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This month's topic is medical apps

Program notes:

0:20 If not the most popular app certainly close

1:20 Help allow patients to become empowered

2:20 Just working with an EKG app

3:20 They’ll be a range of them at different price points

4:20 All important information for the health record

5:52 End

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Anchor lead: Is low glucose the only way to Alzheimer’s disease? Elizabeth Tracey reports

P38 is the unglamorous name of a protein now known to be involved in Alzheimer’s disease development, a new study concludes, showing it to be involved in glucose levels and insulin in the brain.  Constantine Lyketsos, an Alzheimer’s expert at Johns Hopkins, says there are a host of other ways to develop this common type of dementia.

Lyketsos: Alzheimer’s is not one disease. Another final common pathway seems to be a genetically determined overproduction of beta-amyloid, which causes Alzheimer’s disease, and those people whether or not they have glucose deprivation probably doesn’t matter too much, they’re going to get Alzheimer’s disease. So then shift gears and start thinking what are the other final common pathways that in some people will be entirely the underlying cause or might add with other final common pathways this might well be one of them. :29

Lyketsos says involvement of p38 is a great target for drug development and may help stave off or delay Alzheimer’s disease development for some. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How does glucose in the brain affect the development of Alzheimer’s disease? Elizabeth Tracey reports

People with Alzheimer’s disease have lower levels of glucose in their brain, researchers have known for some time. Now it appears that’s mediated through a protein called p38 that’s involved with insulin and glucose metabolism. Constantine Lyketsos, an Alzheimer’s expert at Johns Hopkins, comments.

Lyketsos: It further supports the idea that there may well be this tricking of the brain insulin system that in some people can contribute to the development of Alzheimer’s disease. It gives us a treatment target. If the glucose pathway goes through this single protein then perhaps inhibiting the activation of that protein could have therapeutic benefits. It’s a whole new line of thinking about some cases of Alzheimer’s disease and we’re in bad need to new lines of thinking about how to treat it. So in that sense it’s very good.   :30

Lyketsos notes that this is just one of the ways that Alzheimer’s disease can develop, since other pathways, particularly in those with a familial inheritance pattern, are also well known. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Why do most cancers arise from random mutations? Elizabeth Tracey reports

Random mutations are the cause of most cancers, a new paper published in Science by Bert Vogelstein and Cristian Tomasetti at Johns Hopkins shows. Tomasetti says these mutations do have a purpose.

Tomasetti: From my point of view its an essential requirement for the system. Evolution works because there are mutations. :08

Vogelstein explores the idea further.

Vogelstein: The idea that most of the mutations that are responsible for cancer occur randomly is unsettling. Everyone would like to believe we’re in control. Even Einstein had difficulty with this concept, that some aspects of life are totally random. Cellular mistakes are the engines of evolution. Thought about in that way cancer, to a large extent, is really a side effect of evolution. :27

Both agree that the findings point to early detection as the likely most effective strategy to one day cure cancer.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What percentage of common cancers are due to random mutations? Elizabeth Tracey reports

Randomly acquired mutations in DNA account for the majority of cancer, a striking new Johns Hopkins study published in Science by Bert Vogelstein and Cristian Tomasetti shows. Tomasetti reveals some of the numbers.

Tomasetti: In lung cancer, where it’s very well known the effect of smoking, and other environmental factors, we estimate that 65% of the mutations are due in fact to environmental and lifestyle factors. About 35% of the mutations are due to random mutations. If we look at cancer types like pancreatic cancer in that case we estimate that 77% is due in fact to random mutations. :30

Tomasetti says heredity plays a very small role in the total number of cancers, about 5%. He says that most people can now stop feeling guilty that somehow they’ve caused their disease since so many cancers arise by this random mutation mechanism. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How much of developing cancer is under your control? Elizabeth Tracey reports

How much do your genes or what you choose to eat or drink have to do with whether you will develop cancer? Not nearly as much as you might think, a new Johns Hopkins study published in the journal Science and led by Bert Vogelstein and Cristian Tomasetti shows. Vogelstein explains that another factor is the major driver in most cancers.

Vogelstein: This factor is due to random mutations that normal cells acquire each time they divide. We believe that these random mutations account for the majority of the mutations that cause cancers. This is the first time that the proportion of cancer gene mutations due to these random mutations as well as environmental and hereditary factors has been able to be quantified. :30

So most cancers are the luck of the draw, the findings show. At Johns Hopkins, I’m Elizabeth Tracey.

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DNA molecule

This week’s topics include ‘drip and ship,’ direct to consumer ads, steroid injections for low back pain, and cancer mutations.

Program notes:
0:37 Drip and ship
1:37 Best to closest stroke center
2:37 TPA helpful in expanding window
3:43 Mutations relative to cancer
4:43 Some inherited genes
5:43 So many people feel guilty
6:42 Steroid injections for low back pain
7:42 Would a second injection help?
8:22 Direct to consumer ads and testosterone
9:22 Even without having a blood test
10:49 End
Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/03/24/random-cancers/
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