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Anchor lead: Can you trust medical information from a digital assistant? Elizabeth Tracey reports 

Can you trust medical information you obtain from a digital assistant? No, a recent report concludes. Seth Martin, a cardiologist and developer of health care apps at Johns Hopkins, describes the study.

Martin: We’re really wondering how technology can be more seamlessly integrated into the human experience and into medical care. But needs to be tested for safety. They tested Siri, Alexa and the Google assistant and it certainly raises some alarms. :16

Study participants asked their digital assistant for medical advice, such as whether drugs could be safely taken together.

Martin: We don’t know exactly what would have come of this but it certainly seems like the users were being led astray and they reported that 29% of the actions could have resulted in some degree of harm and 6% could have resulted in death, so that’s pretty scary.  :16

Martin concludes that medical advice needs to come from an expert source. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A new device may benefit those with heart failure and a heart valve problem, Elizabeth Tracey reports

Heart failure can cause the heart to enlarge and stretch, and then cause the mitral valve, on the left side of the heart, to become leaky. Now a new study shows that a clip device can help, resulting in significantly reduced mortality in people who got it. David Kass, a cardiologist and heart failure researcher at Johns Hopkins describes the intervention.

Kass: In this trial they’re basically saying you have heart failure that’s why the valve got overstretched. And you’ve got a leaky valve. We’re going to put a suspenders almost, it’s going to clip on one side and a clip on the other side and it pulls the two leaflets in the middle and it forms like a figure 8. :16

Kass says he thinks the actual number of people who would benefit from this device may be low, if the right combination of medicines and other strategies are employed.

Kass: The answer comes first by making sure that they’ve been evaluated by experienced heart failure clinicians and that they really are optimally medically managed.  :12

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What’s the most likely scenario for a pandemic? Elizabeth Tracey reports

This year marks the 100 year anniversary of a sobering event – the 1918 flu pandemic, which killed millions of people worldwide. Now many experts are sounding the warning that we are sadly underprepared to cope with such an event, even as the chances improve that we’re overdue for a pandemic. Lisa Maragakis, an infection control expert at Johns Hopkins, echoes these concerns.

Maragakis: Respiratory viruses are at the top of my list of concerns for pandemic disease. I think we’ve seen across history that this is the type of infectious disease that can spread most rapidly and cause this kind of widespread worldwide pandemic. So I think influenza and other respiratory viruses that may present like SARS did are at the top of our list of concerns.   :26

Maragakis says worldwide vigilance regarding emerging infectious diseases, including more virulent flu strains but also novel agents like SARS or MERS, remains an important strategy, as does development of molecular biology techniques to produce vaccines more quickly, but notes that for now, obtaining all vaccines for which you are eligible is an important step, as is handwashing. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: If you suspect acute flaccid myelitis in your child, what should you do? Elizabeth Tracey reports

It’s every parents’ nightmare – your child has what you think is a common cold, but then suddenly begins falling down for no reason, or develops other symptoms consistent with a muscle problem. As the CDC has just reported, this syndrome, known as acute flaccid myelitis, has now been confirmed in 62 cases in 22 US states. Carlos Pardo, an expert in the immunology of the nervous system at Johns Hopkins, says if you notice these symptoms, seek help right away.

Pardo: There is no reason to panic but when children are experiencing upper respiratory infection experience weakness, facial paralysis, respiratory difficulty, or difficulties with ambulation they need to be taken right away to the emergency department.  :18

Pardo says the muscle problem can become severe enough to impact breathing, requiring mechanical ventilation, and notes that while mortality relative to the condition is low, long term problems following development of the syndrome occur in the majority of cases. That’s because there’s clear damage to the nerves in the spinal cord that control the majority of our muscles, and at the moment, no treatments have been shown to be effective. For now, the best advice is to practice hand hygiene for everyone in the home. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A disturbing condition called acute flaccid myelytis is now in 22 states in the US, Elizabeth Tracey reports

Acute flaccid myelitis is a condition that follows what seems to be a garden variety upper respiratory infection, causing muscle weakness in children younger than 18 years of age. CDC data just released indicate that so far this year, the condition has developed in 62 children in 22 states. Carlos Pardo, an expert in the immunology of the nervous system at Johns Hopkins, says much more is unknown than is known.

Pardo: We know that there is an association with a viral infection but we haven’t been able to demonstrate clearly which virus is involved, but suspect number one is an enterovirus called D68, that has been circulating in the last several years in the United States and it appears that it causes an upper respiratory infection among children.  :22

Pardo says isolating the virus has been a problem because once children develop the muscle weakness they are no longer producing a lot of virus, so no one has been able to isolate the causative agent. He notes that the muscle weakness can progress to inability to breath without assistance, requiring mechanical ventilation, so if parents notice unusual symptoms following a cold, seeking help immediately at an emergency department is appropriate. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Last year’s flu season was bad. How can you protect yourself this year? Elizabeth Tracey reports

In the wake of CDC data reporting 80,000 plus deaths last year due to the flu, your best strategy to avoid infection this year remains getting vaccinated. That’s according to Lisa Maragakis, senior director of infection control at Johns Hopkins Hospital.

Maragakis: The best case scenario is that the flu vaccine prevents you from acquiring the flu at all and so that you don’t get sick. However it has other benefits, and that could be that people who do get the flu are not as severely ill as they otherwise would have been. And this is really because the vaccine boosts your immune response to the influenza virus, and so even if it doesn’t completely keep you from acquiring the virus it can limit the duration of symptoms and the severity of symptoms.  :30

Maragakis notes that certain groups of people, including those with cancer, pregnant women, elderly people and others who may have compromised immune systems, are especially vulnerable and should discuss vaccination with their physician promptly. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: About 80,000 people died last year due to influenza infection, Elizabeth Tracey reports

Influenza and its complications killed over 80,000 people last year, the Centers for Disease Control and Prevention has reported. Lisa Maragakis, senior director of infection control at Johns Hopkins Hospital, says that should motivate everyone to get a flu shot.

Maragakis: The flu vaccine is imperfect at best but, that being said we know it’s the best thing we have right now to prevent influenza and to reduce influenza complications and influenza deaths. The effectiveness of the vaccine varies from year to year and unfortunately it was only about 40% effective last year in the midst of this very widespread, bad flu season. A lot of research and work is ongoing right now to try to develop better flu vaccines.  :31

Maragakis is hopeful that the so-called universal flu vaccine may be available soon, as well as improved flu vaccines using methods other than eggs to produce them, but reiterates that getting the vaccine is the best choice to avoid infection. At Johns Hopkins, I’m Elizabeth Tracey.

 

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