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Anchor lead: What is the role of inflammation in post-treatment Lyme disease syndrome? Elizabeth Tracey reports

Inflammation in the brain may play a role in so-called post-treatment Lyme disease syndrome, or PTLDS, research by Jennifer Coughlin and colleagues at Johns Hopkins has shown. Coughlin says her previous work looking at the brains of athletes who’ve had repeated head injury has identified a protein called translocator protein that seems to be involved.

Coughlin: From studying other conditions like repeated head injury in sports. We’ve really learned that this marker, this translocator protein in the brain, can yes, be increased in injury but it also can be increased in that reparative process. So our studies really need to track patients over time to see whether this is a chronic persistent condition that we actually need to develop treatments to stop or whether this is a normal reaction that’s reparative for the brain and we should let it continue. :32

Coughlin says serial PET scans from the same person over time would help discern the role of inflammation better. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: We may have a handle on why some people have persistent symptoms after having Lyme disease, Elizabeth Tracey reports

Post treatment Lyme disease syndrome or PTLDS is the condition where people continue to experience symptoms of Lyme disease months or even years after they’ve been treated. Now Jennifer Coughlin and colleagues at Johns Hopkins have used PET scanning to look for a substance called translocator protein in the brains of people with the condition.

Coughlin: We imaged them using our PET technology and showed that compared to people who do not have history of Lyme disease there is diffuse increase in translocator protein across the brain in those patients with PTLDS. What that means is that this translocator protein, a marker of inflammation, may be giving us a readout that there is inflammation in the brain of patients with PTLDS.  :27

Coughlin says this is a hint that inflammation in the brain is involved in post Lyme disease syndrome, but many more studies will be needed to prove that’s the culprit. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How well do prescription pain creams work? Elizabeth Tracey reports

If you have arthritis or an injury to a joint or muscle, applying a pain cream may seem like it would help, and those containing prescription pain relievers would be even better, right? Not so fast, research by Steven Cohen, a pain expert at Johns Hopkins, and colleagues concludes.

Cohen: We classified people based on the type of their pain. So that’s suballocation. And then we randomized them in a one to one ratio. They either got the real creams or they got the placebo creams. We taught them how to apply the creams and they kept pain diaries which they had to fill out, average, worse, pain scores twice a day. And we found that there was no significant differences between the people who got the real creams and the people who got the placebo creams.  :25

Cohen says these specially compounded prescription pain creams often contain things like lidocaine or ketamine, and may cost in the thousands of dollars. People often prefer to use them rather than oral medicines because they don’t have so many side effects. But they also are no more effective than the pain creams that can be bought over the counter, Cohen concludes. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What might be the impact of changing penalties for domestic violence? Elizabeth Tracey reports

Decades of progress in domestic violence may be set back with a change in the definition of this issue as strictly a criminal matter, which the Trump administration instituted last year and has recently come to light. Patricia Davidson, dean of the Johns Hopkins School of Nursing, says identifying domestic violence as a felony or misdemeanor is far too narrow.

Davidson: One of the biggest things I see in changing this definition of domestic violence to with a felony or a misdemeanor is that the event has already happened. Much of the work in the intimate partner violence and domestic violence area is preventing felony and misdemeanor. The rates of homicide due to domestic violence are huge shifting this definition is altering the paradigm whereas we as health care providers should be preventing these critical events.   :30

Davidson points out that verbal, economic and psychological abuse also fall into this category and may defy categorization as misdemeanor or felony. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Screening and treatment have led to many fewer deaths from breast cancer, Elizabeth Tracey reports

A huge national database called Surveillance Epidemiology and End Results has revealed great news: many fewer women have died from breast cancer than would have before improvements in screening and treatment. William Nelson, director of the Kimmel Cancer at Johns Hopkins, describes the data.

Nelson: Somewhere between three hundred and eighty four to six hundred fourteen thousand breast cancer deaths have been averted from 1989, 1990 to 2015. If you just look at 2018 the guess is 27 to 46,000 deaths have been averted. They attribute a lot of this to screening with mammography. Certainly that brings a lot of breast cancer to attention and breast cancer that’s detected in that way is clearly more amenable to treatment.  :27

Nelson says early detection via screening accounts for some of the reduced deaths but that treatment advances have also been substantial, as has identification of risk factors for breast cancer. He says the good news is that these advances have rendered breast cancer more of a chronic disease for most. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Cancer is on the rise among younger people, Elizabeth Tracey reports

Cancer diagnoses are rising among 25 to 49 year olds, a recent study reported, and that’s bad news all around. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says specific types of cancer account for the majority.

Nelson: We’re now seeing younger people get several of these cancers, in particular colorectal cancer, gall bladder cancer, kidney cancer, pancreas cancer, multiple myeloma, at younger ages and we’re talking 25 to 49 years old. Keep in mind for all these cancers most people who get them are still older. It’s just that the cancer in this age group which is a small collection of people we really didn’t see much at all, now we’re starting to see it and they are these obesity related cancers.  :28

Nelson says the agenda for prevention is clear – getting our arms around our obesity problem is both a national and international priority, and not just for cancer prevention but for metabolic syndrome, diabetes and heart disease. He says for now, screening efforts to detect these cancers early are not likely to be helpful as they are still infrequent in younger people. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Treating hepatitis C results in lots of benefits, Elizabeth Tracey reports

Effective treatment for hepatitis C reduces both acute liver inflammation as well as subsequent liver cancer, a recent study found. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the findings.

Nelson: This is a cohort study in France looking at a bunch of treatment centers. This is an observational study. They were following a group of people with chronic hepatitis C. Three quarters of them went on one of these antiviral medications and what you found is that people who took them were substantially less likely, 52% less likely to die generally in the observation period which was about 30 months and there was a 34% reduction in liver cancer. So treating chronic hepatitis with antivirals you get rid of that chronic hepatitis it substantially reduces the risk for liver cancer.  :31

Nelson says while these treatments are currently expensive, more of them are being developed and will bring the price down. He says that juxtaposed against treatment for liver cancer, they are quite cost effective even now. At Johns Hopkins, I’m Elizabeth Tracey.

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