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Anchor lead: With all the peanut allergy around, what should parents do? Elizabeth Tracey reports

Peanut allergy is a frightening thing, with seemingly frequent reports of sudden death among children following peanut ingestion, and new products coming an the market to help parents stave off peanut allergy in their kids. Corrine Keet, an allergist at Johns Hopkins, says feeding peanut to infants doesn't require specialized products.

Keet: Right now the evidence we have is strongest for infants who are at high risk because they have severe eczema or egg allergy and the guidelines recommend that infants who have severe eczema or egg allergy introduce peanut as easy as four to six months. Those who have moderate or mild eczema around six months or so, and for the rest of the population we think it probably does help prevent peanut allergy and so the current guidelines are to introduce peanut in developmentally and culturally appropriate ways. :27

Keet says that allergies to peanuts do seem to be increasing, so adopting the early feeding strategy is something parents should discuss with their pediatrician. Peanut is a good protein source that children seem to like. At Johns Hopkins, I'm Elizabeth Tracey.

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Anchor lead: Do you need a specialized product to introduce your child to peanut? Elizabeth Tracey reports

Hello Peanut is the name of a new product to help parents safely introduce their children to peanuts, a major cause of food allergy and allergic reactions. Corrine Keet, an allergist at Johns Hopkins, says that's not really necessary.

Keet: That introduction does not need any kind of specialized product like Hello Peanut or any other of those kinds of products on the market. You can do that introduction with peanut powder, which is readily available and much cheaper, or with peanut butter or with things like Bomba. The recommendations are that infants have about two grams of peanut protein three times a week which is equivalent to about two teaspoons of peanut butter or peanut powder or 21 pieces of this Bomba which is kind of like a corn puff but with peanut on it. infants can choke on peanut butter so if you use peanut butter it should be diluted with water or with baby food. :34

Keet says that parents should begin with a conversation with their child's pediatrician before embarking on any peanut feeding schedule and be sure to follow safety protocols. At Johns Hopkins, I'm Elizabeth Tracey.

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Anchor lead: Exactly what are so-called "indirect" costs of medical and scientific research? Elizabeth Tracey reports

Biomedical research is expensive, but must be supported. That's the clear take home from Congress's recent action to preserve both so called 'direct' and 'indirect' costs in funding such research. Landon King, executive vice dean of Johns Hopkins Medicine, explains that 'indirect' costs keep the lights on, but serve a much more important function.

King: It's also a very highly regulated environment because of appropriate concerns around safety, more so it you're partnering in research with patients. There is a substantial cost associated with appropriately overseeing that research, recording that research, reporting on that research, and so the indirect cost is just as essential as the direct cost.  :29

So as the federal government searches for ways to trim the budget, don't be fooled by terminology like 'indirect' costs of research. At Johns Hopkins, I'm Elizabeth Tracey.

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iStock_000068724623_MediumThis week’s topics include aspirin discontinuation risks, HIV in those 50 and older, big data and chronic lung disease, and genetic testing and warfarin use.
Program notes:
0:34 Genetic testing and warfarin dosing
1:35 Looked at genetics to determine
2:33 Other agents for blood thinning
3:01 Use of big data and chronic lung disease
4:01 More women smoking
5:02 Not sure of significance of e-cigarettes
5:26 HIV infection in those 50 or older
6:30 Usually diagnosed later
7:30 Still at risk if you’ve over 50
7:43 Perils of discontinuing aspirin
8:43 Stopping increased risk by 30%
9:43 Stop as close to surgery as possible
10:27 End
Related blog:https://podblog.blogs.hopkinsmedicine.org/2017/10/03/hiv-in-the-50-crowd/
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Anchor lead: How much does it really cost to bring a new drug to market? Elizabeth Tracey reports

Soaring drug costs have everyone concerned, but pharmaceutical companies have for years justified them with citation of research and development, or R and D costs needing to be recovered. Now a new study in JAMA Internal Medicine concludes that cancer drug makers reap on average 9 times their R and D costs four years after FDA approval. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, comments.

Nelson: R and D costs are not spiraling out of control, the biopharma industry is getting more efficient. There’s another trend that’s captured in this a little bit and that’s that large pharmaceutical companies have somewhat outsourced this process to smaller companies and then they build those relationships later, leading to a drug discovery and development ecosystem where the costs of developing a drug isn’t as high as we believed it was. Costs are born by the American public, who are paying for their treatment in one way or another.  :32

Nelson notes that public awareness is key. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What’s the relationship between alcohol consumption and blood cholesterol? Elizabeth Tracey reports

Does your consumption of alcohol impact your blood cholesterol levels, known to be important in cardiovascular disease? Research by Zach Kaminsky at Johns Hopkins and colleagues suggests the answer may be yes, via a protein made by the liver known as PCSK9.

Kaminsky: The liver is one of the primary organs that make PCSK9 that really help to regulate the body’s level of cholesterol or LDL cholesterol, the bad cholesterol. What’s important about this is that epigenetic patterns act like light switches to turn on and off genes. And so if alcohol is changing the epigenetic patterns, then alcohol could be regulating, through an epigenetic switch, the amount of this cholesterol regulating gene. And this has implications for cardiovascular health.   :30

PCSK9 inhibitors have been much in the news lately as they have been shown to further reduce blood cholesterol in those who are already taking statins, and epigenetics may explain how. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Viral hepatitis is a killer, Elizabeth Tracey reports

Hepatitis, where the liver becomes inflamed, is most often caused by a group of viruses, and the death toll worldwide from these infections is staggering, according to recently released data. Mike Klag, dean of the Johns Hopkins Bloomberg School of Public Health, describes the findings.

Klag: If you lump all the viral hepatitis together hepatitis A,B, C, D and E, the alphabet soup of hepatitis they account for an estimated 1.3million deaths around the world. That’s more than from tuberculosis or HIV or malaria alone. The other important thing is that we can screen for it and we can treat it. Unfortunately for some of these viral infections the treatment is very very expensive. Knowing that we have a way to treat these diseases, how do we set up systems to screen, find the people with it and then treat?  :31

Klag notes that domestically, baby boomers are recommended to be tested for hepatitis C so they can be identified and treated. At Johns Hopkins, I’m Elizabeth Tracey.

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