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Let’s delve into the groundbreaking application of endoscopic electroporation and semaglutide that’s changing the game in diabetes management. First off, the EMINENT study is unveiling a revolutionary approach in treating type 2 diabetes. This method combines endoscopic electroporation, known as ReCET, with the medication semaglutide. The main goal is to reduce or potentially eliminate the need for insulin, revolutionizing glycemic control. The innovative ReCET procedure employs electroporation to ablate the superficial layer of mucosa in the small intestine. Researchers hope that by rejuvenating the duodenal lining and employing a GLP-1 receptor agonist, they could address insulin resistance, the fundamental problem in type 2 diabetes. Interestingly, ReCET doesn’t use extreme temperatures to ablate intestinal tissue. Rather, it uses a pulsed electric field, yielding precise control and limited depth of penetration. This method disrupts the cellular membrane of the mucosa and superficial submucosa, triggering natural cell death within a day, thereby significantly minimizing the risk of complications. A single-arm pilot study conducted as part of EMINENT involved 14 patients with type 2 diabetes using long-acting basal insulin. All patients underwent the ReCET procedure and started on semaglutide two weeks later. Researchers noted the feasibility and safety of ReCET, with a 100% success […]

Navigate the rapidly changing landscape of patient communication, as we explore the ins and outs of charging for MyChart messages. The COVID-19 pandemic has swiftly transformed the dynamics of healthcare communication. Consequently, healthcare providers increasingly rely on telehealth visits and digital communication tools to connect with patients. A significant offshoot of this shift is the growing trend of charging for MyChart messages. Healthcare systems have begun charging for the time providers spend responding to messages. Some hospitals have even expressed plans to bill up to $50 for MyChart messages. This new approach was permitted through changes to the 2020 Current Procedural Terminology (CPT) codes. The revised codes introduced three new time-based categories, thereby allowing providers to bill for time spent addressing patient-initiated messages over a week. Despite these changes, not all services come with a price tag. As per the Cleveland Clinic, any work taking under five minutes or any service that leads to an in-person consultation will not be charged. Furthermore, no fees apply to prescription refill requests, appointment requests, and follow-up care related to a surgery performed within the last 90 days. However, specific services can be billed. For instance, messages necessitating a clinical assessment, ordering a test […]

In a recent single-center prospective cohort study, the effect of unsuccessful treatment of ventilator-associated pneumonia (VAP) on mortality rates in patients with severe pneumonia was evaluated. The study involved 585 mechanically ventilated patients with severe pneumonia and respiratory failure, including 190 with severe COVID-19, all of whom underwent at least one bronchoalveolar lavage. A novel machine learning approach, CarpeDiem, was employed to group similar ICU patient-days into clinical states based on electronic health record data. Findings indicated that the lengthy ICU stays experienced by COVID-19 patients were largely due to prolonged periods of respiratory failure. The study discovered that although VAP wasn’t a contributing factor to mortality rates overall, patients with a single episode of unsuccessfully treated VAP demonstrated a significantly higher mortality rate (76.4%) compared to those with successfully treated VAP (17.6%). Furthermore, the CarpeDiem model highlighted that unresolved VAP was linked with transitions to clinical states associated with increased mortality. The study underscores that unsuccessful treatment of VAP is correlated with higher mortality and that patients with COVID-19 are at an elevated risk of VAP due to prolonged respiratory failure.

A small study on a pancreatic cancer vaccine has shown promising results, sparking cautious optimism among oncologists. The vaccine, when given alongside chemotherapy to 16 pancreatic cancer patients, stimulated an immune response in half of them, with no signs of disease recurrence after 18 months. Although the vaccine’s long-term success and market viability are yet to be determined, the study provides valuable insights into targeting pancreatic cancer and the potential use of the immune system in treating various types of tumors. Notably, the study demonstrates the feasibility of developing a personalized vaccine quickly enough to make a difference, utilizing technologies like inexpensive genome sequencing, AI, and mRNA. Additionally, the research suggests that an mRNA vaccine can generate an immune response even in cancers with few mutations, suggesting broader applications for personalized cancer vaccines. The study underscores the importance of early diagnosis and intervention for pancreatic cancer. Currently, pancreatic cancer has a five-year survival rate of just 12%, making it one of the deadliest cancers. By 2030, it is projected to become the second leading cause of cancer deaths in the US. However, recent advancements offer hope. Another study utilizing artificial intelligence analyzed medical records of millions of patients and identified […]

The FDA has granted clearance for Casana’s Heart Seat™ toilet seat to be used in homes for monitoring heart rate and oxygen saturation (SpO2) in adults aged 22 and above, weighing between 90 and 350 pounds. The toilet seat is equipped with sensors that can measure these vital signs and transmit the data to the Casana Cloud automatically. Healthcare providers can then access the data generated by three sensors: a ballistocardiogram, which measures heart mechanical activity; an electrocardiogram, which measures heart electrical activity; and a photoplethysmogram, which detects blood volume changes. A study assessing the accuracy of the seat demonstrated consistent measurements of blood pressure, stroke volume, and blood oxygenation compared to a hospital-grade vital signs monitor. Casana intends to conduct further testing and plans to submit an application to the FDA this year to include additional clinical measurements, such as blood pressure monitoring. The Heart Seat is expected to be available by the end of 2023.

In this video, Zack Shinar, MD, discusses the future of cardiac arrest and the role of extracorporeal membrane oxygenation (ECMO) in the emergency department (ED). Dr. Shinar is a leading expert in ECMO and has been instrumental in developing new protocols for its use in the ED. Dr. Shinar begins by discussing the current state of CPR. He notes that CPR is only effective in about 10% of cases, and that even when it is successful, patients often suffer significant brain damage. He then discusses ECMO, which is a life-support machine that can oxygenate the blood outside of the body. ECMO has been shown to be effective in saving the lives of patients with cardiac arrest, and Dr. Shinar believes that it should be used more widely in the ED. Dr. Shinar then discusses the challenges of using ECMO in the ED. He notes that ECMO is a complex procedure that requires specialized training and equipment. He also notes that ECMO can be expensive, and that it is not always available in all hospitals.