DE SASTRE DE SAN JOSE . MY FRIEND VALENTIN TAILOR FROM MAYABEQUE

Sastre is tailor in spanish and a play on the word, de sastre, sounds like disaster.. Was not there a book by John Le Carre The Tailor of Panama? made into a movie starring Geoffrey Rush ?Pierce Brosnan?
My colleague from Sancti Spiritus in Cuba, now working in Miami, is a good example of the excellent tertiary education in the Physical Education Culture before they are allowed to become medical massage therapists. It takes five years of tertiary education, compare that massage therapist courses offered in the USA where with a few thousand dollars and 300 hours of training you could be licensed to massage. Of course in Asia it is even shorter a course and the massages you obtain in places like Cambodia or Thailand would be classified as caressing in Cuba. But even in those places the massage therapists have a psychological function. Imagine you are traipsing around the archeological ruins of Angkor under the hot sun, it does feel heaven to come to an air conditioned place and lie down on a sofa in a semi erect position and have someone stroke your legs, it does relax you, so there is a role for that type of massage too.
But I needed a medical massage therapist who would relax some tight muscles pulling on my scapula (infraspinatus) and my friend in Miami had proven the worth of  his Cuban education and through mutual friends I met the tailor of San Jose who happens to be  a graduate of Physical Education..

As is our custom in Cuba, the relationships are important and the Tailor of San Jose came four times during the week and each time, administered massage therapy and then we would have a nice lunch together assisted by other friends.

I wish you well, my friend Valentin the medical massage therapist, the Tailor of San Jose

PS I plan to bring some nice cotton material from India and would reward with a bundle and hopefully he would craft me a Kaftan!

SAN CRISTOBAL DE LA HABANA 500 YEARS OLD . THE FEAST THAT NEVER ENDS

I have stolen the epithet the feast that never ends from Hemingway when he described his life in Paris. Living in La Habana I can understand the euphoria of being at a place that stimulates your mind, your body and your emotions as well as your spiritual life!
Each day brings something new, you can walk around the streets that you have walked a thousand times and if you look closely you will see new things, new growth and new embellishments.
I also have the luxury of living a minute away from the seawall called Malecon and each evening, if not cloudy, i would walk over there to watch the sunset. Each sunset is different, as each day is different for me in my beloved Havana.

 Two suitcases for Havana: one with food and the other with gifts

 this is the roundabout in Cerro in front of the stadium and I enter my neighbourhood of Vedado

and a hair cut by Adonis..

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