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Celiac Disease and the Liver
Prof. Umberto Volta, Diagnostic Immunopathology, Postgraduate School of Internal Medicine, University of Bologna, Bologna, Italy
Thursday, June 20, 2019 · 6:54 p.m. · 39m 28s
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i propose a lot of work or possibly hope to have the um but imprison them up to be a
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and we have the opportunity for bristol go on a secure this isn't really the one of the main topic
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so maybe the search activity over the last uh for the uh that's uh can i have this so that okay
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and uh there is a growing out of this is that the gavel get access plays
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a crucial role in the maintenance of biological must as isn't believe um in the human body
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and the eh because the the boxes can be view the as it does it weighs three the
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and we're breaking the new responsible but still in full band agency nelson diseases
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and in my opinion uh see these these uh one of the best example over got the boxes paid we're
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and the the the the the easy disease can be able to
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have a there's a note immune disorder probably nowadays we know that the
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is it not immune disorder with the bay i prevalence
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in general population more or less one percent because it
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we are sure that the the prevalence is probably is that i have a than one percent
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terrorists are all the custody showing the the the prevalence in some part of the war but
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i can feel and the is uh uh eh up to two two point five percent
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and the and the the yeah onset of these condition uh can occur at any age or
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from the intrinsic to the elderly this is a very important
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point because of him if you yeah i up few years ago
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uh many people sold to the see the disease was only it can be shown a low eh eh
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close related to the infancy and that there is a a polymorphic
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clinical presentation on a batting from mississippi among absorption with the weight
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loss on a tool a a a is final design infinite died
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by even accordingly interviews patience it would not complain when seeing them
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and that they don't know single standard rely some
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balls the highly productive several vehicle tests including enemies along
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to bad this uh uh the most specific test procedure disease in tissue trans with them isn't about this uh
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eh in which i have the most sensitive test the and on the tape because uh
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uh yeah yeah you stop the logical feature of the the do the normal closer
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showing the bills atrophy in uh in detected the but it would be not biopsy
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the the the budget is of ca diseases being clearly elucidated the
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return propping sam particularly gliding so i have this this it three
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get of the disease that which cannot colour only in people with the
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weather genetic of but it does it well defined genetic predisposition product that
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i that i presently before we could pull and or the way that
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which are the close genetic linkage a procedure diseases it although genetics uh places
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centre role rely in and they'll mm but to jen is associated disease uh
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uh in the there are many other environmental factors uh
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determining these conditions including a mike available changes uh and the
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other three guesses it says this this will bantam pregnancy
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which can determine the caverns of the disease at any age
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and the old union managed to uh all the
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uh the process a leading to see your disease that
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as being clearly demonstrated that in the the paper published by that'll issue plan uh
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i think operation with myself in a tremendous in nineteen ninety seven
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the most rating uh that that these two cars would i mean
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is it did you to ease the the s. c. echo although envision
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and uh the mm eh you wouldn't have died to drive to
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the old union processor a leading up to see a disease uh
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uh in in the baking get bowls that innate and adaptive immunity
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with the parental role on all but the letter on the four matter
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it the should present them in a is a eh in place it in centre role
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uh by the eye mediating a a little time but died this
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uh the the as i'm making them a more human jenny cam
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and uh then we dated route into that it's uh i've presented by the it'd be
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good when the way to positive macrophages a two c. d. for positive or the cells uh
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uh and then we should uh eh uh_huh a in a in a some way
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eh in the activate the the cascade got all the cycle kinds seen this recent
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uh is leaving the building separation of i i had fifteen and
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the other side of kind say l. twenty one t. n. f. alpha
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closing there's more intestinal damage and they'll have that and the
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stimulating the the c. d. for positive feeling for side so
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eh we the the con sequent the old aunt about this scene this is uh
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yes putting in focusing of wouldn't have died some make three yeah the i
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finding a wilton young does or there's a associated we see a disease it
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and the uh the prevalence so with onions or this is just a lucy diseases
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can reaches the feel good over thirty five
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percent that after twenty or so rubin exposure
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elderly stuff all the uh old union dues or this as you can see
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see to receive this is very longer and the prevalence of these opinions or there's a
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desire more is delayed the the that the noises of see your diseases that's suggesting that that
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uh it'll nay nay in every diagnosis subsidy disease can in some way perfect
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the c. e. x. uh from the the ballad band the all all community
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the two most frequent the uh conditions soaking up with visions of sick to receive these ashley market better
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die this invite one babies may lead to stay pound
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baby dismally to share so woozy yeah diseases saying that
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yeah genetic but there are many good when the waiter that out many other conditions
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associated there including the graves disease or not that's a good before ms selective actually efficiency
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uh soon seen the roman your article disorders such
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as routine attacks and uh working on peripheral no property
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and the sorry i'll post surprises other picture out and talking about profit guess that is uh
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and last but not least building only ribs or there's some
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mainly old immune apartheid the same primary be eloquent like this
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the interest on michael buyout that contributes uh to see you
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this is development a buy out telling the intestinal permeability and by
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yeah activity in the in eighteen your
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response uh the interaction between bacteria and lieutenant
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uh can model eight to see a disease re scan in
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a patients same genetically predisposed the patients to see your diseases
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and the unknown in some way some bacteria such as observe the most of you know the
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uh generate a highly mormon janey could group them to to add this
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is that that was okay to sort of interest in a mccall's that
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what is that other uh but the aliases says a lot about you those pieces that
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are able to the the way that would impact that solo wedding it's very much a nice
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the last starts from made another who showing the radical but use pieces are able to uh
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secrete the immediate also all this has seven probably not as is eh levine of that uh
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uh yeah degrees of the image analysis of the all the uh glued into to hide stuff
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yeah it was all they and uh it has been clearly the mostly the target problem
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see the diseases more by well see this
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can be regarded as in systemic absorbers involving get
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many other organs in peace using the human but they uh including the they in never
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sees them uh uh the it female and male reproductive system and then docking system particularly
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with the the involvement of endocrine backgrounds uh and
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the tyrant that and uh also uh the lever heaven
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the spectrum uh all the little does or there was a a associated we see
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your diseases substantially includes a to a final types a overly but then it just
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it could kill janey curving up than a panama is the or sylvia
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a potentially the vegetable after room to improve by the and the a even apply but
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link that too old to me only by this or the us uh just as primary be
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that one guy these primaries glows orange i'd seen by planning to old unit but i guess it
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which is only in a potentially affected the bike route employee died is it
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i will try to show you in the uh the in next the as the lights
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uh they a conclusion make a involvement the only the damaging see the
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diseases correct that either by eliza level the overtones i mean is is uh
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which can reach a there's people over forty seven
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percent that enough old so we see a disease that
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and the uh fifty seven percent in children always see these uh
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l. that then all the people that i was i mean as a
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and see a disease in the survey view average the ballet or would that be
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under maddy comparing a beta already well known
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in the scientific community about the recent radio
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a this button is correct that either by a more frequent elevation
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all valid means an ass but they that doesn't is is uh
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usually with the normality of all uh uh they have that in
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times of colour static in science uh the only the damage done
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i live off of this as well as normal levels of b. b. the increase in two thousand is is
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level is uh uh is usually man i don't know
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what drives the zap mama limited but in some cases uh
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uh and net the lattice of thousand is is uh can uh reach a values i
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isn't ten times that but normally need to shows the people to put this thing we shouldn't
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on the basis of the level of buttons i mean is is a leader in warm in the k. e.
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correct either they could clinically there then major from old
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union leave of them enjoy associated with see the disease
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and then as i mean is is a rapidly normal we think six twelve man so with them
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for that and this is a clear demonstration the the liver damage is good and the band and the
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a sometimes i don't as an as seen it can be
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the only sign or see your disease without uh any gastrointestinal
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or other the c. f. is easily to the scene domes
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present in the analysis and weekly story of these patients uh
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our group was the first that way didn't if i could be to jenny capital as i mean i've seen yeah
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is it possible sign when diagnosis either these in the paper published in the lines it in nineteen ninety eight that
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we are all the sick sounded patience it with the rise level of does any names isn't
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and uh uh we a all these six on the patients fifty five
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the weather classified as a being get people genotype advancing as being yeah
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after reading room with that out the all the known it's knowledge is uh all the
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uh as level doesn't aces including valve emu
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toxic overall related the entire deficiency theology is
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all these uh fifty five patients always the right level uh all the plans i mean is is so well known
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us our g. five is out there to be palms differently the measurement about this so by g. a. class set
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a specific amount get for cod this piece pieces you want in amazement
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about is nowadays uh is around one hundred percent in the in the summer
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yeah yeah guidelines uh a particularly in children productivity for
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uh uh and in the middle and the batteries uh uh
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in the presence all the unseen problems a user usually associated with c. d.'s
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and that all these uh if you divide patience set of these
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vibration it by patient bars different give them isn't about the set
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yeah we are classified as having c. of disease welcome for um does that mean see these big would
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be node biopsy shall we get it all the bills
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atrophy lesions that we see according to manageable but classification
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and the and the the fee were so that we were all the c. i. disease pounding
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to jenny guy but as i mean as being in this study was in nine point saying that
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and the speaker has been confirmed the later but many out the papers
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that publish the only this topic yeah all these uh five patients uh uh
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we use a a final diagnosis of see a disease and uh and uh
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eh thirty and then went to also a liver biopsy showing get a mile that
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a a lever damage a correct i'd buy might be reported information the end uh
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as shown in this slide um email macro issue
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where circles is so we'll sell uh i felt places
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and uh a five this that the publishing the order pathology one as a woman yeah later
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uh come for them the the prevalence over nine per cent of for a a c. i. disease
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uh impatient with the critical jenny guide but uncertain as seen yeah and uh uh the most waiting go
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that that they think patients all that wanna them for be a we
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there and explain arise that the other man is is that see a
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disease and doesn't is it about the the normal within one man so
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with them for the director of these uh uh fifteen patients and nine uh
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uh and that when fell either biopsy ab showing a
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a mean email a macro bushy colour or mike or we
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should chorus that goes into the cases and the remaining six
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cases at a a the mild that could put that this
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the correlation uh uh between c. disease uh and uh narcotics at about that sun
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or call it felt really good disease that is being investigated in the later today
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about the for ten percent of patients uh with the an usher on an apple that
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uh pause deportees it rather than isn't about this but in many
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cases of these positive it is a spectrum of a false positive
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it was ah that not all this patience at affected by see
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a disease that that's that is uh such as the the study
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but it is about television does this lever disease showing
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that only thirty percent about three percent of these patients uh
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ah that uh affected the by c. i. disease in the remaining case it's it's very common
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in a legal does or there's a a to have a full suppose
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the t. v. p. for piece of travel than isn't about this so by
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ga classes and use really is very important to come for them of the
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productivity for this test with positive people and get them is allowed to that
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yeah in a you to the these uh based on these findings of the coexistence uh all
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that nash enough for them to to see this is a likely to be coincidentally my opinion
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rather than it was so sage and due to that
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but i haven't sold both conditions in the general population
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in contrast to see this patient's appended to develop uh in fact believe
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that after routine for it died there are many stat be showing the
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these i don't know and uh in the study from riley and
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colleagues uh i don't know but towards it without them fifteen uh
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a it was is the number of this patient issue with the uh the fact
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billy there with but the same goes that or this embargo generation and evil biopsy
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and the excessive these desire in the first that e. out that after
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about commencing with them for a guide to but it remains uh i
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eh infertile fifteen e. outside after see a disease that ignore this
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yeah this is that in the sense that the from the group of
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borrowing it from a friend just got hourly and uh the sender amigo
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they showed a a and uh that uh the prevalence of fat believe
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uh in a a patients we see a disease immigrant comforted by that
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uh uh reach a eh they now that you've said before that
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saying that with a significant difference with the uh the condor population
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and uh these are old also identified them anybody
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disposing factor for factors for the the development all that
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uh and the fat believe it in c. a disease that
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would improve died including the persistent remark about the changes uh
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after we do with our like it is uh when no matter way out that
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in a does uh did not does not normalised after what in providing see diseases
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they also they out that intestinal permeability still prize and that that would operate
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ah that the increased intestinal absorption due to invest in a really regular old so
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and uh yeah the i content probably be the same car but it's in commercially available
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rooting for the for the for having get the common so metabolic senior but there are but
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uh several papers are showing uh that uh these a condition can knock or
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uh in cedar patients after would've died
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out whether incontinent with last uh a celebration
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the oldest demonstrated that the the all kinds of up to leave it in uh
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and uh see a disease up that would improve died to withdraw significantly different than in uh
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patients uh eh developing a uniquely is the body mass index uh
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bashers patients uh a man thing in or my like body mass index
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in other uh interesting observation uh is uh uh that the
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of the association between a a say via a eh eh
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and leave it at that image of unknown origin it at n. c. yeah disease uh uh
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one of the most interesting contribution cam so from the finnish group of that are also more
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really simple to do some of this is the the first that bit of first importance that the
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a confirming this association i got a copy and it showed
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that the c. i. disease in for patients with good project i
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believe as you or this that or i am role that uh
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for a a problem about that topic early that announced on the
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and the impact you distraction significantly improve the in all of these uh for patience set
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uh after the institutional written feedback that that's the motivating that that that
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uh and the the fashion can improve also when the lever is uh several damage that
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uh in these cases eh recognise this e. x. in
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the city out of these for patient where remove the
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from the or the publicly that last one programmer uh uh based on these as outset e.
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t.'s recommended the a particularly in a patient's
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it with the severely that disease of unknown origin
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uh to perform at this cleaning foresee a disease before that inclusion in the static
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four or politically that last on the uh the other thing not that i probably the damage associated that
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with the c. i. disease the pressing to the by holding you on a uh does all of that stuff
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and one of the best uh eh defined association is between see a disease that in prime
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the the receiver or this now with the isa rename that as a primary vehicle and died this
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based on nine uh orange notice that these uh the mean prevalence all the c. i. disease it in
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a v. b. c. in a primary be adequate inside the these are three point one that's saying that
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is a allows valuable or from zero percent seven percent or one twenty percent but
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and the a and the the prevalence awareness of the prevalence all that
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b. b. c. in a a patient we see a disease uh
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uh is reported that up to three point seven that's saying that
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uh we perform this cleaning guess that before see a disease that in a bet
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i'll just see erase all patients with built in younger statically that does or that stuff
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improving it landed in fifty five patients that a fact that the by but i'm really gotten jobs
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primaries closing quote on diets and holding on current tactics and uh we uh of a set of that
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more or less at private i associate is easy in four percent of patients who we the
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uh in a primary vehicle insights in bolton younger than
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jack this uh and one point six percent with that
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uh primaries colour rose in college i it's a on on the whole we identify the seven
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cases uh all the c. i. disease that over
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one hundred and seventy three cases uh oh primary
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it be adequate and died this at all of them were females uh
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with very nature ranging from a a four three two seventy a set
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and uh as a for this signs uh eh and consistent with
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the possible like noses of see a disease signs in seeing them so
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only three of these patients a a that scene comes consistent with this possibility
00:20:57
to show the uh they re yeah one iota pieces any yeah
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yeah yeah the intestinal biopsy a a show with the uh the uh_huh
00:21:06
or finding got all the city of bills out of only in one
00:21:10
of these uh said in patients so what i said in the remaining get
00:21:14
uh six patients uh they below saturday was mild or passionate and not the other
00:21:20
and the uh the this is the mm collectively stick a difference eating get
00:21:26
the finding of c. disease enough time maybe eric orange active from the finding
00:21:30
go see that is easy no tim collins i'd say that we show you later
00:21:34
and that only one of these seven patients at the now that we can
00:21:37
you know this or that are presented by holding on paradise on the order
00:21:42
based on this that is uh the features of secure diseases associated
00:21:46
with primary be very cut and dried it's uh seems to be
00:21:50
uh that those all that'll be pretty obvious atrophy and if
00:21:54
your number of see a disease that relate to the scene domes
00:21:58
eh all the uh the nine c. e. x. uh uh i i didn't dividing the group but
00:22:03
a patient with the colour statically that is or the us up on the three eight
00:22:07
basically a liver damage are represented by the receiver or the same the remaining six cases it
00:22:13
we add that in my the the that that just a clinical aim biochemical colours that as this
00:22:19
where present a spectral really in a sixty six a and b. in a thirty three percent but
00:22:26
all this page set and that interestingly uh in in the three cases uh we use
00:22:32
uh uh eh see a disease that and say they are legal diseases severely the diseases with
00:22:38
mal absorption referred i collided with a solution on my laptop from uh with the disappearance of
00:22:45
they re yeah and i don't see i mean yeah a battle eleven times of right also
00:22:51
i'm changed that and we can provide the store it means that
00:22:54
that that uh it would provide the not the eh and then modify
00:22:59
uh the outcome of all the the disease
00:23:03
in this is cases with my liver disease uh
00:23:06
uh and then they it for a lot but with the group them free died and the the treatment
00:23:11
the the plastic treatment that was lost a call because you treatments little down the preparation only good diseases
00:23:18
suggesting that the uh and uh these uh a association uh
00:23:23
these uh to be to mend the combined treatment can have positive
00:23:26
effect that was on the evolution of all the the this or
00:23:29
that uh that the association of working on this or that uh
00:23:34
we see the diseases that are presented by opinion about that is in the little they
00:23:39
mean previn associate disease impatiently routine you know but that is a three point five percent that
00:23:45
and uh and uh easy for we considered to difference that this
00:23:49
is the ranges from two point eight or two six point four percent
00:23:54
we study the one and the big one patient willow to minute but i this
00:23:58
uh one and that in fifty seven with type one ultimate but that is set
00:24:03
and the twenty four with type two would be enough but that
00:24:06
descend we eh found a a eight cases uh eight patients uh
00:24:12
pause before nineteen them isn't about this but only five and set the the one that would would be in a biopsy
00:24:17
and that all of these five patient with classified work confirm this easy access
00:24:22
with the finding would pop and we also have to be able to find w. three c. according to much trouble but
00:24:29
how does that eight to patients uh uh the pause before and get them isn't about this uh
00:24:35
seven where females uh again at only one wasn't me
00:24:39
with a a major ranging from twenty seven to sixty four yeah that's it
00:24:43
and that differently from uh uh the finding of cedar disease
00:24:47
in the primary be adequate and that is in this case
00:24:51
yeah we have found a a a a yeah a number
00:24:54
of patients consistent we see the disease we know that the only
00:24:58
the presentation of see a disease is a quite different from the past the many patients uh at the
00:25:04
cost a patient many basing to edit it what about
00:25:07
what seeing them and uh eh about the five uh
00:25:11
whether a patient said seen them so because after we was always
00:25:15
spends in the in the form of a this severe builders atrophy
00:25:19
and each of the c. in all the five patients biopsies and only two cases set a that
00:25:25
invoking whatever that is uh and so on and on
00:25:28
the old a these patients we see a disease it
00:25:32
in the context of holding it provides a issue all the a. i. drivers
00:25:36
of investing unseen bombs that and it is a interesting though that uh damage
00:25:41
the companies on top of the clinical features on the overall thing about by the so we then do without see
00:25:48
a disease that did not the light uh a significant differences
00:25:52
in terms of age or gender level so it doesn't it
00:25:56
gamma goblins and amber patience pause before usually do
00:26:01
which i ease the the well that eh no it's that reach
00:26:05
the genetic marker for both diseases and moral better by comparing yeah
00:26:10
uh the number of patients uh going to to amy shown or pharaoh believe that disease that
00:26:15
uh we have a set of the that that would improve died but not change the outcome
00:26:20
or would you know but i teasing the case is set with associated see your disease that
00:26:25
but the uh whatever it i get a positive effect on preventing or the pros is uh
00:26:30
and the winning best analysts or strong grew being the the absorption of that set him
00:26:35
probably go for the uh the treatment all the uh old thing about that is set
00:26:40
no also station as being the most rated between that see a disease that and uh by another but that is uh
00:26:46
in the temperate previn associated disease impatience with uh provide you see
00:26:51
was bound to be one point two percent of that is a very close uh a tool
00:26:56
the a prevalence in the general population however due to the possible
00:27:01
come cabins or both that this or that is in the same people
00:27:06
yeah a screening of for a uh c. uh this is the recommended in
00:27:09
patients all that but i do see a in because the the fans generation black
00:27:16
in to have it on everybody in a yeah yeah we have
00:27:19
a euros the station we see you with uh it like you see
00:27:24
it was nice and see a busy that should be was the only way see a disease that
00:27:28
was it in every mission was may get the weekly although all c. d. related or
00:27:33
old antibodies that the clinical relevance all these uh all the situation is what now because the
00:27:39
yeah the availability all but uh they
00:27:42
in a database new drives a direct
00:27:46
the active antiviral blacks uh uh it
00:27:49
is a really actually eh overcomes this upset
00:27:54
uh in and that that the c. i. disease can impair the immune response what but that is to be but i was uh that's that's that
00:28:00
destination we should be administered to secure this is patience only after routine
00:28:06
for the guy to have the eh eh the treatment the of the disease
00:28:10
yeah there are several pathways in boarding seeded is easily very really improving get
00:28:16
i think he's got the permeability the intestinal chronic inflammation
00:28:20
there's more intestinal bacteria all the growth with these b. o.s is a
00:28:24
common genetic predisposition which is well known uh for this position between senior diseases
00:28:30
and go to mean about that's about that they think the later to showing that that
00:28:34
sam uh a stat these on a gen on jen normal why the
00:28:39
yes that is a a a show with the that
00:28:41
that is the the last samurai eh common genetic features
00:28:46
between seeded diseases and the primary be that one jackets
00:28:50
molecular mean ugly particularly important for a b.
00:28:54
b. c. and uh it in foresight or
00:28:57
mean you get to the lever as it demonstrated that these last aspect the uh by
00:29:03
yeah the finding the all the lymphocytes uh expressing it
00:29:08
eh and them articles of interest g. s. s. s. jazzy into green uh alpha four but the seven that and uh
00:29:14
it came up prior sector c. c. at nine uh in leave it seems although
00:29:19
in the pay of cells all patients would see it is easy with lever involvement
00:29:24
the crosstalk uh uh between uh amount of several of those men can lead the
00:29:30
it was sort of see a disease uh uh related the liver damage or
00:29:35
they they always directional all downloading a uh does the roots is the integrity of the
00:29:41
tide john assumes a resulting in a ending payer the intestinal bah yeah that and the
00:29:47
in a related the molecular trafficking get that
00:29:50
i have been a bacteria and other got antigens
00:29:54
that can reach a that even for all the corpus equation that and at three get out
00:29:59
in your uh the in a innate and adaptive in your response and the like a sector so
00:30:05
a guy in a in a recognise the deportees
00:30:08
socratic the molecules uh enter generated prior inflammatory mediators so
00:30:13
uh yeah that's possible for topic uh inflammation uh and leave it at that
00:30:18
and the other and doing for side or mean there and the
00:30:22
molecular mean weekly between uh but the area and a a should
00:30:25
be on it's on your way to be originated this can never
00:30:28
all right in the pathogen is your primary vehicle and rightly so
00:30:32
carmen a genetic predisposition as a political band about losing proving that
00:30:38
eh and to the to the powers it's uh in the leave that
00:30:42
can ever over the in the the association between uh eh and eh
00:30:47
i see a disease that and the wait a minute but that is
00:30:51
uh in in zooming resistance in office that is that i scan account the
00:30:55
for the uh the case itself see a disease that associated with the the action
00:31:01
a two main mechanism have so would that work estate leaving during see a disease that
00:31:07
and that they are presented by the levy gap that we deal with this uh
00:31:11
they're wearing the passes away and visions from the got room and pull the lever
00:31:15
and the other a pop is this a you you need this is a pop is is meant to be
00:31:20
eh estes the most rated in effect that is uh that in c. of the the is uh we are but the the most british
00:31:27
in any case uh all that old empty but this at the right big against the t. v. two
00:31:31
that are present and not only there's more about whether but
00:31:34
also in the leave and and the rest investing all these years
00:31:38
uh these others out that being come for um the by corporate i dabble in a
00:31:43
paper having that that without them for uh and the there is a possibility that that also
00:31:48
a human early morning tea can at the roller in a leading to the lever that major
00:31:53
uh in a a c. act a disease not only eh and the the
00:31:59
sale at the moment i'm in my final conclusion now that see a disease or
00:32:04
can be regarded as one of the best example uh all the uh the
00:32:09
interaction of got really that actually sell the pharaoh got me that says uh
00:32:13
and the a we yeah but would be standing we distinguish early but i'm not a marketing tool
00:32:18
uh eh clear fun of life servers and back we presented
00:32:21
to this financial and that ultimately that does or that's uh
00:32:26
no there is a a and b. then says that
00:32:29
lead of damaging see this is patience is partially or properly
00:32:33
root and the band and then didn't suck am so from the healing of see it but i this after we've done for that
00:32:39
either from the improvement over putting fashion uh in the c. i.
00:32:43
disease related the other bands the lever favour and also for the a
00:32:48
eh effective stabilisation or holding your liver diseases set
00:32:52
after the c. two channel route unfit die that
00:32:55
it is very important that to uh say send the value so eleven times
00:33:00
these are they gonna love this uh and also in the follow up and the winning the
00:33:05
for lap utterance i mean is is a particularly when elevated that that that you know this uh
00:33:09
i'm not a normalised the uh it's
00:33:13
very important to reassess also the theology
00:33:16
eh it do what you miss your g. because of that is a possibility all that
00:33:22
the appearance of all the old union leave or this or
00:33:25
this after uh many also with the provided this yet i
00:33:29
uh and the senior patients it in a in a rhythm pretty died the
00:33:34
more for more than twenty hours uh and uh you develop the in noting appetite deceptive
00:33:40
penny i have sort of a rudimentary dad doesn't is evidence that would agree that that
00:33:45
is not protecting the it all the patients it
00:33:50
from the these go overboard community reader fashion should be
00:33:53
a scroll or the uh so in a cod that
00:33:56
you know this is going for ceded the should be performed no patience with working only with this or that
00:34:03
and the final it would like to thank me differently but with a lot of local mocha
00:34:06
i and the group mobil one yeah the makeup department working thank you very much for your pet
00:34:18
every first question of questions
00:34:25
just for this question
00:34:36
it's
00:34:38
it's
00:34:40
he's on a rejection yeah eh
00:34:46
i i mean uh eh this patient uh eh the
00:34:51
what was listed within that if the distance it was provide and uh
00:34:57
that probably this patient uh i i i i mean the treatment that by
00:35:02
other typing than the standards to lay the very
00:35:06
good the other stones in this patient from at
00:35:10
the moment at the moment and generally generally a
00:35:15
in my experience it is uh that uh eh
00:35:19
the the we we must be careful what will eh tape uh
00:35:23
uh with volume the taping of the treatment the to the elderly
00:35:28
eh we need a a in in these patients uh to eh
00:35:33
go on uh with the treatment by the treatment eh you for um
00:35:38
if you're a long time i think it also with the very low voltage all that was uh
00:35:45
but do we long time i i in my experience to see a patient go
00:35:49
to mean appetite is it can uh eh ten that way but a in a
00:35:56
the the caverns uh of the disease that if we is top
00:36:00
of the treatment to we it tape three and that too too fast
00:36:06
yeah
00:36:08
whose c. systems
00:36:14
for me
00:36:21
jesus relation program i there is always
00:36:25
a problem and that we eh and
00:36:30
find the we've eh in see the disease that is
00:36:34
that all the i pushed lane isn't for example yeah
00:36:37
yeah we'll see x. uh and can add diapers plan
00:36:41
is mean about seventy percent of cases so i think um
00:36:45
lower prevalence knots of the percent as opposed to the little bugger static
00:36:50
but in this patience is very important to proceed
00:36:53
with the not remote call colour destination and the
00:36:56
as initial promotion plans and either by a meaningful call also
00:37:01
because this patience i the very i always go infections a little infections
00:37:05
uh in the if they respond very well these are the situation my experience
00:37:17
it's
00:37:22
twelve a possibility although uh the false positive results for peace it runs
00:37:28
with the names of idea class in the ribs or those because probably
00:37:32
isn't about this uh a reactor with different to be
00:37:35
top so all the molecules uh eh in the in
00:37:40
the tool uh antibodies that would be sort of what i mean is the reactor with
00:37:45
that you mean and ugly scene uh it be tops uh eh in a nineteen please
00:37:51
no one to um i remember and a a in a in
00:37:57
in in some cases a a should be you a it could be was full out would be fine
00:38:03
and they get to collect ads into bats but is not possible in the real life in the clinical products
00:38:11
it's it's it's it's really just to chase
00:38:25
for each show you
00:38:29
you could do to die it's loose fine strut
00:38:35
do i think that to the number of patients and not complying with like these uh
00:38:41
is it comes ceased and is ah and uh and my experience it is uh and and uh
00:38:47
so the the these go for the value of the the battle meant all the lymphoma and the
00:38:52
the the factory see these types always cheese it but i'll inform the completion
00:38:57
is that ah a soul uh the evil and the number or not i
00:39:02
but uh the possibility is ah is so eh
00:39:06
in eh in this case is is very important to
00:39:10
to the place where the patients to to to to take again the done thing
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June 20, 2019 · 6:03 p.m.
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Celiac Disease and the Liver
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June 20, 2019 · 6:54 p.m.
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