Monday, August 10, 2020

OVERREADING: How WIFI Changed the Face of Medicine

Introduction by: Dr. Robert L. Bard, MD, PC, DABR, FASLMS

In a recent case study with a Covid-Positive patient locked down at home, I partnered with an ultrasound manufacturer to donate use of their latest scanning model and remote access to their best virtual technical trainer to manage an at-home self-scanning scenario.  The patient had personal hand-held access to a high end ultrasound to monitor and screen for any possible symptoms with the complete remote guidance of the imaging tech and (me) the Radiologist/Overreader. Thanks to  today's teleconferencing tools and remote access to the device, the patient learned how to scan himself accurately and getting his proper cardiovascular readings was fast, easy and efficient.

This program was yet another proof that DIGITAL ULTRASOUND is the future of emergent diagnostics. What makes ultrasound a perfect device for this remote diagnostic paradigm is its ability to come in many PORTABLE models.  Also, ultrasound is fast responding, safe (radiation free), non-invasive and easy to learn with a trainer.   This is the perfect formula for satisfying the many critical care situations where the reality of distance can be addressed with technology.

The concept of REMOTE imaging has been around for decades. My practice has been involved with some of the most complex clinical trials and treatment partnerships with hospitals in Italy, Australia, Germany and other foreign lands, reviewing, investigating or confirming scans like MRI's, CT and Ultrasound.  To operate high-powered imaging technology is a craft in and of itself, but to READ what you see, then to dig deeper to 'play detective' and to drive the investigative process with accuracy and intuition is a solid contribution to any medical team.  

Click to see complete Remote Self-Screening Program
I have built a reputation of being the surgeon's "go-to second opinion".  To have an oversight partner, reviewing your scans and conclusions is accountability at its finest, and peace-of-mind of a second pair of expert eyes.

Thanks to the advancements of our web-based communication tools, overseas collaboration via electronic FILE-SHARING has been streamlined to empower and facilitate the world of patient care.  As with TELEMEDICINE (where a patient and physician's time and safety are better supported) the concept of installing a Radiological Overreader in any patient care facility is part of our next generation of unified medicine.

1) Installing an affordable value added service to any practice
2) A second opinion is PEACE OF MIND of all your scans from a certified Radiologist- adding new diagnostic support to your patients
3) Expands your ability to collaborate with other physicians as well as treating your patients remotely
4) Having advanced imaging analysis reduces the level of RISK by raising a level of validity and added confidence to all your medical reports relating to complex scans
5) As a virtual partnership, having an overreader is an affordable upgrade to your staff without the overhead

D2D: Doctor-to-Doctor is a common term in TeleMed Conferencing uniting physicians in active sites (Point of Care
activity with patient) + a remotely accessed medical radiologist placed on the scene via WIFI.


Diagnostic Imaging in Remote Team Research Studies

From product testing to quality reviews of treatment solutions and medicines, proposed innovations undergo intensive assessment protocols to achieve the highest possible levels of quantitative data-gathering necessary- and to prove the EFFICACY of any product. To pass all the strict regulatory guidelines for public distribution, testing labs are the last line of defense for public health and safety by either confirming or rejecting manufacturers' claims. SAFETY is the other top consideration in product reviews- ensuring the low-to-zero level of risk from public use. Once a product in question has fulfilled the initial staging guidelines of testing, a means to confirm effectiveness and safety (on humans) is through CLNICAL TRIALS where a population of patients is monitored for any and all biochemical effects. Forms of scanning and detection include observational surveying, blood & skin testing, mechanical stress-testing, bio-simulations and the use of clinical imaging technologies (when applicable). Innovations like advanced ultrasound is a common option for repeat checking of any bodily responses. Today's sonograms are preferred by primary investigators for their fast, accurate and affordable data collecting. In addition, repeat use for tracking and monitoring is completely safe (non-radiation) for any patient.

 "Before & After" Studies
The most sensible and logical way to identify the results of any treatment is by tracking the body's response to it. Controlled testing must show the patient's condition PRE and POST effects, where true data-finding is collecting the necessary EVIDENCE of its claims. The investigator can pull a significant amount of data from this form of scan-testing: including stage-by-stage bodily response to future projections of possible side effects. Recording of any and all psysiological response means the researchers are counting on the patient's body to tell us what it is undergoing during the testing phase. To prevent mis-reading and erroneous reports, trials tend to work with a large number of test patients (commonly 50-100) and may also employ redundancies like undergoing multiple testing protocols for a second or even third opinion. To capture the benefits of a BEFORE AND AFTER review, Imaging is often used as a standard screening solution for the response of most of the major organs.

WHAT ARE B LINES? Expert ultrasound readers are trained to identify anomalies in organ performance. In the case of screening for possible Covid-related pathogen response, B-lines are often  sought after as a prime indicator of fluid in the lungs.  They can be visualized as hyperechoic vertical lines extending from the pleura to the edge of the ultrasound screen. These lines are sharply defined and laser-like and they typically do not fade as they progress down the screen. A few B-lines that move along with the sliding pleura can be seen in normal lung due to acoustic impedance differences between water and air. However, excessive B-lines are abnormal and are typically indicative of underlying lung pathology.

GOING PORTABLE: Fast Response for Field Demands
Once upon a time, ultrasound imaging device design were large and cumbersome, often the size of a refrigerator.  They were one-piece units with wheels to support in-hospital traveling.  But over time,  as the medical community took to the ultrasound as the reliable choice for quick, accurate scanning, so did the demand to scan patients out on the field.  From ambulances, cruise ships, commercial airlines and even the space program, the design of the ultrasound steered toward more PORTABLE, and HAND-HELD models.

The battery-powered, pocket-sized ultrasound machine became commercially available in the late 1990s where smaller and lighter devices with higher image quality such as those manufactured by GE Healthcare, Siemens and Philips dominated this portable market. These pocket-sized ultrasound machines allowed clinicians to have immediate visual correlation with physical examination findings. They also allow for quick and instant assessments, which are extremely important for emergency physicians. At a healthcare resource allocation level, they significantly reduce a patient’s waiting time and improve clinician’s workflow. Furthermore, the cost of pocket-sized ultrasound machines is much lower than that of standard ones. [3]

A recent study from emergent care physicians and EMT's have called on the need for "pre-hospital imaging"- where the need for efficiency in applying "precious seconds" of focused care means everything. Portable scanners and handheld ultrasound devices are clearly expanding toward at-home  versions all the way to “battlefield” models called “the modern stethoscope”- today’s solution to fast, initial examinations and real-time response, timely suited for our current health crisis and beyond.

Contributors & Technical Advisors

Advanced Imaging & Diagnostic Specialist
Dr. Bard received the 2020 nationally acclaimed Ellis Island Award for his lifetime achievement in advanced cancer diagnostic imaging. He co-founded the 9/11 CancerScan program to bring additional diagnostic support to all first responders from Ground Zero. His main practice in midtown, NYC (Bard Diagnostic Imaging- uses the latest in digital imaging technology and has been also used to help guide biopsies and in many cases, even replicate much of the same reports of a clinical invasive biopsy. Imaging solutions such as high-powered sonograms, Power Doppler Histogram, sonofluoroscopy, 3D/4D image reconstruction and the Power Doppler Histogram  are safe, noninvasive, and do not use ionizing radiation. 

Dr. Kory is Board Certified in Internal Medicine, Critical Care, and Pulmonary Medicine. He served as the Medical Director of the Trauma and Life Support Center at the University of Wisconsin where he was an Associate Professor and the Chief of the Critical Care Service. He is considered a pioneer and national/international expert in the field of Critical Care Ultrasound and is the senior editor of the widely read textbook “Point-of-Care Ultrasound” (winner of the President’s Choice Award for Medical Textbooks from the British Medical Association in 2015).  Most recently, Dr. Kory joined the emergency volunteer team during the early COVID-19 pandemic in NYC at Mount Sinai Beth Israel Medical Center. He is also a founding member of the Front Line COVID-19 Critical Working Group ( composed of 5 critical care experts that devised the COVID-19 treatment protocol called MATH+. (

Michael is the current Global Product Manager for Terason Ultrasound (Burlington, MA). Commercially he has spent the last 19 years training physicians, clinicians and distribution partners around the world on the uses and benefits of ultrasound. He has been recognized numerous times for outstanding clinical and sales excellence both at Terason and GE Healthcare. Michael holds a AAS in Cardiovascular Technology from Southeast Technical College and is a South Dakota native.

Thursday, August 6, 2020

PPE & Safety Supply Drive for Covid Responders & New Hot Spots

Safety & Prevention Initiatives + Philanthropic Support for the Front Lines: Meet the Advocacy for Professional Safety (NYC) 

July 25, 2020- Diagnostic Science Director of the First Responders Health Resource Dr. Robert L. Bard and medical publisher Lennard M. Gettz officially launched "The Advocacy for Professional Safety" (APS)- a volunteer backed Coronavirus prevention support project for the health care community. APS’ public educational mission promotes all current safety measures for patients and professional caregivers in healthcare facilities. APS also conducts a major humanitarian drive to collect and bring donated PPE to Covid front lines in the U.S.

APS is comprised of volunteer physicians, educators, writers and other professional care-givers who publish all safety protocols to keep viral transmission and contamination down in patient care areas.  APS launched its “Suggested Safety Guidelines in Patient Care Facilities” program in March of this year (at the height of NYC’s pandemic cases).  This project was directed toward the many local practices and hospitals due to their cluster of immuno-compromised and potentially contaminated traffic. Social media greatly aided in APS wide support from physicians in the northeast as they underwent their state re-opening from the Coronavirus shut-down.

Their Safety Guidelines to medical offices expanded to educational videos and webinars to health groups about in-office safety. APS also acquired PREVENTION101.ORG, a health publication featuring current technologies, treatment updates, standardized safety initiatives and new trends in medical diagnostics. “I’ve always felt that there are many areas in patient care that could use an upgrade... this pandemic made us re-evaluate (just about) every part of our work process for better safety, risk prevention and cost efficiency. From modern air disinfecting innovations like the use of UV-C light, to TeleMedicine to portable hand-held ultrasound devices ... it's all about saving lives!"- says Dr. Bard.

Recognizing the current increase in U.S. figures of 4.6M cases and 155K+ deaths, the APS initiatives continue their public safety drive and uniting with healthcare providers to instill vigilance in prevention measures.  Medical professionals began adapting APS' suggested safety guidelines, and many joined to collaborate and share their safety measures to include in the list of “sensible prevention measures”.  The core is based on early postings by the CDC, NIOSH and NIST in pursuit of restoring public confidence in patient care- reducing/removing the risk of infection. “... this pandemic has awakened many changes in the way we do just about anything, and thinking SAFETY is a big part of that!", states Dr. Stephen Chagares, Breast Cancer Surgeon (NJ). "Meanwhile, I’m equally proud of supporting our health responders in the growing hot spots across the country… with our PPE drive.  This is making great use of social media and our many friends in the safety industry!”
Months into the pandemic, the APS Alliance expanded to include all safety resources like Covid-19 testing labs, sanitizing product manufacturers and medical suppliers including one of its’ first PPE supply partners, Jayson Dauphinee, president of the American Health Supply Co. who regularly donated a significant portion of their inventory of respirator masks and surgical gowns to  Covid treatment units in New York, and (now) other new hot-spots of the US.  Dr. Bard mirrors this philanthropic footprint by leading a PPE donation drive by partnering with other domestic distributors and safety equipment manufacturers, aligning target hospitals in the hardest hit states.

In response to the recent hot spots in 12+ states like Florida, Arizona and Texas, APS shares all useful and encouraging information including current press briefings by Governor Andrew Cuomo about the status of NYS’ continued drop in recent cases and mortality rates. "We are inspired by the many dedicated leaders whose commendable tracking and enforcing of New York's case control have helped bring us away from being the epicenter – and keeping us that way with prevention! We hope to share this level of self-leadership with everyone as a key to surviving this virus," says Cheri Ambrose, Male Breast Cancer Coalition.

According to the Texas Medical Center data, COVID-19 cases escalated from 267 in week 10 (5/31) to 962 in week 13 (6/21). Dr. Joseph Varon, Chief of Clinical Care at the United Memorial Medical Center in Houston, TX.  Works at the Covid Unit of one of America's latest CoronaVirus epicenters. "I've had the worst 48 hours of the last 84 days. I have received more patients over the last two weeks than in the last 10 weeks [totaled]. As the state opened up, people get crazy‐‐ this includes Memorial Day weekend and last week's protest and mass gatherings. Out of all this, my ward is getting a flood of patients. I have tested more than 55,000 people for Covid in the Houston metropolitan area‐‐ and out of those 55,000, 10.5% are Covid positive. And these numbers in Texas are still going up." Dr Varon’s unit is just one of many hospitals in the U.S. who are close to (or currently) at capacity with patients as New York was during the early months of 2020. APS’ supply drive aims to send his hospital their first delivery of donations.

For complete information on the Advocacy for Professional Safety, visit: Media contact: / Grace Davi- 631.920.5757

Wednesday, July 22, 2020


"My disease has played a very great role for my whole development… I was of course interested to know what benefit the sun really gave. During my work towards this goal I encountered several effects of light-- I then devised the treatment of small-pox in red light (1893) and further the treatment of lupus (1895)."-  Niels Ryberg Finsen

Written by: Cheri Ambrose  /   Introduction by: Dr. Robert L. Bard

In our current health crisis, prevention terms like DISINFECTING, SANITIZING or ANTI-BACTERIAL treatments are part of our common reality. Until recently, noxious "bio-killing" chemicals in atomized /spray form has been the most widely available choice on the market. With proper repeated use, fogging, spraying or ionizing chemistries in our living space are the popular option in contaminant prevention, but public concerns about the many possible physiological side effects of atomizing toxins into our air supply call for new alternatives.

Per-room disinfecting UV-C "Robot" (Skytron)
A sustainable upgrade in sanitizing was developed through the use of UV-C light. The CDC recognizes this innovation as one of the 'best disinfecting practices'. Ultraviolet germicidal irradiation (or UVGI) is the use of ultraviolet (UV) energy (electromagnetic radiation with a wavelength shorter than that of visible light) to kill or inactivate viral, bacterial, and fungal species. The UV spectrum is commonly divided into UV-A (wavelengths of 400 nm to 315 nm), UV-B (315 nm to 280 nm), and UV-C (280 nm to 200 nm). The entire UV spectrum can kill or inactivate many microorganisms, but UV-C energy provides the most germicidal effect, with 265 nm being the optimum wavelength. [1]

(From an interview with Skytron technology)
The earlier studies on the germicidal efficacy of far UVC light were performed exposing bacteria irradiated on a surface or in suspension. Modern developments have since honed the science of deactivating viruses and their ability to contaminate and transmit diseases with proven success when directly applying 222-254nm of UVC light on airborne viruses and microbes. [4]

On a recent interview, UVC expert Michael Czechowskyj of Skytron, a leading domestic manufacturer of infection prevention technologies presents valuable insight on the effectiveness of light disinfectants and the recent market expansion of UVC devices and installations. He discussed its ease-of-use and integrative friendliness of how a UVC device can take over the age-old spraying solutions.

"Today's UVC lamps are fully automated with complete safety features in place. You literally plug it in, start it up and leave the room to go about your day. Once the machine is done, it's perfectly safe that you can enter immediately. Not all sprayers and foggers can let you do that. And under the wait period, especially with ozone foggers, there's no ongoing chemicals that you're spraying or ongoing chemicals to buy either. Another difference is the coverage; with spray sanitizers, the sprayer can often MISS areas, or not spray enough solution in a specific area that needs it. This manual process of spraying leaves so much room for error and uncertainty. Irradiating a room with a UVC system does it all for you. It calculates the treatment time, intensity and because it's light, it gets into all the nooks and crannies to ensure a complete application."

UV-C devices and lamps uses light wavelengths of around 254 nanometers, which denatures the DNA of the microbe. It creates a Thymine Dimer Pair, which prevents them from replicating. So it essentially does not kill the virus. It prevents it from reproducing, which means it prevents it from being infectious. Within a century of its existence, UV-C technology has maintained a constant design using the 254nm setup with a low pressure mercury amalgam bulb. The latest technology change was the bulb, where we eliminated ozone production. They have a special covering on them, which means that blocks the certain nanometers of light that produces ozone because ozone can be detrimental to humans as well.

Our devices all have a predetermined endpoint- much like filling a bucket of water.  Based on our research and lab studies, our machines identify when to turn itself off once it hits that mark of disinfecting the room. On a safety aspect, its 'dose' or application cycle is contingent upon the exact size of that room. There will be a faint, minor smell (most likely caused by irradiating the many particulates in the air) after the room and we call it "the new smell of clean".

There’s been very few studies done on the SARS COVID-19 virus. Most studies are done on surrogate pathogens. Corona viruses is recognized as a lipid based envelope virus and is fairly easy to kill. As with washing your hands, soap and water alone does a good job of killing this virus. We've also used a lot of similar studies on other types of CoronaViruses like MERS and SARS 14 COVID. Our devices are also calibrated for C-Diff (a spore producing bacteria known to cause a range if disorders from diarrhea to life-threatening inflammation of the colon- a bacteria that is very hard to kill, inactivate or sterilize). It is this lab standard that fosters the health industry's confidence in UVC technology's ability to inactivate the coronavirus.

Our industry undergoes strict efficacy studies with third party labs (to ensure the validity of the data) which is what are our end points were based on. Because of the nature of disinfecting, it's important to gain the confidence of the end user like a hospital- where we try to find more visualization for our clients. Something like a dosimeter color changing device (a device used to measure an absorbed dose of ionizing radiation) lets the director of a medical facility identify the right end point that they're looking for- and to make sure that they know the treatment is working properly.

Facilitating health and safety protocols in this pandemic, UV-C disinfecting has been made available in smaller and larger applications. There's a smaller device that will disinfect masks in about six minutes. We defer to a lot of what the CDC has done with decontaminating N-95's. We know that not all UVC is created the same-- different bulbs, UVC output, wattage etc. And so, you know, we're real careful to make sure that we're keeping the clinicians as safe as possible and giving the people the information. When disinfecting an entire room, we use something called "dose assurance technology". This feature constantly reads the UVC field in real time; it reads the UVC that's being put out by the lamps and the UVC that is being reflected. We calibrated to a predetermined dose, that when they get to that end point, the machines then shut off knowing they've done their job well - within a specified time vs. ray intensity.

For additional information on UV-C technology or SKYTRON, visit or contact Mr. Czechowskyj directly at


Images courtesy of

In 2006, the U.S. Environmental Protection Agency approved a test plan for Biological Inactivation Efficiency by HVAC In-Duct Ultraviolet Light Air Cleaners. (1) The tests were conducted using three organisms, two bacteria (Bacillus atrophaeus and Serratia marcescens) and one bacterial virus (MS2).  These organisms were selected because their sizes, shapes and susceptibility to UV inactivation make them reasonable surrogates for biological warfare agents (BWAs). Generally, vegetative bacteria are readily killed and bacterial spores are more difficult. To model use in a VAC system, RTI used a test duct designed for testing filtration and inactivation efficiencies of aerosol, bioaerosol, and chemical challenges.  The bioaerosol inactivation efficiencies calculated for the three organisms were 9% for B. atrophaeus, 99.96% for S. marcescens and 75% for MS2. The irradiance was measured as 1190 W/cm2 at 161 cm(63 in.) upstream from the lamps with an airflow of 0.93 m3/sec (1970 cfm). The system had four lamps that were burned in for 100 hours prior to measurements.

UV lamps have been used to inactivate airborne microorganisms for many years. Much of the early work was directed at the control of very infectious microorganisms (particularly Mycobacterium tuberculosis, the causative agent of tuberculosis), often in medical facilities. Wavelengths within the short wave, or C band of UV light (UVC), were found to be the most effective germicidal light wavelengths. UVC usually is generated by use of UVC fluorescent lamps. These lamps use electrical discharge through low-pressure mercury vapor enclosed in a glass tube that transmits UVC light (primarily at the mercury wavelength of 253.7 nm). Because this wavelength has been found to be about the optimum for killing microorganisms, UVC from mercury lamps also is referred to as UVG to indicate that it is germicidal. UVG has been shown to inactivate viruses, mycoplasma, bacteria, and fungi when used appropriately.

Due to the recent pandemic, companies developing this technology are (now) on the fast track to advance UVC installations for a wide range of professional and commercial environments.  Specific testing is currently underway as to the efficacy against SARS-CoV-2 (the virus that causes COVID-19) but historically, systems like those developed by Fresh-Aire UV have been tested and proven effective against pathogens that require even greater UVC dosages.  "Every microorganism requires a specific UVC dosage for inactivation including the novel coronavirus. UV disinfection has been employed for decades in water treatment; these microwatt values have been used for reference to gauge UVC efficiency against a large cross-section of microorganisms. UV disinfection systems for room, surface & HVAC are (also) an ideal proactive measure to complement filtration", stated Aaron Engel, VP of Business Development at Fresh-Aire UV. 

Niels Ryberg Finsen (1860-1904) was the first to employ UV rays in treating disease. He was awarded the Nobel Prize for Medicine in 1903 for his invention of the Finsen curative lamp, which was used successfully through the 1950s. [01]  Updates in the technology for commercial use evolved as UV-C germicidal lamps in the 1930's and have been primarily used in healthcare facilities. UVGI is highly recognized for addressing airborne microbial disease prevention (including influenza and tuberculosis). UVC is proven to prevent airborne transmission by deactivating airborne pathogens, but public use has been curtailed due to its potential to cause cancers and cataracts upon direct contact. [02]

The history of UVGI air disinfection has been one of promise, disappointment, and rebirth. Investigations of the bactericidal effect of sunlight in the late 19th century planted the seed of air disinfection by UV radiation. First to nurture this seed was Richard L. Riley and his mentor William F. Wells, who both discovered the spread of airborne infection by droplet nuclei and demonstrated the ability of UVGI to prevent such spread. With the enduring research of Riley and others, and an increase in tuberculosis (TB) during the 1980s, interest in UVGI was revitalized. With modern concerns regarding multi- and extensive drug-resistant TB, bioterrorism, influenza pandemics, and severe acute respiratory syndrome, interest in UVGI continues to grow. Research is ongoing, and there is much evidence on the efficacy of UVGI and the proper way to use it, though the technology has yet to fully mature.  [3]

Epilogue: Straight Answers from the CDC
In our commitment to publish helpful information about innovative solutions, we rely on top health  authorities to provide us with unbiased clarity and technical standards. We inquired about how UV-C Disinfecting technology truly ranked as the future solution to defeating viruses and transmitted diseases. Steve Martin, PhD, an engineer in NIOSH’s Respiratory Health Division provided us with these valuable statements:

Q: Does the CDC see UV-C Disinfecting as the next trend- evolving from chemical spray sanitizing?
A: No.  CDC understands that germicidal UV technologies, including patient room terminal cleaning devices (sometimes called UV robots), can provide enhanced surface disinfection over the use of chemical disinfectants alone. However, UV technologies, as they currently exist, will never replace manual chemical cleaning in healthcare spaces.  While UV can be very efficient at inactivating pathogens on surfaces, UV-C energy cannot substantially penetrate blood and other bodily fluids, or through other simple spills and splashes that occur in the course of patient care, even those that have dried and left residues. Thus, healthcare surfaces need to first be thoroughly cleaned to remove gross contamination before the UV energy can directly impact the surfaces and provide the most disinfection benefit. Then, UV systems that are properly applied can effectively inactivate many of the pathogens that manual cleaning may have left behind.

Q: From an original post on 2016, CDC warned about potential OZONE output from UV.  It has been evident that companies have since been addressing the testing, preventing and validating of ozone output.  Does CDC have enough data on this upgrade?
A: Concerns about UV lamps producing ozone have existed for decades and there have not been any significant “upgrades” since 2016.  There are some UV-C lamps designed specifically to produce ozone.  Ozone-producing lamps generally do not use an internal coating on the glass (or quartz) tube so UV energy at wavelengths below 200 nm (predominantly 185 nm) is emitted from the lamp. These wavelengths are responsible for ozone production.  There is a separate group of UV-C lamps designed specifically not to produce ozone.  This group is the low-pressure mercury vapor lamps used for germicidal ultraviolet (GUV) applications.  GUV lamps have interior coatings to block UV energy at wavelengths below 200 nm from escaping the tube, so ozone is not created. Unfortunately, ozone-producing lamps and GUV lamps of the same type and size can often be powered using the same electrical connectors and electronic drivers (ballasts).  So, it is critical for the end user to choose the proper lamp for their application.  If they choose a typical GUV lamp for a germicidal application, then ozone is not a concern.  If an end user unknowingly chooses an ozone-producing lamp that happens to fit properly into their GUV device, then ozone exposures will happen. CDC always recommends that end users communicate with the UV device manufacturer or a reputable UV system designer when purchasing replacement UV lamps.



Advanced Imaging & Diagnostic Specialist
Dr. Bard received the 2020 nationally acclaimed Ellis Island Award for his lifetime achievement in advanced cancer diagnostic imaging. He co-founded the 9/11 CancerScan program to bring additional diagnostic support to all first responders from Ground Zero. His main practice in midtown, NYC (Bard Diagnostic Imaging- uses the latest in digital imaging technology and has been also used to help guide biopsies and in many cases, even replicate much of the same reports of a clinical invasive biopsy. Imaging solutions such as high-powered sonograms, Power Doppler Histogram, sonofluoroscopy, 3D/4D image reconstruction and the Power Doppler Histogram  are safe, noninvasive, and do not use ionizing radiation. 

Dr. Kory is Board Certified in Internal Medicine, Critical Care, and Pulmonary Medicine. He served as the Medical Director of the Trauma and Life Support Center at the University of Wisconsin where he was an Associate Professor and the Chief of the Critical Care Service. He is considered a pioneer and national/international expert in the field of Critical Care Ultrasound and is the senior editor of the widely read textbook “Point-of-Care Ultrasound” (winner of the President’s Choice Award for Medical Textbooks from the British Medical Association in 2015).  Most recently, Dr. Kory joined the emergency volunteer team during the early COVID-19 pandemic in NYC at Mount Sinai Beth Israel Medical Center. He is also a founding member of the Front Line COVID-19 Critical Working Group ( composed of 5 critical care experts that devised the COVID-19 treatment protocol called MATH+. (

Taking care of patients at the bedside is where Mike Czechowskyj started his nursing career.  After caring for patients in the Progressive Care and Burn ICU, he advanced into different leadership positions at Spectrum Health.  There he helped educate new staff, build new programs and advanced nursing practice.  He then joined the Spectrum Health Innovations team where he worked with local businesses, health systems, and universities to create new medical devices that would help patients and healthcare providers.  This led him to one of their partners, Skytron, where Michael now provides leadership for the Infection Prevention team.

Mr Engel is Vice-President of Business Development for Fresh-Aire UV, a global leader in UV disinfection technologies. Aaron has 20 years experience in the design, manufacturing and marketing of UV disinfection systems for domestic and international applications including those for residential, commercial and healthcare. Aaron has worked on projects with various groups & associations including the definitive study on UV inactivation of airborne bioterrorism agents sponsored by RTI, the United States EPA & US National Homeland Security. Aaron is frequent guest speaker and lecturer and contributes to publications on IAQ technologies and UV disinfection. Aaron is a member on various ASHRAE committees including TC2.9 Ultraviolet Air and Surface Treatment and the Programs Chair for TC2.9.

2) Disinfection and Sterilization Guideline for Disinfection and Sterilization in Healthcare Facilities (2008)
3) US National Library of Medicine National Institutes of Health: The History of Ultraviolet Germicidal Irradiation for Air Disinfection
4) Far-UVC light: A new tool to control the spread of airborne-mediated microbial diseases

©Copyright Intermedia Worx Inc./Prevention 101. All Rights Reserved.

Sunday, July 19, 2020

Chest Ultrasound- Smart Uses in identifying Respiratory Issues

“When conducting lung ultrasound scanning, you look for signs of B-LINES. The more B lines you have equals a bad lung ultrasound score – indicating a high risk of deterioration. For any treatment protocol, if a patient whose lung ultrasound scan was getting worse, I might want to start escalating my therapy.” – Dr. Philippe Kory, MATH+

Monday, July 6, 2020


Collaborative Action Behind COVID-19 Tools R&D supported by The UN Foundation
By: Rachel Bridges-  Senior Global Health Advocacy and Communications Manager for the United Nations Foundation  |    Edited by:

"The COVID-19 pandemic has demonstrated the interconnected nature of our world – and that no one is safe until everyone is safe.  Only by acting in solidarity can communities save lives and overcome the devastating socio-economic impacts of the virus.  In partnership with the United Nations, people around the world are showing acts of humanity, inspiring hope for a better future." - The United Nations, We’re All in This Together. 

Photo credit: Institut Pasteur (courtesy of the UN Foundation)
The United Nations Foundation (UN Foundation) is one of the fiduciary partners behind the COVID-19 Solidarity Response Fund for the World Health Organization (WHO).  The foundation supports WHO and partners’ efforts to prevent, detect, and respond to the global COVID-19 pandemic around the world, especially in vulnerable areas. The Coalition for Epidemic Preparedness Innovations (CEPI), an organization helping to lead the discovery of potential COVID-19 vaccines, received a $10 million disbursement through the Fund to help catalyze and coordinate global vaccine research and development. The UN Foundation also works closely with the WHO, and other partners, to help share the most up-to-date scientific information with the public about COVID-19 which WHO generates and amplifies through its global coordination of the COVID-19 response.

While research developments are still in early stages, we are seeing the fastest R&D efforts in human history unfold. Through WHO’s leadership, a genetic sequence of the novel coronavirus (COVID-19)—a previously unknown disease—was shared with the world just 2 weeks after its initial discovery. Through coordinated efforts led by WHO, research and development is rapidly moving forward so that everyone, everywhere can have access to tools to help prevent, detect, and respond to COVID-19. Some examples of these efforts include:
    Photo credit: University of Queensland (courtesy
    of  the UN Foundation)
  • WHO’s global Solidarity Trial aims to rapidly develop an effective treatment for COVID-19. As of mid-August 2020, the Solidarity Trial has more than 3500 patients enrolled with more than 100 countries participating, including more than 400 hospitals in 35 countries alone. According to the WHO, the Solidarity Trial will reduce the amount of time it normally takes for a drug trial to determine effectiveness by 80%. This, combined with the size and geographic breadth of the trial, will provide a strong evidentiary basis behind specific therapies that can then be acted upon quickly by health systems.
  • WHO has published a research and development roadmap, with a set of protocols for how studies should be done to create potential therapeutics or vaccines. 
  • WHO is already working with scientists across the globe on over 120 different candidate vaccines for coronavirus with eight already in clinical trials in record time — just a few months after sequencing the gene.
  • 10 vaccine candidates in clinical evaluation and 123 in pre-clinical evaluation
In addition to the R&D work WHO and the Fund are helping to support, resources through the Solidarity Response Fund are helping to supply critical personal protective equipment, biomedical supplies, and infection prevention and control measures for vulnerable populations like refugees and displaced people.

Photo credit: UNICEF
Photo credit: UNICEF
As a global effort, donors from more than a 190 countries generously gave to COVID-19 relief efforts through the COVID-19 Solidarity Response Fund. These resources are also helping to support countries around the world get vital information to help protect communities, as well as critical supplies to help prevent, detect, and respond to this global pandemic. As of the beginning of August 2020, WHO has shipped more than 200 million items of personal protective equipment and more than 5.6 million pieces of testing equipment to more than 130 countries. The Fund also supports the work of the World Food Programme, the UN refugee agency (UNHCR), UNICEF, and the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) to work in many vulnerable countries and settings including Bangladesh, Syria, Lebanon, Jordan, Gaza, Kenya, and South Sudan to support at-risk refugee or displaced populations. You can learn more about the Fund’s impact here.

The UN Foundation helps support COVID-19 treatment research through mobilizing resources via the COVID-19 Solidarity Response Fund, as well as supporting WHO and partners working to discover COVID-19 treatments through advocacy and communications efforts with policy makers, global funders, and the general public. We help share scientific information as its being discovered, as well as advocate for continued investments in this critical research and development efforts being coordinated by WHO and global partners like UNITAID, the Global Fund, and others through the ACT Accelerator. 

WHO plays a critical role in coordinating a range of global health initiatives, including the global response to COVID-19. To this point, it has served as the global coordinator of efforts to develop vaccines, tests and treatments; trained millions of health workers; distributed millions in medical supplies, while also continuing the fight against other major health threats that matter to Americans like malaria, measles, and HIV/AIDS.

Currently, WHO’s efforts and the global COVID-19 response are undergoing challenges due to political challenges between member states. However, WHO’s global scientific research initiatives continue to forge ahead toward its imperative to resolve the pandemic. Only though coordinated and collaborative action can we stop this virus for everyone, everywhere. To help support WHO and partners’ global COVID-19 response, visit the COVID-19 Solidarity Response Fund website.

Rachel Bridges is passionate about creating impactful communications to help foster global change in her role as the Senior Advocacy and Communications Manager for Global Health for the United Nations Foundation. Prior to her time at the United Nations Foundation, she worked on various global health issues, including HIV/AIDS, tuberculosis, and neglected tropical diseases for the U.S. Agency for International Development. She holds a Master of Public Health degree from Washington University in St. Louis and a B.A. in English and French, with a minor in Women’s and Gender Studies, from Furman University. 

Feb. 27, 2021 - Health providers and educators at the European Pandemic front and Cancer Care societies, in support of global information sharing- aligned with NYCRA-NEWS, expressing complete support of a global health initiative. NYCRA-TV is forming international partnerships and alliances starting with our first Italian translated video of our top NYC cancer diagnostic expert Dr. Robert Bard with this trailer from his 2021 presentation on cancer diagnostic innovations. (SEE video clip). "This is the start of a collaborative union between countries to exchange information from our respected fields... and drive an inspired bond, presenting the best of what a global coalition of caregivers and scientists can bring!"- states a representative  of the upcoming program "Notizei Globali- IT (Global Health News) "

Dr. Robert Bard (US) presents a review on global advancements in Elastography, digital Pet/CT scans, MRI and the Doppler Ultrasound scanning.  As part of a medical seminar for the NY Cancer Resource Alliance and a list of cancer organizations, this educational overview supports the value of quantifiable readings that successfully reduce/prevent unnecessary biopsies and false positives. The movement to Integrate current cancer scanning modalities paves the way for a faster, and a more accurate way of tracking cancer aggression, allowing for the adjustment of therapies as needed in a timely manner. (Versions: ENGLISH | ITALIAN)

World medical conferences and international forums unite
multidisciplinary experts to continue global info-sharing

This pandemic has clearly illustrated that "Scientists by nature do not see borders or politics - only solutions", states Dr. Robert Bard, cancer diagnostics expert (NYC). "The spirit of teamwork is alive and well with this community- especially in a crisis. Historically, medical and scientific people have always raced to the front lines - always at the ready to pool resources and collaborate. Like the domestic and international health associations, we continue to see some of the sharpest clinical minds in the world- including American teams that are now coming out with promising protocols to help end this pandemic. To contain and eliminate this human threat means UNITING WITH SCIENCE AND WORKING TOGETHER ON A COORDINATED GOAL."

Such is the case with this remarkable grouping of like minds under a targeted objective. They call themselves The Front Line Covid-19 Critical Care Alliance - highly published critical care specialists from major academic medical centers with collectively over 1,000 medical publications.

Meet Some of the "Top Medical Minds in the Front Lines"
(Founding members & clinical advisors of MATH+ formed The Front Line Covid-19 Critical Care Alliance).

Based on the rapidly emerging research into COVID-19, the early clinical experience in China reflected by the Shanghai expert commission, and their decades-long clinical and research experiences in severe infectious diseases around the country, the 5 experts developed the MATH+ Hospital Treatment Protocol for Covid-19. It is intended for use early in the hospitalization of patients presenting with states of respiratory distress requiring supplemental oxygen. These 5 have since been joined by an increasing number of hospitalist and ICU physicians who recognize the sound physiologic rationale, the emerging published research in support of the components, and the data demonstrating good clinical outcomes in hospitals that have adopted the treatment regimen.

Methylprednisolone & MATH+: Treatment Success Data from the Nation's "HOT SPOTS"

With a confirmed global count of 9.27+ Million cases and 470,000+ deaths, the world continues its desperate search for a treatment that will save the lives of COVID-19 patients who come into the ER or hospital with low oxygen levels or struggling to breathe. Where the more popular treatment for patients in ICU is the use of ventilators, a reported 80-85% of Covid-19 patients on ventilators in New York end up dying (Associated Press and state and city officials).

The corticosteroid Methylprednisolone is a key component, based on large studies that have proven its effectiveness in prior viral pandemics‐ and whose potency is significantly increased when administered intravenously with high doses of the antioxidant Ascorbic acid (Vitamin C). Thiamine (Vitamin B1) is given to optimize cellular oxygen utilization and energy consumption, protecting the heart, brain, and immune system and the anticoagulant Heparin prevents (or breaks up) blood clots that increasingly appear as illness worsens. The + represents other supportive treatments by the administering doctor for patients who present other pre‐existing conditions (as needed). The group also plans to add or change components and dosing as published medical literature evolves.

LATEST UPDATES: According to physicians implementing the MATH+ Covid-19 treatment protocol, conclusive data shows significant success by as much as 97%, where only 3-6.6% mortality- from hospital reports including the VIRGINIA DEPT. OF HEALTH. (See complete report)

See LINK for complete "ESSENTIALS on MATH+ Covid-19 intervention protocols"

"MATH+ Saved my Life"- patient story



MEGAN MELLER, MS, MPH - Infection Control at Gundersen Health System
As soon as SARS-CoV-2 began generating international attention, I knew that the scientific community would rally. After working in a virus research lab for 3 years, I know that science and passion often go hand in hand. Collaboration is at the heart of research, especially successful research but it is also notoriously a slow and methodical process. Rushed science is often flawed, which is why peer-review and open access is so critical. … We live in historical times and pandemics set the stage for innovation (e.g. Solidarity Trial and Solidarity Response Fund). Most vaccine technology is the product of many years of hard work. International emergencies have a way of opening the peoples' eyes to fields that typically operate away from the worlds eyes (e.g. research, public health, Infection Control).

EPILOGUE:  Epidemiology

By: Lennard M. Gettz & Cheri Ambrose/ NY Cancer Resource Alliance

June 24, 2020- Months into the CoronaVirus pandemic, the tally of efforts expended by government health agencies and professionals worldwide has been noted to significantly exceed any global campaign in history.  Economists tend to use war terms to help put the pandemic's containment efforts and collateral damage in perspective.  IMF's chief economist Gita Gopinath,  (in an April 15 news conference) stated that "the best case scenario, the world is likely to lose a cumulative $9 trillion in output over two years"- making this a global war 3x the fiscal size of World War II.

As with past wars, alliances were formed, industries were committed to task and scientists worldwide have united by sharing information toward this single directive. The Department of Global Communications (U.N.) announced their drive to mobilize global cooperation in science-based COVID-19 responses, "The United Nations is mobilizing international cooperation to harness the power of science to tackle the coronavirus pandemic, while also working with partners to explore innovative crisis response tools."

Unlike the early months of the year, the second quarter showed the front lines to finally "catching up to the war efforts" with installments of these comprehensive containment measures:
  • a dedicated testing strategy & global data tracking
  • ample access to Covid tests and antibody testing
  • policy enforced education about preventive and safety guidelines
  • ample manufacturing of medical equipment and medicines
  • consistent PPE supply & distribution chains
  • trained critical care response personnel
  • lab research for therapeutics and vaccines

Other articles recently published in

"The Power of Prevention of Covid-19 is in YOUR HANDS"
Source: MD Anderson Cancer Center
Watch how a blacklight reveals what improper hand washing can leave behind. According to Dr. Christina Le-Short of MD Anderson Cancer Center, "Cancer patients are at greater risk of developing complications from respiratory viruses... Effective hand-washing is your best defense against germs that cause the flu or Covid-19". 

Possible Health Hazards Behind the Mask
Reports about Prolonged PPE Use by healthcare workers are aligned with health issues from abnormally elevated carbon dioxide (CO2) levels in the blood causing increased pressure inside the skull, nervous system changes, cardiovascular effects and reduced tolerance to lighter workloads that may lead to possible dizziness, hyperventilation and dehydration. View the report by the CDC about the many physiological effects of breathing increased concentrations of CO2 and the effects of failing overused respirator masks: See complete article

Suggested Safety Measures for Covid Prevention in Medical Offices  From respirators to hand sanitizers to regular use of hospital-grade disinfectants, the medical community is trusted to apply and set standards when it comes to safety measures, risk prevention strategies and sanitizing efforts. This new article offers a collective set of smart and sensible safety ideas from a group of doctors in your area. Promoting SAFETY GUIDELINES in any health practice is everyone's duty in our community.  See complete article

1) Some doctors moving away from ventilators for virus patients:

2) Global economy to be worst hit since Great Depression: Gita Gopinath, Chief Economist, IMF

6) Study: 88% of coronavirus patients on ventilators died in NY

7) Coronavirus patients on ventilators are unusually likely to die, causing some doctors to change strategy

8) Texas Medical Center Data:

9) Nearly 9 in 10 COVID-19 patients who are put on a ventilator die, New York hospital data suggests

10) Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

11) Center for American Progress: Removing Barriers for Immigrant Medical Professionals Is Critical To Help Fight Coronavirus


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