2019 TT HealthWatch Archive

TT HealthWatch – Friday, December 27, 2019

This week’s topics include two studies on vaping (Link 1) (Link 2), a review of the health benefits of fasting, and diabetes data nationwide.

0:40 Surveillance and vaping
1:40 Majority in men and adolescent boys
2:40 Rate is declining
3:43 Captures admission diagnosis, discharge diagnosis
4:40 Bronchoalveolar lavage and vitamin E acetate
5:43 94% of those with EVALI had it
6:41 Now using something else?
7:25 The benefits of intermittent fasting
8:25 Intermittent fasting improves diabetes, cancer, neurodegeneration
9:25 Alternating days to eat
10:22 Most done in animals or observational in humans
11:22 Barriers with physician advice
11:30 Diabetes and ethnic groups
12:30 Not as much difference in Asian subgroups
13:42 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, December 20, 2019

This week’s topics include physician driving behavior, obesity projections by state, hospital at home, and marijuana vaping by youth.

0:41 Vaping in American youth
1:40 53% reported using marijuana via vaping
2:41 Sentiment that it’s safer
3:22 State-by-state projections on obesity
4:23 Used NHANES data to validate
5:30 Most self-reporting underestimate
6:30 One in two obese in the next decade
7:00 Hospital at home
8:00 40% lower than hospitalization
9:00 4 in 10 were willing to be randomized
9:43 Physician driving behavior
10:43 Psychiatrists got tickets most often
11:40 Physicians talk their way out of a ticket
12:58 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, December 13, 2019

This week’s topics include age of transfusions and outcomes in ill kids, cortical thickness and obesity in childhood, time restriction of food consumption, and association between fertility treatment and cancer in offspring.

0:54 Fertility treatment and cancer risk in kids
1:54 Frozen embryo transfer
2:50 Particularly leukemia
3:42 Cortical thickness and obesity
4:42 18 areas significantly decreased
5:42 Inflammation can affect neuron development
6:50 Transfusion age and outcomes in ill children
7:52 Ultimately found that fresh cells were no better
8:53 Only powered to detect a 33% risk reduction
9:41 Restricting duration of eating time
10:44 Decreases inflammation and synchronizes circadian rhythm
11:30 Only about 7% non-compliant
12:13 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, December 6, 2019

This week’s topics include managing hepatitis C in disadvantaged populations, a new treatment for migraine, national suicide data, and treating swallowing disorders.

0:40 New treatment for migraine
1:40 Randomized to three groups
2:40 New medication in the armamentarium
3:21 Treatment for achalasia
4:22 Through the esophagus
5:20 Don’t have enough follow up
6:24 Suicide data from the U.S.
7:25 National Vital Statistics system
8:25 35.4% fatality in those older than 65
9:25 Firearms 9 in 10 fatal
9:40 Hepatitis C care
10:40 Centers serve low income communities
11:40 VA system really embraced
12:29 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, November 29, 2019

This week’s topics include waning measles immunity in infants, a new type of test for norovirus, declining U.S. life expectancy, and a way to diagnose pulmonary embolism better.

0:42 Declining antibodies in infants against measles
1:42 By six months all infants had antibodies that were too low to protect
2:34 Mothers have fewer antibodies
3:40 Most vulnerable the elderly and very young
4:15 Life expectancy in US
5:14 Other countries life expectancy continues to increase
6:10 Novel way to dectect norovirus
7:11 Inexpensive method using a smart phone
8:12 Detecting in water sources very important
9:14 Simulated field conditions
9:41 Diagnosis of pulmonary embolism
10:41 Still doing CT in 70%
11:33 Decreased to 34% use of CT
12:15 Confirm with leg findings
13:02 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, November 22, 2019

This week’s topics include timing of aortic valve replacement, colchicine after heart attack, bedside ultrasound to diagnose increased intracranial pressure, and appropriate LDL levels after a stroke.

0:51 Use of colchicine after heart attack
1:51 Lot of experience with drug
2:49 Inflammasome
3:37 LDL targets after ischemic stroke
4:38 Lower cholesterol helped
5:36 Become the new standard of care
6:00 Timing of aortic valve replacement
7:01 Surgery within two months
8:01 Want a long-lasting valve
8:33 Bedside ultrasound to diagnose intracranial pressure
9:33 Optic nerve sheath swells
11:05 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, November 15, 2019

This week’s topics include atrial fibrillation and the Apple watch, , itching relief for people on dialysis, a new type of smallpox vaccine, and affordability of a sustainable diet.

0:40 Affordability of an optimum diet
1:40 Data from 2011
2:40 A lot of people can’t afford it
3:40 About 2500 calories per day
4:21 The Apple watch and a-fib
5:21 Monitor and correlate with EKG
6:22 Consequences of detecting a problem
7:15 Itching and hemodialysis
8:16 Placebo group also reported improvement
9:17 Helped itch related quality of life
10:10 A new kind of smallpox vaccine
11:11 Can have serious infections with vaccine
12:48 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, November 8, 2019

This week’s topics include colorectal cancer screening guidelines, immune system impact of measles, treatment of C.dif recurrence, and advance care planning encounters and health care costs.

0:43 Measles impact on the immune system
1:42 Before and after natural measles infection
2:43 Not just B cells
3:49 Immune amnesia
4:12 C.diff infection recurrence treatment
5:15 About half treated with fecal transplantation
6:20 Advance care encounters and health care
7:21 Subsequent medical care utilization
8:21 Underrepresents advance care planning
9:16 Colorectal cancer screening
10:18 Clinicians should select test with the patient
11:21 How to frame conversation on aging out of screening
12:22 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, November 1, 2019

This week’s topics include bias in algorithms used to manage population health, new agents for cystic fibrosis, CBT versus antidepressants, and pain and weather.

0:50 Bias in algorithms
1:50 Impacting on black patients disproportionately
2:50 Variations on how the algorithm was trained
3:49 We can lower cost of medical care
4:49 Need to look at health
5:02 CBT and medications for treating major depression disorder
6:02 At five years CBT costs were lower
7:02 What do you prefer?
8:06 New medications for cystic fibrosis
9:12 About 70,000 persons worldwide with CF
10:10 90% of those with CF can benefit
10:27 Pain and weather and citizen scientists
11:20 Correlate symptoms with weather
12:06 I can tell the weather is going to change
13:17 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, October 25, 2019

This week’s topics include beta blockers and COPD, soccer players and cognitive function, long term exposure to disinfectants, and survival into adulthood among persons born prematurely.

0:44 Heading the ball in soccer
1:44 Three times higher rate of death with neurodegeneration
2:45 Some association with professional players
3:46 Asymptomatic events important
4:00 Beta blockers and COPD
5:00 May cause exacerbation
5:45 Disinfectant use in nurses and COPD
6:45 A number of types of disinfectants
7:45 Develop strategies to reduce exposure
8:40 Survival without comorbities in premature birth
9:47 Kids born before 27 weeks gestation only 22%
11:01 Overall have a high quality of life
12:13 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, October 18, 2019

This week’s topics include statins in kids, treating refractory heartburn, gait and aging, and managing agitation in people with dementia.

0:38 Gait and aging
1:38 Neuroimaging, hemoglobin A1c
2:37 First to look at middle age
3:32 Dementia and agitation and aggression
4:34 Multidisciplinary care better
5:36 People move out of it
6:00 Refractory heartburn
7:00 PPI refractory responded to surgery
8:00 PPI plus other meds
9:02 Statins in kids with high cholesterol
10:02 Followed over 20 years
11:02 Slows atherosclerosis and cardiac events
12:08 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, October 11, 2019

This week’s topics include removing blood clots for cerebellar bleeds, clinician burnout and patient quality outcomes, keeping people with COPD out of the hospital, and joint injections for osteoarthritis.

0:51 Provider burnout and quality of care
1:47 Single study as benchmark
2:52 Studies are all over the board
3:46 New treatment for osteoarthritis
4:46 Looked at cartilage with MRI
5:46 Change in cartilage 0.05mm
6:31 Intensive management of COPD and ED visits, hospitalizations
7:31 Actually showed harm
8:31 Don’t have good evidence on how to prevent rehospitalization
9:31 Related to a different medical condition
10:01 Removing cerebellar hematoma and outcomes
11:01 Evacuating didn’t improve neurological function
12:06 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, October 4, 2019

This week’s topics include Hypothermia after cardiac arrest, eating red meat, two drugs for people with diabetes and heart disease, and a triple inhaler for asthma.

0:50 Red meat consumption
1:51 Low certainty evidence only
2:51 Only randomized controlled trial
3:51 Don’t have very good evidence
4:40 Uncontrolled asthma treatment
5:40 Triple therapy over a year
6:42 Cooling people down after cardiac arrest
7:47 A modest survival benefit
8:47 More likely to have minimal or moderate neurologic function
9:40 Aspirin and ticagrelor in people with diabetes
10:40 Do they benefit from two agents?
11:40 Inexpensive and effective
12:44 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, September 27, 2019

This week’s topics include the HPV vaccine and herd immunity, a new agent for major depression, kidney refusals and outcomes, and does ownership of a dialysis center affect kidney transplants.

0:48 Refusal of kidneys for transplants and outcomes
1:50 Offers in the US from 2008-15
2:50 Average of 16 offers
3:50 Those who got a kidney got 17
4:50 Longer they’re preserved the less desirable the kidney
5:40 Ownership of dialysis center and referral for kidney transplant
6:41 Sounds like an indictment of the industry
7:37 HPV vaccination and herd immunity
8:37 37 viral types
9:37 Catch up vaccination promoted by CDC
10:15 New agent for depression
11:15 Larger randomized trial
12:18 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, September 20, 2019

This week’s topics include appropriate revascularization after heart attack, cardiovascular outcomes in people who have metabolic surgery and type 2 diabetes, the best strategy for treating varicose veins, and the dangers of vaping.

0:42 Vaping reports
1:42 Third under 17
2:44 Some have macrophages with lipids
3:34 Metabolic surgery and cardiovascular outcomes in people with type 2 diabetes
4:35 Control group not well matched
5:35 Surgery looks better but needs confirmation
6:02 Revascularization after heart attack
7:03 Decreased heart attacks
8:04 Best treatment for varicose veins
9:04 Favored laser ablation
10:04 The procedures themselves?
11:24 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, September 13, 2019

This week’s topics include a bleeding problem after cannabinoid use, infarcts in middle age and cognitive decline, vitamin D and bone health, and dietary proteins and mortality.

0:41 Animal and plant protein consumption
1:45 More animal protein and more total energy
2:45 Impact of protein on mortality
3:45 Disparage green tea?
4:19 Vitamin D and bone health
5:19 Reduction in bone strength with higher dosess
6:17 Infarcts in brain and cognition
7:18 Those with both small and large infarcts at highest risk
8:18 Hypothesis is big and small vessel disease
9:07 Bleeding and cannabinoid use
10:08 Blood was thin and treatment begun
11:51 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, September 06, 2019

This week’s topics include the assessment and management of patients at risk for suicide, the use of polypills to decrease heart disease, kidney transplant behavior in the U.S., and the association of educational attainment and causes of death.

0:46 The relationship between educational attainment and death
1:17 Between 2010-2017 life expectancy at 25 declined among white and black U.S. residents
1:50 Relationship between drug use and college education
2:31 Between 1999 and 2016 suicide rates have increased by 25%
3:20 Need for better screening tools
4:16 The use of cognitive behavioral therapy to reduce suicidal ideation
4:38 Evidence to support implementation of lethal means safety
5:09 Compared to civilians, veterans have a 20% higher suicide rate
6:04 Polypill combines multiple pharmaceutical ingredients
6:27 Can you use a fixed dose polypill to reduce risk of cardiovascular disease?
7:00 Polypill reduced risk of cardiovascular disease by 33%
7:31 Ease of taking polypill, low cost and less side effects
8:52 Major deficit of kidneys available for transplant
9:10 Transplant behavior in the United States relative to acceptable kidneys
10:58 Compared with dialysis, even lowest quality kidney lengthened lifespan
11:56 Cost-benefit ratio of transplant vs dialysis
12:39 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, August 30, 2019

This week’s topics include antibiotic stewardship in community hospitals, omega-3s and triglycerides, blood pressure and brain health, and a new type of T cell and Type 1 diabetes.

0:42 Omega-3s and triglycerides
1:42 Decrease by about 30% in those with high levels
2:44 Lifestyle factors and medications role
3:20 A new type of peripheral T cell and Type 1 diabetes
4:22 Were associated with progression to frank disease
5:22 Identify individuals who have the antibodies
6:00 Antibiotic stewardship in community hospitals
7:00 Pharmacist engaged about antibiotic appropriateness
8:02 Comprehensive approach
8:27 Blood pressure across adulthood and late life-brain structure
9:30 Composite cognitive score
10:31 Are changes to brain relative to blood pressure?
11:30 Diastolic goes down and systolic goes up
12:42 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, August 23, 2019

This week’s topics include testing for BRCA 1 and 2 mutations, particulate matter and mortality, smoking cessation and heart disease risk, and antibiotic use and colorectal cancer.

0:42 Particulate matter and mortality
1:42 Average over previous day and current day
2:43 Evidence that particulate pollution increases daily mortality
3:17 Smoking cessation and cardiovascular disease
4:16 In the original population decline was faster
5:00 BRCA testing
6:00 No history? Don’t do it
7:00 Occur in about 1 in 300 or 1 in 400
8:00 Antibiotic use and colorectal cancer
9:00 Change in microbiota
10:00 Increased inflammation
11:33 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, August 16, 2019

This week’s topics include the All of Us study, a method for heat stabilizing vaccines, arboviruses in the U.S., and use of medical assistance in dying.

0:42 Look at trends in medical aid in dying
1:42 95% non-Hispanic white
2:42 Began in 1994
3:44 Allows death with dignity
4:05 West Nile virus
5:08 People present with flu-like symptoms
6:07 Seeing more with global warming
7:00 All of Us research program
8:00 Smart phone app
9:00 Particulate matter and health
10:00 Very open study
10:24 Vaccine preservation with sugars
11:25 Stored three months and reconstituted and injected
12:45 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, August 9, 2019

This week’s topics include screening for pancreas cancer, counseling in diabetes and cardiovascular outcomes, resistant bacteria from common surfaces, and use of AI to predict atrial fibrillation.

1:00 Antibiotic resistant bugs
2:00 Collected from a range of places
3:00 Could not account for differences in places
4:22 Atrial fibrillation and AI
5:20 Almost 650,000 normal EKGs
6:15 Use of intensive lifestyle counseling in people with diabetes
7:23 Cardiovascular outcomes relative to counseling
8:19 Motivated patients often enroll
8:50 Pancreas cancer screening update
9:51 Some that have familial disease
10:50 Are you a candidate for surgery
11:47 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, August 2, 2019

This week’s topics include the health effects of urban green space, complications and death after noncardiac surgery, cardiovascular disease among patients with prediabetes and diabetes, and trends in physical activity and sedentary behavior.

0:47 Urban green space and health
1:46 A lower tree canopy was associated with a lower risk of some health problems
3:05 Neither the trees or grass reduced the incidence of depression or anxiety
4:03 Not sure if study results will drive urban planning
4:49 Association between complications and death after noncardiac surgery
5:40 Surprisingly, very few died in the operating room
6:05 Deaths were associated with major bleeding, heart injury after surgery, or sepsis
7:10 Cardiovascular disease among patients with prediabetes and diabetes
8:33 Ideal cardiovascular health metrics associated with reduced risk of cardiovascular events
9:44 Not unique to the Chinese population
10:05 Trends in physical activity and sedentary behavior
11:06 Sedentary behavior has gotten worse
11:56 College educated and obese trends worsened
12:27 Move more, sit less
12:40 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, July 26, 2019

This week’s topics include testing pregnant women for hepatitis B, coronary calcium scanning for younger people, AI, chest x-rays and mortality, and antibiotic use without a prescription.

0:46 Use of antibiotics without a prescription
1:46 66% among migrant farm workers
2:45 Some of the reasons include access
3:47 Hepatitis B virus in pregnant women
4:46 Children may be resistant to treatment
5:46 Universal vaccination?
6:06 Coronary calcium scanning in younger adults
7:06 Higher scores associated with cardiovascular events
8:06 Do if they have a family history
9:04 Did not establish additional information with coronary calcium scan
9:36 AI and chest x-ray
10:36 Data in neural network
11:20 Could divide in low, medium and high risk of death
12:15 Why is your risk higher?
13:11 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, July 19, 2019

This week’s topics include impact of firearm laws on childhood deaths, healthy lifestyle and genetic risk of Alzheimer’s, systolic versus diastolic blood pressure and cardiovascular outcomes, and cognitive reserve, physical activity and Alzheimer’s.

0:44 Genetic risk and Alzheimer’s
1:44 Could moderate genetic risk with lifestyle
2:44 Absolute reduction small
3:40 Systolic and diastolic blood pressure and cardiovascular outcomes
4:41 Both independently predictive
5:41 Routine blood pressure measurement
6:11 Cognitive reserve, physical activity and dementia
7:11 Also had objective assessment
8:11 Lower vascular risk, engage in educational activity
9:11 Do have some control
10:00 State laws and childhood gun deaths
11:10 Stricter gun laws had lower rates
12:38 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, July 12, 2019

This week’s topics include antibiotics for pneumonia, CRP and COPD exacerbations, factors related to lower extremity amputation, and supplements.

0:44 Supplements and cardiovascular outcomes
1:45 Some reduced risk with some supplements
2:45 Relies on a healthy diet
3:16 Pneumonia treatment with antibiotics
4:16 Treated appropriately in hospital
5:15 Keep as short as possible
6:05 COPD, C-reactive protein and antibiotic use
7:05 No evidence of harm in not using antibiotics
8:05 Used clinical criteria in the past
9:03 Peripheral arterial disease and microvascular disease, and amputation
10:01 Amputation over nine years
11:01 How to identify
12:08 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, July 05, 2019

This week’s topics include reanimating the upper extremity after spinal cord injury, raising rates of vaccination in kidsl, obesity and genes, and a bacterium and metabolic syndrome.

0:45 Using a bacterium to change obesity
1:45 Can be pasteurized
2:48 Not transferring the microbiome
3:14 Increasing vaccination rates in kids
4:15 Parents need to submit proof of discussing risks
5:15 Editorialists recommend federal policy
6:10 Address on a national level
6:46 Genes and environment and obesity
7:45 Don’t understand all the genes
8:45 Can’t change genes but can change environment
9:00 Reanimating upper extremity in quadriplegia
10:03 Move the nerve from a less needed muscle
11:00 Full function takes a lot of time
12:40 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, June 28, 2019

This week’s topics include Medicare Advantage plans and readmissions, high sensitivity troponin as part of an assessment tool, adrenal incidentalomas, and dual antiplatelet therapy after stent placement.

0:40 High sensitivity troponin plus other factors in MI risk
1:45 MI or 30-day outcomes
2:40 Complexity of algorithm
3:18 Dual antiplatelet therapy after stent
4:17 Half switched to single therapy
5:17 Decreased risk of bleeding
5:27 Incidentaloma in adrenal gland
6:30 Greater risk for cardiovascular events
7:30 No increase in mortality
8:00 Medicare advantage
9:00 Maybe restrict care?
10:00 Excess 2,700 readmissions for heart attack
11:00 Don’t provide the reasons
11:44 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, June 21, 2019

This week’s topics include a new agent for sickle cell, two ways to assess blood flow in the heart, the dangers of cosmetics for kids, and predicting who will develop dementia.

1:00 ED visits for kids due to cosmetics exposures
2:00 Fifteen-year study period
3:00 Need to store in a locked location
3:11 A new drug for sickle cell disease
4:11 Also received hydroxyurea in 2/3
5:12 Addresses the protein
5:40 Blockage in arteries around the heart
6:40 Fractional flow reserve
7:40 Could place a stent?
8:42 Predicting dementia with three tests
9:43 Ranged in age from 67 to 83
10:43 Thinning of brain
11:41 Somehow identify earlier
12:52 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, June 14, 2019

This week’s topics include preventing Type 1 diabetes, diagnosing meningitis and encephalitis, white coat hypertension and CVD, and screening and prevention of HIV infection.

0:45 A correction
1:25 White coat hypertension and cardiovascular events
2:25 Treated rise in blood pressure
3:25 Increased risk by 36%
4:21 USPSTF recommendations for HIV prevention
5:21 Pre-exposure prophylaxis
6:21 Now will be covered by Medicaid
6:49 Prevention of Type 1 diabetes with an antibody
7:49 Transient drop in white blood cells
8:49 Delayed by two years
9:58 Diagnosing encephalitis and meningitis
11:00 Confirm with more specific tests
12:34 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, June 07, 2019

This week’s topics include treatment of chronic lymphocytic leukemia, the cost of physician burnout, the impact of OpenNotes, and long term follow up of abdominal aortic aneurysm repair.

0:52 Treating chronic lymphocytic leukemia
1:52 Patients were high risk
2:52 No new toxicities
3:15 Abdominal aortic aneurysm repair
4:15 27% of endovascular had a second procedure
5:00 OpenNotes and medication adherence
6:00 Patients remember about half of the information in a visit
7:01 Patients entitled to this information
8:01 Encouraging patients to take a look
8:40 Cost of physician burnout
9:40 $7,600 per physician per year
10:40 Addressing electronic medical records
11:30 I do think it’s worse now
12:21 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, May 31, 2019

This week’s topics include mindfulness for surgeon burnout, cholesterol guidelines, causes of death around pregnancy, and mortality among football and baseball players.

0:38 Mindfulness for surgical trainees
1:38 Conscious awareness of cognitive control
2:29 Feasible and acceptable
3:30 Brain imaging to support
3:50 Cholesterol management
4:51 Consider adding another agent if doesn’t go down enough
5:52 Lowering cholesterol improves survival
6:05 Pregnancy-related mortality
7:06 Preventable in 60%
8:04 Death among NFL and MLB athletes
9:25 Chose other athletes as comparison
10:49 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, May 24, 2019

This week’s topics include best management of mild asthma, suicide data, bariatric surgery in adults and adolescents, and AI and lung cancer screening.

0:45 An AI model to improve lung cancer screening
1:47 Improve model’s predictive value
2:47 Had 42,000 CT scans
3:37 Management of mild asthma
4:38 Eosinophils in their sputum
5:37 Rise in suicides in 10-14-year-old girls
6:40 Guns in 15-19-year-olds
7:40 Social media relationship?
8:40 Use of bariatric surgery in adults and adolescents
9:40 Adolescents more likely to experience remission of diabetes
10:30 Shared decision making
11:15 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, May 17, 2019

This week’s topics include dabigatran for cryptogenic stroke, predicting kidney rejection, obstructive sleep apnea and surgical outcomes, and glucosamine supplements and cardiovascular outcomes.

0:40 Glucosamine and cardiovascular outcomes
1:43 Over 10,000 cardiovascular events
2:45 Many other factors could improve outcome
3:40 Genetic makeup and kidney rejection
4:41 Recipients developed antibodies against it
5:42 Maybe mimic Rh incompatibility?
6:25 Unrecognized obstructive sleep apnea and surgical outcomes
7:30 Did not modify irrespective of strategy
8:30 Don’t know how to treat
9:06 Dabigatran in stroke prevention
10:06 Better than aspirin?
11:00 No use for dabigatran
11:37 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, May 10, 2019

This week’s topics include progesterone in threatened miscarriage, Apgar scores, Mohs surgery use, and late treatment of stroke.

0:35 Mohs surgery use
1:35 Compare one surgeon to another
2:35 How to deal with outlying physicians?
3:33 More money per excision
3:43 Thrombolysis up to 9 hours post stroke
4:45 Did a scan to assess living tissue
5:45 Increased risk for bleeding
6:10 Apgar scores in normal window
7:10 A score of 7, 8 or 9
8:10 Do carry prognostic information
9:00 Progesterone and bleeding in early pregnancy
10:00 Followed to end of pregnancy
10:53 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, May 03, 2019

This week’s topics include PT after knee arthroscopy, management of hypertension in people with diabetes, mammography in older women, and measles update.

0:48 Measles update
1:48 90% haven’t been vaccinated
2:50 Titres may not prove immunity
3:10 Mammography in older women
4:11 Understanding what is the best screening technique
5:15 Women should have screening
6:11 USPSTF says there isn’t as much evidence
6:49 Blood pressure in patients with T2D and heart disease
7:50 Almost 11,000 patients
8:53 Rehabilitation after knee replacement
9:53 No important difference in patient reported pain
10:50 Bundled payment
11:30 More motivated as inpatient?
12:19 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, April 26, 2019

This week’s topics include metformin for long-term weight loss, glucose control and fetal health, Medicaid expansion and pregnancy outcomes, and sedentary behavior in the U.S.

0:41 Metformin and long term weight loss
1:43 At one year intensive lifestyle appeared best
2:43 Increased indications for metformin
3:32 One in 200 women with type 1 diabetes and preterm birth
4:30 The higher your sugar the more likely preterm birth
5:30 Affects both mother and fetus
5:40 Medicaid expansion and birth outcomes
6:40 Did not see a benefit except in racial disparity
7:44 What the causative factors might be?
8:10 Sedentary behavior in US population
9:20 Computer use increased
10:25 Do not offset deleterious impact of sitting
11:44 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, April 19, 2019

This week’s topics include testing pregnant women and children for lead, health benefits of FDA labeling on sugar in foods, outcomes for cancer surgery, and live kidney donation complications.

0:58 FDA sugar labeling of foods and health
1:52 Could save 350,000 people from cardiovascular disease
2:50 What if they reformulated beverages?
3:50 Long time for FDA implementation
4:27 Safety in top-ranked cancer hospitals and affiliates
5:28 As much as 100 percent higher
6:28 Experience of surgeon and team
7:10 Long term outcomes for live kidney donation
8:18 Most of the events not related to surgery
9:15 10,000 patients over a long period of time
10:00 Lead levels in children and pregnant women
11:15 Suggest that blood lead level in kids should be done?
12:31 Chelating agents associated with harms in kids
13:47 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, April 12, 2019

This week’s topics include best treatment after sudden cardiac death, getting more physicians involved in diagnosis, low-dose aspirin and lung cancer prevention, and reducing amyloid and Alzheimer’s disease.

0:44 More than one doctor to make the diagnosis
1:45 Collective intelligence associated with higher diagnostic accuracy
2:42 How do you make this happen?
3:43 More esoteric cases
4:30 Looking for heart disease in people with sudden cardiac death
5:35 Both groups about 2/3 survived
6:40 Low-dose aspirin and lung cancer prevention
7:40 Modest decreased risk of lung cancer
8:41 Dying of a higher rate of other reasons
9:30 Amyloid reduction and Alzheimer’s
10:30 People that have MCI but not dementia
11:30 May be a bystander
12:25 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, April 05, 2019

This week’s topics include treatment of patients lacking health insurance, transplant of HCV-infected organs, alcohol use and health impact, and how nutrition affects non-communicable diseases worldwide.

0:42 Transplant of HCV infected organs
1:42 Donors had high viral load
2:42 Longest followed for a year
3:30 Insurance status and access to hospital care
4:32 Target those seen for pulmonary issues
5:31 Weighs heavy on inner city hospitals
6:33 Alcohol and cigarette comparison
7:35 Run counter to a lot of studies on alcohol
8:33 Cancer just one of the conditions
9:27 Global burden of suboptimal diet
10:27 25% of deaths globally due to this
11:25 Transition to a Western diet
12:14 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, March 29, 2019

This week’s topics include stem cells for heart repair, the very preterm babies and outcomes, malpractice claims and physician behavior, and air pollution and psychosis.

0:44 Air pollution and psychotic experiences in adolescence
1:42 At 18 years of age privately interviewed
2:46 May explain about 60 percent of the association
3:35 Contribute to neurotoxicity
4:24 Physician malpractice and behavior
5:26 Increased odds of leaving practice
6:26 Do not move in response
6:45 Neonatal outcomes in Sweden
7:45 Necrotizing enterocolitis did not decrease
8:45 About 28 weeks still common limit
9:19 Stem cells for heart failure
10:19 Advanced heart failure on LVAD
11:10 Pretty disappointing
12:17 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, March 22, 2019

This week’s topics include best medicines for atrial fibrillation when a stent is used, the an envelope for cardiac devices to reduce infection risk, psychosis and ADHD medicines, and eggs and cardiovascular disease.

0:54 Eggs and cardiovascular outcomes and death
1:53 Linear relationship with consumption
2:50 Egg consumption associated with other unhealthy behaviors in past
3:56 Tied more to cholesterol
4:34 Cardiac device envelope
5:35 Mesh material with antibiotics
6:36 ADHD medicines and psychosis
7:36 Twice as high in the amphetamine group
8:40 0.1 to 0.2% of patients
9:20 One in five people with a-fib need a stent
10:27 Safest anticlotting was apixiban
11:58 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, March 15, 2019

This week’s topics include vaccines and autism, the effects of low-dose aspirin after prostate cancer diagnosis, wearable technologies and surgery recovery, and a report of a patient cured of HIV infection.

0:47 Report of HIV remission in man who tested positive
1:49 After bone marrow transplant, no reported HIV infection
2:45 Autism spectrum disorders and vaccines
3:40 Relationship between vaccines and autism a resounding “no!”
4:20 Two-decade old controversial paper retracted
5:36 Unvaccinated individuals have caused measles outbreaks
6:41 Low-dose aspirin not associated with improvement in mortality
7:40 Wearable devices
8:30 Technology might result in benefit
9:17 Physicians not good at predicting ambulation
10:42 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, March 08, 2019

This week’s topics include testing for breast cancer mutations, peanut allergy treatment, aspirin use for prevention, and FIT testing for colorectal cancer screening.

0:45 Easily treat children for peanut allergy?
1:46 Was able to reduce the response by 21 percent
2:44 Didn’t appear as good as other methods
3:12 Fecal immunochemical test in colorectal cancer
4:15 If you’re not going to use colonoscopy do it annually
5:20 USPSTF recommendations for BRCA mutations
6:20 Autosomal dominant
7:20 Worry and anxiety increase with positive results
8:22 Bleeding risk with aspirin
9:22 Over 4,400 major bleeding events
10:22 Engage patient in decision
11:20 Use EHR to employ
12:19 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, March 01, 2019

This week’s topics include complications of shoulder surgery, induction of labor, sepsis and death and bag ventilation at intubation.

0:37 Induction of labor at 41 weeks
1:39 May be better to induce than to wait
2:40 Studies in pregnant women
3:16 Complications of shoulder surgery
4:16 Serious adverse events
5:21 Sepsis and death
6:24 Hospice qualifying condition on admission
7:24 Less than 5 percent preventable
8:03 Making intubation safer
9:15 Bag mask ventilation
10:10 1.5 million patients ventilated each year
11:15 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, February 22, 2019

This week’s topics include push-ups and mortality, primary care physicians and mortality, osteoporosis in men and early initiation of MS therapy.

0:41 Early use of treatments for MS
1:43 Disease modifying therapy complex
2:43 Several studies relative to MS
3:00 Primary care physician supply and outcomes
4:01 Change in population distribution
5:00 Address risk factors
5:35 Push-ups and mortality
6:35 Mean age almost 40 years
7:36 Cardio fitness was predictive
8:37 Any measure of cardiovascular fitness good
9:00 Osteoporosis in older men and women
10:00 Risk factors, DEXA scans and treatment
11:00 Oral steroids and other factors still didn’t predict screening
11:47 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, February 15, 2019

This week’s topics include decolonizing people with MRSA, perinatal depression guidelines, active surveillance for prostate cancer and reducing opioid use after hip surgery.

0:41 Active surveillance for low-risk prostate cancer
1:42 SEER database for prostate cancer
2:45 Personalized approach
3:13 Perinatal depression guidelines
4:14 CBT or interpersonal therapy helpful
5:17 Psychotherapy via telemedicine
5:50 Effect of acetaminophen and ibuprofen on morphine use
6:50 Combination reduced morphine use
7:51 Doesn’t increase adverse side effects
8:21 Reducing MRSA among carriers
9:23 Use cleansing techniques after discharge
10:24 All done at home
11:39 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, February 08, 2019

This week’s topics include a new tetracycline class antibiotic, a look at topical pain creams and gels, attempts to reduce delirium postoperatively and are you ever too old for statins?

0:36 Are you ever too old for statins?
1:37 Lowering risk of vascular events
2:32 Absolute benefit about the same
3:20 Topical compounded pain creams and gels
4:20 Avoid oral medications
5:23 A new antibiotic
6:23 Just as effective as older antibiotics
7:22 Part of the tetracycline class
7:44 Trying to reduce delirium postop
8:44 Titrate to minimize EEG disruption
9:43 National guidelines recommend and should reevaluate
10:44 Other strategies known to help
11:13 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, February 01, 2019

This week’s topics include antibiotic treatment for bone and joint infection, the benefits of breakfast, a heart failure prediction score and computer-aided decision-making for surrogates in the ICU.

0:41 Assisting surrogate decision-makers with a web-based tool
1:43 Explore options relative to decision-making
2:43 Beliefs more important that facts
3:43 A lot of experience
4:47 Make sure advance directives are in place
5:17 Antibiotic treatment for bone and joint infection
6:17 Treatment failures the same for IV or oral
7:13 Should you eat breakfast?
8:13 Ate more calories in a day
9:13 No support that breakfast helps weight loss
9:42 Acute heart failure risk score
10:41 Risk score very good at predicting 30-day mortality
11:43 Overall mortality about 8 percent
12:55 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, January 25, 2019

This week’s topics include harms related to medical treatment, when to start a common Parkinson’s disease drug, overprescription of antibiotics, and a diabetes drug and prevention of heart disease.

0:38 Using a diabetes drug to prevent heart disease
1:36 Midway change in the trial
2:26 Which diabetes drug is best?
3:20 Harms of medical treatment
4:20 Rate decreased over 21 percent
5:20 Help focus in on places to intervene
6:27 When to start medicine for Parkinson’s disease
7:27 No difference in when levodopa is started
8:25 Viral component?
9:00 Factors related to aging to 90
10:10 Men had a linear association with physical activity
11:54 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, January 18, 2019

This week’s topics include treatment of multiple sclerosis, malaria treatment, overprescription of antibiotics and fecal transplant for ulcerative colitis.

0:43 Overprescribing of antibiotics
1:45 13 percent appropriately prescribed
2:45 Antibiotic stewardship
3:32 Malaria treatment
4:30 Tafenoquine about 67 percent effective
5:30 Fecal transplant for ulcerative colitis
6:30 Primary outcome achieved in about a third
7:33 Better identify patients who would benefit
8:26 Treatments for multiple sclerosis
9:26 Stem cell therapy
10:30 From experienced centers
11:31 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, January 11, 2019

This week’s topics include paying people to take heart medicines, resecting the esophagus, economic impact of cardiovascular events and medical advertising.

0:41 Economic impact of cardiovascular events
1:43 Has societal consequences
2:45 Economic burden on people with cancer
3:40 Incentivizing people to take heart medicines
4:40 Gave half a copay voucher
5:42 Cost wasn’t the entire issue
6:05 Esophagus resection
7:02 Lower incidence of complications with less invasive procedure
8:02 Didn’t compromise survival
8:36 Medical advertising
9:35 $2.1 billion to $9.6 billion increase
10:36 This is a trust issue with patients
11:29 End

Download TT HealthWatch Audio File

TT HealthWatch – Friday, January 04, 2019

This week’s topics include incentivizing healthy behaviors, bundling hip and knee replacements, the cost of a new cholesterol med, and compliance with cancer screening and mortality.

0:48 Incentivizing healthy behaviors
1:48 May provide money to lower premiums
2:46 Patients didn’t understand well
3:36 Adherence to cancer screening and mortality
4:35 Mortality among nonadherents
5:32 Nonadherence identifies them at higher risk
6:35 In observational studies we pick healthier people
7:21 Antibody for cholesterol lowering PCSK9 inhibitor
8:21 Are they cost effective?
9:22 Price has to drop to $1,100 per year
10:00 Bundled knee and hip replacements and impact on cost
11:00 Didn’t discharge to post-procedure care facilities
12:00 Didn’t measure patient factors
13:23 End

Download TT HealthWatch Audio File