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Anchor lead: MRIs and cardiac devices can be compatible, Elizabeth Tracey reports

Good news for people with implanted cardiac devices: if you need an MRI scan you can have one safely, research by Henry Halperin and colleagues at Johns Hopkins confirms.

Halperin: This study has about 1500 patients in it. And about 2000 scans, because again there’s a lot of these patients that have repeat scans. And basically we found no significant long term problems with anybody.  :13

Halperin says while the scan can be done safely, it does require expertise to do so.

Halperin: It’s got to be in a center like this. For the MRI conditional devices there’s a protocol for scanning. The device in interrogated before the scan to see that it’s working correctly, then it’s programmed into an MRI safe mode during the scan.  :17

Halperin says the only time a device may be troublesome is when it is near the end of its battery life and needs to be replaced. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: If you have an implanted cardiac device, you most likely can have an MRI scan safely, Elizabeth Tracey reports

Implanted cardiac devices are lifesavers, restarting the heart or keeping it beating correctly, but when it comes to the need for an MRI scan, concerns arise. Now a new study by Henry Halperin, a cardiologist at Johns Hopkins, and colleagues demonstrates that such scans can be conducted safely.

Halperin: It’s estimated by the device companies that 50-75% of people who get an implanted device will ultimately have an indication for an MRI. The reason you want an MRI it is the imaging modality of choice for a number of diseases, especially neurological diseases.  :18

Halperin says for most such devices, safeguards are already in place.

Halperin: And it turns out the same technology that went into protecting pacemakers and implanted defibrillators from the normal environmental hazards that you see from power stations, radio waves, microwave ovens, cell phones all this kind of stuff, it’s the same technology that’s needed to protect against MRI scans.  :19

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: You may not need to fast before having your blood tested for cholesterol, Elizabeth Tracey reports

Fasting may be thing of the past when it comes to testing for cholesterol in the blood. That’s according to research by Seth Martin, a cardiologist at Johns Hopkins, and colleagues, comparing the older method for calculating the various components of cholesterol with the new one. Martin says the new one is more accurate, and patients are the winners.

Martin: They struggle to get to the lab before eating, they’re missing work, they’re seeing us in the clinic, we’re saying you probably need to come back another day to get your labs drawn, and that still might be important in some patients, but for most patients we believe that they can do the lipid profile in the nonfasting state and still get as good a result, the caveat being that labs need to update to our modern method of LDL estimation.  :27

Martin says the new method is already widely employed.

Martin: I’ve been really glad to see that its happened throughout the US by Quest diagnostics, and many other labs are adopting this.  :07

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Air pollution exposure affects unborn infants, Elizabeth Tracey reports

If you’re pregnant and exposed to a lot of air pollution from road traffic, your baby may be born smaller than babies born to mothers without such exposure, a study in the BMJ found. Corinne Keet, an asthma and allergy expert at Johns Hopkins and air pollution researcher, describes the findings.

Keet: They looked at full term infants and looked at the pollution they were exposed to during pregnancy and saw that there was a relationship between exposure to pollution particularly to particulate matter pollution which is a product of combustion of fuels, that exposure to pollution was associated with lower birth weight. And that’s important because we know that low birth weight is a predictor of many other bad things in childhood. I think this is just another reason why we should pay attention to air pollution.   :30

Consequences of low birth weight can include developmental delays, growth problems, increased risk for infectious diseases and death during infancy and childhood. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Can exercising in polluted air actually be harmful? Elizabeth Tracey reports

If you’re an older adult, when is exercise actually worse than remaining sedentary? When you exercise in an area that has a lot of air pollution, a recent study in the Lancet concluded. Corinne Keet, an asthma and allergy expert at Johns Hopkins and air pollution researcher, comments.

Keet: This study showed that among older adults who walked in a polluted area compared to those who walked in a non-polluted park area, that those people who walked in a polluted area actually ended up having decreased lung function with their exercise and decreased measures of cardiovascular health. I don’t think this means that you shouldn’t exercise if you’re living in a city but I do think it points to the importance of reducing air pollution in our areas where we live and if possible for people to exercise in less polluted areas.  :32

Keet says people who live in areas with a lot of air pollution should consider walking indoors, especially if they have lung or heart conditions. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Another type of air pollution worsens asthma, Elizabeth Tracey reports

Really tiny particles in air pollution have been known for some time to cause problems for people with asthma and other lung disorders, especially children. Now new research by Corinne Keet, an allergy and asthma expert at Johns Hopkins, and colleagues, shows that the larger particles in air pollution are also problematic.

Keet: It’s important because this particular matter pollution, this coarse fraction particulate matter which is the larger fraction, is not systematically monitored in the US and it’s not regulated in the US. Most of the attention has been on the fine particulate matter which is those that are less than 2.5 microns. There’s now more attention being looked at of these health effects of these larger particles which come from things like brake wear and tear they can be sand there’s a lot of different things that can cause them.  And we found that this part of pollution is also important for children with asthma.  :31

Keet hopes her study will inform policy decisions when things like limits to air pollution are formulated, and notes that the effects are especially pronounced in younger children. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: For people with diabetes who need insulin and other expensive drugs, help may be on the horizon, Elizabeth Tracey reports

There’s no question that managing diabetes can be very expensive, with test strips, many oral medications and insulin really adding up. That fact is acknowledged in newly released management guidelines from the American Diabetes Association. Rita Kalyani, a diabetes expert at Johns Hopkins and chair of the guidelines committee, says cost is an issue.

Kalyani: It’s certainly true that we do need to focus on the economic consequences of the treatments we offer. Last year we added new tables on cost for insulins and non-insulins, and this year we added a second set of cost information, just to assist the health care provider when deciding among different therapies because certainly the rising cost particularly of some of our newer medications, can make it difficult for the patient and also the healthcare provider to use these medications.  :25

Kalyani applauds a recent announcement from the FDA that they will expedite approvals for generic insulin.

Kalyani: Having a generic insulin would help so many and it would be really great to see that come to fruition.  So I’m excited to see the next steps of that.   :08

At Johns Hopkins, I’m Elizabeth Tracey.

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