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Anchor lead: Can a drug developed to treat osteoporosis prevent breast cancer? Elizabeth Tracey reports

A class of drugs known as bisphosphonates, originally developed to treat osteoporosis, is increasingly being reported as a way to prevent the spread of breast cancer, a new meta-analysis published in the Lancet, where data from many studies is pooled, concludes.  Ben Park, a breast cancer expert at Johns Hopkins, looks at the study.

Park: They actually took primary data and analyzed it as if it was brand new and used all the patient data.  The outcome seemed that yes, these can prevent breast cancer from recurring in a postmenopausal population. Probably about six or seven years ago there were a couple of studies that suggested that women who were taking bisphosphonate therapies might reduce their risk of even a new breast cancer from coming back.  And so I think with all this data accumulating the overall consensus might actually be enough to push this forward and say these things probably do work.  :30

Park warns that all women should be considered individually to determine whether use of bisphosphonates is right for them. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: The CDC has reported disturbing statistics on just how widespread chronic pain is, Elizabeth Tracey reports

One in ten people is in significant, constant pain daily, the CDC has reported recently, while the majority of adults report some type of pain in the last three months.  How can alleviating pain be juxtaposed against our epidemic of opioid addiction and overdose?  Mike Klag, dean of the Bloomberg School of Public Health at Johns Hopkins, says identifying the source of pain can help.

Klag: Musculoskeletal pain can often be improved with stretching and the right kind of exercise. We need to emphasize those.  We need to recognize that every drug has risk and benefit, and a decision to prescribe them, or use them is based on that risk and benefit, so having good data about the risk and benefit would be important. There needs to be a judgment made for every patient about how severe is the pain, what’s the appropriate treatment, what’s the long term risk versus the long term benefit?  :26

Klag says pharmaceutical companies and researchers are hard at work looking at how our brains process pain and potential places for intervention.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  An effective and safe vaccine for Ebola is here, Elizabeth Tracey reports

A vaccine with 100% effectiveness in preventing Ebola virus infection has been reported in the Lancet.  Mike Klag, dean of the Johns Hopkins Bloomberg School of Public Health, describes the study.

Klag: It was a very innovative trial.  It used an innovative strategy where they randomized by cluster.  These were clusters of index cases and contacts.  Everybody got the vaccine, but the randomization was to early versus late.   :14

About half of the 7500 people enrolled got the vaccine immediately, while the other half waited three weeks.  Klag explains the ethics of this design.

Klag: There is this concept of clinical equipoise.  For a trial to be ethical there has to be substantial uncertainty about whether the treatment is better than no treatment. This was a case where there was incredible uncertainty.  We didn’t know what the side effects would be.  We did not know how effective it would be. There was lots of uncertainty, but there’s not much uncertainty now.   :20

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Women face a dizzying constellation of issues as they age, Elizabeth Tracey reports

Aging populations are at the forefront of many government and policy discussions, but women bear the brunt of the majority of both physical disability and economic compromise as they grow older. As such, gender-specific issues should be integrated into policy discussions, research by Patricia Davidson, dean of the Johns Hopkins School of Nursing, and colleagues, concludes.

Davidson: There’s a tsunami that many of us don’t realize is approaching. And it’s what has been coined the feminization of aging. Women are living longer with more disability.  The scary thing is in poverty. Women are approaching retirement and old age with significant disability, also inability to negotiate the complex financial process of death and dying. It’s not just all about the disease.  As healthcare professionals we need to help and support them in coping and adjusting.   :33

Davidson says the healthcare system needs to integrate financial savvy into its toolkit in caring for older women.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Social factors play a big role in coping with heart disease, Elizabeth Tracey reports

Would you be surprised to learn that things like where you live and how that impacts on food choices, and whether you exercise may be just as important as blood pressure when it comes to reducing heart disease mortality?  That’s one conclusion of a recent paper in Circulation, a journal published by the American Heart Association.  Patricia Davidson, dean of the Johns Hopkins School of Nursing, comments.

Davidson: In the discussion and debate about personalized medicine, when you talk to many physicians it’s all about genomics, but you’ve probably heard the line your zip code is just as important as your genetic code.  This is a big signal to nurses to step up to the plate, to implement many of the interventions we have to increase social support to lose weight, stop smoking, adhere more with their medication.  For that position paper to come out from the American Heart Association is a strong signal for the importance of holistic care.   :34

At Johns Hopkins, I’m Elizabeth Tracey

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This week’s topics include the impact of military parents on kids, a fat cell gene, liraglutide for obesity in type 2 diabetes, and e-cigarettes and smoking uptake in teenagers.

Program notes:

0:34 e-cigarettes and smoking in teens
1:42 Many more used combustible cigarettes
2:40 Risk taking and impulsive behavior
3:40 Some states make smoking age 21
4:00 A gene involved in obesity
5:01 Brown versus white fat
5:50 Liraglutide and obesity in type 2 diabetes
6:50 Twice as many in the liraglutide group lost weight
7:52 Impact of military service on children
8:58 Recent and lifetime substance abuse 50% higher
10:14 End

Related blog: http://podblog.blogs.hopkinsmedicine.org/2015/08/21/e-cigs-and-teenagers/

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This week’s topics include trans fats, testosterone supplements and atherosclerosis, frozen versus fresh oocytes, and cardiac troponin measurement in people with diabetes and cardiac risk.

Program notes:

0:35 Trans versus saturated fats
1:35 Trans fats increased risk for cardiovascular disease
2:35 Controlling more factors relative to heart disease
3:05 Testosterone supplements and atherosclerosis
4:07 Measured thickening of lining of carotid artery
5:12 Cardiac troponin, diabetes, and revascularization
6:15 About half the risk without elevation
7:14 Should prevent us from doing unnecessary procedures
8:18 Fresh versus frozen eggs in IVF
9:15 Live birth about 50% with fresh
10:32 End

Related blog:http://podblog.blogs.hopkinsmedicine.org/2015/08/14/beware-trans-fats/

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