WOMEN'S MENTAL HEALTH COALITION (WHC) + Feature on Dr. R. Bard/ Diagnostic Imaging

 Psychotherapist Jessica Glynn welcomes you to the Women's Mental Health Coalition

THE CRITICAL ROLE OF DIAGNOSTICS IN HEALTH AND WELLNESS  By: Dr. Jess Sabrowsky DNP, RN, FNP-BC What I have learned over the years is the importance of listening to the patient, but equally, the importance of using data-driven diagnostics to make real-time decisions about care. This is not just about numbers on a chart—it is about understanding the full picture of your health, long before symptoms arise. We need to use technology, diagnostics, and assessment techniques to gather real data. Data that can guide each patient on their unique health journey. Diagnostics help us understand the true state of a person’s health, even when they may not feel “sick.” This is where the rubber meets the road: when you find a PCP who truly understands the importance of these tools and works with you to achieve your wellness goals and who also has skills beyond the transitional medical model to help you live your best life. Having difficult conversations is uncomfortable, but it is necessary for growth. If you want a healthcare provider who will partner with you—someone who creates a safe space, builds trust, and encourages honest dialogue to support long-term growth—then you must also be willing to put in the effort. Finding a provider who matches your commitment to your health, and one who uses diagnostics to empower you, is key to achieving your goals. WHY DIAGNOSTICS MATTER In short, diagnostics are essential because they offer concrete, actionable insights into your health that go beyond surface-level symptoms. They help uncover hidden health risks and enable early intervention, which can be the difference between preventing a chronic condition or managing it effectively. Diagnostics allow for personalized care tailoring interventions to meet the specific needs of the individual based on real, measurable data. I also would add that as a provider I prefer to reference functional lab ranges when reviewing results as I find that I can make small preventative recommendations and also challenge individuals and providers to think outside the box when looking to help resolve health conditions, like in the case of my daughter who otherwise would still be suffering. Let’s aim to stop the suffering and optimize wellness for all who seek it.

Wound Healing & Exosomes for the Skin

INTRODUCTION

Our publication's first interaction with Dr. Jordan Plews was during HealthTech Reporter's pilot program where Dr. Robert Bard conducted a performance test of the ELEVAI Exosomes product (Image R).  Dr. Plews, CEO of Elevai collaborated with BardDiagnostics to explore quantifiable  effects of the skin regenerative product, offering a new way of monitoring the progress of a topical serum.  This "test drive" employed the use of hospital-grade 3D Ultrasound, showing remarkable epidermal and subdermal progress with Dr. Plews' exosomes' during a limited time period.

The exploratory relationship continued to grow as both clinical minds entertained other potential benefits of extracellular vesicles (EVs) for its directed use and beyond. The expansion of regenerative medicine brought Drs. Bard and Plews a common appreciation for each others' work in the spirit of publishing new findings for the progress of exosome science as future co-investigators.  This is also evident in this latest report on "Wound Healing & Exosomes for the Skin"- where Dr. Plews brings a clear path of understanding about the regenerative potential for platelet-derived extracellular vesicles.

UNVEILING THE POWER OF CELLULAR COMMUNICATION
Written by Jordan R. Plews, PhD

As a biochemical engineer, molecular biologist, and stem cell researcher, I'm constantly fascinated by the body's intricate communication networks. One particularly exciting area is the field of exosomes, tiny extracellular vesicles released by cells that act as messengers, carrying vital cargo to influence the behavior of recipient cells. In the realm of dermatology, exosomes hold immense potential for promoting and supporting skin health and regeneration. However, it's crucial to understand not only the source of these messengers but also the specific content they deliver for optimal results.

Exosomes: Nature's Nanoscale Communication Network
Exosomes are naturally occurring, membrane-bound nanoparticles (30-150 nm) secreted by various cell types. They carry a rich cargo of proteins, lipids, and genetic material, including messenger RNA (mRNA), microRNAs (miRNAs), and long non-coding RNAs (lncRNAs) [1]. This molecular payload allows exosomes to act as intercellular signaling units, influencing the behavior of recipient cells.

In the context of skin, exosomes play a vital role in various processes. They contribute to wound healing, tissue regeneration, immune modulation, and even pigmentation regulation [2, 3]. However, it's important to differentiate between exosomes derived from different cell sources.

Plant vs. Human Exosomes: A Tale of Two Kingdoms
The recent surge in interest in exosomes has led to the exploration of plant-derived options. While plant exosomes may possess intriguing properties, it's crucial to recognize the fundamental limitations. Human and plant cells belong to distinct biological kingdoms with vastly different cellular structures, signaling pathways, and metabolic processes [4]. Therefore, plant exosomes might not be well-suited for addressing human skin concerns. Their cargo may not effectively interact with our cellular machinery, hindering their ability to deliver the desired effects.

Platelets vs. MSCs: Unveiling the Superior Source for Skin Rejuvenation
Platelet-derived extracellular vesicles (EVs) have garnered considerable attention in aesthetics. However, as a stem cell researcher, I find them to be a limited source for comprehensive skin rejuvenation. While platelet EVs offer some beneficial growth factors, their cargo is comparatively restricted compared to exosomes derived from mesenchymal stem cells (MSCs) [5].

MSCs are multipotent adult stem cells with the remarkable potential to differentiate into various cell types. Importantly, MSCs can be isolated from numerous adult tissues, including bone marrow, adipose tissue, and even umbilical cord and placenta [6].

The Power of Younger Sources: Unveiling a Superior Exosome Profile
Interestingly, the source of MSCs significantly impacts the exosome profile. Human MSCs derived from younger sources, such as umbilical cord (hUMSCs) and placenta exhibit several advantages over those from bone marrow or adipose tissue [7, 8]. Here's why:

1. Enhanced Proliferative Capacity: Younger MSC sources possess a higher proliferation rate, leading to a greater yield of exosomes for therapeutic applications, and have been shown to improve the function of older MSCs [9].

2. Superior miRNA and Growth Factor Profile: hUMSCs secrete exosomes rich in specific miRNAs and growth factors known to promote cell proliferation, migration, and tissue regeneration [10, 11]. These factors include vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), and epidermal growth factor (EGF), all crucial players in the wound healing cascade.

3. Potent Anti-Inflammatory and Immunomodulatory Effects: Exosomes from younger MSC sources display pronounced anti-inflammatory and immunomodulatory properties [12]. This is particularly beneficial for addressing conditions like chronic wounds or acne, where inflammation plays a key role.

Harnessing the Power of Exosomes for Skin Regeneration: The 4-Phase Wound Healing Cascade

The human body possesses a remarkable ability to heal wounds through a well-defined, four-phase process:

● Hemostasis (0-1 day): This initial phase focuses on stopping bleeding through platelet aggregation and clot formation.

● Inflammation (1-3 days): The body initiates an inflammatory response to remove damaged tissue and prepare for repair.

● Proliferation (3-21 days): New blood vessels are formed, and fibroblasts migrate to the wound site to synthesize collagen, the building block of new tissue.

● Remodeling (~14 days – 2 years): The newly formed tissue matures and strengthens, eventually returning the skin to its pre-injury state [13].

Exosomes sourced from young MSCs, such as human umbilical mesenchymal stem cells (hUMSCs), hold tremendous potential to support each phase of this process. Their cargo of growth factors can accelerate the proliferation phase, while their anti-inflammatory properties can shorten the inflammatory phase. Additionally, miRNAs contained within these exosomes can regulate gene expression to promote tissue repair and regeneration [14].

Conclusion

In conclusion, exosomes represent a promising frontier in dermatology. However, it is crucial to select the right exosome source for optimal results. While plant-derived exosomes may offer some benefits, human-derived exosomes, particularly those from younger MSC sources, provide a superior profile of bioactive molecules to more effectively address a broad array of skin concerns, as many trace back to lack of completion of the canonical four phases of wound healing. By understanding the science behind exosomes and the intricacies of the wound healing cascade, we can harness their power to promote healthier, younger-looking skin.

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ABOUT THE AUTHOR

Dr. Jordan R. Plews is an expert at the intersection of biochemical engineering, stem cell research, and regenerative medicine with a particular focus on the cellular and molecular mechanisms of aging and human longevity. He graduated with 1st class honors in Biochemical Engineering from the University of London and completed doctorate research in Molecular Biology and Stem Cell Research at University College London, specializing in Somatic Cell Reprogramming. After working as part of Pfizer's bioprocess development group in bioprocess design and scale up, he conducted postdoctoral research at Stanford, looking at ways to apply stem cells in inventive and practical ways to treat disease. He held key roles at med/biotech companies like Velos, Becton Dickinson, and Xytogen Biotech, where he developed innovative products for researchers, clinicians, and consumers. At Natera, he lead the launch of Signatera, a personalized genomics based cancer diagnostic. In 2020, he co-founded ELEVAI, creating advanced skincare solutions using human stem cell exosomes. His research, published in leading journals, explores the relationship between stem cells, aging, and disease to enhance and extend healthy lifespan.

THE CRITICAL ROLE OF DIAGNOSTICS IN HEALTH AND WELLNESS  By: Dr. Jess Sabrowsky DNP, RN, FNP-BC What I have learned over the years is the importance of listening to the patient, but equally, the importance of using data-driven diagnostics to make real-time decisions about care. This is not just about numbers on a chart—it is about understanding the full picture of your health, long before symptoms arise. We need to use technology, diagnostics, and assessment techniques to gather real data. Data that can guide each patient on their unique health journey. Diagnostics help us understand the true state of a person’s health, even when they may not feel “sick.” This is where the rubber meets the road: when you find a PCP who truly understands the importance of these tools and works with you to achieve your wellness goals and who also has skills beyond the transitional medical model to help you live your best life. Having difficult conversations is uncomfortable, but it is necessary for growth. If you want a healthcare provider who will partner with you—someone who creates a safe space, builds trust, and encourages honest dialogue to support long-term growth—then you must also be willing to put in the effort. Finding a provider who matches your commitment to your health, and one who uses diagnostics to empower you, is key to achieving your goals. WHY DIAGNOSTICS MATTER In short, diagnostics are essential because they offer concrete, actionable insights into your health that go beyond surface-level symptoms. They help uncover hidden health risks and enable early intervention, which can be the difference between preventing a chronic condition or managing it effectively. Diagnostics allow for personalized care tailoring interventions to meet the specific needs of the individual based on real, measurable data. I also would add that as a provider I prefer to reference functional lab ranges when reviewing results as I find that I can make small preventative recommendations and also challenge individuals and providers to think outside the box when looking to help resolve health conditions, like in the case of my daughter who otherwise would still be suffering. Let’s aim to stop the suffering and optimize wellness for all who seek it.

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References

1. Raposo, G., & Stoorvogel, W. (2013). Extracellular vesicles: exosomes, microvesicles, and friends. Journal of Cell Biology, 200(4), 373-383.  

2. Qin, Xinchi, et al. "The functions and clinical application potential of exosomes derived from mesenchymal stem cells on wound repair: a review of recent research advances." Frontiers in Immunology 14 (2023): 1256687.

3. Liu, Ying, Haidong Wang, and Juan Wang. "Exosomes as a novel pathway for regulating development and diseases of the skin." Biomedical reports 8.3 (2018): 207-214.

4. Bloemendal, S., Kück, U. Cell-to-cell communication in plants, animals, and fungi: a comparative review. Naturwissenschaften 100, 3–19 (2013). https://doi.org/10.1007/s00114-012-0988-z

5. Anderson JD, Johansson HJ, Graham CS, Vesterlund M, Pham MT, Bramlett CS, Montgomery EN, Mellema MS, Bardini RL, Contreras Z, Hoon M, Bauer G, Fink KD, Fury B, Hendrix KJ, Chedin F, El-Andaloussi S, Hwang B, Mulligan MS, Lehtiö J, Nolta JA. Comprehensive Proteomic Analysis of Mesenchymal Stem Cell Exosomes Reveals Modulation of Angiogenesis via Nuclear Factor-KappaB Signaling. Stem Cells. 2016 Mar;34(3):601-13. doi: 10.1002/stem.2298. Epub 2016 Feb 19. PMID: 26782178; PMCID: PMC5785927.

6. Dominici, M., Le Blanc, K., Mueller, I., Slaper-Cortenbach, I., Marini, F., Krause, D. E., ... & Horwitz, E. M. (2006). Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy, 8(4), 315-317.  

7. Teng L, Maqsood M, Zhu M, Zhou Y, Kang M, Zhou J, Chen J. Exosomes Derived from Human Umbilical Cord Mesenchymal Stem Cells Accelerate Diabetic Wound Healing via Promoting M2 Macrophage Polarization, Angiogenesis, and Collagen Deposition. Int J Mol Sci. 2022 Sep 9;23(18):10421. doi: 10.3390/ijms231810421. PMID: 36142334; PMCID: PMC9498995.

8. Wang, Zg., He, Zy., Liang, S. et al. Comprehensive proteomic analysis of exosomes derived from human bone marrow, adipose tissue, and umbilical cord mesenchymal stem cells. Stem Cell Res Ther 11, 511 (2020). https://doi.org/10.1186/s13287-020-02032-8

9. Zhang, N., Zhu, J., Ma, Q. et al. Exosomes derived from human umbilical cord MSCs rejuvenate aged MSCs and enhance their functions for myocardial repair. Stem Cell Res Ther 11, 273 (2020). https://doi.org/10.1186/s13287-020-01782-9

10. Zhang, Z., Mi, T., Jin, L. et al. Comprehensive proteomic analysis of exosome mimetic vesicles and exosomes derived from human umbilical cord mesenchymal stem cells. Stem Cell Res Ther 13, 312 (2022). https://doi.org/10.1186/s13287-022-03008-6

11. Bian, D., Wu, Y., Song, G. et al. The application of mesenchymal stromal cells (MSCs) and their derivative exosome in skin wound healing: a comprehensive review. Stem Cell Res Ther 13, 24 (2022). https://doi.org/10.1186/s13287-021-02697-9

12. Yari, H., Mikhailova, M.V., Mardasi, M. et al. Emerging role of mesenchymal stromal cells (MSCs)-derived exosome in neurodegeneration-associated conditions: a groundbreaking cell-free approach. Stem Cell Res Ther 13, 423 (2022). https://doi.org/10.1186/s13287-022-03122-5

13. Velnar T, Bailey T, Smrkolj V. The wound healing process: an overview of the cellular and molecular mechanisms. J Int Med Res. 2009 Sep-Oct;37(5):1528-42. doi: 10.1177/147323000903700531. PMID: 19930861.

14. Toghiani, R., Azimian Zavareh, V., Najafi, H. et al. Hypoxia-preconditioned WJ-MSC spheroid-derived exosomes delivering miR-210 for renal cell restoration in hypoxia-reoxygenation injury. Stem Cell Res Ther 15, 240 (2024). https://doi.org/10.1186/s13287-024-03845-7

SMARTER AGING (Part 1)- DEFINING THE RESET LAUNCHPAD

A NAVIGATION IN AGING TERMS

By: Lennard M. Goetze, Ed.D |   Roberta Kline, MD

Health programs like prevention and early detection are strategies that support wellness and longevity.  They are based on the desire to battle TIME and the culprits that wear down our physical, cognitive, and emotional selves. Pursuing anything 'SMARTER' is a critique on one's status quo, and an invitation to subscribers in need of an intelligent and sensible upgrade. Fresh, innovative insights and proactive measures offers an interventional plan for counter-steering towards NEW HOPE.  It centers on the need for immediate change through next-level education in how we address our current disposition that directly affects our future selves, then acting on it responsibly.

"Smarter Aging" means focusing on a parallel-action set of lifestyle plans NOW while you can still make the most difference. It starts with instilling the doctrines of a healthy diet (focusing on unprocessed foods and controlling simple carbs, sugars, and unhealthy fats), regular EXERCISE (and constant motion), and maintaining ample and consistent SLEEP. These points support cellular regeneration.  Parallel to this is the ever-important brain health and the need for challenging the MIND with stimulating activities.  Alongside this is managing STRESS into a bare minimum. All this in concert makes for a whole-body life plan that is recognized by aging experts to be THE blueprint of longevity and sustainable health.

Smarter Aging reports on the current research about how lifestyle re-programming can actually SLOW DOWN our natural degeneration to get to the end point with optimal enjoyment and the least amount of pain (or none at all). Unlike the commercialization of the term ANTI-AGING, this program pursues a critically different directive - placing paramount emphasis on "SMARTER" actionables.  Smarter Aging is AWARENESS about the land-mines and life traps caused by agents of personal decay. It is about how to MOTIVATE oneself on how to RESET into a better life plan.  

To clarify, SMARTER AGING is not the same as ANTI-AGING. The core of the anti-aging movement stems from a term has become a commercial vehicle for the production, sale and use of aesthetic products, treatments, or practices to reduce the visible signs of aging, such as wrinkles, age spots, and loss of skin firmness.  This is not to disclaim the value of aesthetics, but to promote emphasis on addressing underlying cellular function for health. Not infrequently, these two can coexist.

One area of overlap is with hair loss. There stands significant science to the study of HAIR LOSS associated with a compelling array of health issues. Hair loss (alopecia) can be an aging issue often aligned with heredity/genetic predisposition, but consequently, it can also be associated with hormonal changes, inflammation, or a set of medical conditions for both men and women.  This includes thyroid imbalances, excessive trauma/stress, infections, vitamin deficiencies and reactions to strong medication or cancer treatments. Addressing hair loss pathologically can go beyond an aesthetic or anti-aging solution to become a smarter aging directive.

Another term that needs revisiting is used by many longevity promoters and authors, emphasizing the "curse" of aging as a DISEASE.  Though it is a clever wordsmithing opportunity to lift from "DIS-EASE", this association fails in accuracy when it comes to forging solutions. Seeking the alter (counter?) measure of Dis-Ease (meaning a CURE) drives a misunderstanding from this correlation and a pathway that could prove misleading. We cannot REVERSE, HEAL, REPAIR or CURE aging nor can we actually prevent the aging process itself. 

Once we have established this base understanding, only then can we pursue SMARTER AGING, whereby setting a course for getting the best SUSTAINABLE and FUNCTIONAL existence possible.  This means navigating away from a life of multiple medications, disability and pain by proactively addressing challenges caused by health conditions, bone/muscle changes, cognitive & mental health issues.

To subscribe to SMARTER AGING means MITIGATING the impact of time-based physical wear and tear (and this includes functional, mental, spiritual and social).  It also means identifying habits that speed up aging (like too much sitting, inactivity, sugar/ processed foods, excessive screen time and stress etc).   We can study and learn from the lifestyle and performance of an 85 year old yogi or a 73 year old marathon runner and gain an understanding of what compels them to support a preventive lifestyle.  By comparison, we can recognize what our own road ahead can look like and the many ways that we can RESET or counter-steer (where needed) could make all the difference in how we rebuild our future self- starting NOW!

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AGING is a natural process that is associated with biological changes that lead to a progressive decline in physiological functioning. These changes start as early as the mid-20's, and accelerate in the mid-40's and again at around age 60. While aging is inevitable, the rate at which it occurs can be faster or slower depending on multiple factors, including the interactions of genetics with diet, lifestyle, environment, and stress. It is also impacted by resilience.

Without a doubt, everyone will experience aging. It’s a biological process that begins at birth, and it is inevitable. But how we age is not. We are redefining aging, celebrating it as a time of new opportunities, deeper connections, and ongoing learning. It’s a time where we are actively engaging life with joy and purpose. 

Healthy aging is not just about keeping disease and disability at bay. While we’d all like to stay as healthy and functional as possible, we can age successfully and gracefully even with less-than-optimal  health.

WHAT IS RESILIENCE?
Resilience is the ability to “bounce back” from an adverse event or experience, large or small. This is influenced by biological factors (including genetics) as well as psychological ones, and both forms of resilience can be cultivated. As people with higher levels of biological and psychological resilience tend to experience improved health and quality of life as they age, this heightens its importance for better aging.

Health is created from physical, emotional, mental, spiritual, and energetic balance. But balance is not static. It requires constant adjustment in response to changes and challenges in your inner and outer worlds - and often changes throughout your lifetime. Resilience helps you bounce back and regain balance.  Here are 8 simple strategies to help you cultivate resilience so you can handle whatever challenges come your way in a way that helps you thrive.

8 Easy Tips for Better Aging Starts with RESILIENCE
By: Roberta Kline MD

Tip #1: EAT RIGHT
Focus on fresh whole foods, with an emphasis on colorful vegetables and low-sugar fruits, fish, poultry, nuts, non-wheat whole grains, and cold-pressed olive oil. Adding herbs and spices boosts your food power. Avoid fried foods, processed red meat, trans-fats, and saturated fats, sugars, sweets, and baked goods; swapping sugar substitutes may be worse than sugars, so avoid those too.

Tip #2: MOVE
Aim for 150 minutes a week of moderate to vigorous exercises, such as walking, swimming, biking, dancing, tennis, strength training, gardening, or yoga. House cleaning, gardening, and yard work count too! Ideally, it’s something that you enjoy. Moving throughout the day is just as important. If you have a sedentary job, make sure to get up and move at least 10 minutes every hour if you can.

Tip #3: CHALENGE YOUR BRAIN
Playing chess, solving crossword puzzles, reading books, and learning a new language or skill are examples of brain-boosting activities. Mixing up your daily routine is another great way to increase cognitive resilience. This can include: exploring new neighborhoods or trying out a new coffee shop. 

Tip #4 MANAGE STRESS
Identify stressors in your life and reduce or eliminate the ones you can control, and have strategies to manage the impact of the ones you can’t.  Tai chi, meditation, music, art, yoga and other exercise, being in nature, finding moments of awe, experiencing joy and laughter - these are just some of the ways that can help you cultivate resilience.

Tip #5: GET A GOOD NIGHT'S SLEEP
Aim for going to bed by 10 pm, and getting 7-8 hours of restful sleep nightly. Even one night of insomnia or getting inadequate sleep can have an impact on your resilience.  If you snore or don’t feel refreshed when you wake up in the morning, consider getting checked for a sleep disorder such as sleep apnea. 

Tip #6: FEEL CONNECTED
Having strong social connections - whether a few or many - along with having meaning in our lives, can be one of the most powerful strategies. This does not include social media or other virtual interactions - there is something about the brain that needs interaction with the actual person or people.

 Tip #7: MANAGE YOUR HEALTH
Heart disease, diabetes, chronic pain, and other chronic health issues can reduce your resilience. Staying proactive in managing all aspects of your health can help increase your resilience and minimize their impact.

Tip #8: CULTIVATE PURPOSE & JOY
Having a sense of purpose and connection to a greater meaning is a fundamental human need. So is joy. Identify things that bring you joy. Find something that gives you a reason to be excited about the day. Purpose doesn’t necessarily mean a grand vision - it can be big or small. Whether it’s through your work, your family, or your community, it’s important to feel you are loved and valued and are contributing to something that is meaningful to you.

Aim for incorporating at least 4-5 of these strategies. They each build on each other, so the more you of these you do, the more resilience you’ll have and the more your health will benefit. Every bit counts. As you take steps to improve your resilience, you’ll also be supporting your overall health of mind, body and spirit - feeling better and having more energy to keep doing the things you love! Start small. But you don’t have to feel overwhelmed - incorporating just one of them into your daily habits helps. Start with the change that feels the easiest first. Then build on your success to incorporate all 10 if you can!

Implementing these strategies can greatly improve your success in developing resilience for better aging. 

GO TO PART 3: ALZHEIMER’S DISEASE- A GLOBAL EPIDEMIC 

Dr. Roberta Kline reports on age-related dysfunctions of the brain that can escalate in aggressiveness and complexity over time as the victim progresses toward the end of life.  ALZHEIMER’S DISEASE (AD) is currently viewed as a progressive neurodegenerative disease that is uniformly fatal. The most common form is termed Late-Onset Alzheimer’s Disease (LOAD), which primarily impacts people over the age of 65 and is the focus of this article. In addition to its devasting impact on individuals with AD, it has a wide-reaching impact that touches every aspect of our society.  But there is hope. (Visit Dr. Kline's full report)

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TRAUMA AND TOXINS: Non invasive diagnostics  Written by: Robert Bard MD

The human body is continually assaulted by harmful forces which may be obvious (trauma and burns) or subtle and dismissed as the “flu or nerves” (chronic poisoning and delayed hidden scarring). However, in the unregulated world of fillers, patients and physicians often discover unexpected findings (forgotten surgical sutures) and complication as potential medicolegal traps. One picture is worth a thousand words and one image may launch a thousand lawsuits while possibly giving birth to a new medical image guided treatment paradigm. 

TRAUMA

Soft tissue trauma causes a black and blue area but subcutaneous pathology is best imaged by ultrasound. The normal dermal layer is light gray on scans while inflammation is dark gray and fluid (blood) is black. Dermal ultrasound has been used for 30+ years to find skin cancer and guide scar treatment so the use in subacute trauma victims is a logical progression of this portable and non invasive technology. Foreign bodies such as glass and splinters are easily visible as bright white reflectors that directs the surgeon to the exact removal site under ultrasound guidance with minimal tissue “exploration” Fillers have characteristic echo pattern where HA products appear as black globules when they coalesce.  Often the HA injected aliquot disperses immediately leaving a diffuse hazy picture. Complications of fillers are well described in recent textbooks. A special case is free silicone having specific “snowstorm” pattern that is commonly seen in breast imaging of ruptured implants. The theoretical possibility of immune system compromise by free silicone is still being studied.

FIBROTIC SCARRING

Elastography shows scar tissue quantitatively in the liver parenchyma but also in traumatized muscles and tendons. The “elastic” properties of tissue are used worldwide for cancer diagnostics because malignant tumors are rock hard and “gritty” with the needle biopsy while benign lumps are soft. Ultrasound maps tissue signatures of free silicone has a mean gray (MG) value 35-40 on a black to white scale.

SKIN OF COLOR

The headline from the 2022 fall issue of PSORIASIS ADVANCES noted inflammatory disease is often misdiagnosed in skin of color. Bruises, burns and infections are detected by color-blind ultrasound as dark areas in the light gray tissues often highlighted by a “ring of fire” blood flow reaction to the local tissue reaction 

(Fig 1-L) 45 year female with collagen disease chief complaint of  fullness post filler. Sonogram at 18MHx shows a 0.2mm epidermis which expands to 9mm over the tender area. Black HA filler caps the 16x16mm light grey focus of free silicone. Under ultrasound guidance the needle depth was recalculated to avoid injecting and possibly dispersing the silicone material.

HEALTH PROGRAM: VIRTUALIZATION AND THE AGE OF DIGITIZED MEDICAL ACCESS

Since the Pandemic, going virtual became the urgent new trend in patient care. Doctors’ office visits were replaced with video conferencing and genetic lab tests were mailed directly to the patient’s home. This PERSONALIZED methodology proved to be so efficient that much of its standards continue to be applied today. 

BardDiagnostics formed the concept behind HEALTH GUIDANCE CONSULT program, designed to connect patients with top clinical diagnostic physicians with remote access to help identify an intelligent set of health options.  Starting with your first 45-minute telehealth consult, you  will receive absolute peace of mind and confidence on how to navigate the healthcare maze to achieve your goals.  Our Integrative Personalized Physicians (IPP) specialize in women's comprehensive health, employing advanced research resources and experience-based perspectives to provide your exclusive and custom-designed roadmap to health empowerment and absolute control of your state of health.

Q: Are you trying to make sense of a health issue but aren't finding the answers you need?

Q: Do you want to be more proactive in your health but are overwhelmed by all of the information?

Q: Do you find yourself wasting time and resources, wishing you had an easier way to know the best path for you?

THE HEALTH GUIDANCE CONSULT CAN REALLY HELP YOU FIND THE DIRECTION YOU SEEK

Otherwise known as a HEALTH AUDIT, this highly focused consult offers discussing your questions and concerns.  This is your opportunity to learn more about a wider set of options for your health, and how to navigate the healthcare maze in a way that helps you achieve your goals. As an Integrative Personalized Medicine specialist for women, our experts use her research skills and unique perspective gained from decades of using different approaches to health of mind, body & spirit to guide you in getting the answers and clarity you need to feel empowered in the next steps for your health journey.

Includes:

    · 45-minute telehealth consult   

    · Targeted research as needed 

    · Education and guidance for next steps

FUNCTIONAL & REMOTE IMAGING is one of today's most comprehensive ways to confirm any treatment progress. Thanks to the latest advancements in ultrasound innovation, visiting one of our nearby imaging partners allows you to clinically track disease or chronic disorders. Functional Diagnostic imaging safely and affordably captures quantitative biometric data in real time in support of the regular progress of your health. 

Our TELEMED SCANS APP is fast-tracking to a new standard in diagnostic care.   Thanks to the use of our latest CLOUD-BASED programs, BardDiagnostics can provide expansive access to some of the most current medical imaging solutions, genetic testing and other non-invasive modalities, while significantly adding a new level of efficiency and performance while greatly reducing costs and delays. Join the era of functional diagnostic medicine and personalized access care.

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Genetic Predisposition Program: Your Personalized Guide for Health

Why do some people seem to be healthy despite poor habits, and others try to do everything right and still develop disease? Most chronic health issues result from a complex interplay between our genes and our environment.  But if you don't know what your genes need for health, you're left to guess and hope you get it right. Today, genetic science eliminated ALL THE GUESSWORK.

The Power of Your DNA
Your DNA contains your blueprint for how your body runs. It's your own "operating manual", unique to you. But your DNA code doesn't mean you are necessarily fated to develop disease. It is the interaction of your DNA with your diet, lifestyle, exercise, stress, toxic exposures, medications, and other environmental factors that determine the outcome on your health. This means that your choices DO make a difference! 

Identifying predispositions in your DNA allows you to know what YOU need to be healthy so you can proactively create your personalized health strategies throughout your life. You no longer need to guess at what is right for you. Your genes will guide you to what you need for diet, lifestyle, exercise, supplements, and even medication.

Imagine all the time and resources you'll save - on top of being a healthier you! With this program we'll go deep into understanding your DNA to see where you may need extra support, and how to stay (or get back) on track to be your healthiest self - now and throughout your lifetime.

PHASE 1:  GENETIC PREDISPOSITION 

The first phase of this program establishes your actual genetic blueprint, creating the foundation of a personalized approach to minimizing exposure risks and optimizing health. You'll get a full review of your results, what they mean for you, and a personalized strategy for optimizing your health.

1) GENETIC TESTING: Genetic testing and interpretation of inherited mutations for common cancers (including breast, prostate, pancreatic, ovarian, colorectal, stomach, and melanoma) and cardiovascular disease.  

2) NUTRITIONAL GENOMICS TESTING: Genomic testing and interpretation of SNPs in many systems underlying health, including the processing of environmental toxins, nutrition, sleep, heart disease, brain health, mood, diabetes, inflammation, oxidative stress, mitochondrial health, hormones, cancers, exercise and injury, bone density.   

3) PHARMACOGENOMIC TESTING: Genomic testing and interpretation of SNPs in genes associated with medication response, including adverse reactions and effectiveness.  

For some women, having their personalized predispositions and plan is all they need. For others, they may also need more support by going deeper into their biology and health. 

DIAGNOSTIC PROGRAM: OCCUPATIONAL HEALTHSCANNING THROUGH ADVANCED LAB TESTING

This testing program is designed by Dr. Roberta Kline exclusively for BARDDIAGNOSTCS and its patients.

OCCUPATIONAL HEALTH TESTING PROGRAM
When it comes to toxic exposures, health hazards exist in lesser or greater quantity - especially in the more dangerous jobs (ie. firefighting, construction, engine work etc). For the many Americans who dedicated an extended period of their careers to potentially toxic exposures, this comprehensive clinical testing program offers direct insight into their genetic predispositions for potentially adverse responses to occupational exposures.  The selected testing also identifies predisposition to common cancers, chronic diseases, and other health issues.  

Along with their DNA predisposition profiles, the client also receives personalized guidance about how this gathered information applies to their actual healthcare approach, and proactive strategies they can take to mitigate the impact on their health. 

PHASE 1: GENETIC PREDISPOSITION 

The first phase of this program establishes a client's actual genetic blueprint rendering the foundation of a personalized approach to minimizing exposure risks and optimizing health. 

1) GENETIC TESTING: Genetic testing and interpretation of inherited mutations for common cancers (including breast, prostate, pancreatic, ovarian, colorectal, stomach, and melanoma) and cardiovascular disease.  

2) NUTRITIONAL GENOMICS TESTING: Genomic testing and interpretation of SNPs in many systems underlying health, including the processing of environmental toxins, nutrition, sleep, heart disease, brain health, mood, diabetes, inflammation, oxidative stress, mitochondrial health, hormones, cancers, exercise and injury, bone density.   

3) PHARMACOGENOMIC TESTING: Genomic testing and interpretation of SNPs in genes associated with medication response, including adverse reactions and effectiveness.  

PHASE 2: BIOLOGICAL & HEALTH IMPACT 

The next segment of this program assesses the impact of toxin exposures as they interact with genetic predisposition and affecting the biological systems that support health. Each client also receives personalized guidance and strategies for addressing any ongoing exposures and improving biological functioning and health. 

1. 1) TOXIN TESTING: Specialized testing to assess current levels of a wide variety of toxins encountered in the workplace and home environments, with personalized strategies for supporting your internal detoxification systems to reduce their levels and impact. 

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2. 2) EPIGENETIC TESTING: Epigenetic testing and interpretation to assess how environmental exposures, diet, and lifestyle are interacting with your genetic predispositions, impacting real-time gene expression and health risks including how fast your cells are aging, general cancer and disease risks, immune health, smoking and alcohol exposures. 

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3. 3) FUNCTIONAL LAB TESTING: Additional specialized lab tests to assess areas identified as potential targets of toxins, directly or indirectly. Personalized to each client, these can include assessments of hormones, mitochondria, oxidative stress, microbiome, stress, sleep and more. 

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Monday, May 13, 2024

INSIDE GENETIC PREDISPOSITION

PART 1: MUTAGEN HEREDITY AND ENVIRONMENTAL CANCER EXPOSURES

By: Lennard M. Gettz, Ed.D  /  Edited by: Roberta Kline, MD

First responders of every branch (police, firefighters, paramedics), as well as construction cleanup contractors, were exposed to the many toxic hazards around the World Trade Center (WTC) as a result of the events on 9/11/2001.  For the more than 91,000 individuals involved in this massive response and cleanup effort [1], exposure to the toxicants from dust, smoke, and incendiary chemicals has led to concerns for cancer, diseases, and other health injuries post-exposure.  The James Zadroga 9/11 Health and Compensation Act enacted the World Trade Center Health Program, a federal commitment to offer comprehensive care for 9/11-related conditions. [2]

Numerous environmental contaminants have been shown to have potential carcinogenic (cancer-causing) consequences. [3] Events such as 9/11 are just some of the scenarios that have alerted government agencies, the medical community, and individuals to study the types of common cancers from each scenario.  These exposures also bring new (and heightened) concerns for gene mutations that may be inherited or passed down to the next generations of those directly impacted.

"Learning about how cancer and other illnesses work... I would hate to contract this on the job and give this to my kids", states FDNY Ret. FF Sal Banchitta- 9/11 responder. "Firefighters get a lot of training and gear to protect us from exposure- but let's face it... part of the risk of the job is that there IS no 100% guarantee- ever!  Looking back on all this, from the local house fires of burning plastics and PVC's to the many chemicals and airborne poisons in ground zero-- exposure came from anywhere.  You can only hope that you're not someone who's predisposed, but you never know." 

According to the NCI (National Cancer Institute), up to 10% of all cancers may be caused by inherited genetic changes. Cancer itself (or genetic changes in tumor cells) cannot be inherited by children of cancer patients but a genetic change or mutation that increases the risk of cancer can be passed down (inherited) if it is present in a parent's egg or sperm cells. It is for this reason why cancer may sometimes appear to run in families.  [4]

WTC-RELATED CANCERS: There are now more than 15 cancers specifically associated with exposure to the WTC toxins, with prostate and breast cancer being among the top 3. [5]. Not only do survivors have higher rates of these cancers, but they are often more aggressive. Recent research has demonstrated that DNA mutations and epigenetic changes due to toxin exposures may play a role. [6, 7, 8] 

PART 2: TODAY'S GENETICS

In an exclusive interview about the science of gene expression, genomic specialist Dr. Roberta Kline, professor at the University of Western States, offered clarity on the fundamentals of the human blueprint: what DNA is, what it does, the impact of alterations to DNA on health, and how this is influenced by environmental exposures. 

Genes are specific regions of DNA that contain the code for all of the proteins that run our biology. Gene expression is the ultimate result of this complex process, and gene expression research has greatly accelerated the study of human biology and improved the practice of medicine. Up until the completion of the Human Genome Project in 2003, much of the focus had been on studying rare mutations linked to specific inherited diseases and cancers. We now know that these alterations of the DNA code are not the only ways people can be predisposed. 

The most common types of changes in DNA are called SNPs (single nucleotide polymorphisms), and we each have millions of these. These SNPs can alter our biochemistry and biology, but they typically have a much smaller effect individually than mutations. However, the additive effect of multiple SNPs can create significant predispositions to (or protection from) most diseases, including cancer. 

The latest gene expression research has added a third layer called epigenetics. Epigenetic changes don’t affect the DNA or genetic code itself. Rather, they respond to environmental cues to control when genes are turned on or off. Therefore, epigenetic changes can be easily modified throughout a person’s lifetime.

These processes all work together, and all of them can be inherited. Depending on diet, lifestyle, exercise, stress, medications, and environmental exposures, their impact can be increased or decreased. For example, someone with mutations, SNPs, or epigenetic changes that impair their ability to detoxify environmental chemicals can have a higher risk of DNA damage that can lead to disease or cancer. Diet and lifestyle strategies can counteract some of this risk - or can make it worse. This can help explain why not everyone exposed to the same toxins is affected in the same way, and why the same dietary and lifestyle factors can affect people’s health differently.

GENETIC PREDISPOSITION TESTING

With the existence of cancers in the family, physicians may recommend genetic testing.  Inherited mutations account for approximately 10% of all cancers, and these tend to be more aggressive and occur at an earlier age. [8] Genetic mutations have been identified for certain forms of pancreatic cancer, colorectal cancer, prostate cancer, or breast or ovarian cancer.  These tests for cancers such as Breast, Ovarian, and Pancreatic are known to target pathogenic/ly pathogenic (P/LP) variants associated with increased risk (including BRCA1, BRCA2, CDH1, PALB2, PTEN, and TP53, and recommended approaches to genetic counseling/testing and care strategies in individuals with these P/LP variants. [10, 11]

Genetic testing supports proactive prevention initiatives and active surveillance for these specific cancers that continue to prevail. Gene SNP testing can further support personalized prevention and screening strategies. While epigenetics is emerging as another tool in efforts to identify predispositions and personalize strategies, it is still more informative than prognostic at this time.

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HOW TO HANDLE ON-THE-JOB INJURIES AND MINIMIZE HEALTH RISKS

Written by: Robert Bard, MD

Work related injuries take a toll on the employees as well as the company. With reduced productivity and health insurance payments, the company can suffer heavy financial setbacks. This is why most companies have realized the importance of increasing awareness when it comes to the workplace. Injuries at the workplace are more common than ever. Although manual handling is the most common cause of workplace injuries, sedentary jobs may also put employees at risk of Repetitive strain injuries (RSIs) and lung issues.

Awareness: When it comes to sedentary jobs, posture and height may be doing most of the damage. Educate employees of the best posture and height of their chair in order to minimize the strain and reduce chances of an injury (Cornelio, 2010).

Policy Creation: The very first thing that employers need to do is create a health and safety policy. This policy should be included and presented to employees along with all other contracts and policies in the workplace. This will let your employees know that safety and health are a primary objective.

Health and Safety Program: The health and safety of employees is the responsibility of the employer. A health and safety program is mandatory for any company employing more than 20 individuals (CDC, n.d.)

Control Hazards: Many hazards may be unavoidable depending on the nature of work and the product being created. Some occupations entail more risks than others. If an employee is putting themselves at risk, then it is the employer’s responsibility to identify all hazards and minimize the risks.

Safety Equipment: Safety equipment may be very little and very large. In sedentary jobs, employers need to worry about the provision of ergonomic chairs and keyboards whereas in manufacturing industries they need to worry about safety helmets, jackets, and other similar equipment.

Document Incidents: Accident history may help identify the problems that caused injuries in the workplace. Small details such as correctly fitting equipment may be the cause of an accident. Once the causes of injury are identified, employers can work towards their rectification (WCB, n.d.)

Training Sessions: Train employees and increase awareness about practices which may help minimize workplace injury. Motivate them to keep safety a personal priority, and encourage them to be on a lookout for safety hazards in the company.

Report Procedure: While avoiding injuries would be ideal, we are not living in a perfect world. Notify employees of the protocol that needs to be followed in case of an injury. Who will the employee report to? Is there an in-house clinic that they have access to? How will the severity of damage be assessed? (WSIB, 2014)

Maintaining a safe and healthy workplace is the responsibility of the employer. Safety should be the primary goal of the company and is not only beneficial for employees but also employers.

Once employees are aware of the hazards that they face and the measures that can be taken to prevent them, they can work towards its minimization. This would mean less days of work as a result of injury and increased employee productivity.

References CDC, n.d. Benefits of Health Promotion Programs. Retrieved from <http://www.cdc.gov/workplacehealthpromotion/businesscase/benefits/ > Cornelio, D., 2010. Preventing Workplace Injuries And Illnesses. Worker Occupational Safety & Health Training and Education Program (WOSHTEP). California, USA. Retrieved from <http://www.dir.ca.gov/chswc/WOSHTEP/Awareness/AwarenessModuleEnglish.pdf> WCB, n.d. Preventing Workplace Injuries. Retrieved from <http://www.wcb.ns.ca/wcbns/index_e.aspx?CategoryID=274> WSIB, 2014. What workers should know...about reporting workplace injuries and illnesses. Retrieved from <http://www.wsib.on.ca/en/community...>