Journal of subClinical Investigations©

Clinical Environmental Epidemiology in the News

REPORT FROM ISHAM 2012
 

June 20. 2012 Berlin, Germany 1200 research scientists participated in the 18th congress (held once every 3 years) of International Society of Human and Animal Mycology (ISHAM) during an intensive week of medical lecturers, conferences and presentations at the Berlin Conference Center at Alexander Platz, Berlin (former East Berlin). Delegates from the United States included scientists from the National Institute of Health, Center for Disease Control, Environmental Protection Agencies, notable New Jersey's UDMJ David Perlin, MPH, PhD and numerous other medical schools and universities. Professor J Dumanov Director of the Mycological Institute US EU subClinical Research Group as a US delegate presented what was described as one of the most interesting contributions to advance the science of epidemiology and risk exposure assessment. No recordings, videos or photos were permitted of the presentations but we were able to interview Prof Dumanov on what he briefly describes as "subClinical Investigation Protocols sC-I, sC-II & sC-III: materials, methods and diagnostic algorithms" that the subClinical Research Group has developed, maintains and employs in determining the cause of a full range of so far unexplained or not completely understood medical conditions including allergies, mold related disease (mycoses), toxicosis, pathogenesis and oncogenesis from neoplasia to necrosis. We met with the professor for a brief interview during a break after his presentation and asked him what is new since our 2005 interview:

Interviewed by Cynthia Green from NJIE

United States Delegate

Professor J Dumanov

Prof J Dumanov

Medical Mycologist Mycological Institute US EU
Clinical Epidemiology:Protocols Materials & Methods

Doctor (hon.) Dumanov after five days of conference. How does this one compare with the previous ISHAM?

I missed ISHAM Tokyo 2009 due to scheduling conflicts and was very pleased to be invited by the Scientific Committee of ISHAM to present the subClinical Diagnostic Algorithms at this Berlin conference, a conference that is in my opinion has been so far without comparison in medicine. Not in any of the medical science conferences I have attended including the fields of allergy, immunology, toxicology and others in the last few years and that is sometimes   3-5 in a year has there been so much new in one scientific discipline   and that of mycology and in every area of medical mycology including genomics, taxonomy, pathogenesis, phylogeny and on and on. This conference was outstanding in scope,organization and scheduling. I must be biased? It was also very taxing in that I had to skip the ISHAM conference party and only stayed for half of the dinner party.

Can you share any highlights from the conference?

I will try but there was so much. My high point and on the personal side the most enjoyable part was seeing many of my colleagues, professors and researchers. Especially Miranda, Sybren, Roxana and Ruth to name a few.  Many I knew were attending but some were a complete and most pleasant surprise.

On the scientific side there is no way I can cover much of what was presented in a short time. As my specialty in what we refer to as the field of clinical epidemiology that is about the how, where and why people get sick. There were numerous presentations in the area of health exposure risks associated with and in the occupational, manufacturing, food processing  and hospital/clinical setting.

Generally breaking down conferences the knowledge shared is in the areas of the molecular biochemistry of human/animal host and fungi interaction tri fold; theoretical, hypothetical and practical. For the purpose of this interview I will highlight a few practical presentations-that of which is of immediate import and readily digestible that the common reader will find interesting and applicable. These researchers included:

French Delegate Sandrine Roussel

sandrine roussel 

Docteur Sandrine Roussel

Lab de Parasitologie-Mycologie Hospitalier Universitaire de Besançon, France
Fungi Identified in the Archives

As a researcher, related phenomena are encountered from time to time that raise interest for further study. One such study that we had planned to conduct on our own was a study of mold fungi that contaminated U.S. Defense Department Library books 8 years ago, it  was pleasing to see the French scientist Docteur Sandrine Roussel having completed this most interesting and important study.  We had a dramatic case at a United States defense department library in 2004 wherein the librarian suffered an anaphylactic reaction and was immediately hospitalized after handing a book with mold. we subsequently conducted a subCLinical Investigation™ employing the sC-II© (TOXO)protocol  of the library and identified a near undetectable presence of toxic Penicillium that provoked a severe immune response in the librarian after she touched a book and then her face requiring her immediate hospitalization. Over the years numerous similar exposure risks have been identified. Our data was not dissimilar to the Roussel study and findings. Thank you Sandrine for this study.   Lesson for Librarians: Keep your books dry and clean = do not touch moldy books.

Japanese Delegate 
ken iozumi
Dr Ken Iozumi MD
Tokyo Metro Police Hospital
On the Taxonomy and Terminology in Dermatotphytoses

One of the greatest challenges in dealing with pathogenic mold fungi has been the classification and naming system of the fungi and fungal diseases called collectively mycoses (my-co-sees). This challenge was in part accepted by Dr Ken Iozumi, MD of the Tokyo Metro Police Hospital. Importantly, Iozumi resolved many of the naming conventions including the naming of pathology and fungal agents from different western and eastern schools of medical study. Without a common terminology now crossing borders it makes it difficult to have discussion regarding the fungi of interest. The point: Be aware that what you read about fungi can get very confusing.

Omani Delegate

 abdullah

Dr Abdullah Al-Hatmi, MD

Sultan Qaboos University Hospital Ibri, Oman

Molecular Identification of Candida

Fungi in their many forms including as true mold (Deuteromycota), yeasts, mycoplasma, pleomorphs and for some mycobacterium continuously pose a challenge to medical science for treatment. Timely Identification is critical since Death may arrive quickly if the fungal agent is not identified and the correct  pharmacology prescribed. Dr Al-Hatani compared using PCR method of internally transcribed sequence (ITS) identification and restriction length fragment polymorphism (RFLP) identified the later as a shorter, reliable and more practical method for such identification. Lesson:Timely Fungi identification is key in improving patient health care and patient survivability.

What do you consider is the take-home-message from the conference?

Unfortunately it takes 2-3 years before much of this information is disseminated and much that is here will never be publicly published. For the clinicians and medical doctor attendees I would have to say each had their own message of import for their specific area of practice depending on their medical specialty. Oncologists and immunologists have taken home knowledge of the most current life saving pharmacology and there is no argument lives will be saved from that knowledge. These attendees must be recognized as experts in their respective fields due to their demonstrated commitment to current research and study. Outside of that the rest of the conference advanced the general science of medical mycologie and related mycoses at every level. We all learned so much with so much more to learn. I will  look forward to seeing  you at the next ISHAM in 2015 Melbourne Australia.

Before you leave is there anything else our readers may want to know?

Well, yes. This very important, but you must know, I am very dismayed after many years working with clients and patients many of which are medical doctors, nurses and health care professionals that contact us for health questions with suspect exposure to pathogenic fungi or other disease the problem I encounter most often is that of self diagnosis. With the burgeoning health related information on the Internet there has been a tremendous rise patients' attempts at self-diagnosing. In general those with a higher education and experience (MDs and experienced attorneys) know not to self diagnose. The biggest  group guilty of self diagnosing are the PhDs outside medical/clinical sciences (often our wonderful nurses) that understand science but do not understand the required medical/clinical/molecular integrations. In their cases they review the medical peer papers without the full knowledge of the applied molecular biology, clinical differentials and required integrations and simply they get the big picture but buy into their own incomplete mathematic and now they "know the cause". In other words they develop a faulty hypothesis and then seek the evidence to support it-this happens often and often they go through great expense ordering testing to prove such, with valuable time that becomes lost, exposure continues and the affect of disease amplifies and treatment time is lost. With true toxicosis or fungal mold disease prompt experienced medical specialists and their attention is required.. For any of the self  diagnosing readers go see a MEDICAL DOCTOR IMMEDIALTY and if there is reason to believe there is an exposure risk obtain a medically based subClinical Investigation™ for that purpose.    Clinically based studies must be performed.

One more ting I must say in regards to many of clients and patients: TAKE THE MEDICATION YOUR MEDICAL DOCTOR PRESCIBES. I am alarmed and shocked how many people that contact me for consultations and I learn they are disregarding their medical doctors prescribed care including prescriptions. Get your rest and take your meds! Do not second guess your medical doctor. Doctors see thousands of patients every year and have seen your case hundreds of times and fully understand the pathology or course of your disease. The meds prescribed are not always for the purpose you believe. Unknown to patients some prescriptions are NOT for treatment but for diagnostic purposes. Failing to take your prescription may result in a wrongful diagnosis. If you are reluctant to take your prescription let your doctor know and why. You may obtain an experienced medical undertanding why it was prescribed or you may receive an alternate prescription IF available. In any event you must let your doctor know if you are NOT taking your prescription. Do not self diagnose - take your meds.

Thank you.

For an earlier 2005 interview see Discovery

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