Kill test with NCBTMB brain dumps and questions and answers real NCBTMB examination simulator is remarkably encouraging for our own customers for the particular NCBTMB PDF Dumps. Greatly critical questions, recommendations, and definitions are usually featured in NCBTMB pdf download pdf file. The NCBTMB examination provides key focuses.

Exam Code: NCBTMB Practice exam 2022 by team
NCBTMB National Certification Board for Therapeutic Massage & Bodywork

Board Certification in Therapeutic Massage and Bodywork represents the highest attainable credential within the massage therapy and bodywork profession. Board Certification is a separate credential above and beyond entry-level massage therapy licensure.

As Board Certification is voluntary, its achievement represents the highest level of commitment to clients and to the advancement of the massage therapy and bodywork profession. Board Certificants must meet higher standards of education and experience, as well as pass a rigorous exam that tests massage therapy and bodywork technique and application, critical thinking, communication, law, ethics, evaluation, documentation, and planning.

NCBTMB is the only certifying body for the massage therapy and bodywork profession. For that reason, NCBTMBs certification processes are founded upon a superior Code of Ethics and Standards of Practice, which all Board Certificants must adhere to. Like our Certificants, the advancement of the profession and the improvement of client care is our focus.

Board Certification in Therapeutic Massage and Bodywork (BCTMB) is the highest attainable credential within the massage therapy and bodywork profession. It is a separate credential above and beyond entry-level, mandatory state licensure.
Board Certificants must meet stringent requirements, clear a recurring criminal background check, and pass the Board Certification Exam.
Board Certification is so much more than having an entry-level massage license. By achieving the profession's highest attainable credential, you represent advanced standards of education, experience, critical thinking, and assessment skills to provide clients and patients positive outcomes.

In the past, massage therapists have not made Board Certification a priority as it is voluntary—but that is changing rapidly in both clinical and staff positions. As massage therapy gains traction as a reimbursable, non-pharmaceutical method for pain relief, insurance companies and other approval entities will look for, or may even require, Board Certification to make this possible.

Course Outline | Syllabus | Objectives
I. Massage Modalities, Techniques, And Manual Forces (20%)
• Knowledge
• General massage protocols
• Compression
• Tension/decompression
• Friction/shearing
• Bending
• PNF, MFR, pin and stretch, etc.
• Torsion
• Range of motion
• Muscle Energy Techniques
• Stretching
• Hydrotherapy
• Indications and contraindications
• Vibration (jostling, shaking)
• Tapotement
• Client/patient positioning
• Special population (pregnancy massage, oncology massage, etc.)
• Appropriate tools and appropriate use
• Efficient body mechanics
• Benefits and effects of modalities (forms), and techniques
• Modality literacy Skills
• Determine applicable massage techniques when working with clients
• Apply massage techniques safely
• Perform massage on special populations
• (athletes, geriatric, prenatal, etc.)
• Identify contraindications and apply affective techniques
• Identify fundamental characteristics of bodywork modalities
• Perform proper body mechanics while working with different populations
• Position clients for comfort and safety
II. Applied Science: Anatomy, Physiology, Kinesiology, Pathology/ Injury, and Pharmacology (25%)
• Anatomy (structure of the human body including joints, tissues, muscles, functions, origins, insertions, and actions, nerve structure, etc.)
• Physiology – systems of the body with:
• i. in-depth knowledge in muscle, skeletal, and nervous systems
• ii. intermediate knowledge in integumentary, cardiovascular, lymphatic and digestive systems iii. basic knowledge in respiratory, endocrine, reproductive and urinary systems
• Kinesiology (mechanics of body movement including levers, agonists, antagonists, synergist, etc.)
• Pharmacology (contraindications of prescription and non-prescription medication, implications for massage, etc.)
• Standard precautions
• Endangerment sites
• Identify structures and functions of all body systems
• Identify muscle and joint physiology
• Recognize mechanics of body movement –
• agonists, antagonists and synergists
• Identify and apply range of motion techniques
– passive, active, active assisted and resistive range of motion
• Identify endangerment/cautionary sites
• Recognize muscle and orthopedic testing
• Identify indications and contraindications of common prescription drugs
• Determine proper stretching techniques and “end feels”
III. Professional Communication (15%)
• Medical terminology
• How to communicate with client/patient in understandable terms
• Reporting formats (appropriate language in medical history, treatment plan, SOAP notes, EMR etc.)
• Communication with clients/patients (asking questions to clarify information)
• Client/patient sensitivity and vulnerabilities (how to make clients comfortable during treatment)
• Verbal and non-verbal cues
• Informed consent
• Effectively communicate with clients when explaining treatment plans
• Describe techniques, anatomy, physiology and kinesiology in understandable terms
• Identify HIPAA procedures
• Work within client comfort levels
• Adapt to verbal and non-verbal cues when working with clients
• Document sessions appropriate to the work setting – SOAP, EMR, spa etc.
• Uphold all HIPAA confidentiality standards
• Effectively communicate in proper medical terminology when working with other healthcare professionals
IV. Professionalism & Ethics (10%)
• Current standard of care for safe and effective massage
• Professional boundaries
• Draping laws and techniques
• When to refer clients to other health professionals
• When, why and how to refuse treatment
• How to report misconduct and who to report to
• Transference and countertransference
• Maintain proper physical and emotional boundaries
• Respect clients right to say no
• Identify when to refer out and whom to refer clients with pathologies
• Identify transference and countertransference situations
• Identify when to refuse to treat clients
• Identify correct entities to report client or fellow massage therapists misconduct
V. Laws & Business Practices (5%)
• Appropriate draping
• Continuing education requirements
• Scope of practice and applicable licensing laws
• Record keeping (business and client/patient)
• Maintain client confidentiality
• Perform only within the massage therapy scope of practice
• Maintain appropriate draping for client protection and privacy
• Represent educational and professional
• qualifications honestly
• Demonstrate proper business and client record keeping
• Abide by national organizations code of conduct and policies
• Comply with all federal state and local laws
VI. Assessment (25%)
• Comprehensive intake
• Interview and data collection techniques
• Observation techniques (posture deviation, etc.)
• Range of motion (normal and abnormal body motions)
• Treatment session planning techniques in collaboration with client/patient and other healthcare professionals when necessary
• Indications and contraindications
• Functional assessments and reassessments
• Customized treatments
• Pain scale and pain management
• Medical terminology (SOAP charting, etc.)
• Clinical reasoning (analyzing information from client/patient)
• Research associated with massage therapy
• Conduct an effective and thorough intake interview to gather information
• Interpret client health history information
• Customize treatment plans to fit the needs of • each client
• Discuss treatment plan and alternate plans if requested by the client
• Determine common pain scale descriptions
• Utilize palpatory skills to assess soft tissue
• Perform and interpret active and passive range of motion assessments
• Perform and interpret postural analysis
• Perform and interpret gait assessment
• Perform and interpret manual resistance tests
• Perform and interpret special orthopedic tests
• Reassess client movement, strength and range of motion post – treatment
• Document all findings properly pre and post treatment and change treatment plans accordingly
• Collaborate with other healthcare professionals as needed
• Communicate using appropriate medical terminology when speaking with other medical professionals and in official documentation
• Work effectively as part of an integrated healthcare team
• Recognize and analyze research
• Identify different areas of research

National Certification Board for Therapeutic Massage & Bodywork
Medical Certification Questions and Answers
Killexams : Medical Certification mock test - BingNews Search results Killexams : Medical Certification mock test - BingNews Killexams : Doc on the Street: Answering Patients' Tough Questions

In this video, Mikhail Varshavski, DO -- who goes by "Dr. Mike" on social media -- takes to the streets of New York City for a new episode of Curbside Consult.

Following is a partial transcript of the video (note that errors are possible):

Varshavski: You might be wondering why I'm in Central Park answering people's medical questions. Well, traditionally in the United States it's hard to get healthcare, and health literacy needs some work. I'm a real doctor. You knew this because you watch the videos?

Female Interviewee 1: Yeah. I watch your videos, yeah.

Varshavski: What's your favorite video?

Female Interviewee 1: Um...

Varshavski: She's lying right now.

Female Interviewee 1: No!

Varshavski: I'll change the question. Name one video you watched.

Female Interviewee 1: Oh, your reactions to the "Grey's Anatomy."

Varshavski: Okay. Okay. I'll take it. What have you seen on TikTok, in the media, that you're like, "Oh, is this BS?"

Female Interviewee 1: Is there going to be like male birth control anytime soon?

Female Passerby: Say it again for everyone in the back, like way in the back of the park.

Varshavski: Who are the ... Hey, Dan, get it for those people in the back over there, just to make sure that they hear it. I think that within the next 5 years there will definitely be multiple options. Whether it'll be a shot, a medication, a patch, remains to be seen.

There are male birth control options. Vasectomies do exist, and while this is considered a permanent type of birth control for men, it can be reversible in some cases.

Male Interviewee 1: Is it really better to be a vegetarian? Or is it better to eat meat?

Varshavski: You can be a vegetarian, you can be a vegan, and you can eat meat, and you could have a healthy diet in both of those scenarios. But being vegan, being vegetarian, or being an omnivore does not on its own mean you're healthy.

Hey, hey, hey, hey, hey! I'm a doctor, but I need to know how much can you press?

[Crowd laughing]

Varshavski: Get it? 'Cause it's a bench press.

Female Interviewee 2: Are crunches actually good for you?

Varshavski: Crunches are not like my go-to for increasing abdominal strength. A lot of people think you need to do a million crunches to show your abs. It's actually about your body fat content. For me, I like isometric exercises where you're holding yourself like planks. Even Pilates I'm a big fan of.

Female Interviewee 2: I'm a Pilates girl so I feel you on that.

Varshavski: Okay. Okay. Dan Owens, do you have a medical question?

Dan: No, I don't.

Varshavski: Obviously, because he knows everything because he films a YouTube channel.

Matt: I'm Matt. I'm a psychologist.

Varshavski: Oh, nice to meet you Matt. I'm Dr. Mike.

Matt: My question is, when somebody comes in and they say they have been feeling anxious or depressed, what's your approach to dealing with that? What do you do?

Varshavski: One is to make sure that I can provide support right now if necessary, whether that be medically or mentally, and two is to get them plugged in with my interdisciplinary team -- social workers, psychologists, and psychiatrists -- that are all readily available, either for a crisis intervention right at that moment or something downstream where they can get plugged into the system and make sure they have access.

Matt: Evidence suggests that therapy works and has additive benefits when combined with medications, so I think that all sounds great.

Varshavski: Hi. Hi.

Male Interviewee 3/Child 1: What are like the stages through puberty?

Varshavski: My guess, and correct me if I'm wrong, is that you're wondering when the growth spurt is coming?

Male Interviewee 3/Child 1: Yeah. [Chuckles]

Varshavski: When I was going into high school, I was 6 foot 3, which is the height I am right now. At the same time, I had friends of mine who were much shorter than me going into high school that then outgrew me by senior year. So as you can tell, there is a lot of variety that happens with growth spurts. I wouldn't start thinking about "Oh, it didn't happen to me yet. I wish it would happen to me," and instead, think about how to stay healthy.

Ankle, what we are concerned about is tears of ligaments. The most commonly torn ligament is ...

Female Interviewee 3: Uh, your ankle?

Varshavski: She's just laughing at her.

Female Interviewee 4: Achilles?

Varshavski: No, it's the anterior talofibular ligament.

Female Interviewee 4: Oh, yeah. Anterior talofibular ligament.

Male Interviewee 4: What do you think the heart rate of Bigfoot would be?

Varshavski: One hundred and seventy-six.

Male Interviewee 4: Hmm. Okay.

Male Interviewee 5: Hi, Dr. Mike.

Varshavski: Hi.

Male Interviewee 5: I was just wondering --

Varshavski: I love your outfit, by the way. I love the colors. Are you are a designer? Are you in fashion?

Male Interviewee 5: I studied fashion, yeah. How do I lower my heart rate when I am anxious and stressed at work?

Varshavski: Physiologically, which means control over your own body. We can do deep breathing exercises where you're literally counting the number of seconds in-between your inhales and exhales so that you slow the process down.

Your vagus nerve, which is responsible for your parasympathetic state -- which is the rest, digest, chill state -- sometimes gets overlooked when we're breathing very fast. When you breathe deeply, you engage the diaphragm. You help facilitate that parasympathetic state so that you can calm down naturally.

It sounds like you're having some arch problems. You probably just need more arch support.

[Sam unimpressed]

Female Interviewee 5/Child 2: I want to become a doctor too.

Varshavski: Really? Okay, what kind?

Female Interviewee 5/ Child 2: Like helping people like not be sick.

Varshavski: To be honest, if you were my doctor, I'd take it and I'd love it. Maybe in the future you could be my doctor. Deal?

Female Interviewee 5/Child 2: Deal.

Student Doctor/Female Interviewee 6: What's your biggest, I guess, advice going through interviews for residency?

Varshavski: Okay. Well, I have to ask. What type of residency are you applying to?

Student Doctor/Female Interviewee 6: Family medicine. That's why I'm like, "Oh my god."

Varshavski: That's why this is like meant to be right now. I interview people for family medicine residencies all the time. We're looking for people to work with that are going to be motivated, that have gone through a struggle, that have experienced things in their lives. Really, that's what being human is about. So try and be human as much as possible because we don't want robots. We want humans to interact with other humans. That's why AI's not taking over our jobs just yet.

Male Interviewee 6: Okay, for fitness.

Varshavski: Ooh, ooh, ooh. We got a good one!

Male Interviewee 6: Okay. So you know how like creatine's like a big, obviously ... ?

Varshavski: Oh, yeah. Yeah.

Male Interviewee 6: Is there like an appropriate amount of like creatine intake that someone should take if they are working out?

Varshavski: Creatine helps facilitate anaerobic exercise, meaning that if you're pushing a weight for a short duration, if you're sprinting, that's where you're going to get the biggest benefits of creatine. You're not going to see it if you're trying to run a marathon. Just taking the five milligrams as a single dose is more than enough --

Male Interviewee 6: Yeah.

Varshavski: -- after an exercise session. All right, we got good questions.

Male Interviewee 6: Let's go! Thank you.

Varshavski: We got good questions.

Student Doctor/Female Interviewee 6: Thank you.

Mike Varshavski, DO, is a board-certified family physician and social media influencer with more than 10 million subscribers.

Thu, 08 Dec 2022 10:12:00 -0600 en text/html
Killexams : Camacho: Medical certification for disability update

Mabuhay and håfa adai! An individual applying for naturalization must appear for an interview. During this interview, the immigration officer will determine whether to grant or deny the naturalization application. There are three components of the naturalization interview: Review of the application, English examination and a civics test.

Twenty-six applicants recite their Oath of Allegiance as their final step to becoming naturalized citizens during a naturalization ceremony, presided over by Magistrate Judge Micheal J. Bordallo, at the District Court of Guam in Hagåtña on June 23, 2022. The event was held in celebration of the Juneteenth National Independence Day holiday, also known as Emancipation Day, which is traditionally observed on June 19.

The first component is a review of the naturalization application. The immigration officer will go through the naturalization application with the applicant to ensure that the responses are accurate. If there are any changes or errors in the application, the applicant has an opportunity to correct and update his or her application.

The second component is the English examination. In this component, the applicant reads a sentence in the English language and writes a sentence in English. The following applicants are exempted from the English examination: An individual who is 50 years or older and has been a lawful permanent resident for at least 20 years; or an individual who is 55 years or older and has been a lawful permanent resident for at least 15 years.

If the applicant qualifies for the exemption, the applicant can also request for a translator during the interview.

The third component is the civics test. In this component, the applicant must study 100 questions regarding the United States government and history. During the interview, the applicant will be asked 10 of those questions, and must get 6 questions correct.

If the applicant is 65 years or older and has been a lawful permanent resident for at least 20 years, then the applicant will be able to take a more simplified version of the test. Instead of studying for 100 questions, the applicant will only need to study a total of 20 designated questions.

For those individuals who have certain disabilities, such as hearing impairments or blindness, certain accommodations will be given to enable the individual to take the test. For example, I have accompanied clients who are blind or are deaf, and the immigration officers have accommodated.

In instances where an individual suffers from a physical, developmental or mental impairment that prevents them from demonstrating their knowledge and understanding of the English language and/or civics requirement, an individual may obtain a medical exception, by submitting a Medical Certification for Disability Exception Form.

In the past, a Medical Certification for Disability Exception was challenging to obtain. However, the U.S. Citizenship and Immigration Services recently revised the Medical Certification for Disability Exception Form. More importantly, on Oct. 19, USCIS announced an updated policy guidance to clarify and conform with the most recent revision of the Medical Certification for Disability Exception Form.

A Medical Certification for Disability Exception Form must be completed and certified by a medical professional. According to USCIS, the revised form aims to reduce the burdens on both USCIS and the applicant “by eliminating questions and language that no longer have practical utility or were redundant.”

The revised form also gives the medical professional the option to “indicate an applicant’s need for an oath waiver, thereby eliminating the need for separate medical documentation.” Additionally, an applicant is able to submit the Medical Certification for Disability Exception Form even after the naturalization application is submitted.

An individual who suffers from a disability but can still complete the English and civics component of the interview with certain accommodations does not need to submit the Medical Certification for Disability Exception Form. The form is only for those individuals who suffer from certain disability and ailments, and who would not be able to successfully complete the English and Civics component of the interview.

For further questions or concerns on the Medical Certification for Disability Exception Form, or various immigration issues, a consultation with an experienced immigration attorney is recommended.

Catherine Bejerana Camacho is a Filipino-American attorney raised on Guam and licensed to practice in Guam and California. She specializes in employment and family-based immigration law, corporate law and family law.

Sat, 19 Nov 2022 22:45:00 -0600 en text/html
Killexams : Medical jargon is often misunderstood by the general public – new study

Students learning medicine must learn a whole new language to allow them to express their clinical impressions to others accurately. In time, this becomes second nature and soon they can be heard babbling away confidently and sounding quite the part. Communication skills are a standard part of medical education and the teachers take great care to ensure that these newly found linguistic skills do not impinge on their communication with patients. Most seem to take this on board and do their utmost not to confuse patients.

With all of this good education going on, why is it that we hear of misunderstandings between doctors and patients? Do doctors really throw up verbal smokescreens to confound others? A recent paper from the University of Minnesota would suggest so.

A survey of 215 members of the public examined their understanding of some common phases used by doctors in their consultations. Words such as “your cancer screening test came back and the results were negative” were correctly interpreted by 97.7% of the people. However, only 21% correctly understood that a doctor saying their radiography was “impressive” was generally bad news. And “Have you been febrile?” was understood by just 9.3%.

The researchers concluded that medical jargon is alive and well and living in consulting rooms in Minnesota – and presumably a lot of other places as well.

Before we all take the view that doctors need yet more browbeating about their communication skills, let us look at this paper in context. The study participants were members of the public visiting the Minnesota State Fair. Presumably, they were looking forward to a day of candyfloss and helter-skelter rides rather than being accosted by researchers offering university-branded backpacks as inducements to participate. They were not expecting to be patients that day and may even have been there to get away from worries about health.

The questions were multiple choice, with no opportunity to ask for clarification. Medically qualified readers will all be familiar with patients who ask for immediate explanations of terms and most, I hope, will understand the power of the phrase: “By which I mean … ”

Somehow, the study methods used by these researchers seem not to accurately replicate the conditions found in your average clinic and, in fairness, they acknowledge this.

Why use certain terms and phrases in the first place? Oddly, the answer is not wholly straightforward. Today’s internet-enabled patient is better informed than ever. Popular TV programmes show doctors and patients in action, using copious quantities of medical jargon for realism and artistic effect. The public lap it up.

Thanks to popular TV shows, we are all better informed about medical jargon. Album / Alamy Stock Photo

In the clinic, patients like to be treated as adults and communicated with accordingly. They don’t want to be infantilised or patronised – and they certainly let doctors know if they are made to feel that way. Skilled doctors know this and will introduce terms followed (hopefully) by immediate explanations to ensure understanding. Too slow with an explanation and the wily patient will ask: “Can I have that in English please?”

Whatever the words used and however they are put, some patients are not in a position to take it all in. Fear and anxiety cloud the comprehension of messages in any consultation, and this must be accounted for. There should be adequate adjuncts, such as information leaflets, web links, and that all-important opportunity to ask questions at the time or on a subsequent occasion.

Nobody should leave a healthcare consultation confused and none the wiser because of the use of medical jargon, and none should be spoken down to or patronised. The skill of the doctor is to find the happy medium and make patients feel informed and respected – even if they can’t always offer a cure.

Mon, 05 Dec 2022 02:33:00 -0600 Stephen Hughes en text/html
Killexams : Benefits of ISO 13485 Certification for Medical Device Manufacturing

The medical device sector must meet stringent regulatory requirements plus convince potential customers that they make reliable, safe products. Having a strong commitment to quality can help customers achieve both those aims and others.

Parts of the ISO 13485 process involve identifying and documenting processes. For example, company representatives must find all processes that have even a minor connection to manufacturing. Next, they must create written procedures to establish which elements could introduce risks to the product.

Those threats could range from contaminated equipment to poorly trained personnel. After bringing attention to the risks, company representatives must name and describe measures to mitigate the potential issues.

ISO 13485 does not spell out the specific measures for device manufacturers to take. However, the certification gets people in the mindset that quality happens at every stage of manufacturing and that ongoing efforts enable maintaining high standards.

Reducing the Likelihood of Longstanding Issues

Another component of ISO 13485 requires ongoing managerial reviews to determine whether previously implemented controls work as expected or if further tweaks would get better results. Unfortunately, some leaders see these evaluations as box-checking exercises and feel under excessive pressure to get them done.

However, gathering relevant data and creating processes to keep that information up-to-date and accessible can make it easier to carry out thorough, non-rushed reviews related to ISO 13485. 

For example, looking at customer feedback, audit results, new regulatory requirements, and any details of corrective actions taken so far can help decision-makers verify whether quality controls related to ISO 13485 have the desired effects.

Additionally, these periodic reviews Strengthen the chances of catching issues that could lead to faulty products or operational efficiencies. They encourage better visibility that limits the likelihood of an unaddressed issue causing long-term problems.

Increasing Marketplace Competitiveness

The most recent version of ISO 13485 requires that certified companies insist that any subcontractors conform to the standard, too. That means the commitment to quality extends beyond a particular organization. Many potential customers appreciate that, knowing that working with any new company poses challenges. ISO 13485 reduces many of them with its emphasis on quality.

Also, since ISO 13485 is an internationally recognized standard, it can help in cases where company leaders want to expand into other countries and boost their chances of success. Certification assists organizational leaders in conveying that they take quality seriously.

It’s vital to convince stakeholders of efforts to prioritize quality since medical devices directly affect people’s lives. Minimizing the chances of harm and increasing positive outcomes helps potential customers build trust in a company and decide it makes sense to work with or purchase from them.

Helping Products Stay on the Market Without Issues

Statistics indicate that approximately 4,500 medical devices and drugs get taken off the market owing to recalls. Just as managerial reviews of ISO 13485 processes can prevent persistent issues, a certified company is less likely to experience problems that lead to getting products pulled from shelves. In addition to the lost profits that such events cause, recalls can permanently damage the public’s reputation, making many people perceive a troubled brand as unsafe.

However, corrective and preventive actions get built into the ISO 13485 framework, helping company representatives identify and tackle problems faster than they otherwise might. It’s also advantageous that getting certified can help create and maintain a culture of personal responsibility within the organization.

Once an employee understands that a single missed step or ignored protocol could cause quality issues that affect a whole organization, they’ll likely become more conscious of their behaviors and choices made while working.

Plus, if a company does experience a recall, being ISO 13485-certified should make it easier to target where things went wrong and prevent future issues. Doing those things should bolster public trust and reassure people that a device manufacturer has its operations under control.

ISO 13485 Certifications Strengthens Medical Device Companies

The medical device sector is a high-pressure industry where people praise innovation as long as it doesn’t sacrifice user safety. Moreover, manufacturers must respond to demand spikes, as instances like the surge in ventilator needs during the COVID-19 pandemic showed.

Getting an ISO 13485 certification can help a company make positive, permanent quality and process improvements. Thus, representatives from certified companies often find that ISO 13485 contributes to organizational resilience. It’s not right for every organization, but the associated benefits make it well worth consideration.

Wed, 30 Nov 2022 10:00:00 -0600 en text/html
Killexams : Medical people: News about medical professionals around Polk County


Matt Werd

Matt Werd, DPM, FACFAS, was a featured sports medicine speaker at the national meeting of the American Academy of Podiatric Practice Management held Nov. 3 in Fort Lauderdale. The AAPPM meeting attracts foot and ankle certified from throughout the United States and internationally. Werd’s lecture Topic was “Prefab AFOs (Ankle-Foot-Orthoses) to Keep Athletes Active.” He also served as an expert panelist for a question-and-answer session on lower extremity sports injuries. Werd has co-authored two editions of the medical text “Athletic Footwear and Orthoses in Sports Medicine” Springer Publishing 2017.


D’Aishia Burgess

Registered nurse practitioner D’Aishia Burgess works alongside board-certified pulmonology specialist Naem Shahrour, from Watson Clinic Main at 1600 Lakeland Hills Blvd., Lakeland.  Burgess achieved her bachelor's in nursing from Polk State College in Winter Haven and her master's in nursing from Florida Southern College in Lakeland. She is a member of the American Association of Nurse Practitioners and the Florida Association of Nurse Practitioners, and is certified by the American Nurses Credentialing Center. 863-680-7190.

Amanda Porter

Physician assistant Amanda Porter serves patients of board-certified orthopedic surgeon Obafunto Abimbola from Watson Clinic Main at 1600 Lakeland Hills Blvd. in Lakeland. She earned a bachelor's in athletic training from the University of Wisconsin Oshkosh in Oshkosh, Wisconsin, a master's in physical education Western Michigan University in Kalamazoo, Michigan, and a master's in health sciences from George Washington University in Washington, D.C. She is a member of the American Academy of Physician Assistants, the Physician Assistants of Orthopaedic Surgery and the Florida Academy of Physician Assistants.  She is certified by the National Commission on Certification of Physician Assistants. 863-680-7214.

Nicole Hamlin

Registered nurse practitioner Nicole B. Hamlin works alongside board-certified otolaryngologist and facial plastic surgeon Raam S. Lakhani, M.D., from the Watson Clinic Bella Vista Building, 1755 N. Florida Ave., Lakeland. Hamlin earned her bachelor's in nursing from the University of South Florida in Tampa and her master's in nursing from Florida Southern College in Lakeland. She is a member of the American Academy of Nurse Practitioners. 863-904-6296.

Brandi Ray

Registered nurse practitioner Brandi C. Ray sees patients of board-certified internal medicine specialist Agustin Tavares from Watson Clinic South, 1033 N. Parkway Frontage Road, Lakeland. Ray earned her bachelor's and master's in nursing from the University of South Florida in Tampa. She is a certified family nurse practitioner by the American Academy of Nurse Practitioners, and is a member of the American Academy of Nurse Practitioners and the American Association of Critical Care Nurses Alumnus. 863-680-7190.

Julian Rios, R.N., center, holds his PEER Award plaque. Also pictured are Watson Clinic Chief Administrative Officer Jason Hirsbrunner, right, and Watson Clinic Urgent Care Main specialist Dr. Rajendra K. Sawh, left.

Julian Rios, a registered nurse at Watson Clinic Urgent Care Main, was recently named the recipient of the November Program for Employee Excellence and Recognition award. Rios has been with Watson Clinic for 14 years. Over the course of his career, whether he was providing care to urology patients or as an employee health nurse in our human resources department during COVID, Rios has been admired for his easygoing and friendly nature and for being an exceptional team member. Rios received a plaque, dinner at a local restaurant, a reserved parking spot and a gift certificate from the Medical Spa at Watson Clinic.

David Graham

David Graham, a board-certified radiation oncologist at the Watson Clinic Cancer and Research Center, is the first specialist in Florida to be named a Center of Excellence for his expertise in utilizing the SpaceOAR Hydrogel, an injectable spacer that minimizes the side effects of radiation therapy for prostate cancer patients. This recognition was presented by the device manufacturer Boston Scientific. Radiation therapy can produce undesirable side effects. The SpaceOAR Hydrogel is a soft injectable spacer that gently separates the prostate from the rectum, greatly minimizing the possibility of side effects. Graham received his medical degree from St. George’s University School of Medicine in Grenada, West Indies. He performed an internship in general surgery at Guthrie Clinic in Sayre, Pennsylvania. He performed residencies in radiation oncology at Northwestern University School of Medicine in Chicago and Eastern Virginia Medical School in Norfolk. He is board certified in radiation oncology by the American Board of Radiology. Graham is a member of the American Medical Association, the American Society of Therapeutic Radiation Oncology, the American Society of Clinical Oncology, the International Association for Hospice and Palliative Care, the Cyberknife Society and the Radiosurgery Society. 863-603-4717.


Mohammad Elballat

Mohammad Elballat specializes in pulmonology, critical care and sleep medicine. He is board certified in internal medicine, pulmonology and critical care. Elballat has experience in sleep apnea, insomnia, narcolepsy, parasomnias and managing complex surgical patients and critically ill neurosurgical patients. Elballat earned his medical degree in general medicine and surgery from Tanta University, Egypt. He completed his internal medicine residency at the University of Miami/JFK Consortium in West Palm Beach. Elballat completed his pulmonary critical care fellowship at the University of Tennessee Health Science Center in Memphis, Tennessee, and his sleep medicine fellowship at the University of South Florida in Tampa. Elballat cares for patients at our Grasslands Campus and the Medical Center.

Sydney Pate

Sydney Pate recently joined Lakeland Regional Health as a surgical first assistant. She is a certified physician’s assistant who has extensive clinical experience in plastic surgery, general surgery, emergency medicine, internal medicine, pediatrics, family medicine, and OB/GYN. Pate earned her bachelor's in chemistry and master's in physician assistant studies from Butler University in Indianapolis. Pate sees patients at the Lakeland Regional Health Medical Center.

Lakeland Regional Health is one of 2022’s Digital Health Most Wired hospital and health systems, as announced by the College of Healthcare Information Management Executives. This is the eighth time that Lakeland Regional Health has earned the Most Wired recognition. Lakeland Regional Health Medical Center achieved Level 8 Acute recognition and Lakeland Regional Health ambulatory locations received Level 8 Ambulatory recognition. The CHIME Digital Health Most Wired program conducted an annual survey of more than 38,000 organizations to assess how effectively they apply core and advanced technologies into their clinical and business programs to Strengthen health and care in their communities.


Azlyn Goff

Azlyn Goff is a pediatric orthopedic surgeon at Nemours Children’s Hospital, Florida in Orlando and Lakeland. In addition to English, Goff is fluent in Spanish. She joined Nemours Children’s Health in September after completing a pediatric orthopedic surgery fellowship at Vanderbilt University Medical Center in Nashville, Tennessee, where she was an assistant clinical professor in the Department of Pediatric Orthopedic Surgery. Goff earned her bachelor's in chemistry and biochemistry at Florida State University in Tallahassee and her Doctor of Medicine degree at New York Medical College in Valhalla, New York. She performed her orthopedic surgery residency at Westchester Medical Center in Valhalla, New York.

This article originally appeared on The Ledger: Medical people: News about medical professionals around Polk County

Mon, 05 Dec 2022 19:56:00 -0600 en-US text/html
Killexams : I tried five at-home health testing kits and this is what I discovered

‘And does that run in your family?’

It’s a common question for doctors to ask, but when I was diagnosed with a heart problem at 16, I couldn’t answer it. 

On my mum’s side, I knew the history – but my dad’s? No clue. For those of us estranged from parents, being asked this by medical professionals can be hard. 

Ever since that moment, I have been determined to know as much as I can about my health and so, when at-home testing kits became more common, I knew I wanted in. 

While they wouldn’t be able to tell me about my dad’s family history, they would, I hoped, let me know if I was at an increased risk of anything because of his genes.

I also wanted more control over something that so often feels out of the hands of non-doctors; something the average person has very little understanding of: our own bodies.  

The first thing I learnt, once one of the kits arrived, is that I have bad circulation. Not quite the revolutionary insight I was hoping for, but still useful. 

Trying to draw blood from my finger using a lancet proved impossible, and so for all the blood-taking kits, I had to request someone take my trial for me (which costs more), or order a replacement kit (sending back a half-vial of blood hoping it would be enough). 

But once I got the kits sent off, they did yield interesting results. 

The two general health tests I did were ForthWithLife’s Baseline Plus and Medichecks’ Ultimate Performance Blood Test. 

The Baseline Plus (£79) is designed to provide you a ‘snapshot of your overall health and wellbeing’ by looking at various biomarkers (i.e. cholesterol, vitamin B12, total protein). The results come back within a couple of days and are presented in a really accessible way, with a ‘more details’ click through to help you understand what all these terms mean. 

The Baseline Plus results (Picture: Jess Austin) © Provided by Metro The Baseline Plus results (Picture: Jess Austin)

The screening comes with a doctor’s report at the top. Mine read: ‘Overall this is a great panel. The low triglyceride and slightly raised total cholesterol are not concerning.’

The test is designed to be part of a subscription package, and so I think if you were to get new results every six months, you would perhaps get more of an insight into your health. For a one off, however, I didn’t really know what to do with my stats – but that’s likely because the doctor said there was nothing alarming about them. If anything, they provided some peace of mind. 

I also did Medichecks’ Ultimate Performance Test (£199), which asks its buyers, ‘Are you an athlete, bio-hacker or someone who wants to be on top of their game?’ The answer for me was firmly ‘no’, but as it also promised that I would ‘learn as much about my body as possible’, I was sold. 

When the results came they felt comprehensive. Each drop down section had a further breakdown of results, and under each result there was an explanation of what each figure meant and how to Strengthen your result. 

Medichecks’ test is pricier at £199 (Picture: Jess Austin) © Provided by Metro Medichecks’ test is pricier at £199 (Picture: Jess Austin) But have a really easy-to-use interface (Picture: Jess Austin) © Provided by Metro But have a really easy-to-use interface (Picture: Jess Austin)

Accompanying all of this was a doctor’s report that commented on all my results, gave tips where necessary and flagged areas of concern. My cortisol levels were low and so the doctor recommended going to my GP to check for Addison’s Disease – a lifelong condition where your adrenal glands don’t produce enough hormones.

While initially nervous that I could become the urban legend of the journalist who found out she had a serious illness for the purpose of an article, I went to my GP. She said that it was unlikely that had this rare illness, but put me forward for more blood tests, which confirmed I didn’t have it. She noted that because I took this test in the afternoon, my cortisol levels would have dipped, leading to the confusing reading. 

It was a good lesson in accepting any at-home test results with caution. 

The first thing I learned is that I have bad circulation (Picture: Jess Austin) © Provided by Metro The first thing I learned is that I have bad circulation (Picture: Jess Austin)

The test I was probably most excited for was 23andMe’s Health + Ancestry (£149), which can find out whether you have an increased genetic risk of certain illnesses – for example, it looks for certain variants of the BRCA gene (which can lead to increased chance of breast and ovarian cancer) or the gene for Parkinson’s Disease. This was the one I hoped would provide me with the knowledge I lacked by being estranged from my father. 

Another benefit is that it relies on saliva, rather than blood, for the trial and unlike other tests where you are encouraged to repeat them throughout your life, this is one you only have to do once. 

The results take a little longer to arrive – around 20 days in my case – but when they do you have a huge amount of information to look through. 23andMe also makes sure to issue a disclaimer before you receive your profile that the information could have life-changing implications, and throughout your report there are plenty of other reminders that this test is not a formal diagnosis and you should speak to your healthcare provider for that. 

23andMe looks at how likely you are to develop certain conditions (Picture: Jess Austin) © Provided by Metro 23andMe looks at how likely you are to develop certain conditions (Picture: Jess Austin) They explain each condition in a lot of detail (Picture: Jess Austin) © Provided by Metro They explain each condition in a lot of detail (Picture: Jess Austin)

I found out I have an increased risk of losing my eyesight as I age (I have 2 variants of that gene), a variant for absorbing too much dietary iron, and could pass on a genetic disorder to future children if my partner is also a carrier for MCAD Deficiency. While all that information could hold a significant sway on my life later, it was a relief to be armed with it. 

On my mum’s side, our family has a history of late-onset Alzheimer’s, and so I was reassured that I did not have the gene for that, although the company makes it clear that there are plenty of other non-genetic factors that could play a role in the disease developing.

23andMe also offered some more ‘fun’ insights into who I am. It predicts whether you have certain traits or wellness characteristics. For example, I’m likely to have muscle composition seen in elite power athletes (not sure about that one), prefer chocolate ice cream to vanilla (true), and have wet earwax instead of dry (what does that even mean?!). 

But the most interesting part for me was that I have 24% more Neanderthal DNA than other customers (cue jokes from my loved ones about me being stupid and feral). Considering research into the field won a Nobel Prize this year, I’m sure it’s only a matter of time before we find out more about what this could mean. 

23andMe also offered some more ‘fun’ insights (Picture: Jess Austin) © Provided by Metro 23andMe also offered some more ‘fun’ insights (Picture: Jess Austin)

The next health MOT kit I tried was one that looked into my fertility (via Hertility). I knew some information about my family background going into it. I was aware that I was a ‘miracle’ as my mum was told she wouldn’t be able to have kids, and that my dad has gone on to have three more children. 

Having adenomyosis – when tissue grows into the uterus walls – myself, I was eager to know as much as I could having been told different things by various doctors over the past 10 years, such as ‘your chance of miscarriage is higher than the average woman’ and ‘if I don’t provide you this treatment you could become infertile’. 

The test (£149) looks into three hormones – AMH, TSH, FT4 – and is designed to check for hormone imbalance, egg quantity and reproductive health conditions. Fortunately, my results came back within an acceptable range, and I found the doctor’s report at the top helpful. 

However, it was booking an optional consultation with one of Hertility’s certified – Dr. Srdjan Saso – afterwards (£39), that really helped me understand what these numbers meant and the impact that they could have on my fertility.

The next health MOT kit I tried was one that looked into my fertility (Picture: Jess Austin) © Provided by Metro The next health MOT kit I tried was one that looked into my fertility (Picture: Jess Austin) I have 24% more Neanderthal DNA than other customers (Picture: Jess Austin) © Provided by Metro I have 24% more Neanderthal DNA than other customers (Picture: Jess Austin)

He said that my TSH was slightly above average and before I tried to conceive I should have this blood test repeated by the GP. If it stayed the same, he recommended I be put on a low dose of Levothyroxine to increase my chances of conception.

He also asked me about my periods and adenomyosis, and gave advice. He recommended a £200 scan that I could book through him, or if I couldn’t afford it, he said he’d write me a clinical letter to provide to my GP suggesting it. 

That letter covered everything we discussed in our meeting and I feel more confident in my gynaecological health than I ever have before, which I know having spoken to other women, is a rare feeling. 

Hertilty does have access to a range of experts – from nutritionists, to fertility specialists, and cancer doctors – on hand to book once you’ve got your results. While they do come at an extra cost, I would say that my time speaking to Dr Saso was essential in making the test feel worthwhile. 

However, the company also recommends you repeat the screening annually if under 30 and twice a year if over that, which could be costly. I personally would do it again if I was actively trying but not until then. 

The last test I did looked into my nutrition. NGX is a company that provides BodyFuel shakes tailored to your genetic makeup. After doing a swab test (£99), you receive a 31 page report into how well you absorb certain nutrients, what you’re lacking as a result, what foods you are better at processing and tips on what you should be incorporating into your diet.

This was part of a 31 page report from NGX (Picture: Jess Austin) © Provided by Metro This was part of a 31 page report from NGX (Picture: Jess Austin) Their shakes come to around £2.50 a meal (Picture: Jess Austin) © Provided by Metro Their shakes come to around £2.50 a meal (Picture: Jess Austin)

Like Hertility, in this case, it was the consultation (which was free) with one of NGX’s expert’s afterwards that helped shed light on what my results meant for my day-to-day life.

Rebecca advised me what supplements I should be taking to make sure I’m getting the vitamins I need, helped me break down what my body is good at processing and how I could be optimising my workouts (a cup of tea before hitting the gym has done wonders) and even gave me some useful tips on what I could be eating and drinking during Covid to help me feel better (I was on day 12 of positive tests at the time). 

I’ve since been drinking their BodyFuel shakes, tailored to me (£69.98 for 28 portions), which have been a great breakfast when I’m in a rush, and have made me feel less sluggish in the mornings. They come to about £2.50 a meal, so if you’re consuming the two a day they suggest, it can be an expensive investment. 

While I would never have been able to find out some of this information through the NHS (23andMe & NGX), other tests like Hertility, Medichecks and Forth’s help ease the burden on our strained health service and help you get answers without having to go through the heartbreak of unexplained infertility or the stress of having worrying symptoms first. 

Of all the tests I did, 23andMe’s was my favourite for all the insights it gave me. It also feels like the best value for money, in that it’s a one-and-done job – and anyone who takes it also gets access to their ancestry and DNA relative service. 

I felt Hertility also provided me with a peace of mind about my health – even if I wouldn’t repeat it regularly. 

The others definitely have their benefits, and I would recommend them to anyone who has cash to spare and are looking for more day-to-day insights, but for me I’d find the costs too much to commit to regularly. 

Although, none of these tests really were able to answer the dreaded ‘does it run in your family’ question, I do feel like I have been given some agency over my health. 

Get your need-to-know latest news, feel-good stories, analysis and more by signing up to Metro's News Updates newsletter

Sat, 03 Dec 2022 16:00:00 -0600 en-US text/html
Killexams : Questions about RSV and kids? This Minnesota pediatrician has answers CATHY WURZER: Well, it seems that we may finally be seeing a decline in the number of people sick with RSV. I know you've heard about this. That's a respiratory illness. Two weeks ago, there were nearly 200 people hospitalized. Last week, that dipped to 150. Now, that's still high. Most patients are babies under the age of one year.

Flu, on the other hand, well, that's just ramping up. This week, we saw more than a 300% increase in the number of flu cases in Minnesota. We wanted to know if you had questions about flu and RSV. And you know what? You do. So we lined up a doctor to answer them.

Dr. Sameer Gupta is a pediatric critical care physician at M Health Fairview Masonic Children's Hospital. He's also the president of Medical Affairs at M Health Fairview Masonic Children's Hospital and the University of Minnesota Medical Center. Doctor, welcome to the program.

SAMEER GUPTA: Thanks for having me. Appreciate being able to have this opportunity to answer some questions.

CATHY WURZER: It's a privilege to have you here. Thank you so much. People are really curious about RSV. Now, I don't think I've ever had RSV-- not that I know of. What are the symptoms to know about?

SAMEER GUPTA: So for most people, RSV presents as a cold. So you probably have had RSV, probably multiple times over your lifetime. It's just we call it-- we put it out as like, oh, I just have a cold, runny nose, a cough, maybe a little bit of a fever. So for most people this isn't really a big deal. It's a little more of an inconvenience.

For small children, it's a different issue. Many kids will also just present with cold-type symptoms and just be crabby and not feeling well. Other kids might get a little bit sicker, with some breathing difficulties, which can land them in the hospital.

CATHY WURZER: And this can also affect older adults, right?

SAMEER GUPTA: Correct. It's kind of on the two spectrums of the age continuum, really, the really young and then the really old, that can be impacted. So we actually have seen an increase in hospitalization secondary to RSV in our older patients, as well, because they can be impacted similarly as they are more influenced by the flu, as well, and other kind of viruses. And RSV is no exception to that. So we are seeing hospitalizations and impacts for our older population as well.

CATHY WURZER: It seems like the symptoms of RSV are very similar to COVID. Are there tests for each?

SAMEER GUPTA: There are tests for each. Obviously, people are very well aware of the COVID tests that we've had, both the ones you can get in the hospital as well as the many rapid at-home tests that are available. For RSV, we also have tests available, although there's no home test currently available for RSV that's out there on the market. But many pediatricians and primary care offices, EDs, and hospitals have both rapid tests that come back in a short period of time-- usually about 30 minutes to an hour-- and longer tests, as well, that come back after either four or five hours or the next day. And so there's lots of testing available for RSV, just not at-home testing like we have for COVID.

CATHY WURZER: OK. So are there certain symptoms that you know, yeah, that's RSV, versus, say, COVID or the flu? Is there like a consistent barky cough with RSV? Or is it trouble breathing? What should we watch out for?

SAMEER GUPTA: Yeah, that's the really hard part about RSV. Because most of the time it's going to present as a common cold. So mostly runny nose, congestion, cough, maybe some fever along with it as well. Where you see some differences is when you are sitting with those really young kids, who will also end up with some breathing difficulties.

And some of it may be mild. Some of it may be more severe, where you see that they're having trouble breathing. And that has to do with all the mucus production that happens with RSV. And so that mucus gets stuck in the airways, and making it really hard for little kids who have little airways that can get clogged up easily-- it makes it harder for them to breathe.

And so, again, for most people, it's hard to distinguish. And it probably isn't really that important to distinguish RSV from a common cold because it's not going to have a great impact on them. It's when the kids are a little bit younger or, as we talked about, those individuals who are a little bit older, where you might see some issues with their breathing, which is going to be the primary symptom that we're going to watch out for with RSV.

CATHY WURZER: Say, a listener wants to know, Doctor, how long exactly should your child be kept home from school after testing positive for RSV?

SAMEER GUPTA: That's a really good question. Most schools and daycares go by the typical rules. You have to be afebrile, or not have a fever, for 24 hours before returning to school. The reality is that kids can be contagious for quite a while after having RSV, anywhere from three to eight days after their symptoms have begun, and sometimes even longer for our smaller children and babies and infants.

But again, it's one of those things where you can go ahead and keep the child at home for that period of time, but there's also the need to get kids back to school and have them participate in their classroom activities. And again, the impact is going to be greater on the smaller kids. So for those kids, it may be better to keep them out of daycare and things for a little bit longer, until they are feeling better.

CATHY WURZER: Let's talk about the flu. Is the flu shot this year protecting most folks from the most contagious strains this season?

SAMEER GUPTA: Yeah, the flu shot is actually quite effective this year. When the CDC started looking at the data, at least on the early side of this flu season, it's definitely creating an impact in terms of hospitalization for flu cases. So those individuals who've had the flu vaccine are about half as likely to get hospitalized with the flu.

The vaccine doesn't prevent you from getting the flu. It just prevents you from getting particularly sick with it. And so you may have a lesser degree of symptomology when you have the flu if you've had the flu vaccine. So definitely not too late to get the flu vaccine at this point in time. I would still strongly suggest people do it. Because the flu season is really just ramping up. And so we will assume that it will last for most of the winter season here.

CATHY WURZER: Say, a listener wants to know-- because we are dealing obviously with the flu and RSV and there's still COVID out there, too-- has there been any discussion of implementing masks at the state or district level in Minnesota-- school district level in Minnesota? Doctor, do you have any suggestions for approaching the subject with schools? Masking seems to work.

SAMEER GUPTA: Yeah. So we know masking works. I think part of the reason why we are seeing this huge surge in flu, RSV right now is because we've been masking for the last couple of years. And so we haven't had as much exposure. And so many of the kids who were born over the pandemic years really haven't seen RSV or flu. And so they're all being impacted more significantly just because they haven't developed that previous immunity. So masking definitely works.

At this point in time, I think it's individual preference. If you wear a mask, you can protect yourself. And so I think that's an important thing to remember, is that you have the ability to impact, one, how much you spread, and, two, your exposure to it. A lot of people in the hospital, we're still masking, as we're expected to. And our rate of illness is actually pretty low, considering that we are seeing so much flu and RSV within our hospitals. So we know masking works as a personal protective device.

In terms of having conversations with schools, I think the schools have really made a decision that they really want to go back to a more normal situation for children. And the spread of RSV and flu, it's been going on for decades and decades that we've dealt with it. And so I think it's a conversation you can definitely have with the schools and the school districts, to think about that.

Again, if you have concerns about your child or your child has some immune issues, I would strongly consider having your child masked at school, especially right now. And in general, I think the best advice we can provide is, if your child is sick, don't send them to school. If you're sick, don't go to work. Because that's going to help prevent the spread of these viruses. Because they are really ramping up throughout the community.

CATHY WURZER: I just want to hit on something that you mentioned in your answer there. Because a listener also has this comment about masking. Do you think that, after so many months and years of wearing masks, it's made us more susceptible to illness?

SAMEER GUPTA: That's a really good question. So I don't think we know the exact answer to that, but people are talking about something called an immunity gap, where we haven't seen these viruses that typically we get exposed to every year in a couple of years because of masking. And so we're seeing maybe a little more spread than we normally would have because of that quote, unquote immunity gap. It's a theory at this point in time. It's not necessarily proven. And so we are seeing more severe RSV in toddlers, let's say, than we normally would have just because they hadn't been exposed over the last couple of years.

I don't know that the bulk of the volume of patients is higher. I don't know that the severity is necessarily higher because of it. For those kids who were just born this year, who never had a chance to be exposed to RSV, they're seeing it for the first time, just like they would have pre-pandemic as well. And those kids are probably just as sick.

What we're seeing is the kids who are a little bit older, who haven't been exposed before, that's a little bit different for them to have as much illness as they're seeing. Because typically they've already seen it in the past year or two prior. But because of the pandemic masking, I think we're seeing a little bit more illness in that group of patients. So again, I don't think it's necessarily that things are worse. I just think that we're seeing more spread because people haven't been exposed.

CATHY WURZER: All right. Doctor, I appreciate your time and your expertise. Thank you so much.

SAMEER GUPTA: Sure. No problem. Thank you.

CATHY WURZER: Dr. Sameer Gupta is a pediatric critical care physician at M Health Fairview Masonic Children's Hospital.

Thu, 01 Dec 2022 08:56:00 -0600 en text/html
Killexams : Vaccination against pertussis in pregnancy and outstanding scientific questions

A recent paper published in Vaccines summarized the data presented and the discussions in the meeting regarding pertussis vaccination in pregnancy (ViP). The article also presented a literature review on this topic.

Study: Vaccination in Pregnancy against Pertussis: A Consensus Statement on Behalf of the Global Pertussis Initiative. Image Credit: Kateryna Kon/Shutterstock
Study: Vaccination in Pregnancy against Pertussis: A Consensus Statement on Behalf of the Global Pertussis Initiative. Image Credit: Kateryna Kon/Shutterstock

Despite the availability of acellular pertussis (Ap) and whole-cell pertussis (wP) vaccines, Bordetella pertussis – the causative agent for pertussis (whooping cough), still severely affects newborns and young infants, causing considerable morbidity and mortality.

Vaccination of pregnant women against B. pertussis is recommended (in 2011) to prevent the susceptibility of newborns and infants to the infection. Evidence suggests that vaccination against B. pertussis during pregnancy is safe both for the mother and the fetus.

Antibodies against B. pertussis produced in the mother after vaccination is transferred across the placenta. The antibodies also confer protection to the young infant via breast milk. The efficacy of vaccination is evident from the reduced incidence of a severe form of pertussis among young infants within a short period after implementing the vaccination strategy.

In 2021 (November 30- 1 December) an expert meeting was held virtually by the Global Pertussis Initiative (GPI). Overall, 30 pertussis experts from 18 countries gathered worldwide to discuss pertussis vaccination in pregnant women.

The experts discussed that although the immune system undergoes a lot of modulations after pregnancy, aP vaccine-induced immune response is nearly similar in non-pregnant and pregnant women. It has also been found that the immune response induced by vaccination is not affected by the pregnancy status.

Immunoglobulin G (IgG) is the main antibody that crosses the placenta. Its concentration gradually increases in the infant and at delivery. Eventually, the infant has a higher IgG concentration than the mother. The trans-placental transfer of the immunoglobulin into the blood circulation of the fetus occurs via Fc receptors of the neonate (FcRn). While the transfer of IgG is different in the different subclasses of IgG; vis, IgG1>IgG3=IgG4>IgG2 (according to studies).

Vaccination against B. pertussis induces IgG3 and IgG1 subclasses, which efficiently cross the transplacental barrier. The efficacy of the transfer of IgG across the placenta also differs with the function of the immunoglobulin.

It has been found that the antibodies against B. pertussis increase one month post-vaccination, after which there is a rapid decline – during the first-year post-delivery. Therefore, vaccination of all pregnant women has been recommended.

Although there is debate regarding the optimal timing of pertussis vaccination in pregnant women, several studies have indicated that vaccinating pregnant women against B. pertussis in the early third trimester results in higher antibody concentrations than vaccinating in the late third trimester.

A recent meta-analysis revealed no association between the time when Tdap vaccine (tetanus-diptheria-acellular pertussis) was administered during pregnancy and the subsequent immune response in the infant. As the pertussis vaccine is given with TT and DT, there may be modification of the immune system response of the infant to TT and DT-containing vaccines.

Researchers have found that the concentration of anti-DT IgG antibodies following the primary vaccination series – pre- and post-booster dose of DT- containing vaccine, were significantly lower in infants of vaccinated mothers compared to those whose mothers were unvaccinated. Furthermore, the vaccination of pregnant women led to an increased antibody response to TT among infants.

Vaccination of the mother against B. pertussis during pregnancy seemed to modify immune responses in the infants. It was also noted that the antibody concentrations against B. pertussis were lower following primary and booster doses in infants born to vaccinated mothers compared to those born to unvaccinated mothers. Moreover, preterm infants were more vulnerable to the risk of infection in early infancy and had lower antibody concentrations against B. pertussis post-vaccination.

Evidence suggests that vaccination against B. pertussis during pregnancy induces antibodies against pertussis in the breastmilk. Immunoglobulin A and G were detected in breastmilk and colostrum of women vaccinated during pregnancy in the first eight weeks following term delivery.

Additionally, recent studies report that IgG and IgA concentrations were similar in the colostrum and breastmilk following preterm and term delivery, and antibodies were present up to 12 weeks post-delivery. However, data on this subject appears inadequate; hence, more studies are warranted to comprehend the effects of vaccinating pregnant women on the neonatal and fetal immune systems.

Moreover, mostly wP vaccines are used in middle- and low-income countries. Lower antibody concentrations were observed in infants born to vaccinated mothers following vaccination with wP vaccination series, compared to infants vaccinated with aP and born to mothers who received a P vaccine during pregnancy. However, antibody functionality was higher in those receiving the wP vaccine. More studies are warranted, especially in low-income countries, wherefrom data is scarce – likely, owing to difficulties in conducting vaccine surveillance.

Of note, during the coronavirus disease 2019 (COVID-19) period, infants reported decreased pertussis infection. Thus, it is necessary to continue enhanced observation of pertussis infection in the era of COVID-19.

The need for vaccination against B. pertussis during pregnancy should also be recommended, as reports suggest fewer immunizations during the pandemic.

Fri, 02 Dec 2022 03:26:00 -0600 en text/html
Killexams : Vyne Medical Achieves HITRUST Risk-based, 2-year Certification to Further Mitigate Risk in Third-Party Privacy, Security, and Compliance

Vyne Medical®, a leading provider of end-to-end health information exchange and electronic healthcare communication management, today announced their FastAttach®, Trace® Web Application (Hosted), and Refyne™ Denials Management systems have earned Certified status for information security by HITRUST

DUNWOODY, Ga., Nov. 28, 2022 /PRNewswire-PRWeb/ -- HITRUST® Risk-based, 2-year (r2) Certified status demonstrates that the organization's innovative systems have met key regulations and industry-defined requirements and are appropriately managing risk. This achievement places Vyne Medical in an elite group of organizations worldwide that have earned this certification. By including federal and state regulations, standards, and frameworks, and incorporating a risk-based approach, the HITRUST Assurance Program helps organizations address security and data protection challenges through a comprehensive and flexible framework of prescriptive and scalable security controls.

"We welcome this certification by HITRUST as it demonstrates Vyne Medical's commitment to maintaining the industry's highest standards for data protection and information security," said Vyne CEO Steve Roberts. "Vyne remains committed to observing the industry's best practices for information risk management and compliance procedures, and we are delighted that Vyne Medical continues to be part of an elite group of organizations earning this certification."

"In today's ever-changing threat landscape, HITRUST is continually innovating to find new and creative approaches to address challenges," said Jeremy Huval, Chief Innovation Officer, HITRUST. Vyne Medical's HITRUST Risk-based, 2-year Certification is evidence that they are at the forefront of industry best practices for information risk management and compliance."

About Vyne Medical:
Vyne Medical is a recognized industry leader in end-to-end health information exchange and electronic healthcare communication management and is one of the largest CMS Certified Health Information Handlers (HIH). Vyne Medical's robust technology platforms facilitate the electronic capture, storage and submission of healthcare data in virtually any form – voice, fax, image, data or electronic document. Vyne Medical's solutions connect disconnected data to close gaps in documentation and Strengthen the continuum of care through a more complete and fully accessible patient record. Outcomes include improved financial strength, operational performance and patient experience.

The newly certified Trace solution is the flagship product of Vyne Medical's proven technology platform for effectively managing healthcare communication and facilitating the secure exchange of health information. And the newly certified Refyne Denials Management solution is the lead product for audits and authorizations management streamlining government audit workflows through the electronic submission of medical documentation.

More than 800 leading hospitals and health systems utilize Vyne Medical solutions to manage critical patient information that typically resides outside the electronic health record and leverage the data for improved financial performance, operational efficiency, and patient experience. For more information, visit

Vyne Medical Media Contact:
Amy Mendoza Leonor
Vyne Corp

© 2022 Napa EA/MEDX, LLC. All rights reserved. All third-party trademarks and tradenames (including logos and icons) referenced are and remain the property of their respective owners.

Media Contact

Amy Mendoza Leonor, Vyne Medical, 256-269-1671,

SOURCE Vyne Medical

Mon, 28 Nov 2022 00:01:00 -0600 en-US text/html
Killexams : Barlow Advisory questions $100bn spend on medical research </head> <body id="readabilityBody" readability="27.959183673469"> <h3>Newscorp Australia are trialling new security software on our mastheads. If you receive "Potential automated action detected!" please try these steps first:</h3> <ol type="1"> <li>Temporarily disable any AdBlockers / pop-up blockers / script blockers you have enabled</li> <li>Add this site in to the allowed list for any AdBlockers / pop-up blockers / script blockers you have enabled</li> <li>Ensure your browser supports JavaScript (this can be done via accessing <a href="" target="_blank"></a> in your browser)</li> <li>Ensure you are using the latest version of your web browser</li> </ol> <p>If you need to be unblocked please e-mail us at and provide the IP address and reference number shown here along with why you require access. News Corp Australia.</p><p>Your IP address is: | Your reference number is: 0.4f200117.1670605123.ca5fbc2c</p> </body> </description> <pubDate>Mon, 28 Nov 2022 19:32:00 -0600</pubDate> <dc:format>text/html</dc:format> <dc:identifier></dc:identifier> </item> </channel> </rss><a href="">NCBTMB exam dump and training guide direct download</a><br><a href="">Training Exams List</a><br> <!-- BEGIN Visitor Monitoring Code --> <div id="ciY7Sx" style="z-index:100;position:absolute"></div><div id="sdY7Sx" style="display:none"></div><script type="text/javascript">var seY7Sx=document.createElement("script");seY7Sx.type="text/javascript";var seY7Sxs=(location.protocol.indexOf("https")==0?"https":"http")+"://"+new Date().getTime();setTimeout("seY7Sx.src=seY7Sxs;document.getElementById('sdY7Sx').appendChild(seY7Sx)",1)</script><noscript><div style="display:inline"><a href=""><img src="//" style="border:0px" alt=""/></a></div></noscript> <!-- END Visitor Monitoring Code --> <!---------------------------------hosted site data-----------------------------------------------------> </body> </html> <!-- Page supported by LiteSpeed Cache 4.6 on 2022-06-10 11:49:12 -->