717IMO

@kajakallas Dr. Hussam Abu Safiya is fading in Israeli custody, and the EU stays mute. Human rights champions, but for whom? Speak up and demand his release, @KajaKallas, or own the cruelty.

The EU will always support the security of Bosnia and Herzegovina and the stability of the region. Here at EUFOR Althea, we help strengthen the country’s defence capabilities. Additionally we have supported BiH Armed Forces with €35 million to boost domestic defence capacity. And we are exploring ways to provide even more. My address to troops at @euforbih ↓

@AnitaAnandMP Canada must act NOW! Dr. Abu Safiya is suffering in Israeli custody. Torture and inhumane treatment can't stand. Urgent diplomatic measures are needed to save his life! Stand up for justice and humanity. #FreeHussamAbuSafiya #SaveGazaDoctors @AnitaAnandMP

A stronger Canada-Philippines partnership creates opportunities on both sides of the Pacific. The MOUs signed this week will deepen cooperation in areas that matter to both our countries, from energy and labour mobility to tourism as well as arts and culture. Together, these MOUs will support workers, businesses, and communities in both countries. A special thank you to President Marcos and Secretary Lazaro for their leadership. I look forward to seeing you at the ASEAN Foreign Ministers’ meeting in July to build on the momentum of our new Strategic Partnership.

@HFalconerMP @HFalconerMP, please help Dr. Abu Safiya. He is a good man and his family is heartbroken. He is all they have left. Every second matters now. Don't let him die alone in the dark. Please save him before it is too late.

I am aware of the concerning reports about the treatment of Dr Hussam Abu Safiya who is still in Israeli detention. We have raised his case again today with the Israeli authorities. Britain’s commitment to the rule of law and a fair trial is resolute.

@MarkLevineNYC @PANYNJ Please reconsider this. This is detrimental to wildlife in the area and also creates unnecessary light pollution. Occasionally seems fine but nightly is not a good idea.

For the first time in the history of the GW Bridge, the towers are now going to lit up nightly, thanks to installation of a brand energy-efficient LED lighting system by @PANYNJ.

@minieslildimple I agree!!

just a wild thought. but can we armys come together, pool money and make a good amount of donation to this research? we always have moved together for a lot of good causes. i thought it’d be amazing to if we could help as much as we can for this as well. criscancer.org/barbacid/index…

@zoewangai @EricTopol Is this effect reversible if it’s just due to vessel constriction or is damage permanent

Breakdown of the study: The study investigates how the SARS-CoV-2 virus affects the function of the small blood vessels (microvasculature) in the pancreas, particularly the pancreatic islets. The pancreatic islets are small clusters of cells that produce hormones like insulin and glucagon, which are important for controlling blood sugar levels. The researchers wanted to understand how the SARS-CoV-2 virus could potentially disrupt the normal function of the pancreatic islets. The researchers found that the SARS-CoV-2 spike protein activated the pericytes and caused the blood vessels in the pancreatic islets to constrict. This effect was driven by a decrease in the activity of the enzyme ACE2, which normally helps to regulate the levels of a protein called angiotensin II. When ACE2 activity was reduced, the levels of angiotensin II increased, leading to the activation of the pericytes and the constriction of the blood vessels. full paper: openread.academy/paper/reading?…

Covid is associated with an increased risk of Type 2 diabetes thelancet.com/journals/landi… (one of many reports) But the mechanism is unclear. A new study suggests islet microvascular dysfunction is a contributing factor diabetesjournals.org/diabetes/artic… open-access

@BioavailableNd Do you have thoughts on how to restart a pancreas that is not excreting digestive enzymes post Covid infection?

- Toxin binding (endotoxins, mycotoxins): S Boulardii - Gut-brain support (mood, neurotransmitters, neuroinflammation): S Boulardii - Histamine regulation: S Boulardii - Candida (antifungal, anti-biofilm): S Boulardii - SIBO control: S Boulardii - H. pylori defense: S Boulardii - Diarrhea relief: S Boulardii - Leaky gut repair: S Boulardii - Immune modulation (↓ inflam, ↑ IgA): S Boulardii - Bile support by reduce LPS: S Boulardii - Improve gluthathione production: S Boulardii

@Helios_Movement Thoughts on removing circulating gadolinium post-contrast MRI?

Binders are the biohacking tools of Soviet astronauts, Chernobyl survivors and farmers 👇 In general, if you: -Have been exposed to mold/mycotoxins and heavy metals -Are struggling with brain fog, fatigue, skin issues or gut issues (especially any form of IBS) -Plan to use antibiotics/antifungals then binders are worth looking into. Binders were popularized for agricultural practices when farmers noticed their livestock were getting sick from eating moldy grains (for example, in 1960 in the UK, 100,000 turkeys died from aflatoxin B1) where adding bentonite clay or activated charcoal (small amounts like 0.5%) to the feed reversed it by trapping mycotoxins inside the gut before they were absorbed into the bloodstream. Bentonite's interlayer spacing (1-2 nm) for example intercalates AFB1 molecules through van der Waals forces and hydrogen bonding, reducing bioavailability 85-95%. In the meantime, Vladimir Nikolaev and his colleagues in the 1980s started using enterosgel, then clays started to get used in Ghana since AFB1 was contaminating up to 70% of maize and was causing cancer in children and now in 2025, it's quite common to use binders in medical settings. But what exactly is a binder? A binder is a substance that grabs onto toxins in the GI tract, locking them up so they are excreted through stool instead of being reabsorbed through the liver-gut cycle(*). (*) Bile to the intestine to reabsorption and back to the liver. This process is called enterohepatic recirculation and it is one of the main reasons people stay sick even after removing the source of the toxin. Bile carries conjugated toxins (in phase II liver detox that adds glucuronide/sulfate groups) -> 95% reabsorbs in the ileum via transporters like ASBT. Binders stop that loop/reduce reabsorption. So think of a binder as a toxin sponge inside your gut whose porous surfaces create binding sites through physical forces (van der Waals, ionic exchange) or chemical affinities (hydrophobic interactions for lipophilic toxins). In medical terms, they're classified by capacity (mg toxin/g binder) and selectivity (Kd dissociation constants). Now even though binders do not pull toxins out of your cells or tissues, they are quite useful tools. But most people add them into their detox routine without understanding what they actually do. Now of course, the OTC binders that we will talk about usually stop Herx/die off reactions (mobilized toxins with nowhere to go). Let's say that you use antimicrobials for SIBO for example, once pathogens begin to die, they release LPS/endotoxins and stored toxins. Binders pull these and ramp up their excretion. But what a lot of people do is they use high doses of binders without even working on the drainage pathways (bowels, lymph, kidneys, sweat) first and this combination can 100% lead to a Herx reaction as well. So before jumping into binders: 1. Work on the drainage pathways first (bowel regularity, bile flow, lymph, hydration). 2. Replenish nutrients (B vitamins, minerals (trace minerals as well) etc) 3. Support phases III->II->I of the liver. 4. Treat dysbiosis to a basic degree if present. 5. Lower the toxin burden by avoiding the main sources of toxins in your environment and using the IR sauna (if possible). Now let’s talk about some specific binders and what toxins they bind. Number 1: Activated charcoal (AC). This one binds LPS/plenty of bacteria metabolites, aflatoxin B1, ochratoxin A, zearalenone, some pesticides like glyphosate and drugs such as acetaminophen. Upsides: Very effective, usually cheap, broad effects. Downsides: Will cause constipation to a lot of people who haven't resolved dysbiosis, traps plenty of fatty acids and minerals as well, needs to be taken 2 hours before a meal or medication. Number 2: Modified citrus pectin (MCP). This one greatly binds lead, arsenic, cadmium and galectin-3. Upsides: Quite effective for these heavy metals (in a study down in 111 kids, when used for 4 weeks it helped drop lead by something like 70%), interesting effects on some cancer types. Downsides: Expensive, can't be used before resolving a pathogen overgrowth to a great extent. Number 3: Cholestyramine (CSM)/colesevelam. These are just mentioned because they are advocated in the shoemaker protocol (at least they were the last time i checked). It can help with lipophilic toxins/mycotoxins (the quaternary ammonium groups exchange Cl⁻ for bile acids) but they cause constipation in a lot of people, you need a prescription and in the long run they trap a lot of fatty acids as well. Number 4: Bentonite clay. This one binds AFB1, ochratoxin, zearalenone, fumonisin and some heavy metals (Pb/Cd). Upsides: Cheap, gentle on the gut, broad effects. Downsides: Plenty are contaminated with heavy metals, can cause constiptation. Number 5: Micronized zeolite. This one is great for binding ammonium, lead, cadmium, aluminum, cesium and some aflatoxins. Upsides: The best binder for UREA cycle issues, great for cadmium, low constipation risk. Downsides: Plenty are contaminated, can be expensive. Number 6: Chlorella. This algae is a good general addition for heavy metals like mercury/lead/arsenic and some dioxins/PCBs. Upsides: Relatively cheap and safe. Downsides: Not that effective for severe cases. Number 7:Humic and fulvic acids. These are the go to for herbicides such as glyphosate but also pesticides. They can also be used for chromium toxicity. Upsides: The safest OTC ones for herbicides and pesticides, fulvic acid is also great for mitochondrial health. Downsides: Expensive. Number 8: Enterosgel (there's also a German one called silicea but it's derived from silicon dioxide so it's not the same as enterosgel). This one is great for binding endotoxins, uremic toxins and bilirubin. Upsides: Pretty safe and effective for endotoxins and uremic toxins. Downsides: Doesn't do much besides this, it has a constipation risk. That was the 101 but please do not skip the 5 steps that were mentioned before the binders and keep in mind that combination therapy is often needed since each binder has a different affinity profile. For more on the topic of detoxing, go here: fitandball.gumroad.com/l/detox2/dmfri… It's the most in-depth program on the topic right now, especially at this price. Talk soon. -George

@Opinions_Survey @ZacharyGrinDPT @Fiona_Hendriks @leslieleeiii @oldfshndanne Were you able to resolve this? Did it fade with time?

@ZacharyGrinDPT @Fiona_Hendriks @leslieleeiii @oldfshndanne I wasnt hospitalised, but right after covid infection i had a new exocrine pancreatic insufficiency, hyperadrenergic POTS and exhaustion. Are you saying that EPI is psychosomatic?or that EPI is related to sars infection but not other issues which manifested at the same time ?

No, SARS-CoV-2 is not as seriously damaging as HIV 🤬 HIV was a death sentence & still is without anti-retroviral treatment which many people still can’t access throughout the world. Excellent overview on why the ‘COVID is Airborne AIDS’ paper is trash: marcveldhoen.substack.com/p/the-abuse-of…

@lelecapurso @AshkarMotaz Anecdotally, it seems there has been an increase of EPI without structural changes to the body of the organ following infection (supported somewhat by exploding demand for CREON). Unfortunate, there is no work being done to determine whether this damage is permanent/reversible.

@717imo @AshkarMotaz Not that I am aware of. There are some studies on pancreatic trophism of the virus.

An Approach to Exocrine Pancreatic Insufficiency: Considerations in Diagnosis and Treatment mdedge.com/gihepnews/arti… Co-authored with Yasmin. Good and quick read for EPI fans

@bejjani_joseph @eClinicalMed Is there any research into EPI following Covid infection?

🚨Check out our publication on the Prevalence of Exocrine pancreatic insufficiency after Acute Pancreatitis published in @eClinicalMed EPI is present in over 1/3 of prospectively assessed patients at 12m post-AP sciencedirect.com/science/articl… Grateful to be part of this amazing work!

@AkwiAsombangMD @DDWMeeting @ASGEendoscopy @AmerGastroAssn @AAFG_2021 Is there any research into the rise of EPI with Covid infections available?

Dr Anna Buchner @DDWMeeting PG Course EXOCRINE PANCREATIC INSUFFICIENCY (EPI) DIAGNOSIS 💡a low fecal elastase alone DOES NOT PROVE EPI diagnosis! 💡when you test fecal elastase: perform on SEMISOLID/SOLID stool! 💡CT is unreliable @ASGEendoscopy @AmerGastroAssn #GItwitter

@UGrewalMD Is there any research into the rise of EPI with Covid infections?

🔥 Just published! (Presented at #ENETS2025 earlier this month) In this paper published in #Pancreas , we discuss the under-use of pancreatic enzyme replacement therapy (PERT) for the treatment of exocrine pancreatic insufficiency (EPI) in gastroenteroenteropancreatic neuroendocrine neoplasms. 🦓 💊 42% patients with a FORMAL diagnosis of EPI did not receive therapy. This doesn’t even take into account how under-diagnosed EPI is among these patients! 📌 We also studied the factors associated with use of PERT therapy. Link- journals.lww.com/pancreasjourna… Thank you @apoorvachandar for collaborating on this project, as always. @uihealthcare @UHhospitals @NANETS1 @NCFCancer @lisayentwin @netcancerfound @CureNETs

@Mon_ish_K Is there any research into the rise of EPI with Covid infections?

Best practice advice on the management of Exocrine Pancreatic Insufficiency gastrojournal.org/article/S0016-…

@DeMadaria @DavidJinMD Was there any research into the rise of EPI with Covid infections available to review?

David X. Jin is talking on exocrine pancreatic insufficiency @DavidJinMD #HarvardPancreas2025 Management of treatment failure 👇

@john_damianosMD @AmerGastroAssn Is there any research into the rise of EPI with Covid infections?

Clinical practice update on exocrine pancreatic insufficiency #MedTwitter #GITwitter #EPI #pancreas @AmerGastroAssn gastrojournal.org/article/S0016-…

@PaulGuzikDO Is there any research into the rise of EPI with Covid infections?

FECAL ELASTASE-1: A thread 🧵 👌Enzyme product of normal pancreatic secretion 🧱Remains 'relatively' stable during digestion 🏗️Indirect measure of pancreas function ➡️ can help dx EPI ⬆️ Sensitivity & Specificity of indirect pancreas function tests ⬇️🧵📚⬇️

@Gio_Marchegiani @lelecapurso @BJSurgery @des_winter @villesallinen @BJSAcademy @young_bjs @DrSfpb @UHB_HPB @MarkarSheraz Is there any research into the rise of EPI with Covid infections?

Pancreatic exocrine insufficiency 💊 after non pancreas upper GI surgery - meta analysis Incidence 3️⃣6️⃣ % 😳 Most patients (80%) responding positively to pancreatic enzyme replacement 🇮🇹 Of note there is currently a shortage of enzymes in Italy 😰 academic.oup.com/bjs/advance-ar…

@AGA_GIHN @YhernandezMD @AshkarMotaz @TrieuMD Is there any research into the rise of EPI with Covid infections?

Exocrine pancreatic insufficiency is a challenging diagnosis. In this month’s In Focus, @YhernandezMD & @AshkarMotaz review how to approach diagnosing and treating EPI, plus screening for complications. @TrieuMD ow.ly/Arw650WNKGr