Category Archives: Medicine

Digital, Health, Innovations, Medicine, Technology, Videos

Smart Technology: ‘The Internet Of Bodies’ (IoB)

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Internet-connected “smart” devices are increasingly available in the marketplace, promising consumers and businesses improved convenience and efficiency. Within this broader Internet of Things (IoT) lies a growing industry of devices that monitor the human body and transmit the data collected via the internet.

This development, which some have called the Internet of Bodies (IoB), includes an expanding array of devices that combine software, hardware, and communication capabilities to track personal health data, provide vital medical treatment, or enhance bodily comfort, function, health, or well-being. However, these devices also complicate a field already fraught with legal, regulatory, and ethical risks. In this video,

RAND mathematician Mary Lee examines this emerging collection of human body–centric and internet-connected technologies; explores their benefits, security and privacy risks, and ethical implications; surveys the nascent regulatory landscape for these devices and the data they collect; and makes recommendations to balance IoB risks and rewards.

Read more about the Internet of Bodies here: https://www.rand.org/pubs/research_re…

Health, Medicine, Videos

Interview: Anthony Fauci On Covid-19 (JAMA Video)

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Anthony S. Fauci, MD returns to JAMA’s Q&A series to discuss the latest developments in the COVID-19 pandemic, including the continued importance of nonpharmaceutical interventions (masking, handwashing, physical distancing) for managing rising case numbers in the US and globally.

Recorded October 28, 2020.

Topics discussed in this interview: 0:00 Introduction 0:20 NAM Presidential Citation for Exemplary Leadership 1:19 COVID-19 numbers and excess deaths 4:05 National masking mandate 5:55 How to get people to accept masking 7:07 Herd Immunity and the Great Barrington Declaration 9:51 The holidays and airplane travel 13:44 Therapies update 17:54 Vaccines update 20:08 Vaccine distribution 22:00 Vaccine safety 24:42 How Australia has dealt with COVID-19 spikes 27:00 Acknowledgements and baseball

Aging, Health, Medicine, Obesity, Old Age, Studies

Health Studies: 80% Of Married Couples Share Heart Disease Risks, Poor Health Lifestyles (JAMA)

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OCTOBER 26, 2020

In this cross-sectional study of 5364 couples consisting of employees and spouses (or domestic partners) undergoing an annual employer-sponsored health assessment, 79% of the couples were in the nonideal category of a CV health score. This within-couple concordance of nonideal CV health scores was associated mostly with unhealthy diet and inadequate physical activity.

The study included 10 728 participants (5364 couples): 7% were African American, 11% Hispanic, 21% Asian, and 54% White (median [interquartile range] age, 50 [41-57] years for men and 47 [39-55] for women). For most couples, both members were in the ideal category or both were in a nonideal category.

Concordance ranged from 53% (95% CI, 52%-54%) for cholesterol to 95% (95% CI, 94%-95%) for diet. For the CV health score, in 79% (95% CI, 78%-80%) of couples both members were in a nonideal category, which was associated mainly with unhealthy diet (94% [95% CI, 93%-94%] of couples) and inadequate exercise (53% [95% CI, 52%-55%] of couples). However, in most couples, both members were in the ideal category for smoking status (60% [95% CI, 59%-61%] of couples) and glucose (56% [95% CI, 55%-58%]).

Except for total cholesterol, when 1 member of a couple was in the ideal category, the other member was likely also to be in the ideal category: the adjusted odds ratios for also being in the ideal category ranged from 1.3 (95% CI, 1.1-1.5; P ≤ .001) for blood pressure to 10.6 (95% CI, 7.4-15.3; P ≤ .001) for diet. Concordance differed by ethnicity, socioeconomic status, and geographic location.

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Aging, Health, Medicine, Studies

Infographic: ’12 Dementia Risk Factors’ (The Lancet)

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Executive summary

The number of older people, including those living with dementia, is rising, as younger age mortality declines. However, the age-specific incidence of dementia has fallen in many countries, probably because of improvements in education, nutrition, health care, and lifestyle changes.

Overall, a growing body of evidence supports the nine potentially modifiable risk factors for dementia modelled by the 2017 Lancet Commission on dementia prevention, intervention, and care: less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and low social contact.

We now add three more risk factors for dementia with newer, convincing evidence. These factors are excessive alcohol consumption, traumatic brain injury, and air pollution. We have completed new reviews and meta-analyses and incorporated these into an updated 12 risk factor life-course model of dementia prevention. Together the 12 modifiable risk factors account for around 40% of worldwide dementias, which consequently could theoretically be prevented or delayed.

The potential for prevention is high and might be higher in low-income and middle-income countries (LMIC) where more dementias occur. Our new life-course model and evidence synthesis has paramount worldwide policy implications. It is never too early and never too late in the life course for dementia prevention. Early-life (younger than 45 years) risks, such as less education, affect cognitive reserve; midlife (45–65 years), and later-life (older than 65 years) risk factors influence reserve and triggering of neuropathological developments.

Culture, poverty, and inequality are key drivers of the need for change. Individuals who are most deprived need these changes the most and will derive the highest benefit.

Read full Dementia Study and Report

Health, Medicine, Reviews, Studies

Infographic: ‘Functional Neurological Disorder’ – Signs & Symptoms (BMJ)

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What you need to know

  • Functional neurological disorder (FND) is associated with considerable distress and disability. The symptoms are not faked
  • Diagnose FND positively on the basis of typical clinical features. It is not a diagnosis of exclusion
  • FND can be diagnosed and treated in presence of comorbid, pathophysiologically defined disease
  • Psychological stressors are important risk factors but are neither necessary nor sufficient for the diagnosis

Functional disorders are conditions whose origin arises primarily from a disorder of nervous system functioning rather than clearly identifiable pathophysiological disease—such as irritable bowel syndrome, fibromyalgia, and functional neurological disorder (FND)—they are the second commonest reason for new neurology consultations.1 FND is common in emergency settings,2 stroke,3 and rehabilitation services.4 It causes considerable physical disability and distress, and often places an economic burden both on patients and health services.5 Many clinicians have had little formal clinical education on the assessment and management of these disorders, and patients are often not offered potentially effective treatments.

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Diet, Exercise, Health, Medicine, Studies

Health: ‘Diabetes And Chronic Kidney Disease’ – New Guidelines (OCt 2020)

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Comprehensive care in patients with diabetes and CKD

Management of CKD in diabetes can be challenging and complex, and a multidisciplinary team should be involved (doctors, nurses, dietitians, educators, etc). Patient participation is important for self-management and to participate in shared decision-making regarding the management plan. (Practice point).

We recommend that treatment with an angiotensin-converting enzyme inhibitor (ACEi) or an angiotensin II receptor blocker (ARB) be initiated in patients with diabetes, hypertension, and albuminuria, and that these medications be titrated to the highest approved dose that is tolerated (1B).

Lifestyle interventions in patients with diabetes and CKD

We suggest maintaining a protein intake of 0.8 g protein/kg)/d for those with diabetes and CKD not treated with dialysis (2C).

On the amount of proteins recommended in these guidelines, they suggest (‘recommend’ becomes a ‘suggest’ at this level of evidence) a very precise  intake of 0.8g/kg/d in patients with diabetes and CKD. Lower dietary protein intake has been hypothesized but never proven to reduce glomerular hyperfiltration and slow progression of CKD, however in patients with diabetes, limiting protein intake below 0.8g/kg/d can be translated into a decreased caloric content, significant weight loss and quality of life. Malnutrition from protein and calorie deficit is possible.

Physical activity

We recommend that patients with diabetes and CKD be advised to undertake moderate-intensity physical activity for a cumulative duration of at least 150 minutes per week, or to a level compatible with their cardiovascular and physical tolerance (1D).

Read full guidelines

Health, Medicine, Studies

Infographic: ‘What Is Herd Immunity?’ – Achieving It With Covid-19 (JAMA)

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OCTOBER 19, 2020

What Is Herd Immunity?

Herd immunity occurs when a significant portion of a population becomes immune to an infectious disease, limiting further disease spread.

Disease spread occurs when some proportion of a population is susceptible to the disease. Herd immunity occurs when a significant portion of a population becomes immune to an infectious disease and the risk of spread from person to person decreases; those who are not immune are indirectly protected because ongoing disease spread is very small.

The proportion of a population who must be immune to achieve herd immunity varies by disease. For example, a disease that is very contagious, such as measles, requires more than 95% of the population to be immune to stop sustained disease transmission and achieve herd immunity.

How Is Herd Immunity Achieved?

Herd immunity may be achieved either through infection and recovery or by vaccination. Vaccination creates immunity without having to contract a disease. Herd immunity also protects those who are unable to be vaccinated, such as newborns and immunocompromised people, because the disease spread within the population is very limited. Communities with lower vaccine coverage may have outbreaks of vaccine-preventable diseases because the proportion of people who are vaccinated is below the necessary herd immunity threshold. In addition, the protection offered by vaccines may wane over time, requiring repeat vaccination.

Achieving herd immunity through infection relies on enough people being infected with the disease and recovering from it, during which they develop antibodies against future infection. In some situations, even if a large proportion of adults have developed immunity after prior infection, the disease may still circulate among children. In addition, antibodies from a prior infection may only provide protection for a limited duration.

People who do not have immunity to a disease may still contract an infectious disease and have severe consequences of that disease even when herd immunity is very high. Herd immunity reduces the risk of getting a disease but does not prevent it for nonimmune people.

Herd Immunity and COVID-19

There is no effective vaccine against coronavirus disease 2019 (COVID-19) yet, although several are currently in development. It is not yet known if having this disease confers immunity to future infection, and if so, for how long. A large proportion of people would likely need to be infected and recover to achieve herd immunity; however, this situation could overwhelm the health care system and lead to many deaths and complications. To prevent disease transmission, keep distance between yourself and others, wash your hands often with soap and water or sanitizer that contains at least 60% alcohol, and wear a face covering in public spaces where it is difficult to avoid close contact with others.

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Diet, Health, Medicine, Podcasts

Top Medical Podcasts: ‘Diverticular Disease’ (BMJ)

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Colonic diverticulosis refers to herniation of the mucosa and submucosa through the muscular layer of the colonic wall and may be the result of colonic smooth muscle over-activity. Diverticular disease may be defined as any clinical state caused by symptoms pertaining to colonic diverticula and includes a wide-ranging spectrum from asymptomatic to severe and complicated disease. 

Mohamed Thaha, Senior Lecturer & Lead Consultant in Colorectal Surgery, National Bowel Research Centre, Barts and The London School of Medicine and Dentistry, tells us more. 

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