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Dennis OConnor

Future Patient/Future Doctor - Larry Smarr, PhD and Dr. Michael Kurisu D.O. - 0 views

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    "Computer scientist Larry Smarr and osteopathic physician Michael Kurisu present a vision for healthcare that combines the best of allopathic and osteopathic medicine by using a more personalized, hands-on, systems-based approach to treating patients. They demonstrate this proof of concept with details on how Smarr diagnosed his own Crohn's disease by using blood and stool tests to track changes in his body. And when the symptoms became too severe, Smarr collaborated with his surgeon, Sonia Ramamoorthy, MD, to plan the operation based on 3D images of his organs created at his research institute, Calit2 at UC San Diego. Kurisu then introduces Project Apollo, a group of patients inspired by Smarr who are collecting their own data to develop personalized treatments for their particular conditions. Series: "The UC Wellbeing Channel " [7/2018]"
Dennis OConnor

Antibodies and coronavirus immunity: everything we know. - 0 views

  • Antibodies will probably be key to getting us out of this—in one way or another. By Shannon Palus
  • one promising solution is the idea of antibodies and antibody tests.
  • as with everything about the virus, it’s not yet clear what role antibody tests will be able to play in getting us out of this, and it’s even not completely clear how much getting the coronavirus once prevents you from getting it again
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  • What is an antibody?
  • How do I get the anti-coronavirus antibodies?
  • The most basic (and worst) way to get the antibodies is to get the coronavirus.
  • So once you have the antibodies, you are immune against the virus?
  • We can’t count on immunity right now.
  • Wait, but aren’t there people out there who have gotten the novel coronavirus twice, within a short period of time?
  • So if I’ve been sick with COVID-19 already, should I assume I’m immune, or not?
  • OK. Let’s get to the tests. What’s the deal?
  • The fantasy of antibody tests is that they might be deployed to help us determine who can go back to work and school and normal social gatherings.
  • That sounds very promising!
  • even though the tests can provide a guess at immunity, even a positive result cannot guarantee anything.
  • So what are antibody tests actually good for right now?
  • They are tools to gather more data.
  • This is why the National Institutes of Health is currently recruiting 10,000 volunteers to take antibody tests.
  • There’s one clear way that they could help right now on an individual level: We’ve all been asked to basically assume we have the coronavirus; an antibody test could help clarify our own narratives.
  • If you test positive, you can also apply to donate plasma.
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    Recommended by Dr. Michael Kurisu D.O. 4/15/2020 Good summary. Not scientific or too detailed but good overall big picture view
Dennis OConnor

Coronavirus: Digital Health Projects and Resources | Stats-of-1 - 0 views

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    Recommended by Dr. Michael Kurisu D.O.: ...the owner of the blog is Eric Daza DrPH. He is a biostatitician that does modeling on causal beliefs for Nof1 studies for individuals.
Dennis OConnor

What We Know So Far About SARS-CoV-2 - The Atlantic - 0 views

  • March 20, 2020
  • One of the few mercies during this crisis is that, by their nature, individual coronaviruses are easily destroyed.
  • These viruses don’t endure in the world. They need bodies.
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  • To be clear, SARS-CoV-2 is not the flu. It causes a disease with different symptoms, spreads and kills more readily,
  • his family, the coronaviruses, includes just six other members that infect humans
  • OC43, HKU1, NL63, and 229E—have been gently annoying humans for more than a century, causing a third of common colds
  • MERS and SARS (or “SARS-classic,” as some virologists have started calling it)—both cause far more severe disease.
  • hy was this seventh coronavirus the one to go pandemic?
  • The structure of the virus provides some clues about its success. In shape, it’s essentially a spiky ball. Those spikes recognize and stick to a protein called ACE2
  • This is the first step to an infection
  • he exact contours of SARS-CoV-2’s spikes allow it to stick far more strongly to ACE2 than SARS-classic did
  • But in SARS-CoV-2, the bridge that connects the two halves can be easily cut by an enzyme called furin, which is made by human cells and—crucially—is found across many tissues. “This is probably important for some of the really unusual things we see in this virus,” says Kristian Andersen of Scripps Research Translational Institute.
  • SARS-CoV-2 seems to infect both upper and lower airways,
  • his double whammy could also conceivably explain why the virus can spread between people before symptoms show up
  • All of this is plausible but totally hypothetical; the virus was only discovered in January, and most of its biology is still a mystery.
  • The closest wild relative of SARS-CoV-2 is found in bats, which suggests it originated in a bat, then jumped to humans either directly or through another species.
  • Another coronavirus found in wild pangolins also resembles SARS-CoV-2
  • Indeed, why some coronaviruses are deadly and some are not is unclear. “There’s really no understanding at all of why SARS or SARS-CoV-2 are so bad but OC43 just gives you a runny nose,” Frieman says.
  • Once in the body, it likely attacks the ACE2-bearing cells that line our airways.
  • The immune system fights back and attacks the virus; this is what causes inflammation and fever
  • in extreme cases, the immune system goes berserk
  • These damaging overreactions are called cytokine storms.
  • they’re probably behind the most severe cases of COVID-19.
  • During a cytokine storm, the immune system isn’t just going berserk but is also generally off its game, attacking at will without hitting the right targets.
  • But why do some people with COVID-19 get incredibly sick, while others escape with mild or nonexistent symptoms
  • Age is a factor.
  • other factors—a person’s genes, the vagaries of their immune system, the amount of virus they’re exposed to, the other microbes in their bodies
  • “it’s a mystery why some people have mild disease, even within the same age group,”
  • Coronaviruses, much like influenza, tend to be winter viruses.
  • In the heat and humidity of summer, both trends reverse, and respiratory viruses struggle to get a foothold.
  • irus is tearing through a world of immunologically naive people, and that vulnerability is likely to swamp any seasonal variations.
  • And one recent modeling study concluded that “SARS-CoV-2 can proliferate at any time of year.
  • Unless people can slow the spread of the virus by sticking to physical-distancing recommendations, the summer alone won’t save us.
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    Dr. Michael Kurisu D.O.: We've known about SARS-CoV-2 for only three months, but scientists can make some educated guesses about where it came from and why it's behaving in such an extreme way.
Dennis OConnor

Doctors on the Frontlines of the Coronavirus Fight - The Atlantic - 0 views

  • Yui had always counted herself lucky to be among a family of doctors. Now the family is facing the greatest challenge of their lives as they wrestle with the dilemma of caring for their patients even though this risks exposing their loved one
  • Will her family survive the crisis intact?
  • Doctors across America are facing similar predicaments, made all the more acute by the government’s failure to protect them—to warn the public, to provide tests, and to supply enough protective equipment.
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  • When it comes to us being doctors, I worry about [family members] Stephanie and Alex and Jennifer and Pam—about their health, and about the eventual burnout due to everything that’s going on,”
  • As a primary-care physician, she’s the first point of contact with the medical system for many patients.
  • Pam recommended a hospital visit to be tested. “It was already too late for me and my family,” Pamela told me—she had been potentially exposed. Her patient got tested on March 12, and is still waiting for results. “My patient’s test was sent from Baltimore to a lab in Utah, then due to a reagent shortage [a substance needed to process the tests] sent from Utah to Arizona, Arizona back to a lab in North Carolina,” she said.
  • This is a mirror of the dysfunction and delays surrounding the country’s testing crisis, a major factor hamstringing the fight against the virus.
  • Meanwhile, she started feeling sick on Tuesday, and took the test herself. Self-quarantined at home, she thinks it’s only a matter of time, if she does have the virus, before she infects her two children—totally isolating from them would be all but impossible.
  • As a health-care provider, if I test positive, it has big implications for my office, my staff, and all the patients,”
  • Emergency-room doctors, he noted, are among those most at risk.
  • Her emergency room has been seeing more and more patients who have symptoms
  • She wears protective equipment but knows that the hospital could run out.
  • It’s not lost on Koo and her family that medical professionals worldwide have been dying fighting the coronavirus.
  • the main dilemma they’re grappling with is not so much getting sick themselves but spreading the virus to their families, their patients, and the public.
  • his might be the greatest fear of doctors across the country—that they’ll move from being part of the solution to part of the problem.
  • should. It weighs heavily on people.”Yui, for her part, told me she’d never let her fears over the virus stop her from doing her job.
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    Dr. Michael Kurisu D.O.: Another article capturing the dialogue that i hear from a lot of my colleagues and others. We have doctors as well In my family : -My sister is Neuro ICU and director of stroke at Tri city hospital in Oceanside -Her husband is ER doc -My little sister is the PhD in sociology. (She specializes in education programs for the incarcerated and has interest on health access for prisons - which is a frightful place during this pandemic)
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    We are in a war against this virus. First responders are the first line of defense. There is a lack of supplies and central leadership. However, there is no shortagage of courage. When you meet a first responder, say, "Thank you for your service."
Dennis OConnor

Coronavirus Pandemic Update 37: The ACE-2 Receptor - The Doorway to COVID-19 (ACE Inhib... - 0 views

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    "Dr. Michael Kurisu D.O." called this video "molecurlar biology 101" It is from the Youtube Channel: MedCram - Medical Lectures Explained CLEARLY
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    Forwarded to the Project Apollo listserve by "Dr. Michael Kurisu D.O." from Christina Mnatzaganian. This is from the UCSD Family Medicine Faculty Listserve. Hi Deepa, The statement below is from ACC/HFSA/AHA on March 17th. Essentially, there is no human data yet and data is evolving. See below, particularly the red area: *The following joint statement from the ACC, American Heart Association and Heart Failure Society of America was posted online on March 17 and addresses using renin angiotensin aldosterone system (RAAS) antagonists in COVID-19. "The continued highest standard of care for cardiovascular disease patients diagnosed with COVID-19 is top priority, but there are no experimental or clinical data demonstrating beneficial or adverse outcomes among COVID-19 patients using ACE-I or ARB medications," said Richard J. Kovacs, MD, FACC. "We urge urgent, additional research that can guide us to optimal care for the millions of people worldwide with cardiovascular disease and who may contract COVID-19. These recommendations will be adjusted as needed to correspond with the latest research." Patients with underlying cardiovascular diseases appear to have an increased risk for adverse outcomes with coronavirus disease 2019 (COVID-19). Although the clinical manifestations of COVID-19 are dominated by respiratory symptoms, some patients also may have severe cardiovascular damage. Angiotensin converting enzyme 2 (ACE2) receptors have been shown to be the entry point into human cells for SARS-CoV-2, the virus that causes COVID-19. In a few experimental studies with animal models, both angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) have been shown to upregulate ACE2 expression in the heart. Though these have not been shown in human studies, or in the setting of COVID-19, such potential upregulation of ACE2 by ACE inhibitors or ARBs has resulted in a speculation of potential increased risk for COVID-19 infection in patients with
Dennis OConnor

Conference Schedule | Integrative Medicine Symposium | Touro University Ca - 0 views

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    Mike Kurisu: This is an online symposia from my alma mater medical school. I was one of original founders a long time ago. I am not speaking this year but know all the speakers. I have registered and will get access to recordings and have Dennis post them all for you to view at your leisure.
Dennis OConnor

A Partial Map of Black-led Black Liberation Organizing - 0 views

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    Recommended by Sheri-Lynn Kurisu "This is a part of Resource Generation's It Starts Today! campaign, moving $1,000,000 to Black-Led, Black Liberation Organizing between the day Michael Brown was killed and what would have been his 19th birthday - May 20th, 2015. We aim to support organizing that confronts and dismantles anti-Black violence, whether committed by private citizens or by law enforcement, throughout the US. Resource Generation is a national membership organization organizing young people with wealth toward the equitable distribution of land, wealth and power. Learn more about Resource Generation and learn how to become a member by visiting www.resourcegeneration.org."
Dennis OConnor

White Privilege: Unpacking the Invisible KnapsackPeggy McIntosh - 0 views

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    Recommended by Sheri-Lyn Kurisu
Dennis OConnor

matrix-of-oppression - 0 views

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    Recommended by Sheri-Lynn Kurisu
Dennis OConnor

BLACK-LED ORGANIZATIONS - SHOWING UP FOR RACIAL JUSTICE - 0 views

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    Recommended by Sheri-Lynn Kurisu "SURJ ASKS EVERY DONOR TO MAKE A MATCHING GIFT TO A BLACK-LED RACIAL JUSTICE ORGANIZATION You may know a local organization you want to support, which we fully support.  This list was compiled by leadership from the Movement for Black Lives.  We encourage you to give to one or more of the organizations below:"
Dennis OConnor

www.WhiteAccomplices.org - 1 views

  • “If you have come here to help me, you’re wasting your time. If you have come because your liberation is bound up with mine, then let us work together.”
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    Recommended by Sheri-Lynn Kurisu "The ideas captured on this website, very much a work in progress, have been developed to support White people to act for racial justice. It draws from ideas and resources developed mostly by Black, Brown and People of Color, and has been edited by Black, Brown, and People of Color.  I recognize that categorizing actions under the labels of Actor, Ally, and Accomplice is an oversimplification, but hopefully this chart challenges all of us White folks to go outside of our comfort zones, take some bigger risks, and make some more significant sacrifices because this is what we've been asked to do by those most impacted by racism, colonialism, patriarchy, white supremacy, xenophobia, and hyper-capitalism. I believe that for real change to occur, we must confront and challenge all people, policies, systems, etc., that maintain privileges and power for White people."
Dennis OConnor

COVID-19/Coronavirus Real Time Updates With Credible Sources in US and Canada | 1Point3... - 2 views

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    Dr. Michael Kurisu D.O. "This is from a former student at CalIt2 that has a GREAT site connecting people. It has all great interactive data coming in from national sites about COVID Cases. As it says on top... Made with love by first-generation Chinese Americans.. Also has a 'matching' program for hospital that need PPEs and quantity of them AND.. has a matching program for grocery store chains and what they have in stock etc... AND has a 'job posting' arena trying to get people matched up where jobs are available. AWESOME citizen-run project by computer programmers and students… Why oh WHY is our government not running something like this??
Dennis OConnor

A mysterious company's coronavirus papers in top medical journals may be unraveling | S... - 0 views

  • On its face, it was a major finding: Antimalarial drugs touted by the White House as possible COVID-19 treatments looked to be not just ineffective, but downright deadly. A study published on 22 May in The Lancet used hospital records procured by a little-known data analytics company called Surgisphere to conclude that coronavirus patients taking chloroquine or hydroxychloroquine were more likely to show an irregular heart rhythm—a known side effect thought to be rare—and were more likely to die in the hospital. Within days, some large randomized trials of the drugs—the type that might prove or disprove the retrospective study’s analysis—screeched to a halt. Solidarity, the World Health Organization’s (WHO’s) megatrial of potential COVID-19 treatments, paused recruitment into its hydroxychloroquine arm, for example.
  • The study doesn’t properly control for the likelihood that patients getting the experimental drugs were sicker than the controls
  • Other researchers were befuddled by the data themselves. Though 66% of the patients were reportedly treated in North America, the reported doses tended to be higher than the guidelines set by the U.S. Food and Drug Administration, White notes. The authors claim to have included 4402 patients in Africa, 561 of whom died, but it seems unlikely that African hospitals would have detailed electronic health records for so many patients, White says.
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  • This was very, very annoying, that The Lancet were just going to let them write this absurd reply … without addressing any of the other concerns,”
  • 200 clinicians and researchers, that calls for the release of Surgisphere’s hospital-level data, an independent validation of the results
  • But the revision had other problems, Chaccour and his colleagues wrote in their blog post. For example, the mortality rate for patients who received mechanical ventilation but no ivermectin was just 21%, which is strikingly low; a recent case series from New York City area found that 88% of COVID-19 patients who needed ventilation died. Also, the data shown in a figure were wildly different from those reported in the text. (Science also attempted to reach Grainger, but received no reply to an email and call.)
  • Surgisphere’s sparse online presence—the website doesn’t list any of its partner hospitals by name or identify its scientific advisory board, for example—have prompted intense skepticism.
  • wondered in a blog post why Surgisphere’s enormous database doesn’t appear to have been used in peer-reviewed research studies until May.
  • how LinkedIn could list only five Surgisphere employees—all but Desai apparently lacking a scientific or medical background—if the company really provides software to hundreds of hospitals to coordinate the collection of sensitive data from electronic health records.
  • Desai’s spokesperson responded to inquiries about the company by saying it has 11 employees and has been developing its database since 2008.
  • The potential of hydroxychloroquine for treating COVID-19 has become a political flashpoint, and the questions around the Lancet paper have provided new fodder to the drug’s supporters. French microbiologist Didier Raoult, whose own widely criticized studies suggested a benefit from the drug, derided the new study in a video posted today, calling the authors “incompetent.” On social media, some speculated that the paper was part of a conspiracy against hydroxychloroquine.
  • Chaccour says both NEJM and The Lancet should have scrutinized the provenance of Surgisphere’s data more closely before publishing the studies. “Here we are in the middle of a pandemic with hundreds of thousands of deaths, and the two most prestigious medical journals have failed us,” he says.
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    Recommended by Mike Kurisu, DO.
Dennis OConnor

IT'S TIME TO BUILD | a16z Podcast by Marc Andreessen - 0 views

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    Recommended by Dr. Michael Kurisu D.O.
Dennis OConnor

A portrait of the coronavirus at 1: how it spreads, infects, and sickens - 0 views

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    Mike Kurisu: "a good overview of the science as we know it now..."
Dennis OConnor

Frontiers | Using Self-Study and Peer-to-Peer Support to Change "Sick" Care to "Health"... - 1 views

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    "Camille Nebeker, Bethany Weisberg, Eric Hekler, and Michael Kurisu Frontiers in Digital Health - This paper is also posted on our PHE Website
Dennis OConnor

FiRe Conference Agenda 2018 - Transformational Technologies - 0 views

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    " "The Future Patient, The Future Doctor: A Healthy Relationship" Over the past year, a select group of patients has coalesced to form something groundbreaking - Project Apollo, a movement to build a robust, longitudinal picture of health and wellness for each patient. Future patients will take an active role in their own health, co-creating a team of healthcare providers and using data from family, caregivers, community, and the environment to guide them through a quantified journey of health. Sharon Anderson Morris, Sr. Director, SNS Programs, and CEO, FiReFilms Mary Beckerle, CEO, Huntsman Cancer Institute Larry Smarr, Founding Director, Calit2, (a UC San Diego / UC Irvine partnership) Moderated by Michael Kurisu, Director, Project Apollo and UCSD Center for Integrative Medicine "
Dennis OConnor

Osteopathy and Spainsh Influenza.pdf - 1 views

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    Dr. Michael Kurisu D.O. - This is an article that is well known in our Osteopathic community. Seems to be quite relevant in today's crisis. Although… there are several shortcomings to this article. - it was published over a century ago - it is a retrospective analysis - they did have or keep good public health data on infectivity and virulence and positive tests (We STILL DONT DO THIS!!!) - there is no documentation about what techniques used etc… Nonetheless… for an article that is over 100 years old, it IS a data point. And the data from back then shows that during Spanish influenza… the patients who saw a D.O. had a medical death rate that was 40X lower than the general population… Just another reason to have good D.Os around in the primary care workforce.
Dennis OConnor

Integrative Considerations during the COVID 3.18.20.pdf - 1 views

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    Recommended by Dr. Michael Kurisu D.O.: There is a high level of interest in integrative strategies to augment public health measures to prevent COVID-19 infection and associated pneumonia. Unfortunately, no integrative measures have been validated in human trials. Notwithstanding, this is an opportune time to be proactive. Using available in-vitro evidence, an understanding of the virulence of COVID-19, as well as data from similar, but different, viruses, we offer the following strategies to consider. Again, we stress that these are supplemental considerations to the current recommendations that emphasize regular hand washing, social distancing, stopping non-essential travel, and getting tested if you develop symptoms.
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