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Anchor lead: Cooling the body is recommended for some after a heart attack, but why? Elizabeth Tracey reports

 

If you have a loved one who’s had a heart attack, should you ask whether they would benefit from cooling their body, as recommended by the American Academy of Neurology recently? Michael Blaha, a cardiologist at Johns Hopkins, comments.

Blaha:I think it is worth family members who have a family member who’s had an out of hospital arrest to be aware of what the heart rhythm was and whether a shock was delivered in the field, and then to ask their doctors about whether cooling is right for their family member.  :13

Blaha says cooling works to prevent additional injury by a simple mechanism.

Blaha: It’s kind of like my fish in my fish pond. When they’re cooled they kind of nothing happens, their metabolism shuts down and then it warms up and all of a sudden they start swimming again. So you want to just slow the body’s metabolism down to the point where there’s not a whole lot going on so there’s less injury.   :14

Blaha notes that cooling also reduces the likelihood of fever, a common aftereffect of a heart attack. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: People who’ve had certain kinds of heart attacks should be cooled down afterward, Elizabeth Tracey reports

The American Academy of Neurology has recently advised that when people experience certain types of heart attacks, they should be cooled down for a period afterward to minimize damage, especially to the brain. Michael Blaha, a cardiologist at Johns Hopkins, reviews the guidelines.

Blaha: Recent guidelines from our neurology colleagues reinforce the recommendation for cooling the body after an out of hospital arrest. You have to be sure that you’re cooling the right patients. Patients who are found without a heart rhythm out in the field do not benefit from cooling as much as those patients who are found with a heart rhythm who receive a shock and receive a return of circulation, and are subsequently cooled, thus improving their neurological outcomes.   :25

Blaha says it’s very important to determine what kind of cardiac event has taken place before cooling is instituted, and notes that one common symptom following a heart attack is the development of fever, which cooling the body also benefits. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Can a virus help treat macular degeneration? Elizabeth Tracey reports

Macular degeneration is a common cause of vision loss as people age, with one form of the condition treated with injections of a protein right into the eye. This protein binds to something called vascular endothelial growth factor, abbreviated VEGF, and keeps new blood vessels from forming. Now research by ophthalmologist Peter Campochiaro and colleagues at Johns Hopkins has shown that a virus can be used to enable the protein to be made in the eye itself, easing treatment issues for patients.

Campochiaro: They need injections every four or five weeks in order to keep the disease quiet. Sometimes they’ll miss an appointment, the disease will reactivate, and they can get permanent loss of vision, so we’ve been exploring an alternative approach, which instead of injecting a protein that binds VEGF, we inject a viral vector that goes into the cells in the eye, and then produces the protein that binds VEGF. As a result a single injection can act for a very long period of time.   :32

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Should you take a vitamin D supplement? Elizabeth Tracey reports

Are you getting enough vitamin D or should you take a supplement? That question is even more important in light of research by cardiologist Erin Michos and colleagues at Johns Hopkins showing that vitamin D as well as exercise were important in staving off cardiovascular disease. Michos describes what’s known right now.

Michos: If your vitamin D levels are above 20 ng/ml there’s probably little evidence that more is better. So you need to have adequate vitamin D levels for bone health but once you reach that threshold there is decreasing gain. I think that individuals who are already getting the recommended amount and have adequate blood levels, they don’t need supplements.  But there might be a role for vitamin D supplements  for people who have a deficiency, based on a blood level that’s less than 20ng/ml of vitamin D.    :31

So find out if you really need a supplement before taking one. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How can studying blood vessel formation improve medical care? Elizabeth Tracey reports

Blood vessels form in a process known as vascularization, and it’s important in maintaining healthy tissues as well as in abnormal conditions like cancer. That’s according to Sharon Gerecht, director of the Institute of Nanobiotechnology at Johns Hopkins.

Gerecht: We want to study vascularization because it’s the process that contributes to the development, regeneration and wound healing. But it’s also the process that is actually feeding tumors to grow, prosper but also spread to distant organs.  :16

Gerecht says this research has identified important differences in blood vessel formation at different places in the body.

Gerecht: why one area in the body is responding to whatever is happening in the eye and it’s not in the entire body? Because it’s a specific response to the eye so you have to take into account the surrounding tissue.  :14

Gerecht says people with conditions like macular degeneration as well as cancer and transplants will benefit from this research. At Johns Hopkins, I’m Elizabeth Tracey.

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Rustic homemade chocolate and ingredients

This week’s topics include chocolate and atrial fibrillation, chondroitin and knee osteoarthritis, cannabidiol and seizures, and high fiber consumption and knee pain.

Program notes:
0:34 Chocolate and atrial fibrillation
1:30 Danish Diet Cancer and Health Study
2:33 Not with milk chocolate
3:16 Chondroitin sulfate and osteoarthritis
4:16 Study according to European guidelines
5:16 Take as first line
5:32 Fiber consumption and knee osteoarthritis
6:32 No difference in radiographic evidence
7:15 Cannabidiol and seizures
8:15 Decreased seizures per month
9:15 Didn’t help non convulsive seizures
10:33 End
Related blog:
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Anchor lead: Is there a magic mix when it comes to cardiovascular disease prevention? Elizabeth Tracey reports

What can a study with over 19 years of follow up tell us about preventing cardiovascular disease? Erin Michos, lead investigator and a cardiologist at Johns Hopkins, says meeting American Heart Association guidelines for physical activity is important, but so is the right level of vitamin D.

Michos: Those that were physically active that were meeting those recommendations were far less likely to develop heart attacks or strokes over the next 19 years. We show that people with the lowest risk were people that had both adequate vitamin D levels and adequate physical activity. That they were synergistic, that those people who had adequate levels of both had the lowest risk. So future intervention studies might need to look into whether to optimize cardiovascular health whether we ought to optimize vitamin D levels in addition to optimizing people’s activity levels.  :31

Michos says there’s still some confusion regarding vitamin D and whether supplements are appropriate, so that’s an issue under active investigation. At Johns Hopkins, I’m Elizabeth Tracey.

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