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Johns Hopkins Medicine News Roundup

What is PodMed
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PodMed

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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Archived 2012 podcasts can be found below.

201320122011201020092008200720062005    
JanFebMarAprMayJunJulAugSepOctNovDec
  
 

Week of December 31, 2012

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This week's topics include no benefit seen with managing micronutrients in dialysis patients, follow-up relative to ablation in atrial fibrillation, atherosclerosis in servicemen, and the dangers of transfusion in people who've had a heart attack.
Program notes:
0:49 Presence of atherosclerosis in military 
1:47 45 to 77% of men in the past had it
2:36 What we're doing appears to be paying off
3:35 Any help with change in diet?
3:55 Blood transfusions in people who've had a heart attack
4:55 Routinely or liberally giving transfusions should not be encouraged
5:53 Lots of risks associated with transfusions
6:45 People on hemodialysis maybe look at minerals in blood?
7:45 Didn't work to lower calcium and other micronutrients
8:40 Atrial fibrillation and ablation
9:40 About 60% of episodes occur without symptoms
10:31 End
 

Week of December 24, 2012

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This week’s topics include Rudolph’s nose, treatment for whiplash, hypnotic medications in those with insomnia, and antibiotics for lower respiratory tract infections.
 
Program notes:
 
0:36 Whiplash treatment
1:34 Gave therapy and evaluated neck disability
2:32 In fact will resolve over time
3:18 Antibiotics for lower respiratory infections
4:18 Randomized to amoxicillin or placebo
5:20 Cough persists for several weeks
6:01 Hypnotic medications for insomnia
7:05 Almost 4400 participants
8:05 Manage insomnia by other means
8:31 Rudolph’s nose
9:30 Protect the nose from freezing
10:34 End
 

Week of December 17, 2012

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This week’s topics include outcomes following compression-only CPR, electronic interventions for weight loss and management, keeping teens from smoking, and managing sleep apnea at high altitude.
 
Program notes:
 
0:32 Strategies to stop teens from smoking
1:32 Once smoking began it was hard to stop
2:35 Legal constraints
3:03 Compression only CPR
4:04 How did survival and intact neurological function fare?
5:02 Better than conventional CPR
5:32 High altitude treatment of obstructive sleep apnea
6:32 Adding acetazolamide
7:34 Sometimes central problem rather than obesity
7:53 Electronic interventions for weight loss and management
8:53 Technology more effective than traditional methods
9:40 Conducted in technology naïve folks
10:33 End
 

Week of December 10, 2012

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This week's topics include Viagra plus testosterone, monster caffeine drinks, alcohol and calories, and ADHD medications and criminality.

Program notes:

0:28 Alcohol and calories
1:28 Highest 20 to 40 years of age
2:28 Consume alcohol in moderation
3:01 Caffeinated beverages and health impact
4:03 Study isn't ethical
5:03 Pay attention to how much caffeine is in them
6:03 Using Swedish national registry
7:02 Mechanism of reduction?
8:02 Do you get long acting effects?
8:26 Viagra and testosterone
9:25 Doesn't augment Viagra
10:10 End
 

Week of December 3, 2012

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This week’s topics include brain disease and soccer, fasting to test cholesterol, patient expectation from screening tests, and survival in in hospital cardiac arrest.
 
Program notes:
 
0:39 Head injury in soccer players
1:30 Looked at white matter with MRI
2:36 Helmets in soccer?
3:18 What are patients expecting when they have a screening test?
4:20 What shall we do with this information/
5:31 Change expectations?
5:37 Fasting cholesterol not necessary
6:33 Very little difference with fasting
7:33 Also true with HbA1c
7:50 Survival trends in in hospital cardiac arrest
8:46 Significant increase in survival
9:50 End
  
 

Week of November 29, 2012

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This week’s topics include repair of abdominal aortic aneurysm, 30 years of mammography data, the impact of health screenings, and adolescents and muscle building.
 
Program notes:
 
0:26 Adolescents and muscle building
1:26 Use of muscle building agent
2:25 Really cultural
3:02 Routine health checks don’t improve mortality
4:02 No benefits with regard to a range of health outcomes
5:02 Thirty years of mammography data
6:01 Lots of overdiagnosis of women
6:43 Abdominal aortic aneurysm repair
7:41 Mortality was the same whether open surgery or endovascular repair
8:38 Biggest bang for buck is risk factor modification
9:32 End
 

Week of November 19, 2012

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This week’s topics include steroid injections for sciatica, fungal injection following steroid injection, probiotics for Clostridium difficile infection, and recurrent versus relapsing Lyme disease.
 
Program notes:
0:25 Steroid injections for sciatica
1:22 Number of Medicare recipients who got injections doubled
2:22 Intervention for back pain often unnecessary
2:54 Fungal infection following injection for back pain
3:50 Present with severe headaches
4:50 Prolonged time to develop infection
5:17 Probiotics for C. difficile infection
6:20 Any good evidence for prevention?
7:26 Recurrent versus relapsing Lyme disease
8:23 Very specific molecular typing
9:20 Sometimes immune response continues
10:15 End
 

Week of November 12, 2012

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This week’s topics include exercise for knee osteoarthritis, a comparison of two diabetes drugs and cardiovascular risk, patient expectations of chemotherapy and rescreening methods after a negative colonoscopy.
 
Program notes:
 
0:44 Rescreening methods after a negative screening colonoscopy
1:44 Used a microsimulation model
2:45 Other methods even more sensitive under development
3:07 Managing knee pain due to osteoarthritis
4:10 No adverse effects, needed to do it regularly
4:39 Two common diabetes medications and cardiovascular disease
5:40 Metformin has a number of other benefits
6:09 Patient expectations about chemotherapy
7:05 May not understand that therapy will not be curative
8:04 Overestimate benefits and underestimate costs
9:04 Advance directives
10:00 Encourage practice
10:44 End
 

International Medical Headlines: October 2012

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Program notes:
 
0:15 Benzodiazapines in elderly people
1:17 A third of elderly people take them
2:06 Fifty percent increased risk of dementia
2:36 Screening for diabetes not helpful in preventing cardiovascular death
3:35 Screening should result in prevention of diabetes complications
4:36 We know from very good studies that we can prevent diabetes
5:01 Public response to the H5N1 pandemic
6:01 Least willing to be vaccinated
7:02 These kinds of data useful to target interventions
7:30 Tocolytic therapy for preterm delivery
8:35 Prostaglandin inhibitors
9:34 End
 

Week of November 5, 2012

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This week’s topics include an effective treatment for head lice, smoking in women, a mumps outbreak, and stroke and omega-3 fatty acids.
 
Program notes:
 
0:22 Mumps outbreak
1:20 Vast majority vaccinated
2:21 Didn’t occur in less intensive contact
3:21 Less intensive contact
3:41 Ivermectin for head lice
4:40 Day 2, 95% eradication
5:40 Hold off use to avoid resistance
6:00 Stroke and fish consumption
7:01 Increased risk in those who had had a stroke
7:47 Mortality and cigarette smoking in women
8:50 Women who smoked died 11 years earlier
9:43 Studies don’t really have much impact
10:39 End
  
 

Week of October 29, 2012

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This week’s topics include the dangers of norovirus infection, peripheral arterial disease in men, the impact of studies on clinical outcomes, and neighborhoods and bystander-initiated CPR.
 
Program notes:
 
0:31 Studies and their impact on clinical outcomes
1:30 Small trials showed large treatment effect
2:32 Severe shock and lung injury, ECMO helps
2:53 Diarrheal illness in older folks
3:52 Over 300 nursing homes with 400 norovirus outbreaks
4:52 Oral hydration would reduce mortality
5:31 Neighborhood composition and bystander CPR
6:30 Only about one-fourth of individuals got CPR
7:27 Need to target neighborhoods
8:08 Peripheral arterial disease in men
9:06 Same risk factors for cardiovascular disease
10:15 End
 

Week of October 22, 2012

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This week’s topics include the effects of multivitamins, reusing implanted cardiac devices, sleep and fat, and a new coronavirus.
 
Program notes:
 
0:31 Reusing implantable cardiac devices
1:31 Collected ICDs and reimplanted them
2:28 Largest obstacle is transporting devices
3:09 Multivitamins in cancer and in HIV positive people
4:06 No site specific reduction in cancer but overall
5:03 High dose did not improve outcomes
5:38 New coronavirus reported
6:33 Identify virus, zoonotic source, information transmission
7:21 Sleep and obesity
8:23 Assessed insulin pathways in fat cells
9:01 Sleep deprivation affects peripheral physiology
9:50 End
 

Week of October 15, 2012

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This week’s topics include chocolate and Nobel prizes, hormone replacement therapy, a novel way to preserve lungs for transplant, and fibulin and mesothelioma.
 
Program notes:
 
0:27 Nobel prizes and chocolate consumption
1:28 How much more to consume to increase number of prizes
2:30 Great graph showing Sweden gets most
3:00 Fibulin and mesothelioma
4:01 Measured in fluid around the lung and blood
4:54 Hormone replacement therapy
5:53 Women who start early don’t experience negative outcomes
6:52 Discuss only peer-reviewed literature
7:52 Ways to preserve lungs for transplant
8:52 Can preserve up to 72 hours
10:22 End
 
 

Week of October 8, 2012

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This week’s topics include markers of cardiovascular disease, vitamin D and the common cold, patient access to physician notes, and diabetes screening impact.
 
Program notes:
 
0:31 Patients reading doctor’s notes
1:30 Three primary care practices
2:27 Part of electronic medical record?
3:31 Email now part of communications
4:01 Vitamin D and preventing colds
5:01 No reduction in number or severity
5:49 Screening for diabetes and impact on mortality
6:44 Incidence was very low in study population
7:47 Reducing complications regardless of mortality
8:07 CRP and fibrinogen in cardiovascular disease
9:09 Predicts events modestly in men
10:22 End
 

Week of October 1, 2012

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This week’s topics include the dangers of sugar sweetened beverages, exercise, diabetes and mortality, steroids and tonsillectomy, and total knee replacements.
 
Program notes:
 
0:30 Three studies on sugar sweetened beverages and weight
1:26 Children who were fed sugar-sweetened beverages or not
2:25 Empty calories
3:01 Knee replacement surgeries
4:02 People don’t need to have it
5:03 Aging population contributes
5:14 Two studies looking at exercise, diabetes and mortality
6:19 Weight training and diabetes risk
7:19 Increased muscle mass and insulin uptake
7:55 Steroids and tonsillectomy
8:56 Very effective at reducing nausea and vomiting
9:53 End
  
 

Week of September 24, 2012

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This week’s topics include the risk of pyloric stenosis in bottle feed infants, long term outcomes of gastric bypass surgery, restarting blood thinners and bleeding risk, and a new agent for MS.
 
Program notes:
 
0:43 Fumarate and multiple sclerosis
1:42 Dermatologist and neurologist consulted
2:46 Decreased relapses, new lesions
3:42 Bottle feeding infants and pyloric stenosis
4:45 Over 90,000 infants and fivefold increased risk
5:42 Mechanism may be related to milk content
6:08 Long term outcomes of gastric bypass
7:08 Gastric bypass resulted in weight loss and other health outcomes
8:06 Higher risk of hospitalization
8:24 Resuming warfarin in people who’ve had a GI bleed
9:24 Restart didn’t compromise
10:41 End
 

International Medical Headlines - September 2012

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Program notes:
 
0:19 Male circumcision
1:14 Within the family decisions benefits outweigh the risks
2:12 Data show health benefits
3:07 Screening for chronic kidney disease
4:03 Creates a research agenda
4:36 All people born between 1945 and 1965 should be screened for hepatitis C
5:32 Cirrhosis and hepatocellular carcinoma
6:29 Elevated liver enzymes don’t define
7:25 Early detection needed
7:35 Multidrug resistant TB
8:24 Identified MDR patients and tested
9:16 Need for directly observed therapy
9:49 End
 

Week of September 17, 2012

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This week’s topics include the dangers of tattoos, no change in ovarian cancer screening guidelines, NSAIDS in people who’ve had a heart attack, and allowing your baby to ‘cry it out.’
 
Program notes:
 
0:31 Scarred for life by crying it out?
1:34 Short term studies show benefit
2:25 Better sleep patterns in infants
3:01 NSAIDs in people who’ve had heart attacks
4:02 About 43,000 who took NSAIDs after a heart attack
5:01 Naproxen had the lowest risk of this group
5:25 No change in ovarian cancer screening guidelines
6:25 Twenty or thirty surgeries per one cancer
7:24 Infection due to tattoos
8:25 Reported in 19 people in the weeks after tattoo
9:25 AMA try to get tattoo inks laser removable
10:31 End
 

Week of September 10, 2012

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This week’s topics include hypertension in the US, length of time of CPR in hospital, organic versus conventional foods, and gingko and memory disorders.
 
Program notes:
 
0:43 Gingko and memory problems
1:42 Long term use did not reduce progression to Alzheimer’s
2:28 Organic versus conventional foods
3:30 Nutrient and contaminant levels
4:30 No difference between the two
5:13 CPR length and outcomes in hospital
6:13 Almost half did achieve recirculation
7:13 12% resuscitated after 30 minutes
8:13 Very different than out in the field
8:39 Hypertension in the US
9:40 Important in a number of conditions
10:34 End
 

Week of September 3, 2012

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This week’s topics include screening adults for hepatitis C, circumcision in male infants, cannabis use in adolescence, and benefits of exercise in avoiding chronic disease in aging.
 
Program notes:
 
0:39 Midlife fitness and avoiding chronic disease
1:32 Stress test at fifty and how that correlated with eight chronic diseases
2:37 Hepatitis C screening
3:36 Those born between 1945 and 1965
4:22 Circumcision in infant males
5:21 Health benefits outweigh the risks
6:21 Decreased risk of HIV by 60%
6:49 Cannabis use in adolescence
7:49 Neuropsychological testing both before and after
8:43 Even with cessation it doesn’t help
9:16 Are some therapeutic benefits
10:22 End
 
  
 

Week of August 27, 2012

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This week’s topics include hearing screening for older adults, colonoscopy related factors, lead levels and gout, and kids dying after tonsillectomy.
 
Program notes:
 
0:38 FDA warning on codeine in children
1:38 Ultrafast metabolizers
2:31 Report to FDA needed
3:01 USPSTF recommends against routine hearing loss screening
4:01 Detecting and treating hearing loss is not known to reduce consequences
5:01 Hearing aids not standardized
6:01 Colonoscopy, polyps and colon cancer
7:02 Important to go to experienced person
7:44 Lead levels and gout
8:48 May not be due to opulent lifestyle
9:51 Hearing loss on blog
10:29 End
 

Week of August 20, 2012

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This week’s topics include aspirin and cancer mortality, medical tests on the day of discharge from the hospital, PSA testing and quality of life issues, and stroke, bleeding risk, chronic kidney disease and atrial fibrillation.
 
Program notes:
 
0:39 Quality of life and PSA
1:40 Trade-off between quality of life and consequences of treatment
2:37 Patient must decide
3:06 Follow up tests on day of discharge
4:06 If you’re about to be discharged ask about tests
5:16 Stroke and bleeding, and atrial fibrillation and kidney disease
6:20 Are anticoagulants helpful?
7:18 More and more patients with these conditions
8:14 Aspirin and cancer mortality
9:16 Family history of colorectal cancer
10:02 Podcast having a larger impact
10:49 End
 

Week of August 13, 2012

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This week’s topics include complications of diabetes in blacks, honey for coughs, knee injections for arthritis, and declining lipid levels in American youth.
 
Program notes:
 
0:25 Honey for coughs
1:25 Received one of three honey preparations or placebo
2:25 Children aged one to five, not infants
2:46 Lipid levels in US youth
3:45 What accounts for this decline?
4:43 Injections of hyaluronic acid in knees
5:43 Very small benefit but high rate of complications
6:49 Includes both published and unpublished data
7:07 Diabetes and retinopathy
8:07 When does retinopathy occur?
9:07 Vigilance with regard to keeping blood sugar low
10:27 End
 

Week of August 6, 2012

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Program Notes:
0:40 Malaria vaccine potential
1:40 Response to giving the Malaria vaccine during other vaccinations 
2:13 Prophylaxis of Malaria
2:49 Melanoma issues from tanning beds
3:49 Risk of melanoma increases
4:10 Self-regulation and tanning beds
5:07 Fracture risk and cataract surgery
6:07 Cataract surgery benefits
6:55 Cataract surgery risk reductions
7:21 endoscopic versus open surgery for harvesting of veins
8:36 Differences between endoscopic and open surgery
9:03 Differences in patient satisfaction
  
 

Week of July 30, 2012

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This week’s topics include knee and hip replacement and heart attacks, new HIV management guidelines, HIV and Immigrants, and HIV and blood vessel inflammation.
 
Program Notes:
0:55 HIV infection in people from outside of the United States
1:55 Where the immigrants are from
3:00 HIV and its effects on arteries
4:00 Inflammation tests control verses those with HIV
4:50 Reduce the inflammation in HIV patients
5:34 Treatment recommendations for HIV patients in JAMA
6:10 The cost of anti-retro viral suppression
7:10 Long term impact of anti-retro viral therapy
7:35 FDA’s approval of Truvada and the chance of more risky behavior
8:00 Knee replacement and the risk of MI and heart attack
9:00 The risks increase greatly
9:30 Who is t higher risk for MI and heart attacks
 

International Medical Headlines: July 2012

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Program Notes:
:22 HIV prevention
1:22 Treatments were effective
1:41 Adherence to treatment for Tuberculosis
2:48 Same treatment for prophylactic medicines for HIV
3:15 Motivation to take preventive medications
3:47 Cost of preventative treatments
4:22 Physical inactivity affecting our lives
5:22 Wake up call to the modern day society
5:38 Contraception use helping the world
6:38 Saving lives with contraception
7:22 Family planning improving economics
8:22 GDP helped by family planning
8:33 What contraception do women like?
9:09 Affordable Care Act effecting public health
 

Week of July 23, 2012

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This week’s topics include the dangers of eating disorders, watchful waiting in prostate cancer, trans fat regulation, and treating egg allergies.
 
Program notes:
 
0:22 Prostate cancer treatment outcomes
1:22 Prostate cancer mortality and treatment
2:22 Determining who can benefit from surgery
3:22 Treatment isn’t for everyone
3:25 Reducing trans fats in our Diets
4:25 New York City leads the change
5:25 Everyone benefits from regulations
6:10 Reducing reactions to eggs
7:10 Desensitizing kids that are allergic
8:10 Additional studies needed to improve outcomes
8:26 Dangers of eating disorders
9:26 More likely to lead to negative outcomes
10:26 Links to all studies will be on the blog
 

Week of July 16, 2012

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This week’s topics include the role of cranberry juice in preventing urinary tract infections, whether dogs and cats help keep infants healthy, preventing HIV transmission in some at risk people, and alcohol consumption and rheumatoid arthritis.
 
Program notes:
 
0:30 Pre-exposure prophylaxis for those at risk of HIV infection
1:32 Compliance with medication makes a big difference
2:33 Can be effective
3:01 Alcohol consumption and reduced risk of rheumatoid arthritis
4:03 More than 4 glasses of alcohol each week
4:39 Use of cranberry juice and urinary tract infections
5:35 Looked at all randomized controlled trials
6:35 Has a lot of sugar
6:52 Benefits of dogs and cats in preventing URIs
7:55 Have seen benefits of animal exposure in past
9:04 End
 

Week of July 09, 2012

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This week’s topics include keeping physicians up to date, osteoporosis guidelines for men, obesity screening, and counseling to promote a healthy lifestyle.
 
Program notes:
 
0:30 Lifelong learning for MDs
1:32 Assessment of knowledge and skills
2:25 Sometimes physicians do not keep up
3:10 Everyone should be screened for obesity
4:12 12 to 26 sessions per year
5:12 Individuals who are obese can’t get to a normal weight
5:37 Counseling for a healthy lifestyle isn’t effective
6:36 Medium intensity counseling
7:24 Osteoporosis in men
8:25 DEXA scan
9:25 Bisphosphonates or supplemental calcium?
10:16 End
 

Week of July 02, 2012

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Clot busters and blood thinners, liver injury due to medical supplements, a common blood pressure medication and sprue, and assessing thyroid nodules
 
Program notes:
1:06 Sprue or celiac disease and a blood pressure medication
2:03 Stopped the medication and symptoms improved
3:02 May spill over to related medications
3:20 Foods for dietary management of disease or condition
4:23 Stopped foods and condition resolved
5:25 Use of TPA in people taking coumidin
6:25 TPA is largely safe in these folks
7:25 Thyroid nodule evaluation
8:27 Gene expression analysis
9:30 About 15-30% can’t tell about nodules
10:32 End
  
 

Week of June 25, 2012

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This week’s topics include better cholesterol markers, the walk test, alcoholism and obesity surgery, and kidney disease as equivalent to heart attack.
 
Program notes:
 
0:30 Obesity surgery and alcoholism
1:30 More common following roux en y
2:30 What is the mechanism?
3:30 Blood markers for heart problems
4:30 Apolipoprotein markers help?
5:30 Already have a total picture
5:42 Kidney disease equivalent?
6:43 No significant increase
7:20 Walk test as mortality predictor
8:17 Measure a set distance and see how far in 6 minutes
9:16 Doing such a test in people without symptoms
10:26 End
 

Week of June 18, 2012

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This week’s topics include risks of hormonal contraception, stress testing after cardiac surgery, statins, and insulin and fish oil and diabetes.
 
Program notes:
 
0:45 Role of stress testing after revascularization
1:44 Doesn’t improve outcome even long term
2:44 Evidence based testing needed
2:55 Statins and fatigue
3:52 Those who took statins had worsening of fatigue and energy
4:55 Fish oil, insulin, diabetes and cardiovascular outcomes
5:55 Decrease revascularization or hospitalization?
6:55 Decreased risk of frank diabetes
7:22 Hormonal contraceptives and stroke or heart attack
8:30 Higher the estrogen the higher the risk
9:35 Risk benefit ratio important
10:37 End
 

Week of June 11, 2012

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This week’s topics include basal cell cancer treatment, screening for intimate partner violence, aspirin for primary prevention of cardiovascular events, and multidrug resistant TB.
 
Program notes:
 
0:32 Hedgehog pathway inhibition in skin cancer
1:30 Vismodegib in advanced cancers
2:30 Side effects and cost
3:44 Aspirin for primary prevention
4:49 Risks include higher age, high blood pressure and others
5:45 Multidrug resistant TB
6:47 One in three new patients had some drug resistance
7:46 More likely in TB specialist hospitals
8:35 Screening for intimate partner violence
9:32 How effective are screening techniques?
10:44 End
 

Week of June 4, 2012

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This week’s topics include the dangers of mail order poultry, updated hormone therapy review in women, kidney disease and tight blood sugar control in those with diabetes, and thyroid dysfunction and heart disease.
 
Program notes:
 
0:32 Chicks and health
1:30 Caregivers didn’t know contact could cause salmonella infection
2:30 Young children and elderly should avoid the birds
3:01 Hyper- and hypothyroid and heart disease
4:02 Compared to normal thyroid
5:02 Treatment helped in younger people
6:01 Most incidence in older people but does occur younger
6:22 Intensive glucose control and kidney disease
7:20 Doesn’t help and may harm
8:01 Hormone replacement therapy in women
9:02 Reduced fractures but increased many other conditions
10:22 End
  
 

Week of May 28, 2012

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This week’s topics include the benefits of flexible sigmoidoscopy, dangers of calcium supplements, diabetic foot ulcers, and PSA screening.
 
Program notes:
 
0:24 PSA screening guidelines
1:24 Asymptomatic cancer detected
2:27 Urinary incontinence
3:25 Let patient be involved in decision
4:25 Supplemental calcium harms
5:23 Two fold increased risk of heart attack
6:33 Flexible sigmoidoscopy
7:27 Reduced incidence by 21%
8:38 Management of diabetic foot ulcers
9:34 Multidisciplinary approach best
10:29 End
 

Week of May 21, 2012

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This week’s topics include stress testing after heart procedures, coffee and mortality, air pollution and markers of inflammation, and laxative-free colonoscopy.
 
Program notes:
 
0:32 Laxative-free colonoscopy
1:30 Using CT scanning but laxative-free
2:30 What about polyp removal?
3:25 Coffee and mortality
4:26 More coffee decreased mortality
5:28 Lower LDL?
6:02 Role of stress testing after heart procedures
7:02 Repeat procedure did not improve outcomes
8:06 Air pollution and inflammation
9:07 Pollutants decreased and markers improved
10:32 End
 

Week of May 14, 2012

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This week’s topics include the benefits of probiotics, Millennium villages in Africa, fruits for fruit juice, and infections related cancers worldwide.
 
Program notes:
 
0:31 Benefits of probiotics
1:31 Small studies previously
2:20 Largely lactobacillus
3:08 Burden of infection related cancers worldwide
4:02 Higher burden in developing countries
5:02 Dissemination of vaccines
5:40 Millennium villages and child mortality
6:40 Annual projected cost $120 per person
7:35 Largest reduction in child mortality to date
7:48 Substituting fruit for fruit juice
8:41 Decreased calories by 233 kcal
9:39 Could decrease weight by 5 lbs per year
10:22 End
 

Week of May 7, 2012

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This week’s topics include aspirin versus Coumadin in people with congestive heart failure, the problem of babies born to women who use drugs while pregnant, managing type 2 diabetes in adolescents, and mammography indications.
 
Program notes:
 
0:39 Mammography indications
1:33 Woman at increased risk may benefit from earlier screening
2:32 Focus attention on those most likely to benefit
3:30 Low risk of having cancer a false positive is harmful
4:10 Management of type 2 diabetes in youth
5:13 Failure rate extremely high
6:12 Need societal intervention
6:26 Neonatal abstinence syndrome
7:25 Cost of hospitalization $53,000
8:08 Coumadin versus aspirin
9:08 Very similar in most respects
10:03 Risk of clot versus bleeding
10:47 End
  
 

Week of April 30, 2012

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This week’s topics include use of Botox for migraine headaches, infections in cardiac devices, CT in diagnosing appendicitis, and stem cells for a damaged heart.
 
Program notes:
 
0:40 Infections in cardiac devices
1:38 About one infection in 1000 per year
2:35 Almost everyone over 70 years of age
3:07 Stem cells for heart repair
4:07 Phase II study of stem cell infusion
5:05 Do heart biopsy and use those cells
5:47 Botox and migraines
6:47 Botox, placebo, or medication
7:43 CT to diagnose acute appendicitis
8:43 Low dose versus regular CT
9:50 Must accurately diagnose
10:29 En
 

International Medical Headlines: April 2012

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Program notes:
 
0:21 Antibiotics instead of surgery in appendicitis
1:17 Appendectomy well tolerated
2:14 Might have big implications where surgical care isn’t available
2:33 Emergence of resistant malaria
3:36 Looked at clearance rates for parasite
4:31 Government focused on malaria
5:31 Health disparities in New Zealand
6:31 20% of admissions due to infections
7:31 Determinants of health outside the medical model
8:33 Early treatment of infections helps
9:21 Must be developed in concert with community
10:02 End
 

Week of April 23, 2012

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This week’s topics include the best treatment for sciatica, helicopters versus ambulances, types of radiation for prostate cancer, and the cost of preventive medicines for HIV infection.
 
Program notes:
 
0:32 Treatment of sciatica
1:31 Randomized to two injections of steroids, TNF inhibitor, and placebo
2:32 Most back pain not due to herniated disk
3:12 Treatment of prostate cancer with radiation
4:14 Comparison of three different types
5:16 Helicopters versus ambulances and survival
6:19 Overall survival better in helicopters
7:13 Per patient $3000 to $5000
8:12 Cost of preventive medicine for HIV infection
9:13 High risk $600,000 per infection prevented
10:44 End
 

Week of April 16, 2012

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This week’s topics include comparative effectiveness of urinary incontinence treatments, EKG abnormalities and what they predict, red meat and mortality, and improving colorectal screening compliance.
 
Program notes:
 
0:27 EKG abnormalities and their value
1:36 Increased risk with both minor and major abnormalities
2:26 How much treatment reduction results?
2:41 How to improve routine use of colorectal cancer screening
3:42 Fecal occult blood over 60% adhered
4:44 Red meat consumption and mortality
5:44 One serving per day increased by 13%
6:44 Urinary incontinence management
7:46 Meta-analysis of drugs and exercise
8:47 Exercise preferable
10:04 End
 

Week of April 09, 2012

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This week’s topics include the effectiveness of video to enlist organ donors, intensive screening in women at risk for breast cancer, overdiagnosis of breast cancer, and retinal detachment due to antibiotic use.
 
Program notes:
 
0:25 Use of video to increase organ donation
1:27 Video showing ethnic minorities discussing issue
2:27 Low cost, effective, point of action delivery
3:06 Intensive screening for women at risk for breast cancer
4:10 More cancers detected
5:11 Study from Norway on overdiagnosis of breast cancer
6:11 Population based screening study
7:10 Similar to prostate cancer
8:10 Tough issue to resolve
8:24 Common antibiotic and retinal detachment
9:20 Increased risk five fold
10:22 End
 

Week of April 02, 2012

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This week’s topics include antibodies for psoriasis, where it’s safe to get a stent placed, bypass surgery versus stents, and bariatric surgery for diabetes.
 
Program notes:
 
0:27 Two studies on antibody treatments for psoriasis
1:30 Twelve weeks of study 90% responded
2:17 Where you have your stent placed
3:20 When stenting done at hospitals without surgical backup it’s okay
4:01 Bypass surgery versus stent placement
5:02 Lower mortality over time with CABG
6:02 For less extensive disease equivalent
6:29 Obesity and diabetes treatment
7:29 Bariatric surgery and subsequent resolution of diabetes
8:25 Results occur very early on
9:23 Obesity prevention
10:07 End
  
 

International Medical Headlines: March 2012

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Program notes:
 
0:14  Hepatitis C overtaken HIV as cause of death in US
1:15  Worldwide the burden is immense
2:15  Treatment difficult
3:06  Eradication of polio in India
4:10 How devices are approved in US and Europe
5:11  Leach chromium and cobalt
6:08  How to balance efficacy and safety
7:05  People who get cancer may be delayed in diagnosis
8:05  In UK cancer mortality higher
9:05  How we build new information tools will help
10:04 End
 

Week of March 26, 2012

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This week’s topics include the power of peer mentoring, endoscopic versus open repair of hernias, seven factors related to cardiovascular health and death, and antioxidants for Alzheimer’s disease.
 
Program notes:
 
0:37 Peer help in controlling diabetes
1:39 Matched with like peers
2:38 Makes sense for others to help
3:17 Improving cardiovascular health
4:15 Percentage who accomplish all seven 1.2%
5:15 How to engage more people?
6:06 Hernia repair endoscopically or open
7:02 Endoscopic repair overall better
8:02 Surgeons with 30 or more procedures done
8:18 Antioxidants and Alzheimer’s
9:13 Intensive antioxidants didn’t help and might harm
10:16 End
 

Week of March 19, 2012

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This week’s topics include fixing holes in the heart, the role of inflammation in heart disease, metal on metal hip implant, and whether more money spent equals better health outcomes.
 
Program notes:
 
0:24 Metal on metal hip implants
1:22 Looked at over 400,000 implants
2:24 Challenging oversight
3:11 Inflammation and heart disease
4:11 Genetic abnormality confers resistance to atherosclerosis
5:04 Cryptogenic stroke
6:03 900 patients randomized to device or medication
7:04 80,000 patients had treatment off label
7:44 Cost versus quality in healthcare
8:43 When they spent more it did help
9:36 Lowering what hospitals get won’t get better outcomes
10:06 End
 

Week of March 12, 2012

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This week’s topics include drugs used in Alzheimer’s disease, opioids in returning veterans, variation in tumors, and the increase in a hospital-acquired infection.
 
Program notes:
 
0:35 Tumor heterogeneity
1:31 Two-thirds of mutations not found in all sites
2:33 Can result in therapeutic failure
3:12 Clostridium difficile infection
4:15 75% had onset not while in the hospital
5:15 Employ strategies to prevent infection
5:32 Returning veterans, mental illness and opioids
6:30 PTSD and opioids
7:31 Not providing care really needed by veterans
8:00 Two commonly prescribed medications for Alzheimer’s
9:01 Randomized, placebo-controlled, telling results
10:10 End
 

Week of March 5, 2012

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This week’s topics include flu diagnosis and treatment, stents versus optimal medical therapy for coronary artery disease, and a walking test for hospitalized elderly persons.
 
Program notes:
 
0:39  Stents versus medical therapy for coronary artery disease
1:36  Outcomes of death, heart attack
2:31  Either physicians or patients seem convinced stents help
3:15  Speed of walking to predict outcomes in elderly
4:20  Faster speed 99% went home
5:18  Flu diagnosis
6:16  Sensitivity and specificity of rapid tests
7:17  Helps determine treatment
8:17  Reduced mortality
9:26  Limit treatment to high risk groups
10:29 End
  
 

Week of February 27, 2012

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This week’s topics include the benefits of colonoscopy, two types of testing for colon cancer, vaccination risk in kids, and heart attack fatality risk factors.
 
Program notes:
 
0:31 Whether polyp removal prevents colon cancer
1:28 53% reduction in mortality
2:29 How best to screen?
3:29 If people won’t have colonoscopy
4:29 Need longer term follow up
5:12 Age, sex and risk of heart attack death
6:12 Atypical symptoms in younger women
7:18 Higher mortality in women
8:13 Vaccines in children and seizures
9:12 No increased risk of seizures or epilepsy
10:40 End
 

Week of February 20, 2012

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This week’s topics include air pollution and heart attacks, oral human papilloma virus infection, use of blood thinners in those with cancer, and antibiotics and sinus infections.
 
Program notes:
 
0:39 Blood thinners and cancer therapy
1:35 Only 1% had a clot versus 3% with placebo
2:30 Human papilloma virus infection of oral cavity
3:31 About 7% of people infected
4:30 Authors suggest need for study of vaccine
5:10 Use of amoxicillin in sinusitis
6:10 Compared to placebo doesn’t help
7:10 Not a lot of data on other therapies
7:35 Air pollutants in heart attacks
8:32 Could be as much as 1 in 20 heart attacks
9:25 Developing nations more troublesome
10:15 End
 

Week of February 13, 2012

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This week’s topics include possible prevention of prostate cancer, the new flu virus controversy, when is it safe to have sex, and the lifetime risk of heart disease.
 
Program notes:
 
0:50  If you have heart disease, when is it safe to have sex?
1:50  Events are actually rare
2:41  Sudden death occurs in less than 1%
3:08  Factors related to lifetime risk of heart disease
4:08  Substantial risk increase as factors accrue
5:04  Dutasteride and prostate cancer prevention
6:05  In use for some time so side effects known
6:32  Engineered flu virus and publication
7:26  60% mortality
8:25  Not too easy to grow
9:23  Devastation of 1918 flu
10:34 End
 

Week of February 06, 2012

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This week’s topics include re-excision for breast cancer, a new drug for uterine fibroids, blood pressure readings in both arms, and surviving burns in kids.
 
Program notes:
 
0:40  Blood pressure measurement in both arms
1:45  Very low tech assessment
2:19  Burn size in children and survival
3:17  Critical burn size now 62%
4:18  Doesn’t inform us about adult survival
4:50  A new drug for uterine fibroids
5:49  Luprolide exists but many side effects
6:47  Re-excision for breast cancer
7:47  If the margin was less than 1mm, re-excision more common
8:50  Need to standardize
10:15 End
  
 

Week of January 30, 2012

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This week’s topics include heart risk from fried foods, Avastin and breast cancer, proton pump inhibitors in childhood asthma, and PFCs and immune compromise.
 
Program notes:
 
0:23  Fried foods and heart risk
1:24  Took over 40,000 people and followed them
2:26  Three of four studies failed to establish risk
2:44  PPIs in children with asthma
3:43  Use of PPI didn’t help asthma
4:58  PFCs and compromised immunity
5:58  Measured PFCs and antibody response to vaccines
6:56  No cause and effect relationship
7:15  Avastin and breast cancer
8:12  5 or 6% reduction in pathologic evidence of disease
9:13  Very expensive therapy and not much evidence of efficacy
10:13 End
 

Week of January 23, 2012

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This week’s topics include a plateau in our national obesity epidemic, overdone medical testing, appropriate intervals for osteoporosis screening, and the dangers of sleep apnea in women.
 
Program notes:
 
0:32  Obesity trends
1:30  No increase since 2007-2008
2:30  Multiple factors involved
2:40  Screening tests and appropriate use
3:40  Physicians need to ask themselves why they’re ordering
4:37  People come in with ideas of what they want
5:17  Appropriate interval for osteoporosis screening
6:15  Those with low or nonexistent bone thinning
6:48  Cardiovascular mortality in women with sleep apnea
7:42  Increased risk by 350% over baseline
8:42  Work through treatment if possible
9:42  End
 

International Medical Headlines: January 2012

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Program notes:
 
0:18  Special issue of the Lancet on illicit drug use
1:07  Heroin, cocaine, and marijuana use
2:01  Geographic distribution of drugs
3:01  Cultural variations, supply
4:10  Disability adjusted years of life lost
5:13  Screening and prevention programs have small effects
6:23  Publication of research on flu virus
7:18  Help physicians and public health officials
8:10  I would err on the side of making information known
9:10  Would be possible to manipulate the virus
10:25 End
 

Week of January 16, 2012

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This week’s topics include long distance running and cardiac death, marijuana smoking and lung function, dangers of a new blood thinning agent, and dementia and hospitalizations.
 
Program notes:
 
0:32  Sudden cardiac death and long distance running
1:30  71% of heart attacks were fatal
2:27  Those who survived had bystander CPR largely
2:55  Marijuana smoking and lung function
3:53  Most commonly used drug in US
4:52  There is a clinical use
5:17  Dementia and hospitalization
6:17  78% more likely to be hospitalized
7:16  Looking for them in demented people much harder
7:39  Dabigatran for blood thinning
8:30  One in 400-500 patients at heart risk
9:30 Post-marketing surveillance needed
10:30 End
 

Week of January 09, 2012

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This week’s topics include what to do about neck pain, cardiovascular risk reduction with obesity surgery, a study looking at studies, and the global problem of drug abuse.
 
Program notes:
 
0:24 Benefits of bariatric surgery
1:21 Was associated with a reduction in mortality and strokes and heart attacks
2:21 Neck pain
3:21  12 weeks of spinal manipulation, home exercise, or medication
4:22  May prefer one of these three options
4:38  Global problem of drug abuse
5:35  Only data on major drugs of abuse
6:35 Health consequences of dependence
7:36 A study on studies
8:31  At end of 51 months a third unpublished
9:31  The expectation is results will be available
10:11 End
 
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