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Medical Rounds

Personalizing Radiation Therapy

A new study offers the promise of using noninvasive methods of examining changes in cancerous tumors to determine whether they’ll respond to radiation treatment before treatment even begins.

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Visualizing ‘Brain Fog’ in Post-Treatment Lyme Disease

A Johns Hopkins team has used an advanced form of brain scan to show that 12 people with documented post-treatment Lyme disease syndrome (PTLDS) all show elevation of a chemical marker of widespread brain inflammation, suggesting new avenues for treatment.

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Hip Fractures: Clue to Alzheimer’s Disease?

A new study adds to evidence that brain alterations that lead to poor balance in older people may underpin both increased risk of hip-fracturing falls and Alzheimer’s disease—and that hip fracture itself may therefore serve as a first sign of undiagnosed disease.

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Algorithm Predicts Risk of Deadly Heart Condition

A team led by researchers from Johns Hopkins has developed a computer-based set of rules that more accurately predicts when patients with a rare heart condition might benefit—or not—from lifesaving implanted defibrillators.

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Caregiver Stress Is Exaggerated

A new meta-analysis finds that the long-held belief that being a family caregiver takes a toll on a person’s health has been overstated.

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55%

The reduction among young patients with asthma in the use of emergency department and hospital services after enrolling in a comprehensive care program powered by a mobile app created by Johns Hopkins Pediatrics at Home.

A patient inputs symptoms, and the app creates an algorithm that categorizes a patient by risk. It shows what medication to take, sends information to the patient’s nurse and allows the patient or caregiver to contact the nurse, and vice versa. “This is an interactive way to intervene and encourage patients to take their medication and use inhalers at the right time,” says Sue Huff, senior director of Pediatrics at Home.

“When you realize you’ve lost your keys in a dark room, where do you start looking? Would you start looking in the dark, or would you turn on the light?”

—Vice Dean for Research Antony Rosen, co-author with Scott Zeger of a recent article in the Journal of Clinical Investigation, which advocates a redefinition of precision medicine to ensure its success and proposes a new approach. “Precision medicine today is too focused on a narrow set of ‘-omics’ measurements,” a focus that is “both too narrow and misdirected,” says Rosen. Rather than using measurement alone to understand the cause of disease (a search in the dark), he and Zeger call for defining subgroups of patients based on clinical outcomes (the equivalent of turning on the light).

83%

The percentage of pediatric oncologists who weren’t able to prescribe their preferred chemotherapy agent due to drug shortages, according to a new study published in JAMA Pediatrics by pediatric oncologist Yoram Unguru. In addition, more than 75 percent of the clinicians had to make a major change in treatment, and over 40 percent had to delay the start of treatment.

“Over the past 2.5 years, nearly two-thirds of these essential medicines for children with cancer have been or are currently in short supply in the U.S.,” notes Unguru, adding, “In fact, at this time, five of the 18 essential medicines, nearly 30 percent, are in short supply in the U.S.”