|
Hopkins News For You
This is a service for our friends around the world from Johns Hopkins International. To receive reports, please send e-mail to patientnewsletter@jhmi.edu or visit our website at www.jhintl.net.
July 2004
New Treatment Stops Side Effects of Thyroid Cancer
New Guidelines for Food Allergy Testing in Children
Help for Whiplash Sufferers
More Benefits from Folic Acid ______________________________________________________
Johns Hopkins Ranked #1 Hospital for 14th Consecutive Year
For the 14th consecutive year, The Johns Hopkins Hospital has topped U.S. News & World Report's ranking of American hospitals. This year's guide reports results of a survey of a hospital's reputation in 17 medical specialties among a national sample of doctors, along with analysis of objective indicators such as death rates, technology, nurse staffing, service mix and discharge planning. Hopkins again ranked in the top 10 in 16 of the 17 specialty categories listed. In addition to its #1 overall ranking, the Hospital ranked #1 in Gynecology, Otolaryngology and Urology; #2 in Geriatrics, Kidney Disease, Neurology/ Neurosurgery, Ophthalmology and Rheumatology; #3 in Cancer, Digestive Disorders, Hormonal Disorders, Pediatrics, Psychiatry, and Respiratory Disorders; #4 in Heart/Heart Surgery and Orthopedics; #13 in Rehabilitation.
______________________________________________________
New Treatment Stops Side Effects of Thyroid Cancer
An international study led by researchers from Johns Hopkins and the University of Pisa has tested a new therapy to destroy thyroid gland tissue that often remains after surgery for thyroid cancer. This new approach avoids temporarily stopping thyroid medication and uncomfortable side effects such as fatigue, weight gain, chills, slowed thinking, depression, constipation and muscle cramps.
According to Hopkins endocrinologist Paul Ladenson, M.D., "Recovery from thyroid cancer has been very difficult for patients because thyroid medication - which replaces the thyroid hormone naturally produced by a healthy thyroid gland - has traditionally been withheld for four to six weeks after surgery so radioiodine could be used to identify and destroy glandular tissue that remained. Thyroid cancer patients now can be treated effectively without the very unpleasant side effects that have previously been associated with temporarily withholding their thyroid hormone treatment after surgery."
New Guidelines for Food Allergy Testing in Children
A blood test that measures food-specific allergy antibodies can be used to help children's allergists make the difficult decision of when to reintroduce a food that a child has been allergic to, say researchers at the Johns Hopkins. In their report, the researchers provide guidelines for using these antibody levels to determine which children should be offered an additional allergy test, known as an oral food challenge, in which the child eats small amounts of a food to to establish whether or not a food allergy really exists.
The Hopkins team specifically recommends that challenge tests for milk, egg, and peanut be performed on children with at least a 50-50 chance of "passing." This 50-50 challenge pass rate was most clear for milk, egg, and peanut and was associated with low levels of food-specific IgE, the antibodies produced by the immune system that can cause allergic reaction. These antibodies can be measured using a test that is available in most commercial labs. "These findings make it clear that doing a blood test to measure IgE levels can accurately predict how a patient will fare during a food challenge. We recommend its routine use in clinical practice to screen children with suspected allergies before a food challenge is performed," says Robert Wood, M.D., a pediatric allergist at Johns Hopkins and senior author of the study.
Help for Whiplash Sufferers
Whiplash, or pain that results from a sudden injury to the neck, has a bad reputation. That's because doctors haven't been able to find evidence for why the condition remains painful for some people, even months after the injury has taken place. Now Hopkins neurosurgeon Don Long, M.D., has found both the source of the pain and has developed an effective treatment for persistent whiplash. For about half of patients, injury to a joint in the neck called a facet joint is the culprit. "These are injuries to ligaments and these ligaments are too small to take an image of with any of our current techniques. You just can't see them."
In the new treatment, Dr. Long carries out a procedure called a diagnostic nerve block by placing a needle on the joint and then putting a small amount of the anesthetic on it to determine if the pain subsides. "It's exactly like a dentist anaesthetizing a tooth," says Dr. Long. Patients who experience relief with the nerve block may then be candidates for surgery. According to Dr. Long, about half of patients with persistent whiplash may be suitable for the new treatment but they must be carefully selected and tested beforehand.
More Benefits from Folic Acid
Folic acid is beginning to look like a supervitamin, helping to reduce birth defects and heart disease. Now two major studies suggest that the supplement seems also to reduce broken bones in people with osteoporosis. Don Martin, M.D., a rheumatologist at Johns Hopkins, says one of the ways folic acid works is by causing levels of the amino acid homocysteine to drop. "Folic acid is being used widely to try to drop homocysteine levels to reduce cardiac risk. Could it do the same thing with risk for hip fracture? That would be a tremendous therapeutic intervention because it's easy, it's cheap, it's nontoxic, it’s already being used as a supplement and has already reduced the number of people with high homocysteine levels. My view right now is that since we are already doing this in people who have cardiac disease, it makes sense to try to do it [to reduce broken bones] as well." Dr. Martin stresses that in order to reduce osteoporosis risk, people must also exercise, take calcium supplements and perhaps a prescription medication.
|
