Is Occupational Complexity Associated With Cognitive Performance ... The Cardiology Advisor
Read more here:
Is Occupational Complexity Associated With Cognitive Performance ... - The Cardiology Advisor
AIMed Global Summit 2023 to Focus on Changing Healthcare One … – Diagnostic and Interventional Cardiology
May 10, 2023 The AiMed Global Summit will be held June 4-7, 2023, in SanDiego, Calif, and program details offered include a comprehensive agenda of key leaders on artificial intelligence (AI) and its application and implications on healthcare. The event will offer six high-value tracks, 200+ speakers, a dozen keynotes, pre and post summit partner events over three days, offering attendees a chance to gain insights into the latest use cases, perspective and approaches in AI medicine. Participants will also have an opportunity to access the Smart Health Expo, network with 1500 healthcare game changers and hear from top health AI luminaries, facilitating expert insights, proven best practices and real-world success stories, and interact with more than 60 sponsoring exhibitors, according to AiMed Global Summit planners.
An overview of AiMed Global Summit news features and program highlights has been updated by the editorial team at Imaging Technology News/ITN (itnonline.com) and Diagnostic and Interventional Cardiology/DAIC (dicardiology.com) who will be on site and offer ongoing coverage.
Representatives from the following top healthcare facilities across the country have been tapped to speak during the Summit, and include but are not limited to: Tenet Health, Mayo Clinic, University of California, Duke AI Health, Harvard Medical School, Phoenix Childrens, Rady Childrens, University of Texas MD Andersen Cancer Center, and CHOC Childrens.
Additionally, leaders from leading associations are scheduled to participate as Speaker Advisors, including President-Elect of the American Medical Association, Jesse Ehrenfeld, MD, providing An Update from the AMA on June 5, as well as representatives from the American Hospital Association, and the American College of Cardiology.
Major business speakers include: Bayer - Head of Medical Affairs, Digital Radiology, Ankur Sharma;Nuance Chief Medical Information Officer, Matthew Lungren, MD, MPH;AWS Principal Business Devt Officer-Academic Medical Centers, Rod Tarrago, MD;Google Health Chief Clinical Officer, Michael Howell; Clinical Lead, Public & Population Health, Von Nguyen, MD;Philips Global Practice Leader, Edgar Van Zoelen.
During AiMed 2023, content will be split across six dedicated tracks which planners have described as focusing on these areas:
1) From Data to Delivery:Uncovering how data is being leveraged to drive innovation and help change the way clinicians and healthcare business leaders identify, manage and treat patients.
2) Population Health & Equity:Participants of this track will discuss, question and collaborate on developing, validating, and testing AI approaches for risk prediction, bias situations and areas of prevalence, diagnostics and decision making to provide value for cohorts and improving health equity.
3) Ethics & Regulation:With a lens of ensuring humans remain in the loop, discussions explore the nuances of AI so that it promotes well-being, patient equity, human safety and the public interest. This track deep dives into the R.E.A.L (regulation, ethics, accountability and legal) issues around AI and the wider considerations.
4) Tools & Deployment Track:Participants will be able consider use cases and lessons learned to aid your deployment decisions and benefit from the transformational opportunities that AI can provide in medicine and healthcare operations. Dig into the AI tool kit and explore RPA, wearable technology, NLP, digital twins, neural networks, machine and deep learning, extended reality, etc. For those wondering how to implement AI in their roles, scale up, just getting started or already an expert.
5) Strategies for Healthcare Leaders:This track translates these nuances in detail to build sector resilience as we reimagine the future of healthcare with AI. Seeks to answer the question: do we have the policy, strategy, funding models, education and people in place to deliver at scale?
6) Application in Clinical Domains:As the scope increases, providing clinicians with further insights into patient conditions, this track shares the latest applications and use cases across clinical domains.
The College of Healthcare Information Management Executives (CHiME) is hosting the Innovation in Clinical Informatics as part of AiMed Global Summits Pre-Summit Program onon Sunday, June 4 and Monday, June 5.CHiME is the professional organization for Chief Information Officers and other senior healthcare IT leaders. CHiME enables its members and business partners to collaborate, exchange ideas, develop professionally and advocate the effective use of information management to improve the health and care throughout the communities they serve. Learn from leading experts at this jam-packed program led by C-level healthcare executives, delivering the roadmap to implement next-gen solutions in your practice.
ABAIM AI Review Course
The American Board of Artificial Intelligence in Medicine (ABAIM) is hosting an AI Review Course as part of AiMed Global Summits Pre-Summit Programming. ABAIM is a nascent multidisciplinary AI advisory group of domain experts formed to provide educational content and a certification examination for healthcare participants in the course as they embark on their journey of AI in medicine. In partnership with AiMed Global Summit, ABAIM is offering a CME-accredited course led by industry experts. This one-day course is the perfect foundation for gaining an educational certification assessment in AI. With a live faculty of industry leading experts, it is not to be missed! Learn from AiMed Founder Anthony Chang, and ABAIM executives leading the way for AI in medicine, and join the conversation in developing best practices set to advance digital healthcare. The activity will be worth eightcredit hours based on the current schedule.
The AiMed 2023 Networking Reception will also take place Sunday evening.
CHOCs Chief Intelligence and Innovation Officer, Anthony Chang, MD, MBA, MPH, MS, is the Chairman and Founder of AIMed, who will join with AIMed CEO Freddy White to deliver the Grand Opening Keynote address on Monday, June 5.
The Headlines Stage, featuring expert sources on key topics daily, will kick off on day one with an address focused on AI Foundations: 2023 Update of AI in Healthcare. Presenters joining AIMed Founder Chang for this session include Alfonso Limon of Oneirix Labs,Karen B Seagraves, PhD,Sharief Taraman, MD, University of California, Irvine School of Medicine.
Official opening of the AiMed Smart Health Expo featuring vendors providing solutions, services, inspiration, as well as open floor layout for optimized networking and making connections over refreshments.
AI Foundations: a foundation level masterclass provides a multidisciplinary and comprehensive overview of the principles and application of data science, artificial intelligence and intelligence-based medicine. Covering its basic concepts and its real-life applications at a top level. This masterclass is a must attend for any clinician and practitioner seeking to strengthen their foundational level knowledge of AI.
Additionally, the Smart Health Expo opens Monday, June 5, offering an open floor plan for improved networking.Subspecialty Group Meetups will also take place on the first day of the summit.
Breakfast Workshops will allow participants to take a deep dive into a range of key areas impacting AI in medicine, from Leveraging Natural Language in Healthcare to a C-Suite Primer and additional sessions.
Breakout Tracks allow attendees to engage in all aspects impacting their work: From Data to Delivery; Ethics & Regulation; Population Health & Equity; Tools & Deployment; Strategies for Healthcare Leaders; Applications in Clinical Domains; The Computer Lab.
The Headliners Roundup for June 6 features a session, Whats Influencing Clinical Medicine and Healthcare Today? and will include Michael Howell, MD,Google Health, Jack Hampson, ofDeeper Insights, and PatricioA. Frias, MD,Rady Children's Hospital.
The Shark Tank Startup Showcase on June 6 will allow the shortlisted five start-ups four minutes to deliver a shark tank style pitch of their solution followed by six minutes for Q&A. The prestigious judging panel of healthcare entrepreneurs and VCs who invest in seed rounds will rank each pitch to determine the winner.
AI Champions Awards will presented as an evening to celebrate and recognize the great people and organizations that are helping to drive the agenda for artificial intelligence in healthcare. To be held the evening of Tuesday, June 6, the AI Champion Awards is described as an evening to celebrate and recognize the great people and organizations that are helping to drive the agenda for artificial intelligence in healthcare.
On the final day of AiMed 2023, another 15 sessions will take place, including Breakfast Workshops focused on Digital Twins, Operationalizing AI and other hot topics. Also on June 7, the AiMed Abstract Competition will give students, early and established career clinicians and data scientists the opportunity to present posters to an esteemed panel of judges.
Closing out the 3-day event on the Headliners Stage will be a series of keynotes from senior healthcare leaders. Breakout tracks covering 6 key areas will offer Stargazing AI in Healthcare: What Does the 5 Year Roadmap Ahead Look Like?
Panelists include: Anthony Chang MD, MBA, MPH, MS, of CHOC and Founder, AiMed;Eric Eskioglu, MD, MBA, formerly withNovant Health; Eric Wicklund, from mHealthIntelligence; G. Hamilton Baker, MD, of The Medical University of South Carolina;Karen B Seagraves, PhD, MPH;and William W Feaster, MD, CHOC Children's Hospital.
AiMed is described as a driving force ensuring the healthcare sector is not left behind, whose stated goals are to eradicate challenges, define AI enabled solutions and create an efficient workplace, with patient outcomes at its core. The organization notes that its aim is to assist medical professionals to discover new ways to incorporate advances in technology to help the way they work.The Childrens Hospital of Orange County (CHOC) Medical Intelligence and Innovation Institute (MI3) is funded by the Sharon Disney Lund Foundation with the purpose of advancing data science and artificial intelligence in medicine around the world. Our vision is for this institute as well as AiMed to serve as a clarion call to start a revolution to embrace this exciting new paradigm for healthcare and medicine.
For more information: https://ai-med.io
AiMed Global Summits Lineup Announced
AiMed 2023: Changing Healthcare One Connection at a Time
Find more AiMed23 conference coverage here
See the rest here:
Oxygen therapy improves heart function in patients with long COVID – EurekAlert
Barcelona, Spain 10 May 2023: A small randomised trial in patients with post-COVID syndrome has found that hyperbaric oxygen therapy promotes restoration of the hearts ability to contract properly. The research is presented at EACVI 2023, a scientific congress of the European Society of Cardiology (ESC).1
The study suggests that hyperbaric oxygen therapy can be beneficial in patients with long COVID, said study author Professor Marina Leitman of the Sackler School of Medicine, Tel Aviv University and Shamir Medical Centre, Be'er Ya'akov, Israel. We used a sensitive measure of cardiac function which is not routinely performed in all centres. More studies are needed to determine which patients will benefit the most, but it may be that all long COVID patients should have an assessment of global longitudinal strain and be offered hyperbaric oxygen therapy if heart function is reduced.
Most COVID-19 sufferers fully recover, but after the initial illness approximately 1020% of patients develop long COVID, also called post-COVID condition or syndrome.2 Symptoms include shortness of breath, fatigue, cough, chest pain, rapid or irregular heartbeats, body aches, rashes, loss of taste or smell, nausea, vomiting, diarrhoea, headache, dizziness, insomnia, brain fog, depression and anxiety. Patients with post-COVID syndrome may also develop cardiac dysfunction and are at increased risk of a range of cardiovascular disorders.3
This randomised controlled double-blind trial evaluated the effect of hyperbaric oxygen therapy (HBOT) on the cardiac function of long COVID patients. HBOT involves inhalation of 100% pure oxygen at high pressure to increase delivery to the bodys tissues, which is particularly beneficial for tissues that are starved of oxygen due to injury or inflammation. HBOT is an established treatment for non-healing wounds, decompression sickness in divers, carbon monoxide poisoning, radiation injury and certain types of infections
The study enrolled 60 post-COVID syndrome patients with ongoing symptoms for at least three months after having mild to moderate symptomatic COVID-19 confirmed by a PCR test. Both hospitalised and non-hospitalised patients were included. Severe COVID cases were excluded. Patients were randomised to HBOT or a sham procedure in a 1:1 ratio. Each patient had five sessions per week over eight weeks, for a total of 40 sessions. The HBOT group received 100% oxygen through a mask at a pressure of 2 atmospheres for 90 minutes, with 5 minute air breaks every 20 minutes. The sham group breathed 21% oxygen by mask at 1 atmosphere for 90 minutes. All participants underwent echocardiography at baseline (before the first session) and 1 to 3 weeks after the last session.
Echocardiography was used to assess left ventricular global longitudinal strain (GLS), which is a measure of the hearts ability to contract and relax lengthwise. It indicates how well the heart is functioning and can help detect early signs of heart disease. A healthy heart will have a GLS value of around -20% which means that the heart muscle is able to properly contract and relax in the longitudinal direction. Reduced GLS is an early marker that the heart is not able to contract and relax effectively.
At baseline, nearly half of study participants (29 out of 60; 48%) had reduced GLS. Of those, 13 (43%) and 16 (53%) were in the sham and HBOT groups, respectively. The average GLS at baseline across all participants was -17.8%. In the HBOT group, GLS significantly increased from -17.8% at baseline to -20.2% after the intervention (p=0.0001). In the sham group, GLS was -17.8% at baseline and -19.1% after the sessions, with no statistically significant difference between the two measurements.
Professor Leitman said: It was notable that almost half of long COVID patients had impaired cardiac function at baseline according to GLS despite all participants having a normal ejection fraction, which is the standard method for measuring the hearts ability to contract. This means that ejection fraction is not sensitive enough to identify long COVID patients with reduced heart function.
She concluded: The findings suggest that HBOT promotes recovery of cardiac function in patients with post-COVID syndrome. More research is needed to collect long-term results and determine the optimal number of sessions for maximum therapeutic effect.
ENDS
Authors: ESC Press OfficeMobile: +33 (0)489 872 075Email: press@escardio.org
Follow us on Twitter @ESCardioNews
Notes to editor
Funding: None.
Disclosures: None.
References and notes
1The abstract The effect of hyperbaric oxygen therapy on myocardial function in post-COVID syndrome patients: a randomized controlled trial will be presented during the session COVID which takes place on 10 May at 11:30 CEST at Moderated ePosters 1.
2World Health Organization: Coronavirus disease (COVID-19): Post COVID-19 condition.
3Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med. 2022;28:583590.
About EACVI 2023 #EACVI2023
EACVI 2023 is the first patient-focused and unified multi-modality congress. It is organised by the European Association of Cardiovascular Imaging (EACVI) of the European Society of Cardiology (ESC).
About the European Association of Cardiovascular Imaging (EACVI)
The European Association of Cardiovascular Imaging(EACVI) - a branch of the ESC - is the world leading network of Cardiovascular Imaging (CVI) experts, gathering four imaging modalities under one entity (Echocardiography, Cardiovascular Magnetic Resonance, Nuclear Cardiology and Cardiac Computed Tomography). Its aim is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging. The EACVI welcomes over 11,000 professionals including cardiologists, sonographers, nurses, basic scientists and allied professionals.
About the European Society of Cardiology
The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.
Information for journalists about registration for EACVI 2023
EACVI 2023 will be held 10 to 12 May at the Fira Gran Via, Hall 8, in Barcelona, Spain. Explore the scientific programme.
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.
See original here:
Oxygen therapy improves heart function in patients with long COVID - EurekAlert
New report finds action is required to protect UK health research – Imperial College London
A new report from the Academy of Medical Sciences has outlined that the UK needs to do more to retain its exceptional strengths in health research.
The report titled Future-proofing UK Health Research: a people-centred, coordinated approachwas produced by 30 experts from across the UK, including Imperials Dr Rasha Al-Lamee, Clinical Senior Lecturer at the National Heart and Lung Institute, Imperial College London and cardiology consultant Imperial College Healthcare NHS Trust.
The report calls for coordinated action to secure a sustainable future for research and deliver maximum health benefits for people everywhere, which involves Governments across the UK, public and charitable funders, higher education institutions, industry, NHS leaders, patients, carers and the public.
Listen to Dr Al-Lamee on BBC Radio 4 Today Programme(from 51m 53s)
It concludes that UK health research is in danger of being taken for granted and sets out what needs to be done to improve and future-proof it.
The importance of clinical academics was highlighted as being crucial to support the over-burdened NHS and calls on regulators, funders, the NHS and universities to improve support for clinical academics and pilot a scheme where healthcare professionals have protected time for research.
Dr Rasha Al-Lamee works jointly between Imperials National Heart and Lung Institute and as a cardiology consultant at Imperial College Healthcare NHS Trust and spends 70% of her work-life running clinical trials on how to relieve the symptoms of heart disease and 30% of her time seeing patients.
Dr Al-Lamee noted that"hospitals doing research have better patient outcomes overall.
Despite this, there has been a decline of almost a quarter of the number of clinical academics at my career level across the UK over the last decade.
To avoid detrimental effects on patients and healthcare workers like me, the sector needs to make it easier to hold these dual careers in a secure and flexible way.
Some ofthe report's other key findings include the need to place people at the heart of the UK health research system by improving research culture and career structures, maximise the research potential of the NHS and, crucially, ensure that the true cost of excellent health research is adequately covered by addressing the current model of research funding where universities are required to cross-subsidise research costs from international student fee income.
Original post:
New report finds action is required to protect UK health research - Imperial College London
The Emotional Impact of Bariatric Surgery: Helping Patients … – MedCity News
Bariatric surgery is a life-changing procedure. Its one of the most momentous decisions a person can make, and its one that should be carefully deliberated before reaching a final conclusion.
As people think about what their lives will look like post-surgery, theyre most excited about how the procedure will transform their bodies. They spend hours consulting with their medical teams, reading articles online, and following the success stories of other bariatric surgery patients to anticipate the benefits theyll soon enjoy themselves. And while its okay for them to lose themselves in the excitement, its essential they consider the risks too.
Im not going to discuss the medical risks of bariatric surgery in this article. Thats a conversation they should be having with you, their medical team. I want to discuss the less talked-about risk that comes after a complete physical transformation. Bariatric surgery can help get people closer to their dream bodies, but they dont often think about how it could impact their mental health.
As many as one in five patientsgain at least 15 percent of their weight back in the years following their procedure. But what people dont always know is that a number of patients also report feeling more depressed and anxious post-surgery. This shift doesnt always happen, nor does it always happen immediately, with most people experiencing a newfound sense of euphoria after their procedure. Its usually a gradual decline that occurs over several years. This isnt entirely uncommon given the biological, lifestyle, and social changes that patients have to learn how to navigate post-surgery. But a decline in mental health can actually sabotage the surgerys success.
We want our patients to be the best versions of themselves after bariatric surgery. Helping them understand the emotional impact it can have on their life can mentally prepare them for their transformation. Below are the most significant mental health triggers you should discuss with your patients.
Bariatric surgery buyers remorse
People believe that if they spend enough time thoroughly deliberating their decision and weighing their options, they can walk into their surgery with absolute confidence they made the right decision. But in the days, weeks, and months following their surgery, they may feel that assurance quickly fade as they find themselves regretting their choices. Many people wonder how its possible to second-guess themselves when they were so sure bariatric surgery was the best decision for them, but we know this as bariatric surgery buyers remorse.
Most patients feel buyers remorse as a response to their recovery difficulties. The strict guidelines they must follow as they learn how to eat and drink again with your new stomach might have felt worth it in their planning phase, but now that they have to follow these guidelines, its more overwhelming than they imagined.
Its our responsibility to inform them that this regret is usually temporary, but it can serve as a reminder of why its so important to surround themselves with a good support system. This support can include a partner, family, or friends, but it can also include their provider. Community and support are critical to a patients success, especially during the early stages of recovery. This is why at Be Slim Bariatrics, we provide ongoing support to our patients at no additional cost, medical and nutrition-wise. Our bariatrics packages also include access to a large peer support group which is supervised by our team of dedicated health professionals.
Losing food as a source of comfort
Most bariatric patients share a similar relationship with food. Some patients turn to food and eating for comfort. Food can bring cheer when one is depressed or anxious, but its also a crutch that can help bolster ones happiness and enjoyment.
Bariatric surgery changes this entire dynamic. Food can no longer be a source of comfort, which can stir up some complicated emotions that people have abetted by eating for so long. Bariatric patients can have a difficult time processing these unpleasant emotions while in the midst of a challenging recovery process. They might feel an intense urge to eat, and when they cant, they will grieve the loss of food.
Providers must work with patients to change their relationship with food and help them discover healthy coping mechanisms to aid in their recovery and long-term success, like prioritizing self-care activities, spending more time with their loved ones, or finding other habits to occupy their minds. Behavioral modification is essential in the weight loss journey of a bariatric patient. It should be provided through a medically supervised weight management program like Be Slim Bariatrics offers.
Reclaiming ones self-esteem
Bariatric surgery is not a magical cure-all for poor self-esteem. Bariatric patients might find themselves struggling even more with their self-confidence after their surgery than before. There are a few reasons for this.
First, patients often feel insecure that theyve had to turn to surgery to lose weight. Society tells us that through diet and exercise, all things are possible. This isnt only wrong, but its a dangerous mindset that continues to fuel harmful inaccuracies about weight loss. Opting to undergo surgery to get someone closer to their goal weight isnt taking the easy way out, its a personal commitment to achieving greater physical health. And second, losing excess weight can often elicit an identity crisis. It might take patients some time to believe they are actually the person who is staring back at themselves in the mirror and thats okay. It will take time for patients to reclaim their sense of self and learn how to love this new version of themselves. We should encourage them to give themselves grace and patience.
Bariatric surgery isnt just a physical transformation; its a mental metamorphosis. Our patients physical and mental well-being are interconnected, so helping them care for and heal both sides of themselves is crucial.
Photo:mi-viri, Getty Images
Read more from the original source:
The Emotional Impact of Bariatric Surgery: Helping Patients ... - MedCity News
A legacy that dates back to 1943- CT Plus – UT Southwestern – UT Southwestern
YearWinnerCurrent or last known positionSpecialty2022Cayenne Price, M.D.Resident, UTSWAnesthesiology and Pain Management2021Natasha Houshmand, M.D.Resident, Johns Hopkins MedicineSurgery2020Priyanka Gaur, M.D., M.P.H.Resident, Johns Hopkins MedicineObstetrics and Gynecology2019Bethany Werner, M.D.Physician, Texas Health PresbyterianObstetrics and Gynecology2018Philip D. Tolley, M.D.Resident, Univ. of Washington Medical CenterPlastic and Reconstructive Surgery2017Lauren Elizabeth Kolski, M.DUTSW/Parkland HealthRadiology2016Samuel T. Parnell, M.D.Assistant Professor, UTSWEmergency Medicine2016Donald W. Seldin, M.D.*Professor/Chairman Emeritus, UTSWInternal Medicine2015Laurie Seidel, M.D.Assistant Professor, Univ. of Colorado School of Medicine, Rocky Mountain Poison and Drug CenterPediatric Hospitalist Medicine and Medical Toxicology2014Andrew Avery, M.D.General surgeon, NashvilleAnesthesiology, Surgery2013David Leverenz, M.D.Rheumatologist, Assistant Professor Duke University HospitalRheumatology2012Thomas Heyne, M.D.Mass. General Hospital/Harvard Medical SchoolHospitalist Medicine2011Geof LeBus, M.D.Orthopedic specialist and surgeon, Texas Orthopaedic Associates, Fort WorthOrthopedic Surgery2010Michael Van Hal, M.D.Assistant Professor, Orthopaedic Surgery, UTSWOrthopedic Surgery2009(Stanley) Tyler Hollmig, M.D.Associate Professor of Dermatology, Dell Medical School; Director of Laser and Cosmetic Dermatology,Ascension TexasInternal Medicine2008Sara Lindsey, M.D.Radiologist, Christus Santa Rosa Health System-San AntonioRadiology2008Joshua D. Mitchell, M.D.Assistant Professor of Medicine and Dir. Cardio-Oncology Ctr. of Excellenceat Washington Univ. School of Medicine in St. LouisCardio-Oncology2007James B. Cutrell, M.D.Prog. Director, Infectious Diseases; Assoc. Prof., Internal Medicine, UTSWInfectious Diseases2006Hayden Schwenk, M.D.Clinical Associate Professor, Stanford Medicine, Childrens HealthPediatric Infectious Diseases2005Michael Paul Herman, M.D.Urologist, Rockville Centre, N.Y.Urology2004William F. Schmalsteig, M.D.Associate Professor, Prog. Dir., Adult Neurology Residency, Univ. of Minnesota Medical SchoolNeurology2003James Isbell, M.D.Thoracic Surgical Oncologist and Intensivist, Memorial Sloan Kettering Westchester, N.Y.Thoracic Surgical Oncology2002Christine Kulstad, M.D.Writer, Dallas areaEmergency Medicine2001Preeti Malladi, M.D.Bariatric surgeon, Malladi Bariatrics and Advanced Surgery, Dallas/PlanoBariatric, Obesity, General Surgery2000Kerry Brandt Dunbar, M.D., Ph.D.Section Chief, Dallas VA Medical Center; Professor of Internal Medicine, UTSWInternal Medicine1999Lance E. Oxford, M.D.Otolaryngologist, Ear, Nose, and Throat Specialty Care, DallasOtolaryngology1998Shannon Neville (Houghton), M.D.*Resident, Barnes-Jewish Hospital, St. LouisInternal Medicine1999Lance E. Oxford, M.D.Otolaryngologist, Ear, Nose, and Throat Specialty Care, DallasOtolaryngology1998Shannon Neville (Houghton), M.D.*Resident, Barnes-Jewish Hospital, St. LouisInternal Medicine1997David W. Wimberley, M.D.Private practice, Fondren Orthopedic Group, Houston
Neurosurgery and Orthopedic Spine
Gastroenterology
See the rest here:
A legacy that dates back to 1943- CT Plus - UT Southwestern - UT Southwestern
Health care for profit: How corporate pressures threaten … – Kevin MD
An excerpt from Confessions of a Surgeon: A Deeper Cut.
He screwed us over. I slowly sank deeper into my chair, attempting to digest the letter my group had received from the local hospital CEO. Thank you for your groups interest in our hospital. I appreciate your long-standing dedication to the care of our patients. However, our organization has decided to go in a different direction. I wish your practice the best of luck.
Months earlier, he approached us wearing a Grinch-like smile, talking about joining his team. Our practice was to be the next domino to fall. From the beginning, we were skeptical of his motives. When it came to following through with commitments to physicians, his performances over the last two decades were mediocre at best. Physicians in small towns have long memories, especially those who get undermined by broken promises. Still, we had no choice but to listen. Our referrals were already diminishing because of the competing surgeons hired by this very same CEO. His goal was to complete his surgical department by adding our group to his staff. The competing hospital across town was going through growing pains and had no interest in buying up practices.
Sadly, the sun was quickly setting on our group surgical practice. Despite our historical reputation for stellar surgical care, corporate competition, and salary inflation left us mortality wounded. Two of our senior partners were also retiring. We could not compete in the recruiting process to replace them. We had no extra financial incentives to entice new surgeons into joining our practice. In addition to the hospital using its clout to stifle our referrals, the bureaucratic costs of running a business were rising. It was a perfect storm blowing, affecting practices throughout the country. We had to let go of the past in order to survive the present.
Over the years, our group had managed to resist the economics forcing many surgeons in private practice to jump on the corporate ship. Our naivety, ego, or lack of foresight prevented us from seeing the rolling for-profit landscape of patient care. We knew we were late in coming to the company party. I hated being in this position. I never thought, in a million years, that I would be selling my services to the highest bidder. In our case, the only bidder.
Our group had been in business for close to a half-century, serving patients at two hospitals with no financial strings attached. For years, primary care doctors referred patients to us knowing they would get excellent care. Plain and simple. Money or employer pressure was never part of the equation. There were no promises to operate at a specific hospital in return for the patient business. We naively assumed doing what we do best would sustain our group forever and provide immunity to the pressures squeezing everyone else. Wrong assumption. They were political and corporate pressures that had nothing to do with the ability to efficiently remove a colon cancer or perfectly repair a complex hernia. They had nothing to do with a dedication to stay with a patients family for hours, offering support. These pressures had everything to do with controlling the services physicians provided and maximizing the RVUs. Hospitals were building higher fences around their around their physician-owned perimeters. Fences that locked patients in, restricted their choices, and maximized every dollar their illnesses generated. The concept of shark territoriality among competing hospitals was alive and well. The days of a patient choosing his or her own surgeon were on life support. They ended when hospitals started buying up practices, forcing patients to stay within their walled-off network. They ended when the community surgeon lost control of his or her own destiny.
Lately, the hospital had been buying up primary care doctors in town like it was Black Friday. The gatekeepers of patients, as they were once fondly penned, were also feeling the same financial pressures we were. Only their pressures to produce magnified once they became employed by corporate medicine. Primary care physicians are vital to a hospitals revenue stream. However, many cannot generate the daily revenue for hospitals that surgeons can. Operating rooms are big business for hospitals, crucial to their bottom line. As a result of their financial clout, each has its own unique personality, business model, and revenue stream. First and foremost, there is the robot room. It often is the largest. Robots need a lot of room to flex their titanium arms. The cardiac surgery room (along with its sister cardiac physiology suite) is also a heartful source of revenue for any operating room. The vascular suit also makes up part of this revenue brood along with the joint room and bariatrics room. General surgeons are the Rodney Dangerfields of any community operating room. Despite being necessary, we do not get any respect and often do not have our own room. Our cases get handed off like orphans to different rooms throughout the day.
In the end, of course, the hospital did not hire us. Its CEO never intended to hire us. From the beginning, he was eager to know how much revenue our group created each year. The future business plan for his hospitals surgical department never included our surgical group. His goal was to put us out of business. It was easy to do when you have deep pockets and own half of the primary care physicians in town. Teddy Roosevelts words in 1906 still ring true today. If youve got them by the balls, their hearts, and minds will follow. This CEO clearly had us. Yet, he had no intention of making our hearts and minds follow him.
Paul Ruggieri is a general surgeon and author of Confessions of a Surgeon: A Deeper Cut.
Read the rest here:
Health care for profit: How corporate pressures threaten ... - Kevin MD
What happens in your brain when your head gets hit? – Cosmos
When you hit your head or when something hits it your brain is going to feel it.
While that thud might trigger a pain response (we all know what its like to stand up and suddenly strike your head against something), inside your skull, your brain is probably rattling around.
But it isnt just a strike to the cranium that causes your grey matter to rock back and forth: concussions occur when the body anywhere on the body is impacted such that the head, and the brain within it, suddenly moves.
If the effect of this biomechanical force is enough to cause the brain to hit against the skull, or twist, physical and chemical damage may occur to the neurons brain cells that are essential to its normal, healthy function. Thats when a concussion or mild traumatic brain injury is likely.
Everyone talks about concussion in sport, but theres more to it than that
Even if theres no clinical diagnosis of concussion, the potential for subtle, silent, mild TBI remains.
We know from accelerometer data that the head undergoes quite a lot of significant acceleration/deceleration events [in sport], says Dr Michael Buckland, the head of the neuropathology department at the Royal Prince Alfred Hospital and Executive Director of the Australian Sports Brain Bank at Sydney Universitys Brain and Mind Centre.
Only a small minority of those lead to clinical signs and symptoms that would be diagnosed as concussion the vast majority appear to be clinically silent.
But there is evidence, if you look at circulating biomarkersimaging, [and] advanced MRI studies after a game of sport, that there is actually a subtle traumatic brain injury or settled damage to the brain from those events, even though you feel completely fine.
Its all about how much exposure your brain is getting to these acceleration and rotational forces over short periods of time.
A concussion or mild TBI might be accompanied by a range of symptoms, from headaches, nausea and sensitivity to sound or light, to memory problems, brain fog, sleep problems and heightened emotions.
Sometimes theres a loss of consciousness, sometimes there isnt.
Perhaps the greatest diagnostic challenge for both clinicians and patients is that symptoms vary between people.
Diagnosing concussion isnt as straightforward as you might think, says Dr Sarah Hellewell, a neurotrauma researcher from the Peron Institute and Curtin University, in Perth.
There are various guidelines, but mostly diagnosis is based on reports from patients themselves or people around them at the time of injury. Most guidelines or tests include criteria such as presence of symptoms, alterations in mental state, the time of loss of consciousness or amnesia, if any.
In the simplest terms, neurodegeneration occurs when neurons in the brain deteriorate. Repeated concussions without adequate recovery might play a major role in this process.
Too much cell death and dysfunction could lead to any of several pathologies, including Alzheimers, Parkinsons, Huntingtons, motor neurone diseases, and amyotrophic lateral sclerosis (ALS).
CTE or chronic traumatic encephalopathy is in there too, and that has captured the concerns of the sporting community in recent years.
Mostly diagnosis is based on reports from patients themselves or people around them at the time of injury.
CTE is remarkably like Alzheimers. Both show shrinkage in the hippocampus, which plays a crucial role in learning and processing information as part of short and long-term memory formation. Change to the hippocampus is associated with a range of neurodegenerative and psychiatric disorders.
Both CTE and Alzheimers appear to share a common problem: toxic tau. Tau proteins play an important structural role in stabilising microtubules in brain axons the long cable-like structures of neurons that extend away from the cell body, ending in the synapses used to communicate with other brain cells.
Trauma to the brain causes tau proteins to clump together in tangled masses and alter normal brain functioning.
Get an update of science stories delivered straight to your inbox.
At a molecular level, tau tangles appear in different layers of the brain and may have different folded structures between CTE and Alzheimers.
But while Alzheimers might be triggered by several age, genetic, environmental and lifestyle factors, CTE is found in those with histories of repeated impacts to the head.
Tau is actually a normal, cellular protein. Its found in all neurons in the brain and it serves to stabilise their long outward projections called axons, says Buckland.
Its all about how much exposure your brain is getting to these acceleration and rotational forces over short periods of time.
Within those axons is whats called microtubule associated protein tau or MAPT [pronounced Map-Tee], and the tau stabilises the microtubules to give structural integrity to that axon.
In CTE, as in Alzheimers disease, the tau takes on an abnormal shape, gets abnormally modified chemically a lot of phosphorylation is added to it and it tends to move out of the axon and clump in the nerve cell body.
Buckland explains that many neurodegenerative diseases appear to be characterised by this abnormal accumulation of wrongly folded proteins.
Its not unlike a blood clot obstructing blood flow, except we have neural proteins crammed together in nerve cells.
Technically, both CTE and Alzheimers can only be conclusively diagnosed after death, that is, via a post-mortem examination of a persons brain (although Alzheimers has many clinical symptoms which enables a pre-death diagnosis).
The term mild is attached to TBIs and concussions, but its deceptive no brain injury is truly mild and there is need for close monitoring of the individual athlete.
A tennis player enduring their first nausea-inducing head hit might be fit and firing after two weeks, but a footballer placed on their fifth concussion stretcher might need much, much longer to heal properly. The brain can recover, but subsequent trauma which occurs before that process has been completed is what worries scientists: does repeat injury before recovery compound the problem?
If you subject your head to repeated concussion, you increase the chances that you might have a long-term brain disease. Thats not rocket science, says Emeritus Professor Robert Vink, a neuroscientist from UniSA.
Risk reduction in the immediate aftermath of a mild TBI or concussion is, therefore, crucial not just for short-term recovery but to reduce long-term risk.
For example, Vink warns about post-concussion drug and alcohol consumption.
Drugs worsen the CTE pathways. So, lets say youve initiated CTE by some event take alcohol, that worsens the pathway the chances of developing CTE go up, its another insult to the brain on top of the head knock, Vink says.
48 hours abstaining from drug and alcohol consumption, rest and monitored sleep, and avoiding strenuous activities like reading, television and screen use are among the current best practice care recommendations from Connectivity, a leading brain injury awareness organisation in Australia.
Understanding the physical and chemical changes that take place within the brain is crucial in the quest to provide clarity and information to communities around mild TBI and concussion: what it is, how to manage it, and when a person can return to participate in the activities they love.
When it comes to the sudden impact of biomechanical force on the brain, few, if any, sports are spared. Now science is revealing the potential extent of repeat head injury, codes are mobilising to respond.
But athletes, and the communities around them, also need definitive diagnosis of brain injuries, their seriousness, and to be given clearer management plans to ensure safe recovery.
To achieve this, neuroscientists are chasing elusive but hugely powerful biomarkers that could make the diagnosis and management much, much more effective.
Next week: The hunt for brain injury biomarkers
Continued here:
What happens in your brain when your head gets hit? - Cosmos
Bioengineered Protein May Prevent COVID Infections and Improve … – Feinberg News Center
A novel ACE2 protein developed by Northwestern Medicine investigators improved survival and prevented brain infection in mice infected with SARS-CoV-2 when administered intranasally, according to a recent study published in the journal Life Science Alliance.
SARS-CoV-2, the virus that causes COVID-19, uses the angiotensin converting enzyme 2 (ACE2) protein as a main receptor to infect healthy cells. Since the discovery of this mechanism in early 2020, the use of soluble ACE2 proteins to neutralize SAR-CoV-2 infection has been investigated as a novel therapeutic approach.
Over the last three years, investigators led by Daniel Batlle, MD, the Earle, del Greco, Levin Professor of Nephrology/Hypertension, developed a bioengineered soluble ACE2 protein and have been studying its therapeutic potential in reducing infection first in human organoids and later in mice infected with SARS-CoV-2.
The soluble protein, called ACE2 618-DDC-ABD, intercepts the spike of the SARS-CoV-2 virus before it can attach to the ACE2 receptor, preventing SARS-CoV-2 from entering and infecting healthy cells.
The natural ACE2 protein circulates in a small amount and cannot do much to really prevent the virus from attaching to the cell membrane receptor, so the cell membrane ACE2 receptor always wins. If you provide, however, enough amounts of an adequate soluble ACE2 protein at the right time, you can intercept the virus from attaching to the cell membrane receptor and getting inside the cells; this is whats known as the decoy action of soluble ACE2, Batlle said.
In previous work published in the Journal of the American Society of Nephrology, Batlles team found that when their decoy protein was administered both intranasally and intraperitoneally to mice inoculated with a lethal dose of SARS-CoV-2 virus, the mice experienced near 100 percent survival and reduced lung damage.
Our protein has the property of increased duration of action. That alone is an advantage because the virus is not going to take a holiday break and you want something that stays around for days. Moreover, we modified it further so that the binding power for the virus is enhanced, Batlle said.
In the current study, Batlles team studied the efficacy of this treatment approach by administering their decoy protein, comparing intranasal administration to intraperitoneal (by injection) administration to mice, either before or after infection with SARS-COV-2.
Overall, five-day survival rates were zero percent in the untreated mice, 40 percent in the mice treated intraperitoneally before SARS-COV-2 inoculation, and 90 percent in the mice treated intranasally before SARS-COV-2. Additionally, in the mice treated intranasally, the investigators found the mice had undetectable viral presence in the brain and reduced viral presence and pathology in the lungs.
We expected a difference between intranasal and systemic administration, better by the nasal route, but perhaps not of the magnitude observed, Batlle said.
In the future, Batlle said that ideally their protein could be developed into an anti-viral nasal spray that could be used by patients and healthcare providers the moment they test positive for SARS-CoV-2 or after exposure to infected individuals.
This study demonstrates that soluble ACE2 protein is most effective against the SARS-CoV-2 virus when administered by the intranasal route. We envision that intranasal inhalation of soluble ACE2 could become a new anti-viral strategy, especially when given topatients at risk and medical personnel in hospitals who are constantly exposed to the virus or to people recently infected, said Jan Wysocki, MD, PhD, research associate professor of Medicine in the Division of Nephrology and Hypertension and a co-author of the study.
Luise Hassler, a former research scholar in the Division of Nephrology and Hypertension, was the lead author of the study. Jared Ahrendsen, MD, PhD, assistant professor of Pathology in the Division of Neuropathology, was also a co-author.
This work was supported by the National Institutes of Health grant 1R21 AI166940-01, a gift from the Joseph and Bessie Feinberg Foundation, and the Biomedical Education Program.
See the article here:
Bioengineered Protein May Prevent COVID Infections and Improve ... - Feinberg News Center
My Fathers Brain: Life in the Shadow of Alzheimers – Next Big Idea Club Magazine
Sandeep Jauhar is a New York Times bestselling author and a practicing cardiologist. He writes regularly for the New York Times and has appeared on National Public Radio and MSNBC. His essays have been published in The Wall Street Journal, Time, and Slate.
Below, Sandeep shares five key insights from his new book, My Fathers Brain: Life in the Shadow of Alzheimers. Listen to the audio versionread by Sandeep himselfin the Next Big Idea App.
My father became cognitively impaired in what has been called a hypercognitive world. In this world, swirling with information, we prioritize intellect and reason as predominant virtues. If you do not possess these virtues, you are marginalized. If you cant follow or add to the endless conversation, you are rendered invisible. So, when my fathers cognition degenerated, he became largely invisible to the outside world.
This happened to my father in his own family, too. I wish I could say that we were more patient than the world outside, but we werent. The Etch-a-Sketch that was his Alzheimers mind trapped him in a perpetual present, and his children in perpetual frustration. He is helpless. He wont remember. He is like a child now. We would say those things in front of him, sometimes even to him. There was little to deter us, even as we regretted it, again and again, after the fact. We knew that our father was more than just his damaged brain, we knew it, but we struggled to believe it.
The risk of Alzheimers is twice as high in the loneliest persons as compared with those who have the most social support. Even after controlling for other factors, such as cognitive and physical activity, neuropathology is not the sole driver of clinical dementia.
Moreover, brain damage and the degree of clinical dementia are not as strongly correlated as one might expect. Patients with only a small amount of brain damage often have excess disability out of proportion to their neurological impairment. The converse is also true: Patients with an excess of brain damage may be surprisingly cognitively intact. The usual explanation for this discrepancy is cognitive reserve or higher educational levels, prior intelligence, and so on. However, what is rarely acknowledged is the vital role of psychosocial reserve, relationships, environment, and family support. Studies have shown that this may be just as important in Alzheimers disease as neuropathology.
When our parents got sick, my siblings and I joined the ranks of the 15 million or so unpaid (and untrained) family caregivers for older adults in this country. The busiest half of this largely invisible workforce spends, on average, nearly 30 hours a week providing care to relatives. Many of these relatives have dementia and it amounts to more than $400 billion worth of annual unpaid time. The work takes its toll and these relatives are at increased risk of developing depression, as well as physical and career difficulties, including loss of job productivity. Being sick and elderly in this country can be terrifying, and having a sick and elderly loved one is a full-time job.
In the U.S., government support for dementia care is largely nonexistent. Of the $200 billion in total annual costs for dementia care, Medicare pays only $11 billion. The shortfall is covered by families, to the tune of $80,000 per family per yearalmost double the outlay for cancer or heart disease. Long-term care insurance may help with this burden; however, most Americans dont own, or cannot afford such policies. Therefore, most of the burden of elder care ends up being borne by family caregivers, unless families can afford to hire private help.
When my father was declining from Alzheimers disease, one of the things my siblings and I used to argue about was how much to correct or accommodate his confusions. For example, my father, in his impaired state, expected his live-in aide to work for free and would lash out at her (and us) whenever he learned that she had been paid. My siblings tended to think that it was fine to lie to him and tell him she was receiving no money from us. More pragmatic than I, they had no reservations about employing deception to help our father (and themselves) get through one of his rancorous moods.
I fought against this practice as a matter of principle. To me, a healthy relationship with our father, even in his debilitated state, could only be based on truth and trust. Little lies, even if told with the best of intentions, would erode what little connection we had left with him.
However, while doing the hard work of caring for my father, I came to learn that truth-telling can be a double-edged sword. I came to understand that the relationship between ethics and treatment in dementia is a complicated one. The demands of truth-telling exist in tension with other moral imperatives, such as a sons obligation to do the best for his declining father. Personal ethics, I discovered, may come into conflict with the reality of caregiving.
I remember one day after my father kicked his caregiver out of the house, I took her back to him. I knew that if she left, that would surely be the end of my fathers independent living. He would undoubtedly end up in a locked memory unit like so many dementia patients.
Look, Dad, Harwinder came back, I said. He eyed her suspiciously.
She says she is sorry, I said. She told me she will work for free. No money. Just food and shelter.
His face relaxed, and I discerned a faint smile. Okay, he said, Please come in.
I remember so many details from our first year in America, nearly five decades ago, when I was just eight years old. There was a lawn mower in the backyard whose engine imprinted a coin-sized burn on my thigh. There was a small woodshed that housed shovels, gardening tools, and various rusted hulks. In the middle of the yard was a grand oak tree with a tire swing. I can still see my father sitting on a lawn chair under that tree, his fingers caked with soil, his cold beer trickling condensation, predicting how bountiful the harvest would be that fall.
But did it all really happen this way? Was the garden really visible through the kitchen window? Was that window really framed by frilly white curtains? Memory construction, psychologists say, involves a tension between two opposing principles. Correspondence tries to force our memories to agree with the original event that we experienced. It is how most of us view memory: as a true reproduction of something that occurred in the past.
The principle of coherence, on the other hand, transforms our memories to make them consistent with the way we see ourselves and the world in the present. Through coherence, our memories are reconstructed to support our current values or beliefs and these beliefs may not allow us to see things the way they really happened. Those kitchen curtains may now be white to reflect the nostalgia with which I reflect, 45 years later, on my familys first year in America. Hence, autobiographical memories involve a balance of two conflicting forces, one aiming to represent the past the way it was, the other aiming to reconstruct the past in the way that we need to see it today.
To listen to the audio version read by author Sandeep Jauhar, download the Next Big Idea App today:
Excerpt from:
My Fathers Brain: Life in the Shadow of Alzheimers - Next Big Idea Club Magazine