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Anchor lead: Dogs may help when people must be in an ICU for prolonged periods, Elizabeth Tracey reports

Dogs can help when people must be in an intensive care unit for a long time. That’s one observation of such an intervention underway at Johns Hopkins, and outlined recently in a paper in Critical Care. Megan Hosey, the paper’s first author, says dogs help people cope with things like fear and pain, but also with another condition affecting those hospitalized for prolonged periods.

Hosey: We’ve had some instances where patients have been in the hospital for really long periods of time and start to experience what we call demoralization. And there’s just something about dogs that brings the outside world in and may give patients a spark of hope that there’s still life going on out there. They tend to sort of normalize the experience, so for these demoralized patients having a dog in front of you just sort of gives you a sense of hope or sort of joy in life.  :28

Hosey says dogs are specially trained and prepared for their ICU visits and really seem to enjoy their work there. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What role do dogs play in intensive care units? Elizabeth Tracey reports

Getting people out of bed in intensive care units, even when they’re being mechanically ventilated, is associated with better outcomes. Can dogs help? That’s the hope of a program to utilize dogs in the ICU underway at Johns Hopkins. Megan Hosey is an expert in the recovery of critically ill people and one author of a recent paper describing the strategy in Critical Care.

Hosey: What we do on other units in the hospital is bring in dogs to give a sense of purpose, and maybe alleviate some of the anxiety to the early mobilization so that’s what sparked the idea was if I’m getting up while I’m mechanically ventilated well that’s really scary but if I can get up to pet the dog or give it a treat or do what we call an animal assisted intervention we think that that might spark some excitement in patients maybe give them a little bit of an extra sense of purpose with their mobilization.  :29

Hosey says patients report less pain and feeling more hopeful when dogs are present during interventions. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Do families and doctors walk away from critical meetings with the same understanding? Elizabeth Tracey reports

Doctors may be unintentionally optimistic when conveying difficult information. That’s one interpretation of a study by Renee Boss, a neonatologist at Johns Hopkins, and colleagues, looking at the content of such consults between physicians and parents of critically ill children. Boss says there’s at least one way to address the issue.

Boss:  It’s about saying specific things. I’m worried that your son may not walk. I’m worried that your son may not talk. These very specific predictions I think can really help families imagine what it might be like to have a child who’s going to be in a wheelchair. These sorts of very specific predictions might be really helpful to people and I think they can be taught. So I think the biggest opportunity to change what’s happening would be to emphasize communication skills in medical training much more than it is now.  :33

Boss says other studies support the idea that families welcome realistic prognoses. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Parents of sick kids and doctors may not hear the same things when it comes to family meetings, Elizabeth Tracey reports

When doctors talk with parents about their sick infants, they may think they’re being up front with likely prognoses, but that may not be the case. That’s according to research by Renee Boss, an expert in the care of newborns at Johns Hopkins, and colleagues.

Boss: We found that in fact families and clinicians walk away from those conversations with different ideas about what’s been said. What’s interesting about this study is that we actually recorded what was said, and what we found was that while most clinicians walked away from that conversation telling us that the babies had a very low chance of leaving the hospital without severe disability, most of the communication inside the conversation was pretty optimistic.  :30

Boss says such a result runs counter to parents’ needs to know the most likely outcomes so they are able to prepare better, and points to the necessity to train physicians in communication strategies. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  How would a test that identifies very early cancer change things? Elizabeth Tracey reports

How would you feel about a blood test that may tell you that you have cancer at the stage when it might be just a few cells? Such a test, called CancerSEEK, has been developed at Johns Hopkins by Nickolas Papadopoulas and colleages, and while it’s not ready for prime time yet, Papadopoulas predicts such a test will entirely change clinical management of cancer.

Papadopoulos: After all you are telling a healthy individual somebody who feels healthy that you may have cancer. Trying to explain that this is what actually might save your life so I think one of the biggest barriers is how to change the mind of scientists, the community, to actually think that the first line of offense against cancer is actually to try to catch it as early as possible with tests like this or better tests in the future and then try to cure it, I think we’re doing it the other way around now.  :31

Papadopoulos says much more refinement of CancerSEEK is needed before it will be ready to be used in people who have no symptoms of cancer. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A new blood test may help to detect eight different cancers, Elizabeth Tracey reports

CancerSEEK is the name of a new blood test developed at Johns Hopkins with study results published recently in Science that looks for the presence of eight different types of cancer using a blood sample. Nicholas Papadopoulas, senior author of the paper, describes the method.

Papadopoulos: It’s single blood test that can detect a number of different tumor types. This study was on eight common cancers, or cancers that do not actually have any screening modality right now. And we detect DNA that comes from cancer cells or circulating tumor DNA and also we detect levels of protein biomarkers that are elevated in individuals which may have cancer.   :28

The test varied quite a lot in its ability to discern the presence of the specific cancer types but could identify the presence of cancer at all about 99 percent of the time. Such specificity would allow people to forgo follow-up when no cancer is detected. Papadopoulos estimates several more years of research are needed to get CancerSEEK ready for use. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What’s the best way to handle the opioid crisis? Elizabeth Tracey reports

Fewer opioid medications are being prescribed, that much is certain, but have deaths relative to opioid overdose declined? The most recent data haven’t yet shown such a trend, and Eric Strain, an addiction expert at Johns Hopkins, says careful analysis of this multifaceted problem must continue.

Strain: I think we’re in a somewhat reactive mode right now with respect to the opioid crisis. Culturally we’re looking for quick answers to a problem that took several years to develop, and I’m not sure that there are any quick answers to it, so I think you see strategies like let’s give everybody naloxone as a way to address the opioid crisis. That can be helpful but that’s only a small part of an overall strategy and I think that we need to be cautious in thinking that we’ll find some magic solution that’s going to solve the opioid crisis overnight.  :33

Strain is also concerned that if deaths start to wane attention and resources to address the problem may be diverted elsewhere, a move he calls premature. At Johns Hopkins, I’m Elizabeth Tracey.

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