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When a man is suspected of having prostate cancer he will likely undergo a biopsy, where a needle is inserted into the prostate gland to look for cancer. Now a new study shows that using magnetic resonance imaging or MRI along with ultrasound helps identify suspicious areas and improves the technique. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the study.

Nelson: Three to four biopsy cores were going to be aimed at that suspicious lesion then the men would have the ten to twelve biopsy cores. They found the clinically significant cancer in 21% of the men who got the targeted biopsy, a little bit more than the men in the ten to twelve core biopsies, 18% of them. But the clinically insignificant cancers were somewhat lower in the experimental group. Have the focused biopsy highlighted by MRI, followed by the core biopsy seemed to be better.  :31

At Johns Hopkins, I’m Elizabeth Tracey.

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The ketogenic diet, which consists mostly of fat with some protein and very few carbs, has gained visibility as other diets such as the paleo diet have become increasingly popular for weight loss, and it’s used to control epilepsy. Is such a diet a reasonable choice for the condition instead of a medication? Mackenzie Cervenka, an expert in the management of adults with epilepsy at Johns Hopkins, offers her opinion.

Cervenka: There may be other circumstances where patients are very hesitant to consider antiseizure drugs or medications in general where it’s a personal preference sort of situation and in which case I would counsel patients that we really don’t have strong evidence to guide us with regard to effectiveness of the diet versus trying an initial antiseizure drug but if that is their personal preference, that is available as a potential therapy.  :26

Cervenka says that any attempt to control epilepsy with diet alone must be carefully monitored, both for recurrent seizures as well as other health parameters such as cholesterol and weight, so seek an expert. At Johns Hopkins, I’m Elizabeth Tracey.

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High fat, some protein, very few carbohydrates. That’s largely what constitutes a ketogenic diet, developed 100 years ago to help control epilepsy in children and adults. Now the diet is first line treatment for certain metabolic disorders and is gaining ground for epilepsy management. Mackenzie Cervenka, who specializes in the management of epilepsy in adults at Johns Hopkins, says there is a right time to try the diet.

Cervenka: In my opinion if you’re an adult with epilepsy and you’ve tried at least two antiseizure drugs that are appropriate for your type of epilepsy and continue to have seizures this is a reasonable time to consider the diet. One consideration in addition to that is that if you’re an adult with epilepsy who has a tumor or a lesion or some structural reason for having seizures and there’s an option for having epilepsy surgery, that would be the most appropriate next step to pursue.  :30

Cervenka says support and monitoring are needed when someone tries the diet, so seek expert advice if you’re interested. At Johns Hopkins, I’m Elizabeth Tracey.

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In the midst of rising overdose deaths, Spain and a few other countries implemented supervised injection sites so overdoses could be reversed right away, and sure enough, deaths fell. Now the state of Rhode Island has become the first state to approve such a measure. Eric Strain, a substance use disorders expert at Johns Hopkins, comments.

Strain: I fear that our next pivot will be to ‘well, because methadone, buprenorphine and naltrexone aren’t working, we need to offer people safe injection facilities with heroin. And I’m not convinced that that’s the solution. It’s hard for me to see them as making much of an impact. I’m not convinced that they will really help people to move into having purpose and meaning in their lives.   :29

Strain says substance use disorders require an array of interventions to enable people to overcome addiction, and he’s concerned that the supervised injection sites are a stop gap measure. At Johns Hopkins, I’m Elizabeth Tracey.

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Opioid overdose deaths reached their highest rate ever in the US in the last 12 months, with a new study showing that expanding prescribing medications like naloxone, doesn’t help. What can stem this tide? Eric Strain, a substance use disorders expert at Johns Hopkins, says those who want to leave their addictions behind must look for the right treatment.

Strain: For the individual who is looking for treatment and wants to move forward I think that the critical thing is to not just say well I’ll take whatever I can find, but to really find some treatment provider or program that will do something more than simply prescribe a medication.  That goes back to the difficulties in finding quality treatment, because we’re not paying for quality treatment.  :28

Strain says until government steps in to mandate what constitutes quality treatment things are not likely to improve. He says it is known what helps keep people in treatment once they start, so implementing that first may be one step in the right direction. At Johns Hopkins, I’m Elizabeth Tracey.

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In this next podcast, Elizabeth Scala and Holley Farley discuss disseminating project work. They discuss the types of audience that you can disseminate information to and how disseminating your project’s findings can inform JHH policies and protocols before they are finalized. Finally, Holley explains the avenues to share your project’s information by doing publications, posters, and podium presentations.

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