Siniscalchi’s Sign*. 1
Bedside Recognizing, in one Second, Diabetic Constitution, its Inherited Real Risk, and Type 2 Diabetes Mellitus. 1
Introduction. 1
The war against diabetes: State of the Art. 1
The “screening” of Diabetes Mellitus is not synonymous of Primary Prevention. 3
The five Stages of Type 2 Diabetes Mellitus. 4
Siniscalchi’s Sign. 6
Conclusions. 6
References. 8
Despite screening measures adopted in the secondary prevention, at the moment there is no primary prevention because the traditional and pedantic Medicine ignores Quantum-Biophysical-Semeiotic Constitutions and the correlated Inherited Real Risks (1-9), such as of the diabetes, CVD and Cancer (Oncologic Terrain), pathologies that all the Authors consider ever-growing epidemics (1-5).
Next to Diabetes Mellitus, whose type 2 represents about the 50% of all the cases, arterial hypertension, glaucoma, osteoporosis, CVD, the several forms of dyslipidemia, and cancer (1-10) are generally diagnosed too late, only when the classic clinical and laboratory symptoms set in, “anticipated” and accompanied by harmful complications, often lethal, which notoriously manifest decades after the Congenital Real Risk, dependant of the correlated Constitution, expression of the potential disease (6-12).
These few exemplar FACTS underline the urgency in Medicine to proceed without any further delay towards the New Renaissance of Medicine (1), for the first time with the aid of primary prevention of Diabetes Mellitus, CAD, and cancer, three growing epidemics.
Recently, illustrating my Lecture at I National Meeting of International Society of Quantum-Biophysical-Semeiotics, Riva Trigoso (Genoa), I have announced a paramount clinical tool in the war against type 2 DM, Siniscalchis Sign (1). See also website http://www.sisbq.org
On the 21st December, 2006 the General Assembly of the United Nations declared that diabetes mellitus is a threat for the whole world, designating the 14th November as World Diabetes Day.
In fact, this epidemic, ever-growing and unstoppable, is a serious threat to health, on the same level as infectious diseases like Aids, tuberculosis and malaria. The incidence and predominance of diabetes type 2 are growing in underdeveloped and developing countries.
For example, today in Italy diagnosed diabetics are two millions, without counting those who haven’t been recognized ill, while the numbers of diabetics in the world is foreseen to rise from 171 millions in 2000 to 366 millions in 2030 (Nature Clinical Practice Endocrinology & Metabolism 2007, 3, 667).
To be carefully considered it is the number of adults with arterial hypertension, which affects the 70% of the diabetics, showing a double incidence compared with non-diabetics subjects, and it is foreseen an increase of the 60%, for a total equal to 1.500 millions in 2025.
Diabetic pathology is notoriously characterized by the fact that the affected body can’t make use of the sugar present in the blood and it appears only in patients with Quantum-Biophysical-Semeiotic Congenital Real Risk.
Diabetes mellitus, both type I and type II, can damage heart, kidneys, eyes, nerves, peripheral arteries of the patients affected by the congenital real risks in the target organs (11-15). Without this pathological condition, dependant on the related constitution, the environmental risk factors, like diabetes, are “innocent spectators” (32).
In fact a long and successful clinical experience allows me to state that in the absence of this characteristic parenchimal congenital and microvascular alteration, the “micro vascular remodelling”, all the environmental risks factors are not harmful, similarly to what happens in case of CAD (32).
This at last explains why only about the 50% of patients suffering from Metabolic Syndrome (11) is affected by diabetes type 2 as well as by the regional and not systemic vascular damage, and the existence of several diabetics without lesions in the target organs!
I think that it is no longer possible to delay an honest stance on everyone’s behalf, but especially the Government responsible for Health, Research and University, who must eventually consider the scientific discoveries in diabetology, accepted by Publishers of famous "peer-reviews", aimed to start a new and effective strategy against diabetes mellitus and other serious and common diseases, such as CVD and cancer “clinically” carried out on a large scale in a population “rationally” enrolled (1-22).
Although diabetes keeps being one of the most serious world epidemic, no world authorized Health Authority shows interest in modifying the expensive, obsolete, disastrous management enforced so far, paying the due attention and honest critic to original proposals, that proved effective in a long clinic experience, whose data are by now spread in a wide Literature (1-5, 24).
At the beginning of the third millennium no medical or surgical intervention exists, that can give complete recovering from diabetes. About the dangers of present use of stem cells, the day 11November, 2010, the Federation Argentina de Cardiologia, FAC, has posted in its Forum my comment, I have sent to the most prestigious peer-reviews of the world (Ask Google.com), wherein I referred to my earlier letter published on Washington Post website in 2007.
Furthermore only a small percentage of diabetics is kept under control in a satisfying way, if evaluated and monitored in the best possible way available today: the biophysical-semeiotic evaluation of hepatic PPARs (1-7).
In a few words, the so-called diabetic complications begin decades before leading to the diabetic syndrome, as allows me to state also Quantum Biophysical Semeiotics, showing that primary prevention is the best therapy ever!
Unfortunately up to this day primary prevention of diabetes has been realized in an expensive, limited, impractical, reductive, ineffective way, due to completely wrong principles on which it is founded, in the absolute preference for technology and neglecting a Medicine focused on Man, according to the spirit of the "Single Patient Based Medicine" (5, 7, 9).
In the well-known magazine Diabetologia, considered rightly, in my opinion, the “Bible” for diabetologists, for example in the Volume 50, Number 11, November 2007, there is no article actually clinical, whose data can be cross-examined at the patient’s bedside using a stethoscope.
In other words, the majority of articles published in that magazine, similarly to what happens in the others, report the conclusions of researches based on results from laboratories and sophisticated semeiotic instruments, among them genetic investigations that can only be performed in very few university centres and specialized institutes, and for this reason not applicable on a large scale of the population.
In spite of the progress, only apparently astonishing, of technology applied to diabetology, the paradoxical result is that today, during a physical examination, preferably at the patient’s birth, no doctor and no diabetologist is able to clinically recognize and discern, in a quantitative way, the one with diabetic real risk, that is actually predisposed to diabetes mellitus, from the one who surely will never suffer from diabetes, even if he/she will live surrounded by several environmental risk factors.
Otherwise stated, the doctor who only knows the orthodox, academic, traditional physic semeiotics, based on the deterministic mechanics in the service of power, even having the use of state-of-the-art laboratories and sophisticated and expensive instrumental semeiotics, cannot “bedside” diagnose the diabetic constitution, the dyslipidemic constitution and the congenital Diabetic Real Risk, which represent the "conditio sine qua non" of the onset of diabetes (1-22, 31-35).
The consequences of what mentioned above, a striking example of Medieval Medicine, maidservant of Economy (23), are too evident to be only mentioned!
On the basis of a successful clinical experience of more than 50 years, without fearing refutations I state that the fight against diabetes mellitus, carried out on a very large scale with clinical methods, must necessarily be realised in ALL the individuals who are positive to diabetic “and” dyslipidemic constitutions, quickly recognizable with the help of a simple phonendoscope, and at the same time positive to the “Congenital Diabetic Real Risk” (1-22) (see also the open letter I sent to the former Minister Prof. G. Sirchia on May 2004!: http://www.clicmedicina.it/pagine-n-30/reale-rischio.htm).
In order to predict achievable objectives in a far-reaching enterprise like the primary prevention diabetes mellitus, more than relying on good intentions it is useful to carefully consider the logic held in it, associating the Medicine Based on the Obvious to the more pragmatic, realistic and practical Medicine Based on the Single Patient, which by now is accepted worldwide (5-14).
In the useless and expensive campaigns against diabetes so far fought, due to the irrational selection of the subjects to enrol, the term of primary prevention has been constantly, erroneously and silently substituted by screening (early recognition of a disease already in existence, but not diagnosed for years or decades, independently from the presence or seriousness of its “complications” already acting and from its well-known development).
I think that among the several reasons of the failing and wasteful prevention of diabetes carried on until now, the following facts lead a primary role:
a) The so-called diabetic, kidney, retinic, coronary, etc. “complications” show up decades and decades before the onset of the diabetic symptoms, both haematological (altered glycaemia on an empty stomach and/or post-prandial, high levels of glycosylated haemoglobin, pathologic OGTT, etc.), and clinic, according to the Angiobiopathy theory (31). It follows that the traditional diagnosis of diabetes, even when it seems early, is “always” inevitably late, done when by that time the target organs have already been damaged.
b) Stylish and precise enough evaluations of the alterations of the glycidic metabolism of the initials phases (e.g. hyperinsulinemic-normoglycemic clamping) CANNOT be used on a large scale for obvious economical and organizational reasons, contrary to the quantum-biophysical-semeiotic evaluation of PPARs (alfa) of the liver, the most precise method – to my knowledge – to monitor the gluco-lipidic metabolism (1-5).
c) Metabolic Syndrome, constantly anticipated by the Pre-Metabolic Syndrome, classic and variant, described in previous papers (11, 17), can be diagnosed by a phonendoscope since birth, that is when the Pre-Metabolic Syndrome and the so-called diabetic “complications” are present, but “potential” (5-10).
d) The term "screening", used arbitrarily as a synonymous of primary prevention by the Health Authorities and Doctors, is not correct at all. In fact, in this case we are not talking about primary prevention, carried out before the onset of a disease in individuals who are apparently healthy, but with congenital real risk, dependant on the relative pathology, but it is secondary prevention, carried out on diabetic patients, perhaps not yet diagnosed, but with the complications of the disease already in action. The tertiary prevention aims to contrast the progression of clinically present and advanced complications.
The nature of a prediction is scientific when can’t escape, with the help of ad hoc theories, to falsification: I foresee that in future Diabetology based on Man, in the scrupulous respect of the "Single Patient Based Medicine" (5, 7-10), and accordingly in agreement with the spirit of the NEW RENAISSANCE of Medicine, the “clinical” diagnosis will play the leading role, quantitative of diabetic “and” dyslipidemic quantum-biophysical-semeiotic constitutions, diabetic congenital real risk, followed by the acknowledgement of Pre-Metabolic Syndrome and consequently of the Metabolic one in diabetic evolution and eventually of diabetes mellitus on a very initial stage (21, 31).
Since their births all diabetic individuals show quantum biophysical semeiotic signs typical of dyslipidemic “and” diabetic constitutions, and all the related, ICAEM- dependent, Inherited Real Risks, subsequently evolved first into pre-metabolic syndrome and after into metabolic under the negative influence of well-known environmental factors: sedentary lifestyle, tobacco smoke, overeating, a diet rich in saturated fats and carbohydrates, weight gain (BMI 25 or more), and so on (5, 7, 9-11, 13-15,17, 20). (Table 1)
Natural History of type 2 Diabeyes Mellitus
Stage 1 (individual’s birth)
Diabetic “and ” Dislipidemic Constitutions
Diabetic Inherited Real Risk (e.g. LATENT)
Stage II (under 10 years)
Abnormal synthesis of Perivascular GAGs by fibroblasts, pericytes, mioblasts, megacariocytes, a.s.o.; Amiline in the Interstitial Fundamental Substance, and so on. (Location: Capillaries, Small Arteries, Arterioles, AVA type II, group B, cutaneous, EBD, a.s.o.)
Stage III (Second decade of life)
IIR, Microalbuminurie, Initial ATS Plaques , a.s.o.
Stage IV ( about third decade of life)
Prediabetes, overt microbascular Complications.
(OGTT, Iper-Insulinemic-Normo-Glicemic Clamping, Insulinemia)
Stadio V
Type 2 overt Diabetes
Tabella 1
In fact, it is evident that not “all” the individuals, even though obese and/or hypertensive, are at diabetes risk with different probabilities, obviously, as instead health authorities, both Ministers of Health and Instruction, university professors and also the General Practitioners keep – so it seems – thinking.
On the contrary, the individuals with diabetic “real risk” are all those who are positive to dyslipidemic “and” diabetic biophysical-semeiotic constitutions, inherited only from the mother, and associated to the diabetic Congenital Real Risk, measurable only with a simple phonendoscope, conditio sine qua non of diabetes type 2.
Quantum Biophysical Semeiotics allows physician, since birth, rationally and clinically to select “all” the individuals affected by dyslipidemic “and” diabetic constitutions, even latent, the only ones to enrol in the primary prevention because carriers of the diabetic congenital real risk (1-33).
Furthermore, for the first time the General Practitioner is able to monitor, clinically and objectively, the course of gluco-lipic congenital metabolic anomalies, recognizing the possible progression, slow and gradual, towards diabetes, favoured, but not caused, by the environmental risk factors: from the genetically directed alterations of lipidic “and” glucidic metabolism towards the Pre-Metabolic Syndrome first and, after, the Metabolic one, both absolutely lacking the traditional clinical symptoms, well recognized instead by Quantum Biophysical Semeiotics (21, 34, 35). (Table1)
As for the technical aspect, in the easiest way the doctor can recognize diabetic congenital real risk by an “intense” skin pinch at the level of the VI thoracic dermatome, which corresponds to the superior part of the epicondrium (= the area beneath the right and left costal arches).
In a healthy patient, “simultaneously” the gastric aspecific reflex is absent, appearing after 24 sec sharp (1-35)
On the contrary, in those patients who are predisposed to diabetes, the reflex appears “simultaneously”, showing an intensity inferior to 1 cm, while in the diabetic patient is 1 cm or more, in relation to the here beneath mentioned pathology.
In other words, interesting from the practical viewpoint, reflex intensity parallels the seriousness of the alterations of amorphous fundamental substance as well as glycemic metabolism impairment, which highlights the contemporaneous intense “in toto” ureteral reflex” (1)
Interestingly, from practical view point, the intensity of reflex is directly linked to the seriousness of the glucidic dysmetabolism.
Once diabetes has been recognized, potential or overt, the doctor proceeds to the quantum-biophysical-semeiotic evaluation of the glucidic metabolism, using several methods, all reliable but different in style and information (1-35).
A therapeutic important aspect is played by the war against overweight and obesity, which facilitate diabetes onset, obviously exclusively in individuals at inherited real risk.
As a consequence, doctors have to reach the goal of maintaining the real weight near to ideal weight at the best, i.e., conserving physiological BMI.
In health, lying down psycho-physically relaxed, in supine position with closed eyes to lower melatonin secretion, “intense” (24-28) cutaneous pintchig of VI thoracic dermatomere , i.e., trigger-point of pancreas (= the skin 3 cm. about below costal arch, at right or left), does not bring about “simultaneously” the gastric aspecific reflex, which occurs after exactly 24 sec., as after pancreas preconditioning (5, 12, 14) (Fig. 1).
Fig. 1
The figure shows centripetal lines, along which digital percussion has to be applied, gently and quickly, starting from outer areas and moving towards the bell piece of stethoscope. For further technical information, See www.semeioticabiofisica.it, Technical Page Number 1.
On the contrary, under identical experimental condition, illustrated above, in individuals involved by Diabetic Constitution, Diabetic Constitution-Inherited Real Risk, and overt Diabetes Mellitus, of course, “simultaneously” appears the gastric aspecific reflex (respectively of 0,5 <>
Based on a sclerotized Physiology, incapable of giving persuasive explanations of the several quantum-biophysical-semeiotic signs and of a Biology that disregards a non-local Reality next to a local one, Western Medicine only considers biological systems which are “static” and with a rigid metabolic balance and, according to Claude Bernard and Walter Cannon, intra-correlated only through nervous and vascular ways, arterial, venous, lymphatic.
In contrast with the blind ignorance of traditional Medicine, the physiological behaviour of biological systems is indeed that of a dynamic system far away from a fixed balance, where also the single cellular and sub-cellular structures vibrate in a stochastic, unpredictable, uncertain, chaotic way.
In addition, Western Medicine erroneously considers individuals born equal and “healthy” until the moment of the onset of the disease, according to a platonic-manichean vision, vainly underpinned with "ad hoc" hypothesis. Western Medicine is a giant with clay feet (30).
For all the above mentioned reasons, which surely don’t exhaust my J’Accuse against the present Middle Ages of Medicine, maid of Economy, it now time of its Renaissance, on the basis of the discoveries done in the last 50 years and which brought to the foundation of Quantum Biophysical Semeiotics (33).
Regarding the present war against DM, based on the useless screening, unfortunately until now physician fight such as metabolic, complex disorder exclusively with therapy, however showing to be not able to bring under optimal control metabolic impairment.
Quantum Biophysical Semeiotic primary prevention of type 2 DM, providing an efficacious, reliable tool, as Siniscalchi’s Sign, here illustrated for the first time, allows, easily and quickly, to recognize individuals at real risk of DM, to be enrolled in the original primary prevention.
* Mario Siniscalchi, my dearest Friend, Cardiologist in Neaple, skilled in Quantum Biophysical Semeiotics of hearth disorders.
** Sergio Stagnaro MD
Via Erasmo Piaggio 23/8
16039 Riva Trigoso (Genoa) Italy
Founder of Quantum Biophysical Semeiotics
Who's Who in the World (and America)
since 1996 to 2010
Ph 0039-0185-42315
Cell. 3338631439
www.semeioticabiofisica.it
dottsergio@semeioticabiofisica.it
http://club.quotidianonet.ilsole24ore.com/blog/sergio_stagnaro
1) Sergio Stagnaro. New Renaissance in Medicina. Prevenzione Primaria del Diabete Mellito tipo 2. Sito del Convegno, http://qbsemeiotics.weebly.com/atti-del-convegno.html, 16 novembre 2010; http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/newrenaissance_prevenzionet2dm.pdf; english version http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/report_stagnaro.pdf ; http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Ita/Nuovo%20Rinascimento%20Medicina%20RELAZIONE%20I%20Congr.doc; english version http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/Nuovo%20Rinascimento%20eng.doc
2) Stagnaro Sergio. Pivotal PPARs Activity Bed-side Evaluation in Pre-Metabolic Syndrome and Metabolic Syndrome Primary Prevention. Cardiovascular Diabetology. 2005, 4:13 doi:10.1186/1475-2840-4-13
3) Stagnaro Sergio. Bedside biophysical-semeiotic PPARs evaluation in glucose-lipid metabosism monitoring. Annals of Family Medicine 2007; 5: 14-20. http://www.annfammed.org/cgi/eletters/5/1/14
4) Stagnaro Sergio. Pivotal Role of Liver PPARs Activity Bed-side Evaluation in Monitoring glucidic and lipidic Metabolism. Lipids in Healt and Disease. 02 June 2007, http://www.lipidworld.com/content/6/1/12/comments#284542
5) Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. Travel Factory SRL., Roma, 2004. http://www.travelfactory.it
6) Stagnaro S., Stagnaro-Neri M., La Melatonina nella Terapia del Terreno Oncologico e del “Reale Rischio” Oncologico. Ediz. Travel Factory, Roma, 2004.
7) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Ediz. Travel Factory, Roma, 2004. http://www.travelfactory.it
8) Stagnaro Sergio. Single Patient Based Medicine: its paramount role in Future Medicine. Public Library of Science. http://medicine.plosjournals.org/perlserv/?request=read-response
9) Stagnaro S., Stagnaro-Neri M., Single Patient Based Medicine. La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Travel Factory, Roma, 2005. http://www.travelfactory.it/
10) Stagnaro Sergio Sergio Stagnaro. Biophysical-Semeiotic Diabetic Constitution. Cyber Lecture, www.indmedica.com, 2006, http://cyberlectures.indmedica.com/show/60/1/Diabetic_Constitution
11) Stagnaro Sergio. Pre-Metabolic Syndrome and Metabolic Syndrome: Biophysical-Semeiotic Viewpoint. www.athero.org, 29 April, 2009. http://www.athero.org/commentaries/comm904.asp
12) Stagnaro Sergio. CAD Inherited Real Risk, Based on Newborn-Pathological, Type I, Subtype B, Aspecific, Coronary Endoarteriolar Blocking Devices. Diagnostic Role of Myocardial Oxygenation and Biophysical-Semeiotic Preconditioning. www.athero.org, 29 April, 2009 http://www.athero.org/commentaries/comm907.asp
13) Stagnaro Sergio. Il “Reale Rischio” Semeiotico-Biofisico. http://www.piazzettamedici.it/. URL:http://www.piazzettamedici.it/professione/professione.htm
14) Stagnaro Sergio. Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. Ediz. Travel Factory, www.travelfactory.it, Roma, 2009.
15) Stagnaro Sergio. New bedside way in Reducing mortality in diabetic men and women. Ann. Int. Med. http://www.annals.org/cgi/eletters/0000605-200708070-00167v1
16) Stagnaro S., West PJ., Hu FB., Manson JE., Willett WC. Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. [Medline]
17) Stagnaro Sergio. Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes. Eur J Clin Nutr. 2007 Feb 7; [Epub ahead of print] [Medline]
18) Stagnaro Sergio. Lettera di un medico in pensione ad un neolaureato, aggiornata e commentata.www.mednat.org, 22 marzo 2009. http://www.mednat.org/curriculum_stagnaro.htm
19) Stagnaro S., Stagnaro-Neri M. Valutazione percusso-ascoltatoria del Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131, 1986
20) Sergio Stagnaro. Biophysical-Semeiotic Dyslipidaemic Constitution. Cyber Lecture, www.indmedica.com , 2006, http://cyberlectures.indmedica.com/show/50/1/Biophysical-Semeiotic_Dyslipidaemic_Constitution
21) Stagnaro-Neri M., Stagnaro S., La sindrome percusso-ascoltatoria da carenza di Carnitina. Clin. Ter. 145, 135 [Medline]
1994.
22) Stagnaro-Neri M., Stagnaro S., Semeiotica Biofisica: valutazione clinica del picco precoce della secrezione insulinica di base e dopo stimolazione tiroidea, surrenalica, con glucagone endogeno e dopo attivazione del sistema renina-angiotesina circolante e tessutale – Acta Med. Medit. 13, 99, 1997.
23) Stagnaro Sergio. Middle Ages of today’s Medicine, Overlooking Quantum-Biophysical-Semeiotic Constitutions and Related Inherited Real Risk. http://sciphu.com November 4, 2008. http://sciphu.com/2008/11/meadle-ages-of-todays-medicine.html
24) Stagnaro Sergio. Il test Semeiotico-Biofisico della Osteocalcina nella prevenzione primaria del diabete mellito. www.fce.it Febbraio 2008. http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47
25) Stagnaro S. e Manzelli P. Semeiotica Biofisica: Realtà non-locale in Biologia. Dicembre 2007 http://www.ilpungolo.com/leggitutto.asp?IDS=13&NWS=NWS5217
26) Stagnaro S. e Manzelli P. Semeiotica Biofisica Endocrinologica: Meccanica Quantistica e Meccanismi d'Azione Ormonali. Dicembre 2007, http://www.fcenews.it/index.php?option=com_content&task=view&id=816&Itemid=45
27) Stagnaro S. e Manzelli P. Semeiotica Biofisica Quantistica: Bifasicità della Secrezione Ormonale. www.ilpungolo.com, Dicembre 2007
28) Stagnaro S. e Manzelli P. Natura Quantistica di una Originale Manovra Semeiotico-Biofisica di Epatopatia . Dicembre 2007, http://www.fcenews.it/index.php?option=com_content&task=view&id=862&Itemid=45
29) Stagnaro Sergio e Paolo Manzelli. L’Esperimento di Lory. Scienza e Conoscenza, N° 23, 13 Marzo 2008. http://www.scienzaeconoscenza.it//articolo.php?id=17775
30) Sergio Stagnaro. La Medicina Occidentale: un Gigante dai Piedi d’Argilla. 4 Gennaio. 2010, http://www.fcenews.it, http://www.fceonline.it/images/docs/gigante.pdf
31) Stagnaro-Neri M., Stagnaro S., Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. 6, 617, 1993
[Medline]
32 ) Sergio Stagnaro. Without CAD Inherited Real Risk, All Environmental Risk Factors of CAD are innocent Bystanders. Canadian Medical Association Journal. CMAJ, 14 Dec 2009, http://www.cmaj.ca/cgi/eletters/181/12/E267#253801
33) Sergio Stagnaro. New Renaissance in Medicine. 01 October 2010, http://www.scivox.com.
http://www.sci-vox.com/stories/story/2010-10-01new+renaissance+in+medicine..html
34) Stagnaro Sergio. Valutazione dell'amiloide insulare nel diabete mellito.
www.fceonline.it, 2008, http://www.fceonline.it/wikimedicina/semeiotica-biofisica/211/581-valutazione-dell-amiloide-insulare-nel-diabete.html; e http://xoomer.virgilio.it/piazzetta/professione/amiloide.htm
35) Caramel Simone. Primary Prevention of T2DM and Inherited Real Risk of Type 2 Diabetes Mellitus http://ilfattorec.altervista.org/T2DM.pdf
36) Sergio Stagnaro. Primo neonato negativo per il Terreno Oncologico nato da genitori positivi per la Variante RESIDUA in trattamento con Melatonina-Coniugata, secondo Di Bella-Ferrari. www.fce.it, 13 aprile 2010, http://www.fceonline.it/images/docs/neonato.pdf; nel sito http://junior.cybermed.it/index.php?option=com_frontpage&Itemid=36, alle URLs http://junior.cybermed.it/index.php?option=com_content&task=view&id=1073&Itemid=51 http://www.cybermed.it/index.php?option=com_content&task=view&id=24687&Itemid=134;
http://www.piazzettamedici.it/professione/professione.htm
http://www.liquidarea.com/2010/07/manuels-story-la-melatonina-nella-terapia-del-terreno-oncologico/
37) Sergio Stagnaro. New Way in the War against Cancer. Oncological Terrain-Dependent, Inherited Real Risk based Primary Prevention: Manuel' Story. 2 May, 2010. www.mysun.com. , http://www.mysun.co.uk/stagnaro/blog/2010/05/02/new_way_in_the_war_against_cancer._oncological_terrain-dependent,_inherited_real_risk_based_primary_prevention:_manuel_story, and
http://www.sci-vox.com/stories/story/2010-07-21manuel%27s+story%3A+a+new+way+in+cancer+primary+prevention.html
38) Sergio Stagnaro. Lettera Aperta alle Neo-Spose. La Storia di Manuel, che nessuno racconta. http://www.masterviaggi.it Giovedì, 15 Luglio 2010. http://www.masterviaggi.it/news/categoria_news/40260-lettera_aperta_alle_neo-spose_la_storia_di_manuel_che_nessuno_racconta.php
39) Stagnaro Sergio. Oncogenesis is possible exclusively in individuals Oncological Terrain-positive. www.thescientist.com 2007. http://www.the-scientist.com/blog/print/53498/
40) Sergio Stagnaro. There are other, clinical ways in preventing disease transmission through mitochondria intervention. 15 April, 2010. www.thescientist.com, http://www.the-scientist.com/blog/display/57287/
41) Sergio Stagnaro. Il Terreno Oncologico di Di Bella. www.fce.it, 11 ottobre 2010, http://www.fceonline.it/images/docs/terreno%20oncologico.pdf;
http://www.luigidibella.it/cms-web/upl/doc/Documenti-inseriti-dal-2-11 2007/Il%20Terreno%20Oncologico%20di%20Di%20Bella.pdf; http://www.altrogiornale.org/news.php?extend.6420
42) Stagnaro Sergio. La Diagnostica Psicocinetica migliora l’Esame Obiettivo. http://www.fcenews.it, 15, giugno 2009. http://www.fcenews.it/docs/diagnostica2.pdf ; www.altrogiornale.org, http://www.altrogiornale.org/news.php?extend.4889; http://www.nonapritequelportale.com/?q=la-psicocinesi-esiste-funziona; http://unlocketor.altervista.org/forum/viewtopic.php?t=1192&start=0&postdays=0&postorder=asc&highlight=&sid=af35aa98b69d6f08d116f65d34b55827; http://www.spaziomente.com/articoli/La_semeiotica_biofisica_quantistica_corrobora_la_psicocinesi.pdf
43) Curri S. B., Le microangiopatie, a cura di Inverni della Beffa, Arte Grafica S.p.A. Verona, 1986
43) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica condizione necessaria non sufficiente della oncogenesi. XI Congr. Naz. Soc. It. di Microangiologia e Microcircolaz. Abstracts, pg 38, 28 Settembre-1 Ottobre, Bellagio
44) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. X Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7 Novembre, Siena
45) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. Gazz Med. It. – Asch. Sci, Med. 144, 423
46) JEQUIER E. Leptin Signaling, Adiposity, and Energy Balance. Ann. N. Y. Acad. Sci. 967: 379-388 (2002)
