Latest / Morning Medical with Dr. Chow / Pulse Oximeters, Organ Donation, and Mood Disorder Treatments

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Pulse Oximeters, Organ Donation, and Mood Disorder Treatments · Morning Medical with Dr. Chow

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  Welcome to "Morning Medical with Dr.
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  Chow," your daily dose of the latest medical and health news from around the world.
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  I'm your host, Dr.
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  Chi-Ming Chow, bringing you insights from the intersection of medicine and technology.
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  Today, we're diving into a topic that's been making waves in the medical community: the
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  accuracy of pulse oximeters in patients with different skin tones.
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  Recent studies have highlighted concerning discrepancies in how these devices measure
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  blood oxygen levels, particularly for individuals with darker skin.
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  Two significant studies have shed light on this issue.
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  The first, known as the EXAKT study from the United Kingdom, examined home-use pulse
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  oximeters and found that these devices often gave higher oxygen saturation readings for
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  patients with darker skin tones compared to those with lighter skin.
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  Although the differences were small, ranging from 0.6 to 1.5 percentage points, they could
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  lead to a higher rate of false negatives.
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  This means patients with darker skin might be mistakenly considered to have normal oxygen
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  levels when they are actually experiencing hypoxemia.
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  This has serious implications for treatment and triage decisions.
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  On the other side of the Atlantic, preliminary findings from a United States study, known as
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  the EquiOx study, focused on hospital-grade fingertip pulse oximeters.
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  Interestingly, these devices tended to underestimate oxygen saturation across all skin
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  tones, but the underestimation was less pronounced in patients with darker skin.
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  Despite this, there was still a significant issue with the devices' sensitivity, which was
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  only 72% for detecting hypoxemia in intensive care unit patients.
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  This means that nearly one in three cases might be missed, highlighting a critical area for
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  improvement.
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  Both studies underscore that the problem isn't straightforward.
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  While some have suggested applying a universal correction factor to adjust readings for
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  darker-skinned patients, the findings indicate this approach might not be sufficient.
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  Instead, clinicians are encouraged to consider the full clinical context, integrating patient
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  symptoms and clinical trajectory with an awareness of the limitations of these devices.
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  As pulse oximeters are integral to clinical assessments from home settings to intensive
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  care units, it's crucial that we address these discrepancies.
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  The goal isn't to abandon the use of pulse oximeters but to refine their accuracy and
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  ensure that they do not perpetuate inequalities.
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  By understanding and acknowledging these limitations, we can strive towards equitable
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  healthcare for all.
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  Recent analysis has revealed a concerning trend in the realm of organ transplants.
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  For the first time in over ten years, the number of organ donations from deceased
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  individuals has dropped, leading to fewer kidney transplants.
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  This is a significant finding, as more than one hundred thousand people in the United States
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  are currently on the waiting list for an organ transplant, with the majority needing a kidney.
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  Sadly, thousands of these patients die each year while waiting.
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  The nonprofit Kidney Transplant Collaborative has analyzed federal data, uncovering that
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  there were one hundred sixteen fewer kidney transplants last year than in two thousand
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  twenty-four.
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  Although this might seem like a small difference, it is a warning sign.
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  The decline has been linked to rare but alarming reports where patients, who were
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  prepped for organ retrieval, showed signs of life.
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  These incidents, which were halted in time, have understandably shaken public confidence in
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  the organ donation system.
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  In response to these unsettling reports, the United States is working on implementing
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  additional safeguards within the transplant system, which is crucial as this system saves
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  tens of thousands of lives each year.
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  However, the damage to public trust has already been done, with some individuals opting to
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  remove their names from donor lists.
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  Interestingly, the dip in deceased donor kidney transplants was partially offset by a small
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  increase in kidney transplants from living donors.
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  Last year saw about one hundred more transplants from living donors, where healthy
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  individuals donate one of their kidneys to those in need.
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  The Kidney Transplant Collaborative advocates for increasing living donations, which
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  currently make up only a small portion of the twenty-eight thousand kidney transplants
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  performed annually.
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  Despite the decrease in deceased donor transplants, the overall number of organ
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  transplants did not decline.
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  In fact, there were just over forty-nine thousand transplants last year, compared to
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  forty-eight thousand one hundred fifty in two thousand twenty-four.
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  This growth was largely driven by increases in heart, liver, and lung transplants,
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  highlighting differences in how these organs are evaluated and allocated for transplant.
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  The Association of Organ Procurement Organizations has expressed concern over these
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  findings, urging its members, hospitals, and federal regulators to work together to restore
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  public trust and strengthen the organ donation system.
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  It's a call for collective action to ensure that the system can continue to save lives
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  effectively.
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  A new report from sleep specialists warns that forcing an early wake-up time could be
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  detrimental to your health.
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  While waking up early might be seen as a way to get a jump-start on the day, it isn't suitable
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  for everyone.
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  Experts say that our natural sleep patterns, or chronotypes, play a crucial role in determining
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  when we feel most alert and ready to rest.
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  These chronotypes are essentially our genetic blueprints, dictating whether we're more of a
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  morning person or a night owl.
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  Dr.
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  Aaron Pinkhasov, chair of the Department of Psychiatry at New York University Grossman Long
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  Island School of Medicine, points out that about 40% to 50% of our sleep-wake preferences
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  are inherited.
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  This means that our internal clocks are, to a large extent, hardwired.
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  Forcing a night owl to wake up early can lead to a state of being "wired but tired," where
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  fatigue, mood instability, and long-term metabolic risks become more prevalent.
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  These individuals may also face higher incidences of anxiety, depression, eating
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  disorders, obesity, obstructive sleep apnea, and type 2 diabetes.
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  The science of sleep involves cycles that alternate between deep non-rapid eye movement
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  sleep and rapid eye movement sleep.
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  Deep sleep, which is more prominent early in the night, supports physical repair, immunity,
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  and memory.
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  Later cycles, with more rapid eye movement sleep, aid in learning, emotional regulation,
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  and brain function.
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  Disrupting these cycles by waking too early can rob the body of vital rapid eye movement sleep,
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  which is crucial for mental health and cognitive function.
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  Dr.
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  Nissa Keyashian, a California board-certified psychiatrist, emphasizes that health and
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  productivity are at their peak when sleep quality and consistency are prioritized over
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  arbitrary early-morning goals.
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  While social alignment with a standard 9-to-5 schedule might seem beneficial, the drawbacks
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  of forcing a shift in natural sleep patterns can be significant.
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  Experts suggest some strategies to help adjust to an earlier schedule without compromising
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  health.
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  Regular sleep schedules, even on weekends, can be beneficial.
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  A wind-down routine that minimizes electronics and includes relaxation techniques like
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  meditation or warm showers can help.
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  Gradually adjusting wake-up times by 15 minutes a day and exposing oneself to bright light in
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  the morning can also ease the transition.
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  For those who struggle with mood dips during the winter months, using a therapeutic light
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  box might prove helpful.
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  Additionally, minimizing caffeine and being mindful of the timing of exercise can support
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  better sleep patterns.
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  If adjusting sleep habits proves challenging, consulting with a psychiatrist might be
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  beneficial.
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  In a promising development for mental health treatment, the United States Food and Drug
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  Administration has approved a new at-home brain neuromodulation therapy for adults with
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  treatment-resistant depression.
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  This device, called ProlivRx, is a groundbreaking step forward in providing
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  non-pharmacological options for those who struggle with major depressive disorder and
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  have not found success with at least one antidepressant medication.
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  The ProlivRx device is the first of its kind, delivering what is known as focal,
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  multi-channel, external combined occipital and trigeminal afferent stimulation therapy.
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  Essentially, it works by applying noninvasive electrical stimulation to specific nerve
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  branches that connect to the brainstem and higher brain regions involved in mood
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  regulation.
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  This innovative approach allows for targeted therapy that can be administered in the comfort
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  of one's home, under the guidance of a physician.
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  Dr.
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  Linda Carpenter, who led the pivotal MOOD trial at Brown University, expressed her optimism
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  about this new treatment option.
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  She highlighted the significant gap in non-pharmacological therapies that could be
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  administered at home for this patient population.
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  While transcranial magnetic stimulation offers an alternative, its availability is limited,
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  making home-based solutions like ProlivRx a vital option for many.
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  The approval was supported by data from the MOOD trial, a randomized, double-blind study
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  involving 124 adults with moderate to very severe depression.
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  The results were promising, with participants receiving the active treatment showing
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  significantly higher remission rates compared to those on a sham treatment.
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  Over an eight-week period, those using the device experienced considerable improvements in
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  their depression severity, and many continued to improve during an additional eight-week
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  open-label phase.
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  Importantly, the ProlivRx device was well tolerated by participants, with most adverse
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  events being mild and transient.
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  A small number of individuals withdrew from the study due to headaches or worsening depression,
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  but none due to increased suicide risk.
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  This underscores the potential of ProlivRx as a safe and effective adjunctive treatment for
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  depression.
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  Neurolief, the company behind ProlivRx, expects the device to be available in the United States
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  through authorized prescribers in early 2026.
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  This development marks a significant advancement in the field of mental health,
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  offering hope to those who have struggled with treatment-resistant depression.
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  As we wrap up today's episode, it's clear that innovations in medical technology continue to
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  pave the way for more personalized and accessible healthcare solutions.
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  From addressing disparities in pulse oximeter accuracy to enhancing mental health treatment
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  options, these advancements hold the promise of improving outcomes and quality of life for
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  many.
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  Thank you for joining me today on "Morning Medical with Dr.
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  Chow." Until next time, stay informed and take care of your health.