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Anchor lead: Is providing drug users a safe place to use them a good idea? Elizabeth Tracey reports

Safe spaces are places where people who use drugs can go to have their drugs tested, and then use them in an environment that’s clean, safe, and where a medical professional can attend them. Susan Sherman, a professor of public health at Johns Hopkins, says they’re also poised to roll out in the US, and that’s a good thing.

Sherman: It is associated with reductions in HIV, in hepatitis C, in overdose, in the tens of millions of injections that have happened throughout the world in these places, since 1986, where it started in Bern, Switzerland, no one has even died of a fatal overdose. Plenty of people have experienced overdoses but they’ve been revived. It also has been found that people who go to these spaces are more likely to enter drug treatment, it’s amazing what you do when you treat people with dignity and respect, you kind of take some of the great instability and exposure to violence in their lives, like these spaces provide and what happens next.  :32

Sherman is one author of a recent paper looking at how test strips for fentanyl might help. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Can a test strip for fentanyl help reduce the number of opioid deaths? Elizabeth Tracey reports

What does it feel like to be an opiate addict? Most of us can only imagine why those who use these drugs risk their very lives to do so. Susan Sherman, a professor of public health at Johns Hopkins and one author of a recent study advocating for use of test strips for users to test their drugs for fentanyl, describes what people tell her about the experience.

Sherman: Most people are not getting high they’re getting well and that’s the language that’s used. That when people feel dope sick, so when they’re withdrawing they’re sweating, they’re throwing up, they’re feeling horrible, their body is limp. It’s like the flu on steroids. People don’t want to die. So these strips or the machines really help. We found that 42% of people in our study has witnessed a fatal overdose in their lifetime. There’s so much trauma. That people have seen someone die. People don’t want that to be their reality even if they are people who are using drugs.  :31

Sherman believes testing street drugs for fentanyl, which is much more powerful than heroin, can help preserve life so people can seek treatment. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Can something as simple as a paper test strip help stem the tide of opioid overdoses? Elizabeth Tracey reports

Opioid overdoses continue unabated, with the opioid fentanyl increasingly implicated, the latest data show. Susan Sherman, a professor of public health at Johns Hopkins, says the numbers are startling.

Sherman: The numbers starting shooting up with fentanyl 2013, it’s just over five years. Here in Maryland we have a 38-fold increase in fentanyl death in five years: 11

Sherman and colleagues have just completed a study looking at methods to let drug users test their drugs for fentanyl, comparing three approaches, and finding that simple test strips are most practical.

Sherman:  The strips were the most reliable and valid. They were able to detect the highest percentage that fentanyl was present in a drug when it was present, and when it was not present when it was not present. And these were validated by mass spec used in criminal justice settings. We tested personal use street samples so it mimicked what would happen in a public health setting in a syringe exchange if someone came and tested their drugs.  :24

Sherman says such harm reduction strategies must be employed to stop our tragic number of opioid overdoses. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What do skin infections and tumor responses have in common? Elizabeth Tracey reports

You’ve probably heard of MRSA, a skin infection that can turn deadly for some people. This is just one strain of a bacterium that’s called staph aureus, with this group of bugs responsible for some half a million hospitalizations and $3 to $4 billion dollars in healthcare costs each year. Now research by Lloyd Miller and colleagues at Johns Hopkins has identified a cell type known as gamma delta T as protective against the infection in some people.

Miller: Us finding this new response with gamma delta T cells is very novel. In general gamma delta T cells are very very exciting because they happen to be found around tumors. And in the whole cancer immunology field they’re trying to harness the power of gamma delta T cells to help fight tumors and help shrink tumors, and use those same immune responses. So us finding this as important in Staph aureus we might be able to build on all the discoveries they’ve been working on in cancer immunology with these same cells.  :28

Learning how to turn these cells on is one next step, Miller says. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A special type of cell helps some people fight off severe skin infections, Elizabeth Tracey reports

Many skin infections are caused by a bacterium called Staphylococcus aureus, with the most infamous strain known as methicillin resistant staph aureus, or MRSA, which can be life-threatening. Now research by Lloyd Miller and colleagues at Johns Hopkins offers hope that a specific cell type might be activated against the disease.

Miller: We found a single cell type, a type of T cell, that was able to provide long term protection against recurrent Staph aureus skin infection. It’s been a real problem for the scientific community to understand which mechanisms provide protective immunity against Staph aureus. One of the most difficult situations that we deal with as physicians is that in patients who get a Staph aureus skin infection about 50% will actually get a recurrent Staph aureus skin infection within the next six months.   :29

Miller says it’s not yet known why some people seem to activate these cells while other don’t, but that learning to invoke such a response could help manage the infection. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: When parents take a role in the NICU, babies do better, Elizabeth Tracey reports

Parents who’ve been carefully trained by staff in the neonatal intensive care unit or NICU can successfully help care for their critically ill infants, a recent study in the Lancet showed. Renee Boss, an expert in the care of such infants at Johns Hopkins, describes the study.

Boss: They even had parents do some charting of how the baby was growing or what their development was, so it was a really nice way of integrating care. I think what was intriguing about this study was that the babies were a little sicker than in some of the other studies and still what they found was that the families loved it, and the babies grew better and the babies breastfed better and the families in the end were much happier with the experience, and nothing bad happened.  :28

Boss notes that parents in this study committed to spending 6 hours each day in the NICU with their babies, something many moms and dads simply cannot do, and that the NICU staff were also specially trained to educate parents. At Johns Hopkins, I’m Elizabeth Tracey.

 

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Anchor lead: Two bacteria teaming up may lead to colon cancer in some, Elizabeth Tracey reports

Bacteria in your gut are back in the news with a study by Cynthia Sears and colleagues at Johns Hopkins, showing that in some cases of colon cancer, when two strains work together, malignancy can result. Sears says these bugs form something called a biofilm right next to the cells of the colon, where each releases a chemical that promotes cancer formation.

Sears: Hopefully what we can do is identify ways to be sure the bacteria are there first, and then develop ways to either develop immunity against those bacteria so they’re not so successful in colonizing and changing tissue, or maybe we can develop select ways to sort of knock them out of the microbiome. We don’t think that removing just those two bacteria would actually impede the good parts of the microbiome that we need for our health.  :29

Sears says for now, she doesn’t advocate for individual analysis of the range of bacteria in the gut until more is known. At Johns Hopkins, I’m Elizabeth Tracey.

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