literature review

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

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

Dr. M’s SPA Newsletter Volume 15 Issue 2

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Klotho Protein and Longevity

I am reposting this information from last year because it is going to stay on my mind and I would like everyone to be aware of this peptide and the future of healing and what we can do now to be healthy. The science here is one part fascinating, one part complicated and equal parts necessary.

Ok, it is time for a potential log step shift in the human understanding of neurological decline with age starting from birth.

Enter the peptide, (C)Klotho, named after the greek goddess of fate who spins the thread of life for all. The Klotho protein was discovered by researchers looking at mice that aged faster than the general mouse population. These mice were noted to have a shortened lifespan, stunted growth, renal disease, blood vessel calcification, cardiac hypertrophy, hypertension, pulmonary disease, cognitive impairment, multi-organ atrophy and fibrosis. (Prud’homme et. al. 2022) When they looked closer, these mice were found to have hypoactive klotho proteins leading to an explosion of research over the past two decades to understand why. The next question was, could the hyperactive state provide an anti aging effect? To be clear the word anti aging should really say delayed inevitable aging.

The answer was a resounding yes!…..

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 1

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Some Key Literature Review Studies from Year 14

This is a bit of a long newsletter. That is intentional. This will be a repository for some of the best research for us to look back on from time to time this coming year to solidify the learning moving forward.

1) Time restricted eating patterns are known to help physiology and metabolism by initiating a pause in the action of mTOR and muscle synthesis as well as inducing autophagy. Autophagy is critical to the clearance of broken or damaged cells following injury or disease…..Plus a to do list and recipe of the week.

Dr. M

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