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This week’s topics include the cost of physical inactivity, the mortality impact of sedentary behavior, behavioral activation for depression, and skin inspections for skin cancer.

Program notes:

0:32 Mortality and physical inactivity
1:33 If you sit for 8 hours increased mortality by 58%
2:33 Looked at over a million individuals
3:31 You have to do 60-95 minutes
3:44 Global economic burden of inactivity
4:44 Physical activity declining worldwide
5:11 Behavioral activation for depression
6:11 Go out to exercise or go out to dinner
7:11 May have applicability widely
7:25 USPSTF recommendations for skin inspection
8:25 Only about 50% with dermatologists
9:12 Inspect even scalp
10:08 End

Related blog:https://podblog.blogs.hopkinsmedicine.org/2016/07/29/exercise/

 

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Anchor lead: How well does a new vaccine against meningitis work? Elizabeth Tracey reports

It’s every parent’s nightmare: a meningitis outbreak where your college student goes to school.  Now a new study reports on how well a candidate vaccine performed at a US university where there was an outbreak of so-called meningococcal type B meningitis.  Mike Klag, dean of the Johns Hopkins Bloomberg School of Public Health, explains the results.

Klag: This is a new vaccine.  It was used before FDA approval, and now this study is looking at how effective it was in raising immunity against the type of meningococcus that was vaccinated. So, two thirds of that group were protected. The rest were not.  The important thing is that there were no cases of meningococcal type B disease in this population after this vaccine was administered.   :24

Klag says most vaccines don’t achieve 100% protection.

Klag: Vaccines don’t have to be perfect.  By increasing protection in the group as a whole, you prevent transmission of meningococcal type B disease.  :08

At Johns Hopkins, I’m Elizabeth Tracey.

 

 

 

 

 

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Anchor lead: More data is emerging on the impact of Zika, Elizabeth Tracey reports

The number of cases of Zika virus infection continue to climb worldwide, and additional aspects of infection are being identified.  Mike Klag, dean of the Johns Hopkins Bloomberg School of Public Health, describes what’s known.

Klag: It’s not surprising that we continue to learn more about Zika as the epidemic unfolds. There are now more than 1300 cases in the US, almost all tied to travel.  It appears that there’s the first case in Florida of a domestic transmission, from a mosquito.  Second, a caregiver for an elderly man who had very high levels of Zika, got infected.  And then the third is it appears there’s the first case of female to male transmission.   :23

Klag says such observations are important to disseminate so prevention efforts can be expanded, but says the best hope remains a vaccine.

Klag: Of course it’s going to be important to develop a vaccine for Zika, that’s the way we will stop this infection.  There are a number of candidate vaccines.  The search for a vaccine is moving incredibly rapidly.  :11

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  A new study demonstrates how well medicines to keep HIV in check work, Elizabeth Tracey reports

If your partner is infected with HIV but you aren’t, standard recommendations say use a condom during sex, but many people do not.  Now a recent study reports what happened to thousands of these couples over time.  Joseph Cofrancesco, an HIV expert at Johns Hopkins, explains.

Cofrancesco: This study looked at 14 different European countries. And had over 1000 couples where one member of the couple was positive and one member of the couple was negative, and they had been not using condoms for sexual encounters.  And they were followed for many years.  There were no transmissions of HIV from the positive partner to the negative partner.  :22

Cofrancesco says the study provides proof of principle.

Cofrancesco: The basic fact is that if someone is HIV positive, taking their meds religiously and having an undetectable viral load they do not transmit HIV to anyone.  :12

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How can we get people who are HIV infected engaged in routine healthcare? Elizabeth Tracey reports

Some people who are HIV infected don’t follow recommendations for keeping the virus in check and are therefore at risk for infecting others.  Now a new study looked at whether providing a health navigator and even paying people to stay in care helps.  Joseph Cofrancesco, an HIV expert at Johns Hopkins, describes the results.

Cofrancesco: There have been a number of studies looking at engaging people who know they have HIV into care so they can successfully be the kind of person who becomes undetectable and doesn’t spread HIV. The navigation study and others have been somewhat disappointing.  I think it shows that people with HIV, and particularly some populations with HIV, have complicated lives, and the solution to engage them in care and maintain them in care is going to be fairly complex and require a multifaceted approach.   :32

Cofrancesco says more research is needed to engage this population.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  Negative events in childhood can have lasting consequences, Elizabeth Tracey reports

Did you suffer trauma as a child? Perhaps not a war, or incarceration in a refugee camp, but how about if we expand the definition of trauma to include things like parental divorce, or bullying, or family alcoholism?  Donna Jackson Nakazawa, who gave a presentation recently at Johns Hopkins on the long term impact of childhood trauma on adult health, explains.

Jackson Nakazawa: When children experience early adversity, the brain responds the same regardless of what the source of that adversity is.  The brain responds in a way and the immune system responds in a way that changes the way in which we respond to stress for the rest of our lives.  That sets forth an inflammatory process in which the human immune system becomes set on a high inflammatory response, and this leads to greater likelihood of disease.   :30

Jackson Nakazawa is the author of Childhood Disrupted: How Your Biography Becomes Your Biology, At Johns Hopkins, I’m Elizabeth Tracey.

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Johns Hopkins Kimmel Cancer Director William Nelson discusses changes to physical exams, the HPV vaccine, new information regarding breast cancers in this month's podcast.

Program notes:

0:20 Changes to physical exam?
1:20 An app loaded onto a smartphone
2:21 The right kind of devices
3:03 The HPV vaccine
4:02 Need three injections
5:05 If pediatricians are the problem
5:40 Holy grail with regard to some breast cancers?
6:41 Found progenitor cells that had the receptor
7:42 Treated a few women with drug
8:42 May have similar mechanisms of action
9:44 End

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