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Anchor lead: Will a new hearing aid encourage more people to use the devices? Elizabeth Tracey reports

The audio manufacturer Bose has recently received FDA approval to market a hearing aid. Nicolas Reed, an audiologist and researcher at Johns Hopkins, heralds this as good news for consumers and other prospective manufacturers of hearing aids.

Reed: They have this novel device that’s self-fitted, and they collected data, laboratory data, and real world data, saying that it worked for people. They liked it, they liked it as much as any typical device, that it helped them, that they were able to self-fit accurately. Really really unique in the hearing aid world for them to provide all this data behind it. So this is a unique pathway that they’ve opened up. The pathway for purchase could be online, it could be through a dispensed audiologist if they want to go that way, the actual pathway to purchase hasn’t changed much.  :30

Reed notes that many people find the purchase of hearing aids cost-prohibitive, and predicts that products such as the one from Bose may help shift that. At Johns Hopkins, I’m Elizabeth Tracey.

 

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Anchor lead: Psilocybin’s list of conditions where it may help is expanding, Elizabeth Tracey reports

The FDA is reviewing whether the hallucinogenic drug psilocybin should be reclassified to acknowledge areas where it is clinically useful, at the urging of Matthew Johnson, a psilocybin researcher at Johns Hopkins, and colleagues. Johnson says abundant data from clinical trials provides some guidance.

Johnson: Where we’re furthest along is in the use of psilocybin to treat depression and anxiety in folks with cancer. There’s also more preliminary but still very promising research on helping people to quit smoking, on helping people with depression outside of the cancer context and helping people with alcoholism.  If approached in the right way there’s a good bet that it would be effective for a number of different addictions. :30

Johnson believes skilled use of psilocybin may even be helpful in those who are addicted to opioids. At Johns Hopkins, I’m Elizabeth Tracey.

 

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Anchor lead: Should the FDA approve psilocybin as a medicine? Elizabeth Tracey reports

Psilocybin is a drug that the FDA currently categorizes as having no clinical value, but an initiative underway at Johns Hopkins and several other research facilities is underway to change that. That’s because when used properly, and under specific conditions, the hallucinogenic drug can be quite helpful. Matthew Johnson, a psilocybin researcher at Johns Hopkins, comments.

Johnson: We want to start a dialogue about the appropriate scheduling and the appropriate regulations for psilocybin if and when FDA approves it as a medicine.  So there are several disorders for which there are very promising data. None of them are at the point where FDA is going to approve within the next year or so but we may very well be there within the next five years or so.   :27

Johnson and colleagues believe even more convincing data of psilocybin’s usefulness is accumulating. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: You can have an impact on whether you receive a transfusion, Elizabeth Tracey reports

For many people who are having surgery, having fewer transfusions is both practical and results in fewer harms, with a recent study in the New England Journal of Medicine looking at outcomes out to six months postoperatively. Steve Frank, a transfusion expert at Johns Hopkins, says if you’re having surgery, talk with your doctor about transfusion use.

Frank: I like to say that blood saves lives when you need it, but it only increases risk and cost when you don’t. I think you have a discussion of the risks and benefits of transfusion and understanding with the physician that you’re only going to receive a blood transfusion if you truly need it, because even the Joint Commission and the American Medical Association have called out transfusion as one of the top five overused procedures in US hospitals.  :31

Frank notes that transfusions are also the most common procedure undertaken in US hospitals. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Why are too many transfusions harmful? Elizabeth Tracey reports

More and more evidence is mounting that restricting blood transfusions results in fewer problems for patients and is also less expensive, with the latest study in the New England Journal of Medicine looking at outcomes at six months after cardiac surgery. Steve Frank, a transfusion expert at Johns Hopkins, describes the consequences of transfusion.

Frank: So basically the heart and the lungs take a hit when you give patients more blood than is needed. So all these nine randomized trials, I call them landmark studies, support a restricted transfusion strategy. In other words giving patients less blood than we’re used to, say 10 years ago.  :18

Frank says now a lower hemoglobin level in the blood is used to decide when to transfuse.

Frank: The way we dose blood, if you will, is based on the hemoglobin level. We used to use a hemoglobin threshold of 10. Now these 9 randomized trials show that we should be using 7 or 8.  :12

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Limiting transfusions is best for all concerned, Elizabeth Tracey reports

People who’ve had cardiac surgery and were given fewer transfusions did just as well six months later as those who got more blood, a recent study in the New England Journal of Medicine found. Steve Frank, a transfusion expert at Johns Hopkins, isn’t surprised.

Frank: The bottom line is giving extra blood to patients doesn’t help, and only adds risk and cost. So there’s now 9 randomized studies in the New England journal or JAMA, mostly in the last decade, that show that giving extra blood to patients is not helpful. And four of the nine studies actually show harm in giving more blood than is needed. :25

Frank describes the most serious harm.

Frank:  The number one cause of transfusion related death is called TRALI, for transfusion related acute lung injury.  :07

Frank says many hospitals are on now on board with limiting transfusions unless they’re really needed. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Does it make sense that an EPA product would help in cardiovascular disease? Elizabeth Tracey reports

Vascepa is the name of a concentrated omega-3 fatty acid product that the manufacturer has released results about ahead of any scientific meeting or validation, showing about a 25% reduction in cardiovascular events in those at risk when 4 grams of the drug were taken per day.  Michael Blaha, a preventive cardiologist at Johns Hopkins, says these fatty acids, known as EPA, have known effects.

Blaha: Without a doubt, EPA lowers triglycerides. So we’ve appreciated that blood triglycerides are a causal risk factor for heart disease. Yet we didn’t have evidence until perhaps now that lowering triglycerides was a good thing. But EPA also does a bunch of other things that are potentially beneficial. They inhibit platelets so they thin the blood a little bit. They’re antioxidant and anti-inflammatory drugs, they seem to have a protective effect on heart cells. So it could be when these data are published that EPA has a variety of beneficial effects.  :30

Blaha looks forward to more complete data at the American Heart Association meeting. At Johns Hopkins, I’m Elizabeth Tracey.

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