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Canton, GA, USA - July 24, 2015 A fitbit charge and a android smart phone with the fitbit app. The fitbit is a fitness tracker capable of monitoring your steps per day, distance, stairs climbed, calories burned and also monitors your sleep activity.

This week’s topics include appropriate use of beta blockers after heart attack, timing of allergenic foods for infants, a wearable device and its impact on weight loss, and vasectomy and prostate cancer.

Program notes:

0:38 A device and weight loss
1:39 Those with the device lost less
2:38 Do a real world trial
3:06 Introducing allergenic foods
4:07 Moderate evidence it reduced
5:06 Incidence increased with avoidance
5:31 Vasectomy and prostate cancer risk
6:32 Over 360,000 men
7:34 Beta blockers after a heart attack
8:33 Mortality time points relative to use
9:34 No benefit longer than a year
10:40 End

Related blog: https://podblog.blogs.hopkinsmedicine.org/2016/09/23/no-joy-with-fitness-trackers/

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Anchor lead: A team approach is important for sustained weight loss, Elizabeth Tracey reports

Balloons, staples, evacuation devices – a multitude of minimally invasive techniques are now available to help people lose weight.  Tony Kalloo, director of gastroenterology at Johns Hopkins, says that in order to be successful, every approach must be comprehensive.

Kalloo: What’s really important is for patients to undergo nutritional and behavioral counseling.  We need to understand what are the triggers that make us eat more? Part and parcel of all our endoscopic treatment programs is that we do behavioral modification, and you see a nutritionist, and we do frequent follow-ups. So that you change your lifestyle, because many of these endoscopic treatment options are for the short term only. For example the endoscopic balloons are there for six months.  So it means that if you have not changed your lifestyle in six months you will regain the weight.   :33

Kalloo says when a team approach is taken to weight loss, the majority of people are successful in keeping the pounds off.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  A new minimally invasive technique helps reduce stomach volume, Elizabeth Tracey reports

Gastric bypass surgery has historically been the best choice for weight loss, but newer and much less invasive techniques are continuously being developed.  Tony Kalloo, director of gastroenterology at Johns Hopkins, says one new minimally invasive or endoscopic approach reduces stomach volume similarly to one type of traditional surgery known as gastric sleeve.

Kalloo: The other new endoscopic technique is actually one that doesn’t require devices but one in which we place stitches inside of the stomach so part of the stomach is actually closed off, just like you would do with a gastric sleeve procedure, which the bariatric surgeons would do. Except there are no incisions, it’s all done through the endoscope. We place the stitches in, the stomach is now a smaller pouch, and therefore patients eat less and lose weight.   :28

Kalloo says anyone who is considering weight loss surgery should carefully investigate all their options as well as undergo evaluation for which techniques are most appropriate for them. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  Two new balloon devices for weight loss have recently been approved by the FDA, Elizabeth Tracey reports

Can having a balloon-like device placed in your stomach help in weight loss?  The FDA has recently approved two new such devices for just that purpose.  Tony Kalloo, director of gastroenterology at Johns Hopkins, says the balloons join a range of treatment options that can be utilized without traditional surgical approaches.

Kalloo: We have developed several noninvasive programs that use endoscopy as the mode of treatment.  The goal of endoscopy is to try to simulate some of the surgical procedures without having surgery. One particular procedure is placing a balloon, and now the FDA has approved two different types of balloons that we place inside the stomach that simulates the presence of food.  Because you have this device in your stomach you feel full faster after eating and patients lose weight.   :31

Kalloo says the weight loss achieved with these balloons is not as great as that with gastric bypass but the procedure is much easier. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: More data is emerging showing the benefits of watching low risk prostate cancer, Elizabeth Tracey reports

Ten years of following men with low risk prostate cancer has confirmed that active surveillance is safe for most, a study in the New England Journal of Medicine shows. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, agrees.

Nelson: in this study where they had men with intermediate risk prostate cancer there was an increased number of men who suffered with disease progression.  I think for low risk prostate cancer the chance for that is very low.   :09

Another study looked at side effects of treatment reported by men in the study, and Nelson says this is helpful in making treatment choices.

Nelson: I think there were no surprises in this study. I think the interesting thing is that men diagnosed with prostate cancer are going to do well. Men have choices in terms of how they are treated. Information about quality of life is important in making those choices.  :16

Nelson says the two studies should enable men to feel confident that if they are candidates for active surveillance the strategy is sound.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What are the chronic health effects of conflict? Elizabeth Tracey reports

If you live in an area where there’s conflict, chances are good you’ll have a shortened lifespan, a recent study published in the Lancet found. Mike Klag, dean of the Johns Hopkins Bloomberg School of Public Health, says the impact of conflict is multidimensional.

Klag: The long term impact can come from disruption of where people live.  They can become refugees that live in camps, or you can get destruction of the healthcare system so that you can’t provide care even if people don’t move.  Obviously there are huge mental health impacts and this paper documents it, of being exposed to conflict. And most importantly, the crises, the conflicts, have resulted in a reduction in life expectancy.  In Syria, there’s a five year loss in life expectancy for women and six years for men.   :30

Klag says such data must provide impetus for countries around the world to provide robust assistance to conflict-ridden areas.  He calls the current situation in Syria the greatest humanitarian crisis since World War II. At Johns Hopkins, I’m Elizabeth Tracey.

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Senior man communicating with a male doctor in the office.

This week’s topics include long term results in low risk prostate cancer, ovarian cancer screening, statin benefits, and sex differences in MI.

Program notes:
0:32 Benefits of statins
1:32 Reduces deaths from cardiovascular causes
2:33 Benefit clearly outweighs risk
3:22 Sex differences in heart attack
4:22 Incidence rate for MI
5:22 Persistent gap through age 95
5:44 Outcomes for prostate cancer management
6:44 Risk of dying of prostate cancer low
7:45 Framed up differently
8:50 Monitoring may be more appropriate
9:13 FDA warning on ovarian ca tests
10:10 Ovarian cancer don’t  have a precancerous lesion
10:59 End
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