This week’s topics include health and wealth, gun show sales and gun injury, management of epilepsy, and outcomes relative to robotic surgery.

Program notes:

0:34 Today is last PodMed

1:19 Epilepsy management

2:19 Not a single type of surgery

3:16 Identify the focus

3:30 Robotic surgery outcomes

4:30 Is it that much better?

5:31 Instruments going down in price?

6:05 Gun shows sales and adjacent states

7:05 About 86,000 gun related injuries annually

8:00 Health and wealth linked

9:00 Other factors associated

10:22 End

This week’s topics include Medicare spending on frail elderly, resorbable stents, men with HPV, and procalcitonin to assess antibiotic need.

Program notes:

0:41 Looking at procalcitonin to determine antibiotic use

1:42 Improve or worsen survival

2:40 Point of care testing

2:54 Stents that resorb

3:52 First approved in Europe in 2011

4:50 Post marketing surveillance helpful

5:16 Men infected with HPV

6:17 Infection rate 11.5% in men

7:17 Should men self-identify?

7:35 Preventable spending in the Medicare population

8:35 Account for 50% of preventable cost

9:34 Things can be managed as outpatient

10:51 End

Related blog:

This week’s topics include predicting mortality in those with congestive heart failure, bystander CPR impact, best management of stable COPD, and NOACs and bleeding risk.

Program notes:

0:50 NOACs and bleeding risk

1:51 Also taking other medicines increased risk

2:49 Physicians need to know

3:18 Managing people with COPD

4:21 So many more people with the condition

4:43 Bystander initiated CPR

5:43 2/3 at home, 1/3 in public setting

6:44 Increased survivorship

7:00 How can we predict mortality in patients with heart failure

8:01 Easily obtained variables

9:04 Admission afterward?

10:26 End

Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/10/13/bystander-cpr/

 

This week’s topics include how the Zika virus changed, outcomes after surgery and health literacy, e-cigarettes and healthcare costs, and a reaction to tattooing.

Program notes:

0:36 Case report of an outcome after a tattoo

1:32 Reaction to the tattoo ink but not cancer

2:32 Not cancer just a reaction

2:46 Mutations in the Zika virus

3:44 More likely to have brain malformation

4:46 Lot of controversy over this study

5:00 Health literacy and outcomes after surgery

6:01 No correlation with readmission

7:02 Very few minority patients

7:15 E-cigarettes and cost savings

8:15 People still had exposure to nicotine

9:15 How to quantify e-cigarette safety

10:39 End

Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/10/09/e-cigarette-benefits/

This week’s topics include aspirin discontinuation risks, HIV in those 50 and older, big data and chronic lung disease, and genetic testing and warfarin use.

Program notes:

0:34 Genetic testing and warfarin dosing

1:35 Looked at genetics to determine

2:33 Other agents for blood thinning

3:01 Use of big data and chronic lung disease

4:01 More women smoking

5:02 Not sure of significance of e-cigarettes

5:26 HIV infection in those 50 or older

6:30 Usually diagnosed later

7:30 Still at risk if you’ve over 50

7:43 Perils of discontinuing aspirin

8:43 Stopping increased risk by 30%

9:43 Stop as close to surgery as possible

10:27 End

Related blog:https://podblog.blogs.hopkinsmedicine.org/2017/10/03/hiv-in-the-50-crowd/

This week’s topics include physician assisted suicide, preventing infection post-C-section in obese women, 12 year outcomes of bariatric surgery, and death among triathletes.

Program notes:

0:46 Triathlon events and death

1:43 Half with previously unknown cardiac problems

2:43 Trouble in water harder to resuscitate

3:36 Physician assisted suicide

4:36 In Oregon data gathered

5:36 Should be able to provide

6:40 No cancer excision if futile

7:15 12 year outcomes from bariatric surgery

8:15 3/4ths of diabetes remitted

9:07 Preventing infections in obese women with C-sections

10:45 End

Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/09/23/should-doctors-assist-in-death/

This week’s topics include hospital factors relative to readmission, hormone therapy, lymph node dissection in breast cancer, and the cost of bringing a new drug to market.

Program notes:

0:32 Cost of R and D versus profit in new drugs

1:32 Took 7.3 years

2:35 Reaping in sales far outstrips R and D

3:32 R and D with federal dollars

4:00 What is the long term impact of HRT

5:00 Should be reassuring for women

5:36 Lymph node dissection in breast cancer

6:36 Increases risk of complications

7:32 Least amount of therapy to be effective

7:48 Hospital factors in readmission

8:45 Patients readmitted to different hospitals

9:45 Need to correct poorly performing hospitals

10:31 End

Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/09/18/drug-costs/

This week’s topics include a new antibody for asthma, early treatment in COPD, mumps vaccine to curtail an outbreak, and medical exemptions from routine vaccinations.

Program notes:

0:38 Avoiding vaccines with medical exemptions

1:38 More people who are vaccinated the less likely an outbreak

2:36 Total went down but others are gaming the system

3:23 A third dose of vaccine and a mumps outbreak

4:23 All students had been vaccinated with two doses

5:23 May have been exposed to mumps later

6:22 Currently no early intervention with COPD

7:21 Less likely to have exacerbations

8:01 An antibody in adults with asthma

9:01 Monthly injections

10:29 End

Related blog:https://podblog.blogs.hopkinsmedicine.org/2017/09/07/avoiding-vaccination/

This week’s topics include the right medications for a subset of people with heart disease, the PURE study, inflammation and heart disease, and the impact of neighborhoods on cardiovascular disease.

Program notes:

0:47 PURE study

1:47 Fats and animal protein associated with lower mortality

2:47 Goes against years of research

3:31 Inflammation and CVD

4:32 Had high C-reactive protein

5:31 Not cost effective

6:00 Dual or triple therapy?

7:00 Using just two agents reduced bleeding risk

7:30 Your neighborhood and CVD

8:30 SES not in any risk model

9:30 Tied to quality of care

10:32 End

Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/09/02/should-you-live-pure/

This week’s topics include advance directive impact, approval of high risk medical devices by FDA, maintenance of certification for physicians, and cardiovascular disease impact of a new agent for type 2 diabetes.

Program notes:

0:37 Positive impact of advance directives

1:34 78% died in their chosen location

2:34 Achieving what the patient wants with regard to care

3:02 Maintenance of certification for physicians

4:02 Randomly assigned to open book and time periods

5:03 Evidence based medicine changes

5:22 New agent for type 2 diabetes and outcomes

6:22 Lowered risk by 14%

7:22 Two times higher risk of amputation

7:40 What about FDA approval of devices

8:40 Premarket approval for new devices

9:40 Hold for months or years and deprive patients?

10:38 End