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Fast genetic sequencing saves newborn lives
By two months of age, the boy was near death. He had spent his entire short life in the neonatal intensive care unit (NICU) at Children’s Mercy Hospital in Kansas City, Missouri, while physicians tried to work out the cause of his abnormalities.
Sonar-assisted human navigation
When a biologist who studies bats and a computer scientist cross paths, amazingly cool things can happen. Cool things such as a sonar device to assist the visually impaired.
Holidays are great but they can also be bad for your HEART!
In 2004, Phillips et al, published an article in Circulation (@circaha) that found an increased mortality around Christmas and New Year. We can even appreciate a a trend upwards since Thanksgiving. For cardiac and noncardiac diseases, a spike in daily mortality occurs during the Christmas/New Year’s holiday period. This spike persists after adjusting for trends and seasons and is particularly large for individuals who are dead on arrival at a hospital, die in the emergency department, or die as outpatients
Holidays are a season in which we gather with family and friends. We enjoy good food, a couple of drinks. People with cardiovascular disease, or heart failure, crossing the thin red line of “balance” can be easily done.
Why does this happen? Some proposed but not tested possibilities
1) Respiratory Diseases: Did you get your flu shot? Respiratory disease increase in winter, and on individuals with underlying diseases, this can tip them over the age. Pneumonia, Upper Respiratory Tract infections, leading to decreased oxygenation, increased cathecolamine surge, leading to ischemia, etc.
– In summary! Get you flu shot if you have not done so
– Stay warm 😉
2) Emotional Stress
– Relax, and meditate. I can not prescribe you medication but I can recommend you some apps
– HeadSpace
– Mindfulness app
– Buddhist Meditation Trainer
– Buddhify 2
3) Changes in Diet and Alcohol consumption
– We might tend to indulge ourselves in these days. Remember that family members with history of heart failure, heart attacks, underlying hypertension, might not do so well with the task holiday foods. Increased Salt in foods in addition to quantity intake can predispose patients for increased water retention, causing a Heart Failure exacerbation and thus hospital admission
– They can eat everything, but with moderation
– Alcohol consumption as well as coffee and caffeinated drinks are important. We also see a trend in these parties for energy drinks mixed with alcohol. THIS IS HORRIBLE COMBO which can lead to the Happy Holiday Syndrome. In brief, arrhythmia.
Potential Mechanisms for the “Merry Christmas Coronary” and “Happy New Year Heart Attack” Phenomenon
1. Inappropriate delay in seeking medical attention
2. Reduced levels of healthcare staffing or fewer staff members who are familiar with individual patients during holiday on-call schedules
3. Increased emotional stress
4. Overindulgence (eg, increased intake of food, salt, fats, alcohol) <—– WATCH OUT
5. Increased respiratory problems (eg, upper respiratory infection, influenza, particulate matter generated from wood-burning fireplaces)
6. Colder weather, leading to increased vascular resistance, coronary spasm, hemostasis and thrombus formation, O2 demand
7. Decreased hours of daylight
8. “Postponement of death” concept
Relevant Articles:
1) Cardiac Mortality Is Higher Around Christmas and New Year’s Than at Any Other Time The Holidays as a Risk Factor for Death
2) The “Merry Christmas Coronary” and “Happy New Year Heart Attack” Phenomenon
Democratizing Healthcare = AI+Sensors+EMR+Mobile
If you have been following the news you likely have heard about how WATSON defeated the two Jeopardy Champions in 2011. More recently, you probably read headlines talking about sending WATSON to medical school and it graduating in a week.
More recent headlines have mentioned the concept of Dr. WATSON being in the house. You may be wondering how does beating to Jeopardy champions (crushed is a better term) make a case to use WATSON 
in healthcare. The key lies in the capacity of W making sense of unstructured data. For those that do not know what unstructured data is: “Structured data refers to information that either does not have a pre-defined data model and/or does not fit well into relational tables.
Unstructured information is typically text-heavy, but may contain data such as dates, numbers, and facts as well. This results in irregularities and ambiguities that make it difficult to understand using traditional computer programs as compared to data stored in fielded form in databases or annotated (semantically tagged) in documents”. In other words W read so much that it was able to interpret and understand the english language. Watson understands natural language, not only the meaning. It has the capacity to adapt and learn from particular situations.
With the knowledge it has read and digested W generates many hypothesis, not just a single answer and then uses algorithms and lists the possibilities. It could be hundreds it could be 10. Then, it assigns numeric values to the hypothesis and deciders on the best possible option. W usually ended up with top 3 answers but in Jeopardy W needed one answer. For this, IBM added and additional algorithm that helped W decide depending on the strategic position of the game how much he would risk.
What can WATSON do?
1. Devour Huge volumes of text like information 2. 90% of the data created in the last 2 years, 80% unstructured, WATSON knows it already 3. Most physicians can only read at the most 15 hours a month 2 to 3 journals. 4. WATSON can read 4,000 articles, get the most important concepts, and then present the most relevant.
In healthcare we are not expecting a single answer. There could be several answers. Multiple chronic diseases and contribute to each others outcome. WATSON WILL NOT BE A DECISION MAKER (at least not for now), it will understand the nature of your question and develop educated diagnosis. Then a doctor can decide which is the best possible answer based on evidence based information.
As mentioned, WATSON IS ADAPTIVE, the more it “plays” the more knowledgable he becomes. W teaches itself and keeps getting smarter. W can modify its own algorithms and get rid of those that got him into “trouble” or made a bad call and learn to use the right ones more often. W represents cognitive computing or in other words a thinking computing.
1. ASK – you can ask it a very detailed question based on medical history. W will decide what data to access and come back with relevant information
2. DISCOVER: W is interactive, it can tell you which are his suggestions and if deemed necessary, ask you to give him more info to clarify particular doubts (Adding a symptom, quality, intensity, duration) – WATSON will tell you what he used in order to get this information, highlight the information he used and share it with you
3. Decides which is the most relevant answer in the case
4. Doctor WATSON? Not anytime soon
5. The goal is NOT to replace physicians, but to help them achieve the best treatment Another intriguing characteristic that helps WATSON is that he is not human. Not being human removes from the equation self reinforcing perception bias that physicians encounter after facing a particular patient and solving it succesfully. It protects you and the patients of following a path that you believe is right.
Telehealth/Telemedicine: An Opportunity for Physicians and Providers…
The cost effectiveness of providing health care via telemedicine or telehealth promises to be an effective tool to increase coverage and reimbursement of healthcare provided remotely or through telehealth.
Social Media for Doctors: 5 Rules to get you rolling!
I have been asked a couple of times regarding advice on Social Networks and the feedback has been positive. Therefore I thought making a post would be the next step to share these recs in an easier way. Hope it helps.
It was not long ago that most people, including doctors thought Social Media was a waste of time. As a medical professional I have found it a tremendous tool which proved to be useful for many things
1) Education
2) Engagement
3) Priceless Networking
4) Making conferences more interactive and interesting
5) Spreading advice and more
As a doctor who has been using Social Media for a while, I will give some advice that I consider extremely important for any medical professional. This advice will help you jump start your social media presence
1) NEVER post anything in any social network that you would not say in front of 1 MILLION people. (Many of us used FB or other platforms before we knew better so it is reasonable to delete your digital footprint in some of these platforms. Get a fresh start.)
2) Use different social media to target different audiences Take advantage of this. Tumblr, Facebook, Twitter, G+, and one of my favorites, Reddit (/r/Science and /r/Futurology are great!). I will stay away from mentioning Doctor designed Social Networks since I rarely use them anymore.
3) Learn how to use #Hashtags in a proper manner, engage with the internet (Priceless advice given to me by (@Lucienengelen). In addition when you choose your twitter handle, I would suggest for you to use your name if you want people to find you quickly and interact with you. If not, then create a nickname that is simple and easy to remember.
4) Follow healthcare Power Twitters and learn from them even if they are not from your specialty. Trust me, you will learn a lot.
– @Lucienengelen – Lucien Engelen
– @ZGJR – Rafael Grossman
– @Berci – Berthalan Mesko
– @Daniel_Kraft – Daniel Kraft
– @Johnnosta – Johnnosta
– @Doctor_V – Bryan Vartabedian
– @Hjluks – Howard Luks
– @Seattlemamadoc – Wendy Sue Swanson
– @Epatientdave – Dave deBronkart
– @doctorwes – Westby Fisher
– @erictopol – Eric Topol
– @Christianassad – Christian Assad
5) Never trust Direct Messages in twitter. I don’t care how safe you think they are, always assume this could end up seen by millions.
Follow these 5 steps and you will feel more comfortable. (If you do not so already)
Another tremendous reason why the use of Social Media is important among healthcare providers is that is a tool, that in a way, prepares Physicians, Nurses, PAs, you name it, for Telemedicine. Yes, you heard me.
Once your are done with this. Start exploring platforms like Tweetdeck and Hootsuite. This is what a Power Twitter is about. You will feel like you have cloned yourself and you are in multiple places at once!
Got questions? You know where to find me! Cheers!
CYBERHEART: The Future of Afib Ablation and more
How 3D printing could revolutionize burn treatment
TORONTO – Dr. Marc Jeschke, the head of one of Canada’s largest burn treatment centers, had to admit the 3D skin printer in his hands didn’t look revolutionary. “I actually find it kind of fish-tanky,” he told CBS News, laughing.
Applying a Gamified Social Network to improve medical education and patient care
Back in 2010-2011 before even going to Singularity University Exponential Medicine, I envisioned a different way of rounding and providing patient care. An environment that would engage medical students, residents, fellows faculty as well as the patient in a platform that empowered all of them to participate and learn. When different teams round in an institution, there are straight cases and then there are more challenging ones.
What this platform allowed was for the different teams to share with the institution the cases and create an environment that inspired discussion between individuals. Imagine the facebook or yammer of the hospital. Gamification was incorporated which allowed proper selection of faculty or resident of the month or year. It also empowered the patient to participate in his health inside and outside the hospital.
Back in 2010-2011 this concept was considered crazy-unusual like many great ideas. I proposed it to different institutions, many liked it many did not. Truth is, 4 years later, many talk about this potential now but many too scared to implement it. At this point in time I am the Cofounder and chief medical officer of Curely, which is basically the Uber of Medicine. A telehealth marketplace that aims to democratize medicine. This in addition to my medical profession take most of my time and have no room for this project…
For this reason, I am uploading my sketches, envisioned prototype for anyone to use, modify and create. Have in mind this was created in 2010-2011 and yet, I believe its concept is still pretty innovative for 2014.
The paltform’s name was LRN2DAY or Caseday. In case you want to explore more about the files I am attaching the dropbox folder with slides and a “demo” of it. If you have keynote, check the slideshow and it will give you a better idea. Feel free to use as you please!
Christian Assad, MD Interventional Endovascular Cardiology
TikTok Humor
Videos
Amazon iFastLoCa Keto List
El Rincon del Dr. KakaWate 