Nasal & Throat hygiene become the new norm in a post-COVID world, Q&A

Nasal & Throat hygiene become the new norm in a post-COVID world, Q&A 131 - America Out Loud News

In an article in America Out Loud News, Peter McCullough MD, cardiologist, is never reticent about creative thinking and looking for treatments that are unusual and tend to not be recommended by experts who follow paradigms and cookbook treatments the safest alternatives other than continuing vaccinations for COVID

Many others, including Robert Malone, MD, and Steven Hirsh experts were criticized, canceled, and ridiculed by physicians and others.

CofixRx Nasal Spray was developed by a board-certified anesthesiologist with the assistance and advisory information of seven other physicians. They also worked with a compounding pharmacist and pharmaceutical-grade manufacturer. It contains Povidone-Iodine and a mucoadhesive. Povidone is a well-known antiseptic used for preoperative sterilization of skin. The mucoadhesive is a polysaccharide solution. The initial formula was tested at Utah State University Institute of Antiviral Research and found to have amazing (95% or greater) antiviral properties against SARS-CoV-2, Delta, Omnicron, Influenza, Rhinovirus (common cold), RSV, and HRV 14. The spray lasts for hours in the nasal passages because of another special characteristic of the product’s ingredients. The ingredients also create a polysaccharide solution, which is a mucoadhesive. The mucoadhesive does three things. It creates a physical barrier to prevent viruses, bacteria, and allergens (like pet dander, pollen, mold spores, etc.) from adhering to and irritating the mucous membrane. Then, it allows the povidone-iodine to NOT get absorbed for hours, keeping it on the surface of the nasal passages where it does the best. Finally, it provides a moisturizing effect when combined with Vitamin D3.

There are some unanswered questions about what this spray does to the normal bacteria in the nose and throat, and for how long patients can use this spray.

Those figures exceed the effectiveness of masking and vaccination. It also prevents infection from other viruses...Influenza, Rhinovirus (common cold) RSV and HRV14.

James Bragman, DOFACP, is a board-certified member of the American Board of Internal, Geriatric, and Sports Medicine and has been working with CofixRx since its inception. He is a Full Clinical Professor of Internal Medicine at Wayne State University School of Medicine and an Assistant Clinical Professor at Michigan State University. 

Change Healthcare, owned by UnitedHealth Group has Massive Security Breach

Change Healthcare, owned by UnitedHealth Group has a Massive Security Breach

HIPAA (the Health Information Protection and Privacy Act) a federal mandate is an overriding regulation protecting patient personal information for all health care transactions. It provides penalties to organizations or persons who expose patient information.  Its jurisdiction is over hospitals, clinics, insurance companies or whoever has access to patient data.

It amounts to a classified system, not unlike that of the U.S. government, and the Department of Defense.

When a breach occurs the entity whose data was breached must notify patients and/or hospitals about the breach and when it occurred. Steep penalties and fines can be assessed.

 Matthew Phelan Senior Science Reporter For Dailymail.Com elaborates:

It's being called the largest-ever breach of protected patient health information by a government-regulated medical company in America's history.

Change Healthcare, owned by UnitedHealth Group, fell victim to a cyberattack eight months ago, but revealed on Thursday that 100 million people had been impacted.

That surpassed the previous record-holder for the worst breach of US patient data: a 2015 episode at Anthem Inc. that compromised 78.8 million individuals.

The first official report by Change Healthcare, which manages revenue and payments for medical providers, estimated in July that only 500 people had been compromised.  Now, the scope of the February 21 ransomware attack has spurred Congress to call for lifting the cap on how much a negligent healthcare firm can be fined. Ransomware attacks create a very dangerous method for stealing patient data. It totally blocks users from accessing their own data, stopping all systems in the entity such as patient notes, pharmacy orders, scheduling, and more. The victim's systems are locked and cannot be used unless the entity p says a ransom to unlock the system.

'The healthcare industry has some of the worst cybersecurity practices in the nation,' Senator Mark Warner said, 'despite its critical importance to Americans' well-being and privacy.'

Today, existing legislation provides a ceiling of $2 million per violation for offenders of the Health Insurance Portability and Accountability Act (HIPPA).  If passed, these 'commonsense reforms' would also include 'include jail time for CEOs that lie to the government about their cybersecurity,' Wyden added.

These leaders have not implemented strong cybersecurity systems despite the ongoing penalties.  If the Department of Defense has such strong security it should also be available to ensure patient privacy

Change Healthcare's parent company attributed the hack to a 'foreign nation' this past winter.

Anthem was fined $16 million, the largest penalty imposed for a HIPAA violation, but experts worry such a fine would barely deter today's healthcare giants.

Change Healthcare alerted the Department of Health and Human Services' Office for Civil Rights (OCR) on July 19, noting their internal investigation was ongoing.

Industry observers at the HIPAA Journal noted that the big round number of 100 million, issued in Change's update this month, suggests that 'that figure may change.'  'Neither Change Healthcare nor its parent company, UnitedHealth Group (UHG), has confirmed that the file review has been completed,' the journal noted.

But these eye-popping numbers mask the myriad of intimate tragedies created by Change Healthcare's and UHG's allegedly lax cybersecurity, which led to millions of Americans losing their healthcare privacy.  Linda Barbour, a career medical director for several large health insurance firms, told reporters that she had assumed the firm would have contacted her the moment it knew her data was exposed.  Change did not get around to informing Barbour until this month.

HIPAA Compliance

HIPAA is a federal law that applies to healthcare providers, health plans, and healthcare clearinghouses. These are covered entities. It sets standards for protecting sensitive patient health information, also known as protected health information (PHI). It can also be identified as electronic PHI or ePHI. HIPAA compliance requires that covered entities implement administrative, physical, and technical safeguards to protect PHI. This includes measures like access controls, encryption, secure messaging, and training employees on proper data handling procedures.

HIPAA also requires covered entities to notify patients and regulatory authorities in case of a data breach involving PHI. Failure to comply with HIPAA regulations can result in significant fines and legal action.

Cybersecurity

Cybersecurity refers to the practices and measures organizations use to protect their networks, systems, and data from unauthorized access, theft, and damage. This involves a range of measures like access controls, firewalls, and encryption. It also requires ongoing monitoring and testing to identify and remediate vulnerabilities.

Cybersecurity standards are not limited to the healthcare industry. They are applicable to all industries that handle sensitive data. There are several cybersecurity standards, such as the Payment Card Industry Data Security Standard (PCI DSS) and the National Institute of Standards and Technology (NIST) Cybersecurity Framework, that organizations can adopt to secure their data.

Differences Between HIPAA Compliance and Cybersecurity

While HIPAA compliance and cybersecurity both address data security, they have significant differences. HIPAA compliance focuses specifically on the protection of PHI in the healthcare industry. In contrast, cybersecurity standards are broader and apply to all industries that handle sensitive data.

HIPAA requires that covered entities implement specific administrative, physical, and technical safeguards to protect PHI. Cybersecurity standards provide guidelines for protecting data but do not prescribe specific measures. Organizations are free to choose the measures that best suit their needs and comply with the standards.

Another significant difference between HIPAA compliance and cybersecurity is the consequences of non-compliance. HIPAA violations can result in significant fines and legal action. In contrast, the consequences of cybersecurity breaches can vary depending on the industry and the severity of the breach.

HIPAA compliance and cybersecurity are both critical components of data security, but they address different aspects of it. HIPAA compliance focuses on the protection of PHI in the healthcare industry, while cybersecurity standards provide guidelines for protecting sensitive data in all industries. Understanding the differences between HIPAA compliance and cybersecurity is crucial for organizations that handle sensitive data to ensure that they implement the appropriate security measures and comply with the relevant regulations. At HIPAA Secure Now, we can help you decipher the difference and ensure that your business is properly protected and compliant.

It becomes apparent that interoperability and electronic health record systems are porous to hackers, foreign or domestic.

Prioritizing Spinal Health in Healthcare 💪

Following World Spine Day: Prioritizing Spinal Health in Healthcare 💪

Last week’s World Spine Day was a great reminder of how crucial spinal health is, especially for healthcare workers who face daily physical strain. At Ergotrics, we’re committed to making patient handling safer and more ergonomic for caregivers.

QUADRIPLEGIA

That’s why we developed the Ergotrics Inflatable Board and Inflatable Prone Support (IPS)—innovative solutions designed to protect the spine while improving patient care.

💡 The Inflatable Board ensures safe, effortless patient transfers, reducing the risk of back injuries for caregivers.

💡 The IPS optimizes patient positioning, particularly in prone procedures, offering both comfort and spinal protection.

Let’s continue to put spinal health at the forefront of healthcare practices. Discover how our products can help safeguard your team and improve patient care today!

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Integrating AI-driven technologies like Ray-Ban Smart Glasses and Apple AirPods Pro is a game-changer for accessibility

Even. though I have been a techie and nerd, some of the advancements using AI and other smart devices are mind-boggling

When it comes to medicine and healthcare AI is a game-changer and will enable patients with challenges to lead near-normal lives.

Fascinating! Integrating AI-driven technologies like Ray-Ban Smart Glasses and Apple AirPods Pro is a game-changer for accessibility. Imagine further enhancing this with AI-powered health monitoring wearables that track vital signs in real time, alerting users and physicians to any anomalies instantly. Combining these with AI-driven telemedicine platforms could provide seamless, real-time consultations, making healthcare more proactive and personalized. The potential for improving patient outcomes and quality of life is immense. Exciting times ahead for both patients and healthcare providers!

Apple Air Pods Pro

Rayban Smart Glasses

The combination of easily wearable, artificial intelligence and earpads allows for visual recognition of objects, and text yields an audible result describing the image and its instructions. The smart glasses can recognize a visual space and tell the wearer where the wearer is located. If you do not have AirPods, no matter what, the Rayban Smartglasses have built-in speakers

Additional uses include music and phone calls.

Both of these products can be found on Amazon. The consumer reviews rave about this product.

Cardiovascular Damage Resulting from Chronic Excessive Endurance Exercise

How Much is Too Much?

Cardiovascular Damage Resulting from Chronic Excessive Endurance Exercise - PMC

A daily routine of physical activity is highly beneficial in the prevention and treatment of many prevalent chronic diseases, especially of the cardiovascular (CV) system. However, chronic, excessive sustained endurance exercise may cause adverse structural remodeling of the heart and large arteries. An evolving body of data indicates that chronically training for and participating in extreme endurance competitions such as marathons, ultra-marathons, Iron-man distance triathlons, very long distance bicycle racing, etc., can cause transient acute volume overload of the atria and right ventricle, with transient reductions in right ventricular ejection fraction and elevations of cardiac biomarkers, all of which generally return to normal within seven to ten days. In veteran extreme endurance athletes, this recurrent myocardial injury and repair may eventually result in patchy myocardial fibrosis, particularly in the atria, interventricular septum, and right ventricle, potentially creating a substrate for atrial and ventricular arrhythmias. Furthermore, chronic, excessive, sustained, high-intensity endurance exercise may be associated with diastolic dysfunction, large-artery wall stiffening, and coronary artery calcification. Not all veteran extreme endurance athletes develop pathological remodeling, and indeed lifelong exercisers generally have low mortality rates and excellent functional capacity. The aim of this review is to discuss the emerging understanding of the cardiac pathophysiology of extreme endurance exercise and make suggestions about healthier fitness patterns for promoting optimal CV health and longevity.

Dose of physical activity and all-cause mortality reduction. The mortality benefits of exercise appear with even small amounts of daily exercise and peak at 50 minutes of vigorous exercise.

Mortality and Running Speed

The graph indicates an optimal running speed of 7 mph

Risk Stratification of Endurance Athletes

Currently, we have no proven screening methods for detecting the CV pathology associated with EEE. A logical strategy for now would deploy post-competition cardiac biomarkers, echocardiography, and/or advanced imaging such as CMR to identify individuals at risk for and with subclinical adverse structural remodeling and the substrate for arrhythmias.61 For any individual who is considering EEE efforts such as marathons or day-long aerobic races for any other activity that elevates cardiac output for a sustained period (continuously over several hours), it may be reasonable to obtain a maximal treadmill exercise test to screen for ischemia and/or exercise-induced arrhythmias and Heart CT for CAC scoring, particularly for those who are over age 50 and who have been chronically training for and competing in EEE events. Aortic pulse wave velocity could give an inference into the development of vascular stiffness that may not be readily appreciated by cuff blood pressure measurement.

Avoiding Exercise-Induced CV Damage

Suggestions for an exercise routine that will optimize heath, fitness and longevity without causing adverse cardiovascular structural and electrical remodeling:

Avoid a daily routine of exhaustive strenuous exercise training for periods greater than one hour continuously. An ideal target might be not more than seven hours weekly of cumulative strenuous endurance ET.1,2,9,51

When doing exhaustive aerobic ET, take intermittent rest periods (even for a few minutes at an easier pace, such as slowing down to walk in the middle of a run). This allows the cardiac output to normalize temporarily, providing a ‘cardiac rest period’ when the chamber dimensions, blood pressure, and pulse come down closer to baseline resting parameters before resuming strenuous exercise again.2

Accumulate a large amount of daily light-to-moderate physical activity, such as walking, gardening, housekeeping, etc. Avoid prolonged sitting. Walk intermittently throughout the day. Look for opportunities to take the stairs. 1, 2 Buy a pedometer and gradually try to build up to 10,000 steps per day.

Once or twice weekly, perform high-intensity interval exercise training to improve or maintain peak aerobic fitness. This is more effective in improving overall fitness and peak aerobic capacity than is continuous aerobic exercise training, despite a much shorter total accumulated exercise time spent doing the interval workout.65, 66

Incorporate cross-training using stretching, for example, yoga, and strength training into the weekly exercise routine. This confers multi-faceted fitness and reduces the burden of cardiac work compared to a routine of daily long-distance endurance exercise training. 1, 2

Avoid chronically competing in very long-distance races, such as marathons, ultra-marathons, Iron-man distance triathlons, 100-mile bicycle races, etc., especially after age 45 or 50.

Individuals over 45 or 50 years of age should reduce the intensity and duration of endurance exercise training sessions, and allow more recovery time.

Cascade of Dependency (AKA HOSPITAL ACQUIRED FRAILTY)

So just how fast does the Cascade of Dependency (AKA HOSPITAL ACQUIRED FRAILTY) happen?

Changes begin virtually overnight, and the stampede of systemic attacks on our bodies quickens.

Physical therapy is not just for post-operative care for, joint surgery, such as hip or knee replacement. It is a vital component for recovery from heart surgery, neurosurgery, or chronic medical conditions requiring hospitalization for several days.

UTIs, cognitive decline (no this isn't dementia), muscle wasting, pulmonary challenges, BP changes, etc., etc.

We've all seen this happen with older patients. Sometimes, they hit home a lot harder.

Here is a tragic story.

A grandmother who was VERY clearly mobile healthy, and smart as a whip 2 weeks before her hospitalization.

In 2024, we realize how detrimental bed immobility is.

For the first week in the hospital following a fall and surgery, she was to get PT 2x per day. 14 treatments ordered.

How many did she actually get? 2 times...TOTAL.

Never out of bed, never sitting up at bedside, she just laid in bed while her whole body shut down.

But she was seen by a number of 'specialists' as multiple systems were failing. Awesome, but they missed the root cause.

The family requested repeatedly therapy and even nursing help to get her out of bed. Didn't happen.

Can we at least get her sitting up for meals? Didn't happen.

I should have flown out there to help. I didn't. I trusted the hospital would keep its promises to finally start getting her up. And then it was too late.

We finally got her into skilled nursing with the help of the orthopedist. I called ahead to give them the details and to ensure they got her moving and kept an eye on her--with her cognition now she may be impulsive and try to get up.

She did try to get up (even in her state, she didn't want to be stuck in the bed) and fell all over again. Back to the hospital and back to being confined in bed.

My family lost her in 3 short weeks. Several months later the emotions for many of us are still raw.

For many older persons, hospitalization results in functional decline despite a cure or repair of the condition for which they were admitted. Hospitalization can result in complications unrelated to the problem that caused admission or to its specific treatment for reasons that are explainable and avoidable.

BOTTOM LINE

IF AT ALL POSSIBLE HAVE A FAMILY MEMBER OR CLOSE FRIEND VISIT YOUR RELATIVE TO HELP THEM SIT UP AND/OR GET OUT OF BED DAILY IF POSSIBLE.

I'm Dr. Gary Levin, a retired ophthalmologist who has dealt with many geriatric patients.

A Proactive Approach to Avoiding Seasonal Spike in Hospitalizations - Optimize Health

Brrr!

As colder temperatures approach, healthcare providers have an opportunity to practice preventative care for their at-risk patients. Colder temperatures have very real impacts on hospitalizations, especially for the elderly. One study demonstrated that for every 1 ⁰C decrease in temperature, hospital admissions increased 1.6% overall and 2.4% for the elderly (over 75). 

Seasonal Illnesses

Seasonal illnesses like the flu and Covid always spike in the winter and those with underlying chronic diseases are the most at risk for severe flu and Covid. Patients at high risk for severe flu or Covid during the winter can benefit tremendously from remote patient monitoring (RPM) and chronic care management (CCM). Now is the time to get patients onboarded and engaged with the process before the most serious winter risks set in.

Covid and the flu can cause significant spikes in blood sugar for diabetics. Patients with diabetes, even well-controlled diabetes, need to be checking their blood pressure more frequently when they are sick. A monitoring clinician with access to real-time data can help assess patients and determine if they need additional Similarly, these same illnesses can cause increases in blood pressure or fluid retention for patients with hypertension and heart failure. Using a remote blood pressure device and/or scale can catch spikes early, preventing hospitalizations or more adverse events.

Less Activity, More Eating 

According to a National Recreation and Park Association (NRPA) poll, 58% of U.S. adults are less active in the winter.  Less activity combined with a season full of sugary pumpkin spice, football parties, and holiday desserts isn’t great for anyone’s weight, blood pressure, or blood sugar. And it’s especially dangerous for those with diabetes and other chronic conditions. 

It’s easy to slide into less healthy habits in the winter and this can easily worsen health conditions. Remote patient monitoring is about more than just blood pressure or blood sugar readings. It’s about accountability and developing healthy habits with help from a monitoring clinician. 

Staying on track with lifestyle goals is more important than ever during the holidays when that last slice of pie or one more cookie is ever so tempting. Staying on track with lifestyle goals is more important than ever during the holidays when that last slice of pie or one more cookie is ever so tempting. And throughout the winter when staying on the couch is more appealing than working out. Patients who know someone is watching their vital signs are more likely to make smarter lifestyle choices.

Air Temperature and Heart Attacks

The American College of Cardiology has found that exposure to cold weather does increase hospital admissions for heart attacks.  Particularly, risks increase two to six days after cold spell exposure. The study found the risk decreases on day one of a cold spell likely because patients are staying indoors. This highlights the importance of proactive interventions to protect the most vulnerable patients from cold stress. 

When elderly or at-risk patients have an ongoing relationship with a monitoring clinician, that clinician can coach them to stay indoors and limit exposure during unsafe winter storms. At the same time, the clinician can encourage more frequent readings to check for trends in blood pressure that may require early intervention.

Air Temperature and Heart Attacks

The American College of Cardiology has found that exposure to cold weather does increase hospital admissions for heart attacks.  Particularly, risks increase two to six days after cold spell exposure. The study found the risk decreases on day one of a cold spell likely because patients are staying indoors. This highlights the importance of proactive interventions to protect the most vulnerable patients from cold stress. 

When elderly or at-risk patients have an ongoing relationship with a monitoring clinician, that clinician can coach them to stay indoors and limit exposure during unsafe winter storms. At the same time, the clinician can encourage more frequent readings to check for trends in blood pressure that may require early intervention.

Seasonal Depression

Increased indoor time, decreased physical activity, and reduced sunlight can lead to seasonal affective disorder (SAD), a form of depression. This can exacerbate feelings of isolation and loneliness, which are already common among some elderly individuals. Anxiety and depression can have very real effects on blood pressure, weight, and other physical measures of health. Continuous engagement through remote patient monitoring and/or chronic care management can provide early warning signs of depression and worsening physical health due to anxiety and depression. Monitoring clinicians can watch for the physical signs of depression and also make referrals to help patients get the mental health help they may need.

A Holistic Approach to Health for Every Season

RPM and CCM provide a proactive, holistic approach to preventative health year-round. But with increased health risks – both physical and mental – during the colder seasons, having a monitoring clinician available for your most at-risk patients can save lives. 

And it doesn’t have to be taxing on your staff. Optimize Health can provide managed remote patient monitoring where our team of clinicians becomes an extension of your staff.  Contact us to learn more.

A Proactive Approach to Avoiding Seasonal Spike in Hospitalizations - Optimize Health