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Anchor lead: Could a diet help people with one type of leukemia control the disease? Elizabeth Tracey reports

One type of leukemia may respond to reducing the amount of serine, an amino acid, in the diet, research by Brian Dalton, a leukemia expert at Johns Hopkins, and colleagues has shown. Dalton says employing such a simple strategy has long been a hope of cancer researchers.

Dalton: People have been wanting to use a dietary modification to affect cancer, but to have it be a more precise molecularly guided intervention, I think it is cool and another kind of personalized medicine. Right now we’ve been writing the proposal for a trial to do this in patients who have MDS, which is the precursor to leukemia and they have this mutation. And the ideal would be to model it after metabolic disorders that actually do this as routine practice.  :32

Dalton says people with this specific mutation have cancer cells that can’t make the amino acid on their own. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A molecule called leptin has multiple effects in obesity, Elizabeth Tracey reports

Obesity is linked to high blood pressure, which may be difficult to treat in spite of multiple medicines. Now research by Seva Polotsky and colleagues at Johns Hopkins points to differing effects of a hormone called leptin as potential targets. The research identifies effects of leptin inside the brain, beyond a protective wall known as the blood brain barrier, and in a tiny area inside the artery to the brain called the carotid.

Polotsky: Leptin is a very interesting molecule. In a sense how it works below and above the blood brain barrier. It’s like Dr. Jekyll and Mr. Hyde. Above blood brain barrier it’s Dr. Jekyll. If you inject leptin intranasally, it’s like a spray. It actually improves sleep apnea, and suppresses food intake. If you inject leptin blocker, or you block leptin pathway from carotid body, you will normalize blood pressure.  :27

Polotsky notes that an existing drug might help. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Improved understanding of heart pathology may help young people avoid sudden cardiac death, Elizabeth Tracey reports

We’ve all heard the stories: a young athlete collapses on the playing field and dies. Pathology reveals a heart problem called arrhythmogenic cardiomyopathy, which is inherited. Stephen Chelko, a cardiology researcher at Johns Hopkins, and colleagues, reveal the problem is both electrical and inflammatory in a recent study. If identified, treatment includes an implanted cardiac defibrillator or ICD, and medicine.

Chelko: There is now a drug that is FDA approved, clinically available, that’s safe that we could potentially be giving our patients, on top of beta blockers and an ICD implant, that hopefully will prevent this inflammatory phase. If you have too much inflammation your cells will die. We’re hoping that ultimately there’s a drug that can treat the underlying aberrant cell signaling. Besides the electrical issues going on we want to stop all the downstream progression.  :29

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Can texting and home visits help young women manage pelvic inflammatory disease? Elizabeth Tracey reports

Pelvic inflammatory disease or PID is an infection in women that can result in infertility if not treated. Now research by Maria Trent, an adolescent medicine expert at Johns Hopkins, and colleagues, shows that an approach using text messaging and a home visit from a nurse can help assure the infection is treated.

Trent: One of the things we have to do is to support patients in how they care for themselves at home after they leave the doctor’s office, particularly young women. It’s important because PID is associated with chronic pelvic pain, ectopic pregnancy, and tubal infertility. We actually thought that one of the ways we could support patients was to provide technology enhanced community health nursing. We found that patients in our study were 86 times more likely to receive care, that short term follow up visit per CDC recommendation, than those people who were in the control arm.  :32

Trent hopes to deploy the program widely. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Rising rates of STDs are a concern for everyone, Elizabeth Tracey reports

If you’re sexually active or know someone who is, recent Centers for Disease Control and Prevention statistics should be concerning, as they show a huge increase in rates of gonorrhea and syphilis, the latter of particular concern for newborns. Maria Trent, an adolescent medicine expert at Johns Hopkins, says young people are hit especially hard.

Trent: People are not worried about STDs until they have one. So we have to work hard to make sure that we’re doing asymptomatic screening in primary care settings and that we offer those services to people in a destigmatized way. Rates have been rising for some time now and in young people they are significant. And I think what we’ve seen is really a shift in young people’s ability to access screening services. :24

Trent notes that online access to screening services may be a practical choice for many, and says sites that provide education are also available.

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October 25, 2019

Anchor lead: STDs are rising alarmingly, Elizabeth Tracey reports

Syphilis is infecting more newborns than ever, new CDC data show, with other kinds of sexually transmitted infections, or STDs, also rising dramatically. Maria Trent, an adolescent medicine expert at Johns Hopkins, reviews the numbers.

Trent: We have almost 600,000 cases of gonorrhea, 1.7 million cases of chlamydia, and those are just the STDs that we report. My research has been involved in other STDs too, trichomonas vaginalis and mycoplasma genitalium as an emerging threat. I think the news is troubling. You’ve seen a real shift in how we think about access to sexual and reproductive health services, broadly. And for us to really reverse these findings we’re going to have to, as a nation, take an aggressive approach to offering services to Americans.  :31 

Trent says longstanding support for reproductive health services in the US has eroded, leading to less education, testing and treatment, and these must be restored. At Johns Hopkins, I’m Elizabeth Tracey.

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October 24, 2019

Anchor lead: Clinicians must be on the lookout for bias as they’re developing artificial intelligence systems in medicine, Elizabeth Tracey reports

Bias may be described as an individual’s unique way of looking at things, that may lead to one conclusion over another. In medicine this can give rise to different ways of looking at data and then in managing specific patients, shown in a recent study. Paul Rothman, dean of the Johns Hopkins School of Medicine, says bias must be identified as computers are utilized more in health care.

Rothman: Since we already have those biases and disparities in our system it is not surprising that as we teach computers the way we care for patients today that those same biases are going to be baked in to the paradigms the computers come up with. It’s really important at this point in time where we’re just beginning this journey on how computers can assist in the care of our patients that we carefully look at the biases that come out of these machine learning paradigms.  :30

At Johns Hopkins, I’m Elizabeth Tracey.