Health Newsfeed – Johns Hopkins Medicine Podcasts

One brand of electronic cigarette can now be marketed to help people quit smoking combustible cigarettes, the FDA has decided. Michael Blaha, a cardiologist at Johns Hopkins and antismoking activist, says this does not mean the agency is advocating for use of this produce.

Blaha: I want to emphasize that the FDA has not endorsed this as a smoking cessation product. This decision only reflects the authorization of marketing of this product. Only nicotine replacement products, and pharmaceuticals like Chantix for example are approved for smoking cessation. The implications of this decision are complicated and won’t be known probably for a few years. But I think the FDA is making the decision that by authorizing a particular tobacco product for example they can also deny all the applications for flavored tobacco products.  :30

Flavored tobacco products are well-known to appeal to young users, including children, and act as a gateway to nicotine addiction, Blaha says, so keeping them out of the market is a goal well worth supporting. At Johns Hopkins, I’m Elizabeth Tracey.

At least one brand of e-cigarette seems to have convinced the FDA that its product can help people quit smoking combustible cigarettes, according to the agency’s recent decision. Michael Blaha, a cardiologist at Johns Hopkins and antismoking activist, offers his opinion.

Blaha: Recently the FDA issued an authorized marketing decision for Vuse solo brand and its tobacco flavored pods because the company was able to demonstrate data that adults decreased smoking with very little uptake by kids because kids tend not to prefer tobacco flavored products. This is a complicated decision from the FDA to look at products both in terms of their ability to help adults quit smoking, but also their risk of having young adults and children uptake electronic cigarettes as their first tobacco products.  :34

Blaha says only time will tell if the strategy succeeds in reducing the number of young people taking up the habit. At Johns Hopkins, I’m Elizabeth Tracey.

Women are diagnosed with thyroid cancers much more often than men, but a recent study finds that examination of the thyroid gland itself in men and women finds there is little difference in the actual rate of these cancers. Lilah Morris-Wiseman, an endocrine surgeon at Johns Hopkins, shares her thoughts.

Morris-Wiseman: I think that what is happening, and we have some data to support this, that women are coming to their physicians and saying I have these symptoms, there’s something wrong with my thyroid. The easiest thing to say is well let’s get an ultrasound. Thyroid nodules are extremely common, maybe it’s not the thyroid. I’ve diagnosed anemia, I’ve diagnosed B12 deficiency, and a lot of people come in and say it’s my thyroid but to push to say what is it really? :29

Morris-Wiseman encourages everyone who’s been told they have a thyroid nodule to consider second opinions and the full range of explanations for their symptoms before choosing a procedure or treatment. At Johns Hopkins, I’m Elizabeth Tracey.

Despite vastly different rates of thyroid cancers diagnosed in men and women, a recent study concludes the actual rates are really quite similar. Lilah Morris-Wiseman, an endocrine surgeon at Johns Hopkins, explains the findings.

Morris-Wiseman: Women are being diagnosed far more than men with what we think are indolent thyroid cancers, papillary thyroid cancer typically, in many patients overall slow growing and excellent prognosis. The JAMA Internal Medicine study compared the rates of diagnosis of these small thyroid cancers over time and then looked at autopsy studies to see the true rate of small indolent thyroid cancers, and found that actually the rates in women and men are not significantly different.  :32

Morris-Wiseman says it’s unclear why so many more women are diagnosed with these cancers, but suggests that some may be due to women simply seeking medical care more often than men. She advocates for second opinions always before choosing any treatment. At Johns Hopkins, I’m Elizabeth Tracey.

Men who used statins were much more likely to develop diabetes than men who were otherwise very similar but weren’t taking the cholesterol-lowering drug, a study of a large number of veterans shows. Rita Kalyani, a diabetes expert at Johns Hopkins, explains.

Kalyani: They were looking back to see of those who developed diabetes in a certain period of time, how many of those had used statins in the past versus those who hadn’t. What they found was that people who used statins were much more likely to develop diabetes that those who didn’t and this is not a new finding. It adds to the evidence base of the potential link between statins and progression of diabetes. It is generally felt that cardiovascular risk reduction far outweighs the potential increase in glucose that may occur with use of statins.  :32

Kalyani says anyone who is currently taking statins and is concerned about their own diabetes risk should talk with their doctor about how to lower that risk. At Johns Hopkins, I’m Elizabeth Tracey.

Weight loss ought to be the cornerstone of treatment for newly diagnosed type 2 diabetes, a recent study concludes. Rita Kalyani, a diabetes expert at Johns Hopkins, says such a strategy might be best employed in preventing the disease to begin with.

Kalyani: Prevention of obesity is a key modifiable risk factor for the development of prediabetes and diabetes. Perhaps something that we don’t monitor as often as we should is central adiposity, which is usually measured by waist circumference. Waist circumference should probably be measured more commonly in order to better assess those people who might be at highest risk. The way that we assess obesity needs to be better defined. The advantage to waist circumference is that there are well defined ethnic specific cutoffs for both men and women from the World Health Organization.  :33

Kalyani says you can ask for your waist circumference to be measured if your doctor doesn’t do so. At Johns Hopkins, I’m Elizabeth Tracey.

A drug that causes fat to be metabolized, and in particular around organs like the heart where fat is especially dangerous, has been shown to work well in male mice, research by David Kass, a cardiologist at Johns Hopkins, and colleagues has shown.

Kass: An oral med. It’s been used already in people. There are a couple of large pharmaceutical companies that are developing PD9 inhibitors, almost entirely for neurocognitive diseases. We have side effect profile already and it’s pretty benign. There was no significant adverse effect signature of this oral molecule.  :17

Kass says only male mice and females without ovaries benefit however.

Kass: There’s a pretty striking sex dimorphism. It worked in males. It doesn’t work in intact female mice at all, but you take their ovaries out it works as well if not even better than the males.  :13

Kass notes that the drug has already been used in people so it may be a short step to clinical trials. At Johns Hopkins, I’m Elizabeth Tracey.

A type of mouse used to study obesity and heart problems has demonstrated the efficacy of an existing medicine to help them lose weight, and in the places where it matters most, around organs like the heart. That’s according to new research by David Kass, a cardiologist at Johns Hopkins, and colleagues.

Kass: The difference in body weight between the two groups was 27%. There were many more mice in the treatment arm that actually lost weight. The placebo arm most of the mice gained weight, the relative difference was substantial. And then we did scans and showed that yup this is total body fat. That’s what disappeared, that’s where the weight is going. Lean mass wasn’t changed, and what makes this particularly attractive is that this happened without any change in activity, without any change in food intake. They ate just as much.  :29

Kass says this medication was originally developed as a potential treatment for Alzheimer’s disease so it has already been used in people. At Johns Hopkins, I’m Elizabeth Tracey.

Many women being treated with chemotherapy for breast cancer report ‘brain fog,’ or cognition issues. Now a new study examines whether exercise can help reduce or even eliminate this side effect of treatment. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, explains.

Nelson: When it came to exercise itself and to cognitive issues it was all impacted. So if you look at the immediate end of chemotherapy, the amount of physical activity was less, the cognitive decline was maximal at that point. And that the physical activity and the cognitive decline had largely, although not completely, had largely recovered by six months later. And then they went to look at the women who had the higher levels of physical activity and they seemed to be impacted less at each of the time points.  :30

Nelson says it’s also known that regular exercise can reduce a woman’s chance of developing breast cancer at all. At Johns Hopkins, I’m Elizabeth Tracey.

It stands to reason that people with cancer might be more susceptible to developing severe Covid-19 disease, and now a new analysis confirms it. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the data.

Nelson: It does encompass 18500 subjects with cancer and Covid-19 diagnoses. The 30 day mortality ranged from 13% to 50-60%. Age, gender and comorbidity they all made a difference. The groups that did particularly poorly with cancer were folks with thoracic cancers. The other are hematologic cancers, particularly things like multiple myeloma, and melanoma. And the final group of course are folks undergoing bone marrow transplantation.  :30

Nelson says people with cancer should be sure to get fully vaccinated, received boosters, and use masks. They should also consider limiting their exposure to people they know are also vaccinated while avoiding large groups. At Johns Hopkins, I’m Elizabeth Tracey.