TT HealthWatch

Program notes:

0:35 Global pain burden

1:35 Prevalence increased in 15 countries

2:35 Higher prevalence in older people but not consequence of aging

3:02 Tertiary patents

4:03 in the Orange Book

5:05 Prolonged patent protection and higher prices

6:07 Focused on high revenue products

6:50 Detecting DVT better

7:51 Age specific D-dimer cutoffs

8:51 Age and morbidity factors

9:23 Infant screen time and adolescent anxiety

10:24 Multiple intermediate assessments

11:24 Accelerates development

12:47 End

Program notes:

0:40 IVF clinics and private equity

1:40 Provide over 54% of all IVF cycles in U.S.

2:41 Perhaps a more positive result

3:30 EKGs and liver cirrhosis

4:30 New diagnosis of advanced liver disease

5:30 Most physicians didn't follow up

6:18 Management of acute back pain

7:18 Did it improve pain or disability?

8:18 Four- to eight-hour-long sessions to teach

8:46 Lay health worker led intervention for older adults with cancer

9:46 Reviewed with advanced practice practitioners

10:46 Huge benefit from modest intervention

11:46...

Program notes:

0:40 Saturated fat and CVD

1:40 When it was reduced in diet only helped in those with high risk

2:40 Obesity, diabetes and metabolic syndrome also important

3:30 Diagnostic follow up after lung CT

4:30 Less intensive than recommended in non-Hispanic blacks

5:31 Herpes antiviral and Alzheimer's

6:30 Followed for five years

7:30 80-90% of population exposed

8:30 Change screening criteria for lung ca

9:33 Population based study

10:30 Calculating pack years

11:20 Rolling out through national organizations

12:17 End

Program notes:

0:37 Breast density knowledge outcomes

1:37 Breast density notification and education

2:37 Can't assess the import individually

3:30 CV outcomes with tirzepatide

4:30 HbA1c 8.4

5:30 GLP-1s have many benefits

6:30 No difference in adverse events

7:10 Covid vaccination in pregnancy

8:10 20K women included

9:10 Initial benefit is it durable?

9:30 Complex regional pain syndrome treatment

10:30 Using bisphosphonates for treatment

11:33 Even light contact causes severe pain

12:28 End

Program notes:

0:35 Should surgery efficacy

1:30 10-year follow of ASD surgery

2:30 Exercise does relieve pain

3:00 Association of pain with intrinsic capacity and inflammation

4:00 Domains including locomotion and others

5:01 Pain impacts a number of capacities

6:01 Aspirational to figure out pain

6:30 Scheduling birth at term to avoid preeclampsia

7:30 High-risk pregnancy delivered at term

8:35 Is there impact on the infants?

9:18 AI decision support for large-vessel stroke

10:20 71,000+ patients with ischemic stroke

11:25 U.S. data also not impressive

Program notes:

0:35 Update on RSV, flu and COVID-19 vaccines

1:35 500 studies included

2:35 Rare myocarditis

3:35 Flu vaccine in older adults

4:30 Tai chi or CBT-I for chronic insomnia

5:30 Trained in one or the other

6:30 Inexpensive and accessible

7:30 $150 billion cost of chronic insomnia

7:45 GLP-1s and WHO guidance

8:50 Multimodal approach required

9:45 Prevention is important

9:55 Corticosteroids in pregnancy

10:50 1.3 million pregnancies

11:50 Used for multiple indications

12:46 End

Program notes:

0:40 CVD risk factors and texting

1:40 How many undergo screening?

2:41 Impact of personalized messaging

3:25 Decentralized trials versus centralized 

4:25 Decentralized much larger

5:25 Does the trial move in one way or another?

6:15 Two studies related to use of peripregnancy GLP-1 use

7:15 Stopping at pregnancy

8:15 Is overweight worse than stopping?

9:00 Machine learning model, tissues, genetics and age

10:00 Practical for assessing genetic basis

11:00 Sequential tissue samples

11:57 End

Program notes:

1:25 mRNA flu vaccine

2:25 Phase three trial

3:25 Preventing infection with a respiratory virus

4:25 Prophylaxis with NSAID?

4:45 Umbrella review of acetaminophen in pregnancy, ASD and ADHD

5:42 Confidence was low to critically low

6:45 Other factors such as environmental exposures

7:22 Increasing potassium to prevent heart arrythmias

8:33 Increase with supplements or dietary advice

9:18 Canceling funding for clinical trials

10:18 In the process of receiving interventions

11:18 Can't not analyze 

12:15 End

Program notes:

0:50 Fish oil supplements and hemodialysis

1:50 1200 individuals to fish oil or not

2:50 Needs another study

3:11 PCSK9 inhibitor in people without MI or stroke

4:13 3- or 4-point MACE

5:11 Getting LDL down helps

6:11 Addition of more than one oral agent

6:50 Right therapy for afib and a stent

7:50 Noninferiority trial

8:50 After 12 months single agent works

9:27 Anticoagulation after afib tx

10:30 Low primary safety outcomes

11:25 96% won't have a stroke

12:16 End

Program notes:

0:37 An oral med for obesity

1:37 Five to 10% stopped medication

2:35 Need head-to-head trials with injectable

3:00 Stem cell infusion after MI and heart failure

4:01 Reduced heart failure in recipients

5:01 Twice as many in the control arm

6:01 Moving past BMI in predicting atherosclerosis

7:01 Especially in overweight but not obese

8:01 Almost 3000 participants in Brazil

8:25 Blood samples precede MS

9:04 Seen seven years beforehand

10:02 Twin studies and relatives

11:03 Way to intervene earlier

11:15 Applaud OpenAI

Program notes:

0:45 Steps, more and longer?

1:45 8,000 steps or less

2:45 Nothing on intensity

3:30 Mediterranean diet for IBS

4:30 Reduction in IBS symptom severity scale

5:30 Easy to accommodate with high compliance

6:30 Exercise for knee osteoarthritis

7:30 All types of exercise examined

8:30 Initiated exercise to try to address

9:00 AI intervention in prediabetes

10:00 Based on diabetes prevention program

11:00 AI and human led essentially the same

12:00 99% of eligible group don't have access

13:09 End

Program notes:

0:40 Nicotine reduction for various subgroups

1:40 Native American and Alaskan populations benefit most

2:42 Black, rural populations 10 million lives saved

3:40 19-39 million life years saved

4:00 Food insecurity and blood pressure

5:00 Food vouchers most successful

6:00 May be more involved and motivated

6:35 PFAS and infant brain architecture

7:35 Children assessed with MRI

8:30 Didn't correct for various factors

9:31 Other types of plasticized chemicals

9:50 Afib after cardiac surgery

10:50 Only found with implantable monitor

11:50 Very short duration...

Program notes:

0:40 New drug for SLE

1:41 Monitored for a year

2:43 Only one pathway limited

3:00 AI and health care

4:00 How to assure compliance?

5:00 Policy changes needed

6:01 Pessimistic about oversight

6:50 Genetic treatment for ADA deficiency

7:50 Using a viral vector

8:50 A curative treatment

9:30 Social media and cognitive performance in adolescents

10:30 Low and high increasing social media use

11:30 Good enough evidence

12:31 End

Program notes:

0:40 Aldosterone as a risk factor for heart disease

1:40 Spectrum of renin-aldosterone levels

2:40 As many as 25-30% may have

3:11 All pharmacologic interventions for obesity tx

4:14 All effective compared with placebo

5:12 Meta-analysis 

6:13 Very little data in overweight or massively obese

6:35 Where do U.S. antibiotics come from?

7:35 India leading country for finished product

8:20 Environmental impact of inhalers

9:20 Annual emissions increased by 24%

10:23 Decreased by 43%

11:23 Three forms of inhaler

12:40 End

Program notes:

1:21 Bronchiectasis treatment

2:22 Twenty sites in UK

3:20 Medical imaging and cancer risk in kids

4:20 3000 hematologic cancers

5:20 Consider other types of imaging

6:23 Head CT increases risk by 35%

7:24 Treating pulmonary arterial hypertension

8:24 Improved mortality in another trial

9:25 Antibody prevention of RSV in healthy infants

10:25 Healthy preterm and full term infants

11:25 Argues for use of this antibody globally

12:25 Antibodies against antibody didn't compromise

13:08 End

Program notes:

0:40 Private equity takeover of hospitals

1:40 Reduced salaries or staffing

2:40 Patients likely to cost system

3:30 Use of anti thymocyte globulin to slow down T1D in youth

4:30 Diagnosed within 9 weeks prior

5:30 Serum sickness in 82% of highest dose group

6:30 Incidence increasing by 2% per year over 20 years

7:00 Aspirin in CRC

8:00 1100 patients with mutation

9:00 Can this mutation be acquired?

9:15 Alcohol and dementia

10:15 Confounding factors relative to alcohol use

11:15 Is there a safe level of consumption? Duration: 00:12:47

Program notes:

0:45 Intimate partner violence and CVD

1:45 12% reported stalking

2:46 Screening in primary care

3:47 Fifty to 200% increased risk

4:00 Number of psychiatric disorders and dementia risk

5:00 Important to be aware when mental health disorders exist

6:03 Anxiety and depression associated

6:33 Lipoprotein(a) and widespread vascular disease

7:31 High risk of extracoronary vascular disease

8:32 Also associated with complications

9:32 Unknown why some areas affected

10:00 Second cancers after early invasive breast cancer

11:00 Contralateral breast cancer greater in younger women

Program notes:

0:45 LSD and treatment of generalized anxiety disorders

1:45 Change in anxiety score to 12 weeks post administration

2:45 100 micrograms appear most efficacious

3:45 Require inpatient 12 hours

4:44 Cardiac rehab in older patients after MI

5:44 Frail individuals can improve outcome

6:45 Oftentimes think it won't make a difference

7:10 CT and pregnancy outcomes

8:10 Linear relationship with increasing CT scans

9:10 Closer to conception more likely 

10:10 Sometimes not really necessary

10:21 New tx for resistant hypertension

11:20 Baxdrostat inhibits aldosterone

12:20 What h...

Program notes:

0:53 Who needs a beta blocker after MI

1:53 Those with mild reduction of ejection fraction

2:53 Confined to those with 40-50% ejection fraction

3:15 Revascularization in NSTEMI

4:20 Composite outcome

5:20 Closes gap, do FFR

6:20 May not be physiologically significant

6:40 Is lifelong anticoagulation needed after ablation

7:41 Occurred less in those who stopped

8:30 RSV, cardiac events and hospitalizations

9:30 Lower hospitalization in those who got the vaccine

10:30 Acute respiratory illness hospitalization

11:30 Less benefit with existing CVD or immunocompromise<...

Program notes:

0:44 Drug prices around the world

1:41 German prices as standard

2:40 Wide variation in price and affordability

3:40 Generic pricing 

4:20 ADHD meds and behavior choices

5:20 Largely treated with methylphenidate

6:20 Significantly impacted suicidality and other behaviors

6:49 AI assistance and colonoscopy skills

7:49 When you stop AI assistance

8:50 Does this apply to other procedures that use AI

9:20 Trauma predictive brain networks

10:20 Use of hydrocortisone to damp down

11:20 Previous trauma impact

12:25 Developmental timing

13:30 End

Program Notes:

0:44 Spuds are what we call potatoes

1:47 Followed for over 5million person years

2:45 No mechanism for why french fries are problematic

3:25 DASH4D diet for glycemic control

4:25 4 diets compared 

5:25 Extends benefits outside hypertension

6:20 A new antibiotic for staph infections

7:20 IV therapy until cultures are negative

8:20 Cost of new therapy, cost effectiveness

8:40 Geographic variation in subspeciality cancer care

9:40 Highest income managed by specialists

10:40 Guidelines expanded

11:36 Telemedicine may help

12:10 End

Program notes:

0:40 Alteplase after stroke

1:40 Expand time window

2:40 Imaging crucial in use

3:20 Use of health care and mortality in those with dementia

4:20 Women used much less healthcare

5:20 Focus on prevention in women

5:50 IVF outcomes and weight loss

6:50 Did not appear to increase success with IVF

7:45 Ultraprocessed foods versus minimally processed foods

8:45 Randomized to one diet or the other for 8 weeks

9:45 Minimally processed foods improved risk factors

10:45 Short period of study

11:42 End

Program notes:

0:40 Screening young adults for CRC

1:40 Four different screening options

2:41 Awareness issue

3:40 "Yuck" factor associated

4:34 Persistent Covid infections and variants

5:35 Who ends up with variants?

6:35 Did not render more infectious

7:35 Humans as mixing vessels

7:50 How do men and women respond to antithrombotics

8:50 15% reduction in MI

9:58 Long term contraceptives free and uptake

10:58 48% of pregnancies in North America unintended

11:58 Increase in any type of contraception

12:38 Cost is an important contributor

13:24...

Program notes:

0:44 Flu consequences for young children

1:44 Fulminant course

2:44 16 kids of total unvaccinated

3:10 HPV, T-cell receptor signaling and SCC

4:10 Unresectable disease

5:10 Thought virus facilitated

6:10 Target in recurrent or metastatic disease

6:26 Nonpharmacologic intervention in older adults to improve cognition

7:26 More intensive program a little better

8:26 Eat better, exercise more and use your mind

9:15 Polygenic risk score for obesity

10:15 Explained variance in cohorts

11:15 At birth adds a bit of value

12:08 End

Program notes:

0:40 Human Phenotype project

1:43 Metabolomics

2:42 25 year follow up

3:43 Two control groups

4:00 CBT via telehealth or online

5:00 2000 people with chronic pain

6:00 Completion rate for videos lower

6:50 RNA analysis in cancer molecular diagnostics

7:50 4.8% failure rate

8:50 CNS or blood cancers primarily

9:25 Middle age exposure to air pollution and later cognition

10:25 Poorer processing speed earlier in life

11:58 End

Program notes:

0:44 Reanimating hearts for transplant

1:44 Allow heart to sit for two to four minutes

2:34 Outcomes in DCIS without surgery

3:34 Free of breast cancer six months after diagnosis

4:34 Numbers who went on to develop invasive disease low

5:34 May change how we approach DCIS

6:09 Suicidality around the world in older adults

7:09 Guns, pesticides, hanging

8:10 Increase primary care diagnosis of OUD

9:10 Three clinics in four U.S. states

10:10 Six million adults with OUD

11:10 Many physicians unaware of...

Program notes:

0:40 AHA risk calculator in various ethnicities

1:40 Works well in all of them

2:40 Women and ethnicities

3:00 Hepatitis C screening in EDs

4:01 Many ethnicities represented

5:01 Identified as having the virus

6:01 Once they tested only 24% were referred

7:01 It was free testing

7:40 Failing US children

8:41 78% more likely to die in the US

9:41 Some of these are preventable

10:24 Life expectancy after the pandemic

11:24 Remains almost a year deficit

12:24 Deaths from overdose declining

13:17...

Program notes:

0:40 A novel way to help aphasia after a stroke

1:40 C7 nerve ligation

2:42 Somatosensory function versus speech processing

3:36 Substandard anticancer medications

4:40 Tested many using HPLC

5:40 Alarming that one in six is impacted

6:40 Paying out of pocket

7:38 New type of medicine for treatment resistant hypertension

8:38 Need to follow electrolytes

9:00 ED boarding for elderly

10:00 Length of stay increased

11:00 Elderly more likely to suffer complications

12:00 CMS program for all inclusive care for elderly

12:49...

Program notes:

0:40 Stem cells for type 1 diabetes

1:40 None had hypoglycemia afterwards

2:40 Autologous stem cells?

3:20 Oral GLP-1 agonist

4:20 Primary endpoint HbA1c reduction

5:20 Weight loss modest

6:20 Injectable GLP-1 plus an amylin analogue

7:20 Both those with diabetes and those without

8:20 No increased safety events

8:40 Mental health hospitalizations in adolescents

9:40 KID database

10:40 Females accounting for increase

11:40 67% of hospitalizations

12:57 End

Program notes:

0:35 Screen time trajectories in adolescents

1:33 31% had increasing addictive use trajectories

2:31 Females more involved in social media

3:06 Cannabis and CV risk

4:06 Smoking or using other products

5:06 Mechanisms include oxidative stress

6:06 Haven't regulated

6:28 Tau PET imaging in Alzheimer's

7:28 90% of tau positivity concurs with AB

8:30 Will blood test obviate?

9:30 Imaging to detect spread

9:43 CT perfusion for death by neurological criteria

10:43 Validation threshold 98%

11:43 Maybe adding another technique

12:43 End

This week's topics include family affluence and telomeres in children, gut bugs and respiratory illness in children, heat illness and homelessness, and low potassium diets and hypertension and diabetes.

Program notes:

1:05 Heat illness and homelessness

2:05 No access to water

3:05 More likely in southern states

3:20 Telomere length, family affluence and cortisol

4:20 High affluence had longer telomeres

5:20 Cortisol may need to be measured over longer time interval

6:20 Dietary patterns, sodium reduction, hypertension and those with diabetes

7:20 Dash-D with low sodium

8:20 Low...

This week's topics include treating hot flashes in breast cancer survivors, a blood test for detecting colorectal cancer, exercise to improve survival after colorectal cancer treatment and CAR-T therapy for solid tumors.

Program notes:

0:40 CAR-Ts for solid tumors

1:40 Advanced gastric or gastroesophageal cancer

2:40 Cytokine release syndrome

3:22 Exercise after treatment for colorectal cancer

4:23 Disease free survival superior

5:23 Currently not much exercise

6:23 Potential mechanisms

7:10 Treating hot flashes in breast cancer survivors

8:10 Neurokinin receptors

9:12 A blood test to screen for c...

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 w...

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...

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...

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 Duration: 12:27:00

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...

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 en...