DAVID GRANOVSKY

Posts Tagged ‘PATIENT’

Benefits of PRPs in Stem Cell Therapy

In ALL ARTICLES, SCIENCE & STEM CELLS on April 9, 2013 at 7:29 pm

http://repairstemcell.files.wordpress.com/2009/02/prp.jpg?w=173&h=225

Here are the benefits of PRPs…

A few scientific studies:

  1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819709/
  2. http://www.sciencedirect.com/science/article/pii/S0142961203001145
  3. http://informahealthcare.com/doi/full/10.3109/00207454.2012.742077
  4. http://www.sciencedirect.com/science/article/pii/S1465324912000060
  5. http://www.ingentaconnect.com/content/cog/ct/2013/00000022/00000003/art00005
  6. http://onlinelibrary.wiley.com/doi/10.1002/jcp.20391/full
  7. http://onlinelibrary.wiley.com/doi/10.1002/jbm.b.32808/full

 

Anecdotal:

  1. https://repairstemcell.wordpress.com/2011/10/10/jarvis-greens-adult-stem-cell-treatment-changed-his-life/
  2. https://repairstemcell.wordpress.com/2013/02/14/prp-treatments-show-great-potential/

 

Background:

  1. https://repairstemcell.wordpress.com/2009/02/26/prp-part-1-hines-wards-incredible-receptionprior-to-the-superbowl/
  2. https://repairstemcell.wordpress.com/2009/02/26/prp-part-2-horses-and-humans/
  3. https://repairstemcell.wordpress.com/2009/02/26/prp-part-3-horsing-around-with-stem-cells/
  4. https://repairstemcell.wordpress.com/2009/02/26/prp-part-4-prp-science-a/
  5. https://repairstemcell.wordpress.com/2009/02/26/prp-part-5-prp-science-b/
  6. https://repairstemcell.wordpress.com/2009/02/26/prp-part-6-prp-vs-blood-doping/
  7. https://repairstemcell.wordpress.com/2009/02/26/prp-part-7-regulating-prp-thrapy-in-sports/

 

FDA APPROVED SCHWANN CELL TRANSPLANT

In ALL ARTICLES, SCIENCE & STEM CELLS, STEM CELLS IN THE NEWS on January 29, 2013 at 9:00 am

 nerve1sm

Doctors Perform First FDA Approved Schwann Cell Transplant in Patient with New Spinal Cord Injury

Doctors at The Miami Project to Cure Paralysis, a Center of Excellence at the University of Miami Miller School of Medicine, performed the first-ever Food and Drug Administration approved Schwann cell transplantation in a patient with a new spinal cord injury. The procedure, performed at the University of Miami/Jackson Memorial Medical Center, is a Phase 1 clinical trial designed to evaluate the safety and feasibility of transplanting the patient’s own Schwann cells.

“This historic clinical trial represents a giant step forward in a field of medicine where each tangible step has tremendous value. This trial, and these first patients in this trial specifically, are extremely important to our mission of curing paralysis,” said neurosurgeon Barth Green, M.D., Co-Founder and Chairman of The Miami Project, and Professor and Chair of Neurological Surgery. “The Miami Project team includes hundreds of scientists, clinicians, and technicians who have joined hands to make the ‘impossible possible,’ for which this trial is a key goal and dream now being realized. This achievement reaffirms that the tens of millions of dollars and the incalculable work hours were well invested in this first of a kind human Schwann cell project.”

Led by W. Dalton Dietrich, Ph.D., Scientific Director of The Miami Project and Professor of Neurological Surgery, Neurology and Cell Biology & Anatomy, the Schwann cell clinical trial team at The Miami Project is composed of a multidisciplinary group of basic science and clinical faculty members, scientific staff, and regulatory personnel focused on advancing the trial. The transplantation procedure was conducted by the Principal Investigators of the trial, Dr. Allan Levi, M.D., Ph.D., Professor of Neurological Surgery, Orthopedic, and Rehabilitation, and James Guest, M.D., Ph.D., Associate Professor of Neurological Surgery. The patient had a neurologically complete thoracic spinal injury and received the transplantation of autologous Schwann cells about four weeks post-injury. There have been no adverse events and the team is moving forward with the trial.

 schwann_cell

This image shows a cultured Schwann cell stained for the actin cytoskeleton with phalloidin-Rd.

SCHWANN CELL:

“a cell that forms spiral layers around a myelinated nerve fiber between two nodes of Ranvier and forms the myelin sheath consisting of the inner spiral layers from which the protoplasm has been squeezed out.”   (Source)

“As a basic scientist, the hope is always to increase knowledge and discovery,” said Dietrich. “Not every day are you able to see that translated into the clinical realm with the hopes of bettering the lives of those suffering, so this Phase I clinical trial is a vital step for the field of SCI research, and for The Miami Project team that has been working diligently on this therapeutic concept for more than a quarter of a century. This trial, when completed successfully, will lay the critical foundation for future cell-based therapies to target spinal cord injuries.”

The Miami Project clinical trial will enroll a total of eight participants with acute thoracic SCI. Newly injured patients brought to the trauma center would have to meet the stringent inclusion criteria. The participants will undergo a biopsy of a sensory nerve in one leg to obtain the tissue from which to grow their own Schwann cells. The Schwann cells are then grown in a state-of-the art culturing facility for three to five weeks to generate the number of cells necessary for transplantation, and to undergo the strict purification process. By the time the Schwann cells are surgically transplanted into the injury site, participants will be 26-42 days post-injury.

All procedures will be conducted at UM/Jackson and The Miami Project to Cure Paralysis, with colleagues at the University of Miami Miller School of Medicine. Each participant will be followed intensively for one year after receiving the transplantation surgery, and their neurologic status, medical status, pain symptoms, and muscle spasticity will be evaluated. It is expected that it could be two to three years from the time the first subject is enrolled until the final subject is one year post-transplantation. All participants will continue to be monitored for an additional four years under a separate clinical protocol. This Phase I trial is the foundation upon which The Miami Project will develop future cell transplant trials targeting different types of injuries, times post-injury, and therapeutic combinations.

Posted on January 24, 2013 By Neuroscience News Featured, Neurology (Source)

Stem cells VS chemo resistant metastatic esophageal cancer?

In ALL ARTICLES, STEM CELLS IN THE NEWS, VICTORIES & SUCCESS STORIES on January 28, 2013 at 9:00 am

Picture_16

“…chemo resistant metastatic esophageal cancer…”

I was recently contacted by a patient with chemo resistant metastatic esophageal cancer.  This is the 2nd patient in a row with this condition.  The prior one presented with stage 4 esophageal cancer. We had to determine if the cancer is/is not in the bone marrow to assess how much it has metastasized or whether it is localized to the esophagus. In any case, the first patient was treated with the protocol I posted previously and it reduced the cancer cell markers by 40% within 3 weeks. The mesenchymal stem cells recruited NTK (Natural Killer Cells) which reduce the tumors and cancer cell markers. The patient is now 3 months post op (as of 1/26/13) and is doing extremely well. He is at Stage 1 down from Stage 4. He has decided to receive a second treatment and we are hopeful he will retain full remission.
– DG

Stem cells for cancer? Yes.

This works because:
“…tumor-oriented homing capacity of mesenchymal stem cells (MSCs), the application of specific anticancer gene-engineered MSCs has held great potential for cancer therapies. The dual-targeted strategy is based on MSCs’ capacity of tumor-directed migration and incorporation and in situ expression of tumor-specific anticancer genes.”
From http://www.wjgnet.com/1948-0210/pdf/v3/i11/96.pdf

Look for this article and others on my blog: repairstemcell.wordpress.com

STEM CELL TREATMENT FOR DEMENTIA SHOWS IMPROVEMENT

In ALL ARTICLES, STEM CELLS IN THE NEWS, VICTORIES & SUCCESS STORIES on January 17, 2013 at 9:00 am

demencia-senil1

Stem Cells Shown to Reverse Dementia

Mary Holler, age 80, of Marco Island, Florida is smiling again.  Mary was suffering from dementia and felt her ability to function on a daily basis was slipping away.  Now, after undergoing a successful stem cell treatment in early December 2012, Mary is more like her old self again. She no longer suffers the frustration and agitation of being told she had already asked that question several times. Peter Holler , age 82, had become very concerned that his wife of 60 years was slowly losing her memory. She had been on medications for memory loss for several years but the deterioration in her recall accelerated in the last six months.  It was not unusual for him to answer the same question 4 to 5 times over the course of a day.  He felt he was losing his wife right in front of his eyes.  Mary’s poor performance on an in-depth memory test revealed that she should be in an assisted living facility.  This frightened both the Hollers and their children.

Peter Holler sought out stem cell therapy. He felt it was his wife’s only option. Peter, no stranger to stem cells, had undergone a stem cell treatment for his failing heart in 2008. He had experienced great success. “Even my lung function improved dramatically,” he recalls.  So using the same group that he had trusted with his heart, he made arrangements to get the love of his life treated.

A track record of several successfully treated patients with dementia already existed.  So the doctors knew exactly what to do.  Heading the team is Dr. Hector Rosario , an interventional cardiologist and head of the stem cell program in the Dominican Republic.  Dr. Zannos Grekos, Chief Science Officer for Intercellular, was present as well. “It’s very exciting to be able to have such a positive impact on a disease process that otherwise has such a grim prognosis,” Grekos explained.

After an activation and concentration process, stem cells collected from Mary’s bone marrow were injected into her cerebral circulation. “Look at the difference,” Dr. Rosario exclaimed while pointing to the before and after pictures of the brain circulation. The increase in blood vessel flow was astonishing. Since only adult stem cells from the patient are used, the political, ethical and medical issues are avoided and there is no risk of rejection.

“We’re able to normalize a patient’s brain function testing in 6 months after the treatment,” said Grekos, commenting on the success rate of patients receiving adult stem cell therapy to reverse the effects of dementia.

Dementia is a loss of brain function that occurs with age and certain diseases. Some types of dementia are non-reversible (degenerative) but others have a vascular component, even Alzheimer’s.  These respond especially well to stem cell treatment.

Press Release: Intercellular Sciences, LLC – Mon, Jan 7, 2013 6:01 PM EST

STEM CELLS FOR MS – HOW THEY WORK DISCOVERED

In VICTORIES & SUCCESS STORIES on September 5, 2012 at 2:32 pm

 

Cleveland researchers find key to stem-cell therapy for MS patients: Discoveries
Published: Tuesday, September 04, 2012, 7:21 AM     Updated: Tuesday, September 04, 2012, 2:02 PM

CLEVELAND, Ohio — …Figuring out why the mice improved could help researchers see if the MSC injection will work well in a particular patientbefore the patient is injected, and possibly augment or improve the treatment as well.

In May, the research group atCWRU, headed up by neurosciences professor Robert Miller, discovered exactly what it is in the stem-cell soup that has a healing effect: a large molecule called hepatocyte growth factor, or HGF. The team published their results in Nature Neuroscience.

Miller’s group knew that it could be the stem cells themselves, by coming in physical contact with the myelin damage, that were having a healing effect. Or it could be something the stem cells secreted into the surrounding liquid culture, or media, they were grown in, that was key. HGF is secreted by the stem cells, Miller said.

The team identified the HGF by first injecting only the liquid the stem cells were grown in, but not the stem cells themselves, into the mice they were studying. The mice got better, so the team knew whatever was helping was in the media.

Next, they isolated the small, medium and large molecules from the media and tried each size on the mice. Only the large-molecule treatment had the healing effect, meaning that whatever was helping was somewhere in that mix, Miller said.

“The molecule that jumped out at us was HGF,” he said, because it is the right size, is made by MSCs, and in a couple ofstudies had been shown to be involved in myelin repair.

So the scientists took a purified sample of HGF and injected it into the sick mice. They got better. When they blocked the receptor for HGF in the mice, they stayed sick. It was pretty compelling evidence that they’d found what they’d been looking for, Miller said.

“We went on to show that HGF, like the MSCs, is regulating both the immune response, and it is independently promoting myelin repair in the brain,” he said.

MSCs, taken from the bone marrow, are currently being tested in more than 150 clinical trials in the United States and around the world to treat conditions such as osteoarthritis, diabetes, emphysema and stroke.

JEFFREY-COHEN-CLEVELAND-CLINIC.JPG

The local Phase 1 trial has enrolled 16 of 24 total patients, and eight of them have completed the trial protocol, said Dr. Jeffrey Cohen, Cleveland Clinic neurologist and lead investigator of the trial.

So far, the treatment seems to be working, Cohen said.

“It’s a little early to be saying it, but things have looked encouraging.”

And there have been no safety concerns and almost no side effects. There has also been no activation — an aggravation or return of symptoms — of this relapsing disease in the patients involved, which has happened unexpectedly with other types of MS treatments.

Miller’s discovery won’t change the course of the trial currently under way at the Clinic and UH, but it may change the future of MSC treatment.

While they don’t know yet what the outcome of that trial will be, it’s possible that if a patient doesn’t respond to the treatment, it could mean that hisstem cells aren’t producing enough HGF to be effective at healing, Miller said. Miller will be studying MSC samples from all the patients in the trial to find out if those who are better at producing HGF fare better.

He’ll also be trying to see if they can predict how well a patient will do based on hisHGF levels in the MSC sample…

“Finally, though we’re a long way from this, maybe we could augment the expression of HGF in patients whose stem cells aren’t that effective to enhance their effectiveness,” he said.

But why not just inject the HGF alone? Miller said there are two reasons. First, the receptor for HGF in the cells, called c-MET, has been implicated in liver and breast cancer. Injecting HGF by itself into the body may stimulate the c-MET pathway, he said, and the research team is not willing to risk that.

“The stem cells have the advantage that they tend to home to the area of insult, so they don’t stick around in other parts of the body,” he said. “They target the treatment where it’s needed.”

http://www.cleveland.com/healthfit/index.ss

Heart patient’s stem cells harnessed for healing – CBC News

In VICTORIES & SUCCESS STORIES on January 27, 2012 at 1:26 pm
Not bad. They are only a half decade behind the times. – DG

Heart patient’s stem cells harnessed for healing

Some heart bypass patients are receiving cardiac stem cell transplants to try to repair damage.

This week, a 67-year-old James Culross from Toronto will be discharged from Toronto General Hospital after having 2.83 million stem cells injected into seven sites where his heart had been damaged by a heart attack in November.

When someone suffers a heart attack, part of the heart muscle dies and is replaced by a scar. In larger heart attacks, the patient can develop heart failure — a weakening of the heart that leaves the patient short of breath, said cardiac surgeon Dr. Terrence Yau of Toronto’s University Health Network.

Heart patient James Culross was the donor and recipient of his own stem cells. Heart patient James Culross was the donor and recipient of his own stem cells. (CBC)

Yau and his colleagues at Toronto General’s Peter Munk Cardiac Centre and Maisonneuve-Rosemont Hospital in Montreal are involved in a clinical trial testing the safety, effectiveness and feasibility of injecting stem cells into the hearts of people having bypass surgery.

“This kind of therapy can improve the function and blood flow of hearts that have been injured by heart attacks most commonly and potentially by other means as well,” said Yau.

About 50,000 Canadians are diagnosed with advanced heart failure each year. On average, men live only 18 months and women three years after diagnosis.

While angioplasty, bypass surgery and stents can prevent new heart attacks, they don’t reverse exisiting damage. A new heart is the only known treatment for that, but transplants are invasive and expensive, and there is a lack of available donor organs.

That’s where the stem cells could come in.

Stem cells taken from marrow

In Culross’s case, the stem cells were taken from the bone marrow in the hip and lower back in the operating suite. After four to six hours, the stem cells were isolated, the bypass grafts done and the stem cells injected back into the damaged areas of his heart.

“I thought it was great,” Culross said of the procedure. “It’s your stem cells, nobody else’s.”

Culross is now working on improving his strength and walking more in the hopes of returning to his auto body repair job.

Since 2010, eight patients have also had the experimental procedure in Montreal.

The Montreal and Toronto teams plan to combine their findings once each has results on 20 patients.

No one knows yet whether the stem cell treatment will improve survival or quality of life by healing the heart.

Investigators worldwide are testing whether giving stem cells after a heart attack works better than existing therapies.

Heart patient’s stem cells harnessed for healing – Health – CBC News.

Stem Cell Investigation: A 60 Minutes Fraud

In STEM CELLS IN THE NEWS on January 16, 2012 at 9:55 am
April 18th, 2010  
CBS releases the Sixty Minutes episode: “21st Century Snake Oil.”  
 
January 8, 2012
Both of these episodes were shamefully aired with no regard for the consequences.
 
 
These 2 TV shows, left uncontested, may be enough to convince millions of patients to give up hope for stem cell treatments.  These 2 TV shows, may be enough to condemn millions of patients to die early and unnecessarily.
History will show, too late for most, CBS and much of the US media suppressed information which could have saved millions from lives of suffering and a too-early death. 
This is CBS’ legacy to the sick and dying of the world.
 
This is CBS’s “Harvest of Shame.”
Good for CBS and their “headlines at any cost” tactics, for rooting out the crooked doc in an industry filled with excellent doctors and scientist.  Too bad they had to go through hundreds of stem cell docs and scientists to find a bad one.  Now that they have done so and have their succulent “story” they will move onto the next headline, regardless of whether it is true or not, researched or not accurate or not…or whether it turns millions of patients off of potential recovery from their chronic and/or terminal diseases.
Patients have no such luxury; they need someone to review all the hundreds of treatment centers all the time and even after the cover story is published. Patients need an advocate to wade through the misinformation and guide them today AND tomorrow so they don’t waste time or money or health on the hacks.
Let’s really look at the issues presented by CBS in this expose:
The doctor did not have proper education and experience to administer stem cell treatments: Agreed.  Please be sure to know the quality of the clinic before you go there.
The stem cells the doctor used were damaged:
Just because the cells CBS received from “Stem Tech Labs” were a damaged batch doesn’t mean the doctor used a bad batch of cells to treat his patients.  Also, there are checks and balances for this type of thing.  At any self-respecting clinic, standard quality controls are utilized and cells are checked for viability prior to use.  Please be sure to know the quality of the clinic before you go there.
There is no basis for improvement of Cerebral Palsy from stem cell treatments:
I’m confused.  The CBS investigation bases their information on information from Dr. Joanne Kurtzberg.
“We asked a scientist who’s doing some of the world’s most advanced studies in stem cells, Dr. Joanne Kurtzberg.  Dr. Joanne Kurtzberg: I believe stem cells have a lot of promise. But we are way at the infancy. Because real stem cells are very difficult to control as therapy. I personally think we’re 10 years away from seeing real cell therapies that are working and are safe, but I do believe it will come. Dr. Kurtzberg is a physician and the chief scientific officer of a stem cell research program at Duke University. She advises the federal government and she’s co-director of this multimillion dollar laboratory which works with stem cells harvested from umbilical cord blood. Dr. Kurtzberg told us there’s no evidence yet that stem cells can treat cerebral palsy.”  
 
Well…perhaps she never saw the trial at Northwestern University:
“Two compounds developed by Northwestern University chemists have been shown to be effective in pre-clinical trials in protecting against cerebral palsy.” Two compounds show great promise for cerebral palsy  
But I find it very hard to believe she never saw these results from stem cell treatments/trials for Cerebral Palsy at Duke University!
Duke U. CLINICAL TRIAL for Cerebral Palsy & other newborn brain injuries – http://www.clinicaltrials.gov/ct2/show/NCT00593242?term=hypoxic+ischemic+encephalopathy&rank=3 – for more information – http://parentsguidecordblood.org/content/usa/medical/autocbt.shtml or for anecdotal info – Abby , Chloe, Dallas
Dallas Hextell, a 2-year-old from Sacramento, California, received an infusion of his own umbilical cord blood as part of the Duke University clinical trial. Within five days, he showed improvements in the limitations imposed by the condition.  video: http://www.msnbc.msn.com/id/21134540/vp/23569985#23569985
via http://www.youhavealawyer.com/blog/2008/03/26/cerebral-palsy-improvement/
“a toddler with cerebral palsy, who experienced dramatic improvements in his disability following an experimental procedure involving a stem cell transplant.” – http://pediatrics.duke.edu/modules/dept_peds_annc/index.php?id=79  
 
 
“Caveat emptor” my friends.   
“Let the buyer beware.”   
 
And if you can’t “beware” on your own, you damn well better utilize a proper advocate and guide so you get accurate information on which to base your health decisions.

IMAGINE THERE WAS A STEM CELL INFORMER

In ALL ARTICLES on January 4, 2012 at 3:27 pm

Imagine there was a scientifically complicated subject which was difficult to understand even if you had all the information.  Imagine it would take you days, weeks, months to educate yourself on the subject.  Imagine the subject had more rampant misinformation published than virtually any other subject published in the last 5 years.  Imagine how long it would take you to assess the reams of conflicting information on the subject.  Imagine the subject was further mired in political and religious controversy.

Imagine there was a guy who spent years researching the subject, the science, the studies, the trials, the results, the protocols, the politics and the religious agendas.  Imagine he had one of the premier education blogs on the subject, lectured on the subject, wrote a book on the subject to promote awareness.  Imagine he worked with some of the world’s experts on the subject, wrote their websites and newsletters and internal communications so the layperson could understand the subject. Imagine this guy had an incredible network reaching out to all corners of the world.

Imagine that guy was willing to share all of his information with you free of charge and free of partiality. Imagine he just wanted you to know what your options were so you could make an educated decision just as he did.  Imagine he could shorten your research time logarithmically, he could get your medical data in front of the top stem cell docs in the world withing hours, he could get you an answer to whether you and your specific condition could be treated today or tomorrow.  Imagine he could introduce you to the Director of the Clinic so you could receive the treatment info, the protocol info, the travel info, the costs and the details.

Filling out the form bit.ly/stemcellsnow allows me to approach the top stem cell docs in the world quickly to see if you, with your specific condition, medical history, etc. are a candidate for treatment at their particular facility.  Your condition and needs determine where is best.

I am merely…a bridge or shortcut to get you to your destination with the minimum amount of confusion, time, effort and expense.

GERON’S EMBRYONIC “WASTE OF TIME” CONTINUES…

In ALL ARTICLES on September 21, 2011 at 9:51 pm

Here’s an 867 word article I’d like to not waste your time with.

http://www.epiphanymarketing.com/blog/wp-content/uploads/2010/03/waste-of-time-283x300.jpg

The premise is:  “The study is not meant to determine whether the stem cells can cure or even improve the patients’ condition, but to find out if the treatment itself is safe. Researchers will be monitoring patients over the following months and years to look for side effects, including possible benign tumor growth if the stem cells start to replicate, or adverse immune reactions.”

So let’s not waste your time, I’ll give you the results right now:

EMBRYONIC STEM CELL = ESC

  • SOURCE/DERIVED FROM•comes from embryos
  • PURPOSE IN BODY•split for 7 weeks until you have a fetus the size of a thumbnail
  • OBSTACLES+SIDE EFFECTS•they create cysts and tumors, rejection requires immunosuppressive drugs for the ill patient, they carry the genetic anomalies of the donor, etc
  • TREATMENT HISTORY•can currently treat zero diseases, probably need to cure cancer first to use them

Read it if you want but that’s really “all she wrote.”  Then again, this will allow billions to be pumped into embryonic research for treatments over “the following months and years” despite this fact…

SCREW THE EMBRYOS, THEY’RE IRRELEVANT!

———————————————

———————————————

Paralyzed patient in major Geron stem cell study

Erin Allday, Chronicle Staff Writer, Wednesday, September 21, 2011

A Bay Area patient who recently suffered a serious spinal cord injury and is now paralyzed from the waist down joined the world’s first-ever embryonic stem cell study in humans last week, when Stanford doctors injected 2 million cells designed to replace damaged neurons in the patient’s spine.

The patient, who is not being identified, is the fourth person to be enrolled in the clinical trial being run by Menlo Park’s Geron Corp. and the first person in California. The patient, whose participation in the trial was revealed Tuesday, received the stem cell injection Saturday at Santa Clara Valley Medical Center and is now at the rehabilitation center there.

The study is not meant to determine whether the stem cells can cure or even improve the patients’ condition, but to find out if the treatment itself is safe. Researchers will be monitoring patients over the following months and years to look for side effects, including possible benign tumor growth if the stem cells start to replicate, or adverse immune reactions…

Read more

Higher bleeding risk seen in J&J, Bayer clot drug – Reuters Health Report

In OFF THE BEATEN PATH on April 5, 2011 at 9:43 pm
Higher bleeding risk seen in J&J, Bayer clot drug
April 05, 2011 09:35 AM ET
NEW ORLEANS (Reuters) – A blood clot preventer from Johnson & Johnson and Bayer caused a surprisingly high rate of bleeding in a trial of patients with acute illnesses, representing a significant setback for the drugmakers. | Full Article

http://boogey.me/wp-content/themes/mixedmediared/images/DrippingBlood.png

Gmail – Reuters Health Report – dsgrano@gmail.com.

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