Podcast with Dr. Larry H. Bernstein, MD, FCAP, Interview by Gail S. Thornton, PhDc, Narrator’s Voice: Stephen J. Williams, PhD

Updated on 11/27/2020

From: “Dr. Larry Bernstein” <larry.bernstein@gmail.com>

Reply-To: “Dr. Larry Bernstein” <larry.bernstein@gmail.com>

Date: Friday, November 27, 2020 at 2:39 PM

To: “Aviva Lev-Ari, PhD, RN” <AvivaLev-Ari@alum.berkeley.edu>

Subject: Re: DID YOU AUDIT the Podcast Dr. Williams narrated for you –>>>>>>>> e-VOICES Podcasting | Leaders in Pharmaceutical Business Intelligence (LPBI) Group

It was very well done. It is unfortunate that I only had the hemograms. Much work has been done since. Despite the progress none of the work has been introduced into daily use, or even a large trial. We did not have the enzyme data for heart attack, even though I had previously published a powerful study of heart attack using CK-MB at 0 and 8 hours later (there is a lag prior to admission) with another member of the NACB, who had also participated in the seminal code breaking trial in England. I did a repeat study on heart attack with the great Soviet mathematician, Izaak Mayzlin. This began as a resident at the University of California, San Diego, where the mathematician said he could give me brief moments of his time at no cost. Then the other critical data would pertain to sepsis based on elevated neutrophil count, which would be in part in the hemogram.

It was quite a journey.

Larry

Interview with Dr. Larry H. Bernstein, an icon in the medical field, by Dr. Stephen Williams

Welcome to E-Voices, our podcast series exploring cutting-edge science and medical topics, sponsored by the Leaders in Pharmaceutical Business Intelligence. I’m Dr. Stephen Williams, your host for this podcast.

Today’s guest is Dr. Larry H. Bernstein, M.D., FCAP, who has had a stellar career in medicine. He is a retired pathologist, pathophysiologist, histologist, bacteriologist, chemical geneticist, biochemist, enzymologist, molecular biologist and mathematical statistician.

Since Dr. Bernstein is not available to record this audio podcast with us, he provided us with answers to several questions plus gave us a biographic review of his life.

Most recently, Dr. Bernstein served as Chief of the Division of Clinical Pathology at New York Methodist Hospital-Weill Cornell Affiliate in Brooklyn, New York, followed by an interim consultancy at Norwalk Hospital in Connecticut. Previously, he was Chief of Clinical Chemistry and Chief of the Blood Bank at Bridgeport Hospital also in Connecticut and Acting Chairperson of Yale University’s Department of Pathology at Bridgeport Hospital.

For many years, he was the Chief Scientific Officer and Member of the Board of Leaders in Pharmaceutical Business Intelligence (LPBI) Group, a pharmaceutical media venture with several cloud-based products, such as an open-access online scientific journal called PharmaceuticalIntelligence.com, a BioMed e-Series of 16 volumes in Medicine, real-time press coverage of biotech and medical conferences, and a podcast library of Interviews with key opinion leaders, all involving a team of experts, authors and writers in science and medicine.

Dr. Bernstein had contributed 1,400 curated articles to LPBI’s Journal and served as an Editor and Content Consultant to each of the 16 volumes in LPBI’s BioMed e-Series. Examples of the top articles in the Journal by e-Reader views shows the cardinal positioning of Dr. Bernstein’s publications. The small sample reflects a glimpse of the topics that he had covered in his writing.

In addition, in 2020, the Journal ontology has 700 categories of research, at least 50 percent were created by Dr. Bernstein to allow precise classification of the wide range of topics his body of research had covered, namely Cancer, Genomics, Pathology, Coagulation, Cardiovascular, Nutrition, Cell Biology and biochemistry processes.

Dr. Bernstein served on the Board of Directors of NAACLS and the American Library Association Commission on Accreditation and he is listed in the America’s Top Physicians. He has three patents in the areas of malate dehydrogenase, an enzyme which plays an important role in the body’s metabolic pathway. He also co-chaired the First International Transthyrein Congress in Strasbourg, at the invitation of Yves Ingenbleek, M.D., PH.D., Professor of Pharmacology at the University of Louis Pasteur in Strasbourg. Additionally, he chaired the 14^th Ross Roundtable on Nutrition and was an invited participant at the 17^th Ross Roundtable and chaired the Beckman Roundtable on Prealbumin in Los Angeles, California. He was responsible for the American Association for Clinical Chemistry’s first document of Standards of Clinical Laboratory Practice with Lawrence Kaplan and he was the recipient of the Labbe/Garry award of the Nutrition Division of AACC.

We asked Dr. Bernstein if he…Could you tell us about the research project that had the most significance in his career?

He responded by saying…The mechanism of action of mitochondrial malate dehydrogenase (MDH) isonzyme and the inhibition by the combination of the reduced coenzyme (NAD+), MDH and the substrate oxaloacetate (OAA) as the forward reaction proceeds, which is similar to the reaction of lactate dehydrogenase (LDH), NAD+ and pyruvate, except for the lack of inhibition of the muscle type LDH. The role of this reaction in cancer cells, with implication for the Warburg effect…suppressed oxidation of cancer cells.

Dr. Bernstein worked with two noted researchers – Prof. Gil David, who was a postdoctoral student under Prof. Ronald Coifman, who was past Chairman of Mathematics at Yale University – to develop a software system which is today’s equivalent of electronic health records. He commented on this breakthrough and its value to patients and physicians by saying…

Prof. Gil David and Dr. Bernstein had developed, in consultation with Prof. Ronald Coifman, in the Yale University Applied Mathematics Program, a software system that is the equivalent of an Electronic Health Records Dashboard, that provides empirical medical reference and suggests quantitative diagnostics options. Their dashboard was a visual display of essential metrics.

The primary purpose of their research was to gather medical information, generate metrics, analyze the data in real-time and provide a health diagnosis for an individual’s medical condition, meeting the highest standard of accuracy. The medical diagnosis then provides a risk assessment to the patient’s medical condition, while locating and presenting similar cases of other patients with the same anomalous profile and their corresponding treatment and follow-up. Given medical information of a patient, the system builds its unique characterization and provides a list of other patients that share this unique profile, therefore utilizing the vast aggregated knowledge, such as diagnosis, analysis, treatment) of the medical community.

The main mathematical breakthroughs in creating this software system are provided by accurate patient profiling and inference methodologies in which anomalous sub-profiles are extracted and compared to potentially relevant cases. Their methodologies organize numerical medical data profiles into demographics and characteristics relevant for inference and case tracking. As the model grows and its knowledge database is extended, the diagnostic capabilities become more accurate and precise.

They anticipated that the effect of implementing this diagnostic amplifier would result in higher physician productivity at a time of great human resource limitations, safer prescribing practices, rapid identification of unusual patients, better assignment of patients to observation, inpatient beds, intensive care, or referral to clinic, shortened length of patients’ ICU and bed days.

Dr. Bernstein’s research in nutrition was extensive. He shared his early work in the Burn and Wound Care Unit at Bridgeport Hospital along with Dr. Walter Pleban, a leading physician in burn and wound care by saying…

Dr. Bernstein began the studies after reviewing the work in Boston on the evaluation of patients for malnutrition prior to surgery by an observation of arm muscle circumference weight loss and serum albumin. This was preceded by the work in Philadelphia, and later in Houston by Stanley Dudrick on malnutrition in children and in surgical patients. Dr. Dudrick became the Chairman of Surgery at Bridgeport Hospital before his retirement.

The problem that Dr. Bernstein was concerned with was the inadequacy of serum albumin, the half-life being too long. He studied the protein transthyretin (then referred to as prealbumin) after following the work by Yves Ingenbleek at the University of Louis Pasteur in France.

We asked Dr. Bernstein about his opinion on the future of cancer therapeutics.

He responded by saying…The progress has been good and has varied depending on type. There has been enormous progress in genomics, but much work on metabolic pathways is needed.

We asked Dr. Bernstein about the promise of precision medicine and what needed to be accomplished in the coming decade.

He responded by saying…that he thinks that more than a decade will be needed.

We asked Dr. Bernstein about his interpretation of COVID-19, a complex disease.

He responded by saying…It is not more complex than other viral diseases. It has come at a time that good science is not valued.

Enjoy the podcast!