literature review

Dr. M’s SPA Newsletter Audiocast Volume 14 Issue 44

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Treatment – sometimes it is just better to watch and wait.

Warts are a common ailment of childhood. Mostly a nuisance, sometimes a hindrance to function when located on the fingers and or areas of high use. There are two major types of wart type skin lesions – typical verrucous warts and molluscum contagiosum.

Google has great molluscum and wart Images

WARTS/MOLLUSCUM – To Treat Or Not To Treat?

Common warts and molluscum contagiosum lesions are benign, but bothersome viral skin lesions that are common in children. We see them all the time in clinic. A common viral wart is caused by the human papillomavirus (HPV). HPV infects the epithelium of the skin, leading to keratinocyte proliferation in the skin’s outer layer. This uncontrolled growth of the keratinocytes results in a thickened rough round lesion that we see. If the immune system fails to fully clear the virus, we see this lesion for months to years. Molluscum, caused by an unknown virus, follows a similar course with a dissimilar appearance. Neither molluscum nor warts have roots despite the myth propagated over the years. Molluscum lesions have a turbid white appearance under the umbilicated skin papule with the virus located within the upper skin layer. They are 1-4 mm in diameter. Viral warts are a little larger usually 3 -10 mm in size. They form a protective cap of dead skin (keratinocyte) cells and invade the deeper skin layer. The protective cap is rough like sand paper. Molluscum lesions peak around ages 2-7 years and for common warts the peak age is 7-15 years…. and more on a literature review.

Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 14 Issue 43

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Finding a relational balance with any person or persons can be a struggle if one side of the relationship dyad has a strong need for a gain to feel safe or whole. For example, a parent in a poor quality marriage or with significant childhood wounding may turn to the child for happiness and love when it is missing otherwise. A child in turn being young will often, out of filial love, try to meet the needs of the parent. These types of relationships can take on many forms and can become dysfunctional over time.

I remember a parent child dyad from many years ago that was a budding enmeshed/codependent relationship between a mother and her son. Mom was absolutely unable to draw boundaries with her son as she felt all of his pain and reflected all of her childhood trauma onto the child’s life with boundary-less smothering love and control. She simultaneously would restrict any behavior that she perceived as unsafe controlling his environment while drawing zero boundaries with regard to his behavior toward her and others within this controlled small world. He was a holy terror by 4 years of age. His mother was crying for help while being indignant that he was sweet and well meaning while she enabled every choice that he made. Her fear of drawing boundaries because of her own childhood restrictive parenting wounding left this child completely attached to her yet abusive because he felt completely out of control. The psychological pathology was exhausting for all in the room. Recommendations for therapy and interventions were met with scorn….plus a literature review.

Enjoy,

Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 14 Issue 42

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Review of Dr. Casey Means’ Good Energy

In her book, Good Energy, Dr. Casey Means explores the complex relationship between our metabolic health and the quality of energy we experience in daily life. Dr. Means is an ENT surgeon that graduated from Stanford University Medical School before eschewing it all to dive into the world of disease prevention. Drawing from her background in integrative medicine and her deep understanding of metabolic science, Dr. Means presents a compelling case for why energy levels are not merely a factor of rest and diet, but a direct reflection of how well our cells are functioning on a biochemical level. And this is the key, the understanding of the biochemistry of the why!

In today’s modern world, so many of us feel sluggish, fatigued, or burned out, and the causes are often elusive. We live in a time where external stressors, processed foods, environmental toxins, and sedentary lifestyles disrupt our body’s ability to produce and regulate energy efficiently. Dr. Means calls for a paradigm shift in how we view energy: it’s not just about getting more sleep or drinking another cup of coffee. It’s about restoring the metabolic health of our cells to optimize the energy they generate…..plus a literature review and a recipe.

Enjoy,

Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 14 Issue 40/41

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Literature Review Week

Why do some people react to mosquitoes so vigorously? There is fascinating data for me in the Nature article, as I see lots of kids that react strongly to mosquitoes while others do not at all. A hyper primed immune reaction makes a lot of sense as the immune system is extra sensitive to the insult in individuals that have chronic allergic phenotypes. They are in effect polarized to see the outside world through an irritant lens and thus react in a more robust way. The cell called GD3 releases Interleukin 3 or IL-3 which is a cytokine signaling molecule that tells skin based sensory neurons to become more sensitive to allergens like house dust mites, environmental molds, and in this case mosquito saliva. Thus, the mosquito saliva induces more of the itch scratch cycle. The effect is to increase the gain sensitivity on the skin to 10. This is likely a main reason why having an allergic child take immunotherapy against allergens that they react to lowers the rheostat for all irritants. It is like a global check on the sensory system. This is another reason to consider SLIT and or SCIT immunotherapy in allergic children… Plus a discussion on the Joe Rogan podcast with Callie and Casey Means.

Enjoy,

Dr. M

 

Dr. M’s SPA Newsletter Audiocast Volume 14 Issue 36

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Section I

Literature Review

1) Long Covid in children – the symptoms are getting more clarity in who has what . From JAMA: 898 school-age children (751 with previous SARS-CoV-2 infection and 147 without) and 4469 adolescents (3109 infected and 1360 uninfected) were included in the analysis. The time between infection and symptom analysis was 1.5 years. In models adjusted for sex and race and ethnicity, 14 symptoms in both school-age children and adolescents were more common in those with SARS-CoV-2 infection history compared with those without infection history, with 4 additional symptoms in school-age children only and 3 in adolescents only. These symptoms affected almost every organ system. The cumulative data shows us that neurocognitive (Headache, attention concerns, sleep dysregulation), pain, and gastrointestinal symptoms in school-age children were common, but changed to loss of smell and/or taste, body aches and pain, focus struggles and fatigue related symptoms in adolescents. (Gross et. al. 2024) Age has a huge effect on these outcomes as the older population has more frequent and problematical disease findings. Mood disorder is highly associated with worsened findings. I suspect from the historical data set over the last four years that children with chronic mental stress, poor quality diets, sleep issues, and poor activity levels at baseline have worsened acute and long term prognosis.

Plus a section on a book review for Change Your Genes, Change Your Life.

Enjoy,

Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 14 Issue 34

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Literature Review

1) Does oral health affect your life if you are sick and in intensive care? According to a new study in JAMA, the answer is yes. From the study: 10,742 patients – “toothbrushing was associated with significantly lower risk for Hospital Acquired Pneumonia and ICU mortality. Reduction in pneumonia incidence was significant for patients receiving invasive mechanical ventilation but not for patients who were not receiving invasive mechanical ventilation. Toothbrushing for patients in the ICU was associated with fewer days of mechanical ventilation and a shorter ICU length of stay. Brushing twice a day vs more frequent intervals was associated with similar effect estimates….Non-ICU hospital length of stay and use of antibiotics were not associated with toothbrushing.” (Ehrenzeller et. al. 2024)

Why does this matter? In effect, what this study shows is that patients with oral hygiene needs that are not met will have increased bacterial burdens leading to infectious disease risk via systemic inflammation and possibly bacterial translocation. At the end of the day, oral hygiene is very important to lower the total burden of inflammation in everyone, but especially in the most ill patient. It is super important for everyone to brush 2-3 x daily and floss daily at night…..

Plus a discussion on Back to School.

Enjoy, Dr. M

Dr. M’s SPA Audiocast Newsletter Volume 14 Issue 28

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Klotho Part II

Last week we discussed Klotho as a protein that has pleotrophic effects in the body as it relates to cellular aging. This week let us focus specifically on the brain. What are the effects of klotho as it relates to cognition and function over time? Klotho has neuroprotective effects based on studies that show that better cognitive performance in translational models over time occur with the injections of klotho. Klotho is also shown to have neuroprotective effects if naturally elevated, i.e. individuals with host genetics that promote more klotho production over time without being taken or given.

The pivitol research occurred in 2015 in a mouse model of Alzheimers Disease (AD) where Dr. Dena Dubal and colleagues looked at two groups of intervention mice with and without higher levels of Klotho. and a literature review on micro plastics and screentime.

Enjoy,

Dr. M

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