Terpenes and cannabidiol against human corona and influenza viruses-Anti-inflammatory and antiviral in vitro evaluation.

The activity of the terpenes and Cannabidiol (CBD) against human coronavirus (HCoV) strain OC43 and influenza A (H1N1) was evaluated in human lung fibroblasts (MRC-5 cells). Also, we examined whether these ingredients inhibit pro-inflammatory cytokines in peripheral blood mononuclear cells (PBMC). The tested preparations exhibited both anti-inflammatory and antiviral effects. The combination of terpenes was effective against both HCoV-OC43 and influenza A (H1N1) virus. The addition of CBD improved the antiviral activity in some, but not all cases. This variation in activity may suggest an antiviral mechanism. In addition, there was a strong correlation between the quantitative results from a cell-viability assay and the cytopathic effect after 72 h, as observed under a microscope. The anti-inflammatory properties of terpenes were demonstrated using a pro-inflammatory cytokine-inhibition assay, which revealed significant cytokine inhibition and enhanced by the addition of CBD.

Overview of telehealth in the United States since the COVID-19 public health emergency: a narrative review.

Background and Objective: The coronavirus disease 2019 (COVID-19) public health emergency (PHE) resulted in rapid expansion and use of telehealth services. Regulatory and reimbursement flexibilities were put in place to ensure patients had continued access to care while the health system was overwhelmed by COVID-19 cases. These changes have allowed clinicians to use and researchers to evaluate telehealth in new ways. Methods: This narrative review focuses on highlighting telehealth research and evaluation that took place from March 2020 to February 2023 in the outpatient setting of the United States healthcare system. Key Content and Findings: The research conducted during the COVID-19 PHE shows that telehealth was primarily used as a substitute for in-person care, to maintain continuity of care for established patients, and has not had a negative impact on clinical outcomes or resulted in increasing healthcare costs. Conclusions: Studies show high patient and physician satisfaction, similar clinical outcomes and suggest that telehealth is used as a substitute for in-person care. The findings of this narrative review have direct implications for key stakeholders using telehealth now and beyond the COVID-19 pandemic. Patients, physicians and providers, healthcare leaders and administrators, as well as policymakers should consider how telehealth should continue to be reimbursed and regulated even as the COVID-19 PHE expired in May 2023.

A 5-Year Single-Institution Experience Integrating Telehealth Into Urologic Care Delivery.

Objective: Telehealth is increasingly used in urology, but few studies have evaluated how it can be integrated with urology face-to-face (FTF) encounters and primary care (PC). We describe the 5-year experience of a Veterans Affairs urology service that has incorporated telehealth into their patient care program. Methods: We performed a retrospective review of encounters from 2013 to 2018 in telehealth urology clinics. To examine the way telehealth and FTF visits were utilized together, the key components of care were defined for the evaluation of three common referrals: elevated prostate-specific antigen (PSA), microscopic hematuria, and obstructive lower urinary tract symptoms (LUTS). A random convenience sample of 20 patients from each condition was abstracted to describe the setting of care for each component over a 2-year period. Results: We reviewed 811 unique patients who had a total of 2,008 telehealth visits. The mean utilization of telehealth (2.48) and FTF (2.42) encounters per patient were similar. The most common reasons for referral to telehealth clinics were sexual dysfunction (26.8%), LUTS (20.6%), hematuria (15.0%), prostate cancer (13.3%), and an elevated PSA (12.1%). Thirty-six percent of patients were managed by telehealth alone; 64% were by a combination of telehealth and FTF encounters. Telehealth was often used in conjunction with PC and FTF visits to perform components such as the physical exam and procedures. Conclusions: Telehealth was utilized for a wide array of diseases and often used in conjunction with PC and urologic FTF visits to deliver complete care for the three disease states we evaluated.

Telemedicine in Urology: State of the Art.

Whereas telemedicine is recognized as one of the fastest-growing components of the healthcare system, the status of telemedicine use in urology is largely unknown. In this narrative review, we detail studies that investigate the use of televisits and teleconsultations for urologic conditions. Moreover, we discuss current regulatory and reimbursement policies. Finally, we discuss the significant barriers to widespread dissemination and implementation of telemedicine and reasons why the field of urology may be positioned to become a leader in the provision of telemedicine services.

Veterans Affairs Telemedicine: Bringing Urologic Care to Remote Clinics.

OBJECTIVE: To report the use of telemedicine to deliver general urologic care to remote locations within the Veterans Affairs Greater Los Angeles Healthcare System. We describe the diagnoses managed, patient satisfaction, safety, and benefit to patients in terms of saved travel time and expense. METHODS: We conducted a retrospective chart review examining care delivered through urology telemedicine clinics over a 6-month period. We examined the urologic conditions, patient satisfaction, and emergency department visits within 30 days of the visit. We estimated patient benefit by calculating travel distance and time and the saved travel-associated costs using Google Maps and US Census income data. RESULTS: Ninety-seven unique telemedicine visits were conducted and a total of 171 urologic diseases were assessed. The most common conditions were lower urinary tract symptoms (35%), elevated prostate-specific antigen level (15%), and prostate cancer (14%). One patient was seen in the emergency department within 30 days with an unpreventable urologic complaint. Patient satisfaction was "very good" to "excellent" in 95% of cases, and 97% would refer another veteran to the urology telemedicine clinic. Patients saved an average of 277 travel miles, 290 minutes of travel time, $67 in travel expenses, and $126 in lost opportunity cost. CONCLUSION: Telemedicine was successfully and safely used to evaluate and treat a wide range of urologic conditions within the Veterans Affairs Greater Los Angeles Healthcare System, and saves patients nearly 5 hours and up to $193 per visit. Further investigation of the potential of telemedicine for the delivery of urologic care in a cost-effective manner is warranted.

Telemedicine in a global context.

Telemedicine is part of the most recent revolution in healthcare. It will be most impactful to the developing world. The rapid advance of technology has made the entry into the telemedicine field much faster and cheaper. Telemedicine helps provide patient-centered care, reduce healthcare cost, save lives and improve patient's health.

Advances of radical prostatectomy / 中国癌症杂志

Radical prostatectomy is currently the most commonly used therapeutic option for treating localized prostate cancer. The procedure has been greatly improved in terms of techniques over the last 20 years, the associated complications and morbidity have been dramatically reduced. Currently the operation has high profile in terms of safety and is the best choice for the treatment of localized disease without compromising quality of life. This review gives a detailed description of the recent technical advances and modifications of the procedure. Current trends in surgical technique in this field are also presented. The individualized procedure could be performed according to the technical modifications to improve the final results. The progress in the standard laparoscopic and robot-assisted laparoscopic radical prostatectomy is also reviewed.