THINKING OF GENOMICS . SNP AND MAURITS van PELT MOPOTSYO.org

An advantage of having an independent medical practice, that is no office, no calls, no appointments is that one is free to read voraciously and put into practice judiciously what you read for the welfare of the people who come under your care.
Who comes under my care?
I am dedicated to Indigenous peoples and thus involved in projects involving their general health, such as Education about Industrial Food among the Indians along the Amazon river.
In a few years time, we would look back and see the primitive way we looked after our chronic diseases, much like we look back at "leech therapy and bleeding therapy" of our ancestors. Everything has an anthropological view point. Most doctors do not realize that 50% of HEALING is the relationship between the patient and the doctor.
I have the luxury of time with my patients and excellent scientific help from ISRAEL to bring or trying to bring good healing practices based on scientific methods.
In isolated camps of the Indians, we talk about
GENOMES 
Epigenomics 
Nutrigenomics 
SNP . single nucleotide polymorphism 
and that is where the future is headed and happy to be part of it. Understanding the natural processes of the disease rather than hiding their symptoms with medications may not be the best for the patient 
so it was nice to read this article about a SNP which may predispose Asians and Europeans to Type 2 Diabetes.

Genetic associations between Transcription Factor 7 Like 2 rs7903146 polymorphism and type 2 diabetes mellitus: a meta-analysis of 115,809 subjects

• Liying LouEmail author,
• Jingjing Wang and
• Jing Wang

Diabetology & Metabolic Syndrome201911:56

https://doi.org/10.1186/s13098-019-0451-9

©  The Author(s) 2019

• Received: 5 May 2019
• Accepted: 24 June 2019
• Published: 5 July 2019

Abstract

Background

Some genetic association studies tried to investigate potential associations of Transcription Factor 7 Like 2 (TCF7L2) rs7903146 polymorphism with type 2 diabetes mellitus (T2DM). However, the results of these studies were not consistent. Thus, we performed the present meta-analysis to explore associations between TCF7L2 rs7903146 polymorphism and T2DM in a larger pooled population.

Methods

Systematic literature research of PubMed, Web of Science and Embase was performed to identify eligible studies for pooled analyses. I2 statistics were employed to assess between-study heterogeneities. If I2 was greater than 50%, random-effect models (REMs) would be used to pool the data. Otherwise, fixed-effect models (FEMs) would be applied for synthetic analyses.

Results

Totally 68 studies with 115,809 subjects were included for analyses. The pooled analyses showed that TCF7L2 rs7903146 (dominant model: p < 0.0001; recessive model: p < 0.0001; over-dominant model: p < 0.0001; allele model: p < 0.0001) polymorphism was significantly associated with susceptibility to T2DM in overall population. Further subgroup analyses revealed similar significant findings in both Asians and Caucasians.

Conclusions

In conclusion, our findings supported that TCF7L2 rs7903146 polymorphism could be used to identify individuals at high risk of developing T2DM in Asians and Caucasians.

PS:  a cultural observation, more and more articles are coming out of CHINA 

I was thinking of my friend MAURITZ van PELT of the NGO mopotsyo.org in Cambodia and his tireless efforts to combat DIABETES type 2 in Cambodia . Kudos to you, Mauritz. 

While the Cambodians may lack money to determine the SNPs in their population we can use kindness, empathy, understanding and education .. to achieve the same results, as he has, in the developed nations..

EAT YOUR YOGURT . HERR SVENSON

Microbiome and their importance in the general health maintenance is receiving an enormous attention among the research scientists. Since they reside in the Colon, the effect of Yogurt, a fermented food, capable of changing the Microbiome composition, to decrease the risk of adenoma is of great interest.

July 1, 2019

Eat Your Yogurt

Charles J. Kahi, MD, MS reviewing Zheng X et al. Gut 2019 Jun 17

Men who consumed at least two servings per week had decreased risk for adenomas.

Yogurt consumption has been associated with lower colorectal cancer (CRC) risk, but its relation to polyp risk is unknown. To investigate this issue, researchers assessed yogurt consumption and risk for conventional adenomas and serrated lesions among nearly 90,000 participants in the Health Professionals Follow-up Study and Nurses' Health Study. The analyses were adjusted for demographic and lifestyle factors, and dietary information was updated every 4 years.

Men who consumed ≥2 yogurt servings/week had significantly lower risk for conventional adenomas compared with nonconsumers (adjusted odds ratio, 0.81). The association was stronger for high-risk adenomas (≥1 cm or with villous component or high-grade/severe dysplasia, or ≥3 adenomas), for which the risk reduction was 26%, and for colon adenomas compared with rectal adenomas. No association was seen for serrated lesions, except for large (≥1 cm) lesions (aOR, 0.48). In women, there were no associations between yogurt consumption and either conventional adenomas or serrated lesions.

COMMENT

Yogurt may exert its beneficial effects in CRC prevention by a variety of mechanisms, including favorable microbiome alterations. Regular consumption of yogurt may be a marker of other healthy lifestyle factors that decrease the risk for CRC and its precursor lesions. The lack of benefits observed in women, however, is not clear. In any case, the regular consumption of yogurt is a reasonable recommendation to help decrease CRC risk, in addition to healthy eating habits, exercise, and avoidance of smoking.

MARIE UNO AGED 24 YEARS BECOMES A DOCTOR IN CUBA

 Marie Uno as I call her was born 10 Jan 1995 and at the age of 24.5 years, she will be have the licence to practise Medicine in Cuba accepted as the majority of the graduates into the General Integrated Medicine training programme.
The family came to my house for the weekend to celebrate this occasion and it was a pleasure to have them.
I had introduced Marie Uno to Yoga which she has enthusiastically embraced and also a world of service in the medical profession.

 The family lives about 60 minutes by public transport, more likely 90 minutes, from the suburb of Havana where I live. and they arrived as I was finishing my breakfast 

 My Cuban sister had already arrived and we decided to fete the recent medical graduate with a Lobster Dinner 

 The man in this picture is my massage therapist who also lives in their town.

 You see two other young women, one is sister to Marie Uno and the other is a cousin. the woman on the left is a good friend of mine from the days when I lived in Baracoa.

 I usually try to bring gifts to marie uno which would be of help to her at the hospital, like this uniform which she likes to wear when she is on duty

 Havana never ceases to amaze me, the destruction and regeneration 

A stethoscope the kind I had when I graduated from Medical School, I gave to Marie Uno as a present 

 Once the family left, the three young women busied themselves and prepared the dinner and also the breakfast the next day

 They wanted to get home and just near my home, one can catch almendrones, almonds as they are called, the ancient american cars plying as taxis.

Congratulations, Marie Uno, you studied hard and did well in your studies and now begins the never ending life of sacrifice for others while extending a helping hand 

EATING IN HAVANA . WHAT DOES IT MEAN TO AN ANTHROPOLOGIST?

Eating in Havana

Means two things

FRIENDS

Who will make sure that you have things to eat.

FRIENDS

Who will make sure that they partake in the food they may prepare for you

I had a very tiring visit to the Orient this time, having left Cuba one morning, reaching Yangon three days later with long layovers in Miami, Tokyo and Bangkok. After leaving Yangon, it was Siem Reap via Bangkok and then on to Kuala Lumpur and then a lovely flight to Doha with a stopover of one day and then a nice visit to friends in Barcelona, coming back to Miami and then Havana.

Felt very feeble at the end of this trip, third of its kind this year (in the first six months of this year, not including visits to Argentina, Brasil and Colombia as well as Easter Island and twice to Mexico, also Uruguay, plus quite a few visits to Europe) and felt that I need to rest, not having had a rest from travel ever since I qualified in Anthropology in London many years ago.

I was in touch with my landlady who is my Cuban sister and she went on a shopping spree to fill up the fridge with things that I like: Lobster, Lamb, Chicken, Fish, and all sorts of green vegetables and fruits of the season. All I had to bring was wine!

My friend made sure that they came to visit rather than my visiting them, considering that the heart of July in Cuba was already unbearable.

As is the case with Cuba, this is the easiest place to make friends, and sooner than I arrived, I met a graduate of Physical Education (5 years at the university) who then goes on to practice sports medicine and therapeutic massage. We agreed that I should have at least four therapeutic massages lasting one hour each.

Hairdresser of Havana was another pleasant addition to the circle of friends.

Thanks to my Cuban sister, I ate well each day, in fact an excess of food and choices and being very grateful for it.

THANK YOU THANK YOU THANK YOU

FOR THE FOOD

FOR THE PREPARATION OF THE FOOD

FOR THE COMPANY TO SHARE THE FOOD

PARTICIPANT OBSERVATION OF HAVANA LIFE

PARTICIPANT OBSERVATION OF HAVANA LIFE OR A LIVED IN EXPERIENCE

On this visit, where I was able to relax completely during ten days, without going to a restaurant, a bar, a shopping centre or a supermarket, I realized how busy I make myself during my visits to Havana, culminating usually in two large dinner parties.

My Cuban sister took my food requirements on the phone from Miami: Lamb, Fish, Lobster; fruits of the season, vegetables of the season but prefer my favourites: what we call Quimbombo, Okra; Aubergine or Berenjina, Spinach, Acelga or Bok Choy and the ubiquitous Black beans which I buy in Miami along with some Kidney beans as well. When I arrived I was surprised and content how my Cuban sister had every thing ready, freezer full of my desired chow, along with the fruits and vegetables. I usually bring coffee, tea, olive oil, spices and whatever I had collected in my recent trip out of Cuba: this time, Incense bought at a Hindu store in Brickfields in Kuala Lumpur, dollar store contributions to the welfare of the kitchen.

Thus began my ten days of rest. I live in an apartment with two bedrooms and two bathrooms and a large enough kitchen with a living room/dining room, very adequate for one person to relax. Thanks to Obama’s relaxation of rules, the Internet is here on the phones, and Wi-Fi continues to be available without any sort of censorship by the government.

The park where I connect to Wi-Fi is only two blocks from my flat, is surrounded by a clinic, a polyclinic and a hospital for International patients with Retinitis Pigmentosa and the busy street, called Linea lined with colonial buildings.

It is nice to sit under the trees on dilapidated concrete seats, which had seen better days. Before we had Internet on our phones, the parquet was choc a block full of people searching for Wi-Fi to connect with their loved ones or looking for them. But these days the parquet has reversed to the realm of young children playing under the scrutinizing eyes of grandmothers. Cuba is a multi coloured country so you see people of all colours, white and black and everything in between, sitting and chatting and as always there is laughter

The way people dress here has great anthropological significance. There are no great clothing stores here in Havana so all the clothes have to come from outside, predominantly from Miami or Panama. Also since most people have more or less the same income and the same amount of lack of money, fashion, coordination of clothes are given a secondary role. Every one wears clean clothes and they do their best to coordinate it. But it is not strange to see a completely red outfit from head to toe, even matching red socks. In general, the older ones are wearing what looks like local tailor jobs, where as the younger ones are wearing clothes from TJ Maxx or Marshalls in Miami, discarded fashionable clothes bought at a discount by their relatives in Miami. Young black men have a conglomeration of clothing depicting gifts from Europeans girls they had met at dance clubs. One young man told me, to me dancing well is like having money in the bank, it attracts European women and they have the money. While it is extremely easy to make conversations and chitchat in Cuba, to make good friends who have no interest in you except your personality is as difficult as in any other country. But in any given day, you can be assured to meet someone new, have a nice pleasant chat. Some do become friends eventually. On this visit, I met a rather chubby manager of food distribution, it shows; a very pleasant hairdresser and his lover, a merchant marine just arrived from Jamaica and said hello to numerous new people. Very very seldom do I meet foreigners and when I do, they are usually recommended by some good friends.

La Habana at this time of the year, is not exactly overflowing with tourists and with the new restrictions on travels by north Americans in the horizon, most of this lovely suburb of Vedado has been reclaimed by the people who actually live here, under this relentless sun of the summer months.

I entered the polyclinic, looked around, neat but sparse and no one waiting as there is a family practice clinic just across. Today the Eye specialist is in the clinic, and they wanted to know whether I wanted to say hello to him.

One pride of this revolution is the health care that is available to the population as a whole. It is rather impressive when you think that Cuba is a poor country and it is provided free of charge to every one.

While I was checking Wi-Fi sitting on the concrete walls of the family practice clinic, it was time for it to close and one by one an array of workers streamed out. Obesity is coming to Cuba also, as the amount of industrialized food is increasing in the daily caloric intake. It is a great irony that when the food was scarce Cuba enjoyed the best health of its population in terms of chronic disorders.

Time to walk towards the seawall or Malecon in time for a lovely sunset. I tried to get there as the sun dips into the sea and the spectacle never fails to bring joy.

I have been eating well, cooked meal each time, thanks to my Cuban sister. Have not visited a restaurant for a meal this time and have had only one meal away from the house, during this stay.

Don’t get me wrong, I have had stream of visitors and sharing time and food and conversation and some friends stayed over and nice to have cooked breakfast together, this time cooked by them.

Wine bought at a supermarket in Miami was bad, had an acid taste to it, next time back to the Wine Store near by house and bring good tasting wines for my Cuban friends. This is Rum and Mojito and Beer country but I still prefer a Malbec or Sauvignon Blanc and usually manage to bring quite a few bottles of wine, nice to share the oenological tickle of the tonsils as we used to say when we were junior doctors in Melbourne, Australia.

Watching my Cuban sister being so generous with her time, helping so many people with little things and help, my heart was fired up and I told her

Let us help more and more Cubans as much as we can..

It is so good to have time to leisurely talk to friends, face to face if they are nearby or on the telephone if they are living in the provinces and listen to their trials and tribulations and stories, thus all friendships grow in Cuba