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Anchor lead:  Can a new treatment using stem cells help in multiple sclerosis? Elizabeth Tracey reports

A new therapy using chemotherapy and stem cells appears to help people with multiple sclerosis, a recent study reported.  Peter Calabresi, a multiple sclerosis expert at Johns Hopkins, says a major factor in this strategy is damping down inflammation.

Calabresi: We know in inflammatory diseases like MS that stopping the inflammation with very potent robust therapies like chemotherapy does have an acute effect and it reduces disability.   We saw this when we gave high dose cyclophosphamide that many of the patients had reductions in disability.  It’s been seen in all the clinical trials of FDA approved immune therapies that a certain proportion of patients who have a lot of inflammation when you reduce that inflammation they feel better and their nervous systems function better.   :27

Calabresi says previous studies using stem cells have been disappointing, and because there were no controls in this study, their utility still hasn’t been proven.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  There really are differences in breast cancer diagnosis and course depending on ethnicity, Elizabeth Tracey reports

Women of different ethnicities are first diagnosed at different stages of breast cancer, and even when they all have stage one, more African American women die of their disease than either white or Asian women, a recent study found.  William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the findings.

Nelson: About 50.8% of white women were diagnosed at this stage, 56% of Japanese American women were diagnosed, but only 37% of African American women.  After these women were diagnosed the ones with stage one breast cancer looked at seven years and found out what the outcomes were, about 3% of white women with this breast cancer at seven years were found to have died of breast cancer, about 1.7% of Asian women but about 6.2% of African American women.   :29

Nelson says accounting for these differences, whether social or biological factors are at play, will help.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Some e-cigarettes produce a known carcinogen, Elizabeth Tracey reports

e-cigarettes that produce high-temperature vapor may also be producing formaldehyde, a recent study reported.  William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, explains the data.

Nelson: What this study showed is that when these cigarettes were operated at the higher power they generated formaldehyde.  Now formaldehyde we know it’s a carcinogen, this is bad.  If there’s formaldehyde being generated it will have consequences that we will see years from now.  There are also some inhaled nicotine devices that don’t involve heating, presumably these wouldn’t generated formaldehyde, all of this would be much safer if this were used as a bridge to stop smoking rather than as a substitute for chronic smoking.   :31

Nelson says people who use these devices need to be mindful of by-products of vaporization, as studies are just beginning to emerge. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  In older people, reducing salt intake isn’t helpful, Elizabeth Tracey reports

Salt has been fingered as the latest dietary no-no for several years now, but a recent study shows that restricting salt for older people really doesn’t lengthen life.  Daniel Kim, chief resident in internal medicine at Johns Hopkins Bayview, says starting early may be key.

Kim: Lifestyle or salt intake or diet, these are things that accumulate over time. So I recommend even patients that I see thirties, forties, or even twenties that we need to make these good lifestyle changes now because when you see the effects its going to be decades down the road.  So seeing somebody and restricting them from 70 and seeing outcomes at 80 its very hard to see a big difference.   :23

Kim says too much restriction isn’t good especially in older people.

Kim: We have to reconsider whether asking people to be mindful of their salt intake whether it’s beneficial for all, whether we should target the young, or we should allow, kind of like the blood pressure control, allow it to be a little more lenient on people who are elderly.   :14

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Too much sitting can increase your risk of death, even if you exercise, Elizabeth Tracey reports

Even if you’re a dedicated exerciser, if you spend too much time sitting down you are at increased mortality risk, a recent study found.  Daniel Kim, chief resident in internal medicine at Johns Hopkins Bayview, interprets the findings.

Kim: A lot of the public health focus has been on exercise, exercise, exercise. I think it’s very important however most of the time we spend much of our day sitting around and we exercise for maybe thirty minutes. But that 8 or 10 hours sitting in front of the computer could also be harmful and it might not be totally reversed by just purely physical activity. And so what’s important to realize from this study is we have to be mindful of how long we are sitting for.  As a general rule moving around, getting up using those muscles is generally a good idea.  :33

Kim says getting up once every hour is also known to improve mental acuity as well.  At Johns Hopkins, I’m Elizabeth Tracey.

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This week's topics include chlorhexidine baths in the ICU, dangers of too much sitting, intracytoplasmic sperm injection, and stem cell therapy for MS

Program notes:

0:40 Intracytoplasmic sperm injection
1:36 Outcomes no better
2:32 Bathing patients with chlorhexidine in the ICU
3:32 Randomized by ICU and crossover
4:32 Visitors wash hands too
4:44 Stem cells and MS
5:44 Administered own stem cells
6:40 Not randomized or controlled
7:24 Deleterious effect of sitting
8:24 All-cause mortality increased
9:24 Standing meetings
10:21 End

Related blog:http://podblog.blogs.hopkinsmedicine.org/2015/01/23/stop-sitting-around/

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Anchor lead: Eating more whole grains helps reduce mortality risk, Elizabeth Tracey reports

It’s confirmed: a recent analysis of two very large, long term studies has shown once again that the more whole grains you consume, the more you reduce your risk of death.  Redonda Miller, an internal medicine expert at Johns Hopkins, takes a look at the data.

Miller: They looked at quintiles of dietary whole grain intake and impact on total mortality, cancer mortality and cardiovascular disease mortality.  What they found was that for both total mortality and cardiovascular mortality, the higher the quintile of whole grain intake the lower the risk of death. They did not see a relationship between cancer mortality and whole grain intake.   :26

Miller says it’s not clear why cancer mortality is unaffected by whole grain consumption, but notes that eating more such products is simply a matter of substituting whole grain for refined cereals, breads, pasta and the like, and is also helpful in weight control.  At Johns Hopkins, I’m Elizabeth Tracey.

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