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Anchor lead: Is there a magic mix when it comes to cardiovascular disease prevention? Elizabeth Tracey reports

What can a study with over 19 years of follow up tell us about preventing cardiovascular disease? Erin Michos, lead investigator and a cardiologist at Johns Hopkins, says meeting American Heart Association guidelines for physical activity is important, but so is the right level of vitamin D.

Michos: Those that were physically active that were meeting those recommendations were far less likely to develop heart attacks or strokes over the next 19 years. We show that people with the lowest risk were people that had both adequate vitamin D levels and adequate physical activity. That they were synergistic, that those people who had adequate levels of both had the lowest risk. So future intervention studies might need to look into whether to optimize cardiovascular health whether we ought to optimize vitamin D levels in addition to optimizing people’s activity levels.  :31

Michos says there’s still some confusion regarding vitamin D and whether supplements are appropriate, so that’s an issue under active investigation. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Are men or women more likely to know about and utilize genetic testing? Elizabeth Tracey reports

What do the responses of men and women with cancer to Angelina Jolie’s story of genetic testing and subsequent choices teach us? Joann Bodurtha, a professor of genetics at Johns Hopkins, says there were sex differences.

Bodurtha: It did lead us to think about whether or not we need some more men out there telling their public stories about genetic testing. Clearly there is an uptake in direct to consumer genetic testing around ancestry, around paternity, legal issues. How we move forward I think on this is to recognize that there may be some tailoring that needs to be done around what I’ll call precision communication with regard to female and male stories, but overall there does need to be better understanding and literacy about genetic testing. :30

Bodurtha asserts that cancer is a genetic disease, and having testing may inform other family members about their possible risks and need for vigilance with regard to screening and exposures. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Abuse may complicate healthcare for women, Elizabeth Tracey reports

Health consequences of abuse to women, whether that’s something that happened when they were children or adults, impacts on their management of chronic health problems. That’s according to Carmen Alvarez, a researcher on women’s health issues at the Johns Hopkins School of Nursing.

Alvarez: There is an association between child abuse, adult abuse, so intimate partner violence, and poorer health outcomes. Women who do have a chronic illness and a history of trauma are different from those who have a chronic illness alone, that those with chronic illness and a history of trauma are greater utilizers of care. How can we encourage providers to know when they really need to engage patients a bit more?  :27

Alvarez says providers need to be aware of their opportunity to empower women with a history of abuse to adopt healthy behaviors and recognize how their own history may be compromising them in healing. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How does smoking lead to harm for fetuses? Elizabeth Tracey reports

Everyone knows that pregnant women shouldn’t smoke, with a Johns Hopkins study under the direction of Kristen Voegtline perhaps identifying one way cigarette smoke exposure may harm the developing baby, via the addition of a chemical group known as a methyl group to a specific gene.

Voegtline: We’ve used this opportunity to look at prenatal exposure to cigarette smoking. With that we find that there’s a methylation difference in boys. So boys that are exposed to prenatal cigarette smoking show greater methylation, specifically at this site in the gene called cip1a1, this is a detoxifying gene. So the fact that males may detoxify an adverse exposure differently than girls, where we didn’t find a difference, we find to be potentially very interesting. :29

Voegtline says that this identification may one day be used as a biomarker to assess risk, but for now, reiterates the fact that smoking is known to be harmful to a developing fetus so the best exposure is no exposure. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Depression treatment for younger people needs attention, Elizabeth Tracey reports

Depression is this year’s focus for the World Health Organization, and Patricia Davidson, dean of the Johns Hopkins School of Nursing, says a particular emphasis must be on the recognition and treatment of depression in younger people, who may turn to suicide attempts when the condition persists.

Davidson: That underscores the importance of the media in how we communicate these issues. It also compels us to look at how we engage young individuals in terms of treatment of depression. Also access to guns. Swallowing a handful of pills there is some chance of detoxing and perhaps reversing the effects of what could be perceived as an impulsive act. But sadly, a fatal wound to the heart or the brain, is terminal.   :33

Davidson says we do have treatment strategies that work for depression, but these must be preceded by recognition. At Johns Hopkins, I’m Elizabeth Tracey.

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Confident smiling doctor posing and looking at camera with arms crossed, medical staff working on the background

This week’s topics include physician age and outcomes, abortion via telemedicine, age to begin screening for cardiovascular disease, and vaccination of travelers.

Program notes:
0:31 Physician age and patient outcomes
1:30 Lower for physicians under 40
2:30 More up to date on newer treatments?
3:30 Older physicians should embrace
3:42 Abortion via telemedicine
4:44 Uses a website
5:44 Large majority medical rather than surgical
6:24 Vaccination among travelers
7:24 Can’t prove you’ve had measles vaccine
8:20 Risk of cardiovascular disease among young
9:20 Don’t have high blood pressure and don’t smoke
10:37 End
Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/05/21/physician-age-and-death-in-the-hospital/
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Anchor lead: Asking why some people with Marfan syndrome don’t have its worst consequences has led to new ways to intervene, Elizabeth Tracey reports

Even when someone has the genetic make-up to develop Marfan syndrome, a connective tissue disorder that can lead to rupture of the aorta and death, there are people who don’t develop such a consequence. Hal Dietz, a Marfan expert at Johns Hopkins, and colleagues, studied those people to find out what was protecting them.

Dietz: Quite remarkably, using five truly exceptional families, showing this dramatic degree of variation, we were able to show that a single region of a specific chromosome was passing in the family with protection which led us to a specific gene, and now to a specific drug target. We believe that we can leverage nature’s success at protecting people with Marfan syndrome, by using a drug that mimics the effect of the modifier gene.  :30

Dietz says approaching the issue from this perspective could have broad application for many disorders and diseases with a genetic basis. At Johns Hopkins, I’m Elizabeth Tracey.

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