TT HealthWatch

This week's topics include the worldwide burden of skin cancers, risk of a second stroke when a person is taking anticoagulants, patients supporting each other for weight loss maintenance, and imaging for dense breasts.

Program notes:

0:45 Dense breast tissue imaging

1:40 MRI and contrast enhanced mammography superior

2:40 Giving IV contrast with mammography

2:53 Burden of skin cancer in older adults worldwide

3:52 Greater disease burden in men

4:53 More likely to have exam and biopsy

5:48 Atrial fibrillation, recurrent stroke risk and anticoagulants

6:50 One in six will recur

7:50 Atrial appendage occulsion?

8:20 Patient delivered weight loss management

9:20 Five percent or greater initial weight loss

10:20 Reduced the amount of weight regain

11:22 Much less than a professional's care

12:49 End

This week's topics include treating resistant hypertension, gabapentanoids and the risk of self harm, risk for depression after diagnosis of a medical condition, and fatty liver and pregnancy.

Program notes:

0:35 Depression after medical condition diagnosis

1:36 Any of a number of medical conditions

2:37 A much lower risk in comparison group

3:37 Major depressive disorder could be number one cause of YLL

4:01 Fatty liver and pregnancy outcomes

5:01 Matched to those with obesity or T2D

6:01 Screening general population not indicated

7:00 Gabapentanoids and risk of self harm

8:01 Rates of self harm variable 

9:04 Use has increased fourfold

10:00 Treatment of resistant hypertension

11:01 Spironolactone or amiloride

12:33 End

This week's topics include USPSTF on screening for syphilis in pregnancy, when to take blood pressure medicines, comparing weight loss drugs, and a narrative intervention for PTSD after an ICU stay.

Program notes:

0:40 NEJM publication of comparison of obesity medications

1:40 Tirzepatide versus semaglutide for 72 weeks

2:41 Also had reduction in blood pressure

3:26 Rise in congenital syphilis and screening

4:26 Disparities among various groups

5:26 Highest incidence in the last 30 years

6:26 In 2023 210,000 cases of syphilis

7:00 When to take blood pressure meds

8:00 Monitored blood pressure in a subset

8:40 Intervention for PTSD after ICU stay

9:40 Self reported PTSD symptoms​

​10:40 Must learn to deliver intervention

11:40  Physician needed to spend 45 minutes per visit

12:42 End

Program notes:

0:40 Covid and flu vaccine

1:40 More immunogenic response

2:40 Female urinary incontinence treatment

3:40 Mid urethral sling or botox

4:40 Doesn't require surgery

5:40 Combined therapy group

6:10 Large language models and discharge summaries

7:10 100 hospital encounters 

8:10 Maybe provides a draft

9:00 AI and diagnosing diabetic kidney disease

10:01 Large number of retinal images to train

11:01 Can actually see blood vessels

12:29 End

Program notes:

0:47 Gun injuries and deer hunting season

1:47 Other associated injuries

2:47 Coincidence of hunting?

3:48 Restrict hunting guns to that use

4:10 Can we avoid surgery in some with cancer?

5:10 Dostarlimab treatment

6:10 Can help avoid surgery in few who have this mutation

7:10 Look at specific pathways

7:30 Lung cancer treatment

8:32 71% responded

9:12 Impact of Pepfar funding freeze

10:12 Looked at waiver scenarios

11:12 Decreased deaths and infection

12:13 Takes time to resume

13:06 End

Program notes:

0:40 Polygenic risk score for prostate cancer

1:40 90th percentile or higher

2:40 Genetic risk for cancer

3:41 Avoid false positives

4:00 Cervical artery dissection and subsequent stroke risk

5:00 High in older people, Black and Hispanic people

6:00 Nonspecific symptoms may predict

7:00 Preventing clotting in patients with cancer

8:00 Standard dose followed by half dose

8:44 USPSTF on supporting breastfeeding

9:45 Support systems not that good

10:55 What is the best strategy to support?

12:14 End 

Program notes:

0:33 TAVR outcomes improved

1:33 Dapagliflozin 

2:33 Looked at comorbidities

3:00 Tolebrutinib for relapsing MS

4:00 Annualized relapse rate

5:00 Works in the CNS

6:00 First endpoint wasn't proven

6:20 Invasive group A strep

7:20 Become more resistant to antibiotics

8:01 Not a single type of group A strep

8:25 Hearing loss and heart failure

9:25 Psychological distress mediiates

10:25 With hearing aids, you would think it would go down

11:20 Everything looks associated

12:03 End

This week's topics include aging and diet, blood based biomarkers for dementia, ten and thirty year risk for cardiovascular disease, and global effect of cardiovascular risk factors.

Program notes:

1:00 Five factors and cardiovascular disease

2:00 Additional life years free of CVD

3:00 Irrespective of where you live

3:27 Optimal dietary patterns for healthy aging

4:28 Higher intake of fruits, vegetables

5:28 Little bit better one or another

6:28 Can actually change this

6:40 Ten and thirty year CVD risk

7:40 Risk at ten and thirty years disparate

8:40 Increased cholesterol or blood pressure

9:20 Blood based biomarkers

10:20 Dementia free adults

11:20 Risk low with none of the factors

12:27 End

This week's topics include a better way to treat A-fib, managing bleeding in cardiac surgery, penicillin for strep infections, and treating pulmonary hypertension.

Program notes:

0:55 Ablation for afib

1:51 Pulsed field ablation PFA

2:55 Training physicians

3:23 Prothrombin complex versus frozen plasma

4:24 Noninferiority outcome

5:24 Documented bleeding issue

6:25 New treatment for pulmonary hypertension

7:25 Improve outcomes in advanced disease

8:25 Well tolerated

8:40 Penicillin lowest dose to prevent pharyngitis

9:40 To avoid 8.1 ng/ml steady state

10:40 Get secondary prophylaxis

12:10 End

This week's topics include cell signatures in PCOS, a new technique for prostate biopsies, improving the safety of carotid endarterectomy, and long term risk after TIA.

0:41 Long term risk of stroke after TIA

1:39 About one in five over the next ten years

2:40 Need to continue antiplatelet agents

3:33 New technique for prostate biopsy

4:36 Biopsy naive men

5:35 Microultrasonography used

6:35 Limited availability of MRI

7:33 Improving safety of carotid endarterectomy

8:33 Sonolysis used

9:34 Safe and routinely available

9:40 Single cell characterization of PCOS endometrium

10:40 Cells harvested during proliferative phase

11:40 PCOS causes increased risk of endometrial cancer

12:54 End