survival beyond currently available therapies, especially if provided early in the disease treatment course
  • the dose of nivolumab we used differs from the 2016 recommendation of a fixed 240 mg every 2 weeks
  • 25% of patients develop distant metastases
  • most patients with localised SCCA are cured by chemoradiation
  • More than 90% of cases of SCCA are linked to prior infection with human papillomavirus (HPV)
  • Within tumour cells, HPV oncoproteins are immunogenic and can trigger an anti-tumour host immune response by recruitment of tumour-infiltrating lymphocytes
  • Tumour cells express PD-L1 and, on binding its inhibitory receptor PD-1 on the surface of T cells, downregulate T-cell activation and thwart the local anti-tumour immune response
  • Nivolumab is a humanised monoclonal antibody against PD-1 that disrupts this interaction, enabling T-cell cytotoxicity. It has activity as a monotherapy in advanced solid cancers, such as head and neck cancer, melanoma, non-small-cell lung cancer, and renal cell carcinoma
  • Nathan Goodyear on 13 Jul 18
     
    study finds nivolumab helpful in some patients with surgically unresectable or metastatic anal cancer.  The dose used was 3 mg/kg every 2 weeks. 
wheelchairindia9

Abdominal Support Belt - 0 views

www.wheelchairindia.com/...Tynor-Abdominal-Support

abdominal belt abdominal support tynor abdominal belt tynor abdominal support tynor abdominal support belt tynor abdominal support 9 tynor abdominal belts abdominal support 9

shared by wheelchairindia9 on 01 Apr 16 - No Cached
  • wheelchairindia9 on 01 Apr 16
     
    Tynor Hot and Cold Pack is a convenient device to provide hot fomentation or cold compress. Tynor Hot and Cold Pack is of multipurpose advantage. It is a convenient and effective approach for both hot as well as a cold therapy. Hot pack can be used for body ache, joint pain, etc., whereas a cold pack can be used for fever, sprains, fever, bleeding, etc. It is easy to use and maintains the temperature for a long period of time. It is available in 11.22 x 7.67 inch universal sizes. Hot fomentation of the injured or inflamed area enhances the threshold of pain and thus reduces the perception of pain. It has a synergistic effect along with pain relieving drugs. Raising temperature of the injured tissue also enhances the blood profusion and the healing process. Hot fomentation has a relaxing effect. Cold compress helps in reduction of inflammation in injuries, protects by slowing the metabolic rate around the tissue, reduce oedema and bleeding. Cold compress helps in immediately lowering fever, in very high fever conditions. It can be used after an acute injury or surgical procedure. No heat or cryo burns. Requires no holding. Reusable. Easy application. Appealing aesthetics. Tynor Hot and Cold Pack Features Multi functionality Reduce swelling and odema at the site of injury. Muscles spasm and pain. Headache and minor injuries. Versatile design Can be used as either cold or hot pack. Reusable in either hot & cold condition. Temperature range - Can be used from 0 Cº to 75Cº. Longer temperature retention time. Fabric cover ensures no cryo burns or hot skin burns. Physical features Non-toxic, and biodegradable. Gel remains soft and flexible upto 0 degree. Durable, and puncture resistant. Soft, "frost free" PVC cover. Flexible conforms to the body contours. Easy to clean and maintain. Excellent workmanship. Good aesthetics. Elastic belt Holds the pack against the body, No need to hold by hand. Enhances convenience. Tynor
Nathan Goodyear

Lowered testosterone in male obesity: Mechanisms, morbidity and management Tang Fui MN,... - 0 views

www.ajandrology.com/article.asp

Testosterone male obesity overweight men hormone hormones low T Low T

shared by Nathan Goodyear on 15 Jan 14 - No Cached
  • The number of overweight people is expected to increase from 937 million in 2005 to 1.35 billion in 2030
  • Similarly the number of obese people is projected to increase from 396 million in 2005 to 573 million in 2030
  • By 2030, China alone is predicted to have more overweight men and women than the traditional market economies combined
  • ...37 more annotations...
  • diacylglycerol O-acyltransferase 2 (DGAT2), mechanistically implicated in this differential storage, [10] is regulated by dihydrotestosterone, [11] suggesting a potential role for androgens to influence the genetic predisposition to either the MHO or MONW phenotype.
  • bariatric surgery achieves 10%-30% long-term weight loss in controlled studies
  • The fact that obese men have lower testosterone compared to lean men has been recognized for more than 30 years
  • Reductions in testosterone levels correlate with the severity of obesity and men
  • epidemiological data suggest that the single most powerful predictor of low testosterone is obesity, and that obesity is a major contributor of the age-associated decline in testosterone levels.
  • healthy ageing by itself is uncommonly associated with marked reductions in testosterone levels
  • obesity blunts this LH rise, obesity leads to hypothalamic-pituitary suppression irrespective of age which cannot be compensated for by physiological mechanisms
  • Reductions in total testosterone levels are largely a consequence of reductions in sex hormone binding globulin (SHBG) due to obesity-associated hyperinsulinemia
  • although controversial, measurement of free testosterone levels may provide a more accurate assessment of androgen status than the (usually preferred) measurement of total testosterone in situations where SHBG levels are outside the reference range
  • SHBG increases with age
  • marked obesity however is associated with an unequivocal reduction of free testosterone levels, where LH and follicle stimulating hormone (FSH) levels are usually low or inappropriately normal, suggesting that the dominant suppression occurs at the hypothalamic-pituitary level
  • adipose tissue, especially when in the inflamed, insulin-resistant state, expresses aromatase which converts testosterone to estradiol (E 2 ). Adipose E 2 in turn may feedback negatively to decrease pituitary gonadotropin secretion
  • diabetic obesity is associated with decreases in circulatory E 2
  • In addition to E 2 , increased visceral fat also releases increased amounts of pro-inflammatory cytokines, insulin and leptin; all of which may inhibit the activity of the HPT axis at multiple levels
  • In the prospective Massachusetts Male Aging Study (MMAS), moving from a non-obese to an obese state resulted in a decline of testosterone levels
  • weight loss, whether by diet or surgery, increases testosterone levels proportional to the amount of weight lost
  • fat is androgen-responsive
  • low testosterone may augment the effects of a hypercaloric diet
  • In human male ex vivo adipose tissue, testosterone decreased adipocyte differentiation by 50%.
  • Testosterone enhances catecholamine-induced lipolysis in vitro and reduces lipoprotein lipase activity and triglyceride uptake in human abdominal adipose tissue in vivo
  • in men with prostate cancer receiving 12 months of androgen deprivation therapy, fat mass increased by 3.4 kg and abdominal VAT by 22%, with the majority of these changes established within 6 months
  • severe sex steroid deficiency can increase fat mass rapidly
  • bidirectional relationship between testosterone and obesity
  • increasing body fat suppresses the HPT axis by multiple mechanisms [30] via increased secretion of pro-inflammatory cytokines, insulin resistance and diabetes; [19],[44] while on the other hand low testosterone promotes further accumulation of total and visceral fat mass, thereby exacerbating the gonadotropin inhibition
  • androgens may play a more significant role in VAT than SAT
  • men undergoing androgen depletion for prostate cancer show more marked increases in visceral compared to subcutaneous fat following treatment
    • Nathan Goodyear
      Nathan Goodyear on 16 Jan 14
       
      Interesting: low T increases VAT, yet T therapy does not reduce VAT, yet T therapy reduces SAT.
  • irisin, derived from muscle, induces brown fat-like properties in rodent white fat
  • androgens can act via the PPARg-pathway [37] which is implicated in the differentiation of precursor fat cells to the energy-consuming phenotype
  • low testosterone may compound the effect of increasing fat mass by making it more difficult for obese men to lose weight via exercise
  • pro-inflammatory cytokines released by adipose tissue may contribute to loss of muscle mass and function, leading to inactivity and further weight gain in a vicious cycle
  • Sarcopenic obesity, a phenotype recapitulated in men receiving ADT for prostate cancer, [55] may not only be associated with functional limitations, but also aggravate the metabolic risks of obesity;
  • observational evidence associating higher endogenous testosterone with reduced loss of muscle mass and crude measures of muscle function in men losing weight
  • genuine reactivation of the HPT axis in obese men requires more substantial weight-loss
  • A number of intervention studies have confirmed that both diet- and surgically-induced weight losses are associated with increased testosterone, with the rise in testosterone generally proportional to the amount of weight lost
  • men, regardless of obesity level, can benefit from the effect of weight loss.
  • inconsistent effect of testosterone on VAT
  • Nathan Goodyear on 15 Jan 14
     
    to be read
Nathan Goodyear

Vitamin C preferentially kills cancer stem cells in hepatocellular carcinoma via SVCT-2... - 0 views

www.nature.com/...s41698-017-0044-8

cancer cancer stem cells liver cancer vitamin C IV vitamin C oncology

shared by Nathan Goodyear on 30 Jan 18 - No Cached
  • Chen et al. have revealed that ascorbate at pharmacologic concentrations (0.3–20 mM) achieved only by intravenously (i.v.) administration selectively kills a variety of cancer cell lines in vitro, but has little cytotoxic effect on normal cells.
  • Ascorbic acid (the reduced form of vitamin C) is specifically transported into cells by sodium-dependent vitamin C transporters (SVCTs)
  • SVCT-1 is predominantly expressed in epithelial tissues
  • ...41 more annotations...
  • whereas the expression of SVCT-2 is ubiquitous
  • differential sensitivity to VC may result from variations in VC flow into cells, which is dependent on SVCT-2 expression.
  • high-dose VC significantly impaired both the tumorspheres initiation (Fig. 4d, e) and the growth of established tumorspheres derived from HCC cells (Fig. 4f, g) in a time-dependent and dose-dependent manner.
  • Hepatocellular carcinoma (HCC)
  • The antioxidant, N-acetyl-L-cysteine (NAC), preventing VC-induced ROS production (a ROS scavenger), completely restored the viability and colony formation among VC-treated cells
  • DNA double-strand damage was found following VC treatment
  • DNA damage was prevented by NAC
  • Interestingly, the combination of VC and cisplatin was even more effective in reducing tumor growth and weight
  • Consistent with the in vitro results, stemness-related genes expressions in tumor xenograft were remarkably reduced after VC or VC+cisplatin treatment, whereas conventional cisplatin therapy alone led to the increase of CSCs
  • VC is one of the numerous common hepatoprotectants.
  • Interestingly, at extracellular concentrations greater than 1 mM, VC induces strong cytotoxicity to cancer cells including liver cancer cells
  • we hypothesized that intravenous VC might reduce the risk of recurrence in HCC patients after curative liver resection.
  • Intriguingly, the 5-year disease-free survival (DFS) for patients who received intravenous VC was 24%, as opposed to 15% for no intravenous VC-treated patients
  • Median DFS time for VC users was 25.2 vs. 18 months for VC non-users
  • intravenous VC use is linked to improved DFS in HCC patients.
  • In this study, based on the elevated expression of SVCT-2, which is responsible for VC uptake, in liver CSCs, we revealed that clinically achievable concentrations of VC preferentially eradicated liver CSCs in vitro and in vivo
    • Nathan Goodyear
      Nathan Goodyear on 31 Jan 18
       
      the authors here made similar mistakes to the Mayo authors i.e. under doses here in this study.  They dosed at only 2 grams IVC.  A woefully low dose of IVC.
  • Additionally, we found that intravenous VC reduced the risk of post-surgical HCC progression in a retrospective cohort study.
    • Nathan Goodyear
      Nathan Goodyear on 31 Jan 18
       
      positive results despite a low dose used.
    • Nathan Goodyear
      Nathan Goodyear on 31 Jan 18
       
      Their comfort zone was 1mM.  They should have targeted 20-40 mM.
  • Three hundred thirty-nine participants (55.3%) received 2 g intravenous VC for 4 or more days after initial hepatectomy
  • As the key protein responsible for VC uptake in the liver, SVCT-2 played crucial roles in regulating the sensitivity to ascorbate-induced cytotoxicity
  • we also observed that SVCT-2 was highly expressed in human HCC samples and preferentially elevated in liver CSCs
  • SVCT-2 might serve as a potential CSC marker and therapeutic target in HCC
  • CSCs play critical roles in regulating tumor initiation, relapse, and chemoresistance
  • we revealed that VC treatment dramatically reduced the self-renewal ability, expression levels of CSC-associated genes, and percentages of CSCs in HCC, indicating that CSCs were more susceptible to VC-induced cell death
  • as a drug for eradicating CSCs, VC may represent a promising strategy for treatment of HCC, alone or particularly in combination with chemotherapeutic drugs
  • In HCC, we found that VC-generated ROS caused genotoxic stress (DNA damage) and metabolic stress (ATP depletion), which further activated the cyclin-dependent kinase inhibitor p21, leading to G2/M phase cell cycle arrest and caspase-dependent apoptosis in HCC cells
  • we demonstrated a synergistic effect of VC and chemotherapeutic drug cisplatin on killing HCC both in vitro and in vivo
  • Intravenous VC has also been reported to reduce chemotherapy-associated toxicity of carboplatin and paclitaxel in patients,38 but the specific mechanism needs further investigation
    • Nathan Goodyear
      Nathan Goodyear on 31 Jan 18
       
      so, exclude the benefit to patients until the exact mechanism of action, which will never be fully elicited?!?!?
  • Our retrospective cohort study also showed that intravenous VC use (2 g) was related to the improved DFS in HCC patients after initial hepatectomy
    • Nathan Goodyear
      Nathan Goodyear on 31 Jan 18
       
      Terribly inadequate dose.  Target is 20-40 mM which other studies have found occur with 50-75 grams of IVC.
  • several clinical trials of high-dose intravenous VC have been conducted in patients with advanced cancer and have revealed improved quality of life and prolonged OS
  • high-dose VC was not toxic to immune cells and major immune cell subpopulations in vivo
  • high recurrence rate and heterogeneity
  • tumor progression, metastasis, and chemotherapy-resistance
  • SVCT-2 was highly expressed in HCC samples in comparison to peri-tumor tissues
  • high expression (grade 2+/3+) of SVCT-2 was in agreement with poorer overall survival (OS) of HCC patients (Fig. 1c) and more aggressive tumor behavior
  • SVCT-2 is enriched in liver CSCs
  • these data suggest that SVCT-2 is preferentially expressed in liver CSCs and is required for the maintenance of liver CSCs.
  • pharmacologic concentrations of plasma VC higher than 0.3 mM are achievable only from i.v. administration
  • The viabilities of HCC cells were dramatically decreased after exposure to VC in dose-dependent manner
  • VC and cisplatin combination further caused cell apoptosis in tumor xenograft
  • These results verify that VC inhibits tumor growth in HCC PDX models and SVCT-2 expression level is associated with VC response
  • qPCR and IHC analysis demonstrated that expression levels of CSC-associated genes and percentages of CSCs in PDXs dramatically declined after VC treatment, confirming the inhibitory role of VC in liver CSCs
  • Nathan Goodyear on 30 Jan 18
     
    IV vitamin C in vitro and in vivo found to "preferentially" eradicate cancer stem cells.  In addition, IV vitamin C was found to be adjunctive to chemotherapy, found to be hepatoprotectant.  This study also looked at SVCT-2, which is the transport protein important in liver C uptake.
Nathan Goodyear

Frontiers | Management of Glioblastoma Multiforme in a Patient Treated With Ketogenic M... - 0 views

www.frontiersin.org/...full

press-pulse therapy hyperbaric ketogenic metabolic therapy cancer ketogenic diet Glioblastoma glioblastoma multiforme HBOT nutrition

shared by Nathan Goodyear on 01 Apr 18 - No Cached
  • The SOC for GBM was modified in this patient to initiate KMT prior to surgical resection, to eliminate steroid medication, and to include HBOT as part of the therapy
  • the greatest therapeutic benefit for patients (near 1.0)
  • The observed reduction in blood glucose in our patient would reduce lactic acid fermentation in the tumor cells, while the elevation of ketone bodies would fuel normal cells thus protecting them from hypoglycemia and oxidative stress
  • ...30 more annotations...
  • Previous studies showed that GBM survival and tumor growth was correlated with blood glucose levels
  • Evidence indicates that glioma cells cannot effectively use ketone bodies for energy due to defects in the number, structure, and function of their mitochondria
  • The accuracy of the GKI as a predictor for therapeutic efficacy, however, is better when ketone bodies are measured from the blood than when measured from the urine
  • A reduction of glucose-driven lactic acid fermentation would not only increase tumor cell apoptosis, but would also reduce inflammation and edema in the tumor microenvironment thus reducing tumor cell angiogenesis and invasion
  • Besides serving as a metabolic fuel for GBM, glutamine is also an essential metabolite for normal immune cells
  • therapies that inhibit glutamine availability and utilization must be strategically employed to avoid inadvertent impairment of immune cell functions
  • we used the non-toxic green tea extract, EGCG, and chloroquine in an attempt to limit glutamine availability to the tumor cells
  • EGCG is thought to target the glutamate dehydrogenase activity that facilitates glutamine metabolism in GBM cells
  • Chloroquine, on the other hand, will inhibit lysosomal digestion thus restricting fermentable amino acids and carbohydrates from phagocytosed materials in the tumor microenvironment
  • HBOT to increase oxidative stress in the tumor cells
  • As glucose and glutamine fermentation protect tumor cells from oxidative stress, reduced availability of these metabolites under ketosis could enhance the therapeutic action of HBOT, as we recently described
  • Prior to subtotal tumor resection and standard of care (SOC), the patient conducted a 72-h water-only fast
  • Following the fast, the patient initiated a vitamin/mineral-supplemented ketogenic diet (KD) for 21 days that delivered 900 kcal/day
  • KD (increased to 1,500 kcal/day at day 22
  • the patient received metformin (1,000 mg/day), methylfolate (1,000 mg/day), chloroquine phosphate (150 mg/day), epigallocatechin gallate (400 mg/day), and hyperbaric oxygen therapy (HBOT) (60 min/session, 5 sessions/week at 2.5 ATA)
  • Biomarkers showed reduced blood glucose and elevated levels of urinary ketones with evidence of reduced metabolic activity (choline/N-acetylaspartate ratio) and normalized levels of insulin, triglycerides, and vitamin D
  • This is the first report of confirmed GBM treated with a modified SOC together with KMT and HBOT, and other targeted metabolic therapies
  • Glioblastoma multiforme (GBM) is the most common and malignant of the primary adult brain cancers
  • less than 20% of younger adults generally survive beyond 24 months
  • glucose and glutamine are the primary fuels that drive the rapid growth of most tumors including GBM
  • Glucose drives tumor growth through aerobic fermentation (Warburg effect), while glutamine drives tumor growth through glutaminolysis
  • The fermentation waste products of these molecules, i.e., lactic acid and succinic acid, respectively, acidify the tumor microenvironment thus contributing further to tumor progression
  • Glucose and glutamine metabolism is also responsible for the high antioxidant capacity of the tumor cells thus making them resistant to chemo- and radiotherapies
  • The reliance on glucose and glutamine for tumor cell malignancy comes largely from the documented defects in the number, structure, and function of mitochondria and mitochondrial-associated membranes
  • These abnormalities cause the neoplastic GBM cells to rely more heavily on substrate level phosphorylation than on oxidative phosphorylation for energy
  • dexamethasone not only increases blood glucose levels but also increases glutamine levels through its induction of glutamine synthetase activity
    • Nathan Goodyear
      Nathan Goodyear on 21 May 18
       
      use mannitol instead
  • Calorie restriction and restricted KD are anti-angiogenic, anti-inflammatory, anti-invasive, and also kill tumor cells through a proapoptotic mechanism
  • Evidence also shows that therapeutic ketosis can act synergistically with several drugs and procedures to enhance cancer management improving both progression free and overall survival
  • hyperbaric oxygen therapy (HBOT) increases oxidative stress on tumor cells especially when used alongside therapies that reduce blood glucose and raise blood ketones
  • The glutamine dehydrogenase inhibitor, epigallocatechin gallate (EGCG) is also proposed to target glutamine metabolism
  • Nathan Goodyear on 01 Apr 18
     
    Case study of Glioblastoma treated with ketogenic metabolic therapy as an adjuct to modified standard therapy.
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