Health Topics – Johns Hopkins Medicine Podcasts

Black women often experience breast cancers that are more advanced at the time of diagnosis, and may be more difficult to treat. A recent study looked for the presence of different genes among Black and white women with breast cancer to perhaps explain this. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the findings.

Nelson: They looked at a really large amount of data from a large consortium where the contributors were women with breast cancer back from 1993. These were women diagnosed with breast cancer, they’re not selected in any way for age, ethnicity, age of onset for breast cancer, whether they had a family history. They had data on inherited gene defects for 12 different breast cancer susceptibility genes that they know of, and the most interesting thing about this in looking for differences between black women and white women is that there aren’t many. It’s sort of a large non-story.  :34

Nelson says these findings suggest that screening and access to care likely are involved. At Johns Hopkins, I’m Elizabeth Tracey.

Long Covid is being used to describe continued fatigue, pain, and impaired cognition following Covid-19 infection. Peter Rowe, a ME/CFS expert at Johns Hopkins, says these two conditions may be one and the same, and there are at least two strategies that can be tried to help.

Rowe: One other thing that we’ve found in the patients with prolonged Covid symptoms that merge into ME/CFS is that they have a huge burden of allergic inflammation. Recurrent oral allergy syndrome, with exposure to certain foods or pollens. Recurrent hives. We’re treating them with drugs you would normally use for allergic inflammation like regular antihistamines and a number of other treatments that are in that category. So some of the patients have had improvements as we’re addressed the allergic inflammation, others have had improvements if you treat their circulatory problem.  :33

Rowe says seeking someone with ME/CFS expertise may be wise if you’re not responding to other modalities in managing long Covid. At Johns Hopkins, I’m Elizabeth Tracey.

If you’ve had Covid-19 and are still struggling with things like fatigue and pain months later, the virus may have triggered ME/CFS, the new term for chronic fatigue syndrome. Peter Rowe, a ME/CFS expert at Johns Hopkins, says the good news is there are several options for managing it.

Rowe: Unfortunately I think people have not been paying much attention to ME/CFS in the general medical world over the years, but we’ve learned how to treat these orthostatic disorders at least in the majority of patients we can provide some medication that helps control blood pressure better, normalize it, normalize the heart rate and get blood flow up to the brain more effectively. The approach I hear about a lot in the post-Covid clinics though isn’t really focusing on that as much as I think it needs to.  :30

Rowe says if you’re being seen in a post-Covid clinic and things aren’t improving, it could be that ME/CFS is the culprit. At Johns Hopkins, I’m Elizabeth Tracey.

The chronic medical condition called ME/CFS, the new term for chronic fatigue syndrome, can be triggered by Covid-19 infection, even when the acute illness seems mild. That’s according to Peter Rowe, a ME/CFS expert at Johns Hopkins, who says the mechanism is still unknown.

Rowe: So it could be that there’s inflammation in the brain from direct invasion of the virus. Others are noticing that these orthostatic disorders are starting maybe two weeks after the infection suggesting that perhaps its as the body is making antibodies to coronavirus. Those antibodies are also somehow attacking the individual. And we’re had lots of evidence of other autoantibodies being measurable post-Covid.  :27

Rowe says many cases of what is being called ‘long Covid’ are likely ME/CFS triggered by the infection, and the good news is there are several options for management and treatment, beginning with recognition that ME/CFS is present. At Johns Hopkins, I’m Elizabeth Tracey.

Myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS for short, is a composite term for a constellation of fatigue, pain, cognition issues and other symptoms of unknown cause. Peter Rowe, a ME/CFS expert at Johns Hopkins, says this also describes many cases of so-called ‘long Covid.’

Rowe: People can have really very mild respiratory illnesses with Covid that are debilitating from the beginning because they have such tremendous lightheadedness, cognitive fogginess and difficulty with concentration. And they are, after six months, meeting the criteria for what we now call ME/CFS. The new term for chronic fatigue syndrome and it looks like Covid-19 is yet another of the infectious triggers of this prolonged fatiguing debilitating illness.  :31

Rowe says this syndrome must be distinguished from post-ICU syndromes in those who’ve had severe Covid-19, because their management is very different. At Johns Hopkins, I’m Elizabeth Tracey.

Corrie is the name of an app that integrates all aspects of post-heart attack care so people can avoid having a second one. Corrie was developed at Johns Hopkins by a team, including cardiologist Seth Martin, who says the app development came about because of patient need.

Martin: A big feature of Corrie is high quality patient education. In the form of written articles but also in the form of animated videos, and so it’s about education, it’s about tracking your key heart indicators, your heart rate, your physical activity. It has a connected blood pressure monitor. It’s about understanding your medicines and tracking those medicines on a daily basis, it’s about what appointments are critical for you during follow up, getting calendar reminders to go to those appointments. A lot of it is fundamental pieces of one’s care that often falls through the cracks.  :32

Martin expects Corrie to be available much more widely soon. At Johns Hopkins, I’m Elizabeth Tracey.

Health apps purport to serve lots of functions, with a new one called Corrie simplifying things for those who’ve had a heart attack and would like to make changes to avoid another. Seth Martin, a cardiologist at Johns Hopkins and one of the app’s developers, says simply deluging people with information after a heart attack just wasn’t working for many.

Martin: There has to be a better way, and the better way is a digital forward strategy where we go directly to the smart phone, what’s in all our patient’s hands, the smart watches on their wrists, there’s that intimate personal power that you have there, it’s something that’s with you all time, and our thought was to build something really effective, really easy to use, that can basically extend what we can offer as a healthcare system to really put the power in the patients.  :26

Corrie has a wide range of features that enable people to keep all their information in one place and understand how its integrated in a holistic approach to heart health. The app should be widely available soon, Martin says. At Johns Hopkins, I’m Elizabeth Tracey.

Corrie is the name of an app designed to help integrate the many things people need to do to minimize their risk of a second heart attack. Seth Martin, a cardiologist at Johns Hopkins and one of the app’s designers, says the team started with asking patients about their experience.

Martin: What’s come up again and again is I’m feeling alone, I don’t understand what the medical team is saying, I don’t feel confident that I know what I need to do when I leave the hospital. So Corrie was built directly to address those needs. Corrie’s built on Apple’s research kit, care kit, and health kit. The spirit here is to empower patients to take a more active role in their health care. Ultimately when it comes to patient education a lot of the times it’s confusing to the patients.  :28

Corrie has been tested in several sites and is poised to roll out more widely, Martin says. Reviews from patients have been very positive, he says. At Johns Hopkins, I’m Elizabeth Tracey.

Patients are at the center of a new app to help people improve their cardiovascular health called Corrie. Corrie was developed at Johns Hopkins by Seth Martin, a cardiologist, and colleagues to help those who’ve had a heart attack implement the vast amount of existing medical knowledge to help them prevent a second one.

Martin: We have so much evidence in preventive cardiology about what works, healthy diet and exercise, evidence based medicines that make a real impact in our patient’s outcomes. One of the things that has just been published again and again and again about is, we have all this but we don’t use it well. We really need to start with the patients, interview patients, do human centered design. Understand the needs, work backwards from the needs to the technology to then develop a solution that truly meets those needs.  :29

Martin says in designing the app his team conducted interviews with patients who’d had a heart attack to hear directly from them what was lacking in their follow-up care and hopes the app will be widely available soon. At Johns Hopkins, I’m Elizabeth Tracey.

If you’ve had a heart attack a new app that’s been developed at Johns Hopkins could help you avoid a second one by engaging you in your own care. Seth Martin, a cardiologist at Hopkins and one developer of this app, called ‘Corrie,’ explains.

Martin: Corrie is Cor is Latin for heart. And Corrie is a mobile health app that helps guide patients in a holistic way through their cardiovascular disease prevention. We built an interdisciplinary team here at Hopkins. Clinicians, patients, engineers, coming together to build Corrie. We partnered with Apple. Apple’s a key industry partner for us early on. They helped us make Corrie intuitive and easy for patients to use.  :27

Martin says early validation studies on Corrie have shown that patients begin using it even while they’re in the hospital recovering from a heart attack, and it helps them interact with the medical team taking care of them. He hopes Corrie will be available more widely soon. At Johns Hopkins, I’m Elizabeth Tracey.