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Two centuries after its invention, the stethoscope — the very symbol of the medical profession — is facing an uncertain prognosis.It is threatened by hand-held devices that are also pressed against the chest but rely on ultrasound technology, artificial intelligence and smartphone apps instead of doctors’ ears to help detect leaks, murmurs, abnormal rhythms and other problems in the heart, lungs and elsewhere. Some of these instruments can yield images of the beating heart or create electrocardiogram graphs.Dr. Eric Topol, a world-renowned cardiologist, considers the stethoscope obsolete, nothing more than a pair of “rubber tubes.”It “was OK for 200 years,” Topol said. But “we need to go beyond that. We can do better.”In a longstanding tradition, nearly every U.S. medical school presents incoming students with a white coat and stethoscope to launch their careers. It’s more than symbolic — stethoscope skills are still taught, and proficiency is required for doctors to get their licenses.Over the last decade, though, the tech industry has downsized ultrasound scanners into devices resembling TV remotes. It has also created digital stethoscopes that can be paired with smartphones to create moving pictures and readouts.Proponents say these devices are nearly as easy to use as stethoscopes and allow doctors to watch the body in motion and actually see things such as leaky valves. “There’s no reason you would listen to sounds when you can see everything,” Topol said.At many medical schools, it’s the newer devices that really get students’ hearts pumping.“Wow!” ″Whoa!” ″This is awesome,” Indiana University medical students exclaimed in a recent class as they learned how to use a hand-held ultrasound device on a classmate, watching images of his lub-dubbing heart on a tablet screen.The Butterfly iQ device, made by based by Guilford, Connecticut-based Butterfly Network Inc., went on the market last year. An update will include artificial intelligence to help users position the probe and interpret the images.Students at the Indianapolis-based medical school, one of the nation’s largest, learn stethoscope skills but also get training in hand-held ultrasound in a program launched there last year by Dr. Paul Wallach, an executive associate dean. He created a similar program five years ago at the Medical College of Georgia and predicts that within the next decade, hand-held ultrasound devices will become part of the routine physical exam, just like the reflex hammer.The devices advance “our ability to take peek under the skin into the body,” he said. But Wallach added that, unlike some of his colleagues, he isn’t ready to declare the stethoscope dead. He envisions the next generation of physicians wearing “a stethoscope around the neck and an ultrasound in the pocket.”Modern-day stethoscopes bear little resemblance to the first stethoscope, invented in the early 1800s by Frenchman Rene Laennec, but they work essentially the same way.Laennec’s creation was a hollow tube of wood, almost a foot long, that made it easier to hear heart and lung sounds than pressing an ear against the chest. Rubber tubes, earpieces and the often cold metal attachment that is placed against the chest came later, helping to amplify the sounds.When the stethoscope is pressed against the body, sound waves make the diaphragm — the flat metal disc part of the device — and the bell-shaped underside vibrate. That channels the sound waves up through the tubes to the ears. Conventional stethoscopes typically cost under 0, compared with at least a few thousand dollars for some of the high-tech devices.But picking up and interpreting body sounds is subjective and requires a sensitive ear — and a trained one.With medical advances and competing devices over the past few decades, “the old stethoscope is kind of falling on hard times in terms of rigorous training,” said Dr. James Thomas, a cardiologist at Northwestern Medicine in Chicago. “Some recent studies have shown that graduates in internal medicine and emergency medicine may miss as many of half of murmurs using a stethoscope.”Northwestern is involved in testing new technology created by Eko, a Berkeley, California-based maker of smart stethoscopes. To improve detection of heart murmurs, Eko is developing artificial intelligence algorithms for its devices, using recordings of thousands of heartbeats. The devices produce a screen message telling the doctor whether the heart sounds are normal or if murmurs are present.Dennis Callinan, a retired Chicago city employee with heart disease, is among the study participants. At age 70, he has had plenty of stethoscope exams but said he feels no nostalgia for the devices.“If they can get a better reading using the new technology, great,” Callinan said.Chicago pediatrician Dr. Dave Drelicharz has been in practice for just over a decade and knows the allure of newer devices. But until the price comes down, the old stalwart “is still your best tool,” Drelicharz said. Once you learn to use the stethoscope, he said, it “becomes second nature.”“During my work hours in my office, if I don’t have it around my shoulders,” he said, “it’s as though I was feeling almost naked.” 5223

WASHINGTON – The U.S. Postal Service (USPS) is introducing a new Purple Heart Medal Forever stamp this month.The Forever stamp will go on sale nationwide on Oct. 4 and will be issued in self-adhesive sheets of 20.Like the Purple Heart Medal, the USPS says the stamp will honor the members of the U.S. military who have been wounded or killed in action. The Purple Heart Medal has a long history that starts with George Washington, who established the Badge of Military Merit during the Revolutionary War. It was discontinued after the war, but reinstated with a new design in 1932, the 200th anniversary of Washington’s birth. The new Forever stamp is a redesign that features a purple border that matches the brilliant purple of the medal and its ribbon. Customers can purchase the stamp through The Postal Store at 829

VANCOUVER, Wash. – Police in Vancouver, Washington, said Wednesday a missing teenager was killed by a man after he learned she was transgender.The family of 17-year-old Nikki Kuhnhausen reported her missing in June, telling police they hadn't heard from her since June 5.This month, investigators say, a person walking in the heavily wooded area of Larch Mountain near Vancouver found a skull, and searches by the Clark County Sheriff's Office and Clark County Search and Rescue yielded more human remains. Forensic analysis confirmed the remains belonged to Kuhnhausen.Investigators said Kuhnhausen had been strangled.Wednesday, investigators announced David Bogdanov, 25, has been charged with second-degree murder.Bogdanov's attorney, Erin Bradley McAleer, said his client has a January 2nd court date. It is both a bail hearing and arraignment."My client intends to plead not guilty at that time, " McAleer told CNN.Social media and phone records helped lead them to Bogdanov, after investigators discovered the two were messaging each other on Snapchat and met on the day of her disappearance.They obtained a search warrant for Bogdanov's cell phone records in July, police Lt. Tom Ryan said in a news conference Wednesday.Bogdanov said he picked up Kuhnhausen that morning, according to Ryan."David and Nikki went to a residence in the county and at that time (Nikki) confirmed to him that she was biologically male. David gave a statement saying that made him really, really uncomfortable and disturbed him, and he asked Nikki to get out of his van and she walked away," Ryan said.Prosecutors are reviewing the case.Bogdanov had his first court appearance Wednesday. He did not speak in court. Court documents were not immediately availableHe is being held without bail, 1790

WASHINGTON – The fate of hundreds of thousands of young undocumented immigrants who arrived in the US as children will be on the line Tuesday, when the 164

Why would the #USWNT deserve equal pay with men when they can be beaten by an under 15s boys team?Pay on ability, reward on performance, promote on merit. 15 year old boys are more able than this team Facts don’t care about your feelings. pic.twitter.com/iY4jziil1Z— Katie Hopkins (@KTHopkins) July 8, 2019 318