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Circling the Dome

History goes digital, a commanding presence, telemedicine in the ED, promising partnerships.

illustration of doctor listening to a patients heart with a stethescope

Medical Rounds

How medicine is changing to better serve teens and young adult patients, say goodbye to blood thinners, fewer restraints in pediatric psychiatry, completely scarless thyroidectomies, a smart stethoscope and more.

Hopkins Reader

Mental health at its most harrowing. Plus: The morality of procreation and Catherine DeAngelis’ journey to pursue equity in medicine.

Class Notes

News from and about our graduates. Plus: why Irving Sherman is neurosurgery’s beloved benefactor.

Forum

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Second Opinion

Why physician mindfulness could improve patient care and prevent health care disparities.

stethescope joy illustration

Post-Op

Keeping the joy in medicine.

Letters

This issue’s letter from the editor and reader responses.

In Focus

German shepherd Bax and his handler Andrew Welch

On Patrol

The Johns Hopkins Hospital’s newest staff members include German shepherd “Bax” and his handler, Andrew Welch, a member of the Corporate Security Special Response Unit. The two began making their rounds in December, patrolling parking garages, hospital corridors, emergency departments and other locations, primarily in the evening hours. The goal of the new canine program: to deter aggressive behavior, detect explosives in suspicious packages and reduce hazards faced by security personnel and clinical staff. In early spring, Bax will be joined by “Dexo,” a Dutch shepherd currently being trained in North Carolina.

Photo by Keith Weller

Horizons

health diagrams

Personalized Treatment for Hypertension

For patients whose blood pressure falls in the “gray zone” of prehypertension or mild high blood pressure, doctors have traditionally based treatment decisions on risk calculations and some guesswork—potentially leaving many people vulnerable to heart disease or taking drugs they don’t need.

Heart CT scans could offer an effective way to help personalize treatment in such patients, according to a new Johns Hopkins study. The scans detect levels of calcium in the heart’s arteries, and researchers suggest those people with the highest calcium levels would benefit most from aggressive blood pressure treatment, whereas those with little or no calcium may not need to be treated as intensively, depending on their other heart disease risk factors.

“If a health care provider wants to target blood pressure in a patient with traditional heart disease risk factors and above-normal blood pressure, he or she can look at coronary artery calcium to help with tie-breaker like decisions,” says cardiologist J. William McEvoy, of the Ciccarone Center for the Prevention of Heart Disease.

Conventionally, coronary artery calcium scores have informed physicians’ decisions of whether to put a patient on statins, but McEvoy and team say they haven’t been evaluated before for their potential ability to determine blood pressure treatment.

The team’s findings, based on data from a national study, appeared in Circulation in January.

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