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This week’s topics include manual versus mechanical CPR, duration of dual therapy after stent placement, sudden cardiac death among policemen, and HDL efflux versus level.

Program notes:

0:54 Mechanical versus manual CPR
1:52 Mechanical in an ambulance better?
2:50 Expensive device and training needed
3:42 Sudden cardiac death in police officers
4:40 Happen during emergency situations
5:40 HDL cholesterol fine points
6:40 Cholesterol transport
7:41 Ability to transport cholesterol for excretion
8:25 How long to stay on drugs after stenting
9:30 Fewer heart attacks but not stroke or death
10:30 End

Related blog:http://podblog.blogs.hopkinsmedicine.org/2014/11/21/hands-down-manual-is-better/

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Anchor lead: Kids with food allergies frequently outgrow them, and that may be better for their diet, Elizabeth Tracey reports

Food allergies in kids are common, and becoming more so, with the first line intervention to simply avoid the food.  When that food is milk, however, the consequences on the child’s growth and health may be significant, a Johns Hopkins study led by Corinne Keet, a pediatric allergist, has found. In view of that fact, Keet says there are a few things parents should keep in mind.

Keet: It’s very frequent that children and adults are misdiagnosed with food allergies.  There are symptoms that they interpret as being food allergies that are not food allergy.  The laboratory tests that we have for food allergy are not very good, so we know that many more people have positive laboratory tests than really have food allergy and a lot of people are following avoidance diets they probably don’t need to follow.   :19

Kids also very often outgrow their allergies over time.

Keet: Outgrowing food allergies we know that’s very common and that even if children have had a real food allergy they may no longer need to be following the same avoidance diet that they once did.   :09

Keet says your child’s allergist can advise on safe food reintroduction.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  What’s the impact of milk avoidance in allergic kids? Elizabeth Tracey reports

Kids who avoid milk consumption because of milk allergies do experience a host of consequences by removing milk from their diet, a Johns Hopkins study led by Corinne Keet, a pediatric allergist, has shown.

Keet: We found that they tended to be smaller, they tended to have less intake of protein and calories, and that their calcium and vitamin D tended to be less as well. Milk tends to form a big part of children’s diets, not drinking milk leaves children at some nutritional risk, we hope that children who are allergic to milk and who are not drinking it are getting nutritional counseling so they are choosing appropriate substitutes or are taking vitamins but it seems like there’s more work to be done on this.   :28

Keet says parents should consult with a nutritionist to make sure their children receive adequate calories as well as vitamin D and calcium, which are especially important to bone health as children grow.  Supplements may also be required depending on the child’s dietary choices.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  Can calorie information be conveyed by a standardized stick figure? Elizabeth Tracey reports

When given easily understandable information on calories and their impact, adolescents chose fewer sugary beverages, a Johns Hopkins study led by Sara Bleich has found.  Bleich says she would translate these findings into a standardized, disseminated icon so everyone can be informed when making food choices.

Bleich: I would make sure that anyplace that has calorie information posted had a easily understandable translation was posted alongside. You would have a stick figure which was walking and underneath of it it says five miles.  And everywhere you went it would be the exact same metric and so you could easily make sense of it. The second thing I would do is I would actually push restaurants to make changes to bring down their calories, and that has a much larger potential to have a population impact, because then you’re not relying on individuals to make decisions, you’re just sort of changing their environment, which we know if more effective.   :29

Bleich is in favor of a multipronged approach to stem the tide of obesity worldwide, and believes a standardized icon would help.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: When kids are educated about calories, they continue to make better nutritional choices, Elizabeth Tracey reports

Kids who were exposed to signage detailing how much they’d need to walk to burn off a 20 ounce soda chose such a beverage much less often, a Johns Hopkins study led by Sara Bleich has found.  Bleich says, even more exciting is that this result persisted over time.

Bleich: At the end life we took all our signs down and life returned to usual and we watched the kids.  And this time we found that there was this persistent effect of this information on behavior.  So for six weeks after the signs had come down and life was as usual in these stores, the kids were still buying fewer calories, fewer sugary beverages, and fewer large volume sugary beverages.  So we were really encouraged by these results.   :20

Bleich accounts for some of the success of this intervention by the very simplicity of the signage.

Bleich: Our thought is that if you give it to them in these easily understandable nuggets it’s going to have a bigger impact.   :05

One question that remains is how long such behavior change remains if signs are kept in place, since previous research has shown that once people become accustomed to something they stop paying attention.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: When kids are educated about nutrition choices, does it help? Elizabeth Tracey reports

Simply providing signage in corner grocery stores where kids shop may help inform their buying choices, a Johns Hopkins study led by Sara Bleich has found.  Bleich describes the information provided in this study.

Bleich: We either told them that a 20 ounce bottle of soda has 250 calories, that that 20 ounce bottle of soda was equivalent to 16 teaspoons of sugar, 50 minutes of running or five miles of walking. And so a kid walks into a store and there’s an 8.5x11 sign with this piece of information and they go to make a beverage choice.   :18

Turns out that even though many reported they didn’t even see the signage, most made better choices based on one specific type of information.

Bleich: The punch line is if you tell kids they have to walk five miles they drink fewer sugary beverages, they buy fewer calories, they buy fewer large volume sugary beverages, bigger than sixteen ounces, and in some cases they choose not to buy anything at all.   :12

Bleich would like to expand this study to see if some impact on childhood obesity is seen over time.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  What can be done about an increase in colon cancer in younger people? Elizabeth Tracey reports

Colorectal cancer rates appear to be poised for a rise after falling for some time, a recent study projects. Even more distressing is the fact that this rise is taking place among those in their 20s, 30s, and 40s, not a group who normally undergo screening.  Patrick Okolo, a colon cancer expert at Johns Hopkins, says new molecular tests for the disease couldn’t have arrived at a better time.

Okolo: Tests become better in their performance as both the prevalence and the incidence go up. So we should expect that these tests will be very helpful . It’s good that they’re coming at a time when we’re seeing this disturbing trend because we’re going to need to use more tools, and have tools that are more  available to a wider swath of the population as the younger population becomes the major consumers of healthcare.   :21

Okolo says it seems clear that some type of environmental exposure is involved in this rise, most likely dietary in nature.  He says increased rates of diabetes and obesity likely also play a role, as may sedentary lifestyle, and points out that these risk factors are modifiable.  At Johns Hopkins, I’m Elizabeth Tracey.

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