Play

Anchor lead: MRI helps when it comes to prostate biopsy, Elizabeth Tracey reports

Using magnetic resonance imaging or MRI, in conjunction with ultrasound guidance, improved detection of cancer in prostate biopsies, a recent study in the New England Journal of Medicine found. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, reviews the results.

Nelson: They took 500 men and randomized them to one or the other approaches. On the ones that got the magnetic resonance imaging 28% of them were felt not to have findings on magnetic resonance imaging suggestive of prostate cancer, at least of a significant prostate cancer.  And they were not subjected to biopsies. And then if you look at the clinically significant prostate cancers, these are the ones more likely to be life-threatening, they were detected a little bit more effectively, 38% versus 26% :30

Nelson says one caveat remains regarding reading MRI results, pointing to a clear need for more expert readers to interpret the findings. He predicts that use of both MRI and ultrasound will become the standard of care nationally for prostate biopsy. At Johns Hopkins, I’m Elizabeth Tracey.

 

VN:F [1.9.17_1161]
Rating: 0.0/5 (0 votes cast)
Play

Anchor lead: New guidelines for prostate cancer screening have been released, Elizabeth Tracey reports

If you’re a man, should you undergo prostate specific antigen or PSA screening for prostate cancer? The United States Preventive Services Task Force, known by the acronym USPSTF, has just released its new guidelines. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the recommendations.

Nelson: They believe that there is a possible net benefit for men aged 55 to 69 years, although they believe the trade-off is very significant and sort of mandates an individualized discussion. So they give that a grade C. for screening men above the age of 70 they believe that the risk of side effects and complications outweigh the potential benefits and they give that a grade D. I think that people considering any healthcare maneuver should have a conversation with their physician and I believe this is no exception.  :31

Nelson notes that men with a family history and African American men may be at higher risk, according to the guidelines. At Johns Hopkins, I’m Elizabeth Tracey.

VN:F [1.9.17_1161]
Rating: 0.0/5 (0 votes cast)
Play

Anchor lead: What’s the best way to have dementia diagnosed? Elizabeth Tracey reports

New screening tools for dementia are being developed, with some studies suggesting that they can be used to detect Alzheimer’s disease in a primary care setting. Constantine Lyketsos, an Alzheimer’s disease expert at Johns Hopkins, says while such a strategy may work, getting a definitive answer likely requires an expert.

Lyketsos: There clearly are primary care physicians who are very good at this. For the most part primary care physicians have other priorities and so we see errors on both sides: folks who end up on quote ‘Alzheimer drugs’ when they just have a memory complaint and then we have folks with moderate dementia who’ve been missed. My advice would be if dementia is suspected, and it usually comes from a family member, for a family member to make direct contact with a primary care physician, encourage them to do an assessment and if there’s some doubt, to request a referral to a specialist.  :32

Lyketsos is hopeful that more objective tests may soon allow dementias to be identified more easily. At Johns Hopkins, I’m Elizabeth Tracey.

VN:F [1.9.17_1161]
Rating: 0.0/5 (0 votes cast)
Play

Anchor lead: Chances are good you’ll have more exposure to those with dementia, Elizabeth Tracey reports

Even though there may be fewer people being diagnosed with Alzheimer’s disease and other dementias, because people are generally healthier they are living longer with the disease, and that’s putting a huge burden on all kinds of services. Constantine Lyketsos, an Alzheimer’s disease expert at Johns Hopkins, says the impact, especially for families, is just beginning to be felt.

Lyketsos:  Every person with dementia has one or two caregivers on average through the course of the illness. Oftentimes it starts out with a spouse and then it might become a child because it can be a fairly lengthy illness from start to finish.  It’s therefore going to effect a lot of people. I don’t think it’s really hit our consciousness as to how big a problem it will be. People are terrified it will happen to them, I think that’s hit our conscience, nobody wants to get dementia. But the fact that it’s going to be all around us on a daily basis much more than it is right now hasn’t quite trickled down.  :35

At Johns Hopkins, I’m Elizabeth Tracey.

VN:F [1.9.17_1161]
Rating: 0.0/5 (0 votes cast)
Play

Anchor lead: Just how big a problem is Alzheimer’s disease? Elizabeth Tracey reports

Deaths from Alzheimer’s disease have increased by 123%, while deaths from other causes like heart disease and cancer have declined, the latest data from the Alzheimer’s Association report. Constantine Lyketsos, an Alzheimer’s expert at Johns Hopkins, says even the newest therapies won’t help in the short term.

Lyketsos: These therapies, the amyloid busting drugs, the other things that we’re seeing in the pipeline, even though they are disease targeted, even though they’ll probably bend the curve, they’re not going to stop the curve. Let’s say some of these make it out to the market. It’s going to increase the number of people alive with dementia more likely than not. So this idea that we don’t have to plan for services in the future because we’ll have fewer people with dementia isn’t true, the complete opposite is true, we’ll either have the same number or more.  :30

Lyketsos notes that costs for caring for those with dementia exceed a quarter of a trillion dollars. At Johns Hopkins, I’m Elizabeth Tracey.

VN:F [1.9.17_1161]
Rating: 0.0/5 (0 votes cast)
Play

Anchor lead: Activated immune cells throughout the body are important in multiple sclerosis, Elizabeth Tracey reports

What exactly goes awry in the immune system that results in multiple sclerosis? Recent research by Michael Kornberg, a research fellow and neurologist at Johns Hopkins, and colleagues, demonstrates that immune cells utilize a pathway using sugar for energy to get involved, but that’s just part of the answer.

Kornberg: At various times and for reasons we don’t understand immune cells that are directed against myelin become activated in lymph nodes and the spleen, tricks the brain into thinking there may be inflammation there, maybe a virus or something that needs to be fought, and so the blood-brain barrier kind of opens up for these cells. And then you get this collection of immune cells that are all activated and angry and contributing to injury. A lot of the drugs we use for MS keep immune cells from getting into the brain.   :27

The blood-brain barrier normally keeps most things out of our central nervous system to protect it. Kornberg’s recent work suggests that preventing immune cells from becoming activated to begin with helps. At Johns Hopkins, I’m Elizabeth Tracey.

VN:F [1.9.17_1161]
Rating: 0.0/5 (0 votes cast)
Play

Anchor lead: Could keeping the immune system under control be as simple as managing your diet? Elizabeth Tracey reports

Immune cells involved in multiple sclerosis rely on sugar to activate them, recent research by Michael Kornberg, a research fellow and neurologist at Johns Hopkins, and colleagues, has shown. The common MS drug dimethylfumarate blocks this pathway, Kornberg says.

Kornberg: What I find exciting about the work is the idea that these energy pathways are viable targets to treat the disease, which might extend to dietary measures. I like to be very cautious about this because diet and any kind of disease has become a bit of a cottage industry, but the idea that energy metabolism is important in the way the immune system reacts suggests its very likely that different types of diets are going to have effects on the immune system, which we’re  beginning to understand but we don’t fully understand yet. :31

Kornberg notes that autoimmune diseases like MS may one day include diet as part of a management strategy, as well as other diseases where energy metabolism and the immune system are important, like cancer. At Johns Hopkins, I’m Elizabeth Tracey.

VN:F [1.9.17_1161]
Rating: 0.0/5 (0 votes cast)