When is elbow pain an emergency? Can the elbow joint be replaced? What’s that weird feeling when you hit your funny bone? Orthopedic Surgeon, William Seitz Jr., MD, sits down to answer these questions and more.
Category Archives: Health
“Telemedicine” Is The Way To Treat “Coronavirus / Covid-19” Pandemic (NEJM)
From a New England Journal of Medicine article (March 11, 2020):
A central strategy for health care surge control is “forward triage” — the sorting of patients before they arrive in the emergency department (ED). Direct-to-consumer (or on-demand) telemedicine, a 21st-century approach to forward triage that allows patients to be efficiently screened, is both patient-centered and conducive to self-quarantine, and it protects patients, clinicians, and the community from exposure.
It can allow physicians and patients to communicate 24/7, using smartphones or webcam-enabled computers. Respiratory symptoms — which may be early signs of Covid-19 — are among the conditions most commonly evaluated with this approach. Health care providers can easily obtain detailed travel and exposure histories. Automated screening algorithms can be built into the intake process, and local epidemiologic information can be used to standardize screening and practice patterns across providers.
More than 50 U.S. health systems already have such programs. Jefferson Health, Mount Sinai, Kaiser Permanente, Cleveland Clinic, and Providence, for example, all leverage telehealth technology to allow clinicians to see patients who are at home. Systems lacking such programs can outsource similar services to physicians and support staff provided by Teladoc Health or American Well. At present, the major barrier to large-scale telemedical screening for SARS-CoV-2, the novel coronavirus causing Covid-19, is coordination of testing. As the availability of testing sites expands, local systems that can test appropriate patients while minimizing exposure — using dedicated office space, tents, or in-car testing — will need to be developed and integrated into telemedicine workflows.
Health News Video: FDA Launches (And Explains) New Nutrition Facts Label
What’s new about the new Nutrition Facts label? Watch this Q&A with Susan T. Mayne, Ph.D., Director of FDA’s Center for Food Safety and Applied Nutrition.
Health Update: Comparing “Coronavirus / Covid-19” And “Influenza” (W.H.O.)
From an MIT Technology Review article (March 11, 2020):
Here are six differences between coronavirus and the flu:
Coronavirus appears to spread more slowly than the flu. This is probably the biggest difference between the two. The flu has a shorter incubation period (the time it takes for an infected person to show symptoms) and a shorter serial interval (or the time between successive cases). Coronavirus’s serial interval is around five to six days, while flu’s gap between cases is more like three days, the WHO says. So flu still spreads more quickly.- Shedding: Viral shedding is what happens when a virus has infected a host, has reproduced, and is now being released into the environment. It is what makes a patient infectious. Some people start shedding the coronavirus within two days of contracting it, and before they show symptoms, although this probably isn’t the main way it is spreading, the WHO says.
- Secondary infections. As if contracting coronavirus wasn’t bad enough, it leads to about two more secondary infections on average. The flu can sometimes cause a secondary infection, usually pneumonia, but it’s rare for a flu patient to get two infections after the flu. The WHO warned that context is key (someone who contracts coronavirus might already have been fighting another condition, for example).
Don’t blame snotty kids—adults are passing coronavirus around. While kids are the primary culprits for flu transmission, this coronavirus seems to be passed between adults. That also means adults are getting hit hardest—especially those who are older and have underlying medical conditions. Experts are baffled as to why kids seem protected from the worst effects of the coronavirus, according to the Washington Post. Some say they might already have some immunity from other versions of the coronavirus that appear in the common cold; another theory is that kids’ immune systems are always on high alert and might simply be faster than adults’ in battling Covid-19.- Coronavirus is far deadlier than the flu. Thus far, the mortality rate for coronavirus (the number of reported cases divided by the number of deaths) is around 3% to 4%, although it’s likely to be lower because many cases have not yet been reported. The flu’s rate is 0.1%.
- There is no cure or vaccine for the coronavirus. Not yet, anyway, although work is under way. There is, however, a flu vaccine—and everyone should get it, not least because being vaccinated could help lessen the load on overstretched medical services in the coming weeks.
Elderly & Coronavirus: Nursing Homes Increase Guest Symptom, Travel And Exposure Reviews
From a Harvard Gazette online article (March 10, 2020):
There’s a symptom review, there’s a travel review, and there’s an exposure review. And if the answer to any of those questions is yes, then you’re asked to not come in. And so far people have been compliant and have left. So that is a good thing.
If you have a cough and a fever, if you’ve got respiratory symptoms and you’re short of breath, if you’ve traveled to a place of concern or if you may have been exposed to someone who did — especially if you’re symptomatic — then I would definitely ask, “Do I really need to visit my grandma today? Can I wait and can I Skype her? Can I do FaceTime?”
I know that’s hard for some of our older adults who aren’t technologically savvy, but maybe now is the time to get them hooked up. It really would be heartbreaking if, in wanting to do something positive for someone’s emotional or mental health, you ended up infecting them.
Harvard-affiliated Hebrew SeniorLife offers a continuum of care for 3,000 elderly people daily, with a range of services including residential assisted living, short-term rehabilitation, outpatient services, and long-term care for those with chronic illness. In a Q&A interview aimed at understanding the challenges involved, Harvard Medical School Assistant Professor Helen Chen, Hebrew SeniorLife’s chief medical officer, discussed steps the facility has taken to combat the virus and the outlook going forward.
Health Studies: “Spirulina” Improves Cardiovascular (CVD) Risk Factors, Aids In Weight Loss (BMJ)
From a BMJ Open Heart online study (March 8, 2020):
Overall, the evidence in the literature suggests that spirulina improves several well-established CVD risk factors including hyperlipidaemia and seems to provide benefits around weight loss.
Although caloric restriction and exercise are the mainstay treatments for obesity, spirulina has shown significant benefits in aiding weight loss. The phycocyanin in spirulina contains a light-harvesting chromophore called phycocyanobilin, which is capable of inhibiting nicotinamide adenine dinucleotide phosphate hydrogen (NADPH) oxidase, a significant source of oxidative stress in adipocytes playing a key role in inducing insulin resistance and shifting adipokine and cytokine production in hypertrophied adipocytes. Thus, by suppressing adipocyte oxidative stress, spirulina may lead to systemic anti-inflammatory and insulin-sensitising effects.
Spirulina is both a salt and fresh water blue-green algae, which is being increasingly studied recently. Spirulina was initially classified under the plant kingdom due to its rich plant pigments and its ability to photosynthesize, but was later placed into bacterial kingdom (cyanobacteria) due to its genetic, physiological and biochemical makeup. Spirulina grows naturally in high salt alkaline water reservoirs in subtropical and tropical areas of America, Mexico, Asia and Central Africa.
Health: 24/7 Real-Time “Coronavirus / Covid-19” Global Cases (March 10)
Medicine Lectures: 2019 Nobel Laureates Sir Peter Ratcliffe And Professor William Kaelin (Oxford)
Sir Peter and Prof. Kaelin were awarded the Nobel Prize in Physiology and Medicine last year by the Nobel Assembly at Karolinska Institutet, in recognition of their discoveries of how cells sense and adapt to oxygen availability, an essential adaptive process central to many significant diseases. The professors respectively work for the University of Oxford and Harvard University, and shared the Nobel Prize with Prof. Gregg Semenza, a fellow researcher.
Health Infographics: “Coronavirus / Covid-19” – Symptoms And Exposure Period (CDC Update)
Studies: “Ultra-Processed Foods” Are 58% Of All Calories In U.S., & Obesity Epidemic’s Major Cause
From a The Guardian online article (Feb 12, 2020):
What characterizes ultra-processed foods is that they are so altered that it can be hard to recognize the underlying ingredients. These are concoctions of concoctions, engineered from ingredients that are already highly refined, such as cheap vegetable oils, flours, whey proteins and sugars, which are then whipped up into something more appetizing with the help of industrial additives such as emulsifiers.
From a MedPage Today online article (March 7, 2020):
The top ultra-processed foods by calorie intake were breads, beverages, cakes, 
cookies and pies, salty snacks, frozen and shelf-stable dishes, pizza, and breakfast cereals.
Altogether, ultra-processed foods accounted for 58% of all calories in the U.S. diet and nearly 90% of all added sugars.
They divided foods into four categories:
- Unprocessed or minimally processed foods: Fresh, dry, or frozen fruits or vegetables, grains, legumes, meat, fish, and milk
- Processed culinary ingredients: Table sugar, oils, fats, salt, and other substances extracted from foods or from nature and used in kitchens to make culinary preparations
- Processed foods: Foods manufactured with the addition of salt, sugar, or other substances of culinary use to unprocessed or minimally-processed foods, such as canned food, simple breads, and cheese
- Ultra-processed foods: Formulations of several ingredients that — besides salt, sugar, oils, and fats — include food substances not used in culinary preparations, in particular, flavors, colors, sweeteners, emulsifiers, and other additives used to imitate sensory qualities of unprocessed or minimally-processed foods and their culinary preparations or to disguise undesirable qualities of the final product
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