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Anchor lead:  Will an integrated approach to bladder cancer help reduce deaths from the disease? Elizabeth Tracey reports

For the first time in three decades a new treatment has received FDA approval for bladder cancer. Stephanie Cooper Greenberg, and her husband Erwin, hope many more treatments for this disease will be forthcoming with their establishment of the Greenberg Bladder Cancer Institute at Johns Hopkins. Greenberg says the problem is much bigger than most people realize.

Greenberg: Bladder cancer does affect men and women, it’s four times more prevalent in men than women and actually we’re doing some fascinating research on gender differences. Sadly it is more lethal in women.  A lot of bladder cancer is superficial, then, if not caught in time it does advance to muscle invasive bladder cancer. And then it is a very, very aggressive cancer with an 80% recurrence rate. It also happens to be the most expensive cancer to treat.   :29

Bladder cancer is the sixth most common type of cancer, the American Cancer Society reports, with about 75,000 cases each year in the US.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  Bladder cancer is finally getting much needed attention, Elizabeth Tracey reports

Bladder cancer sometimes gets lost among the other, more common cancers such as prostate or breast, but that’s poised to change with the establishment of the Greenberg Bladder Cancer Institute at Johns Hopkins. Erwin Greenberg, whose generous gift has allowed creation of the institute, frames up the issue.

Greenberg: If I asked you right now what do you know about bladder cancer the chances are you’d tell me oh my uncle had it or somebody else had it I knew, and in the horrible name cancer high on the list were breast cancer, prostate cancer, this disease was swept under the rug.  :20

The numbers of bladder cancer cases are quite large.

Greenberg: In the United States there are 75,000 cases a year mostly men but it can be women as well. Many are never diagnosed so the number could be much higher. From an international point of view we’re talking about 350,000 cases of this disease.  :19

Greenberg hopes the institute will allow a multidisciplinary approach to research and treatment for bladder cancer.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: The Veteran’s Administration is taking the lead on empowering nurses to do more, Elizabeth Tracey reports

Nurses are being empowered by the Veteran’s Administration to take on more responsibility and do as much as they are licensed to do without the oversight of doctors, according to a proposed new rule, with the intention of providing better and more timely medical care to the nation’s veterans.  Trish Davidson, dean of the Johns Hopkins School of Nursing, comments.

Davidson: I think why the VA is focusing on this is because of the chronic and complex needs of many of their patients, and it’s in that area where nurses excel.  Nurses independent practice is drawing upon the best available medical knowledge, and also the knowledge, skills and values we bring to the patient encounter. In particular looking at the whole person and taking time to go beyond the physical to the social, the psychological, and the cultural factors.  So I’m really excited that the VA is leading this debate.  :33

Davidson says if successful, she anticipates more large organizations following suit. At Johns Hopkins, I’m Elizabeth Tracey

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Anchor lead:  Keeping hydrated may be important in stroke outcomes, Elizabeth Tracey reports

People who were dehydrated and had a stroke fared worse both right afterward and a few months later, than those who weren’t dehydrated, a Johns Hopkins study led by stroke expert Mona Bahouth has shown.  But Bahouth says this doesn’t mean if you’re having symptoms of a stroke you should drink.

Bahouth: This really just tells us about your hydration status at the time the stroke happens, and will hopefully help your doctors and nurses to give you more hydration at the time of the stroke, it does not mean to drink water at the time of stroke.   :12

Bahouth hopes this study will encourage everyone to drink more water, especially as they get older.

Bahouth:  We know just from basic physiology and basic medicine that as you get older you lose your sense of thirst, your thirst drive, and so it’s more important to be aware of drinking water as we get older because your body doesn’t always give you those cues.  :13

Bahouth says those who are helping care for older people can also get on board with encouraging them to drink water, and says offering beverages that people are known to like often works best.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: People who are dehydrated at the time they have a stroke may have worse outcomes, Elizabeth Tracey reports

Dehydration may cause strokes to be more severe as well as result in more severe consequences of a stroke down the road, a two part Johns Hopkins study led by Mona Bahouth, a stroke expert, and colleagues has shown.

Bahouth: The study was conducted in two phases, there were about 180 patients in each phase of the study, so 360 total.  And in the first phase we looked at their outcome very early after their stroke, how did they do several days after the stroke happened, and we found that patients were in the worst category of functional change after their stroke. We then shifted in the next 180 patients to look at 3 month outcomes, and again, patients who were dehydrated at the time of their stroke seemed to do worse at 3 months.   :27

Bahouth says because the consequences of a stroke can be life-altering, finding any modifiable risk factors, especially those related to outcomes, have the potential to improve people’s lives.  She says the next step is to see whether rehydration is helpful.  At Johns Hopkins, I’m Elizabeth Tracey.

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This week’s topics include sudden cardiac death in youth, novel anticoagulants, dietary habits of Americans, and plant-based therapies for menopausal symptoms.

Program notes:

0:30 Comprehensive look at dietary habits of Americans
1:30 Less processed meat
2:34 Worth undertaking
2:52 Global look at novel anticoagulants
3:53 Meta-analysis with coumidin
4:53 Limited options for reversal
5:32 Plant based therapies for menopausal symptoms
6:34 Over 6000 women
7:35 Sudden cardiac death in youth
8:38 Establish cause in about a quarter
9:35 Belies exercise risk
10:26 End

Related blog:  https://podblog.blogs.hopkinsmedicine.org/2016/06/24/best-blood-thinner/

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This week’s topics include the mortality benefit of whole grains, changes to primary care practices that don’t seem to have helped, weight loss drugs, and reducing cardiovascular outcomes in people with diabetes and kidney compromise.
Program notes:
0:32 Whole grain consumption
1:34 Compared the extremes of intake
2:32 Decrease by 15-18%
3:10 Weight loss drugs
4:10 Variable weight loss
5:10 Liraglutide also treats diabetes
5:47 Diabetes, chronic kidney disease and the heart
6:48 Avoid going on dialysis
7:44 CMS changes to primary care
8:45  Investment of $115,000 per clinician
10:10 End
Related blog: https://podblog.blogs.hopkinsmedicine.org/2016/06/19/whole-grains-rock/
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