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Patients are transforming from passive recipients of healthcare services to active participants in their own health

This is a preview of a research report from Business Insider Intelligence, Business Insider’s premium research service. To learn more about Business Insider Intelligence, click here. Current subscribers can read the report here.



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The consumerization of healthcare — a fundamental shift in patients’ preferences, behaviors, and demands around healthcare services — is threatening hospitals’ bottom lines. For the first time, patients are transforming from passive recipients of healthcare services to active participants in their own health. They’re flocking to online review sites to choose which doctor to see, skipping hospital visits in favor of a health clinic in their local CVS, and aren’t afraid to ditch providers that don’t offer them an engaging experience.

The superior customer service expectations of millennials, declines in hospital profitability, and threats from startup providers and retail pharmacies intensify the need for providers to revamp the patient experience. Providers’ current engagement capabilities are weak, and deficiencies around scheduling, appointment wait times, and billing are dragging on patient satisfaction, driving patients elsewhere and draining provider revenue.

In The Healthcare Consumerization ReportBusiness Insider Intelligence explores the trends that are driving providers to revamp their care services. We then outline how patients’ expectations for transparency, convenience, and access are transforming the way they interact with providers across each stage of care. Finally, we detail strategies health systems and hospitals can implement to create a consumer-centric patient experience that fosters satisfaction, loyalty, and patient volume.

The companies mentioned in this report are: 98point6, BayCare, Cleveland Clinic, CVS, Integris, Kaiser Permanente, Luma Health, New York-Presbyterian, One Medical, Publix, Target, Walgreens, Walmart, Yelp, and Zocdoc.

Here are some of the key takeaways from the report:

 

  • The consumerization of healthcare is redefining how consumers engage with providers across each stage of care.
  • But the vast majority of healthcare providers haven’t sufficiently altered their services to align with current patient expectations. Only 8% of US hospitals and health systems demonstrate strong consumer-centric performance, per a 2018 Kaufman Hall survey.

 

  • Failure to react to patient preferences hurts provider organizations’ bottom lines. US hospital profit margins are already thinning, and an emerging reimbursement model that ties a portion of providers’ compensation to patient satisfaction means providers can’t afford to preserve the status quo.

 

  • Alternative players with consumer-focused healthcare services threaten to poach patients from traditional health systems. Tech-focused primary care startups, like One Medical and 98point6, and retail outlets, like Target, Walmart, and CVS, offer patients on-demand access to healthcare providers via mobile apps and convenient locations to receive healthcare services, drawing them away from incumbent health systems.
  • In order to retain patients — and keep them from straying to alternative care services — providers must transform their services with an emphasis on transparency, access, and ongoing engagement outside of the clinic.

 

  • Healthcare providers that tailor their services to the new healthcare consumer will be well positioned to see growth. Alternatively, businesses that don’t implement these changes could find themselves falling behind the rest of the industry or closing their doors for good.


In full, the report:

  • Details how patient behavior, preferences, and expectations have changed.
  • Outlines the demographic and industry trends that should add a sense of urgency for providers to revamp the patient experience.
  • Summarizes how the patient experience providers currently offer isn’t conducive to loyalty and is likely driving patients to nonhospital services.
  • Explains strategies health systems and hospitals can implement to create a consumer-centric patient experience that fosters satisfaction, loyalty, and patient volume.
  • Offers examples of provider organizations that have successfully adopted new strategies to encourage patient-doctor communication, improve satisfaction, and drive scheduling capacity.

Reference: https://www.businessinsider.com/the-healthcare-consumerization-report-2018-11?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+businessinsider+%28Business+Insider%29

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Apple Watch 4 can detect D’OXYVA’s benefits.

Did you recently buy yourself a Christmas gift?

Would it happen to be the new Apple Watch Series 4? If so, did you know you can use it to detect D’OXYVA’s benefits?

D’OXYVA is the only fully non-invasive, completely painless, transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.


The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits your health, your immune system and your overall sense of well-being in a variety of ways.

D’OXYVA® plays a vital role in regulating and creating homeostasis (stability) in the autonomic nervous system (ANS) or, more precisely, between its main two functions, the sympathetic and parasympathetic nerve activities.

D’OXYVA® has been shown to achieve this by stimulating parasympathetic nerve activities that are responsible for “rest and digest” functions, reducing heart rate, blood pressure, calming, regenerating, healing, and energy reservation.

About Apple Watch 4

One of the biggest upgrades to the Apple Watch Series 4 from its predecessor is its ability to record an electrocardiogram and detect issues with how the user’s heart is functioning. The company’s FDA-approved feature is now live for users in the US.

The device can detect irregularities in your heartbeat, which can point to critical conditions like atrial fibrillation that may result in a stroke. If your Watch classifies your rhythm as a high heart rate or atrial fibrillation, you’ll want to talk to your doctor.

However, it’s worth noting that the Watch only records a basic single-lead ECG, so it can’t detect a stroke, heart attack, or other heart conditions like the 12-lead ECGs taken at a doctor’s office.

If you’re using a Watch Series 4 in the US, here’s how you can take an ECG:

• Ensure your device is updated to watch OS 5.1.2 and paired with an iPhone 5s or later with iOS 12.1.1 on board.

• Set up the ECG app by opening Apple Health on your device and following the on-screen instructions. A prompt should show up automatically, but if you don’t see it, head to Health Data > Heart > Electrocardiogram (ECG).

• Wear your Watch 4 with a snug fit on the wrist you’ve specified in the Apple Watch app (you can find or change this in the Apple Watch app; tap the My Watch tab, then head to General > Watch Orientation).

• Launch the ECG app on your Watch.

• Rest your arms comfortably on a table or in your lap.

• Hold your finger on the Digital Crown without pressing down for 30 seconds. You’ll then see your results and any symptoms that the device detects.
Tap Save to record your symptoms.

• To review your ECG, open the Health app on your iPhone and head to the Health Data tab. Then, tap Heart > Electrocardiogram (ECG), and tap the ECG. You’ll find an option to export a PDF of it, which you can share with your doctor.

 

 

References:
https://www.msn.com/en-us/news/technology/apple-wa…
https://www.doxyva.com/kb_results.asp?ID=64

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3 Reasons Why Most Wounds Won’t Heal

There are several connected causes for non-healing wounds.

According to figures from the U.S. Centers for Disease Control and Prevention, chronic wounds–injuries that have yet to heal after six weeks–affect some 5.7 American adults. There are many reasons for these non-healing wounds, and understanding each cause is vital to implementing the most effective wound care regimen possible.

Here are three of the more frequent explanations for why many wounds just won’t heal:

Poor circulation
As Johns Hopkins Medical School pointed out, blood is perhaps the most important component of the entire wound healing process. When an injury occurs, it’s the blood that transports cells to the wound site, which begin rebuilding veins and other important tissue structures. When you have poor circulation, blood cannot move around as quickly, and as a result, wounds take much longer to begin healing. According to Healthline, there are several medical conditions that cause poor circulation, including varicose veins, obesity and chronic ailments like diabetes, peripheral artery disease and Raynaud’s disease. Fortunately, there are just as many ways to improve circulation, like frequent exercise and elevating wounds or limbs in general.

Fluid buildup
According to the Mayo Clinic, edema occurs when fluid leaks from blood vessels, causing these secretions to accumulate in nearby tissue. The result is a large bump or nodule that is painful and sometimes prone to infection. Edema is usually the result of a number of medications, including several drug therapies geared toward diabetes. Edema can also occur due to a reaction to steroids, anti-inflammatory drugs and even estrogen supplements. Other than being uncomfortable, edema can wreak havoc on the wound-healing process. Due to fluid buildup, the blood vessels and tissue become rigid and immovable, greatly restricting blood flow. This compression cycle can also kill skin patches, which could lead to ulcers.
Infection
As a rule, infections can be quite traumatic to the host. Perhaps the biggest effect–one that might surprise some people–is that infections can all but halt the wound healing process. According to St. Luke’s Clinic, an average infection has a number of methods for preventing healthy tissue regeneration. For instance, some infections can extend the length of the inflammatory phase, and that can halt the subsequent stages of wound healing. Additionally, there are strains that can interfere with clotting mechanisms, which in turn causes wounds to continue bleeding. According to a 2010 study from the Journal of Dental Research, the two most damaging strains of bacteria are pseudomonas aeruginosa and staphylococcus.

When it comes to handling chronic wounds, patients need advanced wound care products to prevent infection and create a sustainable healing environment; that’s why so many patients turn to Advanced Tissue when they experience most chronic wounds. As the nation’s leader in the delivery of specialized wound care supplies, Advanced Tissue ships supplies to individuals at home and in long-term care facilities.
Reference: https://advancedtissue.com/2016/02/3-reasons-why-most-wounds-wont-heal/

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Anesthesia, Microcirculation, and Wound Repair in Aging

Abstract

Age-related changes in skin contribute to poor wound healing after surgical procedures. Changes in skin with age include a decline in thickness and composition, a decrease in the number of most cell types, and diminished microcirculation, the process that provides tissue perfusion, fluid homeostasis, and delivery of oxygen and other nutrients. It also controls temperature and the inflammatory response. Surgical incisions cause further disruption of the microvasculature of aged skin; however, perioperative management can be modified to minimize damage to aged tissues. Judicious use of fluids, maintenance of normal body temperature, pain control, and increased tissue oxygen tension are examples of adjustable variables that support microcirculation. Anesthetic agents influence microcirculation in a number of ways, including cardiac output, arterial pressure, and local microvascular changes. The authors examined the role of anesthetic management in optimizing microcirculation and potentially improving postoperative wound repair in older persons.

Aged skin is at increased risk of poor postoperative wound healing. Changes in the cutaneous microcirculation with aging contribute to this risk. This review examines the role of anesthesia management in microcirculatory function.

SURGICAL wound repair is a major problem in the older population, who are at increased risk of wound dehiscence and infection. As a specific example, surgical site infections (SSIs) are common (approximately 500,000 cases annually in the United States), lead to worse patient outcome (patients who develop SSI are twice as likely to die), and are an enormous economic burden (1–10 billion dollars annually). Many factors contribute to age-related changes in skin5 and subsequent vulnerability to impaired wound healing and infection. Changes in skin with age (fig. 1) include a decline in epidermal and dermal thickness and composition, as well as a decrease in the number of most resident cell types. The dermal–epidermal junction is flattened and the microcirculation is diminished. The latter is defined as blood flow through arterioles, capillaries, and venules and is the key system that affects the entire skin surface. In the aging patient, the microcirculation in the skin is reduced by 40% between the ages of 20 and 70 yr. The microcirculation provides tissue perfusion, fluid hemostasis, and delivery of oxygen and other nutrients. It also controls temperature and the inflammatory response. Surgical incisions cause disruption of the microcirculation in the skin as manifested by local edema resulting from vasodilation and increased vascular permeability.

Fig. 1.
Numerous changes in skin with age contribute to impaired wound healing.

 

Perioperative management can be modified to optimize the microcirculation. Measures that support the microcirculation include careful use of fluids, normothermia, pain control, and smoking cessation. Factors that can be influenced by intraoperative management (judicious use of fluids, maintenance of normal body temperature, pain control, and increased tissue oxygen tension) have been suggested to be beneficial as well. Most anesthetic agents also influence the microcirculation: a reduction in cardiac output and arterial pressure decreases flow in the microcirculation, whereas anesthetic-induced local microvascular changes and vasodilatation can increase perfusion. Optimization of these variables plays an important role in enhancing the microcirculation in all patients, but is especially relevant if modifications could improve postoperative wound healing in the older population.

In this review, we will use skin as a representative organ to describe age-related changes that negatively affect the microcirculation and have subsequent impacts on wound healing and the incidence of postoperative infection. We will then examine the role of anesthesia management in minimizing detrimental effects on the microcirculation. A greater understanding of these variables could promote improvements that lead to better outcomes with respect to wound repair in older patients.

Summary of Wound Repair and Aging

It has been nearly a century since it was noted that the rate of cutaneous scar formation after a wound is inversely related to the age of the patient. Four decades ago, it was observed that older age was associated with an increased risk of postoperative disruption of the surgical wound, leading to higher mortality. Recent data suggest that in patients older than 65 yr, development of SSI is associated with a two-fold increase in cost and a staggering four-fold increase in mortality.

Wound healing ensues via a sequential chain of events (with variable overlap) that includes inflammation, tissue formation, and remodeling (fig. 2). Circulating factors have a pivotal role in each of these phases. Accordingly, as we will discuss below, immediate changes in the microcirculation influence each stages of the wound-healing response in aging. As human data is lacking, we have taken data from established animal models of aging. Although animal models are not uniformly predictive of responses in human tissues, several animal models of wound healing are generally accepted.

Fig. 2.

The stages of wound healing are a sequential chain of events that include: (A) inflammation, (B) proliferation and granulation tissue formation, and (C) extracellular matrix (ECM) deposition and tissue remodeling. PDGF = platelet-derived growth factor; TGF-β1 = transforming growth factor-β1; TNF-α = tumor necrosis factor-α; VEGF = vascular endothelial growth factor.

 

Summary

Nearly every anesthesiologist who provides care to adults will participate in the care of geriatric patients. A growing older population is undergoing surgical procedures that are increasing in number and complexity. Poor healing of surgical wounds is a major cause of morbidity, mortality, and substantial economic burden. Wound healing is dependent on the microcirculation that supplies the incision area. Measures that support the microcirculation during the perioperative period have a profound effect on wound healing. Some measures such as maintenance of normal body temperature and control of postoperative pain are supported by ample evidence and have been implemented in routine clinical care. Other measures, for example, the choice of anesthesia technique and use of opioids are supported by basic research but need further clinical studies. A better understanding of the effect of aging and anesthesia on the microcirculation can potentially assist in improving postoperative wound repair, thereby benefiting a growing older population.

 

The Surgical Context of Wound Repair and Aging

Measures that support the microcirculation improve wound repair, thereby reducing the risk of postoperative dehiscence and infection.52General preoperative measures such as smoking cessation and optimal management of comorbid medical conditions have been reviewed in other contexts.53,54 For the purpose of this review, we will focus on interventions in the perioperative setting.

Oxygen Administration

Wound healing is dependent upon adequate levels of oxygen.55 Oxygen interacts with growth factor signaling and regulates numerous transduction pathways necessary for cell proliferation and migration.56 It is also an indispensable factor for oxidative killing of microbes.57 Consequently, the effects of oxygen tension on the outcome of surgical wounds have been best studied in the context of postoperative infection. Resistance to surgical wound infection is presumed to be oxygen dependent—with low oxygen tension viewed as a predictor of the development of infection,56 particularly when subcutaneous tissue oxygenation (measured by a polarographic electrode) decreases to less than 40 mmHg.58

In two recent meta-analyses, one found that perioperative supplemental oxygen therapy exerts a significant beneficial effect on the prevention of SSIs,59 whereas the other suggested a benefit only for specific subpopulations.60 Although most authors suggest that supplemental oxygen during surgery is associated with a reduction in infection risk,61,62 others propose it may be associated with an increased incidence of postoperative wound infection.63Notably, in the latter report, the sample size was small and there was a difference in the baseline characteristics of the groups. A prospective trial randomizing patients to either 30 or 80% supplemental oxygen during and 2 h after surgery did not find any difference in several outcome measures including death, pulmonary complications, and wound healing.64 Of note, the administration of oxygen to aged subjects may be limited by the finding that although arterial oxygen tension did not decrease with age, there was reduced steady-state transfer of carbon monoxide in the lungs.65 This indicates that oxygen transport could be diffusion-limited in older subjects, especially when oxygen consumption is increased. Furthermore, longitudinal studies of five healthy men over 3 decades showed impaired efficiency of maximal peripheral oxygen extraction,66 suggesting that tissue oxygen uptake is reduced in the aged subjects.67 This likely reflects a decrease in the number of capillaries as well as a reduction in mitochondrial enzyme activity.68 Animal models (rabbit69 and mouse69,70 ) have suggested that aging and ischemia have an additive effect on disruption of wound healing. Consequently, the potential benefit of increasing tissue oxygen tension during surgical wound repair in older patients should be further evaluated.

 

 

Reference: http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1917910

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10 Things You Should Know About DVT

One of the most important things to talk about in relation to DVT, is varicose veins.

Deep Vein Thrombosis (DVT) is the result of blood clotting whilst it is still inside the blood vessel. In the majority of cases, painful swelling in the leg will be experienced as a ‘warning sign’ however, this is not always the case and, in some instances, no obvious symptoms will be presented.

In short, a DVT is a clot in the deep vein

Despite the fact that many people could be at risk of developing DVT, there is still much uncertainty as to how to prevent the condition from occurring, and a general lack of awareness around the importance of speaking medical treatment if you think you are suffering from the condition.

Here, to help provide some clarity on the condition, leading vascular specialist Professor Mark Whiteley of The Whiteley Clinic, shares the ten key things everyone should know:

DVT CAN OCCUR FOR NO APPARENT REASON

Professor Whiteley says: “Although there are some recognised risk factors for DVT, the condition can also effect people for no apparent reason. If there is a clear reason why DVT has occurred, we call it “provoked” DVT. If there is no known reason for DVT then we call it an “unprovoked” case.

Studies have shown that over 80% of hospital patients will experience a minor DVT. One in 12 people who fly long haul, over 7 hours, will also experience a minor case. However, in most cases these cases will resolve themselves and will not cause the individual any lasting problems. In fact, many people may not even know they’ve had a problem.

However, we must be careful not to trivialise DVT as some individuals will experience much more serious symptoms – such as aching/pain and swelling, clots to the lung (called pulmonary embolism) , and/or scarring of the deep vein with long-term deterioration of the leg post thrombotic syndrome (PTS).”

DVT PRESENTS A NUMBER OF SYMPTOMS

Professor Whiteley says: “Although in some cases there will be no symptoms associated with DVT, in others there will be some distinct warning signs. These can include: pain/swelling/tenderness in the leg (usually in the calf), a heavy aching feeling, warm skin around the affected area, or a redness to the skin. If anyone is concerned that they may be experiencing any of these symptoms, and they become breathless or experience chest pain, then they should seek medical attention immediately.”

PREGNANCY INCREASES YOUR RISK OF A DVT

Professor Whiteley says: “Pregnancy can increase the risks of DVT, particularly at the time of delivery. A normal adult has approximately 5L of blood. However, pregnant women increase their blood volume to 7L at the end of pregnancy. This is because women lose blood whilst giving birth and so the body produces more to keep at a safe level. Not only do women have extra blood, their body also adapts to clot blood quicker after they have given birth to stop haemorrhages.

Unfortunately, the downside of this is that it increases the risk of DVT. If a woman is pregnant and has varicose veins, then the risk is increased even more so.

COMPRESSION STOCKINGS ARE KEY FOR PREVENTION

Professor Whiteley says: “Wear properly measured and fitted graduated compression stockings if you are ever in a position where you cannot move easily such as on a long flight, long car journey, long coach journey etc.

VARICOSE VEINS ARE A SERIOUS FACTOR

Professor Whiteley says: “One of the most important things to talk about in relation to DVT, is varicose veins. Varicose veins occur when the flow of blood within a vein changes. Blood can fall backwards down your veins with gravity if the valves are not working properly – stretching the vein walls as a result. With the flow of blood changing, and the vein wall changing, this is serious potential for clots forming in the veins.

When a clot forms in a varicose vein, it is called “phlebitis”. Since 2012, it has been known that everyone with phlebitis should have a duplex scan for the following reason. If the clot is small and in a varicose vein a long way from the deep veins, then it can be treated safely with aspirin and support stockings. However, if it is within 5 cm of a deep vein, there is a risk of it causing a clot on the lung (pulmonary embolism). Of course, having varicose veins treated properly by the new endovenous techniques will stop the risks of phlebitis and any other associated problems.”

POOR LIFESTYLE CAN INCREASE YOUR RISK

Professor Whiteley says: “Other known factors for developing DVT are malignancy, immobility, major surgery, dehydration, smoking (particularly if combined with oral contraceptive pill) and a family history of getting DVTs (called thrombophilia).”

A SLOW BLOOD FLOW IS CRITICAL

Professor Whiteley says: “In short, a DVT is a clot in the deep vein. Clots form because of one or more of three main reasons – changes in the composition of the blood, changes in the flow of blood, or changes in the vein wall. Any one of these, or combination of these, can increase the risk of a deep vein thrombosis.”

DVT CAN BE FATAL

Professor Whiteley says: “Deep vein thrombosis (DVT) is a diagnosis that will cause huge concern for many patients. However, as with many medical conditions, DVT can affect people in different ways. DVTs can be tiny, and of no significance, or can be huge and can be life threatening. Of course between these two extremes, there is also a whole scale. A duplex ultrasound scan will be able to diagnose a DVT and also assess how severe it is.

The risks associated with DVT are reduced both in the short term (clots to the lung) and in the long term (post thrombotic syndrome-swollen and discoloured leg with or without leg ulceration) if the DVT is diagnosed early and treated aggressively with anticoagulation.”

If DVT is not treated, around one in 10 people will develop a pulmonary embolism. This is a serious condition which can cause chest pain, sudden collapse and/or either gradual or sudden breathlessness.

EXERCISE IS KEY FOR RECOVERY

Professor Whiteley says: “People undergoing major surgery nowadays get blood thinners and support stockings to try and reduce the risk of DVT. Physiotherapists also try to mobilise patient as soon as possible after such operations. Many Surgeons today also prefer local anaesthetic procedures so that their patients can “walk in, walk out”, and keep mobile. This new “ambulatory” surgery performed in local anaesthetic clinics dramatically reduces risks of deep vein thrombosis.

Anything that increases the flow of blood in the veins will reduce the risk of clots, and therefore reduce the risk of DVT. Exercise and movement, particularly walking, is so important. Compression stockings, particularly if properly fitted, have been shown to reduce the risk of DVT but this is markedly enhanced by movement of walking. Those who cannot walk or move often require anticoagulation injections or tablets.”

THERE ARE MANY WAYS TO PREVENT A DVT

Professor Whiteley says: “Keep hydrated, keep active and mobile – particularly through lots of walking. Treat varicose veins as quickly as possible with an endovenous technique, under local anaesthetic, to reduce risk of DVTs occurring.”

 

Reference: https://www.femalefirst.co.uk/health/10-things-you-should-know-about-dvt-1146974.html

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Being mindful of symptoms

LEWISTOWN–Dr. Maya Lichtenstein, neurologist at Geisinger-Lewistown Hospital, said that there are a myriad of potential symptoms that could be signs of a stroke. “Any sudden changes,” said Lichtenstein, “go the E.R.”

A stroke, according to Liechtenstein, is either the result of not enough blood flow to the brain, plaque in the blood vessels or heart, each resulting in a clot, or a hemorragic bleed, resulting in a bursted blood vessel in the brain. Classic symptoms of a stroke include numbness, tingling, weakness on one side of the body and changes in speech, but other sudden changes in in understanding language, vision, vertigo or clumsiness can also be symptomatic.

“It depends on what part of the brain is damaged,” said Lichtenstein.

Treatment options for a stroke vary, depending on the type of stroke.

“If you get seen fast enough,” said Lichtenstein, for a clot, a “clot-busting medication, a form of blood thinner” can be administered via I.V. A thrombectomy, a procedure, not an operation, said Lichtenstein, is another treatment option, similar to a cardiac catheterization. A bleeding stroke often leads to lowering the patient’s blood pressure and surgically relieving pressure on the brain. Taking aspirin can also treat a stroke.

Post-stroke, Liechtenstein said that rehabilitation is important, including physical, occupational, speech, and cognitive therapies. “Aggressive therapy can continue to improve people’s symptoms,” said Lichtenstein. “Everyone thinks they’re better if they can move their arms and legs.” Lichtenstein also encourages stroke patients to be aware of their mood and possible depression, encouraging them to accept all the help available.

To avoid a stroke, Liechtenstein said patients should see their doctors regularly for preventive care and that leading a healthy lifestyle is the key, including regular exercise to keep up the heart rate and eating a diet rich in fresh fruit and vegetables, lean proteins and whole grains. Lichtenstein also encourages patients to keep control of their vascular issues, such as high blood pressure and diabetes, as well as to quit smoking, if they smoke.

 

Reference: http://www.lewistownsentinel.com/news/local-news/2018/05/being-mindful-of-symptoms/

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8 Warning Signs of Poor Blood Circulation

Poor blood circulation is the start of numerous other ailments.

What causes poor blood circulation?

Low blood circulation is caused by different underlying conditions. The most common ones are atherosclerosis (“hardening of the arteries) and peripheral artery disease (PAD).

If you experience symptoms of blood circulation problems, consult your physician right away. Poor circulation can lead to heart attack, stroke and even death.

What are the signs of poor blood circulation?

Symptoms of poor blood circulation mostly occur in the hands, feet, arms, and legs. Here are 8 signs to look out for…

  1. Leg Pain While Walking

A common symptom of poor blood circulation is pain or cramping of your leg or hip muscles. This is felt while walking, climbing stairs or another similar physical activity. This is a condition called intermittent claudication, which is a sign of PAD.

  1. Numbness and Weakness

Your arms or legs may feel weak or numb. This can happen while you are moving, or even sitting still.

If these symptoms in your arms and legs come about suddenly and are accompanied by impaired or slurred speech and drooping facial muscles, you may have low blood circulation to your brain due to atherosclerosis.

Poor circulation in the arteries which supply blood to the brain can cause a stroke.

  1. Coldness and Swelling

If your feet, hands or lower legs feel cold all the time for no apparent reason – it is a sign of poor blood circulation.

Low blood circulation due to PAD or atherosclerosis tends to produce coldness in one foot, hand or leg more than the other. You could also notice swelling in your extremities due to poor circulation, particularly in your legs and feet.

  1. Non-healing Sores

Sores on your feet or legs that don’t seem to heal are a common sign. You may also notice that ulcers or infections in your legs and feet heal very slowly.

You may also notice that you’re losing hair on your legs and feet or that your hair is growing slower than normal. Your toenails may grow slowly as well.

  1. Changes in Skin Colour

Poor circulation can cause your skin in your arms, hands, legs and feet to change colour. You may notice that your skin looks “shiny”.

Your legs and feet may turn pale or bluish in colour, due to the poor blood and oxygen delivery to your extremities.

  1. Weak Pulse in Your Legs

Poor blood circulation due to atherosclerosis or PAD can cause your pulse to become weak in your feet or legs.

When the pulse in your limbs is weak or absent, this means that there is little or no blood circulation to these areas.

The most common method that doctors use to determine blood flow problems is to check your pulse in the leg and groin areas.

  1. Chest Pain

Chest pain or angina, and other symptoms of a heart attack are signs of poor blood circulation in the arteries to your heart.

This may be a sign of atherosclerosis in these arteries. If you have chest pain, you should see your doctor right away to prevent a potentially life-threatening medical problem.

  1. Erectile Dysfunction

If you’re a man, experiencing erectile dysfunction can be a sign of low blood circulation.

Erectile problems can indicate poor blood flow to your groin and lower extremities due to one or more blocked, clogged, or narrowed arteries.

D’OXYVA (deoxyhemoglobin vasodilator) delivers the highest possible concentration of CO2 and has been clinically studied to SIGNIFICANTLY INCREASE BLOOD FLOW volume in the microcirculatory system.

In short, based on current leading neurology, immunology, microvascular, and cellular oxygenation science, D’OXYVA is leading the field by quickly targeting to:

Significantly lower the risk of diabetes and cardiovascular complications

Provide complete healing of difficult wounds together with major pain relief and improved quality of life:

  • Detoxify the skin and body
  • Improve sleep
  • Stamina and skin health
  • Reduce inflammation
  • And much more for all kinds of people
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A new theory on reducing cardiovascular disease risk in binge drinkers, Research identifies potential predictive biomarker

A new study shows that binge drinkers have increased levels of a biomarker molecule — microRNA-21 — that may contribute to poor vascular function.

Researchers believe that measurements of microRNA-21 could help determine if a patient with a history of binge drinking is at risk of developing cardiovascular disease.

The Centers for Disease Control and Prevention estimates that one in six adults binge drinks about four times a month and reports that chronic diseases are among the many health problems associated with binge drinking.

“There is a growing body of evidence that suggests binge drinking behavior contributes to premature cardiovascular disease risk in young adults, but we do not know much about the biologic link between the two,” said Shane Phillips, one of the lead authors on the study.

To understand this link better, Phillips and his colleagues at the University of Illinois at Chicago studied blood samples and tissue biopsies of 14 young adults (ages 18 to 30). Participants with inflammatory or cardiovascular disease, obesity, history of smoking or current pregnancy were excluded from the study group.

Half of the samples were from binge drinkers and half were abstainers. Binge drinking was defined as consuming four or more drinks for women and five or more drinks for men in a two-hour period within the last 30 days. Abstaining was defined as consuming no more than one drink per month.
“We saw that vascular function in the microcirculation, which is a predictor of cardiovascular disease, was worse in binge drinkers,” said Phillips, professor and associate head of physical therapy in the UIC College of Applied Health Sciences. “We also saw that binge drinkers had a 4.7 fold increase in microRNA-21 compared to abstainers.”

The researchers also found that suppressing microRNA-21 helped to restore vascular function in binge drinkers. This effect was not seen in abstainers.
The researchers say that microRNA-21 is a promising potential molecular target for drugs that treat and prevent cardiovascular disease in drinkers.

“Collectively, these study findings provide preliminary evidence for reduced cardiovascular function in binge drinkers, compared to abstainers, and that inhibition of microRNA-21 signaling may help to treat or prevent the early signs of cardiovascular disease,” Phillips said.

Reference: https://www.sciencedaily.com/releases/2018/01/180124131751.htm

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Are Veiny Arms Really a Sign You’re Super Fit?

You’ve seen the crazy photo of cyclist Pawel Poljanski’s insane leg veins after his 70-hour Tour de France pump. And the Rock boasts a pretty impressive bicep vein, too. Plus, go to any bodybuilding competition, and you’ll see a whole slew of guys with impressive vascularity as well.

What all these veiny guys have in common is that they are in tremendous shape. But is vascularity really a sign of superb fitness?First, let’s take a look at the reason your veins pop in the first place.

Your arteries carry blood away from your heart to the tissues throughout your body, like your muscles. Your veins—which have thin walls and dilate easily—pump the blood back toward your heart.

“The venous outflow is slower than arterial inflow, causing a back-up of venous blood causing higher pressure in the veins,” says Doug McGuff, M.D., author of Body By Science. That increases pressure causes the veins to “pop” out. That’s the pump you get.

But what you’re doing also plays a role in the pop, too.

“Swelling in the muscles pushes the veins out to the surface,” says Spencer Nadolsky, D.O., author of The Fat Loss Prescription. “Your muscles swell when working out and push the veins closer to the surface of your skin, which makes them more pronounced.”

You probably notice your veins popping more during weight lifting than when you’re simply taking a walk or doing other kinds of light cardio.

In general, higher-rep weight lifting with fast concentric movements—say, the part of a biceps curl when you bring the weight up toward your arm—would trigger the biggest pump, says Dr. Nadolsky.

“High intensity interval work can produce this effect as well,” says Dr. McGuff. “Muscular loading and fatigue drive arterial inflow into the muscle, so exercise that triggers this will produce venous engorgement.”

Okay, so your veins tend to pop when you’re working out, but does how veiny you get actually depend on how fit you are? Well, sort of.

The leaner you are—meaning, the less subcutaneous fat you have covering your muscles—the more pronounced your veins will look, says Dr. Nadolsy.

But it’s not just about being lean: Having low body fat along with upped muscle mass is the magic combination for veins that pop, even when you’re at rest. So in some ways, pronounced veins are an indirect sign of fitness.

 

 

Reference: https://www.menshealth.com/fitness/vascularity-and-fitness-level

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Diabetes – Understanding a Debilitating Disease and Its Complications

by Dr. James O.

Honors in Epidemiology, Ophthalmology Electives and Albert Einstein College of Medicine

A Sad Case Struggling with Diabetes – Most people remember the popular movie Animal House and would recognize the popular character Flounder, who was played by the actor Stephen Furst. A recent article in “PeopleCelebrity” (people.com) is useful, for it describes Furst’s lackadaisical attitude toward diabetes, which eventually killed him at the age of 63.

According to the article, both of Furst’s parents died from diabetes-related complications when he was only 16 years old. Several weeks later, Furst himself was diagnosed with diabetes, but he basically ignored his condition, stating: “I went into denial…I didn’t realize the long-term effects.”

Unfortunately, after many years spent battling obesity and diabetes, Furst died on June 16, 2017 from “complications of diabetes.”

What Is Diabetes Mellitus – Diabetes mellitus is a devastating chronic illness that can have horrific and debilitating consequences. This condition, if left untreated, can lead to amputations of multiple limbs, blindness, kidney failure, heart attacks, strokes, hypertension, dental disease, poor wound healing, impotence, loss of sensation in limbs, and many other serious health conditions.

Definition – There are three general types of diabetes. Diabetes mellitus type one, which is also called juvenile diabetes, is usually diagnosed in childhood and accounts for approximately 5% of cases of diabetes. This type of diabetes is usually caused by the body’s inability to produce insulin. Diabetes mellitus type 2 is the most common type of diabetes; it involves an elevation of blood-glucose levels in adults.

This can be due either to the lack of production of the hormone insulin by the pancreas or to the development of a condition called insulin resistance, in which the body’s cells no longer react normally to insulin, thereby preventing insulin from transporting glucose from the blood into the cells. The third type of diabetes is gestational diabetes, which refers to the development of high blood-sugar levels during pregnancy.

Statistics – According to Healthline (healthline.com), 29.1 million people in the United States have been diagnosed with diabetes at a cost of 245 billion dollars per year in health expenses (in 2012), with an estimated 8.1 million more people unaware that they too have the condition. Furthermore, in the United States, approximately 1.4 million new cases of diabetes are diagnosed every year. Worldwide, “[d]iabetes kills 1.5 million people every year” (healthline.com).

Risk Factors – Risk factors for diabetes mellitus include obesity, smoking, (advanced) age, sedentary lifestyle, positive family history, poor diet, elevated cholesterol and triglycerides, and hypertension. Also, African Americans, Native Americans, Asian Americans, Pacific Americans and Hispanic Americans all have an increased risk of developing diabetes.

Warning Signs of Diabetes – Common symptoms of diabetes include severe thirst, frequent urination, dry mouth, intense hunger, blurred vision, poor healing of wounds, dry and itchy skin, and yeast infections.

Complications – One of the major complications of diabetes is damage to what is called the body’s “microcirculation.” This term refers to the circulation of blood in the smallest blood vessels, which are composed of terminal arterioles, capillaries, and venules.

The arterioles (tiny arteries) carry oxygenated blood to the capillaries, where oxygen is then transported to the tissues. The venules (tiny veins) carry deoxygenated blood and C02 from the capillaries to the larger veins.

It is critical for microcirculation to work optimally because its function is critical to the regulation of blood flow, tissue perfusion, normal blood pressure, and normal oxygen delivery and cellular-waste removal.

Studies have shown that early in the course of diabetes, changes begin to occur, namely damaging and thickening the “basement membranes” of microcirculation. This causes alterations in blood-flow properties, alterations in oxygen transport, and changes in homeostasis.

These changes in blood supply, tissue perfusion, and oxygen delivery eventually lead to a progressive loss of nerve-fiber function, causing neuropathy, chronic pain, and numbness.

The damage to microcirculation also causes peripheral vascular disease, which can lead to tissue necrosis, nonhealing ulcers, gangrene, and eventual limb amputation. It is estimated that 2 to 6% of patients with diabetes will develop a diabetic foot ulcer (DFU) that eventually becomes infected. Infected DFUs, in turn, can lead to foot or leg amputation, with 50% of those with amputations dying within 5 years.

Diagnosis – Diabetes can be diagnosed using several common blood tests or urinalysis revealing elevated levels of glucose. A fasting blood sugar over 125 mg/dl (for reference, the normal value is less than 100 mg/dl) may indicate diabetes; a Hgb A1C blood test with a value over 5.7%, which measures average blood-sugar levels over a 3-month period, may also indicate diabetes. Another valuable diagnostic test is the glucose tolerance test used to measure blood-sugar levels 3 hours after oral administration of a sugary syrup.

Traditional Treatments – First-line traditional treatment of diabetes usually involves weight loss, a healthy diet low in carbohydrates and high in fruits and vegetables, and increased exercise for at least 20 minutes 3 times a week.
If diet and exercise are not sufficient to lower blood sugar to normal levels, then medication may be necessary. The first medication usually administered is metformin. Metformin, also known as Glucophage, is an oral medication usually taken twice per day; it works by decreasing the level of sugar produced by the liver and by increasing cells’ sensitivity to insulin. It also lowers the amount of glucose absorbed by the intestines.

Since metformin is metabolized by the liver, if someone has decreased liver function caused by liver disease, this may lead to a buildup of metformin, in turn inducing lactic acidosis, which can cause severe medical conditions and even death.

In the same way, since Metformin is excreted from the body by the kidneys, those with kidney disease and/or lowered kidney function are also at risk of lactic acidosis when taking metformin.

Other types of oral medications are also available to treat diabetes. If these medications fail, daily insulin administration can be given either through injections, inhalation, or an insulin pump.

Traditional treatments of diabetic vascular disease causing impaired circulation include revascularization surgery and angioplasties. Treatment of the tingling, numbness, and sharp pain from diabetic neuropathy include medications such as gabapentin (Neurontin), pregablin (Lyrica), and the antiseizure medicine Tegretol.

Alternative treatments for diabetic neuropathy include Chinese medicine, acupuncture, aromatherapy, massage therapy, reflexology, homeopathy, and biofeedback.

Another treatment that has shown great promise both for the treatment of diabetic neuropathy and diabetic microvascular disease is D’OXYVA. This is a noninvasive, nonopioid transdermal delivery system of medical carbon dioxide (C02) and water vapor that boosts microcirculation, balances the sympathetic and parasympathetic nervous systems, lowers blood pressure, decreases chronic pain, promotes healing of wounds and ulcers, and helps prevent amputations.

D’OXYVA improves blood circulation by means of a transdermal transfer of C02 using a transmission device placed over the thumb for a 5-minute period.
Numerous studies have shown “sustained, remote vasodilation and decreased systolic blood pressure” with the use of D’OXYVA. This is because bathing the tissues in C02 stimulates vasodilation in the periphery of the body, thereby improving circulation, blood flow, and oxygenation levels.

In one particular case, a male patient suffering severe diabetic neuropathy and intractable ulcers and open sores on his legs, along with hypertension and an inability to sleep due to severe pain, was placed on D’OXYVA via his thumb for 5 minutes twice a day for 6 weeks.

By the end of the 6-week period, the patient reported a significant decrease in pain; he reported being able to sleep through the night for the first time in years and reported that most of his leg wounds had healed. In addition, his blood pressure dropped from 188/130 to 135/95 within 30 minutes of each application.

Summary – Diabetes is an insidious chronic condition that devastates both patients and families. Increased awareness and preventive measures, such as controlling diet and increasing regular exercise, can encourage weight loss and hopefully prevent the development or worsening of diabetes and the need for oral medications or treatment with insulin. In addition, new advances in therapy such as D’OXYVA offer a noninvasive, transdermal, low-cost, and very effective alternative to help stop the intractable chronic pain of diabetic neuropathy and to help prevent limb amputations.