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Fighting Chaos with Care, community trust, engagement must be cornerstones of pandemic response

Posted in Artificial Intelligence Applications in Health Care, Artificial Intelligence in Health Care - Tools & Innovations, Clinical & Translational, coronavirus, COVID-19, COVID-19, COVID-19 effects on Human Heart, COVID-19: Pandemic Surgery Guidance, Health Care System by Country, Hospital-based Medical Innovations, Mechanisms of infection by SARS-CoV-2, SARS-CoV-2, SARS-CoV-2 circulating variants , SARS-CoV-2 Viral Variants, Support Staff, Supportive therapies, Treatment Protocols for COVID-19, United States, tagged Community based Health care, Contact tracing, coronavirus, COVID-19, Global Health Security Index, Infectious disease, Johns Hopkins University, Partners In Health, Public Health system, SARS-CoV-2, Social Support, World Health Organization on April 13, 2021| Leave a Comment »

Fighting Chaos with care, community trust, engagement must be cornerstones of pandemic response

Reporter: Amandeep Kaur, BSc, MSc (Exp. 6/2021)

According to the Global Health Security Index released by Johns Hopkins University in October 2019 in collaboration with Nuclear Threat Initiative (NTI) and The Economist Intelligence Unit (EIU), the United States was announced to be the best developed country in the world to tackle any pandemic or health emergency in future.

The table turned within in one year of outbreak of the novel coronavirus COVID-19. By the end of March 2021, the country with highest COVID-19 cases and deaths in the world was United States. According to the latest numbers provided by World Health Organization (WHO), there were more than 540,000 deaths and more than 30 million confirmed cases in the United States.

Joia Mukherjee, associate professor of global health and social medicine in the Blavatnik Institute at Harvard Medical School said,

“When we think about how to balance control of an epidemic over chaos, we have to double down on care and concern for the people and communities who are hardest hit”.

She also added that U.S. possess all the necessary building blocks required for a health system to work, but it lacks trust, leadership, engagement and care to assemble it into a working system.

Mukherjee mentioned about the issues with the Index that it undervalued the organized and integrated system which is necessary to help public meet their needs for clinical care. Another necessary element for real health safety which was underestimated was conveying clear message and social support to make effective and sustainable efforts for preventive public health measures.

Mukherjee is a chief medical officer at Partners In Health, an organization focused on strengthening community-based health care delivery. She is also a core member of HMS community members who play important role in constructing a more comprehensive response to the pandemic in all over the U.S. With years of experience, they are training global health care workers, analyzing the results and constructing an integrated health system to fight against the widespread health emergency caused by coronavirus all around the world.

Mukherjee encouraged to strengthen the consensus among the community to constrain this infectious disease epidemic. She suggested that validation of the following steps are crucial such as testing of the people with symptoms of infection with coronavirus, isolation of infected individuals by providing them with necessary resources and providing clinical treatment and care to those people who are in need. Mukherjee said, that community engagement and material support are not just idealistic goal rather these are essential components for functioning of health care system during an outburst of coronavirus.

Continued alertness such as social distancing and personal contact with infected individual is important because it is not possible to rapidly replace the old-school public health approaches with new advanced technologies like smart phone applications or biomedical improvements.

Public health specialists emphasized that the infection limitation is the only and most vital strategy for controlling the outbreak in near future, even if the population is getting vaccinated. It is crucial to slowdown the spread of disease for restricting the natural modification of more dangerous variants as that could potentially escape the immune protection mechanism developed by recently generated vaccines as well as natural immune defense systems.

Making Crucial connections

The treatment is more expensive and complicated in areas with less health facilities, said Paul Farmer, the Kolokotrones University Professor at Harvard and chair of the HMS Department of Global Health and Social Medicine. He called this situation as treatment nihilism. Due to shortage of resources, the maximum energy is focused in public health care and prevention efforts. U.S. has resources to cope up with the increasing demand of hospital space and is developing vaccines, but there is a form of containment nihilism- which means prevention and infection containment are unattainable- said by many experts.

Farmer said, integration of necessary elements such as clinical care, therapies, vaccines, preventive measures and social support into a single comprehensive plan is the best approach for a better response to COVID-19 disease. He understands the importance of community trust and integrated health care system for fighting against this pandemic, as being one of the founders of Partners In Health and have years of experience along with his colleagues from HMS and PIH in fighting epidemics of HIV, Ebola, cholera, tuberculosis, other infectious and non-infectious diseases.

PIH launched the Massachusetts Community Tracing Collaborative (CTC), which is an initiative of contact tracing statewide in partnership with several other state bodies, local boards of Health system and PIH. The CTC was setup in April 2020 in U.S. by Governor Charlie Baker, with leadership from HMS faculty, to build a unified response to COVID-19 and create a foundation for a long-term movement towards a more integrated community-based health care system.

The contact tracing involves reaching out to individuals who are COVID-19 positive, then further detect people who came in close contact with infected individuals and screen out people with coronavirus symptoms and encourage them to seek testing and take necessary precautions to break the chain of infection into the community.

In the initial phase of outbreak, the CTC group comprises of contact tracers and health care coordinators who spoke 23 different languages, including social workers, public health practitioners, nurses and staff members from local board health agencies with deep links to the communities they are helping. The CTC worked with 339 out of 351 state municipalities with local public health agencies relied completely on CTC whereas some cities and towns depend occasionally on CTC backup. According to a report, CTC members reached up to 80 percent of contact tracking in hard-hit and resource deprived communities such as New Bedford.

Putting COVID-19 in context

Based on generations of experience helping people surviving some of the deadliest epidemic and endemic outbreaks in places like Haiti, Mexico, Rwanda and Peru, the staff was alert that people with bad social and economic condition have less space to get quarantined and follow other public health safety measures and are most vulnerable people at high risk in the pandemic situation.

Infected individuals or individuals at risk of getting infected by SARS-CoV-2 had many questions regarding when to seek doctor’s help and where to get tested, reported by contact tracers. People were worried about being evicted from work for two weeks and some immigrants worried about basic supplies as they were away from their family and friends.

The CTC team received more than 7,000 requests for social support assistance in the initial three months. The staff members and contact tracers were actively connecting the resourceful individuals with the needy people and filling up the gap when there was shortage in their own resources.

Farmer said, “COVID is a misery-seeking missile that has targeted the most vulnerable.”

The reality that infected individuals concerned about lacking primary household items, food items and access to childcare, emphasizes the urgency of rudimentary social care and community support in fighting against the pandemic. Farmer said, to break the chain of infection and resume society it is mandatory to meet all the elementary needs of people.

“What kinds of help are people asking for?” Farmer said and added “it’s important to listen to what your patients are telling you.”

An outbreak of care

The launch of Massachusetts CTC with the support from PIH, started receiving requests from all around the country to assist initiating contact tracing procedures. In May, 2020 the organization announced the launch of a U.S. public health accompaniment to cope up with the asked need.

The unit has included team members in nearly 24 states and municipal health departments in the country and work in collaboration with local organizations. The technical support on things like choosing and implementing the tools and software for contact tracing was provided by PIH. To create awareness and provide new understanding more rapidly, a learning collaboration was established with more than 200 team members from more than 100 different organizations. The team worked to meet the needs of population at higher risk of infection by advocating them for a stronger and more reliable public health response.

The PIH public health team helped to train contact trackers in the Navajo nation and operate to strengthen the coordination between SARS-CoV-2 testing, efforts for precaution, clinical health care delivery and social support in vulnerable communities around the U.S.

“For us to reopen our schools, our churches, our workplaces,” Mukherjee said, “we have to know where the virus is spreading so that we don’t just continue on this path.”

SOURCE:

https://hms.harvard.edu/news/fighting-chaos-care?utm_source=Silverpop&utm_medium=email&utm_term=field_news_item_1&utm_content=HMNews04052021

Other related articles were published in this Open Access Online Scientific Journal, including the following:

T cells recognize recent SARS-CoV-2 variants

Reporter: Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2021/03/30/t-cells-recognize-recent-sars-cov-2-variants/

The WHO team is expected to soon publish a 300-page final report on its investigation, after scrapping plans for an interim report on the origins of SARS-CoV-2 — the new coronavirus responsible for killing 2.7 million people globally

Reporter: Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2021/03/27/the-who-team-is-expected-to-soon-publish-a-300-page-final-report-on-its-investigation-after-scrapping-plans-for-an-interim-report-on-the-origins-of-sars-cov-2-the-new-coronavirus-responsibl/

Need for Global Response to SARS-CoV-2 Viral Variants

Reporter: Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2021/02/12/need-for-global-response-to-sars-cov-2-viral-variants/

Mechanistic link between SARS-CoV-2 infection and increased risk of stroke using 3D printed models and human endothelial cells

Reporter: Adina Hazan, PhD

https://pharmaceuticalintelligence.com/2020/12/28/mechanistic-link-between-sars-cov-2-infection-and-increased-risk-of-stroke-using-3d-printed-models-and-human-endothelial-cells/

Artificial intelligence predicts the immunogenic landscape of SARS-CoV-2

Reporter: Irina Robu, PhD

https://pharmaceuticalintelligence.com/2021/02/04/artificial-intelligence-predicts-the-immunogenic-landscape-of-sars-cov-2/

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Live Notes and Conference Coverage in Real Time. COVID19 And The Impact on Cancer Patients Town Hall with Leading Oncologists; April 4, 2020

Posted in Accountable Care Organizations, Biomarkers: Inflammation, Cancer - General, Cancer and Current Therapeutics, Cancer Researchers Fighting COVID-19, Conference Coverage with Social Media, COVID-19, COVID-19: Pandemic Surgery Guidance, Ethics and Leadership, Health Economics and Outcomes Research, Human Immune System in Health and in Disease, Immunotherapy, interventional oncology, Interventional Oncology: Radiofrequency Ablation, Transarterial Chemoembolization, Microwave Ablation and Irreversible Electroporation (IRE), Interviews with Scientific Leaders, Patient Experience, Patient Experience: Personal Memories of Invasive Medical Intervantion, Patient Outlook, Patient-centered Medicine, Patient’s Voice: Personal Experience with Invasive Medical Procedures, REAL TIME Conference Coverage Twitter's Hashtags and Handles per Presentation/session, SARS-CoV-2, Scientific & Biotech Conferences: Press Coverage, Support Staff, Supportive therapies, Virus Infective Acute Respiratory Syndrome: SARS-CoV, Women Health, tagged #COVID-19, Cancer Care, cancer patient, cancer patient advocacy, cancer patient management, Conference Coverage with Social Media, coronavirus, COVID-19, immunosupression, patient-interaction, physician and patient, physician-patient relationship, real time conference coverage, SARS-CoV-2 on April 4, 2020| Leave a Comment »

Live Notes and Conference Coverage in Real Time. COVID19 And The Impact on Cancer Patients Town Hall with Leading Oncologists; April 4, 2020

Reporter: Stephen J. Williams, PhD

@StephenJWillia2

UPDATED 5/11/2020 see below

This update is the video from the COVID-19 Series 4.

UPDATED 4/08/2020 see below

The Second in a Series of Virtual Town Halls with Leading Oncologist on Cancer Patient Care during COVID-19 Pandemic: What you need to know

The second virtual Town Hall with Leading International Oncologist, discussing the impact that the worldwide COVID-19 outbreak has on cancer care and patient care issues will be held this Saturday April 4, 2020. This Town Hall Series is led by Dr. Roy Herbst and Dr. Hossain Borghaei who will present a panel of experts to discuss issues pertaining to oncology practice as well as addressing physicians and patients concerns surrounding the risk COVID-19 presents to cancer care. Some speakers on the panel represent oncologist from France and Italy, and will give their views of the situation in these countries.

Speakers include:

Roy S. Herbst, MD, PhD, Ensign Professor of Medicine (Medical Oncology) and Professor of Pharmacology; Chief of Medical Oncology, Yale Cancer Center and Smilow Cancer Hospital; Associate Cancer Center Director for Translational Research, Yale Cancer Center

Hossain Borghaei, DO, MS , Chief of Thoracic Medical Oncology and Director of Lung Cancer Risk Assessment, Fox Chase Cancer Center

Giuseppe Curigliano, MD, PhD, University of Milan and Head of Phase I Division at IEO, European Institute of Oncology

Paolo Ascierto, MD National Tumor Institute Fondazione G. Pascale, Medical oncologist from National Cancer Institute of Naples, Italy

Fabrice Barlesi, MD, PhD, Thoracic oncologist Cofounder Marseille Immunopole Coordinator #ThePioneeRproject, Institut Gustave Roussy

Jack West, MD, Department of Medical Oncology & Therapeutics Research, City of Hope California

Rohit Kumar, MD Department of Medicine, Section of Pulmonary Medicine, Fox Chase Cancer Center

Christopher Manley, MD Director, Interventional Pulmonology Fox Chase Cancer Center

Hope Rugo, MD FASCO Division of Hematology and Oncology, University of California San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center

Harriet Kluger, MD Professor of Medicine (Medical Oncology); Director, Yale SPORE in Skin Cancer, Yale Cancer Center

Marianne J. Davies, DNP, MSN, RN, APRN, CNS-BC, ACNP-BC, AOCNP Assistant Professor of Nursing, Yale University

Barbara Burtness, MD Professor of Medicine (Medical Oncology); Head and Neck Cancers Program, Yale University

@pharma_BI and @StephenJWillia2 will be Tweeting out live notes using #CancerCareandCOVID19

Live Notes

Part I: Practice Management

Dr. Jack West from City of Hope talked about telemedicine: Coordination of the patient experience, which used to be face to face now moved to a telemedicine alternative. For example a patient doing well on personalized therapy, many patients are well suited for a telemedicine experience. A benefit for both patient and physician.

Dr. Rohit Kumar: In small cancer hospitals, can be a bit difficult to determine which patient needs to come in and which do not. For outpatients testing for COVID is becoming very pertinent as these tests need to come back faster than it is currently. For inpatients the issue is personal protection equipment. They are starting to reuse masks after sterilization with dry heat. Best to restructure the system of seeing patients and scheduling procedures.

Dr. Christopher Manley: hypoxia was an issue for COVID19 patients but seeing GI symptoms in 5% of patients. Nebulizers have potential to aerosolize. For patients in surgery prep room surgical masks are fine. Ventilating these patients are a challenge as hypoxia a problem. Myocarditis is a problem in some patients. Diffuse encephalopathy and kidney problems are being seen. So Interleukin 6 (IL6) inhibitors are being used to reduce the cytokine storm presented in patients suffering from COVID19.

Dr. Hope Rugo from UCSF: Breast cancer treatment during this pandemic has been challenging, even though they don’t use too much immuno-suppressive drugs. How we decide on timing of therapy and future visits is crucial. For early stage breast cancer, neoadjuvant therapy is being used to delay surgeries. Endocrine therapy is more often being used. In patients that need chemotherapy, they are using growth factor therapy according to current guidelines. Although that growth factor therapy might antagonize some lung problems, there is less need for multiple visits.

For metastatic breast cancer, high risk ER positive are receiving endocrine therapy and using telemedicine for followups. For chemotherapy they are trying to reduce the schedules or frequency it is given. Clinical trials have been put on hold, mostly pharmokinetic studies are hard to carry out unless patients can come in, so as they are limiting patient visits they are putting these type of clinical studies on hold.

Dr. Harriet Kluger: Melanoma community of oncologists gathered together two weeks ago to discuss guidelines and best practices during this pandemic. The discussed that there is a lack of data on immunotherapy long term benefit and don’t know the effectiveness of neoadjuvant therapy. She noted that many patients on BRAF inhibitors like Taflinar (dabrafenib) or Zelboraf (vemurafenib) might get fevers as a side effect from these inhibitors and telling them to just monitor themselves and get tested if they want. Yale has also instituted a practice that, if a patient tests positive for COVID19, Yale wants 24 hours between the next patient visit to limit spread and decontaminate.

Marianne Davies: Blood work is now being done at satellite sites to limit number of in person visits to Yale. Usually they did biopsies to determine resistance to therapy but now relying on liquid biopsies (if insurance isn’t covering it they are working with patient to assist). For mesothelioma they are dropping chemotherapy that is very immunosuppressive and going with maintenance pembrolizumab (Keytruda). It is challenging in that COPD mimics the symptoms of COVID and patients are finding it difficult to get nebulizers at the pharmacy because of shortages; these patients that develop COPD are also worried they will not get the respirators they need because of rationing.

Dr. Barbara Burtness: Head and neck cancer. Dr. Burtness stresses to patients that the survival rate now for HPV positive head and neck is much better and leaves patients with extra information on their individual cancers. She also noted a registry or database that is being formed to track data on COVID in patients undergoing surgery and can be found here at https://globalsurg.org/covidsurg/

About CovidSurg

There is an urgent need to understand the outcomes of COVID-19 infected patients who undergo surgery.
Capturing real-world data and sharing international experience will inform the management of this complex group of patients who undergo surgery throughout the COVID-19 pandemic, improving their clinical care.
CovidSurg has been designed by an international collaborating group of surgeons and anesthetists, with representation from Canada, China, Germany, Hong Kong, Italy, Korea, Singapore, Spain, United Kingdom, and the United States.

Dr. Burtness had noted that healthcare care workers are at high risk of COVID exposure during ear nose and throat (ENT) procedures as the coronavirus resides in the upper respiratory tract. As for therapy for head and neck cancers, they are staying away from high dose cisplatin because of the nephrotoxicity seen with high dose cisplatin. An alternative is carboplatin which generally you do not see nephrotoxicity as an adverse event (a weekly carboplatin). Changing or increasing dose schedule (like 6 weeks Keytruda) helps reduce immunologic problems related to immunosupression and patients do not have to come in as often.

Italy and France

Dr. Paolo Ascierto: with braf inhibitors, using in tablet form so patients can take from home. Also they are moving chemo schedules for inpatients so longer dosing schedules. Fever still a side effect from braf inhibitors and they require a swab to be performed to ascertain patient is COVID19 negative. Also seeing pneumonitis as this is an adverse event from checkpoint inhibitors so looking at CT scans and nasal swab to determine if just side effect of I/O drugs or a COVID19 case. He mentioned that their area is now doing okay with resources.

Dr. Guiseppe Curigliano mentioned about the redesign of the Italian health system with spokes and hubs of health care. Spokes are generalized medicine while the hubs represent more specialized centers like CV hubs or cancer hubs. So for instance, if a melanoma patient in a spoke area with COVID cases they will be referred to a hub. He says they are doing better in his area

In the question and answer period, Dr. West mentioned that they are relaxing many HIPAA regulations concerning telemedicine. There is a website on the Centers for Connective Health Policy that shows state by state policy on conducting telemedicine. On immuno oncology therapy, many in the panel had many questions concerning the long term risk to COVID associated with this type of therapy. Fabrice mentioned they try to postpone use of I/O and although Dr. Kluger said there was an idea floating around that PD1/PDL1 inhibitors could be used as a prophylactic agent more data was needed.

Please revisit this page as the recording of this Town Hall will be made available next week.

UPDATED 4/08/2020

Below find the LIVE RECORDING and TAKEAWAYS by the speakers

Town Hall Takeaways

Utilize Telehealth to Its Fullest Benefit

· Patients doing well on targeted therapy or routine surveillance are well suited to telemedicine

· Most patients are amenable to this, as it is more convenient for them and minimizes their exposure

· A patient can speak to multiple specialists with an ease that was not previously possible

· CMS has relaxed some rules to accommodate telehealth, though private insurers have not moved as quickly, and the Center for Connected Health Policy maintains a repository of current state-by-state regulations: https://www.cchpca.org/

Practice Management Strategies

· In the face of PPE shortages, N95 masks can be decontaminated using UV light, hydrogen peroxide, or autoclaving with dry heat; the masks can be returned to the original user until the masks are no longer suitable for use

· For blood work or scans, the use of external satellite facilities should be explored

· Keep pumps outside of the room so nurses can attend to them quickly

· Limit the use of nebulizers, CPAPs, and BiPAPs due to risk of aerosolization

Pool Our Knowledge for Care of COVID Patients

· There is now a global registry for tracking surgeries in COVID-positive cancer patients: https://globalsurg.org/cancercovidsurg/

· Caution is urged in the presence of cardiac complications, as ventilated patients may appear to improve, only to suffer severe myocarditis and cardiac arrest following extubation

· When the decision is made to intubate, intubate quickly, as less invasive methods result in aerosolization and increased risks to staff

Study the Lessons of Europe

· The health care system in Italy has been reorganized into “spokes” and “hubs,” with a number of cancer hubs; if there is a cancer patient in a spoke hospital with many COVID patients, this patient may be referred to a hub hospital

· Postpone adjuvant treatments whenever possible

· Oral therapies, which can be managed at home, are preferred over therapies that must be administered in a healthcare setting

· Pneumonitis patients without fevers may be treated with steroids, but nasal swab testing is needed in the presence of concomitant fever

· Any staff who are not needed on site should be working from home, and rotating schedules can be used to keep people healthy

· Devise an annual epidemic control plan now that we have new lessons from COVID

We Must Be Advocates for Our Cancer Patients

· Be proactive with other healthcare providers on behalf of patients with a good prognosis

· Consider writing letters for cancer patients for inclusion into their chart, or addendums on notes, then encourage patients to print these out, or give it to them during their visit

· The potential exists for a patient to be physiologically stable on a ventilator, but intolerant of decannulation; early discussions are necessary to determine reasonable expectations of care

· Be sure to anticipate a second wave of patients, comprised of cancer patients for whom treatments and surgery have been delayed!

Tumor-Specific Learnings

Ø Strategies in Breast Cancer:

· In patients with early-stage disease, promote the use of neoadjuvant therapy where possible to delay the need for surgery

· For patients with metastatic disease in the palliative setting, transition to less frequent chemotherapy dosing if possible

· While growth factors may pose a risk in interstitial lung disease, new guidelines are emerging

Ø Strategies in Melanoma:

· The melanoma community has released specific recommendations for treatment during the pandemic: https://www.nccn.org/covid-19/pdf/Melanoma.pdf

· The use of BRAF/MEK inhibitors can cause fevers that are drug-related, and access to an alternate clinic where patients can be assessed is a useful resource

Ø Strategies in Lung Cancer:

· For patients who are stable on an oral, targeted therapy, telehealth check-in is a good option

· For patients who progress on targeted therapies, increased use of liquid biopsies when appropriate can minimize use of bronchoscopy suites and other resources

· For patients on pembrolizumab monotherapy, consider switching to a six-week dosing of 400 mg

· Many lung cancer patients worry about “discrimination” should they develop a COVID infection; it is important to support patients and help manage expectations and concerns

UPDATED 5/11/2020

Townhall on COVID-19 and Cancer Care with Leading Oncologists Series 4

Addressing the Challenges of Cancer Care in the Community

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Curation of Resources for High Risk People to COVID-19 Infection: Guidances for Transplant Patients

Posted in COVID-19, COVID-19: Pandemic Surgery Guidance, Economic Impact of Coronavirus Pandemic, Immune-Mediation (independent immunopathology: lung and reticuloendothelial system), number of asymptomatic infections, Patient Experience: Personal Memories of Invasive Medical Intervantion, Patient Outlook, SAR-Cov-2 a vasculotropic (blood vessels) RNA Virus, SARS-CoV-2, SARS-COV2 Hijacking the Complement and Coagulation Systems, Serology tests for coronavirus antibodies, Supportive therapies, Surgical Procedure, Treatment Protocols for COVID-19, Vaccinology, Virus Infective Acute Respiratory Syndrome: SARS-CoV, tagged #COVID-19, Allotransplantation, American Society of Transplantation, coronavirus, COVID-19, immunocompromised, immunosuppression, Immunosuppressive drug, infection, organ donation, safety guidelines, SARS-CoV-2 on April 2, 2020| Leave a Comment »

Curation of Resources for High Risk People to COVID-19 Infection :Guidances for Transplant Patients

Curator: Stephen J. Williams, PhD

From the American Society of Transplantation

Source: https://www.myast.org/information-transplant-professionals-and-community-members-regarding-2019-novel-coronavirus

INFORMATION FOR TRANSPLANT PROFESSIONALS AND COMMUNITY MEMBERS REGARDING 2019 NOVEL CORONAVIRUS

The recent outbreak of a novel coronavirus (COVID-19) in Wuhan, Hubei Province, China and the finding of infection in many other countries including the United States has led to questions among transplant programs, Organ Procurement Organizations (OPOs) and patients. The Organ Procurement and Transplantation Network (OPTN) strives to provide up-to-date information to answer these questions and to provide guidance as needed. Accordingly, the OPTN Ad Hoc Donor Transmission Advisory Committee (DTAC), American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS), after careful review of information available from the Centers for Disease Control and Prevention (CDC), offers information to transplant programs and OPOs in light of these concerns. Please visit the OPTN website for more information.

The American Society of Transplantation recently conducted a Town Hall on guidances for transplant patients with regard to the COVID-19 pandemic. A video recording of the Town Hall is given below

Description of the Town Hall by the AST: A number of transplant organizations from around the world have partnered to develop this educational webinar for the organ donation and transplantation communities. Our goal is to share experiences to date and respond to your questions about the impact of COVID-19 on organ donation and transplantation.

This webinar was recorded on March 23, 2020.

Resource Handout: https://www.myast.org/sites/default/f…

AST COVID-19 Page: https://www.myast.org/covid-19-inform…

The American Society of Transplantation has other up to date resources on their webpage at https://www.myast.org/covid-19-information#

AST Resources For Transplant Professionals

Information for Transplant Professionals (Updated 3/31/20)

Medication Access and Drug Shortage Concerns During the COVID-19 Pandemic: Frequently Asked Questions (posted 3/31/20)

AST Resources For Transplant Recipients and Candidates

Information for Transplant Recipients and Candidates (Updated 3/30/20)

Frequently Asked Questions can be found here https://www.myast.org/coronavirus-disease-2019-covid-19-frequently-asked-questions-transplant-candidates-and-recipients

Mark Spigler from the American Kidney Fund listed some tips specifically for kidney transplant recipients. In his blog

Coronavirus, COVID-19 and kidney patients: what you need to know he wrote:

Because transplant recipients take immunosuppressive drugs, they are at higher risk of infection from viruses such as cold or flu. To limit the possibility of being exposed to the coronavirus that causes COVID-19, transplant patients should follow the CDC’s tips to avoid catching or spreading germs, and contact their health care provider if they develop cold or flu-like symptoms. By being informed and taking your own personal precautions, you can help reduce your risk of coming in contact with the coronavirus that causes COVID-19. You can find more information and resources for kidney patients by visiting our special coronavirus webpage at KidneyFund.org/coronavirus. We’ll update the page with important information for kidney patients and their caregivers as the coronavirus crisis continues to unfold.

Resources from the National Kidney Foundation

Source: https://www.kidney.org/coronavirus/transplant-coronavirus

Coronavirus and Kidney Transplants (please click on the links below)

For more information concerning various issues on COVID-19 please see our Coronavirus Portal at:

https://pharmaceuticalintelligence.com/coronavirus-portal/

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Live Conference Coverage @Medcitynews Converge 2018 Philadelphia: The Davids vs. the Cancer Goliath Part 2

Posted in Best evidence, Cancer - General, Cancer and Current Therapeutics, CANCER BIOLOGY & Innovations in Cancer Therapy, Image Processing/Computing, Imaging-based Cancer Patient Management, interventional oncology, Medical Imaging Technology, Medical Imaging Technology, Image Processing/Computing, MRI, CT, Nuclear Medicine, Ultra Sound, Patents, Patient Experience, Population Health Management, Genetics & Pharmaceutical, Support Staff, Supportive therapies, Uncategorized, tagged cutaneous melanoma, Digital pathology, Glioblastoma, health outcomes research, health outomes, HIPAA, imaging, imaging software, Melanoma on July 12, 2018| Leave a Comment »

Live Conference Coverage @Medcitynews Converge 2018 Philadelphia: The Davids vs. the Cancer Goliath Part 2

Reporter: Stephen J. Williams, PhD

8:40 – 9:25 AM The Davids vs. the Cancer Goliath Part 2

Startups from diagnostics, biopharma, medtech, digital health and emerging tech will have 8 minutes to articulate their visions on how they aim to tame the beast.

Start Time	End Time	Company
8:40	8:48	3Derm
8:49	8:57	CNS Pharmaceuticals
8:58	9:06	Cubismi
9:07	9:15	CytoSavvy
9:16	9:24	PotentiaMetrics

Speakers:
Liz Asai, CEO & Co-Founder, 3Derm Systems, Inc. @liz_asai
John M. Climaco, CEO, CNS Pharmaceuticals @cns_pharma

John Freyhof, CEO, CytoSavvy
Robert Palmer, President & CEO, PotentiaMetrics @robertdpalmer
Moira Schieke M.D., Founder, Cubismi, Adjunct Assistant Prof UW Madison @cubismi_inc

3Derm Systems

3Derm Systems is an image analysis firm for dermatologic malignancies. They use a tele-medicine platform to accurately triage out benign malignancies observed from the primary care physician, expediate those pathology cases if urgent to the dermatologist and rapidly consults with you over home or portable device (HIPAA compliant). Their suite also includes a digital dermatology teaching resource including digital training for students and documentation services.

CNS Pharmaceuticals

developing drugs against CNS malignancies, spun out of research at MD Anderson. They are focusing on glioblastoma and Berubicin, an anthracycline antiobiotic (TOPOII inhibitor) that can cross the blood brain barrier. Berubicin has good activity in a number of animal models. Phase I results were very positive and Phase II is scheduled for later in the year. They hope that the cardiotoxicity profile is less severe than other anthracyclines. The market opportunity will be in temazolamide resistant glioblastoma.

Cubismi

They are using machine learning and biomarker based imaging to visualize tumor heterogeneity. “Data is the new oil” (Intel CEO). We need prediction machines so they developed a “my body one file” system, a cloud based data rich file of a 3D map of human body.

CUBISMI IS ON A MISSION TO HELP DELIVER THE FUTURE PROMISE OF PRECISION MEDICINE TO CURE DISEASE AND ASSURE YOUR OPTIMAL HEALTH. WE ARE BUILDING A PATIENT-DOCTOR HEALTH DATA EXCHANGE PLATFORM THAT WILL LEVERAGE REVOLUTIONARY MEDICAL IMAGING TECHNOLOGY AND PUT THE POWER OF HEALTH DATA INTO THE HANDS OF YOU AND YOUR DOCTORS.

CytoSavvy

CytoSavvy is a digital pathology company. They feel AI has a fatal flaw in that no way to tell how a decision was made. Use a Shape Based Model Segmentation algorithm which uses automated image analysis to provide objective personalized pathology data. They are partnering with three academic centers (OSU, UM, UPMC) and pool data and automate the rule base for image analysis.

CytoSavvy’s patented diagnostic dashboards are intuitive, easy–to-use and HIPAA compliant. Our patented Shape-Based Modeling Segmentation (SBMS) algorithms combine shape and color analysis capabilities to increase reliability, save time, and improve decisions. Specifications and capabilities for our web-based delivery system follow.

link to their white paper: https://www.cytosavvy.com/resources/healthcare-ai-value-proposition.pdf

PotentialMetrics

They were developing a diagnostic software for cardiology epidemiology measuring outcomes however when a family member got a cancer diagnosis felt there was a need for outcomes based models for cancer treatment/care. They deliver real world outcomes for persoanlized patient care to help patients make decisions on there care by using a socioeconomic modeling integrated with real time clinical data.

Featured in the Wall Street Journal, using the informed treatment decisions they have generated achieve a 20% cost savings on average. There research was spun out of Washington University St. Louis.

They have concentrated on urban markets however the CEO had mentioned his desire to move into more rural areas of the country as there models work well for patients in the rural setting as well.

Please follow on Twitter using the following #hash tags and @pharma_BI

#MCConverge

#cancertreatment

#healthIT

#innovation

#precisionmedicine

#healthcaremodels

#personalizedmedicine

#healthcaredata

And at the following handles:

@pharma_BI

@medcitynews

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Art Therapy

Posted in Artificial Intelligence - General, Cognition, Music therapy, Patient Experience, Stress Disorders, Supportive therapies, tagged art, brain on March 26, 2016| Leave a Comment »

Art Therapy

Larry H. Bernstein, MD, FCAP, Curator

LPBI

University Of Houston Brain Study Explores Intersection Of Art And Science

The theory that the brain has a positive response to art is not new to science. But a researcher at the University of Houston is using a different approach to test that belief.

AMY BISHOP JANUARY 20, 2016

This is your brain. This is your brain on art. Any questions? 🍳🤗🎨🗝 yes in fact this raises a TON of questions!

Jennifer Schwartz

When I’m at an art museum, I never know what piece will catch my eye.

On this particular visit to the University of Houston’s Blaffer Art Museum, it’s an art installation by Matthew Buckingham. It consists of is a 16-millimeter film projector on a pedestal, projecting a flickering black and white image of the numbers “1720” on a small screen suspended in mid-air. The music coming from the projector is a baroque flute sonata by Bach.

Picture of Matthew Buckingham's "1720"

Matthew Buckingham’s exhibit, “1720” (2009) is a continuous 16 mm film projection of the date on a suspended screen. A movement from Bach’s Sonata in G for Flute and Continuo plays as the soundtrack accompanied by the flickering sound of the film reel.

http://www.houstonpublicmedia.org/wp-content/uploads/2016/01/15141909/BRAIN-ON-ART-FEATURE-MP3.mp3

http://www.houstonpublicmedia.org/articles/news/2016/01/20/134348/university-of-houston-brain-study-explores-intersection-of-art-and-science/

So, if someone could look into my head at this moment and see what’s going on in my brain, would they be able to see that I like what I’m looking at?

Dr. Jose Luis Contreras-Vidal, (better known as “Pepe”) is in the process of finding out. The University of Houston College of Engineering professor is collecting neural data from thousands of people while they engage in creative activities, whether it’s dancing, playing music, making art, or, in my case, viewing it.

“(The hypothesis is) that there will be brain patterns associated with aesthetic preference that are recruited when you perceive art and make a judgement about art,” Contreras-Vidal says.

Last October, three local artists – Dario Robleto, JoAnn Fleischhauer, and Lily Cox-Richard – took part in an event that allowed people to watch what was going on in their brains as they created art. The process involved fitting each artist with EEG caps, which look like swim caps with 64 electrodes attached. As they worked on their pieces, a screen on the wall showed their brain activity in blots of blue and yellow.

Picture of Contreras-Vidal

Contreras-Vidal at the Blaffer’s “Your Brain on Art” event in October. Amy Bishop | Houston Public Media

To Cox-Richard, it’s a unique chance to help bridge the worlds of art and science.

“Being able to contribute and have it be a two-way street is part of what seemed like a really excellent opportunity for all of us to push this conversation forward,” she says.

It was just one of a series of similar experiments Contreras-Vidal has launched. The project is being made possible by funding from the National Science Foundation to advance science and health by studying the brain in action. Contreras-Vidal explains that, even though art is used as a form of therapy, there’s still a mystery surrounding what’s taking place up there to make it therapeutic.

While there have already been studies showing how creativity influences the brain, this one is different. What separates it from others is the fact that the brain is being monitored outside of the lab, such as while walking through a museum, creating art in a studio, or even dancing onstage.

“It’s as real as it gets,” Contreras-Vidal says. “We are not showing you pictures inside a scanner, which is a very different environment.”

Which brings me back to that art installation of the film projector at the Blaffer. While staring at it, I wonder, “What does my brain activity look like right now?”

I decided to find out. In the second part of this story, we’ll pick up with my EEG gallery stroll, followed by a visit to Contreras-Vidal’s laboratory to get the results.

http://www.houstonpublicmedia.org/wp-content/uploads/2016/01/15173424/IMG_1276.jpg

As Houston Public Media Arts and Culture reporter, Amy Bishop spotlights Houston’s dynamic creative community. Her stories have brought national exposure to the local arts scene through NPR programs such as Here and Now.

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Laughter Therapy

Posted in laughfter, Supportive therapies, tagged laughter on November 16, 2015| Leave a Comment »

Laughter Therapy

Curator: Larry H. Bernstein, MD, FCAP

Give Your Body a Boost — With Laughter

Why, for some, laughter is the best medicine

By R. Morgan Griffin
WebMD Feature

Reviewed by Michael W. Smith, MD

Feeling rundown? Try laughing more. Some researchers think laughter just might be the best medicine, helping you feel better and putting that spring back in your step.

“I believe that if people can get more laughter in their lives, they are a lot better off,” says Steve Wilson, MA, CSP, a psychologist and laugh therapist. “They might be healthier too.”

Yet researchers aren’t sure if it’s actually the act of laughing that makes people feel better. A good sense of humor, a positive attitude, and the support of friends and family might play a role, too.

“The definitive research into the potential health benefits of laughter just hasn’t been done yet,” says Robert R. Provine, professor of psychology and neuroscience at the University of Maryland, Baltimore County and author of Laughter: A Scientific Investigation.

But while we don’t know for sure that laughter helps people feel better, it certainly isn’t hurting.

Norman Cousins, celebrated political writer

In 1979, Cousins published a book Anatomy of an Illness in which he described a potentially fatal disease he contracted in 1964 and his discovery of the benefits of humour and other positive emotions in battling the disease.

Cousins found, for example, that ten minutes of mirthful laughter gave him two hours of pain-free sleep. His story baffled the scientific community and inspired a number of research projects.

Dr William F. Fry, psychiatrist, Stanford University, California

Dr Fry began to examine the physiological effects of laughter in the late 1960s and is considered the father of ‘gelotology’ (the science of laughter).

Dr Fry proved that mirthful laughter provides good physical exercise and can decrease your chances of respiratory infections. He showed that laughter causes our body to produce endorphins (natural painkillers).

Dr Lee Berk, Loma Linda University Medical Centre

Inspired by Norman Cousins, Dr Berk and his team of researchers from the field of psycho-neuro-immunology (PNI) studied the physical impact of mirthful laughter.

In one study heart attack patients were divided into two groups: one half was placed under standard medical care while the other half watched humorous videos for thirty minutes each day.

After one year the ‘humour’ group had fewer arrhythmias, lower blood pressure, lower levels of stress hormones, and required lower doses of medication. The non-humour group had two and a half times more recurrent heart attacks than the humour group (50% vs. 20%).

Dr Hunter (Patch) Adams

Immortalized in film by Robin Williams, Patch inspired millions of people by bringing fun and laughter back into the hospital world and putting into practice the idea that “healing should be a loving human interchange, not a business transaction”.

He is the founder and director of the Gesundheit Institute, a holistic medical community that has been providing free medical care to thousands of patients since 1971. He is the catalyst for the creation of thousands of therapeutic care clowns worldwide.

Dr Annette Goodheart

Goodheart is a psychotherapist and inventor of laughter therapy and laughter coaching.

Find more at: http://www.skillsyouneed.com/ps/therapeutic-laughter.html#ixzz3reQZSqXD

“The most wasted of all days is one without laughter.” – E. E. Cummings

For years, the use of humor has been used in medicine. Surgeons used humor to distract patients from pain as early as the 13th century. Later, in the 20th century, came the scientific study of the effect of humor on physical wellness. Many credit this to Norman Cousins. After years of prolonged pain from a serious illness, Cousins claims to have cured himself with a self-invented regimen of laughter and vitamins. In his 1979 book Anatomy of an Illness, Cousins describes how watching comedic movies helped him recover.

Over the years, researchers have conducted studies to explore the impact of laughter on health. After evaluating participants before and after a humorous event (i.e., a comedy video), studies have revealed that episodes of laughter helped to reduce pain, decrease stress-related hormones and boost the immune system in participants.

http://www.cancercenter.com/treatments/laughter-therapy/