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Anchor lead: If you’ve been told you snore, following up with your physician is likely a good idea, Elizabeth Tracey reports

Obstructive sleep apnea, or OSA, most often is identified when someone is told they snore. Robin Yang, a surgeon who specializes in the condition at Johns Hopkins, says OSA isn’t just a nuisance for bed partners.

Yang: (Robin) The condition gets worse in the sense that it would affect other organ systems such as your heart, blood flow to your brain, as well as just generalized productivity during the day. It is incumbent upon you to get that evaluated as soon as possible to get the proper diagnosis as well as testing.  :17

Such a diagnosis should include a sleep study, Yang says.

Yang: We do recommend that a formal sleep study, which is an in-house laboratory study where they bring you in overnight, you actually sleep in the lab, and they hook you up to monitors that test your brain waves as well as your heart rate and your oxygen saturation, as the gold standard of diagnosis.  :17

Yang says several management and treatment options exist, so getting the diagnosis right is key. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A lot of people have put off routine cancer screening during the pandemic, and that may lead to more precise use of screening tools, Elizabeth Tracey reports

PSA testing, screening colonoscopy, and other cancer screenings have often fallen by the wayside during the COVID-19 pandemic. The next several months will reveal to what degree that impacts cancer diagnoses. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, comments.

Nelson: If you look at the screening tools we have all of them pretty much cry out for evolution toward ever more precision screening. More and more the issue is if you use the screening tool what is the next step, can you say that this cancer is one that needs to be treated aggressively and that this other cancer perhaps is one that doesn’t need to be treated aggressively and you can watch with confidence. That kind of approach has you use all the knowledge you’ve generated to say who do we need to go after, who can we leave alone in a vigilant way? And then respond when you need to.  :33

Nelson says more precise use of screening and subsequent management has been intensely studied for some time, and is bearing fruit for people diagnosed with cancer. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: If you’ve survived breast cancer, how long should you continue annual screening mammography? Elizabeth Tracey reports

If you’ve survived breast cancer and are now in your 70s or beyond, do you still need to have screening mammography? That question was examined in a recent study, and William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says it heralds good news.

Nelson: There’s lots of women surviving breast cancer. So the number of women who are breast cancer survivors reaching these ages are increasing and we need to have an approach to take care of them as best as possible.  :09

Nelson says specific recommendations are based on individual factors.

Nelson: If your life expectancy is greater than ten years, they argue that mammography is probably a good idea. That you might benefit from screening and early detection. In the middle between five and ten years then it’s something that you should think about, talk about, engage in collaborative decision making with your physician.  :17

Nelson says the lifetime risk for developing a second breast cancer can be up to 15%, so careful examination of the risks and benefits of screening is a good idea. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Women who get vaccinated for Covid-19 may develop swollen lymph nodes, Elizabeth Tracey reports

Covid-19 immunizations may cause the lymph nodes in the armpit, or axilla, to become swollen and tender for a time. Women who experience this side effect need not worry that they’ve suddenly developed breast cancer. That’s according to William Nelson, director of the Kimmel Cancer Center at Johns Hopkins.

Nelson: I think the upshot of all this is that lymph nodes can be swollen, by the way in men as well as women, but in this case women are the ones more concerned about their breast cancer risk. It’s probably best not to do the mammogram shortly after being vaccinated after four or five days you might have swollen lymph nodes a sore arm this kind of thing. It’s probably best to wait a month and you can always contact your physician over this. I think to be aware that swollen lymph nodes these kinds of things can occur as a consequence of vaccination. When they do they will get swollen and that swelling will go away.  :31

Nelson hopes such concerns will not cause women to put off being vaccinated against Covid-19. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A new study suggests quite a few people who look to be headed to develop diabetes may not, Elizabeth Tracey reports

Prediabetes refers to a host of conditions such as elevated blood markers that seem to point the way toward frank diabetes, but now a new study that breaks people with the condition down into several subgroups shows that although many will go on to develop diabetes, not all of them will. Rita Kalyani, a diabetes expert at Johns Hopkins, comments.

Kalyani: I think it’s absolutely true that in clinical practice we would tell any patient who has risk factors for diabetes and is obese to lose weight, to follow a healthy lifestyle, to do more exercise, perhaps meet with a dietician. What research studies such as this tell us though is that not all people who have prediabetes will necessarily convert at the same rate, nor will they convert at all to diabetes. Perhaps that’s something that we really need to be mindful of that we are still understanding who’s at highest risk of developing diabetes.  :34

Kalyani notes that healthier choices will benefit all aspects of health, including diabetes risk. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: If you have diabetes what you eat really does make a difference, Elizabeth Tracey reports

Low carb diets do help people with diabetes improve their health, a recent meta-analysis found, although the benefits seemed to wane after a year. Rita Kalyani, a diabetes expert at Johns Hopkins, did a study finding a similar impact.

Kalyani: What we found in a real world setting, so not in a study setting, was the low carbohydrate diet was effective at reducing A1c, at reducing weight and in some of these metabolic outcomes too, even at three months and even up to six months later.  :15

Kalyani cautions that adopting such a diet may prove challenging for some.

Kalyani: Having greater availability of foods to choose from is important. Unfortunately many of these foods that we might consider quote unquote higher quality also are more expensive, so I think looking at the translatability and to prompt us to multiple communities of diverse backgrounds will be important.  :18

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How can the impact of carbohydrates be tested best? Elizabeth Tracey reports

Carbohydrate consumption may be an important tool in helping control diabetes, a new meta-analysis suggests, and most helpful is knowing which carbs to avoid. Rita Kalyani, a diabetes expert at Johns Hopkins, says there is data on that.

Kalyani: The best study model of that is the glycemic index. Where you really look at how carbohydrates lead to elevation of blood sugar, both how fast and how high. It is definitely true that not all carbohydrates are the same. There’s the very simple carbohydrates that are concentrated sugars that spike the sugar right away and then the complex carbohydrates whole grains that might take a little bit longer. The issue is a bit more complicated when you talk about the effects on appetite. We still need to better understand how the quality of the carbohydrate impacts metabolic disease.  :33

Kalyani says that while research is ongoing, educating yourself about which carbs raise blood sugar fastest may be helpful. At Johns Hopkins, I’m Elizabeth Tracey.