Walmart, America’s largest grocer, launched a primary care clinic called Walmart Health, in September 2019. Analysts say the big box retailer faces several hurdles in its quest to scale up nationally with a roster of highly paid doctors and dentists. But with more than 35 million people uninsured as of 2019, and millions more with high deductible health plans, could Walmart Health’s low price point be the future of healthcare in America?
Answers to December 22 Crossword Puzzle:
The common cold is one of the most frequent of human diseases, and causes billions of dollars in lost work yearly. I haven’t heard of many cases of colds or flu recently, in the Era of Covid.
Distancing, mask wearing, and hand washing prevents colds too. The common cold spreads by AEROSOL transmission, and autoinnoculation into the nose from contaminated surfaces, just like Covid.
By far the most common cause of the Common Cold is the RHINOVIRUS, of which there are 100 serotypes. Coronaviruses, Influenza, Parainfluenza, RSV and enteroviruses also produce cold-like symptoms. The large number of viruses causing the Common cold makes developing an effective vaccine difficult.
Adults eventually encounter most of the serotypes prevalent in their community, and don’t catch many colds. However, when adults travel, they experience a new, unfamiliar group of viruses endemic to their destination. How often do we take a trip and come back with a Cold, or worse. We lack immunity to the microorganisms we have not yet encountered, just like children.
When I was in pediatric allergy practice, I feared nothing so much as the cold temperatures in October. The kids would come back to school, and start getting colds, averaging 7-8 per year. It is commonly thought by researchers that cold symptoms are not produced so much by viral damage to the respiratory membranes, as by the body’s immune response to those viruses.
My experience confirms that opinion. A cold was a worry for my patients. Rhinovirus infection often triggered a severe ashmatic response, sometimes sending the children to the ER if not the Hospital ICU.
It was the allergic reaction to the virus that caused the severe wheezing. After the epidemic of Covid subsides, and becomes endemic, don’t give up all of your newly-acquired habits. Hand-washing, distancing, and even masks prevent other respiratory disease transmission too.
DR. C REVIEWS MAJOR HEALTH AND TELEMEDICAL NEWS FOR THE WEEK ENDING DECEMBER 27, 2020.
The common cold is the most common human disease in the world. So, why haven’t we found a cure yet?!
Called human rhinoviruses, these respiratory viruses measure between 15 to 30 nanometers in diameter, making them some of the smallest types of viruses out there. And it’s partly thanks to the viruses’ genetic makeup that they’re so good at replicating.
Human rhinoviruses travel like most other respiratory viruses via nasal secretions, which can be released through sneezing, or through contact with fomites, which are surfaces like a keyboard or a doorknob that can help spread the virus from one person to another. From there, all it takes is for a hand to touch one of the body’s mucous membranes like the eyes, nose, or mouth and bam — the virus has gained entry.
Soon after infection, coughing, sneezing, headaches, a mild fever and body aches can soon follow. And these symptoms may easily be confused with those of the flu. But unlike the flu, where symptoms start quite suddenly, it can take a couple of days for cold symptoms to fully develop. And they usually last anywhere from 7 to 14 days.
Normal Pressure Hydrocephalus, NPH, is an important condition. Although uncommon, affecting less than 5% of the population, it is a TREATABLE form of DEMENTIA.
If you or a loved one has been suspected of having Alzheimers or Parkinsons disease, NPH should be considered. It can be ruled out by MRI. Problems with Walking (“ Gait”) is often the first symptom, followed by mild Dementia. Loss of urinary control, incontinence, is often a later symptom.
The classic 3 symptoms are gait problems, dementia and incontinence, Hakim’s triad. A politically incorrect MNEMONIC is “wet, wacky and wobbly”. Gait “deviations”, with a broad based, slow, “stuck to the floor” movement are present almost all the time, and often suggests the more common Parkinson’s disease.
Some difficulty in planning, attention and concentration is present more than half of the time. Frequency of urination and incontinence comes later, but is often present by the time the diagnosis is made. Block in the reabsorption of Cerebrospinal fluid is thought to be the cause.
This produces intermittent elevation of pressure in the brain cavities, the ventricles. Thinning of the cortex follows, and it is this loss of brain tissue that produces the symptoms the diagnosis, usually by a Neurologist, is made by a number of tests, including MRI, and measurements of CSF Pressure.
An interesting test is to remove 30-50 cc of CSF and see if the walking improves. Treatment is with a tube connecting the Ventricles to the abdominal cavity, which restores drainage of the CSF. One of my friends was diagnosed with NPH, and benefitted with treatment. I consulted a neurologist about another of my friends with dementia, and an MRI to rule out NPH was suggested.
Treatability is the main virtue of discovering NPH, rather than another cause of dementia.
Stephen Hahn, U.S. Food and Drug Administration Commissioner, Sigal Atzmon, founder and chief executive officer of Medix Global, and Roche CEO Severin Schwan, on the pandemic, Covid-19 vaccines and the new mutation.
Technology has made it possible for people to virtually access their healthcare providers. During COVID-19, this has enabled patients and doctors to avoid excess exposure and travel for non-emergency visits. However, state and local regulations frequently limit or ban telemedicine for health and safety reasons. Should telemedicine be considered as the same or different from traditional office visits, and what regulations should govern it? Anastasia P. Boden is an attorney at the Pacific Legal Foundation.