Johns Hopkins Medicine Podcasts

Program notes:

0:36    Mediterranean diet benefits
1:40    Most but not all components contributed to mortality decrease
2:20    Seafood contributed relatively little as well
3:04    Association between migraine headaches with brain lesions
4:05    Abnormal scans in cerebellum
5:01    Clot busting and heart attack
6:03    Angioplasty helps within 24 hours
7:01    Patients often not informed of test results
8:02    Patients need to ask about all results
9:05    End

Week of June 19, 2009

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0:21   Cervical cancer screening
1:23   Use of HPV testing didn’t add anything
2:27   Choice of technique for cervical cancer screening
2:55   A self test for dementia in BMJ
3:50   Examined 11 tasks
4:40   Are some agents that slow the progression
5:21   Treatment of Bell’s palsy
6:20   Easy to recognize
6:36   Update on swine flu
7:27   Comes in multiple waves
8:35   Time to prepare
9:20   Be infectious for longer before symptoms develop
10:21 End

Week of June 12, 2009

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Program notes:

0:25  Hemoglobin A1c for diagnosing diabetes
1:20  Measure over a long period of time
2:20 Patients should expect to have this test done
2:36 Treatment of blood flow to heart in diabetes
3:20 Angiogram demonstrated a blockage
4:15 Those with most extensive disease did better
5:12 Lipoprotein A
6:15 Measurement really isn’t necessary
7:02 Management of nausea in pregnancy
8:10 Probably more effective
9:05 End

Week of June 5, 2009

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Program notes:

0:42    Computer-based interventions for smoking cessation
1:40    In adolescents it wasn’t very effective
2:23    Compared to controls increased by 50%
3:01    Stopping HRT previous to mammography
4:05    Even though it decreased breast density it didn’t decrease recall
5:05    Physicians made them aware of risks and benefits
5:17    Risk score system for diabetes
6:12    Fat cells secrete something that increases risk
7:04    Swine flu risk
8:04    Globalization so infection travels fast
9:10    St. Louis isolated flu cases
10:15  End

Program notes:

0:44   Cardiovascular risk factors in NFL players
1:36   High blood pressure three times that of the general population
2:30   Risk factors may include weight training
3:24   Prevalence of balance disorders
4:22   Adjust body position without cues
5:20   Remove objects, vestibular retraining
5:38   Compression stockings don’t help post-stroke
6:40   Surgical patients do benefit
7:06   Treatment for lesions related to chronic heartburn
8:06   Screen for Barrett’s esophagitis
9:06   Prevention of GERD
10:06  End

Week of May 22, 2009

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Program notes:

0:40   Thumb splinting
1:49   Osteoarthritis of base of the thumb
2:23   About 90% of individuals wore them
3:06   Quality vs. quantity in bypass surgery
4:06   Even in low volume centers high quality brought results
5:03   Treatment of acute coronary syndromes
6:05   Can have procedure done when convenient instead
7:07   Go to the emergency department
7:54   Cataract surgery and Flomax
8:57   Both common conditions
10:21 End

Program notes:

0:30   Infants 6 weeks to 12 months and wheezing
1:38   Avoiding hospitalization
2:15   Often due to respiratory syncytial virus
3:10   Aspirin and clopidogrel in people with atrial fibrillation
4:00   Can’t tolerate coumidin
5:00   Risk of bleeding still fairly low
5:30   Adjuvant chemotherapy for breast cancer in older women
6:22   Combination chemo preferable
7:06   Overall tolerated well
7:31   Acupuncture in low back pain
8:22   All the acupuncture did better
9:22   A year out maintained the benefits
10:05 End

0:21    Botox warnings
1:18    Because of all these indications
2:10    Our third preparation is available
2:57    Parents who refuse to have children vaccinated
3:51    What is so dangerous about not vaccinating?
4:39    Transmit disease to vulnerable others
5:40    Benefits of folate
6:38    Defects early in pregnancy
7:31    Bare metal and drug-eluting stents
8:34    Two reasons for different results
9:54    End

Program notes:

0:30   Swine flu
1:22   We’ve not seen this type of virus
2:02   Symptoms of flu
3:01   Limit exposure
3:53   When people infected with HIV should start treatment
4:53   This study would suggest that the immune system isn’t reconstituted
5:55   Management of hepatitis C
6:51   Chronic hepatitis C leads to problems
7:57   Lifestyle and diabetes prevention in elderly
8:43   About fifty percent of the risk reduction
10:02 End

Program notes:

0:40    Glycemic control
1:38    Prolonged low blood sugar causes problems
2:25    Requires constant glucose monitoring
3:24    Hemoglobin A1c
4:15    Chlamydia screening
5:12    Ectopic pregnancy
5:31    Screening adolescents for depression
6:33    Increased risk of suicidal ideation
6:56    Knee arthroplasty
7:58    Knee replacement is a good strategy
8:45    Equipment and surgery are better
10:12  End

Program notes:

0:30    Heart screening for people with type 2 diabetes
1:25     Low incidence of major cardiac event
2:24    Association between low blood sugar and potential for dementia
3:20    Why folks with type 2 diabetes have low blood sugar
4:20     Regular eating habits important
5:10     Stem cell transplants in type 1 diabetes
6:04     One of many different approaches to cure diabetes
7:11     Type one occurs early in life
7:29     Women with epilepsy during pregnancy
8:35     Women who have seizures must be aware
9:14     Don’t change medication during pregnancy
10:03   End

Program notes:

0:34 Brown fat is present in babies, and burns energy
1:29 To reduce obesity increase caloric expenditure
2:29 School based interventions for obesity
3:42 Didn’t assess blood pressure or type 2 diabetes
4:21 More than just education is needed
4:53 Sugar sweetened beverage consumption
5:45 10-15% of average consumption of children beverages
6:46 May actually increase food intake
7:27 Exercise in patients with heart failure
8:35 Medications are very good at improving symptoms
9:42 End

Program notes:

0:30 Bed bugs
1:13 Transmitted by contact
2:10 Itching and redness
3:08 Cervical cancer assessment
4:08 Great virtue is a one time test
4:41 Statins don’t help in patients undergoing hemodialysis
5:41 You would predict a benefit but its not seen
6:27 Can’t just draw broad conclusions
6:46 Study looking at housing for homeless people
7:46 These individuals ran up at bill of 8 million dollars
8:46 Housing that doesn’t require abstention
9:54 End

Program notes:

0:20   Red meat consumption and risks
1:15   Persuasive since it’s so large
2:11   How do we account for deleterious effects of red meat?
2:52   BMI and impact on mortality
3:44   Increase weight ten to fifteen pounds increases mortality 30%
4:42   Most weight gained in middle years
4:55   Vitamin D deficiency
5:48   Two different sources for vitamin D
6:47   One piece of data that’s persuasive
7:37   Electronic patient records
8:40   Commercial interests
9:40   Patients can get copies of their records and compile
10:11 End

Program notes:

0:20   Life space mobility and its reduction
1:30   After hospitalization contracts markedly
2:15   Could be deconditioning
3:22   Utility of PSA screening
4:26   Didn’t decrease deaths from prostate cancer
5:18   I’m in my early fifties
5:42   US Preventive Services Task Force on aspirin
6:33   Women reduces risk of stroke
7:32   Based upon very good studies
7:41   Concern about chemicals in baby products
8:30   Formaldehyde is a preservative
9:25   None of these products reported them as ingredients
10:14   End

Program notes:

0:27   Two topics regarding prevention
1:04   Postmenopausal women and their breast cancer risk
2:03   Fatty tissue appears dark
3:01   Medications for chemoprevention
3:23   Two techniques for ovarian cancer detection
4:16   CA-125 as a cancer marker
5:20   The authors suggest this as routine screening
5:34   Lack of benefit from some treatments to coronary arteries
6:28   When we restore blood flow why doesn’t death risk decline?
7:21   For stable coronary artery disease medical therapy just as good
8:12   Physicians prescribing more medications but not much impact
9:10   Three out of five people don’t have blood pressure controlled
10:35  End

Program notes:

0:39 Patient-physician connectedness and quality of primary care
1:59 Flu vaccine effectiveness
2:44 Inactivated vaccine
3:36 Those who’ve had injections in the past should continue
4:06 Emergence of drug resistant flu this year
5:08 Report of radiation overexposure
6:08 Ask physicians about their financial interest
7:07 Proton pump inhibitors and a heart medication
8:18 Increased risk of heart attack or hospitalizations
9:17 Can change to H2 blocker
10:07 End

Program notes:

0:40   Weight loss diet comparison
1:40   Year long weight loss the same
2:26   Behavioral factors very important
3:30   Some group aspect is important
3:45   Use of folic acid in preventing age-related macular degeneration
4:30   Due to decrease in homocysteine levels
5:21   Calcium and cancer development
6:22   Benefit seen at recommended level
7:00   Precursor in Alzheimer’s disease
8:00   Pathway in important in amyloid development
9:00   Targets for intervention
10:21 End

Program notes:

0:30   Best way to improve blood flow in hearts with blocked arteries
1:25   Risk of death or MI similar but those with stents may need additional intervention
2:32   About 90% of stents are drug eluting
3:30   At risk for cardiovascular disease and how high is cholesterol?
4:48   In high risk patients we do know it helps
5:42   Current recommendations are 20% risk over the next 10 years
6:40   Dangers of secondhand smoke and cognition
7:37   Those with highest level of cotinine 40% more likely than others to have cognitive impairment
8:38   Doesn’t assess long term exposure
9:00   Assess delivering behavioral therapy for weight loss
10:34  End

Program notes:

0:27   Targeted muscle innervation and artificial arms
1:28   Provides electrical signals
2:28   Potential for stroke or other conditions?
2:45   HIV control via stem cell transplantation
3:27   Lack a receptor for the virus
4:21   1 to 3% of the population lacks receptor
5:19   Exercise and quality of life
6:10   The more exercise the better the mental quality of life
7:07   Lack of benefit from coordinated care
8:10   One hospital did see a benefit
9:07   Where Medicare is headed now
9:51   End

Program notes:

0:27   Respiratory syncytial virus
1:20   Requires special lab tests
2:16   Hormone replacement therapy and breast cancer
3:15   When it stops the risk decreases
4:04   CT imaging of heart’s blood vessels
5:10   Specific ways of imaging
6:10   Different methods available
6:52   Resting heart rate
7:52   63% increased risk
8:52   Women over the age of 50
9:49   End

Program notes:

0:21   Alcohol overview in The Lancet
1:20   Clear relationship between alcohol overuse and accidents
2:21   Questionnaire to assess problem
3:35   Intervention takes time
4:13   Women who don’t get mammography after surviving cancer
5:20   Once you’ve survived one cancer aren’t concerned about another?
6:18   Need to be dedicated to long term follow-up
6:30   No negative consequences to kidney donation
7:23   Followed 3700 kidney donors
8:00   Weight loss for urinary incontinence
9:00   Modest weight loss only
10:21 End

Program notes:

0: 30  Wheezing in children
1:34   Oral administration of steroids didn’t help
2:26   Use of steroids in children with asthma
3:31   Most over the counter inhalers not as effective
4:32   Most of the MRSA in ear infections
5:30   Need to be more effective at diagnosis and treatment
6:01   Heart attacks becoming less severe
7:02   Amount of muscle dying is smaller
8:15   Fine particulate pollution declining
9:15   Transportation produces
10:21   End

Program notes:

0:30 Relationship of sleep habits and susceptibility to colds
1:27 Gave them nasal droplets with cold virus
2:22 We know that sleep quality and duration are important
2:50 Vick’s Vapor Rub dangers
3:34 Number of children with what looked like acute asthma
4:35 Decrease airway clearance
4:51 Salmonella outbreak
5:46 One in five hospitalized
6:51 Change serving platter from preparation
7:56 Can avoid or treat or manage
8:08 Blood vessel disease in legs responds to exercise
9:07 Affects about one in sixteen people over 40
10:12 End

Program notes:

0:20  Clopidogrel and genetic variation
1:10   Inhibit platelet clumping
2:10   As much as thirty percent of population has this
3:00   Sleep and coronary artery calcification
4:15   Suggests that shortened sleep is a risk factor
5:01   Sleep reduction associated with multiple negative effects
5:26   Older adults largest consumers of prescription medications
6:07  Patients need to make physicians aware of medications they’re taking
7:00   Best treatment for pediatric anxiety disorders
8:05   No therapy only about 25% improvement
9:05   No increase risk of suicide attempts or ideation
10:26 End

Program notes:

0:21   Colonoscopy misses right side tumors
1:19   Cancers on left side prevents about 70%
2:25   Why aren’t right side tumors detected?
3:01   Benefits of low glycemic diet in diabetes
4:02   Lower sugar and higher HDL cholesterol
5:03   It is wise to adopt this diet
5:23   Not favorable effect of multiple steroid doses in preterm labor
6:27   Steroids arrest growth
7:00   Family member assessment of doctors
8:00   Physicians have been reluctant to provide specific prognostic information
9:00    Share your decision making process
10:02  Want honest and truthful physicians
10:26   End

Program notes:

0:25 Influenza review in NEJM
1:35 Expanded vaccination guidelines
2:23 Vaccine developed before the flu season
3:21 Flu mist
4:19 JAMA study panning C, E, and selenium
5:16 Antioxidants don’t seem to help
5:28 Unintentional overdose from prescription medications
6:22 Got it from people to whom it was prescribed
7:05 Increase in eye disease
8:12 Diabetics need regular eye exams
9:22 Collect reading glasses for worldwide distribution
9:47 End

Program notes:

0:22 College students and mental illness
1:18 Alcohol use and dependence
2:06 Few sought treatment
3:27 Generic versus brand name medications
4:13 For most of the drugs examined no difference
5:11 FDA approved bioequivalent drugs
5:26 Hypertension treatment
6:25 More expensive drugs under patent
7:30 Try a single medication for several weeks
8:40 Diuretics may drop potassium too low
9:06 Drug for use in advanced Alzheimer’s
10:34 End

0:35    CT assessment of heart's arteries
1:23    Can see to about half a millimeter
2:14    Low risk populations
3:15    Should not be a routine screening device
4:10    Used inhaled steroids in people with COPD
5:12    A worldwide problem
5:43    Everyone should be screened for HIV
6:38    20,000 transmission due to people who don't know they're infected
7:22    New medication for migraines
8:23    Doesn't have same side effects
9:16    Phase III trial
9:51    End

Program notes:

0:30   Room spinning around
1:18   Thousands affected by Meniere’s disease
2:08   If we can manage people medically most people improve
3:08   Use of gingko for prevention of Alzheimer’s
4:07   No reduction in incidence or progression
5:03   Tell your physician about supplements you may be taking
6:02   Adults need routine vaccination
7:12   Important to realize indications
8:10   Clinical practice guideline for depression medications
9:10   Continue treatment for some time
10:24 End

Program notes:

0:21    This week it’s all about the heart
1:03    Almost 400,000 people with fat assessments
2:00    Fat cells are an endocrine organ
3:02    Waist circumference to assess
3:38    Use of statins in people with elevated C-reactive protein
4:30   Absolute risk incredibly small
5:30   People on statins had higher incidence of diabetes
6:13   Non-fasting triglycerides
7:11   If doctor wants blood drawn at a certain time
7:25   Short sleep duration predictor of cardiovascular events
8:20   400% increased risk of event
9:23   Ambulatory blood pressure monitor
10:30 End

Program notes:

0:21   BMJ study on physician prescription of placebos
1:19   Placebos can be inert or active
2:23   Have prescribed placebos
3:03   Alarming increase in medication use in kids
4:57   Use of HPV vaccine in boys
6:34   Oral rinse can detect
7:20   If the incidence was higher we would do
7:36   Two studies on homocysteine
8:00   Homocysteine and depression
9:00   Whether treatment affects disease
10:01  Lowering homocysteine doesn’t help
10:25  End

Program notes:

0:25    Potential drug for obesity
1:22    What’s different is people lose twice as much weight
2:24   Originally developed for Alzheimer’s
3:15   Pneumonia and statins
4:13   Had to take at time of admission
4:52   C-reactive protein
5:49   Increased risk for cardiovascular disease?
6:50   Knowing about genetic makeup influences therapy
7:14   Vaccination against pneumococcal pneumonia
8:14   Flu pandemic and pneumonia
9:07   Seldom see in young individuals
9:46   End

Program notes:

0:25 Macular degeneration
1:23 Evaluated for the presence of macular degeneration
2:20 Healthy lifestyle and proper nutrition
2:55 Alcohol consumption and brain volume
3:50 Excessive intake accelerates
4:48 Studies would suggest that low alcohol intake may help
5:01 Smoking cessation
6:04 Programs in hospital setting
7:01 Has to be sustained effort
7:50 Vioxx update
8:50 Percentage increase versus number
9:32 Convinced of both things
10:33 End

Program notes:

0:21 Role of vitamin D in Alzheimer’s management
1:23 Vitamin supplements in food
2:30 Elderly may be vitamin deficient
3:00 4000 people with diabetes
4:02 Blood pressure control also helped but didn’t persist
5:06 Have to keep blood pressure medications
5:18 Stress testing and stent placement
6:19 Controversy regarding stents
7:15 Stress testing available everywhere
7:45 Management of atrial fibrillation
8:42 Should medication be used long term or intermittently?
9:31 Thyroid complications
10:03 End

Program notes:

0:25      Single reader mammography
1:28      Cancer detection rate similar with both
2:27      How much experience does this person have?
2:50      Continuous glucose monitoring
3:50      Needle sensor placed under skin
4:49      Not difficult to use the sensor
5:43      For adolescents less important to monitor
6:06      Depression and heart attacks
7:12      Two questions to screen
8:20      Treatment with better outcome?
8:45      New medications for HIV
9:31      Could use for prevention?
10:15    End

Program notes:

0:27   CPR information
1:18   Difference in survival after CPR around North America
2:06   Everybody needs to be aware of how to do CPR
3:07   Shouldn't transport if its futile
4:03   Realistic about what CPR can accomplish
4:30   Clot busting agents in stroke
5:18   Benefits clearly outweighed the risks
6:15   Only about 4% get this agent
6:33   Colon polyps in African Americans
7:13   Race matters
8:00   Inhaled medications and heart attacks
9:02   Meta-analysis suggests increased risk
10:05 End

Program notes:

0:23    BPA in plastics
1:25    Leach from plastic into food
2:27    More data there are concerns
3:19    Screening colonoscopy
4:22    Detection of polyps
5:37    Flat polyps
6:13    Negative test doesn't need yearly repeat
6:56    Flu vaccine in pregnant women
7:26    Infants at high risk for flu
8:08    Use of antibiotics in preterm labor
9:17    Premature labor but no active infection
10:25  End

Program Notes:

0:33 Brain derived neurotrophic factor
1:41 Have a specific abnormality helped identify
2:30 Help target specific therapies
3:30 Measles update
4:25 Most children who attend public schools are vaccinated
5:25 Get children vaccinated
5:39 Updated flu vaccination guidelines
6:22 Older people don't respond very well
7:20 In terms of cost effectiveness
7:35 CDC changes HIV testing
8:23 Objections to HIV testing?
9:20 Effective treatment exists
9:46 End

Program notes:

0:32 Consumption of nuts and diverticular disease
1:30 What contributes to it?
2:30 Benefit of nuts in the diet
3:05 Ayurvedic medicines and metals
4:10 Levels very high
5:00 Make your physician aware you're taking them
6:00 Allopurinol and high blood pressure in kids
7:00 Understand the mechanism
8:01 Glucose control in critically ill
9:03 Meta-analysis of many studies
10:31 End

Program notes:

0:24   Chewing gum and bowel surgery
1:25   Nurses giving chewing gum
2:28   Saves a lot of money
2:52   Preeclampsia and kidney failure
3:50   Kidney compromise five or more years later
4:44   Common causative agent
5:09   West Nile virus recovery
6:10   Recovery usually complete
6:55   Statins and myopathy
7:44   Gene responsible for 60%
9:07   End

Program notes:

0:30     Cystic fibrosis treatment
1:30     Truncated protein defect
2:24     Personalized medicine
3:13     HPV vaccination implications
4:15     Use of vaccine at particular ages
5:17     How and to whom to administer vaccine
5:37     B vitamins and heart disease
6:27     Supplementation doesn't help
7:05     Arsenic exposure in water and type 2 diabetes
8:07     Inorganic form deleterious
9:02     Attack at level of water supply
10:23   End

Program notes:

0: 20    Estrogen therapy benefit
1:22     Estrogen affects different pathways in the brain
2:15     Less psychotherapy taking place
3:16     Benefits of CBT in managing mental illness
4:28     Need better reimbursement
4:40     Don't screen older men for prostate cancer
5:33     No benefit in screening in men with less than 10 years to live
6:24     Men over the age of 75
7:21     Problem with patients accepting this change
7:50     Lack of physical activity in immigrant children
8:46     Children with least access to medical care
9:37     End

Program notes:

0: 21    True incidence of HIV infection in US
1:31     10% over the age of 50
2:45     High risk populations should be tested
3:30     People with HIV infection at risk for TB
4:30     Multiple medications interact
5:08     Smoke free environment in Scotland
6:12     Smoking increases risk for blood clots
7:00     H.pylori infection and stomach cancer
8:09     Eradicating H. pylori decreases recurrence
9:00     Screening and eradication in high risk folks
10:10   End

0:45   Latino background and AIDS
1:50   Why are they developing AIDS more often?
2:41   Need cultural sensitivity to Latinos
3:30   Inhibition of a different enzyme
4:30   Become infected with TB and it becomes latent
5:27   High risk groups need screening
6:27   HAART really helps
7:02   Motivation for tattoo removal
8:05   20% of individuals want it removed
9:00   Negative societal connotations
10:24 End

Program notes:

0:30 Salmonella outbreak
1:29 Tomatoes initially implicated
2:20 Perishable food not around anymore
3:23 All utensils washed with water and soap
3:50 Sildenafil in women
4:24 Sexual dysfunction triggers stopping depression medication
4:50 Finding tumor cells in blood in lung cancer
6:08 Predicts who will respond to chemotherapy
7:08 New treatment for liver cancer
8:08 Increasing incidence of liver cancer worldwide
9:07 Effective screens for liver cancer?
10:01 End

0:30   Teenagers' lack of exercise
1:36   What issues account for that?
2:28   Now schools recommending activity
3:25   Two studies looking at treatment of Alzheimer's disease
4:24   Targeting amyloid didn't help
5:27   Older folks with a companion have better outcomes
6:20   More the companion contributes the better
7:14   Routine education about fall avoidance
8:22   Things around the house to avoid falls
9:15    Knee and hip replacement helps those aged 75 and older
10:08  End

0:30    Cholesterol measurement in children
1:30     Children before 10 but after 2 get screened
2:25     Decrease obesity, manage high blood pressure
3:16     Lifestyle modification
3:24     Food diaries to maintain weight loss
4:25     45% African Americans
5:03     Ankle brachial index
6:15     If index is abnormal risk is raised 300%
7:06     Use of androgen deprivation therapy in early prostate cancer
8:05     Trying to use in early stage disease
9:02     Side effects in 10-50% of patients
10:13    End

Program notes:

0:30    Vice chairman of medicine
1:16    MMWR shows increase in diagnosis of HIV
2:18     You can get infected fairly easily
3:17     Side effects of therapy
4:15     Cancer patients with depression
5:09      About 65% on antidepressant
6:00      Acute coronary syndrome or possible heart attack
7:26      Differences between men and women
8:14      Thyroid cancer treatment
9:17      Prevents new blood vessel formation
10:31    End

Program notes:

0:40   One blood pressure number
1:30   As we age the upper number goes up
2:14   Systolic number most important
3:14   Phase two trial for skin patch vaccine
4:00   Sounding board on OTC sale of statins
5:04   Statins may have broad impact
6:10   Available anywhere OTC?
7:00   Electronic health records available to physicians and consumers
8:20   Google and Microsoft testing
9:03   Privacy is major issue
10:36  End

New hope for lung cancer, treating arrhythmias, association with diabetes and depression, and no new medications for heart failure 

Program notes:

0:30   Bidirectional association with diabetes and depression
1:33   Diabetes may predispose to depression
2:31   Patients and physicians need to look for both
3:30   May cause harm in heart failure
4:27   Use devices instead of medications
5:12   Medicines are useful too
6:00   Great interest in restoring heart rhythm
7:00   Ablation therapy possible
8:00   Lung cancer ablation
9:05   Successful in 99% of individuals
10:14 End

This week's topics include vitamin D and heart attacks in men, lack of cardiovascular benefit of tight blood sugar control, avoiding macular degeneration, and a new way to make flu vaccine.

This week's topics include patient perceptions of mortality with heart failure, a potential new treatment of heart attacks, managing nausea related to chemotherapy, and preventing kidney failure in people with diabetes.

This week's topics include obesity in kids, use of home blood pressure monitors, interventions in type 2 diabetes, and gum disease and cancer.

Program notes:

0:30   Increasing obesity in adolescents
1:26   About a third are significantly overweight
2:10   Use insulin early in type 2 diabetes
3:17   Sets the tone for a new type of therapy
4:19   17% reduction in cardiovascular disease
5:19   Home monitoring of blood pressure
6:37   Take machine into doctor's office
7:26   Record throughout the day and the time
8:14   Gum disease and cancer
9:28   14% increased risk
10:13 Does treatment decrease risk?
10:51 End

This week's topics include a new type of LDL, under the tongue allergy treatment, risks of the metabolic syndrome, and treatment of H. pylori infection.

Program notes:
0:31   Helicobacter pylori
1:30   Effective eradication important
2:21   Should screening be done?
3:04   Millions have allergies
4:11   Mix of allergens under the tongue
5:12   A very promising therapy
6:14   Oxidized LDL imporant in atherosclerosis
7:30   Useful as a predictor
8:17   40% of people have metabolic syndrome
9:06   Does metabolic syndrome mean anything?
9:49   Lifestyle modification important
10:47 End

This week's topics include beta blockers and non-heart surgery, carotid sounds, smoking interventions by peers, and monoclonal antibody treatment of psoriasis.

Program notes:
0:31 Beta blockers prior to surgery
1:18 Surgery increases heart rate and blood pressure
2:14 May be too much beta blocker too soon
3:06 Noise in carotid arteries
4:12 Treat patients more aggressively
5:09 Peer intervention and smoking prevention
6:42 Reduces rate of smoking
7:02 Psoriasis treatment
8:02 Struggle to develop a treatment
9:04 Monoclonal antibody can be extremely effective
10:02 Antibody binds to a protein involved in disease
11:00 End

This week's topics include the fit versus fat controversy, osteoporosis genes, blood substitutes, and effects of hormone replacement therapy in women.

Program notes:
0:30   Women who are fit don't lose risk of fat
1:20   BMI measure
2:15   No substitute for weight loss
2:36   Blood substitutes
3:10   Increases risk of death and heart attacks
4:23   Animal models substantiate
5:00   Burden of osteoporosis
6:01   Combination of bone density decrease and genes
7:05   Can tie the genes to bone degradation
8:10   Hormone replacement therapy
9:06   Confirms increased risk of stroke and related to dose
10:01 Need to weigh the risks and benefits
10:45 End

This week's topics include high blood pressure and kidney disease in African Americans, possible negative side effects of drugs to treat osteoporosis, a potential new treatment for Alzheimer's disease.

0:30   New treatment for Alzheimer's disease
1:18   Decreased cognitive defects with mild dementia
2:08   Common medication for osteoporosis
3:03   Atrial fibrillation
4:06   Identified with once yearly injection
5:08   Glitazones to treat oral diabetes
6:02   Substantial number of people use them
7:05   Controlling blood pressure and kidney disease
8:08   Kidney function declined by a high percentage
9:06   Race specific identifiers?
10:41 End

This week's topics include a new test for fertility, mammography in women older than 80, heart risk and ADHD medications, and the heparin debacle.

Program notes:

0:20    Fertility testing
1:19    Anti-mullerian hormone
2:10    May be the most predictive test
3:04    Does mammography help women aged 80 and older?
4:15    Average life expectancy mid-eighties for women
5:01    ADHD medications and heart risk
6:07    Primary care docs must assess
7:15    We want to be aware of risks and benefits
8:00    Heparin and its risks
9:00    Chemical similar to heparin
10:02   Rely too much on FDA
11:06   End

This week's topics include paired kidney transplants, mumps infections in the US, waist size and disease and death, and fish oils in Crohn's disease.

0:33    Paired kidney transplant
1:10    Large databases help match
2:16    Should have recognized this idea
3:06    Successful at living with just one kidney
4:00    Mumps coming back in US?
5:02    Two immunizations may not be adequate
6:07    Overseas travel may result in exposure
7:01    Waist size significantly affects mortality
8:00    Address as a separate risk factor
9:00    Fish oils and Crohn's disease
10:0    Prevention not effective
11:00   No proven dietary interventions
11:22   End

This week's topics include the best treatment for carotid artery blockage, son to father transmission of bird flu, increase in esophageal cancer, and teens with TVs in their rooms.

Program notes:

0:30    Son to father transmission of bird flu
1:22    May be a flu thats easily transmitted
2:21    Passive immunization
3:16    Human to human transmission
4:42    Addressed adolescents
5:28    Esophageal cancer increase
6:24    OTC heartburn medications
7:25    Burn away lining of esophagus
8:00    Carotid stenosis
9:01    Stenting or surgery?
10:17   How long does it last?
11:08   Blockage in carotids
12:44   End

This week's topics include AEDs in homes, compression only CPR, treatment of high blood pressure in older folks, and HPV testing in women with normal Pap smears.

Program notes:

0:30    AEDs in homes
1:32    Distributed widely in public places
2:38    High risk folks perhaps internal defibrillator
3:00    Compression only CPR
4:02    Treatment of high blood pressure in older folks
5:04    20% decreased risk of death
6:01    2/3 required additional medicine
7:07    HPV testing in women with normal Pap smears
8:08    All women got HPV screening
9:15    Test isn't type specific
10:20  Women may question why do it at all
11:30  End

This week's topics include dangers of mechanical ventilation, predictive value of coronary calcium scanning, risks of hair dyes, and kidney function compromise from colonoscopy preparation.

Program notes:

0:30    Occupational hazards related to hair dyes
1:32    Hairdressers have increased risk of cancer
2:24    Coronary calcium scanning
3:23    Increased risk of heart attack
4:42    Screening?
5:30    Preparation for colonoscopy
6:25    Oral phosphate solution compromises kidneys
7:42    Avoid if kidneys are compromised
8:20    Effects of ventilation on diaphragm
9:23    Causes problems with diaphragm anatomy and function
10:56   End

This week's topics include the benefits of clinical trials, receiving care at a teaching hospital, satisfaction after treatment for prostate cancer, and the effects of using old blood.

Program notes:

0:25      Transfusing old red blood cells
1:30      Compared old with new red blood cells
2:35      Other complications of transfusions
3:30      May not apply to all types of surgery
4:02      Family and patient satisfaction after prostate cancer treatment
5:15      Affect quality of life
6:22      Quality of life issues related to cancer treatment
7:17      Clinical trials on cancer
8:18      Randomizing allows comparison
9:10      Outcomes in hospitals that engage in clincial trials
10:06      Patients receive standard of care
11:04     Most important to get to closest hospital
12:49      End

This week's topics include management of urinary incontinence in women, dangers of strangulation games in teenagers, depression and testosterone, and screening for MRSA.

Program notes:

0:37    Testosterone and depression
1:42    Are other health issues factored out?
2:32    No long term randomized data on testosterone supplements
3:25    Prevalent choking game
4:19    Self induced may result in death
5:08    MRSA and screening
6:15    Just testing high risk patients expensive
7:09    Urinary incontinence in women
8:14    Stress vs. urge incontinence
9:18    Pelvic exercises
10:10  May need surgery
11:02  End

This week's topics include modifying TV and computer use by kids, best place to have lung surgery, risks of hormone replacement therapy, and a blood pressure vaccine.

0:19 Benefits of reducing TV and computers
0:56 Impact on very young children
1:40 Children lost weight
2:44 Make suggestion that TV is cue for eating
3:24 Parents calories change too
4:04 Fears of teaching hospitals
5:00 Most have access to teaching hospitals
6:00 Risks and benefits of hormone replacement therapy
7:01 Reserved for women with severe symptoms
8:04 If symptoms are not severe or debilitation, wait
9:03 Immunization against angiotensin II
10:05 Many people can't or won't take medication
11:01 Angiotensin modification and blood pressure
11:52 End

This week's topics include risks of anemia drugs, treating depression in kids, the flu vaccine for children, and an approach to keep elderly people in their homes.

Program notes:
0:28      review of interventions for keeping older folks at home
1:02      number of interventions for assessment and treatment
2:06      multidisciplinary evaluation
3:09      who's giving their medications
4:10      prevented serious problems for elderly
4:20      CDC recommendations that kids get flu shot
5:26     children between 5 and 18 more likely to get flu
6:35     will everyone get the flu vaccine eventually?
7:27     many children don't respond to depression treatment
8:34     individuals who received different medication plus therapy responded
9:40     use of anemia medications
10:35   drugs used to treat cancer suppress red blood cell production
11:20   people with very low red blood cell count may benefit
12:21   End

This week's topics include the best treatment for just diagnosed Crohn's disease, FDA and Supreme Court activity affecting healthcare, post-stroke treatment, and surgery for spinal stenosis.

Program notes:
0:22     FDA has played a role in off label use
1:23     When stents were approved they were for certain indications
2:23     Initial studies it is off label but needs to be studied
3:29     If FDA has approved states can't override
4:29     Appropriate treatment of newly diagnosed Crohn's
5:30     Use of monoclonal antibody
6:17     Key to this study is early use
7:06     Spinal stenosis results from disk bulging
8:21     Unusual to have spinal stenosis in younger people
9:09     Symptoms of stroke
10:12   In the past clot dissolving agents restricted to short window
11:10   If patient has an ischemic penumbra
11:56   End

This week's topics include longevity in older men, obesity and cancer, blood pressure management, and use of probiotics in pancreatitis.

0:20     Longevity in older men
1:14     Started with doctors older than 70
2:15     A lot of this within our control
3:05     Obesity and cancer risk
4:12     70% of men and 60% of women
5:09     BMI 25 or more
6:02     Dietary modifications and blood pressure
7:01     Blood pressure medication issues
8:07     Not all medications cause side effects
9:07     Not just obese have high blood pressure
9:45     Probiotics
10:14   Pancreatitis may respond
11:10   Over the counter supplements need testing
11:33    End

This week's topics include marijuana and your teeth, reblockage of neck arteries, genetic testing to predict drug allergy, and control of diabetes.

0:30     Periodontal disease
1:22     Marijuana smoking associated with periodontal disease
2:20     Even with other confounders risk rises
3:16     Aggressive management of type 2 diabetes
4:11     Multifactorial intervenation improves survival
5:30     Carotid endarterectomy
6:20     Procedures not necessarily curative
6:52     Pharmacogenetics or pharmacogenomics
7:52     Group with testing avoided allergic reactions
8:42     Can identify genetic basis
9:56     End

This week's topics include where to have a heart transplant, effects of aging, risks of being a sports fan, and treatment for aortic aneurysm.

0:15      Sports obeserver
1:02      Just when the German teams played
2:08      Men more than women
3:10      Where you should have a heart transplant
4:12      3000 people on heart waiting list
5:13      Most of the centers that do high volume
6:01      Abdominal aortic aneurysm
7:14      Okay to watch an aneurysm
8:05      Aging and diabetes
8:25      Telomeres
9:10       Exercise and telomere length
10:07     Exercise and anti-aging effect
11:04     Compared elderly diabetics with non-diabetics
12:00    Need to look for chronic diseases
12:28    End

This week's topics include combination cholesterol lowering medications, fitness as a predictor of heart-related death, gastric banding and diabetes, and oral contraceptives and the risk of ovarian cancer.

0:26      Vitorin and cholesterol lowering medications
1:26      Thickening of arteries
2:18      Expense of combinatioin
3:06      Can lower risk of death in infections
3:42      Level of fitness determines cardiovascular mortality
4:51      Men who were highly fit
5:09      Gastric bypass and obesity
6:32      Remind of types of surgery
7:30      Risk associated small
8:30      Reduction in weight produces remission
9:04      American Heart Association goal
10:23    Oral contraceptives and reduction in ovarian cancer risk
11:13    Protective benefit persists up to 30 years
12:30    End

This week's topics include modifying the immune response in congestive heart failure, testosterone supplements in men, palliative care guidelines, and which studies get published.

0:30      Inflammation in congestive heart failure
1:30      Can't find any other cause for the condition
2:30      Has to be given early
3:30      Testosterone supplements
4:35      Benefits mixed
5:33      Use of testosterone does not improve cognition
6:11      Which studies get published
6:49      94% of positive studies published
7:56      Need to interpret the larger picture
8:15      Palliative care
9:06      85% of healthcare dollars spent in last few weeks of life
10:13    Address early advance directives
11:22    Realistic expectations
12:58    End

0:29      FDA warning on bisphosphonates
1:23      Use of these medications increased
2:26      Alert their doctor to symptoms
3:00      Supplements with calcium/vitamin D
4:26      Supplements of vitamin D good?
5:30      Childhood allergic diseases
6:32      Maternal diet not a factor
7:40      Non-whole cow's milk formula
8:21      Weight gain with antipsychotic medications
9:23       Lowered weight by 7%
10:24     Older folks with behavioral issues
11:21      End

This week's topics include a wearable hemodialysis device, no benefit to bowel prep before surgery, too much use of cardiac catheterization, and recent FDA activity.

0:24     Hemodialysis device
1:24     Less fatigue with device
2:23     Continuous dialysis gentler
3:19     Causes gut to move
4:22     Most patients will undergo bowel prep
5:00     Heart attack results from blood flow compromise
6:00     May be measuring wrong thing re: heart attack treatment
7:09     Incorrect diagnoses
7:42     FDA mandates
8:25     Nonoxynol containing contraceptives
9:11     FDA decided no OTC sale of statins
10:13   How often do negative side effects occur?
11:52  End

This week's topics include face transplant follow up, flu and adenovirus concerns, diet and ovulation issues, and coronary calcium scans in women at low risk for heart disease.

0:26   Face transplant
1:20   Close lips and chew and swallow
2:22   Long line of transplants
3:17   Winter flu susceptibility
4:20   Most important to get vaccinated
5:18   Cold gets much worse
6:15   Ovulatory problems and diet
7:15    Refined carbs and trans fats
8:16   Lifestyle and dietary changes
9:25   95% of women considered 'low risk'
10:25 Moved from low risk to moderate or high risk
11:25 Women may want to consider test.

This week's topics include treatment of acute sinusitis, adverse events related to common medications in elderly, osteoporosis in men, and shift work as a risk factor for cancer.

0:30      Acute sinusitis
1:30      Antibiotics aren't effective
2:33      Develop resistant infections
3:43      Re-education needed
4:20      Commonly prescribed medications and adverse drug reactions
5:16      Hundreds of thousands of elderly taking them
6:17      Insulin, warfarin, digoxin
7:33      Osteoporosis in men
8:20      Man's age, weight and emphysema
9:20      Men need to be more awar
9:45      Shift work as cancer risk factor
10:34    Interrrupts melatonin, Circadian rhythm
11:48    End

This week's topics include a cardiovascular age score, the benefits of whole grains, a return of rickets, and too many X-rays in pregnant women.

0:28     Rickets is a vitamin D deficiency
1:10     Sunshine transforms vitamin D
2:12     Osteoporosis as adults
3:10     Cereal intake and diabetes risk
4:18     High glycemic index
5:14     Substitute whole grain bread
6:10     Important to reduce cardiovascular risk factors
7:07     People did modify behavior
8:04     X-rays in pregnant women
9:04     Alternative tests
10:03   Newer CT
11:42   End

This week's topics include using barbers and beauticians to address health issues, obesity's effect on PSA, the benefit of pedometers, and ultrasound for diagnosing ovarian massess.

Program notes:

0:21     Bringing healthcare to those who need it
1:28     Health risk from heart disease 30% greater
2:13     Automated machines
3:09     Obesity and cancer detection
4:10     Diluted PSA due to increased blood volume
5:00     Pedometers
6:00     Most effective when goals set
6:27     Ultrasound for ovarian cancer
7:18     Screening different than diagnosis
8:12     Annual exam important
9:04     Screening applied to populations at risk
10:06    End

This week's topics include the success of vaccines, depression among Iraq war veterans and hospitalized people, increasing rates of sexually transmitted infections, and the dangers of homeopathy.

0:30   Mental health issues in returning veterans
1:12   Six months post-return problems
2:10   Primary or secondary depression
3:10   Treatment both with medication and therapy
4:00   Homeopathy
5:00   Deaths due to substitution of homeopathic remedy
6:11   Vaccines have reduced disease and death
7:14   Small epidemics when vaccines aren't given
8:14   Increase in sexually transmitted diseases
9:22   Part of increase is recognitioin
10:09 Routine screening a good idea
10:39 End

This week's topics include use of automatic external defibrillators, heart risk of childhood obesity, 64 slice CT to look at the heart, and seasonal variation in blood pressure.

0:26     New studies from American Heart Association meeting
0:43     AEDs
1:26     Survival increased 4x
2:43     Easy way to administer lifesaving treatment
3:43     Schools, airports, malls
4:24     33-34% of kid obese
5:29     Thickened heart muscle
6:42     Obesity isn't an isolated health problem
7:50     Cardiac CT
8:44     Advantages of CT
9:40     Seasonal variations in blood pressure
10:28   Independent of climate
11:28   Measure blood pressure at home
12:08   Can adjust medications
13:01    End

This week's topics include screening kids for autism, incident findings on brain MRI, how long HIV has been lurking, and weight and cancer.

0:27    American Academy of Pediatrics recommends screening for autism
1:15    Subtle signs of autism
2:20    Interventions for autism
3:14    Familial occurrence
4:01    No suspected brain problem
5:12    Further testing or biopsy required
6:33    Vast majority benign
7:16    AIDS pandemic surfaced in 1981
8:16    Need to be vigilant about zoonoses
9:00    Mid 1970s, no one thought possible
9:44    Decrease your risk of cancer 15 to 30%
10:42   Not only talks about diet but specifics
11:29   Remain as lean as possible
12:09   All of us should maintain a lean weight
13:04   End

This week's topics include risks of hysterectomy, a rise in maternal deaths in the US, increasing numbers of women choosing double mastectomy, and improved devices to bridge people to transplant.

Program notes:

0:30 First increase in maternal mortality in decades
1:27 Convenience or previous C-section
2:18 Multifactorial cause for increase
3:37 Risk for subsequent pregnancy
4:13 Double mastectomy
4:45 Women with genetic abnormality
5:50 Still need routine follow up
6:30 Stress incontinence after hysterectomy
7:30 Hysterectomy overdone
7:57 Devices to support patients before transplant
8:58 LVAD
9:47 Artificial lung
10:24 Limited donor lungs
11:23 Lung transplant less successful
12:11 End

This week's topics include stents vs. bypass surgery, a new superbug causing ear infections in kids, MRSA, and Pap vs. HPV DNA testing for cervical cancer screening.

Program notes:

0:20     CABG or stents?
1:06     Patients who had CABG required fewer repeats
2:12     Medical therapy can be just as good
2:30     Superbug related to ear infections
3:22     Implies that antibiotic use may select for resistant bugs
4:25     Vast majority of kids resolve on their own
5:05     MRSA
6:07     Test all patients?
7:00     Difficult to completely eradicate
7:33     HPV and Pap smears
8:44     HPV DNA more sensitive
9:17     Some women clear infection
10:03   HPV status determines who needs Pap?
10:28   End

This week's topics include sudden death in athletes, preventing strokes in those at risk, a new medication for alcohol dependence, and the state of healthcare for kids.

Program notes:
0:20     Identification and treatment of TIAs
1:10     Decreased strokes by 80%
2:10     Level of healthcare kids receive
3:10     Didn't depend on socioeconomic status
4:26     Refer to specialist
4:48     Decreasing alcohol dpendence
5:38     GABA receptors involved
6:40     Alcoholism major global problem
7:41     Sudden death in athletes
8:43     Promontory symptoms
10:03   Discerning heart problem
11:10   Heart disease not only cause of death
12:05   Symptoms during event
12:40   End

This week's topics include when to take blood pressure, use of implantable defibrillators, CT vs. traditional colonscopy, and use of flu vaccine in elderly.

Program notes:

0:25     Men get defibrillators more often than women
1:18     Disproportion between men and women
2:24     Differences in patient acceptance
3:25     Not only limited to defibrillators
4:18     Blood pressure rise in doctor's office
5:18     Home blood pressure monitoring
6:20     Contradictory studies on flu vaccine in elderly
7:24     Vaccinate contacts of elderlyl
8:20     Virtual colonoscopy
9:10     Risk of perforation small
10:50    Insurance pays?
11:40    End

This week's topics include ASCO's plans for post-cancer care, more on HDL and LDL, a lack of harm related to vaccine preservative thimerosol, and questions about the flu vaccine in elderly people.

0:19   Thimerosol
0:47   Relationship to autism
1:19   Neuropsychological outcomes
2:00   Currently about 5000 lawsuits
2:51   Parents aren't vaccinating kids
3:42   There is no scientific evidence
4:03   Flu vaccine in elderly
4:52   Influenza starts downward spiral
6:00   Older people should still get flu shot
7:07   ASCO plan for post-cancer care
8:12   Patients survive years or decades
9:00   HDL and LDL
10:06 Medications used to raise HDL harmful
11:02 HDL does matter
11:40 End

This week's topics include using an osteoporosis drug for breast cancer prevention, a once yearly use of another osteoporosis drug to reduce repeat fractures, use of steroids to prevent preterm delivery, and the best way to control type 2 diabetes when insulin is needed.

Program notes:

0:30   Osteoporosis drug in breast cancer
1:37   Reduced risk of invasive breast ca
2:28   Taken daily
2:54   Hip fracture repeat prevention
3:55   Given once yearly
4:21   Steroid use in threatened preterm delivery
5:30   Children at age 2 with steroid exposure before birth
6:30   Slight increase in cerebral palsy and ADHD
7:00   Type 2 diabetes management
8:11   Assess sugar over previous 3 months
9:09   More tight control results in weight gain
10:00   Hemoglobin a1c better measure
11:12   End