EECP/ECP/SECP/Heart attack

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Click to read the following Articles

Article 1.> Bye Bye Bypass Surgery
Article 2.> WE ARE PIONEER IN ECP IN MALAYSIA. ECP purchase permission
Article 3.> An Integrated medicine saved my wife
Article 4.> Chelation therapy is NaNo technology and deals with Microcirculation
Article 5.> The Big Problem with Angiogram, Angioplast and Bypass Surgery
Article 6.> Asia week Jan 29, 1999
Article 7.> MOH Global information HUB
Article 8.> Opponent’s letter to read
Article 9.> Dr Ebrahim’s reply
Article 10.> HBO for stroke patients
Article 11.> ECP for stroke patients
Article 12.> Chelation is mainstream medicine
Article 13.> Bill clinton’s madness after Bypass heart surgery
Article 14.> Secret Cardiology
Article 15.> Avoid unnecessary tests
Article 16.> Toronto News about chelation
Article 17.> Medical errors
Article 18.> Probe Integrated Medicine
Article 19.> Don’t be too quick to judge
Article 20.> Culture of FDA corruption
Article 21.> Health is a rule disease the perception
Article 22.> Invasive procedures don’t prevent Heart attacks
Article 23.> Doctors stop confrontation
Article 24.> Never think of Bypass again
Article 25.> MMA not against alternative medicine
Article 26.> T/CM and DG Health
Article 27.> Don’t separate chelation from Coventional therapies
Article 28.> For heart attack What type of treatment ?
Article 29.> Complementary therapy First choice.
Article 30.> Recent trial on chelation. TACT
Article 31.> Chelation trial results under fire
Article 32.> New research on chelation
Article 33.> Chelation coming in from cold article
Article 34.> Positive results from chelation
Article 35.> Hyperthermic Transcutaneous Ozone
Article 36.> Oxygen therapy – Cerebral ischaemia
Article 37.> ECP Insurance coverage
Article 38.> New guidelines for Heart disease.
Article 39.> Detoxification article
Article 40.> New EECP NCP Plus arrived
Article 41.> US cardiologists admits fraud in unnecessary testing
Article 42.> Alternative care at Government clinics
Article 43.> Cilantro is chelating agent
Article 44.> Mechanism of action of Ozone therapy
Article 45.> Ultraviolet Radiation of blood
Article 46.> Doctors do not ignore proven alternative to coronary artery disease
Article 47.> New Hope for Cancer
Article 48.> Fruits to eat for Cancer
Article 49.> Are You ACID or ALKALINE
Article 50.> DO YOU WANT FREE ANTIOXIDANTS WITH NO COST?
Article 51.> Exercise may be as effective as drugs in some cases
Article 52.> Abuse of stents by some cardiologists in USA.
Article 53.> Too many stents will kill you.


tanyadoktor@bharian.com.my

Article 1

Diagnosis: ECP berkesan rawat angina. ECP therapy is effective for Angina
Oleh Hafizah Iszahanid

Selepas memenuhi setiap sesi rawatan, pesakit bebas daripada masalah sakit dada atau serangan jantung

ANGINA, masalah sakit dada atau berasa tidak selesa pada bahagian itu terjadi apabila otot jantung tidak mendapat darah yang cukup. Biasanya angina menyebabkan seseorang itu berasa seperti dadanya ditekan atau dipicit. Rasa sakit itu mungkin boleh terjadi pada bahu, lengan, tengkuk, rahang dan bahagian belakang.

Angina bukan masalah kecil kerana ia adalah simptom koronori arteri (CAD), iaitu salah satu masalah sakit jantung.

CAD terjadi apabila plak terbina di koronari arteri. Plak yang terbina ini dinamakan �atherosclerosis�. Apabila plak terbina, koronori arteri menjadi sempit dan kaku. Aliran darah ke jantung merosot seperti mana berlakunya penurunan bekalan oksigen ke otot jantung.

Rawatan mungkin memerlukan pesakit berada di bilik bedah, tetapi jika itu bukan pilihan anda, mungkin anda perlu tahu mengenai mesin ECP.

Mesin "External Counter Pulsation" (ECP) satu teknik non-invasif yang membaiki fungsi jantung dengan menurunkan kadar tekanan pada jantung. Pada peringkat global, ECP sebenarnya sudah agak lama diperkenalkan dalam dunia perubatan.

Penggunaannya diluluskan Food and Drugs Administration (FDA) pada 1997. Bagaimanapun, cetusan ideanya bermula pada 1950an.

Dalam rawatan ECP, tiga balutan dibuat pada betis, pergelangan tangan dan bawah pinggang. ECP akan memantau aktiviti jantung dan setiap balutan itu bertindak balas dengan isyarat. Apabila jantung berehat antara denyut nadi (diastole), tiga balutan itu akan mengembung. Ia membantu perjalanan darah ke jantung.

Di Malaysia, hanya beberapa hospital saja memilikinya termasuk hospital kerajaan, tetapi ia tidak begitu popular. Ini mungkin disebabkan masyarakat tidak tahu kelebihannya atau kos rawatannya membebankan.

Perunding Perubatan, Dr Mohamed Ebrahim Sulaiman, berkata seseorang pesakit itu perlu tahu mengenai ECP sebelum memutuskan yang terbaik dalam rawatan angina.

"ECP bertindak meningkatkan aliran darah ke jantung dan koronori arteri dengan menekan darah keluar daripada bahagian bawah badan ke jantung. Sesetengah orang merujuknya sebagai �natural bypass�, ECP menstimulasi pertumbuhan saluran darah baru di keliling arteri yang tersekat," katanya.

Ebrahim berkata, setiap gelombang tekanan mempengaruhi denyutan nadi sekali gus meningkatkan aliran darah yang sampai ke jantung.

Kelebihan ECP menangani masalah angina terbukti dalam satu kajian membabitkan pesakit angina kronik pada 1995. Dalam kajian itu, ECP didapati mengurangkan masalah angina dan keputusan yang sama dilihat pada pesakit lain. Keputusan kajian itu diterbitkan dalam "Jurnal of American College of Cardiology" pada Jun 1999.

Katanya, beliau sudah menggunakan CardiAssist ECP System sejak April 2002.

"Kebanyakan pesakit saya adalah mereka yang sudah menjalani pembedahan pintasan jantung, angioplasty dan lain-lain rawatan tetapi semua itu tidak menyelesaikan masalah. Pada mereka yang gentar menghadapi pembedahan, ECP boleh membantu," katanya.

Pada peringkat global, Klinik Mayo dan Pusat Rawatan John Hopkins membuat pengumuman berkaitan penggunaan terapi ECP berkesan hingga 90 peratus dalam rawatan angina.

Katanya, selepas memenuhi setiap sesi rawatan, pesakit bebas daripada masalah sakit dada atau serangan jantung.

"Mereka tidak perlu menjalani pembedahan pintasan jantung atau angioplasty untuk tempoh antara tiga hingga lima tahun, tetapi pesakit memerlukan 35 kali rawatan ECP bagi mendapatkan keputusan memuaskan," katanya.

Pada 2001, Persatuan Jantung Amerika dilaporkan berkata, ECP boleh menjadi rawatan alternatif kepada angioplasty atau lain-lain pembedahan dalam merawat pesakit angina.




Bagaimana ECP boleh membantu pesakit?

1) Tekanan pada betis meningkatkan aliran darah ke koronori arteri. Koronori arteri menerima darah daripada jantung selepas setiap denyut nadi, pengembungan pada bahagian betis membantu lebih banyak aliran darah ke jantung.

2) Apabila jantung mula berdegup, ECP mengempiskan betis dan menghasilkan satu aksi seakan vakum pada arteri. Keadaan ini mengurangkan kerja otot jantung dalam mengepam darah ke arteri.

Siapa yang tidak boleh menerima rawatan ECP?


Mereka yang menghadapi masalah kegagalan fungsi jantung yang kronik


Masalah injap jantung yang kronik


Masalah denyut nadi (arrhythmias)


Pesakit tekanan darah tinggi yang tidak mengambil ubat


Masalah peripheral artery disease (PAD - masalah arteri darah di kaki)


Hamil

Kelebihan ECP


Membantu mengurangkan simptom angina


Mengurangkan keperluan pengambilan ubat disebabkan angina


Mengurangkan kekerapan dan kesakitan pada dada.


Prosedur ini juga membantu keupayaan pesakit melakukan senaman.








Article 2 : WE ARE PIONEER IN ECP IN MALAYSIA SINCE 2002. ECP purchase permission

ECP purchase permission and launching opening ceremony was supported by Tun Dr Mahathir and DMH Dato Sri Dr Sulaiman Mohamed

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ECP purchase permission and launching opening ceremony was supported by Tun Dr Mahathir and DMH Dato Sri Dr Sulaiman Mohamed. 0n the 5th May 2002, at the Klinik Ebrahim & Surgery , 3.15 The Ampwalk, (North Block) 218 Jalan Ampang, 50450 Kuala Lumpur.Malaysia. Please ref: Tun Dr Mahithir's remarkable speech on 5th May 2002.News Strait times, Headline news. He said if any body bring something new in this country people who are block minded object. Be open minded and the Berlin wall should be demolished.



Article 3 : Recent Articles in www.malaysiakini.com/letters/43967 /An Integrated medicine saved my wife Asia week Jan 29, 1999

An Integrated medicine saved my wife
An article to read which appeared in www.malaysiakini.com/letters/43967


Dr Haji Mohd Ebrahim Sulaiman
Dec 2, 05 4:19pm

I refer to the letter by Prof Dr Anantha Krishnan Health is the rule, disease the perception and the letter by MMA representative’s to the Ministry of Health Standing Committee on Traditional and Complementary Medicine Dr Lee Yan San entitled Do what you’re trained for which appeared in the New Straits Times.

First of all, let me define alternative, complementary and integrated medicine. Alternative medicine is any form of practice that is outside the realm of conventional medicine. If alternative medicine is used along with or in addition to conventional medicine, it is referred to as "complementary Medicine" as the two practices complements each other.

Integrated medicine (or integrative medicine as it is referred to in the US) is practicing medicine in a way that selectively incorporates elements of complementary and alternative medicine into comprehensive treatment plan alongside solidly orthodox methods of diagnosis and treatment.

I was once a very staunch allopathic doctor who rejected any form of complementary medicine until in 1991 when my wife suffered a massive heart attack and was admitted to the National Heart Institute in Kuala Lumpur.

She requried 10 by-pass grafts but by 1996 all her native arteries and grafts were 100 percent leaving only her left internal mamamary artery graft which was patent but kinked. A second by-pass operation was not recommended due to the high risk. So we went to US and found out about integrated medicine. I went for a three-year training stint and passed the series of examination at the American College for Advancement in Medicine.

My wife has been treated by integrated medicine since 1996 and, to this day, with the will of God, she has been living with no chest pains for more than nine years. I have applied this treatment to 5,000 patients (with the permission of the Ministry of Health) and many have escaped by-pass surgery and limb amputation. Many cancer patients, having been given ‘no hope’ by oncologists are also now surviving and living a pain free normal life.

If I would have ignored integrated medicine and followed only ‘Do what you are trained' my wife and my patients might not be alive today. Now 69 years old and practicing for 44 years in medicine, I must admit that our allopathic medicine has its limitations. Double blind control studies are sometimes flawed, corrupted, unreliable, and dangerous - the Vioxx episode, for example.

I am very reluctant to use new medicines. I usually wait for many months and hear from other practitioners first before I start using these newly-launched drugs. I am very careful with the integrated medicine approach as well and apply it to myself, my family and my patients only after it has been proven safe and effective. All the medicines used are legally available in Malaysia. No casualties, no death on the table, no complaints - just an increase in health plus quality of life. So, why are the results not seen as proof that there is validity to this approach?. After all, isn’t our oath to treat our patients to health and well-being?

Things are changing as time goes on. We must accept it. There should not be pride, hard feelings or jealousy. All doctors must be encouraged to learn and do R & D (research and development) to heal their patients. Opponents and critics should study carefully before they comment and find fault with integrated medical practitioners who are trained, qualified and best able to judge what may be best for their patients in providing healing without causing any harm.

With due respect, Dr Lee Yan San is not a practitioner of or has he any experience in integrated medicine, so it would seem unqualified for him to comment on it. Also, to lump these doctors together with those providing cosmetic and elective surgeries is unjust. To be fair, experienced integrated medicine practitioners should represent the approach in the standing committees of the Health Ministry to prevent biasing and raise awareness.

If I had taken the advice ‘Do what you’re trained for’ only and never sought out integrated medicine, what would have happened to my wife and my many patients? Who wants to take the responsibility for the consequences of their health?

Finally, if the media is interested in giving a fair and balanced report on the matter, there are many patients to be interviewed and I welcome the chance to discuss any questions or studies that show integrated medicine does provide an advanced approach to health and patient care.

Where are the facts supporting statements and innuendos to the contrary? As a doctor practicing medicine for so many years, I am not the guy at the dinner telling stories. I am a highly qualified physician that has taken health care past the norm in order to create a higher level of health and well-being for my patients.

It is irresponsible for anyone in the medical community to comment unless they take the time to learn the facts and present them in truthful manner. We should always keep in the mind the ones who will ultimately benefit - our patients.



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The author can be contacted at e-mail: drmaungs@streamyx.com.


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Article 4 : Chelation therapy is NaNo technology and deals with Microcirculaton.

24th October 2007

Datuk Dr. Hj Abd. Latiff Bin Ahmad, D.M.S.M, S.M.J, P.I.S
Pejabat Timbalan Menteri Kesihatan Malaysia,
Kementerian Kesihatan Malaysia,
Aras 13, Blok E7, Parcel E,
Pusat Pentadbiran Kerajaan Persekutuan,
62590 Putrajaya
03 - 88832503 03 - 88884758
pejabatTMK@moh.gov.my


REF: Report on High Information Technology (I.T), Nano Technology and advancement in Chelation therapy. May be helpful to fit in MSC (Multimedia Super Coridor) The world Information Technology for health care in Malaysia.

Dear Sir, As Salaamu Alaikum wrt wbt.

The following is my new findings I hope the Ministry of health may accept it and do more research for the benefit of the patients.

My lecture.
This lecture is sent to the Ministry of Health Malaysia, Institute of Medical research Malaysia, MMA Malaysia, MSCT, Integrative Medical Conference in Singapore , British Society of Integrative Medicine, NIH (USA) and to IBCMT, ACAM. (USA) to pass it to all the members.

Mr President
Scientist , Doctors
Ladies and gentle men.

This is an educational program on my new concept of Advanced chelation therapy. Nanotechnology. (High Information Tecnology). Nano Technology. We talk about Molecular level and Microcirculation. We had lot of questions from Doctors and patients. What is chelation fluid prepared and how it works. Chelation therapy can prevent heart attacks and prevent Bypass surgery. It deals with the root cause of the Ischaemic heart disease at the molecular and Microcirculation level.. Chelation a colloidal solution consisting Na2 EDTA, Magnesium chloride or sulphate, Soda bicarb., Potassium chloride, Sodium chloride, Vitamin C, vitamin B complex, B12 , Heparin dissolved in water or other isotonic solution. Acam and IBCMT have prescribed a Standard Chelation solution which is good but electrical force was not described or taught or mentioned. Chelation Intravenous fluid is used to remove the heavy metals like Calcium, Fe, Copper, lead, aluminum , Hg etc from the blood system.. Properties of chelation: Action:. 1. It is a colloidal solution prepared in such a way that it has electrical charges measured as -50 to -100mv. 2. Anionic Surfactant (like Sea froth ) (like detergent cleaning the greasy Plates) removes plaques and cleans the blood vessel. 3. It is an Antioxidant to remove free radicals and repair free radical damages 4. It will combine strongly with heavy metals and the complex is excreted it out through the kidneys. It is better to use Laminar flow cabinet to prepare Chelation fluid. The laminar flow dock is pressurized , air is filtered, there fore no bacteria or no polluted particles can enter into this cabinet. It is sterilized by UV light. Thus No pyrogen particles can enter into the cabinet and into the fluid. Rom Is free f0.01micron size particles . More advanced method. The chelation fluid is measured by means of a meter or Zeta Potential meter to check the fluid of pH, ORP (Oxidative reduction Potential). The electrical force of the fluid is best at about –minus 100mv. If we add Alumium calorcium the charging will become positive and can cause clotting of blood. And the pH of the Chelation fluid must be alkaline that is about 8pH to 9 pH. Our blood is also a colloidal solution it is charged like a battery fluid it is -30 to - 40 milli volt. Our Red blood cells are charged at -17mV. Fresh Blood fluid has -30 to- 40mv. If our blood becomes -11mv . there will be Intravascular Coagulation and we die. At -7 mv blood becomes solid jell. The Osmolarity of our biood is about 294mmoles. How do we check the electrical force of the fluid? We check by ORP meter or Zeta Meter. Oxidative reduction Potential / Zeta Meter can measure the voltage in Millivolt of the any colloidal fluid blood. If the charging become less than -17milli Volt, blood starts to clot. Patients with IVC can be spot diagnosed by shaking hands. Hands and toes are cold. Such patients can have stroke, heart attack, kidney failure due to poor microcirculation undetected known as Syndrome X. We must keep our blood fluid and thin , and remove clots or separation of rouleaux formation of red cells by dissolving or separation back into the blood. Administration of .I.V Chelation once or twice a week for 20 times and followed by once a month will keep your microcirculation clean and prevent IVC. How do we check Microcirculation . We check it with electronic Microscope. Electronic microscope (Like retinoscope.) Dermatoscope(capillarscope). We see the smallest capillaries. Blood flow of the microscopic vessels. We look for the deformities of the blood vessels clots, swelling, thickening, twisting , budding, bleeding, sluggish flow of blood and fibrosis. All these signs are noticed more often in patients with Diabetes, Chronic degenerative diseases, Coronary heart Disease, stroke , Rheumatoid arthritis, Multiple sclerosis. etc All the above signs can be detected at the capillaries at the junction of nail and skin. Nail bed capillaries... Chelation therapy is Non Invasive acts extracellular, safe , effective. When we infuse Chelation fluid intravenously the clots stuck to walls of the capillaries are dissolved and enter back into solution and the vessels are cleaned. We can see that within two hours after infusion. Now we can prove that Chelation I.V infusion works within two hours. The crooked , twisted, dilated, deformed blood vessels become straight and cleaned. The IVC (Intravenous coagulation) disappears within two hours. No double blind control trial is necessary. Seeing is believing. For maintenance we must drink about 1.5 liters to 2 liters of water a day. To get up in the morning and drink 4 glasses (250cc x 4) of water. Microcirculation study is very important in Coronary Heart disease which is No.1 killer of the world. If microcirculation is improved Coronary heart disease, Stroke, Renal failure and many chronic diseases will be prevented..

CHELATION FLUID is prepared by adding VITAMIN C for many years. But recently some do not add Vitamin C because they are worried for Haber Weiss reaction. Controversial is Fenton's reaction. Haber–Weiss reaction.Whether to use Vitamin C or not ? Fenton's reagent is a solution of hydrogen peroxide and an iron catalyst that is used to oxidize contaminants or waste waters. Fenton's reagent can be used to destroy organic compounds such as trichloroethylene (TCE) and tetrachloroethylene (PCE). It was developed in the 1890s by Henry John Horstman Fenton as an analytical reagent.[1] Contents : • Overview • • Biomedical applications • • References • • Further reading • • External links • Overview Iron(II) is oxidized by hydrogen peroxide to iron(III), forming a hydroxyl radical and a hydroxide ion in the process. Iron(III) is then reduced back to iron(II) by another molecule of hydrogen peroxide, forming a hydroperoxyl radical and a proton. The net effect is a disproportionation of hydrogen peroxide to create two different oxygen-radical species, with water (H+ + OH−) as a byproduct. (1) Fe2+ + H2O2 → Fe3+ + HO• + OH− (2) Fe3+ + H2O2 → Fe2+ + HOO• + H+ The free radicals generated by this process then engage in secondary reactions. For example, the hydroxyl is a powerful, non-selective oxidant. Oxidation of an organic compound by Fenton's reagent is rapid and exothermic and results in the oxidation of contaminants to primarily carbon dioxide and water.[2] Reaction (1) was suggested by Haber and Weiss in the 1930s as part of what would become the Haber–Weiss reaction.[3] Iron(II) sulfate is typically used as the iron catalyst. The exact mechanisms of the redox cycle are uncertain, and non-OH• oxidizing mechanisms of organic compounds have also been suggested.[citation needed] Therefore, it may be appropriate to broadly discuss Fenton chemistry rather than a specific Fenton reaction. Biomedical applications The Fenton reaction has importance in biology because it involves the creation of free radicals by chemicals that are present in vivo. Transition-metal ions such as iron and copper donate or accept free electrons via intracellular reactions and help in creating free radicals. Most intracellular iron is in ferric (+3 ion) form and must be reduced to the ferrous (+2) form to take part in Fenton reaction. Since superoxide ions and transition metals act in a synergistic manner in the creation of free radical damage, iron supplementation must not be done in patients with any active infections or in general any diseases.[7] References Further reading • Goldstein Sara, Meyerstein Dan, and Czapski Gidon (1993). "The Fenton reagents". Free Radical Biology and Medicine 15 (4): 435–445. doi:10.1016/0891-5849(93)90043-T. PMID 8225025. • K. Barbusiński (2009) Ecological Chemistry and Engineering vol 16 no 3 pp 347–358 "Fenton Reaction - Controversy concerning the chemistry" Dr Hj Mohamed Ebrahim Sulaiman M.M.BS, D.T.M&H., FAAFP,, APCT, CMT.



Article 5 : The Big Problem with Angiogram, Angioplasty and Bypass Surgery which your Surgeon would like to hide from you. What has happened to the Quack watch group? Why keep quiet -no comments on this Biggest quackery system?.

The Big problem with Angioplasty and Bypass surgery every one aught to know.
By Dr Hj Mohd Ebrahim Sulaiman ,Family Physician, Kuala Lumpur.
THE big problem with angioplasty is that about 1 in 72 patients dies from the operation and twice that many from a bypass [concluded a recent summary from over 100 hospitals]. The second problem is that neither operation prevents a future heart attack, NONE. This is because bypass bypasses the problem, not solves the ongoing disease process, while ballooning / stenting only opens about 1/2 inch [1 cm] of an artery, and not the part that will cause a future heart attack. They are dangerous relievers of symptoms, such as angina, and for that they work well (for a while). The definitive study of these techniques is the MASS-II trial. Even three-vessel coronary artery disease, as long as it is stable (no rest pain with ECG changes) has a low mortality and lives are not saved by bypass surgery. The MASS-II trial, the best randomized controlled trial to date, showed that angioplasty (PCI) is actually worse than medical therapy (drugs) and is contraindicated in stable coronary atherosclerosis. Disruption of plaque by the balloon inflation causes an immune response to the plaque contents, in particular modified LDL, also called oxidized LDL. Theoretically antibodies to the plaque contents could stimulate an inflammation in the other plaques and increase the chance of rupture of any plaque in the the coronary arteries. Bypass surgery helped anginal symptoms but did not prolong life or prevent heart attacks, as claimed by Bill Clinton's surgeon. Bill Clinton is a Rhodes Scholar and did not think to ask the surgeons for the evidence.
Here are your options if you have 'multi-vessel disease' like Bill Clinton: deaths on drugs alone 1.5% but 2.8 TIMES MORE DEATHS with bypass or angioplasty after one year. Source: MASS II trial (J Am Coll Cardiol. 2004 May 19;43(10):1743-51.) Medline study number 15145093. Moreover, there are no studies that show a survival benefit from ballooning or bypassing apart from possibly the latter in a particular type of heart disease that is determined AFTER you put your life at risk on the operating table, and the benefit is small. These procedures only treat the angiogram and not the vast majority of plaque which is buried in the wall but which can rupture and cause heart attacks
As I said before: these operations don't deal with the cause of the heart disease in the first place, and they clearly don't solve it!
eddie vos [health-heart.org].
MUST EECP (Multicenter ) studies, International EECP patient registry studies and PEECH (Prospective Evaluation of EECP ) Scientific clinical trial studies unanimously declared that Non Invasive MT (medical treatment) and EECP therapy are Safe, Effective and low cost for the treatment of Coronary Heart disease. . Source: American College of Cardiology during the 55th Annual Scientific Assembly Dec 6, 2006, Atlanta Georgia
Therefore Non Invasive treatment (Medicine and ECP -External Counter Pulsation) is definitely safe, effective and low cost.
Source: MASS II trial (Medicine-Angiogram-Surgery-Study) (J Am Coll Cardiol. 2004 May 19;43(10):1743-51.) Medline study number 15145093. American College of Cardiology Foundation
Medicine (drugs) and ECP therapy is better.





Article 6 :Asia week Jan 29, 1999



WHEN THE HEART IS IN PERIL?
Is chelation the answer to blocked arteries?
By Dr. Gopal Baratham


THE MEDICAL ESTABLISHMENT SPENDS great time, effort and money to find alternatives to surgery - particularly for heart problems. (As one who has undergone a coronary bypass, I can confirm that just about anything, including taking your own arm off with a spoon, is preferable to the discomfort of that procedure.) In dire cases, cardiac surgery is the only option. But in some circumstances, there are other means. One of them is a relatively little-known process called chelation.
The word derives from the Greek chele, meaning claw. The theory is that certain chelating agents, especially a substance called ethylenediaminetetraacetic acid (or EDTA for short), can claw out the calcium from the walls of arteries. EDTA is more commonly used to prevent blood collected for tests from clotting in test-tubes.

Calcium build-up is part of the aging process, in which raised patches form on the inside walls of arteries and narrow them. This plaque is made up of a variety of fatty substances, including cholesterol, old blood and scar tissue. Into these calcium is incorporated, adding to the blockage, hardening the arteries and reducing the degree to which they can pulsate. Chelation techniques claim to reduce the amount of calcium, especially in those arteries supplying the heart.

Dr. Mohd Ebrahim, 61, works in a small office in the center of Kuala Lumpur. A Muslim Burmese, he has practiced in Malaysia for 16 years and has used chelation on over a thousand patients. The technique is simple. All it requires is a couch and a basic infusion set to deliver a measured dose of EDTA into the bloodstream over a period of some three hours. The patient can then go home - though not for good, as numerous treatments are usually necessary to maintain the benefits. Says Mohd: "In the U.S., I have met people who have undergone the procedure 500 times in 15 years."

The doctor uses chelation for a broad spectrum of conditions. Itemized in a handout available at the front desk of his office, they range from angina to fatigue to impotency. He says: "The basic cause of all these problems is an accumulation of calcium in arteries." He quotes a case in which chelation reduced the calcium content in a patient's coronary arteries by 8.2%. But not all treatments are this successful. In one instance, a patient's calcium level increased. This is not necessarily viewed as a matter for concern. Mohd says doctors who use chelation report that patients speak of an improvement in cardiac function irrespective of their calcium scores.

What about controlled trials to prove the value of chelation therapy in heart disease? "There must be some in the books somewhere," says Mohd, "but I can't show you them." This apparent lack of scientific basis leaves chelation on the fringes of medical practice. Dr. Yahya Awang, head of the National Heart Institute of Malaysia and the surgeon who performed a bypass procedure on Prime Minister Mahathir Mohamad in 1989, says: "We don't use it." Is Mohd deterred? Apparently not. His wife is one of his patients.





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Article 7 : MOH GlobAL information HUB

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Article 8 : Opponent’s letter to read.

(1) Probe integrative medicine’s dramatic claims L-F Ng, Dec 14, 05 4:25pm

In medical practice, when a treatment is effective, it outshines other competitors - real and bogus - and does not evoke any controversy. When something is dubiously or marginally effective, then practitioners have a duty to their patients to ensure that what is proposed is truly beneficial and that, if given the benefit is quantifiable, this should be weighed against the potential known adverse effects.

The Hippocratic principle of primum non nocere (first, do no harm) has been ringing through in the hearts of ethical registered medical practitioners throughout the world for ages and on this rests the imperative ethical difference in attitude between a registered and an non-registered medical practitioner. But, within modern medicine this divide has become somewhat blurred.

This is made worse in some modern, developing societies by medical practitioners of dubious quality being allowed to be registered. In such environments, doctors have to be wary of some of their colleagues and the methods they use. This is also further made more muddy by the commercialisation of medicine with a pure profit motive being foremost in the mind of a registered practitioner.

Dr Mohd Ebrahim Sulaiman, a Klang Valley-based private practitioner, has made some substantive and tantalising claims alluding to treatments which have been untested, or tested negatively within randomised controlled trials, and which are not in the data bases of evidence-based medicine - principally the Cochrane Library.

He also claims that the Health Ministry had given him permission to treat thousands of patients who had been 'written off' by heart and cancer specialists. A good randomised controlled rrial is the only scientific way to test a superiority (or non-inferiority, i.e. equivalence) of a new treatment and the designed is tightly controlled with an up-front declared required number of subjects to be recruited and statistical methods prospectively planned.

In some designs, placebos are tested against the purportedly beneficial treatment. One or several patients benefitting with the study treatment may be quite meaningless - as this may just represent a placebo effect. Just as with the saying that 'one swallow does not make a summer.'

Dr Anantha Krishnan's call for consideration of integrative medicine strategies to be incorporated is welcome but only with the caveat that such interventions will need systematic rigorous testing using established methods used in evaluating new and established therapies. Otherwise, they will not withstand the test of scientific credibility.

Similarly, if the methods described by Ebrahim do work, the world of peer-reviewed evidence based medicine would have discovered it too and evaluated it critically and published results for the benefit of humankind. But, the sad fact is that this is untrue.

Ebrahim (also known as Dr Maung) had created an uproar in a professional bulletin board by his claims in the second half of the 1990s. This was stimulating and superficially appealing when gleaned over by the uncritical scientist or practicing clinician.

In 1999, when I was based in Kuala Lumpur, I challenged Maung (and offered intellectual support to test his enthusiastic hypothesis), in my capacity as a consultant medical oncologist, to design and conduct a randomised clinical trial to prove or disprove his claims. He was unable or unwilling to do so.

Dr Maung even contacted me by telephone to discuss the design and insisted on incorporating a large heterogenous (biologically very different) mix of heart and cancer patients in the trial design - a strategy which I rejected for obvious reasons and the issue was dropped.

The closed debate in the professional forum continued for a while and when Maung became so heated that he threatened to sue another critic in that closed forum, he was expelled from that bulletin board by the administrator. All this can be all verified by the administrator of Malaysian Medical Resources (previously known as Dobbs or Doctors Only Bulletin Board System).

If we assume that Maung’s present claims are not misleading and completely true, it would be a distinct benefit for the world of medicine - not in Bolehland alone. If however, he has made premature, misleading and unwarranted claims then the Malaysian Medical Council and the Health Ministry should now awake from their slumber and conduct detailed inquiries. They should also register and monitor all health interventions which have potential to cause harm (even economic harm) whether they are allopathic or alternative.

The gullible public needs real answers and any dramatic discovery needs to be encouraged while a hoax quickly extinguished and eclipsed as with all other snake oils. I am particularly interested in the validation of the claim on how the ministry gave permission to Maung to treat his patients.


The follwoing letters can be read in WWW.malaysiakini.com/letters.

Healthcare system should not kill
04:09pm Tue Dec 13, 2005
Hypocritical oaths of private hospitals
12:10pm Mon Dec 05, 2005
Integrated medicine saved my wife
04:19pm Fri Dec 02, 2005
Health is the rule, disease the exception
03:02pm Fri Nov 25, 2005
Have quality rating scale for medical practices
03:30pm Thu Nov 10, 2005
Medical errors need to be checked, monitored
03:51pm Tue Oct 25, 2005
















Article 9 : Dr Ebrahim’s letter in reply to read.

Dear Sir

I refer to the letter "Probe Integrated Medicine’s Dramatic Claims" by L-F Ng.

I reiterate my claim of a fair degree of success in treating cases of atherosclerosis and cases of cancer which were stopped and reversed even for the late stages.

Some heart cases usually come to me when they were booked for heart surgery or post bypass surgery re blockages or in severe congestive failure.

I have attended to 3rd and 4th stage cancer patients who were diagnosed and treated by their specialists, after having gone through surgery, chemotherapy and radiation and sent back home with morphine – presumably to die. Some of these hopeless cases came to me with tears as their money had been exhausted after the expensive treatments and leaving little left to pay for my treatment. I accepted such cases, and treated them with partial payment or full waiver even though their insurance does not cover for my treatment.

The patients came to me recommended by other patients. When they came to me, I had to do what I could to help them – money notwithstanding. Is Dr Ng advising me to reject them when I see there is still hope? Should I throw away compassion? Is it ethical? I have documents to prove my patients’ recovery is not chicanery. Why this closed mind and the need for proof when the end result speaks for itself. The pervading suspicion allopathic doctors have that those giving complementary treatment are charlatans, quacks and bogus operators is highly unfair. I just cannot help smelling the odour of fear and jealousy.

This litany about randomized controlled trials is moving to extremes and placing obstacles to the well-being of patients. The allopathic profession should not hide under its "protection" and allow itself to practise "restricted" medicine. If there is a credible cure which could be replicated with good results with little or no adverse side effects, then the patient should be afforded such treatment especially if no other better alternatives exists. Even if one patient can benefit – placebo effect or not – it is better than let him die. It is better than waiting years for large funds and willingness to carry out the necessary trails by which time the patient would have succumbed to the disease. If impropriety exist, let the law take its course. But please do not allow patients to suffer out of rigid institutionalized technicalities.

After studying Integrated Medicine in the US, I have equipped my clinic, with permission of the Ministry of Health, in very expensive modern medical equipment for healing. The returns after paying off my bank loans is not as attractive as some people think, definitely less than an oncologist’s takings.

Ref http://www.academycmt.com

As a family physician at 69 years of age, my main aim is not to enrich myself but to heal people. This is what makes me happy.

I did not see any possibility of doing double blind randomized placebo studies in Malaysia because I cannot afford to pay for the heavy costs involved. The US National Institute of Health at present has launched such randomized controlled trails for chelation therapy, costing USD 30 million. Please refer:…………..

I agree with Dr Ng’s statement. I was ridiculed with slander and libel and I was expelled from the Doctors Only Bulletin Board (DOBB) when I stood firm on my repeated success in Integrated Medicine. The fact that I could not afford to carry out randomized controlled trails does not diminish the efficacy of my treatments proven by my patients’ successes.

It must be understood that I have no intention to spoil the oncologist LF Ng’s rice bowl. I do not claim that I am oncologist. I treat the patient’s whole body as a family physician to heal them.

There is nothing to hide. I stand by my statement of having beneficially treated my patients and doing it safely where others have failed.

I have written official letters to the Director General of Health, Minister of Health copied to the Prime Minister about my success in Integrated Medicine.

I also requested the authority to integrate such therapies in the hospitals especially in the remote areas (kampongs) for the poor people and save money for the country.

You are welcome to visit my medical centre.

God is my witness.




Article 10 :HBO for stroke patients

By Prof Dr Hj Maung Hnin Ebrahim MD,FAAFP (UHMS)
Family Physician
Kuala Lumpur.

Hyperbaric Oxygen Therapy (HBOT) offers new hope for stroke victims and those that have suffered brain injury.


On 26th April 2006, a 47 years old malay lady suffered a disabling stroke as a complication after undergoing a minor surgery in the neck, in one of our hospitals in Kuala Lumpur.

She appeared to be in excellent condition before the stroke,"says her elder sister.

With that kind of massive infarct of the Brain, with Hemiplegia, the residual effects of the stroke usually takes 9 to 12 months to recover or improve to some degree in spite of extensive conventional therapy.

I was called in for Hyperbaric therapy on the 9th May 2006 and after administration of 20 times of One hour therapy she was almost back to her previous condition. She could lift her hand, speak , wear her slippers and walk fast without assistance. That means all her paralysed muscles of the tongue, face, voice box, upper and lower limbs were back to normal. Her whole family was happy when she was discharged from the hospital on the 5th June 2006 on her own request.


We need to Remember, "Understand the Diagnosis and Defy the Prognosis

The usual gloomy prognosis offered by neurologists for stroke patients is now changing because of their ability to accurately assess damaged brain cells and target those cells that can be rehabilitated using functional magnetic resonance imaging (fMRI) and nuclear PET and SPECT scans. In the last ten years, this quantum-physics technology has caused a paradigm shift in the attitude of neuroscientists and their understanding of how neuropathogenicity and the power of mental force can aid in the recovery of quality of life for stroke victims.

Stroke can be the result of Embolism, thrombosis or Haemorrrhage of the arteries supplying the brain. Thus generally speaking, stroke is caused by a sudden loss of blood supply and oxygen to a specific area of the brain, which kills off the central core of brain cells.. With the death of these cells and the swelling it causes, blood and oxygen are further isolated from the surrounding cells, which also then swell in a repeating cycle.. When these marginal cells , which are viable but not functioning, can be revived with sufficient oxygen, substantial and sometimes dramatic recovery may result.
What ever is the cause of stroke "Hyperbaric Oxygen therapy" improves or shortens the recovery period.
Naturally, the sooner after the stroke the patient receives Hyperbaric Oxygen, the better chance of recovery.

In Hyperbaric Oxygen therapy , a patient is placed in a chamber and the pressure is increased between 15 feet to 66 feet below the surface of water and he or she receives pure Oxygen for one hour.

The brain consumes 20 percent of the oxygen in the body even though it makes up only two percent of the weight, so it is undesirable why the lack of oxygen in brain cells has such a dramatic effect on the body. Indeed, the brain cells receives 15 percent of the cardiac out put.

I believe , we can save drowning victims with this method. Arms .legs , fingers or penis (quite common now a days) that have been cut off will often be replanted and frequently restore more successfully when Hyperbaric Oxygenation is included in the treatment.
Brain injuries and crushing injuries respond to fast treatment with pressurized Oxygen and this can prevent permanent damage. Gas gangrene requires quick treatment or it is fatal. Flesh eating infections (Necrotising faciatitis), frost bites , burns also responds well to HBO. 90% of Diabetic Gangrene foot can be saved from below knee amputation by HBOT.




Hyperoxygenation:

For pressure above 2.5 ATA sufficient quantities of oxygen can be dissolved in the plasma alone to support life in the absences of red blood cells , therefore can save patients who have lost their blood enormously while awaiting blood transfusion.

Another interesting topic is Hyperbaric Oxygen prevents I. R (Ischaemic reperfusion injury).

What is reperfusion injury?
• When ever a disease or injury deprives a tissue of oxygen, reestablishing the blood flow (reperfusion), and therefore reintroducing oxygen, may damage the tissue further.
This applies to stroke, Myocardial Infarct, revasculaization surgery, crush injuries and many diseases due to lack of oxygen and restoration of Oxygen.

HBO treatment is no longer considered experimental .

In 2001 , the American Medical Association and Medicare approved approximately 14 conditions eligible for reimbursement.
Therapy is routinely reimbursed by most major insurance companies as well. So all Health care department and Insurance companies should also look into this matter.

Recently one of our prominent Malaysian sports man had a bad frost bite of fingers of both hands at Mount Everest. His fingers tips became black in colour.

Surprisingly there was no HBO facilities available at that part of the world famous place of Himalaya where thousands of mountaineers worldwide gather to expose themselves to Hypoxia.
He had to come all the way to Bangkok for HBO therapy and then came back to Kuala Lumpur to continue HBOT.

It is sad to say that Hyperbaric Oxygen therapy is still a little understood Potential dimension in community Healthcare.

In my opinion " Every city of any size should have a hyperbaric chamber for emergency cases".

Contact: drmaungs@streamyx.com for any questions








Article 11 : ECP for stroke patients

Stroke. 2012 Nov;43(11):3007-11. doi: 10.1161/STROKEAHA.112.659144. Epub 2012 Sep 20.
External counterpulsation augments blood pressure and cerebral flow velocities in ischemic stroke patients with cerebral intracranial large artery occlusive disease.
Lin W, Xiong L, Han J, Leung TW, Soo YO, Chen X, Wong KS.
Source

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong SAR.
Abstract
BACKGROUND AND PURPOSE:

External counterpulsation (ECP) is a novel noninvasive method used to improve the perfusion of vital organs, which may benefit ischemic stroke patients. We hypothesized that ECP may augment cerebral blood flow of ischemic stroke patients via induced hypertension.
METHODS:

We recruited ischemic stroke patients with cerebral intracranial large artery occlusive disease and healthy elderly controls into this study. Bilateral middle cerebral arteries of subjects were monitored using transcranial Doppler. Flow velocity changes before, during, and after ECP were, respectively, recorded for 3 minutes while continuous beat-to-beat blood pressure data were recorded. Cerebral augmentation index was the increase in percentage of middle cerebral artery mean flow velocity during ECP compared with baseline. Transcranial Doppler data were analyzed based on ipsilateral or contralateral to the infarct side.
RESULTS:

ECP significantly increased mean blood pressure of stroke patients and controls. During ECP, middle cerebral artery mean flow velocities of stroke patients increased on both ipsilateral and contralateral sides when compared with baseline (ipsilateral cerebral augmentation index, 9.64%; contralateral cerebral augmentation index, 9%; both P<0.001), but there was no increase in difference between the 2 sides when compared with each other. Mean flow velocities of controls did not change under ECP. After ECP, blood pressure and flow velocity of stroke patients returned to baseline level.CONCLUSIONS:ECP provides a new method of cerebral blood flow augmentation in ischemic stroke by elevation of blood pressure. Flow augmentation induced by ECP suggests the improvement of cerebral perfusion and collateral supply from infarct ipsilateral and contralateral sides.Refer:same article in
Medical Tribune Malaysia page 16 Dec 1-15 2012 issue by Naomi Ridrig




Article 12 : Chelation therapy is mainstream medicine but misunderstood by many.

By Dr Hj Mohd Ebrahim Sulaiman Tel: 0122400623

I REFER TO STAR NEWS PAPER date 22nd July 2012 -STAR fit4life : Cover story about Dr Hazren and his brother Amran both of them suffering from Thalassaemia and how they were treated by Chelation therapy by Datin Dr Gnanasothie Duraisamy. I also thank The Health Minister Datuk Seri Liow Tiong Lai for announcing that Government would sponsor deferasirose, a chelating agent for Thalassaemia patients.
I would like to recommend that disodium EDTA chelating agent is less expensive and less toxic and the cheapest is herbs called cilantro (Chinese Parsley -Coriander Sativum )-- in Malay called Daun Kathumba, swallowing 50 grams of fresh leaves daily shall reduce the heavy metals from the body by passing it in the urine..(Dr Yoshiaki Omuradis found after research done in New York University in 1992). These two chelating agents are so cheap and bPharmaceautical industry cannot make money by patenting it.

And I also refer to Star news paper dated 18th Oct 2011:
Medical practitioners advised not to use ozone and chelation therapy
PUTRAJAYA: All medical practitioners are advised not to use or apply Ozone and Chelation Therapy as treatment for any medical condition, Health director-general Dr Hasan Abdul Rahman said Tuesday.
Dr Hasan, who is also president of the Malaysian Medical Council (MMC), said there was no evidence to support any therapeutic benefit from the usage of the two therapy treatments for any illness.
"The decision was made after extensive discussions and relying on information obtained from local and overseas scientific databases," he said in a statement.

Chelation therapy is misunderstood and under estimated.
Doctors and public in Malaysia were wrongly informed and threatened that chelation therapy has no place in Medicine at all and should not be included in their practice and some misunderstood that chelation therapy is malpractice. Some exaggerate chelation therapy is very toxic and killing. In the world history there was only one patient 10 yrs old boy died of EDTA chelation . Because he was given high dose of Calcium Editate by an inexperienced doctor for the child’s lead poisoning. One cannot say according to his whims and fancies what he likes without studying it carefully. In USA there is American Academy of Ozone in Medicine, In Russia there is the State Medical Academy of NIZHNY NOVOGOROD, THE Ministry of Health service of the Russian Federation is teaching, providing training and applying Ozone therapy in medical practice. In Germany Ozone therapy is used in Hospitals. Where do we stand?
Clarification. What is chelation? Greek word chele= claw of the crab. Meaning strongly grabs the toxins and discard from the body. I am glad to high light that Chelation therapy is used by Datin Dr Gnanasothie Duraisamy and The Health Minister Datuk Seri Liow Tiong Lai and it is legal to use the term chelation in medicine no matter what chelating agent is administered to remove heavy metals from the body. It is unfortunate that health DG and his informers do not believe that heavy metals (Iron, Lead, Mercury, aluminium etc ) can cause damage to the body. In Thalassaemia the extra iron deposits in the body can damage the organs called haemosidersosis, same as other Heavy metals like Calcium, lead, Mercury, Aluminium, Cadmium, uranium, arsenic can trigger free radical damage and cause damage to the brain, kidneys, liver , blood vessels etc. From where do we get these toxic heavy metals? From water, Fish, smoking, car exhaust, vaccinations and even from the carpets.
Definition of chelation therapy.
Chelation therapy is defined as the administration of chelating agents to remove heavy metals from the body. For the most common forms of heavy metal intoxication—those involving lead, arsenic or mercury—the standard of care in the USA dictates the use of Dimercaptosuccinic acid (DMSA). Other chelating agents, such as 2,3-dimercapto-1-propanesulfonic acid (DMPS) and alpha lipoic acid (ALA), are used in conventional and alternative medicine.
Chelating agents were introduced into medicine as a result of the use of poison gas in World War I. The first widely used chelating agent—the organic dithiol compound dimercaprol, also named British Anti-Lewisite or BAL—was used as an antidote to the arsenic-based poison gas, Lewisite. It binds the arsenic in Lewisite with two strong chemical bonds with the SH groups ("mercaptans"), forming a water soluble compound that entered the bloodstream, allowing it to be removed from the body by the kidneys and liver. BAL had severe side-effects.
After World War II, a large number of navy personnel suffered from lead poisoning as a result of their jobs repainting the hulls of ships. The medical use of EDTA as a lead chelating agent was introduced. Unlike BAL, it is a synthetic amino acid; it contains no mercaptans. While EDTA had some uncomfortable side effects, they were not as severe as BAL.
In the 1960s, BAL was modified into DMSA, a related dithiol with far fewer side effects. DMSA quickly replaced both BAL and EDTA, becoming the US standard of care for the treatment of lead, arsenic and mercury poisoning, which it remains today.
Research in the former Soviet Union led to the introduction of DMPS, another dithiol, as a mercury chelating agent. The Soviets also introduced ALA, which is transformed by the body into the dithiol dihydrolipoic acid, a mercury and arsenic chelating agent. DMPS has experimental status in the US FDA, while ALA is a common nutritional supplement.
Other chelating agents have been discovered. They all function by making several chemical bonds with metal ions, thus rendering them much less chemically reactive. The resulting complex is water soluble, allowing it to enter the bloodstream and be excreted harmlessly.
EDTA chelation is approved by the U.S. Food and Drug Administration (FDA) for treating lead poisoning and heavy metal toxicity.
Chelation therapy is used as a treatment for acute mercury, iron (including in cases of thalassemia), arsenic, lead, uranium, plutonium and other forms of toxic metal poisoning. The chelating agent may be administered intravenously, intramuscularly, or orally, depending on the agent and the type of poisoning.
Several chelating agents are available, having different affinities for different metals. Common chelating agents include:
• Alpha lipoic acid (ALA)
• Aminophenoxyethane-tetraacetic acid (BAPTA)
• Defarasirox
• Deferoxamine
• Diethylene triamine pentaacetic acid (DTPA)
• Dimercaprol (BAL)
• Dimercapto-propane sulfonate (DMPS)
• Dimercaptosuccinic acid (DMSA)
• Ethylenediamine tetraacetic acid (calcium disodium versante) (CaNa2-EDTA)
• Ethylene glycol tetraacetic acid (EGTA)
• D-penicillamine

Indication:
Intravenous infusion of EDTA chelation therapy is performed in a doctor’s office. It takes three hours to complete the infusion for the :

1.Removal of calcium , iron and heavy metals from the body. (Detoxification)
2.Anti-Oxidant to prevent and repair free Radical damages.
3.To improve the Zeta Potential (-ORP)of the blood. Thus improves circulation.
4.To prevent or treat Intravascular coagulation at Micro circulation level.(Anticoagulant).
5. EDTA is used to bind metal ions in the practice of chelation therapy, e.g., for treating mercury and lead poisoning.[11] It is used in a similar manner to remove excess iron from the body. This therapy is used to treat the complication of repeated blood transfusions, as would be applied to treat thalassaemia. Alternative medical practitioners believe EDTA acts as a powerful antioxidant to prevent free radicals from injuring blood vessel walls, therefore reducing atherosclerosis.[12] The U.S. FDA approved the use of EDTA for lead poisoning[13] on July 16, 1953, under the brand name of Versenate[14], which was licensed to the pharmaceutical company Riker. It has not approved it for the treatment of atherosclerosis.[15]

Virtually all the Chronic diseases are associated with the above factors.
How would you test Heavy metal toxicity?
Heavy metal screening tests kits are available. Blood or Urine or hair or nails can be sent to the Laboratory.
How would you test the free radical damage?
Free radical Test kits for urine and machine for blood test are available.
Who will prescribe the appropriate chelating agent?
The Registered medical practitioner only can prescribe oral or Injection of chelation therapy.

Who can prepare the Chelation therapy.

A staff nurse or medical assistant or chemist or trained clinic assistant or a doctor must prepare the chelation fluid.

Standard operating procedures

Sterilized room or clean room or Laminar flow cabinet is used to prepare the I.V solution as preparation of TPN (Total Parental Nutrition) under strict aseptic measures . The staff must wear a face mask and gloves in the handling of medicines.
The staff must follow the standing instructions ordered by the doctor. The dosage of medicines, osmolarity, pH, Zeta Potential and the rate of infusion must be adhered to.

Side effects.
Fast infusion may cause tetany, Hypoglycaemia , Hypotention, Heart failure, pleural effusion, renal failure.
Treatment must be in a clinic set up.

Precautions: Injections calcium gluconate, 50% Glucose, Atophine, Adrenaline, Oxygen, AED , I.V drip sets and drips must be kept ready.

Contraindication & Special Precautions: Severe renal failure. Congestive heart failure.
Bleeding criteria.

Criteria of Registration and Practice

Registered Medical doctor with valid APC.

• Who has attended workshop conducted by ACAM USA or IBCMT or MSCM are members.

• Those who pass the written examination held by ACAM, IBCMT can practice as a beginner under the supervision of a senior chelation practitioners Who hold the certificate of APCT or CMT.

• Those who have passed the Oral examination of ACAM and IBCMT are fully qualified chelation practitioners who can practice chelation independently.


Institutions of Higher Education.

The International Institutions of Higher Education for Chelation available at present is ACAM-USA , IBCMT-USA, and ABCMT (American Board of Clinical Metal Toxicology).

We need to invite them or we go there and get certified.
International Regulatory Control
1.ACAM
The American College for Advancement in Medicine (ACAM) is a not-for-profit medical society dedicated to educating physicians and other health care professionals on the latest findings and emerging procedures in preventive/nutritional medicine. ACAM's goals are to improve skills, knowledge and diagnostic procedures as they relate to complementary and alternative medicine; to support research; and to develop awareness of alternative methods of medical treatment.
Celebrating more than a quarter century of service, ACAM represents more than 1,000 physicians in 30 countries. ACAM is the largest and oldest organization of its kind in the world dedicated exclusively to serving the educational needs of the health professions..

2.IBCMT
IBCMT is the International Board of Clinical Metal Toxicology established in 1994 as IBCT.

The International Board of Chelation Therapy. IBCT together with ABCT, the American Board of Chelation Therapy, have always been the certifying boards for chelation therapy. A few years ago these Boards changed their names appropriately into The International Board of Clinical Metal Toxicology(IBCMT) and the American Board of Clinical Metal Toxicology(ABCMT).

The purpose of the International Board of Clinical Metal Toxicology is:
1. To define and establish the qualifications to be required of licensed physicians and equivalents for International Certification as Board Certified persons in the field of Clinical Metal Toxicology and any other field that may be assumed by this Board.
2. To require all applicants to submit evidence that they meet all established requirements for licensed physicians, or their equivalents, particularly with regard to administering intravenous treatments.
3. To authorize and approve training seminars in accordance with the bylaws, necessary for Board Certification in Clinical Metal Toxicology.
4. To conduct examinations in conformity with the Bylaws of this Board.

The practicing Physician should not mention or claim that you are treating Heart disease or brain disease or any disease specifically so that you are safe from harassment and threatening from various sources. Just say you treat the metal toxicology and free radicals damage which are the root cause of various diseases. (FDA approved).

All the above definition and indications are with in the practice of Conventional medicine and FDA approved.
I understand that all Malaysians must obey the National policy of T/CM where registered practitioners are allowed to practice both Conventional and complementary together (Integrative medicine) provided the practitioner has undergone proper training in that specialty.


5.5. Addition of Chelating Agent TO PLANTS.
The increase of the uptake of heavy metals by the energy crops can be influenced by increasing the bioavailability of heavy metals through addition of biodegradable physicochemical factors such as chelating agents, and micronutrients, and also by stimulating the heavy-metal-uptake capacity of the microbial community in and around the plant. This faster uptake of heavy metals will result in shorter and, therefore, less expensive remediation periods. However, with the use of synthetic chelating agents, the risk of increased leaching must be taken into account [34]. The use of chelating agents in heavy-metal-contaminated soils could promote leaching of the contaminants into the soil. Since the bioavailability of heavy metals in soils decreases above pH 5.5–6, the use of a chelating agent is warranted, and may be required, in alkaline soils. It was found that exposing plants to EDTA for a longer period (2 weeks) could improve metal translocation in plant tissue as well as the overall phytoextraction performance. The application of a synthetic chelating agent (EDTA) at 5 mmol/kg yielded positive results [8]. Plant roots exude organic acids such as citrate and oxalate, which affect the bioavailability of metals. In chelate-assisted phytoremediation, synthetic chelating agents such as NTA and EDTA are added to enhance the phytoextraction of soil-polluting heavy metals. The presence of a ligand affects the biouptake of heavy metals through the and changes the potential formation of metal-ligand complexes to leach metals below the root zone [48].
Ref www.hindawi.com look in th book mark
Hindawi Publishing Corporation

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Article 13 : Bill clinton’s madness

Bill Clinton’s Madness:
A Consequence of Heart-Bypass Surgery Brain Damage
We Need to Understand and Show Some Compassion
One of the savviest politicians of our generation, known for his wit, charm, and calm under extreme pressure, Bill Clinton appears out of character in the speeches and interviews televised since his bypass surgery September 6, 2004—and his mental deterioration may be accelerating. Remember, this is the president who withstood public impeachment before the entire world for his relationship with Monica Lewinski without once losing control. Now, he is easily angered by hecklers, and makes factual mistakes and racial slurs while aggressively defending his wife’s campaign for presidency. Everyone sees his mental and emotional decline, yet to date, no medical professionals have spoken out about the cause or offered help.

Not a single one—not one bypass surgeon, cardiologist or psychiatrist—has stepped forward in his defense; even though all of them are trained to recognize "post bypass surgery cognitive dysfunction." One of the best-kept secrets in medicine is the brain damage caused during bypass surgery. During my 40 years of medical practice I have never heard a doctor warn a patient before bypass surgery that an expected complication is memory loss. After surgery when the family complains of dad’s fits of anger, I have never heard a doctor admit that personality change is a common consequence of surgery. Yet these well-recognized side effects have been reported in medical journals since 1969.1

Brain damage during bypass surgery is so common that hospital personnel refer to it as "pump head." The primary cause is emboli produced during surgery from clamping the aorta and from the "heart-lung machine." This machine pumps blood to keep the patient alive while the heart is stopped during the operation. Unfortunately, this pump also introduces toxic gases, fat globules, and bits of plastic debris into the bloodstream of the patient under anesthesia. Once they are in the bloodstream, these particles migrate to the brain where they can clog capillaries and prevent adequate amounts of blood and oxygen from flowing to the brain. Essentially, all patients experience brain emboli during surgery and for many the damage is permanent.

In 2001, an article in the New England Journal of Medicine reported that 5-years after bypass surgery 42% of patients showed decline in mental function of approximately 20 percent or more.2 A study published this year (2008) in the Annals of Thoracic Surgery using MRI testing just after bypass surgery found brain damage in 51% of patients.3 Three years after their time on the bypass pump, significant permanent reduction in mental capacity was identified in 31% of patients. I am not talking major stroke here; but these patients can't remember names or numbers as they once did, experience sleep disturbances (including nightmares), suffer mood swings, and lose intellectual acuity. Approximately 30 percent of people suffer persistent depression and some even contemplate suicide.

Our former president needs our understanding and support. A simple explanation by his doctors of the cause of his recent aberrant behaviors should bring peace of mind to Hillary and her campaign staff. If Mr. Clinton better understood his current limitations, he and his staff could take precautionary steps to avoid embarrassments. A long-overdue explanation would help his adoring public more easily accept his mistakes and readily forgive him. It is not your fault, Mr. Clinton.

As importantly, public recognition of the harm done to Bill Clinton by the heart surgery business would help the patients who undergo bypass surgery, and their families, to better understand similar changes they have experienced. A little attention from the media could also shine some light on the lack of survival benefits from this $90,000 procedure performed nearly half-a-million times annually in the US, and the superior benefits coming from diet and lifestyle changes.

I am saddened to see our former president suffer from public humiliation, but I am disgraced that my profession has thus far failed to come forward with a long over-due explanation and an apology to the Clintons and our nation for the harm they have done and the secrets they have kept.

John McDougall, MD
http://www.drmcdougall.com

1) Hill JD, Aguilar MJ, Baranco A, de Lanerolle P, Gerbode F. Neuropathological manifestations of cardiac surgery. Ann Thorac Surg. 1969 May;7(5):409-19.

2) Newman MF, Kirchner JL, Phillips-Bute B, Gaver V, Grocott H, Jones RH, Mark DB, Reves JG, Blumenthal JA; Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med. 2001 Feb 8;344(6):395-402.9 Link » (pdf)

3) Knipp SC, Matatko N, Wilhelm H, Schlamann M, Thielmann M, Lösch C, Diener HC, Jakob H. Cognitive outcomes three years after coronary artery bypass surgery: relation to diffusion-weighted magnetic resonance imaging. Ann Thorac Surg. 2008 Mar;85(3):872-9.

Copyright (c) 2013 John A. McDougall, M.D., All Rights Reserved.
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Article 14 : Secret Cardiology
SECRET CARDIOLOGY. WHY CARDIOLOGIST IGNORE ECP Therapy? WHAT SHALL WE DO?

Secret Cardiology –ECP ( EECP). Why cardiologists don't like it - and what you should do about it. By Richard N. Fogoros, M.D., About.com Guide Updated November 28, 2005 About.com Health's Disease and Condition content is reviewed by our Medical Review Board http://heartdisease.about.com/cs/coronarydisease/a/EECP_3.htm (Continued from Page 2) Despite its increasingly apparent potential usefulness, EECP is hardly taking the cardiology world by storm. In fact, it seems that for most cardiologists EECP is not even on the list of potential treatments for coronary artery disease. Why is that? There are several possible reasons. Let us dispense with the most obvious first, namely, that EECP doesn’t pay well. A series of 35 treatments costs $5000 to $6000 dollars. That’s not chicken feed, but keep in mind that we’re talking about 35 hours of therapy over 7 weeks, which involves not only the doctor’s time but also the time of office staff, nursing personnel, etc., etc. Still not a terrible return, but when you consider that a cardiologist can often bill that much by spending a morning in the cath lab, well - - -. Then there’s the fact that EECP remains somewhat intellectually unsatisfying. To your average cardiologist, there’s no reason at all that anyone should have thought it would work in the first place – that temporarily providing counterpulsation would have lasting effects. And the fact that it apparently does work is merely blind luck, and leaves investigators scrambling ridiculously to explain why it does. This is a less than satisfying way to advance science. In addition, to most cardiologists, EECP is logistically difficult. To accommodate patients for EECP, they would not only have to purchase expensive equipment, but also would have to radically change the organization of their offices, their office staff, and their space. Finally, and most importantly, EECP has nothing in common with what cardiologists do. Cardiologists study and treat the heart, for goodness sake. They stress it, image it, measure it, pace it, shock it, stent it, ablate it, revascularize it, and bathe it in drugs. What they do takes years of specialized training and expertise, millions of dollars of high-tech equipment, and tremendous manual dexterity, and it brings them significant prestige, even within the medical community. Now they’re supposed to drop all that? In order to attach fancy balloons to peoples’ legs, throw a switch, watch them bounce around for an hour, then say, “See you tomorrow?” That’s not cardiology. That’s glorified physical therapy. This, in DrRich’s estimation, is the real reason the average cardiologist is completely ignoring EECP, as if it doesn’t even exist. They simply can’t believe anyone really expects them to do this. In any case, you may need to raise your cardiologist’s consciousness. If you have coronary artery disease that has proved difficult to treat, then you need to bring EECP up yourself. Once enough patients show themselves to be aware of this new therapy and to be expecting it, suddenly EECP will no longer be beneath cardiologists, and they’ll eagerly find a way to incorporate it into their practices. How can you receive EECP? If you are a candidate for EECP and wish to pursue it, start with your doctor. If your doctor discourages you from pursuing EECP, make sure he/she gives you a good reason for discouraging it. Good reasons would include: you don’t have the sort of coronary artery disease or angina that would benefit from EECP; your coronary artery disease is of the type that requires revascularization; or you have one of the contraindications (listed above) for having EECP. (Good reasons would not include: it’s unproven; it doesn’t work; it’s voodoo; or I’ve never heard of it.) There are fewer than 200 places in USA today performing EECP, though the number is growing rapidly. If your doctor can’t think of a place to refer you for EECP, go online. The best place to start online would be EECP.com. This is a website run by Vasomedical, Inc., the company that makes the equipment for EECP, so it is not unbiased. But it does offer an excellent means of finding a place where you can get EECP in your area. Your insurance carrier should cover EECP, though these fine humanitarians might well deny coverage initially. Medicare has approved EECP for reimbursement, and once Medicare approves a new treatment, insurance companies normally fall in line quite quickly. In the case of EECP, however, many insurance companies are still balking at paying, perhaps because their cardiology consultants are telling them it’s not really a serious therapy. Don’t let this discourage you. If you are turned down for reimbursement, appeal the decision. Most insurance companies count on patients failing to appeal (which is why they so frequently deny therapy that is obviously needed), and with Medicare supporting your contention that EECP ought to be covered, odds are that if you appeal you’ll win. Hyperbaric and ECP Sdn Bhd , #3.16 The Ampwalk (North Block) 218 Jalan Ampang 50450 Kuala Lumpur Tel 03 21632469



Article 15 : Avoid unnecessary tests.
Avoid unnecessary test for heart problem.One hospital is doing angiogram as a routine to all heart patients.

Unnecessary tests for heart problems
Koon Yew Yin
4:36PM Oct 28, 2005
Although I am not a doctor, I have 22 years experience in consulting cardiologists since my heart bypass operation. I wish to point out that many of the investigations for heart diseases are quite unnecessary according to internationally recognised guidelines.

In the US, a research firm, Mediqual, reported that 35 percent of the coronary angiograms they had studied had none of the objective clinical findings used to validate those angiograms in the first place.

An angiogram that is performed unnecessarily carries two types of dangers - the very real risks of the procedure itself (stroke, heart attack or death) and the risk that it will be followed by another inappropriate operation or procedure.

About three years ago, I failed my treadmill test and despite the fact that I had no symptoms, my cardiologist wanted me to have a coronary angiogram to see how badly my coronary arteries were blocked.

I refused to do it as I wanted a second opinion. However, he arranged for me to have an 'exercise heart scan' at the National Heart Institute (IJN) which showed that there was a 25% blockage in a major artery.

He then strongly advised me to have an angioplasty with possible insertion of one or two stents. This would cost about RM20,000. Unconvinced, I consulted two foreign specialists who advised me not to have any treatment unless I have symptoms of heart disease, which are:

Pain, usually in the chest, with or with shortness of breath and

Breathlessness, usually on exertion, with or without pain.

All responsible will agree that it is quite wrong to operate on coronary lesions that are not causing symptoms. So why do the tests? When cardiologists order such tests, they should do so according to internationally recognised guidelines.

If they do not, one might be tempted to think that they are being over-influenced by financial considerations.

Just for peace of mind, about two months ago, I consulted another cardiologist in Ipoh. This time I passed the treadmill test easily but he still wanted me to get a heart scan done costing RM2,500 by a new 64 slice MRI scanner.

I refused for the simple reason that I had already have passed the treadmill test and I did not have any symptoms of a heart problem.

Fatalities from heart attacks are well-known. It is the commonest cause of death, disease-wise. As a result, most people are over fearful of heart problems, and doctors and cardiologists may take advantage of this fear.

I urge our Malaysian Medical Association to formulate a strict guidelines to control the practice of cardiologists ordering patients to do treadmill tests, scans, angiograms and other what-not.

Without adherence to such guidelines, many patients like me will continue to be subjected to unnecessary, dangerous and expensive investigations.


Second time article by the same author.
Second time article by he same author.

Have strict guidelines for local cardiologists‏.
Have strict guidelines for local cardiologists‏.
This article is from The Star Online (http://thestar.com.my)
URL: http://thestar.com.my/news/story.asp?file=/2009/12/21/focus/5328079&sec=
ALTHOUGH I am not a doctor, my experience in consulting cardiologists over the years may be of interest to Malaysians in this age of high-tech and increasingly expensive health care.
About six years ago, I failed my treadmill test. Despite the fact that I had no heart disease symptoms, my cardiologist wanted me to have a coronary angiogram to see how badly my coronary arteries were blocked.
Although I initially refused to do it, I eventually submitted to an exercise heart scan which showed that there was a 24% chance of total myocardium blockage. On the basis of that result, I was strongly advised to have an angioplasty with possible insertion of one or two stents – a procedure which was rather costly.
Still unconvinced, I consulted two British cardiologists who advised that I should not be too concerned about my condition unless there were clearer symptoms of heart disease. These symptoms included pain, usually in the chest, with or without shortness of breath; and breathlessness, usually with exertion, with or without pain.
The two distinguished experts pointed out that most adults over 40 years old have irregularity in their coronary arteries but this was not necessarily a condition that warranted expensive tests or follow-up surgery.
Following their advice, I decided to leave well enough alone and have had no problems since.
Medical findings from elsewhere in the world confirm that the course of action I took is the right one.
In the United States, the research firm Mediqual reported that 35% of the coronary angiograms they studied had none of the objective clinical findings to validate an angiogram. That is to say, they were not done for an adequate clinical reason.
An angiogram that is performed unnecessarily carries two types of dangers: the very real risks of the procedure itself (stroke, heart attack or death), and the risk that it will be followed by another inappropriate operation or procedure.
If the percentage of unnecessary angiograms is so high in the US where people are better informed, it is likely that the situation in Malaysia is worse.
In view of the public and media attention given to the growing incidence of heart disease in the country and the wrong conclusions and medical aftermath that may result, I would like to suggest that the Malaysian Medical Association formulate strict guidelines to control the practice of cardiologists in ordering patients to do treadmill tests, scans, angiograms and other tests.
Without adherence to such guidelines, many patients like me will be subjected to unnecessary, dangerous and expensive investigations.
hen Malaysian cardiologists order such tests, they should do so according to internationally-recognised guidelines.
If they do not, one might be tempted to think that they are being over-influenced by financial considerations.
KOON YEW YIN,
Ipoh.
__________________________________________________________________
> Your one-stop information portal:
> The Star Online
> http://thestar.com.my




Article 16 : Toronto Star news..

The Toronto Star
Controversial chelation has devoted believers
Infusions provide some with alternative to open-heart surgery

Friday, February 26, 1999
Janice Mawhinney
Life Writer
Source: http://www.drhui.com
Toronto physician Fred Hui's parents both died of heart disease at age 52.
Hui is 48
"This is my genetic inheritance," he states simply.
But Hui doesn't intend to sit around for the next four years waiting to be felled by unpleasant coronary events.
He exercises regularly, eats carefully, and meditates daily.
And is about to start using chelation therapy - for himself and his patients.

He's just become one of the first doctors in Ontario to openly offer the long controversial therapy.

Chelation (pronounced key-Lay-shun) refurs to a series of intravenous infusions of a synthetic amino acad called EDTA.

It has been used for half a century to flush heavy metal toxins out of the systems, but disputes have arisen over its more recent use to dissolve plaque blockages obstructing blood flow that can lead to heart attacks.

A small number of Ontario physicians have quietly offered chelation to their cardiac patients in recent years, but, by and large, the medical community has disapproved of the use of chelation for anything other than cleaning metal toxins out of the body.

In 1987, by order-in-council, David Peterson's government made it illegal in Ontario to use chelation for cardiovascular problems. But new regulations a few years ago didn't mention chelation at all, thus removing its illegality.

The College of Physicians and Surgeons of Ontario adopted a policy in 1987 stating "there is no evidence that this therapy is of any value, and there is clear documentation of significant risks associated with it."

But today the college categorizes it as a form of complementary medicine that physicians may offer as long as they follow a specific set of procedures, including keeping careful records,

doing a standard examination and diagnosis, and advising the patient about conventional treatment options.

Chelation is freely offered for a range of physicical problems in Alberta, British Columbia and Saskatchewan, as well as throughout the United States and in many other countries.

Physician Geoffrey Bond, a district representative on the Ontario College of Physicians and Surgeons council, said on CTV last fall that chelation is allowed as long as the physician follows all proper medical procedures.

"Then it is truly the patient's choice," he said. "That's the position the council adopted."

Hui went to Arizona to get his training in administering chelation, and was accredited by the American College for the Advancement of Medicine.

It has a consistent 85 per cent success rate," he says. "It's like cleaning out the rust blocking a pipe."

Hui says chelation is unlikely ever to get the expensive double blind testing that would, if successful, lead to publication in prestigious medical journals and complete acceptance by mainstream medicine in Ontario. No one is making big profits from it, so no one would be interested in underwriting the research.

"This (EDTA, or ethylene diamine tetra acetic acid) isn't something that can be patented," Hui notes. "The research studies would cost $15 million. Who would pay for that?"

Because he is using chelation as a part of his regular practice, and he has trained and accredited in its use, Hui says he doesn't expect his more traditional colleges to give him a hard time over it.

"As long as I maintain the practice of good medicine and put the interests of my patients first, no one will fault me."

He has no plans to use chelation alone, he adds, but as part of a regimen including standard medical practices, nutritional supplements, Chinese herbs and meditation.

"you do everything you can," he says. "If four men are pushing a car and it doesn't work, but there's a fifth and sixth I can call on for help and it's harmless, then why not?"

Hui charges $120 for each treatment, which lasts three hours while the patient is hooked up to an intravenous line.

Patients aren't hard to come by. A group called the Ontario Chelated Patients Association, which formed last August, has more than 400 members already. They haven't found it easy to locate doctors who offer chelation treatments, says president Gene Dopp, 76, of Orangeville, but they all believe that chelation is their route to good health.

After Dopp's heart attack in 1994 and a battery of subsequent tests, his doctor told him there was nothing they could do but send him home to get his affairs in order. On a trip to California to escape the cold weather, he discovered chelation.

Back in Ontario, he could only find three doctors who offered it, in Smiths Falls, Ottawa and Blythe. He went to Blyth, but is glad to find Hui offering the treatments closer to home.

"This is my 28th treatment," he says. "When I started I could only walk 15 or 20 feet without stopping and resting and taking some nitro spray. Now I can walk five miles."

Dopp says evidence on the sefety and effectiveness of chelation is available in jurisdictions where it is widely used. But, he says, most Ontario doctors don't want to know this. "Doctors are intimidated by the College of Physicians and Surgeons about chelation."

Ross Collins, 68, of Kitchener says he was told twice to schedule triple bypass surgery, and he refused.

"I was unable to walk a block without severe pain," he recalls.

He quit smoking, lost weight, and started nutritional supplements and a series of chelation treatments.

"I've had 11 treatments and I can now walk through 27 holes of golf," he says. "After this treatment I might even carry my own golf bag. The difference is like night and day."

Collins says he believes money is involved in opposition from the medical establishment.

"Physicians and drug companies don't want it around" and many millions are spent on bypass surgery each year in Canada and the U.S., he says.

In England and in New Zealand, Collins says, a patient must take 10 chelation treatments before having bypass surgery, or before having a limb removed because of diabetic gangrene.

"In 90 percent of the cases, they don't need the bypass surgery after all." he says. "Bypass costs $37,000 and 10 chelation treatments costs $1,200.

"Our health care system is in trouble: they could save millions with this. Chelation treats all the arteries, not just one."




Article 17 : Medical errors need to be checked

Medical errors need to be checked, monitored
Kumaraguru
3:51PM Oct 25, 2005
Urgent reforms are needed in the healthcare system so that Malaysians may be better safeguarded against the serious 'side effects' of the modern healthcare system. In addition, the Malaysian Medical Council must be made accountable to Parliament.

The right to a safe, effective, affordable and high-quality of medical care must be given utmost priority as it affects millions of Malaysians.

Deaths or disabilities caused by modern medical care should not be readily accepted as matters of 'fate'. It is not fate but the failure of a system that was to provide us with a safe and effective treatment together with the best clinical practice. Nothing less.

Yes, modern healthcare may have saved many lives but it also may be harming millions of patients around the world each year. Excerpts from research carried out in the US, Australia and United Kingdom indicate the seriousness of the problem.

US � 783,936 patient deaths;

Australia � more than 400,000 adverse patient outcomes;

UK � more than 850,000 adverse patient outcomes in National Health Service hospitals alone.

Malaysian government hospitals treat about 48 million outpatient cases and 1,7 million in-patients (The Star, Dec 16, 2004) while private doctors see about 16 million patients (New Straits Times, Sept 8, 2004) a year.

'All of us in the health sector are aware that clinical risks and medical errors that infringe on patient safety do occur. The question is how many such incidents have occurred....,' said Dr Ismail Merican, the director-general of health (NST, Sept 5, 2004).

Why are such critical questions being asked by the 'guardians' of our healthcare system only now? Aren't medical errors or adverse patient outcomes as old as modern medicine itself? Is there a quota for medical errors before urgent and appropriate attention is given to rigorously safeguarding patients' rights and safety in Malaysia?

The Malaysian Medical Council has said previously that it '�is not ordinarily concerned with errors in diagnosis or treatment �" Then what has it been all this while? As the licensing authority and regulatory body of the medical profession, is it not the MMC's duty to safeguard the public's health through various disciplinary measures, systems, policies and procedures?

The Shipman Inquiry as well as the Review of Professional Indemnity Arrangements for Healthcare Professionals, amongst others, include many invaluable findings and recommendations for making meaningful quality and safety improvements to the healthcare delivery system as a whole.

I am sure our Health Ministry could easily adopt many of the recommendations to further strengthen its rather 'weak' patient protection measures without further delay. This could be carried out immediately while we all await an independent body to conduct a transparent study to answer the director-general of health's question above.

Although, The Patient Safety Council of Malaysia was approved by the cabinet in January 2003, what has it achieved to date? Is it still standing at only having two meetings? And what about the long awaited Private Hospital Facilities and Services Act 1998?

The Health Ministry must also be absolutely open and transparent with the public regarding all issues that concern public safety and its well-being.

We have left our health in the hands of modern healthcare for far too long and have allowed it to dictate our lives. We need assurance that we are not being treated with many dangerous and unproven medicines or medical care which could have serious and fatal 'side-effects.'

We need an effective, transparent and responsible regulatory system that has the interests of the public at heart. We need it now.
Comments




Article 18 : Probe Integrative Medicine.

Probe Integrative Medicines dramatic claims

L-F Ng
4:25PM Dec 14, 2005

In medical practice, when a treatment is effective, it outshines other competitors - real and bogus - and does not evoke any controversy. When something is dubiously or marginally effective, then practitioners have a duty to their patients to ensure that what is proposed is truly beneficial and that, if given the benefit is quantifiable, this should be weighed against the potential known adverse effects.

The Hippocratic principle of primum non nocere (first, do no harm) has been ringing through in the hearts of ethical registered medical practitioners throughout the world for ages and on this rests the imperative ethical difference in attitude between a registered and an non-registered medical practitioner. But, within modern medicine this divide has become somewhat blurred.

This is made worse in some modern, developing societies by medical practitioners of dubious quality being allowed to be registered. In such environments, doctors have to be wary of some of their colleagues and the methods they use. This is also further made more muddy by the commercialisation of medicine with a pure profit motive being foremost in the mind of a registered practitioner.

Dr Mohd Ebrahim Sulaiman, a Klang Valley-based private practitioner, has made some substantive and tantalising claims alluding to treatments which have been untested, or tested negatively within randomised controlled trials, and which are not in the data bases of evidence-based medicine - principally the Cochrane Library.

He also claims that the Health Ministry had given him permission to treat thousands of patients who had been 'written off' by heart and cancer specialists. A good randomised controlled trial is the only scientific way to test a superiority (or non-inferiority, i.e. equivalence) of a new treatment and the design is tightly controlled with an up-front declared required number of subjects to be recruited and statistical methods prospectively planned.

In some designs, placebos are tested against the purportedly beneficial treatment. One or several patients benefitting with the study treatment may be quite meaningless - as this may just represent a placebo effect. Just as with the saying that 'one swallow does not make a summer.'

Dr Anantha Krishnan's call for consideration of integrative medicine strategies to be incorporated is welcome but only with the caveat that such interventions will need systematic rigorous testing using established methods used in evaluating new and established therapies. Otherwise, they will not withstand the test of scientific credibility.

Similarly, if the methods described by Ebrahim do work, the world of peer-reviewed evidence based medicine would have discovered it too and evaluated it critically and published results for the benefit of humankind. But, the sad fact is that this is untrue.

Ebrahim (also known as Dr Maung) had created an uproar in a professional bulletin board by his claims in the second half of the 1990s. This was stimulating and superficially appealing when gleaned over by the uncritical scientist or practicing clinician.

In 1999, when I was based in Kuala Lumpur, I challenged Maung (and offered intellectual support to test his enthusiastic hypothesis), in my capacity as a consultant medical oncologist, to design and conduct a randomised clinical trial to prove or disprove his claims. He was unable or unwilling to do so.

Dr Maung even contacted me by telephone to discuss the design and insisted on incorporating a large heterogenous (biologically very different) mix of heart and cancer patients in the trial design - a strategy which I rejected for obvious reasons and the issue was dropped.

The closed debate in the professional forum continued for a while and when Maung became so heated that he threatened to sue another critic in that closed forum, he was expelled from that bulletin board by the administrator. All this can be all verified by the administrator of Malaysian Medical Resources (previously known as Dobbs or Doctors Only Bulletin Board System).

If we assume that Maung's present claims are not misleading and completely true, it would be a distinct benefit for the world of medicine - not in Bolehland alone. If however, he has made premature, misleading and unwarranted claims then the Malaysian Medical Council and the Health Ministry should now awake from their slumber and conduct detailed inquiries. They should also register and monitor all health interventions which have potential to cause harm (even economic harm) whether they are allopathic or alternative.

The gullible public needs real answers and any dramatic discovery needs to be encouraged while a hoax quickly extinguished and eclipsed as with all other snake oils. I am particularly interested in the validation of the claim on how the ministry gave permission to Maung to treat his patients.




Article 19 : Don’t be too quick to Judge integrated medicine

Don't be too quick to judge integrated medicine

Dr Mohd Ebrahim Sulaiman
4:12PM Dec 19, 2005

May I refer to the letter Probe integrated medicine's dramatic claims by LF Ng.

Yes I have claimed some success in bypassing the bypass heart surgery and in some cases, cancer stopped and reversed from the late stages. During the course of my integrated medicine approach to treatment, I have always advised these patients to follow-up with their specialists and never to stop taking the medications prescribed to them.

I have treated many stage three and four cancer patients who were treated with chemo and radiation and sent back home with morphine. Many of these hopeless cases came to me in tears after their money was drained off by their oncologists leaving them with nothing much to pay for my treatment. I accept such cases and help them in part or full even though most medical insurance do not cover my treatment of them.

These patients came to me recommended by other patients. I had to do what I could to help them, money notwithstanding. Is Ng advising me to reject them when I see there is still hope? Should I throw away compassion? Is it ethical? I have documents to prove my patients' recovery. Why these closed minds and the need for proof when the end result speaks for itself. The pervading suspicion allopathic doctors have that those giving complementary treatment are charlatans, quacks and bogus operators is highly unfair.

If there is a credible cure which could be replicated with good results with little or no adverse side effects, then the patient should be afforded such treatment especially if no other better alternative exists. Even if one patient can benefit � placebo effect or not � it is better than to let him die. It is better than waiting years for large funds and willingness to carry out the necessary trails by which time the patient would have succumbed to the disease. If improprieties exist, let the law take its course. But please, do not allow patients to suffer because of rigid institutionalised technicalities.

After learning integrated medicine from the American College for Advancement in Medicine and the Palmetto Richland Memorial Hospital (University of South Carolina) in the US, I have equipped my clinic (with the permission of the Health Ministry) with modern medical equipment for healing worth millions though there are very little returns to pay off my bank loans.

However, I am happy to serve and sacrifice for mankind. As a family physician at this age of 69, my only hobby, aim and objective is to heal mankind.

I don't see any capacity of doing double blind randomised placebo studies in Malaysia on this matter because it involves millions of ringgit. The US National Institute of Health at present has launched such research works which is costing them US$30 million.

And since Ng has pointed it out, yes I remember. I was discriminated, ridiculed with slander and libel and expelled from Dobbs (Doctors Only Bulletin Board System) when I stood firm on my faith and declared my success in integrated medicine. The fact that I could not carry out randomised controlled trials does not diminish the efficicacy of my treatments as proven by my patients' successes. It has not deterred me from continuing my practice.

Please do not misunderstand me. I am not after the oncologist's or other specialist's rice bowl. I don't claim that I am oncologist. I treat my patient's whole body as a family physician to heal whatever disease they are suffering from.

Ng may refer to the Universiti Hospital in PJ on how I got permission from the well-known professor prior to my treatment of his cancer patient. He was a very humble, polite and highly professional and open-minded oncologist who even thanked me for treating his patient who is at present surviving for more than one year by integrated medicine. I still send the patient back to see the professor for follow up assessments.

I try to lie low with humility and ask permission for every aspect of my practice. I have nothing to hide. Nothing is perfect and I have nothing to lose in trying to help as many patients as I can.

I have written letters with good faith to the director-general of health, the health minister with copies to the prime minister about my successes in integrated medicine. I also requested the ministry to investigate and possibly integrate such therapies into hospitals especially those remote areas in order to help the poor who cannot afford expensive medical treatment.

Dr Ng and his associates, too, are most welcome to visit my medical centre with an open mind.
Comments




Article 20 : Culture of Corruption within FDA Big Pharma

Culture of corruption has become common within FDA, Big Pharma

Sunday, April 22, 2012 by: Ethan A. Huff, staff writer

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(NaturalNews) When pharmaceutical drugs and medical devices are approved for use in medicine by the U.S. Food and Drug Administration (FDA), their safety and efficacy are typically not the primary factors considered during the decision-making process. As pointed out by the Office of Medical and Scientific Justice (OMSJ), the FDA and the drug industry are both now dominated by cultures of corruption that put profits before patient safety in almost every instance, which means that a steady stream of deadly drugs and medical devices continues to flood the market.

Going as far back as the 1950s -- and likely even much earlier than that -- the FDA has made it routine practice to ignore and even deny the dangers associated with drugs and medical devices when approving them. In the case of the Upjohn Company, for instance, which unveiled the antibiotic drug Panalba back in 1957, the FDA ignored many years of complaints about the drug's safety in order to protect the company's profits.

At the time, data showed that as many as 20 percent of patients taking Panalba had suffered severe allergic reactions to the antibiotic, and yet the FDA did nothing. Even Upjohn's own research studies on Panalba showed that the drug was less effective and less safe than alternative drugs on the market, and still the FDA did nothing, effectively sheltering Upjohn's enormous profits from Panalba, which represented 12 percent of its overall profit earnings.

Sadly, the same is true today, as the drug industry and the FDA essentially work in tandem to get dangerous, but highly-profitable, drugs and medical devices to market. It is a win-win situation for both groups as the FDA gets kickbacks in the form of exorbitant new drug and medical device application fees, and the drug industry rakes in billions of dollars for blockbuster drug and device products that would never have been approved had science and facts been legitimately factored into the equation.

FDA's culture of corruption promotes social irresponsibility in all areas of food and medicine
Because the FDA so easily capitulates to the demands of special interests, the food and drug industries have largely become purveyors of social irresponsibility. Back in 2009, the FDA's own scientists came forward and admitted that they are routinely threatened by their superiors to cover up unfavorable study data, and basically promote "corrupt and distorted" information to the public -- and this same type of trickle-down deception is inherent within food and drug firms as well (http://www.naturalnews.com/025827_scientists_FDA.html).

A study conducted back in 1977 by researchers from Penn State University (PSU) revealed that the vast majority of people, when put in such situations by their superiors where they are expected to lie, simply cave to the pressure and comply. Embodying the scenario that has evolved at the FDA and throughout the drug industry, the report explained that:

"[...] ordinary people, simply doing their jobs, and without any particular hostility on their part, can become agents in a terrible destructive process. Moreover, even when the destructive effects of their work become patently clear, and they are asked to carry out actions incompatible with fundamental standards of morality, relatively few people have the resources needed to resist authority."

And this is the situation many lower-level workers in government and industry find themselves in today. Will they have the courage to resist the pressure to commit acts of immorality that serve the voracious greed and malice of their superiors? Or will they just defy their consciences and obey their overlords, claiming all the while that they are "just doing their jobs?"

Sources for this article include:

http://www.omsj.org

http://www.naturalnews.com/FDA.html

Learn more: http://www.naturalnews.com/035641_corruption_FDA_Big_Pharma.html#ixzz2LWXY9t46




Article 21 : Health is a rule disease the disease perception.

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Health is the rule, disease the exception Medical errors need to be checked, monitored.



Prof Dr Anantha Krishnan
3:02PM Nov 25, 2005



I read with profound interest the letter entitled Medical errors need to be checked, monitored.

There is definitely an increasing concern with regards to some major pitfalls in medicine and drug therapy, which is popularly known as allopathy. Its setback lies in its submission to the mechanistic worldview of Cartesian Newtonian Science which has dominated the Western scientific thought.

The limitation of the mechanistic view is that it is trapped in the molecular theory of disease causation, which has become the investigative instrument for biomedicine to explore the cause of diseases leading to the reductionist view of the pathophysiology of disease states.

Trapped in this limited physical perception of disease, all forms of therapy, especially chemical drug therapy, were developed with the view to alter the pathophysiology that seemingly caused the disease. Since the beginning of the development of drugs in the late 19th and early 20th century, drug therapy has become the all purpose treatment for various forms of diseases including infection and physiological disorders such diabetes mellitu, hypertension etc.

While one should acknowledge the great contribution of western biomedical medicine in the field of surgery and trauma care, it has not proven effective without untoward or damaging side effects but as far as metabolic and physiological diseases are concerned. But the chemical drug industry is growing in leaps and bounds, creating new drugs, using the drug receptor technology of pharmacology.

The dangers and the long-term damage of drugs has to be addressed more seriously, But with the trillion dollar drug industry reaping astronomical profits, the biomedical scientific community has become the indirect proponent of this industry, confined and trapped in the mechanistic view of the human life form and caught in the fast-moving chemical drug industry track.

Prescribing the drugs produced by the pharmaceutical companies has been the game of the biomedical doctors whose vision has been obscured by the molecular theory of disease causation. In many ways they are beyond help, subtly controlled by the business strategy of these medical drug barons. They chemically medicate the people who seek treatment, and create a huge medicated population instead of a healthy population.

A medicated population is at a great risk to develop side effects which will weaken the body and make them more vulnerable to diseases. If the biomedical medicine fraternity do not want to think out of the box, become more open to new treatment modalities, or do not venture into research into natural and integrated medicine, they will continue to do significant harm, especially when the global population greys and relies heavily on chemical drugs to maintain the quality of health.

New areas must be explored, their investigating instruments and methods must be revised, a more quantum or cosmic approach to human existence must be studied and new safer modality utilised for human wellness. One area that must be vigorously explored is natural medicine. Since man is essentially a product of nature, nature must be the best teacher and guide for human health.

Integrated therapeutics, which bridges the gap of allopathy with natural and alternative medicine must be another new ground to be explored for when effectively combined with natural therapy, through integrated formulae, the content of chemical drugs can be significantly downsized and reduced up to 80 percent, thereby reducing side effects drastically without compromising on the clinical outcome. This then save the body from the damaging effects of drugs which are naturally not harmonious with the human body.

Integrated therapeutics will be the modality of the near future, the best of both worlds must be synergised to derive the maximum yet safest benefit to humanity. Today, allopathists and regulatory agencies will view this integrated medicine as illegal. But from the view of scientific progress, it will bring good benefit to patients who are tormented with the debilitating side effects of high dosage of medical drugs. More efforts should be put into the preservation of health, rather than disease and injury management, an industry which is over-developed compared to the health preservation industry.

Ironically, while 90 percent of the population are still not in the disease or injury state, only about 5 percent of the health budget goes for health preservation whereas the remaining goes for disease and injury management.

Unless healthcare leaders and decision makers move aggressively into health empowerment through intensive provision of knowledge on healthy living, we will not see a mega-leap in the improvement of the quality of human health. Taking care of one's own health is the birthright of every living soul. Appropriate knowledge on human health is the vital panacea for disease prevention. Health is the rule, disease is the exception.




Article 22 : Invasive procedures don’t prevent heart attack..

Invasive procedures don't prevent heart attacks
•Dr Mohamed Ebrahim Sulaiman
•3:44PM May 7, 2007

I refer to Ahmad Sobri's article Bypass grafting's edge over medical therapy. Allow me to first highlight that the writer is a surgeon and I am a physician.

My sincere request that the statistics regarding the morbidity and mortality rate (after surgical intervention) for coronary artery disease be revealed should not require any court order as Ahmad Sobri stated because there is nothing to hide from the public.

It should just be public health information. I don't believe that the matter falls in the domain of the Official Secrets Act or any other legislation.

Patients should be well-briefed about possible side effects and the consequences of surgical intervention prior to the invasive procedures.

Angioplasty (PTCA) or (PCI) is not superior to medical therapy. Bypass surgery, meanwhile, only eliminates anginal symptoms but does not prolong life or prevent heart attacks. After you put your life at risk on the operating table, the benefit is small. Therefore my presentation of Mass II trial was not out of context as stated. I quote:

"The big problem with angioplasty is that about 1 in 72 patients dies from the operation and twice that many from a bypass (concluded a recent summary from over 100 hospitals). The second problem is that neither operation prevents a future heart attack, none. This is because a bypass bypasses the problem, not solves the ongoing disease process, while ballooning/stenting only opens about 1/2 inch (1 cm) of an artery, and not the part that will cause a future heart attack.

"They are dangerous relievers of symptoms, such as angina, and for that they work well (for a while). Moreover, there are no studies that show a survival benefit from ballooning or bypassing apart from possibly the latter in a particular type of heart disease that is determined after you put your life at risk on the operating table, and the benefit is small. These procedures only treat the angiogram and not the vast majority of plaque which is buried in the wall but which can rupture and cause heart attacks."

Cardiologists say "Yes, we know that and we are relieving the symptoms" but why are so many done on people who are asymptomatic? And why all the 'screening' stress tests?

As a physician, I strongly believe we must think of in terms of Putting That Catheter Away (PTCA).
Comments




Article 23 : Doctors stop confrontation. .Doctors , stop the confrontation.

Doctors, stop the confrontation


Dr MS
2:11PM Dec 22, 2005


I refer to the current debate on the practice of integrative medicine. Why should there be any confrontation between medical doctors who strictly confine themselves to the practice of routine orthodox conventional medicine which revolves around pharmaceutical drugs and those that combine conventional practices with complementary medical practices?

The latter are also medical graduates who made the extra effort of studying alternative medical modalities, spending a fortune to acquire the knowledge and the equipment. The question that I would like to raise is this - why the need to question?

Lets save the flamboyant arguments for keeps sake. If a doctor is using procedures that threatens life then the patient is at liberty to pursue with legal action. At the same time, patients are free to decide if they want to receive any specific form of therapy.

Doctors shouldn't be quarreling over this subject matter at all. The World Medical Association's Declaration of Helsinki has developed a set of ethical principles for doctors worldwide. I quote Ethical rule No 32:

"In the treatment of a patient, where proven prophylactic, diagnostic and therapeutic methods do not exist or have been ineffective, the physician, with informed consent from the patient, must be free to use unproven or new prophylactic, diagnostic and therapeutic measures, if in the physician's judgment it offers hope of saving life, re-establishing health or alleviating suffering".

The above is self-explanatory and should compel doctors from quarreling any further on this matter.

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Article 24 : Never think of Bypass again by doctor from India.

NEVER THINK OF BYPASS AGAIN
Alternative to Bypass Surgery


- For heart, peripheral artery disease, cerebral ischemia, detoxification, etc.
CHELATION THERAPY
Welcome to the educational and information website
Chelation therapy is a slow intravenous therapy to prevent, slow the progression and treat Angina / Chest pain, heart attacks, cardiovascular disease, atherosclerosis (hardening of arteries), Coronary Artery Disease, peripheral vascular disease (leg pain and gangrene), scleroderma, and other age-related and degenerative diseases. Chelation. It is ideal prior to angioplasty with or without stent or bypass surgery and lifesaving for patients unfit for bypass, with failed bypass, recurrence after bypass and for those who do not want or cannot afford bypass and for patients who have no other treatment option to increase blood flow and detoxifies throughout the body.
There are very few doctors who practice this therapy in India, even though it is very popular in the Western countries. Dr Sibia, trained at Arterial Disease Clinic, UK and a member of American College for Advancement in Medicine (ACAM) introduced the therapy in the region in 1994. We follow the protocol recommended by ACAM. Sibia Medical Centre has successfully treated thousands of patients using amazing non-invasive non-surgical treatments from all over India and over thirty countries.
About the website: Information presented on this website is for education and information. Links to published scientific data are provided where possible. Total agreement is rare in any field and it is fully expected that the information will be contradicted by other medical authorities. Even though Chelation Therapy is a patient proven therapy, its not main stream as the majority of professional may have their own agendas due preconceived notions, bias, lack of awareness, lack of experience, commercial interests, etc. The best way to know the truth is to read the science behind the treatment and not individual opinion and to meet treated patients.
Special thanks: To Dr. Elmer M. Cranton, M.D., Dr Gordon, Dr. Tarsem Garg, Mr. John Buckley and all others who have directly or indirectly taught us the art and science of Chelation Therapy.
Disclaimer: We thankfully acknowledge and claim no copyright for the information obtained from other sources. Material from this website may be freely distributed in public interest, without profit and without editing for educational and research purposes − but not for sale or marketing purposes. Credit to the original source and an acknowledgement will be appreciated,
This information is not a substitute for medical evaluation, opinion and treatment and it is strongly advised not to change any current medications or treatments without personally consulting a qualified and licensed health care professional.

"All surgery should be preserved for patients with crippling disease who do not respond to more conservative treatments and we should think of surgery only when all other safer treatments fail."

Dr Sibia, Father of Chelation Therapy and India's pioneer in no-surgery treats since1991.


Dr. Abdul Kalam, President of India
"Ideal practice should be to provide only the minimum essential treatment instead of going in for surgical intervention as a routine management."
SEE DR Sibia website




Article 25 : MMA is Not against Alternative medicine.

Tweet - CARTOONKINI MMA not against alternative medicine


Dr Lee Yan San
7:54AM May 13, 2003



I was brought to the notice of the letter 'MMA, stop misleading public o­n alternative health-care', and was rather amused by it. It looks to me like it was written by a very angry person who felt very threatened by what Malaysian Medical Association is trying to do.

Let me assure him that MMA is not against alternative medicine, but just wanted some control similar to what allopathic doctors are getting to prevent people who want to make a quick buck and take advantage of the public's trust in alternative medicine.

Traditional and complementary medicine certainly have a role to play in our health-care system but those who practise them must be qualified in their field of practice and ethical in their practice.

We have often come across complaints of abuse including false and over claims as well as adulterated alternative medicines and the use of some unproven gadgets. Some practitioners of alternative medicine even use gadgets such as stethoscope they are not trained to use just to impress their customers.

Recently, such businessmen are also very quick in taking advantage of situation like the present severe acute respiratory syndrome (Sars) scare. Unfortunately, some of these unscrupulous people prey o­n the terminally ill. I represent MMA to the Health Ministry committee o­n traditional/complementary medicine. We are working towards integrated medicine and strict, but fair control, of alternative medicine to benefit our population.

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Article 26 : T/CM and Health DG..

MALAYSISKINI ENGLISH | B.MALAYSIA | 中文版 | தமிழ் FIND US | HELP | SEARCH | JOIN US | ABOUT US | ADVERTISE | E-COUPON | RENEW | SUBSCRIBE NOW . MaLAYSIAKINI LETTERS
Traditional medicine: what's the health DG's stand?
Dr Hj Mohd Ebrahim Sulaiman | Apr 24, 08 3:55pm
It is clearly written in the Health Ministry guidelines that Integrated Medicine is allowed in our healthcare system. I quote:
‘The Ministry of Health Malaysia in 2001 defined T/CM (Traditional/Complementary Medicine) as practices other than that of Medicine or Surgery, by registered medical practitioners as defined in the Medical Act 1971.’ - Malaysian Medical Council, Ministry of Health Malaysia (2001).
I understand that the above official guideline permits registered medical practitioners to practice T/CM integrated with the conventional medicine provided they are properly trained in that specialty.
That matter was clarified by Dr Sulaiman Mohamed, the previous deputy health minister of health as well as MS Pillay, the ministry’s deputy director-general and Dr Ramli Abd Gani who is the head of the ministry’s TCM Division in that registered practitioners are allowed to practice T/CM as under the Medical Act 1971and we were encouraged to go ahead with our integrative practice.
As a chapter leader of the Medical Practitioners for Complementary Therapies (MSCT), I have conveyed this message to our members and they are very happy. And trusting this information and by referring to the MOH website, many doctors started investing heavily in their practice set- up.
But on April 19, at a symposium on evidence-based complementary medicine by the Malaysian Medical Association, the Health Director-General said something quite different and shocking. He explained that registered medical practitioners are not allowed to practice T/CM and that they must chose one type of practice - either T/CM or conventional therapy!
Such a statement is against the above 1971 Medical Act and the Health Ministry’s own national policy and not to say, is misleading to all of us. Further, Dr Ismail Merican ridiculed T/CM.
It would seem that the DG is biased against T/CM and does not seem to have taken into account guidelines which have been institutionalised. As such there is a lot of anger, confusion and worry amongst our members.
I believe that in this politically-stable and law-abiding country, all government officers should follow, respect and abide existing law such as the 1971 Medical Act quoted above.






Article 27 : Don’t separate chelation form Conventional medicine.

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Don't separate chelation from conventional therapy


Dr Haji Mohd Ebrahim Sulaiman
5:43PM Nov 5, 2009


I believe that one day all doctors will accept chelation therapy especially the next-generation doctors because those who are endowed with knowledge and experience will stand firm on the truth about the good results of chelation therapy.

I thank Health Ministry Directo-General Dr Ismail Merican for considering chelation therapy to be regulated by the proposed Traditional and Complementary Medicine (TCM) Council.

Chelation therapy has been taught by the American College for Advancement in Medicine and the International Board of Clinical Metal Toxicolog. These organisations are not TCM outfits. They are teaching advanced medicine which have not yet been introduced in the medical colleges.

Yes, it is true as Ismail stated, that chelation is popularly used in many countries including Thailand which has invited us to attend their first conference on chelation therapy. Such conferences and written tests were conducted in Kuala Lumpur in 2005 and in Singapore in 2008.

The purpose of my writing is to suggest that chelation in not a TCM discipline. I have presented a paper on chelation therapy before Health Ministry officials in 2008 and at the end my presentation, a senior officer remarked that he will submit chelation therapy as conventional therapy and not TCM.

It is important to integrate chelation and not to separate it from conventional therapy. Some doctors who are not trained in vitamins, supplements and chelation therapy will usually dismiss these health aids and confuse the patients.

This dismissive attitude shortchanges patients because today so much scientific evidence validates the potentially lifesaving benefits of many nutritional supplements. On the other side of the medical practice spectrum, doctors who offer only alternative therapies to patients with very sick hearts may be foolishly denying them the full range of effective conventional care.

Patients are naturally always looking for less risky alternatives. But based on the condition of the patients, the practitioner must integrate because conventional or alternative therapy alone may represent misguided medicine.

For example, a patient having acute myocardial infarction or third degree heart block, or stage four NYHA failure must be in an ICU - not in a chelation centre. Smart medicine does not choose sides.

The existing law – The Medical Practitioners Act 1971 allows registered medical practitioners to practice integrative medicine and this has been defined and institutionalised by the Malaysian Medical Council.

Chelation therapy also has side effects like hypotention, hypocalcaemia, hypoglycaemia, hypokalaemia, brady cardia, negative inotropic action on the heart muscle leading to heart failure, kidney failure, allergy to ingredients etc..

Chelation solutions must be prepared as TPN (total parentral nutirion) under strict aseptic sterilsation and must be accurately measured with proper medical history and investigations.

Otherwise the patients will suffer. Such was the recent case of one doctor who had one infusion of chelation therapy on herself from a clinic and phoned me to say that she could not get up and go to work for 12 days. The doctor must be properly trained and qualified to do chelation. It took three years for me to get Diploma in chelation from ACAM /IBCMT USA.

Therefore I would like to suggest, as I have submitted to the Health Ministry, that chelation should not be separated from conventional therapy and should be practiced as integrative medicine but only in the medical clinics and hospitals under the supervision of registered medical practitioners trained and qualified to administer chelation therapy for the safety of the patients.




Article 28 : For heart attack what treatment to choose?

For Heart attack… what types of treatment you should choose?
Untuk serangan jantung… apakah jenis rawatan yang anda harus pilih?
1. For acute heart attack you must be in hospital to get the treatment. (ICU)
Untuk serangan jantung akut anda harus berada di dalam hospital untuk mendapatkan
rawatan. (ICU)
2. Angiogram has side effect like death, stroke, kidney damage, blood vessel damage. So it
should not be done as a routine test.
Angiogram mempunyai kesan – kesan sampingan seperti kematian, angin ahmar
(lumpuh), kerosakan buah pinggang,kerosakan salur darah. Jadi ia tidak sepatutnya di
lakukan sebagai satu ujian rutin/harian.
3. Angioplasty and stent will not last for a long time. The stent will block again and stent
cannot be removed once it is inside your body.
Angioplasty dan stent tidak akan berkesan untuk jangkamasa yang panjang. Stent juga
boleh tersumbat kembali dan stent tidak boleh di buang atau di keluarkan dari badan
sebaik ia di dalam badan anda.
4. Bypass surgery is not permanent cure, it is just to relieve the pain. It does not prevent heart
attack. The risk is very high and the benefit is small.
Pembedahan pintasan bukanlah satu rawatan penyembuhan yang kekal, ianya hanya
untuk mengurangkan kesakitan. Ianya juga tidak dapat mengelakan atau mencegah
serangan jantung. Risikonya adalah sangat tinggi dan kebaikannya adalah kurang.
5. External counter pulsation (ECP) and Latest advanced Medicine is 80 to 90% effective
and will last for 3 to 5 years without serious side effects.
ECP dan Rawatan Lanjutan Terkini di dapati berkesan sehingga 80 ke 90% dan boleh
bertahan selama 3 hingga 5 tahun tanpa kesan – kesan sampingan yang serius.
Take your time, study carefully about the options in the websites.
Ambil anda masa dan mempelajari dalam laman website tentang pilihan.
Then you decide whether you want No. 2 to 4 or No. 5 (ECP and medicine).
Kemudian anda tentukan sama ada anda mahu No. 2 hingga 4 atau No. 5 (ECP dan ubat - ubatan).




Article 29 : Complementary Medicine First.
Complementary Therapy: Make it first option in hospitals. NST On line letter Tuesday May 08, 2007, 05.03PM By DR MOHD EBRAHIM SULAIMAN, Kuala lumpur.

Complementary Therapy: Make it first option in hospitals.
By DR MOHAMED EBRAHIM SULAIMAN , Kuala lumpur.

I refer to Professor Dr Mohamed Mackeen's report (Open heart mind and soul" -NST , April 1) on spiritual health care and the complementary system of health therapies under the regulatory control of the Malaysian Society for Complementary Therapies.

I would like to share my experience in treating angina pectoris (coronary heart disease)though what I have to say may become a focus of controversy among heart specialists.

Heart disease is the NO. 1 killer in the world and this is also true of the health situation in Malaysia. For people who experience chest pains, a series of tests, such as the electrocardiogram, Angiogram and tress test, can be done to check for blockages in the blood vessels of the heart.. If the arteries are found to be blocked, then invasive procedures such as angioplasty, stenting or Bypass surgery may be recommended.

All these procedures are only temporary relief measures and the invasive procedures are not free from side effects.

Recent studies in the United States (MASS II trial) Medicine, Angioplasty, Stent, Surgery trial concluded after a survey in more than 100 American Hospitals that one in 72 dies from Angioplasty and twice as many from undergoing bypass surgery.

My wife had an emergency bypass surgery in 1991. But her arteries were blocked again in 1996. A second bypass was not recommended.

I treated her using alternative medicine such as chelation therapy, supplements and external counter pulsation machine (ECP) therapy, which is approved by US food and Drug Administration.
Now she is well and living a normal life free from chest pain.

I have also treated many other patients with chelation therapy since 1996 and other patients with ECP therapy since 2002.. They were 90 percent successful, without any side effects.

I am not against any doctor or Cardiologist. it is my duty to convey to the public and the relevant authorities the message that there are alternative methods to treat coronary heart disease. The chelation and ECP treatments cost much less than other treatments and they are also safe and effective.

It is good news that the health Ministry has approved traditional and complementary medicine (even Chinese herbs) to be integrated into Government Hospitals from this year.

I request that our evidence based , successful alternative therapies be also considered for integration into these hospitals.

This will definitely reduce the cost of health care in the country. Chelation and ECP therapy do not harm to any of my patients and world wide.

Therefore it makes sense to apply such non-invasive therapy as a first line of treatment for Coronary artery disease before switching to more expensive and risky invasive
procedures which should be considered as a last resort.
Current rank : 5.0 (5-High 1-low)

Further comment: Ofcourse some puppets like Quack watchers will always point out some kind of false accusations and condemn and sabotage every kind of alternative therapies, it is their job and they are well paid for it.. Actually they have no knowledge or experience in the subject concerned.The best way to know the truth is to read the science behind the treatment and not individual opinion and to meet treated patients.


Comments from India:
"All surgery should be preserved for patients with crippling disease who do not respond to more conservative treatments and we should think of surgery only when all other safer treatments fail."

Dr Sibia, Father of Chelation Therapy and India's pioneer in no-surgery treats since1991.


Dr. Abdul Kalam, President of India
"Ideal practice should be to provide only the minimum essential treatment instead of going in for surgical intervention as a routine management."
SEE DR Sibia website.




Article 30 : Trial to Assess Chelation Therapy (TACT)
Trial to Assess Chelation Therapy (TACT) showed chelation reduce the risk of heart attack.

Chelation therapy doesn’t alter quality of life in heart attack patients American Heart Association Late-Breaking Clinical Trial Report - Embargoed until 6:02pm PT/9:02pm ET
November 04, 2012
Study highlights:

Patients’ daily functioning and sense of mental well being remained the same while receiving chelation therapy
The weekly infusions, which remove metals from the blood, had no impact on patients’ ability to care for themselves or on their feelings of well being or stress
The new study examined more than 900 patients enrolled in the larger, overall TACT trial which found that chelation therapy reduced risk of some cardiac events.

LOS ANGELES, Nov. 4, 2012 — Chelation therapy didn’t change the ability to perform daily tasks or impact the emotional well being of patients who previously suffered a heart attack, according to late-breaking clinical trial research presented at the American Heart Association’s Scientific Sessions 2012.
Comments: Emotional well being is not important.The research was done to test its effect on CAD heart disease Is quality is more important. Look! It is better than Angioplasty, stent and Bypass surgery because chelation cut the risk of death, second heart attacks, stroke and the need for surgery. That is very good enough. What is quality of life compared to the above findings? See the way it is written! The test is on CAD not on quality of life. The quality of life has been damaged by CABG. It was said, that there was no impact on patient’s quality of life in this sub-study although the overall Trial to Assess Chelation Therapy (TACT) showed chelation therapy cut the risk of death, second heart attacks, stroke and the need for heart procedures among some patients who already suffered an earlier heart attack. It cannot be denied that
Bypass surgery and angioplast and stent do not have such qualities.




Article 31 : Chelation trial results come under fire.


Nature News Blog
Chelation trial results come under fire

07 Nov 2012 | 11:04 GMT | Posted by Ewen Callaway | Category: Biology & Biotechnology, Health and medicine

Wikimedia Commons

A controversial clinical trial has revealed that chelation therapy slightly reduced the risk of heart attacks and other heart problems. The results of the trial were presented at the annual meeting of the American Heart Association in Los Angeles, California.

Leading researchers questioned the US$31 million study’s findings because, they say, many enrolled patients dropped out of the trial and factors besides the chelation treatment could explain why some patients appeared to benefit.
Comment:
May be sabotaged. Many critics , Cardiologists and quack watchers become constipated and surely sabotage chelation therapy. It seems they get diarrhea of the jaw bones whenever confronted by the word chelation.FDA will never approve because FDA is paid by Pharmaceutical to protect the industry.The failure or incomplete trials by the American authorities on the efficacy of chelation therapy is not surprising given the strong FDA lobby. The public is the loser. So the controversial scientists did the research on 911 patients and found to be sucessful. For me no trial is necessary, my experience of 17 years of practice in chelation on thousands of patients is enough evidence / proof for me and my patients.




Article 32 : New research with positive results from Chelation therapy.

Scientist’s (TACT) study had proven in Nov 2012 that Chelation cut the Risk of Heart attacks, prevents Heart attack, stroke and the need for surgery after NIH halted $31 million chelation trial in 2009. By Dr Hj Mohd Ebrahim Sulaiman, Kuala Lumpur.
Dear Sir,
I refer to http://blogs.nature.com/news/2012/11/chelation-trial-results-come-under-fire.html 7 Nov 2012. Chelation therapy proven to reduced risk of heart attack and
http://newsroom.heart.org/news/chelation-therapy-doesn-t-alter-240495.
Trial to Assess Chelation Therapy (TACT) showed chelation reduce the risk of heart attack.
Chelation therapy doesn’t alter quality of life in heart attack patients.
American Heart Association Late-Breaking Clinical Trial Report - Embargoed until 6:02pm PT/9:02pm ET November 04, 2012 Study highlights:

Quote “Patients’ daily functioning and sense of mental well being remained the same while receiving chelation therapy.
The weekly infusions, which remove metals from the blood, had no impact on patients’ ability to care for themselves or on their feelings of wellbeing or stress.
The new study examined more than 900 patients enrolled in the larger, overall TACT trial which found that chelation therapy reduced risk of some cardiac events.
LOS ANGELES, Nov. 4, 2012 — Chelation therapy didn’t change the ability to perform daily tasks or impact the emotional well being of patients who previously suffered a heart attack, according to late-breaking clinical trial research presented at the American Heart Association’s Scientific Sessions .”
The report is biased and high lighted in such a way to wards the negative expression: Emotional well being is not important. The irreversible emotional sufferings were due to brain damage caused by surgery. One must not forget that saying, “You will be elated if you are chelated”. The quality of importance is life saving results which are more important. Look! It is better than Angioplasty, stent and bypass surgery because chelation cut the risk of death, second heart attacks, stroke and the need for surgery. That is good enough. What is emotional quality of life compared to the above findings? See the way American heart Association has interpreted negatively , reluctantly and deceiving. Some thing fishy. More important findings should be elaborated and stated positively.
Quote”There was no impact on patient’s quality of life in this sub-study although the overall Trial to Assess Chelation Therapy (TACT) showed chelation therapy cut the risk of death, second heart attacks, stroke and the need for heart procedures among some patients who already suffered an earlier heart attack.” Bypass surgery , angioplasty and stent do not have such qualities.
Chelation trial results come under fire.
Nature News Blog
Chelation trial results come under fire.
07 Nov 2012 | 11:04 GMT | Posted by Ewen Callaway | Category: Biology & Biotechnology, Health and medicine.
Wikimedia Commons. :
Ref: http://blogs.nature.com/news/2012/11/chelation-trial-results-come-under-fire.html 7 Nov 2012.
Quote”A controversial clinical trial has revealed that chelation therapy slightly reduced the risk of heart attacks and other heart problems. The results of the trial were presented at the annual meeting of the American Heart Association in Los Angeles, California.
Leading researchers questioned the US$31 million study’s findings because, they say, many enrolled patients dropped out of the trial and factors besides the chelation treatment could explain why some patients appeared to benefit.”

NIH abandoned $31 million trial on chelation in 2009.The trial was not successful either because Americans did not like to take the risk of taking placebo for heart conditions since they can afford $100 for chelation therapy and went for the real chelation.. Or May be sabotaged by the gangs of critics.. FDA will never want to approve because FDA is paid by Pharmaceutical to protect the industry not patients. For me scientific trial is not necessary. My experience of 17 years of practice in chelation is enough evidence / proof for me and my patients. The above results are true and good enough for all right thinking people to understand chelation. The best way to know the truth is to read the science behind the treatment and not individual opinion and to meet treated patients.
I made a call in a letter to the NST –Quote “ Complementary Therapy: Make it first option in hospitals. NST On line letter Tuesday May 08, 2007, 05.03PM By DR MOHD EBRAHIM SULAIMAN, Kuala lumpur. I requested that our evidence-based, successful alternative therapies be also considered for integration in the Government hospitals. This will definitely reduce the cost of health care in the country. Chelation and ECP therapy do no harm to patients.”
Chelation therapy is proven to cut the risk of death, second heart attacks, stroke and the need for heart procedures among some patients who already suffered an earlier heart attack. Bypass surgery , angioplasty and stent do not have such qualities. I miss my old friend Dr LF Ng and quack watcher PALMDOC and other opponents and I invite them for chelation therapy for their wellness.
I request the Ministry of Health Malaysia to accomplish what DG Health Tan Sri Dr Ismail Merican had said, “ that the Ministry’s TCM division has already inspected the seven known clinics (At present more than 25 clinics ) offering the treatment and its director has talked to Insurance companies---- which will start considering coverage for chelation once the Act is gazetted. “Ref: Chelation coming in from the cold : Health NST 2009/10/26 by ANNIE FREEDA CRUZ and SANTHA OORJITHAM.
Berkhidmat untuk Negara.
Dr Ebrahim: email: drmaung@hotmail.com





Article 33 : Chelation coming in from the cold.
By DG Health-Tansri Dr Ismail Merican

HEALTH: Chelation coming in from the cold?
2009/10/26 ANNIE FREEDA CRUEZ and SANTHA OORJITHAM

The treatment has been used since World War I to remove heavy metals from the bloodstream. Will it be accepted here as a treatment for heart and circulation problems as well? ANNIE FREEDA CRUEZ and SANTHA OORJITHAM find out.

DOCTORS offering chelation therapy claim that it acts as an antioxidant and anticoagulant, removes toxic metals, reduces blood pressure and makes blood vessels more elastic.

Cardiologists and other “evidence-based” practitioners dismiss it as an “alternative” treatment that is a waste of money at best, and harmful or even fatal at worst (although chelation specialist stress there has only been one death, caused by overdose).

But their differences could be resolved after the Traditional and Complementary Medicine (TCM) Bill is tabled in Parliament – possibly by the end of the year.

Once the Bill is passed, the Health Ministry plans to set up a TCM Council (similar to the Malaysian Medical Council) to register and regulate practitioners.

Chelation therapists would be registered under the TCM Council, director-general of Health Tan Sri Dr Ismail Merican says.

The Ministry’s TCM Division has already inspected the seven known clinics offering the treatment and its director has talked to insurance companies- which will start considering coverage for chelation once the Act is gazetted, Dr Ismail says.

Chelation was originally used to remove poison gas (during World War I) and lead (during World War II) from the bloodstream. The chelating agent would bond with the lead,for example,and the water-soluble compound would be removed by the liver and kidneys. Today, Dr Ismail says, chelation therapy is used to treat cardiovascular diseases with ethylenediamine tetraacetic acid (EDTA) as a chelating agent, administered via an intravenous drip.

“EDTA is only one small part of the orchestra of nutrients such as vitamins, macro- and trace elements, and amino acids,” adds Dr M.S Balajeyagaran,who has attended courses organised by the American Collage for Advancement in Medicine (ACAM).

“It is not difficult to understand that when you give nutrition to a battered body, it improves.” Each session takes between two and three hours and patients come weekly for 20 weeks, once in a fortnight for three months and then monthly, depending on their condition.

“It is considered an alternative treatment to angioplasty,” the director_general says,and in the United States, more than 500,000 patients have been safely treated using a protocol developed by ACAM. It is also used in Britain, New Zealand, Switzerland, Germany, Korea, India and the Philippines.

Exersice programme.
“Although very small trials and uncontrolled studies showed benefits, a 2005 systemic review found that controlled studies did not support chelation therapy for heart disease,” He stresses that before starting such therapy, the patient’s status and medical history must be reviewed and tests, such as electrocardiographs, done


There is a protocol before beginning therapy, to ensure safety. Dr Balajeyagaran checks to see if the patient has a fever, severely damaged kidney, low calcium level and parathyroid or genetic diseases such as glucose-6-phosphate dehydrogenase deficiency.


He also stresses on “lifestyle modification”, insisting that smokers quit and patients with “fatty liver” give up alcohol. “I ask them to exercise and eat lots of green leafy vegetables that have been thoroughly washed, wild game (which is free of pesticides and chemicals0,fish, eggs and fruit.” If chelation therapy gains recognition – and coverage by insurance companies -that would be good news for Stephen Gnanasigamony, now a firm believer in the treatment.


Twenty-five years ago, the planning manager had a pain in his left shoulder aand armpit.When he walked or climbed stairs, the pain would move over to his sternum-warning him that a heart attack could be on the way.

After an angiogram (an X-ray of blood vessels after they have been injected with a radioapaque solution) at a Kuala Lumpur hospital, the doctor told him there were blockages in his aorta and two other arteries, and that he had to go for bypass surgery.

“I did not have the thousand of ringgit required for that, ’he sad. A friend recommended chelation therapy and Gnanasigamony did some research. He thought the treatment, which cost a few hundred ringgit per session, was also expensive and decided to wait

“But I still felt the pain,” he said, so he opted for chelation therapy.

He completed 30 sessions-twice a week at first and once a week later. And then he stopped because he couldn’t afford it.

“I had to pay for it myself as no doctor would recommend it and I couldn’t get it covered by my company or by insurance,”he recalled. Today, he has had no more problems with his heart. Now retired, he goes for walks and has no problems climbing the stairs in his double-storey house. He also does sit-ups and push-ups at home.

If he could get insurance coverage, he said, he would start going for chelation therapy again, “ to remove toxins”






Article 34 : Positive results from chelation therapy possible.

MALAYSIKINI LETTERS 11MARCH 2013.
Positive Results Possible From Chelation Therapy
 Dr Mohd Ebrahim Sulaiman
 5:41PM Mar 11, 2013
Although I am not a cardiologist, my experience in treating patients with coronary artery diseases by integrative medicine, which involves with advanced medicines, chelation therapy and ECP (External Counter Pulsation) therapy over the years may be of interest to Malaysians in this age of high-tech and increasingly expensive health care.
About 17 years ago I started using chelation therapy on my wife who had bypass heart surgery in 1991 and later on, in 2002, I purchased ECP machine from USA and continued to treat her with both the therapies plus medicines since second bypass surgery was not indicated for her severely damaged heart.
I am grateful to IJN's skilful surgeons and the team who took great care of my wife.
With chelation therapy day by day my wife improved from her chest pains and lived a comfortable life with the above integrative medicine until 21st July 2011.
She passed away, at the age of 73, peacefully in the hospital due to other reasons.
I believe and accept that life span is in the hands of Almighty Allah.
Praise be and thanks to Almighty that She lived for 20 years post bypass surgery comfortably with integrated medicine.
Medical findings from elsewhere in the world confirm that the course of action I took is the right one.
Chelation therapy was controversial among allopathic doctors, but the demand is so high in USA that USA Government had allotted $31million to conduct a scientific double blind trial in 2002.
Unfortunately the trial was abandoned in 2009 due to some reasons. About half a million people in USA sought chelation therapy in a year.
A controversial clinical trial was conducted by a group of scientists and revealed that chelation therapy reduced the risk of heart attacks and other heart problems.
The results of the trial were presented at the annual meeting of the American Heart Association in Los Angeles, California on the 7th Nov 2012.
The research continues to report that chelation therapy is proven to cut the risk of death, second heart attacks, stroke and the need for heart procedures among some patients who already suffered an earlier heart attack.
So the scientists questioned why the US$31 million trial was pulled out?
Ref 1: http://blogs.nature.com/news/2012/11/chelation-trial-results-come-under-fire.html
Ref 2: http://newsroom.heart.org/news/chelation-therapy-doesn-t-alter-240495.
On the other hand bypass surgery, angioplasty and stent do not have such qualities, it is only for temporary relief of chest pain.
It does not prevent future heart attack, future blockage of the arteries, stroke and the need for repeated procedures on patients who already has undergone such procedures earlier.
Surgery is expensive, the risks were very high and the benefit was small.
Chelation therapy is now proven to be evidence -based safe therapy, less expensive and effective.
In the United States, more than 500,000 patients have been safely treated using a protocol developed by American College of Advancement in Medicine (ACAM).
It is also used in Britain, New Zealand, Switzerland, Germany, Korea, India and the Philippines.
I believe many doctors (about 40) have gone for training and are at present providing chelation therapy in Malaysia.
I request the Ministry of Health Malaysia to accomplish what DG Health Tan Sri Dr Ismail Merican had said, "that the Ministry's TCM division has already inspected the seven known clinics (At present more than 40 clinics ) offering the treatment and its director has talked to insurance companies... which will start considering coverage for chelation once the Act is gazetted.
(Ref: Chelation coming in from the cold: Health NST 2009/10/26 by Annie Freeda Cruz and Santha Oorjitham.)
In my opinion , If we start chelation and ECP therapy as a preventive measure to the public at the age of 30, 40 ,50's at primary care centres, definitely there will be less severe chronic diseases like heart attack (Myocardial Infarct) and less diabetic patients with severe complications like gangrene and stroke.
This will definitely reduce the cost of health care in the country.
In my 17 years of experience there was not one patient who had any severe adverse side effects from Chelation and ECP therapy.
It's my considered opinion that chelation and ECP therapy do no harm to patients.

ANOTHER ARTICLE about EDTA chelation therapy.

Reverse Heart Disease with EDTA Chelation Therapy.
For over 50 years chelation therapy has served as a highly effective and safe intravenous treatment for the elimination of toxic heavy metals, pathological calcium, and other artery-damaging chemicals from the bloodstream. Since 1994, I have treated over 8,000 patients using Disodium-Mg EDTA Chelation Therapy for arteriosclerosis, heavy metal toxicity, memory problems, heart disease, fatigue, circulation problems and more. This therapy has now been proven to be clinically significant and safe by a large government-funded national study (Trial to Assess Chelation Therapy) . It has helped restore healthy function and quality of life to our patients, many of whom have been able to prevent the need for painful and costly surgeries or to rely on prescription medications. We have recorded many written and testimonials to the power of chelation therapy!
The non-surgical way to improve blood flow

Atherosclerosis, the narrowing and stiffening of arteries due to the accumulation of pathologic calcium and plaque, is a primary cause of poor circulation. EDTA chelation therapy is an effective method of enhancing the health of the arteries, removing calcium, improving elasticity (compliance) and thus improving circulation. Thus, this therapy offers a safe and effective alternative to patients who may otherwise be told they need drugs, invasive stents or bypass surgery.
Chelation Works From the Top of the Head to the Bottom of the Feet

Chelation involves the intravenous administration of a synthetic amino acid called EDTA (ethylene diamine tetra-acetic acid). Disodium EDTA (in a complex with magnesium, vitamin C, and other nutrients) enters the bloodstream by the intravenous route and binds to heavy metals such as lead, iron and cadmium that can cause free-radical damage and calcium deposits inthe arteries and carries these toxic metals harmlessly out of the body through the urine. EDTA cannot be adequately absorbed through the intestine and thus oral administration is ineffective. Some physicians administer intravenous Calcium EDTA as a quick push for removal of lead but this has not been proven to be effective for the improvement of circulation.

Over time, these treatments with Disodium EDTA halt the progress of free-radical disease, which is the underlying condition triggering the development of arteriosclerosis and many other degenerative diseases of aging. This gives the body time to heal and to restore blood flow through our blood vessels. After several months this intravenous therapy often bring profound improvement to many metabolic and physiological processes in the body. The body's regulation of calcium and cholesterol is improved by normalizing the internal chemistry of cells. For an in-depth scientific explanation please read [Trial to Assess Chelation Therapy

Chelation benefits every blood vessel in the body, from the largest arteries to the tiniest capillaries, most of which are far too small for surgical treatment or are deep within the brain and other vital organs where they cannot be safely reached by surgery. In many cases, the smallest blood vessels are the most severely diseased. The benefits of chelation occur from the top of the head to the bottom of the feet, not just in blocked segments of a few large arteries, which can be bypassed or opened by other invasive treatments.
A Host of Health Issues Benefit from Chelation Therapy

EDTA Chelation Therapy has shown benefit in a variety of health concerns, including:

Memory problems or “brain fog”
Heart disease seen as angina & chest pains; heart disease; arrhythmias
Hypertension (high blood pressure)
Heavy metal removal
Fatigue, Fibromyalgia & Autoimmune disorders
Poor circulation, found in cold feet and/or hands; impotency; leg cramps; slow-healing sores; shortness of breath; visual & hearing loss; poor digestion; low energy; Erectile Dysfunction

A Long History of Safe and Effective Use
Chelating agents were first introduced into medicine in World War I, when specific substances were identified to treat soldiers exposed to such disabling chemicals as mustard gas, phosgene and tear gas. In the 1940s, radiation poisoning was well treated with chelating agents, which removed the heavy metals that emitted radioactivity from the body. At the same time, EDTA was being used to remove calcium from pipes and boilers. It wasn't until 1948 that EDTA was first used in the treatment of lead poisoning. Since then, it has become the FDA-approved method of treating lead poisoning as well as other heavy metal toxicities. Interestingly, these patients also showed marked improvement in their health as it seemed to reverse the symptoms of atherosclerosis and improve circulation dramatically. A small group of physicians in the 1960's began to study this therapy by administering to themselves and to their patients. This body of physicians expanded rapidly as did the number of patients. During the past 50 years, over a million patients have undergone chelation therapy for a wide range of circulatory problems. Chelation has an impeccable record of safety, with not a single fatality recorded by physicians certified to administer the therapy and following the proper protocols.

“After only 17 chelation treatments, I was able to get off my Procardia and Diazide because my blood pressure had come down to such an excellent low level!“

- Jim Walker, age 65
Read More Testimonials

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Article 35 : HYPERTHERMIC TRANSCUTANEOUS OZONE THERAPY.

HYPERTHERMIC TRANSCUTANEOUS OZONE THERAPY
________________________________________
Transdermal Ozone, also known as hyperthermic ozone and transcutaneous ozone therapy. Transdermal ozone is a method in which ozone is introduced into the body via the skin while sitting in a hot steam cabinet. As the pores of the skin open as a result of being surrounded by the warm steam, ozone enters the body transdermally (i.e. via the skin). The ozone then penetrates the blood, lymph and fat. By allowing ozone in and toxins out via the sweating process that is induced, transdermal ozone therapy is one of the most powerful methods of detoxifying and oxygenating the body in existence. This method is not new: Dr. Kellogg first used ozone in steam saunas at his naturopathic clinic in Battle Creek, Michigan as far back as 1881. The German army used transdermal ozone, without the use of steam baths, for wound healing on the battlefields of World War I.
As an aside steam cabinets, steam rooms and saunas do have valuable detoxifying effects on their own. During a fever, the functioning of the immune system is stimulated, while the growth of bacteria and virus is forced to slow down. In a 1959 review of studies on the effects of heat treatments, Mayo Clinic researcher Dr.Wakim and colleagues cite findings indicating that the number of white blood cells in the blood increased by an average of 58% during artificially induced fever. The generation of antibodies speeds up, as does the production of interferon, an anti viral protein that also has powerful cancer-fighting properties. However with the addition of ozone the effects are vastly more powerful. People sometime ask how transdermal ozone compares with Turkish steam baths, but the truth is that there is no comparison.
Transdermal ozone also has a very relaxing effect. This is partly because heat has a naturally relaxing effect and partly because ozone oxidises (i.e. breaks down) excess adrenaline in the body, producing overall calm.
This method is also useful for skin complaints and improving the tone of the skin generally. We find that eczema and psoriasis sufferers benefit enormously from this therapy. This is backed up by extensive research summarised in the books "The Use of Ozone in Medicine" 3rd English Edition and "Oxygen Healing Therapies".
Using ozonated steam in cabinets is currently being used around the world for alternative health by aestheticians, chiropractors, massage therapists, and other practitioners because they recognize this as a natural way to detoxify and cleanse the body. Ozonated steam stimulates circulation and increases the oxygen supply to every cell and organ in the body.
Transdermal ozone therpary is suggested as a good method of treating lymph system.
The sixth transdermal technique has been recently developed to take advantage of the therapeutic possibilities of using hyperthermia in conjunction with ozone therapy. The patient sits in an ozone-resistant steam cabinet, with the head out, and the body is surrounded by warm steam. The steam causes the pores to open fully and the ozone, introduced into the cabinet by silicon tubing from the generator output, can penetrate fully into all the tissue - the blood, the lymph and the fat. Since the majority of toxins are held in the lymph and the fat, this treatment is the most effective way to eliminate them from the body. Since the skin is the largest organ of elimination, the
majority of the toxins are sweated out, sparing the liver and kidneys extra work.
Hyperthermia itself is a very effective technique, many thousands of years old. It results in a "false fever" reaction, which simulates the body's own defense mechanism. With the addition of ozone, the treatment becomes doubly powerful. As the toxins are oxidized, and eliminated from the body, the fat containing them is no longer needed, and also leaves. Weight loss of 30, 50 and even 80 lbs over a period of months are reported. The skin becomes smooth, soft and free of blemishes.
Symptoms of a whole host of diseases disappear as the toxins leave the system.
Unlike other methods of ozone application, employing ozone in a steam sauna will induce the "healing crisis", which feels like having the flu for a few days. It can be seen as a sign of beneficial healing. Skin rashes are common as the toxins are pushed out through the skin rapidly. Often the rash is very itchy, and this can be alleviated by using colloidal silver water and taking protease enzymes in large amounts.
The more frequent the treatments, the more rapid the healing, and the more severe the healing reactions will be. It may become so uncomfortable that one will need to reduce the frequency of treatments from once daily to once weekly.
Typical treatments are for once daily for 30 minutes duration. People with heart conditions or stroke should limit the duration to 15 minutes for the first few sessions, increasing to 20, 25 and then 30 minutes, as the body adjusts to the thermal stress.
Flow rate of ozone into the cabinet is at 1/4, 1/2 or 3/4 l/m in order to fill the large volume and overcome the loss of ozone to heat. Concentration ranges from 40 to 20 ug/cc. A series of treatments usually consists of 10-20 applications. If necessary (especially in cancer), a second or third series of treatments can be undertaken. It
is critical that the bowels be open during these treatments, in order that oxidized toxins are completely eliminated from the system and not reabsorbed. The best methods of insuring this is by ingestion of 8 - 12 glasses of ozonated water daily (always on an empty stomach), large amounts of fiber (such as psyllium or pectin) and large amounts of Vitamin C ( 3,000 mg four times daily).
The effect of the ozone on any particular organ can be intensified by cupping with a funnel while in the steam cabinet. This is especially effective with hepatitis, diverticulitis, pancreatitis and cancer. It also involves the person in actively taking responsibility for initiating the healing process. Flow rate for cupping is 1/8 l/m.
Transdermal application of ozone combined with hyperthermia in the steam cabinet is the treatment of choice for all cancers (except brain cancer, which can be treated with ozone insufflation in the ear at 1/32 l/m). Cancer cells are tightly packed as they try to force their way in between other cells, and they are thus less able to shed heat. This accounts for effect that heat stress has in killing cancer. Both heat
stress and ozone kill cancer, so this treatment offers the best opportunity to eliminate cells which are fermenting sugar anerobically, halt metastasis and restore healthy aerobic function. Because of its negative charge, and the positive charge of cancer cells (due to the lack an enzyme coating) ozone is able to seek out and destroy all the cancer cells with more certainty than the surgeon's crude scalpel. In
addition, ozone will oxidize the toxins which caused the original problem, and thus prevent recurrence of the problem. This is in contrast to chemotherapy which is massively immune-suppressive, and radiation which itself causes cancer.
Using ozone in this way will cleanse all the tissues of the body and provoke the healing crisis, which is not seen with other delivery methods, proof that this is the best way to achieve thorough cleansing.
In combination with a comprehensive diet plan, parasite, liver and colon cleanse, and suitable exercise, this program offers the best chance for the patient to recover optimum health.
Benefits of the Hyperthermic Transcutaneous Sauna
 Acts as a powerful anti-fungal
 Anti-viral and anti-microbial agent
 Burn approximately 400 calories per session!
 Boost cellular mediated immunity (part of the immune system)
 Dramatically increase oxygenation of the tissues and cells
 Enhances immune system
 Increase 2, 3, DPG – this is responsible for the blood’s ability to release oxygen in your tissues
 Increase the White Blood cell count
 Increase circulation, oxygen and nutrient delivery within the body
 Increase tumor necrosis factor by up to 500 times
 Reduces weight and cellulite
 Removes toxins and drugs
 Revitalizes and enhances lymphatic drainage
 Purge the body of accumulated toxins such as pesticides, PCBs, drug residues, acidic wastes and much more
 Produce Interleukin II. Gamma interferon (anti-cancer substances)
 Promotes relaxation
 Stimulates circulation
 Stimulate the Immune System

More reasons to use Ozone Therapy
1) Ozone therapy was very effective in the treatment of cancer, heart problems, hypertension, high cholesterol, diabetic wounds, and uric acid.
2) Gangrene has been eliminated by sealing an affected extremity in a bag and pumping ozone into it, allowing the ozone to be absorbed through the skin. Healing takes place very rapidly, and the flesh often turns from black to pink during the first treatment.
3) Ozone Therapy is effective in cardiovascular and cerebrovascular diseases and arteriosclerosis. Restore prompt circulation, relieves angina pain and improves circulation and brain function.
4) Tumors, lymphomas and leukemia may be eliminated without using surgery, radiotherapy or chemotherapy.
5) Ozone Therapy is very effective for all forms of arthritis and arthritic disease.
6) Ozone Therapy is very effective for allergies.
7) Ozone improves multiple sclerosis and other neurological diseases, and improve brain function loss in Alzheimer’s, senility and Parkinson’s disease.
8) External use of ozone therapy is very effective in treating burns, acne, ulcers, open sores and wounds, fungus and skin disorders.
9) Ozone therapy is effective for proctitis, colitis, prostitution, crack, Candidasa and other yeast infections, trichomoniasis, other forms of vaginitis, bladder cysts, fistulas, and Crohn’s disease.
10) Mononucleosis, liver cirrhosis, AIDS, herpes and hepatitis have been successfully treated with ozone, without using any medicine
11) Application of ozone therapy is painless, has no adverse side effects and is extremely safe.





Article 36 : Oxygen therapy reduces secondary hemorrhage after thrombolysis in thromboembolic cerebral ischemia

Oxygen therapy reduces secondary hemorrhage after thrombolysis in thromboembolic cerebral ischemia
Li Sun,1,5 Wei Zhou,1,5 Christian Mueller,1 Clemens Sommer,2 Sabine Heiland,3 Alexander T Bauer,4 Hugo H Marti,4 and Roland Veltkamp1,*
Author information ► Article notes ► Copyright and License information ►
This article has been cited by other articles in PMC.
Abstract

Hyperbaric oxygen (HBO) and normobaric hyperoxia (NBO) protect the brain parenchyma and the cerebral microcirculation against ischemia. We studied their effect on secondary hemorrhage after thrombolysis in two thromboembolic middle cerebral artery occlusion (MCAO) (tMCAO) models. Beginning 60 minutes after tMCAO with either thrombin-induced thromboemboli (TT) or calcium-induced thromboemboli (CT), spontaneously hypertensive rats (n=96) breathed either air, 100% O2 (NBO), or 100% O2 at 3 bar (HBO) for 1 hour. Immediately thereafter, recombinant tissue plasminogen activator (rt-PA, 9 mg/kg) was injected. Although significant reperfusion was observed after thrombolysis in TT-tMCAO, vascular occlusion persisted in CT-tMCAO. In TT-tMCAO, NBO and HBO significantly reduced diffusion-weighted imaging–magnetic resonance imaging (MRI) lesion volume and postischemic blood–brain barrier (BBB) permeability on postcontrast T1-weighted images. NBO and, significantly more potently, HBO reduced macroscopic hemorrhage on T2* MRI and on corresponding postmortem cryosections. Oxygen therapy lowered hemoglobin content and attenuated activation of matrix metalloproteinases in the ischemic hemisphere. In contrast, NBO and HBO failed to reduce infarct size in CT but both decreased BBB damage and microscopic hemorrhagic transformation. Only HBO reduced hemoglobin extravasation in the ischemic hemisphere. In conclusion, NBO and HBO decrease infarct size after thromboembolic ischemia only if recanalization is successful. As NBO and HBO also reduce postthrombolytic intracerebral hemorrhage, combining the two with thrombolysis seems promising.
Keywords: cerebral ischemia, hemorrhage, hyperbaric oxygen, normobaric hyperoxia, thrombolysis
Introduction

Secondary hemorrhage is a feared complication of thrombolysis in ischemic stroke. In large clinical trials, thrombolysis has been shown to increase the risk of symptomatic intracerebral hemorrhage about sixfold and the mortality associated with symptomatic hemorrhage about 10-fold (Hacke et al, 2004). Accordingly, preventing secondary hemorrhage after thrombolysis has become an important goal of ischemic stroke therapy. In preclinical and clinical studies, ischemic blood–brain barrier (BBB) damage is associated with secondary hemorrhage after thrombolysis (Del Zoppo et al, 1998; Kahles et al, 2005; Kastrup et al, 2008; Wang et al, 2003). Mediators of BBB damage include free radical-induced reperfusion injury, various cytokines, and proteases. The activation and proteolytic activity of matrix metalloproteinases (MMPs), particularly MMP-9, are key factors in the proteolytic disruption of the basal lamina and tight junctions of the BBB (Hawkins and Davis, 2005; Wang et al, 2003).

Oxygen therapy has offered a simple, but plausible therapeutic approach in experimental cerebral ischemia for many years and was shown to be particularly effective when therapy was started early in reperfusion models (Calvert et al, 2007; Helms et al, 2005; Nighoghossian and Trouillas, 1997; Singhal, 2007; Poli and Veltkamp, 2009; Veltkamp et al, 2000; Zhang et al, 2005). Beyond protection of the brain parenchyma, oxygen therapy may also have beneficial effects on the postischemic microcirculation. In previous studies, hyperbaric oxygen (HBO) and normobaric hyperoxia (NBO) attenuated BBB permeability after focal and global ischemia (Mink and Dutka, 1995; Singhal et al, 2002; Veltkamp et al, 2005a). However, the effects of NBO and HBO on hemorrhagic transformation after focal cerebral ischemia are controversial (Liu et al, 2009; Qin et al, 2007; Henninger et al, 2006, 2009). Furthermore, the effects of these two forms of oxygen therapy on secondary hemorrhage and the underlying BBB damage after experimental thrombolysis have not been directly compared to date.

The purpose of this study was to examine the differences in the effectiveness of HBO and NBO in combination with intravenous thrombolysis after thromboembolic middle cerebral artery occlusion (tMCAO). Specifically, we tested the impact of oxygen therapy on postischemic BBB damage and secondary hemorrhage in two thromboembolic stroke models in which thrombolysis recanalizes or fails to reopen the MCA, respectively.
Materials and methods

All experiments were performed on spontaneously hypertensive male rats weighing 300 to 350 g (Janvier, Le Genest St Isle, France). The study and all associated procedures were approved by the governmental animal care authorities (Regierungspraesidium, Karlsruhe, Germany). Using a face mask, anesthesia was induced with 4% halothane in O2 and continued with 0.8% to 1.2% halothane in a 70/30 mixture of nitrous oxide/oxygen under spontaneous respiration. During surgery, rectal temperature was maintained at 37°C with a thermostatically controlled heating pad. The femoral artery and vein were cannulated with PE-50 polyethylene tubing for continuous monitoring of arterial blood pressure and heart rate, to provide samples for blood gas measurements, and to inject the magnetic resonance contrast agent.
Thrombus Generation

Focal cerebral ischemia was induced using the tMCAO model described by Toomey et al (2002) with some modifications. Thrombi were generated in two different ways: for thrombin-induced thromboemboli (TT), 500 μL of fresh arterial blood from a donor rat were drawn into an Eppendorf tube and mixed with 1.0 National Institutes of Health (NIH) units of human thrombin (Sigma Aldrich, St Louis, MO, USA) and 5 μL of 1 mol/L CaCl2 for a final CaCl2 concentration of 10 mmol/L. Within 5 seconds, a small portion of the mixture was drawn into a 15-cm-long PE-50 tube and allowed to coagulate for 2 hours at 37°C. Then, the clot was transferred from the tube into a Petri dish, which was then filled with saline and stored at 4°C for 12 hours. Before MCAO, the clot was incubated in deionized water at room temperature for 5 minutes. Subsequently, the clot was placed into isotonic saline and inspected under a microscope at fivefold magnification. Twelve thrombi—each 0.35 mm in diameter and 1.5 mm in length—were cut under the microscope and then drawn into PE-50 tubing.

For the calcium-rich thromboemboli (CT), whole arterial blood from a donor rat was drawn into a PE-50 tube where it was allowed to coagulate spontaneously for 2 hours at 37°C. Then, the clot was transferred from the tube into a dish where it was exposed to a 20 mmol/L calcium solution for 1 minute. After transfer into saline solution, the clot was dissected as described for the TT.
Surgical Procedure and Experimental Protocol

The right external carotid artery was permanently ligated distally and mobilized as described (Toomey et al, 2002). The PE-50 catheter with 12 clots was inserted into the right external carotid artery proximal to the ligation and advanced through the bifurcation into the proximal internal carotid artery. Ischemia was induced by injecting the 12 clots into the internal carotid artery over a 30-seconds period with 50 μL of saline. After removing the catheter, ligating the proximal external carotid artery and closing the neck, rats were placed into a magnetic resonance imaging (MRI) scanner (Bruker Biospec, 2.35 T, Karlsruhe, Germany).

Perfusion-weighted imaging (PWI) was performed to ensure hypoperfusion in the territory of the occluded MCA in all animals. After PWI, rats were allowed to wake up. Sixty minutes after injecting the thrombus, animals were randomly assigned to one of three groups. Animals breathed either air, 100% O2 at ambient pressure (NBO), or 100% O2 at 3 bar (HBO) for 60 minutes in a pressure chamber. Immediately after oxygen therapy, animals received recombinant tissue plasminogen activator (rt-PA) intravenously (9 mg/kg in 2 mL H2O; Actilyse, Boehringer Ingelheim, Ingelheim am Rhein, Germany). Ten percent of the solution was injected as a bolus; the remainder was infused over a 30-minutes period through the femoral vein. In all groups, a PWI–MRI was performed after the end of the rt-PA infusion (i.e., 2.5 hours after tMCAO) and 24 hours after tMCAO to document the perfusion status after thrombolysis and at the end of the experiment.
Magnetic Resonance Imaging Protocol

For PWI, we used a gradient-echo–echo-planar imaging sequence (repetition time (TR)=1 second, echo time (TE)=15 milliseconds, field of view=4.5 cm × 4.5 cm, 4 slices, thickness=2 mm, 20 repetitions with a time resolution of 1 second/image data set) to monitor the bolus passage of 1 mmol/kg of a paramagnetic contrast agent (Omniscan, Nycomed Amersham, Oslo, Norway). For diffusion-weighted MRI, we acquired a spin-echo–echo-planar imaging sequence (b value=200, 300, 400, 500, 600, and 700 seconds/mm2) 2.5 and 24 hours after tMCAO. The MR protocol also comprised a T1 spin-echo sequence with a TR of 400 milliseconds, TE of 15 milliseconds, a flip angle of 90°, a matrix of 128 × 128, field of view=4 cm × 4 cm, and 6 slices with slice thickness=2 mm; the number of averages was 8. T1-weighted imaging was performed 10 minutes after injecting the contrast agent and again 2.5 and 24 hours after embolization. T2*-weighted imaging was performed 24 hours after embolization with a fast low angle shot sequence (TR=300 milliseconds, TE=20 milliseconds, flip angle=20°C, matrix 128 × 96, field of view=4 cm × 4 cm, number of slices=6, and number of averages=4).
Magnetic Resonance Imaging Data Analysis

For analysis of PWI, the relative cerebral blood volume (rCBV) and the relative mean transit time were calculated in two predefined corresponding regions of interest in the parietal cortex of both hemispheres from the signal–time curve determined from the PWI data set as described earlier (Heiland et al, 1997). Diffusion-weighted imaging (DWI) and T1w data were analyzed by encircling areas of abnormal signal intensity for each MR section using a side-to-side comparison on the screen. Volume of abnormally hyperintense signals on DWI and postcontrast enhancement on T1w was calculated by multiplying the total area with a 2-μm section thickness. Areas of abnormally hypointense signal on T2* reflecting macroscopic hemorrhage were measured by a blinded rater. To validate that the DWI lesion size corresponded to parenchymal histologic damage, we analyzed the infarct area on histologic sections at the level of the bregma 24 hours after tMCAO in a subgroup of animals.
Macroscopic Examination of Secondary Hemorrhage

Twenty-four hours after TT-MCAO, brains (n=10/group) were removed. Unstained coronal cryosections were photographed without magnification. Macroscopic evidence of intracerebral hemorrhage was compared with T2* on corresponding sections.
Spectrophotometric Hemoglobin Assay

The hemoglobin content of brains was quantified with a spectrophotometric assay as described earlier with some modifications (Choudhri et al, 1997). Twenty-four hours after MCAO, rats were deeply anesthetized and transcardially perfused with 100 mL of saline. Brains were rapidly removed, divided into left and right hemisphere, frozen in isopentane, and stored at −80°C. The brain hemispheres were homogenized in 1.0 mL of PBS on ice for 30 seconds, insonated with pulse ultrasound for 1 minute, and centrifuged at 13,000 r.p.m. for 30 minutes. After the hemoglobin-containing supernatant was collected, 120 μL of Drabkin's reagent (Sigma Diagnostics, St Louis, MO, USA; K3Fe(CN)6 200 mg/L, KCN 50 mg/L, NaHCO3 1 g/L, pH 8.6) was added to a 30-μL aliquot and the mixture was allowed to stand for 15 minutes. The optical density was then measured at a wavelength of 540 nm with a spectrophotometer (Synergy 2 Multi-Detection Microplate Reader, BioTec, St Louis, MO, USA). To verify that the measured absorbance after these procedures reflected the amount of hemoglobin, blood was obtained from naive mice by cardiac puncture after anesthesia. Incremental aliquots of this blood (4, 8, 16, 20, 32, and 50 μL) were added to freshly homogenized brain tissue obtained from untreated mice to generate a standard absorbance curve. This curve showed a linear relationship between added blood volume and optical density (Supplementary Figure 1).
Histologic Assessment of Hemorrhagic Transformation

In animals without macroscopically visible hemorrhage on T2*, histologic staining was performed using trichrome. Twenty-four hours after CT-tMCAO, rats were deeply anesthetized and transcardially perfused with 100 mL of saline and fixed with 100 mL 4% paraformaldehyde (PFA). Brains were rapidly removed and postfixed in 1% PFA at 4°C. After embedding in paraffin, 5-μm coronal sections were deparaffinized, hydrated, and treated with Harris hemalaun solution for 5 minutes. Then, sections were incubated with a trichrome solution (pH 3.4, 1.2% chromotrop 2R, 1.2% wolframatophosphoracid, 0.6% fast green FCF, and 1% acetic acid). After rinsing briefly, sections were dehydrated, mounted, coverslipped, and observed under a microscope (Leica, Wetzlar, Germany). To assess the severity of erythrocytic extravasations, a blinded rater used a predefined semiquantitative scale (score 0 to 5, with lower scores representing fewer intraparenchymal erythrocytes, Supplementary Figure 2).
Gelatin Zymography

Corresponding samples of ischemic and nonischemic hemispheres were taken from a series of 20-μm-thick coronal cryosections with 1.2 mm distance and homogenized in ice-cold lysis buffer (50 mmol/L Tris–HCl, pH 7.5, 150 mmol/L NaCl, 5 mmol/L CaCl2, 0.05% Brij-35, 0.02% NaN3, and 1% Triton X-100). After centrifugation, the supernatant was collected and protein concentration of each sample was determined in triplicate using Bradford reagent (Bio-Rad Laboratories GmbH, Munich, Germany). Aliquots of lysates containing 50 μg protein were subjected to electrophoresis on 10% sodium dodecyl sulfate polyacrylamide gel copolymerized with 1 mg/ml gelatin (Sigma Aldrich, Munich, Germany) under nonreducing conditions. After washing in 2.5% Triton-X 100 for 2 hours, gels were incubated in a developing buffer containing 50 mmol/L Tris–HCl, pH 7.5, 150 mmol/L NaCl, 5 mmol/L CaCl2, 0.02% Brij-35, and 0.02% NaN3 for 60 hours. Gels were then stained with 0.125% Coomassie blue R-250 in 10% acetic acid and 50% methanol for 30 minutes before they were destained in a solution containing 5% acetic acid and 25% methanol until clear bands appeared on a dark blue background. After scanning (MCID 7.0, InterFocus GmbH, Mering, Germany) densitometry of bands was performed using the public domain Image J software (National Institutes of Health, Bethesda, MD, USA). A mixture of human MMP-9 and MMP-2 (Chemicon International, Millipore, Schwalbach, Germany) was used as positive control.
Statistical Analysis

All values are expressed as mean±standard deviation. For comparison of physiologic values, infarct volumes, and MRI data, analysis of variance (ANOVA) was used, followed by post hoc Fisher's protected least significant difference test. The scores on the histologic hemorrhage scale were assessed by the Kruskal–Wallis test and then by the Mann–Whitney U-test. All analyses were performed using SPSS analysis software. A P-value <0.05 was considered statistically significant.Results
Physiologic parameters before tMCAO and 5 minutes after reperfusion did not differ significantly among groups except for arterial pO2 (Table 1). Arterial pO2 in the HBO group could only be measured after opening the pressure chamber.Table 1
Table 1Physiologic parameters
On injecting emboli PWI, signal intensity declined in the ischemic hemisphere. The rCBV (ischemic and nonischemic hemisphere) did not differ among groups 20 minutes after tMCAO (P>0.5, ANOVA). Thus, ischemia was equally severe in all groups initially. In TT-tMCAO, thrombolysis improved rCBV in cortex at 2.5 and 24 hours after MCAO in all three groups (P<0.05, ANOVA). Relative CBV changes did not differ between 2.5 and 24 hours after embolism (P>0.5). In contrast, in CT-tMCAO, PWI changes did not reverse after rt-PA infusion (i.e., 2.5 hours after MCAO) and 24 hours after MCAO. No significant differences in rCBV were observed at any time point after CT-tMCAO among all groups (P>0.5, ANOVA). Thus, rt-PA did not induce recanalization in CT-tMCAO (Supplementary Figure 3).
Oxygen Therapies Reduce Ischemic Lesion in Recanalized but not in Permanent Thrombembolic Middle Cerebral Artery Occlusion

To delineate the brain parenchymal damage, lesion volume was measured on DWI–MRI. Hyperintensity on DWI correlated well with infarct volume on histologic sections (r=0.76, P=0.001), which was similar to the results of an earlier study (Veltkamp et al, 2005a). An abnormally hyperintense signal on DWI was detected already 2.5 hours after MCAO and became more extensive 24 hours after MCAO. In TT-tMCAO, NBO and HBO significantly reduced lesion volume on DWI compared with air (Figure 1). In contrast, in CT-tMCAO, only a transient trend toward reduced lesion volume was detected on DWI–MRI in the HBO group at 2.5 hours but no differences were seen at 24 hours after tMCAO (Figure 1). Hence, oxygen therapy did not reduce lesion volume in permanent tMCAO.
Figure 1
Figure 1
Hyperintense lesion volumes on magnetic resonance diffusion-weighted images at 2.5 and 24 hours after thromboembolic middle cerebral artery occlusion (tMCAO) (mm3). (A) In thrombin-induced thromboemboli-tMCAO, lesion volume on diffusion-weighted imaging ...
Normobaric Hyperoxia and Hyperbaric Oxygen Reduce Blood–Brain Barrier Damage

Postischemic microvascular permeability was analyzed on postcontrast T1w images, which correlates well with Evans blue extravasation (data not shown). An abnormally hyperintense signal on postcontrast T1w images was detected 2.5 hours after injecting emboli. In TT-tMCAO, volumes of enhancement on T1w images at this time point were 105.8±21.6 mm3 in the air, 89.5±22.2 mm3 in the NBO, and 48.7±10.9 mm3 in the HBO group (P<0.001, n=12 per group). At 24 hours after tMCAO, volumes of enhancement on T1w images were 129.1±20.2 mm3 in air-, 89.5±22.8 mm3 in NBO-, and 51.3±11.4 mm3 in HBO-treated rats. (Figure 2) Thus, NBO and, more effectively, HBO significantly reduced postischemic BBB damage on T1w images 24 hours after tMCAO with reperfusion (P<0.001, ANOVA). In CT-tMCAO, HBO also significantly reduced postischemic, enhancing T1 volumes 24 hours after tMCAO (P<0.05, ANOVA) whereas NBO failed to attenuate the enhancing volume on T1w images (P=0.18, ANOVA) (Figure 2).Figure 2
Figure 2Volume of enhancement on postcontrast T1w magnetic resonance images 2.5 and 24 hours after thromboembolic middle cerebral artery occlusion (tMCAO) (mm3). (A) In thrombin-induced thromboemboli-tMCAO, normobaric hyperoxia (NBO) and, more effectively, hyperbaric ...Macroscopic Evidence of Secondary Hemorrhage
T2* MR imaging was used to detect ‘macroscopic' intracerebral hemorrhage because it corresponded well to hemorrhage on unstained coronal cryosections (Figures 3B and 3C). An abnormally hypointense signal reflecting hemorrhage was observed on T2* MR images 24 hours after embolization (Figure 3). In TT-tMCAO with recanalization, the hypointense T2* signal was found in all animals except for 2 of the 11 HBO-treated rats. (Figures 3B and 3C) The mean number of MRI sections with hypointense T2* signal was 3.8±1.0 in air-, 2.4±1.2 in NBO-, and 1.3±0.9 in HBO-treated rats. Thus, both NBO and HBO induced a significant reduction in macroscopic hemorrhage on T2* MR images (P< 0.01, Kruskal–Wallis test, Mann–Whitney U-test, n=11/group). Moreover, macroscopic hemorrhage was significantly smaller in HBO- than in NBO-treated mice (P=0.037, Mann–Whitney U-test, n=11/group) (Figure 3). Interestingly, the area of hypointense T2* signal at 24 hours after MCAO was located within the area of intense postcontrast enhancement on T1w images at 2.5 hours after MACO (Figure 3). In addition, enhancing T1w lesion at 2.5 hours after MCAO correlated well with the hypointense T2* signal at 24 hours after MACO (r=0.919, P<0.001, Spearman). Thus, a circumscribed, early increase in BBB permeability appeared to indicate a risk for later secondary hemorrhage. Moreover, hypointense T2* signals were mainly observed within areas of the ischemic parenchymal DWI lesion in all the three groups (Figure 4).Figure 3
Figure 3Correspondence of blood–brain barrier damage, infarct lesion, and secondary hemorrhage. (A) Postcontrast enhancement on T1w postcontrast magnetic resonance image (arrow). (B) Corresponding T2* magnetic resonance image showing ‘macroscopic' ...Figure 4
Figure 4Multimodal magnetic resonance imaging images showing the topography of the parenchymal infarct (diffusion-weighted imaging (DWI) at 24 hours), blood–brain barrier permeability (postcontrast T1w at 2.5 hours), and hemorrhage (T2* at 24 ...In permanent CT-tMCAO, only 3/10 animals in the air group and none of the NBO- or HBO-treated rats showed such ‘macroscopic' hemorrhage on T2* MRI, despite thrombolysis.Oxygen Therapy Reduces Postischemic Hemoglobin Extravasation
To quantify hemorrhagic transformation, total brain hemoglobin contents were analyzed 24 hours after embolization using a spectrophotometric assay. On the basis of the standard absorbance curve, the measured absorption of optical density was converted to hemoglobin volume. A pronounced increase in hemoglobin content in the ischemic hemisphere was observed as compared with the contralateral hemisphere in the air-treated rats. In groups with recanalized MCA, both NBO (14.2±5.9 μL) and HBO (11.2±5.7 μL) significantly decreased the mean hemoglobin volume as compared with air in the ischemic hemisphere (25.4±5.6 μL, P<0.05, n=5 per group, ANOVA). Again, there was less hemorrhagic transformation in permanent than in recanalized tMCAO. In CT-tMCAO, only HBO (4.9±2.2 μL) reduced hemoglobin volume as compared with air (12.8±8.3 μL, P<0.05, n=10, ANOVA). No significant differences in mean hemoglobin contents were found between NBO (8.3±4.1 μL) and air (12.8±8.3 μL, P=0.32) or between NBO and HBO (P=0.79) (Figure 5).Figure 5
Figure 5Hemoglobin spectrophotometry of perfused ischemic brain hemisphere and expression of matrix metalloproteinase (MMP)-2 and MMP-9 24 hours after thromboembolic middle cerebral artery occlusion (tMCAO). (A) In thrombin-induced thromboemboli (TT)-MCAO, both ...Normobaric Hyperoxia and Hyperbaric Oxygen Attenuate Erythrocytic Extravasation
As ‘macroscopic' hemorrhage was rarely found after CT-tMCAO, the extent of hemorrhagic transformation was also quantified on trichrome sections at the level of the bregma +0.26 mm (commissura anterior) using a predefined semiquantitative scale. No erythrocytic extravasation was found in the contralateral hemisphere (Figure 6). In contrast, a leakage of erythrocytes into brain tissue was observed in cortex and subcortex throughout the ischemic tissue (Figure 6). However, dense accumulation of erythrocytes developed predominantly in the striatum and in the ventral cortex (Figure 6). Mean scores of erythrocytic extravasation were 4.1±1.3 in the air, 2.4±1.3 in the NBO, and 2.3±1.4 in the HBO group (P<0.05 for HBO and NBO versus air; Kruskal–Wallis test, Mann–Whitney U-test, n=9/group).Figure 6
Figure 6Erythrocytic extravasation on trichrome-stained coronal brain sections at the level of the bregma +0.26 mm (anterior commissure) 24 hours after calcium-induced thromboemboli-middle cerebral artery occlusion without recanalization. (A) ...Hyperbaric Oxygen Attenuates Ischemia-Induced Matrix Metalloproteinase-9
To analyze the effect of oxygen therapy on MMP activity, protein extracts from brains collected 24 hours after TT-tMCAO were analyzed for MMP activity. Both MMP-9 (92 kDa) and MMP-2 (72 kDa) were observed as clear bands (Figure 5). At 24 hours after TT-tMCAO, MMP-2 levels did not differ between ischemic and nonischemic hemispheres in any group. However, MMP-9 levels in the ischemic hemisphere were distinctly higher than in the nonischemic hemisphere in all groups. Remarkably, when comparing the MMP-9 levels in the ischemic hemisphere among groups, HBO treatment resulted in a significant reduction in the MMP-9 band in the ischemic hemisphere in comparison to the air and NBO groups whereas NBO only tended to reduce MMP-9 levels. No differences were noted between MMP-9 bands after tMCAO in the nonischemic hemispheres among air-, NBO-, and HBO-treated mice (Figure 5).Discussion
This study provides several major new findings. (1) Oxygen therapy in combination with thrombolytic therapy only affects infarct size if recanalization is successful. (2) Both NBO and, more effectively, HBO reduce size and frequency of gross parenchymal hemorrhage after thrombolysis-induced reperfusion. (3) HBO and NBO reduce early BBB permeability after tMCAO, which is a marker for subsequent hemorrhagic complications of thrombolysis. (4) Oxygen therapy improves microvascular integrity even in regions that undergo parenchymal infarction.Secondary hemorrhage in ischemic stroke patients is stronger and occurs more frequently if the occluded cerebral artery is recanalized (Molina et al, 2001). Therefore, when experimentally testing the effect of an adjunctive therapy on cerebral hemorrhage after thrombolysis, it is desirable to control the recanalization effect of rt-PA. To appropriately model the variable effect of thrombolysis in patients in our study, two different clots were injected for tMCAO, and reperfusion was monitored using repetitive PW–MRI. Although rt-PA successfully recanalized the MCA in TT-tMCAO, vascular occlusion persisted despite thrombolysis in CT-tMCAO. Intriguingly, the effects of oxygen therapy in combination with rt-PA differed substantially between these two models. First, oxygen therapy reduced parenchymal damage in TT- but not in CT-tMCAO. This is consistent with most previous studies showing a cerebroprotective effect of early oxygen therapy in transient cerebral ischemia (Singhal et al, 2002; Veltkamp et al, 2005a, 2005b) but limited or no infarct size reduction after permanent MCAO (for review, see Helms et al, 2005; Poli and Veltkamp, 2009; Singhal, 2007). A limitation of this study is that neurologic function was not assessed.The primary goal of this study was to examine the effect of oxygen therapy on secondary hemorrhage after thrombolysis. In line with findings from Qin et al (2007), who reported a reduction of hemorrhagic transformation in rats treated with HBO compared with air after filament-induced MCAO, HBO reduced both macroscopic parenchymal hemorrhage in recanalized and and hemorrhagic transformation in permanent thromboembolic ischemia, respectively. Interestingly, NBO also reduced secondary hemorrhage in TT-tMCAO although its effect was less powerful and less consistent than that of HBO. In a previous experimental study similar to ours in which NBO was also administered before thrombolysis, NBO tended to reduce hemorrhage volume (Henninger et al, 2006, 2009). In another recent study, NBO coadministered with thrombolysis failed to decrease secondary hemorrhage after thromboembolic MCAO (Fujiwara et al, 2009). Different timing of thrombolysis and oxygen treatment may underlie the discrepancy in these results. A strength of our study is that our experimental setup frequently induced parenchymal hemorrhage after TT-MCAO, which is clinically more relevant than hemorrhagic transfomation. NBO tended to increase hemorrhagic transformation in a clinical pilot study (Singhal et al, 2005a) but this increase in petechial-type ‘asymptomatic' secondary hemorrhage was related to a higher rate of reperfusion.Our findings confirm a clear association between the effects of oxygen therapy on postischemic BBB permeability and on hemorrhage after thrombolysis. Topographic analysis of multimodal MRI showed that more than 95% of the hypointense T2* signal 24 hours after tMCAO was located within the area of intense postcontrast enhancement on T1w images at 2.5 hours after tMCAO. This is in accordance with previous experimental and clinical findings that early appearance of a circumscribed contrast enhancement on T1w shows tissue at risk for subsequent secondary hemorrhage (Kastrup et al, 2008; Neumann-Haefelin et al, 2002). Although an attenuation of postischemic BBB permeability in animals treated with NBO or HBO has been reported earlier (Liu et al, 2009; Qin et al, 2007; Veltkamp et al, 2005a), it was unclear as to whether this reflected a specific protective effect on cerebral microvessels or was proportional to overall parenchymal protection. As 95% of macroscopic hemorrhage on T2* MRI 24 hours after TT-tMCAO was located within the infarcted tissue (i.e., hyperintense area on DWI) in our experiments, oxygen therapy reduced secondary hemorrhage within the infarcted area. Thus, oxygen therapy had a beneficial effect on microvascular integrity despite its failing to protect the parenchyma. This protective effect on the microvasculature is further supported by our findings in permanent CT-tMCAO where oxygen therapy (in particular HBO) decreased histologic hemorrhagic transformation and hemoglobin content but did not reduce infarct size.The molecular mechanisms underlying the effects of oxygen therapy on the cerebral microvessels remain to be fully elucidated. Our findings are consistent with previous reports showing that oxygen therapy attenuates the activation of MMPs and reduces the digestion of basal lamina components and tight junction proteins (Kim et al, 2005; Liu et al, 2009; Singhal et al, 2002; Veltkamp et al, 2006b). We already showed that HBO reduces tissue hypoxia, and attenuates induction of hypoxia-inducible factor-1 and one of its target gene, the vascular permeability factor vascular endothelial growth factor (Sun et al, 2008). Furthermore, we recently showed that hypoxia-induced edema formation in the brain is mediated by MMP-9-dependent rearrangement and gap formation of tight junction proteins through a vascular endothelial growth factor-dependent mechanism (Bauer et al, 2009). Thus, our data suggest that HBO therapy can attenuate the activation of this hypoxia-permeability axis.In conclusion, our findings are of profound relevance for translational studies analyzing the usefulness of oxygen therapy in acute ischemic stroke. Whether oxygen therapy can reduce an ischemic brain lesion depends largely on successful, subsequent recanalization. As oxygen therapy also attenuates secondary hemorrhage within infarcted tissue, the most dreaded complication of recanalization therapy, combining it with thrombolytic therapy early on appears particularly promising. Despite some differences in efficacy, NBO and HBO could be viewed as complementary treatment strategies in the clinical setting (e.g., prehospital NBO followed by inhospital HBO).Acknowledgments
This work was supported by grants from the Deutsche Forschungsgemeinschaft (VE 196/2-2) and the GEMI fund. RV is supported by an Else-Kröner-Memorial Scholarship.Notes
The authors declare no conflict of interest.Footnotes
Supplementary Information accompanies the paper on the Journal of Cerebral Blood Flow and Metabolism website (http://www.nature.com/jcbfm)Supplementary Material
Supplementary Figure 1Click here for additional data file.(7.9M, tif)Supplementary Figure 2
Click here for additional data file.(7.9M, tif)Supplementary Figure 3
Click here for additional data file.(2.6M, tif)Supplementary Figure 4
Click here for additional data file.(361K, tif)Supplementary Figure Legends
Click here for additional data file.(21K, doc)References
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Article 37 : ECP therapy for coronary artery disease.
INSURANCE COVERAGE - REIMBURSEMENT

ECP therapy for coronary artery disease.
INSURANCE COVERAGE --REIMBURSEMENT
Most private insurance carriers offer reimbursement for ECP therapy and have established coverage similar to Medicare.
Medicare Coverage Policy (under 35-74) provides reimbursement for the use of ECP therapy for patients diagnosed with disabling angina (Canadian Cardiovascular Society Classification Class III or IV, or equivalent classification) who, in the opinion of a cardiologist or cardio-thoracic surgeon, are not readily amenable to surgical intervention such as PTCA or cardiac bypass because:
1. Their condition is inoperable.
2. Their coronary anatomy is not readily amenable to such procedures.
3. They have co-morbid conditions which create excessive risk.




Article 38 : New Guidelines Emphasize Medical Therapy for Stable Ischemic Heart Disease.. (Chelation therapy)

New Guidelines Emphasize Medical Therapy for Stable Ischemic Heart Disease. (Chelation therapy).
http://www.medscape.com/viewarticle/774765?src=mpnews&uac=170504DT
Michael O’Riordan
Nov 19, 2012
PHILADELPHIA — Lifestyle changes and medical therapy should be the mainstay for most patients with stable ischemic heart disease (IHD), according to what some say is a long-overdue update to guidelines for this patient group [1]. The primary focus of interventions in these patients, according to the new guidance, should be reducing the risk of premature cardiovascular death and nonfatal MI while maintaining activity levels and a quality of life.

"Because of the variation in symptoms and clinical characteristics among patients, as well as their unique perceptions, expectations, and preferences, there is clearly no single correct approach to any given set of clinical circumstances," state the new guidelines. "Patient education regarding various therapeutic options, appropriate levels of exercise, diet and weight control, and the importance of various clinical manifestations play a key role in achieving the treatment goal."

Published online November 19, 2012 in the Annals of Internal Medicine, the new guidelines, with lead author Dr Amir Qaseem (American College of Physicians, Philadelphia, PA), are a collaboration of the American College of Physicians, American College of Cardiology Foundation, American Heart Association, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, and the Society of Thoracic Surgeons.

The guidelines include 48 specific recommendations relevant for primary-care physicians and emphasize patient education, managing cardiovascular risk factors, a discussion of unproven risk-reduction strategies, the use of medical therapy to prevent MI and death and to relieve angina symptoms, the use of revascularization to improve survival and symptoms, and patient follow-up.

The initial approach to patient management focuses on eliminating all unhealthy behaviors, such as smoking, and promoting weight loss, physical activity, and a heart-healthy diet. Most important, the new guidelines provide an algorithm that emphasizes an evidence-based set of pharmacologic interventions intended to reduce the risk of future events. Drug therapy includes the use of antiplatelet agents, lipid-lowering drugs, particularly statins, and beta blockers. ACE inhibitors are recommended for many patients with stable IHD, such as those with diabetes or left ventricular dysfunction.

Medical Therapy First

Speaking with heartwire , Dr William Boden (Samuel Stratton VA Medical Center, Albany, NY), the lead investigator of the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial, said that the treatment of stable IHD is a constantly moving target, but a full-scale revision of guidelines for the treatment these patients has not happened since 2002. With the publication of COURAGE and Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes (BARI 2D), it was believed these trials would likely spur the guideline rewrite, but even so, the update was at least three years in making.

"I think the guidelines were long overdue and very much needed, because so much has changed since 2002, both in our approaches to myocardial revascularization as well as medical therapy," said Boden. "Putting this all together was critically important. That said, I think the committee deserves enormous praise and credit because I think they largely got it right. I was particularly pleased to see that out of the gate they discuss the general approach to patient management, that being first and foremost to prevent death and complications from ischemic heart disease, myocardial infarction, and heart failure, and second to restore quality of life and manage symptoms."

The new guidelines strongly support the importance of medical therapy as the first-line treatment for patients with stable IHD. For Boden, the management algorithm, one that begins with lifestyle intervention and eliminating unhealthy behaviors, followed by secondary prevention and pharmacotherapy, is the right sequence of treatment events. "If the ultimate end game is to reduce death and myocardial infarction, then the best way to achieve that is to make sure that we invest heavily in patient education and to make certain that we underscore the importance of lifestyle intervention and secondary prevention," said Boden.

Beta blockers are recommended as the initial treatment for relief of symptoms in patients with stable IHD, and calcium-channel blockers or long-acting nitrates are recommended when beta blockers are contraindicated or cause unacceptable side effects or when initial treatment is unsuccessful. Sublingual nitroglycerin or nitroglycerin spray is recommended for the immediate relief of angina. Should symptoms persist after medical therapy, physicians are advised to consider coronary artery revascularization.
Tackling Patients in Need of Revascularization
For revascularization to improve symptoms, CABG surgery or PCI is recommended in patients with one or more significant (>70% stenosis) lesions. CABG surgery or PCI is not recommended in patients who do not meet the anatomic (>50% stenosis of the left main artery or >70% non-left main stenosis) or physiologic criteria for revascularization. In addition, PCI should not be performed if the patient is unable or unlikely to comply with dual antiplatelet therapy.
In addition, the guidelines recommend CABG or PCI to improve survival in several clinical scenarios, such as in patients with stenosis of the left main coronary artery, patients with lesions in three major coronary arteries, or patients with presumed ischemia-mediated ventricular tachycardia caused by a stenosis in a major coronary artery. PCI or CABG surgery is not recommended to improve survival in patients with stable IHD with one or more coronary lesions that are not anatomically or functionally significant.

Speaking with heartwire , Dr Daniel Simon (University Hospitals Case Medical Center, Cleveland, OH) said that there is increasing concern about the appropriateness of PCI procedures, and this has led to some uncertainty about the goals of treatment. He praises the new document, particularly the efforts to reduce cardiovascular morbidity and mortality through the appropriate application of revascularization strategies. As an interventional cardiologist, he raised some issues that he said are not addressed by the clinical guidelines.

"Knowledge of the coronary anatomy is critical," said Simon. "As the guidelines state, regardless of symptoms, if the patient has left main coronary artery disease or severe three-vessel disease, you revascularize for survival independent of symptoms. So the problem with all of these recommendations is that they recommend physicians do optimal medical therapy, including failing multiple drugs, and only then proceed to revascularization. But remember, the COURAGE trial and other trials that made a comparison between medical therapy and revascularization have always known the coronary anatomy first. This had led to concerns that patients with the most severe anatomy and those at risk for ischemia were never entered into those trials." It also means, he added, that the important information obtained from knowing the anatomy is already embedded in the new recommendations.
As a result of some of those concerns, the National Heart, Lung, and Blood Institute is sponsoring an eight-year trial in about 8000 patients to find the best management strategy for patients with stable ischemic heart disease and moderate to severe ischemia. The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA), planned for at least 150 sites in more than 30 countries, will compare angiography and revascularization plus optimal medical therapy with the conservative strategy of optimal medical therapy only. As Simon notes, even patients randomized to medical therapy will undergo computed-tomography angiography to rule out left main or three-vessel disease.
Gun Shy Given Concerns About PCI Appropriateness.
Simon noted that there is an assumption that PCI is being performed in patients who do not require it, but a recent Canadian study showed that PCI was underused in those with appropriate indications. This suggests that physicians have become "gun shy" about coronary revascularization given concerns about appropriateness, and he would like a statement included in the new guidelines highlighting the adverse effects of underusing PCI when it is clinically indicated. He also noted that coronary artery calcium (CAC) scans, which are not recommended anywhere in the document, can help physicians reclassify patients from intermediate risk to either high or low risk.

Although Simon and Boden both said the document is unlikely to please everybody, they praised the committee for the detailed, thoughtful analysis of the available evidence. For Boden, he was particularly pleased with the revascularization emphasis on a shared decision-making approach in patients undergoing revascularization because of left main or complex coronary disease. According to the new guidelines, the team should include a cardiac surgeon, an interventional cardiologist, and the patient. Although a general cardiologist was not included as part of the group, he thinks one should also be involved in the decision-making process.

A couple of notable trials shed even more light on the CABG-vs-PCI debate, including the recently published and presented Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease (FREEDOM) and FAME II studies. These trials were not used in the guideline-writing process, as the data were only presented within the past couple of weeks and months.

Interestingly, the guidelines recommend that chelation therapy not be used for the intention of improving symptoms or reducing cardiovascular risk in stable IHD patients. They state there is low-quality evidence supporting its use, but the recent Trial to Assess Chelation Therapy (TACT) challenges that, as the randomized, double-blind trial of chelation therapy showed it may modestly improve clinical outcomes in patients after an acute MI.





Article 39 : Detoxifcation

Detox Program by Prof Dr Hj Mohd Ebrahim Sulaiman. Every one should detox once a month.
1.One Lemon ,cut skin , pulp, seeds all into pieces and blend. Take the juice.
2.Add Olive oil one table spoon and mix with the above. And drink
Twice a day with food.
3. Apple cider Vinegar (acetic acid)one table spoon Plus half teaspoon of black
seed oil (Thymoquinone ). Take twice a day with food.
4. Take green Apple juice (two apples) three times a day. Before or after food.
5.The above ( item 1. to item 4) to take every day for 6 days ( Monday to Saturday).
6.On Sunday morning , 5am or 6am ( no food ) take one table spoon of Magnesium Sulphate powder dissolved (mixed) in a two tablespoon of water in a cup and drink. Followed by two glasses of water. (feel warm in your tummy due to bile flow, pancreatic juice flow in to the duodenum).The taste is bitter can add one teaspoon of honey.
7. At 7 am take Lemon juice plus Olive oil as described in No. 1 and 2 above. And take one glass of water. (feel warm in your tummy due to bile flow, pancreatic juice flow in to the duodenum).
8.By 9am you will pass watery stool mixed with bile dark brownish red in colour. You may find gall stones floating . You may find oily fat in the stool. You may pass total of 4 times or 5 times of watery stool. The last watery stool will become normal colour at 11 am or 12 noon..
All the toxins are supposed to be out. Your tummy will be soft.. You will feel great and hungry.
9. By 11 am or 12 noon take your usual late break fast. Two slices of bread and
egg., or nasi lema or what ever light food as lunch.
Repeat the above treatment weekly for 4 weeks. And then followed by once a a month for many months to be free from diseases.
Functions: 1. the lemon plus olive oil is Cholycystagogue. (meaning stimulates the bile flow from the liver and flush the biliary system.)
2.The apple juice makes the gall stones soft and stimulates secretion of bile from the liver. Ready to flush out.
3.The Magnesium sulphate is a laxative and relaxes the bile duct and contracts the gall bladder. (Warm feeling in the stomach is due to the above functions.). The above will reduce the cholesterol, diabetes, fatty liver, Gall bladder wall thickening, sludge in the Gall bladder, reduce body weight. If the surgeon tells you to remove the gall bladder try this treatment for 4 weeks and check by ultrasound again. Please consult your doctor before the above regime to exclude gastro- Intestinal disorders like ulcers, obstructions, infections, appendicitis etc.




Article 40 : New EECP NCP PLUS arrived. .
NEW EECP NCP PLUS FROM USA ARRIVED RECENTLY.

REF; APPLIEDCARDIACSYSTEMS.COM




Article 41 : US cardiologist admits Fraud in unnecessary testing.

Mediscape news. Family Medicine.
Cardiologist Scams to the Tune of $19 Million.
Heartwire
US Cardiologist Admits to Ordering $19 Million in Unnecessary Testing.
Michael O'Riordan
Apr 11, 2013
Ref: http://www.medscape.com/viewarticle/782373?nlid=30303_589&src=wnl_edit_medn_fmed&uac=170504DT&spon=34

Editors' Recommendations.
Unnecessary Stenting Alleged at U of P Health System
Cardiologist Convicted of Fraud Loses Appeal
More Unnecessary Stenting Cases in Pennsylvania
Drug & Reference Information.
Angina Pectoris
Angina Pectoris in Emergency Medicine
Transmyocardial Laser Revascularization

PATERSON, NJ — A New York area–based cardiologist has confessed to ordering unnecessary tests and procedures on patients to the tune of $19 million[1]. Dr Jose Katz, the owner and chief executive officer of Cardio-Med Services and Comprehensive Healthcare and Medical Services, admitted to ordering diagnostic tests regardless of patient symptoms and falsely diagnosing a majority of his patients with angina to justify
The Record, a New Jersey newspaper, reports that Katz also admitted that he allowed unlicensed practitioners to treat and diagnose patients, including Mario Roncal, who obtained a medical degree in Puerto Rico but was never licensed to practice any US state. Katz also kept his wife on the payroll to make her eligible for Social Security benefits even though she did little or no work.
Katz made the admissions to US District Judge Jose Linares during a federal court hearing in Newark, NJ, last week. The government accused Katz of operating a "medical mill," where he ordered the same series of diagnostic tests on his patients, directed other employees or other physicians at his companies to perform the unnecessary tests, and falsely diagnosed a majority of his patients with angina. Katz even billed Medicare and Medicaid $15 million for enhanced external counterpulsation (EECP) for the treatment of angina, something his attorney admitted was unnecessary.
As part of his plea, Katz admitted that he bilked Medicare, Medicaid, and other insurers out of $19 million between 2004 and 2012. This is the largest amount of healthcare fraud discovered in New York, New Jersey, and Connecticut, the article states. Katz denied that the fraud put any of his patients at risk, insisting "the patients are more important than anything else."
According to the Record, Katz was paid more than $70 million from Medicare and Medicaid between 2005 and 2012. His busy practices, which included offices in Paterson and Union City, NJ, and Manhattan and Queens, NY, treated hundreds of patients each day. Katz also advertised extensively, spending $6 million on Spanish-language TV and radio ads over several years.
Katz was released on a $200 000 bond and faces between 57 and 87 months in prison. He is scheduled to be sentenced on July 23, 2013. Roncal, the unlicensed physician, has already pleaded guilty to healthcare fraud and is awaiting sentencing.





Article 42 : Alternative care at Government clinics.
Eventually puppets of FDA and Quack watchers will loose the battle.

27 November 2012| last updated at 11:38PM
Alternative care at all govt clinics soon
By ELVINA FERNANDEZ AND THARANYA ARUMUGAM | news@nst.com.my

0 comments

RELIABLE METHODS: Move can help reduce healthcare costs, says minister

KUALA LUMPUR: THE Health Ministry is considering making traditional and complementary medicine (TCM) available in all government clinics.

Minister Datuk Seri Liow Tiong Lai said TCM could help reduce the ministry's healthcare expenditure.

"It is time we introduce this alternative treatment at the primary care level as it could help bring down the rising chronic diseases statistics in the country," he told a press conference after launching the 4th Conference on Traditional Medicine in Asean countries yesterday.

The diseases include diabetes and high blood pressure.

He said a pilot project was carried out earlier this month at the Masai health clinic in Johor.

"If we are able to create awareness on TCM and prevent the spread of disease, we can transfer the healthcare expenditure to improving the healthcare system."

Liow said he was impressed by China which implemented TCM with modern medicine in the healthcare system, resulting in lower health expenditure.

Eleven government hospitals now offer traditional medicine along with modern medicine.

Among them are Kepala Batas Hospital (Penang), Sultan Ismail Hospital (Johor Baru), Putrajaya Hospital, Sultanah Nur Zahirah Hospital (Kuala Terengganu), Duchess of Kent Hospital (Sandakan, Sabah), Sarawak General Hospital (Kuching), Sultanah Bahiyah Hospital (Alor Star), Port Dickson Hospital, Sultanah Hajah Kalsom Hospital (Cameron Highlands) and Raja Perempuan Zainab II Hospital (Kota Baru).

The TCM services included traditional Malay massage, Malay post-natal care, Shirodhara, acupuncture and herbal oncology as adjunct treatment for cancer patients.

Liow said the three-day conference would see discussions on enabling the ministry's TCM division to come up with a comprehensive policy on alternative medicine in the primary healthcare sector.



Read more: Alternative care at all govt clinics soon - New Straits Times file:///C:/Users/Ebrahim/Desktop/Alternative%20care%20at%20all%20govt%20clinics%20soon%20-%20New%20Straits%20Times.htm#ixzz2LcmSKYs2




Article 43 : Cilantro is chelating agent.

Please see the website:

http://www.rawfoodinfo.com/articles/art_cilantroremheavymetals.html

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Health Issues

Cilantro Pesto Said to Remove Heavy Metals



In Today's Health Issues:

1) Cilantro
2) Cilantro Chelation Pesto
3) Eat While Detoxing Your Body!
4) Cilantro Blend -- Coriander/Yellow Dock Tincture

o>><><1) Cilantro
Dr. David G. Williams
There's nothing I like more than learning about inexpensive, common herbs or spices that exhibit unusual healing properties. Historically, the use of herbs and spices in cooking evolved as a method to preserve foods and make them safer to store and eat. We've grown accustomed to using these items to enhance or accentuate the flavors of food, but researchers continue to discover herbs have much more to offer than just good taste. Cilantro is such an herb and one of its medicinal benefits was uncovered through the work of Dr. Yoshiaki Omura.Dr. Omura treated several patients for an eye infection called trachoma (granular conjunctivitis), which is caused by the micro-organism Chlamydia trachomatis. Following the standard treatment, Dr. Omura found that the patients' symptoms would initially clear up, only to recur within a few months. He experienced similar difficulties in treating viral-related problems like herpes simplex types I & II and cytomegalovirus infections.After taking a closer look, Dr. Omura found these organisms seemed to hide and flourish in areas of the body where there were concentrations of heavy metals like mercury, lead, and aluminum. Somehow the organisms were able to use the toxic metals to protect themselves from the medicine. While he was testing for these toxic metals, Dr. Omura discovered that the leaves of the coriander plant (cilantro) could accelerate the excretion of mercury, lead, and aluminum from the body.This came about accidentally when he noticed that mercury levels in urine increased after an individual consumed Vietnamese soup. The healthy soup contained coriander, or, as it is better known in this country, cilantro. And when cilantro was used concurrently with natural antiviral or antibiotic agents and/or omega-3 fatty acids, the infections could be eliminated for good.Dr. Omura's discovery resulted in a novel technique, which greatly increased the body's ability to clear up recurring infections, both viral and bacterial. By chance, he also discovered an inexpensive, easy way to remove -- or chelate -- toxic metals from the nervous system and body tissues. Chelation therapy using chemical agents like EDTA has long been used to help remove heavy metals, but cilantro is the only natural substance I'm aware of that has demonstrated this ability.I highly recommend you take advantage of this "poor man's chelation treatment." All it takes is adding a quantity of cilantro to your diet daily, for two or three weeks. You can add a handful of fresh cilantro to a salad, mix a couple of teaspoons of cilantro pesto with whole wheat pasta, spread the pesto on toasted Italian bread, or have it with your favorite fish (good in soups). Any of these dishes will give you the dosages Dr. Omura used in his research.*****Courtesy of Sue
o>><><2) Cilantro Chelation Pesto
Heavy metal poisoning is rampant. It is a major cause of hormonal imbalances, cancer, thyroid problems, neurological disturbances, learning problems, depression, food allergies, parasites, etc. etc. This is a great recipe that is not only easy to make but also really yummy, and it tells you how to remove heavy metals from the body!Cilantro is truly a healing food. One friend suffering from high blood pressure due to mercury poisoning had her blood pressure return to normal after eating two teaspoons of this pesto daily for only a week. So whether you need to detoxify heavy metals from your body or just wish to use it as a preventative measure, 2 teaspoons a day is all you need to take. This pesto has now become a regular in my diet. Enjoy!Cilantro Chelation Pesto
4 cloves garlic
1/3 cup Brazil nuts (selenium)1/3 cup sunflower seeds (cysteine)1/3 cup pumpkin seeds (zinc, magnesium)2 cups packed fresh cilantro (coriander, Chinese parsley) (vitamin A)2/3 cup flaxseed oil
4 tablespoons lemon juice (vitamin C)2 tsp dulse powder
Sea salt to tasteProcess the cilantro and flaxseed oil in a blender until the coriander is chopped. Add the garlic, nuts and seeds, dulse and lemon juice and mix until the mixture is finely blended into a paste. Add a pinch to sea salt to taste and blend again. Store in dark glass jars if possible. It freezes well, so purchase cilantro in season and fill enough jars to last through the year.Cilantro has been proven to chelate toxic metals from our bodies in a relatively short period of time. Combined with the benefits of the other ingredients, this recipe is a powerful tissue cleanser.Two teaspoons of this pesto daily for three weeks is purportedly enough to increase the urinary excretion of mercury, lead, and aluminum, thus effectively removing these toxic metals from our bodies. We can consider doing this cleanse for three weeks at least once a year. The pesto is delicious on toast, baked potatoes, and pasta.*****Courtesy of Nance / PLANETNEWS
o>><><3) Eat While Detoxing Your Body!http://www.envirodocs.com/detox_food.htm
© By Lena Sanchez
A delightful healthy and tasty remedy to our environmental polluted bodies. I didn't discover it but I strongly approve of Dr. Omura's findings. How great is it that you can eat and detox at the same time?Dr. Omura said he discovered, almost by accident, that the leaves of the coriander plant can accelerate the excretion of mercury, lead and aluminum from the body. He had been treating several patients for an eye infection called trachoma (granular conjunctivitis), which is caused by the micro-organism Chlamydia trachomatis. Following the standard treatment with antibiotics, Dr. Omura found that the patients' symptoms would clear up initially, then recur within a few months. He experienced similar difficulties in treating viral-related problems like Herpes Simplex types I & II and Cytomegalovirus infections.After taking a closer look, Dr. Omura found these organisms seemed to hide and flourish in areas of the body where there were concentrations of heavy metals like mercury, lead, and aluminium. Somehow the organisms were able to use the toxic metals to protect themselves from the antibiotics.It just so happens that while he was testing for these toxic metals, Dr. Omura noticed that mercury levels in the urine increased after one consumed a healthy serving of Vietnamese soup. The soup contained Chinese parsley, or as it is better known in this country, cilantro. (Some of you may also know it as coriander, since it comes from the leaves of the coriander plant.)Further testing revealed that eating cilantro also increased the urinary excretion of lead and aluminum. And when cilantro was used concurrently with the antibiotics or natural antiviral agents and/or fatty acids like EPA with DHA, the above infections could be eliminated for good. ...Dr. Omura has made a remarkable discovery. He's found a novel technique, which greatly increases our ability to clear up recurring infections, both viral and bacterial. And, perhaps more exciting, he's discovered an inexpensive, easy way to remove (or "chelate") toxic metals from the nervous system and body tissues-one that anyone can use.Great News for Amalgam Sufferers
Cilantro Pesto
1 clove garlic
cup almonds, cashews, or other nuts1 cup packed fresh cilantro leaves
2 tablespoons lemon juice6 tablespoons olive oil
Put the cilantro and olive oil in blender and process until the cilantro is chopped. Add the rest of the ingredients and process to a lumpy paste. (You may need to add a touch of hot water and scrape the sides of the blender.) You can change the consistency by altering the amount of olive oil and lemon juice, but keep the 3:1 ratio of oil to juice. (It freezes well, so you can make several batches at once.)Can you imagine eating and detoxing? Yes by adding cilantro to your foods that's exactly what happens! Go in health!Lena
-----Lena Sanchez a retired Medical office nurse/administrator & a health and business consultant http://www.envirodocs.com/experience_and_experiences.htm Editor of "Natural Environmental Health & Business Facts" *****Courtesy of C Schutz via Mahara Renay
o>><><4) Cilantro Blend -- Coriander/Yellow Dock Tincture
http://www.ferlowbrothers.com/coriander_yellow_dock.htm
Detoxifies Heavy Metal (mercury from amalgamated fillings)By Klaus Ferlow
Excerpt from The Botanical Review -- a technical bulletin published by:The Institute of Quantum & Molecular Medicine:Since Roman times cilantro has been used as food and medicine. A recent study by Dr. Yoshiaki Omura from the Heart Disease Research Foundation, New York, NY, USA (Acupuncture Electrotherapy Res. 96; 21 (2) 133-60 and Acupunct Eletrother Res. 1995 Aug-Dec. 20 (3-4) : 195-229 has discovered that the herb cilantro will detoxify mercury from neural tissue*., is used to help stimulate the appetite and relieves minor digestive irritation.This is a remarkable discovery. It is a novel technique, which greatly increased our ability to clear up recurring infections, both viral and bacterial. Bioactive Cilantro blend is an inexpensive, easy way to remove (or chelate) toxic metals from the nervous system and body tissues. Cilantro blend contains yellow dock to help drain the mercury from the connective tissues. It is an excellent blood cleanser, tonic, and builder, working through increasing the ability of the liver and related organs to strain and purify the blood and lymph system. Achieves it’s tonic properties through the astringent purification of the blood supply to the glands and acts as a cleansing herb for the lymphatic system.Do dental amalgam fillings contain toxic material?Silver fillings are made up of five different metals, amalgamated together to form a solid mass which hardens in the mouth. The main ingredient in amalgam is mercury, which accounts for about 50 percent of the completed filling. The other ingredients are silver, copper, tin, zinc and occasionally nickel. Mercury vapors are released in the mouth in low level concentrations when fillings are subjected to the pressure and abrasion of chewing.Actually, all of the elements comprising dental amalgam are toxic metals, but mercury is by far the most toxic. Sharma & Obersteiner established that mercury is more toxic than lead, cadmium, and even arsenic. Mercury has a very high absorption rate and is capable of entering the human body very rapidly and completely. Mercury vapor is fat soluble and neutral electrically. It has the ability to easily penetrate cell membranes and pass rapidly into the body from the blood into the body cells.Systemic Effects:Neurological: Frequent or chronic headaches, dizziness, ringing or noises in the ears, fine tremors (hands, feet, lips, eyelids, and tongue).Immunological: Allergies, rhinitis (inflammation of the nose), sinusitis, asthma, lymphaddenopathy (especially cervical or neck).Endocrine: Subnormal temperatures, cold, clammy skin, especially hands and feet, excessive perspiration.

Other: Muscle weakness, fatigue, hypoxia (lack of oxygen), anorexia, joint pains, anemia, Edema (swelling), loss of weight.

Severe Cases: Hallucinations, manic depression.

Cilantro’s postulated mechanism of action is to act as a reducing agent changing the charge on the intracellular mercury to a neutral state allowing mercury to diffuse down it’s concentration gradient into connective tissue. This is called connective tissue mercury toxicity. The next step is to remove the mercury from the connective tissue. Mercury is preferentially attracted to the cell wall of the unicellular organism chorella. It can also be bound to sulfhydryl groups in garlic or to sulfur in the form of MSM. To get the mercury out, a cleansing of the liver, intestines, kidneys and lymph should be done. The clinical goal is to convert mercury into a state enabling it to be removed from the cells and be eliminated from the brain, connective tissues, lymph system, liver, gastrointestinal tract, and kidneys.

Good News For Amalgam Sufferers:

Chelation therapy using chemicals like EDTA has long been used to help remove these heavy metals, but cilantro is a natural substance that is good news for people suffering from the ill effects of amalgam dental fillings.

Dr. Omura recently performed another study in which three amalgams were removed from an individual using all of the precautions available to prevent absorption of the mercury from the amalgam. Even with strong air and water suctioning, water rinses, and a rubber dental dam, significant amounts of mercury were later found in the individual’s lungs, kidneys, endocrine organs, liver and heart. No mercury was detected in these tissues prior to the date of removal.

The active components in cilantro are fragile, and processing by heat will destroy the chelating agents. It is therefore recommended that it be taken in a liquid botanical preparation or raw, to get the most out of this remarkable herb.

Indications and Usage:

Metal toxicity, mercury amalgam toxicity, immune disorders, premature aging, cardiovascular disease, allergies, Alzheimer’s, gastrointestinal disorders, psychological disorders, asthma, cancer, chronic fatigue, endocrine disorders and gingivitis.

*The food and drug administration have not evaluated this statement. It
is not our intension to prescribe or make any specific health claims
for this product. Any attempt to diagnose and treat illness should come
under the direction of a health care practitioner.

REFERENCE:

Alternatives, Dr. David G. Williams, Vol.7, No.12, June, 1998, p91-92.
Sharma, R.P. & Obersteiner, E.J. Metals and Neurotoxic Effects:
Cytotoxicity of Selected Metallic Compounds of Chick Ganglia Cultures.
J Comp Path 91:235-44 1981.
Haltiwanger, Steven MD “Clinical Use of Mineral Transporters and their
Effects on Cell Membrane Capacitance”, Lecture, Second International
Congress of BioEnergetic Medicine, Institure of Quantum and Molecular
Medicine, Daniel g. Clark, President, February 20-22, 1998.
Magos, L. Mercury-Blood Interaction and Mercury Uptake by the Brain
After Vapor Exposure. Environ. Res 1:323-37,1967.
Clarkson, T.W.; Friberg, L; Hursh, J.; Nylander, M. The Prediction of
Intake of Mercury Vapor from Amalgams in Biological Monitoring of Toxic
Metals. Eds: Clarkson, Fribert, Nordberg, Sager, Plenium Press, New
York, February, 1988.
Bioprobe Newsletter 6(5) September 1990.

Please Note: It is not our intention to prescribe or make specific
health claims for any of our products. Any attempt to diagnose and
treat illness should come under the direction of your health care
practitioner


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Larry Morningstar
Health Issues
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Article 44 : Mechanism of action of Ozone therapy..

Mechanisms of Action Involved in Ozone Therapy: Is healing induced via a mild oxidative stress?
Masaru Sagai1 and Velio Boccicorresponding author2
Author information ► Article notes ► Copyright and License information ►
Abstract

The potential mechanisms of action of ozone therapy are reviewed in this paper. The therapeutic efficacy of ozone therapy may be partly due the controlled and moderate oxidative stress produced by the reactions of ozone with several biological components. The line between effectiveness and toxicity of ozone may be dependent on the strength of the oxidative stress. As with exercise, it is well known that moderate exercise is good for health, whereas excessive exercise is not.

Severe oxidative stress activates nuclear transcriptional factor kappa B (NFκB), resulting in an inflammatory response and tissue injury via the production of COX2, PGE2, and cytokines. However, moderate oxidative stress activates another nuclear transcriptional factor, nuclear factor-erythroid 2-related factor 2 (Nrf2). Nrf2 then induces the transcription of antioxidant response elements (ARE). Transcription of ARE results in the production of numerous antioxidant enzymes, such as SOD, GPx, glutathione-s-transferase(GSTr), catalase (CAT), heme-oxygenase-1 (HO-1), NADPH-quinone-oxidoreductase (NQO-1), phase II enzymes of drug metabolism and heat shock proteins (HSP). Both free antioxidants and anti-oxidative enzymes not only protect cells from oxidation and inflammation but they may be able to reverse the chronic oxidative stress. Based on these observations, ozone therapy may also activate Nrf2 via moderate oxidative stress, and suppress NFκB and inflammatory responses. Furthermore, activation of Nrf2 results in protection against neurodegenerative diseases, such as Alzheimer's and Parkinson's diseases. Mild immune responses are induced via other nuclear transcriptional factors, such as nuclear factor of activated T-cells (NFAT) and activated protein-1 (AP-1).

Additionally, the effectiveness of ozone therapy in vascular diseases may also be explained by the activation of another nuclear transcriptional factor, hypoxia inducible factor-1α (HIF-1a), which is also induced via moderate oxidative stress. Recently these concepts have become widely accepted. The versatility of ozone in treating vascular and degenerative diseases as well as skin lesions, hernial disc and primary root carious lesions in children is emphasized. Further researches able to elucidate whether the mechanisms of action of ozone therapy involve nuclear transcription factors, such as Nrf2, NFAT, AP-1, and HIF-1α are warranted.
Keywords: ozone therapy, oxidative stress, NFκB activity, Nrf2 activity, antioxidant response element (ARE), nuclear factor of activated T cells (NFAT), activated protein-1 (AP-1), hypoxia inducible factor-1α (HIF-1α)
Introduction

Ozone therapy, or more specifically, the major ozonated autohemotherapy (O3-AHT), has been used for almost 40 years. The first report on ozone therapy was published by Wolff in 1974 [1]. Although ozone therapy is now used all over the world, it has not yet been accepted as orthodox medicine in all countries.

About two decades ago, both nitrogen oxide (NO) and carbon monoxide (CO) were only considered as toxic air pollutants or gases derived from cigarette smoke. However, today, they are regarded to as essential gases, since both NO and CO are responsible for very important physiological actions within the body [2-4]. Similarly hydrogen sulfide, a toxic gas, is now used as a drug for the treatment of osteoporosis [5,6]. Additionally, low dose radiation was also reported to have beneficial effects within radiated cells, in particular, by prolonging the lifespan of cells via the hormesis mechanism [7]. Thus, our understanding of toxic compounds and their effects within the body appears to be constantly changing as we have realized that toxicity depends entirely on the dosage.

Both exercise and caloric restriction are excellent examples of the hormetic effect [8]. It is well known that moderate exercise is beneficial for health. Furthermore, caloric restriction is also well known to delay disease onset and mortality [9], to promote health, and to increase longevity by inducing sirtuin 1 (SIRT1), a gene responsible for longevity [10].

One of the purposes of this review is to propose a hypothesis on the mechanisms of action of ozone from the view point of oxidative stress and nuclear transcription factors, because oxidative stress acts as a second messenger in various intracellular signaling pathways. Furthermore, cells can quickly induce biological responses against oxidative stress to maintain biological homeostasis and adapt to such stresses. And, some nuclear factors induce various biological responses against oxidative stress.

The findings of animal experiments and studies on the clinical applications of ozone therapy are included. Additionally, we explore the possibility that the mechanisms of action of ozone therapy may be via the activation of antioxidant protection systems, where moderate oxidative stress may induce the activation of nuclear transcriptional factors such as nuclear factor-erythroid 2-related factor 2 (Nrf2), hypoxia inducible factor-1α(HIF-1α), nuclear factor of activated T-cells (NFAT), and activated protein-1 ( AT-1).
1. The ozone paradox: is ozone always toxic?
1.1. Reaction with ozone and biological components

Pryor et al [11] have previously described the mechanisms involved in ozone lung toxicity. Briefly, inhaled ozone reacts with polyunsaturated fatty acids (PUFA), which are found in the lipids of the alveolar lining layer (ALL), to produce ozone-specific products, referred to as lipid ozonation products (LOPs). Ozone can also react with unsaturated fatty acids to produce Criegee ozonide in the absence of H2O. However, in the presence of H2O, aldehydes and hydrogen peroxide (H2O2) are produced [11]. Since H2O is abundant within the pulmonary system, the main reaction with ozone will be the formation of aldehyde and H2O2 products. The net reaction is as follows:
H2O2 + Fe++ - - - - - - → OH∘ + OH- + Fe+++

LOPs are proposed to be the more likely species to act as signal transduction molecules. These products may activate specific lipases, such as phospholipase A2 or phospholipase C, to release arachidonic acid (AA). In fact, AA levels increase more than 10-fold in endobronchial washings obtained from rats exposed to 1.1 ppm of ozone for 5 days [12]. The released AA can then be converted into other chemical mediators, such as various prostaglandins (PGs) and platelet activating factors (PAF), via cyclooxygenases (COXs) and lipoxygenases (LOXs) to induce an inflammatory response. Furthermore, it has been reported that 4-hydroxynonenal (4-HNE), the most toxic type of aldehyde [13,14] and H2O2 [15,16], have the ability to partake in signal transduction.
1.2. Effects of ozone on the airways: Airway hyperreactivity and inflammation

Airway hyper reactivity is one of the earlier signs of ozone inhalation. An increase in airway hyperreactivity is accompanied by airway inflammation. These changes are similar to those by cigarette smoking. Lin et al [17] proposed the signaling mechanisms behind airway inflammation induced via smoking. Briefly, it was demonstrated that cigarette smoke extract (CSE) added into a cell culture system of human tracheal smooth muscle cells binds to Toll-like receptor 4 (TLR4). TLR4 then activates NADPH-oxidase via adaptor molecules, such as MyD88, to produce reactive oxygen species (ROS). Further, ROS activate mitogen activated protein kinases (MAPKs), and MAPK phosphorylates IκBα part of the nuclear factor kappa B and IκBα (NFκB- IκBα) complex found in cytosol fractions. As a result NFκB is released from the complex, and this free NFκB enters into nuclei to activate the COX2 gene. COX2 then produces PGE2, which stimulates a number of cytokines, among which TNFα and IL-6. The eicosanoide and cytokines then induce the airway inflammation during the early stage of exposure. These reactions also occur in airway epithelial cells, endothelial cells, and macrophages. This signaling cascade is also supported by the findings of Williams et al. [18]. They demonstrated that TRL2 or TLR4 knockout mice do not have airway hyperreactivity and neutrophil infiltration even after an exposure to ozone of 3 ppm. These observations strongly suggest that there is a strong relationship between inflammation and TLR.

There are good experimental [19,20] and clinical [21] studies showing that exposure by inhalation to prolonged tropospheric ozone damages the respiratory system and extra pulmonary organs. The skin, if extensively exposed, may also contribute to the damage [22,23]. Consequently the strong reactivity of ozone, which has an electrochemical potential value, E°= +2.076V, has contributed to establish the dogma that ozone is always toxic and its medical application must be proscribed. However it will be shown that this dogma is not supported by comparing the action of ozone on the lung surface versus human blood. Obviously it must be said that ozone must be never inhaled by anyone in the clinic. However, it seems that ozone may be produced in our body similar to NO, CO and H2S: it has been reported that antibody-catalyzed water-oxidation pathway produced an additional molecular species with a chemical signature to that of ozone [24]. This species is also generated during the oxidative burst of activated human neutrophils and during inflammation [25].

The fundamental points to consider are: the topography, anatomical and biochemical characteristics of the organs daily exposed to ozone versus the potent antioxidant capacity of blood exposed to a small and precisely calculated dose of ozone for a few minutes. It is clear how the respiratory system undergoing a chronic oxidative stress can release slowly, but steadily, a huge amount of already mentioned toxic compounds able to act locally and to enter the circulation and cause serious damage.
1.3. Origin, distribution and fate of toxic compounds released by the pulmonary system during and after ozone exposure

At the airspace level, the alveolar cells are constantly overlaid by a film composed of water, salts and a myriad of biomolecules such as a profusion of surfactant phospholipids and a very small amounts of proteins, lipophilic and hydrophilic antioxidants. Any inspired gas, depending upon its relative concentration and pressure, must first dissolve into the aqueous layer before reaching the alveolar microcirculation and the erythrocytes. This process implies a physical transport regulated by a pressure gradient and a diffusion process. On the other hand, it is known that ozone, in contact with biological water, does not follow Henry's law and, although it is ten fold more soluble than oxygen, it is not transferred into the alveolar capillaries because it reacts immediately with the biomolecules present in the Alveolar Lining Layer (ALL). It must emphasized that the average thickness of ALL is only 0.2 micron [26]. As it was hypothesized [11], ozone does not penetrate the cells but oxidizes available antioxidants and reacts instantaneously with surfactant's polyunsaturated fatty acids (PUFA) present at the interface to form Reactive Oxygen Species (ROS), such as hydrogen peroxide and a mixture of heterogenous LOPs including lipoperoxyl radicals, hydroperoxides, malonyldialdeyde, isoprostanes, the ozonide and alkenals, particularly 4-HNE [27-29]. As cholesterol is a component of the epitherial lining fluids (ELF) and because its double bond is readily attacked by ozone, it can give rise to biologically active oxysterols [30,31] of which 3β-hydroxy-5-oxo-5,6-secocholestan-6-al (CSeco) has been implicated in pulmonary toxicity, Alzheimer's disease and atherosclerosis.

The antioxidant capacity present in the human ALL is extremely limited and, although different portions of the respiratory tract may have different antioxidant levels, these are always irrelevant in comparison to the amount of antioxidants that, in blood, easily tame the ozone reactivity. First of all, by considering the expanse of the alveolar surface (1 m2/kg body weight) in a 70 kg human, it can be calculated that the normal volume of ALL ranges only between 17 and 25 ml, whereas 5 L of blood include about 2.7 L of plasma. Moreover, the erythrocyte mass, amounting to about 2.3 kg, has an enormous antioxidant capacity due to hydro-lipophilic antioxidants and enzymes able to reduce any antioxidant in a few minutes [32]. Erythrocytes, via glucose-6-phosphate dehydrogenase activity in the pentose cycle, can continuously supply NADPH-reducing equivalents. The amount of plasma albumin acting as a "sacrificial compound" against oxidants is impressive (99.9% higher than in ALL). Moreover erythrocytes have a GSH content of about 2.2 mM (almost 800-fold higher than plasma) and therefore they contain a huge reserve. In the course of evolution, aerobic organisms have developed a sophisticated antioxidant system against oxygen and, although about 2% of the inhaled oxygen generates superoxide anion, this is normally neutralized at an alveolar pO2 pressure of 100 mm Hg. It is useful, however, to bear in mind that rats inhaling pure oxygen (alveolar pressure at about 700 mmHg) die within 60-66 h [33], Ozone is far more reactive than oxygen, and breathing air containing 10.0 ppm ozone causes death within 4 h in rats. In order to understand the effects of a daily 8-hour ozone exposure (April-October), we need to know the average environmental ozone levels that vary considerably for many reasons. The US Clean Air Act has set an ozone level of 0.06 ppm as an 8-h mean concentration to protect the health of workers (U.S. Environmental Protection Agency, 2005). Evaluation of recent studies [34,35] allows establishing an average environmental ozone concentration of 0.09 ± 0.01 ppm. However, ozone concentration in urban air can exceed 0.8 ppm in high pollution conditions [27]. For 8 h at rest (a tidal volume of about 10 l/min and a retention of inspired ozone of no less than 80%), the ozone dose amounts to 0.70-0.77 mg daily or 21.0-23.1 mg monthly. This is likely the minimal ozone intake because physical activity increases the volume of inhaled air and, at peak time, the ozone levels can easily augment to 200-300 ppb, reducing pulmonary functions and enhancing the risk of cardiovascular death [21,34-36]). Moreover, the toxicity is certainly augmented by the presence of NO2, CO, SO2 and particulate matters (PM10). On this basis, it appears clear how the ozone generated ROS and LOPs at the ALL level, after being minimally quenched by the insufficient, antioxidants will act as cell signals able to activate nuclear factor-kappa B (NF-κB), NO-synthase, some protein kinases, thus enhancing the synthesis and release of TNFα, IL-1, IL-8, IFNγ and TGFβ1 and the possible formation of nitrating species. With an increasing inflow into the alveolar space of neutrophils and activated macrophages, a vicious circle will start, perpetuating the production of an excess of ROS including also hypoclorous acid [37,38]. Moreover, during Summer, there is a continuous flow of ozone entering the respiratory space and also the very fact that ozone dissolves in the ALL and reacts immediately; thus, every second, more ozone reacts so that in a 6-month period the cumulative dose (likely up to 150-300 mg ozone) becomes really deleterious. Similarly several months exposure to ozone or to a prolonged oxidative stress due to a chronic inflammatory disease (atherosclerosis, diabetes, cancer) can possibly raise 4-HNE plasma levels up to 5-20 μM and, in spite of continuous detoxification, they can exert pathological effects as those observed in vitro studies performed with leukemic cells [39], lens epithelial cells [40], Jurkat T cells [41] and when testing cholesterol secoaldehyde (CSeco) in cardiomyoblasts [31]. Interestingly, tolerance to ozone or 4-HNE is far more easily achieved by small and repeated oxidative stresses than after a continuous and heavy oxidation [42,43]. On the other hand, a normal endogenous 4-HNE level (0.1- 0.7 μM) appears to act as a defensive agent against itself and other toxic compounds [13,44]. Thus, the biological behavior of HNE is an enlightening example of how the physiological serum level of a potentially toxic aldehyde produced by the normal peroxidation is proficiently used for maintaining homeostasis.

Finally, it is worthwhile to mention that the vast skin surface, possibly exposed for hours to ozone and UV radiation, can contribute to the overall toxicity: several studies performed by exposing hairless mice to ozone have shown not only depletion of the skin antioxidants but the induction of a remarkable oxidative stress [22,23]. As a consequence, humans, living in hot countries and during summer, become particularly susceptible to ozone and UV irradiation. On the contrary, a quasi-total (excluding the neck and the head) exposure of human volunteers to a very low ozone concentration in a sauna cabin for 20 min results in a very transient increase of LOPs in the peripheral circulation that exerts therapeutic effects in chronic limb ischemia's patients [45,46] interpreted as due to an induction of antioxidant enzymes and HO-1. In conclusion, although ozone is not the only culprit for adverse health effects, it significantly contributes to exacerbate respiratory illnesses and enhances mortality in about 40% of the total US population [21]. The problem is linked to the abnormal ozone concentration of troposheric ozone and to the continuously increased production of noxious compounds due to the excess burning of coal, oil and virgin forests. During this century, if human activities continue to release in the atmosphere the actual amount of global emissions, the Earth will experience a new Paleocene-Eocene Thermal Maximum or "a fever period" with dramatic consequences. The overall toxicity, due to the constant aggressiveness of ozone on lungs and partly on the exposed skin, associated with the relative efficiency of the detoxifying system, progressively overwhelmed by the perennial stress, favours pathological effects such as inflammation and cell degeneration particularly on lungs, liver (fibrosis), heart, kidneys and brain [47,48]. Consequently vital organs can be envisaged to be subjected to a kind of a "toxic rain" produced in the pulmonary system. Obviously, this knowledge has popularized the idea of ozone toxicity but, in the next section, it will be clarified that the generalization of this concept is incorrect.
2. How an appropriate ozone dose acts on human blood?

During the period 1970-2000, the ozonated autohemotherapy had been performed in an empirical fashion owing to imprecise ozone generators and the lack of knowledge of the mechanisms of action of ozone in human blood. However, by 1998, two crucial events changed the outlook: firstly, new ozone generators with precise photometers able to accurately measure (at 253.7 nm) the ozone concentration became available, and secondly, it was clarified how ozone works when mixed with blood ex vivo [49,50]. Oxygen equilibrates with the extracellular and intraerythrocytic water before becoming bound to hemoglobin until it is fully oxygenated as shown by the rapid increase of the pO2 from about 40 up to 400 mmHg. Ozone, ten fold more hydrosoluble than oxygen, readily dissolves in the aqueous environment of plasma and is partly (between 20 and 40%) quenched by hydrophilic antioxidants such as reduced glutathione, ascorbic and uric acids acting as sacrificial compounds, while the bulk reacts with PUFA transported by the albumin. The "therapeutic window" has been carefully determined and ranges between 10 and 80 μg/ml (0.21-1.68 μmol/ml) ozone per ml of blood. It ensures a small and precise oxidative stress able to elicit medical efficacy, but no toxicity. It must be noted that ozone acts as a pro-drug because, during this fast reactions, ozone disappears but generates two crucial messengers: the first is H2O2 and the second is a mixture of LOPs finally exemplified by 4-HNE (from omega-6 PUFA) and 4-HHE (trans-4 hydroxy-2-hexenal from omega-3 PUFA).

The behavior and pharmacodynamic of H2O2 have been ascertained: the initial formation of a gradient between plasma and intracellular water [51] allows its entrance into the erythrocytes, lymphocytes and platelets, but its concentration remains around a few micromoles because it is quickly reduced to H2O by free GSH, catalase and GSH-Px [52]. Its half-life is less than 60 seconds and yet its intracellular concentration is critical, because in order to activate some biochemical pathways (formation of GSSG with consequent activation of the pentose cycle in the red cell and activation of a tyrosine kinase in lymphocytes), it must reach a critical threshold that, nonetheless, is not cytotoxic. The concept of threshold is physiologically important and means that an ozone dose below 10 μg/ml of gas per ml of blood, in most cases, is biologically ineffective because the ozone dose is totally neutralized by the plasma antioxidants. In other words, the concept of a threshold helps to understand that a too low ozone dose may be ineffective (placebo effect) while a dose higher than the therapeutic one can be toxic. It is almost needless to add that saline-washed erythrocytes suspended in saline, even if exposed to very low ozone concentrations, undergo conspicuous hemolysis, an artificial result [53] that has favoured the concept of ozone toxicity. Provided that the ozone dose is within the well defined range, there is only a transitory decrease (no more than 25%) of the potent antioxidant capacity of plasma [54] fully reconstituted within 20 min owing to the efficiency of the redox system [32]. There is neither damage to erythrocytes nor to other cells: hemolysis is negligible (from 0.4 up to 1.2%), there is no leakage of K+ and methemoglobin remains normal [55]. It must be added that ozonated erythrocytes show an improved glycolysis with an increase of ATP and 2,3-DPG levels, which are able to shift the dissociation curve of HbO2 to the right, confirming the observation of an improved delivery of oxygen in peripheral obstructive arterial disease. Extensive data have been reported in reviews [56-58] and two books [46,50]. It is now clear that a "physiological" ozone dose (most frequently ranges between 20 and 40 μg/ml ozone per ml of blood) triggers an acute and precisely calculated oxidative stress able to activate several biological processes summarized in Table ​Table1.1. What happens during the rapid infusion of the hyperoxygenated-ozonated blood into the donor ? The hyperoxygenation of blood (pO2, at about 400 mmHg) is irrelevant because, during the 15-min infusion period, it mixes with venous blood so that the final venous pO2 relative pressure is hardly modified. Oxygen-ozone behaves similarly when this gas mixture comes in contact with either a moist human skin [45] or the rabbit colon-rectal mucosa [59], ozone dissolves immediately in the water overlaying the epithelium and reacts with either sebum, or mucoproteins, faeces and any other biomolecules present in the liquid film generating hydrogen peroxide and LOPs. Only LOPs are absorbed via lymphatics and venous capillaries and reach first the liver and then enter into the general circulation where these have been measured [59].
Table 1
Table 1
Ozone therapy can induce the following biological responses

The next important step was to evaluate the distribution, the fate and the biological significance of alkenals. After the 5 min mixing blood with the gas mixture ex vivo, the ozonated blood is ready to be infused back into the donor patient. Both ozone and hydrogen peroxide have been exhausted but alkenals have formed adducts with either the Cyst 34 of albumin or/and GSH and will be infused into the patient's circulation. They will interact with endothelial cells and then with billions of cells of various organs [46]. Just in case an inexpert ozone therapist uses an excessive ozone dose, he may oxidize Cys 34 to sulfenic acid: RSOH, which however can be reduced again.

The distribution of 4-HNE and similar alkenals has pharmaco-toxicological relevance: owing to the intrinsic toxicity of aldehydes, it is important to know their metabolism and fate: Alary et al. [60] have reported that about 70% of 4-HNE is excreted in urine within 2 days after its intravenous administration in rats. Siems and Grune [61], after investigating the metabolism of 4-HNE in several mammalian cells and organs, demonstrated that 4-HNE, at a concentration of 100 μM, was degraded within 3 min of incubation at 37°C, and it took only 10-30 s to restore the physiological level of about 0.2 μM. The kinetic of disappearance from mildly ozonated blood of thiobarbituric acid reactive substances (TBARS), including MDA and 4-HNE has been measured in six patients with age-related macular degeneration (ARMD), and their half-life was equivalent to 4.2 ± 1.7 min [62]. On the other hand, when the same samples were incubated in vitro (at 37°C and pH 7.3), LOPs levels hardly declined during the next 9 h, indicating their stability in an acellular medium and suggesting the relevance of cellular catabolism [49]. On the whole, it appears that mammals have developed an efficient detoxification machinery to metabolize 4-HNE and minimize its toxicity: Awasthi et al. [42] not only have indicated six enzymes: glutathione S-transferases, aldoketoreductases, aldose reductase, aldehyde dehydrogenases Cyp450 4A and β-oxidation enzymes, important in the metabolism of 4-HNE, but they and other authors [40,43,44] have emphasized that 4-HNE stress-preconditioned cells can develop a significant adaptive response by upregulating the synthesis of γ-glutamate cysteine ligase, γ-glutamyltransferase, γ-glutamyl transpeptidase, HSP-70, heme oxygenase-1 and a variety of antioxidant enzymes. There is now ample consensus on the importance of the induction of cell tolerance to submicromolar levels of 4-HNE [13,63-66]. At this point, it seems useful to point out that mammalian organisms, for controlling 4-HNE toxicity due to oxidative stress and maintaining it at physiological plasma level of 0.3-0.7 μM enact the following processes:

a) Dilution, a simple calculation indicates that a bolus injection of a dose of 500 μM 4-HNE in 10 ml of plasma, once diluted in a plasma-extracellular fluid volume of 12 l, irrespective of any other process, yields a concentration of as low as 0.04 μM.

b) Detoxification, due to the direct inactivation of 4-HNE with GSH and ascorbate or to the interaction with billions of cells endowed with detoxifying enzymes [42]

c) Excretion, into bile and urine after hepatic detoxification [67] and renal excretion [60], and

d) Cell internalization, this is a crucial and interesting point because the consequent biological effects can be either negative or positive. Several months exposure to inhaled ozone or to a prolonged oxidative stress due to a chronic disease (atherosclerosis, diabetes, inflammation) can possibly raise 4-HNE plasma levels up to 5-20 μM and, in spite of continuous detoxification, they can exert pathological effects. Interestingly, tolerance to ozone or to 4-HNE is far more easily achieved by small and repeated oxidative stresses than after a continuous and heavy oxidation [42.43]. On the other hand, a normal endogenous 4-HNE level (0.1- 0.7 μM) appears to act as a defensive agent against itself and other toxic compounds. At this stage, alkenals acquire the great value to hypothetically trigger the molecular mechanisms leading to elicit medical efficacy without toxicity. This aspect is discussed in the next section.
3. Oxidative stress and nuclear transcriptional factors in carcinogenesis

Chronic inflammation plays a critical role in neoplastic growth (transformation), as well as in many other diseases. Inflammation is induced via NFκB activation by various inflammatory factors, such as LPS and severe oxidative stress derived from drugs that induce iNOS, COX-2, and inflammatory cytokines. These factors induce the survival, growth, and proliferation of tumor cells, and result in neoplasia [68]. Therefore, inhibition of NFκB is an important target for the prevention and treatment of cancer. For example, it is known that the inhibitors of NFκB, such as vitamin E, resveratrol, curcumin, catechin, and aspirin may delay or suppress tumor growth.
3.1. Anti-neoplastic mechanisms of Nrf2

Chronic inflammation plays a critical role in neoplastic growth as well as in many other inflammatory diseases. Therefore inhibition of NFkB is an important target for the prevention and possibly treatment of cancer. Has Nrf2 a role in ozone therapy ? Li et al [69] demonstrated that Nrf2, an important cytoprotective nuclear transcription factor, suppresses NFκB-activation. As shown in Fig.​Fig.1(left1(left side), Nrf2 is usually present within the cytosol as a complex with Keap-1 protein. The question is: are alkenals able to dissociate this complex ? The Keap-1 protein has two SH-groups and the formation of adducts may cause a conformational change favoring its dissociation. Besides other pathways to be experimented and a mild oxidative stress, Nrf2 is released from this complex and is transported into nucleus. The transported Nrf2 forms a new complex with Maf protein, and induces the transcription of various antioxidant and phase II detoxification enzymes by binding to antioxidant response element (ARE) on DNA. The specific antioxidative enzymes that are activated, include SOD, catalase (CAT), GSH, GSH-reductase, GPx, GSH-S-transferase (GSTr), HO-1, NADPH quinine-oxidoreductase 1 (NQO1), heat shock protein 70 (HSP70), and phase II enzymes. These enzymes may elicit anti-neoplastic effects.
Figure 1
Figure 1

Sulforaphane (SFN), a component in broccoli is the most common phytochemical that induces the transcription of various antioxidant enzymes via the activation of Nrf2. In fact, SFN alone may also act as an oxidative stressor in cells.
3.2. Anti-neoplastic phytochemicals are not effective in Nrf2 knockout mice

In the previous section, the anti-neoplastic effects of phytochemicals, such as SFN, have been explained with respect to their via activation of Nrf2. It is well known that SFN possesses potent chemopreventive effects through the induction of cellular detoxifying/antioxidant enzymes via the Nrf2 [70]. If these effects are really mediated via Nrf2, then the actions of SFN should be inactived in Nrf2 knockout mice, and active in wild-type mice. Indeed, this observation was made by Xu et al [68] when they examined the chemopreventive efficacy of SFN in Nrf2 wild type (+/+) and Nrf2 knockout (-/-) mice. A topical application of 100 nmol of SFN once a day for 14 days prior to 7,12-dimethyl-benz(a)anthracene/12-O-tetradecanoyl-phorbol-13-acetate treatments decreased the incidence of skin tumors in the Nrf2 (+/+) mice compared to the vehicle-treated group. More importantly, there were no chemopreventive effects elicited by SFN pre-treatment in Nrf2 (-/-) mice. Taken together, these results demonstrate, for the first time, that Nrf2 (-/-) mice are more susceptible to skin tumorigenesis, and that the chemopreventive effects of SFN are mediated via Nrf2 activation.
3.3. Oxidative stress induced by moderate exercise induces Nrf2 -activation

Moderate and severe exercise results in the production of ROS in both muscle and internal organs. ROS are not only toxic, but also play an important role in cell signaling and the regulation of gene expression. Moderate exercise is known to be good for health, as opposed to severe exercise. However, the mechanisms of action of the ROS produced during exercise are not fully understood.

The production of ROS during exercise is primarily due to disorders of the mitochondrial electron transport system induced via an increase in oxygen consumption, elevations in NADPH-oxidase activity resulting from ischemia and reperfusion of internal organs, and inflammation induced via the infiltration of inflammatory cells, such as macrophages and neutrophils. ROS production levels may also depend on the intensity of exercise.

Gomez-Cabrera et al [71] reported that moderate exercise results in the activation of MAP kinases and the NFκB pathway, and consequently the expression of eNOS, iNOS, and MnSOD. Interestingly, all of these changes were abolished when ROS production was inhibited with allopurinol, an NADPH-oxidase inhibitor. These findings suggest that exercise-induced ROS production results in the expression and activation of antioxidant enzymes, such as MnSOD and GPx, primarily via the activation of the NFκB pathway. However, evidence regarding the induction of antioxidant enzymes via the NFκB pathway is still lacking. Thus, we cannot reject the possibility that Nrf2 is also activated. Thus, to hypothesize that moderate exercises induces the expression of antioxidant enzymes, and that ROS production induces the activation of NFκB and Nrf2 may be reasonable, but it remains to be clarified.
3.4. Biological responses induced via the activation of Nrf2/Keap1/ARE

Nrf2 is activated by mild oxidative stress, and increases the transcription of ARE [72,73]. This may be a possible mechanism behind the anti-neoplastic effects of this pathway. Other potential biological responses elicited via an activation of the Nrf2/Keap1/ARE pathway are summarized in Table ​Table2.2. Items 1 to 7 were already discussed by Dinkova-Kostova [74], whereas items 8 and 9 will be discussed in the next sections.
Table 2
Table 2
Biological responses induced via the activation of Nrf2/ARE with mild oxidative stress
3.5. Nrf2 is associated with apoptosis and DNA repair

Numerous reports suggest that oxidative stress induces cell apoptosis, and antioxidants, such as increased levels of HO-1, protect the cell against apoptosis. HO-1 is induced by Nrf2, and prevents against apoptosis. For example, the complex work of Brunt et al [75] demonstrated that apoptosis of human vascular smooth muscle cells is induced by H2O2, and that the activation of the HO-1 promoter via Nrf2 protects these cells from the apoptotic effects of H2O2. Furthermore, apoptosis induced via either chromium (VI) [76] or LPS [77] also protected by Nrf2-dependent HO-1 induction. These findings suggest that anti-apoptotic effects are due to the activation of antioxidant protection systems induced via the activation of Nrf2.

Nrf2 has been also shown to be involved in DNA repair (#9 in Table ​Table2).2). Villeneuve et al [78] found that Nrf2 is significantly associated with DNA repair. In fact, both Nrf2 and p21 were found to regulate the fine balance between life and death by controlling ROS levels. That is, the cytoprotective effects, specifically those concerning DNA repair or apoptosis, are likely dependent on the magnitude of oxidative stress. Therefore, p21-mediated activation of the Nrf2 signaling pathway may be the first defense mechanism used to reduce ROS under low stress conditions. At low levels of oxidative stress, p21 activates the Nrf2-dependent antioxidant response, which protects the cell from ROS-induced cellular damage. At moderate levels of oxidative stress, which involves DNA damage, p21 induces cell cycle arrest to allow for DNA repair. At high levels of oxidative stress, or at the point of no return, Nrf2 is destroyed, and thereby, the Nrf2-dependent pro-survival response is inhibited, and the pro-apoptotic response initiates apoptosis.

In conclusion, the Nrf2-dependent antioxidant response has been shown to protect against oxidative-stress related diseases, such as cancer [79,80] neurodegenerative diseases [81,82], cardiovascular disease [83-85], lung emphysema [86], inflammation [87,88] and aging [89]. This background will be useful for evaluating the role of Nrf2, but its actual relevance remains to be demonstrated by selected experiments connected with ozone therapy.
4. Biological responses and therapeutic effects induced by ozone therapy

The versatility of ozone therapy applications is impressive but there are some limitations, and therefore ozone therapy is not a panacea. From the available data, vascular and some degenerative diseases are the most suitable to be treated, while acute and chronic infectious diseases such as HIV infection and chronic hepatitis C cannot be cured with ozone therapy, because both viruses and other pathogens, either free in the plasma or/and present insides cells, cannot be inactivated by the ozone messengers and actually are well protected by the potent antioxidant capacity of blood.
4.1. Clinical results in peripheral obstructive arterial diseases (POAD)

Since the initial work of Rokitansky [90], several small clinical studies have been performed on POAD showing a consistent improvement of the local circulation after a cycle of 13-18 ozonated AHT [reviewed in Bocci, 46]. It is well known that even a modest obstruction of limb arteries due to atherosclerosis, diabetes, or Buerger's disease (thromboangiitis obliterans) leads to a progressive reduction of blood flow to the limb.

Tissue ischemia and any minor trauma facilitate the formation of an ulcer, which will no heal because of reduced oxygenation, lack of nutrients and growth factors indispensable for the repair process. Ozone therapy firstly lead to the activation of glycolysis with an increase in adenosine triphosphate (ATP) and 2,3-diphoshoglycerate (2,3-DPG). Consequently the sigmoidal oxygen-binding curve of Hb shifts to the right and increases the release of oxygen in the ischemic tissues. The modest but critical entrance of H2O2 in the erythrocyte is promptly reduced it to water through the action of GSH. The increased formation of oxidized GSH as GSSG alters the GSH/GSSG ratio but this change is rapidly corrected by either expelling some of the GSSG, or by reducing it via GSH-reductase at the expense of either ascorbic acid or thioredoxin. It is noteworthy that this critical recycling proceeds within 3 minutes [32]. Moreover the activation of glucose-6-phosphate dehydrogenase (G6PDH) can provide reducing power and activates glycolysis [91]. It must be noted that the metabolic profile of ozonated blood is practically over imposable with that of simply oxygenated blood [92].

According to the Fontaine-Leriche classification, patients at either stage II (intermittent claudication and transitory pain), or stage III (continuous pain, cyanosis, and possibly initial ulcers) achieve the best results. Stage IV includes incipient necrosis of toes and unbearable pain leads to surgical amputation that can be reduced or delayed with ozonated-AHT in about 50% of cases. In comparison to pentoxyfilline and prostanoids (the gold standard of orthodox treatment), ozonated AHT has proved more effective and without side effects in ischemic vascular disease. There is no substantial difference in the results either using AHT or the extravascular ozonation of blood, which is an invasive and expensive method. By using the former procedure [93.94], 28 patients, randomized to either receive their own ozonated blood or a cycle of prostacyclin infusion were evaluated. All patients continued conventional treatment with statins, anti-hypertensive and anti-platelet aggregation drugs. Ozone therapy proved more effective than prostacyclin in terms of pain reduction and improvement of the quality of life, but no significant difference was seen in vascularization of the lower limbs in either group, most likely due to the short duration of treatment (14 treatments in 7 weeks). In this complex pathology, more prolonged treatments asscociated with topical therapy with ozonated oil may led to a satisfactory healing of ulcers, because it is a mistake to stop therapy too early. Actually this therapy should be continued for life with less frequent treatments. An improved schedule on a trial in progress consists of two ozonated-AHTs (225 mL blood plus 25 mL of 3.8% sodium citrate solution), given weekly for at least 4 months. In patients at stage III and IV, the topical therapy is most important when performed with ozonated water and olive oil because it helps to accelerate healing of ulcers. How well ozonated-AHT works it appears evident by the fact that the nocturnal excruciating pain disappears after the first two to three treatments, indicating the improvement of blood flow in the ischemic tissue and the lack of ''stealing'' blood away from underperfused muscle.

An experimental confirmation of Nrf2 activity regarding the positive mechanisms inducing the antioxidative protection systems, is warranted. Furthermore, Nrf2 may be a potential mechanism involved in the upregulation of cellular antioxidant enzymes and induction of HO-1 and HSP70 (Table ​(Table1,1, c). It has been already shown that therapeutic ozone concentrations can induce both HO-1 and HSP70 [95], but the role of Nrf2 remains to be ascertained. It seems evident that the therapeutic activity of ozone in POAD is due to an improvement in blood flow and oxygen delivery in the ischemic areas. Moreover it was recently demonstrated that a nuclear transcription factor, hypoxia inducible factor-1α (HIF-1α), may participate in improving the outcomes of ischemic tissues [96-98]. HIF-1α, an ubiquitously expressed molecule, regulates a number of genes (i.e. hypoxia response elements, HREs) that elicit compensatory responses during states of hypoxia, metabolic compromise, and oxidative stress. Activation of HIF-1α results in increases of vascular endothelial growth factor (VEGF), erythropoietin (EPO), and glycolytic enzymes, all of which enhance cell proliferation and survival. Furthermore, an increase in the biosynthesis of VEGF can stimulate neoangiogenesis, and consequentially improve blood flow, and increase the biosynthesis of erythropoietin, which augments oxygen delivery. An increase in glycolytic enzymes enhances glucose metabolism, and consequently increases the biosynthesis of NO and CO, which also stimulate blood flow and oxygen delivery into hypoxic tissues. Thus, these biological responses may induce the excellent therapeutic effects of ozone-induced mild oxidative stress in POAD. Additionally, points a) and b) in Table ​Table22 may be explained by the role of HIF-1α. In the normoxic state, HIF-1α is inactivated by proline hydroxylases (PHDs) and VHL within the cytosol. On the other hand, in hypoxia, PDHs and VHL are inactivated by mild oxidative stress, and HIF-1α is released from PHDs and VHL, transferred into nuclei, where HIF-1α forms a heterodimer with HIF-1β, and results in the transcription of hypoxia response elements (HREs) on DNA. It was reported that about 2000 genes in HREs are regulated by HIF-1α [99] including genes involved in the regulation of apoptosis, pH regulation, and proteolysis, as well as angiogenesis, erythropoiesis and glucose metabolism. Another remark regards the postulation that 4-HNE reaching the bone marrow environment may favor the release of staminal cells, which may be able to switch on angiogenesis in the ischemic tissues. It is hoped to clarify if any of these hypothesis are valid in the near future.

Millions of people suffer from chronic limb, brain, and heart ischemia, which represent the major cause of death worldwide. This has a huge socio-economic impact, particularly in the developing world. If only orthodox medicine will accept ozonated AHT as an adjunct to standard medication, a great leap forward will be noted. It is most unfortunate that owing to the lack of sponsors and funds it has not yet been possible to carefully evaluate controlled clinical results in either stroke or chronic heart failure patients
4.2. The relevance of ozone therapy in Age-Related Macular Degeneration (ARMD)

In the UK alone, some 250,000 patients affected by the ''dry'' (atrophic) form of ARMD are suitable for treatment with ozonated AHT, but all over the world there are more than 30 million people searching for a therapy. Nonetheless, ophthalmologists can only prescribe antioxidants and zinc, which are minimally effective. Since 1995, almost 1,000 patient with the dry form of ARMD have been treated with ozonated AHT at the Siena (Italy) polyclinic and three-quarters have shown an improvement of one to two lines on the visual acuity chart (reviewed in 46). Moreover it is relevant that the disease does not progress during ozone therapy. Usually 15-18 treatments, at an initial ozone concentration of 20 mg/ml of gas per ml blood, slowly upgraded to 60 mg/ml (twice weekly), followed by two monthly session as a maintenance therapy, allows to maintain the improvement. Although uncontrolled, this study emphasizes that ozone therapy is the only treatment able to dramatically improve the patient's quality of life. In this disease there is progressive degeneration and death of the fovea centralis photoreceptors and of the pigmented retinal epithelium (PRE) as a consequence of several factors, one of which is chronic hypoxia. Although O3-AHT induces a pleiotropic response, the main advantage is due to an increased delivery of oxygen to the retina, which is the bodily tissue with the highest oxygen consumption. It is worth noting that AHT is useless, even harmful, in the exudative form of ARMD and in multigenic and progressive disorders (e.g., retinitis pigmentosa and recessive Stargardt's disease). The exudative form, characterized by an aberrant choroidal vascular growth and a vascular hyper-permeability beneath the retina and the PRE, is caused by worsened ischemia, which stimulates the release of the vascular endothelial growth factor [99]. In the exudative form it seems that the intravitreous administration of anti-VEGF antibody may temporarily slow down angiogenesis with a slight functional improvement. It must be emphasized that O3-AHT (in the dry form) not only improves visual activity but at least, in part, helps the patient to re-acquire the capacity of autonomous life. Finally it is interesting to inform that only during the last month a preliminary trial evaluating whether the intravitreal injection of staminal PRE in blind patients with Stargardt's disease will be able to restore vision. Although patients will receive an immunosuppressive therapy, there are other risks but after ten years of preliminary studies, the trial needed to be performed.
4.3. The effects of ozone therapy in diabetes

Diabetic nephropathy induced via diabetes mellitus is linked with oxidative stress. The potential therapeutic effects of ozone therapy were studied in streptozotocin (STZ)-induced diabetic rats [100]. The induction of diabetes mellitus significantly elevated blood pressure, HbA1c, BUN, creatinine, and renal tissue levels of MDA, whereas SOD, CAT and GPx activities were significantly reduced. Treatment with either insulin or ozone therapy significantly reversed the effects of diabetes mellitus. Furthermore, a combination of both insulin and ozone therapy even further reversed the effects of diabetes mellitus in comparison to monotherapy. Thus, ozone administration in diabetes mellitus rats reduced levels of oxidative stress markers and improved renal antioxidant enzyme activities, especially when rats were treated with a combination of ozone and insulin. This initial result suggested that ozone therapy may be useful for treating diabetic patients, specifically by mediating antioxidative responses. Clinical evidence that ozone therapy is useful has been anecdotically reported several times by private ozone therapists but a valid, controlled clinical trial has yet to be performed. Chronic limb ischemia is often accompanied by type 2 diabetes and these patients have been advantageously treated with ozonated AHT [46]. The need of reducing the insulin dose, suggesting either an improved insulin secretion or/and an increased receptor sensitivity has become a common observation.

As ozone is used in all Cuban hospitals, Cuban ozone therapists have performed a randomized controlled clinical trial in diabetic patients with peripheral arterial diseases and diabetic foot [101]. One group (n = 51) was treated with ozone administered via rectal insufflation of 200 ml of gas with an ozone dose of 10 mg together with topical ozone both as gas and ozonated oil. The control group (n = 49) was treated with systemic and topical antibiotics. The efficacy of the treatments was evaluated by comparing the glucose level, the area of the ulcers and several biochemical markers after only 20 days of treatment. A drawback was the lack of a follow-up after the 20 days therapy. The experimental group, after receiving a total dose of 200 mg ozone showed an improved glycemic control, a reduced oxidative stress, an increase of SOD, a significant improvement of the lesions without any side effects and with a fewer amputations than the control group. Human diabetic foot is a chronic disease and these results are even more surprising not only because they were achieved only after 20 days therapy, but also because among the five routes of ozone administration, [reviewed in 102], i.e.: (1) the major and minor ozonated autohemotherapy; (2) the extracorporeal circulation of blood against oxygen-ozone; (3) the quasi-total body exposure to oxygen-ozone; (4) the intracavitary, subcutaneous, intramuscular administration, and (5) the ozone insufflation via rectum is the most unreliable administration route because we never know the percentage of the really effective ozone dose insufflated into the rectum. Moreover in Europe at least 40% of patients: (i) refuse the administration of ozone via rectum; (ii) part of the ozone dose may be unwillingly eliminated immediately after the gas introduction; (iii) the fecal content and the abundant mucoproteins certainly neutralize part of the ozone dose, and (iv) in all cases ozone, unlike oxygen, is not absorbed by the rectal mucosa. In previous rabbit experiments [59], it was clarified that only peroxidation products could be detected in portal blood. This is because ozone immediately reacts with a variety of biomolecules present in the luminal content and only some of the generated compounds are absorbed and may exert therapeutic activity. The concentration of ozone (50 mg/ml) used in the Cuban patients is too high and unwise because it can cause painful intestinal cramps. Moreover it must keep in mind that Eliakim et al. [103], after repeated enema in rats with ozonated water, have reported the appearance of a microscopic colitis. As a consequence, even though results are spectacular, they need to be confirmed, not only by repeating the trial, but preferably by using the reliable strategy of ozonated autohemotherapy [104]. On this basis it appears urgent to organize an appropriate clinical trial in order to evaluate whether an initial cycle including at least 32 treatments during four months (twice weekly) can modify critical parameters including glycemic and C-reactive peptide levels, nonenzymatic glycosilation, aldose reductase activity, advaced glycated endproducts (AGEs) and the antioxidant-pro-oxidant balance. Although more expensive, the precise stoichiometry of the ozonated AHT method can give far more precise information than the rectal insufflation. The adopted strategy 'start low, go slow' appears the most idoneous for inducing ozone tolerance and the rebalance of the redox system [46]. Bearing in mind that O2-O3 therapy may modify glycemic levels, a strict control of the insulin level is imperative.

A debate on a scientifically proved application of a complementary approach based on the knowledge that O3-AHT can abate the chronic oxidative stress, delay serious complications and improve the quality of life of diabetic patients has been proposed [104]) and is urgent.
4.4. Possible mechanisms for activating the immune system by ozone therapy

T-cells serve a very important role in protecting our body against foreign components: when the T-cell antigen receptor (TCR) recognizes any foreign antigens, the ZAP-70 molecule undergoes a tyrosine-phosphorylation, and then activates phospholipase C γ1 (PLCγ1) [105]. Activated PLCγ1 hydrolyze phosphatidylinositol-4,5-bisphosphate (PIP2), a membrane lipid, to produce second messengers, inositol triphosphate (IP3) and diacylglycerol (DG). IP3 binds to the inositol triphosphate receptor (IP3R) on the endoplasmic reticulum (ER) membrane, resulting in a release of Ca+2 from the ER into the cytosol. Increases in cytosolic Ca+2 levels activate calcineurin (CN), a phosphatase dependent on Ca+2/calmodulin, which dephosphorylates nuclear factor activated T-cells (NFAT) and transports it into the nucleus. NFAT then induces the transcription of cytokines, such as IL-2, TNFα, IL-6 and IFNγ, and immune response elements on DNA, which are, then, translated into their proteins [106]. The produced cytokines and transcription products of immune response elements support the immune functions of our body. NFAT is also expressed in other cells and tissues, and can itself combine with DNA elements. However, the combination of NFAT with DNA is primarily induced via the coexistence of activated protein-1 (AP-1), a nuclear transcription factor. AP-1 is activated through the Ras-MAPKs (mitogen activated protein kinases) pathway, which is also mediated by DG.

It was previously reported that immunosuppressive drugs, such as cyclosporine A and KF506 (tacrolimus), can inhibit the de-phosphorylation of NFAT induced by CN, and thereby the transportation of NFAT into the nucleus [107]. Ca2+-antagonists, such as anti-hypertensive drugs, inhibit Ca+2 influx into the cytosol and the constriction of vascular smooth muscle cells. However, several epidemiological studies suggest that prolonged use of Ca2+-antagonist may result in tumors or the development of chronic diseases. Ca2+-antagonist inhibits Ca+2 influx into cytosol of T-cells, and the activity of CN. Thus, they also may induce the de-phosphorylation NFAT, and its transportation into the nucleus. Consequently, the biosynthesis of cytokines would also be inhibited. This may explain the why long-term use of Ca2+-antagonist may result in tumors or the development of chronic diseases. Furthermore, it is well known that these nuclear transcription factors are also induced by mild oxidative stress. For example, Maziere et al [108] found that high levels of UVA radiation inhibit the CN-NFAT system, and low levels of UVA activate the CN-NFAT system. Therefore, mild oxidative stress induced by ozone therapy may also activate NFAT and AP-1 to then activate immune functions. This may explain of point d) in Table ​Table2.2. However it remains to be seen whether a mild ozone therapy does really activate the CN-NFAT system

Therefore, beside this possible pathway, it must be kept in mind that several studies [109-111] have been carried out by using human normal blood treated with ozone concentrations within the "therapeutic window". With these parameters ozone acts on human blood and yields a hormetic dose-response relationship without any toxicity [112]. After incubation of up to 8-9 hours, the plasma was isolated and several cytokines synthesized and released by immune cells such as IFNγ, TNFα, IL-2, IL-6 and IL-8 have been measured and their small but consistent amounts were ozone-concentration dependent. During each ozone therapy session, this induced bland immuno-stimulation regards only about 4% of the lymphocytes and monocytes present in the blood exposed to ozone ex vivo [46]. It was postulated that the small percentage of immunocytes activated ex vivo by H2O2, via NFkB may transfer the activation in vivo after the infusion of ozonated blood into the donor patient. Indeed, after blood infusion into the donor, the activated lymphocytes, by releasing cytokines, can activate other cells in vivo [46]. If this is true, repeated therapeutic sessions may indeed reverse a condition of immune-depression. Actually these observations have suggested to use ozone therapy in both acute and chronic bacterial and viral infections keeping in mind that all pathogens, either free in the plasma or located intracellularly, are paradoxically well protected by the potent antioxidant capacity of blood and cells [113]. This is so, because with the ozone concentration established by the therapeutic index, neither ozone or its messengers can deliver a bactericidal or virucidal effect. Indeed, contrary to what is commonly believed, ozone can act only as a supportive therapy in infectious diseases and we know already that both HIV [114] and chronic hepatitis C infections cannot be proficiently treated only with ozone therapy unless we simultaneously combined with the appropriate dosages of antiviral drugs.

Moreover we are totally at a loss to discover if ozone therapy can be useful in autoimmune diseases, such as rheumatoid arthritis, multiple sclerosis and psoriasis. Once again private ozone therapists have treated these diseases claiming positive results, which have been never reported in medical journals. The key problem is to discover the ideal ozone concentration for quenching the activity of cytotoxic T cells and to enhance the number and activity of CD4+ T-Regulatory cells [46].
4.5. May ozone kill cancer cells and have therapeutic effects?

An early paper by Sweet et al [115] elicited great enthusiasm having shown that ozone selectively inhibits the growth of a variety of human cancer cells in vitro. Unfortunately this approach does not reflect the situation in the patient because ozone as such is never able to reach any cancer cells in vivo. Another hypothetical possibility had been to restore normoxia and apoptosis of tumor cells after the infusion of ozonated blood [91], but clinical experience in pre-terminal patient with hepatic or/and pulmonary metastasis has shown the irreversibility of the cancer. An experimental attempt [116] to insufflate an ozone and oxygen mixture into the peritoneum at an advanced stage of cancer led to a higher survival rate of treated rabbits (i.e. 7/14) versus sham-treated rabbits (i.e. 1/7). In a letter, Bocci [117] have suggested that these anti-tumor effects may be induced via an ozone/oxygen-mediated activation of the body's immuno-surveillance, which is a real possibility in a virgin animal. Indeed these results are evident only in experimental oncology, particularly in mice and not in humans where, once the cancer is discovered, the immune system is already suppressed. To be objective, there are a number of rather old and uncontrolled clinical studies demonstrating that ozone therapy extends the life expectancy of patients with cancer. This is partly true in the sense that ozonated autohemotherapy improves the quality of life as often observed [46], but is unable to block the tumour progression. Chronic inflammation plays a critical role in neoplastic growth (transformation), as well as in many other diseases. NFκB is activated by various inflammatory factors, such as LPS and severe oxidative stress derived from drugs that induce iNOS, COX-2, and inflammatory cytokines. These factors induce the survival, growth, and proliferation of tumor cells, and result in neoplasia [118]. Therefore, inhibition of NFκB is an important target for the prevention and treatment of cancer. For example, it is known that the inhibitors of NFκB, such as vitamin E, resveratrol, curcumin, catechin, and aspirin may have some effects in slowing tumor growth.
4.6. A possible mechanism by which ozone therapy improves neurodegenerative diseases

The pathogenesis of neurodegenerative diseases is significantly associated with oxidative stress. Increased oxidative stress is also associated with neuronal cell death during the pathogenesis of multiple chronic neurodegenerative diseases, including Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS). It was found that the Nrf2/ARE pathway protects against neurodegeneration [81,119] as mentioned previously. Figure ​Figure22 demonstrates that PD may result from apoptosis of neuronal cells and death of Nigral cells induced via ROS. Increases in ROS result in mitochondrial dysfunction and neuro-inflammation, a common denominator of PD. On the other hand, Nrf2 acts as an emerging target to counteract mitochondrial dysfunction and inflammation. Nrf2 activates the antioxidant response element (ARE) pathway, including a battery of cytoprotective genes, such as antioxidants and anti-inflammatory genes, and several transcription factors involved in mitochondrial biogenesis [119].
Figure 2
Figure 2

Jazwa et al [82] also found that Nrf2 and HIF-1α play a crucial role in neuroprotection and suppression of neuroinflammation in neurodegenerative diseases, especially through the activation of HO-1 via the Nrf2/ARE pathway (for HO-1 see also Idriss et al. [120]). Furthermore, drugs activating Nrf2 may also be good candidates for inducing HO-1, in concert with other antioxidant and detoxification enzymes. In fact, it was previously reported that there are many phytochemicals that are effective in protecting against neurodegenerative diseases [121-124]. These findings may explain the rationale (point g) in Table ​Table1.1. Thus, further investigation into the effects of ozone therapy in activating the Nrf2/ARE pathway is warranted. Indeed several anecdotal observations have been done by private ozone therapists performing ozonated AHT in patients with initial Alzheimer's disease. It is unfortunate that these promising observation have been never published and therefore the precise parameters remain unknown. Once again orthodox medicine remains skeptical about the value of ozone therapy and this make progress very difficult.
4.7. The topical use of ozone therapy in skin and mucosal infections and lesions

Regarding both cutaneous and mucosal infections and lesions, both ozonated water and different gradation of standardized ozonated vegetable oils will be used twice daily until complete healing. Both ozonated water and oils have been already proved to be excellent disinfectants and healing stimulators, more effective than topical antibiotics, growth factors, only oxygenation, maggot and negative pressure wound therapies. In conclusion, this paper aims to emphasize the possibility of a new approach for improving the gloomy prognosis of the diabetic foot, ischemic ulcers and necrosis, decubitus, abscesses, anal fissures, fistulae, aphthae, inveterate osteomyelitis stomatitis, vulvovaginitis and onycomycosis. There are experimental studies [125,126] clearly showing the advantages of using ozonated oils and a great number of pertinent patents have been reviewed [127,128]. Any wound or lesions must firstly be cleaned possibly with ozonated water or diluted H2O2 solution, because the removal of purulent material or fibrin or necrotic cells markedly reduces the effect of ozonated oil because of the residual presence of biological substances [113]. To date, in western countries there is not yet the mental attitude to profitably use ozonated oil, but once a patient has tried that, he will continue to use it.
4.8. The problem of backache and orthopedic diseases has been successfully solved with ozone

In reality the use of ozone in hernial disk is a real breakthrough and, while the use of ozonated AHT is still regarded with suspicion, the application of ozone in low back pain is practically accepted world-wide. During lifetime low back pain is a common disturbing symptoms that can affect up to 80% of the population at least once. Under radioscopic control, 3 to 7 ml of the gas mixture (usually ozone 3% and oxygen 97%), with an ozone concentration of 30-35 μg/ml are directly administered into the centre of the intersomatic space corresponding to the disc herniation [129]. An expert neurosurgeon can do it in about ten minutes and, after a suitable rest, the patient frequently gets up amazed by the disappearance of pain.

What are the mechanisms of action ? They are quite different from those of ozone in blood. Ozone readily dissolves in the water of the nucleus pulposus and reacts with macromolecular glycoproteins composed of carbohydrates and polypeptide chains, namely proteoglycans and collagen types II and IV. Formation of ROS is likely followed by generation of hydroxyl radicals according to the Fenton's reaction:
PUFA + O3 + H2O - - - - - - - - - - → aldehyde 1 + aldehyde 2 + H2O2

because traces of catalytic iron ions can easily be released from the needle during the injection. By using the Electron Paramagnetic Resonance (EPR) spin trapping technique, the transitory formation of




Article 45 : Ultraviolet Blood Irradiation therapy.

Int J. Biosocial Med Research Vol. 14(2) 115-32, 1996
115
Please note this is a scanned version of the original and may not be formatted in
the exact version of the original article. The correspondence information has also
been updated
Int J Biosocial Med Research, Vol. 14(2), 115-132, 1996. 1044-811 X/96/8/7 151$1.50.
Copyright © 1996 Foundation for Biosocial Research. All rights reserved. Printed in the U.S.A.
Ultraviolet Blood Irradiation Therapy
(Photo-Oxidation)
The Cure That Time Forgot
Robert Jay Rowen, MD
Omni Medical Center
Abstract
In the 1940s, a multitude of articles appeared in the American literature detailing a
novel treatment for infection. This treatment had a cure rate of 98 to 100% in early
and moderately advanced infections, and approximately 50% in terminally moribund
patients. Healing was not limited to just bacterial infections, but also viral (acute
polio), wounds, asthma, and arthritis. Recent German literature has demonstrated
profound improvements in a number of biochemical and hematologic markers. There
has never been reported any toxicity, side effects or injury except for occasional
Herxheimer type reactions.
As infections are failing to improve with the use of chemical treatment, this safe
and effective treatment should be revisited. (Int J Biosocial Med Res., 1996; 14(2):
115-132)
Key Words: Ultraviolet blood irradiation (photo-oxidation), infection, asthma, oxygenation, oxidation,
vascular disease, toxin, immune system, chronic fatigue, infectious disease, bacterial
anti-infective, detoxification, viral anti-infective, thrombophlebitis, botulism, toxemia of
pregnancy, polio, i!eus, immune modulation, cytokine induction, Raynaud's disease,
migraine, circulatory and vascular disease
History
Ultraviolet (UV) light has been known for decades to have a sterilizing effect
and has been used in many different industries for such a purpose. Almost all
bacteria may be killed or attenuated by ultraviolet rays, but there is considerable
variation in the rapidity of
Correspondence address:
95 Montgomery Dr Ste 220
Santa Rosa, CA 95404
Rowen Ultraviolet Blood Irradiation Therapy
116
their destruction. Those which live in the body are most easily affected,
while those in nature adapt to the action of sunlight and become relatively
resistant to irradiation.[1] LTV-sensitive bacteria have not been shown to
become resistant and toxins have been found to be very unstable in the
presence of UV irradiation (Diphtheria, tetanus, and snake venom are
inactivated by ultraviolet rays).[2]
At the turn of the century, Niels Finson was awarded the Nobel Prize for
his work on UV rays and various skin conditions which showed a success
rate of 98% in thousands of cases, mostly lupus vulgaris.[3] Walter Ude
reported a series of 100 cases of Erysipelas in the 1920s, claiming a nearly
100% cure rate with UV skin irradiation.[4] Emmett Knott pioneered the
irradiation of autologous blood on dogs before treating a moribund woman
with postabortion sepsis in 1933, who was thought to be untreatable. With
his treatment of blood irradiation, she promptly recovered, resulting in more
research and further development of the "Knott" technique.[5] The technique
involved removing approximately 1.5cc/pound, citrating it for anticoagulation,
and passing it through a radiation chamber. Exposure time per
given unit amount (1cc) was approximately 10 seconds, peak wavelength of
253.7nM (ultraviolet C) provided by a mercury quartz burner and
immediately re-perfused.[6]
By the early 1940s, UV blood irradiation was being used in several
American hospitals. Into the late 1940s, numerous reports were made about
the high efficacy for infection and complete safety of UV blood irradiation.
With the emergence of antibiotic therapy, the reports suddenly ceased.
In the ensuing years, German literature demonstrated the effectiveness
of UV irradiation in vascular conditions. Additionally, more thorough
observations of significant improvement in many physiologic processes and
parameters have been reported.
American Findings
The most prolific American researcher was George Miley, a clinical
professor at Hahnemann Hospital and College of Medicine, who
practiced the Knott technique at their blood irradiation clinic. In 1942, he
reported on 103 consecutive cases of acute pyogenic infections at
Hahnemann Hospital in Philadelphia. Such conditions included puerperal
sepsis, sinusitis, pyelitis, wound infections, peritonitis (ten cases), and
numerous other sites. Results of recovery were 100% for early infections,
46 out of 47 for moderately advanced, and 17 out of 36 of those who
were moribund.[7] Staphylococcus had a high death rate, but those
patients were also using sulfa drugs, which may have
inhibited the effectiveness of the UV irradiation treatments. In fact, when
Miley reviewed his data, he found that all the Staph failures had been on
Int J. Biosocial Med Research Vol. 14(2) 115-32, 1996
117
sulfa. A second series of nine patients (six Staph aureus, three Staph albus)
had a 100% recovery rate with one or two treatments when sulfa was not
used.[8] (Table 1).
Rebbeck and Miley documented the fever curve of septicemia in
patients who received UV therapy, demonstrating detoxification and
recovery within a few days.[9](See Fig. 1). In 1947, Miley reaffirmed his
initial findings reporting on 445 cases of acute pyogenic infection, including
151 consecutive cases. Again, results showed a 100% recovery in early cases
(56), 98% recovery in moderately advanced (323), and 45% in apparently
moribund patients (66) (see Table 2).[10] Detoxification usually began
within 24 to 48 hours, and was complete in 46 to 72 hours. Some patients
required only one or two irradiation treatments, while a few needed one or
two more.
Figure 1.
Ultraviolet Blood Irradiation in Peritonitis
Male of 20, who after operation was comatose, in shock, and apparently moribund, with a
fulminating toxemia due to generalized peritonitis secondary to a ruptured appendix. Within
24 hours of ultraviolet blood-irradiation therapy detoxification was pronounced and the
downhill course of the patient reversed. An eventful convalescence ensued.
Rowen Ultraviolet Blood Irradiation Therapy
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Int J. Biosocial Med Research Vol. 14(2) 115-32, 1996
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Rowen Ultraviolet Blood Irradiation Therapy
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Int J. Biosocial Med Research Vol. 14(2) 115-32, 1996
121
In 1943, Rebbeck[11], reported on eight cases of E.coli sepsis treated
with UV phototherapy - six lived. Barrett reported in his cases of septic
toxemia, that pain associated with infection was typically relieved with
ten to 15 minutes of hemo-irradiation.[12] Toxemia of pregnancy
responded in all 100 patients with no serious complications, even after
the onset of convulsions.[13]
Spectacular detailed reports of hopeless cases responding to UV
phototherapy regularly appeared in the American literature. Barrett
reported on a patient who had cerebellar artery thrombosis, pneumonia,
pulmonary emboli - left femoral leg, deep-venous thrombosis, left-sided
paralysis, and paralysis of the left vocal cord. This dying patient
responded dramatically, almost instantly, and had a full recovery over a
period of several months.
Miley reported on 13 patients with thrombophlebitis, including some
infections. Nine received only one treatment, while two had two
treatments and healing was noted within hours to two days. Most were
discharged from the hospital in an average of 12 days.[14]
Rowen Ultraviolet Blood Irradiation Therapy
122
In June, 1943, Miley reported on asthma response in a series of 80
"intractable" patients. Twenty-four patients were not followed up, which left
only 56 patients to document. Of these, 29 were moderately to greatly
improved, 16 were slightly improved, and 11 had no improvement after a
period of six to ten months. The 45 who had improved remained so for six to
ten months, after an initial series of up to ten irradiations.[15] In 1946,
Miley,[16] reported on a larger series of 160 consecutive patients with
"apparently intractable asthma"; 40 cases could not be followed, leaving
120. The results (Table 3) were better than his initial findings, with 32.5%
apparently cured, 31.6% definitely improved, 22.5% slightly improved, and
13.4% unchanged. The authors commented that two to five treatments a year
were often required for maintenance. Cyanosis of many years' duration,
disappeared within one year of therapy, and a marked increase in general
resistance was observed; no deleterious effects were noted.
Miley and Christensen reported on polio treated with blood
irradiation[17] (Table 4). Fifty-eight cases were followed, including seven
with Bulbar polio (40% death rate expected). Only one death
Int J. Biosocial Med Research Vol. 14(2) 115-32, 1996
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occurred in the Bulbar group and none in the others. Rapid recovery was
reported after the first treatment (24 to 48 hours). One to three treatments
were all that was necessary in the majority of cases.
Effectiveness in other viral conditions was further documented by
Olney.[18] His report documented 43 patients with acute viral hepatitis
treated with the Knott technique. Thirty-one patients had acute infectious
hepatitis; 12 had acute serum hepatitis (hepatitis B). An average of 3.28
treatments per patient were administered; the average period of illness after
the treatment, was 19.2 days; two recurrences were observed among the 43
patients during a follow-up period averaging 3.56 years, one in each type of
hepatitis. The one suspected recurrence in the "serum" variety was in a
heroin addict and reinfection was suspected. No deaths occurred among the
43 patients during the follow-up period. Marked improvement and rapid
subsidence of symptoms was noted in all patients treated and within three
days or less, in 27 patients. 11 showed marked improvement in 4 to 7 days,
and five patients showed improvement in 8 to 14 days.
Rebbeck reported a remarkable effect on the autonomic nervous system,
documenting how postsurgical paralytic ileus could be relieved very quickly
with UV blood irradiation.[19] He attributed this effect to toning the
autonomic nervous system. Autonomic effects also can be appreciated in the
reports on asthma.
The authors were so impressed with the results that they included
numerous case reports of hopeless and long-suffering infectious conditions
resolving with UV blood irradiation. Rebbeck reported on its prophylactic
preoperative use in infectious conditions, concluding that the technique
provided significant protection with a marked decrease in morbidity and
mortality.[20]
The authors consistently reported beneficial peripheral vasodilation. A
significant rise in combined venous oxygen was also repeatedly
mentioned.[21] The remarkable lack of any toxicity was consistently noted
by all authors. In addition to polio, Miley reported that viruses, in general,
responded in similar fashion to pyogenic infections.[22]
Botulism, a uniformly fatal condition, was treated by Miley.[23] The
patient was in a coma and could not swallow or see. Within 48 to 72 hours
of one irradiation treatment, the patient was able to swallow, see, and was
mentally clear. She was discharged in excellent condition in a total of 13
days.
LTV blood irradiation resulted in the prompt healing of chronic very
long-term, non-healing wounds. [24]
Miley went on to discuss an "ultraviolet ray metabolism," based on the
profound physiologic effects he noted, along with discoveries that
hemoglobin absorbs all wavelengths of ultraviolet rays, and Gurwitsch's[25]
demonstration of "mitogenic rays, tiny emanations given
Rowen Ultraviolet Blood Irradiation Therapy
124
off by body tissues in different wavelengths, all in the ultraviolet
spectrum and varying in wavelength according to the organ emitting the
rays..."
A summary of physiologic changes documented through the 1940s
included the following.[26] An inactivation of toxins and viruses,
destruction and inhibition of growth of bacteria, increase in oxygencombining
power of the blood, activation of steroids, increased cell
permeability, absorption of ultraviolet rays by blood and emanation of
secondary irradiations (absorbed UV photons re-emitted over time by the
re-perfused blood), activation of sterols into vitamin D, increase in red
blood cells, and normalization of white cell count.
Cancer
In 1967, Robert Olney privately printed, short, undated pamphlet,
sent to me by a friend, and entitled Blocked Oxidation, in which he
presented 5 cases of cancer, which were cured by a combination of
techniques, including ultraviolet blood irradiation. He theorized, based
on the work of previous researchers, that cancer was a result of blocked
oxidation within the cells. Utilizing detoxification techniques, dietary
changes, nutritional supplements, the Koch catalyst, and ultraviolet blood
irradiation, he reported the reversal of generalized malignant melanoma,
a breast cancer penetrating the chest wall and lung, highly metastatic
colon cancer, thyroid cancer, and uterine cancer.
Modern research on ultraviolet treatment for cancer is continuing.
Edelson reported on a variation of the technique called extracorporeal
photophoresis.[27] In this particular technique, a photosensitizing agent,
8-methoxypsoralen (8-MOP), is given to patients two hours before blood
is withdrawn and separated into cellular components. White blood cells
were irradiated with UV-A and returned to the patient. This therapy has
proven highly successful and actually has received FDA approval for its
use in cutaneous T-cell lymphoma (CTCL). Gasparro explains the
observed and presumed biochemical events underlying the response in
this condition. Such response includes the induction of cytokines and
interferons.[28]
German Findings
Recent German research reports significant improvement in vascular
conditions when using ultraviolet blood irradiation, including peripheral
arterial disease and Raynaud's disease. One study
Int J. Biosocial Med Research Vol. 14(2) 115-32, 1996
125
demonstrated a 124% increase in painless walking for patients with Stage
Ilb occlusive disease (Fontaine), as compared to 48% improvement with
pentoxifylline.[29] UV blood irradiation was found to improve
claudication distances by 90% after a series of ten treatments.[30] The
authors also reported an 8% drop in plasma viscosity with the treated
group, compared to no change with Pentoxifylline.
Significant changes and improvements in physiologic, biochemical,
and blood rheological properties have been observed. A summary of
these effects, based on the works of Frick[31] appear in Table 5.[32] This
article expanded on indications to all circulatory diseases, including
post-apoplexy, diabetes, venous ulcers, and migraines.
Frick reported an increase in prostacyclin and a reduction in
arteriosclerotic plaque. The biochemical effects are generated by the
activation of molecular oxygen to singlet oxygen by UV energy. This
active species initiates a cascade of molecular reactions, resulting in the
observed effects. Ultimately, this controlled oxidation process leads to a
rise in the principle antioxidant enzyme systems of the body - catalase,
superoxide dismutase, and glutathione peroxidase. Contraindications
included porphyria, photosensitivity, coagulopathy (hemophilia),
hyperthyroidism, and fever of unknown origin, but not pregnancy.
The device utilized in these reports is the Oxysan EN 400
manufactured by the Eumatron Company.
Discussion
In the 1800s, arguments raged between Pasteur and his rival,
Bechamp, over the true cause of infectious disease. Pasteur claimed the
cause was the organism alone, while Bechamp claimed the disease rose
from organisms already within the body, which had pleomorphic
capability (the ability to change). It is rumored that Pasteur, on his
deathbed, admitted that Bechamp was correct. Forgotten in the debate
was Bernard who argued it was the terrain or fertility of the body, which
permitted disease or allowed bacterial infection to take root. Perhaps UV
blood irradiation can be explained best in the general effect of the
treatment on the physiology and terrain of the body. For example, it is
known that the phagocytic respiratory burst, in response to infection,
consumes up to 100 times the oxygen that white cells require in the
resting state. The improvement in oxidation, rise in red blood cells, and
increase in red cell 2,3 DGP[33] may provide a significant boost to the
body.
Table 5.
Findings of German Research
Rowen Ultraviolet Blood Irradiation Therapy
126
BIOPHYSICAL AND CHEMICAL EFFECTS
• Improvement of the electrophoretic movability of the red blood cells
• Elevation of the electrical charge on the red blood cell
• Lowering of the surface tension of the blood
• Origin of free radicals
• Elevation of the chemical illuminescence of blood
HEMATOLOGIC CHANGES
• Increase in erythrocytes
• Increase in hemoglobin
• Increase in white blood cells
• Increase in basophilic granulocytes
• Increase in lymphocytes
• Lowering of thrombocytes;
HEMOSTATIC CHANGES
• Lowering of fibrin
• Normalization of fibrinolysis
• Trend towards normalization of fibrin-split products
• Lowering of platelet aggregation
BLOOD PARAMETER CHANGES
• Lowering of full-blood viscosity
• Lowering of plasma viscosity
• Reduction of elevated red blood cell aggregation tendencies
METABOLIC CHANGES - IMPROVEMENT IN OXYGEN UTILIZATION
• Increase in arterial P02
• Increase in venous P02
• Increase in arterial venous oxygen difference (increased oxygen release)
• Increase in peroxide count
• Fall in oxidation state of blood (increase in reduction state)
• Increase in acid-buffering capacity and rise in blood pH
• Reduction in blood pyruvate content
• Reduction in blood lactate content
• Improvement in glucose tolerance
• Reduction in cholesterol count, transaminases, and creatinine levels
HEMODYNAMIC CHANGES
• Elevation of poststenotic arterial pressure
• Increase in volume of circulation
IMPROVEMENT IN IMMUNE DEFENSES
• Increase in phagocytosis capability
• Increase in bacteriocidal capacity of blood
• Modulation of the immune status (Table 5)
Infection produces inflammation, edema, and a significant lowering of
oxygen tension and diffusion in the affected tissues, which is critical to
immune cell functions. Benefits of higher oxygen tension can be seen in the
Int J. Biosocial Med Research Vol. 14(2) 115-32, 1996
127
accepted use of hyperbaric oxygen therapy for osteomyelitis, where healthy
circulation is already slow. Deductive reasoning would suggest that any rise
in oxygen tension would help the body's immune defenses. Such can be seen
in anecdotal reports of hyperbaric oxygen therapy alone resolving
necrotizing fascitis.
German research (Table 5) documents a rise in oxygen consumption and
oxidation within the body stimulation of mitochondrial oxidation results in
greater ATP production.
In effect, UV blood irradiation therapy may be providing an inactivation
of bacteria, a more resistant terrain, improved circulation, alkalinization, etc.
While perhaps not as dramatic a treatment as hyperbaric oxygen therapy, it
may provide a similar and longer-lasting effect through the secondary
emanations of the absorbed ultraviolet rays. Such emissions, which last for
many weeks, may account for the observed cumulative effectiveness of the
therapy. UV photons, absorbed by hemoglobin, are gradually released over
time, continuing the stimulation to the body's physiology.
For eons, nature has utilized the sun's ultraviolet energy as a cleansing
agent for the earth. The lack of resistance of bacteria to ultraviolet treatment
is not surprising, since if bacteria could develop resistance, they have had
approximately 3 billion years to do so.
Only two discrepancies in accounts of this therapy could be found
between the older American and modern German literature. Venous oxygen
tension was reported by Miley to be increased, even up to one month after
treatment. Frick, on the other hand, reported a rise in Pa02, and a fall in
PV02, suggesting greater oxygen delivery and absorption in the tissues. A
rise in 2,3 DGP can account for the latter. Miley recommended the treatment
for fevers of unknown origin,[34] yet Seng's article suggested that as a
contraindication. Perhaps the German author feels the infections should be
clearly diagnosed first, while Miley was so impressed with his results and
the safety of the treatment, he thought it was proper to treat any presumed
infection with the technique.
For years, there have been anecdotes and reports of another oxidative
therapy (ozone) helping a variety of chronic conditions including, but not
limited to, rheumatoid diseases, arterial and circulatory disorders,
osteoporosis pain, viruses, and immune deficiencies. Some recent findings
shed light on how this particular oxidative therapy might help such a wide
variety of conditions.
Bocci has determined that exposure of blood to ozone at concentrations
used by practitioners for years induces cytokines and interferons.[35,36] In
fact, he went on to call ozone "an almost ideal cytokine inducer." He
concluded that such immune system modulation could explain the benefits
of ozone reported for decades on a very wide variety of conditions.
Mattman has detailed hundreds of reports linking cell wall deficient
bacteria to a wide span of disease states.[37] Autoimmune disease may not
be autoimmune at all, but rather an immune attack a hidden infection with
native tissue being damaged by a prolonged or dysfunctional immune
response to these "stealth pathogens."
The broad spectrum of biologic effects of these nonspecific oxidative
therapies may explain the broad range of benefits. It is quite possible that all
Rowen Ultraviolet Blood Irradiation Therapy
128
of the oxidative therapies may operate through similar mechanisms
postulated by Bocci for ozone (namely the generation of reactive oxygen
species, which in turn induce some very exceptional biochemical events).
Ultraviolet has clearly been shown to be a superior anti-infective. It is
possible that the secondary emanations previously described could inactivate
pathogens deep in tissues. However, of possible greater import is its effect
on the other various physiologic factors affecting the terrain. The
improvement in oxygen delivery and consumption, rise in circulation, blood
elements, stimulation of mitochondrial oxidation and shift towards
alkalinity, while all nonspecific in themselves, may help hasten the cellular
response in very many disease states.
Personal experience with UV blood irradiation therapy has been limited
strictly to an outpatient practice. However, I have observed significant and
dramatic effects on pharyngitis, cellulitis, otitis media, wounds, viral
infections, and gastroenteritis, and chronic fatigue. In several years of use, I
have had only one patient who suffered from apparent chronic fatigue and
failed to respond to a series of UV treatments; the patient had a significant
psychological factor. Several patients with multiple chemical sensitivities
have also experienced significant improvement. Chronic and intractable pain
has been reported by an anesthesiologist pain specialist to be surprisingly
responsive.[38]
Modern medicine has focused on drugs to suppress symptoms or inhibit
certain physiology (NSAID drugs as prostaglandin inhibitors, hypertensive
drugs as enzymatic blockers) to treat disease. As a result, we have seen the
frightening rise of resistant organism and the side-effects of chemical
pharmacology. Perhaps medicine should consider the concept of nonspecific
modalities that encourage the body's healing response and immune system.
What could be a safer or more effective agent against infection than the
bacteriocidal capabilities of our own phagocytes and a properly functioning
immune system?
At least 20 American physicians are currently utilizing photooxidation
and have advised me of dramatic cures of intractable infections, including
osteomyelitis. Communications from these physicians are verifying my
findings in the use of this modality with chronic fatigue. A German
videotape related that several hundred physicians are currently employing
the technique in Germany with hundreds of thousands of treatments having
been performed through the years and never any reported incidents of
toxicity (other than a mild Herxheimer reaction).
"Ultraviolet irradiation of blood has been approved by the FDA for the
treatment of cutaneous T-cell lymphoma. Thus, the method is legal within
the context of FDA's definition of legality. It is also legal, from the
standpoint of long (over 50 years) and continuous use by physicians in the
United States as a commercially viable product before the present FDA was
even in existence. "[39]
The technique is taught at workshops and seminars sponsored by the
International Association of Oxidative Medicine (telephone: 405634-1310).
The American Board of Oxidative Medicine (a member of the American
Board of Specialities of Alternative Medicine) certifies doctors in the
various techniques of oxidative medicine, including UBIT.
Int J. Biosocial Med Research Vol. 14(2) 115-32, 1996
129
Conclusion
This simple, inexpensive, and nonspecific technique was clearly shown
years ago to be a totally safe and extremely effective method of treating and
curing infections; promoting oxygenation; vasodilation; improving asthma;
enhancing body physiology, circulation, and treating a variety of specific
diseases. Its use in hospitals and offices could significantly reduce mortality,
morbidity, and human suffering. Much more research needs to be done in
determining all of the potential uses of ultraviolet blood irradiation therapy
and also its correlation with other oxidative therapies.
References
1. Laurens, Henry, The Physiologic Effects of Ultraviolet Irradiation,JAMA,
Vol. 11, No. 26, December 24,1938, p. 2390.
2. Ibid, p. 2391.
3. Douglas, W.C., Into The Light, Second Opinion Publishing, Inc., 1993, pp.
18-19.
4. Ibid, p. 28.
5. Knott, Emmett, Development of Ultraviolet Blood Irradiation, American
journal of Surgery, August, 1948, pp. 165-171.
6. Miley, George, Ultraviolet Blood Irradiation Therapy, Archives of Physical
Therapy, September, 1942, pp. 537-538.
7. Miley, George, The Knott Technique of Ultraviolet Blood Irradiation in
Acute Pyogenic Infections, The New York State Journal of Medicine,
January 1, 1942, pp. 38-46.
8. Miley, George, Efficacy of Ultraviolet Blood Irradiation Therapy and
Control of Staphylococcemias, American journal of Surgery, Vol. 64, No. 3,
pp. 313-322.
9. Rebbeck and Miley, Review of Gastroenterology, January-February, 1943.,
p. 11.
10. Miley and Christensen, Ultraviolet Blood Irradiation Therapy: Further
Studies in Acute Infections, American journal of Surgery, Vol. 73, No. 4,
April, 1947, pp. 486-493.
11. Rebbeck, E.W., Ultraviolet Irradiation of Blood in the Treatment Of
Escherichia coli Septicemia, Archives of Physical Therapy, 24:158-167,
1943.
12. Barrett, Henry, The Irradiation of Autotransfused Blood by Ultraviolet
Spectral Energy: Results of Therapy in 110 Cases, Medical Clinics of North
America, May, 1940, pp. 723-732.
13. Douglas, W.C., Into The Light, Second Opinion Publishing, Inc., 1993, pp.
97-98.
14. Miley, George, The Control of Acute Thrombophlebitis With Ultraviolet
Blood Irradiation Therapy, American journal of Surgery, June, 1943, pp.
354-360,
15. Miley, Seidel, and Christensen, Preliminary Report of Results Observed in
Eight Cases of Intractable Bronchial Asthma, Archives of Physical Therapy,
September, 1943, pp. 533-542.
Rowen Ultraviolet Blood Irradiation Therapy
130
16. Miley, Seidel, and Christensen, Ultraviolet Blood Irradiation Therapy of
Apparently Intractable Bronchial Asthma, Archives of Physical Medicine,
January, 1946, pp. 24-29.
17. Miley and Christensen, Archives of Physical Therapy, November, 1944, pp.
651-656.
18. Olney, R.C., American Journal of Surgery, Vol. 90, September 1955, pages
402 - 409.
19. Rebbeck, E.W., Review of Gastroenterology, January-Februarv, 1943.
20. Rebbeck, E.W., Preoperative Hemo-Irradiations, American journal of
Surgery, August, 1943, pp. 259-265.
21. Miley, George, The Ultraviolet Irradiation of Autotransfused Human Blood,
Studies in Oxygen Absorption Values, Proceedings of the Physiological
Society of Philadelphia, Session of April 17, 1939.
21. Miley and Christensen, Ultraviolet Blood Irradiation Therapy in Acute Virus
and Virus-Like Infections, The Review of Gastroenterology, Vol. 15, No. 4,
April, 1948, pp. 271-276.
23. Miley, George, Recovery From Botulism Coma Following Ultraviolet Blood
Irradiation, The Review of Gastroenterology, Vol. 13, No. 1,
January-February, 1946. pp. 17-18.
24. Miley, George, Ultraviolet Blood Irradiation Therapy (Knott Technique) in
Non-Healing Wounds, American journal of Surgery, Vol. 65, No. 3,
September, 1944, pp. 368-372.
25. Gurwitsch, A.: In Rahn, Otto, Invisible Radiations of Organisms, Protoplasma
- Monographien, Berlin, Vorntraeger, 1936, Vol. 9.
26. Douglas, W.C., Into The Light, Second Publishing, Inc., 1993, pp. 14-15.
27. Edelson, Richard, Scientific American, August 1988, pages 1-8.
28. Gasparro, F.P., Mechanistic Events Underlying the Response of CTCL
Patients to Photophoresis. In: Extracorporeal Photochemotherapy: Clinical
Aspects in the Molecular Basis for Efficacy, Austin, Texas, RG Landes
Company, 1994; 101-20.
29. Pohlmann, et al, Wirksamkeit Von Pentoxifyllin und der Hamatogenen
Oxydationstherapie, Natur-und GanzheitsMedizin, 1992; 5:80-4.
30. Paulitschke, Turowski, and Lerche, Ergebnisse der Berliner HOT/UVB -
Bergleichstudie bei Patienten mit peripheren arteriellen
Durchblutungsstorungen, Z. gesamte Inn. Med., No. 47, 1992, pp. 148-153.
31. Frick, G., A Linke: Die Ultraviolet bestrahlung des Blutes, ihre Entwicklung
und derzeitiger Stand., Zschr.arztl., Forth. 80, 1986.
32. Seng, G., Hernatogenic Oxydationstherapie, Therapeuticon Six, June, 1988,
pp. 370-373.
33. Krimmel, Hematogena Oxidationstherapie - Eine Moglichkeit bei der
konbinierten Tumortherapie, Arztezeitschr. f. Maturheilverf., November,
1989, 30., Jarhg.
34. Miley, George, The Present Status of Ultraviolet Blood Irradiation (Knott
Technique), Archives of Physical Therapy, Vol., 25., No. 6., June, 1944, p.
361.
35. Bocci, Vielio, Studies on the Biological Effects of Ozone, 1. Induction of
Interferon Gamma on Human Leukocytes, Haernatologica, 1990, 75:510-5.
Int J. Biosocial Med Research Vol. 14(2) 115-32, 1996
131
36. Bocci, Vielio, Ozonization of Blood for the Therapy of Viral Diseases and
Immunodeficiencies: A Hypothesis, Medical Hypothesis, 1992, Vol., 39, pp.
30-34.
37. Douglas, William C., Into the Light, p. 257.
38. Mattman, Lida, Cell Wall Deficient Forms - Stealth Pathogens, CRC Press,
1993.
39. Weg, Stuart, Private Conitnunication, January, 1996.




Article 46 : Doctors do not ignore proven alternative to coronary artery disease..

Malaysiakini Published: dated 5th August 2013 3.44pm and
NST News paper published. 5th August 2013
Doctors do not Ignore Proven Alternative to Coronary Artery disease.
By Dr Mohd Ebrahim Sulaiman, Kuala lumpur.
ECP therapy , A unique opportunity to save countless lives and billions of dollars is being overlooked by the medical community. This technique increases blood flow to the heart, strengthens the circulation, and offers a proven way to treat heart disease in lieu of stents or bypass surgery.
What is this technic? It is called ECP (External counter Pulsation) FDA approved since 1987 for 1.Stable Angina Pectoris 2. Unstable Angina Pectoris 3. Acute Myocardial Infarction 4. Cardiogenic Shock. 5. Congestive heart failure.
In Malaysia , ECP Medical device has been used in our medical centre since 2002, may 5th after the Inaugural opening ceremony launched by His Excellency Dato Sri Dr Muhammad Suleiman , former Deputy Minister of Health.
External counterpulsation (ECP) is a safe, non-invasive procedure that can overcome heart disease in two ways—by passively exercising the heart to strengthen the vascular system and by targeting inflammation, the underlying culprit in damaged blood vessels that inhibits blood flow.
More than 100 studies have demonstrated its overwhelming effectiveness and unquestioned safety in improving blood flow in patients with heart disease. Some experts are calling for the ECP procedure to become first-line therapy for heart disease, long before surgery or other invasive procedures are used. Approved by the FDA for chronic stable angina, cardiogenic shock, congestive heart failure, as well as during a heart attack, ECP not only saves lives but is also considerably cheaper and safer than traditional invasive procedures such as angioplasty and coronary stents, which continue to be the mainstay of therapy which requires repeated procedures. Insurance even pays for it!
ECP By improving circulation, this simple procedure prevents arteries from becoming blocked, allowing the heart to do its job more effectively. As is often the case, health care in the United States and else where is often driven by lucrative revenues making many in the medical community reluctant to embrace alternative therapies.
We have first enlightened our members to the benefits of ECP therapy in May 2002, yet most Foundation members still don’t realize this life-saving technology is available. In this article, we’ll review why we should no longer afford to ignore the benefits of this inexpensive, life-saving procedure. Good news is our new DG Health of Malaysia has been calling for reformation of Health care system soon. Insurance policies should also be reformed.
There are now about 15 Medical centres and hospitals providing ECP therapy in Malaysia. In our 11 years experience in treating thousands of patients with ECP therapy it was found to be at least 85% successful, for patients with some forms of heart disease.
External counterpulsation (ECP) is a non-invasive, high-tech, low-risk procedure, performed on an outpatient basis, which offers a remarkable reprieve from some of the potentially disabling symptoms of stable angina and coronary heart disease. Patients lucky enough to be offered this underused therapy may experience changes in their conditions that range from significant pain relief to renewed mobility and energy, to a rekindled libido. They may also literally gain a new lease on life, simultaneously avoiding the dangers of coronary bypass surgery . But chances are, unless you inquire about it, you’ll never even be told this option exists. Therefore we need to make awareness among public and doctors.
Imagine this scenario. You’ve developed troubling symptoms recently—shortness of breath,difficulty climbing stairs without resting frequently, and maybe even some pressure or pain in your chest. If you’re a man, you may have noticed a decrease in libido, or an occasional inability to sustain erection during sex. You may even break out into a sweat inexplicably from time to time. Such patients should ask for ECP therapy as a first line of therapy.
I would also like to share our experience in using External counterpulsation (ECP) for the treatment of cardiac Syndrome X . ECP has been shown to be an effective treatment for refractory angina in end stage coronary disease patients, improving both subjective and objective measures of ischemia and associated functional impairment . ECP increases coronary blood flow and velocity and has been shown to increase nitric oxide and cGMP, decrease endothelin and angiotensin II levels, mobilize endothelial progenitor cells and inhibit intimal hyperplasia. ECP has also been demonstrated to promote collaterals, coronary vasodilation, and decrease vascular disease progression. ECP therapy increases shear stress and could be expected to improve the endothelial dysfunction associated with Syndrome X . It is amazing that elderly patients above 90years old enjoys ECP therapy with some physical and mental improvement.
Patients without significant angiographic epicardial coronary artery disease can suffer chronic disability from microvascular angina (cardiac Syndrome X) which is unresponsive to usual antianginal medical therapy. Microvascular coagulation and flow rate can be demonstrated by means of latest Video microscope at the junction of skin and finger nails on the doctor’s office table within two minutes. Ref: International Journal of cardiology , 1 March, 2008.
What you need to know about ECP therapy.
i.Stable coronary artery disease and angina can cause disabling symptoms including shortness of breath, pressure or discomfort in the chest, exercise intolerance, and fatigue.
ii.Physicians commonly treat coronary artery disease and angina using invasive procedures such as angioplasty/stents and coronary artery bypass grafting. While such treatment temporarily restores blood flow to the heart, but it will not last for long, reclosing of the arteries is common.
iii. ECP ,a safe, effective, non-invasive therapy for the symptoms of coronary artery disease and angina is now available.
iv.External counterpulsation (ECP) alleviates cardiac symptoms by enhancing coronary collateral circulation—alternate pathways by which blood can reach the heart muscle.
v. The procedure is performed in a series of outpatient treatments, in which inflatable cuffs wrapped around the legs inflate and deflate in rhythm with the patient’s heartbeat.
vi. More than 100 published studies show that ECP can effectively relieve symptoms of heart failure, increase exercise tolerance, reduce reliance on medication, and improve quality of life. Benefits of treatment can last up to five years.
Warning!!! . ECP is the Medical Device, United States Federal law restricts this device for use on or by the order of Licensed Physician , the same applies to Malaysia.
While ECP may benefit many individuals suffering from the effects of coronary heart disease, it is not for every patient.
Contraindications for the therapy include:
i.Severe peripheral vascular disease
ii. Decompensated congestive heart failure
iii. Uncontrolled hypertension
iv. Phlebitis
v. Deep vein thrombosis
vi. Pregnant or potentially pregnant women
vii. Significant aortic insufficiency
viii. Aortic Aneurysm 5cm diameter.
ix. Markedly irregular heart rhythm
Consult with your registered physician who is trained and aware of ECP therapy to determine if ECP is an appropriate choice for you. This novel therapy simulates the circulatory benefits of exercise, increase BMR, allowing patients to overcome symptoms and resume a healthy, active lifestyle.
FORGING NEW PATHWAYS—REPAIRING THE HEART’S BLOOD SUPPLY
Regarded as a form of physical therapy, ECP stands in sharp contrast to the other, far more common approaches to angina; namely invasive interventions such as cardiac catheterization, angioplasty, stent placement, and coronary artery bypass surgery.
(CAD) Coronary Artery Disease is the progressive systemic disease, Invasive procedures don’t address the underlying heart disease.
Atherosclerotic plaques can prevent blood flow to the heart muscle, resulting in oxygen starvation of the cardiac muscle tissue.
These clinical manifestations are often characterized by the pain of angina and some loss of cardiac function. But these blockages often become irrelevant .
ECP improves blood flow by improving blood vessel function as a whole…New pathways form.
The first time I heard about it, I thought it sounds too good to be true. But that was 11 years ago. Now, I am a firm believer in this deceptively simple therapy for a deadly N0. 1 killer disease . I was amazed by the science behind it and the simplicity of the technique. In our Islamic culture, we always intend to think the higher-tech, the better, the cheaper, safer , no surgery, but the results with this technique are phenomenal. Reward from Almighty God depends upon our intention to please Him. Are we going to be greedy or be honest and serve our fellow human with sympathy?
To save the space: References regarding this article are available on request.

Hi do you want to read the same article slightly squeezed in the Medical tribune page 17, 15 -31st August 2013 issue. Go ahead below. Please do remember this is very important article to alert the doctors especially GP's and the public to be aware of the treatment. I thank all the editors who accepted my articles and published NST, Malaysiakini and Medical Tribune.
Medical Tribune
17 15-31 August 2013 Views
Doctors overlooking alternative
treatment for coronary artery disease
External counterpulsation (ECP) therapy, a unique opportunity to save countless lives and billions of dollars, is being overlooked by the medical community.
ECP increases blood flow to the heart,
strengthens circulation, and offers a proven
way to treat heart disease in lieu of stents and
bypass surgery. It is a safe, non-invasive procedure which can overcome heart disease in
two ways – by passively exercising the heart
to strengthen the vascular system and by targeting inflammation, the underlying cause in
damaged blood vessels that results in inhibited blood flow.
ECP therapy has been approved by the
US FDA since 1987 for stable angina pectoris,
unstable angina pectoris, acute myocardial
infarction, cardiogenic shock and congestive
heart failure.
More than 100 studies have demonstrated
its effectiveness and safety. Some experts are
calling for the ECP procedure to become firstline therapy for heart disease, long before surgery or other invasive procedures are used.
ECP not only saves lives, it is also considerably
cheaper and safer than traditional invasive
procedures such as angioplasty and stents.
There are now about 15 medical centers
and hospitals providing ECP therapy in Malaysia. ECP therapy has been used for 11 years
to treat thousands of patients with some forms
of heart disease.
Patients who have developed troubling
symptoms recently – shortness of breath, difficulty climbing stairs without resting frequently and maybe even some pressure or pain in
their chest – should be first treated with ECP
therapy.
I would also like to share our experience
in using ECP for the treatment of cardiac
syndrome X. ECP has been shown to be an
effective treatment for refractory angina in
end-stage coronary disease patients, improving both subjective and objective measures of
ischemia and associated functional impairment. ECP increases coronary blood flow and
velocity, and has been shown to increase nitric
oxide and cGMP, decrease endothelin and angiotensin II levels, mobilize endothelial progenitor cells and inhibit intimal hyperplasia.
ECP has also been demonstrated to promote coronary vasodilation and decrease vascular disease progression. ECP therapy can be
expected to improve endothelial dysfunction
associated with cardiac syndrome X. Elderly patients aged above 90 have shown some
physical and mental improvement after ECP
therapy.
What you need to know about ECP therapy
ECP therapy alleviates cardiac symptoms by
enhancing coronary collateral circulation – alternate pathways by which blood can reach
the heart muscle.18 15-31 August 2013 Views
The procedure is performed in a series of
outpatient treatments, in which inflatable
cuffs wrapped around the legs inflate and deflate in rhythm with the patient’s heartbeat.
More than 100 published studies show that
ECP can effectively relieve symptoms of heart
failure, increase exercise tolerance, reduce reliance on medication and improve quality of
life. Benefits of treatment can last up to 5 years.
As the device used to provide ECP is a
medical device, US Federal law restricts its use
to a licensed physician – the same rule should
apply to Malaysia.
While ECP therapy may benefit many individuals suffering from the effects of coronary
heart disease, it is not for every patient.
Contraindications for the therapy include:
l Severe peripheral vascular disease.
l Decompensated congestive heart failure.
l Uncontrolled hypertension.
l Phlebitis.
l Deep vein thrombosis.
l Pregnant or potentially pregnant women.
l Significant aortic insufficiency.
l Aortic aneurysm.
l Markedly irregular heart rhythm.
Forging new pathways
Coronary artery disease is a progressive, systemic disease. Invasive procedures do not address the underlying heart disease.
Atherosclerotic plaques can prevent blood
flow to the heart muscle, resulting in oxygen
starvation of cardiac muscle tissue. These clinical manifestations are often characterized by
angina and some loss of cardiac function. But
these blockages often become irrelevant. ECP
improves blood flow by improving blood vessel function as a whole and forming new pathways.
Note: References regarding this article can be
obtained from the author on request.
Dr. Mohd Ebrahim Sulaiman
Kuala Lumpur
Disclaimer: Views expressed by the writer are not necessarily those of
Medical Tribune.










Click picture to ZOOMArticle 47 : New Hope for Cancer.
News Conference announcement of the discovery of Th17 Regimen

An Immune System Trained to Kill Cancer

New findings on Th17 cells pave way for human cancer treatment protocol

Thai Researches create Anti-Cancer Formula from the mangosteen fruit

Th17 cells summon an immune system strike against cancer

Thai scientist unveils mangosteen anti-cancer properties.

What you should know about cancer
THINGS TO KNOW ABOUT CANCER

1. Every person has cancer cells in the body. These cancer cells do not show up in the standard tests until they have multiplied to a few billion. When doctors tell cancer patients that there are no more cancer cells in their bodies after treatment, it just means the tests are unable to detect the cancer cells because they have not reached the detectable size.


2. Cancer cells occur between 6 to more than 10 times in a person's lifetime.

3. When the person's immune system is strong the cancer cells will be destroyed and prevented from multiplying and forming tumors.

4. When a person has cancer it indicates the person immune system is weak. These could be due to genetic, environmental, food and lifestyle factors.

5. To overcome the multiple nutritional deficiencies, changing diet and including supplements will strengthen the immune system.

6. Chemotherapy involves poisoning the rapidly-growing cancer cells and also destroys rapidly-growing healthy cells in the bone marrow, gastro-intestinal tract etc.
It also can cause organ damage, like liver, kidneys, heart, lungs etc.

7. Radiation while destroying cancer cells also burns, scars and damages healthy cells, tissues and organs.

8. Initial treatment with chemotherapy and radiation will often reduce tumor size. However prolonged use of chemotherapy and radiation do not result in more tumor destruction.

9. When the body has too much toxic burden from chemotherapy and radiation the immune system is either compromised or destroyed, hence the person can succumb to various kinds of infections and complications.

10. Chemotherapy and radiation can cause cancer cells to mutate and become resistant and difficult to destroy. Surgery can also cause cancer cells to spread to other sites.

11. An effective way to battle cancer is to starve the cancer cells by not feeding it with the foods it needs to multiply.

CANCER CELLS FEED ON:

a. Sugar is a cancer-feeder. By cutting off sugar it cuts off one important food supply to the cancer cells.
Sugar substitutes like Nutrasweet, Equal, Spoonful, etc are made with Aspartame and it is harmful.
A better natural substitute would be Manuka honey or molasses but only in very small amounts.

Sugar consumption in all forms (glucose, fructose, and sucrose) will impair the ability of white blood cells to destroy biological agents. This effect begins within a half hour of consumption and lasts for 5 hours. After 2 hours, immune function is reduced by 50%.

Table salt has a chemical added to make it white in color. Better alternative is sea salt.

b. Milk causes the body to produce mucus, especially in the gastro-intestinal tract. Cancer feeds on mucus. By cutting off milk and substituting with unsweetened soya milk cancer cells are being starved.

c. Cancer cells thrive in an acidic environment. A meat-based diet is acidic and it is best to eat fish rather than beef, chicken or pork. Meat also contains livestock antibiotics, growth hormones and parasites, which are all harmful, especially to people with cancer.

d. A diet made of 80% fresh vegetables and juice, whole grains, seeds, nuts and a little fruits help put the body into an alkaline environment. About 20% can be from cooked food including beans.
Fresh vegetable juices provide live enzymes that are easily absorbed and reach down to cellular levels within 15 minutes to nourish and enhance growth of healthy cells.
To obtain live enzymes for building healthy cells try and drink fresh vegetable juice (most vegetables including bean sprouts) and eat some raw vegetables 2 or 3 times a day. Enzymes are destroyed at temperatures of 104 degrees F (40 degrees C).

e. Avoid coffee, tea, and chocolate, which have high caffeine. Green tea is a better alternative and has cancer-fighting properties.
Water- best to drink Filtered water, to avoid known toxins and heavy metals in tap water. Distilled water is acidic, avoid it. Alkaline water is good.

12. Meat protein is difficult to digest and requires a lot of digestive enzymes. Undigested meat remaining in the intestines become putrefied (decomposition) and leads to more toxic buildup.

13. Cancer cell walls have a tough protein covering. By refraining from or eating less meat it frees more enzymes to attack the protein walls of cancer cells and allows the body's killer cells to destroy the cancer cells.

14. Some supplements build up the immune system ( anti-oxidants, vitamins, minerals etc.) to enable the body's own killer cells to destroy cancer cells. Other supplements like vitamin E are known to cause apoptosis, or programmed cell death, the body's normal method of disposing of damaged, unwanted, or unneeded cells.

15. Cancer is a disease of the mind, body, and spirit. A proactive and positive spirit will help the cancer warrior be a survivor. Anger, un- forgiveness and bitterness put the body into a stressful and acidic environment. Learn to have a loving and forgiving spirit. Learn to relax and enjoy life.

16. Cancer cells cannot thrive in an oxygenated environment. Exercising daily, and deep breathing help to get more oxygen down to the cellular level. Oxygen therapy is another means employed to destroy cancer cells.


Fruits to eat. see pictures

Refer: www.th17.sg

Vegetables to eat see pictures




Article 48 : Fruits to eat for Cancer and what you should know about cancer.
THINGS TO KNOW ABOUT CANCER

1. Every person has cancer cells in the body. These cancer cells do not show up in the standard tests until they have multiplied to a few billion. When doctors tell cancer patients that there are no more cancer cells in their bodies after treatment, it just means the tests are unable to detect the cancer cells because they have not reached the detectable size.

2. Cancer cells occur between 6 to more than 10 times in a person's lifetime.

3. When the person's immune system is strong the cancer cells will be destroyed and prevented from multiplying and forming tumors.

4. When a person has cancer it indicates the person immune system is weak. These could be due to genetic, environmental, food and lifestyle factors.

5. To overcome the multiple nutritional deficiencies, changing diet and including supplements will strengthen the immune system.

6. Chemotherapy involves poisoning the rapidly-growing cancer cells and also destroys rapidly-growing healthy cells in the bone marrow, gastro-intestinal tract etc.
It also can cause organ damage, like liver, kidneys, heart, lungs etc.

7. Radiation while destroying cancer cells also burns, scars and damages healthy cells, tissues and organs.

8. Initial treatment with chemotherapy and radiation will often reduce tumor size. However prolonged use of chemotherapy and radiation do not result in more tumor destruction.

9. When the body has too much toxic burden from chemotherapy and radiation the immune system is either compromised or destroyed, hence the person can succumb to various kinds of infections and complications.

10. Chemotherapy and radiation can cause cancer cells to mutate and become resistant and difficult to destroy. Surgery can also cause cancer cells to spread to other sites.

11. An effective way to battle cancer is to starve the cancer cells by not feeding it with the foods it needs to multiply.

CANCER CELLS FEED ON:

a. Sugar is a cancer-feeder. By cutting off sugar it cuts off one important food supply to the cancer cells.
Sugar substitutes like Nutrasweet, Equal, Spoonful, etc are made with Aspartame and it is harmful.
A better natural substitute would be Manuka honey or molasses but only in very small amounts.

Sugar consumption in all forms (glucose, fructose, and sucrose) will impair the ability of white blood cells to destroy biological agents. This effect begins within a half hour of consumption and lasts for 5 hours. After 2 hours, immune function is reduced by 50%.

Table salt has a chemical added to make it white in color. Better alternative is sea salt.

b. Milk causes the body to produce mucus, especially in the gastro-intestinal tract. Cancer feeds on mucus. By cutting off milk and substituting with unsweetened soya milk cancer cells are being starved.

c. Cancer cells thrive in an acidic environment. A meat-based diet is acidic and it is best to eat fish rather than beef, chicken or pork. Meat also contains livestock antibiotics, growth hormones and parasites, which are all harmful, especially to people with cancer.

d. A diet made of 80% fresh vegetables and juice, whole grains, seeds, nuts and a little fruits help put the body into an alkaline environment. About 20% can be from cooked food including beans.
Fresh vegetable juices provide live enzymes that are easily absorbed and reach down to cellular levels within 15 minutes to nourish and enhance growth of healthy cells.
To obtain live enzymes for building healthy cells try and drink fresh vegetable juice (most vegetables including bean sprouts) and eat some raw vegetables 2 or 3 times a day. Enzymes are destroyed at temperatures of 104 degrees F (40 degrees C).




e. Avoid coffee, tea, and chocolate, which have high caffeine. Green tea is a better alternative and has cancer-fighting properties.
Water- best to drink Filtered water, to avoid known toxins and heavy metals in tap water. Distilled water is acidic, avoid it.

12. Meat protein is difficult to digest and requires a lot of digestive enzymes. Undigested meat remaining in the intestines become putrefied (decomposition) and leads to more toxic buildup.

13. Cancer cell walls have a tough protein covering. By refraining from or eating less meat it frees more enzymes to attack the protein walls of cancer cells and allows the body's killer cells to destroy the cancer cells.

14. Some supplements build up the immune system ( anti-oxidants, vitamins, minerals etc.) to enable the body's own killer cells to destroy cancer cells. Other supplements like vitamin E are known to cause apoptosis, or programmed cell death, the body's normal method of disposing of damaged, unwanted, or unneeded cells.

15. Cancer is a disease of the mind, body, and spirit. A proactive and positive spirit will help the cancer warrior be a survivor. Anger, unforgiveness and bitterness put the body into a stressful and acidic environment. Learn to have a loving and forgiving spirit. Learn to relax and enjoy life

16. Cancer cells cannot thrive in an oxygenated environment. Exercising daily, and deep breathing help to get more oxygen down to the cellular level. Oxygen therapy is another means employed to destroy cancer cells.
17. Fruits to eat to prevent and treat cancer.




Article 49 : Are you ACID OR ALKALINE ?

We Are Acid Machines.
Bob Livingston | Sep 07, 2013 |
It’s not “where’s the beef.” It’s where’s the acid? It’s kind of important. No, it’s all-important — like life or death. And doctors pay no attention-
Remember these three points:
Acid in your stomach—good.
Acid in your tissue—bad.
Acid water to cleanse your face—good.
Acid In The Stomach Is Good.
The pharmaceutical companies and TV advertisers tell Americans that stomach acid is bad. It is bad, indeed, if we don’t have any. And if we take their antacids as they insist, we won’t have any stomach acid and we eventually wind up with stomach cancer.
Without proper stomach acid somewhere around a pH of 3 to 4, our food rots — causing putrefaction and backup poison. This is serious and leads to disease, most likely cancer. Your digestive process breaks down if you don’t have enough stomach acid. Hydrochloric acid (HCl) is the only inorganic acid our body makes.
Ever wonder why your dog can eat all kinds of compromised food and thrive? The answer is that dogs have lower pH stomach acid levels — they are about 1.5 to 2. They can digest and process much better than human beings, and they don’t take antacids.
Adequate stomach acid becomes ever more critical as we get older because we have less of it. This means that we get less nutrition assimilation, which in turn causes a lowering of immunity.
But once again, pharmaceuticals and doctors are practicing symptomology. Symptoms of acid indigestion in the absence of ulcers are actually symptoms of lack of acid. Ever heard of a doctor prescribing acid for an “acid stomach”?
Without enough hydrochloric acid we cannot absorb minerals or digest protein.
Our digestive capacity diminishes as we age, but it’s easily compensated for with betaine hydrochloride, which we should take with our meals. Another good habit is taking one or two teaspoons of whole apple cider vinegar in a glass of water before meals.
Speaking of hydrochloric acid, I by chance found some anecdotal evidence of the high efficacy of hydrochloric acid by injection. The dosage ranged from 1-250 to 1-1,000 in 10cc of distilled water without any toxic or inflammatory reaction no matter if it was given orally, intravenously or intramuscularly. The results were astounding.
Generally, the oxygen content of the blood doubled within 30 minutes and a significant stimulation of phagocytic (white cells) system was also noted. In one instance, phagocytosis increased the white blood cell count from 7,800 to 2.6 million within 48 hours.
This is not the effect of drug activity. This is the injection of the basic acid of the human body. What a stimulation of the forces of resistance!
The conclusion here is that hydrochloric stomach acid needs to be adequate at all times!
Acid In The Tissue Is Bad
The ideal situation is for the body to be slightly alkaline; but due to our very high acid diet from commercial foods, our acid buildup is getting worse with time. With the progressive accumulation of acid, we come closer to death. New babies are highly alkaline. Acid in the tissue is very different from acid in the stomach. The difference is the pH. Tissue acid should range around 7.2 to 7.4 pH as measured by pH paper or test strips using saliva.
Acid in the stomach is inorganic acid. Acid in the tissue is organic acid. One is life and assimilation, and one is pollution.
As we age, we get more acid accumulation. This means a shortage of oxygen and a shortage of breath. Most cells die in an acid environment, but some cells survive by becoming abnormal cells. This is cancer.
To get more oxygen and to dispose of acid waste, we drink alkaline water and eat an alkaline diet. The amount of organic acid accumulation is directly related to the amount of oxygen we have. The more acid you have, the less oxygen your body has — and the more potential for disease.
When the environment for the cells becomes too acidic, there isn’t enough oxygen to go around.
But when we drink alkaline water, we are drinking water with excess oxygen, not in the form of O2 but in the form of OH, which is very stable because it is mated with positively ionized alkaline minerals.
Two of these hydroxyl ions can form a water molecule (H2O) and give off one oxygen atom. The alkaline mineral is used to detoxify poisonous acid compounds while supplying excess oxygen to the cells preventing the development of cancer.
Acid On The Face Is Good!
Acid water should be used on the face. It will keep the face skin fresh and clean and will protect the face from acne and discoloration. So-called pH-balanced cosmetics are acid. Soft water is acid.




Article 50 : Do you want antioxidants with no cost?
Do you want free Natural AntiOxidants with no cost? (Gift from Allah SWT) ?
Antioxidants deliver Negative elecrons (-e) to donate to free radicals lacking in negative electrons. Antioxidants (Free negative electrons) prevent free radical damage of our body.
Many antioxidants have free extra negative electrons to donate.
1.Vitamin C has 4 free negative electrons.
2.Vit E has 2 negative electrons .
3.EDTA has 6 negative electrons.
4.Tumeris has 260,000 /100gram ORAC (Oxygen Radical Absorption capacity).
5.Cinnamon has 130,000 /100gram ORAC .
6.Ionised water from alkaline water machine has 400 to 600 ORP (Oxidative reduction Potential).
The simplest Anti- Oxidant is negative electrons from the EARTH. Just put you bare feet on the ground or ground yourself.
The positive electrons from you body will be pushed up is called umbrella effect. The ground is negative . Cancer and other chronic diseases can be healed by grounding.
If you wear shoes you are insulated from the ground , at your head level (One meter height) there is Positive electricity +380 volts.
At the level of the 1stnd floor there will be about +600 volt.
At the level of the 2nd floor there will be about +1200 volt. Earth is negative sky (cloud) is positive.
Grounding is important otherwise you are living in a sick building. I know you have many questions . Please read the Book “ EARTHING” by Dr Stephen Sinatra that will answer all your questions..







Article 51 : Exercise may be as effective as drugs.ECP therapy is passive cardiovascular excercise.

Exercise may be as effective as drugs.
http://www.bmj.com/content/347/bmj.f5577 October 02, 2013
Exercise May Be As Effective As Drugs for Some Conditions
(HealthDay News) – Exercise and drug interventions may be similar regarding their effect on mortality in the secondary prevention of coronary heart disease, stroke rehabilitation, and prevention of diabetes, according to research published online Oct. 1 in BMJ.
Huseyin Naci, of the London School of Economics and Political Science, and John P.A. Ioannidis, MD, of Stanford University in California, conducted a metaepidemiological study using meta-analyses (four for exercise and 12 for drug therapy) of randomized, controlled trials to examine the comparative effectiveness of exercise vs. drug therapy on mortality outcomes for four common medical conditions.
The researchers found no difference in outcomes for exercise vs. drug interventions for the secondary prevention of coronary heart disease and prediabetes. For stroke rehabilitation, exercise was more effective than drug treatments, including anticoagulants (odds ratio [OR], 0.09) and antiplatelets (OR, 0.1). Exercise was less effective than diuretics for heart failure outcomes (OR, 4.11).
"This comprehensive look at the existing body of evidence highlights the need to perform randomized trials on the comparative effectiveness of exercise and drug interventions," the authors write.

Full Text




Article 52 : Abuse of coronary artery stent by cardiologists.

NEW YORK, NY ” An article in yesterday's financial press surveys recent high-profile cases of alleged coronary-stenting overuse, described by a sources as "just the tip of the iceberg," and alternates them with stories from some of the patients involved[1]. Although there are a few comments from leaders in the cardiology community that try to put the cases in perspective, the 3500-word story ultimately portrays a subspecialty too often abused by practitioners bending or ignoring the guidelines in pursuit of procedure-based profits.

"When stents are used to restore blood flow in heart-attack patients, few dispute they are beneficial," notes the story from reporters Peter Waldman, David Armstrong, and Sydney P Freedberg published yesterday in Bloomberg BusinessWeek . But heart attacks account for only about half of stenting procedures, it notes.

"Among the other half —elective-surgery patients in stable condition—overuse, death, injury, and fraud have accompanied the devices' use as a go-to treatment," the article says, citing "thousands of pages of court documents and regulatory filings, interviews with 37 cardiologists and 33 heart patients or their survivors, and more than a dozen medical studies."

Coronary stenting "belongs to one of the bleakest chapters in the history of Western medicine,” the article quotes Dr Nortin Hadler (University of North Carolina, Chapel Hill).

Most of the story's words are devoted to the cases of alleged overuse, many of which have been settled and have been covered previously by news organizations. They include the case of Dr Samuel DeMaio , who is said to have implanted 21 coronary stents in one patient over an eight-month period. The patient's later death was related to the placement of "unneeded stents," according to the Texas Medical Board.

There is also the case of Dr John McLean of Salisbury, MD, a cardiologist convicted of billing for unwarranted stenting, who "argued in a federal appeal last year that inappropriate usage is widespread, and [he] was prosecuted for behavior that’s the industry norm."

Also described is the broader story of Baltimore cardiologist Dr Mark Midei, whose "license was revoked in 2011 when the Maryland Board of Physicians found he falsified records to justify unwarranted stents."

A hospital at which Midei worked, St Joseph Medical Center in Towson, MD, "paid the government $22 million without admitting liability" after "at least five hospitals" settled with the Justice Department "over allegations that they paid illegal kickbacks to doctors for patient referrals to their cath labs."

Those are only a few of the abuse cases covered by article. Considerably less space is devoted to potentially balancing observations from cardiologists or others in the field. Overall, "Doctors are using fewer stents and choosing more appropriate patients than they were a few years ago, according to Dr John Harold [David Geffen School of Medicine at University of California, Los Angeles and the Cedars-Sinai Heart Institute, Los Angeles, CA], president of the American College of Cardiology." Harold contends that "cardiologists who've been accused of fraud or are serving prison time are 'outliers' who don't represent the overwhelming majority.

References:Coronary-Stenting Abuse Cases Highlighted in Bloomberg Story
http://www.medscape.com/viewarticle/811805




Article 53: Too many stents will kill you.

WHAT A SELFISH PEOPLE OF THE WORLD.
CASH FLOW - MONEY is supported by ALL. ECP (EXTERNAL COUNTER PULSATION ) therapy is so good can save heart attack, can save thousands of lives and billion dollars of the country but many overlooked it because cannot make money.
Stenting belongs to one of the bleakest chapters in the history of Western medicine,” said Nortin Hadler, a professor of medicine at the University of North Carolina at Chapel Hill. Cardiologists “are marching on” because “the interventional cardiology industry has a cash flow comparable to the GDP of many countries” and doesn’t want to lose it, he said.



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