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Anchor lead: Could one form of severe lung disease have its roots in vitamin D levels? Elizabeth Tracey reports

Interstitial lung disease is an uncommon but sometimes deadly form of progressive scarring of lung tissue. Now research by Erin Michos, a cardiologist at Johns Hopkins, and colleagues, has shown that the condition may be related to low vitamin D levels.

Michos: Vitamin D in activated form is a hormone. It has anti-inflammatory effects, it modulates the immune system, it also may have antifibrotic effects, regulate different genes that are involved in fibrosis or scarring. So we think that the progression of these spots in the lungs, these interstitial abnormalities, may result from inflammation and fibrosis and if you don’t have adequate vitamin D levels that may be a contributing factor.  :27

Michos notes that many cases of interstitial lung disease aren’t related to any specific factor, so vitamin D levels may be a novel risk factor that would be easy to assess. She says future studies should focus on correcting vitamin D levels and seeing if the condition stabilizes or resolves. At Johns Hopkins, I’m Elizabeth Tracey.

 

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Anchor lead: Should postmenopausal women have their testosterone level measured? Elizabeth Tracey reports

How can we explain why women who’ve experienced menopause have a much increased risk of cardiovascular disease? The culprit may be higher testosterone levels, research by Erin Michos, a cardiologist at Johns Hopkins, and colleagues has shown. Testosterone is a type of hormone known as an androgen and is dominant in men.

Michos: Higher levels of androgen in women were associated with increased blood pressure, with glucose intolerance, adverse lipid profile, and all those things taken together can place a woman at risk. We accounted for those factors as much as we could and we showed that higher levels of androgen still placed a woman at higher risk. So I think at this time although we’re not currently screening for hormone levels that might be something that one might do in the future to consider as part of other labs that we get to identify individuals at risk.    :31

Testosterone is normally found in women but becomes more dominant after menopause. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Is high testosterone hurting women’s hearts? Elizabeth Tracey reports

Women typically manifest heart disease after menopause, and for years estrogen was thought to be important. Now new research by Erin Michos, a cardiologist at Johns Hopkins, and colleagues shows that the dominant male hormone, testosterone, is also a factor.

Michos: We had individuals representing four race ethnicities, these women were all after menopause, and no history of heart attacks or strokes. So we measured hormone levels and then followed them to see who went on to develop a heart attack or stroke. What we found was that women with higher levels of testosterone, male type hormones, relative to estrogen, had increased risk of stroke, of heart failure, compared to women with lower levels. So this is after we took into account other risk factors for heart disease such as blood pressure, cholesterol, smoking.   :31

Michos notes that in women, testosterone is known to be important in libido as well as muscle health, and says it’s the relative levels of estrogen and testosterone that may be the issue. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What are the dangers of medical marijuana? Elizabeth Tracey reports

Medical marijuana is very helpful for treating pain, but using it regularly is just the same as using an opioid or other habit-forming drug. That’s according to Marie Hanna, a pain expert at Johns Hopkins and director of a pain clinic.

Hanna: People take it recreationally and very short time and feel fine, and they don’t feel like they need to take more. But if you persistently take the same dose, every day, every time you have pain, you’re going to build tolerance. No different in medical marijuana. The medical marijuana is very, very powerful and few puffs can make you really feel great. So patients think hmm, if it makes me feel great, I don’t have the side effects of narcotics, why not feeling great all the time?  :32

Hanna says that medical professionals need to speak up about their experiences with pain relieving drugs, including medical marijuana, before widespread use creates a crisis beyond what we are seeing now with opioids. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Can a comprehensive approach keep pain under control but avoid narcotics? Elizabeth Tracey reports

Getting everyone on board to manage pain both achieves that objective and minimizes use of opioids. That’s according to Marie Hanna, a pain expert at Johns Hopkins who’s established a multidisciplinary pain clinic engaging physicians, massage therapists, acupuncturists, psychiatrists and patients to kick the opioid habit. Hanna says one fundamental is an actual contract with the patient.

Hanna: They sign a contract with us saying that they will not use drugs while they are getting prescriptions from us. And they will not do anything outside getting another prescription from another provider. I will tell them we will be randomly doing urine analysis and we tell them if you keep getting positive urine tox screens we are not going to be working with you, you are going to go find another provider. Once in a while we have a positive tox screen and we confront them and we tell them okay this is come, if it happens again you’re not going to come to this clinic anymore.  :31

Hanna says even those who have used opioids for years benefit. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A new clinic at Johns Hopkins takes a comprehensive approach to pain management, Elizabeth Tracey reports

Pain relief can be achieved without opioid medications or with limited use, but it takes a team of people to treat the many facets of pain. That’s according to Maria Hanna, a pain expert at Johns Hopkins and director of an acute pain management team, who firmly believes that patients with pain can be helped.

Hanna: Some of them have real pain but they don’t understand that physical therapy can take care of their pain. Or anxiety and depression and insomnia is a big part of the equation with pain so if you have these three elements with pain in those patients I need to treat those elements while I’m treating the pain. So that’s why we thought physical therapy, integrative medicine, like acupuncture, massage, all of this, and psychiatry are extremely, extremely important for these patients. :31

Hanna’s approach can also help people who’ve been taking pain medicines for years, she says. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What works best to help smokers quit? Elizabeth Tracey reports

Many current smokers who are invited to make an attempt to quit turn down the invitation, a study published recently in the New England Journal of Medicine shows. In fact, only 20% of the 6000 smokers queried joined in the study. Enid Neptune, a lung expert and tobacco activist at Johns Hopkins isn’t surprised.

Neptune: Some of it is a reflection of how inadequate our smoking cessation programs are in this country. When someone who is a lifelong smoker, when they hear we’d like for you to try our product to stop smoking I think they have a healthy degree of skepticism as to whether that’s even possible. What I do believe is that the vast majority of smokers with they hadn’t started, and the vast majority of smokers would like to quit.   :31

Neptune says we do know how to help smokers to quit but must take a multifactorial approach to improve the odds. At Johns Hopkins, I’m Elizabeth Tracey.

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