Highlights in Medicine 2017 – Stephen Genuis



annual many animal cages measuring integrative medicine and to do the introduction for that I'd like to welcome dr. Steve and presents good morning welcome everyone to the 10th annual Betty Ann and Wade Peggy's a kinship in integrative medicine I turn these real estate to turn out this morning the the lecture was started in 2005 for this purpose wasn't called lectures and other delivery methods provide continuing education opportunities for faculty residents and practitioners in the field of complementary alternative medicine the lecture exists in purpose because she would be able to it brings high-profile knowledgeable and experienced positions to our colleagues to address current topics in complementary and integrative levels so integrative medicine it reaffirmed the importance of the relationship between the practice there and the patient it focuses on the whole person it is informed by evidence and it makes use of all appropriate therapy approaches healthcare professionals and disciplines to achieve optimal health and healing it's now a board-certified medical specialty and it's taught in virtually every Medical School in Canada and United States and certainly I'm proud of the curriculum that we have here at U of S Betty and I love to have you Bay in and we Negi have both been prominent members of the business volunteer and philanthropic communities in this province for many years Wade has been involved in aviation life insurance and financial planning and then some prominent volunteer roles with several community-based organizations Betty Ann has that company lost his career as a senior executive in corporate relations upon s industry and attend how numerous directorships in the public and private sector the Hagins have been wonderful supporters the universe's catch one have also provided tremendous volunteer assistant in the attracting of other donors in university saskatchewan made in Betty Ann both that expensive personal experience in leading integrated health centers through it North America so this lectureship created to their gifts College of Medicine is their way of articulating their vision for his problems and I think TV says the first time in 10 years that they haven't been able to be here certainly represented I think in the matter Katie Moulton and her family here today but have but they would ease up to be here promote our speaker dr. Stephen genuine it just people of us with the privilege of hearing from the 2017 Hecky lecturer dr. Stephen genuine whose topic is the clinical practice of environmental medicine dr. Jenn Ulis is the clinician researcher involved in many areas in medical science he's a board-certified obstetrics and gynecology as well as an environmental medicine practices at the University of Alberta in Emerson he's authored over 110 scientific publications for over 50 different peer-reviewed medical journals elections extensively in his review papers for over 70 different scientific and medical publications he holds a commemorative medal from the governor-general and recognition of significant contribution to Canada edition and it is all that enjoys ballroom dancing with its wife Sheila being brought to the five children and Obama's five grandchildren please join me in a warm welcome for our tenth Betty Ann and lead Peggy lecturer dr. Stephen he's missed thank you so much it's a real privilege to be today and have the opportunity to chat with you I am most grateful to the people at the Center for integrated medicine it was wonderful to meet you last night in chat I have such a generation for what you're doing and all you've accomplished I also want to thank any family providing the opportunity to be able to do this I have been asked speak a little bit about clinical practices environmental medicine I'd like to do is divided into session from session I'd like to talk over to go to background with the problems of chronic disease and I want to go into the clinical aspects of environmental medicine to talk about practical aspects so let me first of all begin to talk a bit about the challenge who said what's our most grateful to live in Canada and have a wonderful healthcare system it's all we considered fundamental pillar of our national identity in a recent survey found 90% of Canadians considered health care to be a main priority for decision makers and they preserving our health care system even more important than any other issues including environment and the economy many people don't realize is that the health care system is often thought by many to be in a position of crisis we look at the expenditures they have skyrocketed over the last couple of decades and the rising costs are keep population growth and economic growth and inflation many people now consider it to be unsustainable if we will healthcare expenditure that meeting its miniature for every province approximating 50% the newest problems is what's astonishing it despite unprecedented amounts of resources expended and the fact now that we have more MDS for population in Canada article 4 availability of services appears to be declining we have more more people who are able to find a family documents we have longer reading lists people have difficulty with access in various regions of the country is often for long waiting lists and emergency departments and so there have been calls many sources to it to fix the health care system for example Bruce the president a Medical Association that we have a moral imperative to fix the healthcare system in time for action recognizing the challenge of sustainability there have been a number of commission the number of groups a number of the continent that have met all time through panel to produce report and Alberta we had an athlete house to report and attempts by federal provincial ministers one of the recent prime ministers talked about 16 health care per generation it has been a leading issue in almost every federal election yet the problem through sustainable cost is nice right and the decline in availability services and so what I ask you to consider today when we want to propose a get a primary factor between two the escalating health care challenges has not been adequately addressed and not been adequately explored many people are not aware and this is what's being described in the medical literature is rapidly escalating an often neglected problem of chronic disease the editor The Lancet one of the talks returns in the world talking of rising rates and profound academic of chronic complete the building North America for example no product to female and accounting for more than 85 percent of healthcare costs and over half the American population out and at least in chronic conditions more than one in four has multiple chronic conditions if we look at three DS for example diabetes in the 1890s really mostly wrote his book on the principles and practices of medicine the incidence of diabetes with about 1 in 50,000 now it's about 7% of the population and a lot of that profound right in the last year we look at mental health problems when I went to medical school I was taught it you know 120 Canadians will develop mental health problem that was recently at a conference or psychiatrist for New York was talking about the sitter's now in the United States it's about one in four Americans and rising and a couple of weeks ago W a joke came out indicating the depression now the leading cause of disability like dementia has been increasing at a rapid rate so let's go into the head of the Alzheimer's Association for the number of people affected with Alzheimer's and dementia is growing at an epidemic big in skyrocketing financial and personal cost would devastate the world's economy how persistent now when this kind of information present different people respond by think about to be expected we have an aging population the my friend a lot of the pandemic chronic fatigue is happening in children and generally we recently had an article entitled the increased child chronic condition in the United States and they say that help from social welfare systems are unprepared for the rapid growth demand that overrides for you to have them so we see it where it's your stages of life but as well as the eye stages of like people are expressing concerns both rising rates of disease and impact on the healthcare system let's look at autism for example 1975 it was a relatively uncommon disease it will be 5,000 published in nature most recent official statistics that's one of thousands of percent see now one in 68 in the US people sometimes think it's because of improve diagnosis and expanding definition as a spectrum disorder the epidemiology world has looked at that and they said yeah that's absolutely true and that accounts for a small percentage that doesn't account for the multiple thousands of percent increase in addition we look at pediatric medical health in Canada half of the pediatric hospital beds are now filled the children teenage to treat mental health problem in the u.s. they look forbidden for bipolar over the last number of years they increase more than 44 if we looked at children with cancer in September in the UK demand for children with cancer often they talk about an incredible arrived at 40% over the last while particularly in teenage not only children of course a couple of days ago and with the announcement in Canada in the Canadian Cancer Society nearly half of all Canadians powers-that-be diagnosed with some form of cancer and the World Health Organization came out pro cancer report stating that they anticipate that that increases and it continued with an anticipated 50% increase in rates of cancer or the we're seeing rising rates of chronic pain trying to get into a chronic pain clinic people often are waiting for over a year even to be assessed a bursting teenagers now with chronic pain and as well we're seeing all tons of unexplained illnesses people recycle myalgia with chronic fatigue and one Canadian province recently formed the task force that I would Maps beyond the claim that they have over half a million people with unexplained environmental literacy that are consuming enormous amount of health care law so we're good of course these are not just statistics these are rural people who are suffering right who have a decreased quality of life who have functional decline we have a crisis of disability I recently was speaking at an autism conference and there was a number of submissions there who themselves had children with autism and one of them gave a talk said that every day in u.s. 50 autistic children are now becoming battle if the levels now are increasing increasing disability rates and she was saying you know I'm a single mom looking after my son but I'm getting older and I can't support him now who's going to care for him so we see the impact on families and of course the impact on society with a greater than men for health services and escalating health care now in a response when i chat with people sometimes it opens crazy often the response will be like you know he said that we have better healthier than ever before we have helped healthier people than ever before don't win but get the life expectancy and life expectancy figure they're often given to this setback impression that we have a healthier population and often people will give these bigger than it's a very legitimate question we look at the 1900 for example edge expectancy of both men in women was in authority the you look at 2014 the life expectancy for both is an 80 range surely that you drive and life expectancy would suggest that we have healthier populations is healthier than ever before but if we unpack these then when you look at me what is life expectancy took me of the average age of death and the human rides a lot is expectancy over the last century predominately been because of a dramatic decline in infant mortality you know history ago they often would start keeping statistics in each one because there was such a high infant mortality it's declined by over 9 percent so agree what that somebody who dies at 90 and another who dies at 80 we had an off point seventy divided by two and life expectancy is 85 where we have somebody dies economy in a neonatal death and it's 90 plus 0 divided by life expectancy is 45 so you start bringing me all those generals from the agreement of course you have a massive bump up right and so we see that huge rise in life expectancy because it was phenomenal improvement in character and if you want to really look at life expectancy we can look at it from 864 word and over the last sixty years or so in both men and women private life expectancy has been about five years and then Shias contribution to that of course has been phenomenal dependency acute care trauma care cardiac event management and even our management of acute illness is incredible president challenge line with the neglected epidemic be so what's causing all this problem and the rising racism oh let's look at the way you manage chronic trauma if you look at a lot of the clinical practice guidelines for people coming in with all kinds of illnesses so we assess patients districts as at all appropriate investigation we assign a diagnosis and then we often commence free medicine combined surgeon surgery if necessary and many people then are you doing interventions to try to cope with their problems for the rest or again if somebody comes in and they have symptoms that are suggestive of bipolar illness and doing assessments they get a diagnosis and then intervention consistent clinical trial type of sideline when somebody has a bone-density in town to have osteoporosis right diagnosis and appropriate interventions what will be the knowledge if I protocol whatever etiology of reemployed arthritis what about the etiology the underlying cause of the analysis that's what etiology is also not exploring surely if there was a corruptible Carnation he would be investigating it and try and compress it there's often a fundamental reflection in the way that we approach and this general algorithm of assessment diagnosis and treatment often presumes that the underlying etiology or clause not readily explainable and it's often assumed to be genetic and we have this bad luck hypothesis that we are the you know hapless victim to make a long story short let's look at what some of the major medical institutions throughout the world are saying Center for Disease Control recently came out with a toxic a quote virtually all human diseases result from the interactions of genetic susceptibility yes oh our genes predispose us they're very important but it's the interaction with modifiable environmental factors the National Institute of Health another major organization well-respected through a world major research body again I'll quote then directly nearly all diseases result from a complex interaction between individuals genetic makeup and the environmental agent appears is exposed to run so what has been realized genetic predestination paradigm in incomplete so our sixth genome does not predestined us that the environmental factors when you can Barnett will determine it it is fact modifiable we can be changed which is very opal are interacting with her and in fact the recent talk to the number Public Relation Kurtzman a recently published in science review findings now indicate that 70 to 90 percent of chronic disease is primarily related to environmental attorney interactive energy and even diseases that are thought to be genetic in found that various environmental conservatives are potential alter DNA function may be our app acting through epigenetics where they're not altering the DNA code but they're controlling gene expression regulation so they're turning genes on and off so the environmental component of etiology to chronic building has increased dramatically and it appears that this is where a lot of the video controls for my friend I have three children over lots of years graduated from different medical school didn't even learn but when environmental determinants are so how can they look for causation of disease and health patients who have chronic illness if they're not treated and a recent study published a public library Public Library of Science looked at this question directly and they found that most it's rare for clinician these days to be asking about environmental exposures and the majority of you said if the topic is not open to it that they just haven't been trained so they don't have the skills in order to do and so we begin to see faculty and Department of Environmental Health Sciences beginning to open up in some major universities and department of set of separate and different to University California now they have residency training in it okay so in the first half what have we said that's all if there's an increasing problem of chronic disease that having a significant effect on individuals in society treat an entire medical term identified primary causes chronic ravenna and finally medical trainees currently lack education environments so now I'd like to move into our clinical approach to discuss an environmental medicine or medical product so what does this locus so if we say then that you know ste see that personally all healing a diva's result from this interaction create six genome and a modifiable environment and we can't do anything to change people's predisposition to disease but we can do stopping the modifiable environment so with environmental medicine has been is investigating and managing modifiable and climate alternative environments or well to prevent health problems and to promote recovery and restoration for those who have trying together so this is a big topic and your various environmental refrigerants we don't have time to go with all of them today but I'll just talk a little bit about clinical exposures it's just an example of this and I'll tell you where you can get further information is this is something and you'd like to learn more let's begin by talking about cigarettes something okay everyone in the room knows that there's increased risk for all kinds of or reactivity inspiratory disease all kind cancers with increased exposures in cigarettes but what is it about smoking that causes the problem it does because we're putting something mouse it's because you're directly inhaling into your body various classifications so for example address hope there is a lot of cadmium cadmium is a persistent metal antibody for half-life it's very long it's a carcinogen already been teen is another thing that's found in cigarettes so again a persistent lipophilic chemical source material tissues purse images so if you have percentages that are persisting in your body and you're at increased risk for developing the other kind of what those things are recognized to do which is cancer for us a new function so we all recognize that and we all take enormous efforts to try to encourage people not self as well except the bioaccumulation of these toxic agents in the body that is causing etiology of this problem for my friends in the last 50 60 years we've had a chemical revolution which is resulted in a production of tens of thousands of any chemicals that have been created and released into the environment the people of breathing eating and soil from 90 watt are part of daily life how many of these chemicals are totally harmless when they leave but some of the chemicals like within cigarette smoke of persistent they get into the body they reabsorb in the enteric attic circulation many of some of them are Michael Phillip means that are attracted practices perforated gaudiness organ in the body so some will accumulate in the brain firing likelihood values of some accumulate saira and kanne creosote depending on the nature of the chemical and the some of these persistent agent like the Asian see cigarette smoke persistent bioaccumulative Asians are just as bad or worse than what's found in so I can give you dozens of examples areas pesticides now they're being recognized to be really toxic perfluorinated compounds that are often used like saw chart and carpet Teflon they're extremely persistent chemicals that can cause all kinds of problems there's layers of flavor target or this my idea friends there's tons of stuff on this and knowledge the Center for Disease Control just recently updated their figures in 2017 this is the document it's online I invite you to look at it David they've been spending the u.s. population looking at these persistent chemicals and the levels in people in United States and Health Canada begun to do it in Canada as well and what have they found not that it's the exception was the rule and they've concluded the most American adults and children to biotech simulated numerous toxic now the initial thinking was okay well it's no big deal though levels are relatively low you know there in parts per billion but with the ongoing study was really recognized that some of these levels are enormously potent for example if we look at our own QA biochemistry so I studied in obstetrics and gynecology so the telling a woman's reproductive cycle her level of free estradiol the estrogen which is controlling for reproduction or sexuality and so on right depending on where you are in the cycle is from point zero zero zero six point zero zero seven one parts per billion very small amounts right like we're talking about a drop in a in a lake of announcer so small a we're finding some very potent hormonal reactive chemicals that are hundreds and thousands of times higher in people's life and as one article published long ago talks about the large effect from a small exposure now some people want and are interested what do these chemicals actually do when they get into the body well we annotate words publishes a couple weeks ago a toxicology journal on my colleagues myself exploring and reviewing the literature of all the mechanism identified and some of these Asians all for genetics some induced genetic mutation summer directly title talk to himself some destroy and also mitochondrial function some produce inflammation some induced autoimmune changes some you know summer it was regards to neurological disease has now been found that MS and ALS for example appear to be related to what's called reactive nitrogen species one particular one called proxy nitrate it's been found in various toxic agents are inducing this formation of this peroxy night so if you're Asian said the paper is online and our website and reluctant to look at about the mechanism but let me give a concrete example to put a face on this and then we begin to talk about what can absolutely be done one group of chemical is called ruminated flame retardant circle called polybrominated i analgesics and PVD needs we affectionately refer to these are fire attorneys and they are used all over but the most commonplace and the biggest source of exposure are people's mattresses in the nineteen fifties and sixties when television became ubiquitous people started smoking in bed playing it dead watching television people would fall asleep watching cigarettes would burn event bezels catch on fire people got burned houses burned down and so so government's instituted a wall that all matters because of the highly flammable polyurethane foam patter but but much respect a certain standard that they set for not catching excitement in order to do that they have to soak the bed with these flavors work tbe in order to maintain the standard they were about 25 to 30 percent bodies he talks accountable 11 only with the toxicity at that time so every night if people slept in her bed and we're again through a pillow that were often made from this painful material does the swinger party they would be inhaling he eats for seven or eight hours every night children in their crib I don't know how many children smoke but in their wisdom they also you know treated instant crib it's what happened well if you look at recent studies on the levels of blood levels of these PBDEs over the last two decades is skyrocketing because they recycle they buy accumulate or like so if extorted tissues and they're persistently have a long top life in the body and I will tell you it's recently been found that these serum levels are only a fraction of the amount that people have in her body because the body tries to defend itself and it puts them into tissues to get them out of the circulation where they're most potent so this is only a glimpse of that sword in the brain and in the thyroid the adrenal and pull but recently over the last two years there's been extensive exploration what these things actually do in the body and there's tons of literature on thought that he found direct correlation with IVs dementia under adult mental problems just like cigarettes causing a whole host of problem we're now beginning to see what these flame-retardant that are in most people are causing this their hormone disruptors are coordinated fertility for causing some cancers are causing thyroid disease how would they cause Tyler's both by a mechanism called endocrine disruption it's being found many chemicals are eating Caesar as a criminal can chemical and they can interfere with the synthesis and transport the action or excretion of hormones that can mimic Marone for example these ones are estrogen some of our parenting masters and these many chemicals are what are called endocrine disruptor they accept ility thyroid function puberty they have sex sexual impede development and various organs like breath up or resented of this problem and Dimitri okay but it's not just the PBG as we look at fire boy disruption I mean thyroid disease has gone up very very naturally all kinds of chemicals have been found to be etiological agent disrupting thyroid function you know some plastics or priming thyroid hormone receptors some are binding other chemicals certain pesticides at ETV aletheia phase receptors from either induce flowering anybody's other chemical you know also the IE metabolism and on and on it goes by many different mechanisms a whole slew o chemicals and years here acai berry' okay so what can we do about this from an environmental medicine perspective but let's look at anything if we say the person is healthy and if we introduce into a cause environmental genetic combination what does it do it alters their empire chemistry and it induces a chapel to theology like the abnormal process the process of illness the disease is simply the manifestation the effect it's the label that we do so somebody has rheumatoid arthritis order and after all biochemistry has been caused by something the clause the root cause is simply with the HLC biochemistry and converts it into a neural boxes success in our diagnose so if we talk about intervening what are the possibilities well we can intervene and biochemical process or we can intervene in the etiology or we can ensure peace and hope so typically what's often done with our current clinical practice guideline we have people with diseases we know maybe testing and finder biochemistry is altered and we use intervention occasion my supplements to try to overcome their biochemical change to make them feel their right and it can be assuming that disease is genetic that's all we have but it environmental medicine we have a little bit of a different approach what we believe in doing investigations to find out where the alter by the chemistry is we want to leave it there we now have the ability to do assessments and investigations on people to look for the underlying geology of the problem so when we're assessing people with chronic illness as well as addressing their aisle chemistry to mitigate harm and to diminish suffering we're also at the same time looking for what's causing this altered biochemistry universe so let me put a face on it just took one example from the medical literature from okay so here is a six year old gentleman who had multi orbit and suffering for quite a while he was insulin dependent I bet he had various neurological problems in a program to work and they his assessment for EOG and they found that he was loaded with PCBs a PCB now people think all that big band in the seventies and so why why would that be a Chanel I investigate people of all time because their distance occasion they passed you know creatively vibrational transmission for mother child so I think person enrolled people travel you know they may acquire their you still being used so this is not an uncommon we find all kind of mechanical review so it is gentleman yes his biochemistry was aggressive relieve symptoms of insulin and so on but then he was treated with an agent that widening the TCB interrupts the in Toronto paddock circulation so they don't reabsorb and illuminate for in his door for her body so he was treated with me his level went from thirty two hundred milligrams kilogram over a number of 1056 deities was way okay normal by cement off insulin resolution of other symptoms was Margaritaville it also is very effective for prevention and educating our population about how to be helpless to unit example with Alzheimer's which we assess is going up dramatically in Claude multi-modal that as we all agree it's time to stuff it with medical literature which converts the exercise and the phenomenal benefits of exercise regards cancer heart disease are all kinds of ready that's one of exercise induces mitochondrial biogenesis all kinds of wonderful things that have been now another thing that's kind of interesting is expense consciously exercise the natural mechanism for helping and preventing all kinds killing them so I'd encourage it that sweating is a natural way to eliminate a lot of chemical and if they challenge you know causes on anything where we're able to dump a lot of chemicals by use of mobilization to the skin and there's a number of papers in the literature help it of examines sweating and the canal so not their briefing todo but many chemicals here just to give you a paper that recently came out highlight with this is looking at this is looking as a sweating through song in finland it's very common cultural practice design so this is a paper that was published I believe in September's of recently and what they did is they look in Finland with three groups it's a large study take over 2,000 men or 2,500 men and they follow them for over 20 years on average so this isn't some shorter briefs you know sampled you example and what they found they look at people who started once a week focus on it two to three times a week and those who fought as for the second time to eight right so the more you sweat more you're eliminating chemicals from your body and they found that compared that those who saw in once a week go to sauna for seven times week sixty six percent decline in developing dementia so and so now so this is one of the modalities that we use depending on which agents we find any oh and where did this particularly a problem as an obstetrician I'm going to mention is vertical transmission from mother to child right see both International Federation of obstetrics and gynecology a couple of years ago Cana and release the special communication saying that exposure to toxic environment chemical theory pregnancy and breastfeeding is everywhere and is now a threat of human reproduction and they talk about what a serious problem is trying to alert the medical community throughout the world because loggia tentacles an hour the path with the children and utero it's being found appear to cause a lot of pediatric disease now there are fetal origins of paddles to be they're being uncovered so this would be a particularly concerning area as we see a huge right key activity this appears to be at the root of loss this was just a study that locks along the border they looked at cord blood so the childhood you know they take it right at birth they found existed for a few hundred chemicals this was in the u.s. they also in a study in Quebec st. John the average childhood multiple chemical in its system effort reflecting what's going on feel developed two quick studies and I will move to conclusion listen to study was published in JAMA okay so what they put here is women exposed to solvent what they found is that you know these are people who are not drinking solvents but they may work in factories with the cleaning agent of like that we're breathing the stuff in they found that those women working with solvents their children are 13 times more likely a major cardiac and major neurological defect at Birth recently saw women found alcohol with inertia to children wrote that has serious area one is that three older person but it doesn't start just at birth this is looks about plenty of Epidemiology Journal looking at pediatric cancer for the children died for these one to 15 and what they found is they looked at the first children who died over 50 year period a long-term study and where the mother was during a pregnancy and they found it in every single case a PDF of death even at age 14 and 15 that the mother during the pregnancy would live in close proximity to certain specific industrial you

1 comment

  1. You forgot to mention that this guy is a fundamentalist Christian that thinks condoms do not protect people from AIDS.

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