Anchor lead: Can a new technique reduce the need for repeat brain tumor surgeries? Elizabeth Tracey reports.
It’s a good bet most people would rather not have brain surgery, yet when a tumor is detected there is often little choice. But what about additional surgeries, which may be needed to monitor suspicious areas for tumor recurrence? A new technique developed at Johns Hopkins that examines DNA found in CSF, the fluid surrounding the brain and spinal cord, may help. Jon Weingart, a neurosurgeon and part of the research team, says such a test would be most welcome.
Weingart: For brain tumors in particular there are changes that occur with the treatment, and it is often very difficult to assess whether than represents tumor, or treatment effect, and sometimes people have surgery just to figure that out, and brain surgery is a big experience to go through, and if you could avoid that then that would be a positive thing. :24
Weingart says the majority of brain tumors were detected in a study using this technique, and he’s hopeful about its clinical utility. At Johns Hopkins, I’m Elizabeth Tracey.
Anchor lead: Can new techniques allow better monitoring of brain tumors? Elizabeth Tracey reports
All cells shed DNA into blood and bodily fluids when they break open, a fact that’s being exploited in discerning whether cancers have returned or metastasized. Now the same technique has been used in looking at brain tumors, where the DNA is shed into the fluid surrounding the brain and spinal cord known as CSF or cerebrospinal fluid. Jon Weingart, a neurosurgeon at Johns Hopkins, explains.
Weingart: This is a new concept that’s been developed in cancer research and in cancer monitoring where there’s evidence that cells as they die or break up in their natural growth or with treatment, that the DNA that’s within them gets shed out into the bloodstream or into other bodily fluids. This DNA is different than the patient’s normal DNA. There are unique fingerprints so to speak of the tumor DNA that can be detected elsewhere in the body. :29
Weingart is one member of a group at Hopkins with a recent publication showing detection of over 70% of tumor markers using the technique. At Johns Hopkins, I’m Elizabeth Tracey.
Anchor lead: Just how aggressively should you manage your blood pressure? Elizabeth Tracey reports
Blood pressure managed to a target of 120 millimeters of mercury for the top number, also known as the systolic blood pressure, reduced deaths by about one-quarter in a large group of patients without diabetes, including people older than 65, a recent study in the New England Journal of Medicine found. Gregory Prokopowicz, a blood pressure expert at Johns Hopkins, interprets the findings.
Prokopowicz: The trial got a lot of publicity because of the benefit in the group that was more aggressively treated. The figure we often hear is a 25% reduction in heart attack, stroke, or similar events or a 27% reduction in death from any cause. But it’s important to put those figures in context. In the intensive treated group the rate of the events was a little bit less than 2% per year and in the standard treatment group was little bit more than 2% per year. :28
Prokopowicz says the findings must be considered for each individual within their own risk-benefit calculus, so talk with your provider. At Johns Hopkins, I’m Elizabeth Tracey.
Anchor lead: Do young children with TB put everyone at risk? Elizabeth Tracey reports
How risky is it for everyone to be around a child with XDR TB, the most deadly form of the disease? Sanjay Jain, who led a team at Johns Hopkins that recently treated a young toddler with this type of tuberculosis, says most of us can rest easy.
Jain: The good thing with young children is they are considered noninfectious, now, there’s not a lot of data about this but most experts would agree that very young children, especially children younger than five years of age, do not transmit TB even if they have full-blown, primary TB. The bad thing of course is it’s very difficult to diagnose. Often these young children are considered as sentinels of TB transmission. The majority of these children go undiagnosed and die of something we don’t know about. :29
Jain says the case underscores needs relative to tuberculosis in children, from rapid diagnostic tests to forms of antibiotics that can be taken by young children, to an imaging technique that monitors how treatment is going. He says the fact that young children don’t pose an infection risk should allow research to proceed without fear. At Johns Hopkins, I’m Elizabeth Tracey.
Anchor lead: What can a case of TB in a young child teach us in the United States? Elizabeth Tracey reports
A case of extremely drug-resistant tuberculosis, or XDR-TB, in a young child has been successfully treated by a team of physicians led by Sanjay Jain at Johns Hopkins. The case report is published in the Lancet Infectious Diseases, and Jain says that while the team is very happy about the outcome it brings awareness to a number of issues.
Jain: It’s amazing. It’s also humbling. The bottom line is we’re glad the child is doing very well, but this is a wake up call. TB in general, but I think more so TB in young children, is underdiagnosed. People don’t really know how tough it is to treat and to monitor young patients. It’s a very different ball game than adults, that was the wake up call. That this can happen here in the United States, and in the United States where we have a lot of resources it was so tough for us to treat and monitor this patient. :30
Jain says children are not young adults, and research specific to them is needed with regard to tuberculosis recognition, treatment and monitoring. At Johns Hopkins, I’m Elizabeth Tracey.
This week’s topics include health impact of coffee, measuring body temperature, germ line mutations and cancer in kids, and a treatment for respiratory syncytial virus.
0:35 Coffee and health
1:31 Decrease in cardiovascular mortality
2:36 Way to measure body temperature
3:36 Peripheral thermometers
4:36 Specificity 94%
5:17 Germ line mutations and childhood cancer
6:18 Whole genome analysis
7:18 Most comprehensive study yet
8:10 RSV treatment
9:11 Treated when they became symptomatic
Related blog: http://podblog.blogs.hopkinsmedicine.org/2015/11/20/coffee/