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Environmental Determinants of Chronic Disease and Medical Approaches: Recognition, Avoidance, Supportive Therapy, and Detoxification

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The World Health Organization warns that chronic, noncommunicable diseases are rapidly becoming epidemic worldwide. Escalating rates of neurocognitive, metabolic, autoimmune and cardiovascular diseases cannot be ascribed only to genetics, lifestyle, and nutrition; early life and ongoing exposures, and bioaccumulated toxicants may also cause chronic disease. Contributors to ill health are summarized from multiple perspectives—biological effects of classes of toxicants, mechanisms of toxicity, and a synthesis of toxic contributors to major diseases. Healthcare practitioners have wide-ranging roles in addressing environmental factors in policy and public health and clinical practice. Public health initiatives include risk recognition and chemical assessment then exposure reduction, remediation, monitoring, and avoidance. The complex web of disease and environmental contributors is amenable to some straightforward clinical approaches addressing multiple toxicants. Widely applicable strategies include nutrition and supplements to counter toxic effects and to support metabolism; as well as exercise and sweating, and possibly medication to enhance excretion. Addressing environmental health and contributors to chronic disease has broad implications for society, with large potential benefits from improved health and productivity.
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... The linear regression provides important information on association between the OCPs variables in the two media (i.e., blood and urine). The extent of association is measured on a scale 1 (perfect positive relationship), 0 (no relationship) and -1 (perfect negative relationship) [56][57][58][59][60]. The regression, although positive is poorly linear with r values less than 0.5 except for DDT. ...
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Despite reported effects and synergistic harm, organochlorine pesticides (OCPs) are less studied in Africa children. Therefore, concentrations of eight OCPs in blood and urine of children within Owerri municipality were determined. Thirty-six (36) blood and urine samples were collected from children aged 4-14 years. Concentrations were determined using 6890 GC systems coupled with 5971 mass selective detector. 1µl sample was loaded in a split less mode and the GC helium with carrier gas had at temperature of 80 o C to 180 o C and finally to 300 o C. Result shows that Aldrin (45233±65473ppm) was the highest while mirex (38±5.099ppm) was lowest in blood of children. In urine Aldrin (193±22.84ppm) was highest and P'P'DDD (4.56±4.90ppm) was lowest. P'P'DDD was not detected in children at UPS, WCP, CSO and HEO. Therefore, both blood and urine concentrations of OCPs had no significant difference (P<0.05) between schools. Elimination ratios were highest for DDT (20.390 at MNO. Linden (5.11) at MNO was amongst the lowest ER. In blood, Pearson correlation coefficient was highest for DDT-DDD (0.612), DDT-methoxychlore (0.599), DDD-methoxychlore (0.658) and aldrine-methoxychlore (0.840) and methoxychlore-chlordane (0.750). OCPs in the urine showed low correlation with each other. Principal component analysis (PCA) plot in rotated space for OCPs in blood and urine revealed two major clustering in OCPS in each group highly correlated. The strong association amongst OCPs in each group could be an indication of cochemical toxicology effects. Regression analysis revealed poor limpidity between OCPS in blood and urine except P'P'DDT. Therefore, some OCPs in blood may not show similar concentrations in urine. The questionable concentrations of OCPs in blood and urine are a serious call for concern.
... In describing the humoral theory and giving such an original description of temperament, she provided not only a clear distinction between man and woman, but she highlighted the dependence of the balance of humors with the elements of the cosmos in order to underline the essential link between human beings and the environment (Flanagan, 1996;Moulinier, 2003). Nowadays, epigenetic studies carried out on humans demonstrate how environmental factors, ranging from stress to various chemicals, may alter DNA and, consequently, its expression (Westberry et al., 2011;Sears and Genuis, 2012) and how this epigenetic modulation of DNA differs between the two sexes (Wang et al., 2017). Starting from Hildegard of Bingen's vision and the importance she gives to sex differences, we thought to identify in sex hormones and, in particular, estrogens, a biodynamic interface which intervenes in the transmission of messages between the environment and the organism in both directions. ...
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Introduction Hildegard of Bingen (1098-1179) interpreted the origins of chronic disease highlighting and anticipating, although only in a limited fashion, the importance that complex interactions among numerous genetic, internal milieu and external environmental factors have in determining the disease phenotype. Today, we recognize those factors, capable of mediating the transmission of messages between human body and environment and vice versa , as biodynamic interfaces. Aim We analyzed, in the light of modern scientific evidence, Hildegard of Bingen's medical approach and her original humoral theory in order to identify possible insights included in her medicine that could be referred to in the context of modern evidence-based medicine. In particular, the abbess's humoral theory suggests the identification of biodynamic interfaces with sex hormones and their receptors. Findings We found that the Hildegardian holistic vision of the organism-environment relationship can actually represent a visionary approach to modern endocrinology and that sex hormones, in particular estrogens, could represent an example of a biodynamic interface. Estrogen receptors are found in regions of the brain involved in emotional and cognitive regulation, controlling the molecular mechanism of brain function. Estrogen receptors are involved in the regulation of the hypothalamic-pituitary-adrenal axis and in the epigenetic regulation of responses to physiological, social, and hormonal stimuli. Furthermore, estrogen affects gene methylation on its own and related receptor promoters in discrete regions of the developing brain. This scenario was strikingly perceived by the abbess in the XIIth century, and depicted as a complex interplay among different humors and flegmata that she recognized to be sex specific and environmentally regulated. Viewpoint Considering the function played by hormones, analyzed through the last scientific evidence, and scientific literature on biodynamic interfaces, we could suggest Hildegardian insights and theories as the first attempt to describe the modern holistic, sex-based medicine. Conclusion Hildegard anticipated a concept of pathogenesis that sees a central role for endocrinology in sex-specific disease. Furthermore, estrogens and estrogen receptors could represent a good example of molecular interfaces capable of modulating the interaction between the organism internal milieu and the environmental factors.
... However, the adaption of existing techniques developed for other environmental contaminants may provide opportunities by which to reduce PFAS accumulation. Unfortunately, most of these techniques are only newly recognized and as such are still at an early stage of research with inadequate evidence of efficacy (221). ...
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