Tag Archives: Harvard Medical School

HARVARD STUDY: VITAMIN D LOWERS THE RISK OF YOUNG-ONSET COLORECTAL CANCER

COMMENTARY:

Vitamin D has many beneficial effects, but my comments will be restricted to the effect of vitamin D on cancer.

Interest in this association was started by the observation that certain cancers are less common near the equator, where there is more sunlight exposure, and therefore more natural vitamin D generation in your skin.
The most information on cancer in humans Is available on colorectal, breast, prostate, and pancreatic cancer. Colorectal cancer, highlighted DWW our posting, is the only cancer that apparently is affected by vitamin D.

Several studies have suggested that vitamin D can decrease cancer cell growth, stimulate cell death, and reduce cancer blood vessel formation. Increasing cell death, or apoptosis, is what interests me the most, since this is one of the factors which increases inflammation in aging.

The infographics stated that only 300 international units of vitamin D is necessary to produce a 50 Percent reduction in cancer, and that a healthy diet generally supplies this.

I personally take 5000 international units vitamin D. This produces a blood level of about 60 ng/mL, and what the NFL recommends to keep their players healthy, and well within the maximum recommended level of 120 ng/milliliter.

Excessive vitamin D can produce an elevated calcium blood level, and mine is within normal limits. I take the higher dose because of vitamin D’s other effects, such is benefiting the immune system in a time of Conid-19.

I suggest that you get a vitamin D blood level, and also a calcium blood level if you elect to take more of this useful vitamin.

–Dr. C

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ATHEROSCLEROSIS: STRESS, LACK OF SLEEP & EXERCISE AND POOR DIET RAISE RISKS

Swirski acknowledged that “there is no question” that genetics play a role in cardiovascular health, but in the last several years, four risk factors — stress, sleep interruption or fragmentation, diet, and sedentary lifestyle — have been clearly identified as contributing to atherosclerosis, commonly referred to as hardening of the arteries, which can lead to a variety of complications, including death.

VIEWS: IS U.S. HEALTHCARE SYSTEM BROKEN? (HARVARD)

Here’s a question that’s been on my mind and perhaps yours: Is the US healthcare system expensive, complicated, dysfunctional, or broken? The simple answer is yes to all.

Below are 10 of the most convincing arguments I’ve heard that our system needs a major overhaul. And that’s just the tip of the iceberg. Remember, an entire industry has evolved in the US just to help people navigate the maddeningly complex task of choosing a health insurance plan.

The cost is enormous

  • High cost, not highest quality. Despite spending far more on healthcare than other high-income nations, the US scores poorly on many key health measures, including life expectancy, preventable hospital admissions, suicide, and maternal mortality. And for all that expense, satisfaction with the current healthcare system is relatively low in the US.
  • Financial burden. High costs combined with high numbers of underinsured or uninsured means many people risk bankruptcy if they develop a serious illness. Prices vary widely, and it’s nearly impossible to compare the quality or cost of your healthcare options — or even to know how big a bill to expect. And even when you ask lots of questions ahead of time and stick with recommended doctors in your health insurance network, you may still wind up getting a surprise bill. My neighbor did after knee surgery: even though the hospital and his surgeon were in his insurance network, the anesthesiologist was not.

Access is uneven

  • Health insurance tied to employment. During World War II, healthcare was offered as a way to attract workers since employers had few other options. Few people had private insurance then, but now a layoff can jeopardize your access to healthcare.
  • Healthcare disparities. The current US healthcare system has a cruel tendency to delay or deny high-quality care to those who are most in need of it but can least afford its high cost. This contributes to avoidable healthcare disparities for people of color and other disadvantaged groups.
  • Health insurers may discourage care to hold down costs. Many health insurance companies restrict expensive medications, tests, and other services by declining coverage until forms are filled out to justify the service to the insurer. True, this can prevent unnecessary expense to the healthcare system — and to the insurance company. Yet it also discourages care deemed appropriate by your physician.

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Dr. C Commentary:

Please refer to the DWWR Posting on “concierge doctors” for my rant on the current healthcare system, which I will not repeat.

The truth is more nuanced. All countries are having trouble of one sort or another with their healthcare systems. This is due to the inherent expense of today’s top flight medicine. The very best care requires costly high technology and drugs that are intrinsically hard to produce. And you have to know where to look. I am very thankful for my medical degree, and that I have kept up with current advances.

You would probably need a Government entirely of physicians to develop the willpower to do something for health, which always starts with PREVENTATIVE MEDICINE, A hard sell, given that you must spend money and effort to block something which will probably, but may not always, occur.

There is low hanging fruit. Why are sugary drinks not heavily taxed, since they produce obesity which causes a lot of costly medical disorders, such as diabetes, inflammatory diseases, and cancer, but not everybody all the time?

Why is efficiency of telehealth not more widely embraced, but stymied by moneymaking lobbiests and lawyer powered difficulties, in addition to Patient’s and doctor’s old habits?

And then there are the jealously guarded  American freedoms to do stupid things, such as avoid vaccines and masks, even in a prodigiously expensive and dangerous Covid  epidemic.

Given human nature, a complete solution would seem to be impossible, and we should content ourselves with minor victories wherever they can be attained.

Embrace sleep, diet, and exercise, and KEEP HEALTHY.

–Dr. C

Intensive Care Views: ‘Pain & Airway Management’

Pain Management in the Intensive Care Unit.

Institution: Department of Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin & Massachusetts General Hospital, Harvard Medical School, Boston

HEALTH: ‘RISKS & BENEFITS OF AI REVOLUTION IN MEDICINE’

It has taken time — some say far too long — but medicine stands on the brink of an AI revolution. In a recent article in the New England Journal of Medicine, Isaac Kohane, head of Harvard Medical School’s Department of Biomedical Informatics, and his co-authors say that AI will indeed make it possible to bring all medical knowledge to bear in service of any case.

Properly designed AI also has the potential to make our health care system more efficient and less expensive, ease the paperwork burden that has more and more doctors considering new careers, fill the gaping holes in access to quality care in the world’s poorest places, and, among many other things, serve as an unblinking watchdog on the lookout for the medical errors that kill an estimated 200,000 people and cost $1.9 billion annually.

“I’m convinced that the implementation of AI in medicine will be one of the things that change the way care is delivered going forward,” said David Bates, chief of internal medicine at Harvard-affiliated Brigham and Women’s Hospital, professor of medicine at Harvard Medical School and of health policy and management at the Harvard T.H. Chan School of Public Health. “It’s clear that clinicians don’t make as good decisions as they could. If they had support to make better decisions, they could do a better job.”

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STUDY: “ANTI-INFLAMATORY” DIET OF VEGETABLES, FRUITS, COFFEE & TEA LOWERS HEART DISEASE AND STROKE RISKS

Dietary patterns with a higher proinflammatory potential were associated with higher CVD risk. Reducing the inflammatory potential of the diet may potentially provide an effective strategy for CVD prevention.

Background

Inflammation plays an important role in cardiovascular disease (CVD) development. Diet modulates inflammation; however, it remains unknown whether dietary patterns with higher inflammatory potential are associated with long-term CVD risk.

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TELEHEALTH: ‘ADVANTAGES & DISADVANTAGES’ (HARVARD)

Telehealth is defined as the delivery of health care services at a distance through the use of technology. It can include everything from conducting medical visits over the computer, to monitoring patients’ vital signs remotely. Its definition is broader than that of telemedicine, which only includes the remote delivery of health care.

Telehealth can be delivered in one of three ways:

  • Synchronous—when the doctor communicates with the patient in real time via computer or telephone
  • Asynchronous—when data, images, or messages are recorded to share with the doctor later
  • Remote patient monitoring—when measurements such as weight or blood pressure are sent to the health care provider

What you can do with telehealth

All of the following activities and services are possible with the help of telehealth:

  • Recording measurements like your weight, food intake, blood pressure, heart rate, and blood sugar levels either manually, or through a wearable device, and sending them to your doctor.
  • Having a virtual visit with your doctor or a nurse over your computer or smartphone.
  • Using an online portal to check your test results, request prescription refills, send your doctor a message, or schedule an appointment.
  • Sharing information such as your test results, diagnoses, medications, and drug allergies with all of the providers you see.
  • Coordinating care between your primary care provider and any specialists you visit—including the sharing of exam notes and test results between medical offices in different locations.
  • Getting email or text reminders when you’re due for mammograms, colonoscopies, and other screenings, or routine vaccinations.
  • Monitoring older adults at home to make sure they are eating, sleeping, and taking their medications on schedule.

Downsides to telehealth

Telehealth offers a convenient and cost-effective way to see your doctor without having to leave your home, but it does have a few downsides.

  • It isn’t possible to do every type of visit remotely. You still have to go into the office for things like imaging tests and blood work, as well as for diagnoses that require a more hands-on approach.
  • The security of personal health data transmitted electronically is a concern.
  • While insurance companies are increasingly covering the cost of telehealth visits during the COVID-19 pandemic, some services may not be fully covered, leading to out-of-pocket costs.

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Telecardiology: Wearable Devices Monitoring Heart Patients Using AI (Harvard)

In the future, remote monitoring of health data using wireless–enabled devices that measure a person’s weight, blood pressure, blood sugar, pulse, and heart rhythm could further advance telehealth’s promise.

“I imagine a world where we are continuously monitoring key health factors and using artificial intelligence to monitor those signals,” says Dr. Schwamm. 

From a patient’s perspective, virtual visits save a lot of time. You don’t need to take time off work or other commitments to drive, park, and sit in a waiting room before your visit. And even though you’re not in the same room, you may actually get more direct eye contact with your physician, thanks to the face-to-face nature of video calling.

Another advantage: you may be able to have another person — such as a family member who lives across town or across the country — join the video call. That could be especially helpful if you’re facing an upcoming procedure or discussing a serious health concern. Just as with in-person visits, it’s nice to have another person listening, asking questions, and taking notes.

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STUDIES: CHRONIC SLEEP DEPRIVATION CAUSES TOXIC CHANGES IN GUT HEALTH, INCREASED EARLY MORTALITY

From Harvard Medical School (June 4, 2020):

“We took an unbiased approach and searched throughout the body for indicators of damage from sleep deprivation. We were surprised to find it was the gut that plays a key role in causing death,” said senior study author Dragana Rogulja, assistant professor of neurobiology in the Blavatnik Institute at HMS.

The first signs of insufficient sleep are universally familiar. There’s tiredness and fatigue, difficulty concentrating, perhaps irritability or even tired giggles. Far fewer people have experienced the effects of prolonged sleep deprivation, including disorientation, paranoia, and hallucinations.

Total, prolonged sleep deprivation, however, can be fatal. While it has been reported in humans only anecdotally, a widely cited study in rats conducted by Chicago-based researchers in 1989 showed that a total lack of sleep inevitably leads to death. Yet, despite decades of study, a central question has remained unsolved: Why do animals die when they don’t sleep?

Now, Harvard Medical School (HMS) neuroscientists have identified an unexpected, causal link between sleep deprivation and premature death.

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Podcasts: “The Usefulness of Telehealth and Digital Health During COVID-19 “

In the current times that we live in health care professionals are looking for ways to provide safe, quality care from a distance. Telehealth and Digital health are proving to be the perfect tools during this COVID-19 pandemic. 

PART I

In today’s episode Part I, we are joined with Dr. Amit Sachdev and Dr. Curtis Lowery. Dr. Sachdev is a physician most recently at the Brigham and Women’s Hospital, Harvard Medical School and he is currently working on the COVID response.

Dr. Curtis Lowery is the director of the UAMS Institute for Digital Health and Innovation. He also serves as a professor for the UAMS Department of Obstetrics and Gynecology. This episode is in two parts and it serves as an introduction to telehealth and digital health amidst the COVID-19 pandemic.

PART II

In part 2 of our conversation with Dr. Amit Sachdev and Dr. Curtis Lowery over the usefulness of telehealth and digital health during the COVID-19 pandemic. Dr. Sachdev is a physician most recently at the Brigham and Women’s Hospital, Harvard Medical School and he is currently working on the COVID response. Dr. Curtis Lowery is the director of the UAMS Institute for Digital Health and Innovation. He also serves as a professor for the UAMS Department of Obstetrics and Gynecology. Let’s continue the conversation.

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