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Anchor lead: Although there are some benefits to marijuana use there are also harms, Elizabeth Tracey reports

Cannabis or marijuana use can help people with cancer, chronic pain and multiple sclerosis, a National Academy of Sciences panel concludes, but significant harms can also accrue with use of the drug. William Checkley, a panel member from Johns Hopkins, describes some of them.

Checkley: Long term cannabis use is associated with worsened respiratory symptoms and chronic bronchitis. There was moderate evidence that if you stop smoking cannabis there was resolution of these symptoms. There was also an association with low birth weight. Pregnant women who smoked cannabis would have babies that were smaller in size at birth. Also on the harm side there were associations between cannabis use and development of schizophrenia.  :26

Checkley says these are clearly observations that have not been studied in a rigorous scientific way but they are sufficient to raise concerns. He says an additional risk includes driving while in the acute phase of cannabis intoxication. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What can the latest review teach us about marijuana? Elizabeth Tracey reports

More US states have legalized marijuana in the last round of elections, with the National Academy of Sciences stepping in with a comprehensive look at the literature relative to the drug. William Checkley, a member of the review committee from Johns Hopkins, says there are a few benefits to marijuana, or cannabis.

Checkley: When you’re looking at the therapeutic effects, a couple of things we found on that side. For people with cancer, use of cannabis appears to be an effective antiemetic. For people who have chronic pain, cannabis also relieves pain, and for people who have multiple sclerosis related spasticity, muscle spasticity, cannabis is also effective at reducing this spasticity.  All these effects were on the modest range however. :25

Checkley says a dose-response relationship does appear to exist, where increasing doses of cannabis to a point may offer more symptom relief, but says harms relative to smoking and inhalation of burned materials also need to be considered. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A new program aims to expand the role of Meals on Wheels, Elizabeth Tracey reports

Meals on Wheels, which is already bringing food to those who are home-bound, is poised to expand its role into helping keep people healthy, in partnership with Johns Hopkins and a funding organization called Quantified Ventures. Dan Hale, assistant professor of geriatrics at Hopkins, says Meals on Wheels will take on three responsibilities.

Hale: They will continue to provide meals, in addition to that these volunteers could be trained to actually be observing a little bit more.  Is there a sign that perhaps the person is a little more confused than last time? Or took a lot longer to get to the door? These might be warning signs that they really need some medical attention. And then the third would be to do an extensive home safety check and if needed, some actual modifications.  :27

Hale says expertise from Johns Hopkins will help inform both training and interventions, and aims to keep people out of the hospital. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  Can Meals on Wheels improve health outcomes? Elizabeth Tracey reports

Meals on Wheels is a national organization that brings two meals a day to home bound people, mostly seniors.  Now Dan Hale, assistant professor of geriatrics at Johns Hopkins, describes a new venture with this organization, Johns Hopkins, and a novel type of investment firm that helps fund ventures with potential social impact by issuing what are known as ‘social impact bonds.’

Hale: Meals on Wheels of central Maryland, Meals on Wheels America, and Quantified Ventures, that handles these sorts of social impact bonds, have been working with us to see if by expanding the range of services that Meals on Wheels offers, we could actually decrease the readmissions to the hospital, even admissions to the hospital, and ED visits.  :24

Hale says there’s no question keeping people out of the hospital is a win-win for everyone. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How can bacteria in the mouth and rheumatoid arthritis be related? Elizabeth Tracey reports

Looking at someone’s genes may one day help determine whether they are at risk to develop rheumatoid arthritis, research by Felipe Andrade and colleagues at Johns Hopkins suggests. Andrade describes the findings.

Andrade: What we found is there is a specific group of antibodies are developed in patients that have the genetic predisposition but they need to have also the evidence of the infection by the bacteria.  Evidence of the infection in the mouth is found in 10% of healthy people but not everybody develops the disease. So you need to have the combination of the genetic plus the infection and likely the genetic part involves many genes not only one.   :29

Andrade says people thought to be at risk might be genetically tested as children, then provided with rigorous oral hygiene to avoid infection with the bacterium and thereby prevent such stimulation of their immune response. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Bacteria in the mouth may contribute to the development of rheumatoid arthritis, Elizabeth Tracey reports

Bacteria that reside in your mouth, known as oral flora, have been known for some time to be involved in various diseases and conditions, such as atherosclerosis. Now Johns Hopkins physician researcher Felipe Andrade and colleagues have found a link between a common mouth bacterium and rheumatoid arthritis.

Andrade: Our contribution to this knowledge has to do more with understanding of how the gum disease might be driving rheumatoid arthritis and we identified these bacteria, we make the argument that these bacteria could explain many things that haven’t been found for many years when we are studying the gum disease and rheumatoid arthritis.  :22

Andrade says the bacteria cause chemical changes to certain proteins in the body, which then activate the immune system and lead to a cascade of reactions resulting in RA, in those who are genetically susceptible. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How do genes and proteins influence whether someone gets a common viral infection? Elizabeth Tracey reports

Nod1 is the name of a protein that when altered, may increase susceptibility to infection with cytomegalovirus, abbreviated CMV.  That’s according to Ravit Boger, a pediatric infectious diseases expert at Johns Hopkins and long time CMV researcher. Boger says since CMV can be every bit as devastating as Zika to the developing fetus, it’s important to understand risk.

Boger: These diseases give us an opportunity to understand who is a more susceptible host to CMV, and what is the genetic makeup of a host that is more susceptible to CMV. And if we knew, if we could characterize this genetic makeup, then we could develop hopefully better vaccines or better treatment against CMV.  :26

Boger says even being able to identify people at risk for CMV infection could help physicians be on the lookout. At Johns Hopkins, I’m Elizabeth Tracey.

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