Chest pain is a common chief complaint. It may be caused by either benign or life-threatening aetiologies and is usually divided into cardiac and non-cardiac causes. James E. Brown, Professor and Chair, Wright State University Boonshoft School of Medicine, Kettering, Ohio, gives us an overview of assessing chest pain in the emergency setting.
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.
28:50 The latest coronavirus research papers
Benjamin Thompson takes a look through some of the key coronavirus papers of the last few weeks.
Diagnostics World (June 30, 2020): The shift from face-to-face patient visits to remote medical appointments is a worldwide phenomenon, but most especially in the U.S., finds a recent global survey conducted by the doctors-only social networking platform Sermo. Unsurprisingly, Zoom tops the list of most-mentioned technologies. About one-fifth of surveyed doctors say they expect to be using telehealth tools “significantly” more post-pandemic than before COVID-19 upended business as usual.
From iScience / Cell.com (June 26, 2020):
…the beneficial effects of TRE are dose dependent, with greater reductions in body weight, fat mass, and improvement in glucose tolerance when a 9-h protocol was implemented versus 12 and 15 h. The optimal TRE time frame to recommend for people has not been tested. Clear improvements have been noted after 6-, 8-, 9-, and 10-h protocols. It is likely that the greater time restriction would result in greater weight losses, which may maximize the metabolic benefits.
Eating out of phase with daily circadian rhythms induces metabolic desynchrony in peripheral metabolic organs and may increase chronic disease risk. Time-restricted eating (TRE) is a dietary approach that consolidates all calorie intake to 6- to 10-h periods during the active phase of the day, without necessarily altering diet quality and quantity.
TRE reduces body weight, improves glucose tolerance, protects from hepatosteatosis, increases metabolic flexibility, reduces atherogenic lipids and blood pressure, and improves gut function and cardiometabolic health in preclinical studies. This review discusses the importance of meal timing on the circadian system, the metabolic health benefits of TRE in preclinical models and humans, the possible mechanisms of action, the challenges we face in implementing TRE in humans, and the possible consequences of delaying initiation of TRE.
UCSF orthopedic surgeon Dr. Paul Toogood discusses the types and origins or Arthritis.
Dr. Jesse Mills, Director of The Men’s Clinic at UCLA talks about what to expect during a first prostate checkup.
His mission was to educate the world about the importance of sleep, which he believed was dangerously undervalued. His motto, “drowsiness is red alert,” is a message he tirelessly broadcast to his students, trainees, members of Congress and the world at large.
William Dement, MD, PhD, known as the father of sleep medicine, died June 17 after a two-year battle with cardiovascular disease. He was 91.
With a handful of other scientists, Dement, a longtime faculty member of the Stanford School of Medicine, created the fields of sleep research and sleep medicine, and his many books and lectures helped raise awareness of sleep disorders and the dangers of sleep deprivation.
Dement’s many other accomplishments and accolades range far and wide: Dement and Guilleminault were the founding editors of the journal Sleep, the first major international journal devoted to sleep, publishing the first issue in 1978. He was the author of books for lay readers, including The Promise of Sleep, Some Must Watch While Some Must Sleep and The Sleepwatchers. The 2012 comedy film Sleepwalk with Me featured The Promise of Sleep and Dement in a cameo.
H4D facilitates access to healthcare by allowing patients to consult a doctor remotely in the Consult Station®, the first connected local telemedicine booth. This medical device allows quality healthcare to be delivered for primary care, occupational health, and general health promotion.
There is consistent evidence that higher amounts of body fat are associated with increased risks of a number of cancers (6), including:
- Endometrial cancer: Obese and overweight women are two to about four times as likely as normal-weight women to develop endometrial cancer (cancer of the lining of the uterus), and extremely obese women are about seven times as likely to develop the more common of the two main types of this cancer (7). The risk of endometrial cancer increases with increasing weight gain in adulthood, particularly among women who have never used menopausal hormone therapy (8).
- Esophageal adenocarcinoma: People who are overweight or obese are about twice as likely as normal-weight people to develop a type of esophageal cancer called esophageal adenocarcinoma, and people who are extremely obese are more than four times as likely (9).
- Gastric cardia cancer: People who are obese are nearly twice as likely as normal-weight people to develop cancer in the upper part of the stomach, that is, the part that is closest to the esophagus (10).
- Liver cancer: People who are overweight or obese are up to twice as likely as normal-weight people to develop liver cancer. The association between overweight/obesity and liver cancer is stronger in men than women (11, 12).
- Kidney cancer: People who are overweight or obese are nearly twice as likely as normal-weight people to develop renal cell cancer, the most common form of kidney cancer (13). The association of renal cell cancer with obesity is independent of its association with high blood pressure, a known risk factor for kidney cancer (14).
- Multiple myeloma: Compared with normal-weight individuals, overweight and obese individuals have a slight (10% to 20%) increase in the risk of developing multiple myeloma (15).
- Meningioma: The risk of this slow-growing brain tumor that arises in the membranes surrounding the brain and the spinal cord is increased by about 50% in people who are obese and about 20% in people who are overweight (16).
- Pancreatic cancer: People who are overweight or obese are about 1.5 times as likely to develop pancreatic cancer as normal-weight people (17).
- Colorectal cancer: People who are obese are slightly (about 30%) more likely to develop colorectal cancer than normal-weight people (18).A higher BMI is associated with increased risks of colon and rectal cancers in both men and in women, but the increases are higher in men than in women (18).
- Gallbladder cancer: Compared with normal-weight people, people who are overweight have a slight (about 20%) increase in risk of gallbladder cancer, and people who are obese have a 60% increase in risk of gallbladder cancer (19, 20). The risk increase is greater in women than men.
- Breast cancer: Many studies have shown that, in postmenopausal women, a higher BMI is associated with a modest increase in risk of breast cancer. For example, a 5-unit increase in BMI is associated with a 12% increase in risk (21). Among postmenopausal women, those who are obese have a 20% to 40% increase in risk of developing breast cancer compared with normal-weight women (22). The higher risks are seen mainly in women who have never used menopausal hormone therapy and for tumors that express hormone receptors. Obesity is also a risk factor for breast cancer in men (23).In premenopausal women, by contrast, overweight and obesity have been found to be associated with a 20% decreased risk of breast tumors that express hormone receptors (22).
- Ovarian cancer: Higher BMI is associated with a slight increase in the risk of ovarian cancer, particularly in women who have never used menopausal hormone therapy (24). For example, a 5-unit increase in BMI is associated with a 10% increase in risk among women who have never used menopausal hormone therapy (24).
- Thyroid cancer: Higher BMI (specifically, a 5-unit increase in BMI) is associated with a slight (10%) increase in the risk of thyroid cancer (25).