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Category Archives: Health
Healthcare: “Rethinking How Hospitals Operate”
From the Wall Street Journal (June 8, 2020):
“We have to operate a hospital within a hospital, taking care of the needs for patients who have had strokes or a newborn delivery or need surgery while dealing with an otherwise healthy 35-year-old who picked up Covid-19 at a social event,” says James Linder, chief executive of Nebraska Medicine…
For instance, more hospitals are remotely triaging and registering patients before they even arrive. Clinicians can consult with patients from their home via telemedicine to help determine how sick they are and if they need to come to the ER at all. From there, admissions are made with as little contact with staff or other patients as possible.
Hospitals are rethinking how they operate in light of the Covid-19 pandemic—and preparing for a future where such crises may become a grim fact of life.
With the potential for resurgences of the coronavirus, and some scientists warning about outbreaks of other infectious diseases, hospitals don’t want to be caught flat-footed again. So, more of them are turning to new protocols and new technology to overhaul standard operating procedure, from the time patients show up at an emergency room through admission, treatment and discharge.
Study: “Fragmented Sleep” Increases Inflammation & Hardening Of The Arteries
From UC Berkeley (June 4, 2020):
“We’ve discovered that fragmented sleep is associated with a unique pathway — chronic circulating inflammation throughout the blood stream — which, in turn, is linked to higher amounts of plaques in coronary arteries,” said study senior author Matthew Walker, a UC Berkeley professor of psychology and neuroscience.
Disrupted nightly sleep and clogged arteries tend to sneak up on us as we age. And while both disorders may seem unrelated, a new UC Berkeley study helps explain why they are, in fact, pathologically intertwined.
Some tips to improve sleep quality
- Maintain a regular sleep routine, going to bed and waking up at the same time each day.
- As part of a nightly wind-down routine, avoid viewing computer, smartphone and TV screens in the last hour before bedtime, and keep phones and other digital devices out of the bedroom.
- Engage in some form of physical exercise during the day.
- Get exposure to natural daylight, especially in the first half of the day.
- Avoid stimulants, like caffeine, and sedatives, like alcohol, later in the day.
UC Berkeley sleep scientists have begun to reveal what it is about fragmented nightly sleep that leads to the fatty arterial plaque buildup known as atherosclerosis that can result in fatal heart disease.
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.
Infographics: “Covid-19 Compared To Other Diseases And Conditions”
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.
Study: “Intensive Diet And Exercise” Reverses Type 2 Diabetes In 61% Of Patients
From The Lancet Diabetes & Endocrinology (June 2020):
Our findings show that the intensive lifestyle intervention led to significant weight loss at 12 months, and was associated with diabetes remission in over 60% of participants and normoglycaemia in over 30% of participants. The provision of this lifestyle intervention could allow a large proportion of young individuals with early diabetes to achieve improvements in key cardiometabolic outcomes, with potential long-term benefits for health and wellbeing.
Type 2 diabetes is affecting people at an increasingly younger age, particularly in the Middle East and in north Africa. We aimed to assess whether an intensive lifestyle intervention would lead to significant weight loss and improved glycaemia in young individuals with early diabetes.
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Between July 16, 2017, and Sept 30, 2018, we enrolled and randomly assigned 158 participants (n=79 in each group) to the study. 147 participants (70 in the intervention group and 77 in the control group) were included in the final intention-to-treat analysis population. Between baseline and 12 months, the mean bodyweight of participants in the intervention group reduced by 11·98 kg (95% CI 9·72 to 14·23) compared with 3·98 kg (2·78 to 5·18) in the control group (adjusted mean difference −6·08 kg [95% CI −8·37 to −3·79], p<0·0001). In the intervention group, 21% of participants achieved more than 15% weight loss between baseline and 12 months compared with 1% of participants in the control group (p<0·0001). Diabetes remission occurred in 61% of participants in the intervention group compared with 12% of those in the control group (odds ratio [OR] 12·03 [95% CI 5·17 to 28·03], p<0·0001). 33% of participants in the intervention group had normoglycaemia compared with 4% of participants in the control group (OR 12·07 [3·43 to 42·45], p<0·0001).
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Podcasts Interviews: The 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 Vaccines: The Promise And Peril In Fast-Tracking (WSJ Video)
As the coronavirus continues to spread around the globe, companies and academic labs are racing to develop a vaccine that would help society get back to normal. But there could also be costs to moving too quickly.
WSJ’s Daniela Hernandez explains. Photo illustration: Laura Kammermann
Boomers Daily 