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Johns Hopkins Medicine PodMed Archives - 2010

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PodMed is a weekly podcast looking at the top medical stories of the week for people who want to become informed participants in their own health care. With Elizabeth Tracey, director of electronic media for Johns Hopkins Medicine, and Rick Lange M.D., professor of medicine at Johns Hopkins and vice chairman of medicine at the University of Texas Health Science Center at San Antonio.

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Week of December 31, 2010

Related Blog

This week’s topics include accountable care organizations, vitamin D levels at birth and health, collaborative care for multiple diseases and depression, and sleepy surgeons and informed consent.

Program notes:

0:55  Please see blog for more information regarding studies discussed:
http://podblog.blogs.hopkinsmedicine.org/
1:29  Vitamin D levels in cord blood at birth
2:15  Two fold difference in respiratory infections
3:14  Should prompt randomized trial
3:28  Accountable care organizations
4:23  Meant to be a group integrated and accountable
5:23  May limit their care or increase costs to patients
6:16  Since 95% of all practices are five physicians or less
6:32  Chronic diseases and collaborative care
7:24  Medically supervised nurse coordinated their care
8:28  What happens when your surgeon is sleepy?
9:24  Need to minimize likelihood of sleep deprivation
10:24  Patient should be advised
10:56  End

 

Week of December 24, 2010

Related Blog

This week’s topics include some good fats, preventing falls in older adults, Echinacea for colds, and exercise and weight gain in middle life.

Program notes:

0:46   Exercise in prevention of weight gain in middle life
1:30   Those in high physical activity gained less weight
2:16   Thirty to sixty minutes per day only 11% do so
3:01   Certain fats are beneficial
4:06   Dairy products good source
5:04   Maybe switch back to dairy products
5:31   Lack of benefit to Echinacea
6:15   Randomized into four groups
7:12   Preventing falls in the elderly
8:07   Exercise and physical therapy, plus vitamin D supplements
9:03   Gait, balance or functional training
10:05 End

 

Week of December 17, 2010

Related Blog

This week’s topics include adrenal masses found incidentally, pain relievers in the elderly, when to take thyroid medication, and promoting colorectal cancer screening.

Program notes:

0:43  Thyroid medication timing
1:27  With evening administration there were higher levels of hormone in the blood
2:00  Feeble attempts to increase colorectal cancer screening
3:01  Only a few looked at web-based assessment
4:01  Even with intensive intervention 18% underwent screening
4:20  Adrenal gland incidental findings
5:01  Did they secrete hormone?
5:53  Pain treatment in elderly
6:50  Elderly individuals taking analgesics for arthritis pain
7:50  Codeine has higher mortality
8:31  Inform you as patient of risks
9:19  The safety of opioids in elderly questionable
10:22 End

 

Week of December 10, 2010

Related Blog

This week’s topics include sex in older men, aspirin and cancer prevention, new food allergy guidelines, and aspirin and screening for colorectal cancer.

Program notes:

0:30    Sex and older men
1:15    40 to 50% said sex was still important
2:01    We assume it’s not an important part of their life
2:15    Aspirin use and ability to detect blood in the stool
3:03    Fecal occult blood tests
3:57    Doubt it will replace colonoscopy
4:20    Aspirin and reduction of cancer risk
5:19    Role for inflammation in cancer
6:01    New food allergy screening guidelines
7:02    Still primarily a clinical diagnosis
8:02    May be associated with asthma
9:03    Increasing amounts of specific foo
10:02  End

 

Week of December 3, 2010

Related Blog
 

This week’s topics include routine HIV testing, variations in dosing in kid’s OTC medications, vitamin D and calcium recommendations from the Institute of Medicine, and mitochondria defects and autism.

0:32  Not HIV tested
1:17  Every adult should be tested at least once
early treatment
2:56  Variations in dosing in kid’s OTC medications
3:56  What percentage adhere to the guidelines?
4:52  Affects a large number of parents and kids
5:23  Institute of Medicine guidelines on vitamin D and calcium
6:23  Exposure to sunlight produces vitamin D
7:20  Bone health with bisphosphonates
7:33  Mitochondria and autism
8:33  Ten children with autism vs. 10 without
9:33  Males more likely to have than females
10:22  End

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 Week of November 26, 2010

This week’s topics include the best type of diet for weight maintenance, preventing HIV infection, fructose and gout in women, and dialysis 6 times per week.

Program notes:

0:25    Chemoprophylaxis in HIV negative men
1:21    Take men who are at risk and give them medicine ahead of time
2:12    Reduced risk by 44%
3:14    Limited study time and cost effectiveness unknown
4:00   Six times per week dialysis helps
5:02     Less likely to experience death, increased heart mass and better health overall
6:09    Weight maintenance
7:07    High glycemic index not good
8:02    The concept of high protein/low glycemic index valid
9:01    Gout in women and consumption of fructose
10:04  Both orange juice and

 

Week of November 19, 2010

Related Blog

This week’s topics include high caffeine/alcohol beverages, fish oil and the heart, nerve destruction technique in controlling high blood pressure, and leaving prescriptions at the pharmacy.

Program notes:

0:23   FDA crackdown on high caffeine/alcohol beverages
1:23  Wide awake drunk
2:14   FDA calling them illegal and mislabeled
3:23    Fish oil and the heart
4:17   Took previous heart attack patients
5:30    Lack of benefit in atrial fibrillation as well
6:18    Leaving prescriptions at the pharmacy
7:23   Cost of prescription drugs often a problem
8:18    Patients need to advise
8:32    Nerve destruction in high blood pressure
9:28   Catheters used to ablate nerves
10:40 End

 

Week of November 12, 2010

Related Blog

Vick’s VapoRub, PPIs, pregnancy and Plavix, supervised exercise and diabetes, and vitamin E and stroke.

Program notes:

0:30  Vick’s VapoRub
1:33  Parents had to use under their own nose
2:22  Don’t use in kids with seizures
3:06  Exercise in people with diabetes
4:05  Wasn’t reliant on one leader
5:04  Get involved in a group exercise activity
5:16  Proton pump inhibitors with clopidogrel and in pregnancy
6:12  Clopidogrel in those with stents or a previous heart attack
7:23  PPI safe in first trimester in pregnancy
8:28  Vitamin E and stroke
9:22  Increased risk of bleeding stroke
10:29 End

 

Week of November 5, 2010

Related Blog

This week’s topics include pain at the end of life in elderly people, a lack of benefit with implanted defibrillators, screening adolescents for depression, and fish oil and Alzheimer’s.

Program notes:

0:27   Fish oil and Alzheimer’s disease
1:22   Brain MRI tests
2:04   Other studies looked at normal people
3:02   Pain at the end of life
4:03   About a third have pain in two years preceding their death
5:01   Particularly difficult to treat in the elderly
5:25   Use of implantable defibrillators
6:20   Could not show a benefit in mortality
7:03   Screening for depression in teens
8:01   Nine point questionnaire
9:08   Can successfully treat
9:40 End

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Week of October 29, 2010

Recent Blog

This week’s topics include who responds to the anticlotting drug clopidogrel, the dangers of trying to kick an opiate drug habit, how to reduce your risk of colorectal cancer, and controlling high blood pressure with a visit to the barber.

Program notes:

0:30   The role of barbers in helping African American men manage blood pressure
1:31    In fact barbers were really the first physicians
2:18    Able to drop their systolic pressure
2:49    How lifestyle changes can reduce risk of colon cancer
3:43    If population adopted all five 25% reduction
4:35    A medication would be widely adopted
4:49    Risk of stopping an opioid addiction
5:50    10 fold increased risk of dying
6:35    All decrease respiration
7:53    Genetic variability and clopidogrel
8:50    Used in atrial fibrillation, acute coronary syndrome
9:40    Risk for clot is higher with stent placement
10:28  End

 

Week of October 22, 2010

Recent Blog

 

This week’s topics include home monitoring for blood thinning, risks of hormone replacement therapy, dental procedures and cardiovascular events, and the upside of stressful life events.

Program notes:

0:27   Does that which does not kill you make you stronger?
1:25   Several thousand people surveyed
2:16   Adverse life events can improve quality of life
3:20    Rather than see stressful events as interfering see them as benefits
3:43    Use of hormone replacement therapy and breast cancer
4:39   Mortality was increased in women who took HRT
5:40  It’s a very uncertain tradeoff
5:58    Cardiovascular events after invasive dental procedures
6:48   Anything that causes an inflammatory state increases risk
7:45   90% of dentists recommend stopping aspirin
8:03   Home monitoring of blood thinning therapy
9:00   Really wasn’t any safer
9:43   If you do it at home your machine must be calibrated
10:22 End

 

Week of October 15, 2010

Related Blog

This week’s topics include cancer screening for adult survivors of childhood cancer, screening people with HIV for cancer, advanced radiology tests in the ED, and maternal flu vaccination and benefits for the infant.

Program notes:

0:47   Reluctance of adult survivors of childhood cancer to undergo screening
1:44   Took 10,000 survivors and asked about screening
2:42   Patient needs to be aware and the system needs to help
3:32   HIV and cancer risk
4:30   Recommend HIV infected have same screening as uninfected
4:56   Maternal vaccination during pregnancy beneficial
5:43    41% reduction in infection in child
6:22    ED and radiation exposure due to assessments
7:24   About 6% a decade ago, now 15%
8:16   Oftentimes driven by patient
9:04   A lot of radiation exposure at a young age
10:04 End

 

Week of October 8, 2010

Related Blog

This week’s topics include dangers of low blood sugar, sleep and weight loss, public health effects of mass media, and compression only CPR.

Program notes:

0:45  Public health messaging
1:37 With regard to tobacco there is benefit
2:22 Advertising by industry may detract
3:28 Need comprehensive approach
3:44 Compression only CPR
4:44 Survival to hospital discharge higher
5:31 Hypoglycemia and its dangers
6:39 Increased risk of events but a marker, not a cause
7:25 Weight loss and sleep
8:22 Less sleep resulted in less weight loss
9:17 Don’t know long term impact
9:47 End

 

Week of October 1, 2010


Related Blog

This week’s topics include a lack of benefit to early detection of ovarian cancer recurrence, a urine test for a common pneumonia, benefits of breastfeeding, and a dialysis update.

Program notes:

0:27    Good news about dialysis
1:01    Peritoneal dialysis versus hemodialysis
1:37    Mortality the same
2:07    Only about 7% do so peritoneally
2:42    Benefits of breast feeding
3:22    Followed infants for a year for all types of infections
4:04    Emerging body of evidence supporting breastfeeding
4:50    Lack of benefit in early detection of ovarian cancer recurrence
5:36    Typically initiate treatment early when cancer marker rises
6:33    Early detection helpful in primary cancers
7:14    Need better markers
7:51    Urinary marker for pneumococcal pneumonia
8:33    About 40% of hospitalized patients had this infection
9:01    Can narrow down antibiotic therapy early
10:05  End

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Week of September 24, 2010

Related Blog

This week’s topics include screening for testicular cancer, percutaneous replacement of the aortic valve, a common anticlotting agent and antacid taken together, and promoting sunless tanning.

Program notes:

0:22  Screening for testicular cancer
1:20  Very treatable even when advanced
2:01  Treatment involves surgical removal of testicles?
3:01  Interaction between proton pump inhibitors and clopidogrel
4:03  Both prodrugs that require cleavage by same enzymes
5:02  Seen a lot of emerging data about PPIs and health outcomes
6:05  Start with conservative measures
6:38  Increased use of sunless tanning products
7:24  Went to a beach in Massachusetts
8:08  Percutaneous aortic valve replacement
9:02  Risk of dying without surgery 40-50%
10:22 End

 

Week of September 17, 2010

Related Blog

This week’s topics include PSA screening again, COPD worsening, asthma and cigarette smoking in kids, and the best strategy for avoiding clotting and bleeding in people at risk.

Program notes:

0:27   PSA screening and lack of benefit
1:12   Screening, does it change outcome?
2:03   If you’re at higher risk does it help?
2:36   PSA less than one you were very unlikely to develop cancer
3:28   Overdiagnosis of 30 to 70%
4:25   Chronic obstructive pulmonary disease, and worsening or exacerbation
5:25   What we don’t have is a way to identify who is at risk
6:17   Implies an underlying problem
6:35   Smoke-free legislation and childhood asthma hospitalizations
7:33   Hospitalizations used to be increasing
8:05   Best strategy for anti-clotting but not increasing bleeding
9:17   Certain medicine combinations increased the risk 4 times
10:14 End

 

Week of September 10, 2010

Recent blog

This week’s topics include patient and physician expectations of stenting, comparisons of surgical centers for bypass surgery on the heart, age-related responses to removing blockages of the carotid artery, and sleep and obesity in youth.

Program notes:

0:39    Consumer reports rating surgical centers
1:50    Society for Thoracic Surgery database
2:32    Identifies programs outside the norm
3:21    Informs consumers/patients
3:59    Patient and physician perceptions of stenting
4:44    Patients thought it would prevent heart attacks
5:45    Oftentimes we blame physicians for too many stents
6:28    Carotid stenting in the elderly
7:27    Older people may have more vulnerable arteries
7:54    Sleep and obesity
8:37    The less sleep you had the more likely you were to be obese
9:30    Hormones may affect appetite
10:16 End

 

Week of September 3, 2010

Recent blog
 

This week’s topics include the costs of prostate cancer treatments, management of adult ADHD, vitamin D and the genome, and underinsurance of kids.

Program notes:

0:35   Underinsurance of children
1:41   Health of our children impacts on health as adults
2:35   ADHD in adults
3:27   Cognitive behavioral therapy or CBT
4:30   Pediatric referral
4:44   Vitamin D and the genome
5:43   Probably show a similar result with other vitamins
6:18   True costs of prostate cancer treatment
7:24   Comparative effectiveness studies and costs
8:25   Look at a number of factors before deciding on therapy
9:19   Active surveillance results in fewer side effects
10:20 End

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Week of August 27, 2010

Recent blog
 

This week’s topics include the genetics of a common corneal problem, the egg recall, health consequences of oil spills for fisherman, and drug treatment for herpes and birth defects.

Program notes:

0:24  Egg recall
1:25  Usually goes away on its own
2:12  Other countries give vaccines to hens
3:12  Eggs should be destroyed
3:30  Oil spill consequences
4:30  Air exhaled had increased inflammatory markers
5:12  Acyclovir and birth defects
6:11  Does not appear to be increased risk
6:33  Fuch’s corneal dystrophy
7:16  Leading cause of cornea becoming cloudy
8:15  Two gene copies increase risk by 3000%
9:02  Are different medications to perhaps affect this
9:45  End

 

Week of August 20, 2010

Recent blog

This week’s topics include tai chi and fibromyalgia, early palliative care benefits, sponges to prevent infection in heart surgery, and delays in treatment for heart attack and mortality.

Program notes:

0:37   Tai chi and fibromyalgia
1:38   Mind body practice originating in China
2:30   Beneficial in preventing falls in elderly
3:25   Not a blinded study
3:39   Early palliative care in lung cancer patients
4:29   Do patients feel better and how does it affect survival?
5:33   151 patients randomized
6:32   Use of a sponge to prevent infections in cardiac surgery
7:28   It didn’t help
8:25   System delay and mortality in heart attacks
9:34   Time delays linearly related to mortality
10:49   End

 

Week of August 13, 2010

Recent blog
 

This week’s topics include pregnancy after miscarriage, taking medications to prevent a second stroke, decline in hospital associated MRSA, and more.

Program notes:

0:24    BMJ study on timing of pregnancy after miscarriage
1:21    Women who became pregnant earlier had better outcomes
2:19    Good news because it may reduce interval for pregnancy
2:45    Timing of dialysis for kidney disease
3:32    Do it early or late? Later no adverse impact
4:35    Decline of MRSA
5:30    To what do we attribute decline?
6:27    Vigilance is still required
7:22    Medical tourism promotes
8:06    About 25% of those who’ve had a stroke don’t take meds with those who did
10:28   End

 

Week of August 6, 2010

Recent blog

This week’s topics include replacing a heart valve through the skin, the long term effects of childhood hunger, the later life consequences of younger life cholesterol problems, and suicide risk and antiseizure medications.

Program notes:

0:23  Childhood hunger and it’s health consequences
1:18  Female headed households about 40% are affected
2:17  Problem is growing and we must tackle it societally
3:17  Ask children about food intake
3:43  Lipid levels early in life and its impact later
4:42  Average cholesterol of 115-125 and that has an impact
5:30  Instead of waiting we need to intervene early with diet and exercise
5:47  Suicide risk and medicines used to treat seizures
6:46  People take these medicines for a number of reasons
7:35  When taking these medicine for seizures no increased suicide risk
7:45  Replacing aortic valve through skin
8:43  Valve placed through blood vessel
9:14  Two different valves being tested in US
10:05 End

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Week of July 30, 2010

This week’s topics include prostate cancer with low PSA, complications of obesity surgery, compression only CPR, and heart problems in childhood cancer survivors.

Program notes:

0:22   Chest compression only CPR
1:24   Survival the same whether breaths are used or not
2:24   Survival still remains low so bystanders need to start immediately
2:50   Heart problems in people who’ve survived childhood cancers
3:50   Helps to tailor treatments today to avoid long term problems
4:46   Complications of obesity or bariatric surgery
5:42   Helps establish the risks and benefits
6:42   Gastric banding had fewest complications
7:15   PSA levels and prostate cancer
8:14   Low PSA still had aggressive treatment
9:09   Active surveillance in lieu of treatment
10:27 End

 

Week of July 23, 2010

Recent blog

This week’s topics include loss of smell due to zinc, surgery for ACL tears, HDL cholesterol goals, and no seizures related to whooping cough vaccine.

Program notes:

0:31   Good news about whooping cough vaccine
1:24   We’ve become blasé about these diseases
2:20   When people come into the ED a booster is recommended
3:04   Management of anterior cruciate (ACL) tears
4:04   Rehab and delayed surgery did just as well
5:02   Need longer follow up
6:06   More data from the JUPITER trial
7:02   HDL didn’t influence outcomes
8:03   This was a primary prevention setting
8:30   Zinc and loss of smell
9:32   Showed that it is related
10:53 End

 

Week of July 16, 2010

Related Blog

This week’s topics include who gets treated for end stage renal disease, vitamin D and cognitive function, a new medication for obesity, and cholesterol screening in youths.

Program notes:

0:26   Lorcaserin for weight loss
1:22   Differences in serotonin receptors
2:21   Obesity is multifactorial
2:46   Lipid screening in children underutilized
3:40   75% of kids would be screened
4:42   Increase activity and restrict diet
4:50   Regional differences in treatment of end stage renal disease
5:50   Profound differences in practice
6:50   Need to have discussion with patients
7:25   Vitamin D and cognitive decline
8:19   Low levels of vitamin D more likely to experience decline
9:19   Don’t know supplements improve any of these things
10:27 End

 Week of July 9, 2010

Related Blog
This week’s topics include use of erectile dysfunction drugs and sexually transmitted infections, patient help in high blood pressure control, depression and Alzheimer’s risk, and telomeres and cancer risk.

Program notes:

0:41   Telomere length and cancer risk
1:30   Short telomeres have higher cancer risk and more fatal ones
2:34   Don’t know exactly why
3:10   Association between depression and Alzheimer’s disease
4:11   Twice as likely to develop dementia if depressed
5:13   Home blood pressure monitoring and drug dosage adjustment
6:20   Engaging patient in their own care
7:17   Somewhat of a niche
7:41   Men who use erectile dysfunction medications
8:41   2.5 times more likely to have a sexually transmitted infection
9:32   Increasing incidence of STIs in older populations
10:27 End

 

Week of July 2, 2010
 

Related Blog

This week’s topics include the benefits of prostate cancer screening, new technology for managing insulin delivery, avoiding diabetic retinopathy and testosterone in older, frail men.

Program notes:

0:25  Testosterone supplements in older, frail men
1:28  It’s a relatively small study but showed an increase in cardiovascular events with supplements
2:35  Confined to this population
2:59  Does prostate cancer screening have a benefit?
3:59  Routine screening or not
4:40  Still going to be overall concern about increased unnecessary procedures
5:41  New technology for insulin management
6:42  Does it improve hemoglobin A1c?
7:40  Take a look at what this looks like on our blog
8:28  Prevention of diabetic retinopathy
9:28  Three strategies tested but glucose control and statins helped
10:20  It’s difficult to get patients to comply
10:56  End

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Week of June 25, 
2010

Related Blog

This week’s topics include hearing loss related to mp3 players, homocysteine reduction isn’t helpful, two old diabetes drugs delivered in a novel way, and a new type of diabetes drug.

Program notes:

0:23   Hearing loss related to mp3 players
1:19   Significant hearing loss even at 50% level
2:24   Long term hearing loss?
3:16   Listen at lowest possible volume
3:29   Reducing homocysteine and second heart attack
4:29   Even though homocysteine was lowered it didn’t reduce risk
5:16   Two studies on diabetes medications used in a different way
6:16    Multiple problems with insulin
7:14   Once a week injection of insulin regulator
8:22   Novel diabetes medication
9:22   Allows sugar to be excreted in urine
10:22 End

 

Week of June 18, 
2010

Related Blog

Common high blood pressure drug and cancer, gastrointestinal bleeding and NSAIDs, testosterone levels in older men, and racial variation in hemoglobin A1c.

Program notes:

0:27    NSAIDs and gastrointestinal bleeding
1:35   Alternative to cox-2 inhibitor, diclofenac
2:33   Would you still start with acetaminophen?
2:57   Angiotensin receptor blockers and cancer risk
4:00   Incidence in ARB group
5:00   Don’t have to be the first drug tried
5:14   Racial difference in measure of diabetes indicator
6:15    Target values for management
7:10    Testosterone levels in aging men
8:05    How can we correlate symptoms with blood testosterone levels?
9:10    Is low testosterone a problem?
10:22 End

 Week of June 11, 
2010


Related Blog
This week's topics include a new use for a drug for gout, prescription drug abuse among US children, dangers of nonsteroidal antiinflammatory drugs, and body checking in youth hockey.

Program notes:

0:31   Hockey and injuries in children
1:21   Body checking allowed in some leagues but not in others
2:13   Probably inappropriate for young children
2:30   Prescription drugs for recreational use
3:22   Where are they obtained?
4:13   False belief they're safer than street drugs
5:02   Use of allopurinol, a drug for gout, in treatment of angina
6:03   What it probably does in make more energy and oxygen available
7:02   Although it may help angina but may not prevent heart attacks
7:50   NSAIDs and heart risk
8:50   Some raised risk by about 90%
9:46   Cardiovascular risk small to begin with in this population
10:30  Absolute risk is still low
11:26  End
 Week of June 4, 
2010


Related Blog
This week’s topics include benefits of teeth brushing, upside of antiretroviral therapy for partners, time to treatment after heart attack, and group medical appointments.

Program notes:

0:20   Teeth brushing and heart attacks
1:21   Over eight years how many heart attacks?
2:10   Inflammation and cardiovascular disease
2:29   Treatment of one partner’s HIV protects the other
3:29   CD4 counts low then therapy used
4:19   Group medical appointments
5:18   Seven or eight patients and health care team
6:23   Timely treatment of heart attack
7:23   Go to closest hospital
8:21   Fast therapy is most important
9:21   Not a big fan of public information
10:13 End

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 Week of
May 28, 
2010


Related Blog

This week’s topics include metformin and vitamin B12 deficiency, drowning prevention, eyeglasses and falls in the elderly, and sugar containing soft drinks and blood pressure.

Program notes:

0:23   Drowning prevention
1:12   Perfectly fine for children younger than 4 to take swimming lesions
2:10   How big a problem drowning continues to be
3:16   Children who know how to swim can still drown
3:28   Sugar sweetened beverages and blood pressure
4:24   Reduced intake results in modest drop in blood pressure
5:25   There was a dose relationship
5:37   Eyeglasses and fall incidence
6:30   Multifocal or single focus glasses
7:21   Active older adults should use single focus outside
7:44   Metformin and declining vitamin B12 levels
8:45   Need to be following B12 levels in those on metformin
9:45   Increasing use of metformin
10:40 End

 Week of 
May 21, 
2010


Related Blog
Antibiotic use and resistance, important causes of depression, sildenafil for pulmonary fibrosis, and pesticide levels and ADHD

Program notes:

0:40   Antibiotic exposure and bacterial resistance
1:29   Twelve times more likely to develop resistant bugs
2:28   Duration of therapy needs to be as short as possible
2:44   Pesticides and ADHD
3:35   Higher level of urinary metabolites correlated with higher ADHD incidence
4:35   No good way to see if organophosphates are present
5:14   Two studies in JAMA relating depression to two different circumstances
6:21   One in ten fathers develop depression
7:00   Fifty percent of men who had traumatic brain injury develop depression
7:27   Sildenafil or Viagra for pulmonary fibrosis
8:27   Originally developed for cardiac conditions
9:28   Rogaine and Latisse
10:22 End

 

Week of 
May 14, 
2010

Related Blog

This week’s topics include overuse of proton pump inhibitors, modest benefit of fibrates, nut consumption and cholesterol levels, and food allergies.

Program notes:

0:40   Food allergies- how many people really have them?
1:34   Food allergies increased? Don’t know
2:40   We need to really determine how best to diagnose
3:00   Nut consumption and cholesterol profile
4:00   About 3 ounces of nuts four times a week
5:01   Nuts don’t cause weight gain
5:36   Fibrates and cardiovascular disease
6:26   Fibrates have modest benefit in those with high triglycerides
7:07   Proton pump inhibitors and adverse side effects
8:07   Between fifty and seventy percent of people don’t need them
9:10   People remain on them after hospital discharge
10:01 Lots of interventions rather than PPIs
10:29 End

 

Week of 
May 7, 
2010

Related Blog

This week’s topics include diagnosing celiac disease, a new stent, risk of Alzheimer’s in caregivers, and follow up after discharge for congestive heart failure. And watch our YouTube!

Program notes:

0:23   We have a YouTube:
http://www.youtube.com/watch?v=0g7SiX9E5_E  
1:10   A risk of dementia in those who care for people with Alzheimer’s
2:14   Environmental factor?
3:15   Vigilance in caring for caregivers
3:37   Benefit of early follow up after discharge for heart failure
4:40   A new type of stent for heart disease
5:40   More expensive than older ones
6:44   Individual with persistent symptoms do help
7:08   Celiac disease
8:07   Immune reaction to wheat proteins
9:10   Iron deficiency anemia
10:44 End

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Week of April 30, 2010

Related Blog

This week’s topics include the benefits of sigmoidoscopy, vitamin B, diabetes and kidney problems, deep brain stimulation for Parkinson’s disease, and assessing older drivers.

Program notes:

0:31    Driving Miss Daisy
1:33    In US a real problem since public transportation isn’t very good
2:24    Twice as likely to have accidents when cognitively impaired
3:25    What should family members do?
3:54    Deep brain stimulation in Parkinson’s disease
4:54    Deliver electrical signals that improve muscle symptoms
5:47    20% of people who did this had serious complications
6:04    Vitamin B can be harmful
7:04    High dose of vitamin B resulted in higher rates of strokes, etc.
7:48    Colon examination and prevention of colon cancer
8:43    Last part of the colon is the sigmoid
9:33    Can prevent about 50% of colon cancers
10:16 End

 

Week of April 23, 2010

Related Blog

This week’s topics include head lice treatment, overcoming jet lag, commotio cordis, and health effects of hot weather.

Program notes:

0:36   Jet lag management
1:25   Take medications and other strategies
2:25   Melatonin use
3:00   Head lice treatment
4:01   For resistant lice, change shampoo or oral medication?
5:02   Commotio cordis
6:01   Common cause of sudden death in athletes
7:02   Even with protection is this can still be a problem
7:38   Health effects of heat
8:39   Wear light clothing and seek air conditioning
9:31  As heat stroke develops people lose sensation
10:38 End

 

Week of April 16, 2010

Related Blog

This week’s topics include CMV testing in newborns, open versus endovascular repair of aortic aneurysm, managing atrial fibrillation, and cost barriers to treatment of heart attacks.

Program notes:

0:31   Screening of newborns for cytomegalovirus or CMV
1:20   Missed 80% of the time with dried blood spot screening
2:21   Dried blood spot screening
3:00   Health insurance status and heart attack treatment
4:08   Those with financial concerns delayed their treatment
5:10   People with financial concerns delay other types of treatment
5:28   Management of atrial fibrillation
6:28   No outcome difference but many more visits for tight control
7:28   Third study looking at tight control and finding no more benefit
7:53   Repair of aortic aneurysm
8:42   Open surgery very durable
10:00 End

 

Week of April 9, 2010

Related Blog

This week’s topics include obesity genes and exercise, lung function post 9/11, mothers and infant sleeping position, and more complex spine surgery.

Program notes:

0:30   Lung function after 9/11 rescue
1:30   Huge amount of particle exposure and long lasting
2:30   Long term follow-up should continue
2:52   More older people having more complex operations
3:49   Complex surgeries increased 15 fold
4:42   Patients need to question need for complex operation
5:42   Obesity genes and exercise
6:42   Kids who exercised overcame genes
7:55   Mothers and infant sleeping position
8:45   African Americans more reluctant to sleep on back
9:45   Within first month of child’s life must hear
10:22 End

 Week of April 2, 2010

Related Blog

This week’s topics include factors related to happy partners, the safety of parachutes, placebos, and knuckle cracking.

Program notes:

0:27   The perfect wife
1:24   Optimal allocation of spouses
2:24   With mathematical models find the perfect wife
2:54   Knuckle cracking
3:42  Systematically cracked left but not right hands
4:42  A lot of finger pointing
5:45  Parachute safety
6:41 No randomized controlled trials
7:34 We want them to believe that jumping without a parachute is problematic
8:21 Different categories of placebo
9:27 Normally we wouldn’t identify but they wanted to hear their names
10:15 The more expensive the placebo the greater the impact
11:13 End

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Week of March 26, 2010

Related Blog

This week’s topics include weight gain and exercise in middle aged women, BNP and congestive heart failure, the clinical impact of a measure of kidney function, and kids and food allergies.

Program notes:

0:20 Food allergies in kids
1:20 45% of kids needed epinephrine and one in eight needed two doses
2:12 Better tolerated in children
3:11 Use of food itself in treating allergy
3:37 Weight gain in middle life and exercise
4:30 60 minutes seven days a week
5:32 Utility of kidney function estimate
6:28 Seventy percent increase in referral to a kidney doctor
7:06 Congestive heart failure and BNP
7:31 Brain natriuretic peptide
8:30 Increase medications to maximal doses
9:25 Is being used with other biomarkers to predict risk
10:15 End

 

Week of March 19, 2010

Related Blog

This week’s topics include management of secondary symptoms of Parkinson’s disease, utility of tight blood pressure and cholesterol control in people with type 2 diabetes, and hand bacteria.

Program notes:

0:25   Hand bacteria
1:05   Only about 13% shared among individuals
2:01   Lacking blood samples or others
3:03   Flora are abundant
3:15   Two studies looking at tight management in diabetes
4:10   Most of us want blood pressure below 140 but 130 in diabetes
5:01   Increased side effects and cost but no benefit
5:31   Lipid modifying also doesn’t help
6:31   Old standbys weight loss and exercise
7:04   Parkinson’s disease symptom management
8:02   Very debilitating symptoms besides movement
9:02   Medications don’t stop disease progression
10:01 New feature to a single issue
10:59 End

 

Week of March 12, 2010

Related Blog

This week’s topics include aging and sexuality, coronary artery assessment in those without symptoms, fluctuations in blood pressure and stroke, and the benefits of alcohol in weight maintenance for women.

Program notes:

0:26   Sex and healthy aging
1:22   At age 55, the sexually active life expectancy
2:14   High blood pressure and its fluctuations
3:14   Diuretics and calcium channel blockers decrease swings
4:15   Give more information about stroke risk
5:14   Coronary artery assessment when no symptoms exist
6:14   Don’t need additional therapy
7:12   Many times patients ask for testing
8:01   Women who consume moderate amounts of alcohol
9:04   Chance of being overweight only 30% of that for nondrinkers
10:09 End

 

Week of March 5, 2010

Related Blog

This week’s topics include screening athletes for cardiac problems, salt, aspirin to prevent cardiovascular events, and treating blockage of the carotid arteries.

Program notes:

0:40   Salt intake and health effects
1:34   Age 50, 90% of us have high blood pressure
2:27   In my mind it’s always been a problem
3:06   Benefits of screening athletes for heart disease
4:03   Would cost about 2 billions dollars
4:21   Aspirin for primary prevention
5:21   Can aspirin prevent events?
6:22   Treatment of carotid blockage
7:26   Lancet article shows that stents had higher complications
8:24   Stents are disappointing in some cases
9:24   End

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Week of February 26, 2010

Related Blog

This week’s topics include Avandia concerns, poor treatment of high blood pressure, cognitive decline after hospital stays in the elderly, and management of muscle cramps.

Program notes:

1:02   FDA report on Avandia
2:02   Use of these agents to begin with
3:01   Lifestyle recommendations important
3:55   Institute of Medicine’s report on high blood pressure
4:56   2.3 grams of sodium per day recommended
5:50   JAMA study on cognitive decline after hospitalization
6:50   Hospitalization resulted in increased risk of dementia
7:45   People who have hospitalization or anesthesia at risk
8:29   Look at use of quinine and other treatments for muscle cramps
9:23   Vitamin B complex may help
10:22 End

 

Week of February 19, 2010

Related Blog

This week’s topics include King Tut and his pedigree, aspirin and breast cancer recurrence, assessing vegetative states, and the placebo effect.

Program notes:

0:25   Assessing vegetative states with MRI
1:27   Image portions of the brain that were involved in movement
2:20   Doesn’t tell about streams of consciousness
3:25   One of these patients were in locked in state
3:44   Placebo effect
4:43   How we can use it clinically
5:25   King Tut and mummy pedigrees
6:24   Bones in his feet had prematurely died
7:18   Aspirin and breast cancer recurrence
8:16   Women who took two or more per week decreased their risk
9:19   Helpful in secondary capacity
10:29 End

 Week of February 12, 2010

Related Blog
This week’s topics include preventing childhood obesity, lap band surgery in teenagers, antidepressants and breast cancer drugs, and utility of MRI in reducing reoperations for breast cancer.

Program notes:

0:45   Interaction between an antidepressant and tamoxifen
1:45   A lot of depression in women with breast cancer
2:45   Other medications can be used
3:41   Utility of MRI in helping plan breast cancer surgery
4:45   Did not decrease the risk of reoperation
5:47   Refine the use of MRI
6:02   Gastric banding in obese teenagers
7:08   Less risky and doesn’t have metabolic problems
7:51   Prevention of childhood obesity
8:45   Decrease TV, increase sleep and eat dinner with family
9:31   Only one in seven involved in all three
10:15 End

 

Week of February 5, 2010

Related Blog

This week’s topics include multiple studies on exercise, weight loss, strength training and diet and their effects on multiple measures in Archives of Internal Medicine.

Program notes:

0:53 Fatness and fitness
1:29 As we age cognitive function declines but exercise slows down
2:09 Whole range of resistance training
3:01 Moderate to high intensity exercise fine
3:12 Exercise in midlife and mortality
4:11 Older women increased bone density and decreased falls
5:00 DASH diet and its impact
6:01 About 70% stayed with the diet
6:17 Extremely obese people and weight reduction
7:16 A chronic disease
8:16 Catch it early on and address it
9:10 End

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Week of January 29, 2010

Related Blogs

This week’s topics include managing atrial fibrillation, use of antibiotics in ICU patients, how low should blood sugars be held in critically ill people, and avoiding the most common cause of severe childhood diarrhea.

Program notes:

0:30   Email response
1:10   Diarrhea related to rotavirus infection
2:10   Vaccine effective but logistic problems
3:10   Oral rehydration can help but isn’t available
3:55   Steroids and insulin in patients in ICU
4:48   Intensive sugar lowering
5:30   Trying to get blood sugar as low as possible not helpful
5:44   Atrial fibrillation treatment
6:42   70% treated with ablation were successful
7:37   This therapy does have associated risks
8:00   Reducing antibiotic use in ICU
9:00   Procalcitonin used to decide when to discontinue antibiotics
9:44    End

 

Week of January 22, 2010

Related Blogs

This week’s topics include obesity update data, warning on opioids, sudden death due to cocaine use, and telomeres and heart disease.

Program notes:

0:23 Ask all listeners to send an email to etracey@jhmi.edu
1:01   Teleomeres and heart disease
2:03   The more cell divides, the shorter the telomeres
3:00   Fish oil preserves telomere length
3:16   Update on obesity and screening for it
4:16   Beginning at age 6 children should be screened for obesity
5:13   Obesity carries same risk of premature death as smoking
5:48   Pain relievers and overdose risk
6:44   Reason to give these medications is to return people to a normal lifestyle
7:26   Cocaine use and sudden death
8:31   Recreational use and small amounts
9:25   Are some medicinal uses
10:36 End

 

Week of January 15, 2010

Related Blog

This week’s topics include mammography update, hormesis, infectious disease and stroke risk, and no benefit to a blood product in tendon repair.

Program notes:

0:20   Mummy medicine
1:00   Lead salt medicinal qualities
2:01   Hormesis describes the phenomenon where small amounts are okay
3:00   Impact of infectious disease on stroke risk
4:00   What can we do about chronic low level disease?
4:48   Disappointing results in treatment of tendon problems
5:48   Platelet rich plasma injection
6:27   Shows no benefit
6:40   Changing guidelines for mammography
7:29   Evidence based medicine
8:35   For middle aged women every two years
9:52   End

 

Week of January 8, 2010

Related Blog

This week’s topics include smoking and type 2 diabetes risk, adult immunizations, depression severity and treatment, and prevention of surgical site infections.

Program notes:

0:31   Two studies in NEJM on reducing surgical site infection
1:18   Chlorhexidine solutions superior
2:15   Decrease staph infections by 40%
2:46   Adult immunization schedule
3:49   Primary care physicians may forget
4:27   Antidepressants and severity of depression
5:30   Depression rating scale and medication benefit
6:26   Side effects associated with depression meds
7:10   Development of type 2 diabetes and smoking risk
8:10   Smoking has other deleterious side effects
9:02   Risk goes up somewhat
9:56  End

 

Week of January 1, 2010

Related Blog

This week’s topics include an increase in autism disorders, no help with telemedicine, how many household contacts become infected with H1N1 and the risk of blood clots following surgery.

Program notes:

0:34   Household contacts and H1N1
1:24   Less than one third of contacts become infected
2:19   Oftentimes several peaks of flu infection
2:52   Million women study and blood clots after surgery
3:32   Much more commonly than we suspected
4:30   At least three months after surgery increased risk
5:32   Prevalence higher than we suspect
6:20   Higher incidence of autism
7:15   Increase may be due to better diagnosis or frank increase
7:43   Increased surveillance doesn’t help
8:43   Disconcerting because intensivists usually help
9:29   Should transfers be considered?

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