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Anchor lead: The Surgeon General has issued a report on substance abuse, Elizabeth Tracey reports

Use of opioids is just one of the issues in the recently released Surgeon General’s report on addiction, which also covers multiple other drugs, including alcohol, and calls for a cultural change in both perception of addiction as well as treatment.  Eric Strain, a drug abuse expert at Johns Hopkins, says this report is important for several reasons.

Strain: I think it helps to focus us, both as a medical profession and a culture, to put a stamp on it saying this is a problem we need to be thinking about. So it helps to focus us, to galvanize us hopefully, to set forth a research agenda and a cultural agenda for how we’re going to approach these disorders. And what we do at a preventive level as well as a research and a treatment level that perhaps we haven’t had before.  :27

Surgeon General’s reports have been credited with bringing awareness to public health crises, and with overdose deaths at almost 50,000 in 2014, it’s not a moment too soon.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Is there a statin in your future? Elizabeth Tracey reports

The USPSTF, the federal task force charged with reviewing scientific data and making healthcare recommendations based on available evidence, has issued new guidelines for the use of statins.  Michael Blaha, a preventive cardiology expert at Johns Hopkins, explains.

Blaha: The United States Preventive Services Task Force has now come full circle on statins. While before they were more conservative with their use, they’re now stating that a wide array of patients, those patients who are between 40 and 75 with at least 10% 10 year risk of cardiovascular disease, would benefit from a statin.  This is a large swath of the population. This does say that even if you have a younger patient but with enough risk factors to get them to that 10% risk threshold, absolutely we’re going to talk about a statin, because a statin might  actually slow or reverse the progression of atherosclerosis.  :33

Blaha says the risks of statins are quite low and most people tolerate them very well, with few experiencing muscle aches or any other side effect.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Is there a way to overcome a genetic risk for heart problems? Elizabeth Tracey reports

There’s good news from a study of overcoming genetic risk of heart disease at the recent American Heart Association meeting. Michael Blaha, a preventive cardiology expert at Johns Hopkins, explains.

Blaha: Patients commonly ask me, how do I mitigate the genetic risk of heart disease that I have given the fact that my dad or grandfather had a heart attack? Now we have strong data that suggest that diet and exercise therapy strongly mitigates the genetic risk. This study looked at patients who had high genetic risk for coronary heart disease and then looked at their lifestyle habits.  Those patients with the strongest lifestyle habits, healthy diet, nonsmoking, and exercising,  had greater than 50% reduction in the cardiovascular risk compared to those people who had unhealthy lifestyle but similar genetic risk.  :33

Blaha says this risk reduction can translate to that of a person with no family history of cardiovascular disease.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  How do some types of pain relievers effect your heart? Elizabeth Tracey reports

A study presented at the recent American Heart Association meeting comparing the pain relievers celecoxib or Celebrex, naproxen and ibuprofen for people with chronic arthritis pain found no increased heart risk for celecoxib.  Michael Blaha, a preventive cardiology expert at Johns Hopkins, interprets the results.

Blaha: While this study doesn’t show that NSAIDs and the related Cox-2 inhibitors are safe it does show if you need to be on a chronic pain medication, for example for rheumatoid arthritis, it does appear the celecoxib is just as safe, if not safer, than ibuprofen and naproxen, with cardiovascular, gastrointestinal, and kidney endpoints.  :20

The study was also practical.

Blaha: This is a very real world study in a very difficult patient population that’s difficult to treat, and that’s chronic arthritis.  In my patients with chronic arthritis who need these pain medications I will consider using celecoxib in those patients who need chronic pain therapy.  :14

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Outcomes are better when nurses are more educated, Elizabeth Tracey reports

Hospitals staffed with more nurse assistants relative to those with more registered nurses see many more adverse outcomes for patients, a recent study in the British Medical Journal concludes.  Patricia Davidson, dean of the Johns Hopkins School of Nursing, says fingerpointing isn’t the answer.

Davidson: Healthcare is a team sport. Nursing assistants are phenomenal and wonderful people. Hospitals could not survive without technical assistants, nursing assistants, and a whole range of personnel, to the person who keeps the floors clean.  So I would really like a shift in the discussion and the debate from nurses versus doctors, from nursing assistants versus nurses, to more about how we configure optimally the healthcare team to make a difference for patients and their families.   :30

Davidson says staff uniforms and badges reveal who is delivering care, so patients and families can be aware.  At Johns Hopkins, I’m Elizabeth Tracey.

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Carer Helping Senior Woman To Walk In Garden Using Walking Frame

This week’s topics include frailty and postoperative risk, smoking, age and myocardial infarction, sports and cardiovascular mortality, and artificial intelligence and diabetic retinopathy.

Program notes:

0:37 AI and diabetic retinopathy
1:37 Showed over 60,000 images to a computer
2:37 Device takes a picture and computer evaluates
3:23 Presurgical assessment of frailty
4:24 Three or four years before and after risk assessment
5:25 Even in non-frail it helped
5:43 Different sports and cardiovascular mortality
6:44 Racket sports reduced most
7:44 Hard to hypothesize plausibility
8:25 Smoking, age and heart attack
9:25 One of the most important risk factors
10:30 End

Related blog: https://podblog.blogs.hopkinsmedicine.org/2016/12/04/frailty-and-surgery/

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Anchor lead: Putting resources in one place helps those who care for adolescents, Elizabeth Tracey reports

Y2CONNECT is the name of a comprehensive, online resource also accessible by smartphone apps that brings together programs designed to keep teenagers healthy and engaged. Arik Marcell, an adolescent medicine expert at Johns Hopkins, describes the need.

Marcell: We have small resource guides but really no comprehensive guide like this that helps to compile across all health as well as arts, work and recreation type programs so that it’s easy for professionals who work with youth, parents as well as youth themselves to access and learn about resources for them in the city.  :23

Marcell says Y2CONNECT is not limited to Baltimore.

Marcell: This is a model for how one can do it not only here in the city but also in other cities like Baltimore.  :06

Marcell says because of its online nature, adolescents anywhere can access Y2CONNECT to get information.  At Johns Hopkins, I’m Elizabeth Tracey.

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