Audio

COVID-19 UPDATE PODCAST: HOW RESEARCHERS ARE SIMULATING OUTBREAKS

Researchers have run numerous military-style simulations to predict the consequences of fictitious viral outbreaks. We discuss how these simulations work, what recommendations come out of them and if any of these warnings have been heeded.

24:08 One good thing

Our hosts pick out things that have made them smile in the last week, including audience feedback, the official end of the Ebola outbreak in the northeastern Democratic Republic of the Congo, and an enormous t-shirt collection.

News: World’s second-deadliest Ebola outbreak ends in Democratic Republic of the Congo

28:50 The latest coronavirus research papers

Benjamin Thompson takes a look through some of the key coronavirus papers of the last few weeks.

PODCASTS: TELEMEDICINE TECHNOLOGY CAN LEAVE MANY PATIENTS BEHIND

Amid the Covid-19 pandemic, more doctors are turning to telemedicine. That’s a problem for tens of millions on the wrong side of the digital divide.

SPEAKING ON A landline, the patient complained of an itchy eye. On the call’s other end, physician Carla Harwell considered the possibilities, from seasonal allergies to vision-damaging herpes. Luckily, the elderly patient’s daughter was visiting during the phone consultation, so Harwell asked her to text a picture of her mom’s eye. The photo shocked Harwell. It was the worst case of bacterial conjunctivitis the doctor had ever seen.

Without the picture, Harwell would have told the octogenarian patient to call back in a few days or come to her office, risking an in-patient visit during the Covid-19 pandemic. She certainly wouldn’t have prescribed the antibacterial eye drops needed to treat the infection. “I probably would not have prescribed anything,” Harwell says. “That’s a scary thought.”

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COMMENTARY

Telehealth is here, will remain after the pandemic, and is useful in many situations.

Being older, poorer, minority, Linguistically challenged, rural, less informed and less Tech-savvy reinforce each other in comprising Barriers to proper Medical care of ANY kind, especially Telemedicine. These handicaps will hopefully improve with time, and should be A societal priority.

Special internet-connected roving Aid-mobiles in afflicted areas is one feasible idea that would help. Responding to a lesser “911” number, the health-van could go to the calling persons location,  help the person to the van, take pictures and other data for a Telehealth Doctor to evaluate, and facilitate treatment.

A neighborhood Telehealth site is also workable, and was a precondition to Rural Telehealth access, pre-pandemic.
If you are reading this message, congratulations! You are increasing your information, technical facility and your access to better Healthcare.

—Dr. C.

PODCAST: “MEDDIET” ALTERS GUT MICRIOBIOME IN OLDER PEOPLE, IMPROVES FRAILTY, COGNITION, INFLAMMATION

We observed that increased adherence to the MedDiet modulates specific components of the gut microbiota that were associated with a reduction in risk of frailty, improved cognitive function and reduced inflammatory status. 

Dr Philip Smith, Digital and Education Editor of Gut and Consultant Gastroenterologist at the Royal Liverpool Hospital interviews Professor Paul O’Toole; who is Professor of Microbial Genomics, Head of School of Microbiology and Principal Investigator in APC Microbiome Ireland, an SFI funded centre at University College Cork, Ireland, on “Mediterranean diet intervention alters the gut microbiome in older people reducing frailty and improving health status: the NU-AGE 1-year dietary intervention across 5 European countries” published in paper copy in Gut in July 2020.

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COMMENTARY

Diet is one of the 3 pillars ( or 4, if you don’t consider intellectual stimulation a form of exercise) of health. And there are 3 prime dimensions to diet: Quality, Quantity, and Timing. This excellent study addresses the Quality of the diet. Vegetables, fruits and whole grains are the foundation.

Dietary Fiber is the main difference between the healthful Mediterranean diet and the highly processed diet so common in America.

How can you be sure you are eating enough fiber? Read on.
On almost all cans and boxes, you will find a nutritional statement, by law. Assuming that the contents are “real food”, and preferably “organic”, look for the “fiber” in grams, and the “calories” in 100’s, and mentally divide the grams of fiber by 100s  of calories, and you get a number. Let’s say that your fiber for the day totals “25” gms. and your calories for the day Totals 2500; that is “25” hundred calories. Divide the 25 grams by the 25 hundred calories, and you get “1”. Anything less than 1 is low in fiber.

25 grams of fiber is about the daily recommendation for fiber. 25 hundred calories is a ballpark figure for an average diet.
PORTION SIZE DOESN’T MATTER, since your dividend is a ratio.
The bacteria in your MICROBIOME feed on the fiber, and the higher and more diverse the fiber ( within reason. Hay is high in fiber) the healthier the food.

Blueberries are good for a fruit at 4-5 gms. of fiber per hundred calories. Broccoli is a good vegetable at 10 gms fiber per hundred calories, carrots about 3, and so on.

Sugar is the perfect “bad” food, at no fiber for as many calories as you can pack in. It makes you Want more, and “desensitizes” your taste buds to the natural sweetness of fruit, or even vegetables.

HIGH FIBER foods are MORE FILLING, leading you to eat less.
Civilization and Capitalism pushes too much food and too many calories at us. Overeating , obesity, and many of the modern illnesses is the result.
Generally, fresh fruits and vegetables are preferred, though cooking doesn’t do much harm, other than some vitamin loss that can be replaced.

Whole grain cereals have fiber in addition to other nutrients. Also, the complex carbohydrates in whole grains  are released more slowly than wIth refined cereals. This floods your blood less rapidly with glucose, and elicits a Less precipitous insulin response. This results in a lower, healthier  “glycemic Index”.

Vegetables, fruits Legumes, seeds, nuts and their oils are the mainstay of the Vegan diet, which is healthful If enough protein and essential fats are ingested.

Fish, eggs, milk and cheeses are other components of the Mediterranean diet.

I take many of my daily Vegetable and fruits and  liquefy them in a food blender. Drinking my daily vegetables and fruits is a tasty and convenient way to improve my diet. I Savor individually those items I find most tasty, like nuts, apples, avocado, And fruit in season. This exercises my jaws, which is probably healthy.

YOUR MICROBIOME helps you in many ways that science is just beginning to understand. A healthy Microbiome is a DIVERSE Microbiome. FIBER is the food of the Microbiome, and a diversity in dietary fiber leads to a diverse Microbiome. A diverse, happy Microbiome produces many biological substances, like neurotransmitters, and probably communicates with the brain directly through the gut-brain Axis.

The Podcast on the 1 year Meddiet showed how directly a diet can BENEFIT HEALTH STATUS.

-Dr. C.

PODCAST INTERVIEWS: DIAGNOSIS AND EARLY TREATMENT OF COVID-19

In this audio interview conducted on June 3, 2020, the editors discuss two new studies: one comparing test swabs collected by health care workers with swabs collected by the patients themselves and one assessing hydroxychloroquine treatment in people who had been exposed to Covid-19 but weren’t yet ill.

The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal.

Eric Rubin is the Editor-in-Chief of the Journal. Lindsey Baden is a Deputy Editor of the Journal. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal.

CORONAVIRUS: CONFUSING HYDROXYCHLOROQUINE STUDIES (NATURE PODCAST)

President Trump’s preferred coronavirus treatment is the focus of a new study suggesting it could cause more harm than good, but not everybody agrees. We discuss the fallout as trials around the world are paused and countries diverge over policy advice.

12:12 Are we rushing science?

Coronavirus papers are being published extremely quickly, while normally healthy scientific debate is being blown up in the world’s press. Is there a balancing act between timely research and accurate messaging?

18:49 One good thing

Our hosts pick out things that have made them smile in the last week, including hedgerow brews and a trip into the past using AI.

Recipe: Elderflower ‘Champagne’

Video: Denis Shiryaev restores historic footage with AI

22:30 The latest coronavirus research papers

Noah Baker takes a look through some of the key coronavirus papers of the last few weeks.

News: Coronavirus research updates

medRxiv: Full genome viral sequences inform patterns of SARS-CoV-2 spread into and within Israel

Harvard Library: Reductions in commuting mobility predict geographic differences in SARS-CoV-2 prevalence in New York City

Science: DNA vaccine protection against SARS-CoV-2 in rhesus macaques

PODCAST: “THE EFFECTS OF HEARING LOSS ON COGNITIVE DECLINE” (JAMA REVIEWS)

Even limited hearing loss might be associated with cognitive decline. If true, early intervention with hearing aids might help people have better cognitive performance. 

Michael Johns III, MD, online editor for JAMA Otolaryngology, speaks with Justin Golub, MD, MS, assistant professor of otolaryngology at Columbia University, whose research has shown that very mild hearing loss can be associated with cognitive disability.

COMMENTARY

Hearing loss and cognitive ability decline together as we age, starting earlier in some people than others.

LIVING A HEALTHY LIFE STYLE-with good SLEEP, DIET, EXERCISE and COGNITIVE STIMULATION -seems to help benefit almost everything, including hearing, while a poor life style, neglecting the 4 Pillars, smoking, and drinking alcohol to excess seems to hasten our aging.

Certain medications, often taken to treat the results of a poor life style, can also harm our hearing.

LOUD SOUNDS (such as AMPLIFIED MUSIC), especially if prolonged, are particularly bad. SOUND POLLUTION contaminates the modern world as much as industries‘ excesses. I would often wear ear plugs to Football games (108 dB on my meter) and even in row 4 of the Symphony.

Once damaged, the delicate HAIR CELLS of our inner ear don’t grow back, although medical science once again is working feverishly to save us from ourselves.

Hearing aids can now be programmed to compensate for our particular pattern of frequency loss.

The premise made in the above article and podcast, that decreased HEARING is accompanied by (and Causes?)decreased COGNITION could be supported by a study demonstrating that Improved hearing restores the cognition. I understand that early results may suggest a cognitive benefit of hearing aids.

But PRESERVING BOTH with healthy living would of course be better- at least in my opinion.

Prevention, unfortunately, is a very hard sell in a world of costly medical treatments, where we are protected from directly confronting those costs by ever-expanding insurance. How about Medical savings accounts?

—Dr. C.

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CARDIOLOGY PODCAST: “ATRIAL FIBRILLATION – A COMPREHENSIVE OVERVIEW”

Atrial fibrillation is chaotic and irregular atrial arrhythmia, the prevalence of which increases progressively with age. It causes significant morbidity and death. Many patients are asymptomatic or have symptoms that are less specific for cardiac arrhythmias, such as mild dementia or silent strokes. 

Gregory Lip, Price-Evans Chair of Cardiovascular Medicine, University of Liverpool, gives us an overview of the condition.

Read more on Atrial Fibrillation at BMJ