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