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.
Tag Archives: Videos
HEALTH: VALUE OF A HEALTHY ‘SKIN MICROBIOME’ (VIDEO)
Our skin is home to billions of microorganisms, the vast majority of which are bacteria. Much like the microbiome in our gut, these microbes play a crucial part in keeping us healthy. They are part of a finely balanced ecosystem of friendly or ‘commensal’ bacteria, which protect our skin by creating an inhospitable environment for would-be invaders, bolstering the physical integrity of the skin, and training the immune system to distinguish commensal inhabitants from pathogens. A number of skin conditions are now understood to be influenced by a breakdown of this microbial ecosystem. Researchers are working out whether restoring the balance can treat these conditions. Understanding the ecology of this rich community is likely to be an important part of both dermatology and the study of the microbiome. Read more in https://www.nature.com/collections/sk…
HEALTH: WHAT ARE ‘SALIVA TESTS FOR COVID-19’? (VIDEO)
Screening testing is one tool the University of Pennsylvania is using to help reduce the risk of COVID-19 spread within the University community. That’s why we’re performing saliva-based viral testing for students, faculty, postdocs, and staff who are on campus.
HEALTH: HOW ‘STATINS’ PREVENT HEART ATTACKS AND STROKES’ (CDC VIDEO)
Statins are a type of medication used to lower the level of bad cholesterol in the blood and reduce build-up in arteries that can cause a heart attack or stroke. This short animated video explains the importance of statins, how they work, and why your doctor may prescribe them.
MEDICINE: ‘THREE CRITICAL BREAKTHROUGHS IN STROKE RESEARCH’ (YALE VIDEO)
Stroke is far more common than you might realize, affecting more than 795,000 people in the U.S. every year. It is a leading cause of death and long-term disability. Yet until now, treatment options have been limited, despite the prevalence and severity of stroke.
Not so long ago, doctors didn’t have much more to offer stroke victims than empathy, says Kevin Sheth, MD, Division Chief of Neurocritical Care and Emergency Neurology. “There wasn’t much you could do.” But that is changing. Recent breakthroughs offer new hope to patients and families. Beating the Clock Think of stroke as a plumbing problem in the brain. It occurs when there is a disruption of blood flow, either because of a vessel blockage (ischemic stroke) or rupture (hemorrhagic stroke).
In both cases, the interruption of blood flow starves brain cells of oxygen, causing them to become damaged and die. Delivering medical interventions early after a stroke can mean the difference between a full recovery and significant disability or death. Time matters. Unfortunately, stroke care often bottlenecks in the first stage: diagnosis. Sometimes, it’s a logistical issue; to identify the type, size, and location of a stroke requires MRI imaging, and the machinery itself can be difficult to access.
MRIs use powerful magnets to create detailed images of the body, which means they must be kept in bunker-type rooms, typically located in hospital basements. As a result, there is often a delay in getting MRI scans for stroke patients. Dr. Sheth collaborated with a group of doctors and engineers to develop a portable MRI machine. Though it captures the images doctors need to properly diagnose stroke, it uses a less powerful magnet. It is lightweight and can be easily wheeled to a patient’s bedside.
“It’s a paradigm shift – from taking a sick patient to the MRI to taking an MRI to a sick patient,” says Dr. Sheth. Stopping the Damage Once a stroke has been diagnosed, the work of mitigating the damage can begin. “Brain tissue is very vulnerable during the first hours after stroke,” says vascular neurologist Nils Petersen, MD. He and his team are using advanced neuro-monitoring technology to study how to manage a patient’s blood pressure in the very acute phase after a stroke.
Dr. Petersen’s research shows that optimal stroke treatment depends on personalization of blood pressure parameters. But calculating the ideal blood pressure for the minutes and hours after a patient has a stroke can be complicated. It depends on a variety of factors—it is not a one-size-fits-all scenario. Harnessing the Immune System Launching an inflammatory reaction is how the body responds to injury anywhere in the body – including the brain, following stroke. However, in this case, the resulting inflammation can sometimes cause even more damage.
But what if that immune response could be used to the patient’s advantage? “We’re trying to understand how we can harness the immune system’s knowledge about how to repair tissues after they’ve been injured,” says Lauren Sansing, MD, Academic Chief of the Division of Stroke and Vascular Neurology. Her team is working to understand the biological signals guiding the immune response to stroke.
That knowledge can then direct the development of targeted therapeutics for the treatment of stroke that minimize early injury and enhance recovery. “We want to be able to lead research efforts that change the lives of patients around the world,” says Dr. Sansing.
Learn about these developments and more in the video above.
For more information on aneurysms or #YaleMedicine, visit: https://www.yalemedicine.org/conditio…
HEALTH: ‘AT-HOME COVID-19 TESTS’ – ON THE WAY (VIDEO)
OraSure Technologies has blazed a trail in at-home diagnostic tests. Now, the Pennsylvania-based biotech company is working to produce a quick, over-the-counter coronavirus test that consumers can take in the privacy of their home with results available in minutes. NPR’s Allison Aubrey reports.
MEDICINE: NEW ‘SMART CELL’ THERAPIES TO TREAT CANCER
Finding medicines that can kill cancer cells while leaving normal tissue unscathed is a Holy Grail of oncology research. In two new papers, scientists at UC San Francisco and Princeton University present complementary strategies to crack this problem with “smart” cell therapies—living medicines that remain inert unless triggered by combinations of proteins that only ever appear together in cancer cells.
Biological aspects of this general approach have been explored for several years in the laboratory of Wendell Lim, PhD, and colleagues in the UCSF Cell Design Initiative and National Cancer Institute– sponsored Center for Synthetic Immunology. But the new work adds a powerful new dimension to this work by combining cutting-edge therapeutic cell engineering with advanced computational methods.
For one paper, published September 23, 2020 in Cell Systems, members of Lim’s lab joined forces with the research group of computer scientist Olga G. Troyanskaya, PhD, of Princeton’s Lewis-Sigler Institute for Integrative Genomics and the Simons Foundation’s Flatiron Institute. Using a machine learning approach, the team analyzed massive databases of thousands of proteins found in both cancer and normal cells. They then combed through millions of possible protein combinations to assemble a catalog of combinations that could be used to precisely target only cancer cells while leaving normal ones alone.
In another paper, published in Science on November 27, 2020, Lim and colleagues then showed how this computationally derived protein data could be put to use to drive the design of effective and highly selective cell therapies for cancer. “Currently, most cancer treatments, including CAR T cells, are told ‘block this,’ or ‘kill this,’” said Lim, also professor and chair of cellular and molecular pharmacology and a member of the UCSF Helen Diller Family Comprehensive Cancer Center.
“We want to increase the nuance and sophistication of the decisions that a therapeutic cell makes.” Over the past decade, chimeric antigen receptor (CAR) T cells have been in the spotlight as a powerful way to treat cancer.
In CAR T cell therapy, immune system cells are taken from a patient’s blood, and manipulated in the laboratory to express a specific receptor that will recognize a very particular marker, or antigen, on cancer cells. While scientists have shown that CAR T cells can be quite effective, and sometimes curative, in blood cancers such as leukemia and lymphoma, so far the method hasn’t worked well in solid tumors, such as cancers of the breast, lung, or liver.
Cells in these solid cancers often share antigens with normal cells found in other tissues, which poses the risk that CAR T cells could have off-target effects by targeting healthy organs. Also, solid tumors also often create suppressive microenvironments that limit the efficacy of CAR T cells. For Lim, cells are akin to molecular computers that can sense their environment and then integrate that information to make decisions. Since solid tumors are more complex than blood cancers, “you have to make a more complex product” to fight them, he said.
POST COVID: “THE FUTURE OF ELDERLY CARE’ (VIDEO)
Across the rich world around half of covid-19 deaths have been in care homes. Countries need to radically rethink how they care for their elderly—and some innovative solutions are on offer.
COMMENTARY:
This video has a lot of information that would be of help to anyone who has a spouse or parent who is aging, especially if their frailty includes dementia. There were several good, general points.
As hard as it is to get old, it is even harder to be a caretaker of someone whose aging includes memory loss. Hired caretakers burn out at a high rate. The video highlighted Indonesia as a location that is compassionate, and gives quality care at about half the cost in developed countries.
The percentage of the elderly population needing care may well be 50% in 2050. I would not have guessed it, but the video asserts that 50% of individuals over 65 years of age need some help.
It is much better to stay at home, and medical sensor technology is making this increasingly possible. AI would be able to detect changes in a person’s routine that could be flagged.
Of course, it is much better to stay healthy longer. My posting “growing old” addresses this.
–Dr. C.
COVID-19 VIDEO: ‘CRITICAL CORONAVIRUS-BUSTING THERAPIES EXPLAINED’
Health experts say having a vaccine is just one front in a two-front battle against COVID-19. The other is effective treatments for those who are already sick with the disease. WSJ breaks down the three most promising types in development. Photo Illustration: Jacob Reynolds/WSJ.
TELEMEDICINE: EYE & EAR TELE-CONSULTS, PRIMARY CARE AT MOUNT SINAI (NYEE)
From tele-consults in the ED to on-site fundus imaging at Primary Care offices, New York Eye and Ear Infirmary of Mount Sinai (NYEE) is adapting to the rapidly changing healthcare environment with innovative new applications and technologies and making them a permanent part of our patient service. These approaches are not only valuable social distancing tools, to reduce coronavirus exposure of physicians, staff, and patients, but they also allow greater access to care and quicker and more effective triage of patients.
For more information about NYEE, visit www.nyee.edu
Doctors Without Waiting Rooms 