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How does COVID-19 reveal the need for better telemedicine?

The worldwide pandemic is making another ordinary where each part of the manner in which we work, live, learn, and play is changed, and one of the ventures that will experience the best change is medicinal services.Specialists may never return to pre-COVID-19 days when routine up close and personal interviews were the standard. The coronavirus opened the conduits and put existing systems administration advances to a test. While many specialist co-ops went without a hitch by taking care of spikes in arrange traffic, COVID-19 uncovered availability deficiencies that must be tended to going ahead.Telehealth is the method of things to comeThe current social insurance model of getting in a vehicle, drive across town, sit in a lounge area to see somebody is obsolete. In the course of recent years, I have met numerous human services experts about telehealth, which was beginning to see some utilization, despite the fact that it was the special case, not the standard. COVID-19 quickened something that was a "smart thought" into genuine arrangements in spite of the fact that there is more work to be finished.For the University of Texas Galveston Medical Branch (UTMB), which comprises of clinics and crisis divisions on four grounds, moving half of its patient visits to telehealth video visits needed to happen rapidly. Luckily, UTMB as of now had the foundation set up to give far off patient consideration years before the pandemic, so its own system dealt with the expansion in telehealth visits adequately.The huge issue UTMB ran into was web access for patients. Telemedicine frequently comes up short on the nature of-administration controls that inward systems have, Mike King, UTMB's head of system and broadcast communications, said during an ongoing Cisco virtual roundtable concentrated on web network during COVID-19. UTMB ended up helpless before transporters, and found that a few applications flop more much of the time than others."At the point when you have telemedicine software platforms experience that are just 10 or 15 minutes to begin with, you don't possess energy for an intricate arrangement of an application or dropped calls. That can break the patient experience a lot," said King.UTMB's CIO Todd Leach said it needed to prepare its suppliers to ensure they got settled with the necessities of telemedicine. A major piece of UTMB's telehealth program serves the state jail framework, with a large number of those detainment facilities situated in rustic zones where web access is inconsistent and where the accessible access gadgets are obsolete, he said.About 20% of the Texas jail framework doesn't approach rapid web, and without it almost 40,000 detainees can't get telehealth administrations. UTMB is as of now leading a remote web pilot to empower excellent sound and video visits with doctors for the jail populace bypassing the need to wire expensive systems administration framework.COVID-19 stressed basic administrationsBasic administrations were likewise put to a test during the pandemic, uncovering that catastrophe alleviation can utilize some network enhancements. AT&T and the First Responder Network Authority (FirstNet) together work an across the nation arrange that bolsters crisis interchanges. Indeed, even with FirstNet's broad calamity reaction experience, COVID-19 resembled "a fire, flood, and cyclone in each city the nation over simultaneously," said Jason Porter, FirstNet's senior VP who took an interest in the Cisco gathering.FirstNet modernized crisis reaction when the interest for basic administrations spiked during the underlying COVID-19 emergency. It worked with flexibly affix accomplices to ensure specialists on call had enough gadgets, and it summoned assistant system foundation where existing framework was inadequate. The system requires broad inclusion in distant areas for specialists on call, who need prompt access to information and interchanges.The helper bolster included deployables, a FirstNet armada of 76 quickly deployable units that can bring web access to places that don't have it. This incorporates ground resources, for example, cell towers on wheels (COWs) and light trucks.FirstNet conveyed each of the 76 deployables for the COVID-19 reaction, however Porter needs to "enhance the armada" later on by including different alternatives like automatons – flying cell on wings known as Flying COWs, which should be accessible in the not so distant future. These can expand inclusion if there should be an occurrence of catastrophes, add limit or be accustomed to carry Internet to new places.Chiefs from Cox and Verizon tolled in regarding the matter, laying out what specialist co-ops can do to make a more pervasive web. Notwithstanding growing web access and network, framing organizations to carry gadgets and substance to the underserved is basic. Suppliers said they'd work without any difficulty the development procedure and lower expenses to quicken arrangements. Be that as it may, they underscored, endowments might be required to convey broadband in territories where it's at present not gainful to do as such.Access to wellbeing and social administrations later on should be nonstop, said UTMB's Leach. "Also, it can't occur without being consistently associated. Telehealth applies in a larger number of circumstances than we've generally suspected happy with applying."The worldwide advanced partitionNo single organization has the innovation or the plan of action to without any assistance close the computerized isolate. Industry joint effort and little interests in growing network choices is the thing that will have a major effect in individuals' personal satisfaction.3.8 billion individuals – about a large portion of the overall populace – needs web get to, restricting their entrance to data, instruction and human services, as per Cisco's Inclusive Future Report 2020. Holes in get to exist in creating nations as well as in provincial zones and ruined networks in the U.S.Cisco approached tech pioneers to coordinate their vitality and assets toward creating arrangements concentrated on worldwide consideration. This implies making more extensive access to human services and social administrations controlled by financially savvy, effective innovations that address neighborhood issues.Carrying the web to underserved populaces could lift 500 million individuals out of destitution and add more than $6 trillion to the worldwide economy, said Jonathan Davidson, senior VP, and head supervisor of Cisco's Mass-Scale Infrastructure Group.

How does the Zika virus harm a man if he plans to conceive a child in the near future?

There is as yet no direct evidence of Zika harming a man's reproductive capacity, i.e., no evidence as yet that Zika renders a man either temporarily or permanently sterile. However, multiple reports document presence of Zika in semen. A Zika-infected man could thus potentially transmit this virus during intercourse. Pregnancy resulting from such intercourse is one way for a fetus to get infected. A man's Zika infection could thus potentially harm his future child.Data suggest Zika is present in semen and could be sexually transmitted: As of April 2016, there are at least 5 official reports of Zika virus in semen of infected menCase #1 (1, 2): Long before Zika became a global news story, in 2008 two Colorado State University researchers, Brian D. Foy and Kevin C. Kobylinski, were collecting mosquitoes in a southeastern Senegalese village called Bandafassi for a malaria study. While there, both reported being bitten many times. They returned to Colorado on 24 August, 2008. ~Five days later both became ill with extreme fatigue, fever, headaches and rash on torso, swollen and painful wrists, knees and ankles, symptoms suggestive of an infection. Foy also had genital pain (from undiagnosed prostatitis?), painful urination and possible hematospermia (bloody semen). 10 days later, on 3 September, Foy's wife showed similar clinical symptoms including chills, malaise, extreme headache, hypersensitivity to light and muscle pains. Yet, their 4 children remained healthy and unaffected.Foy, his wife and Kobylinski recovered within a week though with lingering joint pains. Tests showed the two researchers, but not Foy's wife, had serum anti-Dengue antibodies. Dengue's another Flavivirus with symptoms similar to Zika. Foy and Kobylinksi had been vaccinated against another flavivirus, Yellow fever, which could explain their anti-Dengue antibodies. Antibodies raised against Dengue, Yellow fever or Zika cross-react because these related viruses contain shared antigens. No definitive answer forthcoming for what had infected them, Foy stored all three frozen serum samples.By chance when Kobylinksi went back to Senegal a year later, he met Andrew Haddow, a University of Texas Medical Branch (UTMB), Galveston medical entomologist working on Zika. Coincidentally Haddow's grandfather was one of three scientists who originally isolated Zika virus from a rhesus monkey in the Zika forest near Entebbe, Uganda in 1947 (3). After Kobylinksi returned to the US in December 2009, he and Foy sent all three frozen serum samples to Haddow to test for Zika.All three samples contained anti-Zika antibodies. How did Foy's wife get infected with Zika? Colorado doesn't harbor Zika transmitting mosquito species. In fact, at that time Zika was a little known flavivirus with no report of it in the US. As well, the timing of Foy's wife's infection didn't fit the scenario of a mosquito that 1st bit her infected husband and then bit her. Zika transmitted from human to mosquito needs to complete a 2 week life cycle within it before it can infect another human. Foy's wife fell ill within 10 days of his return. However, Foy and his wife had had vaginal sexual intercourse shortly after his return from Senegal and before he showed clinical symptoms. This strongly implied sexual transmission.Case #2 (4): In 2013, French Polynesian researchers found live Zika virus in the semen of a 44 year old Tahitian man. The man reported having fatigue, low-grade fever, and joint pains for ~3 days in early December 2013. ~ 8 weeks later, he had symptom recurrence. ~ 2 weeks post-recurrence, he noticed hematospermia and only then sought treatment. Authors collected blood and semen samples from him 3 days apart as well as an urine sample during the 2nd visit. Observing hematospermia only in the 1st semen sample, they detected Zika virus in semen and urine, not in blood. In urine they only detected it by Reverse transcription polymerase chain reaction (RT-PCR) but not by culture. OTOH, they detected it in both semen samples by both RT-PCR as well as culture. Virus levels were high in semen and the culture results suggested presence of live virus, even >10 weeks after symptoms first appeared.Case #3 (5): In February 2016, Texas health officials reported Zika in a person after they had sex with someone who'd recently returned from Venezuela.Case #4 (6): UK researchers found Zika in a man's semen 62 days after he first had fever. In this case the 68 year old man had fever, fatigue and rash one week after returning from the Cook Islands. Serum samples collected 3 days after fever onset were negative for Dengue and Chikunguniya viruses by RT-PCR. Tests also didn't detect anti-Dengue or -Chikunguniya antibodies. OTOH, samples were positive for low levels of Zika virus by RT-PCR. Authors collected convalescent phase serum, urine and serum samples. Only semen samples were positive for Zika virus by RT-PCR 27 and 62 days after patient 1st had fever. They were also positive for anti-Zika antibodies.Case #5 (7): In January 2016, a 32 year old man was diagnosed with Zika infection at Toulouse University Hospital in Toulouse, France. Two days after he returned from Brazil and French Guyana, he developed symptoms suggesting an flavivirus infection. RT-PCR test detected Zika, not Dengue nor Chikunguniya. Two weeks post-diagnosis, authors again took blood, urine and semen samples. Virus loads were semen > urine > plasma. In fact, authors estimate semen viral load was ~100,000X that of blood or urine even >2 weeks after symptoms began. Virus present in semen was live because authors could get it to replicate in cell cultures.Implications of Finding Zika Virus in SemenFlaviviruses like Dengue, Chikunguniya, Yellow fever are similar to Zika in that they're transmitted by the bite of infected Aedes mosquitoes. However, they'e not known to be sexually transmitted. What's being observed about Zika in this regard is thus truly novel and it means approaches to contain it can't simply borrow from the play book developed and used for those other flaviviruses. Instead, it'll be much harder, necessitating both vector-borne control measures as well as measures commonly used for sexually transmitted diseases. Meantime, several critical issues about this aspect need urgent answers.Is this virus present in the semen of every Zika-infected man? If not, what risk factors predispose to its presence in semen: age, health status, past infection history especially for Zika or other flaviviruses, genetics are some obvious factors to consider. Since these case studies found Zika in semen from men aged in their 30s to their 60s, a broad age range, age may be a less important factor.Zika in semen implies infected testes. If this is so, how long does such infection last? And what risk factors predispose to likelihood and duration of testes infection?How long post-infection is Zika virus present in an infected man's semen? Virus is found in blood only during the acute phase (1 to 2 weeks). Available data suggests it lasts longer in semen but how much longer?Is a Zika-infected man with hematospermia (bloody semen) more likely to harbor Zika in semen and transmit it? Both Cases 1 and 2 reported genital pain (from undiagnosed prostatitis?) and hematospermia.Since majority of Zika infection is asymptomatic, viral presence in semen represents a potentially enormous reservoir. It's thus necessary to estimate how long after Zika infection a man carries the risk of transmitting it during intercourse.So what precautions should a man living in or traveling to Zika-prevalent regions take?“If I was a man and I got Zika symptoms, I’d wait a couple of months before having unprotected sex,” said Scott Weaver, director of the Institute for Human Infections and Immunity at the University of Texas Medical Branch in Galveston and an expert on the virus. “If my wife was of childbearing age, I’d want to use protection, certainly for a few weeks.”(8).Bibliography1. Foy, Brian D., et al. "Probable non-vector-borne transmission of Zika virus, Colorado, USA." Emerg Infect Dis 17.5 (2011): 880-2. http://wwwnc.cdc.gov/eid/article/17/5/pdfs/10-1939.pdf2. Sex After a Field Trip Yields Scientific First. Science, Martin Enserink, April 6, 2011. Sex After a Field Trip Yields Scientific First3. Dick, G. W. A., S. F. Kitchen, and A. J. Haddow. "Zika virus (I). Isolations and serological specificity." Transactions of the Royal Society of Tropical Medicine and Hygiene 46.5 (1952): 509-520. Zika Virus (I). Isolations and serological specificity4. Musso, Didier, et al. "Potential sexual transmission of Zika virus." Emerging infectious diseases 21.2 (2015): 359. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4313657/pdf/14-1363.pdf5. Zika Infection Transmitted by Sex Reported in Texas. The New York Times, Donald G. McNeil Jr., Sabrina Tavernise, Feb 2, 2016. Zika Infection Transmitted by Sex Reported in Texas6. Atkinson, Barry, et al. "Detection of Zika virus in semen." Emerg Infect Dis 22.5 (2016). Emerging Infectious Disease journal7. Mansuy, Jean Michel, et al. "Zika virus: high infectious viral load in semen, a new sexually transmitted pathogen." Lancet Infect Dis 16.405 (2016): 00138-9. https://www.researchgate.net/profile/Guillaume_Martin-Blondel/publication/297597948_Zika_virus_high_infectious_viral_load_in_semen_a_new_sexually_transmitted_pathogen/links/56e1d44c08aebc9edb19ca07.pdf8. The New York Times, Donald G. McNeil Jr., Jan 25, 2016. Zika Virus: Two Cases Suggest It Could Be Spread Through SexThanks for the A2A, Diana Tan.

What is The University of Texas Medical Branch at Galveston known for?

It is the first Medical School in Texas, and Galveston was chosen I believe is that Houston at the time was relatively new and Galveston was chosen because at the time it was the largest city in Texa and believe west of the Mississippi.The medical school survived the 1900 Hurricane that killed around 10,000 people and sort of sealed Galveston fate. The other thing at the time was, the fact it was and is an island and there is only so much room.I know that it is highly regarded in the country, thus the World as a leading Pediatric Medical School.I had no idea of the size and stature of the place until the mid-1990 and two of my now-grown children Doctors left practice to teach there. I asked one of them why, and he explained to me what is known for. I had been to Galveston numerous times over the years, but again just never thought about it.It is also a well-known Burn Center and patients with serious burns from all over the state often get sent there for serious burn recovery.Also, the state of Texas Prison System TDCJ sends most of the state prisonsystem sends all of there long term or seriously ill patients there. I presume they still do. IT is cheap because the state owns it and the prison system and there are plenty of Doctors and Medical students so it can provide a good deal of patience to train on/with.Otherwise, it sits there in Galveston, sort of tucked out of sight to the general public. They or one of their hospital John Sealy are also the only Level 1trauma center for the area north and eats of Galveston to the Louisiana Border.Keep in mind that the UT Medical Branch in the Houston Medical Center also trains all sorts of other specialties and is in the top 10 in size in the County.And the Medical Center itself it the largest in the world. Dr. Debakey and Cooley the inventors of the heart transplant, coronary implant and heart bypass for open-heart surgery operate here. The ended up having two Heart Centers are among the best in the World, Debakey Heart Institute associated with Methodist Hospital, and the Cooley Heart Center is associated with St. Lukes. It has the world's largest children's hospital in Texas CHildren’. It also houses the M.D. Anderson Cancer Institute, arguably one of the top three in the world. Memorial Herman, Texas is known for its work on SPinal Court and Brain Injuries with a lot obrain dameChildren's, St.Lukes in the country.e, arguably one of the top three, int he county.With full-size hospital's, the have all expanded and have Centered in the West Part of Houts, the North Part of Houston, the South and East side near Nasa, and The Woodlands, Tx is probably the largest having them all within a couple of mile radius, Memorial Herman, Methodis 1.5 years old, St Luke, about 14 years old by but always expanding, Texas Children's is about 1.5 years old and M.D> Anderson just opened in the past several MD Anderson.That's great for everyone because one in Med Center is so huge, connected by overhead walkways, underground tunnels. From my house to there is 51 miles. My wife has an ongoing serious debilitating medical issue and we're making three trips per week for a month, every 3 rd month, she still sees her neurologist and thoracic specialties, vision there twice per month once per month.The rest of the treatments, 2 days s a week every other week we started to do there when they staffed up fully back in the Spring. it 7 minutes away, I drop her off, she calls and I pick her up 8–10s laterSo that was WAY more than you ask…nut it fun describe it.We routinely ho to Methodist for illness, have been in Texas Children four days after my then7 year old go bitten twice n his hand and rit by a copperhead.AMy dad went to Md Anderson for treatments before he did in 66–68. I had hand surgery after a and nerve regrafting after a gunfight while still with gov as a special agent.My wife has been to M.D Anderson for cancer, her present medical issue over the past 2 plus years I have to spend 7 days with her on 7 different occasions when she was in crisis for her disease.My wife was an RN at Texas Children when she, and my cardio work has been done there at the Methodist Debakey Heart Center and was trained with im and is Debakeys still alive sister doctors and the have a penthouse on the floor.That should explain what UTMB and the UT Medical Center Shools both do.

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