Lung Cancer Diagnosis: Robotic Bronchoscopy

Robotic GPS system for early lung cancer detection.

Lung cancer typically is diagnosed at a later stagethan other malignancies, due to the lack of early warning indications. In 2020 it was China’s most common cancer and the leading cause of cancer-associated mortality. LungHealth MedTech, a medical robotics company in Shanghai, has developed a robotic-assisted bronchoscopy platform that can address some of the current diagnostic challenges and treatment limitations.

Health: American Heart Association Checklist

The American Heart Association (AHA) recently revised its checklist for achieving optimal heart health, introducing its new Life’s Essential 8. The list replaces the AHA’s decade-old Life’s Simple 7.

Sleep health is the new addition to the cardiovascular health scoring tool, which now advises that adults get seven to nine hours per night. The organization updated four of the categories:

  • Diet: More emphasis was given to following heart-healthy diets like the DASH and Mediterranean.
  • Nicotine exposure: Secondhand smoke and vaping were added as risk factors.
  • Blood lipids: People now can get a non-fasting blood sample that measures total, HDL, and non-HDL cholesterol. Non-HDL cholesterol can provide similar risk information as LDL cholesterol.
  • Blood sugar: Measurements now include hemoglobin A1c, a key component to assessing type 2 diabetes risk.
  • Three categories were unchanged:
  • Physical activity: The optimal weekly level is at least 150 minutes of moderate activity or 75 minutes of vigorous activity.
  • Body mass index (BMI): A BMI of 18.5 to 24.9 is ideal for heart health.
  • Blood pressure: Levels less than 120/80 millimeters of mercury (mm Hg) remain optimal. Stage 1 hypertension is 130 to 139 mm Hg for systolic pressure (the first number) or 80 to 89 mm Hg for diastolic pressure (the second number).
  • You can calculate your heart health score at mlc.heart.org. The guidelines were published online June 29, 2022, by Circulation.

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Women’s Health: Finding A Lump In Your Breast (JHM)

Johns Hopkins Medicine: What To Do When You Find a Lump in Your Breast? Breast imaging radiologist, Emily Ambinder discusses common questions one may have when discovering a lump in the breast.

Video timeline: 0:03 Why do lumps form in the breast? 026 What are the different types of lumps? 0:55 Can breast lumps form because of physical impact? Could those lumps become cancerous? 1:23 What do i do if i have found a lump? 1:47 What makes breast imaging at Johns Hopkins different? 2:01 What is a mammogram? 2:29 What is a breast ultrasound? 2:53 What else do I need to do if I have a lump?

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Medicine: Parkinson’s Disease And Bone Health

Keeping bones healthy is important for everyone and especially important for people with Parkinson’s. We share some top tips for keeping your bones in tip top condition.

Key points

  • Bone health is important for everyone, but especially if you have Parkinson’s. 
  • You are at more risk of getting osteoporosis when you have Parkinson’s, which can weaken bones and make them more likely to break.
  • Your healthcare team can assess you and may prescribe medication to help improve your bone health. 
  • Strength exercises and maintaining a good diet can also help. 

What is bone health?

Bone health really means having ‘healthy bones’. Healthy bones are strong enough to prevent fractures, for example when we have a fall. Our bones are more healthy when we have enough calcium in our diet (from milk, and dairy products like cheese) and when we use our arms and legs (such as with exercise).

Find out more https://www.parkinsons.org.uk/informa…

Research: ‘Rejuvenating The Aging Brain’ (Scripps)

REJUVENATING THE AGING BRAIN

As humans live longer, they’re at increased risk of developing devastating NEURODEGENERATIVE diseases, such as Alzheimer’s—in a treatment landscape with few options and little hope. At Scripps Research, scientists are closer than ever to understanding how these diseases harm the brain and identifying possible drugs to stop them.

“This early preclinical work may identify proteins that protect against cognitive loss. We know it’s a long path to get to a drug, but we’re creating the foundation. We know there’s an entire landscape of potential molecular interactions that maintain healthy synapses, and any of these proteins could be a drug target.”— Hollis Cline, PhD

Science: New Research Into Diseases Of The Brain

Take an animated look inside the neuron, and learn how scientists are addressing brain disease. With approximately 86 billion neurons in the brain, humans contain the most complex communications network imaginable. To address diseases of brain development and degeneration, neuroscientists are investigating how and why this network breaks down, and what can be done to repair it.

One area of study is dendrites, which are the tree-like structures of neurons, that receive electrical impulses. Researchers are carefully mapping out brain circuits and uncovering how connectivity changes can result in defects of the visual system or behavioral problems. The core section of the neuron is the cell body. Genetic engineering tools are revealing how mutations impact brain development and contribute to autism spectrum disorder or rare, inherited forms of neurological disease.

The transmission of nerve impulses occurs along the axon, which is insulated, much like an electrical wire, by a fatty layer called the myelin sheath. Scientists have invented a medicine to stop the immune system from mistakenly attacking this layer, which occurs during multiple sclerosis. Other molecules currently in development instruct the body to regenerate the sheath and repair damage. The axon also transports valuable cellular cargo, such as neurotransmitters, along tracks from one end of the neuron to the other.

Researchers are testing drug candidates for their ability to remove molecular traffic jams when this transport system fails, as often occurs in Parkinson’s and Alzheimer’s disease. The axon terminals make connections called synapses with other cells, using neurotransmitters as signals. Some scientists are evaluating how finely tuning the receptors for these chemicals could ease depression and anxiety.

Others are finding ways to promote the regrowth of lost synapses, which could halt neurodegeneration. From genetics to behavior, neuroscience is accelerating new interventions for the most challenging disorders of the nervous system.

Learn more: https://www.scripps.edu/

Women’s Health: Benefits Of An Endometriosis Diet

If you have endometriosis, you’re all too familiar with the heavy periods, pain and nausea it can cause. Eating these foods might help control the pain and make all the difference.

Chapters: 0:00 Introduction 0:10 What is endometriosis? 0:45 Eating the right foods can help the body fight inflammation 1:01 Fiber rich foods 1:41 Omega-3 fats 2:10 Monounsaturated fats 2:30 Magnesium and zinc 3:25

It’s always important to eat good, healthy food Resources: The Best and Worst Foods for an Anti-Inflammatory Endometriosis Diet – https://cle.clinic/3VeYzyG

Endometriosis: Symptoms, Causes, Treatment & Tests – https://cle.clinic/31ntZLx

NEJM: Atrial Fibrillation And Catheter Ablation

In this instructional video, Drs. Jane Leopold, Elliott Antman, William Sauer, and Paul Zei provide an overview of the classification and diagnosis of atrial fibrillation, management strategies, and mitigation of stroke risk with anticoagulation therapy.

Video timeline: 0:00 Pathophysiology and Symptoms 3:11 Stroke Risk, Anticoagulants, and Arrhythmia Control 6:32 Catheter Ablation 10:11 Post-Procedural Monitoring and Care

The video also focuses on the new rhythm-control strategy of catheter ablation therapy, with attention to the success rate, potential complications, postprocedural monitoring for recurrence of atrial fibrillation, and consideration of ongoing anticoagulation therapy in these patients. The New England Journal of Medicine is the world’s leading general medical journal.

Continuously published for over 200 years, the Journal publishes peer-reviewed research along with interactive clinical content for physicians, educators, and the global medical community at https://NEJM.org.

COMMENTARY:

This is a very good video well worth watching by general physicians and interested patients. There are several general and some specific comments I would like to make.

First, in my opinion, the best physician is none too good. In any operative or serious procedure, the decision to operate should be made by the patient in conjunction with a physician that does not do the operating. In my case, as a physician, I consulted an electrophysiologist.

Second, in my opinion, a good medicine is better than surgery. For atrial fibrillation, there has been no new medication treatment for decades. The main drugs are still amiodarone and Propafenone. The latter is less consistently effective, but has a better long-term safety profile; amiodarone often produces ‘floaters”  in the eye, and Propafenone merely a bitter taste which you’ll get used to.

Third, it must be realized that catheter ablation is often not curative, especially as you get older, which was rather glossed over in this video. Ablation also requires a great deal of expensive equipment, which is constantly evolving, hence the importance of getting your ablation at a major center where it is done all the time. These major centers have less complications such as  atrial wall perforation; Yes, you can rarely wind up worse off after any operation.

I am a physician, currently 90 years old. I developed atrial fibrillation of the persistent type when I was in my late 70s. I had a cardioversion to get me into sinus rhythm, and then tried Propafenone, which kept me in sinus rhythm for less than a month. My main motivation to get a radio frequency ablation was to stay off of anticoagulants. I had my ablation, and remained in sinus rhythm, and off anticoagulants, for three years. I could always tell when I went into atrial fibrillation from normal sinus rhythm because I produced a lot of urine and had to go to the bathroom all the time; atrial fibrillation causes release of a hormone called atrial naturetic peptide. I could also tell by taking my own pulse, which was quite irregular in comparison to my very regular sinus rhythm pulse, which ticked along with a rate in the high 50s. I had always thought my rate was low because I exercise a lot. Actually, my EKG shows a second-degree heart block which is probably partially responsible.

After three years, I returned to atrial fibrillation, and needed a another ablation. They found very few areas of abnormal electrical activity, and gave me a “touchup”, which lasted another two or three years after which I went back into atrial fibrillation. Probably as a result of my age, a fibrillated at a slow rate, and at least did not need any extra medication for rate control, although I did, of course, need to take a regular anticoagulant, in my case Eliquis.

In summary, atrial fibrillation is a common electrical storm in the upper chambers of the heart, causing a rapid, irregular beat. AF increases in frequency as you get older. In the video they mention the “substrate”, which is the structure of the atrium. In my own case, this was an enlarged atrium, and probably a tendency towards atrial fibrillation; my brother also has AF. The main complication is stagnation of blood in the atria, resulting in increased tendency toward stroke. Fibrillation therefore requires an anticoagulant.

There is some discussion about the irregular rate causing an inefficiency of cardiac action, contributing to heart failure, This is logical, but not clear cut statistically.

—Dr. C.