December 10th, 2015 | The Blog
How do surgeons prepare to perform an intricate life-saving procedure? They observe a lot of operations and assist with some of the procedures. At Boston Children’s Hospital, that is the old-fashioned way to learn. The new regime is to practice with hands-on life-like models until they get it right without risking the health or safety of a live patient.
Residents training at Boston Children’s Hospital are doing practice runs on plastic body parts. The plastic models look and feel real on the outside with 3-D printed organs on the inside.
The models are created and manufactured by a California make-up and special effects company, Fractured FX. Fractured FX usually produces special effects for television but now, they are working with Boston Children?s Hospital to perfect life-saving surgical procedures.
The Simulator Program (SIM)
The surgery practice program is called the Simulator Program. It allows surgeons to actually rehearse and perfect complex procedures before touching a live patient.
Standardly, some training physicians use a cadaver. The downside of using cadavers is the expense and the fact that they are not reusable. There is also not realistic pulsing when using a cadaver, which is an added feature in the SIM models.
A profitable by-product of the Simulator Program is that Boston Children’s Hospital and Fractured FX is planning to sell the simulators to other medical institutions starting in the coming year.
The Creation of SIM Models
In order to most accurately create SIM models that are closest to a live patient situation, the Fractured FX creators studied CT scans of the human body and consulted Boston Children’s Hospital surgeons.
The creation team paid special attention to the replication of membranes, cartilage and other important and palpable landmark within the body. The goal was to make this a life-like and realistic model.
The simulated pulsing of membranes in the brain, when using the SIM model, creates a realistic situation in which to practice surgical procedures.
The Simulator Models
There are a couple of SIM models available, so far. One is a Caucasian tween, complete with a freckly face, and the other is a life-like model of a newborn.
The tween model is currently used by neurosurgeons to practice intricate brain surgery techniques. Surgeons practice specialized lung and heart surgery utilizing the newborn SIM model.
The SIM model parts are 3-D printed and snap together like LEGO bricks. They can be used or operated on several times. And are then replaced within the SIM body model.
The SIM model program is apart of a larger program called SimPEDS, which has been developing teaching tools for training MDs at Boston Children’s Hospital for the past 12 years.
The program also has a 3-D printing unit that makes scaled replicas of organs for learning and teaching.
The Simulator Program has a sizable staff of 18 full-time employees. Every year, about 250 different clinicians utilize a variety of SIM models and program software while they engage in about 1,500 simulation events that literally save lives while they hone their techniques and anticipate issues that can present in the live-patient situation.
The next step in the evolving Simulator Program is to include a virtual clinic with areas to simulate operating and recovery rooms. The plan is to have the entire Simulator Program in one space.
Boston Children’s Hospital is leading the way in training residents in perfecting surgery before they perform a procedure on a live patient. There is much to be learned from their research and Simulation Program.
December 7th, 2015 | The Blog
Let’s take a look at emotional health this week. With the crazy world around us, adults are nervous and concerned about their safety and well-being but most adults are able to fend for themselves. What about the pediatric population who hears the concern in their parents or care-takers voices? What can they truly process and how can we, as adults, make them feel safe?
The National Association of School Psychologists (NASP) has recently published a list of tips to help children cope with terrorism and threats to their safety and well-being. It is important that we keep pediatric patients feeling safe and secure at all times, to the best of our adult ability.
What Should Adults Do?
This is a list of NASP’s recommendations to help children cope with the fear and anxiety that accompany terrorism in their world:
The world we live in needs to be safe and secure for future generations. As healthcare providers (and parents or responsible adults), it is our duty to keep children feeling safe.
December 1st, 2015 | The Blog
A good cup of java, a hot cup of coffee or a cuppa Joe…call it whatever you want but it all boils down to America’s favorite hot drink…a simple cup of coffee.
A recent study, which was published in the Circulation journal, confirms that individuals who drink three to five cups of coffee per day have a lower risk of premature death than those individuals who did not drink coffee everyday.
The Facts Revealed in the Study
People who drink three to five cups of coffee per day have a 15% lower risk of premature death than those who do not drink coffee. This study-found statistic refers to caffeinated coffee drinkers but decaf drinkers also reaped the positive health benefits.
For most people, 200 mg or the equivalent of two cups of coffee is the optimal amount of caffeine per day. This amount helps to potentiate cognitive function and elevate the drinker’s mood. It is a fine balance between too much and just enough coffee consumption to reap the benefits.
The Variables Related to Coffee Consumption
There are many variables when it comes to drinking a cup of coffee, which include but are not limited to the following:
The?Benefits of Drinking Coffee
According to earlier information and this current study, the benefits linked to drinking coffee, regular or decaf, include but are not limited to the following:
The Bad Effects of Coffee Consumption
While everything we do has benefits and downsides, the downside to coffee drinking is pretty consistent. The effects of consuming too much caffeine, over 400 mg, can cause nausea and insomnia. The most commonly reported side effect of which is insomnia.
Bottomline Results of the Study
There were similar benefits noted for caffeinated and decaffeinated coffee drinkers so the basic answer to longevity is not the caffeine. Coffee beans are a blend of a variety of nutrients and phytochemicals that work together to achieve the aforementioned health benefits, rather than the sole effect of caffeine.
The study authors do not recommend that people who does not like coffee should start to drink it for the proposed benefits. The results are not absolute enough to make the recommendation that, no matter what, everyone should drink coffee.
The study confirms an association, as coined by one of the lead authors of the study, between coffee consumption and longevity. It does not totally qualify the fact that drinking coffee will increase a person’s life expectancy.
Coffee should be enjoyed for what it is. If there are health benefits enjoyed as a result, then consider it a bonus.
November 20th, 2015 | The Blog
Exercise is important in all stages of life, young, old and in between. A recent study determined that a lack of regular exercise is potentially twice as deadly as being obese. This is a significant finding given that past information focused on being a person being obese and/or overweight, not making a direct link to the exercise factor.
The study declared that 20 minutes of walking per day can be enough exercise to change the risk of early death, when leading a sedentary or inactive life, for the better. Too many people have sedentary jobs and sit at a desk staring at a computer screen all day. It is time to get up and move, every single day.
The report was published in the American Journal of Clinical Nutrition and states that, “Just a small amount of physical activity each day could have substantial health benefits for people who are physically inactive.”
The Correlation Between Exercise and Obesity
The study looked at height, weight, waist size and, especially, physical activity levels with regard to lowering the overall number of early deaths. The key component of the evaluation was to research the link between early death and physical inactivity. The physical inactivity component was then compared against the the risks related to being obese.
A modest increase, not a radical upswing, in a person’s physical activity level can make a substantial difference reducing their risk of early death.
The measurement of obesity’s impact on an early death is more difficult to determine than measuring adequate physical exercise. In the study, obesity was measured in two ways:
Physical exercise can also be measured in several ways, especially with regard to a specific workout or exertion time frame.
It is important for the American public to be aware of the health risks related to obesity. Reducing overall obesity levels in the U.S. will improve the public’s general health in so many ways.
Exercise should be a part of everyone’s daily life routine, whether they are young or old, rich or poor or lean or obese. Good habits are hard to break so starting to show and teach young people the importance of daily exercise will help to combat the current obesity crisis in America.
The End Result
A lack of exercise carries a doubly high risk, literally, of an early death than does obesity, according to the recent study statistics.
Participating in a regular exercise regime that burns 90 to 110 calories per day accomplishes several positive things including:
The 16% to 30% reduction in the risk of an early death is significant and should be heeded by all. Healthcare professionals need to discuss with all patients and encourage the implementation of a ?simple exercise regime, which can be tweaked as tolerated.
It is the most important to get at least 20 minutes of exercise everyday but more exercise than that is even better. Get up and get moving!
November 20th, 2015 | The Blog
Doctors at Cleveland Clinic are preparing to perform the first ever uterine transplant. This ground-breaking surgical option will change the lives of women who have no uterus.
Sweden, at the University of Gothenburg, is the only country in the world to have done successful uterine transplants. The Swedish results include:
The Qualifications for the Study
About 50,000 women in the U.S. are potential candidates for uterine transplantation. There are some basic qualification, which include:
The Study Plan
The uterine transplant will be temporary. It will be removed after the recipient has one or two babies. The removal is mandated so the recipient can stop taking the sometimes harsh transplant anti-rejection drugs.
Transplanted uteruses will be harvested from deceased donors, rather than putting a live donor at risk. A live donor harvesting takes seven to eleven hours, due to the tiny uterine vessels that are wrapped around the ureters. A uterus can be removed from a deceased donor much faster than from a live donor.
A uterus can survive outside the body for six to eight hours, if it is kept cold.
Candidates undergo psychological testing before committing to the study. They need to be financially stable because they will need to live in Cleveland during portions of the study.
How the Process Works
The candidate will be given hormone therapy to stimulate egg production.
Ten eggs are needed so the woman may need multiple cycles of hormone treatment. Eggs are harvested, fertilized with her partner’s sperm and frozen.
When there are ten frozen embryos, she is placed on the transplant waitlist. The recipient and donor must have matching blood and tissue type.
The actual transplant surgery takes about five hours because it involves:
The woman must wait one year after the transplant, while the anti-rejection drugs are regulated, before getting pregnant.
Fallopian tubes are not connected to the uterus so natural pregnancy is not an option. Transplant recipients undergo in vitro fertilization. One embryo at a time will be implanted until the woman becomes pregnant.
The baby will be delivered via cesarean section before the actual due date to prevent the transplanted uterus from the undue strain of labor.
Final Uterine Removal
After delivering one baby, the mother can opt to keep the uterus intact and have a second baby. For safety reasons, there is a two baby limit imposed on a transplanted uterus.
The uterus can be surgically removed or, some believe, the woman can stop the anti-rejection drugs and let her body reject the organ and it will wither away.
Eight women are currently in the screening process. Cleveland Clinic will perform ten uterine transplants, assess the outcomes and decide if they will move forward with the program.
Uterine transplants are expanding the role of organ transplantation. When organ transplantation was first done, over 50 years ago, it was a means to save lives. Today, it not only saves lives but also improves the quality of life. This is demonstrated in face transplants, hand transplants and now the potential of uterine transplants that will bring a miraculous gift to the recipient-a baby.
November 17th, 2015 | The Blog
Healthcare spending in the United States is projected to surpass $3.3 trillion in 2015, with annual growth expected to take that total to almost $4.8 trillion by 2021, according to the federal Centers for Medicare & Medicaid Services.
Various factors are driving this trend while also transforming the industry, including expanded access to healthcare services, an aging population and evolving technology, such as electronic medical records, telemedicine, mobile health apps and big data analytics.
“Across the world, health care systems are recognizing the need for innovation; advances in health technologies and data management can help facilitate new diagnostic and treatment options,” according to a 2014 outlook by Deloitte.
As healthcare providers seek to maximize efficiency and productivity, they are expected to turn increasingly to enterprise resource planning. By providing access to real-time data, ERP systems can boost the performance of business processes such as customer relationship management, analytics, supply chain management and human resources management.
ERP is “positioned for accelerated growth among hospitals,” HIMSS Analytics noted in its 2014 report “Essentials of the U.S. Hospital IT Market.”
Benefits of ERP
Through the availability of internal and external data across departments and functions, ERP systems allow for automation of processes in order to reduce risk and increase efficiency. Additionally, the implementation of enterprise resource planning in the healthcare industry may lead to:
Overall, ERP systems can enable healthcare organizations to sharpen their focus on their primary mission: providing patients with the right care at the right time.
Although ERP can provide benefits in areas such as information technology spending and business process efficiency, effective implementation is the key to success. Even the most advanced software systems will perform poorly in the absence of a carefully integrated and customized plan for implementation.
In a healthcare setting, ERP implementation may include input from clinicians, healthcare managers and other stakeholders, as well as intensive training programs for all users, not just IT specialists.
Healthcare providers also must determine which type of enterprise resource planning solution best fits their specific needs and goals. Hospitals, physicians’ groups and other organizations may need to select from among on-premises, cloud-based or hybrid ERP systems.
“A well-defined ERP strategy that is agreed to by business leaders is key to success for ERP initiatives,” noted a 2014 report by Gartner, a global IT research firm.
Why is ERP Needed in Healthcare?
Implementing an ERP system can provide significant benefits for healthcare providers, not only in the promotion of proficient performance and functionality, but also in positioning organizations to respond to a quickly evolving industry.
From complying with patient confidentiality regulations to shifting to digital-based record keeping and attracting highly qualified employees, healthcare providers face numerous challenges in a competitive, multitrillion-dollar marketplace. As it has done for decades in manufacturing and other industries, enterprise resource planning can bring greater efficiency and heightened effectiveness to the healthcare arena.
This post was written by Haley DeLeon, who writes content for Florida Tech University Online’s website, including health, business and tech articles for Florida Tech’s online MSIT in Enterprise Resource Planning?program.
November 2nd, 2015 | The Blog
Last week’s post asked, Are You Getting Enough Vitamin D? This week’s discussion about vitamin D turns to the highs, the lows and the treatment plan available.
Vitamin D is the buzz in the world of medicine. Most healthcare providers recommend that a patient take a vitamin D supplement, if their blood level is proven to be low, because past research reported that it is important to sustain bone health. New research reports that a vitamin D deficiency might cause damage to the brain and other body organs.
Why is there such a growing vitamin D deficiency in the US? There are some simple and obvious reasons, which include but are not limited to:
Insufficient Vitamin D Level Downsides
Symptoms of a low vitamin D level include tiredness and general body aches but most people are totally asymptomatic. Low levels of vitamin D are associated with:
Without sufficient vitamin D, the body only absorbs 10-15% of dietary calcium. When the vitamin D levels are proper, the body absorbs about 30 to 40 % of dietary calcium. Bone health is strongly impacted by low levels.
Women with low levels during the first 26 weeks of pregnancy have a greater chance of preeclampsia.
Too Much Vitamin D Downsides
When vitamin D levels are high, the symptoms include, but are not limited to:
The normal level of vitamin D in the body is up to 21 nanograms per milliliter. Vitamin D levels that are too high are worse than having too low of a level. Levels higher than normal can case arteriosclerosis or hardening of the arteries, which increases a person’s risk of heart disease.
The Treatment of Low Levels of Vitamin D
The key to addressing potential health problems is to maintain adequate vitamin D blood levels. There is a simple blood test to check the vitamin D level. Patients should talk to their PCP to be tested so they can be appropriately treated.
If the serum level is low, there are vitamin D supplements available. Eating foods rich in vitamin D include fish, eggs and vitamin D fortified milk.
There are limited foods that contain vitamin D, which include oily fish (salmon, sardines, mackerel), eggs, some breakfast cereals, fortified milk and fortified fat spreads. Vitamin D that is ingested through the GI tract, rather than that which is absorbed through the skin from sunlight, is processed by the body in the same way that it is from sunlight.
Try to absorb the vitamin from the sunshine. At least 10 to 15 minutes of exposure to sunshine is needed to maintain adequate vitamin D levels.
The Bottom Line Message
Most people should acquire enough vitamin D from sunshine and do not need to take a supplement. Patients should check with their PCP for professional guidance and recommendations.
October 27th, 2015 | The Blog
Vitamin D is a fat-soluble vitamin that comes in five forms, D1, D2, D3, D4 and D5. That said, vitamins D2 and D3 are the most important of the five for the human body.
The Purposes for Vitamin D
Vitamin D has several essential baseline purposes for the body. It helps to regulate calcium and phosphorus absorption in the bones of the body. It also helps the cells of the body to effectively communicate and is essential to strengthen the immune system.
This vitamin is also important for muscle function, respiratory system health, anti-cancer properties, brain health and development and heart health.
Getting Enough Vitamin D
Most people are aware that getting vitamin D from sunlight, specifically ultraviolet B rays, is the most common practice. It is important to note that, according to the Vitamin D Council, “you do not need to tan or burn your skin to get vitamin D.” There is no specifically prescribed time of sun exposure to achieve the necessary vitamin D level, according to most healthcare experts. Some recommend 10 to 15 minutes in the midday sun with our sunscreen and wearing shorts and a t-shirt. This exposure time gives a person sufficient radiation to produce 10,000 IU of vitamin D. Fair-skinned people need less exposure than dark-skinned people to get adequate vitamin D.
How do we process vitamin D? Solar energy derived from sunlight changes a chemical in the skin to vitamin D3. The vitamin D3 travels to the liver and kidneys where it is transformed into active vitamin D. The body then utilizes the active vitamin D in the ways in which it is meant to help.
How Much Vitamin D Is Needed??
The daily recommended dose of vitamin D is 600 IU for those ages 1 to 70 years old and 800 IU for anyone over 70 years old. The maximum amount of vitamin D that should be taken per day varies between 4,000 to 10,000 IU, depending upon the individual case.
Those at risk of a vitamin D deficiency are:
The Study At Hand
In the results of a recent study done on middle-age rats, the human implications are far-reaching. When the rats were fed a diet low in vitamin D for a few months, there were changes noted in their behavior.
The Study Results
After eating a diet low in vitamin D, the rats were found to have developed free radical damage to the brain and changes in learning and memory cognitive function.
There were high levels of brain proteins noted, which added significant nitrosative stress and subsequent cognitive changes in the rats. Nitrosative stress is the result of exposure to high levels of nitric oxide or peroxynitrite, an oxidant.
With the vitamin D deficiency cases on the rise in the US, it is important to heed the effects noted on the brain function, especially in the elderly.
Stay tuned for more in-depth information about vitamin D next week when we explore the facts about too much or too little vitamin D in the system and how to effectively treat a low level.
October 23rd, 2015 | The Blog
According to a recent study, there is good data to support the recommendation that smartphones should be kept a safe distance from implanted cardiac devices. There is a rare chance that signal interference can happen when they are in close proximity. The devices affected include the 2.9 million pacemakers implanted between 1993 and 2009 and implanted defibrillators.
The study was done using the Samsung Galaxy 3, Nokia Lumia and HTC One XL smartphones. Patients with implanted cardiac devices placed a smartphone directly on the skin over the implanted device to document the effect.
Patients with implanted cardiac devices were connected to a radio communication tester, which works like a mobile network station. Then, using the maximum transmission power and 50 Hz frequency, which are known to cause interference, the implanted device function was observed and recorded. At the same time, the patients were connected to an electrocardiogram machine to record their cardiac activity.
There were 3,400 tests conducted and only one implanted defibrillator misinterpreted the electromagnetic waves sent by the Nokia and the HTC smartphones. This confirmed that there is a potential for a problem, albeit a rare situation.
The Study Interpretation
In this day and age, most people have a smartphone of some sort. Patients with an implanted cardiac device can use a smartphone but should not place the phone directly over the cardiac device.
A pacemaker can misinterpret the electromagnetic interference (EMI) from smartphones. This can be potentially dangerous to the patient.
The most vulnerable times during a cellphone call are while the call is ringing and when it is connecting to the network. Actually talking on a cellphone was not a vulnerable time.
What Does the Information Mean for Daily Life?
A pause in the cardiac device function can cause a pacemaker dependent patient to experience syncope or faint. Another issue is that an implanted cardiac device can misinterpret smartphone interference as a life-threatening, abnormal heart rhythm called ventricular tachycardia. This malfunction causes the implanted device to deliver a very painful and alarming shock to the heart.
Here are some recommendations derived from the study for patients with implanted cardiac devices to follow:
There is no major concern for patients whose pacemakers are programmed in the usual configuration. The most concern about the interaction between smartphones and implanted cardiac devices is for those with pacemakers in the unipolar mode or with extremely sensitive settings for a variety of reasons.
It is always best to seek the advice of the specific cardiac healthcare professional that cares for the patient. The standard of care expectation is that each patient will be counseled at the time a cardiac device is implanted and at subsequent follow-up visits.
October 14th, 2015 | The Blog
Everyone’s mother always said it and now a study has been done to prove the importance of it…eating breakfast is important. There are many studies investigating what affect eating breakfast has on a person’s general health. One study in particular, done by the Harvard School of Public Health (HSPH), was a long-term look at almost 27, 000 men, ages 45 to 82 years old, over a 16-year span of time.
The Effects of Skipping Breakfast
Skipping breakfast can have one or more of the following effects on a person, when compared to a person who does eat breakfast, according to the recent study:
People who skip breakfast also crave and tend to eat high calorie, more appealing snacks later in the day, especially the late morning hours. Hence, they over eat and tend to lean towards obesity.
At the outset of the study, no one had been diagnosed heart disease or cancer. At the end of the 16 year study, 1,572 of the male study participants experienced non-fatal heart attacks or died of coronary artery disease.
Men who admitted not eating breakfast reported a 27% higher risk of heart attack or death from coronary artery disease than those who regularly ate breakfast.
Interestingly, another finding of the study reports that eating late at night is also not a healthy life choice. Those who eat late at night have a 55% higher risk of developing coronary artery disease than those who do not eat late at night.
A Good Breakfast
Eating a nutritious breakfast is important to keep a person healthy and provide the energy needed to make it through the day.
Here are some guidelines to eating a healthy breakfast:
The advice derived from this eating study is quite simple. It is this: do not skip breakfast. Why? Because eating a healthy breakfast is key factor in lowering a person’s risk of having a heart attack.