This week’s topics include a look at beta blockers, intranasal flu vaccine efficacy, acetaminophen during pregnancy, and a new osteoporosis treatment.
0:32 Intranasal flu vaccine versus intramuscular vaccine
1:34 Studied in Hutterites
2:32 Previously thought more effective in children
3:24 New osteoporosis drug
4:25 Compared to both placebo and previous medication
5:25 Injected medicine
5:42 Association between Tylenol use and childhood behavior
6:42 Primarily second and third trimester
7:42 What are alternatives?
8:04 Beta blockers after stenting
9:04 Did not lower their risk of heart-related issues
10:01 Payment based on guidelines
Anchor lead: Good choices help the dying and those who survive them, Elizabeth Tracey reports
Loved ones of someone who has died feel better when both palliative care and hospice are called in than when someone dies in an ICU, a recent study found. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, comments.
Nelson: Making good use of palliative care and hospice care for people with life-threatening cancers seem sensible, this if anything buttresses that. Even among the survivors of the family who helped them make decisions. :13
Nelson says what’s needed is a change in the timeline.
Nelson: So that people are educated and begin themselves and in talking with their family to articulate goals of care and preferences of care. I think introducing palliative care specialists at the time of diagnosis at the beginning of care is more effective than waiting until the last few days of life to think about palliative care and then using a hospice. I think that’s the challenge. :21
Nelson notes that suffering is also reduced when palliative care is employed. At Johns Hopkins, I’m Elizabeth Tracey.
Anchor lead: Insurance status influences cancer outcomes, Elizabeth Tracey reports
Men with testicular cancer and either no insurance or Medicaid fared worse than men with commercial insurance, a recent study concluded. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, explains.
Nelson: They showed up with larger tumors, cancers that were more likely to have spread throughout the body. They were more likely to die as a result of testicular cancer. They had less surgery less radiation therapy, and so this looked like a delay in the ability to get care, and once one was ready for care an inadequate level of care even when one showed up and this really seems like it was related to the amount of insurance coverage in what was largely a fee for service kind of enterprise. :31
Nelson notes that another recent study showed the same outcome for those with a type of brain tumor, and says intervention on a policy level is needed to correct this disparity as soon as possible. At Johns Hopkins, I’m Elizabeth Tracey.
Anchor lead: What is the upside to Pokemon Go? Elizabeth Tracey reports
If you’re a parent with children at home or just a video game fan, you know that most of these activities involve a lot of screen time while seated. Now a new force has been unleased on the world, Redonda Miller, president of Johns Hopkins Hospital, explains.
Miller: Pokemon Go. A person playing this game is involved in their environment. The way they win points and capture various objects is by going to various areas in their surroundings and doing those activities. We’ve always talked about video games, our children sitting in front of TVs and being sedentary. This is the antithesis. In order to play this game you have to get up and move around. So if we want to increase our weekly METs this is a game that punches that ticket. :30
Miller notes that Pokemon Go has also been unfortunately associated with an uptick in injuries that occur as a result of screenwalking, where someone is so focused on their smartphone screen they miss curbs or walk into traffic, so she cautions that vigilance is still needed. At Johns Hopkins, I’m Elizabeth Tracey.
Anchor lead: Do we really know how much physical activity is best? Elizabeth Tracey reports
All of your physical activity during the day counts when you calculate METs, or metabolic equivalent tasks, simply defined as a comparison to how much energy is burned at rest. A new study says striving for 3-4000 METs per week will reduce our risk for common cancers, heart disease, stroke and diabetes. Redonda Miller, president of Johns Hopkins Hospital, comments.
Miller: What they found is probably not surprising to many of us. There was a dose-response. But in general you could expect a 25% reduction, roughly, in each of the five conditions, when you hit a good level of activity. And then it plateaued. You hit a level of around 3000 to 4000 METS per week, where the added benefit of additional exercise was really very minimal, but up until that point, the more the better. :29
Miller notes that the WHO has previously recommended only 600 METs per week, so this is a substantial uptick in activity for most. At Johns Hopkins, I’m Elizabeth Tracey.
Anchor lead: A new way of looking at physical activity also extols its benefits, Elizabeth Tracey reports
METs may sound to you like a New York baseball team, but in the world of exercise that stands for metabolic equivalent task, or simply a comparison of any activity to how much energy is burned while seated and still. Now a new study uses METs to calculate daily activity, Redonda Miller, president of Johns Hopkins Hospital, explains.
Miller: By exercise most studies define that as I decided to go to the gym and exercise for an hour, sort of an intentional physical activity. This meta-analysis looked at studies that included all physical activity one expends over the course of a day. So not just going to the gym, but how much physical activity do you expend at work, or doing household chores, or doing leisure activities? So it was a more robust picture of a patient’s true metabolic expenditure. :31
The study found that the MET sweet spot was around 3-4000 per week, resulting in reduced risk for breast and colon cancer, stroke, heart disease, and diabetes. At Johns Hopkins, I’m Elizabeth Tracey.