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	<title>Dr.  Sarah Lobisco</title>
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		<title>The Lyme Paradox &amp; The Power of Holism</title>
		<link>http://www.dr-lobisco.com/the-lyme-paradox-the-power-of-holism/</link>
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		<pubDate>Sat, 18 Feb 2012 00:31:15 +0000</pubDate>
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		<description><![CDATA[<p>By Sarah A LoBisco, ND</p> <p></p> <p>The prevalence of Lyme is reaching an all-time high. According to various experts, Lyme Disease isn’t just a tick-borne disease we thought it was. Lyme disease and its co-infections can now be spread through mosquito, spiders, and more. I wrote about Lyme and my philosophy a few years [...]]]></description>
			<content:encoded><![CDATA[<p>By Sarah A LoBisco, ND</p>
<p><img class="alignnone" src="http://www.michigan.gov/images/lyme_19701_7.jpg" alt="" width="213" height="137" /></p>
<p>The prevalence of Lyme is reaching an all-time high. According to various experts, Lyme Disease isn’t just a tick-borne disease we thought it was. Lyme disease and its co-infections can now be spread through mosquito, spiders, and more<a href="../712009-lyme-disease/">. I wrote about Lyme and my philosophy a few years ago</a>. However, as with every topic in medicine, as more information is discovered, more solutions and more controversy heats up!</p>
<p>There are various philosophies with Lyme. One international Lyme expert, Dr. Dietrich Klinghardt, was recently interviewed by integrative Osteopathic Doctor and whistle blower, Dr. Mercola. I have much admiration for both of these physicians and listened to the entire 90 minute interview, summarizing it’s key points below. I feel it’s important, because more and more of my patients are effected by Lyme, if not as the primary problem, a contributor to immune imbalance that makes healing more difficult. As a Naturopathic and Functional Medical Doctor, I agree with Dr. Klinghardt that the environment and the whole person need to be considered in treatment. It’s not about just killing the spirochete with antibiotics-natural or otherwise.</p>
<p>Here is a summary from this world-renowned, yet humble, talented, and kind Modern-Medicine-Man:</p>
<p><img class="alignnone" src="http://external.ak.fbcdn.net/safe_image.php?d=AQAYzysnvkS8WyGl&amp;url=http%3A%2F%2Fi3.ytimg.com%2Fvi%2FRkXqxRfG0jk%2Fhqdefault.jpg" alt="" width="261" height="206" /></p>
<p><em><strong><span style="text-decoration: underline;">The Lyme Paradox:</span></strong></em></p>
<p><span style="text-decoration: underline;">Lyme is a two-fold Paradox:</span></p>
<p>1. <strong>According to Klinghardt, Lyme may have been part of our human genome for a long period time. It&#8217;s only when the body is chronically hit with stressors that the opportunistic bug and its co-infections create symptoms and chronic problems in a biten individual.</strong> (Hence, he believes ‘tis the terrain not the bug that creates the opportunity for the disease, I concur).</p>
<p>2. <strong>Lyme disease is notoriously difficult to diagnose using conventional tests</strong>. This is due to various reasons. First, many are infected with Lyme and the test to verify its presence is based on an immune system strong enough to produce a defense against it! Furthermore, many co-infections and the tick itself are not found in the blood, but instead hide in tissues. Therefore, blood testing has flaws in diagnosing.</p>
<p>For these reasons, Dr. Klinghardt builds up his patients for 6 months before he will even test them for Lyme. After this, he will use more sophisticated tests through specialized labs that look into other means for diagnosing, including Isagenix and Frye Labs. He monitors progress using CD57 counts, immune cells that are specific for Borrelia.</p>
<p><em><strong><span style="text-decoration: underline;">LYME: the Great Mimicker</span></strong></em></p>
<p>Lyme has great variation in its presentation, depending on where you contracted it, and whether or not you have any other coexisting infections. There is a group of seven or eight microbes that are the most common. According to Klinghardt, the worst ones are Babesia microti and the different forms of Bartonella.</p>
<p><em>&#8220;Underneath that, there&#8217;s often an infection with Mycoplasma. We still don&#8217;t know if it&#8217;s really transferred with the same bite or if the people had it all along and become symptomatic when the immune system is suppressed by the spirochetes,&#8221;</em> Dr. Klinghardt says.</p>
<p><em>Other than the co-infections, there is what I call the &#8220;opportunistic infections.&#8221; The combined effect of the initial infection is an immune suppressive effect, and then the patient becomes vulnerable to all sorts of other things. The most common things people contract early on in the course if the illness are different forms of parasites, such as protozoa; Babesia itself being one of them.</em></p>
<p><em>There is Giardia, amoebas, Trichomonas, malaria, and different forms of infections that aren&#8217;t labeled yet. There is a new one, called FL1953. Stephen Frye discovered that. It&#8217;s a protozoan organism that&#8217;s causing severe fatigue and illness in chronically ill people. It&#8217;s almost always present in a patient with Lyme disease.</em></p>
<p><em>And then we find a lot of worms in people. They may be microscopic and they may be macroscopic. That means they may be visible in the stool or they may not be visible.&#8221;</em></p>
<p><em><strong><span style="text-decoration: underline;">Treatment Approaches by Klinghardt:</span></strong></em></p>
<p><strong>1<span style="text-decoration: underline;">. Get Rid of Mold</span></strong>-Lyme and mold are very commonly found together.</p>
<p>I must interject here. There are 600 species of mold and most testing is not accurate or  sophisticated enough to find it. If you have water damage or you can see  it, it&#8217;s a problem!</p>
<p><strong><span style="text-decoration: underline;">Mold depletes the immune system making any infection or chronic disease hard to fight, creates imbalances in the hormones, neurotransmitters, and biotransformation of the liver. Bottom line-if you have mold, you have to address this in any treatment protocol!</span></strong></p>
<p><strong>2.<span style="text-decoration: underline;"> Protection in an Electromagnetic Smog</span></strong><span style="text-decoration: underline;">-</span> the body can&#8217;t get better when its nervous system is chronically depleted and stimulated by cell phones, Wi-Fi, and IPads. Read more about EMF exposure <a href="../cell-phones-emfs-cancer-art-2/">here</a>.</p>
<p><strong><span style="text-decoration: underline;">3. Treat emotional issues</span></strong>-Chronic emotional stresses deplete the immune system and cause hormonal imbalances.</p>
<p><strong>4. <span style="text-decoration: underline;">Treat the Parasite for fatigue- </span>Dr. Klinghardt addresses the parasites before hitting the spirochete. </strong></p>
<p><strong>5. <span style="text-decoration: underline;">Natural Solutions of Klighardt for bugs:</span></strong></p>
<p><span style="text-decoration: underline;">Liposmal Lyme Cocktail:</span></p>
<ol>
<li>Artemisinin kills spirochete and is antimicrobial, anti-parasitic</li>
<li>Apple      Pectin to bind its toxins</li>
<li>Vitamin      C for immune health and antioxidant power</li>
</ol>
<p><span style="text-decoration: underline;">Anti-Viral</span>: Artemeisin (affective against SPV), Berebine</p>
<p><strong>Remember, antibiotics create relief, but hit a plateau in a worn out system, hence you must treat the terrain of a whole person. In Naturopathic terms, this means address the gut, the home of the immune system! </strong><strong> You also want to monitor blood sugar, neurotransmitters, adrenals, and hormones! </strong></p>
<p><strong>Summary: Treat the bacteria and virus, but also treat the person.</strong> &#8220;It doesn’t matter what sort of disease has the person, rather, what kind of person has the disease!”</p>
<p><span style="text-decoration: underline;">Sources:</span></p>
<p>Mercola, J. Why is Lyme Disease Not JUST a Tick-Borne Disease Any More? February 5, 2012. http://articles.mercola.com/sites/articles/archive/2012/02/05/dr-dietrich-klinghardt-on-lyme-disease.aspx?e_cid=20120205_SNL_Art_1</p>
<p>DFH Clinical Rounds Teleseminar: Functional Neurology Update: Lyme and other Weird Neurological Symptoms. Featuring: Helena Kerekhazi, M.S., N.R.N.P. February 8, 2012</p>
<p>Be sure to check out more on the subject of weight loss in my  Naturopathic Fun Facts on <a href="http://www.saratoga.com/living-well/2012/02/lyme-disease-holism.html" target="_blank">Saratoga.com</a>!</p>
<p>&nbsp;</p>
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		<title>Integrative Care for Heart Health &amp; Cardiovascular Disease</title>
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		<pubDate>Thu, 09 Feb 2012 21:07:52 +0000</pubDate>
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		<description><![CDATA[<p> </p> <p>February is the month of the heart. </p> <p>Sure, some may argue that St. Valentine&#8217;s Day is a made up  holiday manufactured by the greeting card companies (and an excuse to indulge in a little extra dark chocolate- gotta get those flavone antioxidants!). Still, the celebration on February 14th serves as a [...]]]></description>
			<content:encoded><![CDATA[<p><img class="size-full wp-image-1806 alignnone" title="open heart" src="http://www.dr-lobisco.com/wp-content/uploads/2012/02/open-heart.jpg" alt="" width="197" height="207" /><span style="text-decoration: underline;"><strong> </strong></span></p>
<p><span style="text-decoration: underline;"><strong>February is the month of the heart. </strong></span></p>
<p>Sure, some may argue that St. Valentine&#8217;s Day is a made up  holiday manufactured by the greeting card companies (and an excuse to indulge in a little extra dark chocolate- <a href="../the-perfect-new-year%E2%80%99s-resolution-do-less-and-eat-more-chocolate/" target="_blank">gotta get those flavone antioxidants</a>!).<strong> Still, the celebration on February 14th serves as a convenient and poignant selling point of the importance of heart health to the medical community.</strong> According to the US Department of Health and Human Services (Office of Disease Prevention and Health Promotion):</p>
<blockquote><p><em>American Heart Month is a time to battle cardiovascular disease and educate Americans on what we can do to live heart-healthy lives.</em><br />
<em> Heart disease, including stroke, is the leading cause of death for men and women in the United States.</em><br />
<em> You are at higher risk of heart disease if you are:</em><br />
<em> • A woman age 55 or older</em><br />
<em> • A man age 45 or older</em><br />
<em> • Or a person with a family history of early heart disease</em><br />
<em> Heart disease can be prevented. To keep your heart healthy:</em><br />
<em> • Watch your weight.</em><br />
<em> • Quit smoking and stay away from secondhand smoke.</em><br />
<em> • Control your cholesterol and blood pressure.</em><br />
<em> • If you drink alcohol, drink only in moderation.</em><br />
<em> • Get active and eat healthy.</em><br />
<em> • Talk to your doctor about taking aspirin every day if you are a man over the age of 45 or a woman over 55.</em><br />
<em> • Manage stress.</em></p></blockquote>
<p>The <a href="http://www.dr-lobisco.com/building-the-foundation-for-health-in-2012/" target="_blank">healthy lifestyle shifts mentioned above are important to modulate chronic disease patterns</a>. <strong>Yet, I find above guidelines lacking in giving a complete picture of what is truly important for overall heart health.  For example, let&#8217;s look at the controversial topic between integrative and conventional medicine- <em><span style="color: #ff0000;">cholesterol.</span></em></strong></p>
<p>As the above quote shows, medical experts are touting that an important way to prevent cardiovascular disease is to take medications that stop the formation of this critical steroid manufactured in our liver. In a previous blog, I spoke <a href="../cholesterol-to-the-rescue-cholesterol%E2%80%99s-not-the-bad-guy-part-2/">about the many benefits of cholesterol</a>, including its role in the formation of hormones, Vitamin D, and brain support.</p>
<p><strong>Now, from a common sense point of view, think of the implications of taking a medicine which stops the precursor to hormones and a vitamin, which in itself is being touted for overall heart benefits. <a href="http://www.dr-lobisco.com/is-cholesterol-the-bad-guy/" target="_blank">Besides the side effects of this biochemical manipulation, studies are lacking in the benefits of  suppressing cholesterol</a> in most cases. The fact is, most drug companies s<a href="http://www.dr-lobisco.com/the-problem-with-evidenced-based-medicine-to-assess-natural-modalities/" target="_blank">hare only the favorable results in their trials.</a> </strong>Bio-individuality and dosage is usually not taken into account in most studies, creating clinical judgment of what to use and when hard to determine for most physicians. An excerpt from the American Journal of Clinical Nutrition explains this issue in relation to Vitamin D:</p>
<blockquote><p><em>Vitamin D is unique in the field of nutrition because of the range of  its pleiotropic effects. CHF is a chronic disease involving                      many body systems and is the long-term consequence  of several major risk factors, most of which may be moderated with  improved                      vitamin D nutrition (<a href="http://www.ajcn.org/content/83/4/731.full#R3">3</a>, <a href="http://www.ajcn.org/content/83/4/731.full#R6">6</a>-<a href="http://www.ajcn.org/content/83/4/731.full#R10">10</a>). To expect a therapeutic response to a modest dose of this one nutrient in patients with CHF is surely too much to ask.                      The more realistic question raised by Schleithoff et al (<a href="http://www.ajcn.org/content/83/4/731.full#R3">3</a>) and Witte and Clark (<a href="http://www.ajcn.org/content/83/4/731.full#R2">2</a>) is whether the use of an appropriate dose of vitamin D, as one part of a nutritional strategy, could help in the primary                      prevention or treatment of CHF.</em></p></blockquote>
<p>What about for gender differences? Most trials use men and may be why women aren&#8217;t showing the benefit men are with statins. A recent article by Dr. Hyman discusses  the implications of taking a medication based on misguided medical  theory and lab numbers, <a href="../treating-people-not-diseases-detoxification/">vs. on biochemistry and individualized health</a>.</p>
<blockquote><p><em><span style="text-decoration: underline;">Women with No Heart Disease shouldn’t be on Statins</span></em></p>
<p>In this new study researchers reviewed the effect of statin prescriptions in a group of 153,840 women without diabetes and with an average age of 63.2 years. About 7 percent of women reported taking statin medication between 1993 and 1996. Today there are many, many more women taking statin medications, thus many more are at risk from harm from statins.</p>
<p><strong>During the 3-year period of the study, 10,242 new cases were reported – a whopping 71 percent increase in risk from women who didn’t take statins. This association stayed strong at a 48 percent increased risk of getting diabetes, even after taking into account age, race/ethnicity, and weight or body mass index. These increases in disease risk were consistent for all statins on the market.</strong></p>
<p><strong>This effect also occurred in those with and without heart disease. Surprisingly disease risk was worse in thin women. Minority women were also disproportionately affected. The risk of diabetes was 49 percent for white women, 57 percent for Hispanic women, and 78 percent for Asian women.</strong></p>
<p>But in a typical “my mind’s made up, don’t confuse me with the facts” statement by the medical establishment, the researchers said we should not change our guidelines for statin use for the primary prevention of heart disease.</p>
<p><strong>In a large meta-analysis published in the <em>Lancet</em> last year, scientists found that statins increased the risk of diabetes by 9 percent. If current guidelines were followed for those who should take statins, and people actually took them (thank God only 50 percent of prescriptions are ever filled by patients), there would be 3 million more diabetics in America. Oops.</strong></p>
<p><strong>Other studies have recently called into question the belief that high cholesterol levels increase your risk of heart disease as you get older. For those over 85 it turns out having high cholesterol will protect you from dying from a heart attack, and, in fact, from death from any cause.</strong></p></blockquote>
<p>The problem with generalized recommendations is that the focus is too narrow. I encourage you to read the rest of the article that discusses the risks associated with statins. It highlights <strong>research that disputes poorly designed studies on the connection of  a lowered risk of heart disease and lowering cholesterol and discusses articles that demonstrate how low cholesterol does not necessarily decrease mortality from heart events. In fact, <em>too low cholesterol can INCREASE </em>arterial plaques, and have other other serious heart effects. </strong></p>
<p><strong>Still, let&#8217;s remember the individual. These drugs aren&#8217;t all bad. New studies are showing they may provide an antioxidant and anti-inflammatory effect that is effective in preventing secondary heart attacks for those MEN who have a history of a heart attack.</strong></p>
<p><strong><span style="text-decoration: underline;">There&#8217;s More to Heart Health than Numbers!</span><br />
</strong></p>
<p>The<a href="http://www.dr-lobisco.com/have-heart-how-to-think-with-and-protect-your-most-loved-organ/" target="_blank"> heart itself has a &#8220;brain&#8221; and contains hormonal and healing effects to the whole body.</a> <strong><span style="text-decoration: underline;">Beyond numbers and weight, it&#8217;s the sense of isolation that is the primary predictor if one will die or live in all cause mortality.</span> It isn&#8217;t just a cliche, emotions play a big part in heart health!</strong> Studies show that you can literally have a heart attack from a broken heart. According to a study in <em>Circulation</em>:</p>
<blockquote><p>Acute  psychological stress is associated with an abrupt increase in the risk  of cardiovascular events. Intense grief in the days after the death of a  significant person may trigger the onset of acute myocardial infarction  (MI), but this relationship has not been systematically studied.</p></blockquote>
<p>Dr. Mercola offered some more<strong> insight on the mechanism behind this grief and heart health:</strong></p>
<blockquote><p>It&#8217;s well known that psychological stress exacts a great physical toll on your health, but new research reveals just how extreme that toll can be.</p>
<p>In comparing how grief affects your heart disease risk within a period of time, researchers found that losing a significant person in your life raises your risk of having a <a href="http://www.ncbi.nlm.nih.gov/pubmed/22230481">heart attack the next day by 21 times</a>, and in the following week by 6 times. The risk of heart attacks began to decline after about a month had passed, perhaps as levels of stress hormones begin to level out.</p>
<p><strong>The study did not get into the causes of the abrupt increase in risk of cardiovascular events like heart attack, but it&#8217;s likely related to the flood of stress hormones your body is exposed to following extreme stress.</strong></p>
<p>For instance, adrenaline increases your blood pressure and your heart rate, and it&#8217;s been suggested it may lead to narrowing of the arteries that supply blood to your heart, or even bind directly to heart cells allowing large amounts of calcium to enter and render the cells temporarily unable to function properly.</p>
<p>Interestingly, while your risk of heart attack increases following severe stress, so does your risk of what&#8217;s known as stress cardiomyopathy &#8212; or &#8220;broken heart syndrome&#8221; &#8212; which is basically a &#8220;temporary&#8221; heart attack that occurs due to stress.</p></blockquote>
<p><span style="text-decoration: underline;"><strong>An Emotional Tip for Heart Health</strong></span></p>
<p><strong>Therefore, think of ways to handle stress, emotions, and isolation for heart healthy tips that goes beyond a statin deficiency.</strong> Dr. Northrup reminds us of the emotional component of heart health,</p>
<blockquote><p>But it’s also important to find out what your heart is  yearning for. One of my patients with heart palpitations found that they  stopped soon after she asked for a promotion at work, something she  hadn’t had the courage to do before. She got the promotion and finds her  work more fulfilling than ever. Her heart no longer has to speak so  loudly.</p></blockquote>
<p><strong>In fact, the American Heart Association recently reported how Yoga is connected to heart health:</strong></p>
<blockquote><p>Thinking prevention? <strong>As part of an overall healthy lifestyle, Cunningham  said yoga can help lower blood pressure, increase lung capacity,  improve respiratory function and heart rate, and boost circulation and  muscle tone. It can also improve your overall well-being while offering  strength-building benefits.</strong></p>
<p>Yoga also has proven benefits for those who have faced <a href="http://www.heart.org/HEARTORG/Conditions/More/CardiacArrest/Cardiac-Arrest_UCM_002081_SubHomePage.jsp">cardiac arrest</a>, <a href="http://www.heart.org/HEARTORG/Conditions/HeartAttack/Heart-Attack_UCM_001092_SubHomePage.jsp">heart attack</a> or other <a href="http://www.heart.org/HEARTORG/Conditions/More/CardiacRehab/Cardiac-Rehab_UCM_002079_SubHomePage.jsp">heart event</a>,  according to Cunningham. “The acute emotional stress of such an event  certainly has a significant and adverse effect on the heart,” she said.  “That’s where yoga can be a tremendous benefit to manage the  stress.” For example, Cunningham said that half of <a href="http://www.heart.org/HEARTORG/Conditions/HeartAttack/PreventionTreatmentofHeartAttack/Cardiac-Procedures-and-Surgeries_UCM_303939_Article.jsp">bypass surgery</a> patients go through depression, facing emotions ranging from anxiety to  grieving. “All these things come into play when you’ve got a  potentially chronic disease to manage for the rest of your life.”</p>
<p>The calming benefits of yoga may help with that — and you may see benefits right away. After your first yoga class, your <a href="http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Blood-Pressure-vs-Heart-Rate_UCM_301804_Article.jsp">blood pressure</a> will likely be lower, you’ll be relaxed and you’ll feel better, Cunningham said.  Long-term, sustained yoga may play a role in improving overall health, according to Cunningham.</p>
<p>“The  more energy you put into it, the more you’re going to get out of it,”  she said. “After 12 weeks, you may see a dramatic increase in exercise  functionality, and blood pressure and <a href="http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/What-Your-Cholesterol-Levels-Mean_UCM_305562_Article.jsp">cholesterol levels</a> may decrease.”<br />
If you have heart disease, <a href="http://www.heart.org/HEARTORG/Conditions/Diabetes/Diabetes_UCM_001091_SubHomePage.jsp">diabetes</a> or are <a href="http://www.heart.org/HEARTORG/GettingHealthy/WeightManagement/Obesity/Obesity-Information_UCM_307908_Article.jsp">obese</a>,  check with your doctor before starting a yoga program. “I highly  recommend going to a qualified and trained cardiac medical yoga  instructor,” Cunningham said.  To find an instructor in your area, check  with your local cardiac rehab center or visit cardiacyoga.com.</p></blockquote>
<p><span style="text-decoration: underline;"><strong>The Physical Approach to Heart Health</strong><strong>: An Inclusive Approach</strong></span></p>
<p>A good physician will look at the whole picture of heart health. Dr. Hyman summarizes the action steps and nutritional support to keep in check for the heart.</p>
<p><span style="text-decoration: underline;"><strong>Measuring Your Risk Factors:</strong></span></p>
<blockquote>
<ol>
<li><strong>Get the right cholesterol tests.</strong> Check NMR particle sizes for cholesterol by asking your doctor for this test at <a href="https://www.labcorp.com/wps/portal/" target="_blank">Labcorp</a> or <a href="http://www.liposcience.com/" target="_blank">LipoScience</a>. You want to know if you have safe light and fluffy cholesterol particles, or small dense, artery damaging cholesterol particles. A regular cholesterol test won’t tell you this.</li>
<li><strong>Check for metabolic syndrome.</strong> Do you have a fat belly? Measure you waist at the belly button and your hips at the widest point—if your waist/hip is greater than 0.8 if you are a woman or 0.9 if you are man, then you have a problem. If you have small LDL and HDL particles, you have metabolic syndrome. If your triglycerides are greater than 100 and your HDL is less than 50, or the ratio of triglycerides to HDL is greater than 4, then you have metabolic syndrome.</li>
<li><strong>Do a glucose insulin challenge test. </strong>This is very important and most physicians do not test for insulin and glucose.</li>
<li><strong>Check your hemoglobin A1c, </strong>which measures blood sugar over the last 6 weeks. If it is greater than 5.5, you may have metabolic syndrome</li>
</ol>
</blockquote>
<p><span style="text-decoration: underline;"><strong>Action Steps:</strong></span></p>
<blockquote>
<ol>
<li><strong>Eat a healthy diet.</strong> Eat a diet with a low glycemic load, high in fiber, and phytonutrient and omega-3 rich. It should be plant based, and you should consume plenty of good quality protein such as beans, nuts, seeds, and lean animal protein (ideally organic or grass fed). I have described specific diets that abide by these parameters in my book <a href="http://store.drhyman.com/Store/Show/Books/758/UltraMetabolism-The-Simple-Plan-for-Automatic-Weight-Loss-Hard-Cover" target="_blank"><em>UltraMetabolism</em></a>.</li>
<li><strong>Exercise.</strong> Enough said.</li>
<li><a href="http://drhyman.com/how-to-sleep-better-lose-weight-and-live-longer-565/"><strong>Get good quality sleep</strong></a><strong>.</strong> Sleep is essential for healing your body, maintaining balanced blood sugar, and your overall health.</li>
<li><strong>Use </strong><a href="http://store.drhyman.com/Store/Show/SearchResults/815/UltraWellness-Healthy-Cholesterol-Support-Kit-w--Essentials-%281M%29" target="_blank"><strong>supplements to support healthy cholesterol</strong></a><strong> particle size. </strong>These include:</li>
</ol>
</blockquote>
<blockquote>
<ul>
<li>A multivitamin including at least 500 mcg of chromium, 2 mg of biotin and 400 mg of lipoic acid. For most you will take 3 capsules twice a day.</li>
<li>1000 mg of omega-3 fats (EPA/DHA) twice a day.</li>
<li>2000 IU of vitamin D3 2000 a day.</li>
<li>1200 mg of red rice yeast twice a day.</li>
<li>2-4 capsules of <a href="http://drhyman.com/the-super-fiber-that-controls-your-appetite-and-blood-sugar-2994/">glucomannan</a> 15 minutes before meals with a glass of water.</li>
<li>Broad-range, balanced concentration of plant sterols. You will usually take 1 capsule with each meal.</li>
</ul>
</blockquote>
<blockquote><p><strong>5. Consider using high dose niacin or vitamin B3.</strong> This can only be done with a doctor’s prescription. It is useful to help raise HDL cholesterol, lower LDL cholesterol and triglycerides, and increase particle size.. <strong> </strong></p></blockquote>
<blockquote><p><strong>6. Use low-dose statins ONLY if you have had heart disease</strong> or are a male with multiple risk factors, while carefully monitoring for muscle and liver damage.</p></blockquote>
<blockquote><p><span style="text-decoration: underline;"> </span></p></blockquote>
<p><span style="text-decoration: underline;">Sources:</span></p>
<p>US Department of Health and Human Services. Office of Disease Prevention and Health Promotion. February 2012 Toolkit. American Heart Month. http://healthfinder.gov/nho/PDFs/FebruaryNHOtoolkit.pdf</p>
<p>American Heart Association. Yoga and Heart Health. February 2012. http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/StartWalking/Yoga-and-Heart-Health_UCM_434966_Article.jsp#.TzBaXOQ7_IU</p>
<p>Hyman, M. Why Women Should Stop Their Cholesterol  Lowering Medication. January 21, 2012.  http://drhyman.com/why-women-should-stop-their-cholesterol-lowering-medication-8209/?utm_source=Publicaster&amp;utm_medium=email&amp;utm_campaign=drhyman%20newsletter%20issue%20#51&amp;utm_content=Get+the+story.</p>
<p>Barter  P, Gotto AM, LaRosa JC, Maroni J, Szarek M, Grundy SM, Kastelein JJ,  Bittner V, Fruchart JC; Treating to New Targets Investigators. HDL  cholesterol, very low levels of LDL cholesterol, and cardiovascular  events. N Engl J Med. 2007 Sep 27;357(13):1301-10.</p>
<p>Hansson GK Inflammation, Atherosclerosis, and Coronary Artery Disease N Engl J Med 352:1685, April 21, 2005</p>
<p>Schatz  IJ, Masaki K, Yano K, Chen R, Rodriguez BL, Curb JD. Cholesterol and  all-cause mortality in elderly people from the Honolulu Heart Program: a  cohort study. Lancet. 2001 Aug 4;358(9279):351-5.</p>
<p>Mercola, J. How Grief Can Break Your Heart. February 3, 2012. http://articles.mercola.com/sites/articles/archive/2012/02/03/how-grief-can-break-your-heart.aspx?e_cid=20120203_FNL_art_2</p>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed?term=%22Mostofsky%20E%22%5BAuthor%5D">Mostofsky E</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed?term=%22Maclure%20M%22%5BAuthor%5D">Maclure M</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed?term=%22Sherwood%20JB%22%5BAuthor%5D">Sherwood JB</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed?term=%22Tofler%20GH%22%5BAuthor%5D">Tofler GH</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed?term=%22Muller%20JE%22%5BAuthor%5D">Muller JE</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed?term=%22Mittleman%20MA%22%5BAuthor%5D">Mittleman MA</a>. <a title="Circulation." href="http://www.ncbi.nlm.nih.gov/pubmed/22230481">Circulation.</a> Risk of Acute Myocardial Infarction After the Death of a Significant Person in One&#8217;s Life: The Determinants of Myocardial Infarction Onset Study. 2012 Jan 24;125(3):491-6. Epub 2012 Jan 9.</p>
<p>Source: Hyman, M. Seven Tips To Fix Your Cholesterol without Medication. January 21, 2012. http://drhyman.com/seven-tips-to-fix-your-cholesterol-without-medication-3997/?utm_source=Publicaster&amp;utm_medium=email&amp;utm_campaign=drhyman%20newsletter%20issue%20#51&amp;utm_content=Read+more</p>
<p>Northrup, C. Palpitations: A Message From Your Heart at Midlife. February 1, 2012. http://www.drnorthrup.com/blog/2012/02/palpitations-a-message-from-your-midlife-heart</p>
<p id="article-title-1">Reinhold Vieth and                       Samantha Kimball. Vitamin D in congestive heart failure (editorial)<sup>1</sup><a id="RFN2" name="RFN2"></a><sup>,<a href="http://www.ajcn.org/content/83/4/731.full#FN2">2</a></sup><cite><abbr title="The American Journal of Clinical Nutrition">. Am J Clin Nutr</abbr> April 2006                                                                        	                                         vol. 83                                                                           no. 4                                                                           731-732. </cite>http://www.ajcn.org/content/83/4/731.full</p>
<p><strong><span style="text-decoration: underline;">Be sure to check out my informational blog on<a href="http://www.saratoga.com/living-well/2012/02/-normal-0-false-false-3.html" target="_blank"> </a></span><a href="http://www.saratoga.com/living-well/2012/02/-normal-0-false-false-3.html" target="_blank">Saratoga.com</a><span style="text-decoration: underline;"><a href="http://www.saratoga.com/living-well/2012/02/-normal-0-false-false-3.html" target="_blank"> </a>which includes:</span></strong></p>
<p><strong><span style="text-decoration: underline;">Naturopathic Philosophy Highlight… Fun Facts</span>: </strong></p>
<ol>
<li>An Unexpected Solution to Rising Health Costs</li>
<li>Statins and Nerve damage</li>
<li>Should Pediatricians Fire Patients- The Unvaccinated Controversy</li>
<li>OSHA’s statement on Mandatory Health Care Vaccinations</li>
</ol>
<p><strong><span style="text-decoration: underline;">Happenings</span>:</strong></p>
<p>Upcoming Essential Oils Workshops with Terry Quigley at the Healing Garden.</p>
<p>Contact Terry at 518-831-9469</p>
<p><strong>Next Health Forum is February 9<sup>th</sup> at 6:15pm. </strong><a href="../naturopathic-doctor-to-offer-third-integrated-healthcare-forum-in-saratoga-county/"><strong>Learn more about future events.</strong></a></p>
<p><strong><span style="text-decoration: underline;">New Office Manager</span></strong></p>
<p>It is with a sad heart that we will be saying farewell to my wonderful office manager, Emma Rombach, LAc. She has been a wonderful addition and help to us all. Within the next few weeks, I will be interviewing prospects and training her replacement. I ask you all for your patience during this transition. Please be reminded that email and phone calls will continue to be filtered and won’t be only viewed by me.</p>
<p><span style="text-decoration: underline;">Next week, starting February 15<sup>th</sup>,  I will begin a trial with Holistic Answering Services who will be receiving forwarded emails and tasks. Please provide feedback if necessary. </span></p>
<p>Congratulations to Emma’s success and best wishes to her moving forward with her practice and other career endeavors.</p>
<p>PATIENTS: Please review follow ups and cancellation policy on <a href="../contact/">my websi<strong>te.</strong></a></p>
<p><a href="../contact/"><strong> </strong></a><strong> <span style="text-decoration: underline;">Don’t miss out:</span></strong></p>
<ul>
<li><span style="text-decoration: underline;">This Weeks Radio Show Highlight:</span><a href="http://www.hayhouseradio.com/archive_preview.php#"> Happiness: How to Bring More of it Into Your Life Right Now!!<br />
</a>For  decades psychologists have focused mostly on negative moods such as  depression and anxiety. But what about happiness? Is it possible to  measure and increase your happiness set point? Join Dr. Northrup and  Roko Belic, the director of the phenomenal new film Happy, to find out  exactly how you can set the stage for more happiness in your life&#8211; and  help spread it to the rest of the world!</li>
<li>The Rest of Fun Facts on my <a href="http://www.saratoga.com/living-well/">Saratoga.com</a> blog.</li>
<li>Listen to my colleagues and other experts as they discuss solutions to menopausal issues on a show dedicated just for women in mid-life! Here is a link from my <a href="http://www.blogtalkradio.com/magnificentmenopause/2011/03/31/magnificent-menopause-and-beyond-enbracing-midlife">interview on 360menopause Radio Show</a> on <em>Panic Attacks and Menopause </em>and a list of archived shows.</li>
<li>Check out my latest answer on <a href="http://www.sharecare.com/user/sarah-lobisco/answers">Dr. Oz’s Sharecare</a><em>:The link of emotions on the heart<br />
</em></li>
<li>View the Updated Link Resources on <a href="../">my homepage</a></li>
</ul>
<p><em> </em></p>
<p>&nbsp;</p>
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		<title>January 2012 Top Reads</title>
		<link>http://www.dr-lobisco.com/january-2012-top-reads/</link>
		<comments>http://www.dr-lobisco.com/january-2012-top-reads/#comments</comments>
		<pubDate>Fri, 03 Feb 2012 17:36:26 +0000</pubDate>
		<dc:creator></dc:creator>
				<category><![CDATA[Top Reads of the Month]]></category>
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		<category><![CDATA[functional doctor and saratoga springs ny]]></category>
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		<guid isPermaLink="false">http://www.dr-lobisco.com/?p=1580</guid>
		<description><![CDATA[ <p></p> <p>By Sarah LoBisco, ND</p> <p>Welcome to the beginning of 2012’s Top Reads!</p> <p>For 5 years now, I’ve been highlighting and summarizing some of the most talked about health topics in Integrative, Naturopathic, and Functional Medicine. I’ve also been giving you some very  important updates in conventional medicine.</p> <p>It continues to be my [...]]]></description>
			<content:encoded><![CDATA[<h1><span style="text-decoration: underline;"><strong> </strong></span></h1>
<p><img class="alignleft size-full wp-image-746" title="mixer" src="http://www.dr-lobisco.com/wp-content/uploads/2011/06/mixer.jpg" alt="" width="245" height="179" /></p>
<p>By Sarah LoBisco, ND</p>
<p><span style="text-decoration: underline; color: #ff0000;">Welcome to the beginning of 2012’s Top Reads!</span></p>
<p>For 5 years now, I’ve been highlighting and summarizing some of the most talked about health topics in Integrative, Naturopathic, and Functional Medicine. I’ve also been giving you some very  important updates in conventional medicine.</p>
<p>It continues to be my intention to synergize all of these medical viewpoints monthly, under the topics of Nutrigenomics, Health, and Pharmaceutical Updates. It’s the best mix of  modern medicine! The beginning of this New Year is no different.</p>
<p><span style="text-decoration: underline;">Here are some of the most not-to-miss highlights for this month:</span></p>
<ol>
<li>A continued discussion from <a href="../how-to-modulate-your-risk-of-breast-cancer-the-pros-and-cons-of-screening/">last week’s blog on breast health</a> including an abstract about the sensitivity of mammograms in breast cancer detection and a discussion on calcium supplements and heart disease links!</li>
<li>The safety of Naturopathic and Chiropractic Modalities (discussed by Dr. Mercola).</li>
<li>Potent Nutrigenomic effects of Milk Thistle on Cancer, Vitamin C on Asthma, and Zinc for Bone health</li>
<li>Various Drug updates such as Dr. Northrup’s blog on HRT and safety studies on MS medications.</li>
</ol>
<p><span style="text-decoration: underline;">And…Be sure to check out my informational blog on </span><a href="http://www.saratoga.com/living-well/">Saratoga.com</a><span style="text-decoration: underline;"> which includes: </span></p>
<p><strong><span style="text-decoration: underline;">A new blog: <a href="http://www.saratoga.com/living-well/2012/02/2012-top-reads-are-posted.html" target="_blank">Calcium Supplementation for Women- Does it really stand the test for bone health or heart health?</a></span></strong></p>
<p>There’s also more news on latest happenings, Dr. Oz’s Sharecare, updated links, and so much more! Enjoy!</p>
<h1><span style="text-decoration: underline;"><strong><img class="alignleft size-full wp-image-1071" title="integrative medicine" src="http://www.dr-lobisco.com/wp-content/uploads/2011/08/integrative-medicine.jpg" alt="" width="101" height="150" />HEALTH</strong></span></h1>
<p><a href="http://articles.mercola.com/sites/articles/archive/2011/12/30/rethinking-medical-associations-best-interests.aspx?e_cid=20111230_DNL_art_1" target="_blank"><em>Are NDs and DCs Safe  (Dr. Mercola)</em></a></p>
<blockquote>
<blockquote><p>Even with the success of the Wilkes Case, the AMA has continued to  wage war against natural medicine for the past 20 years—but in more  covert ways. It&#8217;s the &#8220;Cold War&#8221; phase of this battle, but every bit as  fierce. And now the AMA has rallied up a few significant allies,  including:</p>
<ul>
<li>The American Dental Association (ADA)</li>
<li>The American Cancer Society (ACS)</li>
<li>The American Academy of Pediatrics (AAP), and</li>
<li>The American Psychiatric Association (APA)</li>
</ul>
<p>… not to mention governmental regulatory agencies; all willing to  march toward a common goal—a monopoly on medical care in this country.  Together, they form a formidable lobbying force that controls just about  every regulatory and legislative body in America. The truth is that  chiropractic, naturopathic, and osteopathic medicine have PROVEN to be  medically effective and cost effective for the patient, and the AMA  can&#8217;t stomach this, viewing natural medicine as a huge threat to their  bottom line.</p></blockquote>
<p>In 1987, the federal courts found the AMA and several other medical  groups guilty of seeking to create a healthcare monopoly. Specifically,  they were found guilty of the following actions (published in the <a href="http://jama.ama-assn.org/content/259/1/81.extract">January 1988 issue of JAMA</a>):</p>
<blockquote>
<blockquote>
<ol>
<li>Systematic defamation of naturopathic, chiropractic, and osteopathic physicians</li>
<li>Publishing and distribution of propaganda specifically intended to ruin other healthcare professionals&#8217; reputations</li>
<li>Forcing MDs to refuse collaboration with naturopathic,  chiropractic, and osteopathic physicians in the co-management of  patients</li>
<li>Denying hospital access to naturopathic, chiropractic, and osteopathic physicians</li>
</ol>
<p>The attack on osteopathic medicine has largely faded away since then,  but chiropractic and naturopathic practitioners, as well as other  legitimate natural medicine practitioners, continue to be the targets of  suppression and misrepresentation. The war isn&#8217;t over, but the rules of  engagement have changed.</p></blockquote>
</blockquote>
</blockquote>
<p><strong><span style="text-decoration: underline;">Likelihood That a Woman With Screen-Detected Breast Cancer Has Had Her &#8220;Life Saved&#8221; by That Screening</span></strong><em> (Arch Intern Med.</em> Published online October 24, 2011. doi:10.1001/archinternmed.2011.476)</p>
<blockquote><p><strong>Background: </strong>Perhaps the most persuasive messages promoting screening mammography come from women who argue that the test &#8220;saved my life.&#8221; Because other possibilities exist, we sought to determine how often lives were actually saved by mammography screening. <strong>Methods: </strong>We created a simple method to estimate the probability that a woman with screen-detected breast cancer has had her life saved because of screening. We used DevCan, the National Cancer Institute&#8217;s software for analyzing Surveillance Epidemiology and End Results (SEER) data, to estimate the 10-year risk of diagnosis and the 20-year risk of death—a time horizon long enough to capture the downstream benefits of screening. Using a range of estimates on the ability of screening mammography to reduce breast cancer mortality (relative risk reduction [RRR], 5%-25%), we estimated the risk of dying from breast cancer in the presence and absence of mammography in women of various ages (ages 40, 50, 60, and 70 years). <strong>Results: </strong>We found that for a 50-year-old woman, the estimated risk of having a screen-detected breast cancer in the next 10 years is 1910 per 100 000. Her observed 20-year risk of breast cancer death is 990 per 100 000. Assuming that mammography has already reduced this risk by 20%, the risk of death in the absence of screening would be 1240 per 100 000, which suggests that the mortality benefit accrued to 250 per 100 000. Thus, the probability that a woman with screen-detected breast cancer avoids a breast cancer death because of mammography is 13% (250/1910). This number falls to 3% if screening mammography reduces breast cancer mortality by 5%. Similar analyses of women of different ages all yield probability estimates below 25%. <strong>Conclusions: </strong>Most women with screen-detected breast cancer have not had their life saved by screening. They are instead either diagnosed early (with no effect on their mortality) or over diagnosed.</p></blockquote>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/22007042" target="_blank">Cumulative probability of false-positive recall or biopsy  recommendation after 10 years of screening mammography: a cohort study. (Ann of Internal Medicine)</a></p>
<blockquote><p>After 10 years of annual screening, more than half of women will receive  at least 1 false-positive recall, and 7% to 9% will receive a  false-positive biopsy recommendation. Biennial screening appears to  reduce the cumulative probability of false-positive results after 10  years but may be associated with a small absolute increase in the  probability of late-stage cancer diagnosis.</p></blockquote>
<p><a href="http://www.4yourtype.com/2012_newsletter_v9n01.asp#Martha" target="_blank">How to Kick the Sugar Habit and Yummy Recipes for Blood Type (D&#8217;Adamo Newsletter)</a></p>
<ul>
<li>Stay hydrated.  When you become dehydrated you tend to crave glucose,           instead of going for the candy, drink a large glass of water.</li>
<li>Avoid           juice. Juice is LOADED with sugar. If you like your water with a little           flavor, add a teaspoon of <a href="http://www.4yourtype.com/prodinfo.asp?number=NP023">Proberry           Syrup</a> to your water. It’s sugar free, provides a light  berry flavor and gives you a boost of anti-oxidant protection during  cold and flu season.</li>
<li>Exercise.   Exercise oxygenates the body and increases endorphins           and those mood boosting hormones tend to give us the strength to say           no to sugary snacks.</li>
<li>Sleep. Getting enough sleep gives you the energy           that you need to get through your day. When you’re feeling  sluggish in the afternoon, you may tend to reach for a candy bar or  leftover donut from the office conference room – while it may appear  that they give you a slight boost in energy, they are actually doing the  opposite – setting you up for a big crash that will leave you feeling  even more exhausted than you were before.</li>
<li>Eat fruits and vegetables.  Eating plenty of right for your type           fruits and vegetables fills you up with fiber, and the natural sugars           give you the sweet taste that you are craving without all the empty           calories that you  don’t need.</li>
<li>Avoid foods labeled “fat free” or “low fat.”  These foods normally contain more sugar than their full fat counterparts.</li>
<li>If you absolutely must have something sweet, go for dark chocolate           that is at least 70% cocoa and limit yourself to one square or make           a hot cocoa by swirling a tablespoon of Dr. D’Adamo’s           Carob Extract into warm almond, soy or rice milk (according to your           blood type).</li>
<li><a href="http://articles.mercola.com/sites/articles/archive/2012/01/17/fda-action-on-dental-amalgam.aspx?e_cid=20120117_DNL_art_1" target="_blank">Find sweetness in your life; when you are fulfilled and           happy you are less likely to crave sweets.</a></li>
</ul>
<p><a href="http://articles.mercola.com/sites/articles/archive/2012/01/17/fda-action-on-dental-amalgam.aspx?e_cid=20120117_DNL_art_1" target="_blank">World Health Organization Urges Phasing Out of Dental Amalgam (Dr. Mercola)</a></p>
<blockquote>
<blockquote><p>Many hoped that the FDA would reconsider this foolish stance after  the World Health Organization called for the phasing-out of amalgam in  their <a href="http://www.who.int/oral_health/publications/dental_material_2011.pdf">2011 report: Future Use of Materials for Dental Restoration</a>.  In May 2011, the Council of Europe also issued a proclamation calling  for restrictions and prohibitions of mercury fillings, which are already  banned in Norway, Sweden, and Denmark. Health Canada also stopped  endorsing amalgam for use in children, pregnant women, and people with  impaired kidney function, all the way back in 1996!</p>
<p>The World Health Organization noted the following <a href="http://www.shdc.com.au/dental-news-blog/uncategorized/the-world-health-organization-urges-%E2%80%9Cswitch%E2%80%9D-away-from-amalgam/">three reasons for its new position</a>:</p>
<ol>
<li><strong>Amalgam releases a &#8220;significant amount of mercury&#8221; into the environment</strong>, including the atmosphere, surface water, groundwater, and soil. WHO reports:<em>&#8220;When released from dental amalgam use into the environment  through these pathways, mercury is transported globally and deposited.  Mercury releases may then enter the human food chain especially via fish  consumption.&#8221;</em></li>
<li><strong>WHO determines that amalgam raises &#8220;general health concerns&#8221;:</strong> While the report acknowledges that a few dental trade groups still  believe amalgam is safe for all, the WHO report reaches a very different  conclusion: &#8220;Amalgam has been associated with general health concerns.&#8221;  The report observes:<em>&#8220;According to the Norwegian Dental Biomaterials Adverse Reaction  Unit, the majority of cases of side-effects of dental filling materials  are linked with dental amalgam.&#8221;</em></li>
<li><strong>WHO concludes &#8220;materials alternative to dental amalgam are available&#8221;</strong> and cites studies indicating they are superior to amalgam. For example,  WHO says &#8220;recent data suggest that RBCs [resin-based composites]  perform equally well&#8221; as amalgam. And compomers have a higher survival  rate, says WHO, citing a study finding that 95% of compomers and 92% of  amalgams survive after 4 years.In particular, WHO explains that &#8220;Alternative restorative materials  of sufficient quality are available for use in the deciduous [baby]  dentition of children&#8221; – the population whose developing neurological  systems are most susceptible to the neurotoxic effects of dental  mercury. Perhaps more important than the survival of the filling, WHO  asserts that:<em>&#8220;Adhesive resin materials allow for less tooth destruction and, as a result, a longer survival of the tooth itself.&#8221;</em></li>
</ol>
<p>The report also included mention of the known toxic effects of mercury exposure, stating that:</p>
<blockquote><p><em>&#8220;Mercury is highly toxic and harmful to health. Approximately 80%  of inhaled mercury vapor is absorbed in the blood through the lungs,  causing damages to lungs, kidneys and the nervous, digestive,  respiratory and immune systems. Health effects from excessive mercury  exposure include tremors, impaired vision and hearing, paralysis,  insomnia, emotional instability, developmental deficits during fetal  development, and attention deficit anddevelopmental delays during  childhood.&#8221;</em></p></blockquote>
</blockquote>
</blockquote>
<p><a href="http://fitness.mercola.com/sites/fitness/archive/2012/01/20/physically-active-children-perform-better-academically.aspx?e_cid=20120120_FNL_art_1" target="_blank"><em>Why Exercise is Good for your Brain. (Dr. Mercola)</em></a></p>
<ul>
<li> A review of 14 studies  has demonstrated that the more physically active schoolchildren are, the better they do academically.</li>
<li> One  US test program at Naperville Central High School powerfully  illustrated this point two years ago. Students who participated in a  dynamic morning exercise program nearly doubled their reading scores  while math scores increased 20-fold.</li>
<li> Exercise  encourages your brain to work at optimum capacity by causing nerve  cells to multiply, strengthening their interconnections and protecting  them from damage. This is true for all age groups.</li>
<li> To  get your kids moving, limit the amount of time your child spends  watching TV or playing computer and video games, and to replace these  sedentary activities with active ones. Overweight and obese children  need at least 30 minutes of exercise each day, and may benefit from  closer to 60 minutes.</li>
</ul>
<p><a href="http://articles.mercola.com/sites/articles/archive/2012/01/30/calcium-supplement-on-heart-attack.aspx?e_cid=20120130_DNL_art_1" target="_blank">Calcium &amp; Increased Risk of Breast Cancer &amp; Cardiovascular Disease! (Dr. Mercola)</a></p>
<blockquote>
<ul>
<li> Taking  elemental calcium supplements (with or without vitamin D) in amounts of  500 mg or more may actually increase your relative risk of heart attack  by up to 27 percent, and may even increase your risk of stroke</li>
<li> Taking  the wrong type of calcium and in isolation, without complementary  nutrients like magnesium, vitamin D and vitamin K, which help keep your  body in balance, can have adverse effects, such as calcium building up  in coronary arteries and causing heart attacks</li>
<li> Osteoporosis,  as defined by DXA bone screenings using the T-score, are highly  misleading, because they compare your bone density to a 25-year old (and  not your age group) as the standard of normality. Bone density and bone  strength are two different things, and having highly dense bones may  increase your risk of breast cancer as a woman by 300% or more.</li>
<li> Evidence  that supplementing with calcium safely prevents fractures is lacking,  but plentiful research suggests calcium deposits are major contributors  and even causative factors in many health conditions</li>
<li> In  order for calcium to do your body good, it must be in a biologically  appropriate form and balanced out with vitamins D and K and other  important trace minerals, as part of a total nutritional plan</li>
<li>Bone density, while an excellent measurement of compressive strength,  does not reveal tensile strength, i.e. whether or not your bone will  resist breaking from being pulled or stretched, as commonly occurs in a  fall or similar trauma. Moreover, &#8220;osteoporosis,&#8221; as presently defined by bone scans (DXA  scan) using the T-score, inappropriately defines &#8220;normal bone density&#8221;  according to the standard of a 25-year old, young adult.  In other words, if you are 40, 50, <em>or even 100</em>, the  T-score-based system says your bones are not normal, or even diseased if  they are not as dense as they were when you were a young adult. If in fact they used the age-appropriate Z-score, most cases of  &#8220;osteopenia,&#8221; and many cases of &#8220;osteoporosis,&#8221; would suddenly disappear  because they were inappropriately classified from the start.</li>
</ul>
</blockquote>
<h1><span style="text-decoration: underline;"><strong><img class="alignleft size-full wp-image-883" title="drugs" src="http://www.dr-lobisco.com/wp-content/uploads/2011/07/drugs1.jpg" alt="" width="97" height="145" />DRUGS</strong></span></h1>
<p><a href="http://www.drnorthrup.com/blog/2012/01/hormonal-support-can-be-a-smorgasbord" target="_blank">To Use or Not to Use: HRT (Dr. Christiane Northrup)</a></p>
<blockquote><p>Too many women see the hormone therapy decision as an either/or,  yes/no decision. It is important for you to know that you don’t  necessarily have to choose between traditional HT and alternatives.  Think of your perimenopausal support as a smorgasbord. You get to choose  what appeals to you at the moment and leave what doesn’t.</p>
<p>Every day more and more studies are showing how effective modalities  such as dietary change (in particular, a low-sugar diet), food  supplements, exercise, and herbs can be in supporting a woman through  her menopausal transition. Though some doctors still don’t know about  these approaches and may not mention them to you, they often work as  well or better than hormone therapy (HT). They can also be used in  addition to hormone therapy, to reduce dosage levels, side effects, and  potential risk.<a name="sa" href="http://www.fda.gov/Drugs/DrugSafety/ucm284240.htm" target="_blank"><strong><br />
</strong></a></p></blockquote>
<p><a name="sa" href="http://www.fda.gov/Drugs/DrugSafety/ucm284240.htm" target="_blank">Safety Announcement with Gilenya (FDA)</a></p>
<blockquote><p><strong>[12-20-2011] </strong>The  U.S. Food and Drug Administration (FDA) has received a report of a  patient with multiple sclerosis (MS) who died within 24 hours of taking  the first dose of Gilenya (fingolimod). At this time, FDA cannot  conclude whether the drug resulted in the patient&#8217;s death. FDA is  continuing to evaluate the case and will communicate any new information  that results from this investigation.Gilenya may cause serious side effects, such as slow heart rate  (bradycardia), which may be related to slowed conduction of electrical  impulses from the upper chambers of the heart to the lower chambers of  the heart. These effects usually do not cause symptoms, but they can  cause dizziness, fatigue, and palpitations.</p></blockquote>
<p><a href="http://articles.mercola.com/sites/articles/archive/2012/01/07/eat-like-a-caveman-to-protect-your-brain-from-shrinking.aspx?e_cid=20120107_DNL_art_2" target="_blank"><strong>MS Drugs related to Brain Infection, Immune System Problems and More</strong></a> (Dr. Mercola)</p>
<blockquote>
<blockquote><p>Tysabri is a type of drug known as a monoclonal antibody, meaning it  is derived from a mouse antibody that has been genetically engineered to  mirror a human antibody (antibodies are proteins that help your body  fight infection). Unlike Gilenya, which is taken orally, Tysabri is  given every four weeks by infusion directly into a vein, where the  antibodies bind to immune system cells, inhibiting them from crossing  over from the bloodstream to the brain.</p>
<p>However, if destructive immune system cells break free of the  bloodstream, they can reach your brain, gastrointestinal tract and  joints and cause severe damage, including progressive multifocal  leukoencephalopathy (PML), a rare brain infection that results in death  or severe disablement. The drug was pulled from the market after just  three months because of this deadly risk – but years later the FDA  allowed it to return!</p>
<p>Other toxic MS medications include:</p>
<ul>
<li>Prednisone, a steroid hormone that can significantly impair your  immune system, and cause diseases like osteoporosis and cataracts</li>
<li>Interferon. This drug is quite deceptive, because even though  it&#8217;s a natural substance, it&#8217;s typically given in a dose that shuts down  your body&#8217;s natural feedback loop. As a result, it tends to do more  harm than good</li>
</ul>
<p>So what, then, are your options other than drugs if you&#8217;re struggling  with MS? Many conventional physicians would have you believe there are  none, but they obviously have not heard Dr. Terry Wahls&#8217; inspiring story  of how she reversed her multiple sclerosis by switching to a  Paleo-style diet focused on fresh raw foods, high in specific nutrients  needed for proper function of myelin and mitochondria.</p></blockquote>
</blockquote>
<p><a href="http://www.medscape.com/viewarticle/757524?src=nl_topic" target="_blank">New Rheumatoid Arthritis Drug Shows Disappointing Results (Medscape)</a></p>
<blockquote><p>Apilimod mesylate, which inhibits interleukin-12 and IL-23, was shown earlier to have no benefit in Crohn&#8217;s disease. The new study tested the safety and effectiveness of the drug in 29 patients with active RA, with a 3:1 ratio of drug:placebo. Although there were slight improvements in DAS28  (disease activity scores in 28 joints), none of the changes could be  classified as a response &#8211; and ACR20 responses (at least a 20%  improvement on American College of Rheumatology criteria) were rare.</p>
<p>Moreover, apilimod did not decrease IL-12 or IL-23 expression, nor did it decrease other biomarkers in synovial tissue. Fifteen of 17 patients (88%) treated with 100 mg  once a day for four or eight weeks had mild, mainly gastrointestinal,  adverse events. But when the dosage was doubled to 100 mg twice a day  for eight weeks, all five treated patients had headaches and nausea.   (All seven placebo-treated patients reported side effects, too.)</p></blockquote>
<h1><span style="text-decoration: underline;"><strong><img class="alignleft size-medium wp-image-1070" title="nutrional genomics" src="http://www.dr-lobisco.com/wp-content/uploads/2011/08/nutrional-genomics-300x188.jpg" alt="" width="224" height="175" />NUTRIGENOMICS</strong></span></h1>
<p><span style="text-decoration: underline;"><strong><a href="http://www.medicalnewstoday.com/releases/233591.php?form_372.replyids=2&amp;form_363.replyids=2&amp;form_346.userid=215&amp;form_346.replyids=11158" target="_blank">Vitamin C &amp; Asthma (Medical News Today)</a><br />
</strong></span></p>
<p><span style="text-decoration: underline;">The interaction between environmental toxins, age, and condition:</span></p>
<blockquote><p>Depending on the age of asthmatic children, on their exposure to molds  or dampness in their bedroom, and on the severity of their <a title="What is Asthma?" href="http://www.medicalnewstoday.com/info/asthma/">asthma</a>,  vitamin C has greater or smaller beneficial effect against asthma,  according to a study published in the Clinical and Translational  Allergy.</p>
<p>Drs Mohammed Al-Biltagi from the Tanta University in Egypt and Harri  Hemila from the University of Helsinki in Finland analyzed the effect of  0.2 grams per day of vitamin C on 60 asthmatic children aged 7 to 10  years. The effect of vitamin C on the forced expiratory volume per one  second (FEV1) was modified by age and exposure to molds or dampness. In  the younger children aged 7.0 to 8.2 years with no exposure to molds or  dampness, vitamin C administration increased the FEV1 level by 37%. In  the older children aged 8.3 to 10 years with exposure to molds or  dampness in their bedroom more than one year before the study, vitamin C  increased the FEV1 level by only 21%.</p></blockquote>
<p><a href="http://newsletter.vitalchoice.com/e_article002310969.cfm?x=bks07Vd,b1h0JlRD" target="_blank">Key Nutrients Boost Brain Ability (VitalChoice)</a></p>
<blockquote><p>The Oregon study <span style="text-decoration: underline;">links higher blood levels of omega-3s from fish (EPA and DHA) and vitamins B, C, D, and E to better performance on tests of mental acuity</span> (thinking and memory).<span style="text-decoration: underline;"> Higher blood levels of omega-3s and vitamins B, C, D, and E were also linked to having less brain shrinkage</span>. (Brain shrinkage both promotes and characterizes Alzheimer’s disease and other forms of dementia.)</p>
<p>In contrast, the <span style="text-decoration: underline;">participants who had the lowest blood levels of nutrients did the worst on mental acuity tests and showed the most brain shrinkage</span>. Low blood levels of the key nutrients in question suggest that a person is eating lots of “empty-calorie” foods … such as the processed, refined foods that predominate in the standard American diet.</p>
<p>The results of prior studies comparing people’s diets to their brain health – most of which used nutrient-intake estimates based on diet surveys – have been mixed and inconclusive.</p></blockquote>
<div>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/21622228" target="_blank"><em>Synergism is Key (Front Biosci. 2011 Jun 1;17:3183-95.)</em></a></p>
</div>
<blockquote>
<div>
<p>Vitamin E represents a family of  compounds that is divided into two subgroups called tocopherols and  tocotrienols, which act as important antioxidants that regulate  peroxidation reactions and control free-radical production within the  body. However, many of the biological effects of vitamin E are mediated  independently of its antioxidant activity. Although tocopherols and  tocotrienols have the same basic chemical structure characterized by a  long phytyl chain attached to a chromane ring, only tocotrienols display  potent anticancer activity, by modulating multiple intracellular  signaling pathways associated with tumor cell proliferation and  survival, and combination therapy with other chemotherapeutic agents  result in a synergistic anticancer response. Combination therapy is most  effective when tocotrienols are combined with agents that have  complementary anticancer mechanisms of action. These findings strongly  suggest that the synergistic antiproliferative and apoptotic effects  demonstrated by combined low dose treatment of ?-tocotrienol with other  chemotherapeutic agents may provide significant health benefits in the  prevention and/or treatment of breast cancer in women, while at the same  time avoiding tumor resistance and toxic side effects associated with  high dose monotherapy.</p>
</div>
</blockquote>
<div>
<p><span style="text-decoration: underline;">Milk Thistle and Cancer</span></p>
</div>
<blockquote>
<div>
<p><a href="http://onlinelibrary.wiley.com/doi/10.1002/mc.20595/abstract" target="_blank">Lung Cancer(Molecular Carcinogenesis): C</a>onsistent with these observations, silibinin caused a reduction in  kinase activity of CDK4 and 2 in all cell lines except no effect on CDK4  kinase activity in H460 cells, and concomitantly reduced Rb  phosphorylation. Together, for the first time, these results identify  potential molecular targets and anticancer effects of silibinin in NSCLC  cells representing different NSCLC subtypes.</p>
<p><a href="http://onlinelibrary.wiley.com/doi/10.1002/mc.20670/full" target="_blank">Prostate Cancer (Molecular Carcinogenesis):</a> Overall, our results demonstrated that isosilybin A activates apoptotic  machinery in PCA cells via targeting Akt–NF-?B–AR axis; thereby,  indicating a promising role for this phytochemical in the management of  clinical PCA.</p>
</div>
</blockquote>
<div>
<p><a href="http://www.sciencedirect.com/science/article/pii/S000629520900728X" target="_blank">NAC inhibits inflammation in Lungs from Bird Flu (<strong>Biochemical Pharmacology</strong>)</a></p>
</div>
<blockquote>
<div>
<p>Therefore, antioxidants like NAC represent a potential additional  treatment option that could be considered in the case of an influenza A  virus pandemic.</p>
</div>
</blockquote>
<div>
<p><a href="http://naturalmedicinejournal.com/article_content.asp?edition=1&amp;section=2&amp;article=235" target="_blank">Clinical efficacy of boswellia in inflammatory disease (Natural Medicine Journal 9/2011)</a></p>
<blockquote><p>A systematic review of data from randomized clinical trials  showed boswellia extracts are clinically effective in asthma, rheumatoid  arthritis, Crohn&#8217;s disease, osteoarthritis, and collagenous colitis.<sup>38</sup> However, of the 47 potentially relevant studies considered, only 7 met  all inclusion criteria. No serious safety issues were noted. The authors  found the totality of the evidence encouraging, but not compelling,  mainly due to the prevalence of methodological flaws in many studies.  The heterogeneity of materials studied should also be considered. Modern  extracts of boswellia are standardized to AKBA content. The most  effective extracts to date employ as standardization level of 30% AKBA.</p>
<p>In a randomized, double-blind, placebo-controlled clinical trial of a  30% AKBA boswellia extract (5-LOXIN), researchers found that the extract  significantly reduced pain and improved physical functioning in OA  patients.<sup>41</sup> Seventy-five  participants received either 100 mg or 250 mg (delivering 33 mg or 75  mg AKBA, respectively) per day of boswellia extract for 90 days. Each  patient was evaluated for pain and physical function using the visual  analog scale, Lequesne&#8217;s Functional Index, and Western Ontario and  McMaster Universities Osteoarthritis Index at baseline and at days 7,  30, 60 and 90. The cartilage degrading enzyme matrix metalloproteinase-3  was also evaluated in synovial fluid from OA patients. Measurement was  also made of several other biochemical parameters in serum and  hematological parameters, and urine analyses were performed to evaluate  safety of the extract. At the end of the study, both doses of boswellia  extract conferred clinically and statistically significant improvements  in pain scores and physical function scores in the OA patients.  Significant improvements in pain score and functional ability were  recorded in the treatment group supplemented with 250 mg as early as 7  days after the start of treatment. The authors also reported a  significant reduction in synovial fluid MMP-3 in the treatment group. A  later clinical study comparing 2 different extracts of boswellia  produced similar results.<sup>42</sup></p>
<p>Conclusion<br />
Turmeric and frankincense are two herbs with ancient medicinal usage  undergoing intense scrutiny and study for their modern applications and  mechanisms of action. Many of the actions of key actives within these  plants have been identified and described. Unlike most drugs, however,  even single actives in these plants (eg, curcumin) work via multiple  mechanisms, rather than targeting a single enzyme or receptor.</p></blockquote>
<p><a href="http://onlinelibrary.wiley.com/doi/10.1002/mnfr.201000659/abstract" target="_blank">Low Zinc is Bad for Bones (Molecular Nutrition &amp; Food Research)</a></p>
<blockquote><p><strong>Conclusion:</strong> Our findings suggest that zinc deprivation inhibits  extracellular matrix calcification in osteoblasts by decreasing the  synthesis and activity of matrix proteins, type I collagen and ALP, and  decreasing Ca and Pi accumulation. Therefore zinc deficiency can be  considered as risk factor for poor extracellular matrix calcification.</p></blockquote>
</div>
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		<title>How to Modulate Your Risk of Breast Cancer &amp; the Pros and Cons of Screening</title>
		<link>http://www.dr-lobisco.com/how-to-modulate-your-risk-of-breast-cancer-the-pros-and-cons-of-screening/</link>
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		<pubDate>Fri, 27 Jan 2012 22:46:05 +0000</pubDate>
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		<description><![CDATA[<p>By Sarah A LoBisco, ND</p> <p>One of the scariest diagnoses for a woman to receive is breast cancer. As an integrative practitioner, the labels that are placed on people serve as a guidepost which explains how their body has been led off the track of optimal health. With the emergence of nutrigenomics, the healing [...]]]></description>
			<content:encoded><![CDATA[<p><img class="alignleft" 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EnG3gXJu+Yl7l0Su3+V7/ZFdxd+fejryesn/duyyX+eN+kv3036y/Qp73/54QfTPv54+sdTf/zw3QUf/WXF55PWfznF+pupx+ZMu7nyR/tN8z1slgQfXJV0bmveDeuyh/vqnh9rcTnT6X25L/BmX/CtvrA7A+EPhmSPR2LsRuLsR+OfjyU7jqU6TaS5jWe4q7K91Tk+2jw/fb6vIc8DlARQVZG6miRdazEz1mtEtFHCFDRCDiMeQwZDaEJQEJAoIckEjVjEAsSEjgVAAkgCSBJNWBKxenQMA6qlMO/UxnV75/4YfO28PMxzKM1/KN1zKN17MO0tL+O8UUJmE8QmZDYxZgu2YJQEsyhgyYg5HvNGLJpNFGcYVql6R9RKrZ4xqxmzBhj1hEQaJJowcgDztBkSDKkx6EaVGFCYMIzVVuX7+XiePpB640D+TZvC27uL7tpUPNwrf3Wky+1066sjCvt9jXa29Q92Vd22Kr2yOf/cuuxTa3KOr8o6sDhj3+KUfcvi9i4P2rH48dJv9n/2zqo//WHtlD8tm/LO/Ml/nTn53e8+eP+bqVO+/fTjWZ98uOTT99Z/MWnbjKm2P3x8Ys4XN1Z+93LbQt+9K6OO/5x0YVvB3b1Vz442vDrV8vpij//NwbD7A+EPBiIf9sseDcU8HY63VyY5KFMcx1JcdHl+unx/fUGgvjjYUBpOlkdSFVGgUkZVRMD6eNicSXeWCsoODHVYEATeREEjLWDIYYIy0rRRFLCRM0ECcbRgFjALjQY9ooHAsWaWMXGMiAhaJIjxVvm9owfWTvvQ9/LJwXTZQGrwcGbgcKbvcKb/UIbP28Y2ITOGGCMz5kwm3ihJkmAWOSyymGOwJGBJMgGg6hvolTeP9wxAAmmhOIFMWtpkACaCMgHKTAMMIR4d1QOaI0lAafVGgsAEOd7QGG9/P/HagfSLW1LObcy5vq3g5o6KR7vaXh1rst/f8GR33SOb2nvWFTe3FV/amH9uXe7JNTnHV6UfXJ52aGX83uU+m2bfnffZkc//5/bJ/7p+0h/XT/3ryqnvLpr67vwPJ839ePLcTz+c98VHS76YuuHLKTunTz744ydn5n15c/m3DpvmBe5fHXdqc/oVq4K7tjXPj8tdz7d5X+kMuNkf8WA49tlQ3LOhuOfDiQ7KFMfxVNfxDPeJLC9VtjdRGkqUhJPlMqoyhq5OoOuSYH0ybEijFRmGpkzQUWoc78BQg3lk4jiOlSBrAgwmaJOBlBAySyLmGSNpoCHN04AjCQQonuewwJoQyQK1wUzSmKbdb1+3mj3D49KRruQgUJkynBGkzAkZyQ0azgkczgl8y8u4ZGJMmDFhzoh5o0mSpF+kBYQFGkuMERjGejpaa6q6mhoMylGJ47U0o4aCjjaSwETTZpo2A2AigWlcQ+soVkfSFEXTGr2oI7BGr6kuzX9yrvzhgZxrO4rv7Sq+Y5NzbWPNw93VD21qH1rXPdhZfduq/PqWkosbCs6uzTu5Jvv4mpRDq6L3rvDZNPvBvE9PTPuLzdQ/7vzkHZuvP9jw2aR1n01e9dnk5Z9NWf75B6u+/Gjt9E83zfhk94wPjn7/0fk5X9xaOuPZuh+9rRfFHd+YfXlHyZ091U8PK1zOtftc7Qy63R12vz/Wbijp5WiqkzLNdSzdbSLbQ53joykI0BQGa4tCDGVRRHkMUZlA1iSBulTYkE43ZgF5LugoHZcXGrrqMDWGjQgzkAE0gwSexwQQtQaWgkaOwwxjooFAA45CnJ6CBM1wvElgTQItmmgRQx4LUoa/n828WfbHdg/lRatLY1QFYYayqIn80In80PG8oPG8oLeOzUuYl7AoYcvzDyxwWECYp7FACeSEsqdZXlXcXFc2MdTDAgPHIi1FaWmGpAUEJYY2QWCkKNFACRoDq4cCAVkKQM34BKPTY8RynS2pd442OpwqvL27+N6u0nu70y+uLb21vfL+zopbW8pvbi69uqnw4vr8M2tyTq7MOroi/fCKmH3LfbbMebTg80vfTTn97ZRj307d9+1HNjM+3j794y3TP9k4/eON0z/e/M2n277/wmbWl/tmfXHqp8+vzZt2f+m3z9f++Hrb3MgDK7MvbC+/u7fe7ojC6Uynz7We4DvdEQ+6Yx73J74YSnMZy/YYz/FW5flqCgIsKzZRLjNUxhoqYw1VCWRNMlmXDhoyaXkuVORRLUWGrrrxjlpiuAszBmzijYiGJMVAludMBMHq9QghM8tiihJJUqAZox6xBpZhJbMoYQR4CQhYxJg3DVbW7F4wz+7w7v6cmImiGKIqTlMWosz10RSG/prgt92NmyQRGy0jM8GEeQHzLOZpzFOcdkTZo1DUFDZW5w/0yCnDGMPoaGjQEzqCIhHN8FAQocTRAqB4gmA1BIKSmeZErc6gUo6JFCD7B1PdHB22Lyx/cij7qlXS2bW517alX1xbdtuq4t6OvAurc86tzD69Muv4svRDi1P2L0jesyDedlHwjgWvVn9/c/anF3/86OLcaecXfHNs9te7v/9s1w/TrH/4cucPX1r/8MWumV/sm/31kfkzTi+ccWfZd89W/uC8YY73toURe1akndpYftNW/vRIu9OZbq/LQ6H3h6OfDMY/60t2GMx0Hc31UBf6awoDdcXB+rJwoiKSrI6lahKo2mSyPoWoT6UaM4E8FzbnM63FbFsJ6KxSdzUZRvt5Uo1ZgHnGLLAiy7GIoylIAxbSPIQSABJJChQlUoykRsggMIzZhBiOoVjMY0xwakXH46PHL23e2JIQITaXDueGwPp4Q3XoYKarvjhYXxSqLwrVF/9nYWMeY17AHIs5CnMGzOnU3Q3ttYUNZTndLTWaiQGKUgNaDxGhN6gpUsfSQEC8gESGFgDFGwwcZDEFRZ2eovQGpNVxKlVNSsrp1Yt9D2+YkD1vcbuYfmVbznWr1HPrsy7+nHpqRcqJZSlHlyQfWpSwf3687bwYm9myHTPDrWZ7bZz9YvUPdxd+eW3O55fnfnlp/vQzc78+9tO0wzOnHZz5xcGZXxz68bOjP007Ne/rCwu/vb74m5frZ7lv+snPakHonqXxR9bkXtxW9+hQm+PpHs/L/UG3RqPtlEkOw6mOQxnOw3keY4V+muIgbUmovixcb5Gui6cbkkFjGi3PBIps0JJPtxWjjjK2q4Lrrqb7mkY6mxGpx0ZBYiGPIDabsBmziNNrDRwjCrwJUKxOB0mSg9BEInECQB3HAY4jCEqAHBZNZE9/srv71m+/rgr1ISqzJwqj2aY0XUXYUO5rXh5rKA01lIRY8raXcUyyZlbCRlHCHI15Ags6rO9j+uoHavK6qvK6GyqUvR2UTg1pCpCUQa9lEMkwBohICBkABBKYSGAmAYY01qtZMzLBUTXWk9rG+mMrllxbv6g96Hm904U6x/ONLpdKHh1Ku7w16czPscdWJhxblXRsdeyBpeE750TunBu3Z3G09Ty/jd+5/fyT489zHdb+9Gz1j09W/HB/6bd3F39ze+H06/O/vD7/yxvzvrw5/6s7i2Y8XP6D/erZL9fPCrCeF2Y7P+bosoyLG4vv7ap/cbTF7UK7z9W+0Hv9UY9Hkx1UWe6aQm9dSYC6NEhVEqQrj9BXyIiqGLI2jm5IpOXJsDkdtmSJfSWwo0DfnG9oLUI91fxgEzcgJwfaONLAQFbgREkwGkWTwIks4mjAAoqxhAYsDTgacJDmKSiO65EasEaMGYgwhKJK2ZGfcWTlvEy3x0PZEbi1QGhKJ8pldE0MXRenrwzXlodqy0MsedvdOGbMGElYEDjMk1jSYWYEjynItuLh6pyuitw+ea1+dBgRFKUj9VqSIkgGkQjpaURSiCGgQNBmAmCCxFqVCDQ8ZjAmGbazy//6lX0zZ8TePtMT/rLV+1aj27VapwtV9qdqXpyqtj9RcMs25cymmEPLg3bMDtg6U7Z7YeLB5XF7Fgdtn+O1dYH7toVumxc6bZzzcu1Pz1d9/2zF90+Xf/N4yYzHS762Wzzj2dIZL1b84LR2lvvGBV5b5obvWSA7OC/x9PLs6xtLH9vWO55o8bzU5n+9P+rxYPyz0VSn8dzXmgJfTYm/pjhwojhQXyEzVMYSNbFUXTzVmEgrUmBrBmjN4nqKQFehoaNI31lG9dTBAQU73EaP9PA0zTIizxlFwSzwJo6VIM1RJPpbbJYGLKQ5GvIUwhQycbwJmzBGAA51O10+7nvj6EhuBF2bIjSlUxXRmqIwsiKaqonTV0RqKkI1FSGWvPUGTcCYM2KBZ7EIsKDB2k7QWTZWlz1QndtTUzDW1cISeh4xWrVOPaGDACFIQkTQCJCQJWiJoM0EhSkSszQGEwjrOXZgJNfHe/fMGQ+s1jWHuvaEv2jzu9XidbPR/VKV/Ykq+xMVdkdzr+/MuLAlYu9Cr43f+G/9IX7/0rRjq1IOL4/ZtzR41zL/Xcv9dy73slrksXmB24bZLutnO6+b6bR2ltPaH53XzHJdP8tj43w/q8XBNqvC9qyIP7o8+dTyzMsbiu7urH5+WOF2ttPvelfw7dH456PJDuMZrhN5Hr/HNlRGE1VxZG0CqE+im1JhczpqzYbtOagzH/aUwt5KqreK7K2jBuTsaBerGjayLM8ZBd5kkUaQBxRDGOh/lLZgQw4jDkOax0YTltjimNAL21e1pQbjngqpJRdUxWuLw/WlkaAqlqyO11ZE6arCdVVhlrx1bAlj0YyxUcBGGpPDoKtaWZs1XJ3VU5E1rKgix4aNiOYg0qp1WrUBkDSEgEaAhIikOYKWCMpIkSZAmjCHGTXNjWpq4hPPrl99cN53ha6P28Odu8OfKbyuyT2uNLpfKHlyOO/u7oK7tgW3bZLPrA+znRuwfWbUvgWpJ1ZnnFyVfmxV2sl1sv2rw/evDrVdEbhrqf+ORd7b53tunvN682zPzXM8N8/x2jLXd/uCIJul4XtXxRz+Of74z5mXNuVe31R8d2f10/1NLqc7fK/0htwdiHyoSnNSZTirs1+r8j3Vhb6aEn91aZC6NJisjrVIg8YU2JyO2jJRRy7qzAedBUxfOTNUDwcbyP4marCZn+g3ERosSJKILdIMEmjAkgS0YP+dNKQ5BAUABISMAhKxwHMTQzcOWcte3gHyfNxVTNcl6UoiqMoYtj6JrkswVMfpq6INNZGGmghL3vq4VDRjEzZjM495Eo20DtZk9ZYlDdfldFZkafvbJECKCEGCJg00aaD1egLQiISIgCwBOQKIFGUEpBEaBJHgMc2PNchfnTu9+auPPE7t7YjybAl26A61a/W7Lve4VON0qsL+aIPTabnz2Sq7A9FHlsoOLkg4ujz7ws95Fzemn16ZeWp17oVNsYdWyQ6ule1fHbZnRYjNEv8dC/23z/fZNi9wx8LAHQuDrReH7V4m27868djG9DPbMy5sK7tvW/F4T93zQwrXU50+VwZC7wxHPxmJf6bLclNnv1bneqnzfTRFAbrSYF1FqL4ynKpLBHUpsCENyjOY1my2PZftKmC7C0FXMTNQxY7I0UgzGGqBo91GnRJDCktGScQ8Z2SQAGkOUAxJQJKAfyeNIG8JpDgWcFgwmikyzsft4q6N47XZqKUANKZrymWa0gi6Lo5pTDZURmsrosnaOEOdzFAfZclbfxAiSKLZJGARivoRVXtVd1lKd1nKSGNBf30xnBjEPMtBRBpoCFgIWJ2WJCFrkTbQPAFEihCggeN0DIYSPzoe9vTJjh9nXF63qMrnRb3v0/5o57bAez2hd3uC7zS9vtDkdq4n8EaTy+n4s6tiTyxLPb+26Ob2irs7S25szbmwLvfc2vxLm1JOrEs6ti7hyJrYgytl+5aF2y4OtVkQbD0/Ys+SyL1Lo/Ytiz20KvnEz1nntxVe21V827bx5fFGp+Mt7me6/C4PhN4ZjXk8lvRiItVRn+upzfXU5HmrCny0xYFERRhVGwUbYumGZIs0asmySHM9RWxfKeqvRIM1cFiBlG3MWC+nGTaTaswiLBkF3sQyokX69wX9j9IM5I2cyQh5zHG5DK4AACAASURBVDBjHc1Ht65N9XkF20uBIhspMomaWH1FJFUTQ1TFqErDNeUyuiGRbIghG6Mteet30ExG0SxAnhjT9clHGgsGqjMHa7L66/LHu+RIN2FkWUQzFAFpwCGaIww0AQU9FAw0TwCeokRAcKyeEXU0PzaR6uO9f/Gc/fO+TX5ypTPavdbrwUi8c1vgrY6QmwOR9zuDblQ5Hit9ujf3rlXs6RW5N7aW3t9Z/Wh31QPr8tvbS29uLb6yMf/C+twLW7LPbs48vTHtxPrko2viD6+M3b8sev/SxKOrk46tSTmxLvPspvzLVuW399Q+Plxvf6zN40K794Ue/+sDoXdGo+0mEl9o0py1ma76XE9Njoc610tV4KcrDqaqIpmmeKE5FTWmM02ZSJHFtuZyHfl8TxHbV8r2V7DDdXCwjhpS0KNtnGbYRKkxojDHSILR0pQBiqFIRAMWQd5i/7vVm0eQZ5DAIs6EBAxZTj0e7upwbd82fUupvjGHlmcau/JZRSpVF0vWxpC1cfqqaKImnmpMpBrjqcZYS97+HTSziFkDNdo1rCgZrMsdlxcq5UXd1bnESA/UqTmIEOQBxQKKpSmGBhxBSzraaACiRRoZGF5Hm7T6poz0o6uXbfzqA9+LB/sS/ZoCn3aEPuuJeNYX+ajJ52J7wLWOwOtZ96wCj8zPvLml0/dSjf2+uhcHau1sS+9uL79rVfPApvLW9txza0uvWpVc2V50aXv++U2ZZzaknVyTcnxN8rGVmWc3Zp3fkHNhS+G17eW3beueHGx2ONXqfKbL92p3wNX+kNtDUQ/G4u1Vqa+0ma66HHeL9ESuj6rAT1caQtfI+OYkY1sG05SBFFmoOZttz2O7CrieEra/gh2s5pVyMNhkGJBTo12CfgwjArPIyLICJ77Zqi3YLCMKvOnvpC3YPOR4jR5DSPZ2HNqwLN3PyTjURCpyYXOmqSePa06hG+JhYwLfks63pNNNqUR9PGhKAE1xlvyHYRv/2QdLPOaBqB8Z76juq80Zqc/tq8zsrcnV97WIQM/SgAYsoDmK4i3YgGIBg6GAR5QkIEWtUsdqKFGlI7u67E8e2TL9k2sbFlf5PW+PcmkPt++PeSn3u1XndaHR92Kdx9kyh8Olz/dXOR6pczxa+fyAwvmY3Omo3OFgg/2+uie21Q9tKu/uqLq9o/qOTdXNnWXXdhRf2VJ4cUvhpU2FV7YVXd1afGNH6a0dFfds6+z2K14cb3c+1e12odvr8lj049HYJ8o4u7Ek+4mUl6p0R3WmiyrLnSwKIIoDiNIQqjIcVEfB2mhYH48akpimTCTPQc25TFs+01GIeopRfyXdXwWGGuiRFjTRw+pHRaA1MbSZ582iBAH6hy6MR5DHZmzQA8sXUTAzSGCQYOIEo1aL9Wqfh7eu7N4IO6u1DdlidxHRkEQ1xv+KmkDLk2l5Mt2UChUpdHPSm/wnYJPsWOdgQ35/TeaEomikPn+osVg30C4AAtEQ0BxJCwT4DZtm8ZgaIYQ1EyRnYNgJDa8cjXF8sX/RrEs/L4y6faJD5jaQ4N4Zad8V8bQz7EF76O3mwKtNPhfrPc/Vu5+pcz3R4HJC7nZK7nJS7nS06eXhxuf76+321DzaVX3fuuqedfWdnVU3d5bfsCq9tq3k6taS69vLbu4ou72z5uGe2if7Gu0PKRyPt7ud6fW+NOh/bSDohjL2yUi83WjC07GU5xNpr1QZzqosd1XOa6I4wFASSJSHkpXhoDoK1cXA+njYmATlmVCRg1rzUHsB01WEestQXxU9UEsONlLKNqgZECiNEQEjhySOFzjx39ueWUY06AFFojdHcJYRRYCwQauqr7y1Z1v0i7ua+mzYlk83Z7JtGW/KFzTF0fJEWp4M5Wm0IoX+nffbXcaxyGI4QfTU9lQkD9ZmGNpL1S1lY63V5GgvR5PQIk1LBOApwNIUQ5PshBrRCANS5IEgEjQ/Nl4YFnx05YJtM6aGXD/WGuXSF+c+muIxmODcJbMfTnQYinvWEXanNfBGR8jt9oAbcs/zzR7newKuyl1OKpxOKByPNzocani2v85ub+0j29qHu2vuWlff2lF5y6ryllXFnR3V923qHtnWP9nb4nCk1fFYu9upbu/zAwFXRkJujEfcGZM9UMbZjSTaK5NfjKW+VGU4q7JdNTkemjxPfXGAvjSYKAsjKyMs4yrUkICakpEiCzXno5YC1F4Eu0pgXwUcqKYG64lBOTXWyRJKI0OaBFbkBcvG/E/LGkHe8k/LdIVjJcu+zhoIrFOlub24tHHlQF6cpjqVbs4y1CdyHemUPI6Sx1LyWKCIB4pEIE+mFb9gg+YkS946Nj/RPdFc0FeeONaQZWgvVbWWaXubWMMES0MK8gQt6aHJAMRfsClGrUZmMx4f0kkUj0VTT1nJiXUr13/2/pPd6yu97QaTfTsiXw4muY1neg0lu4yluw0nOvRGPeoKvdcVdrcr+E6r37V2v+u9QTflrmcUrqcUTqfkr47JXxxpen6w8enBRrt9dfd31d6zqb1nU/NgV/3jPU3PDrQ4HGlzOt7tfqbL42yv78X+wKvDoTeVUXdVsQ9VcU/GkuyVKQ5jqS/HM51U2a7qXHdtvpemwFdfGmwoCyEqwqmqSFAbC+vjmcZERp7GKHJRSwFsK0Sdxai73FLW1FCDYbgZqPoEWo1F1mySRNFIQ95AwH/aiDFIYBnRZMSWXwOCPGGgacAaaWhorr+/a1PAtVOMvIhR5Opq46mmJLIp9lfpOKCIA4pEWpFCK9JoRRpofgvY4j/7YAFqOmvG6jOUdena5jy1Im9MUUyOdJo5gGiGRKIemnTQbAAiRfE0BWmKEXkMSJFU0eSoBmt0ThfPr/lk0v6fplX62nfI3PrjX/fEOg4kOo9keIxmeigz3Hpjnw3E2fdGPWkLvNXmd6sz6HZX4O1Ov+vN7hea3c62uJxrcTrd+upU88tjLQ4nml8cbbTbZ0nT0/0tLw63Ox7vdj/T43W+2/t8t+/FXv/LAyHXRyJuK6PvTcQ9HEt4Mp76Qpn+ajzTWZXtqs311BV4G4r89cUBhrIQojyUrIwA1VGWsmbkKUiRzrTkoZYC1F4Cu8pQTyUcqAZDDdSIHIx3If2IyBqwUTCbzbxgIgCv0UMa8n/XhVnCc0azCUOas9S0VkNwrIRZNsvL5fSSWR0JwVJrsdiaR8uTubY0okEGmmNAcwzVHAda4kFzEmhOoVvS6ZZ0uiX1Td469lB9nrImRS/PNrQUjNVlTrSUsuoBzDOQ5kho1EGzDpoNwGjBRiRkoXFiWI9ZjJSasJcvN3zzpe3M6cHXjo1lhvXHe44ke6qy/QZT3fqSXYYy3AdTXbujnw0lvOiPtm8JvK3wvdEVdK8n+H6Hz/WW15da3C60uV1odT3f4Xy+3elMh9OZdsfTrS+OtTocaXU40vryaKfzyZ7XZ/t9Lw0GXu31v9wbeKU/+Npg+M2RqDujMffH4h4qk+wmMn6raV2Bt67Y11ASaCgLIspDiYowqiqSrpHRdXFMY+IbbNhWyHSUou5yprcKDdbRw41gpIXXDwpgwsgBk1GUjGbEGQ1A1OgZ+lfm30uzjGjxtuzZCPIUiSQR64aG7tpue7ZrA1eXZ2wtpGtTcH8R05KEWuJAsww0y0BLLGiJBy0JdEvqr9jp/3nYA9WZ4zVJhDxL15SlrM0gempN5IRIkzTkDMisg1gHsY7+DdugAkCDOC2sycxd9923W7770umIbVec/0iy/1iqnyrTV5PrN57jM5jm3pvi0p/qMpjoNBT/si/qeWfYo47gBxbs3sB7ra+vtrpfane71O52qcv1UpfrxS7Xi92u53tcznY7n+lyOdPlcqbX/fyA9+WhgOsjwbeGQm4Nhd0ejrg7Ev1AGftoPNFOlfxsPNV+IstxIsdFneuuzfcwFPkaSv3JsmCyIuQNNlUTA+sTmcZkVpHKNGewrfmoveRvsEeayNEWE1SZWL1RQKLIs6IJsEYDMGoJDiLhH6Ut4TkjYaBZRkSQl0SMIJ8mkx1a9FOJm51ZUSQ0ZlE1CbgnV1cbAZtjf49Ntya+wYatGbA1zZL/T9jGX97bE/4OWxItV2ZYzBEjNanq6nhdY+p4XcZwXQ4c6cA0SWn1kBZJaNbTWE+bDcBoacgRyYgkhyl+oqXzwk7rFZ9NvbplTbGX/UhGUEe0sy4/SJXtM5Tsos73V+X796a4DKS6KdNfD8a96pU9H4h26I16avEeirRr8bja+vpq2+vLHe6XO90ud7pd7nS/1O12qc/jcq/HhZ7X57s8zvd4Xez3uzoQdGM49K4y8qFS9mg05vFY/NOJRPuJlBfqtJfqDCdVtqsq57Umz1NX4K0vDiBKg6jyEKoylKwIIyvDiepIUBtLNyQy8hTUnMo0Z7Gt+WxbEdNZhrormP5aMNgERloNyi7ME0aBFgWO53nISgBJJC0ZKAFBgYE8A3kWCeybsmZFUcKSEVMkYiDLABqbTKRq/MnF04cXfa8vSTQ1FxCVCWxTGlUXqywJ1NVGgOYY+reyTrZgw9aMX7Ez/t9gi5LltVvJKAlmkbPEKAkmMxYlE8eLGGMTj7AIsQgG67JHKsLHyoP0ijRlfaaupwnTJE8ihhQgaSIN0ugICYAJsdgAjEjChI7GagKPT7hfPL/qo/cOzf+21Pf5RGFkd5KLutBfXeiryvMez/EczfYczvAYSvccTPMYSHQeSHDsj3foj3neK3vWE2nXHfawN/Rhu9+tTt9bXb43enxv9vje7Pe91e93s9/vZrfv1R6/a30BN/qDbg2F3h2JfKCUPRqLtlMnOqiTX2pSXqnTHDVpztp0F12Gqzb7taEwyHLNw1ASQpWEgNJQUBpKlYeBqghQHQnqokF9HC1PtjzKRK3ZfEce31nA95azfbW6jpqJjgaoVWKzyDIQMRxiBMQIiBEZJDBIZKHI0ILl9S2O5jmaZSAPEQ+QQCJRraNFCXMQmWgKE+rGzHirWZ97XNqtqYwj65P0NfFCRxZRH083J6HWFKBIBIpEyxELNqeiljTUkobaMmFrBmjNAK1ZoDXjfw9bNEqihH/F5rDIYZF9g80bMceLGJswh7AEMKsdrk0dKw+aqPDXK1KUTbnavnYjRAwp0JQJkCYGYJowUoQEgElHilpo5Bkj1hAVvj4230zb/f1nsntn2+M9ulNejxf5q4v9VEXeqgKv8TwvZbb3SKb3ULr3UKrXQKLzQKJTf7xDb+zzXtmz7ki7nvBH3WEPO/xvd/jf7va/1eN/q9fvVp//7QH/W33+t7r9rnUHXO8NutkXdmcw8v5I9CNlzFNl3DNNiqMqxVGd6qRJc9amu+ky3HVZr3XZXvqiUF1xuKE4jCgJB6VhoDSMLgujysPo6ki6JgrURdMN8bQ8mW5JB61ZdFs205otdBUKfRWgu1LTVWcY7uYpAzaZESPQjEgzRpoRGST+Mg6DFmmBBwIPLNgsRALFCBQyUYwEkcABiGkDJsbS3J4dXPhVvu99viOLaU0nGxNRS5q6SkY1JVFNSUCeDOTJlrOWBZtpTUdt6bAlC7T+kv8wbKMJc5JZEI1msxHzDJYABuODVSnjZcHq8kBtU8pES6F+qIunEaRFAEwkYaQIIwMwpCQIjDRt1BKcCMWunNxj8+eseO9Prid296eFjOSE9Gd4astD1MV+6mI/VYHPeJ6PMtt3JNN3ON1vOM17MMllKMl5IOFlX9yLvmj7nqinvRGPe8IfdQXe7Q661xt4pzfwTn/Q3f6guwOBdwaC7/YG3ewNvd0ffncw8v6I7Iky7tl4wvOJxBe6NGcLszbTXZ/tYcjxJHK9DLk+huIwfWmkoTScKIugysOp8nBQEQ4qwmFNFF0TRdfHgKYES1nTbdmwPYduzuS6ipmeCkNnJdEvFw3jmEMiL/x72Awt/K64f8OmWSxiTBggS9GYoYSRrieHrW5sWzRWJsNDJVx7JmxOBfJkVWUUrUghGxPfYL8p67eILUomTjJLRrPJJGGBxUbaqB3sL0tUlYZqyoK1DSnajnJyvJ+lIQVFgjZp9bxez1OEAClBPa4ndDTPmNX9wzd2Ws374//5dM+Wtjj/0dyI4ZxAsjp6JM9HUxyoLgpQF/pP5PmN5QSMZgaMZASOpPsNJbsOJ7sMJr56s5L3RT7pjXjcG/qwL/ThQMj9gZD7Q6EPhkIfDIfcHw57MBR+bzDy/rDs4Wjsk7F4e1WSg2Xp1me66bLcLMxknjdZ4AMKfIlCf6IswlAWRZZHkuWRoCKCroyEVZF0dSSqlVmmZpaLR3RbNt2RAzvy6LYc2FEEOsuovlpO1YtZAxZZgePfYP+6hv8eW/pbbB4gAfJmCWOSQAIFMKLaclMOLf4+4MZhti1H7MoB8mSmNR3Ik/V1cVx7Jq1I+ceyZlrTmfYM1JpNt/2S/zBsXpBY0WQyY0kSsMhhE2SUXT3FceqSUH1ZqLo2heytg1olAIBgJB0yjekYwJgpkgF6Wtk7hDQkp0eRbq9/+vO/Hpr7dXO0j74iZTg7RJkfQlZHD2Z7akuCNMWBmsJAVX7geE6wMit4JCNoND1wJNVjJMV1KMlxMPHVQOyL/pjn/VF2fZFPBiKeDEQ8GYx4NBT5eCTi8UjEY2Xk49GoxyPRj0ZiHivjno0lvVClvtJmOOsz3fTZ7kSuB5nnSeX7UIW+oDCAKg6ExUGgNJQsjzRURpOVUVSVjK6KgtUyWBOFamVMbQxsiIWNv5S15S4K3VWIuksNbYX6zjJurANDNeaBiWcslY0Y0ZK/xZb+Dtvy4jUjYl7CHCNKNDTrVKHP7uxfML0q1JFrz6WaknS1saglDTanUk1JbFsG2Zj4e2kLNtuW8bawOV5kRZMZY1HkscRjEyT6mzsLotUl4fqy8InqFHqomSVVeorUc5IKieMUC3izXkdRWr1IUBiyNek5iz/7fMuMj1Je3FAVx/dnBuorYgyV0UPZPqqSIF1psLYkWFsUoi4ImcgNG8sOHc0IHU0PHE3zHE11G0lxHkpyHIp/ORD7oj/6aX+U3bDs2bDs2YjMbjT66Zjs6Xj0s/GYp+MxT8fin1oeaajTHHWZLoZcdzLPkyzwAgXeoMiHLvYHJQF0aTAsC0HloXRlBFUlI6piQHU0XRMDq2WoJpqpi0Z10Ux9rGU++svFo4482F0Ee0pRX5Wuo5TsrTPrB7FAYQEKDM3zPIP+HptF/y42RDwnYshKIi+ZEVS1Nt203fJwzwZ1SRzflk02Jurr4iylDOTJVFOStibGIv2mrNm2jLeIzXKCBVsQOGwUsAlquhra86I1RRGGEtl4VSoz2s5Dg5aitLw0wYh60aRHLCAppNVgllU2NFy12f3jv/0x7P75kdyI0fzw/iw/sjqWqokZyfPRlofqSkN0pSG/x1ZmhikzgpXpXso0d2Wy82iS01D8y8E4h4GYZ/3RT4djnw/HPlfG2Svj7Mfjno/HPR+Psx+Ps59IeTmR9kqd4aTNcjHkvCYLvECRD1XiC0sCLMx0eQisCGWqwpmqcFgTRVZHEzWxVE0MqI1FdTGoLoapj2HqY9iGONSUCH8p61zUWYh6iunecrK7muxvYsc6zdQ4FigssCLLQAgZ9Ftx/4otsFD897B5CbOcxEFkgqA6PeHYugVpjncFRY7QnsO2ZVBNSRZv1JJGNiaSjYkW6b/DZjsymbYc2P5L/sOwGZZnBKMZY55nLdgT7bVtuTJVkcxQFjtWkcqOdQssUFGkVjCOsTyDMYEQNomMaozo6fS/f3fWn/9012bLSEGsriJuOC8I1CeM5vnryiNQY9xYob++LFRXGqYtCtMUhE/kho3nhP0eeyzFZTTJaTjh1WCcw2Cs/UDMs9F4h9F4h7H452Pxz8cTXownvJiIfz6R+GIi7ZUqw0mT5aLLcSPyPcliH1DqB8r86dJAUBZIl4eAilBYFY6qI5iaSFQro2piyNoYUBsLamPp+himPpZtiEWNcUxj4puyRu0FsKsE9pSCvkpNZw1UdkqGUSOtwTyNjbwocARB/O9iS0bMCyZKbzDRRKr/62Or53QlBxlb84X2HLErh1akqCqjqKYkviMLtaQJndlvpN9gc+2Zbwvb0qAJotFkkjCHsECOKCpac6JH8yJHciNAeyUGKgZRGgBVrDAGWT3P60iCI/XkYFdtUvT8d/9kO+u7ocyEiaIYVWm4uixCWxGhr4gkqiPJmiiqVkZVycjKKENppLYwYiI3bDQzeDgteCjFbzTFQ5nsaqnskUTH4YRXIwkOw/EvRhNfjia+HEt0GE96aTlT6dKcNOlORL6nodCLKPKmSnxBqR9dHgArgumqELY6AlVHoOoIWBMBa6IsoWuiqLpYsiEO1MfRjbGwKY5pirfE2JGJmlOJhiR9UyrVmgu7SkBXqbajXD/YIlIT2ISwEZl4ZOQZjkUAgF8HZL+04m+wKZIDBIdIlqFYFjAs4hgkMKyIGIFleQFCQae2O3vY/fIh3FlubM4BjSmWs9bf5ZeD9ZvW7Nc9m23PRR25qCP3rWO35EQPFciGC6NBVy2mNQyiNQCqGH4cshMEZTSKnH7C0Cnft3T2/Hf+pSrgtaowUVUiU5dFaMrDtRUR+spwCzZZE0VVyYhy2RtsZVbIcHrgcKr/aIrHWIqbBdviPZLgMJLgoEx6pUx6NZb8cjzllTrVSZ3urM1w1mQ6Gwq9DEXeRLEPWeILyvypigC6KgRUhfzKHEHXRtCWY1VNFFUrIxviyIY4qjHWgo3k8YwigVEk8O3pqCWNkqcTigyiNR90ldI9FYbeOqgZ4oHGLEBsEow8gyCAEDIM97/ApgiBJnmGYlnAsYhjLRNTToIAcQCAscFr+7aluTzEHSWiPIOWJ4N/lv//sRW50X0F0SPlyXS/3AS1CNFaGmkhr6UZggQ8JM2Gcb+H16b9H3/wungI1uST5Sma0iiLtKWyDZVRRJWMqJKRFdFvsFV5oWPZIaOZQSPpfsrU1+Op7mMpLr95J70cSXo5luo0luo0nuY4ke6kTndWZ7pos1y02a6GIm99iY+h1Jco86MqgkBVCF0dDmrC3zBTtW8iI+tkRGMc2RRPNsWCpjhaHk/L46EiASoSUHMyasmg23JAWx7RXkR1lTH9tXC01cwQHKQEhjYZeYFnSZKkKEoQpDej77+NSBGCBRuCN9gcy/I8ZyQNFE8RPfVVl2029udFm1vypaYM1PRfFVueF9tZEK2sz4bKdiPUI4T0gNEDjgAspTcIhLY5L23pp3+5snkRasjrSw6kKhJ15VG6ykhLLNiWEOUyQ1mUviRCWxSmyg8ezw1UZvsrM33G0jwm0l6Pp7qOpbj8Qp78ajT51US6y0S6iyrDWZ3pos120+W463PdtXnuhlJffZkvUeZHVgaAqhBQE0rXRsC6SFgXCeojQZ3MEqpeRtVHE/XRZFM80RRPyeOA4g1zImxJppqSUFsm21VAdxZTnSVkTyU/opA0fdgkCILAsizLshBCkiRpGvG8+P8Mm3mDzTIiMBAiRaaE+L66eFTqrBQbs4yK9P+62I15sc0F0WOtxYymj4cGhBBJMQTB0hQDNVo4MnB227pdc79qTfTXlyf2p/jR1QlEVYy+KsoSQ2W0vkL2S0oj9aWRuuJQbVGIuiBIlR84nus/keurSvdQp3lMpLlNpLlZyJUpjsoUR3WmmybL3cKszXuty/fQF3joizwN5X6GikCyIoiqDgE1obAuHNVHwcY3wL8xE/XRhoZoUhFnUMRRzfFUczzdnABbElFrCmpNoZqS6LZstrsQ9pTSPRVosM6s6sBgDJtE0YxZTiBIQJAAMRzPiwzD/ZK/lWaQkST/DpuxYCPEMoBmdNoX1y/mBbrjwQa2NtUkT2fkKb9cNvrb/JfAbiyUTfRWcuQohwwIsRTJkHqGJVkTAWLdnRd/9NdUp/uGyuTuZG+qMg7UxpO1cURNtKFaZqiWWbB15VG68ihdSYSuJEJXHKotCtIUBqoLAlT5/up8P3WGpybdU53xWpXubvEeT3MeS3XS5Xjocjz0ua8NeR76Ak+iyJso8iJKvMmKIKLyN2m6IQI2ymBTNGj4JWRjNNkQYwnRGEM1xxPN8aAlAbRYpJNQawrTlgqa00BrFurMR71l3GCtNNaKiQGMNEajKJgxzYk6kjYAJIhGSTIhxP4vsEnyn2MLDKvs6bp/5uhIZbapq1KoTxUbkv7rYjfkx9YWRquHG0Sk5hCJEAsIhtIikeQUBUV7ly1+uH+HqjRlolimLZNRNXFEVQxVZ/GONVTHGCpjdeXR2rJI7f/N230GR3JnB4Lvu4j7uBu7txe6uNNFrC72YrV7Cmk1K4VOGu1oNIbkOFKc4ZAzQyMOvW3apmvDZrO99wZAN7x3BVvw3hQKKAdUFVBAoVAob9Jn/m1mVv3vQ6KLoGlqOIqYjhf9AY1P/auX+TfvvZqqy4/X5Mdr8mOVFnZurDw7WpYbKcv1Xcv3Xsv1Xs7d9U73nE91n8sPXuWGrvEjO2tvafyGNHlDnLopz96R5yulhSrZWa0u1QN3I/Q0AU/Tl5mtKGGrK5Z0B/R3QX+X1a6n+Ie09Wkz4WX8BlNjDHO6acjE4AEWVAiIQQtMNwoQEQu7dI/5L2JTrOsIO8ZGLh16XwnMA88Q89nhbOMfDtuw2reMgjXgrKhTpuOiTk3dMIwC1U1dN4s72PK2d25xuG1utCOXWNOhhFWJqAjxAGYlJijvPfH4P/3FnwY6a8DSgOK0KQvN4lxDdrpSWWyzvIX5JmG2kZuuz0/V5SZr8+M1+Ymq/Njt/Njt/HhFbqw8N3YrP3or33+V67+a77uS672Y6bmU6b1gva25oWv88PXPpCduylM3pekyZa7SSmtlsQYuNVjY0NtsYSu7sK2/rZxWfB3qcqeV08DfAwP9anBAWBnIrwxLGw6aDTE1xRDHiKwbhbwKc6KqYkMvMt1gmOhUXPJfJAAAIABJREFUN++BvfPOVmSiyRioOws0DAnTzYKm9jfWdN46D4Iz4kI3Wx3lJ6qRt6t0frI77okdtIOgHQQHtcA3vAgxdubYGbtHzloBZUABYQVmQMh0wkyUXPNO9XU6J6eQDBhhugSNvKxtJViWC48Of+eP/1dn3Q3oGsxPN/Nz9fnZKuhtlRcbuNk6brbhs1f1TJ04UyfO1AmTNcJkFT9RyU3c5sYqciNl2eFb+eEbeftlrv8yb7/C2y/xg1eFoSvC0BVx+KplbG2x5MlbylSZMlUmTZdpjmor1IXqnRX4Qq3srBXmavj5GnG+TnI2yIuN0lKT6mqWXc2cs1F0tYDlbhLsp6EBsjaoBQbklUGy5ZDD8/K2D/HbusZhTaYUFxnjBUWUNFXDCBuEFigpEGwSbFoVohgZVhVKyVvKaRIPVdkAwISwAJGBACUqMnhJi241nj0W6GtiMTfw9gN3J/B1ar6dGqNS/Qnw93x9/J7FCzsjzKjBdoxZKYhGTaSzAitCxChmJomvLU/a+1b9G4qk62oBcZqeERgnKv7ltx/60alnH02OtKiL3bnJ+vx0VXK8TF6s4+erPo9dV8IWp6qFySp+8o6FnR8tz42UWdi8/RJvvyQMXN5hHr7Kj1yVxm9YCV3ClmfK5ZnyErbmqP5sY71QK8zViPO1Owc4i43KUpPqalbcbeJSm3XFhFf7ydogXB1SA4OCf1han1W2fSi/hdQcwRDphqoXJGTygipLwCoUtBpxvyyNdh2iSTlN4aAqGyosAswALiJN1xXEBEkM+NvOHN0e7WTheeDtUzyd2k4JyjfALv3aN65BK2HfTWhm6sykzNSZQYsGNVmRFTBmFDOK4+uBmfGRRDKLTVYwGZQB4UWGQPvVCw/95X/2dFSq7mFxvoOfaRJm69Pj5dJCTXaq3MK24nPYMzXCdLUwVWl558cr8qPl3MjN3MAVfvAqP3hVGLomDl+XRm4IIzfE0ZvyeJk0USZPlsuT5dJ0hTxzW565rczeUeerSqE4ahRHjTJfp8zXifO1kmMnrUvSqqdd83VpK90o2EfW7Ba2HBwWgmP82izJrDE1ZyDZ0AktMAmZ8ZwkSkCRIdAIRkYppxHUvyxdwlZ5dBe7CHARA8NQMZOUrdkZ24WT4uIo9Y8Db5/saQMrtt8P+/cpONx5hu8aQWrozNCZbrBCkZkGY0VmEsooZQQlwqElxywniZQxSIkk8swg2bD/8fu/c/vT91LzfZLLnp9rU5c6wVKb6qhHrsbs+C1htp6fa7TC2mFLO1ErztSI01Ulb26sghsr44ZulJilkRvi6E1p7JY4fstiVqYqLGll9o51UrZL+jNsyVEnL9RLzvpd0i2qp131daBgH1jtg2v9KGRHa4NwbUQNTYihKW3ba/JRhoQihYZhIFrkVD2WlSUZqgqCgFrYVte11eHxBWmrK1POAwtbQwzgIsBmCdvV022/fkFfXVBdA8DbJ7lbwUrHN8W2flnx2RSf7ffApqUVmW4wYjJr+JXJGDFZkTGr4NAkMB3bCgWWkYEpMzg5z/NJZihl54888r2/isz3RWc60/MduflWZbFNWWhGS82mr02YqhTnGoT5prvRIMw3WCdo8lydPFcnzdYIu7z58XJh5JaVyhazPF4mj5d9LXPNjrGjRnHUSAs1kqNOctQpzkZLWnY1K+42zdsBfJ3acicK9cH1Phiya+uDYH0EbEzAyJy2tcTkeEFKG6pQJISSgqTSvEh5mSoqtmittLZqQ612vS9I78bWVF1DBUgYJAULu8gJY/XV0zW3WHhJcPRAX7/oatGW278ptsWs+Gyyt/ObL9BK5aSmQcwCNhk2GSwwgzGoFwzGqLFTXcpnkulYxDA0w9AMIhUJv7ky//A/fuvOmY+44GRszpZxdOYdbbnputxktepoIK4WZa7WulK8G42io1Gab5TmG5X5emW+Xp6rlWY/y29h4o4wVlZiVia+mM3K7J0Ss7Uok+d3QnTcjflawVFrrcNlV7PibtG8HdpyJ1ixaSs2uN6nhvrVUL+6MQjCYzg6RxMekgowQyxoeSoJOsIQ6KJIeNkEhGmAfiGtrXbc3TvsUqE4ULHCa5qAd2MTZJgaIul0T9n15a6mwrpTcPRAX6/oalF9pcrR3xVb9naW4l+FjQsFWCzAAgNFRhiTiU4LRQu7qGONyyEuYwhJlAoXuCjjtypP7X/q/r+OLfSlXf25pW5+0ZZ3tGSnavmZOmW+XpqplufqREcjv9BshYVthbzQIC80KPN18lytOFNt5bc4WSmOl0sTFdJEhTx5W5m6I09XWqHMVMmzVcpcteKosZZg1pnoDvN8bWn4hOCo4xx1Vgez4m5TvDvvaeDvUQM9ylqfFLKLawPi+rAamcaJRSMXLAhbTFcYVk0NYJVoqq6qRRUwiBkAZimtS5MzZAl8WVpT8Q62CIFGATYhKZSwlWi07cr56Hg/WpmWnD1ouU9ytyre1t8PW/J0SJ5v3v5jGtQwqGFQchcbFBkoMsiYiBE2dEpxUceMIirmmZxnsbXs9EBspDM7a3/zp39f98leyTscnWgUXd35hfbsXBPnaMI+m7rYlB4p42aqpYUmwdlihbTQVIrd2NJsjThTbeW3cFdamrojTd3ZzWxlsIVtSatL9aKjWnBUl6S5hVquhO1pUbztiq/D+q8E/h4l0COt9XNrdm51gA+NydE5lPYWhEhRTTMoMR0Xia7JWJF0ghjBTFMZgoXdSzNrII4kal/A3mnu+jw2okVITYKoqQF+I9Ry6WzWMa64x+TFXrTSI7mbJXfzN8W2mH9P7GLBKBQM09RpUbfGS4NiARQLoGAS06AUU6QwrDIoafFw2jmV6mreqrw2eeyjulee2Pu3/yXSURbtqVAXu4WFDmGhjd9xbZKcDVYIzqa7P2wRnE2CcwdbW2rWlprVxUbF+Rm5PFtTSuUvMIPFerBYrznrZGet6KgW5qv4uUpurlJy1otLDeJSg+RqtB7airtlp/PxLjMM9ForMhga5EMD3MYoH54QIrM6t8qMPCsoDAmGJlNNIxpGmg61ItQY0BjQGATmV955lD4B1vgURYYCr/B5SRMBBTolRRXqKtSRXsCQIEEMTE82XzyTc44rnhFpsUtftfOLDWClHfi7fseN1pfj98I29d3YsGiAgg4NDJBCkcKwXBRSwrov6ZqWZkfUlurtc0dch95qfvrhU/f9te/GJ9xAlTrbKjtapIUWwdnC30UVnA2Cs0lYbBUWW8WdaBYXm2Vns+xs3o2tOupL3tLMXezZKnm2qvRKBov16lK9slgnO2ulhRrBUc3PV+UdVZ9Ju5sUd4t1nSX7rGa4DnW5Sw30lJbfYH1EDI/l1ie48CxI+YrKNiM5RqQiVnakAUWaaWHvBPjqC65vir0yOd56+Vx+caKELSw1QH/HHxTb2nKZpklMAxcMXDCQSVABFRhlJmSGyrQc2lpJzo8kJnrRVC+uupo8/K73zWfaH/3h1fv/+/LFD9ShSm26Xltolp3N4mKzsPT5WGwthYVtheZu0dwt2lKTutgoL9RLjjpxvlaeq5Wt/J6tkWZr5LlaKyRHnbrYqCw1WrdYkrNeWKznnXW8s05aarKeh19mVvzdaqBHDfaCtQEYGsQbwyA8Jm/NZ8JzfNRlSFGGORNyRJN0ZB1i75xvQ61417v4Ndi7V20WNpcT72IXVERVREvYntFh242L3NK47B6SFrtosF90Nf5BsU3dsHbWxs5q3LD2F9SEhqGwgsaklLC6EJ3oitgbYr11XEuZdvVo7sDrS88/0vDjvz7zt3+Sqz8JhirQbB1wNio79w0tu8Mqn7NCdrWWAnhaS9iKs8Hylhx10i5ma8csOerEhbrSfaWVx1aIrkbZsyubl9vUlXZtxab4bYq/W9mR7rekSXgERqbk6JIQWwbZjQLMMl3WoQQVWVPU0k1GKZBmIk2/F7Z1rvI7YBsYIiTyi4N9fRXXeNeE5BqUFruwv1tyN6FA5x8U2zpUMXXDMAxqEGoQakJdl1lBKapJMbS4OdYWst2J2iriLTdSd07mT74T2/f04vMPnvvWH1347v/NRsrJ5B04V6O5GmR3k+RuFj3NkrtVclujfdpld4fkuVta5WmTPW2Ku01xt2neNtXTqrmbVdfnvK39tzJfv1O9tNBgVZjslB7c3VCVjBXvzn2lxawGutRAlxbs1oK92mofWBvQ1gdheBhHRklkAm3NKrFlxG8XAFdAooFUShAAgBcUAHUATPCZtE603ZccX41thdWCy3MylxM1UaWAfBl7rtc2UlsheqYk16C81IVWuhRvC179w2Z28W4YVNd1QnVIddXURaYLwqYrPNkRGahP9N5JtF2L1ZzKVhyJHnrW99JPpn/7gw/+5H/ue/UBNlPFlurV+SrVXSd5GkRPk4Utu1rVpXZ1qV3xdMreuwUYVrOap131tO9UiXhaNHfz7vy29t8lZutsRF5sFJwNFrbsala8O3UH2nK7utKurrRr/g4Q6LSYwWqPttYD1vrBWv9n0ltjdGsSxeZRNlyEIjORgVSkKgghDZC8oKrQVKEJgNXhoaOdon98L2/rUMU6NC1h57PCvbCnbG2TTdWyb0ZcGpCXuoCvU11uJmt/4MymhSItFKh+FxuYVGZUSG+4QjM9PtvtTVt5prss3Xg2cmN/5NybK+8+MvvM96ru+09H/+rfJqo+LM7eNly1srNS9tZL3kbB1yx5WxR3m+bqQIs2sGTNANmJ3ZN+gK8d+Nqhdye5laVGq36oxGxdYFihLDVZ2KKrSfa0WNLQ34kCNs3fofk7SsxgdYcZhuzauh2Gh9HmCN6aINFJuj2FY06mZhhBzNRNgoEKZQmICpKAriBTQWapnQcBTAAk4G556L2T2xqlIokal5c+w6aGirCKcAl7vL15rqNOWZ4VFu3yUpfm7dBWWmjI9q/EpveOz/7c7dQtmHrBoHqBkiJFDAOGZYY5hjL+qY7QeFN44M5293Wh+zqwXclWHAodfX7utR+PP/+99//z/1T2yz/Xx8t0Z400d0dy1creRsnbKHmbJa/1jG2TPW2yu6Mkrfg+N+kH+DqBrx3eTW51sfFucjeUcrp05KkstgjOJmGpWXS1yJ421ddhbahQsAcEOtRgBwx2wqANrXbhtW4UunsaujEEwqMoMoEj0zQ6b0QdOO5lBc0wccHUmWESFQlZUeI1QosqNBVkSlhXEAWQIoCpBqkGv/5JjqCBoKGpRBIBl5c/j71rgSbyo62NDluDsjwtLPbJS12qpx2stNO17n8dtokME5nG7sCmgRkzCgWDUkp0aphFa94sNorItKaR6oyoDElMSkiBGf9ATWKuJT5Vmxor50Zu8h3n4mUfhU+8sv7Js91P/G3Nz/9i75/+LzOnXpQnqoTZ+vR0reRuBb524Gmh/nZ9vVMNtnCB5lyonduwyau9WqBfC/RrwV4Y6IWBXuTvRYFufbXPCPTqy93E1wHdrXCxWVtoVB0Nd5dm9ZKjXppvtGr6pYUWzdOters1X5+23A9W7Kp/QAsMqsF+ZbVNXW2Cq80k2GYEO83VbmOtV18f5Jd7ldAwjMzA6ALdcrN4gHHbDIuyrkjMNBhjetHgNZwWDQ4WgQmRIRND1HWBUgVRqBFDJqZEiPYVVYUQ6ECjCBoEM4IZ0AyBB+mUEI+mKSAUIgioCk0VFhVQgCrVFeDo717qbZF847KnH3j7NK8NB3twsAcF+1DQDgP9VgB/nxV3++6/IkrzNvYYJjBMYJbiLrlOIaWYUqqbhmEWaYFhnQFqSlApMp0VESMyS67DwFx2pitsv52YqEqMlWXHbyljt7TeS5nbB1cPP+d44+HxNx588T/u2f+dP9nquKivDJLVMXNjind2FIMDxN2mLtSqS7XKSqMUaue2uvORbjnUp61axRV2FOxDwT4c6MOBvs+wvTbs+mps2dEkO5tlZ6u42Kr5elRfn7ZsV1bs6sqQ5h9WA8Pa6qC01qaGmtBaC1lr1dc6jFCPsW6nGyN6bAZsz0nRBSXuxZkQE5MMCMwAKtNlVtRMQ5FUmleYiJmqF1SCoC4Tndd1jlIJ60CjpkSLIr03toFgYQdbLQgcSielXdi6CosqYIrGoGroCnAO9Lv6mkvYwNuDA33I34uC9m+EvWuySs8evYD0ArLy2zCRYWIrMIaUYtM0zWLBGqkAkQ4RwRQwhpgJSHI95xzfHmnbGqzbHqzk5xozE7cTA9fSPef59tOZ24f8h54dffGnF374X3/9x3smzr5b8A0Vww64Oq2vz3OObrLUhxc6tel6ZaYWuFrQape60aduDqihAbA2AFcH4OoAXu3Hq/0k2E+C/TTYq/t79OVu7On8PHZdaYGmLDQriy3qUrvi7gDLvdYoBNVv1wKDWnAIrA6DtQElZFM3WrVwBwp34XAv2RzAkVG4NSGFp/Ph2WzMIwphpHOUqWpR5ogImclDkM5zHCcQhTBYYJppKBRDXcW6uINNgUZMiZrSv4yNUfEL2ARAC1vRdrCprHlGhz32VtE7Jrn7gLcP+npJsN/C/v3SWvF179FNXIodaYMaBi3ufH8iKxaLuq5jTDGmOsWMoYKW4zc84am+1Z76cE91wl6THq5SHU35sduxrovRlpPphuOJ8v3Lh56zv/jgG3/+v9e+8WsWXiD+KRhckFZmBfck8E4k++vAZBudaoUTDXC+FbltYMWON0ZhaBCGBtHaIFobJGt2smanq3a6aqfBXhLoIctd2NOJllqAs0l1NCjz9fJcnZXTymKLutSqeto1q3PV37fzOlgdBGtDMDQMQ8NofQht9IJwD4j0gq1+LTqsbU+A2IwWXyjyIZpbh7mIJiWxrmCmK6wAGaOAiIlcNpHRNKgbDGgEitAABgU6RLpEd7A1QIyvxdZUHQIToyJGRU0xBQ6lEmI8miYatrAVULCwgaJTWQtMTy4PdYjeMdHVC7x9aLmPrtqRv/cbSZewFV+34uveQwq0FLpphaGbBmOMMVYs7FxzFc0CKzJW1JmWF8LutbFOd3tFoK0s0lWRtldxQ5XccHm6/1qq60LGdiHXfGb7xkeug8/ZX/tl94cvgPkBltkUXDNSYEld80keB112RjtqZXuz0FWZbrmhDjVQZw/xDumhMRwaQetDVuD1Abw+QEMD+tpACRt5O4GrRV3cwRbnGkRHo+xsVZfagbsTWhV3gd5S0YH16QEbQzA8jDeGjY0BGh5AW8NqfFxKTUtph5Jyg8RybtmBNtZYJsdUyJBRICYymEEYyyCWwUzWCTYlTHmAAKSmzijQrSe5QKlIqAKJLhNDvuc7+wvYfB6mEmJsK2VhA40qoCCrRVktWtgbC/OB0S7BM8ovdkNfP/Hb9bUBuNKzW/rrma343H229RWZu8PCLhaLlFKMgIERKxo7oYOEb3pzqivQW73adWej41a040aq56Y4eFsYvJXpupzuPJ/tOB+r/jRw/m3f0Ve8p97B032F4JLqcxS2N5Tgct6zKLudwvQob28XbLX+S584TuzLtN5krgG2MqYHxsj6KN4YtoJsDJKNQX19UF8fxMEe7O/GPhv0dABXi+JsVB0N0nyjMN/ELzTLzlbF3QF8Xcjfi1f7UciOQnYYssOQHWwMwPAgjAzByAiOjBbDY8XNSRKb1pIOMbMkZn1aetWIR1giy3KQ8YxxjG3rLCgq3ozqSjBngqVMBhkCNCWrvGkYjJkGo0DfeZKT3xXbepIjWFBlo4SNVYQ1ADQqa6aFrcmUSOq2x7U20St4RjlnF/T108CAERqEKz1fTuhdI7Duib1zn40LhS8EMXfmISEAoSIXCGQFnRUIFbPSVsBvbwx2V4RsZdu9t+NdN7eaLyTaL0j2W4r9VrbjfK79fK717NqN/Y4jL62d3ye234BTffLCpOp1skxcCfhyiw7ZOZsf6pP6W/PN5dOH9va++WSk+ixbsrOVEeIfohtjaHOEhEdIeISGh2h4yNgYMjaGcLAHBbrhsk3zdqiuZnmxUXLUi3MNnKOJW2iVFjsUTxdc6cOrAzg0RMIjaH0IbAzB8CDYHISRIRgdRtsjZGuMbU6ziINuL4KUR84Gtcy6kYiySIqFFTadYNWL3OGutb2VnpfLXW9V+T6o487ZWa+fRTRD0fPEyBcLkDGqM10zKDC0u9gyJEQhuky+auulQ6CrCt2NzeVAMi58GVtSChZ2yr+8PtXPu0fyCzbo69eDg1+JXXol3/Mxbo0v9XQqnntjF4tFgiHRZKZDZiKGhPz68upEd6i3erX18lrLxZjtWrLzSrT5TKr1nNJ3Pdd6NtN4QrZdhn03IuWHpz5+LnjxfTLcEG27Y3jnWWQVLC9pPhcLBwu+RTwzmGmqSNdcnjnwQvcbv1y/c9RY6CDeXrBip5ujODJKN0fp5qi+OaxvDpvhYTM8/JXYwnxD3tGUd7aKSx2Krxv4+9DaIN4YxpFRsD4CNofB5jCIjMCtUbA9BrbHUHSiuOUsRlwktoySqygVNhIxFsmwoLB+qHbjxZv+B0/5vndk5QfHAz+7EPzlNf9vri3+/ETgnQqu18cUZjCWp2ZWQZgUdM3QNQMiXcI72FglRPlm2NuRpIWtqeQL2Jmgf2PazrtHco5O6Os3VofM9aES9pfXX1+DXeoH22OViZJikRSL5O6XZuqmoanyXWlQFBIZ/8L6dN/mWNtqy5VI26VY5+V095Vcz1W++7LQeV7oOJOoPJStOaK0ngvf+CBSfmjp1F7UV87Zbq7XXIKzduabF2eGo31twZbKzbY7YKhF7rwVuX5w5dTepdOvtO97BDoa6FoP3Rym0XEcHcORUbQ5QsJDemTE3Botbo+ry52qrwOtdJFAj7LUlBwvT46X8wuNwN+n+u3QPwBXh3BoBG+MovAYiozT7WkSmyKxKRSfQvEpuBOzRnoZRpdRfI3xqWIswQRd61kcefrE6Pc+2PjxmcT953M/vCQ9VB778ZW1n13KPVvPv1iz8XLZ9Id30pNrDDMRGjI0ZJnsYAOqQCIBLGlIUwCQNPSlchRNJZpKSktxVaGKpEsCScaFUHBTE1UdYYILvESyecQJVJMpFhUtFk17prPOAdnTLy3aFJcNrvSA5e4vL7usKK3Sv5D04lKbtNRi3RzuobpJzAIxC7hQoAVGC9bEo4KBAStgZgKmZnHMz/kmotNdkaG6SNulRPuFVOfFTPfFbNf5fOcZru0U33w8dftAuuJArvLwyqnXlk68tHDyFbX/Vq7j6tLlQ2tVF1bunJ+/fmLuxonpix+PfPrm+KGXls+84T32gv/0i54zLzS//RNpthytdsCtfhwdQVujOGLl97CFXYiOaVZFmL9L83YIjrrM1J3cTJW42Gw1Z4DgIAwN441RFB5HkQm0NU22Z3F8DsfnUGIOJeZAwgESDjW5qObXTJDR+QTTAFMKxoh/4oWzA/d9uPzA8dRPrwo/vZn+0dXEg9fjv7mz+kT50s8vpJ6qyO2tc+2rDNdOs6ReUJkiUkoYUU2i6daUBFXDioo0BWgK+HLtkYUNgUkwQ7BgYcsiTSXEUHBT4WUKEUbmvxJ79yp91y/YpKW20jXxHkII0Sk1dGIahlk0C6xYZKxgMgyYAZmalTdcifm+6ERrZKB6o/Nq0nYpY7uQ7bqY7Tqf7jydajmWajicrj6YLP8gfmNf5MJex8En+/Y+uHj6Fbn/arLtfK7tSr7zRrTh4lr12Wjz1e3GSytXPlo48sLEWz+fe+9h9+Ffzx5+tOblv+cmryqBZinUibaG0dYo2hrF0TGyNUKjo8bWqLk1CvxdKNgDVmz8YlN2tjo/X6ssNSnuNhC0q2tDcG0Eboyh8DiOTJOtGbI9T+KLOLGIE0so6cIpN0p7ccan5AJJfk0leYYUBg0Ww8Ejdd0/2Lfy8LnQA+fc3z6y/L2Tq4/e8D5dtvRmbejsgHhjHh3oM/b3Lr90a/qdMmV0gyUpH+ZUHgFF19SdOjKgQqBCTQGqek9soBnWd10rMrGw00lpfTUiZHmkaggaJWxVIpCXtFg0453JLQ7Knn55qet3xP68dLfis5VqQARn0x6CISGIUkwN3TTNQqHACkVW0BnRmMqReDCxMLDaeyfYcXW9/WK49Uyu6wrffTHXfSFjO5NoPx5tOLRV9X60/O3Y9be3L+0NHn/W8eGv2l74gf/6W0L/pVjLiVDFwWjV0Y3KYytlHwfLDgev7/ecft1x4Im5tx+cf/snc+/8aOD175c9+d+4iStaoDG73AQ2B2FkBEfHaGxC3x6j0VE9MkI3h9VAF1nr05Y7M3O16elK2dVMVjrBig2tD4H1EbgxhiITFjONOUh8kSRdOOXFqWWSCdLsKs2t6/kwELc4mt0WYwxDpjE2s+148fL8Px0PPnxx/RfXVn5+Zf2lOv22jy0htm6yoMLcEhsH7Lwz/Ez52KMnUtfG2LKsBjk+JikyERWkWuMxZIAUqGlQ1eC9sFWFIliAwLSwFUnPpORwKJpNZFRRAhrlJZLjMCdQRcSAE0F828JWvHYLG/l74UrPvbBL7/LSP8neLsXTebcKqIlfaNxjEqhTqFOs68TaUjNDZzpmWDFyUXnVkZy1rXff9Dee3Gw9neu9LPRcsrCTnaeirZ+Eaz9YL39z4/prW5de3Tr3UuDTp5YOPNa/94Ht2gP5/vORliOr5e9HKg9Fao8Fyw+6L73rOrvXdeRZx75fzr32I+dr9zn33j/08nduPfpnwuAFtNwkrrSpG3Ztc5hsj+vxSTM+oW+P0c1hvDGoBrpQsEfxtmfmavPztWil01jrxcEeEh5BkXG8NYm3p2hsjiadetJNk149tUJSAZoN6fmwycVMMVGQ0ljLQkaSSqagaExmbCo++dTZgR8e6PuH/b33f0JvedisasxkoTsLNwS4LbE0Y54iOzQU/c0Nz0MnQ69X6u1+4s5mN3KcCHMKUEQIRagLgMoQAKsL86unZB7gAAAgAElEQVSxFZkAzQCaochElQ1VNnIZNbIRS2zFxTynKtjC5kVdFpCa4y3s/NKQ4rUrrm7V3fX12F/4ueztkjw22d3BLzSKC/VW7GEGZiYu6tjQSYESk0ATA4YULRnhV51JR39srGHTdmW1/uh281HZfknovsh1Xch0n413nog0f7xW827w1utrV17ePP9i+OSzKx//xrn/kZkDj2RbjyS7j222fbLd8mms4chW3ZG12wfdl952n33NeeipsZfuH3vy7xzPfXf5zZ/Mvnpf+cP/Nd16HDsb9FC/stanbQ7T2ISZnC4kJo3YON0cRusDaqBLWu4QXC2cs1H1tOqrPYX1fhrqJ1tjJDpJYtN6fJ4mnUbKbaSX9WyAptdoZl3PR0wuURAzTOaYKhlIFnQZMcIkyHJFNrjZ9fDH7T/8yLe3jg1kWZDhJT444E35YgaHmEBYSmdV7s3Hb0Ufupz4xVXfQ2diH3eAiQi3nsvyMC2roqBhHpicZogQAKQifC9sSUSaqmuqbmFripnPalvh+NZ6hMtkZQnyEsnzhBd1iYdyJg/i21nfbH5pSPUNWNg40Pf12F+Qljw2ydXOL1hf2lcnOOr2sCJhRZ2ZpKjjAoE6VHVVMhUuvDgdmR/cmmgL22+H2y9EW47nOk9o/Rc429mM7Vyy6/RWx7Fw86FgzTuBm6+tXn5p4+yzoaNPuj54ePqtn7iOP5Fp/XizZX+061N+4GKq41Si7VSk4Vjg5oerl99ZOfr89Es/mn/2+4vPfM/30gNzz//g5g//n0jFAXWs0gza1WC/Gh4isQkzNVNMTxuxcRIeAmv9it+WdzXnnY2yt52u9Zgb/WaoT1+369sTND6tJ2aNhMNILxUyvkI2aGTX9My6nt00uQQTckwRmaYxhBjFnJBlxQITKNtCmbLJwWcuRE8OsCmJ+XVuIR1Z3I4H01IkxzIq2+IKE6HIobb1J27xv7iFHru99eOz4Rcr1P5VNSImOS0myQKv4rxWzGsFEUIIVULuhS0KUFWoqlBZwqpsALXA5cB2JBle3cgmU5IIdmNL6RxMxL6MjfxfcQhqxZelRXen5GrnHA2WND9fu2fX6RgqIq2gigUxx4REYLQrOt2TmmrbHqiId1/m7VfgyHUwfCXbeTrdeTppO7nddmSzcX/oztuh66+uX3pp88zzgcOPz7/14OCL3/OefCbVeGCtbl+690S09ZPNho+jTZ+Gqg+5Lr3hPvuK59NnJ1/98cZHv1l66YHpf/6H/sf+9vy3/6+1S/v43hvUZdMC/Wp4hMQmCulZCxttDoBQr7zSmV6oTy/Uw0B3MTJcCA/qoX4aHqLxGZycJykHTS3SjNfI+Y18SM+HcW6L5GOUTxuyWFRVhjAjJjMLuGAws8A4g23g0JG29Gk7CzK2zSRHbq5zwTsd4CI8jatMYSwkLx+ojLzTyL3SIj5crj50M3rfWf9vrmQbF3l/Np1T44LCcwrMqyYHCyKEEGv4ntgCDxSZ7GArFGgGn4fbkeR6IJSJp0UBCgLO81QUdZEDUjqnJaOZ5dns0pDsG5Dd3aq3m/jtyN9vXfDsXoIpvm5rvGHp/ER2d+zU8S21CfMN4nydMFcrzNXuMcyiaRYNnTAMGFGZlJUCS+GhjvhYW2ywNm6/kxksF8fuqJN35PEycfgq13c+03F8u+FAtPa9RPW7sfI3Ns694D/6z4vvPbZx7JXxVx+2v/jTqQ9/nWs6JvWd4XpOCj1n8raTiZYjm7X7g+XvLF9+zXv6Bd+x37r3Pz7x8k9Gnr+/8qd/fuRv/o/pw8/mbZeL3m5zY1xdH5FWB7TwkBEbLyYn6PYgCPfm3I15Twvva5NXukDQTkNDxvoYiUzC5CJIu2DGDbI+kAvCfAhwmxq3VcQCIyozMDMNZpgG1TEkMkIpE6m6yTiTTcXBiYGtvTWsa5O51Nk7o872BXGFK0QxSxfZspg+0732zPXIU+Xmm73k8frMTy5nf1Mx8dAxYt/AGzKX1VK8yvNAFQAVkSETDHWEDaARoFELWFOJ9dXXqoKtL6qzQpagLEFZwpIIIuHtyEYsn1Fl0cxloJgnSNblTF6MhTNBR9o3IiwPaYFBzduvefqgrx8s91pTS3d0fR2q16Z5O+CyDS7bgK9d87YBT6vqalZdzepik+pokucahOlabrJ6j8kYoYZJMDMoA4IeXeWcY9nxzvxYc3aoKmuvyA3eEkYrxPFyfvRWbuBKru9cuuPTWP2H8ap3khVvxK+/snnm+cCRp0OfvrSw78nR1x5reer+0X1PSJ0XhO5zaOSqhZ1s/TRS/9FqxdvLV1/1nH/Bc/rZpcNPTb79i5FXf3bzR//vob/6o8lDv822XdCdbXpoVF0fUddH0NaoGZ8w42Mo0i+tdgqBdjFgUwI9YG0ArY+QjXF9c5ZsObSES0551Yxf40JQ3CRKjGoZAnJFA+gUEKxBqEFEMNGJyTBj2xTKxGBpg3WHwEe2jcevpo/1p6scY5e6I8Mhfi7J1hCLM63Js/Ziee65Su3FVvx8K/h1Te4XN9d+cXn6yQvmRIxuqmIWZXnI80ARIRGx/hk2/Xrsu9JQEoEkgu1IcnM9nkkoMm/wWSpmEeCxmsvzsXB61ZHyjXD+Ic0/rHn7Nbcd+uzQtwvbGiXv7dC8HXi5A/naka8NeFqAa6dMT11s1OablNkGcaqWn6jeU2QMY1wgkJmI8amsayo52aUs9ImTLcJIdW6wPD94kx++yY1czwxcTvaezXSdTrYc3q55f6vireiN1yKXXlw7+ezKkeeCR16ZevNxx4cvlf387wf2PY4GbnHd5+D4TbHnPNd1KtV2dKv+YOjOu/7rr69ceGnlzPPuw084Pnhs4o2HL33vP+3/y/8wfvDJTOtZNFNPV4fB+ijenDBik4XUFI2NyKGerK81t9zG+W1SwA7WR+nWTCHmZCkfy/i1hF9Nr2r5dSxGdTVVRByjEjM1k1rjIRUAVACxha0zllUBlgnbwnrtInivffMXF1Z+fXnl7frZMz2J4Q1pJsnWdDaWD71R5X7sXPb56sLrNvJMM3qyPvnozfmfnQx+1MyWOGVDFHI4JyBRgJoIiYiJQiCgGtY18DthW9KSCFLxXDgUi0fzMm/IOYNPAymjgjwnfkNs5GtHvnbobQWezwquFWeDOtcoz9QLkzXceNUeVjRNAhkFDEkwGtia6o2NtsKlfnW6TR6r5oZu5Qev84NXc4OXkj3nYx0nUm1HU42HopX7wjdeD118MXjmOf+x53yfvDC372nfkbcWP37rzA++NX7oJTxSlem+yNuvCL0X8l1n0u0nths/3qh6b/XWm8HLr65eeHnx4K8XPnx08q1/OvV3/+dHf/nvxg8+mWs/j2bqkX8ArI/q0eliYs5MTsPICOe3JdzNfLBXWLXLoVGwOY23Foy4p5j0m+mQzkeJGNfltKFli5BnVGE6YCYiUCZYoxTruk51E2GqQKKoSJIh43QWBODyBH23M/vYzcB9J9eevr1xfiTa5GFLKnNh6WC/+4FjW4/fSD9Zrj/XzF6x0eebNx+7OvXYGa5qXvdy+XVO5DEvEU3AWCBUwFjGCiQyJF+D/YWctiKfETfX45GNlJDDKmdwCZWPc5Djxdi6hc2vfA77c4/xXdjQ2wY8rcDTsrvUWl6oV2brpOk6YbImP1a5h1GNGYAhiWYiOe90dLIzPdmmzneoM03yWKUweIMbuMLbL+X6zydsp6KtnyYbDydq929VvL16+eXlk791H/2t+5Nn3UdeWTy0d/3ipw1PP3Lku98K3DwuDVQnbZeyvZe53ktc99lMx8lY0+HNmg/WK95Zv/H6xpVXF/b/0vn+Lyf3/vTIf//3+7/170f3/zrfeY44GjVfjxYaodvTheS8HptW14dzKz0xd7u2NaFtTWnReS3qULddatSjbS+r2wGGRIZlhlWGVYaUItJMDEwMChRZPYi6riNMVQ0KoszlJawYLM+YU5AOd6PXW4VHysLfORl/tDx9eECocLFZwCr9oZ+ej3znaPaR69Ljt40n6tjePu3Zho3fli1/2CjZ1xKOLT6pybKuSDoWiM5TKmCkEAFiHmHlHthflhYFTRQ0kVeim4mNtXg2qaqckY8ruWgW5jhpez2zOp/2DX2G/eV39i5sq4miVHdbappRZuuk6Rp+ojI3WrGHIZHpChPjfNARm+3JznULc+3CRIM2XauM3ubtV/J9Fzj7hVzfuaTtZLz5k0Tt/kTlB5s33wice3HxyD/PHXxy4eMXnJ/sDV89OXf4g3f+259eePg+rrsu3XM70X1DGCnP913KdZ9Ld56OtR7dqj+4WfXuZtmbW9df93z8m8UPH5l4/SeH/uLfHPyr/9D37iOJ5hNooVHy2OS1IRKd0rfnYGRKXB3O+u2pZbu4MSVuzsrRJS3uw5mQno8U+HhBzDCDMp0yqjNMihAZEOoAEQBZkRUME2OsaZokq9YIOlkCOigygbGxDP9uC//Unfj958N/d3zr/ovR52qLV1ysOhR6tmrrH8+I378Q+/vj7Ila9mQ9e6Uz/c+3t/Y1xMsnEyNB/9wqhExVTaCYVKAmT6mANRlzEOUR+nrsL0oLmiSoie3M+mosFuHkHOWTSi6SUVIZZXs9G7SwB7TAoOr7F7CtFdlOx9NdaWGuRp6pFaequfE7udGKPYzwDKTx9krcYY9NtYuLPaqzgxutVCYqxeHr+b4L+d5zXN/5fO+ZVOfxRPMn8coPEhXvbV57w3fy+bmDT0x8+OT0gZfmj7zjO3vs1q8eeepP/rh3/7tgojveU5kbrZKmqrn+q/meixnbmXjbsWjDoa2a96K334ndenPj7PPeQ7+efOvBA//t3xz46/+t5dUfByoPStM1vLtLCg7D8CSMzIjr47ngaH51PB+aFiNOOeZRU0GSjxSVLCMSMzVWIAzpDJsMFQvYMJFuIt2AVIeUIIoAVlUgy6osq6oKNIAg0lVoMpWxkZT6Tlv2V7dC/3As/N3Twe+c2PzJVfqWnXux2fvDU6kfXOD//nTmLz9hD5azp5vZq23xF+5sHG5bq5lanfCH19PAYAooQNUwBL0g6FTAqoJzAGXg12F/WVrgVYFXMml+Y207spYQ01BJA24rK8eSanQ9H5jPeoeEHey+fxFbWWqyGttK0vxstTRdI0xW5cduZ0fK9zAjz6SIHJyNTrYnp1uAqwc62/OjFdJYuTB0Jdd3Ltdzlus7m+89k7adSLYcid1+L1G2L3x1r+vE85MfPTHy3pNj+1+Z+eSD7rff3Pf//c3Lf/HnwepyeaI7Za9V5lr5icp8//V8z+V017lE+/Htxo+jte9v33k3XvZW4vob/qP/PPXOzw/85b/78G/+6PZz981ffy81XpV3dQnBEXljWt6Yzq+OpwPjudC8EHEzNcFAmml5BnmGJEZURiCjlKqUqrquFgxgFlCxQIrW9KZ8VhA4UZZVCDEhOiE6whQQg9coQ4xNpNGh3txTt4P/eGzrp1cC/3Bi6wcXkw9cC3z7aOwHF1L/eG77Wx/jb5/Tvn2KPd3A3ulM7GtyH2maLO9dng8IwOSQqUKTqKYpGgVBJyJWZJQDKA3gvbB3v6d3SasCr+RzUjgUW/dH+aQGskjcyopbUS0aygfmc57PsNWvxVaWmkrYJekvYdM03JiLz9iyC92C0ybMNssz9cpkVX7warbvfKrrVNJ2PNN1MtN1Mt72aazx48CFV9cvvu498dzoe49OHHxm7ujeoY/2tux94cTPfvrb//Jn1575rTo1ShbHksP1wmxjYvBGbuBGpvtiouN0ou1EpuN4rv2TbMOBTPX76xdeilx8zfPps8e+8x9f/rN/e/P5B6ZvHIhN1Kfc/anlodzalLy1iNOBghBhWpphjkGeIaH0VjYwMDAyMCkQZiJmQEa1AlYMTcaqhBQRYmDgUnsVppY3pKZiMoYY8ykrr9+OPVXm++6ngQfO5X5TtfH9s9n7rwj3XU19+3Tkb49lvnum8INr5gPX2PMN4pv1oQNN7itdy8OueJzPQyOrYQUYWDF0kegiwTJRVMxBnIdY1khJeneUHuOioPGcwuXlfE7K5yRZgaKgJrZzoZWtaCApbksgIYjhCBfw8ME5yT8mr9jl5T51uUf19qreXs3XU9pkK952qxdOdrXKi42Ss0FcqBMcO9LcTBU3UyVMVZZG0Oxh2pbkG9mebMnPt3PzLbnJWn6ikh8vzw9ezfSeTdhOJm3H07YTaduJeNun2w2HNm+8s3r2NefRZ3r2PmTf93j3O7+dOPpR1/vvHLzvR2/8j+92HzmizE5wk13J4Vputi4xeD3Tfy3VeTHWdjrWcizZ+mm6+XCi9sP4nX3bN97cuLR36djzl/7pr8499j+6jr4+W31qZbCGJDw4HaD5tYIQYUqSwTwjMtPBLmZkYEQxoZhQrFPECGQ6YBgwpJlQNYBCgEI++zx8Hjur4YLO2DYJnbKlX6lLPnpz8+fXNn9+bfuh6+LD5cZDldoPr/I/uZp54Dx98CZ7vAq+Xr/84rWJd2+6a4aTobQMCrLBJFLQNAMrBpUIlglQiKJiHmAeYEXFpWzeHSVsgVd3YYuipAiimk7wm6vxaCDJRfJqLCdvRni/RwzMSf4xZcWu+krY3Rb2zmGZt132tO00ut4Dm5u4bU0Sy42V7ylszKZn2xITDbyjnZttSI3ezo1XcOM3s4OXUn1nE7aT8c4Tqa5Tqa5T221Ht+sPR8s+8J95ZenEC/b3fjV04Pn2t5+eu3i88d239v/4Zx/8+Gezt8pUx2R6rC05Vp0YuZkcvJzqvZLsuBBtObnVeCTWdDjWeDBa/V6k/K1s7cdbNz8Ilx8cO/paerCGpVaYtMVIhpEMI1lG8owKTFcY1ZhOmEENCHWEdYQJwgRhq7QZI8Pqm0WaCYFpFf1YLTZWlBond+ZeEFOGtKAzlqOxxtn024345Wbl+UbxuXrh5Rb9tQ72dJt832X8eJXyRAV9vh6+0ex9+qLzvbLgnUHOsw0lqpCijAuAMqAZ1gdLU4mqEUnFknpP6dI723p6l7BzWSHPCbwg5TNifDMdCyayoZS8mVLCEXHFI/nnFP/IvbCtxsd/ETs7ejM7ejMzciMzcmMPv9AVG6vLzjSr7i5hvik7eYefqhSmyjPDl1P2c/HuUwnbyVT36XTXmVjb8e3GI6uX3/KdfmXu6HMTh58bOvxK/ydvjZ87evzXjx56+JH3f/bQTPktcX48P9WRGa/c6D2VHbuS67uS6rwYbTkZaTqy3fhxtH5/pPK99VtvRSs+9F54Y/n6gcnzH5LlSUbyjHCMCswQmSEzKjOiMAIZhgVMC9jQoUHQTuxIY4ox1VRiHVpBoCNoYGQSXKCk+JXYVnt0ARWZbJKZCP+xjX3Qy97rZ4dGwAfd7NNx9q5d+qfr7LU2/d0Obb9t873ahffLk83TbF1koilLmJORquoIFrBiQNWQNSIBIkAialiT8c5LRP6KKL2tLWzrGZ7LCplsnuNFIa9k43wylE4GYtxqVF3fFP0u2T+nrowoK/07hWY72LvOwD1tVgPs12Cnh69bkRq6tic50RAfq5MXOnV/n+Zqk5wN6mKj4qjKT1xPD12K959L9p1L95/P9l1Mdp1NNJ+IV38cufXB9JHnxo680PnBszNXjg6c+mTfT3+872cPHvnN486aqvR4T3K0Ljt5OzpwQpq5Jg5f53quJTvPxdqOJ1uPxZsOb1V/tFG+L9N0LFTx8Ub9OWfFWdk3w4hYxJJJVR2LOhYNohhEs97KBjJ1XMRgd9bqCBErNIA0QACkEOkIG5iYVhF8qUUWo51PAMEFik1NVBlhDDC2zEknutnxEXZwgB0cgPu72Ylx9uk4faOF7e+VD3bET3b5L3TAqVBxk2eSgWXCC6okQwoMExaIQoFGeURymHBIFzWKREpEqomwtKXeHaV12a60FnNZIZ3J5fK8yCtiWsmF88mV7exyWAysSSsudWVGXRnRli3srp3brV3Vohb2zhdb/I7YyYl6banbDNqxz4aX2+lyh7pUL87ezk9cT49czgxfzg9f44au5fqupDvPo/7rmYbjU0de6P7wqdsvPzJx8UjN+2++85MfvX7fj26/937Y3rU10BzqvsZN3RRmL2HnTTJ9Wxsp5+3Xcr3ncz1nMx3Hk42Ht6oPhG8fWr51KFh7ca7yon/QVpDzOoUGMzHRCNUIQZRSSg2dFg2dGZTdHWVRhMCEoDSuHUKMIEYQEYQpwhThz00J/TI2lSFDRZahxd7l2Ic17MQgO2wn77az46PFTweLh+36J73pfQ2bhxoS1RPAGWFSoSgSolFCCwibigipgBlkukyBRnOYpCjJYl3UqLXnVgWwe+H9hUX455/hYibLZ3NcJpvncqKSV6WYmPJHk+5g1uOVl13qygxYvie27O6whhh8PfbnHuOZicb0eL3itJHlHuTt1AM2PWBTFuuUxRpx9jY3cYufuGUNGuOHy/J9V9DAjWTdUd/V90eOvtrw3jNdxz745Fc/f+UH3z/wq9/Yr1xJTgxsDTWF+66Kc2XEfcNw3WBLDYW5ejhxRxm5Lg9dkfrP5zpOJZqOJhpPRxrORTpvu1vuDDVUqvmMirBMdKRTomNCDUxMhE2EihAyBBhQrSgAzYAqhRqCGgIAUENHBoaUQEosdQCxBtCXsSkqGMhkiNL1pN7lzJ5s3Xy7Qvu0Cx7oJO+1sWOjxQPd+feb8ke7vO+WZ6vGTFecyQVDJpqKATUpY7rBgABoRmM8MSQKNJomJG6QFNVFjZo8ZXmq8feU3o2dy4rZjJDJ8nlOSKWz2TSnchpIa9nVeGxxJelwfg32Tlq7OyR3q+hqsYpH771AK+cmyvPjZbmxW3uy4w3psRpxrgW6OqGr3fB3GX6b6KgG7kbFUSVOV4jTFcpMlTpdKY6XC4M38OjtXOcFPF6dsl1dqT07dunQ/oe//+YD3yl/93VHza3oYEtirDE3UyU7KqjvtuGuYCsdbKmdztZrU5VgskIZuc71Xsq0n8u2X0q2X0/01a72NPbevoF4jmBTAsQ6FEHYUCBRVCxJWBAwz6Md6c+wCdSQBgEpmrBoYEPHlGCIEMCaBlUVQKRrWAfEQNjQoVkEBaYVmGSyNE43T8QO1Ob2VYsftwsHW3N7a4z/n7T7am6kSffE3h9EH0Cha30AXShCF9JKERvas9JKexRrdM7ZM5qZnXl9+2bTe++99yRIwhCgAeht03t4oHxVVmaWB0CWLhJEo9nsd+Y9E/GPDnb35Y9PZlZV5pPfT9r/deL+zxPMnwb4kvmLd4P2EW/LtsUpKjawkZIMk8cqVoy0nkkDE8XEFLQU1WLNp5WNRCX3zuTr5CbsR2xJlFAiydIJXhFVg1f4m1h07zC8sQ5Pd/BZAJ/6lBPXF1sVSEOKL8fwb2FLaz1SoFMKdIr+DmG1/QW/2iMG+uDmkLo7ZhyMGwfjxsGYfjAsb/bI690kYK1DXuuQ1zqAvxOstKPVbnmlK+6oi0zXSr7em5Hqge//3W5bQXi2FfiHBX8v6+/E+4P3lxP2jcPYGzP2psz9aWNvStsaV9YG5aUuuNjBTNcJ8+3xmfabmb6Rsg/S9ZWt3z9YtixhCWAoqwjrqmLm1lyPlyR90aEG6wa4T4H7lJpKGYZ1r1oPSjqlpHQtJWFNfbBROiPIOCUbtm7bQsb+xNLl8+j1rPXDtPhPfejnKfnHCftHB/77TuP/6hT/rgn+cQgWOC5/6rMXb2zuwZZThppW9DTSU0hPYS2lqNl7cRVsytgQVUPQDEHRAdIR1BHQfkU6h/15JOdQPC7GYkIizvOUICdZORJhL44Sh2vy2SY8X81fjZOtCvDTBDocgwfj8GBU3h8hxvLuENwZIl1lwNZAtqnveh9Y75UCneJKO+droT2NL/jlTsnfgzYGtJ0RY2/M3B839kf1vRHSViyHnQvc6BH9XZyvjXI3Mc5Gzt18M1i4VPKP1Hw9WO5U1vrAWg/c7Nc/jWtH43BvWN+b0vdm1D2HsjuLt6aAf1jy9UruDtbRkJiojU61Ut7x2YqPtyvLGU42RR1LigwUBDWMCHa2ydCzvQywboFMBmQyqpUx9fS9kr7HKYItG5Zy/6Cl7i01ZaN7mzat1Su6dl576cj8furh/5uS/1O/+McR6p96jX8cUv6Pdv3ftKJ/24J/Pyi/mb77sV8ZO7CTVkq0CDZpUoa1FFItEvKsRQKQDpAuQU2GvxmbolA8DmJRlo5RUiIJEyE5eCFd7YLzdXi+8hn7eCG7L+WQYI/C7PvRv4AN/N152Esd4koXXOtTt4aM3RFzb9TYHdF3htF6D1rvIW264Xqn/Fjc6s6AFOhkFpv4pVa40pGcq7kZLLgZLDC3BrTNPrzWLa93G4cj6fMpfDCUXGnT9sb1vRlldxbvzMCNCXFlkPd08Qut1HRtcLAsMtkSWRis+Ie/r/vh+5utAzHGKUAl0go28psMPYutapZqZXAqo5ppgzyVaSkygBsZGytGBqdsw7bjKlg4uKwYu/mp2/xp1vqnsfQ/DKP/2Au/m2B/NyD8+zbuf6tR/nWT/n93Kn8YAq+nwr8MRJpcdlgxON1Q07kLUxXVIsGKibBBApFOIv+LsAEwOU5JJgQ6RonxhBwPovAVvD14xF58Utl/EzbrbROWO+VAr7I5qG0P6TvD2vaQtj1EsNFG1xNvdWcAbfZyvhZhuU1d66HmayPjpbK3VV3rkVc7xKVWsNZlfhol2Oxal7Y3ru1O4t0puDUF1sY4Xx/jbGccTTf9haft7+7G6kNzfcX/4f8s+d0/C9dhW3/QkaFgI9uhOa/J0LcalWTX3kZaNdPYSGEjhXQL65ahpx+UtC1Y9gUnzezcVowH3/bDD5PKH0fv/zBt/2lG+S9D0vfjwp9HmX/fyv/vDfq/bbP/cdD6fgK/d9AfJk5LRu0rKS2YpvKMdA77iQCFrMoAACAASURBVPRvxeY5pOs2hCmRwwLNg2QCxO6EmyPubBNcBB6xnTlsfPQvxGa9zbSn8QWz2Mr52qXVLrTep24NqluD6la/stmHN3rxRm+2i/NGB7lzAa53os1ebXcQ+DuF5Tbs7+I9Tex8nbHWy7oaGHeD4GuR17vJhWjybr+8O0iw0c4k2BwT/UO0pzs515KYqouOVVz3Ft2N1Uedg72vvptrbrKRYQH9yZHXr3uyf/G/qnWvpNNqWs/rgwBMS9Wse2jZ0LbPuGS396ZgUCqZTpc7rXfTwj/33/80Z792i78bjPyxj/15nP3PXdZ/Gc785z77u5mHVw6zxCmVzh2/H0gdJm0pQ7DzmUmeYZZVIKu/FRuhNAAmEDASZIVjYSLEXR0mD1fl86fY2Yeu34gtrXYJy22st5lyN7yg3M2st01c6YRrvXijX9kcIMx4oxdvduPNboKd80ab3erOAFrvkVY74EoHWGqTva3qahfjrGc9jWClHW/1yZs9bKCdW++Ee0Pq7pi6MwG3J6SNUW65P+luj87URScqublGerohOt1yPdXZ8/JPu1PjNtJAQkjrmecuTnk+pmI9KOkMzp6LFyxLsCykWylo2opt78W47iW6dFItmX0ocz58dBivJ9CrGfnnaeHPo9E/9DPF8/ftO9L3Y2Q1br9yZt7Mpss9SrnzsmAY+i5s6cFE1hPp/Jp+Kv3bsSlKppMyR0uQB5rAq1QU3J6wJ+vyeQCfreDTxbw3aDP4eOpvwqadjZynRVrqQP4eZb1H3ehV1nvwWre6kUunst6hrHfgtXa43q7t9kuBdnmtA292o9V2sNQCl1qkxUbJ1yz4mlCgQ98bUHb7uLU2bqMd7Q+quyMEW1wfYZf6Ygst4ama0GhZeKSMnqkLTzacjjT2vvpzfGvdtu5t4z5jfL5EJYdNhvRnse9ximDLhiVZlmxYJjJt3rRPWLFrKfFu6KHCZdet3r+b1n4atormpBLX3aux0OsxtWXd9tP2LpSK51MfFuyXDvvNnPZqMlXmhkUzoY8j8dGAzWSfp3NfLZ/sKft6m9FvxU4kpHiMS0QZLsHAZBInwvLdqXixLZ8H8PkSPnMrJ87PHz/+Rdj8Uiuz2JR01b+gFhpYd7Poa4er3eSecLzWjdc6tc0eIp3DVtY74Hq7dTDE+BrF1VZzf1AJdEq+ZtnXzDlrlUCnuNQM/e3mwZB1NAJ3e8Fuj/ppRN0dUXZG5a1RYW2Y8fVG55tDk9XBkZLwSGlisvp6uOpstGmq9J1xd21DFSS4e/MhZT0Qb4Kdm7+fHcYzj8tv0kfMVCxbMO2EGW2cU2qcdpnLLlx4eDttvpkwP87gKuen9yO7RePCwI59admCbUdsqtZtd+yk3jvSr2fAz6NmiRO8G48XjN62LtgxNSP/hj1lvy79HLbMcQqVFBNhKhGKcOGgGLoUrw/Fi035fBWfL6mnbuV0/kvssd+ELa50fsbmFpu4xSbB1yItt8mrHSjQhdc6lfUuFOggd2GhQBtaayWR19rgeqf8uGTD/g7s71BW28m18ijQgdc6c1fiyXu9cG/AOBjT9sblrVE+MEB7u2ILTdGZmthkJTVdE5+ouhqqPBtt6n75Byt0a8uKyskGfro0y1228XUMLaUA1U7Z9oOdMu9tNWMzKlg+vawax9ULdqnTrliyCxasV+P3lW6tzr33qmOlckT9xNiJB5u1bWTbEc3y3ojNy3aD/77E/VC1CN9N6EUOucxxVTGWPojaKEM4Hw9jWuT9/HP7wDX56S4UnNPN/fVJRF7jOcQleTYSZ26uqfND6miDPlhGF37lwqedebTTBe14XjtxqMfT6vH0t7AJMzkPkL0paa1XDHQLyx1kKZ5w1r1gPY0EW1xqlVc7oL/9Ebvta2y01grX2/96bHm3X98fVXdHwOYQ5+/Px05OV8bGK876ig8Hqvre/Ik92LGxqvGQYOe8c9+snizZcp+z7Adbg7olG7Zh25wh+c9jHW6uYsaucNuVS/br6fs3U3b1Yvh1/85PLde9i+iSs1Xblux7/v5Bt+/FjLIZuaubU+p9WslCpsqDP0yli+dxieO2eET3X9lymtRxrrjJqP6tfeBP6vgvYgNJk3hFoiUhnhBCt/zNiXCxI54G0MWqcubNYj9K/63YnLuR9zQJi82Sr1VebkWr7djfoay1I38r8rcif0temmCgBa63yxtkZd6OA2040KastiqrrcjfSu5Kkzfa4VanvNMl73XLe73a3oiyMyxtDLKrPZS3Pe5sjs3WxqeqElMVkdGyT50ftrtKBt9/vz4yYItA42Hu0StHS1Cz9yzk/RKYRsYyMmk9c49TtvJgcyYOXF7VT4c/DqcrXfaHWfvNlF3sTJc7g6/7dt90RIaWzUvGTtsZ21ZgGskpaNlpy87cgZuuRbp6QS6eMavcWuGsXbKgFc4EC4bE2V1bMHUlpWHr8xdMoGFZzwUBDQENSirJcxuPCOrzA7ssakDAMifJFC3HwnL4Et19Um928NmKcubVztz52MrRxN9W2a4G4i16W8jdZ4QQrrbA1Ra42pyXRtnf+Ndgy5sdYLsT7HbJe714exBtDQpr/cxKN+VtjzsbY7M1ienK+GR5cKj4sOP9Tnfp0Ifvar7/vXh7qwuyBtV811wpY6Q/edNiGpmMcW/wiq3bNp9Cy2ehlnmqYlotn0sVOTIfZu4LHQ91Xrp0cudNR2Jy3aYMW7FVNSNqGVnJKCmbMtLQuL+ntOj4Rrh8kiuc1KtcVumCXeYyi2Yj7wZjfb50AplaxtQyWNYVaCCgAQFDSc0x50tD6Vsbzb6JLXIYcFBiBJCk5FgYhi6VuyPtdhefrWhnXu3UpZ44tJMZIv23YjPOWtZVx7nrhcVGydcsL7cifysOtIHlxrzUk0gr9d/Cho+3IOZjg90euNUL1vv4QB+93JVcbIs7G+OO2uRMVXyy/Hag8KSn8HCgarTwx3/4n//H660tU0KqrORc871zvwH5M/q9krbRgx2GwHMUanRw1Q67LWA3ruofph6qPHabP1gyulfUB5dObVq3eSMFTKikBJzSLTtt2wmsMUBNJ5Tk9NZt2ThbPKVXOTMVLrvcnSpyxD8MXjXN4lvW1DIp44EAY1mXeAQl9WtpWVRkUfnWLtJvYXO0xFMCn2SFWFwM3Uq3Z/D6AF9t4bMV9TRb1vrRtHY0QY4B/E3Y9EIN46zNx4arLcjfKi015KWORFyug+tt38Imt16C9bZ8bGm9Swx0s6s91FInwU7M1VGz1fHJ0ruhj1fDpScjdXPV7//j//Q/XG5spKGqytkX4znvfN3c+pzYW0C3GUNyHV7XTNKVM3bDkl3ttcvddo1XqXHeFo+c1E0IK6c2b9nKgymoGtAzaVtR7jV8n0rZjGbKasqWMkbgJlgxKZY7jGrXfbXHLvdkSuaZ4rGzmlH2OGyo6ZTxAARMRnKJR8+M3qKSw35+f/g3PnILrCzQIp9k+WhECN4IN0fSxa58HkCny+qpWz2Z105mCLb6afxvxX68Qb5O9DQAbwNcakLLzXilBXjrgbce+GrzI/pq4XqbvNEG19vgehsOtOJAq7Laoqy2wNVm2d8MAy1gvRVstknb7dJOB9jtEtc6BX8Xs9Kd9HU8wY6Ol4Ymq09Gavyd1e//379nLy9t1VTIJ6/H1+M579zzmPZ4LZoMFJPF3NJxrMMdKR1XK+btcvfD+5nUh+l0tTtcMvapcgRuXtu6bcOUyuMH4yGlpDO6rYO0wqmWci/rmZRl25ptnwqJmllYvWDWuO1ar13hfiiblypnjmtGopvnBrbS+j3goAYNA1tIVAxsKUDDkkqCRIUECPhbz2PfwkZAQyKWOQkkEyASlO5OwOVePrZ6PK19Iqd7xtRPY3/bMD5fzS5U8a460VOXh938lXQ1wcbrj9JfYssrTXC1GQZa5LVWeaNN3mqH2x1ou0sIdPCrnexyR9LXkfC0ZrEdlfHxkuR0ZWy67mSw6mC0vafwzT3H23oKQiwhFUENQ02Duo4MTTFVxczc2+mMbVr3hpYygW5xSioJ7ZB8WzcNahdwmUN6O2oUTNu1PqV87uRl52HVSOoobuu2bdpp60FVTAgUXUlpOG3CdFowyfyt4JQN0vY5F2teQA1uq9Zj13rtykW70qnUOC8rxhJLRxnRSOv3PCcr2NTUFJZUS03jvHk6Jy2Jfxk7f4KHkmqpaROZBkAqx6iJIAqdwptddBlAZz7lxKWeONXjWeVohhzwwZ/GlcMxdDj2eP5jBO5lr7eTtwcfb7DMYoNArxToFpbbPmNL7jrRXcMvVPPOKsFVDRbr0FKjstIoearBYhWJ7K2WfZWyt1peqsmuyQPZtZu80kSSm+CllUaw2gRWm2R/s+RvEVZbBX+XGOgR/N38cifrbWWc9cx8NTVVHhoqDA6Xnw1Vb3TXLXY225JsQUVWDVE3sWKayHoA1gOw0iilKymoWTh1b6RsxGNbs+2YoS8cR0onjMIZ++Oc/nZCL3FYTb5w2fhp1Rjj2rd5y5YtU7FUzcK6Rb6OYN2SNFPB5oNo2pJlYEtRLU1N2VIKe06omrlMw5JW7LDrlx/qvFr5QrJ06lPNuB0CBjQZGePMA07dG9iCHCK0ooQlEUMBQwGLEuYlTF6afvEMJmAgYIlHEo9EDgIOAg5KrCyxMmBkTdA1Hqssr1JRJXamhPfV4IZ2E8Cni8qJRzly4qN59GkOHk7Bg3F5fwTtf3GaS94eyN15hDb74UafvN4L1nrI3ZXiSifrbWZ9jYy3gfE2vJA8taK7hndWEWzJUwt9dXi5QfJUSp7KLLavkgT4qhV/E/J/XqXnsHMTPCHP/gasNAsrLcJqu+jvItjMYgu9UMc4qqip0vBwUXi08mqsfrOnfryq5IHlLaiIuiHoJlbMFLRsybIlKwNTupKCqQyw0lrqwRR1m0vb/jvcuoQKpuxil/nnwYeiuUy99+p9/37ZoLRyarP6PbR01cK6JRvZIN2SDUvQTaiYD6Jpi5aJLKRaspFKo5Sydh2vmzPqFq1yZ6bOZ1V7rHInXzh5VTpqn3GWZLBYldIZYKZ0ZKq8Ah51RenXsCUR52MTacDIJJCWVVbVaagmKSV+iyPHOLip3Kyol95HbDf+tIAO5+HhjHwwSbDz7kcZIPebEWm02Y/W++RAD/B3E2nyvYtg04v1L8BiHcHmFip5Z5XorpG9tWipPh8beCvysb+WlleaRF89Sb66tNwkrLTwK23ZrepL7ay7mV6oo2cr6emK6GhJZLLmbqp5q7eh5eX3ZjxpQU3SDFE3FfwZO41SqpbCmQfRsBQzk4EpOwTjvUvRwjGlcEZ7PWa9n3qoWRQqZs9Lh+X5A5tN2eghDU1VMaFmAt2Emgk1E2km0E3OMGXVvJdMW/qMbeHUw6dktGFeqXI+1HgzNYtG+UKqzCkVTN5+HLa3Ig+8DpAu6iaPNQ0aGtAlEfNfYpNCf/I5JIctcjBX1kRaooFMAZiEOC6iWByFr+TgIbgOyBdedObGZ27lxPXXY2fvN1vrzccWltu4xSZusYH11LOe+heyt17y1JJzmsRb8lSDxRqCnfX2VhBv4KvGq43PDuD8Yi2/WCt46wRvXQ5e9DUIviZ+qVVY7uBXOjhfG+NuoB011EwFNVUemyiLTdeFZts2euur/vR7LZawoAZVQ9JMFZkpaD0A0sE7hbUUvrcFKwU1KyNb9rV42zQX+TCsljjk9+PpusVk4dh14VDGe2HTaVtI3XOqiUxF/YyNNJOcn+YMU9LMFDAfgEW+aBFsOwiTHYtiucNuWElXurXC2XTxvPx+IvJmMDV/YseQjkxRVjkRqZJGthVzAHMA8xKGAkY8JgO7BBQJfPnG9HEAFx8HcCJNsKWYJEc4EI6Au3Phelu4WBZP3eB4QT3Nw/40l4c9/C1sef2JdAe/1MotNhFpxl33AvoawGKd4Kpm5yvY+QpuoZJ3VojuKtFdIborsuSL5cRb8lYR7K+nas5Tk0sefD3vbeSWmvilVn6plfO00K56arY6OV2enCyLT5YnZhtup1oDXXWtr382krQFNawYUDF1ZKaglZGttGzpSgrpKfn+QUylBaimBd0OwmSXjy+fhSWzerMvUjq+/66LG1mzkylbfEgnoK09GPgpNvkrZ5iiblqymZGzc7ZspEwlZbMpfnSDLp2y65dSZU6jYCb90YFej3Evh7SeNfuSv5dMIGCBh4qomsgSJczImJGz2AqHoYCBgIGkSOCLF+M5bIGVyVRNpCUagKQkRUQQZqVQSLo9E6+2xPMl8cQlHc+pp2712KUeOZVPC/hwDn2es5/HJlP1l9Lt/FIr62lk3HWMu4521X6BzcyVM3Pl7HwZt1BOsLPei+VZ78UqtNLwzKJsqYFxVTGuKtZdTZIHX8d7GwVfC+9tJmN4crYiMVUWGytOTFXEZ5tOR+u9rZXz7c33EjBlVcWGgk0DmilopWXLRJaqpYCZ4lMpkLnnJZwRDTuqSYNrqM7NFU6Gq6YOyoeEmR07rNhJ3WZ1W32wsKVgA6qGrBqyakDVwIpB/oUzTEHP/jJ9gQ1s3XseLZs0q9zpkoVMgSP1blr9ZVT5ZRRUzj/sRG3OwCwCAtYEVQM6L2EaYhpiDmDEY5XFiMdQwEBSyKrt81vxR2mCLTJZaZGSQFICUQlGODkUku5OpOtt6WJZOnWCo3zseXw4m8POu/boC2yw1pPDJtKcr43ztTDuBiJNOWteoKVG2VtPsGlHGe0oY+ZK2fmyHLborniCjZab0HITXGokkX0Nsq+BXagk4ZxVnLOKd1WTCO5a3tMgLDYLi82sq4Gar03MlMcnSyMjhcnpyvhs035fxUJj2fmSxzbThqTpyNRRFpt4YC0lmamkrkvpjAAUG2XsuEH3LAtVc+GCkb3ywaRz12ZTtmJn4rItW3baFngZK1npr7E5w1SRaSJLw5aiWkhP6UrKRrZ9mLwrn5BKZtLF83bhgvXLuPnDyP3LSf7NSHrpyqY0lUGKqGqCikSFA5iCmMrDJsWdW6ITaVHIDuAEW2QAwRYpiWDDhIRjHIpEYPAM3uzCy1Vw5oInC+qpSz1x5mFPwINR+WD4W9jktGZ+WXO+NtbbTLvqGWct46ylF/KwmblycoCPdpQwc6WCq/wJtrRY/jU2kZZ9Dcx8BTNfke9NIrpqRU+d6GngPU2sq4F21CSny2MTJeHhj4np6shs42Zn8UxdMXd+YqdtVVINaBrQtGQzBS3igfSUZKYSiiKm0jLUbN22E8Z181yoeOyyYPBufNVOYFu1bU57AKYlGxAohpn5WlrNq2ysmAb+jK2pKVu17RvpqnKCKRhPF8/bRS7rx1Hz+2H79Qz9Q5/hPLETqsFgXTZ0XpV59DU2Ke7fio2SQInzSiyGwxfodgddrcALDz5zac9hkzH8L2I/Srey3mbGWU+kqfnqF7SjjEzVgquad1ax8xXUbHFypiiHLXkqc6tx2VsNfXXQ1wB9DWipkQQvN+HlJvIIJ7pryFovNylwcxXMTHlyujw2VRqbLE9MV9KzlZyjWnTVM3P1lyMVO/1Vg6VvqNNPaaiStQ/BNpFlYEtVLNlISWZKzGQkMyWRyk7o8WH/5s+tR6XDNmPawMzIZhqaJjI1JTs350Jma1XJ/hew0sBKq1pKV1K6klIVC6mWolo6r9rIpgf9kQ/DRsGM8f2w/Xpa+WOf+oe+5Hc9Z3VT6Rtep5EqaaaoY0kVoMpglcEqLytYUDROIdi5OZvsUBD4LDPPAJ4BOezcAk1NAhxj5NCdeH0kXqyDcx86c+OzBfRpDh/OqQdzyr5DOZhRDibwwdf3kD7eG7/emz9nC8sdOWxqvpaar07OVSXnql5Qs6W0o4yswwk27Sgh2MSbYGe987Bz3jns3CP7Z+zZMn62nJ0uTU6WxCZKYhNliakyerqCna0SnHWhifKr8aqD4bqmX/4Q2t990FKqrJMxnER7nFMlMyWlM5yiIajbKdtmrcsh36fqMX3lyhZME5kGNsmLNkXNrrqfSOewoZmWrTTWUpqaMsm3S9VSVAtKqo1t6DoKfRzR3k/p3w3dv5zEf+yzfhyN/Llzr2JYu6RNQdOArouaKusEm0YKwc4N47k5O7cdhUhztMTRkkBLAi2RsiaVrSQkJUrD4J14fSheBqQzLzxzqmcL+PAR+2BGOZj6dWxprSeHTYZxgs0tNlHztUQ6OVf1IjFdTM2WMnPl5NHrWWwyYWdfonlrZW/9k+JGS41gsS6HTaZ/araUmi7hpovZqaLkeFFsrDA6XhybKKGmyunpMn6h9mak+Hq89tNYc+0P/3x3sHtvpFWUUqChQYPM3EQCahbQLdlKC4quYNNO2baYingPGNeBLdoPwPzcO1LNPmLlJ4edbQRvpMnZDk1NmcgihzGhYkpQs5UH+4gKl0/C12PanweNn0blP/Xpryeuf+zaqB6Wr6g0SinQMCRdlw0BKAxSGKTkhnHIIZlHZBjPlTXPZWv6L2CHbsD1IbgIgDMPOnUqp/P4cFY9nFX3Z9T9GXV/StkfxQcj+GCIdDfLYZOyltZ6wFrPk2GcWWzhFpuSczX0XBU9V0U5Kl9EJz7Gp4qIN3n6oh0l1Gwxwc56Pz565bC/9pa99bn3M2T6T0wXJyY/MpOFzFhBYqQgOvwhPPwxMlYUHy9KTpYwjqrIVOXNRN3BWNNQ1QcxfKcjAyMLo+xBZ9JAgQyzULNE1VCte6yYGtDvJTMVh3ZYtqFtYUvVnomimrl8ga2lsJZStZSGLbIGVJEJFVNQ9JSStimLanYJL4fVPw0oPwwJ3/UxPw/cFo4cDXpAmLP0e4wMDehYUPIfvWQeYRbJ5GFaQIL4WZpjs8zfwlYTkhqh4d21dLUnnfsJtnoyjw9nlYNH6b1Jgo32B3MNzsDW57KW1npyc3aurJnFFtbTSLApRyXlqHwRGn0fGS9ITBfTjjIyyxJs3lnGO8ty2LnVuOypgYv1JMjbQIJ9jcjbIHvqJFcNP1/JzJYlp4rjE4Xx0ff06Adq5H108F148F1w8ENoqCA6+jE2VpicLudcLXczjZv91YfOCVtXRF6WZQMinfQvIN7ZzUCqJUFNtx4QNngG6LJhm7aNMjqn6KpFesM+PSyifGGcS/biJdXSsEU6oujIlFWTM0xFtWxow5FN/tWw8t2g/P0A/+PA1Q+dVPcSvX0FOKgaGQlqGtAlGogSZiXESogTEeCgzEKRgwIPeQHywmdplpE4WmIpkYSnRJ4ShWQ2UkJU4qISTsC7a3C5J537pVM3PJlTTxzocEo5mFL3Z5S9SWVvEu+N4L1h/IhN+iHlsMXHxin5ZU17mhl3AzVbTc9Wkry4HXoTGn0fmyxMzpTksGlHSQ5bcJWLnrJ8bNlT97U38jbAxXqCTc+UxicKI6MfosNvk8NvEoOvov2vQn2vg/1v7gbeh4beR0YK4pPl4mJ7zNm+1FnCne3YmRTHiKKsA2SCL70JOYI62bMtQ418fVKRiYCmaylN/7z/8HOwqSmfJ3IywiuqSY7lqYqlIzMNzDQwNWgAxWBTKVE1bPBge6/4NyPaD8Py9wPsq6G7D0Oq98xMQglqMJWhAVKAxsV5UUCciFgB8kL2vRjPyRwv8wLkePnzOU1aZCmRSQrfwBYItnx7BS73xLNlgq0czxJsZW9a2ZvEu2M5bFLWBDsnLT62yMmVNe1pptxN5BUWkaZmKl5cD7y6G36bX9wEm1so/VzcnrLcoxfB/tob+xoJNjdXQU2XxMY/hkfehwdfJwZfxQdehnt/uet5edv76q7vdXDwXWjofXyyPDFbx6z0e1o/ipf7diYliUiAuoRNCetfe+tKCsoaRDpSLaAYHFIlzdTTNpEmwJb6OU9WbTlsA1vkoUtH5r1kZkRDlw2gGGwmzam6TWv2ISu8H9d/HoU/DjFvR2CP3z5h0rLFYhVk7uMiwJIqJUSRg7wAWQFyfPa9GMsBmgMcL3N8VppgM0nhr8C+kC52pdNl+cSNT+aU41l4MIn3Jwm2ujum7g6jvQG0N5D72CVt9uVj574+5Mo66WrMYVMzFdRMxYvrvpd3g28iox+SU8XMbBnrKGcdpbSjhM/HJiO5p1LyVD7B/mLy9jYQ7ORUcXy0IDL0LjzwKj7wMtb/S6jn5W33LzfEe+BtcPBdcrLserhIXh91NX9IHK7dY6gppijrEtafxU4ZDxgZMtQkqAlQBbqlPtimbeeXdT62gZ/H1rBlYEvBJqnslGTosoGwIaUzEtb1qGTf4kjZJFMwHn0/fFcylvLf2FFkwjQlI5SxY5wIBFWigchhgYcchzheFljEM4BlIc0BjkMcCzgWsoxEappJClxe+EQ2YlyQ4jyOcUokhm4upMsd6XQZHC+gY4dyPIv3s9h4dwLvjuG9L7BJp7MctuDvIi2R+KV21tvMLLZQ7oakq55y1lGOrDQ1U/GCnSqKj7wL9v0SHnhFTXzkZ0v52VJqukhwlPHz5cJCheislFxVwFMJFmvAYg1w1wJ3LVysh74GvNyEV5qV1RbV34qWm9BSI3DX8vOV7HRpcvRjYuh9bOB1fOBltO/nYO+r295Xd71v7wbeR4c/REc/co7q8FhZbL7NVff20jdrG6qlGJm0jRUTK9nXIPn54uSmlv1KjXVL09Oanla1VO6a6ifJHch7coqHeOce8wxsIQbacsam9NupNV9J91mPS9kN2axpiiYClijrvKQLgiJwqshhgVN5DvGswnOIYzDHwuyfNOJomaUgSwEuIbFxkYkJbFRgoiwTZZkow0Wy4SOMEKZQOAlvg+DqRDrbkE4W5eN5fDKrnEzj/XG8P4n2puDuuLwzQg7ag50+uDOYvW52IzuMk7P25OsD622mF+tpV31yoToxX5VwVMYmiuLkUWj04wtuojAx9DbS9zI28JoaL+BnSriZEmaqSHCUiXN52O5qsFgje2uBu1b2glnrXAAAIABJREFU1JGCRstNeKWZ7FfBK81wqVH21AkLVdxUKTVWSA19SAy8ifa+jPT8ctv9y3X3Lzfdr2/63oYH30WHPyQny4IjJcGphtmKn7cn++y0CVgxY9lPjL/GfppH7CdnLb8V0t8IPnqr6PGFnWQYDLZhxuaNm8CRf9R1tbSPw7wmpSCwILCAaEiCLvKawKkCp/KsQsIxmISlEUsjgUIChfgk5BIyGxfZuMhGBTYqcBGWi7A5Zj6HHYzBu1v58kg6WxOPPfKxAx1PKSeTeH8c74+jvYkctrg7AHb65O0vsMVAdw6b87WwvkZ6sZ521SYXqhPzFYm58thEUWysMIvNjBUkht6GB15FBl8nxz6wU0XsdDE7XczPl+cqW3RXkbLOx0ZLjWi5SVltwYFWZa0NrzSj5SaCzWfv+/qQGHgT7fkl1PXTbedPl+0/XrT/fNX58rbnzV3v2/Bw0Vn3u9vJxv43vztwjNqplEiJhv5ALsv6TdjPnp/+VnINy3LThAYNXTYMQTN41YbpB9Fkz6Oh3QtwTd1LpipaEFiyZBLsZ6UJMwmfhESaYGfLOsKzYYYNM2yYZsM09xg+lETBmHx7Ay4+iacB8dgDjmbh0SQ+nsD742hvDO9OoJ1xeWcE7AyCnQFpu/cL7LUeKdAt+jty2Ly3kfVkseNz5Ym58uh44WdsauR9YuhtZPB1ZPB1fOQdNV7ATBURbGGhQliokFzZL9yyt1b21pIJm2CTMZxgK6staLlJ9taLzmpupoweL6JGCpKDbyPdP4Y6v79p++6y9bvz1h/P23667PjlqvP1bf+Hg5afL0fr2n/8B+n80EZIgwYEZOw1v863sH+T9NfYOW9D0i3JSMuWKWgoJqKYaHHqPUwp0mdpUtZfVzNLI4aCJHnSgIkJdJRnIjwd5pgQzYRoJkQxIYp9jBBMyLcReH0tnR8KJ37+aEH6NCN/msCfxtHeGNobQzvjOWxpu1/a7kVbnzea5bCF1XaCzS02MO46ylmTmK+Kz5XHHWUEOzr6MTJS8CI6+I4kMvA2MvQuPlpATxZzM2WkGbHgqhbdNZKnFixmh+7s0szXQLCz0mtt2ZHc1yC5avjZcmaimB79SA29i3f/FO384bb9+8vW785afjhv/fGi9ZeL9pcXnW9PO98HGt+NFv5oY6AwQsqwAUipSvpfgP3XMOefq84/qYVlXZV1DRomsjSgyyxUOKwJqiaoiMfwOen8Us4x00mZTmaZ2ThgYhId5ekoT4c5OszRQYoOUnQwSQeTzGP4uzi4DcpXF+L5nnC8yn2aFw6m5MNxdEikR9HOONwek7eGwVa/tN0rbffCzX64OQDX++W1vse9Zh2ktwLrbSbY9EJNcq4q7ihLzpbFxgrjox/jox9jIwUvwv1vooPvYkPvo4PvQgNvIkPvqIki1lEuLFTlsHPSBDs3YcPVLLa63q6stSF/C1pqlFw1gqOCnSyhRz/Sw++pvpeJnp9DnT/etP1w2fLjI/br45aXtyOVQz//p4X6YltXNB7qqg2xrfxG7K8LOtcA49l8jU28FWho2AIC5hmgAE0BmsgAlhKJNBnA86VzxjlmKgGoBMiTFukoT0U4KsRSIfZb2NLNHTg/E092uE/L/MEcvz8JDsbgwSjaGUU7o3B7DG6PyNuDWeytHrjZL2/0ky7ijy9S2nPYZEcK+fIRd5QlZkqjj9KxkYIXd32vI0PvYyMFkaH3wf43oYG38fEizlEpzFcLzhrBWSO566TFeuBtkH2Nsq+RvCslEzbyt+BAK15vUzY+YwN3LcFmxgrp4ff80Fum/1W8+5dg58/XbT9ft/181f7qsuPNccvLm6Gq9t//u5GiV7YkmpKG4YOq26r6fK+cvxL716URNp7tNZklRwY5RqtqKYh0hpU4XibSubJ+tppz0lQCMDGJhI6KVIRLhlkqxCaDDHWXpO6S1F2CukvQj+FuY+L1LTg/E463uU/L3L5D2BuT9oflg2G0O4x2h/H2CNoazmJv9RDsbFkHeh/3pbQLy228t5n3NnPuesZZS81XJxyVT7Cjwx9e3Pa+Cg++I9h3fa9v+9/Exgo5RyW/UC04a0RXbT42XGqSvfWyrwEuNcorTcjfgtZalY12ZaNdXW/HgVa03CR5sk9f1FghM/JBHHnPD72l+l6Hu1/edry8af/luuP1Vefbs/Y3x52FPX/+f6p+9x9shlE5hOGDZvwLsf/Ksn4Wm9Q6kFUZaiwHeAnr1gNUTJoDEtRE8TM2KesnzPnSyXi+tECwk0Hm17Gls1PheJs78HL7M8LemLQ7BPeG8rAHwdYA2O6VtrrkzR640fdbsUlZR4c/vLju/iXY/yY2UpAcL4qPF0VHP4aG3t8NveMXqkVXrbRYT44NwKUm0dcgeOs/b1Ahm5P8zbK/WfI3o7VW5G8h07bsqQML1ZKjEsyWcUNvuaG39NC7xMC7aN/7UN+7YM/7254P6+W/P+n+6Cz97u/++/92oqEuJakasnnRwjh7IlfBBjkaYpn39oP9W7G/2dAIZI/ffT5aJ2FRwgJQBKDwj9sIyXtvVkIc93nhnS+d+yHHnIiJiZhIRYRkmE+G+USIiwfp2B0Vv6ViN8nYVTR2FY1dRWJXkfhjqMsQc3LOnxwKx5vi0TI4mgeH4/BwBO2Tj1oDcHOILMfkzR55swtsdIK1HuDvAf4ecSW7/UjwtQi+Fs7dyLoaiDTlqEzMlMemimMTRYmxwvhwQWTgXbD39Yvb3le3va9CA28jIwVk2RYcfn/d/5qbr+JdNdJiPSnoJ9hkZ/jjSYAsNjk5IPsawGKd5KqR5qvgXAU3+l4YeU8PFySHCqKDBZGBD+H+98G+D2ftrz+1vnaW/Nf/9b/7b373r/9V9OScpaAkWQhmT3lhpENZhbL6a89df11lf9H/5Evs7BdJKbsvmGDnpBkREuyvazp/qs5Jx6OfpXPYsZvkt7HvmJMz4ehAPN4UjrzSJ4d8OC4fDOP9wcet/2Tt3Sdv9oCNTrDRKQd6gL9HWu3Ox+a9zQSb7EhJzlY8wQ73vw32vn5x2//usvvVRdfLm7630dGi2ETJ3dCH8+6XlKOSXagR3PWitwkstUi+ZtHb9DW29IgtP2LDpUbZWy976mRnDVyoESaKhIkibqKYGiuKjxTFhgujQx8jgwX0dMVV/8ezoaqPf/+//Onv/hWOxzWgY2QBSZFEJAoQSBjKKkY6Odb17KpNVcy/iP20rdFX5ysJtihhTkQkrABJGF5mWfxEmpTyk5qORwWSPGk2dkdFb5Oxm2T0OhG9jEQvI9HLcPQyHHtM8uKWPToVjvaFo3Xpk1c8nAUHY2B/CO0NZPf9bwzAdbInvAtstIONduDvzmGLvnbB25bb38e6GtiFGnquKjlbEZ8ui08Wx8eLEiMfE4Mfon1vQ92vXoSGCi66Xh63/nDR9TI8WkiwTzt/TsyUU45KxllLTnfmYT9uKl1tEvOwQaAFBFrgajN5b4q8DdhTj9x1sqMczFYIMxXsdBk1VZ6YKI2PFyXGChMTxeHRYsrVvtpWOFlbaJvITt1jqCnYkETEsRLPASir5GNl7pDfM/lV7F/vU0b2gAoiEkREPk2SkI8ZLAdYDuRWZPm6ybiU+4FIxyJ8LMJHw1yeNBO9TUZvk9HrRPQ6EbkIRy7CkYtQ5CIUfUzi/Ib5dMId7gqHa8KBRziYkfZH5d1BuPt4nCcr3SOvd4KNdnmjXVrteizrTtHXzi+2CovNZH8f46zPxyYvSuPDBfGB95HeN8Guly8iI4VXPa+P2n446/olNPIxNlFyN1Jw3vsqOlkSny6j5qs5d73gaxKXmsWlZsHXAJafYouBZjHwGRuvNOPlJmWpSfM1qd5G6KqFrlpxoYZfqGbnqhlHFTNTTs+UJsY+8gvVibn6i6mGM9egFru2dTWlG/aDbehpIGGBl3MFTUb1Z/Mt7F/vU/ak4Umu2/tjG3Dw+bPVc8N1LqSaCXMkxEZCbDzIPkrT0dtk5CYRuYpHruLh81D4PBQ+D4bPg5HHxM+u6cNj9mCH2/fz+25xb1rcGwI7fWC7W97sgRs9aL0PrvXK693yeidYbwPrbeJKJ1jukpY6RV+H4G3jF1t5TxPnbuSdDdxCPTNfTTkqk9Pl8clS8qKUYId7Xge7Xr6IjRXfDbw/73550fMqOFwQmygJjxfdDn8IjRVGJ0sSjkrWVcd7Gx+xmwg2Ob2Xj52duf0tyN+irraoqy3Gcoux3IJ9jWipEXobpcV6wV3Pu2p4ZxU/X85MFWkrLYyzPjjfFPFPnK/MyvGgCYH9YN9nbF1LIaiROVsGCpDwvwz72T5lX0sLPCSbh3gGkM0k5FskS4nPDtexCJ/7IScdDjLhIBO7Yx6l6chNInwdD1/Gwpexb2En9z+x+9vs3iq35xT2JsSdQWm7V9rqIr1j4VovwQZrHQQbLHc+Srfzi62cJ7s04xbq2fm6r7FjQx9i/e/CPa/vOn95EZ8sD48W3w4W3Ax8CA4XRsdLY5Pl8amKm5HC4HhJbKaSXqjLddgRl5r/GmzN36oH2qzVNsPfpq22KauteKWNTPzSYr3kqZVcVdxskeisFH0NlLc9tDy4v9B/uxu4Pf4kCyKCWq6FJYIakLAkIgS1Z/PXYH+WllUyPT+z1fdxz1DuYzOfELikQD83XOcSDXM56dAdHbqj86Sp8HU8dBUj2KGzYOgsGDq7C53dhR8TO71K7n9i9raYvSVud4HfHRe2B8StHnGzMx8brHXlsKWljs/YnhbOnZ2tCTY7V03PZrGzL0oH35MJ+7bj5xd3Uw23U7XXE9VXo+XXIyXB8bLEdCUzV0uKOz5dRi/UEGx+qV1cas0fxvMXaJI/exgfB1q1QJseaDPW2o1AhxZoVwKd2N8hr2a9gbcBLNYpK43JmSLkbwVrPVFfd2JzKrS1cLTsuDvco4MhE8i2mb63UrpqIKQgqEGUDTm6jaGmyhqGWvYjJs5+xXp84036GKm5sYEk+6AlqqKoCoIiCoooKAKPBR5ztMzRMp8EfBJwCYlLSHxc4hJSTjqHTYDzazoSZMJBJnxHh+/onDTBzkpfRJ/Fjp9cJfd22b01ftcr7Mzx2xPi5qC40Qs2uuFGD1zrJsm2hF5vk9ZapeU2si7jF1v5x7L+FnZ09OMX2LbBXvjG10fqL+e7zifrz0ZLozPViZny2ERRYrqYcVRwzmrW00i5mxKuprizUVhszH/Hku2z42/Fa+25KI/Ba+3Kepey3qOs96D1HiWbLmW9C6y0gpVWablFWG5jlzuopc7EUld0aTDond0ZG+Y/7dsKNHkuhaH9YNOMoBgpxcyoRkZTUwrQFA4bopqGpipn+fP/xFAhfyIZQ4CwhJAIoSADEYmiyokaJ2qsoHKcwrKYJJGQniQZlxIJKRYTolE+GuUjkc9jdeiOjgQZEgIcvssCR26o6HUuifhjYheR2EWErMti56HoWTB6FqROL6mdNX7LI2wtiFsOaXMCboygjQG80Z/fJRisdUiBdiHQJvrbpOUWydcq+VpFb4uw2Mx7GkRPg+Cu5xdqufkaxlFFzVQkJkpjY8WRkcLoUBY72PWSYEMcu9qaH/J0Vx3Ptl07Gi9HSxhnbWyyMDFdzMyVE2za05zwtCZcTcJiI/DUy4sN0NuYfd+y2oL8rTndXLK9Tkl3469CXt9n3/6QY3++FtbXyfkmwLr3cLT3zDVrG9i2NCoWzWQekGbK2IBKStfudWRiFmFKVjlE6vurKArAJBjISIRQlJAgSwIUBI0TDJbXWV5nOI1mVYpRKEaJJeRn81k68sVwTaTz6/graSqehx09D0fPw9l1+FkwehaMnN4lT86YrWVhawFszksb03B9Em6MobVBtN5HqgKut8trbVKgPYctLmWfjERvk7DYyHsaBHe94K7n5mvI+jc5Xf4EmyzFb9p/emFbip1CiZPNlZGW7dGG05mG66kqxt0QnSwiWxA5ZzXnrifFnXQ1ip6Gr7HhastvxQb+TuDvJOTCchsh55a6hJUxad15MtG73FV/41/MCMl7BRlIUZAq8FAUFE3NGOo9EjRIIywo6PnbdlQIFAgUWcKyBIGIJAEAThY5yPMqz+scp3GcxrIqwygMo9A0jsfBs8lJh8OfpYO3FBm0c8bh62Tk6mliV/FcCDZZlxHpLPb2krC1IG3MSRvT8vq4vD5MsElTUXmtjWCL/jYh0CastopLX0hzbrLsrSPYZAxPTJRGR4sIdmTgXR52Wrc12VY48XJnfbRpe6gyutgZna8PT5cnZkqZ+UreVSO4azl3PeNuYJz1oqdBctdlvf8GbLjWLQe65EBXjlxcaReWOznfQGiuR9iYP58fnKopPFtasFWIadqCishIPANUlDL0BwRNBAxDvZeB/u2rdhAQsCiQTb6ywGZ7hRJmIk3TmKIQRaFYTHo2OelQ6LN08JYK3VKhWyp8nQxfJ0NXidBVInz5NNHLWC6Rs1DkLBQ5D4bP7iKnd+GT2/DJbfL4lN7yCZtz4vqMtD4lr4/La0MwMADXevFaN+koCgKtor9NWG3l/a38Sovg+0Kac9fzrron2PHxkuhoUXj4Y2Sw4AvsB0u3ELAzup2CiYOVY0fX9UL7raMhOF0Zc1QRbNFTJ3rqBHct76ojn0YIdvbTyEozXG0hbbLym2CS38rPDa2/zLPk0moX4+1KerqY5SHaP3E00bHYUXvsnr1nKRsrpgixgBVoYWSJsinjtG7ZkqQ9G0FQBBEJPOZ4mecQywGWkRlGZln8hDmZhMkkjEbFZ0OenvNrOniTDN5kgbO5iIcu4sHzWPA89i3s8GkwfBoMn92FTm+JdOj4JnF0Qm16+Q2HuD4jro2DtRF5bUAO9CJ/D/Z3QX879Ldm+9KstnKrLfxKC7l2KyfNuuo4Zy3nrCVjOD1bmZgqi4+XREYKCXa4/y157rpu+/GFoen2fcY2NDut2ClZvtg4nm27nm+9m62NOGqo+WrBXZs7xyW4qrPfwdx1+djySvNvxf7cvz6PXA50CaudINAbc7YmFnuFtelPY21rvc2JLb/NULYkPyBTA7ooKIygcjAlqRlO1ARB+To8jzkOkSUYwyCahjQNKUomzESaMCcSciIhfws7tyIj0nc3ybvrxN11IngZJ7m7iBHmu7Po3VmUwJNELqK5hE7uQid3odPb0Olt6PiGJP7pKLnh5tanhbVJcW1cCgyDQD9c7YH+TrTajlbb5dUWsNIsrrbyKy3ccjO33MwtNuRLM85adqGGXchO2NRM9ux7ZKQwNFQQHvjwBbZppuwH29LUjALsjGKrdHLXdeHsvnQ0h+bqE84Gzl0veWqBu1pyVYnOStFdkytu0krrL2Bv9T0bZbtf2e7HW31oszfv8plOuN4OAu3iSiflao0vtPPLo3HP+O5gR2IjYIYjNlQNEXO0xIoah9O0rHOiJgqKIGhPQnOY5jBZfyVpnKBQgkLxJKRpzFCYTiIqAZNxORmXEzGQiIFoWHg2T2r67jpbzXcXsSfMwZNI8CRC/iVb5eeRXAh28OQmeHITOr4JHl0Hj67jn46oDaewNikExoTAqBQYlPw9cLUb+jvhShtcaSPYQlY6u/EoX5om0n8J+7bj5+u2H19k7m0r9WA/2GldScmcnUY2iB47+8/n2m7nm+PORtbTCBbrZE+N7KoAC5WS6wts2dcIlpvklWbS2BbmBQRaQaD117G/8u6E623yejP0t/LeZmqhmV3sYTzDN1O9271t3N62zfMmJ4o0L0MNaGlW1ngeCzwWOJXnvwj7uMxO0jhB4QSFYxSKJxFFITqJcthEOh6VvoWdP0/nsElB311kme/Oorenkb+IHTy+JdhEOnh0HTv8lFxf4NeI9LDk7wP+HrjaLa+2ZbFXmqXlJmm5hV9u5nwtnK+F9WSl87GZ+WrGUUWw45Ol38Q207aVekilMveWaRuqrUNbE2yV3hpvCnp6b2br+aV21d/GOkqhs4KfKZJcNWQYz2FLS41g+fMDNwq0kQUauWxCXu8GG93yZo+82QO3etF2H9ruwzv95IcnwVs9YK0JBhrgaqO80gx9beJip7DYz3iGryZ6z2dGEltrFpVMIyhwPMWJUDV4TmYpkUlKHAslUZWBLnAqTUMyVmeZk0o0gSNxFI3L8TiIR6V4VIpFxGhYiIR4knCQIwndsSTBWyZ4m31VErqlcvM0Gb1vTyME+O44THJ7FLo9Ct2chHO5OwnmkhvGSWWT4o5/Oor5Z5jVIXZ1gF/pE1Z6xJVOsNIuL7fCpRaw3CQtNYpLjYKviVtqIti5YZx11ZEPmtlDmjMVyenyxFRZbCK7OgsOfggPfLjtfnnX+ctd5y+3HT+/MNN2Km1bqYe0lXr0BrbGBdfmP8203yy0Md42eqEGuGuxu4pg51c28DZIS43SUmMOO+eNNjrg5jPYeKf/V7Dl9WYYaED+JnmlCS61yN524OkUFvuTzqGoa/zaNXW96hFuLjIYmipiaUbmIeCgQEtMUqATPJOUeAYKnMpQmKYxlcTxJIol8GfsKCDSOewc89fSwVuGrLpzi7JcTRPsJ9J/EfurYfww5p/Kk+4Cy53ycqu83AqXmkghSUuNgq9J8DWRXWa8J4ud66fwG7BTaTubVCZtpe5NzdZVWwN6/Gp3uuva1RVxtd5NlCBfE/bUCo4y0VktumrztyuJvgZpqZGsyeXH4kaBNtK/OIedX9bfirL9/zd3Z89pa3ccwPs/t9NO19x2Om2z2DHeMGBjY+P4Jk5ixxtii+0YgdhX7WhDQkISSCBsbAM2fTiyzHVy096XTme+D7x/5vx+h6OzbHQvPNaF2zpf7p25e/Fl4N2JrDeP/Vr8HQP9mHu/XoI+6kR5qEsDXbUUvaeYhmJ05I4OjtiIHVlsy5LZbJqS1G1IXUHs8g2TE7qcYDR4o8G2G2xbYHS+rvF1jaNVjlZZquWEIRWGVOqEXCfkaWZbGpTuKWO6yFCFOlWok4U6UWKcUCXaSb1E1UsUXSLoElEvEnQBpwu4kM81TneVzxtqfEOL+/W4rxP3GDE3kAYB14vpUTe4ScEZ1tPY4IzPw/cPeypeD/6V2fzhJ9ijoY09Gtre97eDybU1GRjkxXHl0F/bW6Q+vGpDC0ZozjyeaR/be9PAZSmd8Hw7utCOLoDObXxedrzNLx4z4f3msO6nt34mAQte7Se81oXHOvf0zla6nz1m3GvEfCrkVaNbzdgb8iiQfecr7G8rufNJq3Grapaid5uqKetdpW0oRrvZaTXastgGX6tE0WwIJicYnNDluY7APUo/YQbGj8yETONNmhAp3GamajxZ5agKR5YfinahTgLmPE3maSJPk4U6XrRDFikndJGkiyRVxKkiThdwKo9ReYzPZYXP7+T4Wiu+psZ8Wszbji07zGZ0EdTOdsStRZa18ArYkTKNLT0ctJc+vnhYErcb9jew70b34/H9aDgBefQeXt7IVPEokN+db4TcwqeZ1sErE3JpR7POXkQ9NNeGXHpkXo/MG/ElI75kTHkb5+A66vVOct1IbZhIwEQC3fQmOKD2zfTTW/3kej+5bsF++72hs5Xumdc89fThLSXiE0OrUmSTOwqguz7qMNiEI32WsUR5oGiWrJmiYohqTzEvO1dqQ1MEvWl/rerwfJvnOjzX4Vl9ekxPGz9lBgFFu8aTVQ4UZzBqyUKdyNO2cY4CwbIkkaexgh2iQDqhCgSZx8kCRhYwMoeCsJk0H99pxlaV2Gor5lGjbj26BIDBLl7wWw8vA2w1vKSGFsHszN6B9HDQHtTwaWx664d64NkT7PHdaAy8nXp+d3szubYmox6dOCrurQiRNXL3ubj3oh16rR7OqIczwFsPzemhOS3s0sIu0F06U97G+Urny4oJrxupDYA9LW1lg1/nMhO8RLbtV+Rgfy+xZia89l842G+er+nxVT22oYc35UM/u7tS3vHUoqFGpXrTUu+M3kDR2rzUabSsVlfjWy1BlXlN5PUGCzp0m2fbT0r3E2OHmcIkELLKkVWOqLBEhSVKDBiyWIHGcxT+YIxnSTxLYhkCyxBYlqzl7GA53AmRw4gcRuRRIo8S2RqRreGZKpNG+PiOEvO2ol416tGj7nbkKXYnPA/2oqiQ28F2ajjABlfLgYbNvbUb9jewJ+MRwB47zXs0Gd0O766sybg/4CtUdAfdXyJ2X7Dv/6l8egmwgbe9kgrNaWEX6NztB2/z1N05c7fP3d3kxtfYVjbYz21/navMzhWyM0B2LpHtfmqzB/tN2GcmvGbCY1x4LlP+KzhgxHydY69xtKru+ai33uTbrXw02iiVurxw1ZQtUdY5scWIKqcofEtm1SanNjhNYFXAzNe1Rl0TaJWnWhypcKTCEjJLyAzedFLHpDom0ahIoyJgxssMXmammfEchWXJaWY8TaBpHM0Q1awdNIs5IXIYnkXxXA3P1fBMFaSOpLjYGznqUSKeVmRFiyzbHxXDLhsbmn+C3TpZmMYWP72S9l8CbLthfwf7fnx3P74D3sPRHchoNBpdX04G5uS6wydD8PYsvr9AvX/Jf3wJ7idXD2fU41nt5LV28lqF5lRoDnRugD3t3YP93aS/l1rvpdZBt77MBC8zwavsNsgT7EH6xytkp49sW6lgLxXoJv0m7DMS3kE20IV97dhyO+LuRXxWeNU49sqHfgp6j+y/SewGK+EDvVYYNvkbqdlheJ1tqlxLZlWJ1QRWFViVZ8CGIRUEYD+RZrEmg0oMKtVrIohTt6elsSwJ4kijaRxDcDSNo1ms+gCMZeygWQzP4gAby1bxTJVIl0ikxCdhIRpUoiv25CuyqEfmO2FXJ+wyI/OdsAtga9DCFLZrumF/B5vafFYPPKuvTU/QRnej0Wg8HI1Ht6PR7Wh0Oxzf3oxH4/u7wVVvcn9zownV8LvinleKbXEHC439mcb+S/lgpnk467wvokEL07/18GLiHsTIAAADXklEQVQ7stSJLnfiS85krXvh7SXWLNjfg/092G8l163kupV8nJz3ke0+sg0udXvMQ4Xvp7f6qc0evNG7CHRP/ebntU5sVYuuCZE1NuynT1bxT178YF0627/CixNVadOCzqmq0BU5g6VUGm9ypNioy2CPmLNNDHyU5HCJxUQGbbBVganw4N+zMwUj8jQARjMEmsZrCFZDsDJc/TqlZLmULpczlRpSQVM1AkEJBMUQHMtg1XStlqmi2SqWrRKpInGRIU7hegRqQgHwtJoaXtDCLnDtqxae1aEZFZrRQ69VaA4smamhRTW0qJ24tJPX6vGscvhKPnjZ/PSiufe8ufdc/vi8+eFf4u4/hLd/F3b+xgafMVt/qW/+mV3/E7P2B8r7O9z9m18NR3fDMcC+Ho+uR+PBcHx7c3d7O5mYfet+eD0ZdKUSXD4KEgdrzKdlYf91Y/+l+OnVN7FbJ66fYMcW7feizj3WF6/9zCPst2C/PREDC2oP2L30tpV508vamVYHY91KbnUT9oE27bNP++yToCUJWhKPF9g9F7nrIvc8bOR9Az7tEEybU9tSvyX1Rc7gqZZASg360fsJNo+KXM3GZspcvcTSRYYuMs4UDAxiIF1Nod/BLqVLNaSCIhUiWSMQlEjhaBqvINVyplLLVNFMiUoWyS8IHUtw4RMZ2tCgJQ0C0gB7VgvPqtCMCs3YV8A+Ys//Imwm8N9hDycTw+oNB/3JeHCvcVT8Q+HHhfr+Er8362DLR6+nsacfEvomNvAG2HamsK1UsIsEfw77Mv2mj2xPY4OLJcTQvAwtytBi42iBfj9XfePK7bhTbwM0jHBFUqRbrUZX5g2RUSVKlChRpH8ZtjMFwx6GdTWFVpK172NXU+Vaqkwka3iqhiexJ9gkXCDOU3QswULH/xfYo8mkfz24vbIm48Hk1pBSoez2HL236GBLBzPOy0FqaB78flrJH7CdZbX+hQ8Uc/sJX3jDSj6stPwn7Mv0m34q2IM3zQv7AKN+uqqEl1Rw/gVyNw7d1Ifl8jtf6m3gbOddCjpFMwRHKiKjOqetfim2MwUD0g5zKVH5OkW4VERKRaRYSZZqqTIOV7FkFU9iNQQrpyqldLmartTSRSKRx8+SVPTif4DN+P9YX/096fkttvzrfwOIzRLRgyVorQAAAABJRU5ErkJggg==" alt="" width="164" height="164" />By Sarah A LoBisco, ND</p>
<p>One of the scariest diagnoses for a woman to receive is <a href="../../../../../breast-cancer-awareness-month-prevention-with-functional-medicine/">breast cancer</a>. As an integrative practitioner, the labels that are placed on people serve as a guidepost which explains how their body has been led off the track of optimal health. With the emergence of <a href="../../../../../let-food-be-thy-medicine/">nutrigenomics</a>, the healing power of food, functional diagnosis, and the Naturopathic philosophy of the body’s own innate wisdom, <a href="../../../../../naturopathic-medicine-toolkit-for-health-potent-cost-saving/">there exists powerful, holistic tools</a> that can provide the body with support when pathology seems to be winning. This is even true with cancer.</p>
<p>Dr. Mercola recently interviewed Dr. Horner, a board certified plastic surgeon regarding the topic of breast cancer. Dr. Horner discussed how her journey of treating breast cancer shifted from conventional surgery to a more integrative focus. As Dr. Horner found herself operating on younger and younger women, she made the realization that environmental risk factors had to be at play. Below I highlight some key points she discussed in this 90 minute interview:</p>
<p>1. Studies have demonstrated that breast cancer <strong>risk is related to lifestyle</strong>. One study showed how the relatively low risk of Japanese women to breast cancer was reversed once Japanese population exposed to American diet.<br />
<strong> </strong></p>
<p><strong>2. </strong><strong>Two factors exist that tell how useful a screening tool is: </strong></p>
<ul>
<li>Sensitivity (does the test pick the pathology up?)</li>
<li>Specificity (a factor that determines if the test diagnoses the correct disease or gives too high false positive or negative results). High false positive rates led many people to be improperly diagnosed with cancer when the condition is benign. False negative rates miss the diagnosis.</li>
</ul>
<p><strong>3. </strong><strong>Mammograms:</strong><br />
<em> </em></p>
<p style="padding-left: 30px;"><em>[M]ammography produces radiation, which has been shown to increase the risk of breast cancer. It&#8217;s like, &#8220;Why are you doing the test to look at a disease when it&#8217;s actually causing the disease, too?&#8221;  … It does pick things up at earlier stages, but the problem is that it&#8217;s not very specific. So when it looks and it sees something… that looks suspicious, it is wrong 80 percent of the time. In the United States, there&#8217;s roughly a million breast biopsies done per year, and 800,000 of them are unnecessary.&#8221;</em></p>
<ul>
<li>Are not recommended yearly for women not at risk. Every 2 years is now recommended by the American Cancer Society.</li>
<li>Chronic radiation exposure can be a risk factor in itself.</li>
<li>Mammograms are not a good sensitive marker for screening dense breast tissue.</li>
<li>Younger tissue is more sensitive to radiation.</li>
</ul>
<p><strong> </strong></p>
<p><strong>4. Other options screening options include thermography, electrography, MRIs, and Ultrasounds</strong>.</p>
<p style="padding-left: 30px;"><em>&#8220;Now there&#8217;s a relatively new ultrasound that uses a color mode,&#8221; </em>Dr. Horner says<em>. &#8220;It&#8217;s called elastography. But there aren&#8217;t very many centers in the United States that use it. I go to the Center of the Hoxsey Clinic, to Dr. Arturo Rodriguez at Tijuana. It has a color scale that measures the elasticity of the cell membranes. Cancer cells are very stiff, whereas normal cells have more fluidity to them. It&#8217;ll show up as red if it has a lot of stiffness to it, as a cancer cell, or blue if it has elasticity… It&#8217;s a very good tool.&#8221;</em><br />
<strong> </strong></p>
<p><strong>5. </strong><strong>A note for your men: PSA levels can be helpful, but are only one screening tool, as discussed below for women.</strong><br />
<strong> </strong></p>
<p><strong>6. </strong><strong>Thermography:</strong></p>
<ul>
<li>Has the potential to find cancer at an early stage.</li>
<li> It has good sensitivity and is safer than mammography in that it uses infrared images vs. radiation.</li>
<li>It is not fully standardized, creating confusion and controversy and mixed trial results.<strong> </strong></li>
<li><strong>The best way to check for standardized and trained thermographers  is to find a practitioner certified by a third party:</strong> <em>To ensure you&#8217;re getting the highest standard of care, Dr. Horner recommends using a practitioner certified by the </em><a href="http://www.iact-org.org/"><em>International Academy of Clinical Thermography</em></a><em>, an independent non-profit organization that provides objective, third-party certifications. Their website lists qualified thermography centers across the US, Canada, and some other countries, such as France, Trinidad, and Zambia.</em></li>
</ul>
<p><strong>7. <span style="text-decoration: underline;">The most effective thing you can do for cancer prevention is choosing the food you eat. </span></strong>Whatever you consume is what your body is made out of. Dr. Hornor discusses that Vitamin D cuts cancer risk in half, but so do many other things.<br />
<strong>Certain foods affect cell growth by how they turn up or down cellular functions. They affect the volume of the response at the cellular receptor</strong>. <a href="../../../../../let-food-be-thy-medicine/">(AKA Nutrigenomics!)</a></p>
<p><strong>8. </strong><strong><span style="text-decoration: underline;">Foods to avoid</span>: </strong></p>
<ul>
<li>Non-organic red meat (contains high amounts of toxins and a high iron level, leading to increased oxidative stress)</li>
<li><a href="../../../../../how-sugar-can-cause-cancer-how-family-dinner-may-help/">Sugar (glucose is cancers favorite food and suppress immune system by up to 90% for five hours)</a></li>
<li>Trans fats such as hydrogenated oils make cellular communication less effective.</li>
<li>Alcohol stimulates prolactin, estrogen, and inhibits liver enzymes to process out extra estrogens and toxins. It also disrupts folic acid (needed for the repair of DNA). (For a different viewpoint, check out Naturopathic Fun Facts this week)</li>
</ul>
<p><strong>9. </strong><span style="text-decoration: underline;"><strong>What to Eat:</strong></span></p>
<ul>
<li> Cruciferous vegetables which have been shown in many studies to have powerful anti-cancer properties.  <a href="../../../../../breast-cancer-awareness-month-prevention-with-functional-medicine/">This class of vegetables and many others have been shown in studies to modulate cells at the cellular level.</a></li>
</ul>
<ul>
<li>Flax seeds which contain: healthy fats for cell membrane structure, fiber to bind excess estrogen, and lignans that give structure to the cell wall and are anti-cancer. Concerned about estrogenic effects? Dr. Horner puts this question to rest:</li>
</ul>
<p style="padding-left: 30px;"><em>There are all sorts of different strengths to estrogens. Let&#8217;s say estradiol, which is the strongest, most abundant form– if it hooks on to the estrogen receptor, it may cause a thousand cell divisions. But if a plant estrogen hooks on, it may cause one. When you flood your system with these plant estrogens, I&#8217;d say it&#8217;s kind of like a game of musical chairs. There are only certain numbers of receptors, and whoever gets their first, gets it. They&#8217;re blocking the strong estrogens from getting on, so that&#8217;s why it has an inhibitory effect</em>.</p>
<ul>
<li> Combo Meals! The combination of healthy foods together is multiple. One study  found that combining broccoli with various foods boosted its cancer  fighting enzyme:<em> &#8220;Researchers  found that myrosinase from the young sprouts enhances the levels of  sulforaphane formed and absorbed from the broccoli when the two are  eaten together. Eating broccoli with mustard, radishes, rocket or wasabi  can boost its benefits further. Professor Jeffery said: “To get  broccoli’s benefits, the enzyme myrosinase has to be present. If it’s  not there, sulforaphane, broccoli’s cancer-preventive and  anti-inflammatory component, doesn’t form.” She said foods containing  sulforaphane which can be teamed with broccoli to boost its benefits are  mustard, radishes, rocket and wasabi.&#8221;</em></li>
</ul>
<p><strong>10. </strong><strong>Factors that are increasing early puberty and resultant heightened breast cancer risks include:</strong></p>
<ul>
<li>Hormones in meats</li>
<li>Chemicals in our personal care products and household products</li>
<li>Early radiation and toxin exposure</li>
<li>Exercise reduces the risk of cancer, even during chemotherapy!</li>
</ul>
<p><strong>11. </strong><strong>Sleep is crucial:</strong></p>
<ul>
<li>Most recuperative sleep hours are between 10pm-6am related to the healing and hormonal fluctuations between cortisol and melatonin (a peak occurs between 12-1am).</li>
<li>Melatonin helps build the immune system, is an antioxidant, and decreases inflammatory estradiol. Optimize endogenous melatonin by contrasting sunlight in AM and creating a very dark sleeping environment.</li>
<li>Sleep is also preventative for obesity, diabetes, weight loss, and all chronic diseases</li>
</ul>
<p><strong>12. </strong><strong>Stress management:</strong></p>
<ul>
<li>There is an increased risk of breast cancer within 5 years of major stressor raises.</li>
<li> The risk increases twelve times!Ways to manage stress include prayer, meditation, tai-chi, yoga, deep breathing, and social support (see fun fact #1)</li>
</ul>
<p><strong>13. </strong><strong>Integrative treatment has the best survival and outcomes in some comparative studies</strong></p>
<ul>
<li> Dr. Block’s patients utilize a combination of chemotherapy at lower doses because he optimizes chemo doses with natural means that also decrease its side effects of nausea, weight loss, and fatigue.</li>
<li> Saunas have been found to kill tumor cells and to help detoxify</li>
<li> Infrared adds energy into cells to help expel toxins by affecting their frequency. The physics of the energy and wavelengths combine to kill off unhealthy cells of a different frequency than healthy cells.</li>
</ul>
<p><strong>13. </strong><strong>Life Vessel  Technique: </strong>A new technique Dr. Horner utilizes to balance the Autonomic Nervous System. It is said to decrease the fight and flight system by providing electrical signals that stimulate cells to secrete messenger chemicals to reprogram DNA.<br />
<strong> </strong></p>
<p><strong>14. </strong><strong>Breast Implants:</strong></p>
<ul>
<li>No increased risk has been found for saline and new materials according to literature</li>
<li>Polyurthane implants did pose risk in past.</li>
</ul>
<p>For more information on how to mitigate your risk for cancer, keep empowering yourself by listening to interviews like this, reading holistic blogs, and surrounding yourself with healthy relationships!</p>
<p><span style="text-decoration: underline;">References:</span></p>
<p>Dr. Mercola. How to Starve Cancer Out of Your Body &#8211; Avoid These Top 4 Cancer-Feeding Foods January 14, 2012. <a href="http://articles.mercola.com/sites/articles/archive/2012/01/14/dr-christine-horner-interview.aspx?e_cid=20120114_DNL_art_1">http://articles.mercola.com/sites/articles/archive/2012/01/14/dr-christine-horner-interview.aspx?e_cid=20120114_DNL_art_1</a></p>
<p>Jo Willey. SERVE BROCCOLI WITH MUSTARD TO BEAT CANCER . UK News (online). January 29,2011. http://www.express.co.uk/posts/view/225897/Serve-broccoli-with-mustard-to-beat-cancer</p>
<h6><a href="http://www.saratoga.com/living-well/2012/01/holistic-preventation-of-breast-cancer-anti-aging-foods-more.html"><span style="text-decoration: underline;"><strong>Visit my blog on Saratoga.com for:</strong></span></a></h6>
<p><span style="text-decoration: underline;">1. Naturopathic Philosophy Highlight&#8230; Fun Facts</span>:</p>
<ol>
<li>The most important determination of health and Longevity Revealed!</li>
<li>Healthy Aging Foods</li>
<li>The Good and Bad of Wine and Breast Cancer</li>
<li>Your Diet woos&#8230;.Gluten Free, Dairy Free, &amp; Sugar Free. Yet, you still have symptoms!!?? <a href="http://www.youtube.com/watch?feature=player_embedded&amp;v=AFKtG_f8FF4">Watch this Video</a>.<strong> </strong></li>
</ol>
<p><strong>2. </strong><span style="text-decoration: underline;">Happenings</span>:</p>
<p>Upcoming Essential Oils Workshops with Terry Quigley at the Healing Garden. Learn tidbits such as what is mentioned below:</p>
<p><span style="text-decoration: underline;">The Miracle of Onycha</span><br />
<em>by David Stewart, PhD, DNM</em></p>
<p>Onycha is an oil mentioned in the Bible, Exodus 30:34, as an ingredient in the Holy Incense to be diffused in temples of worship. Onycha oil (Styrax benzoin) is also a powerful antiseptic and facilitator of rapid healing. It goes by several common names including Friar&#8217;s Balm and Javanese Frankincense. It is extracted from the resin of a tree that grows in the Far East, specifically in Indonesia.</p>
<p>For more than 200 years, hospitals have used an alcohol solution of this oil as their primary antiseptic. Dissolved in ethyl alcohol, it is called Benzoin or Tincture of Benzoin. It is the smell of this tincture that used to give hospitals their peculiar &#8220;hospital smell.&#8221;</p>
<p>Following World War II, hospitals started to employ other antiseptics derived from petroleum that were less expensive. They are now discovering that bacteria can become resistant to these synthetic antiseptics, but do not become resistant to Tincture of Benzoin. Hence, many of today&#8217;s hospitals are returning to the natural antiseptic of Benzoin realizing it is more effective and does not contribute toward the creation of resistant strains of virulent pathogens.</p>
<p>Resistant strains of bacteria are a major and growing problem in hospitals today resulting in thousands of deaths every year. Even visitors to hospitals can pick up these pathogens, which can be fatal. Even the most powerful antibiotics, such as vancomycin and methycillin, do not kill these germs. The answer is to be found in natural products such as essential oils.</p>
<p>Contact Terry at 518-831-9469 for more information.</p>
<p><strong>Next Health Forum is February 9<sup>th</sup> at 6:15pm. </strong><a href="../naturopathic-doctor-to-offer-third-integrated-healthcare-forum-in-saratoga-county/"><strong>Learn more.</strong></a></p>
<p><span style="text-decoration: underline;">PATIENTS: Please review follow ups and cancellation policy on </span><a href="../contact/">my website</a></p>
<p><span style="text-decoration: underline;">Time for a symptom re-evaluation</span>?</p>
<p><strong><em>All patients can now download the symptom survey done at the original </em></strong><a href="../new-patient-intake-forms/"><strong><em>visit online</em></strong></a><strong><em>.</em></strong> If you haven&#8217;t re-evaluated your symptoms in a year or more, it may be a good time to fill out the form again and bring it in to your next visit. (Please add the numbers in every section when you return it)<br />
<strong> </strong></p>
<p><strong>3. </strong><a href="http://click.linksynergy.com/fs-bin/click?id=YS5wNadRhrI&amp;offerid=206928.10000064&amp;type=3&amp;subid=0%22%20%3EHay%20House%20Radio%3C/a%3E%3CIMG%20border=0%20width=1%20height=1%20src=%22http://ad.linksynergy.com/fs-bin/show?id=YS5wNadRhrI&amp;bids=206928.10000064&amp;type=3&amp;subid=0%22%20%3E">Radio For Your Body-</a>Mind-<em>Soul: Resonance with Joyce Whiteley Hawkes, Ph.D.</em></p>
<p><em>Joyce Hawkes, Ph.D., joins Diane Ray to discuss her new book <a href="http://www.amazon.com/gp/product/1401929087/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1401929087%22%3eResonance:%20Nine%20Practices%20for%20Harmonious%20Health%20and%20Vitality%3c/a%3e%3cimg%20src=%22http://www.assoc-amazon.com/e/ir?t=drsarlobsnatm-20&amp;l=as2&amp;o=1&amp;a=1401929087%22%20width=%221%22%20height=%221%22%20border=%220%22%20alt=%22%22%20style=%22border:none%20%21important;%20margin:0px%20%21important;">Resonance: Nine Practices for Harmonious Health and Vitality</a>. Dr. Hawkes explores the uncharted interfaces between science and spirit in relation to health and well-being. Discover how to enhance your health at the cell level, your spirit at the soul level, and your consciousness at the mystery level.</em><br />
<strong> </strong></p>
<p><strong>4. </strong><strong><span style="text-decoration: underline;">Book of the week: </span></strong></p>
<p><a href="http://www.amazon.com/gp/product/1591201551/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1591201551%22%3eWaking%20the%20Warrior%20Goddess:%20Dr.%20Christine%20Horner%27s%20Program%20to%20Protect%20Against%20&amp;%20Fight%20Breast%20Cancer%3c/a%3e%3cimg%20src=%22http://www.assoc-amazon.com/e/ir?t=drsarlobsnatm-20&amp;l=as2&amp;o=1&amp;a=1591201551%22%20width=%221%22%20height=%221%22%20border=%220%22%20alt=%22%22%20style=%22border:none%20%21important;%20margin:0px%20%21important;">Waking the Warrior Goddess: Dr. Christine Horner&#8217;s Program to Protect Against and Fight Breast Cancer</a></p>
<p><em>&#8220;[W]e have the answers to the breast cancer epidemic,&#8221; </em>she says.<em> &#8220;We truly do- and it&#8217;s very simple. If you have a terrible diet and lifestyle and you do just one thing, you cut your risk in half. You do more than one thing and they will multiply up together. They don&#8217;t add up together. They multiply up together, so it becomes extremely easy to dramatically lower your risk of breast cancer.&#8221;</em><br />
<span style="text-decoration: underline;"> <strong> </strong></span></p>
<p><span style="text-decoration: underline;"><strong>5. </strong>Don&#8217;t miss out:</span></p>
<p>The Rest of Fun Facts on my <a href="http://www.saratoga.com/living-well/">Saratoga.com</a> blog.</p>
<p>Listen to my colleagues and other experts as they discuss solutions to menopausal issues on a show dedicated just for women in mid-life! Here is a link from my <a href="http://www.blogtalkradio.com/magnificentmenopause/2011/03/31/magnificent-menopause-and-beyond-enbracing-midlife">interview on 360menopause Radio Show</a> on <em>Panic Attacks and Menopause </em>and a list of archived shows.</p>
<p>Check out my latest answer on <a href="http://www.sharecare.com/user/sarah-lobisco/answers">Dr. Oz&#8217;s Sharecare</a><em>: Learn about holistic treatments for Alzheimer&#8217;s, HPV vaccination side effects, and more.<br />
</em></p>
<p>View the Updated Link Resources on <a href="../">my homepage</a></p>
<p><a class="a2a_dd a2a_target addtoany_share_save" href="http://www.addtoany.com/share_save#url=http%3A%2F%2Fwww.dr-lobisco.com%2Fhow-to-modulate-your-risk-of-breast-cancer-the-pros-and-cons-of-screening%2F&amp;title=How%20to%20Modulate%20Your%20Risk%20of%20Breast%20Cancer%20%26%23038%3B%20the%20Pros%20and%20Cons%20of%20Screening" id="wpa2a_8"><img src="http://www.dr-lobisco.com/wp-content/plugins/add-to-any/share_save_171_16.png" width="171" height="16" alt="Share"/></a></p>]]></content:encoded>
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		<title>A New Perfect Diet?</title>
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		<pubDate>Fri, 20 Jan 2012 01:42:52 +0000</pubDate>
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		<description><![CDATA[ <p>Brilliant Physicist and Medical Wife Provide Full Picture of Diet </p> <p></p> <p>&#160;</p> <p>By Sarah A LoBisco, ND </p> <p>January 2012, the time for New Year’s Resolutions to shape a New You!  After two weeks of blogging, in which I introduced to you the importance of using diet and lifestyle to protect and [...]]]></description>
			<content:encoded><![CDATA[<div>
<p><strong>Brilliant Physicist and Medical Wife Provide Full Picture of Diet </strong></p>
<p><a href="http://www.dr-lobisco.com/wp-content/uploads/2011/08/diet1.jpg"><img class="alignleft size-full wp-image-990" title="diet" src="http://www.dr-lobisco.com/wp-content/uploads/2011/08/diet1.jpg" alt="" width="120" height="103" /></a></p>
<p>&nbsp;</p>
<p><strong>By Sarah A LoBisco, ND<br />
</strong></p>
</div>
<p>January 2012, the time for New Year’s Resolutions to shape a New You!  <a href="../../../../../building-the-foundation-for-health-in-2012/">After two weeks of blogging, in which I introduced to you the importance of using diet and lifestyle to protect and optimize our health in this toxic world</a>, I thought I’d take a moment to discuss the topic of dieting. There are so many experts with so many different viewpoints, one can get lost in a pool of confusion between low fat, high fat, and meat fat!  If the goal for diet is weight loss, you can pick any diet, because most diets will work, but results are usually only short-term. This is because most are aimed at starving out when particular component making the body work harder. Long term use of restrictive plans such as no carbohydrates or no proteins can cause a lot of strain on the body.</p>
<p>However, if the aim is health maintenance, body weight with adjust without severe and restrictive plans, and a lot less stress. So the question remains-do you eat like a caveman, a vegan, according to your blood type, all organic, all juice or what??…Too many experts, too many viewpoints….it’s enough to make your head spin! <strong>There’s a place for  all of these diets. They will work for some people some of the time, but not all people, all of the time. </strong></p>
<p><strong>Various factors such as disease pathology, current health status, environment, ethnicity, and genetics all interact to create individualized needs that a one-size-fits- all-diet can’t provide. My job in part of the nutritional approach of a wellness program is to guide someone on why certain diets and foods may be most beneficial at certain times. The body changes and so must the diet.</strong></p>
<p>Dr. Mercola recently had an interview with Physicist, Dr. Paul Jamine,t on his viewpoint of the optimal diet.  <strong>Dr. Jaminet was called to search out an optimal eating plan due to his own failing health. He and his wife, who is a medical doctor, have complied what they have learned and studied in epidemiological and biochemical journals into a dietary plan that compromises three key points: </strong></p>
<p><strong>1. Optimizing health and energy </strong></p>
<p><strong>2. Repletion of key constituents missing from our modern diet, such as minerals</strong></p>
<p><strong> 3. Decreasing the toxic burden on our body.</strong></p>
<p><strong>In the interview, Dr. Jaminet pointed out that food is not simply calories, but is information and energy. He felt that the best way to find an optimal diet is to study:</strong></p>
<ol>
<li>How the body uses food during famine, when metabolism and energy intake must be at its fullest capacity to maintain survival.</li>
<li>The nutrients needed for optimal growth; specifically he studied the component that is found in breast milk. His conclusion was that it was compromised of 40% carbohydrates, in which 50% are metabolized in the brain.  Protein is only 7% of breast milk’s volume.  He concluded that high protein diets are not suitable for young children and can cause an increased risk of obesity.</li>
<li>Dr. Jaminet looked at other species and saw that although we eat different foods, the metabolic breakdown products are similar.  For example, vegetarians make the claim that many other mammals are herbivores; however, their colon flora is designed to deal with the many toxins that plants excrete to survive. He found that various herbivores metabolize and break down these plant carbohydrates into fats.</li>
</ol>
<p><strong>Therefore, Dr. Jaminet concluded that we need a balance of micro and macronutrients and came up with the following guidelines</strong>:</p>
<ol>
<li><strong> </strong><strong>To have a diet with 2/3 calories from fat and 1/3 from carbohydrates and  proteins.  Include eggs, which are 52% fat.</strong></li>
<li><strong> </strong><strong>The bottom line is to mix fats with carbohydrates and proteins, meat should taste moist, not dry as to maximize nutrient content.<br />
</strong></li>
<li>Glucose from healthy carbohydrates are vital to maximize our body’s ability to fuel cellular processes.</li>
<li><a href="../../../../../cholesterol-to-the-rescue-cholesterol%E2%80%99s-not-the-bad-guy-part-2/">Healthy fats are crucial for satiety, membrane permeability, cell signaling, and energy. Fats should be high in saturated and monounsaturated fatty acids</a> and have a balanced omega 3 to 6 ratio. Dr. Jaminet recommends to achieve this optimal balance, eat a pound of fish with a pound of  carbohydrates such as veggies, fruits, and rice, a day. When these carbohydrates and proteins are combined with fats, lactic acid bacteria in the gut is produced for an additional benefit of  immune health. He recommends bone broth as a drink which provides minerals, collagen matrix and it contains approximately 30% proteins. He Beverages to include teas, broths, coffee, some red wine.</li>
<li><strong> </strong><strong>The diet should contain 15% protein with the best sources being red meats and sea fish. This is the equivalent of 200-600 calories a day of protein.</strong> Too much protein, beyond 600 calories a day, or from lean meat sources (which are a higher in toxic content and lower in omega 3s than red meat or seafood), causes the release of excess nitrogen which is converted into ammonia. The body only has a limited capacity to convert this ammonia to urea or uric acid for safe excretion.  When this capacity is exceeded, these byproducts are eaten by gut microflora and create dysbiosis in the gut and various health issues.</li>
<li><a href="../../../../../probiotics-supplementing-your-diet-with-bugs/">Use fermented foods for probiotics or take supplements to keep your gut healthy, as it’s approximately 80% of your immune system</a>. Overuse of antibiotics and an imbalanced diet squish the immune system and suppress symptoms. Probiotics modulate receptors in the gut and if overpopulated or under populated and feed too little or too much fiber can affect symptoms positively or negatively.<strong> </strong></li>
<li><strong>Supplement with minerals</strong>. Dr. Jaminet recommends to take a mineral supplement with iodine (if choose to go higher, build up slowly), copper, zinc, magnesium (200 – 400mg), selenium (200mcg), calcium supplementation usually not necessary, 200 mg if need to, chromium. Seafood, sea vegetables, and bone broths help optimize mineral status.</li>
</ol>
<p><strong>What I liked about Dr. Jaminet’s approach is that he is stressing health, not weight loss. I too recommend a balanced approach. However, how can we take all this science and put into general guidelines that can then modified for each individual? Here are some tips from Dr.  Mercola:</strong></p>
<p style="padding-left: 30px;">Eventually, you&#8217;ll want to eat 5-6 small meals per day, with protein and carbs combined in each meal, and about 50 percent or more of your calories should come from healthy fats like avocados, coconut oil, butter, eggs and animal fat that is not heated at high temperatures and is organically- and humanely-raised. In order to get the most results from your fitness routine you must:</p>
<ol style="padding-left: 30px;">
<li>Learn about the timing of your meals in reference to your wake-up and bed time, and your workout time.</li>
<li>Learn about your macro-nutrient totals. That&#8217;s just a fancy word for the optimal percentage of carbs, proteins, and fats in each of your meals.</li>
<li>Use good sources of acceptable proteins and carbohydrates.</li>
<li>Determine your nutritional type, which will indicate the ideal ratio of carbohydrates, proteins, and fats that your body needs for optimal performance.</li>
</ol>
<p style="padding-left: 30px;"><strong>Beneficial sources of protein include:</strong></p>
<ul style="padding-left: 30px;">
<li>Organic chicken (dark meat for protein types)</li>
<li>Fish (as long as it is free of heavy metals and other contaminants.)</li>
<li>Organic free-range eggs</li>
<li>Lean, grass-fed red meat</li>
<li>Whey protein</li>
<li>Nuts and seeds</li>
</ul>
<p style="padding-left: 30px;"><strong>Beneficial sources of carbohydrates (fibrous veggie type) include:</strong></p>
<ul style="padding-left: 30px;">
<li>Any vegetable (the more colorful the better)</li>
<li>Dark green, leafy vegetables such as spinach</li>
<li>Apples</li>
<li>Grapefruit</li>
</ul>
<p style="padding-left: 30px;"><strong>Good sources of starchy carbohydrates are:</strong></p>
<ul style="padding-left: 30px;">
<li>Brown or wild rice</li>
<li>Yams/ sweet potatoes</li>
<li>Bananas</li>
</ul>
<p><strong><span style="text-decoration: underline;">So, here’s the next baby steps to take this week:</span></strong></p>
<ol style="padding-left: 30px;">
<li style="padding-left: 30px;">Add some healthy fats into your diet this week. Work on increasing the ratios to an optimal 2/3 fats and 1/3 protein and carbohydrates by making sure you eat a protein, carbohydrate and fat at every meal. This will balance blood sugar and not only help with health, but weight loss.</li>
<li style="padding-left: 30px;">Substitute a major source of your meat for all organic.</li>
</ol>
<p><span style="text-decoration: underline;">References:</span></p>
<p style="padding-left: 30px;">Dr. Mercola. This Food Can Slow Your Brain &#8211; and it Lowered IQ 4 Points in Recent Study.  Interview with Paul Jaminet, PhD. January 07 2012. <a href="http://articles.mercola.com/sites/articles/archive/2012/01/07/dr-paul-jaminet-interview.aspx?e_cid=20120107_DNL_art_1">http://articles.mercola.com/sites/articles/archive/2012/01/07/dr-paul-jaminet-interview.aspx?e_cid=20120107_DNL_art_1</a></p>
<p style="padding-left: 30px;">Dr. Mercola. Try this Simple Trick to Slim Down and Build Muscle Faster January 13, 2012. http://fitness.mercola.com/sites/fitness/archive/2012/01/13/what-should-you-eat-after-your-workout.aspx?e_cid=20120113_FNL_art_1</p>
<p><span style="text-decoration: underline;">Be sure to check out my informational blog on </span><a href="http://www.saratoga.com/living-well/">Saratoga.com</a><span style="text-decoration: underline;"> which includes:</span></p>
<p><strong>1. </strong><span style="text-decoration: underline;">Naturopathic Philosophy Highlight… Fun Facts</span>:</p>
<ul>
<li>How One Doctor Reversed Her MS with her Diet</li>
<li>A tax on Soda Helps Health</li>
<li>A New Approach to Heart Disease Treatment-Chelation?<strong></strong></li>
</ul>
<p><strong>2. </strong><span style="text-decoration: underline;">Happenings</span>:</p>
<ul>
<li>Upcoming Essential Oils Workshops with Terry Quigley at the Healing Garden. Contact Terry at 518-831-9469 to get more information on attending workshops or to learn more about how to use this powerful therapeutic ancient modality to create a non-toxic, safe medicine cabinet for you and your family.</li>
<li><a href="http://www.bizjournals.com/albany/news/2012/01/06/trader-joes-confirms-store-opening-in.html">Trader Joe’s is Coming-It’s True. Thanks Bruce Roter and the Crew.</a></li>
<li><strong>Next Health Forum is February 9<sup>th</sup> at 6:15pm. Join me a lovely group of like-minded individuals at the Healing Garden in Rexford, NY in an open forum discussion on the latest in health and wellness. </strong><a href="../../../../../naturopathic-doctor-to-offer-third-integrated-healthcare-forum-in-saratoga-county/"><strong>Learn more about this and the upcoming events in 2012.</strong></a></li>
<li><span style="text-decoration: underline;">PATIENTS: Please review follow ups and cancellation policy on </span><a href="../../../../../contact/">my website</a></li>
<li><span style="text-decoration: underline;">Time for a symptom re-evaluation</span>?</li>
<li><strong><em>All patients can now download the symptom survey done at the original </em></strong><a href="../../../../../new-patient-intake-forms/"><strong><em>visit online</em></strong></a><strong><em>.</em></strong> If you haven’t re-evaluated your symptoms in a year or more, it may be a good time to fill out the form again and bring it in to your next visit. (Please add the numbers in every section when you return it)</li>
</ul>
<p><strong></strong><a href="http://click.linksynergy.com/fs-bin/click?id=YS5wNadRhrI&amp;offerid=206928.10000064&amp;type=3&amp;subid=0%22%20%3EHay%20House%20Radio%3C/a%3E%3CIMG%20border=0%20width=1%20height=1%20src=%22http://ad.linksynergy.com/fs-bin/show?id=YS5wNadRhrI&amp;bids=206928.10000064&amp;type=3&amp;subid=0%22%20%3E">3. Radio For Your Body-</a>Mind-<em>Soul</em></p>
<p>January 18, 2012 <a href="http://www.hayhouseradio.com/archive_preview.php#">Weighing It Out<br />
</a>Join  Marcelle to learn the myths, facts, and fiction about maintaining a  healthy weight. Today Marcelle talks about the plethora of information  which we all see about losing weight and keeping it off! You&#8217;ve heard  them, too! Call in today with your questions about the latest fad you&#8217;ve  seen.</p>
<p><strong><span style="text-decoration: underline;">4.Book of the week</span></strong><span style="text-decoration: underline;">:</span><em></em><a href="http://www.amazon.com/gp/product/0982720904/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0982720904%22%3ePerfect%20Health%20Diet:%20Four%20Steps%20to%20Renewed%20Health,%20Youthful%20Vitality,%20and%20Long%20Life%3c/a%3e%3cimg%20src=%22http://w"> Perfect Health Diet: Four Steps to Renewed Health, Youthful Vitality, and Long Life</a> by <a href="http://www.amazon.com/s/ref=ntt_athr_dp_sr_1?_encoding=UTF8&amp;sort=relevancerank&amp;search-alias=books&amp;ie=UTF8&amp;field-author=Paul%20Jaminet">Paul Jaminet</a> (Author), <a href="http://www.amazon.com/s/ref=ntt_athr_dp_sr_2?_encoding=UTF8&amp;sort=relevancerank&amp;search-alias=books&amp;ie=UTF8&amp;field-author=Shou-Ching%20Jaminet">Shou-Ching Jaminet</a></p>
<p>See this weeks blog that highlights 10 key points to Dr. Jaminet’s philosophy on human nutrition.<em></em><strong></strong></p>
<p><strong></strong>5. Don’t miss out:</p>
<ul>
<li>The Rest of Fun Facts on my <a href="http://www.saratoga.com/living-well/2012/01/the-perfect-diet-how-one-doctor-reversed-ms-atax-on-soda.html" target="_blank">Saratoga.com</a> blog.</li>
<li> Listen to my colleagues and other experts as they discuss solutions to menopausal issues on a show dedicated just for women in mid-life! Here is a link from my <a href="http://www.blogtalkradio.com/magnificentmenopause/2011/03/31/magnificent-menopause-and-beyond-enbracing-midlife">interview on 360menopause Radio Show</a> on <em>Panic Attacks and Menopause </em>and a list of archived shows.</li>
<li> Check out my latest answer on <a href="http://www.sharecare.com/user/sarah-lobisco/answers">Dr. Oz’s Sharecare</a><em> </em></li>
<li> View the Updated Link Resources on <a href="../../../../../">my homepage</a></li>
</ul>
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		<title>Upcoming Events in 2012</title>
		<link>http://www.dr-lobisco.com/upcoming-events-in-2012/</link>
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		<pubDate>Mon, 16 Jan 2012 21:01:08 +0000</pubDate>
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		<guid isPermaLink="false">http://www.dr-lobisco.com/?p=1600</guid>
		<description><![CDATA[<p>&#160;</p> January 25th 2012: Host DFH Clinical Rounds Teleseminar with Dr. Amber Brooks on Yeast Infections in Children. February 9th 2012: Integrative Forum V: Healing Garden February 15th 2012: Host DFH Clinical Rounds Teleseminar with Jordon Hoffman, LAc on Mold Exposure and its Various Clinical Presentations March 10th 2012: Presentation on Integrative Medicine at [...]]]></description>
			<content:encoded><![CDATA[<p>&nbsp;</p>
<h5><a href="http://www.dr-lobisco.com/wp-content/uploads/2011/07/foliage-narrow.jpg"><img class="alignleft size-full wp-image-951" title="foliage-narrow" src="http://www.dr-lobisco.com/wp-content/uploads/2011/07/foliage-narrow.jpg" alt="" width="185" height="227" /></a>January 25th 2012: Host <a href="http://designsforhealth.com/index.php/research-education/clinical-rounds.html" target="_blank">DFH Clinical Rounds Teleseminar </a>with Dr. Amber Brooks on Yeast Infections in Children.</h5>
<h5>February 9th 2012: <a href="http://www.dr-lobisco.com/naturopathic-doctor-to-offer-third-integrated-healthcare-forum-in-saratoga-county/?preview=true&amp;preview_id=757&amp;preview_nonce=dcc57009a6" target="_blank">Integrative Forum V: Healing Garden</a></h5>
<h5>February 15th 2012: Host DFH Clinical Rounds Teleseminar with Jordon Hoffman, LAc on Mold Exposure and its Various Clinical Presentations</h5>
<h5>March 10th 2012: Presentation on Integrative Medicine at<a href="http://www.oneroofsaratoga.com/home/one-big-roof" target="_blank"> One Big Roof</a> in Saratoga, NY from 3-5pm.</h5>
<h5>March 21st 2012: Grand Rounds at University of Bridgeport College of Naturopathic Medicine: Drug-Nutrient Interactions.</h5>
<h5>April 14th 2012: Open Discussion at <a href="http://paradisenaturalfoods.com/" target="_blank">Paradise Natural Foods</a> in Albany, NY from 3:15-4pm.</h5>
<h5></h5>
<h5>More to come&#8230;..</h5>
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		<title>2012- The Time to Fully Ignite a Change in Medicine</title>
		<link>http://www.dr-lobisco.com/2012-the-time-to-fully-ignite-a-change-in-medicine/</link>
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		<pubDate>Sat, 14 Jan 2012 00:23:09 +0000</pubDate>
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		<description><![CDATA[<p>By Sarah LoBisco, ND</p> <p>&#160;</p> <p></p> <p>Since the beginning of my medical career, there existed within me an internal prodding to explore and find the missing link between holistic patient care and the fragmented approach of modern medicine in place today. Although, the US has a beautiful system in place for acute care, surgery, [...]]]></description>
			<content:encoded><![CDATA[<p>By Sarah LoBisco, ND</p>
<p>&nbsp;</p>
<p><img class="alignleft" src="http://ecx.images-amazon.com/images/I/51RiajwuOhL._BO2,204,203,200_PIsitb-sticker-arrow-click,TopRight,35,-76_AA300_SH20_OU01_.jpg" alt="" width="300" height="300" /></p>
<p>Since the beginning of my medical career, there existed within me an internal prodding to explore and find the missing link between holistic patient care and the fragmented approach of modern medicine in place today. Although, the US has a beautiful system in place for acute care, surgery, and disease management<a href="../../../../../treating-people-not-diseases-detoxification/">, the statistics for our health model is quite lacking</a>. This may in part be due <a href="../../../../../the-problem-with-evidenced-based-medicine-to-assess-natural-modalities/">that the assessment of health tools themselves is lacking</a>. According to article in this winter’s edition of Holistic Primary Care:</p>
<p style="padding-left: 90px;">Citing new data on the country’s 2010 drug utilization, recently published by the IMS Institute for Healthcare Informatics (www.imshealth.com), Dr. Guarneri noted that last year, the country spent $13.6 billion on statin therapies alone. Despite the nation’s exorbitant expenditures on surgical interventions and drugs, 2,200 Americans die from CVD each day, and coronary disease still causes 1 in 6 deaths. “Statins do not cure CVD.”</p>
<p style="padding-left: 30px;"><strong><em>Psychotic, Depressed, Dyspeptic</em></strong></p>
<p style="padding-left: 30px;">The IMS data indicate that Americans spent $308 billion on pharmaceuticals last year; collectively, we consume 47% of all pharmaceuticals by the drug categories with the biggest total expenditures, one can conclude that, “the US is psychotic, depressed, has hyperlipidemia and heartburn!” Dr. Guarneri joked. But it’s really not a joke. It’s a frightening reality, one that’s economically unsustainable.</p>
<p style="padding-left: 30px;">Like many clinicians involved with Bravewell, Dr. Guarneri believes that a fundamental shift from disease-based interventions to wellness focused care has tremendous potential to save lives and save money.</p>
<p style="padding-left: 30px;">“We have the tools. We know that for every dollar we spend on, say, the Ornish lifestyle based programs for CVD, we save $6. We have the research. We need to apply it.” Last year, Dr. Guarneri co-authored a review paper entitled <em>The Efficacy and Cost- Effectiveness of Integrative Medicine, </em>documenting the actual real-world outcomes and savings from application of integrative principles and practices in treatment of heart disease, stroke, cancer, diabetes and depression.</p>
<p>It is not my intention to suggest that our current model is not needed, rather that I’ve found it to be lacking and not in resonance to this idealized prevention and wellness model in my mind. To me, <a href="../../../../../mission-statement/">health is more than the absence of symptoms</a>; it is about thriving and the ability to participate in life with full vitality and joy! <a href="../../../../../treating-people-not-diseases-detoxification/">This is why I continue to study Naturopathic and Functional medicine</a>. This is also why most of my blogs continue to stress the importance of a holistic and systems biology approach to medicine.</p>
<p><a href="http://www.aaemonline.org/introduction.html">Environmental medicine</a> is one example that highlights how preventing and maintaining health is not just about looking at the individualized pathology of one system, but in evaluating the interaction between the patient and his or her surroundings. This approach exhibits that factors such as the quality of food and <a href="../../../../../i%E2%80%99m-back%E2%80%A6-detox-holistic-news-from-arizona/">environmental toxicity</a> can no longer be ignored and must become an integral part to the solution. (Be sure to see a great example of this in my Naturopathic Fun Facts this week!)</p>
<p><a href="../../../../../building-the-foundation-for-health-in-2012/">Last week, I gave you two baby steps to take to move forward</a> in creating a strong foundation for a holistic and integrated approach to health. This week, I’ll continue with two more infant footies by encouraging you to:</p>
<p>1. Plan on food and you first, especially when stress rears its ugly head</p>
<p>2. Make your way safely through the grocery store aisles—with a very famous doctor!</p>
<p><strong><span style="text-decoration: underline;">Choosing Food First- The importance of Planning</span></strong></p>
<p>Stress, it’s a major obstacle to choosing wisely, <a href="../../../../../whole-food-whole-body-whole-mind-stress-busting-tips/">regarding any decision</a>. It creates an overdrive into flight and fight and reactive urgency over relaxation and setting priority. In other words, the emotional brain is over-driving the executive functions of the prefrontal cortex. These emotional cues trigger various biochemical changes in response patterns, including food choices. An article in Vital Choice explored this connection between stress and food decisions:</p>
<p><strong>The stress-food-fat connection</strong></p>
<p style="padding-left: 30px;">Five years ago, UCSF psychologist Elissa Epel, Ph.D., and a colleague reviewed the evidence available at that time, and saw likely connections between chronic excess stress and overeating.  As they wrote, “… it appears the obesity epidemic may be exacerbated by the preponderance of chronic stress, unsuccessful attempts at food restriction, and their independent and possibly synergistic effects on increasing the reward value of highly palatable food.” (Adam TC, Epel ES 2007)</p>
<p style="padding-left: 30px;">Prior studies in rodents showed that abdominal obesity resulted when chronic stress caused chronic secretion of glucocorticoid hormones, such as cortisol. Fat cells are among the direct targets for cortisol and other glucocorticoid hormones. In comparison to subcutaneous fat cells – ones located just under the skin – abdominal fat cells have more glucocorticoid receptors to capture the hormones.</p>
<p style="padding-left: 30px;">After putting on more belly fat, the rats’ cortisol secretion becomes blunted in response to acute stress, and their day-to-day glucocorticoid secretion goes down as well. The hormone system that controls cortisol secretion, known as the hypothalamic-pituitary-adrenal (HPA) axis, was turned down. “The rats appeared to be self medicating,” Epel said. “Their stress eating in turn dampened their HPA-axis activity. We wanted to know if this happened in people as well.” (UCSF 2011)</p>
<p style="padding-left: 30px;">The researchers found that <span style="text-decoration: underline;">women who were the most stressed out were the most likely to report that they eat more in response to emotional upsets</span>. And these <span style="text-decoration: underline;">highly stressed women had significantly more abdominal fat</span>, on average, in comparison to women who did not experience such a high degree of chronic stress. Among women who ranked in the top quarter for chronic life stress, having more abdominal fat was associated with lower daily cortisol secretion, and with less hormone secretion in response to acute stress.</p>
<p>This leads us to baby step #3 in this series on using food as a foundation for health. It is is to remove the obstacles that causes you to reach for candy over carrots from that Christmas credit card bill or a work mandated overtime. For dietary emergencies like these, the power is in planning in advance for these times. It’s a hard balance act to do in this hyperactive society, but a critical component in preventative medicine.</p>
<p>Even for myself, I have to admit, it can be tough. I often catch myself popping supplements and grabbing something quick while doing charts vs. sitting down to a nice, nurturing lunch. Thank goodness, I have healthy bars and nuts and seeds on hand for such occasions. (I learned in Arizona, eating nuts can help with blood lipid profiles, are anti-inflammatory, nutrient dense, and balance blood sugar, and as we know cortisol cause a spike in blood sugar).</p>
<p>Dr. Hyman’s blog discusses the importance of food planning:</p>
<ol>
<li><strong>Plan, plan, plan:</strong> You wouldn’t take a trip to climb a mountain or take a vacation to France without planning first. It is THE most essential activity you can do to create health. Plan your day, your week, your month and schedule in time for the things in your life that support health—food, fun, sleep, exercise, friends or whatever else puts deposits in your health bank account.</li>
<li><strong>Think of food first</strong>: Most of us are opportunistic eaters—when the opportunity comes, or when we get hungry we eat whatever’s in our path. In our culture that means junk food, fast food and vending machine “food like substances.” We live in a vast nutritional wasteland, a food desert. Every week plan where you are going to get all your meals. Think ahead; don’t end up in a food emergency where the only thing open is a fast food restaurant or convenience store. Think breakfast, lunch, dinner, and snacks. It will become a habit. Plan, shop, prepare, eat. Create an emergency food pack and buy quick-to-cook meals or make whole foods at home.</li>
<li><strong>Design fun and play into life: </strong>MacDonald’s was good for something—it gave us the ditty—“you deserve a break today.” Think of your day as a canvas and think of how you can paint yourself some fun. Learn new things—try yoga, dance, or learn a new sport. I like to get my exercise by having fun and playing not by going to the gym.</li>
</ol>
<p>I’d also like to add that <a href="../../../../../self-compassion-weight-loss/">there are many ways to manage stress and prevent this cortisol rush</a>. One big tip is to remember to be kind to ourselves as we make the transition from stress eating to nurturing behavior.</p>
<p><strong><span style="text-decoration: underline;">Surviving the Grocery Store Enticement</span></strong></p>
<p>High fructose corn syrup, trans-fats, and claims of “health foods” which are actually loaded with sugar, are lurking on even the kindest grocers’ shelves. Like everything else, with food, awareness is the key to change. Now that we’ve planned what to eat, we need to follow through and actually grab the right things for our body, and bypass that endcap of HoHos and Peeps (I used to love the pink chicks).</p>
<p>Therefore, to guide you in step four- follow through with the plan, <a href="http://drhyman.com/supermarket-savvy-avoid-the-bad-5958/">here is a link to a video commentary with</a> Dr. Hyman and Tanya Amen. In this 20 minute video, these pioneers in true medicine show us how to avoid harmful foods and survive your next grocery store trip with little to no temptation. How fun! You can actually take a shopping trip with two of the most well-known and educated integrative physicians in the world! Whoo-hooo…..</p>
<p><span style="text-decoration: underline;">References:</span></p>
<p>Goldman, Eric. Bravewell Collaborative Honors Guarneri, Celebrates a Decade of Progress. Holistic Primary Care Winter Edition 2011.</p>
<p>Hyman, M. Six Ways I changed My Life and How You Can Change Yours. Drhyman.com. December 31, 2011. <a href="http://drhyman.com/six-ways-i-changed-my-life-and-how-you-can-change-yours-6242/?utm_source=Publicaster&amp;utm_medium=email&amp;utm_campaign=drhyman%20newsletter%20issue%20#48&amp;utm_content=Get+the+story">http://drhyman.com/six-ways-i-changed-my-life-and-how-you-can-change-yours-6242/?utm_source=Publicaster&amp;utm_medium=email&amp;utm_campaign=drhyman%20newsletter%20issue%20#48&amp;utm_content=Get+the+story</a></p>
<p>Wetherby, C. Stress Fuels Overeating, Simple Solutions Found. Vital Choice. January 6, 2011. http://newsletter.vitalchoice.com/e_article002314779.cfm?x=bktnKmw,b1h0JlRD</p>
<p><span style="text-decoration: underline;">Hyman, M. Avoid the Bad. Drhyman.com. Accessed December 31, 2011. </span><a href="http://drhyman.com/supermarket-savvy-avoid-the-bad-5958/">http://drhyman.com/supermarket-savvy-avoid-the-bad-5958/</a></p>
<p><span style="text-decoration: underline;">Be sure to check out my informational blog on </span><a href="http://www.saratoga.com/living-well/2012/01/2012--the-ignition-of-true-medicine-is-your-birth-control-affecting-his-mojo-prostate-help-saw-palme.html" target="_blank">Saratoga.com</a><span style="text-decoration: underline;"><a href="http://www.saratoga.com/living-well/2012/01/2012--the-ignition-of-true-medicine-is-your-birth-control-affecting-his-mojo-prostate-help-saw-palme.html" target="_blank"> </a>which includes:</span><br />
<strong>1. </strong><span style="text-decoration: underline;">Naturopathic Philosophy Highlight… Fun Facts</span>:</p>
<ul>
<li>Is Your Birth Control Hurting your Partner?</li>
<li>Saw Palmetto &amp; Prostate Cancer</li>
<li>Nature’s Antifungal as Good as Rx Drug?</li>
<li>Genetic Differences in Detox highlight Negative Drug Reactions- Functional Medicine to the Rescue!</li>
</ul>
<p><strong>2. </strong><span style="text-decoration: underline;">Happenings</span>:</p>
<p>Upcoming Essential Oils Workshops with Terry Quigley at the Healing Garden. Contact Terry at 518-831-9469</p>
<p><a href="http://www.bizjournals.com/albany/news/2012/01/06/trader-joes-confirms-store-opening-in.html"><strong>Trader Joe’s is Coming! </strong>It’s True. Thanks Bruce Roter and the Crew.</a></p>
<p><span style="text-decoration: underline;">PATIENTS: Please review follow ups and cancellation policy on </span><a href="../../../../../contact/">my website</a></p>
<p><span style="text-decoration: underline;">Time for a symptom re-evaluation</span>?</p>
<p><strong><em>All patients can now download the symptom survey done at the original </em></strong><a href="../../../../../new-patient-intake-forms/"><strong><em>visit online</em></strong></a><strong><em>.</em></strong> If you haven’t re-evaluated your symptoms in a year or more, it may be a good time to fill out the form again and bring it in to your next visit. (Please add the numbers in every section when you return it).<strong> </strong></p>
<p>&nbsp;</p>
<p><strong>3. </strong><a href="http://click.linksynergy.com/fs-bin/click?id=YS5wNadRhrI&amp;offerid=206928.10000064&amp;type=3&amp;subid=0%22%20%3EHay%20House%20Radio%3C/a%3E%3CIMG%20border=0%20width=1%20height=1%20src=%22http://ad.linksynergy.com/fs-bin/show?id=YS5wNadRhrI&amp;bids=206928.10000064&amp;type=3&amp;subid=0%22%20%3E">Radio For Your Body-</a>Mind-<em>Soul</em><strong> </strong><a href="http://click.linksynergy.com/fs-bin/click?id=YS5wNadRhrI&amp;offerid=206928.10000064&amp;type=3&amp;subid=0%22%20%3EHay%20House%20Radio%3C/a%3E%3CIMG%20border=0%20width=1%20height=1%20src=%22http://ad.linksynergy.com/fs-bin/show?id=YS5wNadRhrI&amp;bids=206928.10000064&amp;type=3&amp;subid=0%22%20%3E">Radio For Your Body-</a>Mind-<em>Soul: <a href="http://www.amazon.com/gp/product/1401928196/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=217145&amp;creative=399373&amp;creativeASIN=1401928196%22%3eAre%20You%20Tired%20and%20Wired?:%20Your%20Proven%2030-Day%20Program%20for%20Overcoming%20Adrenal">Marcelle Pick</a></em><em> </em></p>
<p><em>January 11, 2012 <a href="http://www.hayhouseradio.com/archive_preview.php">Are You Fizzling Instead of Sizzling in the New Year?</a></em><em> Has the hustle and bustle of year end activities taken its toll on you? Are you finding getting out of bed in the morning to be harder than usual? Is your energy dipping earlier in the day? Listen in today as Marcelle talks about getting your energy back!</em></p>
<p><strong> </strong></p>
<p><strong>4.</strong><strong><span style="text-decoration: underline;"> Book of the week</span></strong>:  <a href="http://www.amazon.com/gp/product/0201898284/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0201898284%22%3eManifesto%20For%20A%20New%20Medicine:%20Your%20Guide%20To%20Healing%20Partnerships%20And%20The%20Wise%20Use%20Of%20Alternative%20Therapies%3c/a%3e%3cimg%20src=%22http://www.assoc-amazon.com/e/ir?t=drsarlobsnatm-20&amp;l=as2&amp;o=1&amp;a=0201898284%22%20width=%221%22%20height=%221%22%20border=%220%22%20alt=%22%22%20style=%22border:none%20%21important;%20margin:0px%20%21important;">Manifesto for Medicine: Your Guide to Healing Partnerships &amp; the Wise Use of Alternative Therapies</a>. By James Gordon</p>
<p>Learn from a leader and pioneer in the importance of self-care and how mind-body and science unite for truly holistic medical system.</p>
<p><strong>5. </strong>Don’t miss out:</p>
<ul>
<li>The Rest of Fun Facts on my <a href="http://www.saratoga.com/living-well/">Saratoga.com</a> blog.</li>
<li>Listen to my colleagues and other experts as they discuss solutions to menopausal issues on a show dedicated just for women in mid-life! Here is a link from my <a href="http://www.blogtalkradio.com/magnificentmenopause/2011/03/31/magnificent-menopause-and-beyond-enbracing-midlife">interview on 360menopause Radio Show</a> on <em>Panic Attacks and Menopause </em>and a list of archived shows.</li>
<li>Check out my latest answer on <a href="http://www.sharecare.com/user/sarah-lobisco/answers">Dr. Oz’s Sharecare</a><em>:The side effects of Birth Control Pills<br />
</em></li>
<li>View the Updated Link Resources on <a href="../../../../../">my homepage</a></li>
</ul>
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		<title>Building the Foundation for Health in 2012</title>
		<link>http://www.dr-lobisco.com/building-the-foundation-for-health-in-2012/</link>
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		<pubDate>Thu, 05 Jan 2012 23:46:23 +0000</pubDate>
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		<description><![CDATA[<p>By Sarah A LoBisco, ND</p> <p>Can you believe it!??? It’s time to make our way forward into a new year. Wouldn’t it be great if 2012 became the year that society united in setting positive intentions and moved into their goals of healthier life decisions? New Year cycles are humanities ways of refocusing our [...]]]></description>
			<content:encoded><![CDATA[<p>By Sarah A LoBisco, ND</p>
<p><img class="alignleft" src="http://healthybalanceddiet.org/wp-content/uploads/2011/08/healthy-foods-to-lose-weight.jpg" alt="" width="324" height="175" />Can you believe it!??? It’s time to make our way forward into a new year. Wouldn’t it be great if 2012 became the year that society united in setting positive intentions and moved into their goals of healthier life decisions? New Year cycles are humanities ways of refocusing our goals on the positive and releasing what no longer serves us. Although we&#8217;d all like to change to a diet of Brussels sprouts and broccoli over milkshakes and lollipops, the caveat is that change is hard. We&#8217;re up against a lot of momentum of habitual programming in our brain. This is why most New Year’s resolutions fall short of long term commitments.</p>
<p>I explained this phenomenon in the blog I <a href="../../../../../getting-fit-for-change-in-2011/">wrote at the beginning of 2011</a>. It’s called <a href="http://www.systemic-medicine.eu/Chap/4.4.cybernetics.html">cybernetics</a> (brain set points) and trying to make huge lifestyle shifts all at once, rather than changing a little bit at the time leads to literal brain overload. A broad resolution will most likely fail in the long term; because the brain goes into overwhelm by too many changes way too quickly. Our pre-frontal cortex loses its safety reference point amongst all the new life style shifts implemented and the result is that our brain reverts back to our diet of ho-hos, dingle dos, and too many &#8220;adult beverages&#8221;. Therefore, the solution is to stop the overload and calm the brain and stress response, hence my belief in the power of <a href="../../../../../the-benefits-of-baby-steps-the-ever-increasing-exercise-conundrum/">Baby Steps</a>!</p>
<p>Therefore, for 2012, I want us to <a href="../../../../../i%E2%80%99m-back%E2%80%A6-detox-holistic-news-from-arizona/"> look at the first important foundation</a> of health, food, and I want to give you some gentle tips to start your growth from a little junkie foodie  into a full out nutritional expert.  Why? Well beyond nutrition and weight, food is medicine. It is not just calories; it’s information for our genes.</p>
<p>This is called the science of <a href="../../../../../let-food-be-thy-medicine/">NUTRIGENOMICS</a>- the study of how a specific food modulates how our genes express themselves. <a href="../../../../../breast-cancer-vegetables/">Literally, certain foods can turn off and on cancer promoting signals.</a> This means, no more excuses for a bad gene pool and no more pointing fingers at your mom for your health woos. Although it is true that some may have to be more careful with their food <a href="../../../../../cleansing-safely-in-naturopathic-functional-medicine-style/">choices depending on the cards their parents dealt, especially relating to their own detoxification power</a>. (This relates to finding out which <a href="../../../../../cleansing-safely-in-naturopathic-functional-medicine-style/">single nucleotide polymorphisms (SNPs)</a> are present, and modulating this with foods and supplements, but I&#8217;ll stop on this point here.)</p>
<p>So, for the next few blogs, I’m going to highlight specific nutrigenomic effects of certain categories of foods. Now, I promised to share with you more information in what I learned in Arizona, and I’ll tie that in with specific examples. Let’s start with a group of compounds that are antioxidants called polyphenols. They are found in various fruits and vegetables. Here&#8217;s a summary on their powerful effects from a few articles in VitalChoice:</p>
<p style="padding-left: 30px;">We should note that humans absorb only very small amounts of polyphenol “antioxidants” from foods or supplements, and that is true. But it’s recently become clear that – instead of exerting direct, substantial antioxidant effects in the body – polyphenols from plant foods serve as friendly “nutrigenomic” factors &#8230; ones that exert significant effects at very low levels (Graf et al. 2005; Hollman PC et al. 2010).</p>
<p style="padding-left: 30px;">They&#8217;re considered nutrigenomic agents because polyphenols affect genetic switches (transcription factors) in ways that tend to moderate inflammation and stimulate the body’s own antioxidant network. The new study in mice supports the hypothesis that foods high in a class of polyphenols called flavanols (e.g., catechins, procyanidins, and OPCs) – which also abound in cocoa, grapes, and tea – may help curb cancer growth.</p>
<p style="padding-left: 30px;">Recently, researchers from Germany’s Federal Research Institute of Nutrition and Food explained why polyphenols should act as preventive-health allies (Watzl B 2008):</p>
<blockquote>
<ul style="padding-left: 30px;">
<li>“Inflammation is a pathological      condition underlying a number of diseases including cardiovascular      diseases, cancer, and chronic inflammatory diseases.</li>
<li>Epidemiological data suggest that dietary      patterns strongly affect inflammatory processes. Primarily the intake of      fruit and vegetables as well as of whole wheat is inversely associated      with the risk of inflammation.”</li>
<li>“At the level of bioactive      compounds occurring in plant foods, primarily carotenoids and flavonoids      [part of the polyphenol family] seem to modulate inflammatory as well as      immunological processes.”</li>
<li>“In conclusion, there is      convincing evidence that plant foods and non-nutritive constituents      associated with these foods modulate immunological and inflammatory      processes. By means of anti-inflammatory activities a plant-based diet may      contribute to the lower risk of cardiovascular diseases and cancer.”</li>
</ul>
</blockquote>
<p>This is great news, these “non-nutritive constituents” serve as the nutrigenomic mediators of health vs. just calories leading to weight gain or loss!  The way to health is really is  through our mouth and there are lots of yummy, healthy options to modulate these pathways! Below, I give examples of  how these foods  promote healthy detox pathways, protect our body from free radical damage, enhance and modulate our immune system and inflammatory response, prevent cancer, inactivate metals, and more! At my training, Dr. Mayfield gave us some examples:</p>
<ol style="padding-left: 30px;">
<li>Flavonoids      are anti-estrogenic, inhibit      several cancer cells, terminator of free radicals, and can inactivate      metal chelates, such as lead. There are different types (Flavonols,      flavones, flavan-3-ols, anthocyanidines, flavanoens, isoflavones). (see above for food examples.)</li>
</ol>
<ol style="padding-left: 30px;">
<li><strong>Proanthyocyanidins,      found in grape seeds and mulberries, have been found to be beneficial for      their properities of being </strong>anti-inflammatory, antioxidant, anti-diabetic, and cardioprotective.      Blueberry has nutrigenomic      effects on metabolic syndrome in obesity-prone rats via the PPAR gene      transcripts in adipose and muscle tissue involved in fat and glucose      metabolism.</li>
</ol>
<p><span style="text-decoration: underline;"><strong> Now, it&#8217;s time for some promised, easy, action steps for the New Year. Here are your baby steps for a healthy food foundation for this week. </strong></span></p>
<ol style="padding-left: 30px;">
<li>Include flavonoids in your diet. One example of a common flavonoid food is onions. Onions contain the flavonal querectin, According to Dr. Brown’s blog onions may also help bone health:</li>
</ol>
<p style="padding-left: 30px;">For example, we’ve seen that white women 50 years or older who ate onions every day had a 5% greater overall bone density than those who ate onions once a month or less. And — <strong>older women who consume onions most frequently may decrease their risk of hip fracture by more than 20% versus those who never consume onions.</strong></p>
<ol style="padding-left: 30px;">
<li>Eat an extra cup full of berries or veggies every day this week. Dr. Hyman further commented on adding “Organic berries and all fruits and vegetables because they contain various photochemicals like antioxidants (vitamins C, E, beta-carotene and various minerals), bioflavonoids (like quercitin, limonene, hesperidin), and fiber which is needed for daily elimination of waste and support the healthy balance of the micro flora of the digestive tract. Grown women should aim for at least 7 servings a day and men should get 9. A serving is between ½ – 1 cup. The more COLORS the better!”</li>
</ol>
<p><span style="text-decoration: underline;">References:</span></p>
<p style="padding-left: 30px;">Rountree, B. Ensure a Safe Detox. Detox Advanced Module. IFM. (presented by Kristi Hughs)December 10, 2011. Phoenix, AZ</p>
<p style="padding-left: 30px;">Mayfield, R. Phytochemicals and Nutrients to Improve Detoxification. Detox Advanced Practice Module. December 10, 2011. Phoenix, AZ</p>
<p style="padding-left: 30px;">Brown, S. Onions, Nothing to Cry For in Bone Health. Better Bones Blog. December 12, 2011. <a href="http://www.betterbones.com/blog/post/Onions.aspx">http://www.betterbones.com/blog/post/Onions.aspx</a>?</p>
<p style="padding-left: 30px;">E. Mitchell Seymour, Ignasia I. Tanone, Daniel E. Urcuyo-Llanes, Sarah K. Lewis, Ara Kirakosyan, Michael G. Kondoleon, Peter B. Kaufman, and Steven F. Bolling. Blueberry Intake Alters Skeletal Muscle and Adipose Tissue Peroxisome Proliferator-Activated Receptor Activity and Reduces Insulin Resistance in Obese Rats (abstract). Journal of Medicinal Food. December 2011, 14(12): 1511-1518. doi:10.1089/jmf.2010.0292.</p>
<p style="padding-left: 30px;">Mayfield, R. Key Nutrientional Modulators in Detoxification. IFM Detox Advanced Practice Module. Phoenix, AZ. December 9, 2011.</p>
<p style="padding-left: 30px;">Wetherby, C. Antioxidant Foods Cut Stroke Risk. Vitalchoice Newsletter. December 16, 2011. http://newsletter.vitalchoice.com/e_article002299703.cfm?x=bkpnkf9,b1h0JlRD</p>
<p style="padding-left: 30px;">Wetherby, C. <strong>Blueberry Slowed Breast Cancer in Mice. </strong>Vitalchoice Newsletter. December 20, 2011. http://newsletter.vitalchoice.com/e_article002303661.cfm?x=bkqbncp,b1h0JlRD</p>
<h6><span style="text-decoration: underline;">Be sure to check out my informational blog on </span><a href="http://www.saratoga.com/living-well/2012/01/easy-steps-to-a-new-you-in-2012-fun-facts-on-exercise-yoga-and-mindfulness-for-pain.html" target="_blank">Saratoga.com</a><span style="text-decoration: underline;"><a href="http://www.saratoga.com/living-well/2012/01/easy-steps-to-a-new-you-in-2012-fun-facts-on-exercise-yoga-and-mindfulness-for-pain.html" target="_blank"> </a>which includes:</span><strong> </strong></h6>
<p><strong>1. </strong>Naturopathic Philosophy Highlight Fun Facts:</p>
<ul>
<li>Yoga and Low Back Pain</li>
<li>Exercise Boosts Brain Power</li>
<li>Mindfulness Decreases Fatigue in RA</li>
</ul>
<p><strong>2. </strong><span style="text-decoration: underline;">Happenings</span>:</p>
<ul>
<li>Upcoming Essential Oils Workshops with Terry Quigley at the Healing Garden. Contact Terry at 518-831-9469</li>
<li><a href="../../../../../naturopathic-doctor-to-offer-third-integrated-healthcare-forum-in-saratoga-county/">Integrative Forum to begin again on February 9th</a>! Look for more information in my newsletters and on my website.</li>
<li><span style="text-decoration: underline;">PATIENTS: Please review follow ups and cancellation policy on </span><a href="../../../../../contact/">my website</a>.
<ul>
<li><em><span style="text-decoration: underline;">Note</span></em><em>: Appointments open as people reschedule. In order to avoid being charged the full consultation, we need notice 24 hours (counted as business days) prior to the appointment. My office is keeping tight with our cancellation policy and rescheduling because of our commitment to continued progress and monitoring therapeutic supplements responsibly. As a Naturopathic and Functional Medicine doctor, I feel it’s essential that my patients have a mutual commitment to wellness by making their health a priority every 3-8 weeks.</em></li>
<li><span style="text-decoration: underline;">Time for a symptom re-evaluation</span>? <em> </em>
<ul>
<li><strong><em>All patients can now download the symptom survey </em></strong><a href="../../../../../new-patient-intake-forms/"><strong><em>online</em></strong></a><strong><em>.</em></strong> If you haven’t re-evaluated your symptoms in a year or more, it may be a good time to fill out the form again and bring it in to your next visit. (Please add the numbers in every section for comparison when you return it to our office.)</li>
</ul>
</li>
<li><strong><em>NEWSFLASH: My book manuscript is almost finished…be on the lookout within the next months for pre-ordering availability! </em></strong><strong><em>J</em></strong></li>
</ul>
</li>
</ul>
<p><strong>3. </strong><a href="http://click.linksynergy.com/fs-bin/click?id=YS5wNadRhrI&amp;offerid=206928.10000064&amp;type=3&amp;subid=0%22%20%3EHay%20House%20Radio%3C/a%3E%3CIMG%20border=0%20width=1%20height=1%20src=%22http://ad.linksynergy.com/fs-bin/show?id=YS5wNadRhrI&amp;bids=206928.10000064&amp;type=3&amp;subid=0%22%20%3E">Radio For Your Body-</a>Mind-<em>Soul: </em></p>
<p style="padding-left: 30px;"><a href="http://www.hayhouseradio.com/show_details.php?show_id=138&amp;episode_type=0" target="Index">Flourish!</a><a href="http://www.amazon.com/gp/product/0553386727/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0553386727%22%3eThe%20Wisdom%20of%20Menopause%20%28Revised%20Edition%29:%20Creating%20Physical%20and%20Emotional%20Health%20During%20the%20Change%3c/a%3e%3ci"> with Dr. Christiane Northrup</a>: January 4, 2012 <a href="http://www.hayhouseradio.com/archive_preview.php">The New Wisdom of Menopause<br />
</a>Midlife is a time of rebirth and renewal. The midlife transition is replete with weight gain, mood swings, and hot flashes. Tune in and learn how to negotiate this transition comfortably and joyfully.</p>
<p><strong>4. </strong><strong><span style="text-decoration: underline;">Book of the week</span></strong>:</p>
<p style="padding-left: 30px;">It’s so packed full of what all women need to know, I’m making this week’s book a repeat celebrating its release today: <em><a href="http://www.amazon.com/gp/product/0553386727/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0553386727%22%3eThe%20Wisdom%20of%20Menopause%20%28Revised%20Edition%29:%20Creating%20Physical%20and%20Emotional%20Health%20During%20the%20Change%3c/a%3e%3ci">The Wisdom of Menopause</a> by Dr. Christian Northrup</em><strong> </strong></p>
<p style="padding-left: 30px;">Now completely revised, this groundbreaking classic draws on the current research and medical advances in women’s health, and includes:</p>
<ul>
<li>All you need to know about perimenopause, and why it is critical to your well-being</li>
<li>Updated mammogram guidelines</li>
<li>Nurturing your brain: sleep, mood, memory</li>
<li>Hormone therapy and the options available</li>
<li>Midlife weight control</li>
<li>Sex and menopause: myths and reality</li>
</ul>
<p><span style="text-decoration: underline;"><strong>5. </strong>Don’t miss out:</span></p>
<ul>
<li>The Rest of Fun Facts on my <a href="http://www.saratoga.com/living-well/">Saratoga.com</a> blog.</li>
<li>Listen to my colleagues and other experts as they discuss solutions to menopausal issues on a show dedicated just for women in mid-life! Here is a link from my <a href="http://www.blogtalkradio.com/magnificentmenopause/2011/03/31/magnificent-menopause-and-beyond-enbracing-midlife">interview on 360menopause Radio Show</a> on <em>Panic Attacks and Menopause </em>and a list of archived shows.</li>
<li>Check out my latest answer on <a href="http://www.sharecare.com/user/sarah-lobisco/answers">Dr. Oz’s Sharecare</a><em>: </em><span style="text-decoration: underline;">Avoiding Emotional Binges.<br />
</span>&nbsp;</p>
<ul>
<li><span style="text-decoration: underline;">Here’s an excerpt</span><em>:</em><em> If you are addicted to certain foods, abstaining is the only true way to avoid a binge. That being said, with any slippage, it&#8217;s best to be gentle with yourself and plan so that you have safer alternatives for the future. Planning your meals and initiating a social support system around triggering emotional events, gatherings, and a crazy work schedule can prevent grabbing an unhealthy sugar/caffeine binge. This kind of planning allows your prefrontal cortex to respond verses react to situations. Whereas, social support aids in dopamine release, a feel good chemical that can be obtained without through friendship verses cookies.  You also want to make sure the following biological factors are in order to support your biochemistry and keep your mood in check&#8230; Read more at the link above….</em></li>
</ul>
</li>
</ul>
<ul>
<li>View the Updated Link Resources on <a href="../../../../../">my homepage</a></li>
</ul>
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		<title>December 2011 Top Reads</title>
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		<pubDate>Fri, 30 Dec 2011 21:40:23 +0000</pubDate>
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		<description><![CDATA[ <p></p> It’s the final Top Reads of 2011! <p>Can you believe it!?</p> <p>This month’s highlights continue with the themes in Nutrigenomics, Health, and Drug Updates.</p> Here are just some of the topics covered in my summaries covered below of what I feel are top headlines of this month: The power of FOOD AS [...]]]></description>
			<content:encoded><![CDATA[<h1><span style="text-decoration: underline;"><strong> </strong></span></h1>
<blockquote><p><a href="http://www.dr-lobisco.com/wp-content/uploads/2011/08/integrative-medicine.jpg"><img class="alignnone size-full wp-image-1071" title="integrative medicine" src="http://www.dr-lobisco.com/wp-content/uploads/2011/08/integrative-medicine.jpg" alt="" width="101" height="150" /></a></p></blockquote>
<h5><span style="text-decoration: underline;">It’s the final Top Reads of 2011!</span></h5>
<p>Can you believe it!?</p>
<p>This month’s highlights continue with the themes in Nutrigenomics, Health, and Drug Updates.</p>
<h5>Here <span style="text-decoration: underline;">are just some of the topics covered in my summaries covered below</span> of what I feel are top headlines of this month:</h5>
<ul>
<li>The power of <em>FOOD AS MEDICINE</em>: The benefits of antioxidant packed and Mediterranean style diets and a study on B vitamins link lower lung cancer risk</li>
<li><em>PROBIOTIC POWER</em>: The balance of bugs in your gut is not just to relieve symptoms of constipation or diarrhea. Microbiota balance in the gut, supplemented with probiotics, have links to many health effects. Highlights include the modulation of weight, metabolism, brain health, blood sugar, and even MS!</li>
<li><em>OREGANO POWER</em>:These feature studies are too good to miss! Learn how this powerful essential oil could be a solution to resistant superbugs!</li>
<li><em>Drug Updates:</em> <em>FDA warnings of 2011</em> including Simvastatin, 5 alpha reductase inhibitors, and various antidepressants are reviewed. Other drug updates include a warning on Zofran, adverse drug reaction statistics, and pertussis vaccination efficacy is also included.</li>
<li><em>Various Health Highlights</em> such as the use of exercise for depression, how violent video games affect brain health, 8 tips to mind-body balance…..and there’s so much more….check it out and have a great New Year.</li>
</ul>
<h6><span style="text-decoration: underline;">Don’t forget to watch for next week’s New Year’s blog!</span> It will include more on the power of food and what I learned in Arizona. <em>Here’s a little <span style="text-decoration: underline;">preview of what’s to come.</span> In this excerpt, Dr. Hyman discusses various studies that show how food is medicine:</em></h6>
<blockquote><p>– Supplementing with conjugated linoleic acid (a special fat from meat and dairy fats) caused a modest loss in body fat. It also may prevent cancer, heart disease, and inflammation.</p>
<p>– Long-term fish consumption protects against arrhythmia or irregular heart beats.</p>
<p>– Eating a diet high in monounsaturated fats from olive oil can help reduce blood pressure while a high refined-carbohydrate diet can increase blood pressure.</p>
<p>– Combining fish oil supplements with regular aerobic exercise helps improve body composition and reduce heart disease risk factors (lower triglycerides, higher HDL).</p>
<p>– Women need more choline (a nutrient that is needed for cell membrane formation and to make the neurotransmitter acetylcholine necessary for brain function) after menopause or are at risk of liver and muscle damage.</p>
<p>– If women with HIV are given a multivitamin, they have less anemia and their children also have less anemia.  Anemia in HIV is associated with a much faster rate of disease progression and death.</p>
<p>– In Bangladesh, where arsenic poisoning is common, giving folate, vitamins B12 and B6, choline, and niacin reduced the toxic effects of arsenic.</p>
<p>– People who eat more meat and saturated fat have a higher risk of skin cancer.</p></blockquote>
<p>References:</p>
<p>Hyman, M. The Overwhelming Evidence of the Healing Power of Food. drhyman.com. December 24, 2011. <a href="http://drhyman.com/the-overwhelming-evidence-of-the-healing-power-of-food-3324/?utm_source=Publicaster&amp;utm_medium=email&amp;utm_campaign=drhyman%20newsletter%20issue%20#47&amp;utm_content=Get+the+story">http://drhyman.com/the-overwhelming-evidence-of-the-healing-power-of-food-3324/?utm_source=Publicaster&amp;utm_medium=email&amp;utm_campaign=drhyman%20newsletter%20issue%20#47&amp;utm_content=Get+the+storyA</a></p>
<h1>AND NOW&#8230;.<br />
<span style="text-decoration: underline;">DECEMBER 2011 TOP READS!</span></h1>
<p>&nbsp;</p>
<h1><strong><a href="http://www.dr-lobisco.com/wp-content/uploads/2011/08/nutrional-genomics.jpg"><img title="nutrional genomics" src="http://www.dr-lobisco.com/wp-content/uploads/2011/08/nutrional-genomics-300x188.jpg" alt="" width="257" height="139" /></a></strong></h1>
<h1><span style="text-decoration: underline;"><strong>Nutrigenomics</strong></span></h1>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/20551408" target="_blank">B Vitamins Lower Lung Cancer Risk (JAMA)</a></p>
<blockquote><p>Similar and consistent decreases in risk were observed in never,  former, and current smokers, indicating that results were not due to  confounding by smoking. The magnitude of risk was also constant with  increasing length of follow-up, indicating that the associations were  not explained by preclinical disease. A lower risk was also seen for  serum folate (fourth vs first quartile OR, 0.68; 95% CI, 0.51-0.90; P  for trend = .001), although this was apparent only for former and  current smokers. When participants were classified by median levels of  serum methionine and B(6), having above-median levels of both was  associated with a lower lung cancer risk overall (OR, 0.41; 95% CI,  0.31-0.54), as well as separately among never (OR, 0.36; 95% CI,  0.18-0.72), former (OR, 0.51; 95% CI, 0.34-0.76), and current smokers  (OR, 0.42; 95% CI, 0.27-0.65).<strong> CONCLUSION: Serum levels of vitamin B(6) and methionine were inversely associated with risk of lung cancer.</strong></p></blockquote>
<p><a href="http://www.medscape.com/viewarticle/752000?src=mp&amp;spon=17" target="_blank">Mediterranean Diet Aides Stroke Risk (Medscape)</a></p>
<blockquote><p><strong>Lifestyle changes and, especially, dietary interventions are  cost-effective means for the prevention of CVD and the reduction of the  social and economic burden of this condition.<sup><a>[1, 3, 4]</a></sup> The Mediterranean dietary pattern is one of the most well-known dietary patterns regarding its cardioprotective effects.<sup><a>[5]</a></sup> This pattern is characterized by high consumption of monounsaturated  fatty acids, primarily from olives and olive oil.</strong> It encourages daily  consumption of fruits, vegetables, whole grain cereals, and low-fat  dairy products; weekly consumption of fish, poultry, tree nuts, and  legumes; monthly consumption of red meat; and a moderate daily  consumption of alcohol, normally with meals. The beneficial role of the  Mediterranean diet regarding mortality from all causes, CHD, some types  of cancer, and metabolic disorders, has already been reported.<sup><a>[6–9]</a></sup> In a recent meta-analysis of 530,000 participants from 50 studies,  greater adherence to the Mediterranean diet was associated with a lower  risk for metabolic syndrome and its constituents.<sup><a>[10]</a></sup> The main mechanism for this cardiometabolic protection is the  antioxidant and anti-inflammatory effects that the aforementioned  pattern has.<sup><a>[11, 12]</a></sup> However, despite the fact that many studies have underlined the  beneficial role of the Mediterranean diet regarding the development of  CHD, the role of this diet on the development of stroke has not been  thoroughly examined.<sup><a>[13, 14]</a></sup> To the best of our knowledge, only one study has evaluated and  attempted to compare the effect of the Mediterranean diet on the  development of both acute coronary syndromes (ACS) and stroke.<sup><a>[13]</a></sup> Posted: 11/15/2011; American Heart Journal. 2011;162(4):717-724.</p></blockquote>
<p><a href="http://www.webmd.com/stroke/news/20111201/diet-loaded-with-veggies-fruits-whole-grains-cuts-stroke-risk?ecd=wnl_hrt_120611" target="_blank">Antioxidants of Fruit and Veggies Prevent Stroke (WebMD)</a></p>
<blockquote><p>Researchers led by Susanne Rautiainen, a PhD student at the  Karolinska Institutet in Sweden, grouped 31,035 women without heart  disease and 5,680 women with a history of heart disease. Then they  measured the amount of antioxidant-rich foods and beverages they ate and  drank. About 11.5 years later, there were 1,322 strokes among women  without a history of heart disease or stroke. Among women with previous  heart disease or stroke, there were 1,007 strokes after about 10 years. The amount of antioxidants in the diet seemed to make a difference in stroke risk, the study showed. <strong>Women without a history of heart disease or stroke who ate diets  loaded with antioxidants were 17% less likely to have any type of  stroke, compared to women who ate the least amount of antioxidants.  These results held even after researchers took into account <a href="http://www.webmd.com/fitness-exercise/guide/default.htm">exercise</a>, <a href="http://www.webmd.com/smoking-cessation/default.htm">smoking</a>, and other behaviors that could affect stroke risk.</strong></p></blockquote>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/20584092" target="_blank">Antioxidants &amp; ED (Intern J of Adrol)</a></p>
<blockquote>
<blockquote><p>Upregulation of antioxidant enzymes SOD and AR failed to protect  ischaemic erectile tissue from oxidative injury. <strong><em>Pomegranate  extract  significantly improved intracavernosal blood flow, erectile  activity,  smooth muscle relaxation and fibrosis of the atherosclerotic  group i</em></strong>n  comparison with the atherosclerotic group  receiving placebo, but did not  normalize them to the age-matched  control levels. Pomegranate extract  appeared more effective in  diminishing oxidative products, preventing  SOD and AR gene  upregulation, and protecting mitochondrial, endothelial  and caveolae  structural integrity of the atherosclerotic group. <strong>Our data   suggest the presence of oxidative stress in ED and a more efficient   action of antioxidants on molecular and ultrastructural alterations than   on distinct functional deficit and structural damage in the ischaemic   penis.</strong></p></blockquote>
</blockquote>
<p><span style="text-decoration: underline;"><strong>The Power of Gut Bugs!</strong></span></p>
<p><a href="http://www.abstractsonline.com/Plan/ViewAbstract.aspx?sKey=87c44946-dc64-4b13-9785-05a0556d96eb&amp;cKey=670862ba-c4d5-40f3-9df9-d21d4b647300&amp;mKey={10A86782-07E4-4A2D-9100-F660E5D752A9}" target="_blank"><span style="text-decoration: underline;"><strong>The Use of Fecal Implant of Bugs to Modulate Metabolism &amp; Weight (Oasis)</strong></span></a></p>
<blockquote><p><strong>Lean donor faecal infusion improves hepatic and peripheral insulin  resistance as well as fasting lipid levels in obese individuals with the  metabolic syndrome underscoring the potential role of gut microbiota in  the disturbances of glucose and lipid metabolism in obesity. </strong>Our data  could provide pathophysiological insight in the metabolic deviations in  obese subjects and a rationale for therapeutic intervention.</p></blockquote>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed?term=%22PloS+one%22[Jour]+AND+Gut+Microbiota+in+Human+Adults+with+Type+2+Diabetes+Differs+from+Non-Diabetic+Adults&amp;TransSchema=title" target="_blank">Another Study on Weight and Bugs (PLos)</a></p>
<blockquote><p><strong>The proportions of phylum Firmicutes and class Clostridia were  significantly reduced in the diabetic group compared to the control  group</strong> (P = 0.03). Furthermore, the ratios of Bacteroidetes to Firmicutes  as well as the ratios of Bacteroides-Prevotella group to C.  coccoides-E. rectale group correlated positively and significantly with  plasma glucose concentration (P = 0.04) but not with BMIs. Similarly,  class Betaproteobacteria was highly enriched in diabetic compared to non-diabetic persons (P = 0.02) and positively correlated with plasma glucose (P = 0.04).</p></blockquote>
<p><a href="http://articles.mercola.com/sites/articles/archive/2011/12/05/gut-bacteria-for-your-health.aspx?e_cid=20111205_DNL_art_1" target="_blank">Multifaceted Bug Power (Dr. Mercola)</a></p>
<blockquote><p>You can also visit <a href="http://www.greenmedinfo.com/substance/probiotics">Green Med Info</a>,  which has assembled an amazing list of more than 200 studies, which  together explore more than 170 diseases that may find relief with  probiotics. Some of the most interesting research to date includes  studies linking your gut bacteria to:</p>
<ul>
<li><strong>Behavior:</strong> A study published in <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2982.2010.01620.x/abstract">Neurogastroenterology &amp; Motility</a> found mice that lack gut bacteria were found to behave differently from  normal mice, engaging in what would be referred to as &#8220;high-risk  behavior.&#8221; This altered behavior was accompanied by neurochemical  changes in the mouse brain. Researchers stated:</li>
</ul>
<p style="padding-left: 60px;"><em>Bacteria colonize the gut in the days following  birth, during a sensitive period of brain development, and apparently  influence behavior by inducing changes in the expression of certain  genes.</em></p>
<ul>
<li><strong>Gene Expression: As noted above, researchers  also discovered that the absence or presence of gut microorganisms  during infancy permanently alters gene expression.Through gene profiling, they were able to discern that absence of  gut bacteria altered genes and signaling pathways involved in learning,  memory, and motor control.</strong> This suggests that gut bacteria are closely  tied to early brain development and subsequent behavior. These  behavioral changes could be reversed as long as the mice were exposed to  normal microorganisms early in life. But once the germ-free mice had  reached adulthood, colonizing them with bacteria did not influence their  behavior.</li>
</ul>
<p style="padding-left: 60px;"><em>In a similar way, probiotics have also been found to <a href="http://articles.mercola.com/sites/articles/archive/2010/10/11/probiotics-healing-power-impresses-researchers.aspx">influence the activity of hundreds of your genes</a>, helping them to express in a positive, health-promoting manner.</em></p>
<ul>
<li><strong>Diabetes:</strong><a href="http://www.ncbi.nlm.nih.gov/pubmed?term=%22PloS+one%22%5bJour%5d+AND+Gut+Microbiota+in+Human+Adults+with+Type+2+Diabetes+Differs+from+Non-Diabetic+Adults&amp;TransSchema=title">Bacterial populations in the gut of diabetics</a> differ from non-diabetics, according to a study from Denmark. In   particular, diabetics had fewer Firmicutes and more plentiful amounts of   Bacteroidetes and Proteobacteria, compared to non-diabetics. The study   also found a positive correlation for the ratios of Bacteroidetes to   Firmicutes and reduced glucose tolerance. LINE SPACE Researchers   concluded:</li>
</ul>
<p style="padding-left: 60px;"><strong><em>The results of this study indicate that type 2   diabetes in humans is associated with compositional changes in   intestinal microbiota.</em></strong></p>
<ul>
<li><strong>Autism:</strong><em><strong> Establishment of normal gut flora in  the first 20 days or so of life plays a crucial role in appropriate  maturation of your baby&#8217;s immune system. Hence, babies who develop  abnormal gut flora are left with compromised immune systems and are  particularly at risk for developing such disorders as ADHD,</strong> </em>learning  disabilities and autism &#8212; particularly if they are vaccinated <em>before</em> restoring balance to their gut flora.To get a solid understanding of just how this connection works, I highly recommend reviewing the information shared by <a href="http://articles.mercola.com/sites/articles/archive/2011/07/31/dr-natasha-campbell-mcbride-on-gaps-nutritional-program.aspx">Dr. Natasha Campbell-McBride in this recent interview</a>.</li>
</ul>
<ul>
<li><strong>Obesity: The make-up of gut bacteria tends to  differ in lean vs. obese people. </strong>This is one of the compelling areas of  probiotic research to date, and you can <a href="http://articles.mercola.com/sites/articles/archive/2011/06/18/good-gut-bacteria-may-help-fight-obesity.aspx">read about a handful of such studies here</a>.</li>
</ul>
</blockquote>
<blockquote>
<p style="padding-left: 60px;"><em>The bottom line: restoring your gut flora should be an important  consideration if you&#8217;re struggling to lose weight, and doing this is  straightforward, as I&#8217;ll describe below.</em></p>
</blockquote>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/22031325" target="_blank">Multiple Sclerosis &amp; Bugs (Nature 2011)</a></p>
<blockquote>
<blockquote><p>We show further that recruitment and activation of   autoantibody-producing B cells from the endogenous immune repertoire   depends on availability of the target autoantigen, myelin   oligodendrocyte glycoprotein (MOG), and commensal microbiota. <strong>Our   observations identify a sequence of events triggering organ-specific   autoimmune disease and these processes may offer novel therapeutic   targets.</strong></p></blockquote>
</blockquote>
<p><a href="http://articles.mercola.com/sites/articles/archive/2011/12/10/dr-don-huber-interview-part-1.aspx?e_cid=20111210_DNL_art_1" target="_blank">GMOs affecting Gut Flora (Dr. Mercola)</a></p>
<blockquote>
<ul>
<li> Dr.  Don Huber, an agricultural scientist and  expert in microbial  ecology,  has issued stern warnings about shockingly<strong> devastating effects  of  genetically engineered food crops</strong> after discovering a brand new  organism  in GE animal feed—an organism that has since been clearly  linked to  infertility and miscarriage in cattle, horses, pigs, sheep,  and poultry</li>
<li> Glyphosate,  the active ingredient in Monsanto’s  herbicide Roundup, and this  new-to-science microbe are now linked to a  new phenomenon referred to as  “<strong>Sudden Death Syndrome” (SDS)</strong></li>
<li> Herbicides  and pesticides are<strong> metal chelators, w</strong>hich means they  immobilize  specific nutrients, rendering them unavailable to the plant  and any  animal or human who consumes that plant</li>
<li> The   nutritional efficiency of genetically engineered (GE) plants is   profoundly compromised. <strong>Micronutrients such as iron, manganese and zinc   can be reduced by as much as 80-90 percent in GE plants</strong></li>
</ul>
</blockquote>
<p><a href="http://www.greenmedinfo.com/toxic-ingredient/glyphosate" target="_blank">Links to Other Dangers of GMOs (Green Med Info)</a></p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<h1><a href="http://www.dr-lobisco.com/wp-content/uploads/2011/07/courses_home11.jpg"><img class="alignnone size-medium wp-image-884" title="courses_home1" src="http://www.dr-lobisco.com/wp-content/uploads/2011/07/courses_home11-300x287.jpg" alt="" width="267" height="225" /></a></h1>
<h1><span style="text-decoration: underline;"><strong>Health</strong></span></h1>
<p><span style="text-decoration: underline;"><strong>Let&#8217;s Hear it For Oregano! </strong></span></p>
<blockquote><p><a href="http://jmm.sgmjournals.org/content/early/2011/10/20/jmm.0.036988-0.short?rss=1%20ForceRecrawl:%200" target="_blank"><strong>Constiuents &amp; Quality Affect Anti-fungal activity (JMM) </strong></a></p>
<p>Significant quantitative differences in chemical composition were found  between the essential oil samples and, while the three                      samples generally displayed potent fungicidal  activity, <strong>antifungal potencies varied and appeared to be intensified by  increasing                      carvacrol contents. The inhibition of  filamentation, on the other hand, may correlate more to ?-terpinene  content.</strong></p>
<p>The essential oil of <em>O. vulgare</em> subsp. <em>virens</em> is a  broad-spectrum fungicide, thus justifying its potential for use in the  treatment of superficial or mucosal fungal infections.                      The essential oil shows significant variability in  chemical composition between samples, which, in turn, closely affects  its                      biological activity.</p>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/21030907" target="_blank"><span style="text-decoration: underline;"><strong>Antibacterial Activity (Molecules 2010)</strong></span></a></p>
<p>The chemical composition and antibacterial  activity of essential oils from 10 commonly consumed herbs: Citrus  aurantium, C. limon, Lavandula angustifolia, Matricaria chamomilla,  Mentha piperita, M. spicata, Ocimum basilicum, Origanum vulgare, Thymus  vulgaris and Salvia officinalis have been determined. <strong>The antibacterial  activity of these oils and their main components; i.e. camphor,  carvacrol, 1,8-cineole, linalool, linalyl acetate, limonene, menthol,  a-pinene, b-pinene, and thymol were assayed against the human pathogenic  bacteria </strong>Bacillus subtilis, Enterobacter cloacae, Escherichia coli  O157:H7, Micrococcus flavus, Proteus mirabilis, Pseudomonas aeruginosa,  Salmonella enteritidis, S. epidermidis, S. typhimurium, and  Staphylococcus aureus.<em><strong> The highest and broadest activity was shown by O.  vulgare oil. Carvacrol had the highest antibacterial activity among the  tested components.</strong></em>PMID:21030907</p></blockquote>
<p><a href="www.sciencedaily.com/releases/2011/11/111101171042.htm" target="_blank">Physical Activity Fights Depression (ScienceDaily)</a></p>
<blockquote><p>ScienceDaily (Nov. 1, 2011) — Regular physical  activity is associated with a lower risk of suffering depression in old  age. This is shown by one of the largest studies on elderly Europeans  to have been carried out, by researchers at the University of  Gothenburg, Sweden, among others. Research also shows that  self-determined motivation and perceived competence are important  factors in persuading elderly people to exercise more The results support the recommendations to use physical activity as a  powerful preventive measure against mental ill-health in the elderly. &#8220;But <strong>regular physical activity is required, otherwise there is a  great risk of the long-term favourable effects on health being lost. It  is therefore important to identify the barriers, for example depression,  that prevent the elderly from being physically active and focus on how  to increase the motivation of elderly people for physical activity,&#8221;  says Lindwall.</strong></p></blockquote>
<p><span style="text-decoration: underline;">Bad News on Fructose:</span></p>
<blockquote><p>1. <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2673878/" target="_blank">Increases Toxic Fat around viscera (JCI)</a></p>
<p><strong>Although both groups exhibited similar weight gain during the  intervention, visceral adipose volume was significantly increased only  in subjects consuming fructose.</strong> Fasting plasma triglyceride  concentrations increased by approximately 10% during 10 weeks of glucose  consumption but not after fructose consumption. In contrast, hepatic de  novo lipogenesis (DNL) and the 23-hour postprandial triglyceride AUC  were increased specifically during fructose consumption.<strong> Similarly,  markers of altered lipid metabolism and lipoprotein remodeling,  including fasting apoB, LDL, small dense LDL, oxidized LDL, and  postprandial concentrations of remnant-like particle–triglyceride and  –cholesterol significantly increased during fructose but not glucose  consumption</strong>. In addition, fasting plasma glucose and insulin levels  increased and insulin sensitivity decreased in subjects consuming  fructose but not in those consuming glucose.</p>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/20948525" target="_blank">2. There&#8217;s more in that soft drink than you think (Obesity 2011)</a></p>
<p>Total sugar content was calculated as well as percent fructose in the  beverages that use HFCS as the sole source of fructose. Results showed  that the total sugar content of the beverages ranged from 85 to 128% of  what was listed on the food label. The mean fructose content in the HFCS  used was 59% (range 47-65%) and several major brands appear to be  produced with HFCS that is 65% fructose. Finally, the sugar profile  analyses detected forms of sugar that were inconsistent with what was  listed on the food labels.</p></blockquote>
<p><a href="http://www.chopra.com/files/newsletter/Nov11/Newsletter-Nov11-mindbodyshape.html" target="_blank">8 Ways to Mind-Body Balance (Chopra Newsletter)</a></p>
<blockquote><p><strong> Relate to Your Body Consciously</strong>. Most of us were trained to live from the neck up,  valuing the mind and the intellect over the body. Yet our body is our  most reliable guide to balance, happiness, and health. Every day it  consciously tends to us, never losing focus or attention.  It stands by  us without asking for any rewards, and it sustains every cell through  the universe’s infinite supply of energy and intelligence. We can return  this faithful service by consciously relating to our body, and  cultivating a bond based on trust, consideration, and loving  appreciation. You can develop a healthy, intimate relationships with your body by cultivating the following qualities:</p></blockquote>
<blockquote><p><strong>Trust</strong>.  In every second,  billions of cells in your body are carrying out millions of infinitely  complex operations to keep you alive.  The few times that your body has  become distressed or ill are miniscule in comparison with its faithful,  steady functioning.  You can trust your body by allowing its signals of  comfort and discomfort to guide you rather than talking yourself into  denial or judging what you’re feeling. <strong> </strong></p></blockquote>
<blockquote><p><strong>Consideration</strong>.   Treat your body lovingly, like the loyal companion it is.  Instead of  making it submit to relentless stress, loud noise, excessive physical  demands, and emotional toxicity, nurture your body. Offer it basic  considerations, including rest and regular daily rhythms and routines.</p></blockquote>
<blockquote><p><strong>Loving Appreciation</strong>.   Your body is going to serve you for a lifetime, and it will be much  happier if you lavish it with love, attention, and affection.  Most  people treat their body like an old model of a car, judging its  appearance and complaining about the need for repairs.  If you treat  your body like a beloved companion, giving it what it needs most, your  relationships will grow more comfortable, fulfilling, and intimate. Click on the above Link to learn 7 more.</p></blockquote>
<p><a href="http://www.nytimes.com/2011/09/25/opinion/sunday/is-junk-food-really-cheaper.html?pagewanted=2&amp;_r=3" target="_blank">Addiction to Processed Foods-Not a Fair Trade off (NYT)</a></p>
<blockquote><p><strong>This addiction to processed food is the result of decades of vision and  hard work by the industry. For 50 years, says David A. Kessler, former  commissioner of the Food and Drug Administration and author of “<a href="http://www.amazon.com/End-Overeating-Insatiable-American-Appetite/dp/B004NSVE32/ref=sr_1_1?ie=UTF8&amp;qid=1316255104&amp;sr=8-1">The End of Overeating</a>,”  companies strove to create food that was “energy-dense, highly  stimulating, and went down easy.</strong> They put it on every street corner and  made it mobile, and they made it socially acceptable to eat anytime and  anyplace. They created a food carnival, and that’s where we live. And if  you’re used to self-stimulation every 15 minutes, well, you can’t run  into the kitchen to satisfy that urge.”</p>
<p><em><strong>Real cultural changes are needed to turn this around. Somehow,  no-nonsense cooking and eating — roasting a chicken, making a grilled  cheese sandwich, scrambling an egg, tossing a salad — must become  popular again, </strong></em>and valued not just by hipsters in Brooklyn or locavores  in Berkeley. The smart campaign is not to get McDonald’s to serve better  food but to get people to see cooking as a joy rather than a burden, or  at least as part of a normal life.</p>
<p>As with any addictive behavior, this one is most easily countered by  educating children about the better way. Children, after all, are born  without bad habits. And yet it’s adults who must begin to tear down the  food carnival.</p></blockquote>
<p><a href="http://newsletter.vitalchoice.com/e_article002288246.cfm?x=bklRCNc,b1h0JlRD" target="_blank">Fish and Bones (Vitalchoice)</a></p>
<blockquote><p><span style="font-family: verdana,arial; font-size: x-small;"> </span></p>
<div><span style="font-family: Tahoma; font-size: x-small;"> </span></div>
<p><strong>The key bone minerals are calcium, magnesium, boron, copper, manganese, phosphorus, and zinc, while the critical vitamins are D, K, A, B6, B12, C, and folic acid.</strong></p>
<p><strong>But another, long-overlooked factor in the bone-health equation is fatty acids</strong> … namely, the contrasting effects of omega-3 and omega-6 fatty acids.</p>
<p>The researchers <strong>measured key signs of bone health </strong>at the outset, and again after 12 and 24 weeks:</p>
<ul>
<li>Bone mineral density in the lumbar spine and pelvis      (femoral neck)</li>
<li>Inflammation markers (TNF-alpha, IL-6, and PG-E2)</li>
<li>Markers for bone health (estrogen, osteocalcin, vitamin      D3, C-telopeptide, parathyroid hormone, and calcitonin).</li>
</ul>
<p>The results were surprisingly clear and dramatic, with only the Exercise + Omega-3s group showing desirable increases in blood levels of estrogen, calcitonin, vitamin D3, spine and pelvis BMD.</p>
<p>Likewise, only the Exercise + Omega-3s group showed desirable drops in blood C-telopeptide, parathyroid hormone, TNF-alpha, IL-6, and PG-E2.</p>
<p><span style="font-family: verdana,arial; font-size: x-small;"> </span></p>
<div><span style="font-family: Tahoma; font-size: x-small;"> </span></div>
</blockquote>
<p><a href="http://www.webmd.com/kidney-stones/ss/slideshow-kidney-stones-overview?ecd=wnl_dia_121311" target="_blank">The Kidney Stone Slideshow (WebMD)</a></p>
<blockquote><p>Take a look and learn about the pathology of kidney stones and some common measures to treat and prevent.</p></blockquote>
<p><a href="http://www.sciencedaily.com/releases/2011/11/111130095251.htm" target="_blank">Violent Video Games Not Good for Brain (Science Daily)</a></p>
<blockquote><p>For the study, 28 healthy adult males, age 18 to 29, with low past  exposure to violent video games were randomly assigned to two groups of  14. Members of the first group were instructed to play a shooting video  game for 10 hours at home for one week and refrain from playing the  following week. The second group did not play a video game at all during  the two-week period.</p>
<p>Each of the 28 men underwent functional magnetic resonance imaging  (fMRI) analysis at the beginning of the study, with follow-up exams at  one and two weeks. During fMRI, the participants completed an emotional  interference task, pressing buttons according to the color of visually  presented words. Words indicating violent actions were interspersed  among nonviolent action words. In addition, the participants completed a  cognitive inhibition counting task.</p>
<p><strong>The results showed that after one week of violent game play, the  video game group members showed less activation in the left inferior  frontal lobe during the emotional Stroop task and less activation in the  anterior cingulate cortex during the counting Stroop task, compared to  their baseline results and the results of the control group after one  week.</strong> After the video game group refrained from game play for an  additional week, the changes to the executive regions of the brain  returned closer to the control group. Stroop task tests an individual&#8217;s  ability to control cognitive flexibility and attention.</p>
<p><em><strong>&#8220;These findings indicate that violent video game play has a long-term  effect on brain functioning,&#8221; Dr. Wang said. &#8220;These effects may  translate into behavioral changes over longer periods of game play.</strong></em></p></blockquote>
<p>&nbsp;</p>
<h1><a href="http://www.dr-lobisco.com/wp-content/uploads/2011/07/drugs.jpg"><img class="alignnone size-full wp-image-830" title="drugs" src="http://www.dr-lobisco.com/wp-content/uploads/2011/07/drugs.jpg" alt="" width="219" height="194" /></a></h1>
<h1><span style="text-decoration: underline;"><strong>Drugs</strong></span></h1>
<p><a href="http://www.medscape.com/viewarticle/749066?src=mp&amp;spon=17" target="_blank">Adverse drug events are a serious public health problem. Consider the following facts (Medscape):</a></p>
<blockquote>
<ul>
<li><strong>An estimated 82% of American adults take at least 1 medication and 29% take 5 or more;</strong></li>
<li><strong>700,000 emergency department visits and 120,000 hospitalizations are due to adverse drug events annually;</strong></li>
<li><strong>$3.5 billion is spent on extra medical costs of adverse drug events annually; and</strong></li>
<li><strong>At least 40% of costs associated with adverse drug events occurring outside hospitals can be prevented.</strong></li>
</ul>
<p>How can the emerging science of genomics  help?<strong> Pharmacogenomics is the study of genetic variation as a factor in  drug  response, affecting both safety and effectiveness. The intended   applications of pharmacogenomics research include indentifying   responders and nonresponders to medications</strong>, avoiding adverse  events,  optimizing drug doses, and avoiding unnecessary healthcare  costs. The US  Food and Drug Administration has added pharmacogenomic  information to  the labeling for more than 70 drugs. Labels may include  information on  genetic determinants of clinical response or risk for  adverse events.</p></blockquote>
<p><a href="http://www.medscape.com/features/slideshow/new-in-primarycare/nov2011?src=mp&amp;spon=17" target="_blank">Drug Updates: Fenofibric Acid not found to decrease risk of CHD in DM2 (Medscape)</a></p>
<blockquote><p>On November 9, 2011, the FDA issued a <em><strong>Drug Safety Communication  explaining that use of fenofibric acid (Trilipix®, Abbott Laboratories,  North Chicago, IL) may not reduce risk of heart attack or stroke.  Fenofibric acid is a peroxisome proliferator receptor alpha (PPAR-alpha)  activator indicated in combination with a statin for patients with  mixed dyslipidemia and coronary heart disease (CHD) or a CHD  risk-equivalent. </strong></em>In addition, fenofibric acid monotherapy is indicated  for primary hyperlipidemia, mixed dyslipidemia, and severe  hypertriglyceridemia. Fenofibric acid (dose equivalent to 135 mg of  Trilipix) was not associated with a decrease in CHD morbidity and  mortality in 2 randomized controlled trials in patients with type 2  diabetes mellitus. As a result, updates have been added to prescribing  information and the medication guide. In addition, the FDA is requiring  further trial investigation to<strong> evaluate cardiovascular effects of  fenofibric acid in patients at high risk of CV disease who are taking  statins.</strong></p></blockquote>
<p><span style="text-decoration: underline;">Warning on Zofran</span></p>
<blockquote><p>According to an FDA Drug Safety Communication issued September 15, 2011,  <em><strong>ECG changes, including QT interval prolongation and torsade de pointes,  have been reported in patients receiving ondansetron (Zofran®;  GlaxoSmithKline, Research Triangle Park, North Carolina, also available  as generics). Patients with congenital long QT syndrome should not  receive ondansetron.</strong></em> ECG monitoring is recommended in the following  situations: patients with electrolyte abnormalities, congestive heart  failure, bradyarrhythmias, or patients receiving other drugs that cause  QT interval prolongation. Labeling is being revised to reflect the  findings of this ongoing safety review.</p></blockquote>
<p><a href="http://www.medscape.com/viewarticle/753111?src=mp&amp;spon=17" target="_blank">Opiates Surpass Heroin ODs (Medscape)</a></p>
<blockquote><p>November 8, 2011 (Washington, DC) — <em><strong>Rates of hospital admissions for  prescription opiate overdoses from 1993 to 2007 far exceeded heroin  overdoses, rising by as much as 291%</strong></em>. The shift included a sharp  increase in admissions of whites and middle-aged women, according to  research presented here at the American Public Health Association 139th  Annual Meeting.</p>
<p>Researchers from the University of Maryland, in Baltimore,<strong> evaluated  data from the Nationwide Inpatient Survey on hospital admissions for  opiate overdose. They found that the rate of overdoses related to  prescription opiates, primarily oxycodone and methadone, started to  exceed those of heroin overdoses at the end of the 1990s.</strong></p></blockquote>
<p><a href="http://www.medscape.com/medline/abstract/20797803" target="_blank">Diabetic Drug and Heart Risk (Medscape<strong> from Int J Cardiol.  		 2011; 		152(3):327-31</strong> )(ISSN: 1874-1754)</a></p>
<blockquote><p>BACKGROUND:  					<strong>Sulfonylureas have been linked to an increased cardiovascular risk  by inhibition of myocardial preconditioning. </strong>Whether individual  sulfonylureas affect outcomes in diabetic patients after emergent  percutaneous coronary intervention for myocardial infarction is unknown.</p>
<p>METHODS: 					All Danish patients receiving glucose-lowering drugs admitted with  myocardial infarction between 1997 and 2006 who underwent emergent  percutaneous coronary intervention were identified from national  registers. Multivariable Cox proportional hazards models were used to  analyze the risk of cardiovascular mortality and morbidity associated  with sulfonylureas.</p>
<p>CONCLUSIONS:<strong> Glyburide is associated with increased cardiovascular mortality and  morbidity in patients with diabetes mellitus undergoing emergent  percutaneous coronary intervention after myocardial infarction. </strong>Early  reperfusion therapy is the mainstay in modern treatment of myocardial  infarction and the time may have come to discard glyburide in favour of  sulfonylureas that do not appear to confer increased cardiovascular  risk.</p></blockquote>
<p><a href="http://www.medscape.com/features/slideshow/year-in-medicine/2011?src=ptalk" target="_blank"><strong>FDA Drug Warnings 2011 (Medscape)</strong></a></p>
<blockquote><p>A variety of drug warnings made news in 2011: <strong> </strong></p>
<ol>
<li><strong>The FDA recommended in June that physicians should <a href="http://www.medscape.com/viewarticle/744242" target="_blank">refrain from using the 80-mg dose of simvastatin</a> unless the patient has already been taking the drug for 12 months and  there is no evidence of myopathy</strong>.</li>
<li> Also in June the <strong>FDA warned of an <a href="http://www.medscape.com/viewarticle/744325" target="_blank">increased risk of being diagnosed</a> with a high-grade prostate cancer while taking 5-alpha reductase  inhibitors.</strong></li>
<li> In July the FDA warned that clinicians generally should <a href="http://www.medscape.com/viewarticle/747076" target="_blank">a<strong>void prescribing either methylene blue or linezolid</strong></a><strong> in combination with serotonergic agents</strong> to avoid a potential drug  interaction causing serotonin syndrome.</li>
<li> And in August, <strong>the FDA said the  antidepressant <a href="http://www.medscape.com/viewarticle/748498" target="_blank">citalopram should not be used in doses higher than 40 mg</a> per day because of concerns that it can cause potentially fatal changes in heart rhythm.</strong></li>
</ol>
</blockquote>
<p><a href="http://www.medscape.com/viewarticle/753954?src=mp&amp;spon=17" target="_blank">Pertussis Vaccinated not lower in Occurrence (Medscape)</a></p>
<blockquote>
<blockquote><p><em><strong>Despite the availability of an effective  vaccine and recommendations  for its use dating back to the 1940s,  pertussis infection has continued  to plague persons at either end of  the age spectrum with the most  serious infections occurring in the very  young and very old. A more  recent worrisome increase in infection,  however, has been found in  adolescents, notably including those who  were fully vaccinated as young  children. </strong></em>Despite high  vaccination levels, pertussis cases have been on  the rise since the  1980s, with the most dramatic increase in cases seen  in California.</p>
<p>Concerns over incidence were a factor in a recent change in the <a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6041a4.htm?s_cid=mm6041a4_w">American   Academy of Pediatrics (AAP) and Advisory Committee on Immunization   Practices (ACIP) recommendations for administration of pertussis   vaccine.</a> The organizations removed their previous minimum interval   between administering tetanus or diphtheria vaccine and the tetanus   toxoid, reduced-content diphtheria toxoid, and acellular pertussis   vaccine (Tdap). The groups also now recommend extending the age for   administering Tdap to people aged 65 years and older and to healthcare   workers of all ages who may come in contact with infants too young for   vaccination. Finally, the groups also recommended vaccination of   adolescents, including pregnant adolescents, and pregnant women during   pregnancy rather than waiting until after delivery.</p></blockquote>
</blockquote>
<h6><strong><span style="text-decoration: underline;">Be sure to check out my informational blog on </span><a href="http://www.saratoga.com/living-well/2011/12/dont-miss-top-reads-emotional-eating-depression-alternative-medicne-more.html" target="_blank">Saratoga.com</a><span style="text-decoration: underline;"><a href="http://www.saratoga.com/living-well/2011/12/dont-miss-top-reads-emotional-eating-depression-alternative-medicne-more.html" target="_blank"> </a>which includes:</span></strong></h6>
<blockquote>
<blockquote><p><strong>1. </strong><span style="text-decoration: underline;">Naturopathic Philosophy Highlight… Fun Facts</span>:</p>
<ol>
<li>Good Fats/Bad Fats to Eat</li>
<li>Depression and “Alternative Medicine”</li>
</ol>
<p><strong>2. </strong><span style="text-decoration: underline;">Happenings</span>:</p>
<ol>
<li>Upcoming Essential Oils Workshops with Terry Quigley at the Healing Garden. Contact Terry at 518-831-9469</li>
<li><span style="text-decoration: underline;">PATIENTS: Please review follow ups and cancellation policy on </span><a href="../contact/">my website</a></li>
<li>Emma and I will be taking some time to be with family and loved ones this holiday season;<span style="text-decoration: underline;"> therefore, the office will be closed later in the afternoon </span>on <span style="text-decoration: underline;">December 30<sup>th</sup> and January 1st</span>. May you all have a beautiful holiday season filled with blessings and joy!</li>
<li><span style="text-decoration: underline;">Time for a symptom re-evaluation</span>?</li>
<li><strong><em>All patients can now download the symptom survey done at the original <a href="../new-patient-intake-forms/">visit online</a>.</em></strong> If you haven’t re-evaluated your symptoms in a year or more, it may be a good time to fill out the form again and bring it in to your next visit. (Please add the numbers in every section when you return it)</li>
</ol>
<p><strong>3. </strong><a href="http://click.linksynergy.com/fs-bin/click?id=YS5wNadRhrI&amp;offerid=206928.10000064&amp;type=3&amp;subid=0%22%20%3EHay%20House%20Radio%3C/a%3E%3CIMG%20border=0%20width=1%20height=1%20src=%22http://ad.linksynergy.com/fs-bin/show?id=YS5wNadRhrI&amp;bids=206928.10000064&amp;type=3&amp;subid=0%22%20%3E">Radio For Your Body-</a>Mind-<em>Soul: <a href="http://www.hayhouseradio.com/show_details.php?show_id=235&amp;episode_id=8081&amp;schedule_id=68096">Year End Wrap Up</a></em><br />
<em> </em></p>
<p>Join the Hay House Book Club for a review of their favorite books of 2011. The Book Club members will go over the titles that have been reviewed over the past year and discuss what Hay House titles have really inspired them. Book Bloggers will join in to share there favorites. We&#8217;ll also discuss our favorite Hay House titles of the past and what books have been influences over the years. Please leave your comments on the Book Club link at HayHouseRadio.com to share which Hay House titles have inspired and helped you the most.<br />
<strong> </strong></p>
<p><strong>4. </strong><strong><span style="text-decoration: underline;">Book of the week</span></strong>: Highlights from<em> The Year End Wrap Up</em></p>
<p>HayHouse’s Booklovers Book Club Recommendations of 2011: which did you miss?</p>
<ol>
<li><em><a href="http://www.amazon.com/gp/product/1401928463/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1401928463%22%3eMarried%20to%20Bhutan:%20How%20One%20Woman%20Got%20Lost,%20Said%20%22I%20Do,%22%20and%20Found%20Bliss%3c/a%3e%3cimg%20src=%22http://www.assoc-ama">Married to Bhutan</a></em></li>
<li><em><span style="text-decoration: underline;"><a href="http://www.amazon.com/gp/product/1401926916/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1401926916%22%3eRavenous:%20A%20Food%20Lover%27s%20Journey%20from%20Obsession%20to%20Freedom%3c/a%3e%3cimg%20src=%22http://www.assoc-amazon.com/e/ir?">Ravenous</a></span></em></li>
<li><em><a href="http://www.amazon.com/gp/product/1401928234/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1401928234%22%3ePeace%20From%20Broken%20Pieces:%20How%20to%20Get%20Through%20What%20You%27re%20Going%20Through%3c/a%3e%3cimg%20src=%22http://www.assoc-amaz">Peace from Broken Pieces</a></em></li>
<li><em><a href="http://www.amazon.com/gp/product/1401918360/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1401918360%22%3eThe%20Angel%20Therapy%20Handbook%3c/a%3e%3cimg%20src=%22http://www.assoc-amazon.com/e/ir?t=drsarlobsnatm-20&amp;l=as2&amp;o=1&amp;a=1">Angel Therapy Handbook</a></em></li>
<li><em><a href="http://www.amazon.com/gp/product/1401931707/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1401931707%22%3eShift%20Happens:%20How%20to%20Live%20an%20Inspired%20Life...Starting%20Right%20Now%21%3c/a%3e%3cimg%20src=%22http://www.assoc-amazon.c">Shift Happens</a></em></li>
<li><em>You Can Create an Exceptional Life</em></li>
<li><em>Winter Moon Rises</em></li>
</ol>
<p><strong><span style="text-decoration: underline;">5. Don’t miss out:</span></strong></p>
<ul>
<li>The Rest of Fun Facts on my<a href="http://www.saratoga.com/living-well/2011/12/dont-miss-top-reads-emotional-eating-depression-alternative-medicne-more.html" target="_blank"> Saratoga.com </a>blog.</li>
<li>Listen to my colleagues and other experts as they discuss solutions to menopausal issues on a show dedicated just for women in mid-life! Here is a link from my <a href="http://www.blogtalkradio.com/magnificentmenopause/2011/03/31/magnificent-menopause-and-beyond-enbracing-midlife">interview on 360menopause Radio Show</a> on <em>Panic Attacks and Menopause </em>and a list of archived shows.</li>
<li>Check out my latest answer on <a href="http://www.sharecare.com/user/sarah-lobisco/answers">Dr. Oz’s Sharecare</a><em>: <strong><span style="text-decoration: underline;">This week I focused on Emotional Overeating and Brain Chemistry.</span></strong></em></li>
<li>View the Updated Link Resources on <a href="../">my homepage</a></li>
</ul>
</blockquote>
</blockquote>
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		<title>Thriving through the Holidays</title>
		<link>http://www.dr-lobisco.com/thriving-through-the-holidays/</link>
		<comments>http://www.dr-lobisco.com/thriving-through-the-holidays/#comments</comments>
		<pubDate>Wed, 21 Dec 2011 21:11:57 +0000</pubDate>
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		<description><![CDATA[<p></p> <p>&#160;</p> <p>By Sarah A LoBisco, ND</p> <p>In the next few weeks, I’ll be sprinkling in my blogs more of what I learned at the IFM’s Advanced Practice Module on Detoxification. However, this week I’m aware that most have their vision more on dancing sugar plums and running out for last minute gifts than [...]]]></description>
			<content:encoded><![CDATA[<p><a href="http://www.dr-lobisco.com/wp-content/uploads/2011/12/letitsnow.jpg"><img class="alignnone size-full wp-image-1543" title="letitsnow" src="http://www.dr-lobisco.com/wp-content/uploads/2011/12/letitsnow.jpg" alt="" width="250" height="188" /></a></p>
<p>&nbsp;</p>
<p>By Sarah A LoBisco, ND</p>
<p>In the next few weeks, I’ll be sprinkling in my blogs more of what I learned at the <a href="http://www.functionalmedicine.org/ifm_ecommerce/Products.aspx?Category=2">IFM’s Advanced Practice Module on Detoxification.</a> However, this week I’m aware that most have their vision more on dancing sugar plums and running out for last minute gifts than on the biotransformation of the high fructose corn syrup in fruit cake. (By the way, did you know <span style="text-decoration: underline;">that high fructose corn syrup contains <em>MERCURY? Yikes!) </em></span>Therefore, in keeping with the season, I have decided to present another holiday blog on how to modulate some of food transgressions and tips for dealing with the added stress that holidays can bring.</p>
<p>Sugar and processed foods can deplete our body of needed nutrients, create inflammation, and suppress our immunity. According to an article in USA today:</p>
<p style="padding-left: 30px;">Denver nutrition therapist Kate Pfeiffer has no doubt. &#8220;Limiting sugar should be the first line of defense against infectious disease,&#8221; she says. She wrote a column for Examiner.com titled: &#8220;Worried about the Swine Flu? Avoid Sugar!&#8221; In it she cites a 1973 study, published in the <em>American Journal of Clinical Nutrition.</em> The same study is cited at AskDrSears.com and on many alternative-medicine sites.</p>
<p style="padding-left: 30px;">In the study, researchers at Loma Linda University gave volunteers 100 grams of sugar (20 teaspoons, roughly the amount in a liter of soda). The researchers then drew blood from the volunteers and mixed in some bacteria. They found that infection-fighting white blood cells from people who had just gorged on sugar gobbled up many fewer bacteria than those who had just fasted or eaten an unsweetened starch.</p>
<p>The good news is the article doesn’t end there. It’s about balance:</p>
<p style="padding-left: 30px;">But it&#8217;s unlikely any one food is the key to a strong or weak immune system, she says. Instead, she says, &#8220;we can optimize the building blocks for immune system by eating a healthy, balanced diet.&#8221;Sears says he agrees wholeheartedly that overall nutrition is more important than any one substance. But he still says there&#8217;s something about a sugar overdose that makes people vulnerable.</p>
<p>In past blogs, I discussed how triggers from biological and emotional stressors can cause imbalances in <a href="../mood-imbalances-part-iii-the-thyroid-depression-connection/"> thyroid,</a> <a href="../weight-loss-cravings-part-iv-and-the-french-paradigm-of-weight-loss/">progesterone, or estrogen hormones. <strong>For example, stress decreases thyroid function and thyroid hormone modulates detoxification. Low intake of vitamin A contributes to lowered thyroid function via decreased detoxification in this enzyme pathway. </strong>This can create shifts in neurotransmitters and an imbalance in the liver and gut which can create cravings for high sugar and carbohydrate foods for soothing</a>.</p>
<p>I recently wrote a blog on <a href="../feast-on-the-turkey-and-pass-the-pie-for-turkey-day-weight-the-holidays/">several steps to modulate the food cues and blues of the holidays.</a> The fact is, once one decides to partake a little, the addictive part of food can take hold. Remember how <a href="../brain-health-food-addiction-february-top-reads-highlighted/">sugar stimulates pleasure neurotransmitters in the brain</a>?  So, what to do?</p>
<p>There are various options. The optimal way is to avoid the treat trigger all together <a href="http://www.saratoga.com/living-well/2011/11/in-this-newsletter-naturopathic-philosophy.html">and bring your own yummy, healthy treats</a>. However, there’s another side. By modulating insulin response and cortisol, through increased healthy protein and fat intake, the emotional and physical effects after a “fudge feast”can be minimized. What about other hints? For those who are more of the moderate temperament and enjoy the bonding experience that food can bring, <a href="../11262008-turkey-day-tips-enjoying-the-good/">read here</a> for my recommendations on how to boost immunity and support you from transgressions.</p>
<p>What about dealing with the emotional repercussions of the holiday? WebMD offered a <a href="http://www.webmd.com/depression/holiday-depression-8/slideshow-depression-triggers?ecd=wnl_dep_121611">wonderful slide show</a> with 10 tips for dealing with the emotional impacts that lead to the holiday blues. Similar to success with diet, awareness of emotional triggers and feeling blue is an important step to prevent slips into sadness and emotional upheaval. Our poor adrenals have been through enough this year, and wouldn’t it be nice to have tools that would allow them more rest over stress this holiday season?</p>
<p>In another WebMD article, several tips were provided to arm oneself against holiday eating:</p>
<ul>
<li><strong>Soothe your senses:</strong> “Find other ways to comfort your body      besides food, such as taking a warm bath, wrapping yourself in a soft      blanket, or sipping hot tea,” Albers suggests.</li>
<li><strong>Tune in to your hunger:</strong> When you think you feel hungry, Fain      recommends pausing and asking yourself: am I really hungry or am I feeling      something else? “You may find that what you’re really craving isn&#8217;t a      cookie or a bag of chips, but a heart-to-heart talk with a friend or a      loved one,” she says.</li>
<li><strong>Eat a varied diet:</strong> Nutritional deficiencies can make      depression worse. So focus on eating a variety of foods, including whole      grains, vegetables, fruits, lean meats, and low-fat dairy      products. Consider meeting with a nutritionist who can create simple,      balanced meal plans for you.</li>
<li><strong>Boost your energy:</strong> Seek activities that give you energy,      such as going for a walk, playing with your dog, or listening to music.      “When you do something that brightens your outlook and improves your mood,      you’ll be less likely to overeat and make poor food choices,” Fain says.</li>
</ul>
<p>Sometimes emotional triggers can lead into a downhill slide of unconscious food choices or overeating that can perpetuate self-loathing and <a href="../dealing-with-the-holiday-blues-food-cues/">create further cravings of holiday munchies.</a> The good news is, eating the right foods can actually <a href="../more-on-the-mind-mood-food-weight-control-connection/">curb cravings and modulate mood</a>. One trick is making sure that you are eating some good quality foods during transgressions to <a href="../more-on-the-mind-mood-food-weight-control-connection/">modulate the negative effects of some treats</a>! Furthermore, there have <a href="../pain-on-the-brain/">been links between depression</a> and inflammation, and food can be anti or pro-inflammatory, so be sure to <a href="http://www.saratoga.com/living-well/2011/12/flourish-through-the-holidays-the-future-of-medicine.html" target="_blank">read my fun facts for tips on modulating this.</a></p>
<p><span style="text-decoration: underline;">References:</span></p>
<p>WebMD. Holiday Depression Triggers Slidshow. December 16, 2011. <a href="http://www.webmd.com/depression/holiday-depression-8/slideshow-depression-triggers?ecd=wnl_dep_121611">http://www.webmd.com/depression/holiday-depression-8/slideshow-depression-triggers?ecd=wnl_dep_121611</a>.</p>
<p>Jen Uscher. Holiday Food Trips. 3 Food Traps to Avoid When You&#8217;re Depressed: Learn how depression can affect your eating habits and what you can do to start making healthier choices. December 16, 2011. <a href="http://www.webmd.com/depression/features/depression-food-traps?page=2">http://www.webmd.com/depression/features/depression-food-traps?page=2</a></p>
<p>Mayfield, R. Phytochemicals and Nutrients to Improve Detoxification. Detox Advanced Practice Module. December 10, 2011. Phoenix, AZ</p>
<p>Painter, K. Does a Spoonful of Sugar Make the Flu Take Hold? 10/5/2009. USA Today (online). http://www.usatoday.com/news/health/painter/2009-10-04-your-health_N.htm</p>
<p><span style="text-decoration: underline;">Be sure to check out my informational blog on </span><a href="http://www.saratoga.com/living-well/2011/12/flourish-through-the-holidays-the-future-of-medicine.html" target="_blank">Saratoga.com</a><span style="text-decoration: underline;"><a href="http://www.saratoga.com/living-well/2011/12/flourish-through-the-holidays-the-future-of-medicine.html" target="_blank"> </a>which includes:</span></p>
<p><strong> </strong><span style="text-decoration: underline;">1. Naturopathic Philosophy Highlight… Fun Facts</span>:</p>
<p>A Bonus: A mini- blog on <em>Treating the Cause of Disease</em><br />
Nature’s Anti-inflammatory Foods- Include these foods in your holiday fare to decrease the effects of some of the holiday treats you may partake in!</p>
<p><span style="text-decoration: underline;">2. Happenings</span>:</p>
<ul>
<li>Upcoming Essential Oils Workshops with Terry Quigley at the Healing Garden. Contact Terry at 518-831-9469</li>
<li><span style="text-decoration: underline;">PATIENTS: Please review follow ups and cancellation policy on </span><a href="../../../../../contact/">my website</a></li>
<li>Emma and I will be taking some time to be with family and loved ones this holiday season;<span style="text-decoration: underline;"> therefore, the office will be closed from December 23<sup>rd</sup>-December 27<sup>th</sup> </span>and again on December 30<sup>th</sup>. May you all have a beautiful holiday season filled with blessings and joy!</li>
</ul>
<p><strong>3. </strong><a href="http://click.linksynergy.com/fs-bin/click?id=YS5wNadRhrI&amp;offerid=206928.10000064&amp;type=3&amp;subid=0%22%20%3EHay%20House%20Radio%3C/a%3E%3CIMG%20border=0%20width=1%20height=1%20src=%22http://ad.linksynergy.com/fs-bin/show?id=YS5wNadRhrI&amp;bids=206928.10000064&amp;type=3&amp;subid=0%22%20%3E">Radio For Your Body-</a>Mind-<em>Soul: </em></p>
<p>December 14, 2011 <a href="http://www.hayhouseradio.com/archive_preview.php">Intention Setting for 2012 with davidji<br />
</a>Why wait until January to set your intentions for the New Year? Today davidji will help you get ready for the wonderful opportunities that await you in 2012. It’s the perfect time to let go of any speed bumps, obstacles, and frustrations you’ve encountered in 2011 – and begin to plant your seeds of intention for the year to come. No matter what has happened in your life up until now, you are always capable of new choices that will allow you to experience more happiness, love, and genuine fulfillment. Join davidji for an inspiring hour of conversation, meditation, and insight – and call in with your questions about setting powerful intentions.<br />
<strong>4. </strong><strong><span style="text-decoration: underline;">Book of the week</span></strong>: <em>JUST IN TIME FOR XMAS-A PREVIEW OF THE POWER OF MID-LIFE &amp; WOMEN!</em></p>
<p>Book of the week: <em><a href="http://www.amazon.com/gp/product/0553386727/ref=as_li_tf_tl?ie=UTF8&amp;tag=drsarlobsnatm-20&amp;linkCode=as2&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0553386727%22%3eThe%20Wisdom%20of%20Menopause%20%28Revised%20Edition%29:%20Creating%20Physical%20and%20Emotional%20Health%20During%20the%20Change%3c/a%3e%3ci">The Wisdom of Menopause</a> by Dr. Christian Northrup</em><strong> </strong></p>
<p>Now completely revised, this groundbreaking classic draws on the current research and medical advances in women&#8217;s health, and includes: <a href="http://www.elabs6.com/c.html?rtr=on&amp;s=7cmao,vhxc,g5x,idyg,5uoo,1ti,c4gw" target="&quot;_blank&quot;"></a></p>
<ul>
<li>All you need to know about perimenopause, and why it is critical to your well-being</li>
<li>Updated mammogram guidelines</li>
<li>Nurturing your brain: sleep, mood, memory</li>
<li>Hormone therapy and the options available</li>
<li>Midlife weight control</li>
<li>Sex and menopause: myths and reality</li>
</ul>
<p><strong>5. </strong><span style="text-decoration: underline;">Don’t miss out:</span><em> </em></p>
<ul>
<li><em> </em><em> </em>Listen to my colleagues and other experts as they discuss solutions to menopausal issues on a show dedicated just for women in mid-life! Here is a link from my <a href="http://www.blogtalkradio.com/magnificentmenopause/2011/03/31/magnificent-menopause-and-beyond-enbracing-midlife">interview on 360menopause Radio Show</a> on <em>Panic Attacks and Menopause </em>and a list of archived shows.</li>
<li>Check out my latest answer on <a href="http://www.sharecare.com/user/sarah-lobisco/answers">Dr. Oz’s Sharecare</a>. This week I focused on how to ensure that what you are putting in your mouth is GMO free.</li>
<li>View the Updated Link Resources on <a href="../../../../../">my homepage</a></li>
</ul>
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