1) Clinicore is a leading nursing home telemedicine provider whose physicians have experience in nursing homes, hospitals, and clinics.
2) The telemedicine program allows physicians to remotely assess patients using video conferencing to view clinical results, examine patients, and document encounters.
3) Inconsistent physician coverage in nursing homes can lead to poor outcomes like unnecessary emergency visits and hospital admissions/readmissions; telemedicine aims to improve access to physician care.
By introducing eye care at your doorstep service, we ensure that a daycare cataract surgery for your loved ones at home need not wait until your next vacation.
Geriatric Telehealth modalities are presented including Store & Forward Telehealth, Clinical Video (Real-Time) Telehealth, Home (Remote Monitoring) Telehealth and SCAN (Specialty Care Access Network) for inter-professional TeleWound Care across the healthcare continuum.
By introducing eye care at your doorstep service, we ensure that a daycare cataract surgery for your loved ones at home need not wait until your next vacation.
Geriatric Telehealth modalities are presented including Store & Forward Telehealth, Clinical Video (Real-Time) Telehealth, Home (Remote Monitoring) Telehealth and SCAN (Specialty Care Access Network) for inter-professional TeleWound Care across the healthcare continuum.
19 Massive Telehealth Learnings After 4,000,000 Visits in 2021Aggregage
Join Matt McBride, CEO of Mend, for an engaging discussion of the current state of Telehealth and patient engagement, including how your organization can streamline workflows to improve patient care.
Enjoy the Dash2CARE.com presentation that was delivered at the 1st #CLEmedHACK in the Global Center for Health Innovation in Cleveland, Ohio on September 27, 2015.
19 Massive Telehealth Learnings After 4,000,000 Visits in 2021Aggregage
Join Matt McBride, CEO of Mend, for an engaging discussion of the current state of Telehealth and patient engagement, including how your organization can streamline workflows to improve patient care.
Enjoy the Dash2CARE.com presentation that was delivered at the 1st #CLEmedHACK in the Global Center for Health Innovation in Cleveland, Ohio on September 27, 2015.
The information reflects information available as of June 2, 2020.
We encourage monitoring subsequent regulation updates pertaining to telehealth in wound care
Radiology Workflow: Recognizing Clinical & Financial Benefits of Implementing...TriMed Media Group
Rutland Regional Medical Center in Vermont, is a 188-bed rural hospital that effectively weds high-tech imaging with patient-centric care. This high-tech hospital with a hometown touch utilizes an intuitive RIS-PACS-reporting solution in its radiology department that is delivering benefits across the health system. The ability to provide local, state-of-the-art imaging is convenient for patients and referring physicians. It keeps patients close to home, which, in turn, improves the medical center’s bottom line.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
Telemedclinicore 124319536368 Phpapp02
1. Nursing Home
Telemedicine Program
MARK SINGH MD
A.CHAKRABARTI MD
DEB ZONA RN
May 20, 2009
Mark Singh MD, A.Chakrabarti MD, Deb Zona
2. Background: Clinicore
Leading edge Nursing Home Telemedicine company
Staff Back Ground
Nursing home, hospital and clinic based medical practice
Medicare Advantage, Tufts Medicare Preferred case
management
Nursing home medical management
Affiliated with multiple hospitals in the south of Boston region
Relationships with Boston Tertiary hospitals
Active involvement with major EMR implementation projects
in the region
Mark Singh MD, A.Chakrabarti MD, Deb Zona
3. Telemedicine: The Concept
John Doe
John Doe Encounter Notes
Clinical Results Assessment:
Labs: WBC 12 Pneumonia,
Hct 32 uncomplicated, stable
Bun 45, Cr 2.4 Plan: observe, Abx
Visualize patient, Document the
View Results
examine with nurse Encounter
• Physician can remotely assess a patient using high-definition
video conferencing and formulate a plan
• Key elements
• View clinical results
• Visualize the Patient
• Document the encounter: assessment and plan
Mark Singh MD, A.Chakrabarti MD, Deb Zona
4. Medical Care Issues in Nursing Homes
Inconsistent Physician coverage
Physicians generally not onsite to address medical
problems as they arise:
Pneumonia
Wounds
Rashes/lesions
Post-Op issues, complications
Other medical problems that usually require onsite
examination or close daily monitoring
Mark Singh MD, A.Chakrabarti MD, Deb Zona
5. Consequences of Sub-optimal Physician Coverage
Needless emergency room
visits/Ambulance rides
High admission and re-admission rates to
hospitals
Delay in treatment for wounds/infections
with resulting complications
Poor outcome measures (DPH, JCAHO)
Decreased Patient/Care-giver satisfaction
Mark Singh MD, A.Chakrabarti MD, Deb Zona
6. Medicare Implications
Nursing Home Pay-for-Performance demonstration
“Nursing Home Value-Based Purchasing”
demonstration
Criteria includes “appropriate hospitalization”
Implications for re-imbursement/quality measures
30 day Re-Admission Reduction
May be tied to hospital reimbursement
Likely to be a reportable outcome by hospitals
Hospitals transfers will go to SNFs with low re-
admission rates and with good clinical programs in
place
House Bill, HR 2068: will expand Medicare
telemedicine coverage if passed
Mark Singh MD, A.Chakrabarti MD, Deb Zona
7. Telemedicine Allows for On Demand Physician Care
Allows medical problems to be addressed
by a physician as they occur
Treat patients onsite appropriately
without having to transfer to the ER.
Cost savings: fewer ambulance trips
Improved Outcomes:
Lower hospital admissions and re-admission
rates
Fewer complications: wound care, post-surgical
care
Mark Singh MD, A.Chakrabarti MD, Deb Zona
8. Does Telemedicine Work?
Telemedicine via video conferencing is comparable
to in person evaluation (study done at MGH, May 2009, Journal of Telemedicine and
Telecare)
Telemedicine can increase physician “virtual onsite”
availability
Does Onsite physician availability improve
outcomes?
Multiple studies have concluded that onsite physician
availability at the nursing home and effective communication
is key in reducing hospital admission rates and improved
quality of care
Mark Singh MD, A.Chakrabarti MD, Deb Zona
9. Nursing Home Implementation
Prerequisites
Wireless broadband access in Nursing home
DPH notification: intent to implement telemedicine
Promotion and training
Staff physician consent process
Nursing staff
Procedural and Compliance
Nursing home credentialing of Clinicore physicians
Approval of patient consent forms and process
Telemedicine equipment deployment
Go live
Mark Singh MD, A.Chakrabarti MD, Deb Zona
10. Clinicore Telemedicine Extension Program
Leveraging telemedicine equipment for
administrative functions:
virtual conferencing with multi-site organizations
Remotely located “Lead Administrator” can “meet” with entire
local leadership team via high definition video conferencing
Nurse Training/Education via Video conferencing
Educational rounds with local specialists
Infectious disease: i.e.,H1N flu, MRSA, review of in-house
infections
Wound care
Post-operative care
Mark Singh MD, A.Chakrabarti MD, Deb Zona
12. Telemedicine Cart Features
• Wireless high-definition videoconferencing
• Mobile: can be moved to patient room
• Wireless connectivity, internal battery
• Peripheral devices
• Exam camera for wounds, close ups
• Digital Stethoscope
Mark Singh MD, A.Chakrabarti MD, Deb Zona
14. Images captured remotely during live sessions
Patient with recent MRSA
wound infection
Patient with new rash
Mark Singh MD, A.Chakrabarti MD, Deb Zona
15. Telemedicine Clinical Documentation
Consult note is generated for each encounter
Note sent/faxed to patient’s nursing home physician
Note for sent to nursing home for insertion into chart
Sample note
See attached
Mark Singh MD, A.Chakrabarti MD, Deb Zona
