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Anchor lead: A new device helps screen people with head injuries for bleeding in the brain, Elizabeth Tracey reports

Brain bleeds after a head injury may now be more quickly identified with use of a hand held device tested at Johns Hopkins and several other centers. Called AHEAD 300, the device uses EEG type measurements and an algorithm to predict bleeding. Dan Hanley, lead investigator at Hopkins, says there may be other applications.

Hanley: Not only does this device find brain bleeding it also appears to have much potential in identifying who’s had a concussion, with substantial symptoms, with only mild symptoms, or in someone who’s had an event, that, to witnesses could be a concussion but that their EEG is completely normal, that in this group correlated with absence of symptoms of concussion. :24

Hanley says AHEAD 300 could be used for evaluation in places where no CT or other sophisticated imaging is available, with results used to determine if a patient should be transported. It may also have a role in reducing unnecessary CT scans for head injury, which are expensive and involve radiation. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Family history may be key to prescribing healthy interventions, Elizabeth Tracey reports

Your family history can help your physician to easily recognize some of your health risks and discuss things to lower your risk, without the need for tests that delay that discussion. That’s the conclusion of a Johns Hopkins study by Mariana Lazo and colleagues.

Lazo: in the US population the prevalence of family history is quite high. Almost one-third of the population have a family history of diabetes. Almost 6% have a family history of cardiovascular disease, and 6.5 have family history of both.  :15

Even when family history was present, the study showed many people still engaged in risky behaviors.

Lazo: And yet, those with family history were more likely to be overweight or obese, to be current smokers, and we did not find any association with physical activity.   :11

Lazo says patients can easily recall diabetes or heart issues in their relatives, and that gives physicians a window to talk about diet, exercise, and weight loss. So the message to doctors is clear: asking about family history is a must, and patients should volunteer these facts if they’re not asked. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Are mice really any use in medical research? Elizabeth Tracey reports

Mice are under fire in the scientific community lately, with detractors pointing out that discoveries made in this animal model rarely make the transition to utility in humans. Yet Janice Clements, an HIV researcher at Johns Hopkins, points out that all research questions benefit from a multitude of methods to address them.

Clements: You can’t choose one model. You need to be informed by multiple models. An organ on a chip is still on a chip. It doesn’t have the immune system, it doesn’t have the blood. A mouse does have that system working. The organ on a chip, which is maybe more human, has some things that are better than mice but not everything. Even a nonhuman primate model isn’t ideal. What we always explain to people is animal models are models, and you use the best one for the question you’re asking. :30

Clements says the mouse model has been a scientific workhorse, enabling very precise genetic lineages to be developed. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A new survey says most docs would choose medicine again, Elizabeth Tracey reports

Burnout among medical professionals, especially doctors, is much in the news lately, but now a new survey undertaken by the American Medical Association reveals that 90% of physicians would choose medicine again. Janice Clements, Vice Dean for Faculty Affairs at Johns Hopkins, says she’s not surprised, but issues remain.

Clements: They are happy, they are doing one of the best things that they can do, take care of people. What the lack of joy is in, is all the things doctors have to do now that don’t involve taking care of their patients. They have to spend less and less time with their patient and more time on all the regulatory, processing, getting their patients scheduled or getting their patients the right kind of medication, fighting with insurance companies for their patients, it’s a hard job.   :28

Clements says recent requirements relative to electronic medical records are especially burdensome but strategies to help are being developed. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How can salary disparities between physicians be overcome? Elizabeth Tracey reports

Recent release of 2016 analysis of physician salaries reveals that gaps remain between men and women doctors, in some cases very large gaps. Janice Clements, Vice Dean for Faculty Affairs at Johns Hopkins, says the Hopkins model may help address this issue.

Clements: Women get paid very much the same as men now. The difference in base salary is 1.6% that’s not even statistically different. Outside it’s 19%. We do studies every year of women’s salaries, and men’s, salary equity and we call it the salary equity study, because men sometimes don’t get paid what they should. So it’s good for everyone. It was a strategic approach of how you don’t advocate for something unless you provide reason and data and a process, and then it becomes a strategic priority.  :30

Clements says salary parity is something that concerns everyone as persistent wage gaps can affect whether women remain in the workforce. She says some of the disparity is accounted for by the fact that many women physicians don’t go into the highest paid specialties, but that’s changing also. At Johns Hopkins, I’m Elizabeth Tracey.

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Molecular Model of Fluticasone.

This week’s topics include the dangers of short term corticosteroids, troponin assay for assessing MI, azithromycin and arrhythmia, and eye screening intervals for people with diabetes.

Program notes:

0:33 Short term corticosteroids and consequences
1:32 20% got a prescription for steroids
2:34 Steroids for minor indications
3:02 Azithromycin and ventricular arrhythmias
4:02 Over 14 million antibiotic users
5:01 Evaluating MI with troponin
6:03 No EKG abnormalities
7:02 Immediately employed
7:27 Diabetic eye problems and screening interval
8:27 Follow for 30 years and take pictures of eyes
9:25 If we lengthen must remind patients
10:11 End

Related blog: http://podblog.blogs.hopkinsmedicine.org/2017/04/24/the-dangers-of-steroids/

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Anchor lead: Cancer cells may utilize epigenetic changes even more than normal cells, Elizabeth Tracey reports

DNA is modified by actual changes in the sequence, known as mutations, and by so-called epigenetic changes, which use certain chemical groups to turn genes on or off. Now research by Andy Feinberg and John Goutsias at Johns Hopkins has shown that these epigenetic changes occur in a specific pattern in normal cells but become very disorganized in a cancer cell.

Feinberg: One of the most important aspects of cancer is that it has a very high degree of variability. One of the main things that really defines what a cancer is is that the epigenetic code becomes very variable, and that allows for tumor cells to have many different properties. We call that tumor cell heterogeneity. So that when the tumor gets exposed to different environments it’s much easier for the tumor cell to adapt to its environment if there’s a certain randomness in which genes are going to be turned on and off. :31

Feinberg says inhibition of this process may be a likely target to reduce a cancer’s ability to adapt and outwit many therapies. At Johns Hopkins, I’m Elizabeth Tracey.

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