In one study published in JAMA Open Network, researchers found that 87% of the preliminary diagnoses made during telemedicine appointments were later confirmed during in-person appointments.
To put it simply: diagnoses over video are usually spot on.
December 2, 2022 – Researchers evaluated more than 97,000 video visits across Mayo Clinic between March and June 2020. Of those visits, 2,400 patients had a visit for a new health concern and followed up with an in-person appointment within 90 days.
The highest rate of matching telemedicine and in-person diagnoses was found in specialties that included psychiatry and psychology, allergy and immunology, orthopedics, and urology. While diagnostic concordance was slightly lower in specialties such as dermatology and ear, nose and throat (ENT), still, close to 80% of those diagnoses were confirmed in person.
“The data we analyzed suggested a nearly threefold reduction in revision surgery in patients who received bone marrow aspirate concentrate, compared to those who did not,” says Bradley Schoch, M.D., an orthopedic surgeon and principal investigator. “This procedure is growing in use throughout the practice of orthopedic surgery and commonly added as a surgical adjunct to rotator cuff tears.”
Mayo Clinic researchers analyzed the largest set of data available to determine if adding bone marrow aspirate concentrate to repaired tissue after standard rotator cuff surgery would improve outcomes for patients. Bone marrow aspirate is fluid taken from a patient’s bone marrow that contains concentrated growth factors, stem cells and other specialized cells that may regenerate tissue and cartilage.
The analysis identified 760 patients who had a regenerative intervention added to augment rotator cuff repair surgery. Those patients were compared to 3,888 patients who did not have any biologic intervention at the time of surgery. The data indicated that 114 patients who opted for bone marrow aspirate concentrate at the time of surgery were less likely to need a second surgery.
Low vitamin D levels were linked with an increased risk of both dementia and stroke over the following 11 years. Based on this observational study, people with low vitamin D levels were found to have a 54% greater chance of developing dementia compared with people whose levels were normal.
A study published online April 22, 2022, by The American Journal of Clinical Nutrition suggests vitamin D deficiency may raise risk for dementia and stroke.
The study analyzed more than 294,000 people (most of them women over 60) living in the United Kingdom. Using blood tests on all participants and neuroimaging tools on about 34,000, researchers looked for associations between vitamin D levels and risks of dementia and stroke. A normal blood vitamin D level was defined as at least 50 nanomoles per liter (nmol/L); a deficiency was defined as less than 25 nmol/L.
Often described as the silent thief of sight, glaucoma is the most common cause of irreversible blindness in the world. High pressure in the eye damages the optic nerve, first stealing peripheral vision (what you see at the corners of your eyes) and later harming central vision (what you see when looking straight ahead). Usually, people notice no symptoms until vision loss occurs.
Lowering high eye pressure is the only known treatment to prevent or interrupt glaucoma. But does everyone with higher-than-normal eye pressure need to be treated? A major long-term study provides some clues, though not yet a complete answer.
Does everyone with high eye pressure develop glaucoma?
In the US, glaucoma affects an estimated three million people, half of whom do not know that they have it. An ophthalmologist can perform a comprehensive eye exam to determine if someone has glaucoma, or is at risk for developing it in the future due to high eye pressure (ocular hypertension). Research from the long-running Ocular Hypertension Treatment Study (OHTS) shows that some people with high eye pressure may never develop glaucoma, while others will.
Consuming just a half-tablespoon or more of olive oil a day is linked to a lower risk of dying from heart disease and other chronic health conditions, new research suggests.
The study included more than 92,000 women and men from the Nurses’ Health Study and the Health Professionals Follow-up Study, who filled out diet questionnaires every four years for 28 years. Olive oil intake was calculated from how much they reported using in salad dressings, on bread and other food, and in baking or frying.
Compared with participants who rarely or never consumed olive oil, those who consumed the most (about a half-tablespoon or more daily) had a 19% lower risk of dying from heart disease during the study. Researchers also noted lower death rates over all among people who substituted olive oil for a similar amount of margarine, butter, mayonnaise, or dairy fat. The findings, published Jan.18, 2022, in the Journal of the American College of Cardiology, lend further support for choosing olive oil — a key component of the heart-friendly Mediterranean diet.
People with knee osteoarthritis may reduce their risk of knee pain by walking more, according to a study published online June 8, 2022, by Arthritis & Rheumatology.
Researchers looked at the walking habits of more than 1,200 people with knee osteoarthritis (average age 63, 45% men). They were asked how often they walked for exercise since age 50 and whether they had frequent knee pain. X-rays were done to assess structural knee damage.
The investigators first looked at participants who did not report regular knee pain. They found that among this group, those who walked for exercise were less likely to later develop knee pain (26%) at the follow-up eight years later compared with those who did not walk for exercise (37%).
Researchers have identified universal features of the inflammatory responses of patients who successfully recovered after surgery or acute illnesses https://t.co/DwYOMYOcSV
Inflammation is the body’s first line of defense, occurring as droves of immune cells rush to the site of injury or acute illness to make repairs and stem further damage.
When successful, inflammation helps the body survive and heal after trauma. However, when recovery following an inflammatory response goes awry, it signals that damage is still occurring — and the inflammation itself can cause further injury, leading to more-severe illness or even death.
But what differentiates a good inflammatory recovery from a bad one?
The scientists identified universal features of the inflammatory responses of patients who successfully recovered after surgery or acute illnesses such as COVID-19, heart attack, and sepsis. These features, they discovered, include precise paths that white blood cell and platelet counts follow as they return to normal.
In December 2020, a week before cardiologist Stuart Katz was scheduled to receive his first COVID-19 vaccine, he came down with a fever. He spent the next two weeks wracked with a cough, body aches and chills. After months of helping others to weather the pandemic, Katz, who works at New York University, was having his own first-hand experience of COVID-19.
On Christmas Day, Katz’s acute illness finally subsided. But many symptoms lingered, including some related to the organ he’s built his career around: the heart. Walking up two flights of stairs would leave him breathless, with his heart racing at 120 beats per minute. Over the next several months, he began to feel better, and he’s now back to his normal routine of walking and cycling. But reports about COVID-19’s effects on the cardiovascular system have made him concerned about his long-term health. “I say to myself, ‘Well, is it really over?’” Katz says.
In one study1 this year, researchers used records from the US Department of Veterans Affairs (VA) to estimate how often COVID-19 leads to cardiovascular problems. They found that people who had had the disease faced substantially increased risks for 20 cardiovascular conditions — including potentially catastrophic problems such as heart attacks and strokes — in the year after infection with the coronavirus SARS-CoV-2. Researchers say that these complications can happen even in people who seem to have completely recovered from a mild infection.
Some smaller studies have mirrored these findings, but others find lower rates of complications. With millions or perhaps even billions of people having been infected with SARS-CoV-2, clinicians are wondering whether the pandemic will be followed by a cardiovascular aftershock. Meanwhile, researchers are trying to understand who is most at risk of these heart-related problems, how long the risk persists and what causes these symptoms.
COMMENTARY:
The heart and Covid are connected from a variety of angles.
Obese people with high blood fats, diabetes, the metabolic syndrome tend to have atherosclerosis and heart problems, making them more susceptible to severe Covid and long Covid. Covid loves to involve the lining of blood vessels and the heart, the endothelium, where the number of ACE receptors are high.
The respiratory tract and lung are a particular target for Covid, and reduced oxygen from lung involvement can compromise the hard-working heart.
Heart cells, cardio myocytes, can be directly infected with the virus. Even Covid vaccines can rarely produce myocarditis, raising the possibility that there is some antigenic similarity between the virus and heart cells, similar to the beta hemolytic streptococcus and the heart which sets up rheumatic fever.
If this similarity is real, the tendency of Covid to compromise the immune system and produce a cytokine storm in severe cases could therefore specifically involve the heart.
The nature article indicates several different varieties of heart problems and is a recommended read. From my personal standpoint, arrhythmias were mentioned, and I already have trouble with a couple of different types, AF and NSVT.
To make definite statements about the likelihood of heart involvement in Covid is problematic. The patients reported on were infected with an earlier strain of Covid, and the present one, BA.5, seems to be milder, and may not be as hard on the heart as previous strains. Many more people are now immunized, and the most susceptible patients may have passed away. There are medications to take, such as remdesivir, and even select immune globulins, such as an immuno-suppressed friend of mine was given when he contracted Covid recently.
The bottom line for me is that I am 90 years old and have no desire to let Covid have a crack at me, so I avoid big gatherings, and wear a mask whenever I am exposed.
Using a smartwatch capable of estimating blood oxygen levels & recording an electrocardiogram could be an effective way to remotely monitor people at home following a minimally invasive heart valve replacement, according to a recent study. https://t.co/pIkchmOPTA#HarvardHealth
Smartwatches just keep getting smarter: the latest versions can estimate your blood oxygen level and record an ECG (a measurement of your heart’s electrical activity). A new study suggests these sophisticated devices may provide a safe, accurate way to monitor people at home after they undergo a minimally invasive heart valve replacement procedure.
The study included 100 people who had a transcatheter aortic valve replacement, most of whom went home within a day or two after the procedure. All received a smartwatch that recorded their heart rate, steps, pulse, oxygen saturation, and an ECG measurement. During next 30 days, the smartwatch detected 29 of 38 heart-related problems — mostly heart rhythm abnormalities — among 34 participants.
The findings suggest that smartwatches could be an effective way to remotely monitor patients from home, say the authors, whose study was published March 29, 2022, in the Journal of the American Heart Association.
A new study suggests a high-fiber diet may protect against dementia. In a group of about 3,700 older adults, those who consumed the most fiber had the lowest rates of dementia, and those who ate the least fiber had the highest rates: https://t.co/XbUNndYghs#HarvardHealth
Fiber is known for keeping your digestive system healthy and lowering cholesterol levels. Now, study findings suggest it also may protect the brain from dementia.
The study involved approximately 3,700 healthy adults, ages 40 to 64, who completed routine dietary surveys for 16 years. Researchers then monitored the participants for two decades to see which ones developed dementia. The study revealed that people who consumed the most daily fiber had the lowest rates of dementia. The reverse also was true — those who ate the least fiber had the highest rates. Specifically, the low-risk group consumed an average of 20 grams daily, while those with the highest risk averaged only 8 grams. (The USDA recommends that men over age 50 eat 30 grams of fiber daily.)
Empowering Patients Through Education And Telemedicine
Doctors Without Waiting Rooms 