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Anchor lead: People may now consider the HPV vaccine up to the age of 45, Elizabeth Tracey reports

Certain human papilloma viruses, or HPV, cause cancer. Now a Centers for Disease Control and Prevention panel recommends the HPV vaccine for everyone through age 26 and for some adults up to age 45. Amber D’Souza, an epidemiologist and HPV expert at Johns Hopkins, explains.

D’Souza: People in their 30s or 40s very likely haven’t been exposed to all nine types of HPV that are in the HPV vaccine and so there’s still some benefit. That doesn’t mean that everyone needs to run out and get the HPV vaccine because the chances that it will protect you decrease as you’re older because you’re more likely to have already been exposed to more types and you’re not as likely honestly to have as many new partners so you’re not likely to have as much future risk but there are some older individuals who would benefit  and should get the HPV vaccine.   :32

So if you’re over 26, talk with your doctor about receiving the HPV vaccine. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A new device may make treating a common eye disease much easier, Elizabeth Tracey reports

Macular degeneration or AMD is an eye disease that is a leading cause of blindness in people older than fifty. One form of the disease can be treated by injecting the eye with a drug known as an anti-VEGF, but this must be done fairly often. Now a new study by Peter Campochiaro, an ophthalmologist at Johns Hopkins, and colleagues, shows an implanted drug delivery system safely reduces the need for frequent injections.

Campochiaro: Vision gets worse, then they get an injection it gets better, a much better system is to have sustained delivery of an anti-VEGF. Patients who received the highest concentration went an average of 18 months before they needed a refill. So we don’t have to have them come in every few months but rather every six months to get a refill. This could greatly improve compliance and improve outcomes in patients with wet AMD.    :30

Campochiaro says a much larger study will need to be completed to confirm these results. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Do you need two different medicines if you have a stent placed in your heart? Elizabeth Tracey reports

When stents are placed in the heart’s blood vessels, medicines called antiplatelet drugs are used to prevent blood clot formation. Now a new study shows that for many, the traditional two medicine approach after stent placement may not be needed. Michael Blaha, a preventive cardiologist at Johns Hopkins, explains.

Blaha: It used to be considered standard of care that you had to be on two different antiplatelet drugs, aspirin and another drug, for at least twelve months after stent placement, but we’re now realizing that there are groups of patients that may not need to stay on dual antiplatelet therapy as long, may need to have a course of aspirin let’s say three or six months, and then continue on another antiplatelet drug alone for an extended period of time to prevent that stent from creating blood clots.  :25

Blaha says the big advantage to dropping the aspirin is that aspirin is known to increase bleeding risk. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Will San Francisco’s ban on e-cigarettes get the FDA to step up? Elizabeth Tracey reports

Tobacco products fall under the purview of the FDA, but the agency has been slow to act in regulating them, including e-cigarettes. Now that San Francisco has outlawed the devices, Michael Blaha, a preventive cardiologist at Johns Hopkins, says the agency may be spurred to action.

Blaha: One interesting thing about this approach that San Francisco has taken is they said they’re going to ban electronic cigarette sales for only those products that haven’t been approved by premarket approval by the FDA. The catch is no products have been approved by the FDA to date, so this effectively bans the sales of all electronic cigarette products. This is a nudge to the FDA that they have to move faster to create a regulatory framework for electronic cigarettes, so we can really know which products might create a health benefit and which ones  are clearly harmful.  :32

Blaha says regulation by the FDA is important in imposing constraints where they are needed. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What are the implications of the new law to ban e-cigarettes in San Francisco? Elizabeth Tracey reports

E-cigarettes will not be sold in San Francisco if a new law takes effect. Michael Blaha, a preventive cardiologist at Johns Hopkins, says at least one at risk group from the devices will likely benefit.

Blaha: The city of San Francisco has chosen to ban the sales of electronic cigarettes to all individuals. And this also covers flavored tobacco products as well as the online sale of electronic cigarettes with their shipment to San Francisco. And I think this is really a good thing from the perspective of signaling that electronic cigarettes are a big problem, particularly when it comes to youth use, use by young people who’ve never used a tobacco product before but perhaps are using electronic cigarettes as their first tobacco product. :29

Blaha says use of e-cigarettes among teenagers is common and growing, so efforts to stem this addiction are needed. He notes that such a ban may also prevent smokers of traditional cigarettes from using the devices in quit attempts. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Stopping routine cancer screening is an option for some, Elizabeth Tracey reports

Sometimes it is appropriate to stop routine cancer screening, since all screening tests are associated with harms as well as benefits. Nancy Schoenborn, a geriatrics expert at Johns Hopkins, looked at attitudes toward stopping routine screening of both care providers and patients, and found patients welcomed advice from their doctor.

Schoenborn: For the patient who may not want to continue screening, to give them permission to stop, so that they don’t feel obligated, that they’re disobeying a recommendation from their doctor.  :12

Schoenborn says it’s also important to understand what patients are understanding about stopping screening.

Schoenborn: What do the patients actually think of these guidelines? Does that make sense to them, does that resonate with them? We’re trying to find patients’ preferred ways for clinicians to have these conversations.  :12

Schoenborn hopes this and further studies will help inform both clinicians and patients so the best individualized approach can be taken. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: When is it appropriate to stop routine cancer screening? Elizabeth Tracey reports

Cancer screening may entail some risk, and for some people, it may be appropriate to discontinue the practice. According to the American Cancer Society, those with less than 10 years of expected life remaining are one such group. Nancy Schoenborn, a geriatrics expert at Johns Hopkins, and colleagues, examined the perspectives of both patients and physicians on the issue.

Schoenborn: At some point for a certain patient the harms of cancer screening and the harms of detecting and the follow up testing related to a positive result, all that and just the burden of getting to the screening test and undergoing it, the harms and the risks and the burdens at some point may outweigh the benefit and I think that it should be at least discussed whether for that patient it still makes sense to continue.  :30

Schoenborn says thoughtful discussion helps both sides reach a decision. At Johns Hopkins, I’m Elizabeth Tracey.

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