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one young man runner jogger running jogging in silhouette isolated on white background

This week’s topics include alcohol abuse and CVD, gun violence in adolescents, social networks and gun violence, and weekend warriors.

Program notes:
0:34 Weekend warriors
1:34 Compared to sedentary, they did have a reduction in mortality
2:32 For those who can’t do daily
3:00 Is gun violence contagious?
4:00 Looked at relationships
5:00 Now we know there is social contagion
5:15 Adolescents and gun violence
6:15 All homicides in 13-20 year olds
7:15 Must change the entirety
7:27 Alcohol abuse and CVD
8:30 Much increased and almost the same as other risk factors
9:30 What quantity of alcohol use?
10:20 End
Related blog:
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Yellow ear wax on a swab isolated over white

This week’s topics include managing earwax, metformin and other diseases, atypical antipsychotics in palliative care, and firearm purchase without a background check.

Program notes:

0:51 Managing ear wax
1:51 Industry relative to removal
2:53 Putting cotton swabs not good
3:31 Metformin use and comorbidities
4:31 Does metformin increase or decrease mortality?
5:34 Firearm purchase without background checks
6:35 Where and when firearms were purchased
7:37 33,000 deaths annually due to firearms
7:59 Atypical antipsychotics in palliative setting
9:00 Placebo, haloperidol, or risperidone
10:22 End

Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/01/08/how-to-manage-ear-wax/

 

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Anchor lead:  A new treatment offers hope for people with non-small cell lung cancer, Elizabeth Tracey reports

A new type of therapy for people with non-small lung cancer, which has historically been very hard to treat, has shown quite promising results, a study in the New England Journal of Medicine shows.  William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the results.

Nelson: The osimertinib did very well. Progression-free survival was improved dramatically the response rate was 71% of the tumors shrunk more with the osimertinib versus only 31% with the chemotherapy combination and the high grade toxicities were less, so this is clearly a drug that is going to be part of the arsenal to treat this kind of non-small cell lung cancer. :23

Nelson says osimertinib targets a known problem in many with this disease.

Nelson: You knew that this receptor was the driver, and yet you couldn’t stop this particular mutant from working and so now that you can I think it opens up the ability to treat many more people.   :09

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Some tumors evade the best defenses, Elizabeth Tracey reports

Even as cancer treatments are becoming more targeted and specific, some tumors are demonstrating their ability to evade them, a recent case report in the New England Journal of Medicine illustrates.  William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says this isn’t a new observation.

Nelson: It appears there are significant differences at different metastatic sites. Usually there is similarity of the driver kinds of alterations that are pushing the cancer and there are a lot of little differences so the genes of cancer cells are innately unstable. They’re constantly dealing new genetic alterations, and the worry is that that propensity to generate new variants of cancer cells may mean that there’s almost always one that can be generated that can outfox some kind of treatment, that’s the real worry.   :32

Nelson says strategies to manage a variety of mutations are under investigation. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  The FDA is stepping out to regulate many cigarillos, Elizabeth Tracey reports

Little cigars, known as cigarillos, are coming under the scrutiny of the FDA, and that’s good news, says Enid Neptune, a lung expert and antismoking advocate at Johns Hopkins.

Neptune: The cigarillo industry specifically targets youth. Where you see these cigarillos is if you go to convenience stores or gas stations you will see them displayed behind the cash register. What jumps out is that they look like candy. They’ll have pineapple packaging, coconut, all the flavors that children associate with candy.   :22

Nepture applauds action from the FDA.

Neptune: The decision by the FDA to go after these products is helpful.  What that says is that this issue of flavorings is going to be a critical component of what’s going to be used for premarket review going forward.  :17

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Fewer and fewer people are smoking in the US, Elizabeth Tracey reports

A shrinking proportion of the US population is choosing to smoke cigarettes, welcome federal data released at the end of 2016 show. Mike Klag, dean of the Johns Hopkins Bloomberg School of Public Health, says this is good news indeed with regard to a primary driver of many diseases.

Klag: It’s remarkable when I think about when I started in medicine in the late 70s how the prevalence of smoking has dropped from above 30%  to now less than 15%. In 2005 we were at 21% and now we’re at 15%. And we see this across all age, race, sex and ethnic groups. And across the country and in various levels of socioeconomic status. The biggest declines were in the youngest age groups although we still see too many young people smoking. 13% of 18-24 year olds still smoke.   :30

Klag reflects that some of the drop among younger folks has been replaced with an increased rate of e-cigarette use, or vaping, something we need to watch carefully.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Huge variations in cause of death exist around the country, Elizabeth Tracey reports

What will you die from? Turns out where you live in the United States may have a much greater impact than what you may think, a recent huge study published in the Journal of the American Medical Association indicates.  Mike Klag, dean of the Johns Hopkins Bloomberg School of Public Health, identifies implications of the study.

Klag: The important message is that when you see these kinds of hot spots you then have to delve deeper, you have to understand what are the reasons for it, who are the individuals involved, what are the individual risk factors? And how does it vary within a county? It predicts where attention should be turned, and then depending on what the reasons are then resources should flow. But I think it’s useful for me because I care deeply about the US to look at these broad differences and in one sense differences can represent inequities, but they can represent opportunities.  :30

Klag says targeted inventions may be a useful place to start. At Johns Hopkins, I’m Elizabeth Tracey.

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