#Pulmonary/Sleep Medicine Specialty Clinic

[hammondhenryhospital]

When Is The Right Time To Visit A Doctor For A Sleep Disorder?

If you are one of the 70 million Americans that don’t get a regular good night’s sleep, you might not know what you are missing. Sleep technologists have seen first-hand what a difference a CPAP machine can make in a patient after just one night. If you're regularly feeling tired during the day, despite getting a full night's sleep, you may have a sleep disorder. Many people don't realize that they have a sleep disorder and don't get the treatment they need. It's important to visit a doctor to discuss your sleep habits if you're regularly feeling exhausted. HHM clinics and the Pulmonary/Sleep Medicine Specialty Clinic can help you determine if you have a sleep disorder.

When should you visit a doctor for a sleep disorder?

Sleep disorders can disrupt your life and negatively affect your health. If you think you might have a sleep disorder, it’s important to see a doctor to get a diagnosis and start treatment. There are many different types of sleep disorders, and not all of them are equally serious. Some, like insomnia, can be annoying but are not usually harmful. Others, like sleep apnea, can be much more serious and can lead to health problems like high blood pressure and heart attacks.

Common signs of possible sleep disorder

If you are experiencing any of the following signs, it may be time to consult your physician about a sleep disorder:

You regularly have trouble falling asleep or staying asleep.

You are excessively tired during the day.

You have difficulty concentration or memory problems.

You experience changes in mood or behavior.

You snore loudly or stop breathing during sleep.

You have restless legs or experience regular muscle cramps during sleep.

If you are experiencing any of these symptoms, consult with your physician to rule out any underlying medical conditions. Sleep disorders can be caused by a variety of factors,

What does PAP therapy do to treat sleep apnea?

Positive airway pressure therapy or PAP therapy is the most common treatment for sleep apnea. There are two kinds of PAP therapy - one is CPAP which stands for continuous positive airway pressure and the second is BiPAP, which is bi-level positive airway pressure. The technologist will find the best therapy for you the night of your treatment study. PAP therapy uses room air to gently open the airway to allow a consistent flow of air to move in and out of your airway. It typically takes a brief period of time to get adjusted to the use of PAP therapy, but most people cannot believe the difference it makes on their daily life compared to before PAP therapy.

How do I schedule a sleep study?

Speak with your primary care physician, specialist physician, or nurse about a sleep study. Their office will handle placing an order for a sleep study at a center like Hammond-Henry Sleep Disorder Center. The sleep center will then contact you to schedule your specific date for the sleep study. It’s also important to first speak with your doctor since sleep disorders can be caused by a variety of things and it's important to get to the bottom of what's causing your sleeplessness. Along with determining if a sleep study is needed, your physician will help rule out any underlying health conditions to end up with a treatment plan to help you get the rest you need.

Conclusion

If you're finding it difficult to concentrate or fall asleep during the day, or if your sleep patterns are interfering with work or social activities, it may be time to consult your Geneseo physician. Your physician will assess if you have any medical conditions that may be affecting your sleep, such as diabetes, heart disease, or respiratory problems. It's important to discuss these with your physician to rule out any potential underlying causes as it is determined whether a sleep study is needed.

[harryskanes]

Today was my last day of med school.

To be admitted in Internal Medicine, which is the specialty I chose to pursue in the hope of getting into pulmonary and critical care medicine, I had to attend a specific admission examination this morning, during which I had to sit in front of professors of all the IM specialties and get tested on my knowledge of each subspecialty. This comes after a complementary written part of this exam we had on Monday (2 open questions testing our clinical approach), a more general exam 6 weeks ago (about the entirety of medicine including pediatrics, obgyn... written and oral) and the defense of a memoire (over which i lost so many nights of sleep).

Have to say the last year has probably been the worst of my life so far, lol. I learned a LOT, got so much better at everything, got a sense of what kind of doctor I want to be, met many wonderful people, but being placed in different hospitals all over Belgium, feeling so excluded in some settings (obgyn and surgery lol...), not giving a shit about some department (hi pediatrics), having to study on top of spending 10 hours at the hospital, not seeing my friends for weeks because I was far away and had to work on my memoir during the weekend, the stress of not being sure to get a place in IM, the grind, I've honestly never been more exhausted in my entire life and worst, I feel like I don't even know who I am anymore and how to exist outside of medicine. Even talking to the professors this morning I felt like I couldn't align two words properly after staying home studying for so long ! Anyway this is just me rambling because it's kind of a big deal and I'm very anxiously waiting for the results... but I'm so happy to be done with it. Even if I don't get IM, I'll still be able to work as a Dr next year before trying again. I'm so fucking happy that this nightmare is over. I'll finally be able to sit down and read a book without a jolt of guilt or a voice in my head telling me I should study instead. I can go outside for my own enjoyment !! And not be worried about making it up the following day. I still can't believe it for real omg. Goodbye med school you won't be missed ❤️‍🔥

[hammond-henry-hospital]

If you are one of the 70 million of Americans that don’t get a regular good night’s sleep, you might not know what you are missing. Sleep technologists have seen first-hand what a difference a CPAP machine can make in a patient after just one night. If you're regularly feeling tired during the day, despite getting a full night's sleep, you may have a sleep disorder. Many people don't realize that they have a sleep disorder and don't get the treatment they need. It's important to visit a doctor to discuss your sleep habits if you're regularly feeling exhausted. HHM clinics and the Pulmonary/Sleep Medicine Specialty Clinic can help you determine if you have a sleep disorder.

[narayanihospital]

Infertility Treatment with 24x7 Medical Treatment - Narayani Hospital

Serving People Through Exemplary Health Care

Health care which includes blood sugar monitoring, suture removal, ECG recording, vaccination etc. Plans for Geriatrics care and physical therapy, Holistic Stroke Rehabilitation, Dementia, Post-Surgery and Cancer care also exist in the health care services.

Specialty Medicine with Compassion and Care

Medicine and Health encompasses the study of the prevention, cure, and understanding of disease as well as the investigation of physical and mental wellbeing.

Caring For The Growing Needs Of Community

Engaging in community service provides students with the opportunity to become active members of their community and has a lasting, positive impact on society at large.

Services & Amenities

24/7 Emergency and Critical Care

Availability of all Specialists

Medical Intensive Care Unit

Perioperative Critical Care Unit

ICU and Critical Care Illness

Pathology Service

Rehabilitation Facility

Dialysis and Kidney Care

Chest Medicines

Respiratory infections including tuberculosis and other infections, respiratory critical care, lung cancer sleep medicine, pulmonary function test, bronchoscopy and biopsy, medical thoracoscopy, videoassisted thoracoscopic surgery, pulmonary rehabilitation.

Heart Specialist Nashik.

Neurology

Stroke (paralysis), Headache, Vertigo, Epilepsy (seizures), Parkinsonism, Spondylosis, Neck/Back Pain, Neuropathy, Memory Loss (dementia), Meningitis, Encephalitis, Pediaric Neurological problems: mental retardation cerebral palsy, developmental delay.

Nephrologist Near Me in Nashik.

Orthopedics

24/7 care for emergency fracture treatment, Advanced and multidisciplinary team for polytrauma care, Primary and revision joint replacement, Advanced arthroscopy and sports medicine, Care for paediatric trauma and congenital and developmental orthopedic problems, Spine care centre, Osteoporosis and arthritis clinic.

Orthopedic Doctor Near Me.

Contact us:

Nashik

Mumbai Naka, Shri Vallabh Nagar, Nashik, Maharashtra, 422009 Email: care@narayanihospital.co.in Phone: +91 838-009-2580

[asianhospitalph]

ASIAN HOSPITAL AD MEDICAL CENTER NEWSLETTER ISSUE 8

ACVI SPECIAL FEATURE

ACVI NEW LYMPHEDEMA CLINIC

The Asian Cardiovascular Institute in collaboration with the Asian Cancer Institute launched the new Lymphedema Clinic where it offers comprehensive services to patients with Lymphedema of various origins to help them in the management and treatment for a better quality of living.

Below are some of the services of the new Lymphedema Clinic:

· Initial and Post Consultation & Assessment for Vascular Cardiologist

· Initial Consultation & Assessment for DVT Screening

· Initial Assessment for Vascular Lymphedema Therapy

· Vascular Lymphedema Therapy

o 3 sessions

o 6 sessions

o 12 sessions

To know more about the services of the Lymphedema Clinic, you may contact the Asian Cardiovascular Institute’s Heart Station at (02) 8771-9000 local 5748 and 5929. ƒ

TIPS ON HEART DISEASE PREVENTION

1. Don’t Smoke or Use Tobacco

Stop smoking or using smokeless tobacco and avoid secondhand smoke.

2. Get Moving: Aim at least 30 to 60 Minutes of Activity Daily

Physical activities help control weight and lower the risk of heart disease.

3. Eat a Heart-Healthy Diet

A healthy diet can help protect the heart, improve blood pressure and cholesterol, and reduce the risk of type 2 diabetes.

4. Maintain a Healthy Diet

Reducing weight by just 3% to 5% can help decrease certain fats in the blood, lower blood sugar, reduce the risk of type 2 diabetes, help lower blood pressure, and blood cholesterol level.

5. Get Good Quality of Sleep

Adults need at least seven hours of sleep each night. Make sleep a priority in your life.

6. Manage Stress

Finding alternative ways to manage the stress that can help improve your health such as physical activity, relaxation exercises, or meditation.

7. Get Regular Health Screenings

Better to seek consultation from your doctor if you have a condition such as high cholesterol, high blood pressure, or diabetes.

ACVI MILESTONES THROUGH THE YEARS

In February 2018, The Asian Cardiovascular Institute (ACVI) was established, bringing together the best among Cardiovascular doctors and Allied Health Professionals to provide high-quality, comprehensive, and value-based care to its patients.

Dating back to its roots during Asian Hospital’s inauguration in 2002, ACVI has been steadfast in providing quality cardiovascular care to its patients, with the establishment of individual units such as Heart Station, Cardiac Catheterization Laboratory, and Pulmonary Services among others.

Through the years, ACVI has offered various services in line with its vision to provide world-class and compassionate cardiac health care within the reach of every individual. In 2015, Pacemaker and Syncope Clinic was established at the Heart Station, a specialty clinic that offers various services for patients with arrhythmia, and those with implants and devices.

In 2016 marked the creation of the Smoking Cessation Program of Pulmonary Services, a program designed to create awareness about the effects of cigarette smoking and to provide support services for smokers to help them quit the habit.

In 2018, ACVI celebrated its first wins such as the First CRTD (Cardiac Resynchronization Therapy Defibrillator) using MRI Implant. Later that year, our First TAVR (Transcatheter Aortic Valve Replacement) and the first successful Hybrid TEVAR (Thoracic Endovascular Aortic Aneurysm Repair).

To optimize the quality of life, reduce disease burden, and re-hospitalization of patients who suffer from Heart Failure, ACVI established its very own Heart Failure Clinic in November 2018.

In 2019, in collaboration with the Asian Cancer Institute and the Department of Nuclear Medicine, the first-ever Selective Internal Radiation Therapy (SIRT) or Radio Embolization was performed as one of the newest treatments for liver cancer and metastasis.

The Cardiology Fellowship Training Program was also established in 2019. This three-year intensive program aims to provide the doctors with opportunities to develop competence and proficiency in various fields of cardiology practice.

To better serve its patients, ACVI’s Catheterization Laboratory (Cath Lab) has acquired its 2nd state-of-the-art Philips Azurion Angiography System. True to its promise of continuously improving the clinical outcomes in patients with DES implantation, ACVI has acquired Intravascular Ultrasound (IVUS), Fractional Flow Reserve (FFR), and Rotablator Rotational Atherectomy System.

Despite the challenges of the pandemic, ACVI innovated and improved its facilities and services for the safety and convenience of the patients. 2021 proved to be a step forward for ACVI where they have an expanded and newly improved Heart Station and Cardiac Rehabilitation Unit with advanced equipment and a Treadmill Stress Laboratory built under a negative pressure-controlled environment.

ACVI also launched their new Vascular Lymphedema Clinic that caters to patients with lymphedema of various origins. They also continue to offer a wide range of vascular ultrasound studies to help in locating blockages, abnormal valves, peripheral vascular disease, and stroke symptoms. ACVI’s highly specialized services are designed to provide comprehensive care using advanced imaging techniques and physiological studies. This 2022, the ISCV (Intellispace Cardiovascular) technology will be utilized as the main Cardiovascular Information System of ACVI.

ACVI’sheart and vascular specialists will continuously provide a wide range of minimally invasive treatments for heart and vascular diseases, including lifesaving care for heart attacks. ACVI’s experienced multidisciplinary team of experts is geared to serve and care for all patients seeking help for their Cardiovascular needs.

To know more about the services of the Asian Cardiovascular Institute, you may contact the Heart Station at (02) 8-771-9000 local 5748. ƒ

HOW TO KEEP YOUR HEART HEALTHY

Heart disease is a leading cause of death, but it’s not inevitable. While you can’t change some risk factors — such as family history, sex, or age — there are plenty of ways you can reduce your risk of heart disease.

Asian Hospital and Medical Center’s Interventional Cardiologist, Dr. Marc Louie Del Rosario shared his knowledge on “How to Keep Your Heart Healthy on One News PH Radyo Singko 92.3 last February 19.

If you missed the ONE News PH Radyo Singko on “How to Keep Your Heart Healthy”, the video may be viewed anytime on Asian Hospital’s Facebook page – facebook.com/AsianHospitalPH. ƒ

COMMON THYROID PROBLEMS

1 in 8 women will develop thyroid problems in their lifetime. On the contrary of popular belief, men can get them as well. Your thyroid plays a vital part in regulating your metabolism. It produces hormones that are responsible for controlling how you respond to heat or cold, how your heart rate may increase or decrease, and how much you burn calories. But when it produces too much or too little of these hormones you can develop several diseases.

Asian Hospital and Medical Center’s Endocrinologist, Dr. Monica Therese Cabral talked about “Common Thyroid Problems on CNN Philippines’ Med Talk Health Talk last February 18.

The CNN Med Talk Health Talk on “Common Thyroid Problems” may be viewed anytime on Asian Hospital’s Facebook page – facebook.com/AsianHospitalPH. ƒ

AHMC CONDUCTS CLINICAL TRIAL ON MOLNUPIRAVIR

Asian Hospital and Medical Center (AHMC) is currently conducting a clinical trial for Molnupiravir as a preventive treatment for those exposed to others who have tested positive for COVID-19.

Molnupiravir is an investigational, orally administered form of a potent ribonucleoside analog that inhibits the replication of multiple RNA viruses including SARS-CoV-2, the causative agent of COVID-19. Molnupiravir has been shown to be active in several preclinical models of SARS-CoV-2, including for prophylaxis, treatment, and prevention of transmission, as well as SARS-CoV-1 and MERS.

To find out if you can be part of the clinical trial, contact the Asian Hospital and Medical Center (AHMC) at (0968) 558 3091 or (0927) 007 6602. ƒ

SUSTAIN AND RETAIN OUR NURSES

Just like how we keep in sight our patient outcomes, we also pay attention to our nurses who are at the bedside delivering the best possible Tatak Asian Pusong Asian care. The global COVID-19 pandemic rages across the world. Despite this, we are proud to share with you that result of our overall RN Satisfaction Survey for 2021 yielded - SATISFIED with Nursing Practice Environment, a score of 3.71 out of 5. In addition, since 2018, our RN to RN Interaction ranked first in the domains which significantly shows teamwork among our nurses with or without the pandemic. Let this be our guide as we continue to SUSTAIN and RETAIN our nurses TOGETHER in 2022 and beyond as we continue in our interventions and improve on the areas that need improvement.

To be part of Asian Nursing Family, contact Nursing Recruitment at (02) 8771-9000 local 8301. ƒ

UPCOMING EVENTS

[desunsiliguri]

How Patients With Severe COPD Can Benefit From Long-Term Pulmonary Rehabilitation?

For people with chronic respiratory diseases or lung problems due to other circumstances, pulmonary rehabilitation is a medically supervised program that combines health education, structured exercises, behavior modification, nutrition counseling, and the teaching of breathing techniques. Through pulmonary rehabilitation from the respiratory medicine hospital siliguri, people with chronic respiratory disease can improve their physical and psychological conditions and learn how to establish and maintain healthy behaviors that will benefit their health for years to come.

People with chronic obstructive pulmonary disease, or COPD, can benefit from pulmonary rehabilitation. Studies have shown that it reduces symptoms of breathlessness, improves physical function, and improves quality of life. People who begin pulmonary rehabilitation within three months of hospitalization for COPD-related issues have a significantly lower risk of death after one year when compared to those who begin pulmonary rehabilitation from respiratory medicine hospital siliguri later or who do not participate in pulmonary rehabilitation.

People with lung conditions such as interstitial lung disease, asthma, pulmonary hypertension, cystic fibrosis, as well as those undergoing surgery for lung cancer, lung volume reduction, or a lung transplant may benefit from pulmonary rehabilitation.

A team of health care professionals from a variety of specialties and backgrounds provides pulmonary rehabilitation services, including pulmonologists, respiratory therapists, and exercise physiologists. A pulmonary rehabilitation team may also include experts in nursing, physical medicine and rehabilitation, nutrition, psychology and psychiatry, and sleep medicine, depending on an individual's needs.

As a general rule, pulmonary rehabilitation is provided in outpatient clinics or in respiratory medicine hospital siliguri. It usually involves one to three supervised sessions per week for a period of six to ten weeks.

During pulmonary rehabilitation, the health care team will:

·    Exercise capacity and lung function should be measured.

·    Medical history and current treatments should be reviewed.

·    Questions about physical activity, mental health, and diet should be asked.

·    Make sure each participant has specific goals to achieve.

Based on this information, a specialized care plan can be developed for each patient.

Exercise training is central to pulmonary rehabilitation

A personalized exercise training plan, or exercise prescription, is based on the results of the exercise tests conducted before starting the program, and such a plan is developed for each participant. As per respiratory medicine hospital siliguri the purpose of pulmonary rehabilitation is to improve strength, stamina, and reduce fatigue, breathlessness, and tiredness in participants by combining aerobic exercise, such as treadmill walking, with strength and flexibility training.

[medi-healthcare]

Top 7 Pulmonology Hospitals in India

Source:- https://www.rateyourtreatment.com/General/single-Blog.aspx/top-7-pulmonology-hospitals-in-india

Check out top-rated pulmonology hospitals in India: -

Apollo Hospital

Location: Greams Road, Chennai

Accreditation: JCI

One of the renowned healthcare facilities, Apollo Hospital, has established its position in the healthcare industry by serving patients with the best treatment and care. It is recognized among the top pulmonology centers across India. The center of respiratory medicines serves top-quality treatment with a well-qualified team of chest physicians and pulmonologists.

Indraprastha Apollo Hospital

Location: Sarita Vihar, New Delhi

Accreditation: JCI

The Indraprastha Apollo Hospital, situated in Delhi, has an advanced, fully equipped respiratory, sleep and critical care department. With world-class infrastructure, it houses state-of-the-art facilities and a hi-tech environment to treat patients. A team of highly qualified doctors manages its medical Intensive Care Unit, Bronchoscopy unit, two pulmonary functional laboratories, and Sleep Lab.

Max Super Speciality Hospital

Location: Saket, Delhi

Accreditation: NABH & JCI

Max Healthcare offers multidisciplinary treatment, including bronchoscopy for patients who have respiratory ailments, lung cancer, COPD, sleep problems, and Cystic Fibrosis. It renders top-notch treatment and the finest quality care to its patients. With a fully equipped pulmonary function laboratory and advanced infrastructure, it comprises a team of experts who also provide ancillary services, including respiratory care and nutrition. Emergency and pharmaceutical services are available round the clock.

Nanavati Hospital

Location: Vile Parle West, Mumbai

Accreditation: NABH

Spread across 10,000 sq. ft., Nanavati Hospital is among the most well-known centers of healthcare excellence in India. The comprehensive unit of pulmonology comprises state-of-art departments, ultra-modern systems, with modern medicine. This healthcare facility has a committed team of chest physicians, interventional pulmonologists, technicians, and staff to treat various pulmonary illnesses. From hypertension, respiratory diseases, asthma to sleep disorders, allergic diseases, tuberculosis, etc., the hospital provides the best of its services. Moreover, it uses 3 Tesla 32 channel wide-bore MRI scanners for chest and breast imaging to diagnose lung disorders.

Fortis Hospital

Location: Bannerghatta Road, Bangalore

Accreditation: NABH

Fortis is yet again one of the esteemed healthcare facilities in the country. The Pulmonology department provides both flexible and rigid bronchoscopy services. Equipped with the highest technology and top-quality facilities, the department utilizes all the latest and modern tools to treat respiratory illnesses. The team of skilled pulmonologists works hand-in-hand with the experts of other specialties to deliver personalized and effective care.

BLK Super Speciality Hospital

Location: Delhi

Accreditation: NABH

Situated in Delhi, BLK Super Speciality Hospital embraces a dedicated department of respiratory medicine dealing with an entire range of respiratory conditions. With best-in-class technology and expert professionals, the healthcare facility ensures world-class treatment for its patients. It treats a range of respiratory problems including, asthma and allergic diseases, chronic obstructive pulmonary disease (COPD), lung infections like tuberculosis, interstitial lung diseases, pulmonary hypertension. The Centre offers quality diagnostic, therapeutic, and medical interventions as part of its advanced care and treatment plan.

Columbia Asia Hospital

Location: Hebbal, Bangalore

Accreditation: NABH

Columbia Asia Hospital incorporates one of the finest pulmonary centers in India. It is specially designed for patients suffering from clinical pulmonology disorders. The department is structured with digitized systems and the latest technological innovations to provide a complete range of medical assistance. The division offers management of acute and chronic lung diseases by a team of highly proficient and experienced physicians.

Also, do not forget to read their reviews on RateYourTreatment.com!

[patakareweb]

Dr. Ujjwal Sharma

MCI Registration No.: 12468

Specialty: Pulmonologist

Fee: Rs.300.00

CLINIC:

Advance Chest Clinic, Opp. Veenus City Scan Hospital Road,  Gwalior,  Madhya Pradesh

HOW TO REACH

CALL US

Mob: 9977040512,9977116880

EMAIL ID

ujjwalsharma004@gmail.com

AVAILABILITY

HOSPITALS

Former Doctor of :-

Rajeev Gandhi Cancer Hospital, New Delhi.

Apollo Speciality Hospital, Bangalore

Hinduja Hospital, Mumbai

Jaipur Golden Hospital, New Delhi

AIIMS Hospitals

CLINIC

Speciality Expertise of:-

Allergy, Asthma, Bronchoscopy, COPD, CA Lung, Hemopthysis, Thoracoscopy, Tuberculosis,  Pneumonia, ILD(Fibrosis), MDR TB, Sleep Disorder and Treatment Of All Serious Pulmonary Disease.

Facilities of:-

Bronchoscopy,Thoracoscopy,  Lung Biopsy, Intercostal Tube, Pigtail insertioin, Pleural Tapping, Pleurodesis, Foreignbody, Glue Insertion , EBUS-TBNA, Lymph Node Checkup

For Appointment Call:-9977116880

DESCRIPTION

Advance Chest ClinicDr. Ujjwal SharmaMBBS, DTCD, DNB Pulmonary Medicine(Mumbai)Fellowship in Sleep MedicineFellowship in Interventional PulmonaryFor Appointment Call:- 9977116880Timing :-2:00 pm - 4:00 pm - 6:00 pm - 8:00 pm

[stuartgaray-blog]

Stuart M. Garay, MD, FCCP, is a Leading Pulmonologist with NYU Langone Pulmonary & Critical Care Associates in New York City, NY

Stuart M. Garay, MD, FCCP, is a well-versed pulmonologist who diagnoses and treats patients at NYU Langone Pulmonary & Critical Care Associates in New York City, NY. Furthermore, he has staff memberships at several local hospitals, including NYU Langone Tisch Hospital. Dr. Garay is also a Clinical Professor in the Department of Medicine at NYU Grossman School of Medicine. As a pulmonologist, he specializes in preventing, diagnosing, and treating conditions and diseases of the respiratory tract, including the lungs, bronchial tubes, and the respiratory system, including the nose, pharynx, and throat. Dr. Garay has an impressive professional journey that spans forty-one years and has expanse expertise in the diagnosis, treatment, and prevention of asthma, pulmonary fibrosis, sarcoidosis, chronic bronchitis, COPD, and sleep disorders, including apnea. For more information about Dr. Stuart M. Garay, please visit https://nyulangone.org/doctors/1841392826/stuart-garay.

Stuart M. Garay, MD, FCCP, attended Harvard Medical School in Boston, MA, and received his medical degree in 1974. Furthermore, he conducted his internal medicine residency at Mount Sinai Hospital in New York City, NY (1974-1977). In addition, he completed his fellowship training in pulmonary disease medicine at NYU Grossman School of Medicine/Bellevue Hospital (1977-1979). Dr. Garay received board certification in internal medicine (1977) and pulmonary disease medicine (1980) from the American Board of Internal Medicine. He remains at the forefront of his challenging specialty via memberships and affiliations with prestigious professional societies and associations. In addition to his medical degree, he holds a Bachelor of Arts degree acquired at Columbia College in 1970. For more information about Dr. Stuart M. Garay, please visit https://www.findatopdoc.com/doctor/1367632-Stuart-Garay-pulmonologist-New-York-NY-10016.

[kathleenseiber]

Study finds 30.9% mortality rate from COVID-19

A new study suggests the mortality rate from COVID-19 may be lower than previous reports have indicated.

As COVID-19 has become the leading cause of death in the US, researchers at Emory University report a lower number of deaths than what most have reported for critically ill COVID-19 patients using mechanical ventilation. The research and outcomes appear in the journal Critical Care Medicine.

The researchers conducted a review of critically ill adult patients diagnosed with COVID-19, the disease caused by the coronavirus, SARS-CoV-2, across its academic health system. From March 6 through April 17, 2020, 217 critically ill adults with COVID-19 infection were admitted to six COVID-designated intensive care units (ICUs) at three Emory Healthcare acute-care hospitals.

In contrast to previous reports from Wuhan, China, Italy, and Seattle, where mortality rates ranged from 50 to 97%, Emory researchers reported a mortality rate of 35.7% for patients who required mechanical ventilation (59 patients died out of 165 who received mechanical ventilation) and an overall mortality rate of 30.9% (67 patients died out of 217 in the study) to date. Of that overall number, 60.4% of patients (131 patients out of 217 in the study) have survived to hospital discharge.

“While any death related to COVID-19 is tragic, we felt it was important to share these outcomes among COVID-19 patients requiring ICU admission and mechanical ventilation,” says Sara Auld, assistant professor in the Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine and first author of the paper.

“Other reports, both in the US and globally, have painted a starkly different picture with mortality rates often exceeding 50% in ventilated, critically ill COVID-19 patients. Our early experience indicates that the majority of patients can survive their critical illness.”

About the patients in the study

Among the 217 patients in the study population, 147 (67.7%) have been transferred alive from the ICU, 62 patients (28.6%) died in the ICU (five additional deaths occurred among patients transferred to the floor), and eight (3.7%) remained in the ICU as of May 7.

“In contrast to some of the earliest reports on mortality in COVID-19 ventilated patients, our data provide evidence that COVID-19 mortality rates can be comparable to those seen with ARDS (acute respiratory distress syndrome) due to other causes,” says David J. Murphy, associate professor in the Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine and senior author of the paper.

“These findings suggest that clinical outcomes and survival from the virus may be better than initially reported.”

In the study, the median patient age was 64, with 49 patients who were 75 years or older. Of 217 patients in the study, 98 were women, and the majority of patients (70.5%) were African American. Hypertension, or high blood pressure, was the most common additional health condition in this population of patients (134 patients) followed by diabetes (99 patients). Twenty-one patients were morbidly obese.

“There has been growing concern among both the public and the medical community that survival among those requiring mechanical ventilation was particularly low,” says Mark Caridi-Scheible, assistant professor in the department of anesthesiology in the Division of Critical Care Medicine and co-first author of the paper. “Our hope is that these data can provide some reassurance to medical providers and communities that mechanical ventilation continues to be a life-saving intervention.”

In the study, mortality was associated with older age, with 42.5% mortality in those ages 65 and above as compared to 11.3% in those under age 55. Mortality was also associated with the presence of coronary artery disease, severity of illness on arrival to the ICU, and the need for interventions including mechanical ventilation and dialysis.

“Race and sex did not differ in terms of survival, but patients who died were less likely to be morbidly obese and more likely to have underlying renal disease,” says Caridi-Scheible.

Why the different outcomes?

The researchers say intense planning, the skill of care teams, and a later arrival of COVID-19 illness in Georgia likely influenced outcomes.

“While we did repurpose several existing specialty ICUs to COVID-ICUs, all critically ill patients were cared for by critical care teams with experience managing acute respiratory failure and at standard patient-to-provider and patient-to-nurse ratios,” says study coauthor Craig Coopersmith, professor of surgery and director of the Emory Critical Care Center.

“With our findings of a mortality rate of 30.9% overall and 35.7% for COVID-19 patients who received mechanical ventilation, these results suggest that many patients with acute respiratory failure from COVID-19 can recover, even for those with severe disease requiring intubation and mechanical ventilation,” says Auld.

Funding for this research came from NIH/NIAID and NIH/CTSA grants.

Source: Emory University

The post Study finds 30.9% mortality rate from COVID-19 appeared first on Futurity.

Study finds 30.9% mortality rate from COVID-19 published first on https://triviaqaweb.weebly.com/

[jmhjoco-blog]

You  might have heard it before: Smoking is one of the biggest risk factors for  chronic lung diseases and lung cancer. Because of this risk, Johnson Memorial  Health pulmonary physician Dr. Isam Habib has candid conversation with his  patients about their tobacco use, including vaping. “I have always open and  honest discussion with my patients about their smoking habits, and I do offer  them all the help they might need to quit smoking either by counseling or  medications,” Dr. Habib says.

Dr.  Habib is board certified in pulmonary medicine, critical care medicine and  sleep medicine and his specialties include interventional pulmonology,  bronchoscopy and endobronchial ultrasound (EBUS) and sleep medicine. He has  studied Jordan University  in Amman, Jordan,  Gundersen-Lutheran Medical Center  in La Crosse, Wisconsin  University, Oklahoma Health Sciences  Center in Oklahoma   City and the Mayo Clinic in Rochester,   Minnesota.

Learn  more about Dr. Habib at johnsonmemorial.org/isam-habib-md.

[phawareglobal]

Nicole Reid - phaware® interview 246

Nicole Reid, RN discusses her pulmonary hypertension diagnosis, its impact on her nursing career and the importance of clinical trials.

My name is Nicole Reid, and I have pulmonary hypertension.

I was diagnosed in December 2015. For at least four years prior to that, I had been having a lot of vague symptoms. Things like dizziness and exercise intolerance, and I gained a lot of weight. I kept seeing doctors. I see ENT, I saw cardiology, I saw my regular doctor, all kinds of doctors, and they kept telling me, "You have asthma. You're just a little overweight. You need to work out more, and you're just getting older. I mean, after all, you are 36, so you could expect to have a little change." Then in October 2015, I turned 40 and I got married, and two weeks after my wedding, I could not walk up a flight of stairs without stopping, I was so short of breath. I was short of breath sitting on the couch.

So, I made an appointment with a cardiologist, the one who diagnosed me with asthma, and she came into the room after I had my EKG done and said, "If you weren't sitting here in front of me, I would have thought you were dying of a heart attack. Let's look at pericarditis as a possible diagnosis." So, in order to do that, in order to treat that, you have to go get an echocardiogram. So, she sent me for an echo. She called me that day at work and said, "You have pulmonary hypertension, and it's pretty severe."

Actually, I'm a nurse, and so I had heard of it before, and I was terrified. I'd heard of it and thought it was pretty much just a death sentence, and there was going to be no hope for me. My life was over, and I was devastated. Everything I had worked for, everything that I treasured and loved was being ripped away from me.

I went in for the cardiac catheterization the day after the echo. My pressures were very high. They diagnosed me and sent me to a specialty center at National Institute of Health to join a clinical trial, and also to join a registry there. They're absolutely necessary for any advancement in this field of pulmonary hypertension improvement, cures, or treatments. I think that people get scared about going into a clinical trial, thinking, "Oh, I'm being experimented on," and that you don't have any choices in the matter, but that's not really true. You can always choose to be in a clinical trial or to choose to stop it if anything makes you uncomfortable about it. They explain everything to you before you get started. Without people joining clinical trials, we wouldn't have the medications that we have today to improve our quality of life.

I think I'm really, really privileged being a nurse, because I understand the language that the doctors are using. I speak this language myself, and so I understood what they were telling me when they were talking about things like the medication classes and how they worked, and whether or not we should try something like an intravenous line instead of oral drugs. I also understood the meaning of actually taking better care of myself.

Before the diagnosis, I was working a lot of night shifts and all kinds of shifts, and not eating properly, not resting, no exercise because I didn't feel good, and I really was sort of heading downhill that way. I know it sounds weird, but in a way, the diagnosis was a blessing because it made me realize how short life is in that I really need to take really good care of myself in order to live my best life.

So, I started pulmonary rehab. I take my medicines. I'm very strict about a low-salt diet, and I actually get a decent amount of sleep every night. I'm not working myself to death anymore, and I have a really good quality of life. And I'm looking forward all the new things on the horizon.

So, if I had to give some advice to someone being newly diagnosed, I would say, listen to your doctors and do the hard things. You may not feel like getting up and going to pulmonary rehab every day, but it will help you and you need to push through it. Take your medications even though the side effects are terrible. They will get better, or if you talk to your doctor about it, they can help you manage those side effects better. Take good care of yourself, and don't give up. There's a whole new world out there, and research is coming along every day. You want to stay in your best possible condition so that you can take advantage of that research when it comes through for you.

My name is Nicole Reid, and I'm aware that I'm rare.

Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Never miss an episode with the phaware® podcast app. Follow us @phaware on Facebook, Twitter, Instagram, YouTube & Linkedin Engage for a cure: www.phaware.global/donate #phaware #ClinicalTrials @antidote_me 

Listen and View more on the official phaware™ podcast site

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Maternal-Fetal Medicine

ICYMI: Urbana, IL, USA Cambay Consulting, LLC Job Title: - Maternal Fetal Medicine Specialist Location: - Urbana, IL Contract: - Full Time with Benefits Education: Board certification or eligibility. Relocation Allowances: - Yes (Employer will assist with relocation costs) Job Summary: * Join a growing team of 16 Obstetricians/Gynecologists, 6 Neonatologists, Pediatric Surgery, Gynecologic Oncologist, Geneticist with dedicated MFM genetic counseling, Dietitian and highly skilled subspecialty midlevel staff * Three MFM Apps provide clinic consultations and outreach * Pediatric specialties on site including Gastroenterology, Neurology, Developmental-Behavioral, Pulmonary, Sleep and Genetics; additional consultation services available for Pediatric Cardiology, Infectious Disease, Hematology/Oncology and Endocrinology * Practice the full range of maternal fetal medicine, including prenatal diagnosis, fetal therapy, complex obstetrics, genetic and perinatal consultation * Large referral base of 50 regional referring OB-GYN physicians * In-house coverage for deliveries by BE/BC OB/GYN, NICU and Anesthesia * Dedicated neonatal and perinatal air and ground transport services * 90% office practice within main campus, Client Foundation Hospital * Opportunity for academic and/or research affiliation http://dlvr.it/QxYDvG

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Getting Health Care Right: A Conversation with Deb Rice-Johnson

Deb Rice-Johnson, president of Highmark Inc., has been working to get health care right with the organization for more than 30 years. Her motivations are personal as well as professional.

Six months after taking a leadership role at Highmark, she learned that her late husband, Harry, had been diagnosed with cancer. In the difficult journey that followed, she and her family experienced the health care system’s challenges firsthand.

She knows what it’s like to balance personal, business and family responsibilities while helping someone through an intensive health crisis. She understands the stress of transporting medicine and x-rays from one facility to the next, staying on top of administrative issues, and connecting the dots across different parts of the health care system. She experienced the many challenges of needing to travel to a distant hospital for treatments, away from the comforts of home. When, after a long fight, her husband stopped treatment and was sent home, she also had the emotionally taxing experience of needing to return to the facility where her husband’s treatments took place — where she had hope at one time — to obtain medicine to keep him comfortable during his final days.

And yet, seeing all those flaws in how the system worked, she knew that, relatively speaking, she was one of the lucky ones.

“I worked in a place where I knew the right people,” she explains. “But what happens to people who don’t know where to turn after such a devastating diagnosis?”

Inspired by the example of “tireless doctors and nurses who did everything possible for my husband day in and day out” she became more passionate than ever about “ensuring that every patient receives a superior level of care and support.”

Rice-Johnson says her faith played a profound role in getting through the difficult journey with her husband, guiding her younger daughter, and coming out on the other side of the experience with new resilience, strength and hope. Those qualities also served her well in leading Highmark through unprecedented industry shifts and challenges in the decades since as she strived to keep Highmark at the forefront in changing the health care system to provide greater access to high-quality, affordable care that is well-coordinated and, whenever possible, close to home. I asked about her thoughts on some of the company’s recent efforts.

Bringing Care Closer to Home

Tracey Rapali (TR): I know that improving cancer care is especially meaningful for you — how are we making progress?

Deborah L. Rice-Johnson, president of Highmark, Inc.

Deb Rice-Johnson (DRJ): For patients and families dealing with cancer, we want to make sure you’re getting treatment close to home, receiving the highest quality care, and also doing what we can to provide a good patient experience during a difficult time. While undergoing treatments, continuing to participate in your day-to-day activities as much as possible really helps the patient and family stay grounded and focused. Compared to when my husband had cancer, it’s a big step forward that we offer more treatment options near people’s homes, or even in the home, and care that’s personalized to fit into real lives.

You see this reflected in investments made at Allegheny Health Network (AHN). In June 2017, we announced a $200 million investment to help patients fight cancer close to home and have better access to high-quality, affordable cancer care and leading-edge technology. That includes construction of a new, state-of-the-art AHN Cancer Institute Academic Center at Allegheny General Hospital, which will serve as the hub for cancer-related academic and research activities and will house quaternary medical and radiation oncology programs.

Another part of that investment is creating community-based cancer treatment centers that allow for more care to happen in our local communities, so that patients don’t always have to travel into the city. That means they can spend more time at work or home, they avoid the stress of commuting, and they save money on travel costs.

Across the enterprise, we believe that no one can transform health care alone, so we pursue strategic partnerships and collaborations to drive innovation, leverage best-in-class research and technology, and develop better ways of doing health care.

With cancer, the partnership with Johns Hopkins Medicine in western Pennsylvania is one of the most collaborative, innovative, and integrated programs working to transform cancer care. Working together has benefits in driving research, helping control costs, and providing world-class care to patients. Some specific benefits of this for Highmark health plan members and AHN patients include remote second opinions from Johns Hopkins doctors for people with rare and complex cancers, and expedited, prioritized access to clinical trials. In fact, through this collaboration, patients have access to more than 500 active clinical trials.

We are helping to bring about a new era in cancer care that is much different than when my husband was seeking treatment.

TR: That goal of delivering care closer to home isn’t limited to cancer care — it pertains to care in general?

DRJ: Yes — and it’s closely tied to the issue of access, which has always been part of our mission.

To help create greater access for our customers, we partner with community hospitals and independent physicians who share our values of providing high-quality, affordable care close to home. No one wants to travel far to see a physician when they can receive care right in their own community.

In addition, same-day appointments, which were introduced at AHN in October 2016, are an excellent example of how our health insurance plan and provider network collaborate to improve the customer experience and provide greater access. Since launching, more than 251,000 same-day appointments have been booked, so clearly people value this.

Getting back to investments, we focus on what makes sense for our customers, and what people need now and in the future. Ensuring high-quality care that’s close to home is a top priority in every area. My husband’s care wasn’t close to home, and running from facility to facility and home in between was extremely stressful.

AHN’s state-of-the-art health and wellness pavilions are another example of improving access. Instead of making people come to big hospitals in the city, let’s put facilities in the community that can handle infusion therapies, diagnostic tests, preventive screenings and a broad range of procedures and outpatient services. You see the same principle with AHN’s joint venture with Emerus, which is building four AHN neighborhood hospitals to improve access to emergency, primary and specialty care.

We have 120,000 Highmark health plan members in Erie, so we’ve also been investing in that community, including a $115 million investment in St. Vincent Hospital, which has plans for a new AHN Cancer Institute and is expanding specialized care options through a new Chest Diseases, Pulmonary Rehab and Sleep Center facility.

There are so many facility expansion and renovation projects in progress or planned over the next few years to further improve access to affordable, high-quality health care in western Pennsylvania, and to advance AHN’s leading clinical programs in cardiovascular care, women’s health, neuroscience, and orthopedics. All told, in 2017 we announced more than $1 billion in community investments over the next four to five years, with a total western Pennsylvania community investment of nearly $2.5 billion by 2022.

I’ll add that these investments are having positive economic impacts, as well as medical impacts, for the regions we serve.

Value-Based Care

TR: One area where the payer side of the system is leading the way in transforming health care involves value-based business models. Could you talk about what that means?

DRJ: Our health care model is different than what anyone else has tried to build. As an integrated delivery and financing system, we focus on value, not volume, on all sides of the health care system. So that’s not just reimbursement, it’s also redesigning care models around value. When we say value we mean better experience, access and outcomes at a lower total cost. Prioritizing value addresses flaws in the current health care system that are tied to volume-based business models.

I am especially proud of our True Performance reimbursement program, which launched in 2017. This is a strong example of payer and provider working together around the shared goals of improving health care outcomes for patients, reducing total care costs, and helping physicians engage in patient care coordination and population health management.

True Performance really puts primary care physicians (PCPs) at the center of managing care, and then evaluates and rewards their performance on quality, cost and utilization measures. Highmark has transitioned more than 7,500 providers onto True Performance. In 2017, members covered by the program had 11 percent fewer emergency room visits and 16 percent fewer inpatient admissions, and generated avoided cost savings of more than $260 million.

TR: You mentioned payer and provider working together — that’s an important part of this model, isn’t it?

DRJ: No one has all the answers in a system as complex as health care, so we’ve embraced the power of community and provider partnerships. That also means actively empowering the clinicians in our network by asking them to hold key leadership positions and work together to drive our strategy.

TR: Outside of western Pennsylvania and AHN, how are we working with other provider networks to achieve the same kind of patient-focused improvements?

DRJ: We’re forging partnerships with those who share our values. We don’t have to own everything to provide the highest quality care for our members. If we look at central Pennsylvania, we signed a letter of intent with Geisinger Health System in May 2017 to create a clinical joint venture to provide high-value, high-quality, community-based care and greater patient choice.

There’s also the Penn State Health partnership — an innovative strategic partnership that includes a collective investment of more than $1 billion toward developing a high-value, community-based health care network designed to keep care local and enhance collaboration with community physicians. We will partner with independent community physicians to develop this community-based provider network. This differentiates us from other network models in this market.

That’s just two examples from a very diverse, dynamic approach to strategic partnering and collaboration.

Taking on the Big Challenges

TR: You’ve overcome or led Highmark in overcoming so many big challenges. Can you talk about how we’re responding to one of today’s biggest challenges, the opioid epidemic?

DRJ: Almost everyone is affected by the opioid epidemic in some way. It’s getting worse and we need to pull together in our communities to fight it. We also need to look at all facets of the epidemic, so in February 2018, we declared war on opioid abuse with a three-prong strategy.

Part one is to reduce the use of opioids. Through benefit designs, we are making available effective non-pharmacy therapies for our members to address pain through physical therapy, occupational therapy, chiropractic services and acupuncture. We also offer cognitive behavioral therapy as adjunctive therapy for pain. In addition, Highmark members can access discounted programs for yoga, Pilates and more.

Part two is to ensure safe utilization of opioids if non-narcotics prove ineffective. Here, we monitor prescriber and member behaviors when opioids are needed for chronic pain to ensure that there is no misuse. We accomplish this through our Narcotics Management Program, which places controls on opioids so members have access to appropriate medications in the right amount for the right duration, to help manage and control their pain.

The third prong of our approach is to ensure members have access to effective addiction treatment. Our addiction treatment is part of a comprehensive program that includes counseling, behavioral therapy and access to medications that help them through their treatment programs.

TR: There is so much change in health care right now, and many people talking about “transforming health care.” Why do you think Highmark, and the entire Highmark Health organization, is particularly well positioned to take on that challenge?

DRJ: In addition to our willingness to make bold changes in the health care business model, I would say we have some cultural advantages over many organizations. The collaborative mindset here is important — getting everyone aligned on the goal of creating value for the customer and then working together to achieve that goal. Collaborating leads to smarter change and faster change.

And then looking at priorities — some organizations make investments that are more about power than patients. That’s not going to overcome our nation’s health care challenges. I think our focus on the customer — the health plan member, the patient, the employer paying for care — is the way forward.

Getting Health Care Right: A Conversation with Deb Rice-Johnson published first on