JAMA Report Videos

The following are JAMA Report videos made publicly available once the related article in JAMA has published.

  • December 22, 2015

    New Research Suggests Increased Number of I-V-F Cycles Can Be Beneficial

    New Research Suggests Increased Number of I-V-F Cycles Can Be Beneficial

    INTRO:Women facing infertility often turn to in vitro fertilization or I-V-F.  Although I-V-F technology has improved, there is still a widely held belief that if a woman doesn’t experience a successful live birth after three or four I-V-F cycles her chances of a successful live birth going forward are very low.  A new study looked at I-V-F success rates after repeated treatment cycles well beyond the third or fourth attempts.  Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Babies in nursery, cu of babies hand

    AUDIO
    VO
    Having a healthy baby is the goal of every woman trying to conceive, including those seeking the help of in vitro fertilization, or I-V-F.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@:07
    Runs:07
    “When you first embark on IVF treatment you should not be put off if you don’t have success after the first, the second, the third cycle.”

    VIDEO
    B-ROLL
    Various shots of technicians in lab

    AUDIO
    VO
    I-V-F technology has improved over recent years. One treatment cycle includes ovarian stimulation, transfer of a fresh embryo and any subsequent frozen embryos from that same ovarian stimulation.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@:26
    Runs:08
    “Once that you’ve exhausted the stores of frozen embryos would be then starting another treatment cycle.”

    VIDEO
    B-ROLL
    Dr. Lawlor walking down hallway, to her computer, IVF procedure, baby crying

    IVF video
    Mandatory Courtesy:
    University of Glasgow

    AUDIO
    VO
    Dr. Debbie Lawlor from the University of Bristol, in England, says no one has really looked at the success rate when you define an I-V-F cycle in that way. She and her co-authors studied almost 160 thousand women in the United Kingdom who underwent nearly 260 thousand full i-v-f cycles between 2003 and 2010. They examined live birth rates among these women thru 2012.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@ 1:00
    Runs:18
    “Women who are under 40 and using their own eggs within the first cycle, the success rate was 33 percent, it remained over 20 percent by their 6th cycle, they’d a cumulative live birth rate of 68 percent.”

    (Video covering 1st part of bite: baby being rocked)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The Study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@ 1:18
    Runs:17
    “You continue to increase your chances of success right up to the 9th cycle. You’re gaining similar levels of success at around 5 or 6 cycles which takes around two years to what couples naturally conceiving would reach in about a year.”

    VIDEO
    B-ROLL
    Women pushing baby strollers, cells dividing under microscope

    Mandatory Courtesy:
    University of Glasgow

    AUDIO
    VO
    Dr. Lawlor says women between 40 and 42 also increased their success rates right up until the ninth cycle. There was also encouraging news for women who produced no eggs or a very small number during a single ovarian stimulation.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@ 1:47
    Runs:17
    “That importantly didn’t relate to the success with your next cycle of treatment. When you first embark on IVF treatment, I think you have to think about it as a set of repeated treatments and a longish term intervention.”
    (Video covering last part of bite: egg being injected)

    Mandatory Courtesy:
    University of Glasgow

    VIDEO
    B-ROLL
    Egg being injected

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:In women 42 and over success rates were very low across all cycles and the study authors did not see increases in live-birth rates.

  • December 15, 2015

    New Technology Improves Survival In Patients With Aggressive Type Of Brain Cancer

    New Technology Improves Survival In Patients With Aggressive Type Of Brain Cancer

    INTRO:It’s the most aggressive kind of brain cancer in adults. Most patients with glioblastoma (glee-oh-blastoma) die within 1 to 2 years of diagnosis. A new study examined whether treating this type of brain cancer with a new technology, using focused electrical currents, could help prolong survival in patients with the disease. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Roland walking thru hospital doors

    AUDIO
    VO
    Roland Frischherz (Free-shh-herts) was diagnosed with glioblastoma, (glee-oh-blastoma) an aggressive type of brain cancer, more than a year ago.

    AUDIO
    SOT/FULL
    Roland Frischherz – Glioblastoma Patient
    Super@:09
    Runs:13
    “It was a very tough time. I’m married. I have two daughters, so it was a very moving, moving period. Your life you lived before is closed.”

    VIDEO
    Roland and Dr. Stupp talking, technician applying electrodes to mannequin, cu of Roland’s backpack, Roland on floor wiring up his backpack with electrodes on his head

    AUDIO
    VO
    After completing standard chemotherapy and radiation treatments, he began additional therapy using something called tumor treating fields. The device is carried in a special backpack. Inside is a battery that powers electrodes, which are attached to his head.

    AUDIO
    SOT/FULL
    Roger Stupp, M.D., – University Hospital Zurich
    Super@:33
    Runs:19
    “The purpose is to keep the tumor from growing. The machine is applying an electrical field at a certain frequency and strength with alternating current. It will perturb, during cell division, the dividing glioblastoma cells while it will hardly affect any of the normal cells.”

    (Video covering middle of bite: technician showing battery connected to mannequin, cu of battery, connection cable)

    VIDEO
    B-ROLL
    Dr. Stupp at desk, brain image on computer, Roland zipping up backpack and putting it on

    AUDIO
    VO
    Dr. Roger Stupp from University Hospital in Zurich, Switzerland and co-authors are conducting a worldwide trial with 695 glioblastoma patients, all of whom completed standard courses of radiation and chemotherapy. One out of three received a maintenance course of chemotherapy, while the other two, received maintenance therapy plus the electrical tumor treating fields for up to two years.  The current results are for the first 315 patients.

    AUDIO
    SOT/FULL
    Roger Stupp, M.D., – University Hospital Zurich
    Super@ 1:17
    Runs:10
    “Both progression free survival, so the time until the tumor comes back, as well as overall survival is prolonged by a median of 3 months.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The Study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Roger Stupp, M.D., – University Hospital Zurich
    Super@ 1:36
    Runs:11
    “At two years the overall survival is prolonged by about 14 percent which means 14 percent more patients are alive at two years when they got the device.”

    (Video covering 1st part of bite: technician applying electrodes to mannequin)

    VIDEO
    B-ROLL
    Roland and Dr. Stupp talking

    AUDIO
    VO
    Roland continues to receive therapy with the tumor treating fields.

    AUDIO
    SOT/FULL
    Roland Frischherz – Glioblastoma Patient
    Super@ 1:46
    Runs:06
    “If this helps me, well I will continue like this as long as I can.”

    AUDIO
    SOT/FULL
    Roger Stupp, M.D., – University Hospital Zurich
    Super@ 1:52
    Runs:08
    “It’s far from being a cure. But it is another step in the right direction and some patients truly benefit from it.”

    (Video covering last part of bite: Roland walking out of hospital)

    VIDEO
    B-ROLL
    Roland walking out of hospital

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Because the initials results of the trial were so compelling, the International Data Monitoring Committee decided the findings should be made public so that other patients could be offered this treatment.

  • December 08, 2015

    Depression In Medical Residents, A Growing Problem

    Depression In Medical Residents, A Growing Problem

    INTRO:Even in the general population, people don’t want to talk about depression, which is one of the major reasons it isn’t always treated properly.  Depression is also a concern in the medical community, particularly affecting physicians in training known as medical residents.  A considerable number of medical residents suffer significant depressive symptoms at various times during their training.  What should be done to address the problem? Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Group of residents walking down hospital hallway, cu of feet walking down hallway, patient with IV pole walking into room

    AUDIO
    VO
    After medical school, the next step for a physician in training is residency. A growing number of these residents are not only dealing with long hours and the pressure of patient care but also with depression.

    AUDIO
    VO
    SOT/FULL
    Thomas L. Schwenk, M.D., – University of Nevada School of Medicine
    Super@:12
    Runs:27
    “A quarter to a third of the residents are suffering either specific diagnoses or significant symptom burden, I mean that’s, that’s an endemic, that is such a high prevalence of such a serious problem that we all should be extraordinarily worried. It doesn’t really matter whether it’s an actual diagnosis or just significant symptoms it means that they’re suffering. They’re not functioning well in their personal roles, they’re not functioning well in their professional roles.”

    (Video covering middle of bite: resident walking down hallway)

    VIDEO
    B-ROLL
    Dr. Schwenk sitting at table looking at papers, cu of Dr. Schwenk pan down to papers on table, people walking on the street, resident looking at computer screen,GXF FULL JAMA LOGO

    AUDIO
    VO
    Dr. Thomas Schwenk (shwank), Dean of the University of Nevada School of Medicine says while medical students and practicing physicians have a prevalence for depression roughly similar to the general population, the diagnosis is much more common in residents and also carries a great deal of stigma.  Dr. Schwenk discusses this issue in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Thomas L. Schwenk, M.D., – University of Nevada Medical School
    Super@:58
    Runs:23
    “We want people who are confident and strong and have shown great energy and decision making and have taken charge of situations in their undergraduate preparation. So it’s not surprising that these same people are going, to have a hard time admitting vulnerability or that they need help. When residents apply for jobs they do not want a hint that they’ve suffered from mental illness.”

    (Video covering middle of bite: Resident working on computer, cu of computer, resident going into patient exam room)

    VIDEO
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    Resident walking outside patient rooms, resident talking with patient, resident going into on-call room

    AUDIO
    VO
    There have been several efforts to address this problem.  Confidential mental health care is now more easily available and mental health records are not included in academic records.  Resident duty hours have also been scaled back in recent years.

    AUDIO
    SOT/FULL
    Thomas L. Schwenk, M.D., – University of Nevada School of Medicine
    Super@ 1:36
    Runs:23
    “The reduction in hours, probably because it still is an incredibly high level of work load, hasn’t really improved residents’ quality of life and it seems to have caused some problems in performance and in the quality of care. The world is just so dramatically different, yet we’re still training residents the same way. It looks exactly like it looked in the 1950’s and 1960’s.

    VIDEO
    B-ROLL
    Dr. Schwenk walking in library

    AUDIO
    VO
    Dr. Schwenk is calling for even better mental health care and a national conversation about today’s medical education system.

    AUDIO
    SOT/FULL
    Thomas L. Schwenk, M.D., – University of Nevada School of Medicine
    Super@2:05
    Runs:37
    “What I would really like to see is the accrediting bodies, the residency review committees, the accreditation counsel for GME, ACGME, really take this to a high level. What if we built teaching programs from the ground up for teaching and clinical care was actually a secondary objective. Right now, what happens is the teaching in many regards kind of gets added on to an extremely high powered, high intensity, high productivity, very busy clinical system. And it makes it hard for residents I think, to really process everything that’s going on.”

    VIDEO
    B-ROLL

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Dr. Schwenk also says residents should be encouraged to take care of themselves so they can take care of others.

  • December 01, 2015

    Cesarean Section Rates And Health Outcomes For Mothers And Babies

    Cesarean Section Rates And Health Outcomes For Mothers And Babies

    INTRO:The most common operation done worldwide is the cesarean or C-section. In order to see better health outcomes, in the mid-1980s, the World Health Organization recommended that member countries C-section rates shouldn’t exceed 10 to 15 percent.  A new study evaluated the relationship between current cesarean section rates around the world and key health outcomes for mothers and babies.  Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Babies in nursery, cu of babies hand

    AUDIO
    VO
    Chances are the mothers of many of these babies underwent a cesarean or C-section birth.

    AUDIO
    SOT/FULL
    Alex B. Haynes, M.D., M.P.H., – Ariadne Labs
    Super@:06
    Runs:04
    “Almost one out of every 5 births on the planet, occur via cesarean section.”

    AUDIO
    SOT/FULL
    George Molina, M.D., M-P.H., – Ariadne Labs
    Super@:10
    Runs:07
    “Poorer countries were actually doing more C-sections as a proportion of all the care that they were providing, compared to wealthier countries.”

    VIDEO
    B-ROLL
    Cu of Dr. Haynes, wide shot of Dr. Molina and Dr. Haynes standing at white board, Graphic: Globe with 194 Member Countries, 2012 C-Section Rates, woman having ultrasound

    AUDIO
    VO
    Doctors Alex Haynes and George Molina from Ariadne (Air-ee-ahd-nee) Labs at Brigham and Women’s Hospital and co-authors gathered publicly available data from the 194 World Health Organization member countries. Using this information, they estimated two thousand and twelve C-section rates worldwide and examined how those rates affected maternal and neonatal health outcomes.

    AUDIO
    SOT/FULL
    George Molina, M.D., M-P.H., – Ariadne Labs
    Super@:35
    Runs:08
    “Up to a rate of about 19 C-sections per 100 live births we see reductions in maternal and neonatal mortality.”

    AUDIO
    SOT/FULL
    Alex B. Haynes, M.D., M.P.H., – Ariadne Labs
    Super@:43
    Runs:13
    “Across the world the average cesarean section rate is over 19 percent. Going from 19 to 25 to 30 percent did not result in improvements in neonatal or maternal mortality on a nationwide level.”

    (Video covering middle of bite: surgery video)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Alex B. Haynes, M.D., M.P.H., – Ariadne Labs
    Super@1:00
    Runs:17
    “There are many countries where not enough cesarean sections are being performed, meaning there is inadequate access to safe and timely emergency obstetric care and conversely, that there are some countries where probably more cesarean sections are being performed than yield health benefits.”

    VIDEO
    B-ROLL
    Dr. Haynes and Dr. Molina sitting at computer talking, woman walking with baby in hospital

    AUDIO
    VO
    The authors caution that these findings do not apply to any individual patients, facilities or hospitals.

    AUDIO
    SOT/FULL
    George Molina, M.D., M-P.H., – Ariadne Labs
    Super@1:25
    Runs:09
    “Our research can give some guidance for why countries should make their healthcare systems stronger so that they can provide safe, reliable and timely C-sections.”

    (Video covering 1st part of bite: mother walking with baby and video covering last part of bite: baby in nursery)

    VIDEO
    B-ROLL
    Baby in nursery

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study suggests that W-H-O target rates for cesarean section may be too low and need to be re-examined.

  • November 17, 2015

    Early Antibiotic Use May Halt Progression of Severe Respiratory Illness in Young Children

    Early Antibiotic Use May Halt Progression of Severe Respiratory Illness in Young Children

    INTRO: Preschool children who experience repeated episodes of severe lower respiratory tract infections often present with symptoms like wheezing and difficulty breathing.  A new study looked at whether a common antibiotic given early in these episodes could prevent the illness from getting worse. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of children in preschool class

    AUDIO
    VO
    When pre-school children experience repeated lower respiratory infections, It’s much more than just a simple cold.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@:06
    Runs:09
    “A lower respiratory tract illness is a cold that ends up going to the chest and that causes substantial coughing, wheezing, shortness of breath.

    VIDEO
    B-ROLL
    Steroid medication being poured out onto table

    AUDIO
    VO
    The usual treatment often includes steroids like prednisone.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@:18
    Runs:06
    “We wanted to provide a safe alternative that allows these children to experience fewer episodes.”

    VIDEO
    B-ROLL
    Dr. Bacharier walking down hallway, various shots of children, azithromycin medication

    AUDIO
    VO
    Dr. Leonard Bacharier (bah-CARE-ee-er) from Washington University in St. Louis and co-authors studied more than 600 children, from one to six years old, with a history of repeated episodes of severe  respiratory illness.  Children were randomly assigned to either receive the antibiotic azithromycin or a placebo early in these episodes.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@:41
    Runs:10
    “The parents were to have this medicine at home and were to start it at the very earliest signs of an illness in an effort to try to prevent the progression of the episodes.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@ :55
    Runs:10
    “The children in the azithromycin group were significantly less likely to have progression of their episodes to the point where prednisone would have been required.”

    VIDEO
    B-ROLL
    Azithromycin medication, children playing

    AUDIO
    VO
    Researchers also looked at whether increased antibiotic use could result in more bacterial resistance.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@ 1:16
    Runs:13
    “There was a slight increase in the number of children who had resistant organisms at the end of the study among those who received azithromycin compared to those who received placebo, but the numbers were relatively small.”

    (Video covering 1st part of bite: various shots of children)

    VIDEO
    B-ROLL
    Dr. Bacharier at his desk, looking at computer

    AUDIO
    VO
    Dr. Bacharier says further research is needed to understand how often these resistant organisms will emerge.

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    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@1:29
    Runs:21
    “How to put this strategy into clinical practice is going to take some time. This requires a proactive discussion with the child’s health care provider in advance so that if this strategy is to be undertaken, it is available at home, with the parent well instructed as to the earliest signs of illness and knows when to start this.”

    (Video covering middle of bite: children playing)

    VIDEO
    B-ROLL
    Children playing

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Dr. Bacharier says even when used perfectly, there are many children who will develop severe illness despite these therapies.

  • November 13, 2015

    An Alternative Treatment For Diabetic Eye Disease

    An Alternative Treatment For Diabetic Eye Disease

    INTRO: Vision loss is one of the most feared complications of diabetes.  If not diagnosed and treated early, diabetic retinopathy can lead to blindness.  For decades, laser therapy has been used to treat this complication.  However this procedure can come with some important side effects.  A new study tested a different kind of treatment using an injectable medication called ranibizumab, to see if it would be as effective as laser therapy. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    People walking on the street, pictures get blurred, graphic: fade in words: Diabetic Retinopathy

    AUDIO
    VO
    Imagine your vision going from this…to this. These changes can happen slowly or all at once. It’s called diabetic retinopathy and it’s the leading cause of vision loss in patients with diabetes.

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    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@:11
    Runs:10
    “The most severe form of diabetic retinopathy is called proliferative diabetic retinopathy. There’s a development of abnormal scar tissue and blood vessels that are tugging on the retina.”

    VIDEO
    B-ROLL
    Graphic: pic of eye leaking vessels circled on left in red, blood vessels on right not leaking and circled in green

    AUDIO
    VO
    This eye, injected with dye, shows abnormal blood vessels that are leaking.  This often causes bleeding or even a detached retina. Healthy blood vessels are very tight and don’t leak. Laser therapy is the standard treatment to stop the vessels from leaking.

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    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@:34
    Runs:09
    “It’s not an ideal treatment because it can affect your side vision. It can affect your adjustment to dark and in some cases can make your vision worse.”

    VIDEO
    B-ROLL
    Dr. Jampol walking into exam room, sitting down and examining patients eyes, medication vial with syringe, various pictures of eye on computer

    AUDIO
    VO
    Dr. Lee Jampol from Northwestern University and co-authors studied more than 300 patients with this severe form of diabetic retinopathy.  Patients either received standard laser therapy or treatment with a newer medication called ranibizumab (ran-e-biz-u-mab), which was injected directly into the eye. In total, researchers treated almost 400 eyes.  Outcomes, especially vision loss, were compared at two years.

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@1:04
    Runs:07
    “Over the course of the two years the patients receiving the injections of the medication did somewhat better than the ones that got the laser.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@1:15
    Runs:18
    “It had less side effects. The peripheral vision stayed about the same in the medication group but it was diminished in the patients that had the laser treatment. There are other changes that occur in the retina with swelling of the back of the retina and we know that the injections help to prevent that better than the laser treatment.”

    (Video covering middle of bite: pic of eye)

    VIDEO
    B-ROLL
    Dr. Jampol examining Michael’s eyes

    AUDIO
    VO
    Routine eye exams helped identify Michael Graff’s retinopathy.  Today, he sees his ophthalmologist regularly because maintaining his vision is vital.

    AUDIO
    Michael Graff – Retinopathy Patient
    Super@1:41
    Runs:06
    “I’m an artist…it’s very important. I couldn’t imagine being without it.”

    (Video covering end of bite: Michael being examined by Dr. Jampol)

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@1:49
    Runs:07
    “So when the patient goes in now to their doctor with proliferative diabetic retinopathy there’s two choices, where before there was only one.”

    (Video covering end of bite: Dr. Jampol and Michael talking)

    VIDEO
    B-ROLL
    Dr. Jampol and Michael talking

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The injectable medication, ranibizumab, had a low complication rate and showed good safety.

  • November 08, 2015

    Shared Financial Incentives For Physicians And Patients Helped Improve Cholesterol Levels

    Shared Financial Incentives For Physicians And Patients Helped Improve Cholesterol Levels

    INTRO: Financial incentives for physicians or patients are one way healthcare organizations are trying to improve health outcomes.  A new study examined whether providing financial incentives would help improve L-D-L or the “bad” cholesterol level in people at high-risk for cardiovascular disease. Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:01
    “…I’m going to get your vital signs this morning…”

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    Nurse getting ready to take patients temperature, cu of patient with thermometer in mouth, blood pressure being checked

    AUDIO
    VO
    In addition to vital signs, a visit to the doctors office often includes a discussion about cholesterol levels, especially if a patient is at high-risk for cardiovascular disease.

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    SOT/FULL
    David A. Asch, M.D., – University of Pennsylvania
    Super@:10
    Runs:11
    “You can substantially reduce that risk if you take statins or other medications to lower your cholesterol.  Many patients aren’t taking statins or if they are they stop them after a few months.”

    (Video covering  middle of bite: statin medication)

    AUDIO
    SOT/FULL
    Kevin G. Volpp, M.D., Ph.D., – University of Pennsylvania
    Super@:22
    Runs:09
    “And what we did in this study was to test a variety of strategies to try to help patients and their doctors get their cholesterol under better control.”

    VIDEO
    B-ROLL
    Dr. Volpp and Dr. Asch walking down hallway with colleague, colleague and doctors at white board, writing on white board while Dr. Asch and Dr. Volpp look on, doctor examining patient and doing different tests in exam room, patient and doctor talking

    AUDIO
    VO
    Doctors Kevin Volpp and David Asch from the University of Pennsylvania and co-authors studied the effect of different financial incentives on cholesterol levels in more than 15 hundred patients at high risk for cardiovascular disease.  The researchers randomly assigned 340 doctors to one of four groups. One group didn’t receive any financial incentives.  in another group, financial incentives were given only to the patients who showed improvements in their cholesterol.

    AUDIO
    SOT/FULL
    David A. Asch, M.D., – University of Pennsylvania
    Super@:53
    Runs:09
    “We also tried different approaches including giving financial incentives to physicians or giving financial incentives in a shared way to both patients and physicians.”

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    SOT/FULL
    Kevin G. Volpp, M.D., Ph.D., – University of Pennsylvania
    Super@ 1:03
    Runs:07
    “The most effective way of improving cholesterol control was a shared incentive between patients and providers.”

    (Video covering end of bite: doctor and patient talking)

    AUDIO
    SOT/FULL
    David A. Asch, M.D., – University of Pennsylvania
    Super@ 1:11
    Runs:03
    “They had the greatest reduction in their LDL cholesterol.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Kevin G. Volpp, M.D., Ph.D., – University of Pennsylvania
    Super@ 1:21
    Runs:15
    “If patients weren’t on statins, they were started on statins Having both the provider intensify therapy as appropriate and having the patients take those medications once prescribed, and that’s really why we think the shared incentive group was the most effective.”

    (Video covering  1st part of bite: statin medications)

    AUDIO
    SOT/FULL
    David A. Asch, M.D., – University of Pennsylvania
    Super@ 1:32
    Runs:12
    “We shouldn’t just think of these as mechanical economic transactions. Getting your cholesterol down is a team effort. It requires physicians to prescribe the medications and it requires patients to take the medications.”

    (Video covering middle of bite: patient getting blood drawn)

    AUDIO
    SOT/FULL
    Kevin G. Volpp, M.D., Ph.D., – University of Pennsylvania
    Super@ 1:45
    Runs:07
    “Both of those are critically important to the end goal of improving LDL cholesterol and reducing cardiovascular risk.”

    (Video covering end of bite: doctor and patient talking)

    VIDEO
    B-ROLL
    Dr. and patient talking

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:L-D-Llevels improved 25 points in the group receiving no financial incentives. Incentives given to physicians only and patients only did not work as well as when incentives were given to both physicians and patients.

  • November 03, 2015

    Prescription Drug Use Continues To Rise In The U.S.

    Prescription Drug Use Continues To Rise In The U.S.

    INTRO: Prescription drugs represent a major healthcare expense and the number of adults in the U-S taking prescription medications is increasing. A new study examined trends in prescription drug use from 1999 to 2012 among U-S adults. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various pharmacy signage, people walking on street, various pharmacy signage

    AUDIO
    VO
    Today there seems to be a pharmacy on almost every street corner. With hundreds of different drugs coming and going from the market, It’s not surprising that prescription drug use is on the rise.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@:09
    Runs:14
    “We observed an overall increase in prescription drug use. In 1999-2000 51 percent of all U-S adults age 20 and older reported any use of prescription medications and this increased to 59 percent in 2011-12.”

    (Video covering 2nd half of bite: people walking, Graphic: 1999-2000
    51% U.S. ADULTS 20+ YEARS
    59% 2011-2012)

    VIDEO
    B-ROLL
    Dr. Kantor walking down hallway, people outside walking, sitting at desk looking at charts on computer, Graphic:
    5 or More Prescription Drugs
    8.2 % in 1999-2000
    15 % in 2011-20012

    AUDIO
    VO
    Dr. Elizabeth Kantor from Memorial Sloan Kettering Cancer Center and co-authors examined more than a decade data from nearly 40 thousand U-S adults, 20 years and older, participating in the National Health and Nutrition Examination Survey or N-HANES. The number taking five or more prescription drugs almost doubled from 8 point 2 percent in 19-99 to two thousand to 15 percent in two thousand-11 to two thousand 12.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@:46
    Runs:12
    “This is particularly notable among older adults, ages 65 and older. When we account for age we find that the trends persist, suggesting that there are factors other than the aging of the population driving this increase.”

    (Video covering middle of bite: older people exercising)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@1:02
    Runs:13
    “When we look at drugs taken to control high-blood pressure, diabetes, high cholesterol, depression we see increases in all of those drug classes.  We also see increases in some less commonly used drug classes such as muscle relaxants.”

    (Video covering 2nd part of bite: various prescription medications)

    VIDEO
    B-ROLL
    Graphic:
    2011-2012
    SIMVASTATIN
    NEARLY 8% OF ALL ADULTS

    AUDIO
    VO
    Simvastatin, used to treat high cholesterol, was the most commonly used prescription drug in 2011-12, taken by nearly 8 percent of all U-S adults.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@1:23
    Runs:12
    “And when we look at the 10 most commonly used drugs in 2011-12, most of these drugs are taken for conditions associated with cardiovascular disease as well as the factors contributing to cardiovascular disease, such as obesity.”

    (Video covering 2nd part of bite: overweight man getting blood pressure checked)

    VIDEO
    B-ROLL
    Pills being counted

    AUDIO
    VO
    The sharpest increases in prescription drug use occurred in the early two thousands.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@1:40
    Runs:06
    “Within the later 2000’s we actually saw that some drug classes remained stable and some modestly decreased.”

    (Video covering 2nd half of bite: pills being counted)

    VIDEO
    B-ROLL
    Pills being counted

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Prior studies about prescription drug use were limited in scope and often restricted to certain populations.

  • October 27, 2015

    Death Rates In U.S. Continue To Decrease

    Death Rates In U.S. Continue To Decrease

    INTRO: Are Americans living longer and what are they dying from? In a new study, researchers from the American Cancer Society reviewed changes in the overall U-S death rate as well as trends in the six leading causes of death. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    People outside

    AUDIO
    VO
    Americans are living longer.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@:03
    Runs:07
    “We are making progress in reducing death rate from all-causes and leading causes of death.”

    VIDEO
    B-ROLL
    Dr. Jemal walking down hallway with colleague, Dr. Jemal in his office looking at graphs on a computer, walking down hall

    AUDIO
    VO
    Dr. Ahmedin (Ah-meh-deen) Jemal along with colleagues from the American Cancer Society used data from the National Center for Health Statistics to examine trends in the overall death rate in the U-S from 1969 to 2013.  They also looked specifically at the six leading causes of death.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@:24
    Runs:06
    “Overall death rates have decreased by 42 or 43 percent.”

    VIDEO
    B-ROLL
    Graphic:
    1969-2013
    HEART DISEASE
    CANCER
    STROKE
    INJURIES
    DIABETES
    Arrows next to each point down,
    Three arrows down for heart disease, stroke, diabetes

    AUDIO
    VO
    During this time period, death rates continued to decrease for heart disease, cancer, stroke, injuries and diabetes.
    Although the decrease has slowed during the last five years for heart disease, stroke and diabetes.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@:45
    Runs:09
    “The slow-down could be due to the obesity epidemic that has unfolded over the last three decades.”

    (Video covering 1st part of bite: obese people)

    VIDEO
    B-ROLL
    X-rays of lungs

    AUDIO
    VO
    On the other hand, deaths from chronic obstructive pulmonary disease, or C-O-P-D, doubled.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@:55
    Runs:11
    “COPD rates in men increased through the early 1990s, now it is decreasing but in women, the COPD rates continue to increase since 1969.”

    (Video covering middle of bite: male patient being examined)

    VIDEO
    B-ROLL
    Various people smoking

    AUDIO
    VO
    Dr. Jemal says this difference may result from women starting and stopping smoking later than men.

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@1:15
    Runs:16
    “Cancer has been increasing from 1969 thru 1990 when it peaked and since 1990 it has been steadily decreasing because of a reduction of tobacco use as well as improvements in early detection.”

    VIDEO
    B-ROLL
    People outside, people smoking, obese people

    AUDIO
    VO
    Although death rates are down, there is still room for improvement.  One in five U-S adults still smoke and one in three are obese.

    AUDIO
    SOT/FULL
    Voice of:
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@1:37
    Runs:09
    “Smoking, obesity, physical inactivity and bad diet account for about half of the total deaths in the U-S.

    (Video covering entire bite: various shots of people smoking, eating and obese people)

    VIDEO
    B-ROLL
    Woman walking across street

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Unintentional injuries such as accidents or drowning increased until the mid-1990s but have been decreasing during the most recent time period.

  • October 20, 2015

    New Recommendations For Breast Cancer Screening In Women With Average Cancer Risk

    New Recommendations For Breast Cancer Screening In Women With Average Cancer Risk

    INTRO: Breast cancer is the second leading cause of cancer deaths among American women. Early detection remains the best way to prevent breast cancer related deaths.  Many experts have tried to understand how to best balance potential benefits and harms of breast cancer screening. The American Cancer Society reviewed existing research and updated its recommendations for women who are at average risk for breast cancer. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@:02
    Runs:08
    “Mammography does save lives. It’s the single best tool that we have for preventing a premature death from breast cancer in a woman.”

    VIDEO
    B-ROLL
    Dr. Oeffinger at his desk, looking at mammograms, Graphic: several studies piled on top of one another, American Cancer Society logo

    AUDIO
    VO
    Dr. Kevin Oeffinger (EH-fen-jur) from Memorial Sloan Kettering Cancer Center along with a panel of other experts examined decades of research to update the American Cancer Society’s recommendations for breast cancer screening.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@:19
    Runs:21
    “What we realize is that there’s areas that the evidence is very clear and there’s other areas that there may be a trade-off. We recommend starting regular screening at age 45. The evidence clearly shows that there is substantial magnitude of benefit, life saved, compared to the risks of having a false-positive biopsy, false-positive additional images or over diagnosis.”

    (Video covering middle of bite: woman getting a mammogram)

    VIDEO
    B-ROLL
    Screening Mammography

    START YEARLY SCREENING
    AGE 45

    EVERY TWO YEARS
    AGE 55

    AUDIO
    VO
    In addition to starting yearly screening at 45, the American Cancer Society recommends that women transition to screening every two years at age 55.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@:50
    Runs:12
    “Women age 40 to 44 will benefit from screening mammography. We recommend that women have a visit with their health care professional and discuss their risk and benefits and then weigh how they look at false-positive testing.”

    (Video covering middle of bite: doctor talking with patient)

    VIDEO
    B-ROLL
    Screening Mammography

    INFORMED DECISION MAKING

    WOMEN 40-44
    OPTION TO SCREEN EARLY

    WOMEN 55+
    OPTION TO CONTINUE YEARLY SCREENING

    AUDIO
    VO
    For the first time, the guideline supports informed decision making, saying some women ages 40 to 44 should have the option to screen early and women 55 and older have the opportunity to continue yearly screening if they choose.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@1:24
    Runs:15
    “We do not recommend a particular age to stop screening. There is definitely benefit into the mid-70’s, and we think benefit beyond that in women who are active and have a ten year life expectancy of reasonably good health.”

    (Video covering middle of bite: older woman having mammogram)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D., – Memorial Sloan Kettering Cancer Center
    Super@1:34
    Runs:06
    “We no longer recommend doing clinical breast examinations for women in the United States.”

    VIDEO
    B-ROLL
    Doctor talking with patient

    AUDIO
    Dr. Oeffinger says this time could be better spent counseling women about individual screening preferences.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@1:45
    Runs:12
    “This guideline however, is not a ‘one-size-fits-all.’ It’s very key that a woman is able to express her beliefs, her own values and preferences to her health care professional in making that shared and informed decision.”

    (Doctor walking with woman, sitting and talking in exam room)

    VIDEO
    B-ROLL
    Woman talking with doctor

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:About 8 to 10 percent of women are at high risk for breast cancer, the rest of women are at average risk.  Only 65 percent of U-S women are getting screened within a two-year time period.

  • October 19, 2015

    Seizures from Solving Sudoku Puzzles

  • October 06, 2015

    Minimally Invasive Approach Not as Effective as Standard Operation For Rectal Cancer

    Minimally Invasive Approach Not as Effective as Standard Operation For Rectal Cancer

    INTRO:The usual treatment of stage 2 or 3 rectal cancer includes surgery to remove the tumor. Traditionally, patients have undergone a major, “open” operation to remove the cancer. A new study compared whether a minimally invasive approach would be as good as an open or full operation.  Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    Various shots of laparoscopic procedure

    AUDIO
    VO
    This patient is undergoing a laparoscopy. This operation is done with small incisions, smaller instruments, and a fiber optic scope to see inside the abdomen. Most times the patient has less pain and a quicker recovery compared to a traditional open procedure that involves making a large incision. This technique works well for treating colon cancer.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@:17
    Runs:21
    “Rectal cancer which is at the other end of the G-I tract at the very bottom of the colon, is a different ballgame. There is a high risk of local recurrence of the tumor in the pelvis after an operation no matter whether you do it open or anything else.”

    VIDEO
    B-ROLL
    Dr. Fleshman walking down hallway, looking at computer with colleague

    AUDIO
    VO
    Dr. James Fleshman from Baylor University Medical Center and co-authors wanted to know if a minimally invasive approach was as good as an open procedure for patients with stage two or three rectal cancer.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@:48
    Runs:12
    “We wanted to make sure that we were giving our patients the best chance for curing their cancer not just giving them the advantage of a small incision and a minimally invasive approach.”

    VIDEO
    B-ROLL
    Computer screen showing various views of rectal area, cu of image, surgical team working in OR, various shots of staff examining slides with microscope

    AUDIO
    VO
    486 patients were randomly assigned to receive a standard, open operation or the minimally invasive, laparoscopic approach. All the procedures were done by 46 highly trained surgeons. Specimens from each procedure were examined under a microscope to see whether the entire tumor was removed, known as a “complete” resection.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@ 1:17
    Runs:15
    “Patients who underwent an open operation, 90 percent of all the patients had the complete resection. In the laparoscopy group only 81.7 percent of patients ended up with a complete resection.”

    (Video covering middle of bite: staff looking at slides)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@1:36
    Runs:10
    “That told us that laparoscopy for rectal cancer was not as good as open operation for rectal cancer.”

    VIDEO
    B-ROLL
    Dr. Fleshman scrubbing

    AUDIO
    VO
    Dr. Fleshman also says tumor location is important.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@1:49
    Runs:25
    “So, if this is a very straightforward small tumor and the surgeon is comfortable in stating that this will be able to be done perfectly then laparoscopy may be the appropriate way to go. In a tumor that’s very deep in the pelvis and very large laparoscopy may not be the right way to treat this anymore.”

    (Video covering 2nd half of bite: Dr. Fleshman in surgery)

    VIDEO
    B-ROLL
    Dr. Fleshman in surgery

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study is one of the first trials to evaluate surgical techniques for treating rectal cancer.

  • October 05, 2015

    Flu Vaccine Reduces Hospitalizations For Pneumonia

    Flu Vaccine Reduces Hospitalizations For Pneumonia

    INTRO:Influenza or the flu, is a viral infection affecting the respiratory system. Pneumonia is a serious complication of influenza.  A new study examined whether getting a flu shot can help reduce hospitalizations due to influenza pneumonia. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Children in doctor’s office with nurse

    AUDIO
    VO
    For many people, getting a flu shot is an annual tradition.

    AUDIO
    NATSO/FULL
    Runs:04
    …what happened punkin’…whaaaa….whaaa.. that’s it…”

    VIDEO
    B-ROLL
    Baby crying after getting flu shot

    AUDIO
    VO
    Pneumonia is one of the most serious complications of influenza…

    AUDIO
    SOT/FULL
    Kathryn M. Edwards, M.D. – Vanderbilt University Medical Center
    Super@:11
    Runs:06
    “Pneumonia means an infection, deep down in your lungs.”

    (Vide covering 2nd part of bite: cu of chest x-ray)

    VIDEO
    B-ROLL
    Chest x-ray

    AUDIO
    VO
    …often requiring hospitalization.

    AUDIO
    SOT/FULL
    Carlos G. Grijalva, M.D., M.P.H. -Vanderbilt University Medical Center
    Super@:18
    Runs:05
    “The most effective way to prevent some of the influenza infections is vaccination.”

    VIDEO
    B-ROLL
    Dr. Grijalva and Dr. Edwards walking outside, looking at chest x-rays on computer, EMT’s taking patient into hospital

    AUDIO
    VO
    Doctors Carlos Grijalva (Gree-hahl-BAH) and Kathryn Edwards from Vanderbilt University Medical Center and co-authors evaluated more than 27 hundred patients over three consecutive flu seasons. All patients were admitted to the hospital from the emergency department at four sites around the U.S.

    AUDIO
    SOT/FULL
    Kathryn M. Edwards, M.D. – Vanderbilt University Medical Center
    Super@:38
    Runs:05
    “Everyone had the pneumonia but one group had flu and one group did not.”

    AUDIO
    SOT/FULL
    Carlos G. Grijalva, M.D., M.P.H. -Vanderbilt University Medical Center
    Super@:43
    Runs:05
    “About 6 percent of those patients had pneumonias  due to influenza.”

    VIDEO
    B-ROLL
    Nurse preparing flu vaccine, patient getting shot

    AUDIO
    VO
    Next the researchers determined how many patients with pneumonia had been vaccinated against influenza.

    AUDIO
    SOT/FULL
    Kathryn M. Edwards, M.D. – Vanderbilt University Medical Center
    Super@:53
    Runs:13
    “The people that had received vaccine had 57 percent less chance of getting hospitalized with flu-pneumonia than those patients that were not vaccinated.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Carlos G. Grijalva, M.D., M.P.H. -Vanderbilt University Medical Center
    Super@1:11
    Runs:11
    “The effectiveness of the vaccines seems to be a little lower for older subjects and for patients with underlying immunosuppressive conditions.”

    AUDIO
    SOT/FULL
    Kathryn M. Edwards, M.D. – Vanderbilt University Medical Center
    Super@1:25
    Runs:07
    “The vaccine seemed to work very well in young children and in individuals less than 65.”

    (Video covering 1st half of bite: young girl getting nasal flu vaccine)

    VIDEO
    B-ROLL
    Nurse preparing to give a flu shot to young boy

    AUDIO
    VO
    The study’s results provide one more reason to get a flu shot this fall.

    AUDIO
    NATSO/FULL
    Runs:05
    “Ouch…she’s all done…that hurt a little…a little?”

    VIDEO
    B-ROLL
    Child after he gets his shot

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The study was sponsored by the Centers for Disease Control and Prevention.

  • September 22, 2015

    Combination Drug Treatment Reduces Agitation in Patients With Alzheimer’s Disease

    Combination Drug Treatment Reduces Agitation in Patients With Alzheimer’s Disease

    INTRO:Agitation and aggression are common in patients with Alzheimer’s dementia and are a source of distress for caregivers. Patients may shout, curse or even become violent. Currently available medications have lots of side effects and are only modestly effective for treating agitation.  A new study tested a combination of two existing medications and whether this would help control agitation in patients with Alzheimer’s. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Laurie walking into hospital, pictures of her mother and father

    AUDIO
    VO
    Laurie Gabello is very familiar with hospitals and doctor’s offices. Her father has Alzheimer’s disease and her mother, dementia. But it wasn’t always that way.

    AUDIO
    SOT/FULL
    Laurie Gabello – Caregiver
    Super@:09
    Runs:05
    “They were extremely active. They traveled a lot.  They were extremely social.”
    (Video covering 1st part of bite: picture of parents)

    VIDEO
    B-ROLL
    Pictures of Laurie’s parents

    AUDIO
    VO
    Now in full time care, both of Laurie’s parents have frequent bouts of agitation.

    AUDIO
    SOT/FULL
    Laurie Gabello – Caregiver
    Super@:18
    Runs:14
    “When people do come in to help him with his showers or his daily care and stuff he does get extremely agitated. She gets very upset and very agitated, no matter what it is. What they’re serving for dinner, the fact that they play the same music over and over.”

    (Video covering middle of bite: pictures)

    AUDIO
    SOT/FULL
    Jeffrey L. Cummings, M.D., Sc.D. – Cleveland Clinic Lou Ruvo Center for Brain Health
    Super@:32
    Runs:08
    “These are things that make caregiving so extremely difficult, when there is a violent or aggressive reaction by the patient.”

    VIDEO
    B-ROLL
    Dr. Cummings walking down hallway, older people in the community, Dr. Cummings looking at brain images on computer, graphic

    AUDIO
    VO
    Dr. Jeffrey Cummings from the Cleveland Clinic and co-authors recruited 220 patients with Alzheimer’s dementia and agitation. During a preliminary 10-week trial, participants were randomly assigned to receive either the combination of dextromethorphan and quinidine or a placebo.

    AUDIO
    SOT/FULL
    Jeffrey L. Cummings, M.D., Sc.D. – Cleveland Clinic Lou Ruvo Center for Brain Health
    Super@:55
    Runs:10
    “The dextromethorphan-quinidine combination had a substantial effect in reducing agitation and far greater than was seen in the placebo treated patients.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Jeffrey L. Cummings, M.D., Sc.D. – Cleveland Clinic Lou Ruvo Center for Brain Health
    Super@:55
    Runs:03
    “And we showed that the drug was safe and effective.”

    VIDEO
    B-ROLL
    Laurie talking with a staff person

    AUDIO
    VO
    Dr. Cummings says there also appeared to be benefit for the caregivers of these patients.

    AUDIO
    SOT/FULL
    Jeffrey L. Cummings, M.D., Sc.D. – Cleveland Clinic Lou Ruvo Center for Brain Health
    Super@1:18
    Runs:09
    “There was a reduction in the stress experienced for caregivers of the patients who were treated with the dextromethorphan-quinidine combination.”

    VIDEO
    B-ROLL
    Photos of Laurie with her parents

    AUDIO
    VO
    Although caring for her parents is sometimes overwhelming, Laurie takes comfort in knowing they have lived full lives.

    AUDIO
    SOT/FULL
    Laurie Gabello – Caregiver
    Super@1:32
    Runs:06
    “They didn’t not do anything they set their heart out to do, that was on their bucket list, they did all of it.”

    (Video covering 2nd half of bite: various pictures of Laurie’s parents)

    VIDEO
    B-ROLL
    Various pictures of Laurie’s parents

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The combination of these two medications is not yet available for patients. More studies are needed before the results can be presented to the F-D-A for approval.

  • September 14, 2015

    Low Vitamin D Levels Associated with More Rapid Cognitive Decline in Older Adults

    Low Vitamin D Levels Associated with More Rapid Cognitive Decline in Older Adults

    INTRO: About 42 percent of the general U-S adult population has low vitamin D levels. That number is even higher among Hispanics and African-Americans. Besides promoting calcium absorption and bone health, vitamin D may also affect the brain and cognitive function. A new study looked at the association between baseline vitamin D levels and the rate of cognitive decline in a group of ethnically diverse older adults. Catherine Dolf has more this week’s JAMA Report.
    VIDEO B-ROLL Sun through the clouds, woman drinking milk, vitamin D bottles, older people walking AUDIO
    VO
    Sunlight and diet are the two main sources of vitamin D. Many people also take vitamin D supplements. However, having a low vitamin D level is still very common.

    AUDIO
    SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@:16 Runs:15
    “As the population ages, the fastest growing segment are the old and the oldest of old and with that, is an increase in the risk of cognitive dysfunction and outright Alzheimer’s disease and dementia.”
    VIDEO
    B-ROLL Dr. Miller walking, Graphic:382 Older Adults 75 Years of Age 61% Women 41 % White 30 % African-American 25 % Hispanic
    AUDIO
    VO
    Dr. Joshua Miller from Rutgers University, along with colleagues from the University of California Davis, studied 382 older adults with an average age of 75. 61 percent were women, 41 percent White, about 30 percent African-American and 25 percent Hispanic.

    AUDIO
    SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@:41 Runs:08
    “Some of the subjects had outright dementia, some had mild cognitive impairment and some had what we would call normal cognitive function.”
    VIDEO
    B-ROLL Dr. Miller in lab, person taking cognitive test

    AUDIO
    VO
    Vitamin D levels and cognitive function were measured at baseline. Cognitive function was also followed in 318 of the participants for an average of 5 years.

    AUDIO
    SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@:58 Runs:08
    “About 60 percent of the group, regardless of their race or ethnicity, was low in vitamin D.”
    GXF FULL JAMA LOGO

    AUDIO
    VO The study appears in JAMA, Neurology.

    AUDIO SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@ 1:09 Runs:09
    “Those who had dementia also had lower vitamin D status than those who had mild cognitive impairment or who had normal cognitive function.”
    VIDEO
    B-ROLL Vitamin D capsules, graphic:Episodic Memory Executive Function AUDIO
    VO
    Those low in vitamin D declined more in short term memory, known as episodic memory, as well as more complex cognitive tasks, known as executive function.

    AUDIO
    SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@1:26 Runs:06
    “They were declining about two and a half times faster than those who had adequate vitamin D.” (Video covering 2nd half of bite: Vitamin D capsules)
    VIDEO
    B-ROLL Vitamin D capsules

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study is observational. Future studies are needed to determine whether vitamin D supplements can slow cognitive decline.

  • September 08, 2015

    Diabetes Continues To Rise In U.S. Population

    Diabetes Continues To Rise In U.S. Population

    INTRO:If left untreated, diabetes can cause many serious health-related complications including kidney failure and blindness.  The total estimated cost of diabetes in the U.S. was $245 billion in 2012, which includes both health care costs and lost productivity. A new study examined the prevalence of diabetes in the U.S., including undiagnosed diabetes, and pre-diabetes. Catherine Dolf has details in this week’s JAMA Report.

    VIDEO
    B-ROLL
    People sitting and walking outside

    AUDIO
    VO
    DIABETES CONTINUES TO RISE IN THE U-S.

    AUDIO
    SOT/FULL
    Andy Menke, Ph.D., – Social & Scientific Systems Inc.
    Super@:05
    Runs:07
    (graphic lower third: wipes in 14% DIABETES)
    “14 percent of the people in the United States have diabetes and this is even higher in Asians and Blacks and Hispanics.”

    AUDIO
    SOT/FULL
    Catherine C. Cowie, Ph.D., – National Institutes of Health
    Super@:09
    Runs:10
    (graphic lower third: wipe in1988-2012 ADULTS 20+)
    “And we specifically looked at data from 1988 until 2012 in adults age 20 and above.”

    VIDEO
    B-ROLL
    Dr. Cowie and Dr. Menke walking outside, various shots of people outside

    AUDIO
    VO
    Dr. Catherine Cowie from the National Institutes of Health and Dr. Andy Menke from Social and Scientific Systems Incorporated along with their co-authors used data from a long running national survey of american adults known as N-HANES. About 26 thousand people were evaluated to determine prevalence and trends in diabetes.

    AUDIO
    Catherine C. Cowie, Ph.D., – National Institutes of Health
    Super@:36
    Runs:11
    (Graphic lower third: wipe in
    1/3 DIABETES IS UNDIAGNOSED
    1/3 POPULATION HAS PRE-DIABETES)
    “One third of diabetes is undiagnosed and we also found that one third of the population has pre-diabetes.”

    AUDIO
    SOT/FULL
    Andy Menke, Ph.D., – Social & Scientific Systems Inc.
    Super@:47
    Runs:05
    (Graphics lower third: wipe in
    ABOUT HALF THE POPULATION HAS DIABETES OR PRE-DIABETES)
    “This means half of people in the United States have either diabetes or pre-diabetes.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    SOT/FULL
    Catherine C. Cowie, Ph.D., – National Institutes of Health
    Super@:56
    Runs:16
    “For the first time in 2011-2012 we had data on Asian-Americans. Their prevalence of diabetes was as high as it is in the Blacks and Hispanics, around 20 percent of the population.”

    AUDIO
    SOT/FULL
    Andy Menke, Ph.D., – Social & Scientific Systems Inc.
    Super@1:13
    Runs:05
    “Up to 50 percent of Asians and Hispanics with diabetes were unaware that they had the condition.”

    VIDEO
    B-ROLL
    Man getting blood glucose test

    AUDIO
    VO
    That’s compared to about a third with undiagnosed diabetes in the White and Black populations.

    AUDIO
    SOT/FULL
    Catherine C. Cowie, Ph.D., – National Institutes of Health
    Super@1:22
    Runs:09
    “Diabetes continues to rise and it continues to rise in all age and sex, race, ethnic groups and in groups according to education and income.”

    (Video covering 2nd part of bite: people eating outside)

    VIDEO
    B-ROLL
    People eating outside

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say the high rate of diabetes in Asian Americans is occurring despite the fact that their body mass index or B-M-I is lower than the B-M-I in the general population.

  • September 01, 2015

    Genetic Testing in Children with Autism Spectrum Disorder

    Genetic Testing in Children with Autism Spectrum Disorder

    INTRO:Autism spectrum disorder or A-S-D represents a diverse group of conditions. If researchers can better understand the genetics of A-S-D, it may be possible to identify and diagnose at-risk children sooner.  A new study examined the results of two kinds of genetic tests in children diagnosed with A-S-D. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Owen walking with his mom and Dr. Fernandez

    AUDIO
    VO
    Owen was diagnosed with autism at two and half.

    AUDIO
    SOT/FULL
    Melissa Blundon  – Owen’s Mother
    Super@:03
    Runs:03
    “He wasn’t walking, he didn’t talk.”

    VIDEO
    B-ROLL
    Various shots of Owen sitting and talking with his mom and Dr. Fernandez

    AUDIO
    VO
    He’s much different today. Almost 13, Owen attends school, has plenty of friends and talks a lot. Even surprising his mom with a new word now and then.

    AUDIO
    SOT/FULL
    Owen Blundon – Study Participant
    Super@:14
    Runs:04
    “A brain and a heart. They’re squeezable.”

    AUDIO
    SOT/FULL
    Melissa Blundon – Owen’s Mother
    Super@:19
    Runs:03    “I’ve never heard him say squeezable before.”

    VIDE0
    B-ROLL
    Owen, his mom and Dr. Fernandez coming down stairs, Dr. Fernandez walking in the building, Graphic; names of two tests and number of children who received them

    AUDIO
    VO
    Owen participated in a study with more than 250 other children diagnosed with autism spectrum disorder. Dr. Bridget Fernandez from Memorial University in Newfoundland and co-authors used two newer genetic tests.  The first, chromosomal microarray analysis, was performed on each child.  The second, whole-exome sequencing, on 95 randomly selected children.

    AUDIO
    SOT/FULL
    Bridget A. Fernandez, M.D., Memorial University Hospital, Newfoundland
    Super@:42
    Runs:10
    “16 percent of the children had an ASD related genetic finding on either the microarray or the whole-exome sequencing.”

    VIDEO
    B-ROLL
    Researcher looking at genetic readouts on computer, various shots of people working in lab

    AUDIO
    VO
    The children were also closely examined for subtle physical differences and screened for birth defects. They were put into three groups based on the severity of these physical differences.

    AUDIO
    SOT/FULL
    Bridget A. Fernandez, M.D., Memorial University Hospital, Newfoundland
    Super@1:01
    Runs:09
    “And when we did that, the children in the morphologically complex group, 35 percent of them had a positive genetic test.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Bridget A. Fernandez, M.D., Memorial University Hospital, Newfoundland
    Super@1:14
    Runs:15
    “In that complex group, the diagnosis of autism was even more delayed than in the children without those types of problems. Sometimes there are other problems that are detracting from the fact that they have these red flags for autism.”

    VIDEO
    B-ROLL
    Owen and Melissa in exam room, cu of Melissa

    AUDIO
    VO
    As part of the study, Owen’s I-Q testing was normal, prompting his mother to send him to school.

    AUDIO
    SOT/FULL
    Melissa Blundon – Owen’s Mother
    Super@1:34
    Runs:08
    “Because I knew that he was smart enough, I said you’re going but now he’s developed into a lovely young man.”

    AUDIO
    SOT/FULL
    Bridget A. Fernandez, M.D., Memorial University Hospital, Newfoundland
    Super@1:42
    Runs:14
    “If we can understand the underlying genetics more completely we’d have the possibility to actually identify at-risk children through genetic testing and get earlier diagnosis and improve the outcome.”

    (Video covering last part of bite: Owen and Dr. Fernandez doing hi-5)

    VIDEO
    B-ROLL
    Owen giving hi-5 to Dr. Fernandez and she smiles

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The chromosomal microarray analysis has been performed for more than five years. The whole-exome sequencing test, a way of scanning most of the coding parts of the genome for mutations, is just entering routine clinical practice.

  • August 25, 2015

    Does Exercise Improve Cognitive Function in Older Adults?

    Does Exercise Improve Cognitive Function in Older Adults?

    INTRO:The ability to process complex thoughts, learn things and retain things we’ve learned, are all aspects of cognitive function. As we age, many of these skills decline. Some older adults have reported improvement in cognitive function when they exercise regularly. A new study compared moderate exercise with a health education program to see which one would better preserve cognitive function in older adults. Catherine Dolf explains in this week’s JAMA Report.
    VIDEO B-ROLL Bobby walking on track AUDIO
    VO
    After Bobby Cox retired, he wasn’t doing much of anything.

    AUDIO
    SOT/FULL Bobby Cox – Study Participant Super@:03 Runs:02
    “Sometimes it was hard for me to get up and move.”
    VIDEO
    B-ROLL Carol sitting at table working with test giver
    AUDIO
    VO
    For Carol Miller, living alone means it’s especially important for her memory and thinking to remain clear.

    AUDIO
    SOT/FULL Carol Miller – Study Participant Super@:12 Runs:05
    “I have to be in charge of a household and an automobile and my health.”
    VIDEO
    Split screen of Carol and Bobby, various shots of seniors working out, Dr. Sink talking with staff member, more of Bobby walking on the track

    AUDIO
    VO
    They both participated in a two-year study that included more than 16 hundred sedentary adults, between the ages of 70 and 89. Dr. Kaycee Sink from Wake Forest Baptist Medical Center and co-authors divided the seniors into two groups. Bobby was in the physical activity group.

    AUDIO
    SOT/FULL Kaycee M. Sink, M.D., M.A.S., – Wake Forest Baptist Medical Center Super@:32 Runs:09
    “The goal was to get folks to walk at least 30 minutes at moderate intensity. We also did some lower extremity strength and some flexibility exercises.”
    (Video covering 2nd half of bite: Bobby using ankle weights and lifting his legs with trainer)

    VIDEO
    B-ROLL
    Carol at table with staff member, taking different cognitive tests

    AUDIO
    VO
    Instead of exercise, Carol’s group attended health education seminars on different topics of interest to seniors.

    AUDIO
    SOT/FULL Kaycee M. Sink, M.D., M.A.S., – Wake Forest Baptist Medical Center Super@:47 Runs:08
    “We measured how they were thinking with their memory and complex processing and language function at the very start of the study.”
    AUDIO
    NATSO/FULL Runs:07
    “…I want you to say the name of each picture… acorn…dominoes…”
    GXF FULL JAMA LOGO

    AUDIO
    VO The study appears in JAMA, Journal of the American Medical Association.

    AUDIO SOT/FULL Kaycee M. Sink, M.D., M.A.S., – Wake Forest Baptist Medical Center Super@1:09 Runs:11
    “Both groups preserved their cognitive function over the course of two years. They stayed the same which is really remarkable because we would have expected older adults in this age range to have declined at least some over two years.”
    VIDEO
    B-ROLL Bobby exercising and Carol split screen taking a test AUDIO
    VO
    Bobby is exercising almost every day and Carol stays active by spending time with her grandchildren.

    AUDIO
    SOT/FULL Kaycee M. Sink, M.D., M.A.S., – Wake Forest Baptist Medical Center Super@1:26 Runs:09
    “Older adults should stay active physically, cognitively and socially. All of those things are important to maintaining independence and cognitive function as you age.” (Video covering 2nd half of bite: Seniors exercising)
    VIDEO
    B-ROLL Seniors exercising

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Participants 80 years and older and those who had poorer baseline physical function appeared to get more cognitive benefit from exercise compared to health education.

  • August 18, 2015

    Teens Who Use E-Cigarettes More Likely to Start Smoking

    Teens Who Use E-Cigarettes More Likely to Start Smoking

    INTRO:Over the past several years, electronic or e-cigarettes have grown in popularity.  Today’s e-cigarette users include a growing number of teenagers, many who have never smoked tobacco. A new study looked at whether younger teens that begin using e-cigarettes might also be more likely to experiment with smokable tobacco products.  Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Man smoking e-cigarette, outside of vape shop

    AUDIO
    VO
    E-cigarettes first entered the market as an alternative for adults who wanted to quit smoking. But over the years, things have changed.

    AUDIO
    SOT/FULL
    SOT/FULL
    Adam M. Leventhal, Ph.D. – University of Southern California
    Super@:08
    Runs:09
    “They come in attractive flavors like cotton candy, bubble gum, they’re very hi-tech and you know, they’re modern and cool.”

    VIDEO
    B-ROLL
    Man holding e-cigarette, Michelle smoking cigarette, Michelle using vape pen

    AUDIO
    VO
    Which helps make them very popular with young people. Michelle Mercado, now in her 20’s, smokes regular cigarettes but also started using e-cigarettes in her teens.

    AUDIO
    SOT/FULL
    Michelle Mercado – E-cigarette and Tobacco User
    Super@:25
    Run:09
    “I do see a lot of people like high schoolers and like young adults getting into the whole vape pen and e-cigarette thing.”

    VIDEO
    B-ROLL
    Dr. Leventhal entering room and meeting with his staff, high school kids walking, teen smoking

    AUDIO
    VO
    Dr. Adam Leventhal from the University of Southern California, Keck School of Medicine and co-authors surveyed more than 23 hundred Los Angeles area high school students at the beginning of 9th grade. Students included in the survey all reported never using any smokable tobacco products.

    AUDIO
    SOT/FULL
    Adam M. Leventhal, Ph.D. – University of Southern California
    Super@:49
    Runs:13
    “We compared teens who had used e-cigarettes to teens who hadn’t and we looked to see whether there were differences between those two groups and the initiation of smoking of combustible tobacco products.”

    VIDEO
    B-ROLL
    People getting on bus

    AUDIO
    VO
    THESE STUDENTS WERE SURVEYED AGAIN SIX MONTHS LATER AND ALSO WHEN ENTERING 10TH GRADE.

    AUDIO
    SOT/FULL
    Adam M. Leventhal, Ph.D. – University of Southern California
    Super@1:06
    Runs:17
    “The teens who used e-cigarettes were more than four times more likely to start smoking than teens who hadn’t used e-cigarettes. The associations were consistent across all the different types of tobacco products, regular cigarettes, cigars or even hookah tobacco water pipe.”

    (Video covering 2nd part of bite: guy smoking cigarette)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Adam M. Leventhal, Ph.D. – University of Southern California
    Super@1:27
    Runs:10
    “They were more likely to use two or more products for the first time during high school in comparison to teens who hadn’t used e-cigarettes.”

    VIDEO
    B-ROLL
    Students walking and girl on bike, girl smoking cigarette

    AUDIO
    VO
    This trend continued as the students entered 10th grade. Even when adjusting for other factors like peer pressure, impulsive tendencies, and socio-economic status, all risk factors for starting smoking, these associations remained.

    AUDIO
    SOT/FULL
    Adam M. Leventhal, Ph.D., University of Southern California
    Super@1:50
    Runs:12
    “This uptick that we’re seeing in adolescent e-cigarette use could potentially down the road lead to a new generation of tobacco smokers.”

    (Video covering end of bite: man standing on street smoking cigarette

    VIDEO
    B-ROLL
    Man on the street smoking cigarette

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This was an observational study. Further research is needed to determine whether the association between e-cigarette use and subsequent smoking is causal.

  • August 11, 2015

    Testosterone Therapy Neither Advances or Slows Down Hardening of the Arteries in Older Men with Low or Low-Normal Testosterone Levels

    Testosterone Therapy Neither Advances or Slows Down Hardening of the Arteries in Older Men with Low or Low-Normal Testosterone Levels

    INTRO:As men age, some experience declining testosterone levels. This may affect sexual function, vitality and overall quality of life. The popularity of testosterone supplementation has increased substantially over the last decade, but the long-term effects remain unclear. A new study evaluated whether using testosterone had any effect on hardening of the arteries, which is linked to heart attack and stroke. Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Peter Nowak – Study Participant
    Super@:02
    Runs:10
    “The aging population, the baby boomers, we’re all getting up into our 60’s and so there’s a lot of men’s health issues around our generation.”

    VIDEO
    B-ROLL
    Peter walking out of elevator, testosterone supplements, still pic of clogged arteries

    AUDIO
    VO
    One issue for Peter Nowak and other older men is declining testosterone levels and whether testosterone supplementation has serious side effects like hardening of the arteries or atherosclerosis.

    AUDIO
    SOT/FULL
    Shalender Bhasin, M.B.B.S., – Brigham and Women’s Hospital
    Super@:22
    Runs:13
    “The hardening of the arteries can impair blood flow to the heart and can lead to heart attacks and hardening of the arteries that supply blood to the brain can lead to strokes.”

    VIDEO
    B-ROLL
    Dr. Bhasin walking with Peter, various shots of men walking outside, testosterone gel, Peter in exam room showing where he applied the gel, pic of dye being pumped through heart arteries

    AUDIO
    VO
    Dr. Shalender Bhasin (bah-seen) from Brigham and Women’s Hospital and co-authors studied more than three hundred men. They were 60 years and older, in relatively good health, with low or low-normal testosterone levels. Half the men applied a testosterone gel daily to the skin for three years. The other half applied a placebo gel. Hardening of the arteries was measured in the coronary and carotid arteries, which supply the heart and brain.

    AUDIO
    SOT/FULL
    Shalender Bhasin, M.B.B.S., – Brigham and Women’s Hospital
    Super@:56
    Runs:13
    “Testosterone did not affect the rate of hardening of arteries over the three years duration of the testosterone therapy compared with placebo.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Shalender Bhasin, M.B.B.S., – Brigham and Women’s Hospital
    Super@1:12
    Runs:11
    “Testosterone also did not improve either the sexual function or quality of life in these otherwise healthy men, who had low or low-normal testosterone levels.”

    VIDEO
    B-ROLL
    Various shots of Peter and Dr. Bhasin in exam room talking

    AUDIO
    VO
    The study was blinded so Peter still doesn’t know if he received testosterone or placebo. However, when he saw his doctor last winter, his overall health was stable.

    AUDIO
    SOT/FULL
    Peter Nowak – Study Participant
    Super@1:32
    Runs:05
    “I got a fine bill of health.  She said everything’s good.”

    VIDEO
    B-ROLL
    Peter on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors note that this trial only looked at hardening of the arteries.  Larger studies are needed to determine whether taking testosterone increases the risk of heart attacks, strokes or other cardiovascular events.

  • August 04, 2015

    MINDFULNESS-BASED THERAPY DECREASES POSTTRAUMATIC STRESS DISORDER SYMPTOMS FOR U-S VETERANS

    MINDFULNESS-BASED THERAPY DECREASES POSTTRAUMATIC STRESS DISORDER SYMPTOMS FOR U-S VETERANS

    INTRO:Almost a quarter of U-S Veterans returning from the wars in Iraq and Afghanistan are diagnosed with post-traumatic stress disorder or P-T-S-D. The Veterans Administration has invested heavily in first-line treatments but up to 60 percent of veterans either don’t begin these treatments or drop out early. A new study evaluated another intervention, mindfulness-based stress reduction, to see if it would help veterans improve their P-T-S-D symptoms. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:02
    “…ring…”

    VIDEO
    B-ROLL
    Various shots of Veterans meditating

    AUDIO
    VO
    These Veterans are using mindfulness-based meditation to help manage P-T-S-D symptoms.

    AUDIO
    NATSO/FULL
    Runs:04
    “…becoming aware of the wandering mind…”

    AUDIO
    SOT/FULL
    Kelvin O. Lim, M.D., – Minneapolis VA Medical Center
    Super@:16
    Runs:09
    “Mindfulness is a type of technique that allows one to be more aware of what one is experiencing.”

    (Video covering 1st half of bite: veteran meditating)

    AUDIO
    SOT/FULL
    Melissa A. Polusny, Ph.D., – Minneapolis VA Medical Center
    Super@:19
    Runs:07
    “To be present and aware of their thoughts, their feelings, their experiences in a non-judgmental and accepting way.”

    VIDEO
    B-ROLL
    Freeze shots of all three Veterans

    AUDIO
    VO
    For Veterans John, Jeff and Jeunai (Jeh-nay) this was an unfamiliar way to help with their
    P-T-S-D symptoms.

    AUDIO
    SOT/FULL
    John – U.S. Veteran
    Super@:32
    Runs:05
    “I was skeptical. I didn’t see how it could help me with my problems.”

    AUDIO
    SOT/FULL
    Jeff – U.S. Veteran
    Super@:38
    Runs:07
    “If you could envision a California freeway at night, that’s the type of traffic I had in my head.”

    AUDIO
    SOT/FULL
    Jeunai – U.S. Veteran
    Super@:44
    Runs:12
    “I thought it was hogwash to tell you the truth. I didn’t think it would be beneficial but obviously all the other stuff I was trying wasn’t really working.”

    VIDEO
    B-ROLL
    Dr. Polusny,Dr. Lim and Dr.Erbes walking down the hospital hallway, more group meditation and group therapy, various shots of program facilitators assessing Veterans

    AUDIO
    VO
    Doctors Melissa Polusny (puh-LEWS-knee),Kelvin Lim and their colleagues at the
    Minneapolis V-A Medical Center wanted to determine if the mindfulness intervention
    could help. 116 Veterans with a diagnosis of P-T-S-D participated in the trial. Half the group completed 9 weeks of mindfulness-based stress reduction therapy.The other had group therapy, focusing on current life problems. The Veterans were monitored before, during and after treatment…

    AUDIO
    NASOT/FULL
    Runs:03
    “…does he have any rituals at home, does he check the locks…”

    VIDEO
    B-ROLL
    Facilitators talking

    AUDIO
    VO
    …and also two months after completing therapy.

    AUDIO
    SOT/FULL
    Kelvin O. Lim, M.D., – Minneapolis VA Medical Center
    Super@1:23
    Runs:09
    “There was a greater improvement with the mindfulness
    or meditation intervention but this was a moderate change.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Melissa A. Polusny, Ph.D., – Minneapolis VA Medical Center
    Super@1:36
    Runs:10
    “Mindfulness skills were significantly associated with
    greater improvements in PTSD symptoms and quality-of-life at the two month follow up.”

    AUDIO
    SOT/FULL
    Jeunai – Study Participant
    Super@1:45
    Runs:09
    “I don’t feel like I am treading water anymore and I feel mindfulness has brought me back to who I am and who my family can enjoy again.”

    (Video covering 2nd half of bite: Jeunai talking and smiling)

    AUDIO
    SOT/FULL
    Jeff – Study Participant
    Super@1:55
    Runs:08
    “I wish I would have had this opportunity when I was a young man to be able to have this resource. I would have been a completely different person today.”

    (Video covering 2nd half of bite: Jeff listening to other Vets talking

    AUDIO
    SOT/FULL
    John – Study Participant
    Super@2:03
    Runs:11
    “I feel peace and that has been a situation that has escaped me in the, 40 years since I was last in combat.”

    (Video covering middle of bite: John talking in group session)

    VIDEO
    B-ROLL
    John on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: More studies are needed but study authors say mindfulness may offer a milder form of exposure to trauma then the first-line treatments currently available.

  • July 28, 2015

    Death Rates, Hospitalizations, and Costs Decrease for Medicare Patients

    Death Rates, Hospitalizations, and Costs Decrease for Medicare Patients

    INTRO:Improving the health of Americans and the U.S. health care system in general has been a large focus for Medicare in recent years.  With so many different efforts being undertaken, what exactly are the benefits? A new study examined key outcomes among the Medicare population over the last 15 years.  Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:04
    “…I was very impressed by the service at the hospital…”

    AUDIO
    NATSO/FULL
    Runs:02
    “…everyone was thinking very hard how to help you…”

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@:07
    Runs:07
    “We’re experiencing an unprecedented improvement in the experience of people in the Medicare program.”

    VIDEO
    B-ROLL
    Dr. Krumholz talking with nurses, Dr. Krumholz examining patient, patient’s wife, couple holding hands, Dr. Krumholz talking to patient

    AUDIO
    VO
    Dr. Harlan Krumholz from the Yale University School of Medicine and co-authors reviewed the records of nearly 70 million medicare beneficiaries during a 15 year period, from 1999 thru 2013.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@:28
    Runs:09
    “It’s really important to keep tabs on what we are achieving in health care. We spend a lot of time, a lot of effort, a lot of resources trying to make things better.”

    VIDEO
    Older people outside hospital in wheelchairs

    AUDIO
    VO
    The researchers first looked at improvements in both the Medicare Advantage and fee-for-service programs combined.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@:39
    Runs:07
    “The chance of dying each year has gone down. Almost a 20 percent reduction in the mortality rate on an annual basis.”

    VIDEO
    B-ROLL
    Patient being pushed in a wheelchair, older person walking with cane

    AUDIO
    Then they took a closer look at the fee-for-service group, representing about 75 percent of the overall medicare population.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@:54
    Runs:15
    “We saw for every 100 thousand people in Medicare about 10 thousand fewer hospitalizations. That translates into millions of people not hospitalized in 2013 who would have been hospitalized had those rates not declined.”

    (Video covering middle of bite: empty hospital room)

    VIDEO
    Out of focus shot of patient in hospital room

    AUDIO
    VO
    OTHER PATIENT OUTCOMES WERE ALSO BETTER.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@1:11
    Runs:06
    “The chance of dying after being hospitalized among Medicare beneficiaries dropped dramatically during this period.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@1:21
    Runs:11
    “Many more people were spending many fewer days in the hospital in the last six months of their life.  When you consider in hospital costs and at the end of life there were also fewer dollars being spent.”

    (Video covering 2nd half of bite: doctors in patient room talking, staff working)

    VIDEO
    B-ROLL
    Older people in the community

    AUDIO
    VO
    These improvements were seen across the nation in all populations, by age, gender, and race.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@1:40
    Runs:05
    “We just have to make sure to continue this trend so the next time we look we’re that much better than we are today.”

    (Video covering first half of bite: Doctor looking at monitor)

    VIDEO
    B-ROLL
    Dr. Krumholz on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Overall spending of Medicare patients in the hospital also declined over
    the study period.

  • July 21, 2015

    SURVIVAL AFTER CARDIAC ARREST IMPROVES WHEN MORE PATIENTS RECEIVE BYSTANDER C-P-R AND EXTERNAL DEFIBRILLATION

    SURVIVAL AFTER CARDIAC ARREST IMPROVES WHEN MORE PATIENTS RECEIVE BYSTANDER C-P-R AND EXTERNAL DEFIBRILLATION

    “SURVIVAL AFTER CARDIAC ARREST IMPROVES WHEN MORE PATIENTS RECEIVE BYSTANDER C-P-R AND EXTERNAL DEFIBRILLATION”

    INTRO:If a family member, someone at work, or even the person standing next to you experiences sudden cardiac arrest, would you be able to help? Performing C-P-R and using an automated external defibrillator can mean the difference between life and death. A new study examined what happens if more ordinary people in the community and first-responders, like police officers and firefighters, learn to use these two interventions—can survival for patients having cardiac arrest be improved? Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:03
    “…hey hey buddy, are you ok, are you ok?”

    VIDEO
    B-ROLL
    Volunteers practicing CPR, cu of instructor, volunteers doing CPR

    AUDIO
    VO
    These volunteers are learning about cardiac arrest and how to provide compression only c-p-r.

    AUDIO
    NATSO/FULL
    Runs:02
    “This is CPR without the breaths.”

    VIDEO
    B-ROLL
    Cu of defibrillator pads being fastened onto mannequin

    AUDIO
    VO
    They are also learning how to use an automated external defibrillator or A-E-D.

    AUDIO
    NATSO/FULL
    Runs:08
    “…open packet and apply pads onto patient’s bare skin… analyzing heart rhythm…shock advised…”

    AUDIO
    SOT/FULL
    Christopher B. Granger, M.D., -Duke Clinical Research Institute
    Super@:22
    Runs:08
    “It’s very important that people not be afraid to act when one sees a cardiac arrest.”

    VIDEO
    B-ROLL
    “Miracle Man” video, David at Duke game, getting CPR and defibrillation

    Mandatory Super@:30

    Courtesy: Contrast Creative
    “Miracle Man”

    AUDIO
    VO
    David Foster had a cardiac arrest while attending a Duke basketball game. First responders performed C-P-R and also used an A-E-D located in the arena.

    AUDIO
    SOT/FULL
    Carolina Malta Hansen, M.D., – Duke Clinical Research Institute
    Super@:39
    Runs:07    “We know that the chances of survival fall about 10 percent per minute without any intervention.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Christopher B. Granger, M.D., -Duke Clinical Research Institute
    Super@ 1:26
    Runs:15
    “The only improvement was when people got bystander CPR so this highlights the critical importance for people to learn how to do compression only CPR and then to do it and don’t be afraid to do it.”

    AUDIO
    SOT/FULL
    Carolina Malta Hansen, M.D., – Duke Clinical Research Institute
    Super@1:41
    Runs:12
    “Patients who received bystander or first responder interventions before arrival of the EMS were more likely to survive compared to those who received EMS interventions alone.”

    (Video covering 2nd half of bite: gurney being taking out of ambulance)

    VIDEO
    Newspaper article, pic of David with medical staff
    (Mandatory Super@ 1:53)

    AUDIO
    VO
    Often called the “Miracle Man”, David survived his cardiac arrest and is doing well today.

    AUDIO
    SOT/FULL
    Carolina Malta Hansen, M.D., – Duke Clinical Research Institute
    Super@1:58
    Runs@:06
    “Any intervention is better than no intervention when a person is having a cardiac arrest.”

    VIDEO
    B-ROLL
    David playing basketball with his children

    (Mandatory Super@ 2:04)

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study looked at counties in non-metropolitan areas with very diverse communities.

  • July 13, 2015

    UNDIAGNOSED MATERNAL CANCER MAY EXPLAIN SOME DISCREPANCIES IN PRENATAL TESTING RESULTS

    UNDIAGNOSED MATERNAL CANCER MAY EXPLAIN SOME DISCREPANCIES IN PRENATAL TESTING RESULTS

    INTRO:An increasing number of pregnant women are undergoing non-invasive pre-natal testing to help identify fetal genetic abnormalities. This is done using a blood test that looks at both the D-N-A of the mother and the fetus.  In a small percentage of these tests, the results appear abnormal but the baby’s genetics are actually normal.  A new study examined if the rare diagnosis of maternal cancer could be one cause of such discrepancies. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Pregnant women having blood drawn

    AUDIO
    VO
    This increasingly common blood test can help detect whether a woman is carrying a fetus with a genetic abnormality.

    AUDIO
    SOT/FULL
    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@:07
    Runs:12
    “The test analyzes not only the DNA fragments from the fetus and the placenta but it analyzes DNA fragments from the mother herself.”

    VIDEO
    B-ROLL
    Lab technician working, Dr. Bianchi in lab

    AUDIO
    VO
    For every one thousand women tested, about two will have an abnormal result. It’s recommended those women have additional diagnostic testing looking at only the fetal D-N-A.

    AUDIO
    SOT/FULL
    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@:27
    Runs:19
    “In a small minority of women the test showed that the fetal chromosomes were normal and that disagreed with the blood test. We were examining whether cancer could explain the discrepancy between these two test results.”

    VIDEO
    B-ROLL
    Dr. Bianchi talking in lab with colleagues, Graphic: over lab video
    NON-INVASIVE PRENATAL SCREENING TESTS
    125,426 Tests
    2 Years
    3,757 Abnormal Tests
    10 Diagnosed with Cancer

    AUDIO
    VO
    Dr. Diana W. Bianchi from Tuft’s Medical Center and co-authors examined more than 125 thousand non-invasive prenatal test results done over a two year period. 3,757 women had abnormal test results. 10 of those women were subsequently diagnosed with cancer.

    AUDIO
    SOT/FULL
    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@1:02
    Runs:08
    “If she does have cancer, there’s the possibility that she is shedding DNA from these tumors into her blood.”

    VIDEO
    B-ROLL
    Woman getting an ultrasound

    AUDIO
    VO
    Medical records and additional genetic information were examined in 8 of those women to look for patterns suggestive of an underlying cancer.

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@1:27
    Runs:16
    “There’s a very rare situation in which the mother has cancer, cancer DNA can cause a discrepancy between the prenatal fetal genetic screening test and the fetal chromosome test.”

    (Video covering middle of bite: Ultrasound of fetus)

    VIDEO
    B-ROLL
    Babies in nursery

    AUDIO
    VO
    All 10 women diagnosed with cancer delivered healthy babies.

    AUDIO
    SOT/FULL
    SOT/FULL
    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@1:46
    Runs:14
    “Even though the test was not designed to detect cancer, cancer is an incidental finding. If you recognize the proper signatures then you can go on and have further care.”

    (Video covering end of bite: Dr. Bianchi talking with colleagues)

    VIDEO
    B-ROLL
    Dr. Bianchi talking with colleagues

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This was a preliminary study.  There is currently no clear guidance about follow up testing when discrepancies are found.  Further research is needed.

  • July 07, 2015

    Stroke Associated with Both Immediate and Long-Term Declines in Cognitive Function

    Stroke Associated with Both Immediate and Long-Term Declines in Cognitive Function

    “Stroke Associated with Both Immediate and Long-Term Declines in Cognitive Function”

    INTRO:Each year in the United States nearly 800 thousand people experience a stroke. Stroke is associated with declines in cognitive function, including memory and thinking speed. Although many patients experience these declines immediately after a stroke, a new study looked at whether cognitive decline also continues and even accelerates years after the initial stroke. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    David and nurse leaving hospital waiting room

    AUDIO
    VO
    David Ramon (Rah-man) was at home watching T-V when he had his stroke.

    AUDIO
    SOT/FULL
    David Ramon – Stroke Survivor
    Super@:05
    Runs:05
    “I couldn’t close my hand, the right side of my face was numb.”

    VIDEO
    B-ROLL
    David walking to exam room with nurse

    AUDIO
    VO
    He knew something was very wrong and went to find his wife.

    AUDIO
    SOT/FULL
    David Ramon – Stroke Survivor
    Super@:13
    Runs:11
    “I opened the door and tried to tell her that she should call the doctor.  It was just babble. I couldn’t speak.”

    VIDEO
    B-ROLL
    Various shots of David and Dr. Levine talking in exam room

    AUDIO
    VO
    After his stroke, like many patients, David had immediate problems with memory and his ability to think clearly was impaired.

    AUDIO
    SOT/FULL
    Deborah A. Levine, M.D., M.P.H. – University of Michigan
    Super@:30
    Runs:15    “We have known that stroke is associated with cognitive decline over the short term we did not know whether stroke is associated with declines in thinking speed and memory over the years after the event.”

    VIDEO
    B-ROLL
    Dr. Levine walking down hallway, older people walking outside, computer showing brain images, Dr. Levine doing memory test with David, cu of test, pan from Dr. Levine to David, brain image

    AUDIO
    Dr. Deborah Levine (Lih-veen) from the University of Michigan and co-authors followed more than 23 thousand people, 45 years and older who participated in a national study. The participants were free of any cognitive impairment when they entered the study. Memory and other aspects of cognitive function were measured at the beginning and at regular intervals throughout a six-year follow up period. 515 people experienced a stroke during the study period. The rest remained stroke free.

    AUDIO
    SOT/FULL
    Deborah A. Levine, M.D., M.P.H. – University of Michigan
    Super@1:13
    Runs:15
    “Stroke is associated with significant long-term cognitive decline. Stroke survivors may experience decline in their memory and thinking speed over years after the event, not just right after the event.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Deborah A. Levine, M.D., M.P.H. – University of Michigan
    Super@1:31
    Runs:12
    “Our findings highlight why it’s so important for stroke survivors and people at high risk for stroke to control their risk factors and to make behavior changes.”

    VIDEO
    B-ROLL
    Various shots of Dr. Levine checking David’s heart, David using apps on phone

    AUDIO
    VO
    David is doing just that. He lost 61 pounds and continues to be monitored closely by his doctors. He also uses programs on his phone to help improve his memory and thinking speed.

    AUDIO
    SOT/FULL
    David Ramon – Stroke Survivor
    Super@1:58
    Runs:10
    “I feel more energetic, happier. I do want to live a long time and I’d like that to be as well as possible.”

    (Video covering 1st and last part of bite: various shots of David using apps on his phone)
    VIDEO
    B-ROLL
    David using apps on his phone

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Stroke survivors warrant close monitoring to help detect declines in cognition years after their stroke.

  • June 23, 2015

    Implantable Defibrillators Underused Among Older Patients After Heart Attack

    Implantable Defibrillators Underused Among Older Patients After Heart Attack

    INTRO:Each year more than 350 thousand people die from sudden cardiac death. Placement of an “implantable cardioverter-defibrillator” , or I-C-D, can prevent sudden cardiac death in patients who have weakened heart function, including those who have experienced a previous heart attack.  A new study examined older patients who had weakened heart function after a heart attack and whether or not they underwent placement of these defibrillators and also what portion of the patients were still alive 2 years later. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Paul sitting on exam table talking with Dr. Pokorney, Dr. Pokorney checking monitor

    AUDIO
    VO
    Paul Harrison is getting his defibrillator checked.  His heart was left weakened after three heart attacks and no longer pumps blood as effectively as it should.

    AUDIO
    SOT/FULL
    Paul Harrison – Heart Patient
    Super@ :07
    Runs:07
    “It gave me a warning that something was happening. When it went off my heart had spiked to a really high number.”

    (Video covering middle of bite: cu of monitor, Dr. Pokorney listening to Paul’s heart)

    AUDIO
    SOT/FULL
    Sean D. Pokorney, M.D., M.B.A., – Duke University
    Super@:17
    Runs:12
    “The implantable cardioverter defibrillator when it senses one of these fast life-threatening heart rhythms can deliver a shock to reset the heart and hopefully get the heart back into a regular rhythm.”

    (Video covering 1st part of bite: doctor listening to Paul’s heart)

    AUDIO
    SOT/FULL
    Paul Harrison – Heart Patient
    Super@ :27
    Runs:05
    “It’s happened three times since I’ve had it. It’s actually saved my life.”

    VIDEO
    B-ROLL
    Doctor implanting a defibrillator in patient, nurses monitoring patients vital signs, doctor implanting defibrillator

    AUDIO
    VO
    Guidelines recommend that patients with weakened heart function that qualify for defibrillator placement wait 40 days after a heart attack. This includes patients 65 years and older.

    AUDIO
    SOT/FULL
    Tracy Y. Wang, M.D., M.H.S, M.Sc., – Duke University
    Super@:41
    Runs:13
    “We wanted to see how many of these patients got a defibrillator within the next year after their heart attack and then we wanted to look at their outcomes to two years to see if their death rate was impacted by the defibrillator.”

    (Video covering end of bite: Dr. Pokorney showing Paul his defibrillator on computer screen)

    VIDEO
    B-ROLL
    Various shots of Dr. Wong and Dr. Pokorney looking at heart on computer screen, cu of screen, Dr. Pokorney talking with Paul, examining skin around defibrillator

    AUDIO
    VO
    Doctors Tracy Wang(Wong) and Sean Pokorney from Duke University along with their co-authors examined clinical information from more than 10 thousand Medicare beneficiaries who had had a heart attack from 2007 to 2010. These patients were treated at more than 4 hundred hospitals across the U-S.

    AUDIO
    SOT/FULL
    Sean D. Pokorney, M.D., M.B.A., – Duke University
    Super@1:09
    Runs:06
    “Less than one in ten patients received an ICD within one year of their heart attack.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Tracy Y. Wang, M.D., M.H.S, M.Sc., – Duke University
    Super@1:19
    Runs:11
    “Patients two years later were surviving longer with a defibrillator. The patients who are 80 years or older we found an association with better survival when a defibrillator was implanted.”

    Video covering 2nd half of bite: doctor implanting a defibrillator)

    VIDEO
    B-ROLL
    Various shouts of Dr. Pokorney showing Paul his defibrillator

    AUDIO
    VO
    Patients who followed up with their doctors within 2 weeks after hospital discharge were more likely to get a defibrillator as were patients who underwent previous heart bypass surgery.  Paul says he is grateful for this life-saving technology.

    SOT/FULL
    SOT/FULL
    Paul Harrison – Heart Patient
    Super@ 1:41
    Runs:11
    “You come to a crossroads in your life to where you either give up or make the most of what you have left. I felt like they gave me three chances and not many people get one or two.”

    (Paul and his wife walking out of hospital)

    VIDEO
    B-ROLL
    Paul and wife walking

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The study results found that larger hospitals also had low defibrillator implantation rates in this medicare population.

  • June 09, 2015

    New Control System Shows Potential to Improve Function of Motorized Prosthetic Legs

    New Control System Shows Potential to Improve Function of Motorized Prosthetic Legs

    INTRO:Bending an ankle or knee while walking is second nature to most of us. Tiny electrical signals contract the leg muscles helping the joints move. Currently, most prosthetic legs can’t move that way. A new study examined if using the electrical signals generated when muscles contract, which already help guide motorized prosthetic arms, can also make it easier for people to walk with a motorized prosthetic leg.  Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Split screen of Terry and Hailey walking with motorized leg, Terry going down step

    AUDIO
    VO
    Artist Terry Karpowicz (Car-pah-wits) and tri-athlete Hailey Danisewicz (dan-ih-seh-vich) are helping test the next generation of prosthetic legs. A motorized leg that bends at the knee and ankle.

    AUDIO
    SOT/FULL
    Terry Karpowicz – Study Participant
    Super@:10
    Runs:08
    “This one allows me the opportunity to flow down the stairs and not really think about the process of what the next step is.”

    (Video covering 2nd half of bite: Terry going walking down stairs)

    VIDEO
    B-ROLL
    SOT/FULL
    Hailey Danisewicz – Study Participant
    Super@:18
    Runs:04
    “It feels great, you know just being able to go down with that really natural movement.”

    VIDEO
    B-ROLL
    Hailey walking up ramp, cu of TV screen showing EMG signals

    AUDIO
    VO
    This motorized leg harnesses electrical signals generated by their upper leg muscles.These signals are known as E-M-G.

    AUDIO
    SOT/FULL
    SOT/FULL
    Levi J. Hargrove, Ph.D., – Rehabilitation Institute of Chicago
    Super@:29
    Runs:10
    “We pick them up with tiny antennas called electrodes. When the electrodes touch the skin you can detect the EMG signals and we pick those signals up and decode them.”

    (Video covering 2nd half of bite: woman sitting at desk looking at computer, reverse shot computer screen, cu of computer screen)

    VIDEO
    B-ROLL
    Hailey walking down ramp

    AUDIO
    VO
    These signals help tell the leg how to move.

    AUDIO
    NATSO/FULL
    Runs:03    “…looking good…”

    VIDEO
    B-ROLL
    Terry walking up stairs with current prosthetic leg

    AUDIO
    Traditional prosthetic legs are passive, functioning almost like a fancy walking stick.

    AUDIO
    SOT/FULL
    Levi J. Hargrove, Ph.D., – Rehabilitation Institute of Chicago
    Super@:48
    Runs:07
    “With this prosthetic leg the power pushes you along.  It can push you up and out of a seat.  It can push you up stairs or slopes.”

    (Video covering middle of bite: Hailey going up stairs with motorized leg)

    VIDEO
    B-ROLL
    Dr. Hargrove walking with Hailey as she comes down the ramp, team members sitting and standing near Hailey, Terry going up ramp, Hailey going up steps with therapist

    AUDIO
    VO
    Dr. Levi Hargrove from the Rehabilitation Institute of Chicago and co-authors tested two different ways to use the motorized leg in a group of 7 patients, all with lower limb amputations. One way incorporated E-M-G, the other way did not.  Each patient tested both methods but was not aware of which method was being used at a given time.

    AUDIO
    SOT/FULL
    Levi J. Hargrove, Ph.D., – Rehabilitation Institute of Chicago
    Super@1:14
    Runs:09
    “The system that did not incorporate neural signals, we noticed that it had a few more errors.  It’s like stubbing your toe or kicking the bottom of the stair.”

    (Video covering 2nd half of bite: Hailey hitting leg on step)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Levi J. Hargrove, Ph.D., – Rehabilitation Institute of Chicago
    Super@1:26
    Runs:11
    “Using EMG signals resulted in a leg that behaved better, made fewer mistakes and people liked to use it better. It reduced error rates by almost 50 percent.”

    (Video covering 2nd half of bite: Terry walking up stairs)

    AUDIO
    SOT/FULL
    Terry Karpowicz – Study Participant
    Super@ 1:38
    Runs:07
    “It allows me that freedom to just be who I am, not necessarily an amputee.”

    AUDIO
    SOT/FULL
    Hailey Danisewicz – Study Participant
    Super@1:44
    Runs:12
    “This is kind of the closest I’ve gotten to having, having two legs again. What we’re working on in this lab is eventually going to change the lives of amputees everywhere. I mean it’s great.”

    (Video covering middle of bite: Hailey walking with leg)

    VIDEO
    B-ROLL
    Hailey on camera

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:All the participants had above the knee or through the knee amputations.

  • June 02, 2015

    Antidepressants in Late Pregnancy May Be Associated with a Small Increase in Risk of Severe Breathing Disorder in Newborns

    Antidepressants in Late Pregnancy May Be Associated with a Small Increase in Risk of Severe Breathing Disorder in Newborns

    INTRO:A 2006 health advisory from the Food and Drug Administration alerted women that taking certain types of anti-depressants late in pregnancy could increase the risk of a severe and life-threatening breathing disorder in their newborns. In 2011, the F-D-A updated the advisory saying it was too early to reach firm conclusions about a possible link. A new study examines whether taking anti-depressants during late pregnancy increases the risk for this condition known as P-P-H-N. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Babies in nursery, babies feet and stomach going up and down

    AUDIO
    VO
    Babies breathe very differently before and after birth.

    AUDIO
    SOT/FULL
    Krista F. Huybrechts, M.S., Ph.D., – Brigham and Women’s Hospital
    Super@:05
    Runs:05
    “Before birth, the baby’s blood circulates differently while in the uterus.”

    VIDEO
    B-ROLL
    Various shots of pregnant woman getting ultrasound, graphic: full screen of incubator with PPHN sliding onto screen and highlighting first letters PPHN, Dr. Huybrechts walking in hospital, cu shots of antidepressant medications, Dr. Huybrechts talking with nurse, showing nurse the medication

    AUDIO
    VO
    The fetus gets oxygen from its mother. The developing lungs are not used for breathing.  After birth this should change. Persistent pulmonary hypertension or p-p-h-n occurs when the baby does not adapt to breathing outside the womb. Dr. Krista Huybrechts (Hau-brecks) from Brigham and Women’s Hospital in Boston and co-authors examined medical records of nearly 4 million publicly insured women, all diagnosed with depression, who filled a prescription for anti-depressants during the last 90 days of pregnancy.  The researchers were most interested in use of selective serotonin re-uptake inhibitor anti-depressants or S-S-R-Is.

    AUDIO
    SOT/FULL
    Krista F. Huybrechts, M.S., Ph.D., – Brigham and Women’s Hospital
    Super@:42
    Runs:08
    “The large majority of those women, around 80 percent, used an SSRI as opposed to a non-SSRI antidepressant.”

    VIDEO
    B-ROLL
    Pregnant women walking, baby in incubator with nurse and doctor around him

    AUDIO
    VO
    The records of women who did not take an antidepressant were also examined.  The number of babies born with P-P-H-N was compared in each group.

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Krista F. Huybrechts, M.S., Ph.D., – Brigham and Women’s Hospital
    Super@1:09
    Runs:17
    “Once we accounted for potential differences in the characteristics of women belonging to these different exposure groups we did not find an increase in the risk of PPHN associated with either SSRI antidepressants nor for non-SSRI antidepressants.”

    (Video covering middle of bite: babies in nursery)

    VIDEO
    B-ROLL
    Pregnant women, babies in nursery

    AUDIO
    VO
    Those characteristics included diabetes and obesity, both of which are known risk factors for P-P-H-N.

    AUDIO
    SOT/FULL
    SOT/FULL
    Krista F. Huybrechts, M.S., Ph.D., – Brigham and Women’s Hospital
    Super@1:33
    Runs:15    “This is important information for clinicians and their patients when they are weighing the risks and benefits of continuing antidepressant medication use during pregnancy or potentially initiating medication use during pregnancy.”

    (Video covering 2nd half of bite: antidepressant medications)

    VIDEO
    B-ROLL
    Antidepressant medications

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The risk of P-P-H-N in the study population ranged between 20 and 30 cases per ten thousand births.

  • May 26, 2015

    Mild Thyroid Overactivity Associated With Increased Risk of Fractures

    Mild Thyroid Overactivity Associated With Increased Risk of Fractures

    INTRO:The thyroid gland makes hormones that regulate metabolism.  The thyroid also has other important effects throughout the body.  An overactive thyroid can increase the risk of osteoporosis and fractures. A new study examined whether the risk of these fractures also increases among patients with only mild abnormalities of the thyroid, those who have not developed any physical symptoms as a result of having too much or too little thyroid hormone.  Catherine Dolf explains in this week’s JAMA Report.

    NATSO/FULL
    Runs:08
    “…the thyroid is a butterfly shaped gland and it sits right at the base of your neck…the thyroid can cause problems from overactivity or from underactivity…”

    VIDEO
    B-ROLL
    Graphic: Underactive/Overactive thyroid and symptoms, Dr. Cappola examining patient

    AUDIO
    VO
    An underactive thyroid can cause constipation, unexplained weight gain, or fatigue. An overactive thyroid can do the opposite; symptoms might include, weight loss, anxiety, and heart palpitations.  Too much thyroid hormone can also increase the risk for osteoporosis and fractures. But for people who only have mild abnormalities in thyroid activity and don’t have any of these symptoms, do they also increase their risk for fractures?

    AUDIO
    NATSO/FULL
    Runs:01
    “…can you swallow please…”

    VIDEO
    B-ROLL
    Dr. Cappola walking down hall into an exam room, looking at x-ray on the computer, people walking outside, technician doing testing, Dr. Cappola looking at x-rays

    AUDIO
    VO
    Dr. Anne Cappola from the University of Pennsylvania and co-authors examined the results of 13 individual research studies that included more than 70 thousand patients from all over the world. All patients had testing of their thyroid hormone levels and were followed for an average of 12 years to see whether or not they experienced fractures.

    AUDIO
    SOT/FULL
    Anne R. Cappola, M.D., Sc.M., – University of Pennsylvania, Perelman School of Medicine
    Super@:52
    Runs:06
    “We found that three percent had a slightly overactive thyroid, five percent had a slightly underactive thyroid.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Anne R. Cappola, M.D., Sc.M., – University of Pennsylvania, Perelman School of Medicine
    Super@1:01
    Runs:14
    “Those who had the slightly overactive thyroid were more likely to have hip fractures and more likely to have any kind of fracture. The people who had just a little bit underactive thyroid didn’t have any fracture risk at all from having that thyroid problem.”

    VIDEO
    B-ROLL
    Dr. Cappola and patient talking in exam room

    AUDIO
    VO
    Currently, routine thyroid screening is not recommended.

    AUDIO
    SOT/FULL
    Anne R. Cappola, M.D., Sc.M., – University of Pennsylvania, Perelman School of Medicine
    Super@1:18
    Runs:15
    “If someone has a slightly overactive thyroid that’s something that needs to be paid attention to. What it suggests is if somebody has increased risk of fracture from having a slightly overactive thyroid that perhaps if we were to correct that and treat that we could prevent fractures.”

    (Video covering last part of bite: Spinal x-ray on computer)

    VIDEO
    B-ROLL
    Spinal x-ray

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The average age of patients that underwent thyroid testing was 64 and 61 percent were women.

  • May 19, 2015

    Oral Steroids Do Not Improve Sciatica Pain

    Oral Steroids Do Not Improve Sciatica Pain

    INTRO: Steroids are commonly prescribed for patients who suffer from lower back and leg pain caused by a herniated disc. But how well do these anti-inflammatory medications actually work? A new study looked at a common oral steroid medication and its effectiveness in decreasing pain and improving function for patients with a herniated disc. Catherine Dolf has more in this week’s JAMA Report.

     

    VIDEO

    B-ROLL

    Various shots of people walking outside

     

    AUDIO

    VO

    Every day, thousands of people head to their doctor’s office looking for relief from a very common problem.

     

    AUDIO

    NATSO/FULL Runs:02

    “…if you have any discomfort you tell me…”

     

    VIDEO

    B-ROLL

    Dr. Goldberg examining patient

     

    AUDIO

    VO

    It’s called sciatica.

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern California

    Super@:16

    Runs:10

    “Acute sciatica is often disabling, extremely painful condition felt down the leg. It’s usually caused by a ruptured disc in the lumbar area.”

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@:20

    Runs:08

    “We’ve begun looking at other ways to decrease the pain and improve function more easily for patients with sciatica.”

    VIDEO

    B-ROLL

    Dr. Goldberg lifting patients leg, prednisone tablet poured out on table

     

    AUDIO

    VO

    There are limited options for treating this painful condition. One of the most common approaches is to prescribe the oral steroid medication called prednisone.

     

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@:36

    Runs:04

    “But it’s never been studied to see if in fact it makes a difference.”

    VIDEO

    B-ROLL

    Dr. Goldberg and Dr. Avins walking, looking at MRI, patient going into MRI machine, cu of prednisone tablets

    AUDIO

    Doctors Harley Goldberg and Andrew Avins from Kaiser Permanente Northern California and co-authors studied 269 patients with sciatica. All patients underwent an m-r-i to confirm that they had a herniated disc. Two-thirds were given oral prednisone and the other third got a placebo. Patients were assessed for pain and overall function after three weeks and again at one year.

     

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@1:01

    Runs:13

    “People got no better with the prednisone than they did with the placebo, that is to say, they both got better equally. There was actually a little bit of improved functional capacity for people that took prednisone.”

    GXF FULL

    JAMA LOGO

     

    AUDIO

    VO

    The study appears in JAMA, Journal of the American Medical Association.

     

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern

    Super@1:17

    Runs:10

    “We also found that patients who took steroids had more side effects than patients who took the placebo but most of those side effects were fairly mild and transient in nature.”

     

    VIDEO

    B-ROLL

    Dr. Goldberg raising patients leg

     

    AUDIO

    VO

    The authors say these results provide important evidence about the relative risks and benefits of steroid therapy.

     

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern

    Super@1:33

    Runs:15

    “We now have guidance, we have information and we can provide for our patients, true meaningful and informed discussions about the relative benefits and risks of this kind of therapy for this kind of condition.”

    VIDEO

    B-ROLL

    Cu on computer screen, pan up to Dr. Goldberg and Dr. Avins

     

    AUDIO

    Catherine Dolf, the JAMA Report.

     

     

    Tag:Study authors say, while these new data are important, additional studies are needed to evaluate other treatments that may be effective for this common condition.

  • May 19, 2015

    Oral Steroids Do Not Improve Sciatica Pain

    Oral Steroids Do Not Improve Sciatica Pain

    INTRO: Steroids are commonly prescribed for patients who suffer from lower back and leg pain caused by a herniated disc. But how well do these anti-inflammatory medications actually work? A new study looked at a common oral steroid medication and its effectiveness in decreasing pain and improving function for patients with a herniated disc. Catherine Dolf has more in this week’s JAMA Report.

     

    VIDEO

    B-ROLL

    Various shots of people walking outside

     

    AUDIO

    VO

    Every day, thousands of people head to their doctor’s office looking for relief from a very common problem.

     

    AUDIO

    NATSO/FULL Runs:02

    “…if you have any discomfort you tell me…”

     

    VIDEO

    B-ROLL

    Dr. Goldberg examining patient

     

    AUDIO

    VO

    It’s called sciatica.

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern California

    Super@:16

    Runs:10

    “Acute sciatica is often disabling, extremely painful condition felt down the leg. It’s usually caused by a ruptured disc in the lumbar area.”

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@:20

    Runs:08

    “We’ve begun looking at other ways to decrease the pain and improve function more easily for patients with sciatica.”

    VIDEO

    B-ROLL

    Dr. Goldberg lifting patients leg, prednisone tablet poured out on table

     

    AUDIO

    VO

    There are limited options for treating this painful condition. One of the most common approaches is to prescribe the oral steroid medication called prednisone.

     

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@:36

    Runs:04

    “But it’s never been studied to see if in fact it makes a difference.”

    VIDEO

    B-ROLL

    Dr. Goldberg and Dr. Avins walking, looking at MRI, patient going into MRI machine, cu of prednisone tablets

    AUDIO

    Doctors Harley Goldberg and Andrew Avins from Kaiser Permanente Northern California and co-authors studied 269 patients with sciatica. All patients underwent an m-r-i to confirm that they had a herniated disc. Two-thirds were given oral prednisone and the other third got a placebo. Patients were assessed for pain and overall function after three weeks and again at one year.

     

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@1:01

    Runs:13

    “People got no better with the prednisone than they did with the placebo, that is to say, they both got better equally. There was actually a little bit of improved functional capacity for people that took prednisone.”

    GXF FULL

    JAMA LOGO

     

    AUDIO

    VO

    The study appears in JAMA, Journal of the American Medical Association.

     

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern

    Super@1:17

    Runs:10

    “We also found that patients who took steroids had more side effects than patients who took the placebo but most of those side effects were fairly mild and transient in nature.”

     

    VIDEO

    B-ROLL

    Dr. Goldberg raising patients leg

     

    AUDIO

    VO

    The authors say these results provide important evidence about the relative risks and benefits of steroid therapy.

     

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern

    Super@1:33

    Runs:15

    “We now have guidance, we have information and we can provide for our patients, true meaningful and informed discussions about the relative benefits and risks of this kind of therapy for this kind of condition.”

    VIDEO

    B-ROLL

    Cu on computer screen, pan up to Dr. Goldberg and Dr. Avins

     

    AUDIO

    Catherine Dolf, the JAMA Report.

     

     

    Tag:Study authors say, while these new data are important, additional studies are needed to evaluate other treatments that may be effective for this common condition.

  • May 05, 2015

    Non-Aggressive Strain of Bacteria Helps Reduce Recurrent C. difficile Infection

    Non-Aggressive Strain of Bacteria Helps Reduce Recurrent C. difficile Infection

    INTRO:C-difficile or C-diff., is a common and sometimes deadly health care-associated infection. Almost 500 thousand cases are diagnosed each year in the U.S., usually affecting hospitalized patients and others taking antibiotics. The symptoms include severe diarrhea and colitis. Even after treatment, C-diff. frequently returns. A new study examined a potential way to prevent the infection from coming back. Catherine Dolf has more this week’s JAMA Report.

    VIDEO
    B-ROLL
    Pics of Cheryl biking and traveling, pic of C diff

    AUDIO
    VO
    Cheryl O’Riordan loves to bike, travel and volunteer but a bout with this bacteria, c-difficile, changed her life.

    AUDIO
    SOT/FULL Super@:06 Cheryl O’Riordan – C. difficile Patient Runs:07
    “I felt like the lining of my colon was being ripped out.” “I needed to be near a washroom at all times.”

    VIDEO
    B-ROLL
    Dr. Johnson listening to Cheryl’s heart

    AUDIO
    VO
    Dr. Stuart Johnson from Loyola University Health System treated Cheryl for her c-diff infection.

    AUDIO
    SOT/FULL Super@:18 Stuart Johnson – Loyola University Health System Runs:11
    “C diff is an opportunistic bacteria.” It can travel down the gut, start to replicate, produce the toxins and cause the manifestations that we refer to as C diff.”

    (Video covering 2nd half of bite: technician looking at petri dish)

    VIDEO
    B-ROLL
    Graphic: pic of C diff , various lab shots, technician working with vials

    AUDIO
    VO
    About 25 to 30 percent of patients see a return of the infection. However, some patients carry strains of c-diff that do not make the toxins that are responsible for symptoms of infection, in this case, severe diarrhea; these are called non-toxigenic strains.

    AUDIO
    SOT/FULL Super@:42 Dale N. Gerding, M.D., – Edward Hines Jr. VA Hospital Runs:09
    “If that strain can be established in your gut it will keep out the toxigenic strains, in fact, it may even force out some of these toxigenic strains.”

    VIDEO
    B-ROLL
    Dr. Gerding walking in his lab, technician laying out several petri dishes, technician taking sample from petri dish

    AUDIO
    VO
    Dr. Dale Gerding from the Edward Hines V-A Hospital and co-authors looked at 168 patients who had been successfully treated for c-diff and randomly assigned them to four groups. Three of the groups received varying doses of the non-toxigenic c-diff strain. The fourth group received a placebo.

    AUDIO
    SOT/FULL Super@1:06 Dale N. Gerding, M.D., – Edward Hines Jr. VA Hospital Runs:16
    “The secret clearly was to get these patients to be colonized with this nontoxigenic strain, which just means that these strains set up housekeeping in the G-I tract. We got about 70 percent of patients to colonize with this strain after treatment.”

    (Video covering middle of bite: Dr. Gerding looking into microscope, cu of lens)

    GXF FULL
    JAMA COVER

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL Super@1:26 Dale N. Gerding, M.D., Edward Hines Jr. VA Hospital Runs:16
    “We were able to reduce the recurrence rate from 30 percent in the placebo group down to 11 percent for all patients who got the nontoxigenic strain and for the dose that worked the best the recurrence rate was 5 percent.”

    VIDEO
    B-ROLL
    Technician taking specimen out of freezer

    AUDIO
    VO
    Administration of non-toxigenic strains did not result in any severe side effects compared with placebo.

    AUDIO
    SOT/FULL Super@1:47 Dale N. Gerding, M.D., Edward Hines Jr. VA Hospital Runs:08
    “It’s the first time that we’ve taken a strain of the same bacteria that causes the disease and actually used it as a preventive measure.”

    VIDEO
    Cheryl walking, sitting outside talking on phone

    AUDIO
    VO
    Luckily Cheryl did not have a recurrence of c-diff.  Her health is back to normal and she is looking forward to…

    AUDIO
    SOT/FULL Super@2:02 Cheryl O’Riordan – C. difficile Patient Runs:02
    “My next trip.”…(laugh)

    VIDEO
    Pic of Cheryl on vacation

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The non-toxigenic c-diff bacteria only stays in the g-i tract temporarily.  Study authors say this corresponds to when a patient’s normal bacteria is recovered, which pushes out the non-toxigenic strain.

  • April 28, 2015

    Emergency Department Intervention Improves Rate of Treatment for Opioid Dependence

    Emergency Department Intervention Improves Rate of Treatment for Opioid Dependence

    INTRO:Those struggling with addictions to prescription drugs and heroin often seek care in hospital emergency departments. However, the primary option available for emergency department staff is referral to addiction treatment services. A new study evaluated whether these patients would be more successful in seeking and staying in addiction treatment if they began effective treatment in the emergency department. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Michael walking into hospital emergency department

    AUDIO
    VO
    Like others who have struggled with drug addiction, Michael McCrorken was no stranger to hospital emergency departments.

    AUDIO
    SOT/FULL Super@:07 Michael McCrorken Runs:07
    “I was literally just enslaved to my addiction and it was awful.”

    AUDIO
    SOT/FULL Super@:14 Gail D’Onofrio, M.D., M.S., – Yale School of Medicine Runs:09
    “These patients often seek care in the emergency department and often are just turned away and not directed to treatment.”

    VIDEO
    B-ROLL
    Dr. D’Onfrio, Dr. Fiellin and another doctor walking down hallway in ED, EMT’s walking with gurney, staff treating patient, wide shot of emergency department desk, pan of medication buprenorphine, cu of person getting blood pressure taken

    AUDIO
    VO
    Doctors Gail D’Onofrio (dah-naw-free-oh) and David Fiellin (feh-leen) from the Yale School of Medicine and co-authors enrolled 329 patients with opioid dependence from the emergency department at Yale-New Haven Hospital. One group received a referral to drug treatment. The second group underwent a brief intervention and referral to treatment.  The third group was started on buprenorphine (bew-puh-nor-feen), a medication that helps ease withdrawal symptoms and drug cravings. This group also followed up in primary care for maintenance therapy.

    AUDIO
    SOT/FULL Super@:49 David A. Fiellin, M.D., – Yale School of Medicine Runs:10
    “Once they came to the primary care center we organized their treatment and provided them that treatment for at least a 10 week period of time.”
    AUDIO
    SOT/FULL Super@:58 Gail D’Onofrio, M.D., M.S., – Yale School of Medicine Runs:06
    “Those patients that were randomized to the buprenorphine group, almost 80 percent of them were in treatment at 30 days.”

    AUDIO
    SOT/FULL Super@1:04 David A. Fiellin, M.D., – Yale School of Medicine Runs:07
    “And this is twice the number who will be engaged in treatment if they simply receive a referral to treatment.”

    GXF FULL
    JAMA COVER

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL Super@1:15 Gail D’Onofrio, M.D., M.S., – Yale School of Medicine Runs:07
    “We also found that those patients that were assigned to the buprenorphine group used less illicit opiates.”

    (Video covering 2nd half of bite: medication box)

    VIDEO
    B-ROLL
    Michael walking with ED nurse

    AUDIO
    VO
    Michael says one of the biggest concerns he and others faced was waiting to get into treatment.

    AUDIO
    SOT/FULL Super@1:27 Michael McCrorken Runs:07
    “If you go to the emergency room and they’ll treat you immediately versus waiting then it’s an asset.”

    (Video covering bite: Michael and doctors talking)

    VIDEO
    Michael walking outside

    AUDIO
    VO
    Michael has been in recovery for six years and is now studying business management.

    AUDIO
    SOT/FULL Super@1:39 Michael McCrorken Runs:05
    “I’ve never seen such a bright future and I never knew that I had it in me.”

    VIDEO
    Michael on camera

    AUDIO
    Catherine Dolf, the JAMA Report.
    Tag:In order to provide buprenorphine, emergency room physicians must complete extra training on opioid dependence and receive a special wavier from the Federal Drug Enforcement Agency.

     

  • April 21, 2015

    No Association Found Between Measles, Mumps, Rubella Vaccine and Autism, even among Children at Higher Risk

    No Association Found Between Measles, Mumps, Rubella Vaccine and Autism, even among Children at Higher Risk

    INTRO:Although multiple studies over the past 15 years have shown no link between the measles-mumps-rubella (or M-M-R) vaccine and autism spectrum disorders, parents and others continue to associate the vaccine with autism. A new study examined whether or not the M-M-R vaccine was associated with an increased risk of autism spectrum disorders especially in children whose older sibling already had an autism diagnosis. Catherine Dolf has more in this week’s JAMA Report.

    NATSO/FULL
    Runs:03
    “…waaaaaah…all done…”

    VIDEO
    B-ROLL
    Child getting vaccinated, vaccine in refrigerator, children in park

    AUDIO
    VO
    Receiving the measles-mumps-rubella or m-m-r vaccine has been a sometimes painful but routine part of a young child’s visit to the doctor. However, there have been questions about the safety of the MMR vaccine especially from parents who have children diagnosed with autism spectrum disorders or A-S-D.

    AUDIO
    SOT/FULL Super@:19 Anjali Jain, M.D., – The Lewin Group Runs:14
    “Many of them attribute their child’s autism spectrum disorders to the MMR vaccine. As a result they’re not always vaccinating those kids and their siblings as readily as other parents.”

    (Video covering 2nd part of bite: child getting vaccinated)

    VIDEO
    B-ROLL
    Dr. Jain walking outside, dissolve to her in office, cu of her on computer, various shots of children in park, family walking

    AUDIO
    VO
    Dr. Anjali (un-juh-lee) Jain (Jan) from the Lewin (LOO-WIN) Group and co-authors studied more than 95 thousand children enrolled in a large commercial health plan, following them from birth to at least five years of age. These children all had an older sibling enrolled in the plan. Researchers were particularly interested in children whose older sibling had an A-S-D diagnosis since that puts the younger child at a higher risk for A-S-D.

    AUDIO
    SOT/FULL Super@:54 Anjali Jain, M.D., – The Lewin Group Runs:18
    “We found no evidence of a harmful association between the MMR vaccine and autism spectrum disorders. This was true even among those children who were at an increased risk of having autism spectrum disorders by virtue of having an older sibling with ASD.”

    (Video covering middle of bite: vial of MMR vaccine)

    GXF FULL
    JAMA COVER

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIOSuper@1:16 Anjali Jain, M.D., – The Lewin Group Runs:12
    SOT/FULL
    “We found parents who have a child with an autism spectrum disorder already are vaccinating about 10 percent less than the parents of children who have unaffected siblings.”

    VIDEO
    B-ROLL
    Various shots of children walking outside

    AUDIO
    VO
    Dr. Jain (jan) says among the 95 thousand children just under a thousand were diagnosed with A-S-D, about one percent, similar to the prevalence in the general population.

    AUDIO
    SOT/FULL Super@1:37 Voice of:Anjali Jain, M.D., – The Lewin Group Runs:12
    “This study confirms the safety of the MMR vaccine using recent objective data in a very large data set. We hope that this reassures parents when they are making healthcare decisions for their children.”

    (Video covering first part of bite:  MMR vaccine in boxes, nurse showing mom information, mom holding child)

    VIDEO
    B-ROLL
    Mom holding child

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:Using a very large objective data base is important when looking at autism spectrum disorders because the condition varies so much from child to child.

  • April 14, 2015

    Intrauterine Exposure to Maternal Gestational Diabetes Associated With Increased Risk of Autism

    Intrauterine Exposure to Maternal Gestational Diabetes Associated With Increased Risk of Autism

    INTRO: When a fetus is exposed to high blood glucose because of maternal diabetes, this can have long-lasting effects on development. A new study examined whether exposure to maternal diabetes during pregnancy is associated with an increased risk of autism spectrum disorders in children. Catherine Dolf has more in this week’s JAMA Report.

    NATSO/FULL
    Runs:05
    “…wow, look at you…say yay…”

    VIDEO
    B-ROLL
    Megan clapping and hugging Levi, Levi working with therapist, Megan watching Levi and the therapist

    AUDIO
    VO
    2 year-old Levi Dahlberg was only recently diagnosed with autism but his mom Megan knew there was something different about him before that.

    AUDIO
    SOT/FULL Super@:11 Megan Dahlberg – Levi’s Mother Runs:11
    “Levi was saying hi and bye, kitty and tree and right about the same time he started walking he just stopped. Any sort of communication just went away around 16 months.”

    (Video covering end of bite: Levi walking to mom)

    AUDIO
    SOT/FULL Super@:23 Edward S. Curry, M.D., – Kaiser Permanente Southern California Runs:13
    “Early in pregnancy that first and second trimester is where the fetal brain is developing That’s a period of time where the brain is most susceptible to insults, so having an elevated blood sugar is an insult to that fetus.”

    (Video covering middle of bite: woman getting ultrasound)

    VIDEO
    B-ROLL

    AUDIO
    VO
    Doctors Edward Curry and Anny (Eh-knee) Xiang (She-ong) from Kaiser Permanente Southern California and co-authors reviewed the medical records of more than 322 thousand children, born at Kaiser Permanente hospitals between 1995 and 2009. They identified the mothers’ diabetes status during pregnancy and also examined how many children were diagnosed with autism spectrum disorders.

    AUDIO
    SOT/FULL Super@:54 Anny H. Xiang, Ph.D., – Kaiser Permanente Southern California Runs:13
    “Exposure to gestational diabetes diagnosed before 26 weeks gestation was associated with increased risk of autism spectrum disorders in the offspring.”

    GXF FULL
    JAMA COVER

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL Super@1:15 Anny H. Xiang, Ph.D., – Kaiser Permanente Southern California Runs:09
    “For the children of mothers diagnosed after 26 weeks of gestation, there was no increased risk of having autism spectrum disorders.”

    (Video covering 1st part of bite: pregnant women walking)

    VIDEO
    B-ROLL
    Pregnant women walking and sitting

    AUDIO
    VO
    There was also no increased risk of autism spectrum disorders observed in children of mothers diagnosed with diabetes before pregnancy as well as those without diabetes.

    AUDIO
    SOT/FULL Super@1:32 Edward S. Curry, M.D., – Kaiser Permanente Southern California Runs:13
    “Early pre-natal care is vitally important for mothers. You want the mothers to come in not only to check for diabetes but also to be on their pre-natal vitamins, those things that can have a positive impact on the developing fetus.”

    (Video covering middle and end of bite: ultra sound screen pan down to mother’s belly)

    VIDEO
    B-ROLL
    Megan watching Levi working with therapist

    AUDIO
    VO
    While Megan did not have diabetes during her pregnancy, she is grateful for ongoing autism research.

    AUDIO
    SOT/FULL Super@1:50 Megan Dahlberg – Levi’s Mother Runs:11
    “I hope that one day he does not have a diagnosis, that it can be cured.  You just want them to be able to thrive both socially and intellectually and that’s my hope.”

    (Video covering end of bite: Levi working with therapist on mini-trampoline)

    VIDEO
    B-ROLL
    Levi smiling at therapist

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The study authors note that this was an observational study and further studies are needed to confirm the findings and better understand the nature of this association.

  • December 22, 2015

    New Research Suggests Increased Number of I-V-F Cycles Can Be Beneficial

    New Research Suggests Increased Number of I-V-F Cycles Can Be Beneficial

    INTRO:Women facing infertility often turn to in vitro fertilization or I-V-F.  Although I-V-F technology has improved, there is still a widely held belief that if a woman doesn’t experience a successful live birth after three or four I-V-F cycles her chances of a successful live birth going forward are very low.  A new study looked at I-V-F success rates after repeated treatment cycles well beyond the third or fourth attempts.  Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Babies in nursery, cu of babies hand

    AUDIO
    VO
    Having a healthy baby is the goal of every woman trying to conceive, including those seeking the help of in vitro fertilization, or I-V-F.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@:07
    Runs:07
    “When you first embark on IVF treatment you should not be put off if you don’t have success after the first, the second, the third cycle.”

    VIDEO
    B-ROLL
    Various shots of technicians in lab

    AUDIO
    VO
    I-V-F technology has improved over recent years. One treatment cycle includes ovarian stimulation, transfer of a fresh embryo and any subsequent frozen embryos from that same ovarian stimulation.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@:26
    Runs:08
    “Once that you’ve exhausted the stores of frozen embryos would be then starting another treatment cycle.”

    VIDEO
    B-ROLL
    Dr. Lawlor walking down hallway, to her computer, IVF procedure, baby crying

    IVF video
    Mandatory Courtesy:
    University of Glasgow

    AUDIO
    VO
    Dr. Debbie Lawlor from the University of Bristol, in England, says no one has really looked at the success rate when you define an I-V-F cycle in that way. She and her co-authors studied almost 160 thousand women in the United Kingdom who underwent nearly 260 thousand full i-v-f cycles between 2003 and 2010. They examined live birth rates among these women thru 2012.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@ 1:00
    Runs:18
    “Women who are under 40 and using their own eggs within the first cycle, the success rate was 33 percent, it remained over 20 percent by their 6th cycle, they’d a cumulative live birth rate of 68 percent.”

    (Video covering 1st part of bite: baby being rocked)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The Study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@ 1:18
    Runs:17
    “You continue to increase your chances of success right up to the 9th cycle. You’re gaining similar levels of success at around 5 or 6 cycles which takes around two years to what couples naturally conceiving would reach in about a year.”

    VIDEO
    B-ROLL
    Women pushing baby strollers, cells dividing under microscope

    Mandatory Courtesy:
    University of Glasgow

    AUDIO
    VO
    Dr. Lawlor says women between 40 and 42 also increased their success rates right up until the ninth cycle. There was also encouraging news for women who produced no eggs or a very small number during a single ovarian stimulation.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@ 1:47
    Runs:17
    “That importantly didn’t relate to the success with your next cycle of treatment. When you first embark on IVF treatment, I think you have to think about it as a set of repeated treatments and a longish term intervention.”
    (Video covering last part of bite: egg being injected)

    Mandatory Courtesy:
    University of Glasgow

    VIDEO
    B-ROLL
    Egg being injected

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:In women 42 and over success rates were very low across all cycles and the study authors did not see increases in live-birth rates.

  • December 15, 2015

    New Technology Improves Survival In Patients With Aggressive Type Of Brain Cancer

    New Technology Improves Survival In Patients With Aggressive Type Of Brain Cancer

    INTRO:It’s the most aggressive kind of brain cancer in adults. Most patients with glioblastoma (glee-oh-blastoma) die within 1 to 2 years of diagnosis. A new study examined whether treating this type of brain cancer with a new technology, using focused electrical currents, could help prolong survival in patients with the disease. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Roland walking thru hospital doors

    AUDIO
    VO
    Roland Frischherz (Free-shh-herts) was diagnosed with glioblastoma, (glee-oh-blastoma) an aggressive type of brain cancer, more than a year ago.

    AUDIO
    SOT/FULL
    Roland Frischherz – Glioblastoma Patient
    Super@:09
    Runs:13
    “It was a very tough time. I’m married. I have two daughters, so it was a very moving, moving period. Your life you lived before is closed.”

    VIDEO
    Roland and Dr. Stupp talking, technician applying electrodes to mannequin, cu of Roland’s backpack, Roland on floor wiring up his backpack with electrodes on his head

    AUDIO
    VO
    After completing standard chemotherapy and radiation treatments, he began additional therapy using something called tumor treating fields. The device is carried in a special backpack. Inside is a battery that powers electrodes, which are attached to his head.

    AUDIO
    SOT/FULL
    Roger Stupp, M.D., – University Hospital Zurich
    Super@:33
    Runs:19
    “The purpose is to keep the tumor from growing. The machine is applying an electrical field at a certain frequency and strength with alternating current. It will perturb, during cell division, the dividing glioblastoma cells while it will hardly affect any of the normal cells.”

    (Video covering middle of bite: technician showing battery connected to mannequin, cu of battery, connection cable)

    VIDEO
    B-ROLL
    Dr. Stupp at desk, brain image on computer, Roland zipping up backpack and putting it on

    AUDIO
    VO
    Dr. Roger Stupp from University Hospital in Zurich, Switzerland and co-authors are conducting a worldwide trial with 695 glioblastoma patients, all of whom completed standard courses of radiation and chemotherapy. One out of three received a maintenance course of chemotherapy, while the other two, received maintenance therapy plus the electrical tumor treating fields for up to two years.  The current results are for the first 315 patients.

    AUDIO
    SOT/FULL
    Roger Stupp, M.D., – University Hospital Zurich
    Super@ 1:17
    Runs:10
    “Both progression free survival, so the time until the tumor comes back, as well as overall survival is prolonged by a median of 3 months.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The Study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Roger Stupp, M.D., – University Hospital Zurich
    Super@ 1:36
    Runs:11
    “At two years the overall survival is prolonged by about 14 percent which means 14 percent more patients are alive at two years when they got the device.”

    (Video covering 1st part of bite: technician applying electrodes to mannequin)

    VIDEO
    B-ROLL
    Roland and Dr. Stupp talking

    AUDIO
    VO
    Roland continues to receive therapy with the tumor treating fields.

    AUDIO
    SOT/FULL
    Roland Frischherz – Glioblastoma Patient
    Super@ 1:46
    Runs:06
    “If this helps me, well I will continue like this as long as I can.”

    AUDIO
    SOT/FULL
    Roger Stupp, M.D., – University Hospital Zurich
    Super@ 1:52
    Runs:08
    “It’s far from being a cure. But it is another step in the right direction and some patients truly benefit from it.”

    (Video covering last part of bite: Roland walking out of hospital)

    VIDEO
    B-ROLL
    Roland walking out of hospital

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Because the initials results of the trial were so compelling, the International Data Monitoring Committee decided the findings should be made public so that other patients could be offered this treatment.

  • December 08, 2015

    Depression In Medical Residents, A Growing Problem

    Depression In Medical Residents, A Growing Problem

    INTRO:Even in the general population, people don’t want to talk about depression, which is one of the major reasons it isn’t always treated properly.  Depression is also a concern in the medical community, particularly affecting physicians in training known as medical residents.  A considerable number of medical residents suffer significant depressive symptoms at various times during their training.  What should be done to address the problem? Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Group of residents walking down hospital hallway, cu of feet walking down hallway, patient with IV pole walking into room

    AUDIO
    VO
    After medical school, the next step for a physician in training is residency. A growing number of these residents are not only dealing with long hours and the pressure of patient care but also with depression.

    AUDIO
    VO
    SOT/FULL
    Thomas L. Schwenk, M.D., – University of Nevada School of Medicine
    Super@:12
    Runs:27
    “A quarter to a third of the residents are suffering either specific diagnoses or significant symptom burden, I mean that’s, that’s an endemic, that is such a high prevalence of such a serious problem that we all should be extraordinarily worried. It doesn’t really matter whether it’s an actual diagnosis or just significant symptoms it means that they’re suffering. They’re not functioning well in their personal roles, they’re not functioning well in their professional roles.”

    (Video covering middle of bite: resident walking down hallway)

    VIDEO
    B-ROLL
    Dr. Schwenk sitting at table looking at papers, cu of Dr. Schwenk pan down to papers on table, people walking on the street, resident looking at computer screen,GXF FULL JAMA LOGO

    AUDIO
    VO
    Dr. Thomas Schwenk (shwank), Dean of the University of Nevada School of Medicine says while medical students and practicing physicians have a prevalence for depression roughly similar to the general population, the diagnosis is much more common in residents and also carries a great deal of stigma.  Dr. Schwenk discusses this issue in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Thomas L. Schwenk, M.D., – University of Nevada Medical School
    Super@:58
    Runs:23
    “We want people who are confident and strong and have shown great energy and decision making and have taken charge of situations in their undergraduate preparation. So it’s not surprising that these same people are going, to have a hard time admitting vulnerability or that they need help. When residents apply for jobs they do not want a hint that they’ve suffered from mental illness.”

    (Video covering middle of bite: Resident working on computer, cu of computer, resident going into patient exam room)

    VIDEO
    B-ROLL
    Resident walking outside patient rooms, resident talking with patient, resident going into on-call room

    AUDIO
    VO
    There have been several efforts to address this problem.  Confidential mental health care is now more easily available and mental health records are not included in academic records.  Resident duty hours have also been scaled back in recent years.

    AUDIO
    SOT/FULL
    Thomas L. Schwenk, M.D., – University of Nevada School of Medicine
    Super@ 1:36
    Runs:23
    “The reduction in hours, probably because it still is an incredibly high level of work load, hasn’t really improved residents’ quality of life and it seems to have caused some problems in performance and in the quality of care. The world is just so dramatically different, yet we’re still training residents the same way. It looks exactly like it looked in the 1950’s and 1960’s.

    VIDEO
    B-ROLL
    Dr. Schwenk walking in library

    AUDIO
    VO
    Dr. Schwenk is calling for even better mental health care and a national conversation about today’s medical education system.

    AUDIO
    SOT/FULL
    Thomas L. Schwenk, M.D., – University of Nevada School of Medicine
    Super@2:05
    Runs:37
    “What I would really like to see is the accrediting bodies, the residency review committees, the accreditation counsel for GME, ACGME, really take this to a high level. What if we built teaching programs from the ground up for teaching and clinical care was actually a secondary objective. Right now, what happens is the teaching in many regards kind of gets added on to an extremely high powered, high intensity, high productivity, very busy clinical system. And it makes it hard for residents I think, to really process everything that’s going on.”

    VIDEO
    B-ROLL

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Dr. Schwenk also says residents should be encouraged to take care of themselves so they can take care of others.

  • December 01, 2015

    Cesarean Section Rates And Health Outcomes For Mothers And Babies

    Cesarean Section Rates And Health Outcomes For Mothers And Babies

    INTRO:The most common operation done worldwide is the cesarean or C-section. In order to see better health outcomes, in the mid-1980s, the World Health Organization recommended that member countries C-section rates shouldn’t exceed 10 to 15 percent.  A new study evaluated the relationship between current cesarean section rates around the world and key health outcomes for mothers and babies.  Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Babies in nursery, cu of babies hand

    AUDIO
    VO
    Chances are the mothers of many of these babies underwent a cesarean or C-section birth.

    AUDIO
    SOT/FULL
    Alex B. Haynes, M.D., M.P.H., – Ariadne Labs
    Super@:06
    Runs:04
    “Almost one out of every 5 births on the planet, occur via cesarean section.”

    AUDIO
    SOT/FULL
    George Molina, M.D., M-P.H., – Ariadne Labs
    Super@:10
    Runs:07
    “Poorer countries were actually doing more C-sections as a proportion of all the care that they were providing, compared to wealthier countries.”

    VIDEO
    B-ROLL
    Cu of Dr. Haynes, wide shot of Dr. Molina and Dr. Haynes standing at white board, Graphic: Globe with 194 Member Countries, 2012 C-Section Rates, woman having ultrasound

    AUDIO
    VO
    Doctors Alex Haynes and George Molina from Ariadne (Air-ee-ahd-nee) Labs at Brigham and Women’s Hospital and co-authors gathered publicly available data from the 194 World Health Organization member countries. Using this information, they estimated two thousand and twelve C-section rates worldwide and examined how those rates affected maternal and neonatal health outcomes.

    AUDIO
    SOT/FULL
    George Molina, M.D., M-P.H., – Ariadne Labs
    Super@:35
    Runs:08
    “Up to a rate of about 19 C-sections per 100 live births we see reductions in maternal and neonatal mortality.”

    AUDIO
    SOT/FULL
    Alex B. Haynes, M.D., M.P.H., – Ariadne Labs
    Super@:43
    Runs:13
    “Across the world the average cesarean section rate is over 19 percent. Going from 19 to 25 to 30 percent did not result in improvements in neonatal or maternal mortality on a nationwide level.”

    (Video covering middle of bite: surgery video)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Alex B. Haynes, M.D., M.P.H., – Ariadne Labs
    Super@1:00
    Runs:17
    “There are many countries where not enough cesarean sections are being performed, meaning there is inadequate access to safe and timely emergency obstetric care and conversely, that there are some countries where probably more cesarean sections are being performed than yield health benefits.”

    VIDEO
    B-ROLL
    Dr. Haynes and Dr. Molina sitting at computer talking, woman walking with baby in hospital

    AUDIO
    VO
    The authors caution that these findings do not apply to any individual patients, facilities or hospitals.

    AUDIO
    SOT/FULL
    George Molina, M.D., M-P.H., – Ariadne Labs
    Super@1:25
    Runs:09
    “Our research can give some guidance for why countries should make their healthcare systems stronger so that they can provide safe, reliable and timely C-sections.”

    (Video covering 1st part of bite: mother walking with baby and video covering last part of bite: baby in nursery)

    VIDEO
    B-ROLL
    Baby in nursery

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study suggests that W-H-O target rates for cesarean section may be too low and need to be re-examined.

  • November 17, 2015

    Early Antibiotic Use May Halt Progression of Severe Respiratory Illness in Young Children

    Early Antibiotic Use May Halt Progression of Severe Respiratory Illness in Young Children

    INTRO: Preschool children who experience repeated episodes of severe lower respiratory tract infections often present with symptoms like wheezing and difficulty breathing.  A new study looked at whether a common antibiotic given early in these episodes could prevent the illness from getting worse. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of children in preschool class

    AUDIO
    VO
    When pre-school children experience repeated lower respiratory infections, It’s much more than just a simple cold.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@:06
    Runs:09
    “A lower respiratory tract illness is a cold that ends up going to the chest and that causes substantial coughing, wheezing, shortness of breath.

    VIDEO
    B-ROLL
    Steroid medication being poured out onto table

    AUDIO
    VO
    The usual treatment often includes steroids like prednisone.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@:18
    Runs:06
    “We wanted to provide a safe alternative that allows these children to experience fewer episodes.”

    VIDEO
    B-ROLL
    Dr. Bacharier walking down hallway, various shots of children, azithromycin medication

    AUDIO
    VO
    Dr. Leonard Bacharier (bah-CARE-ee-er) from Washington University in St. Louis and co-authors studied more than 600 children, from one to six years old, with a history of repeated episodes of severe  respiratory illness.  Children were randomly assigned to either receive the antibiotic azithromycin or a placebo early in these episodes.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@:41
    Runs:10
    “The parents were to have this medicine at home and were to start it at the very earliest signs of an illness in an effort to try to prevent the progression of the episodes.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@ :55
    Runs:10
    “The children in the azithromycin group were significantly less likely to have progression of their episodes to the point where prednisone would have been required.”

    VIDEO
    B-ROLL
    Azithromycin medication, children playing

    AUDIO
    VO
    Researchers also looked at whether increased antibiotic use could result in more bacterial resistance.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@ 1:16
    Runs:13
    “There was a slight increase in the number of children who had resistant organisms at the end of the study among those who received azithromycin compared to those who received placebo, but the numbers were relatively small.”

    (Video covering 1st part of bite: various shots of children)

    VIDEO
    B-ROLL
    Dr. Bacharier at his desk, looking at computer

    AUDIO
    VO
    Dr. Bacharier says further research is needed to understand how often these resistant organisms will emerge.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@1:29
    Runs:21
    “How to put this strategy into clinical practice is going to take some time. This requires a proactive discussion with the child’s health care provider in advance so that if this strategy is to be undertaken, it is available at home, with the parent well instructed as to the earliest signs of illness and knows when to start this.”

    (Video covering middle of bite: children playing)

    VIDEO
    B-ROLL
    Children playing

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Dr. Bacharier says even when used perfectly, there are many children who will develop severe illness despite these therapies.

  • November 13, 2015

    An Alternative Treatment For Diabetic Eye Disease

    An Alternative Treatment For Diabetic Eye Disease

    INTRO: Vision loss is one of the most feared complications of diabetes.  If not diagnosed and treated early, diabetic retinopathy can lead to blindness.  For decades, laser therapy has been used to treat this complication.  However this procedure can come with some important side effects.  A new study tested a different kind of treatment using an injectable medication called ranibizumab, to see if it would be as effective as laser therapy. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    People walking on the street, pictures get blurred, graphic: fade in words: Diabetic Retinopathy

    AUDIO
    VO
    Imagine your vision going from this…to this. These changes can happen slowly or all at once. It’s called diabetic retinopathy and it’s the leading cause of vision loss in patients with diabetes.

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@:11
    Runs:10
    “The most severe form of diabetic retinopathy is called proliferative diabetic retinopathy. There’s a development of abnormal scar tissue and blood vessels that are tugging on the retina.”

    VIDEO
    B-ROLL
    Graphic: pic of eye leaking vessels circled on left in red, blood vessels on right not leaking and circled in green

    AUDIO
    VO
    This eye, injected with dye, shows abnormal blood vessels that are leaking.  This often causes bleeding or even a detached retina. Healthy blood vessels are very tight and don’t leak. Laser therapy is the standard treatment to stop the vessels from leaking.

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@:34
    Runs:09
    “It’s not an ideal treatment because it can affect your side vision. It can affect your adjustment to dark and in some cases can make your vision worse.”

    VIDEO
    B-ROLL
    Dr. Jampol walking into exam room, sitting down and examining patients eyes, medication vial with syringe, various pictures of eye on computer

    AUDIO
    VO
    Dr. Lee Jampol from Northwestern University and co-authors studied more than 300 patients with this severe form of diabetic retinopathy.  Patients either received standard laser therapy or treatment with a newer medication called ranibizumab (ran-e-biz-u-mab), which was injected directly into the eye. In total, researchers treated almost 400 eyes.  Outcomes, especially vision loss, were compared at two years.

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@1:04
    Runs:07
    “Over the course of the two years the patients receiving the injections of the medication did somewhat better than the ones that got the laser.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@1:15
    Runs:18
    “It had less side effects. The peripheral vision stayed about the same in the medication group but it was diminished in the patients that had the laser treatment. There are other changes that occur in the retina with swelling of the back of the retina and we know that the injections help to prevent that better than the laser treatment.”

    (Video covering middle of bite: pic of eye)

    VIDEO
    B-ROLL
    Dr. Jampol examining Michael’s eyes

    AUDIO
    VO
    Routine eye exams helped identify Michael Graff’s retinopathy.  Today, he sees his ophthalmologist regularly because maintaining his vision is vital.

    AUDIO
    Michael Graff – Retinopathy Patient
    Super@1:41
    Runs:06
    “I’m an artist…it’s very important. I couldn’t imagine being without it.”

    (Video covering end of bite: Michael being examined by Dr. Jampol)

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@1:49
    Runs:07
    “So when the patient goes in now to their doctor with proliferative diabetic retinopathy there’s two choices, where before there was only one.”

    (Video covering end of bite: Dr. Jampol and Michael talking)

    VIDEO
    B-ROLL
    Dr. Jampol and Michael talking

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The injectable medication, ranibizumab, had a low complication rate and showed good safety.

  • November 08, 2015

    Shared Financial Incentives For Physicians And Patients Helped Improve Cholesterol Levels

    Shared Financial Incentives For Physicians And Patients Helped Improve Cholesterol Levels

    INTRO: Financial incentives for physicians or patients are one way healthcare organizations are trying to improve health outcomes.  A new study examined whether providing financial incentives would help improve L-D-L or the “bad” cholesterol level in people at high-risk for cardiovascular disease. Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:01
    “…I’m going to get your vital signs this morning…”

    VIDEO
    B-ROLL
    Nurse getting ready to take patients temperature, cu of patient with thermometer in mouth, blood pressure being checked

    AUDIO
    VO
    In addition to vital signs, a visit to the doctors office often includes a discussion about cholesterol levels, especially if a patient is at high-risk for cardiovascular disease.

    AUDIO
    SOT/FULL
    David A. Asch, M.D., – University of Pennsylvania
    Super@:10
    Runs:11
    “You can substantially reduce that risk if you take statins or other medications to lower your cholesterol.  Many patients aren’t taking statins or if they are they stop them after a few months.”

    (Video covering  middle of bite: statin medication)

    AUDIO
    SOT/FULL
    Kevin G. Volpp, M.D., Ph.D., – University of Pennsylvania
    Super@:22
    Runs:09
    “And what we did in this study was to test a variety of strategies to try to help patients and their doctors get their cholesterol under better control.”

    VIDEO
    B-ROLL
    Dr. Volpp and Dr. Asch walking down hallway with colleague, colleague and doctors at white board, writing on white board while Dr. Asch and Dr. Volpp look on, doctor examining patient and doing different tests in exam room, patient and doctor talking

    AUDIO
    VO
    Doctors Kevin Volpp and David Asch from the University of Pennsylvania and co-authors studied the effect of different financial incentives on cholesterol levels in more than 15 hundred patients at high risk for cardiovascular disease.  The researchers randomly assigned 340 doctors to one of four groups. One group didn’t receive any financial incentives.  in another group, financial incentives were given only to the patients who showed improvements in their cholesterol.

    AUDIO
    SOT/FULL
    David A. Asch, M.D., – University of Pennsylvania
    Super@:53
    Runs:09
    “We also tried different approaches including giving financial incentives to physicians or giving financial incentives in a shared way to both patients and physicians.”

    AUDIO
    SOT/FULL
    Kevin G. Volpp, M.D., Ph.D., – University of Pennsylvania
    Super@ 1:03
    Runs:07
    “The most effective way of improving cholesterol control was a shared incentive between patients and providers.”

    (Video covering end of bite: doctor and patient talking)

    AUDIO
    SOT/FULL
    David A. Asch, M.D., – University of Pennsylvania
    Super@ 1:11
    Runs:03
    “They had the greatest reduction in their LDL cholesterol.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Kevin G. Volpp, M.D., Ph.D., – University of Pennsylvania
    Super@ 1:21
    Runs:15
    “If patients weren’t on statins, they were started on statins Having both the provider intensify therapy as appropriate and having the patients take those medications once prescribed, and that’s really why we think the shared incentive group was the most effective.”

    (Video covering  1st part of bite: statin medications)

    AUDIO
    SOT/FULL
    David A. Asch, M.D., – University of Pennsylvania
    Super@ 1:32
    Runs:12
    “We shouldn’t just think of these as mechanical economic transactions. Getting your cholesterol down is a team effort. It requires physicians to prescribe the medications and it requires patients to take the medications.”

    (Video covering middle of bite: patient getting blood drawn)

    AUDIO
    SOT/FULL
    Kevin G. Volpp, M.D., Ph.D., – University of Pennsylvania
    Super@ 1:45
    Runs:07
    “Both of those are critically important to the end goal of improving LDL cholesterol and reducing cardiovascular risk.”

    (Video covering end of bite: doctor and patient talking)

    VIDEO
    B-ROLL
    Dr. and patient talking

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:L-D-Llevels improved 25 points in the group receiving no financial incentives. Incentives given to physicians only and patients only did not work as well as when incentives were given to both physicians and patients.

  • November 03, 2015

    Prescription Drug Use Continues To Rise In The U.S.

    Prescription Drug Use Continues To Rise In The U.S.

    INTRO: Prescription drugs represent a major healthcare expense and the number of adults in the U-S taking prescription medications is increasing. A new study examined trends in prescription drug use from 1999 to 2012 among U-S adults. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various pharmacy signage, people walking on street, various pharmacy signage

    AUDIO
    VO
    Today there seems to be a pharmacy on almost every street corner. With hundreds of different drugs coming and going from the market, It’s not surprising that prescription drug use is on the rise.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@:09
    Runs:14
    “We observed an overall increase in prescription drug use. In 1999-2000 51 percent of all U-S adults age 20 and older reported any use of prescription medications and this increased to 59 percent in 2011-12.”

    (Video covering 2nd half of bite: people walking, Graphic: 1999-2000
    51% U.S. ADULTS 20+ YEARS
    59% 2011-2012)

    VIDEO
    B-ROLL
    Dr. Kantor walking down hallway, people outside walking, sitting at desk looking at charts on computer, Graphic:
    5 or More Prescription Drugs
    8.2 % in 1999-2000
    15 % in 2011-20012

    AUDIO
    VO
    Dr. Elizabeth Kantor from Memorial Sloan Kettering Cancer Center and co-authors examined more than a decade data from nearly 40 thousand U-S adults, 20 years and older, participating in the National Health and Nutrition Examination Survey or N-HANES. The number taking five or more prescription drugs almost doubled from 8 point 2 percent in 19-99 to two thousand to 15 percent in two thousand-11 to two thousand 12.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@:46
    Runs:12
    “This is particularly notable among older adults, ages 65 and older. When we account for age we find that the trends persist, suggesting that there are factors other than the aging of the population driving this increase.”

    (Video covering middle of bite: older people exercising)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@1:02
    Runs:13
    “When we look at drugs taken to control high-blood pressure, diabetes, high cholesterol, depression we see increases in all of those drug classes.  We also see increases in some less commonly used drug classes such as muscle relaxants.”

    (Video covering 2nd part of bite: various prescription medications)

    VIDEO
    B-ROLL
    Graphic:
    2011-2012
    SIMVASTATIN
    NEARLY 8% OF ALL ADULTS

    AUDIO
    VO
    Simvastatin, used to treat high cholesterol, was the most commonly used prescription drug in 2011-12, taken by nearly 8 percent of all U-S adults.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@1:23
    Runs:12
    “And when we look at the 10 most commonly used drugs in 2011-12, most of these drugs are taken for conditions associated with cardiovascular disease as well as the factors contributing to cardiovascular disease, such as obesity.”

    (Video covering 2nd part of bite: overweight man getting blood pressure checked)

    VIDEO
    B-ROLL
    Pills being counted

    AUDIO
    VO
    The sharpest increases in prescription drug use occurred in the early two thousands.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@1:40
    Runs:06
    “Within the later 2000’s we actually saw that some drug classes remained stable and some modestly decreased.”

    (Video covering 2nd half of bite: pills being counted)

    VIDEO
    B-ROLL
    Pills being counted

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Prior studies about prescription drug use were limited in scope and often restricted to certain populations.

  • October 27, 2015

    Death Rates In U.S. Continue To Decrease

    Death Rates In U.S. Continue To Decrease

    INTRO: Are Americans living longer and what are they dying from? In a new study, researchers from the American Cancer Society reviewed changes in the overall U-S death rate as well as trends in the six leading causes of death. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    People outside

    AUDIO
    VO
    Americans are living longer.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@:03
    Runs:07
    “We are making progress in reducing death rate from all-causes and leading causes of death.”

    VIDEO
    B-ROLL
    Dr. Jemal walking down hallway with colleague, Dr. Jemal in his office looking at graphs on a computer, walking down hall

    AUDIO
    VO
    Dr. Ahmedin (Ah-meh-deen) Jemal along with colleagues from the American Cancer Society used data from the National Center for Health Statistics to examine trends in the overall death rate in the U-S from 1969 to 2013.  They also looked specifically at the six leading causes of death.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@:24
    Runs:06
    “Overall death rates have decreased by 42 or 43 percent.”

    VIDEO
    B-ROLL
    Graphic:
    1969-2013
    HEART DISEASE
    CANCER
    STROKE
    INJURIES
    DIABETES
    Arrows next to each point down,
    Three arrows down for heart disease, stroke, diabetes

    AUDIO
    VO
    During this time period, death rates continued to decrease for heart disease, cancer, stroke, injuries and diabetes.
    Although the decrease has slowed during the last five years for heart disease, stroke and diabetes.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@:45
    Runs:09
    “The slow-down could be due to the obesity epidemic that has unfolded over the last three decades.”

    (Video covering 1st part of bite: obese people)

    VIDEO
    B-ROLL
    X-rays of lungs

    AUDIO
    VO
    On the other hand, deaths from chronic obstructive pulmonary disease, or C-O-P-D, doubled.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@:55
    Runs:11
    “COPD rates in men increased through the early 1990s, now it is decreasing but in women, the COPD rates continue to increase since 1969.”

    (Video covering middle of bite: male patient being examined)

    VIDEO
    B-ROLL
    Various people smoking

    AUDIO
    VO
    Dr. Jemal says this difference may result from women starting and stopping smoking later than men.

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@1:15
    Runs:16
    “Cancer has been increasing from 1969 thru 1990 when it peaked and since 1990 it has been steadily decreasing because of a reduction of tobacco use as well as improvements in early detection.”

    VIDEO
    B-ROLL
    People outside, people smoking, obese people

    AUDIO
    VO
    Although death rates are down, there is still room for improvement.  One in five U-S adults still smoke and one in three are obese.

    AUDIO
    SOT/FULL
    Voice of:
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@1:37
    Runs:09
    “Smoking, obesity, physical inactivity and bad diet account for about half of the total deaths in the U-S.

    (Video covering entire bite: various shots of people smoking, eating and obese people)

    VIDEO
    B-ROLL
    Woman walking across street

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Unintentional injuries such as accidents or drowning increased until the mid-1990s but have been decreasing during the most recent time period.

  • October 20, 2015

    New Recommendations For Breast Cancer Screening In Women With Average Cancer Risk

    New Recommendations For Breast Cancer Screening In Women With Average Cancer Risk

    INTRO: Breast cancer is the second leading cause of cancer deaths among American women. Early detection remains the best way to prevent breast cancer related deaths.  Many experts have tried to understand how to best balance potential benefits and harms of breast cancer screening. The American Cancer Society reviewed existing research and updated its recommendations for women who are at average risk for breast cancer. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@:02
    Runs:08
    “Mammography does save lives. It’s the single best tool that we have for preventing a premature death from breast cancer in a woman.”

    VIDEO
    B-ROLL
    Dr. Oeffinger at his desk, looking at mammograms, Graphic: several studies piled on top of one another, American Cancer Society logo

    AUDIO
    VO
    Dr. Kevin Oeffinger (EH-fen-jur) from Memorial Sloan Kettering Cancer Center along with a panel of other experts examined decades of research to update the American Cancer Society’s recommendations for breast cancer screening.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@:19
    Runs:21
    “What we realize is that there’s areas that the evidence is very clear and there’s other areas that there may be a trade-off. We recommend starting regular screening at age 45. The evidence clearly shows that there is substantial magnitude of benefit, life saved, compared to the risks of having a false-positive biopsy, false-positive additional images or over diagnosis.”

    (Video covering middle of bite: woman getting a mammogram)

    VIDEO
    B-ROLL
    Screening Mammography

    START YEARLY SCREENING
    AGE 45

    EVERY TWO YEARS
    AGE 55

    AUDIO
    VO
    In addition to starting yearly screening at 45, the American Cancer Society recommends that women transition to screening every two years at age 55.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@:50
    Runs:12
    “Women age 40 to 44 will benefit from screening mammography. We recommend that women have a visit with their health care professional and discuss their risk and benefits and then weigh how they look at false-positive testing.”

    (Video covering middle of bite: doctor talking with patient)

    VIDEO
    B-ROLL
    Screening Mammography

    INFORMED DECISION MAKING

    WOMEN 40-44
    OPTION TO SCREEN EARLY

    WOMEN 55+
    OPTION TO CONTINUE YEARLY SCREENING

    AUDIO
    VO
    For the first time, the guideline supports informed decision making, saying some women ages 40 to 44 should have the option to screen early and women 55 and older have the opportunity to continue yearly screening if they choose.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@1:24
    Runs:15
    “We do not recommend a particular age to stop screening. There is definitely benefit into the mid-70’s, and we think benefit beyond that in women who are active and have a ten year life expectancy of reasonably good health.”

    (Video covering middle of bite: older woman having mammogram)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D., – Memorial Sloan Kettering Cancer Center
    Super@1:34
    Runs:06
    “We no longer recommend doing clinical breast examinations for women in the United States.”

    VIDEO
    B-ROLL
    Doctor talking with patient

    AUDIO
    Dr. Oeffinger says this time could be better spent counseling women about individual screening preferences.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@1:45
    Runs:12
    “This guideline however, is not a ‘one-size-fits-all.’ It’s very key that a woman is able to express her beliefs, her own values and preferences to her health care professional in making that shared and informed decision.”

    (Doctor walking with woman, sitting and talking in exam room)

    VIDEO
    B-ROLL
    Woman talking with doctor

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:About 8 to 10 percent of women are at high risk for breast cancer, the rest of women are at average risk.  Only 65 percent of U-S women are getting screened within a two-year time period.

  • October 19, 2015

    Seizures from Solving Sudoku Puzzles

  • October 06, 2015

    Minimally Invasive Approach Not as Effective as Standard Operation For Rectal Cancer

    Minimally Invasive Approach Not as Effective as Standard Operation For Rectal Cancer

    INTRO:The usual treatment of stage 2 or 3 rectal cancer includes surgery to remove the tumor. Traditionally, patients have undergone a major, “open” operation to remove the cancer. A new study compared whether a minimally invasive approach would be as good as an open or full operation.  Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    Various shots of laparoscopic procedure

    AUDIO
    VO
    This patient is undergoing a laparoscopy. This operation is done with small incisions, smaller instruments, and a fiber optic scope to see inside the abdomen. Most times the patient has less pain and a quicker recovery compared to a traditional open procedure that involves making a large incision. This technique works well for treating colon cancer.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@:17
    Runs:21
    “Rectal cancer which is at the other end of the G-I tract at the very bottom of the colon, is a different ballgame. There is a high risk of local recurrence of the tumor in the pelvis after an operation no matter whether you do it open or anything else.”

    VIDEO
    B-ROLL
    Dr. Fleshman walking down hallway, looking at computer with colleague

    AUDIO
    VO
    Dr. James Fleshman from Baylor University Medical Center and co-authors wanted to know if a minimally invasive approach was as good as an open procedure for patients with stage two or three rectal cancer.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@:48
    Runs:12
    “We wanted to make sure that we were giving our patients the best chance for curing their cancer not just giving them the advantage of a small incision and a minimally invasive approach.”

    VIDEO
    B-ROLL
    Computer screen showing various views of rectal area, cu of image, surgical team working in OR, various shots of staff examining slides with microscope

    AUDIO
    VO
    486 patients were randomly assigned to receive a standard, open operation or the minimally invasive, laparoscopic approach. All the procedures were done by 46 highly trained surgeons. Specimens from each procedure were examined under a microscope to see whether the entire tumor was removed, known as a “complete” resection.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@ 1:17
    Runs:15
    “Patients who underwent an open operation, 90 percent of all the patients had the complete resection. In the laparoscopy group only 81.7 percent of patients ended up with a complete resection.”

    (Video covering middle of bite: staff looking at slides)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@1:36
    Runs:10
    “That told us that laparoscopy for rectal cancer was not as good as open operation for rectal cancer.”

    VIDEO
    B-ROLL
    Dr. Fleshman scrubbing

    AUDIO
    VO
    Dr. Fleshman also says tumor location is important.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@1:49
    Runs:25
    “So, if this is a very straightforward small tumor and the surgeon is comfortable in stating that this will be able to be done perfectly then laparoscopy may be the appropriate way to go. In a tumor that’s very deep in the pelvis and very large laparoscopy may not be the right way to treat this anymore.”

    (Video covering 2nd half of bite: Dr. Fleshman in surgery)

    VIDEO
    B-ROLL
    Dr. Fleshman in surgery

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study is one of the first trials to evaluate surgical techniques for treating rectal cancer.

  • October 05, 2015

    Flu Vaccine Reduces Hospitalizations For Pneumonia

    Flu Vaccine Reduces Hospitalizations For Pneumonia

    INTRO:Influenza or the flu, is a viral infection affecting the respiratory system. Pneumonia is a serious complication of influenza.  A new study examined whether getting a flu shot can help reduce hospitalizations due to influenza pneumonia. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Children in doctor’s office with nurse

    AUDIO
    VO
    For many people, getting a flu shot is an annual tradition.

    AUDIO
    NATSO/FULL
    Runs:04
    …what happened punkin’…whaaaa….whaaa.. that’s it…”

    VIDEO
    B-ROLL
    Baby crying after getting flu shot

    AUDIO
    VO
    Pneumonia is one of the most serious complications of influenza…

    AUDIO
    SOT/FULL
    Kathryn M. Edwards, M.D. – Vanderbilt University Medical Center
    Super@:11
    Runs:06
    “Pneumonia means an infection, deep down in your lungs.”

    (Vide covering 2nd part of bite: cu of chest x-ray)

    VIDEO
    B-ROLL
    Chest x-ray

    AUDIO
    VO
    …often requiring hospitalization.

    AUDIO
    SOT/FULL
    Carlos G. Grijalva, M.D., M.P.H. -Vanderbilt University Medical Center
    Super@:18
    Runs:05
    “The most effective way to prevent some of the influenza infections is vaccination.”

    VIDEO
    B-ROLL
    Dr. Grijalva and Dr. Edwards walking outside, looking at chest x-rays on computer, EMT’s taking patient into hospital

    AUDIO
    VO
    Doctors Carlos Grijalva (Gree-hahl-BAH) and Kathryn Edwards from Vanderbilt University Medical Center and co-authors evaluated more than 27 hundred patients over three consecutive flu seasons. All patients were admitted to the hospital from the emergency department at four sites around the U.S.

    AUDIO
    SOT/FULL
    Kathryn M. Edwards, M.D. – Vanderbilt University Medical Center
    Super@:38
    Runs:05
    “Everyone had the pneumonia but one group had flu and one group did not.”

    AUDIO
    SOT/FULL
    Carlos G. Grijalva, M.D., M.P.H. -Vanderbilt University Medical Center
    Super@:43
    Runs:05
    “About 6 percent of those patients had pneumonias  due to influenza.”

    VIDEO
    B-ROLL
    Nurse preparing flu vaccine, patient getting shot

    AUDIO
    VO
    Next the researchers determined how many patients with pneumonia had been vaccinated against influenza.

    AUDIO
    SOT/FULL
    Kathryn M. Edwards, M.D. – Vanderbilt University Medical Center
    Super@:53
    Runs:13
    “The people that had received vaccine had 57 percent less chance of getting hospitalized with flu-pneumonia than those patients that were not vaccinated.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Carlos G. Grijalva, M.D., M.P.H. -Vanderbilt University Medical Center
    Super@1:11
    Runs:11
    “The effectiveness of the vaccines seems to be a little lower for older subjects and for patients with underlying immunosuppressive conditions.”

    AUDIO
    SOT/FULL
    Kathryn M. Edwards, M.D. – Vanderbilt University Medical Center
    Super@1:25
    Runs:07
    “The vaccine seemed to work very well in young children and in individuals less than 65.”

    (Video covering 1st half of bite: young girl getting nasal flu vaccine)

    VIDEO
    B-ROLL
    Nurse preparing to give a flu shot to young boy

    AUDIO
    VO
    The study’s results provide one more reason to get a flu shot this fall.

    AUDIO
    NATSO/FULL
    Runs:05
    “Ouch…she’s all done…that hurt a little…a little?”

    VIDEO
    B-ROLL
    Child after he gets his shot

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The study was sponsored by the Centers for Disease Control and Prevention.

  • September 22, 2015

    Combination Drug Treatment Reduces Agitation in Patients With Alzheimer’s Disease

    Combination Drug Treatment Reduces Agitation in Patients With Alzheimer’s Disease

    INTRO:Agitation and aggression are common in patients with Alzheimer’s dementia and are a source of distress for caregivers. Patients may shout, curse or even become violent. Currently available medications have lots of side effects and are only modestly effective for treating agitation.  A new study tested a combination of two existing medications and whether this would help control agitation in patients with Alzheimer’s. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Laurie walking into hospital, pictures of her mother and father

    AUDIO
    VO
    Laurie Gabello is very familiar with hospitals and doctor’s offices. Her father has Alzheimer’s disease and her mother, dementia. But it wasn’t always that way.

    AUDIO
    SOT/FULL
    Laurie Gabello – Caregiver
    Super@:09
    Runs:05
    “They were extremely active. They traveled a lot.  They were extremely social.”
    (Video covering 1st part of bite: picture of parents)

    VIDEO
    B-ROLL
    Pictures of Laurie’s parents

    AUDIO
    VO
    Now in full time care, both of Laurie’s parents have frequent bouts of agitation.

    AUDIO
    SOT/FULL
    Laurie Gabello – Caregiver
    Super@:18
    Runs:14
    “When people do come in to help him with his showers or his daily care and stuff he does get extremely agitated. She gets very upset and very agitated, no matter what it is. What they’re serving for dinner, the fact that they play the same music over and over.”

    (Video covering middle of bite: pictures)

    AUDIO
    SOT/FULL
    Jeffrey L. Cummings, M.D., Sc.D. – Cleveland Clinic Lou Ruvo Center for Brain Health
    Super@:32
    Runs:08
    “These are things that make caregiving so extremely difficult, when there is a violent or aggressive reaction by the patient.”

    VIDEO
    B-ROLL
    Dr. Cummings walking down hallway, older people in the community, Dr. Cummings looking at brain images on computer, graphic

    AUDIO
    VO
    Dr. Jeffrey Cummings from the Cleveland Clinic and co-authors recruited 220 patients with Alzheimer’s dementia and agitation. During a preliminary 10-week trial, participants were randomly assigned to receive either the combination of dextromethorphan and quinidine or a placebo.

    AUDIO
    SOT/FULL
    Jeffrey L. Cummings, M.D., Sc.D. – Cleveland Clinic Lou Ruvo Center for Brain Health
    Super@:55
    Runs:10
    “The dextromethorphan-quinidine combination had a substantial effect in reducing agitation and far greater than was seen in the placebo treated patients.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Jeffrey L. Cummings, M.D., Sc.D. – Cleveland Clinic Lou Ruvo Center for Brain Health
    Super@:55
    Runs:03
    “And we showed that the drug was safe and effective.”

    VIDEO
    B-ROLL
    Laurie talking with a staff person

    AUDIO
    VO
    Dr. Cummings says there also appeared to be benefit for the caregivers of these patients.

    AUDIO
    SOT/FULL
    Jeffrey L. Cummings, M.D., Sc.D. – Cleveland Clinic Lou Ruvo Center for Brain Health
    Super@1:18
    Runs:09
    “There was a reduction in the stress experienced for caregivers of the patients who were treated with the dextromethorphan-quinidine combination.”

    VIDEO
    B-ROLL
    Photos of Laurie with her parents

    AUDIO
    VO
    Although caring for her parents is sometimes overwhelming, Laurie takes comfort in knowing they have lived full lives.

    AUDIO
    SOT/FULL
    Laurie Gabello – Caregiver
    Super@1:32
    Runs:06
    “They didn’t not do anything they set their heart out to do, that was on their bucket list, they did all of it.”

    (Video covering 2nd half of bite: various pictures of Laurie’s parents)

    VIDEO
    B-ROLL
    Various pictures of Laurie’s parents

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The combination of these two medications is not yet available for patients. More studies are needed before the results can be presented to the F-D-A for approval.

  • September 14, 2015

    Low Vitamin D Levels Associated with More Rapid Cognitive Decline in Older Adults

    Low Vitamin D Levels Associated with More Rapid Cognitive Decline in Older Adults

    INTRO: About 42 percent of the general U-S adult population has low vitamin D levels. That number is even higher among Hispanics and African-Americans. Besides promoting calcium absorption and bone health, vitamin D may also affect the brain and cognitive function. A new study looked at the association between baseline vitamin D levels and the rate of cognitive decline in a group of ethnically diverse older adults. Catherine Dolf has more this week’s JAMA Report.
    VIDEO B-ROLL Sun through the clouds, woman drinking milk, vitamin D bottles, older people walking AUDIO
    VO
    Sunlight and diet are the two main sources of vitamin D. Many people also take vitamin D supplements. However, having a low vitamin D level is still very common.

    AUDIO
    SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@:16 Runs:15
    “As the population ages, the fastest growing segment are the old and the oldest of old and with that, is an increase in the risk of cognitive dysfunction and outright Alzheimer’s disease and dementia.”
    VIDEO
    B-ROLL Dr. Miller walking, Graphic:382 Older Adults 75 Years of Age 61% Women 41 % White 30 % African-American 25 % Hispanic
    AUDIO
    VO
    Dr. Joshua Miller from Rutgers University, along with colleagues from the University of California Davis, studied 382 older adults with an average age of 75. 61 percent were women, 41 percent White, about 30 percent African-American and 25 percent Hispanic.

    AUDIO
    SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@:41 Runs:08
    “Some of the subjects had outright dementia, some had mild cognitive impairment and some had what we would call normal cognitive function.”
    VIDEO
    B-ROLL Dr. Miller in lab, person taking cognitive test

    AUDIO
    VO
    Vitamin D levels and cognitive function were measured at baseline. Cognitive function was also followed in 318 of the participants for an average of 5 years.

    AUDIO
    SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@:58 Runs:08
    “About 60 percent of the group, regardless of their race or ethnicity, was low in vitamin D.”
    GXF FULL JAMA LOGO

    AUDIO
    VO The study appears in JAMA, Neurology.

    AUDIO SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@ 1:09 Runs:09
    “Those who had dementia also had lower vitamin D status than those who had mild cognitive impairment or who had normal cognitive function.”
    VIDEO
    B-ROLL Vitamin D capsules, graphic:Episodic Memory Executive Function AUDIO
    VO
    Those low in vitamin D declined more in short term memory, known as episodic memory, as well as more complex cognitive tasks, known as executive function.

    AUDIO
    SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@1:26 Runs:06
    “They were declining about two and a half times faster than those who had adequate vitamin D.” (Video covering 2nd half of bite: Vitamin D capsules)
    VIDEO
    B-ROLL Vitamin D capsules

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study is observational. Future studies are needed to determine whether vitamin D supplements can slow cognitive decline.

  • September 08, 2015

    Diabetes Continues To Rise In U.S. Population

    Diabetes Continues To Rise In U.S. Population

    INTRO:If left untreated, diabetes can cause many serious health-related complications including kidney failure and blindness.  The total estimated cost of diabetes in the U.S. was $245 billion in 2012, which includes both health care costs and lost productivity. A new study examined the prevalence of diabetes in the U.S., including undiagnosed diabetes, and pre-diabetes. Catherine Dolf has details in this week’s JAMA Report.

    VIDEO
    B-ROLL
    People sitting and walking outside

    AUDIO
    VO
    DIABETES CONTINUES TO RISE IN THE U-S.

    AUDIO
    SOT/FULL
    Andy Menke, Ph.D., – Social & Scientific Systems Inc.
    Super@:05
    Runs:07
    (graphic lower third: wipes in 14% DIABETES)
    “14 percent of the people in the United States have diabetes and this is even higher in Asians and Blacks and Hispanics.”

    AUDIO
    SOT/FULL
    Catherine C. Cowie, Ph.D., – National Institutes of Health
    Super@:09
    Runs:10
    (graphic lower third: wipe in1988-2012 ADULTS 20+)
    “And we specifically looked at data from 1988 until 2012 in adults age 20 and above.”

    VIDEO
    B-ROLL
    Dr. Cowie and Dr. Menke walking outside, various shots of people outside

    AUDIO
    VO
    Dr. Catherine Cowie from the National Institutes of Health and Dr. Andy Menke from Social and Scientific Systems Incorporated along with their co-authors used data from a long running national survey of american adults known as N-HANES. About 26 thousand people were evaluated to determine prevalence and trends in diabetes.

    AUDIO
    Catherine C. Cowie, Ph.D., – National Institutes of Health
    Super@:36
    Runs:11
    (Graphic lower third: wipe in
    1/3 DIABETES IS UNDIAGNOSED
    1/3 POPULATION HAS PRE-DIABETES)
    “One third of diabetes is undiagnosed and we also found that one third of the population has pre-diabetes.”

    AUDIO
    SOT/FULL
    Andy Menke, Ph.D., – Social & Scientific Systems Inc.
    Super@:47
    Runs:05
    (Graphics lower third: wipe in
    ABOUT HALF THE POPULATION HAS DIABETES OR PRE-DIABETES)
    “This means half of people in the United States have either diabetes or pre-diabetes.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    SOT/FULL
    Catherine C. Cowie, Ph.D., – National Institutes of Health
    Super@:56
    Runs:16
    “For the first time in 2011-2012 we had data on Asian-Americans. Their prevalence of diabetes was as high as it is in the Blacks and Hispanics, around 20 percent of the population.”

    AUDIO
    SOT/FULL
    Andy Menke, Ph.D., – Social & Scientific Systems Inc.
    Super@1:13
    Runs:05
    “Up to 50 percent of Asians and Hispanics with diabetes were unaware that they had the condition.”

    VIDEO
    B-ROLL
    Man getting blood glucose test

    AUDIO
    VO
    That’s compared to about a third with undiagnosed diabetes in the White and Black populations.

    AUDIO
    SOT/FULL
    Catherine C. Cowie, Ph.D., – National Institutes of Health
    Super@1:22
    Runs:09
    “Diabetes continues to rise and it continues to rise in all age and sex, race, ethnic groups and in groups according to education and income.”

    (Video covering 2nd part of bite: people eating outside)

    VIDEO
    B-ROLL
    People eating outside

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say the high rate of diabetes in Asian Americans is occurring despite the fact that their body mass index or B-M-I is lower than the B-M-I in the general population.

  • September 01, 2015

    Genetic Testing in Children with Autism Spectrum Disorder

    Genetic Testing in Children with Autism Spectrum Disorder

    INTRO:Autism spectrum disorder or A-S-D represents a diverse group of conditions. If researchers can better understand the genetics of A-S-D, it may be possible to identify and diagnose at-risk children sooner.  A new study examined the results of two kinds of genetic tests in children diagnosed with A-S-D. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Owen walking with his mom and Dr. Fernandez

    AUDIO
    VO
    Owen was diagnosed with autism at two and half.

    AUDIO
    SOT/FULL
    Melissa Blundon  – Owen’s Mother
    Super@:03
    Runs:03
    “He wasn’t walking, he didn’t talk.”

    VIDEO
    B-ROLL
    Various shots of Owen sitting and talking with his mom and Dr. Fernandez

    AUDIO
    VO
    He’s much different today. Almost 13, Owen attends school, has plenty of friends and talks a lot. Even surprising his mom with a new word now and then.

    AUDIO
    SOT/FULL
    Owen Blundon – Study Participant
    Super@:14
    Runs:04
    “A brain and a heart. They’re squeezable.”

    AUDIO
    SOT/FULL
    Melissa Blundon – Owen’s Mother
    Super@:19
    Runs:03    “I’ve never heard him say squeezable before.”

    VIDE0
    B-ROLL
    Owen, his mom and Dr. Fernandez coming down stairs, Dr. Fernandez walking in the building, Graphic; names of two tests and number of children who received them

    AUDIO
    VO
    Owen participated in a study with more than 250 other children diagnosed with autism spectrum disorder. Dr. Bridget Fernandez from Memorial University in Newfoundland and co-authors used two newer genetic tests.  The first, chromosomal microarray analysis, was performed on each child.  The second, whole-exome sequencing, on 95 randomly selected children.

    AUDIO
    SOT/FULL
    Bridget A. Fernandez, M.D., Memorial University Hospital, Newfoundland
    Super@:42
    Runs:10
    “16 percent of the children had an ASD related genetic finding on either the microarray or the whole-exome sequencing.”

    VIDEO
    B-ROLL
    Researcher looking at genetic readouts on computer, various shots of people working in lab

    AUDIO
    VO
    The children were also closely examined for subtle physical differences and screened for birth defects. They were put into three groups based on the severity of these physical differences.

    AUDIO
    SOT/FULL
    Bridget A. Fernandez, M.D., Memorial University Hospital, Newfoundland
    Super@1:01
    Runs:09
    “And when we did that, the children in the morphologically complex group, 35 percent of them had a positive genetic test.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Bridget A. Fernandez, M.D., Memorial University Hospital, Newfoundland
    Super@1:14
    Runs:15
    “In that complex group, the diagnosis of autism was even more delayed than in the children without those types of problems. Sometimes there are other problems that are detracting from the fact that they have these red flags for autism.”

    VIDEO
    B-ROLL
    Owen and Melissa in exam room, cu of Melissa

    AUDIO
    VO
    As part of the study, Owen’s I-Q testing was normal, prompting his mother to send him to school.

    AUDIO
    SOT/FULL
    Melissa Blundon – Owen’s Mother
    Super@1:34
    Runs:08
    “Because I knew that he was smart enough, I said you’re going but now he’s developed into a lovely young man.”

    AUDIO
    SOT/FULL
    Bridget A. Fernandez, M.D., Memorial University Hospital, Newfoundland
    Super@1:42
    Runs:14
    “If we can understand the underlying genetics more completely we’d have the possibility to actually identify at-risk children through genetic testing and get earlier diagnosis and improve the outcome.”

    (Video covering last part of bite: Owen and Dr. Fernandez doing hi-5)

    VIDEO
    B-ROLL
    Owen giving hi-5 to Dr. Fernandez and she smiles

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The chromosomal microarray analysis has been performed for more than five years. The whole-exome sequencing test, a way of scanning most of the coding parts of the genome for mutations, is just entering routine clinical practice.

  • August 25, 2015

    Does Exercise Improve Cognitive Function in Older Adults?

    Does Exercise Improve Cognitive Function in Older Adults?

    INTRO:The ability to process complex thoughts, learn things and retain things we’ve learned, are all aspects of cognitive function. As we age, many of these skills decline. Some older adults have reported improvement in cognitive function when they exercise regularly. A new study compared moderate exercise with a health education program to see which one would better preserve cognitive function in older adults. Catherine Dolf explains in this week’s JAMA Report.
    VIDEO B-ROLL Bobby walking on track AUDIO
    VO
    After Bobby Cox retired, he wasn’t doing much of anything.

    AUDIO
    SOT/FULL Bobby Cox – Study Participant Super@:03 Runs:02
    “Sometimes it was hard for me to get up and move.”
    VIDEO
    B-ROLL Carol sitting at table working with test giver
    AUDIO
    VO
    For Carol Miller, living alone means it’s especially important for her memory and thinking to remain clear.

    AUDIO
    SOT/FULL Carol Miller – Study Participant Super@:12 Runs:05
    “I have to be in charge of a household and an automobile and my health.”
    VIDEO
    Split screen of Carol and Bobby, various shots of seniors working out, Dr. Sink talking with staff member, more of Bobby walking on the track

    AUDIO
    VO
    They both participated in a two-year study that included more than 16 hundred sedentary adults, between the ages of 70 and 89. Dr. Kaycee Sink from Wake Forest Baptist Medical Center and co-authors divided the seniors into two groups. Bobby was in the physical activity group.

    AUDIO
    SOT/FULL Kaycee M. Sink, M.D., M.A.S., – Wake Forest Baptist Medical Center Super@:32 Runs:09
    “The goal was to get folks to walk at least 30 minutes at moderate intensity. We also did some lower extremity strength and some flexibility exercises.”
    (Video covering 2nd half of bite: Bobby using ankle weights and lifting his legs with trainer)

    VIDEO
    B-ROLL
    Carol at table with staff member, taking different cognitive tests

    AUDIO
    VO
    Instead of exercise, Carol’s group attended health education seminars on different topics of interest to seniors.

    AUDIO
    SOT/FULL Kaycee M. Sink, M.D., M.A.S., – Wake Forest Baptist Medical Center Super@:47 Runs:08
    “We measured how they were thinking with their memory and complex processing and language function at the very start of the study.”
    AUDIO
    NATSO/FULL Runs:07
    “…I want you to say the name of each picture… acorn…dominoes…”
    GXF FULL JAMA LOGO

    AUDIO
    VO The study appears in JAMA, Journal of the American Medical Association.

    AUDIO SOT/FULL Kaycee M. Sink, M.D., M.A.S., – Wake Forest Baptist Medical Center Super@1:09 Runs:11
    “Both groups preserved their cognitive function over the course of two years. They stayed the same which is really remarkable because we would have expected older adults in this age range to have declined at least some over two years.”
    VIDEO
    B-ROLL Bobby exercising and Carol split screen taking a test AUDIO
    VO
    Bobby is exercising almost every day and Carol stays active by spending time with her grandchildren.

    AUDIO
    SOT/FULL Kaycee M. Sink, M.D., M.A.S., – Wake Forest Baptist Medical Center Super@1:26 Runs:09
    “Older adults should stay active physically, cognitively and socially. All of those things are important to maintaining independence and cognitive function as you age.” (Video covering 2nd half of bite: Seniors exercising)
    VIDEO
    B-ROLL Seniors exercising

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Participants 80 years and older and those who had poorer baseline physical function appeared to get more cognitive benefit from exercise compared to health education.

  • August 18, 2015

    Teens Who Use E-Cigarettes More Likely to Start Smoking

    Teens Who Use E-Cigarettes More Likely to Start Smoking

    INTRO:Over the past several years, electronic or e-cigarettes have grown in popularity.  Today’s e-cigarette users include a growing number of teenagers, many who have never smoked tobacco. A new study looked at whether younger teens that begin using e-cigarettes might also be more likely to experiment with smokable tobacco products.  Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Man smoking e-cigarette, outside of vape shop

    AUDIO
    VO
    E-cigarettes first entered the market as an alternative for adults who wanted to quit smoking. But over the years, things have changed.

    AUDIO
    SOT/FULL
    SOT/FULL
    Adam M. Leventhal, Ph.D. – University of Southern California
    Super@:08
    Runs:09
    “They come in attractive flavors like cotton candy, bubble gum, they’re very hi-tech and you know, they’re modern and cool.”

    VIDEO
    B-ROLL
    Man holding e-cigarette, Michelle smoking cigarette, Michelle using vape pen

    AUDIO
    VO
    Which helps make them very popular with young people. Michelle Mercado, now in her 20’s, smokes regular cigarettes but also started using e-cigarettes in her teens.

    AUDIO
    SOT/FULL
    Michelle Mercado – E-cigarette and Tobacco User
    Super@:25
    Run:09
    “I do see a lot of people like high schoolers and like young adults getting into the whole vape pen and e-cigarette thing.”

    VIDEO
    B-ROLL
    Dr. Leventhal entering room and meeting with his staff, high school kids walking, teen smoking

    AUDIO
    VO
    Dr. Adam Leventhal from the University of Southern California, Keck School of Medicine and co-authors surveyed more than 23 hundred Los Angeles area high school students at the beginning of 9th grade. Students included in the survey all reported never using any smokable tobacco products.

    AUDIO
    SOT/FULL
    Adam M. Leventhal, Ph.D. – University of Southern California
    Super@:49
    Runs:13
    “We compared teens who had used e-cigarettes to teens who hadn’t and we looked to see whether there were differences between those two groups and the initiation of smoking of combustible tobacco products.”

    VIDEO
    B-ROLL
    People getting on bus

    AUDIO
    VO
    THESE STUDENTS WERE SURVEYED AGAIN SIX MONTHS LATER AND ALSO WHEN ENTERING 10TH GRADE.

    AUDIO
    SOT/FULL
    Adam M. Leventhal, Ph.D. – University of Southern California
    Super@1:06
    Runs:17
    “The teens who used e-cigarettes were more than four times more likely to start smoking than teens who hadn’t used e-cigarettes. The associations were consistent across all the different types of tobacco products, regular cigarettes, cigars or even hookah tobacco water pipe.”

    (Video covering 2nd part of bite: guy smoking cigarette)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Adam M. Leventhal, Ph.D. – University of Southern California
    Super@1:27
    Runs:10
    “They were more likely to use two or more products for the first time during high school in comparison to teens who hadn’t used e-cigarettes.”

    VIDEO
    B-ROLL
    Students walking and girl on bike, girl smoking cigarette

    AUDIO
    VO
    This trend continued as the students entered 10th grade. Even when adjusting for other factors like peer pressure, impulsive tendencies, and socio-economic status, all risk factors for starting smoking, these associations remained.

    AUDIO
    SOT/FULL
    Adam M. Leventhal, Ph.D., University of Southern California
    Super@1:50
    Runs:12
    “This uptick that we’re seeing in adolescent e-cigarette use could potentially down the road lead to a new generation of tobacco smokers.”

    (Video covering end of bite: man standing on street smoking cigarette

    VIDEO
    B-ROLL
    Man on the street smoking cigarette

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This was an observational study. Further research is needed to determine whether the association between e-cigarette use and subsequent smoking is causal.

  • August 11, 2015

    Testosterone Therapy Neither Advances or Slows Down Hardening of the Arteries in Older Men with Low or Low-Normal Testosterone Levels

    Testosterone Therapy Neither Advances or Slows Down Hardening of the Arteries in Older Men with Low or Low-Normal Testosterone Levels

    INTRO:As men age, some experience declining testosterone levels. This may affect sexual function, vitality and overall quality of life. The popularity of testosterone supplementation has increased substantially over the last decade, but the long-term effects remain unclear. A new study evaluated whether using testosterone had any effect on hardening of the arteries, which is linked to heart attack and stroke. Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Peter Nowak – Study Participant
    Super@:02
    Runs:10
    “The aging population, the baby boomers, we’re all getting up into our 60’s and so there’s a lot of men’s health issues around our generation.”

    VIDEO
    B-ROLL
    Peter walking out of elevator, testosterone supplements, still pic of clogged arteries

    AUDIO
    VO
    One issue for Peter Nowak and other older men is declining testosterone levels and whether testosterone supplementation has serious side effects like hardening of the arteries or atherosclerosis.

    AUDIO
    SOT/FULL
    Shalender Bhasin, M.B.B.S., – Brigham and Women’s Hospital
    Super@:22
    Runs:13
    “The hardening of the arteries can impair blood flow to the heart and can lead to heart attacks and hardening of the arteries that supply blood to the brain can lead to strokes.”

    VIDEO
    B-ROLL
    Dr. Bhasin walking with Peter, various shots of men walking outside, testosterone gel, Peter in exam room showing where he applied the gel, pic of dye being pumped through heart arteries

    AUDIO
    VO
    Dr. Shalender Bhasin (bah-seen) from Brigham and Women’s Hospital and co-authors studied more than three hundred men. They were 60 years and older, in relatively good health, with low or low-normal testosterone levels. Half the men applied a testosterone gel daily to the skin for three years. The other half applied a placebo gel. Hardening of the arteries was measured in the coronary and carotid arteries, which supply the heart and brain.

    AUDIO
    SOT/FULL
    Shalender Bhasin, M.B.B.S., – Brigham and Women’s Hospital
    Super@:56
    Runs:13
    “Testosterone did not affect the rate of hardening of arteries over the three years duration of the testosterone therapy compared with placebo.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Shalender Bhasin, M.B.B.S., – Brigham and Women’s Hospital
    Super@1:12
    Runs:11
    “Testosterone also did not improve either the sexual function or quality of life in these otherwise healthy men, who had low or low-normal testosterone levels.”

    VIDEO
    B-ROLL
    Various shots of Peter and Dr. Bhasin in exam room talking

    AUDIO
    VO
    The study was blinded so Peter still doesn’t know if he received testosterone or placebo. However, when he saw his doctor last winter, his overall health was stable.

    AUDIO
    SOT/FULL
    Peter Nowak – Study Participant
    Super@1:32
    Runs:05
    “I got a fine bill of health.  She said everything’s good.”

    VIDEO
    B-ROLL
    Peter on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors note that this trial only looked at hardening of the arteries.  Larger studies are needed to determine whether taking testosterone increases the risk of heart attacks, strokes or other cardiovascular events.

  • August 04, 2015

    MINDFULNESS-BASED THERAPY DECREASES POSTTRAUMATIC STRESS DISORDER SYMPTOMS FOR U-S VETERANS

    MINDFULNESS-BASED THERAPY DECREASES POSTTRAUMATIC STRESS DISORDER SYMPTOMS FOR U-S VETERANS

    INTRO:Almost a quarter of U-S Veterans returning from the wars in Iraq and Afghanistan are diagnosed with post-traumatic stress disorder or P-T-S-D. The Veterans Administration has invested heavily in first-line treatments but up to 60 percent of veterans either don’t begin these treatments or drop out early. A new study evaluated another intervention, mindfulness-based stress reduction, to see if it would help veterans improve their P-T-S-D symptoms. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:02
    “…ring…”

    VIDEO
    B-ROLL
    Various shots of Veterans meditating

    AUDIO
    VO
    These Veterans are using mindfulness-based meditation to help manage P-T-S-D symptoms.

    AUDIO
    NATSO/FULL
    Runs:04
    “…becoming aware of the wandering mind…”

    AUDIO
    SOT/FULL
    Kelvin O. Lim, M.D., – Minneapolis VA Medical Center
    Super@:16
    Runs:09
    “Mindfulness is a type of technique that allows one to be more aware of what one is experiencing.”

    (Video covering 1st half of bite: veteran meditating)

    AUDIO
    SOT/FULL
    Melissa A. Polusny, Ph.D., – Minneapolis VA Medical Center
    Super@:19
    Runs:07
    “To be present and aware of their thoughts, their feelings, their experiences in a non-judgmental and accepting way.”

    VIDEO
    B-ROLL
    Freeze shots of all three Veterans

    AUDIO
    VO
    For Veterans John, Jeff and Jeunai (Jeh-nay) this was an unfamiliar way to help with their
    P-T-S-D symptoms.

    AUDIO
    SOT/FULL
    John – U.S. Veteran
    Super@:32
    Runs:05
    “I was skeptical. I didn’t see how it could help me with my problems.”

    AUDIO
    SOT/FULL
    Jeff – U.S. Veteran
    Super@:38
    Runs:07
    “If you could envision a California freeway at night, that’s the type of traffic I had in my head.”

    AUDIO
    SOT/FULL
    Jeunai – U.S. Veteran
    Super@:44
    Runs:12
    “I thought it was hogwash to tell you the truth. I didn’t think it would be beneficial but obviously all the other stuff I was trying wasn’t really working.”

    VIDEO
    B-ROLL
    Dr. Polusny,Dr. Lim and Dr.Erbes walking down the hospital hallway, more group meditation and group therapy, various shots of program facilitators assessing Veterans

    AUDIO
    VO
    Doctors Melissa Polusny (puh-LEWS-knee),Kelvin Lim and their colleagues at the
    Minneapolis V-A Medical Center wanted to determine if the mindfulness intervention
    could help. 116 Veterans with a diagnosis of P-T-S-D participated in the trial. Half the group completed 9 weeks of mindfulness-based stress reduction therapy.The other had group therapy, focusing on current life problems. The Veterans were monitored before, during and after treatment…

    AUDIO
    NASOT/FULL
    Runs:03
    “…does he have any rituals at home, does he check the locks…”

    VIDEO
    B-ROLL
    Facilitators talking

    AUDIO
    VO
    …and also two months after completing therapy.

    AUDIO
    SOT/FULL
    Kelvin O. Lim, M.D., – Minneapolis VA Medical Center
    Super@1:23
    Runs:09
    “There was a greater improvement with the mindfulness
    or meditation intervention but this was a moderate change.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Melissa A. Polusny, Ph.D., – Minneapolis VA Medical Center
    Super@1:36
    Runs:10
    “Mindfulness skills were significantly associated with
    greater improvements in PTSD symptoms and quality-of-life at the two month follow up.”

    AUDIO
    SOT/FULL
    Jeunai – Study Participant
    Super@1:45
    Runs:09
    “I don’t feel like I am treading water anymore and I feel mindfulness has brought me back to who I am and who my family can enjoy again.”

    (Video covering 2nd half of bite: Jeunai talking and smiling)

    AUDIO
    SOT/FULL
    Jeff – Study Participant
    Super@1:55
    Runs:08
    “I wish I would have had this opportunity when I was a young man to be able to have this resource. I would have been a completely different person today.”

    (Video covering 2nd half of bite: Jeff listening to other Vets talking

    AUDIO
    SOT/FULL
    John – Study Participant
    Super@2:03
    Runs:11
    “I feel peace and that has been a situation that has escaped me in the, 40 years since I was last in combat.”

    (Video covering middle of bite: John talking in group session)

    VIDEO
    B-ROLL
    John on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: More studies are needed but study authors say mindfulness may offer a milder form of exposure to trauma then the first-line treatments currently available.

  • July 28, 2015

    Death Rates, Hospitalizations, and Costs Decrease for Medicare Patients

    Death Rates, Hospitalizations, and Costs Decrease for Medicare Patients

    INTRO:Improving the health of Americans and the U.S. health care system in general has been a large focus for Medicare in recent years.  With so many different efforts being undertaken, what exactly are the benefits? A new study examined key outcomes among the Medicare population over the last 15 years.  Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:04
    “…I was very impressed by the service at the hospital…”

    AUDIO
    NATSO/FULL
    Runs:02
    “…everyone was thinking very hard how to help you…”

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@:07
    Runs:07
    “We’re experiencing an unprecedented improvement in the experience of people in the Medicare program.”

    VIDEO
    B-ROLL
    Dr. Krumholz talking with nurses, Dr. Krumholz examining patient, patient’s wife, couple holding hands, Dr. Krumholz talking to patient

    AUDIO
    VO
    Dr. Harlan Krumholz from the Yale University School of Medicine and co-authors reviewed the records of nearly 70 million medicare beneficiaries during a 15 year period, from 1999 thru 2013.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@:28
    Runs:09
    “It’s really important to keep tabs on what we are achieving in health care. We spend a lot of time, a lot of effort, a lot of resources trying to make things better.”

    VIDEO
    Older people outside hospital in wheelchairs

    AUDIO
    VO
    The researchers first looked at improvements in both the Medicare Advantage and fee-for-service programs combined.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@:39
    Runs:07
    “The chance of dying each year has gone down. Almost a 20 percent reduction in the mortality rate on an annual basis.”

    VIDEO
    B-ROLL
    Patient being pushed in a wheelchair, older person walking with cane

    AUDIO
    Then they took a closer look at the fee-for-service group, representing about 75 percent of the overall medicare population.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@:54
    Runs:15
    “We saw for every 100 thousand people in Medicare about 10 thousand fewer hospitalizations. That translates into millions of people not hospitalized in 2013 who would have been hospitalized had those rates not declined.”

    (Video covering middle of bite: empty hospital room)

    VIDEO
    Out of focus shot of patient in hospital room

    AUDIO
    VO
    OTHER PATIENT OUTCOMES WERE ALSO BETTER.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@1:11
    Runs:06
    “The chance of dying after being hospitalized among Medicare beneficiaries dropped dramatically during this period.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@1:21
    Runs:11
    “Many more people were spending many fewer days in the hospital in the last six months of their life.  When you consider in hospital costs and at the end of life there were also fewer dollars being spent.”

    (Video covering 2nd half of bite: doctors in patient room talking, staff working)

    VIDEO
    B-ROLL
    Older people in the community

    AUDIO
    VO
    These improvements were seen across the nation in all populations, by age, gender, and race.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@1:40
    Runs:05
    “We just have to make sure to continue this trend so the next time we look we’re that much better than we are today.”

    (Video covering first half of bite: Doctor looking at monitor)

    VIDEO
    B-ROLL
    Dr. Krumholz on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Overall spending of Medicare patients in the hospital also declined over
    the study period.

  • July 21, 2015

    SURVIVAL AFTER CARDIAC ARREST IMPROVES WHEN MORE PATIENTS RECEIVE BYSTANDER C-P-R AND EXTERNAL DEFIBRILLATION

    SURVIVAL AFTER CARDIAC ARREST IMPROVES WHEN MORE PATIENTS RECEIVE BYSTANDER C-P-R AND EXTERNAL DEFIBRILLATION

    “SURVIVAL AFTER CARDIAC ARREST IMPROVES WHEN MORE PATIENTS RECEIVE BYSTANDER C-P-R AND EXTERNAL DEFIBRILLATION”

    INTRO:If a family member, someone at work, or even the person standing next to you experiences sudden cardiac arrest, would you be able to help? Performing C-P-R and using an automated external defibrillator can mean the difference between life and death. A new study examined what happens if more ordinary people in the community and first-responders, like police officers and firefighters, learn to use these two interventions—can survival for patients having cardiac arrest be improved? Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:03
    “…hey hey buddy, are you ok, are you ok?”

    VIDEO
    B-ROLL
    Volunteers practicing CPR, cu of instructor, volunteers doing CPR

    AUDIO
    VO
    These volunteers are learning about cardiac arrest and how to provide compression only c-p-r.

    AUDIO
    NATSO/FULL
    Runs:02
    “This is CPR without the breaths.”

    VIDEO
    B-ROLL
    Cu of defibrillator pads being fastened onto mannequin

    AUDIO
    VO
    They are also learning how to use an automated external defibrillator or A-E-D.

    AUDIO
    NATSO/FULL
    Runs:08
    “…open packet and apply pads onto patient’s bare skin… analyzing heart rhythm…shock advised…”

    AUDIO
    SOT/FULL
    Christopher B. Granger, M.D., -Duke Clinical Research Institute
    Super@:22
    Runs:08
    “It’s very important that people not be afraid to act when one sees a cardiac arrest.”

    VIDEO
    B-ROLL
    “Miracle Man” video, David at Duke game, getting CPR and defibrillation

    Mandatory Super@:30

    Courtesy: Contrast Creative
    “Miracle Man”

    AUDIO
    VO
    David Foster had a cardiac arrest while attending a Duke basketball game. First responders performed C-P-R and also used an A-E-D located in the arena.

    AUDIO
    SOT/FULL
    Carolina Malta Hansen, M.D., – Duke Clinical Research Institute
    Super@:39
    Runs:07    “We know that the chances of survival fall about 10 percent per minute without any intervention.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Christopher B. Granger, M.D., -Duke Clinical Research Institute
    Super@ 1:26
    Runs:15
    “The only improvement was when people got bystander CPR so this highlights the critical importance for people to learn how to do compression only CPR and then to do it and don’t be afraid to do it.”

    AUDIO
    SOT/FULL
    Carolina Malta Hansen, M.D., – Duke Clinical Research Institute
    Super@1:41
    Runs:12
    “Patients who received bystander or first responder interventions before arrival of the EMS were more likely to survive compared to those who received EMS interventions alone.”

    (Video covering 2nd half of bite: gurney being taking out of ambulance)

    VIDEO
    Newspaper article, pic of David with medical staff
    (Mandatory Super@ 1:53)

    AUDIO
    VO
    Often called the “Miracle Man”, David survived his cardiac arrest and is doing well today.

    AUDIO
    SOT/FULL
    Carolina Malta Hansen, M.D., – Duke Clinical Research Institute
    Super@1:58
    Runs@:06
    “Any intervention is better than no intervention when a person is having a cardiac arrest.”

    VIDEO
    B-ROLL
    David playing basketball with his children

    (Mandatory Super@ 2:04)

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study looked at counties in non-metropolitan areas with very diverse communities.

  • July 13, 2015

    UNDIAGNOSED MATERNAL CANCER MAY EXPLAIN SOME DISCREPANCIES IN PRENATAL TESTING RESULTS

    UNDIAGNOSED MATERNAL CANCER MAY EXPLAIN SOME DISCREPANCIES IN PRENATAL TESTING RESULTS

    INTRO:An increasing number of pregnant women are undergoing non-invasive pre-natal testing to help identify fetal genetic abnormalities. This is done using a blood test that looks at both the D-N-A of the mother and the fetus.  In a small percentage of these tests, the results appear abnormal but the baby’s genetics are actually normal.  A new study examined if the rare diagnosis of maternal cancer could be one cause of such discrepancies. Catherine Dolf explains in this week’s JAMA Report.

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    Pregnant women having blood drawn

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    This increasingly common blood test can help detect whether a woman is carrying a fetus with a genetic abnormality.

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    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@:07
    Runs:12
    “The test analyzes not only the DNA fragments from the fetus and the placenta but it analyzes DNA fragments from the mother herself.”

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    Lab technician working, Dr. Bianchi in lab

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    For every one thousand women tested, about two will have an abnormal result. It’s recommended those women have additional diagnostic testing looking at only the fetal D-N-A.

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    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@:27
    Runs:19
    “In a small minority of women the test showed that the fetal chromosomes were normal and that disagreed with the blood test. We were examining whether cancer could explain the discrepancy between these two test results.”

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    Dr. Bianchi talking in lab with colleagues, Graphic: over lab video
    NON-INVASIVE PRENATAL SCREENING TESTS
    125,426 Tests
    2 Years
    3,757 Abnormal Tests
    10 Diagnosed with Cancer

    AUDIO
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    Dr. Diana W. Bianchi from Tuft’s Medical Center and co-authors examined more than 125 thousand non-invasive prenatal test results done over a two year period. 3,757 women had abnormal test results. 10 of those women were subsequently diagnosed with cancer.

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    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@1:02
    Runs:08
    “If she does have cancer, there’s the possibility that she is shedding DNA from these tumors into her blood.”

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    Woman getting an ultrasound

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    Medical records and additional genetic information were examined in 8 of those women to look for patterns suggestive of an underlying cancer.

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    JAMA LOGO

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    The study appears in JAMA, Journal of the American Medical Association.

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    SOT/FULL
    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@1:27
    Runs:16
    “There’s a very rare situation in which the mother has cancer, cancer DNA can cause a discrepancy between the prenatal fetal genetic screening test and the fetal chromosome test.”

    (Video covering middle of bite: Ultrasound of fetus)

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    Babies in nursery

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    All 10 women diagnosed with cancer delivered healthy babies.

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    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@1:46
    Runs:14
    “Even though the test was not designed to detect cancer, cancer is an incidental finding. If you recognize the proper signatures then you can go on and have further care.”

    (Video covering end of bite: Dr. Bianchi talking with colleagues)

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    Dr. Bianchi talking with colleagues

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    Catherine Dolf, the JAMA Report.

    Tag:This was a preliminary study.  There is currently no clear guidance about follow up testing when discrepancies are found.  Further research is needed.

  • July 07, 2015

    Stroke Associated with Both Immediate and Long-Term Declines in Cognitive Function

    Stroke Associated with Both Immediate and Long-Term Declines in Cognitive Function

    “Stroke Associated with Both Immediate and Long-Term Declines in Cognitive Function”

    INTRO:Each year in the United States nearly 800 thousand people experience a stroke. Stroke is associated with declines in cognitive function, including memory and thinking speed. Although many patients experience these declines immediately after a stroke, a new study looked at whether cognitive decline also continues and even accelerates years after the initial stroke. Catherine Dolf explains in this week’s JAMA Report.

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    David and nurse leaving hospital waiting room

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    David Ramon (Rah-man) was at home watching T-V when he had his stroke.

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    David Ramon – Stroke Survivor
    Super@:05
    Runs:05
    “I couldn’t close my hand, the right side of my face was numb.”

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    David walking to exam room with nurse

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    He knew something was very wrong and went to find his wife.

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    David Ramon – Stroke Survivor
    Super@:13
    Runs:11
    “I opened the door and tried to tell her that she should call the doctor.  It was just babble. I couldn’t speak.”

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    Various shots of David and Dr. Levine talking in exam room

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    After his stroke, like many patients, David had immediate problems with memory and his ability to think clearly was impaired.

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    Deborah A. Levine, M.D., M.P.H. – University of Michigan
    Super@:30
    Runs:15    “We have known that stroke is associated with cognitive decline over the short term we did not know whether stroke is associated with declines in thinking speed and memory over the years after the event.”

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    Dr. Levine walking down hallway, older people walking outside, computer showing brain images, Dr. Levine doing memory test with David, cu of test, pan from Dr. Levine to David, brain image

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    Dr. Deborah Levine (Lih-veen) from the University of Michigan and co-authors followed more than 23 thousand people, 45 years and older who participated in a national study. The participants were free of any cognitive impairment when they entered the study. Memory and other aspects of cognitive function were measured at the beginning and at regular intervals throughout a six-year follow up period. 515 people experienced a stroke during the study period. The rest remained stroke free.

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    Deborah A. Levine, M.D., M.P.H. – University of Michigan
    Super@1:13
    Runs:15
    “Stroke is associated with significant long-term cognitive decline. Stroke survivors may experience decline in their memory and thinking speed over years after the event, not just right after the event.”

    GXF FULL
    JAMA LOGO

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    The study appears in JAMA, Journal of the American Medical Association.

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    Deborah A. Levine, M.D., M.P.H. – University of Michigan
    Super@1:31
    Runs:12
    “Our findings highlight why it’s so important for stroke survivors and people at high risk for stroke to control their risk factors and to make behavior changes.”

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    Various shots of Dr. Levine checking David’s heart, David using apps on phone

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    David is doing just that. He lost 61 pounds and continues to be monitored closely by his doctors. He also uses programs on his phone to help improve his memory and thinking speed.

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    David Ramon – Stroke Survivor
    Super@1:58
    Runs:10
    “I feel more energetic, happier. I do want to live a long time and I’d like that to be as well as possible.”

    (Video covering 1st and last part of bite: various shots of David using apps on his phone)
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    David using apps on his phone

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    Catherine Dolf, the JAMA Report.

    Tag:Stroke survivors warrant close monitoring to help detect declines in cognition years after their stroke.

  • June 23, 2015

    Implantable Defibrillators Underused Among Older Patients After Heart Attack

    Implantable Defibrillators Underused Among Older Patients After Heart Attack

    INTRO:Each year more than 350 thousand people die from sudden cardiac death. Placement of an “implantable cardioverter-defibrillator” , or I-C-D, can prevent sudden cardiac death in patients who have weakened heart function, including those who have experienced a previous heart attack.  A new study examined older patients who had weakened heart function after a heart attack and whether or not they underwent placement of these defibrillators and also what portion of the patients were still alive 2 years later. Catherine Dolf has more in this week’s JAMA Report.

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    Paul sitting on exam table talking with Dr. Pokorney, Dr. Pokorney checking monitor

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    Paul Harrison is getting his defibrillator checked.  His heart was left weakened after three heart attacks and no longer pumps blood as effectively as it should.

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    Paul Harrison – Heart Patient
    Super@ :07
    Runs:07
    “It gave me a warning that something was happening. When it went off my heart had spiked to a really high number.”

    (Video covering middle of bite: cu of monitor, Dr. Pokorney listening to Paul’s heart)

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    Sean D. Pokorney, M.D., M.B.A., – Duke University
    Super@:17
    Runs:12
    “The implantable cardioverter defibrillator when it senses one of these fast life-threatening heart rhythms can deliver a shock to reset the heart and hopefully get the heart back into a regular rhythm.”

    (Video covering 1st part of bite: doctor listening to Paul’s heart)

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    Paul Harrison – Heart Patient
    Super@ :27
    Runs:05
    “It’s happened three times since I’ve had it. It’s actually saved my life.”

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    Doctor implanting a defibrillator in patient, nurses monitoring patients vital signs, doctor implanting defibrillator

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    Guidelines recommend that patients with weakened heart function that qualify for defibrillator placement wait 40 days after a heart attack. This includes patients 65 years and older.

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    Tracy Y. Wang, M.D., M.H.S, M.Sc., – Duke University
    Super@:41
    Runs:13
    “We wanted to see how many of these patients got a defibrillator within the next year after their heart attack and then we wanted to look at their outcomes to two years to see if their death rate was impacted by the defibrillator.”

    (Video covering end of bite: Dr. Pokorney showing Paul his defibrillator on computer screen)

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    Various shots of Dr. Wong and Dr. Pokorney looking at heart on computer screen, cu of screen, Dr. Pokorney talking with Paul, examining skin around defibrillator

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    Doctors Tracy Wang(Wong) and Sean Pokorney from Duke University along with their co-authors examined clinical information from more than 10 thousand Medicare beneficiaries who had had a heart attack from 2007 to 2010. These patients were treated at more than 4 hundred hospitals across the U-S.

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    Sean D. Pokorney, M.D., M.B.A., – Duke University
    Super@1:09
    Runs:06
    “Less than one in ten patients received an ICD within one year of their heart attack.”

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    JAMA LOGO

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    The study appears in JAMA, Journal of the American Medical Association.

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    Tracy Y. Wang, M.D., M.H.S, M.Sc., – Duke University
    Super@1:19
    Runs:11
    “Patients two years later were surviving longer with a defibrillator. The patients who are 80 years or older we found an association with better survival when a defibrillator was implanted.”

    Video covering 2nd half of bite: doctor implanting a defibrillator)

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    Various shouts of Dr. Pokorney showing Paul his defibrillator

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    Patients who followed up with their doctors within 2 weeks after hospital discharge were more likely to get a defibrillator as were patients who underwent previous heart bypass surgery.  Paul says he is grateful for this life-saving technology.

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    SOT/FULL
    Paul Harrison – Heart Patient
    Super@ 1:41
    Runs:11
    “You come to a crossroads in your life to where you either give up or make the most of what you have left. I felt like they gave me three chances and not many people get one or two.”

    (Paul and his wife walking out of hospital)

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    Paul and wife walking

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The study results found that larger hospitals also had low defibrillator implantation rates in this medicare population.

  • June 09, 2015

    New Control System Shows Potential to Improve Function of Motorized Prosthetic Legs

    New Control System Shows Potential to Improve Function of Motorized Prosthetic Legs

    INTRO:Bending an ankle or knee while walking is second nature to most of us. Tiny electrical signals contract the leg muscles helping the joints move. Currently, most prosthetic legs can’t move that way. A new study examined if using the electrical signals generated when muscles contract, which already help guide motorized prosthetic arms, can also make it easier for people to walk with a motorized prosthetic leg.  Catherine Dolf has more in this week’s JAMA Report.

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    Split screen of Terry and Hailey walking with motorized leg, Terry going down step

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    Artist Terry Karpowicz (Car-pah-wits) and tri-athlete Hailey Danisewicz (dan-ih-seh-vich) are helping test the next generation of prosthetic legs. A motorized leg that bends at the knee and ankle.

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    Terry Karpowicz – Study Participant
    Super@:10
    Runs:08
    “This one allows me the opportunity to flow down the stairs and not really think about the process of what the next step is.”

    (Video covering 2nd half of bite: Terry going walking down stairs)

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    Hailey Danisewicz – Study Participant
    Super@:18
    Runs:04
    “It feels great, you know just being able to go down with that really natural movement.”

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    Hailey walking up ramp, cu of TV screen showing EMG signals

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    This motorized leg harnesses electrical signals generated by their upper leg muscles.These signals are known as E-M-G.

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    Levi J. Hargrove, Ph.D., – Rehabilitation Institute of Chicago
    Super@:29
    Runs:10
    “We pick them up with tiny antennas called electrodes. When the electrodes touch the skin you can detect the EMG signals and we pick those signals up and decode them.”

    (Video covering 2nd half of bite: woman sitting at desk looking at computer, reverse shot computer screen, cu of computer screen)

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    B-ROLL
    Hailey walking down ramp

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    These signals help tell the leg how to move.

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    NATSO/FULL
    Runs:03    “…looking good…”

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    Terry walking up stairs with current prosthetic leg

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    Traditional prosthetic legs are passive, functioning almost like a fancy walking stick.

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    Levi J. Hargrove, Ph.D., – Rehabilitation Institute of Chicago
    Super@:48
    Runs:07
    “With this prosthetic leg the power pushes you along.  It can push you up and out of a seat.  It can push you up stairs or slopes.”

    (Video covering middle of bite: Hailey going up stairs with motorized leg)

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    Dr. Hargrove walking with Hailey as she comes down the ramp, team members sitting and standing near Hailey, Terry going up ramp, Hailey going up steps with therapist

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    Dr. Levi Hargrove from the Rehabilitation Institute of Chicago and co-authors tested two different ways to use the motorized leg in a group of 7 patients, all with lower limb amputations. One way incorporated E-M-G, the other way did not.  Each patient tested both methods but was not aware of which method was being used at a given time.

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    Levi J. Hargrove, Ph.D., – Rehabilitation Institute of Chicago
    Super@1:14
    Runs:09
    “The system that did not incorporate neural signals, we noticed that it had a few more errors.  It’s like stubbing your toe or kicking the bottom of the stair.”

    (Video covering 2nd half of bite: Hailey hitting leg on step)

    GXF FULL
    JAMA LOGO

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    VO
    The study appears in JAMA, Journal of the American Medical Association.

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    SOT/FULL
    Levi J. Hargrove, Ph.D., – Rehabilitation Institute of Chicago
    Super@1:26
    Runs:11
    “Using EMG signals resulted in a leg that behaved better, made fewer mistakes and people liked to use it better. It reduced error rates by almost 50 percent.”

    (Video covering 2nd half of bite: Terry walking up stairs)

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    SOT/FULL
    Terry Karpowicz – Study Participant
    Super@ 1:38
    Runs:07
    “It allows me that freedom to just be who I am, not necessarily an amputee.”

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    SOT/FULL
    Hailey Danisewicz – Study Participant
    Super@1:44
    Runs:12
    “This is kind of the closest I’ve gotten to having, having two legs again. What we’re working on in this lab is eventually going to change the lives of amputees everywhere. I mean it’s great.”

    (Video covering middle of bite: Hailey walking with leg)

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    B-ROLL
    Hailey on camera

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    Catherine Dolf, the JAMA Report.

    Tag:All the participants had above the knee or through the knee amputations.

  • June 02, 2015

    Antidepressants in Late Pregnancy May Be Associated with a Small Increase in Risk of Severe Breathing Disorder in Newborns

    Antidepressants in Late Pregnancy May Be Associated with a Small Increase in Risk of Severe Breathing Disorder in Newborns

    INTRO:A 2006 health advisory from the Food and Drug Administration alerted women that taking certain types of anti-depressants late in pregnancy could increase the risk of a severe and life-threatening breathing disorder in their newborns. In 2011, the F-D-A updated the advisory saying it was too early to reach firm conclusions about a possible link. A new study examines whether taking anti-depressants during late pregnancy increases the risk for this condition known as P-P-H-N. Catherine Dolf has more in this week’s JAMA Report.

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    Babies in nursery, babies feet and stomach going up and down

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    Babies breathe very differently before and after birth.

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    Krista F. Huybrechts, M.S., Ph.D., – Brigham and Women’s Hospital
    Super@:05
    Runs:05
    “Before birth, the baby’s blood circulates differently while in the uterus.”

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    Various shots of pregnant woman getting ultrasound, graphic: full screen of incubator with PPHN sliding onto screen and highlighting first letters PPHN, Dr. Huybrechts walking in hospital, cu shots of antidepressant medications, Dr. Huybrechts talking with nurse, showing nurse the medication

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    VO
    The fetus gets oxygen from its mother. The developing lungs are not used for breathing.  After birth this should change. Persistent pulmonary hypertension or p-p-h-n occurs when the baby does not adapt to breathing outside the womb. Dr. Krista Huybrechts (Hau-brecks) from Brigham and Women’s Hospital in Boston and co-authors examined medical records of nearly 4 million publicly insured women, all diagnosed with depression, who filled a prescription for anti-depressants during the last 90 days of pregnancy.  The researchers were most interested in use of selective serotonin re-uptake inhibitor anti-depressants or S-S-R-Is.

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    Krista F. Huybrechts, M.S., Ph.D., – Brigham and Women’s Hospital
    Super@:42
    Runs:08
    “The large majority of those women, around 80 percent, used an SSRI as opposed to a non-SSRI antidepressant.”

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    Pregnant women walking, baby in incubator with nurse and doctor around him

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    The records of women who did not take an antidepressant were also examined.  The number of babies born with P-P-H-N was compared in each group.

    GXF FULL
    JAMA LOGO

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    VO
    The study appears in JAMA, Journal of the American Medical Association.

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    Krista F. Huybrechts, M.S., Ph.D., – Brigham and Women’s Hospital
    Super@1:09
    Runs:17
    “Once we accounted for potential differences in the characteristics of women belonging to these different exposure groups we did not find an increase in the risk of PPHN associated with either SSRI antidepressants nor for non-SSRI antidepressants.”

    (Video covering middle of bite: babies in nursery)

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    Pregnant women, babies in nursery

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    Those characteristics included diabetes and obesity, both of which are known risk factors for P-P-H-N.

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    Krista F. Huybrechts, M.S., Ph.D., – Brigham and Women’s Hospital
    Super@1:33
    Runs:15    “This is important information for clinicians and their patients when they are weighing the risks and benefits of continuing antidepressant medication use during pregnancy or potentially initiating medication use during pregnancy.”

    (Video covering 2nd half of bite: antidepressant medications)

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    B-ROLL
    Antidepressant medications

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    Catherine Dolf, the JAMA Report.

    Tag:The risk of P-P-H-N in the study population ranged between 20 and 30 cases per ten thousand births.

  • May 26, 2015

    Mild Thyroid Overactivity Associated With Increased Risk of Fractures

    Mild Thyroid Overactivity Associated With Increased Risk of Fractures

    INTRO:The thyroid gland makes hormones that regulate metabolism.  The thyroid also has other important effects throughout the body.  An overactive thyroid can increase the risk of osteoporosis and fractures. A new study examined whether the risk of these fractures also increases among patients with only mild abnormalities of the thyroid, those who have not developed any physical symptoms as a result of having too much or too little thyroid hormone.  Catherine Dolf explains in this week’s JAMA Report.

    NATSO/FULL
    Runs:08
    “…the thyroid is a butterfly shaped gland and it sits right at the base of your neck…the thyroid can cause problems from overactivity or from underactivity…”

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    Graphic: Underactive/Overactive thyroid and symptoms, Dr. Cappola examining patient

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    VO
    An underactive thyroid can cause constipation, unexplained weight gain, or fatigue. An overactive thyroid can do the opposite; symptoms might include, weight loss, anxiety, and heart palpitations.  Too much thyroid hormone can also increase the risk for osteoporosis and fractures. But for people who only have mild abnormalities in thyroid activity and don’t have any of these symptoms, do they also increase their risk for fractures?

    AUDIO
    NATSO/FULL
    Runs:01
    “…can you swallow please…”

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    Dr. Cappola walking down hall into an exam room, looking at x-ray on the computer, people walking outside, technician doing testing, Dr. Cappola looking at x-rays

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    Dr. Anne Cappola from the University of Pennsylvania and co-authors examined the results of 13 individual research studies that included more than 70 thousand patients from all over the world. All patients had testing of their thyroid hormone levels and were followed for an average of 12 years to see whether or not they experienced fractures.

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    Anne R. Cappola, M.D., Sc.M., – University of Pennsylvania, Perelman School of Medicine
    Super@:52
    Runs:06
    “We found that three percent had a slightly overactive thyroid, five percent had a slightly underactive thyroid.”

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    JAMA LOGO

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    VO
    The study appears in JAMA, Journal of the American Medical Association.

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    Anne R. Cappola, M.D., Sc.M., – University of Pennsylvania, Perelman School of Medicine
    Super@1:01
    Runs:14
    “Those who had the slightly overactive thyroid were more likely to have hip fractures and more likely to have any kind of fracture. The people who had just a little bit underactive thyroid didn’t have any fracture risk at all from having that thyroid problem.”

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    Dr. Cappola and patient talking in exam room

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    Currently, routine thyroid screening is not recommended.

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    Anne R. Cappola, M.D., Sc.M., – University of Pennsylvania, Perelman School of Medicine
    Super@1:18
    Runs:15
    “If someone has a slightly overactive thyroid that’s something that needs to be paid attention to. What it suggests is if somebody has increased risk of fracture from having a slightly overactive thyroid that perhaps if we were to correct that and treat that we could prevent fractures.”

    (Video covering last part of bite: Spinal x-ray on computer)

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    Spinal x-ray

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    Catherine Dolf, the JAMA Report.

    Tag:The average age of patients that underwent thyroid testing was 64 and 61 percent were women.

  • May 19, 2015

    Oral Steroids Do Not Improve Sciatica Pain

    Oral Steroids Do Not Improve Sciatica Pain

    INTRO: Steroids are commonly prescribed for patients who suffer from lower back and leg pain caused by a herniated disc. But how well do these anti-inflammatory medications actually work? A new study looked at a common oral steroid medication and its effectiveness in decreasing pain and improving function for patients with a herniated disc. Catherine Dolf has more in this week’s JAMA Report.

     

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    Various shots of people walking outside

     

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    Every day, thousands of people head to their doctor’s office looking for relief from a very common problem.

     

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    NATSO/FULL Runs:02

    “…if you have any discomfort you tell me…”

     

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    Dr. Goldberg examining patient

     

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    It’s called sciatica.

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    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern California

    Super@:16

    Runs:10

    “Acute sciatica is often disabling, extremely painful condition felt down the leg. It’s usually caused by a ruptured disc in the lumbar area.”

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    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@:20

    Runs:08

    “We’ve begun looking at other ways to decrease the pain and improve function more easily for patients with sciatica.”

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    Dr. Goldberg lifting patients leg, prednisone tablet poured out on table

     

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    VO

    There are limited options for treating this painful condition. One of the most common approaches is to prescribe the oral steroid medication called prednisone.

     

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    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@:36

    Runs:04

    “But it’s never been studied to see if in fact it makes a difference.”

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    Dr. Goldberg and Dr. Avins walking, looking at MRI, patient going into MRI machine, cu of prednisone tablets

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    Doctors Harley Goldberg and Andrew Avins from Kaiser Permanente Northern California and co-authors studied 269 patients with sciatica. All patients underwent an m-r-i to confirm that they had a herniated disc. Two-thirds were given oral prednisone and the other third got a placebo. Patients were assessed for pain and overall function after three weeks and again at one year.

     

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    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@1:01

    Runs:13

    “People got no better with the prednisone than they did with the placebo, that is to say, they both got better equally. There was actually a little bit of improved functional capacity for people that took prednisone.”

    GXF FULL

    JAMA LOGO

     

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    The study appears in JAMA, Journal of the American Medical Association.

     

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    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern

    Super@1:17

    Runs:10

    “We also found that patients who took steroids had more side effects than patients who took the placebo but most of those side effects were fairly mild and transient in nature.”

     

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    Dr. Goldberg raising patients leg

     

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    The authors say these results provide important evidence about the relative risks and benefits of steroid therapy.

     

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    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern

    Super@1:33

    Runs:15

    “We now have guidance, we have information and we can provide for our patients, true meaningful and informed discussions about the relative benefits and risks of this kind of therapy for this kind of condition.”

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    Cu on computer screen, pan up to Dr. Goldberg and Dr. Avins

     

    AUDIO

    Catherine Dolf, the JAMA Report.

     

     

    Tag:Study authors say, while these new data are important, additional studies are needed to evaluate other treatments that may be effective for this common condition.

  • May 19, 2015

    Oral Steroids Do Not Improve Sciatica Pain

    Oral Steroids Do Not Improve Sciatica Pain

    INTRO: Steroids are commonly prescribed for patients who suffer from lower back and leg pain caused by a herniated disc. But how well do these anti-inflammatory medications actually work? A new study looked at a common oral steroid medication and its effectiveness in decreasing pain and improving function for patients with a herniated disc. Catherine Dolf has more in this week’s JAMA Report.

     

    VIDEO

    B-ROLL

    Various shots of people walking outside

     

    AUDIO

    VO

    Every day, thousands of people head to their doctor’s office looking for relief from a very common problem.

     

    AUDIO

    NATSO/FULL Runs:02

    “…if you have any discomfort you tell me…”

     

    VIDEO

    B-ROLL

    Dr. Goldberg examining patient

     

    AUDIO

    VO

    It’s called sciatica.

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern California

    Super@:16

    Runs:10

    “Acute sciatica is often disabling, extremely painful condition felt down the leg. It’s usually caused by a ruptured disc in the lumbar area.”

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@:20

    Runs:08

    “We’ve begun looking at other ways to decrease the pain and improve function more easily for patients with sciatica.”

    VIDEO

    B-ROLL

    Dr. Goldberg lifting patients leg, prednisone tablet poured out on table

     

    AUDIO

    VO

    There are limited options for treating this painful condition. One of the most common approaches is to prescribe the oral steroid medication called prednisone.

     

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@:36

    Runs:04

    “But it’s never been studied to see if in fact it makes a difference.”

    VIDEO

    B-ROLL

    Dr. Goldberg and Dr. Avins walking, looking at MRI, patient going into MRI machine, cu of prednisone tablets

    AUDIO

    Doctors Harley Goldberg and Andrew Avins from Kaiser Permanente Northern California and co-authors studied 269 patients with sciatica. All patients underwent an m-r-i to confirm that they had a herniated disc. Two-thirds were given oral prednisone and the other third got a placebo. Patients were assessed for pain and overall function after three weeks and again at one year.

     

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@1:01

    Runs:13

    “People got no better with the prednisone than they did with the placebo, that is to say, they both got better equally. There was actually a little bit of improved functional capacity for people that took prednisone.”

    GXF FULL

    JAMA LOGO

     

    AUDIO

    VO

    The study appears in JAMA, Journal of the American Medical Association.

     

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern

    Super@1:17

    Runs:10

    “We also found that patients who took steroids had more side effects than patients who took the placebo but most of those side effects were fairly mild and transient in nature.”

     

    VIDEO

    B-ROLL

    Dr. Goldberg raising patients leg

     

    AUDIO

    VO

    The authors say these results provide important evidence about the relative risks and benefits of steroid therapy.

     

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern

    Super@1:33

    Runs:15

    “We now have guidance, we have information and we can provide for our patients, true meaningful and informed discussions about the relative benefits and risks of this kind of therapy for this kind of condition.”

    VIDEO

    B-ROLL

    Cu on computer screen, pan up to Dr. Goldberg and Dr. Avins

     

    AUDIO

    Catherine Dolf, the JAMA Report.

     

     

    Tag:Study authors say, while these new data are important, additional studies are needed to evaluate other treatments that may be effective for this common condition.

  • May 05, 2015

    Non-Aggressive Strain of Bacteria Helps Reduce Recurrent C. difficile Infection

    Non-Aggressive Strain of Bacteria Helps Reduce Recurrent C. difficile Infection

    INTRO:C-difficile or C-diff., is a common and sometimes deadly health care-associated infection. Almost 500 thousand cases are diagnosed each year in the U.S., usually affecting hospitalized patients and others taking antibiotics. The symptoms include severe diarrhea and colitis. Even after treatment, C-diff. frequently returns. A new study examined a potential way to prevent the infection from coming back. Catherine Dolf has more this week’s JAMA Report.

    VIDEO
    B-ROLL
    Pics of Cheryl biking and traveling, pic of C diff

    AUDIO
    VO
    Cheryl O’Riordan loves to bike, travel and volunteer but a bout with this bacteria, c-difficile, changed her life.

    AUDIO
    SOT/FULL Super@:06 Cheryl O’Riordan – C. difficile Patient Runs:07
    “I felt like the lining of my colon was being ripped out.” “I needed to be near a washroom at all times.”

    VIDEO
    B-ROLL
    Dr. Johnson listening to Cheryl’s heart

    AUDIO
    VO
    Dr. Stuart Johnson from Loyola University Health System treated Cheryl for her c-diff infection.

    AUDIO
    SOT/FULL Super@:18 Stuart Johnson – Loyola University Health System Runs:11
    “C diff is an opportunistic bacteria.” It can travel down the gut, start to replicate, produce the toxins and cause the manifestations that we refer to as C diff.”

    (Video covering 2nd half of bite: technician looking at petri dish)

    VIDEO
    B-ROLL
    Graphic: pic of C diff , various lab shots, technician working with vials

    AUDIO
    VO
    About 25 to 30 percent of patients see a return of the infection. However, some patients carry strains of c-diff that do not make the toxins that are responsible for symptoms of infection, in this case, severe diarrhea; these are called non-toxigenic strains.

    AUDIO
    SOT/FULL Super@:42 Dale N. Gerding, M.D., – Edward Hines Jr. VA Hospital Runs:09
    “If that strain can be established in your gut it will keep out the toxigenic strains, in fact, it may even force out some of these toxigenic strains.”

    VIDEO
    B-ROLL
    Dr. Gerding walking in his lab, technician laying out several petri dishes, technician taking sample from petri dish

    AUDIO
    VO
    Dr. Dale Gerding from the Edward Hines V-A Hospital and co-authors looked at 168 patients who had been successfully treated for c-diff and randomly assigned them to four groups. Three of the groups received varying doses of the non-toxigenic c-diff strain. The fourth group received a placebo.

    AUDIO
    SOT/FULL Super@1:06 Dale N. Gerding, M.D., – Edward Hines Jr. VA Hospital Runs:16
    “The secret clearly was to get these patients to be colonized with this nontoxigenic strain, which just means that these strains set up housekeeping in the G-I tract. We got about 70 percent of patients to colonize with this strain after treatment.”

    (Video covering middle of bite: Dr. Gerding looking into microscope, cu of lens)

    GXF FULL
    JAMA COVER

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL Super@1:26 Dale N. Gerding, M.D., Edward Hines Jr. VA Hospital Runs:16
    “We were able to reduce the recurrence rate from 30 percent in the placebo group down to 11 percent for all patients who got the nontoxigenic strain and for the dose that worked the best the recurrence rate was 5 percent.”

    VIDEO
    B-ROLL
    Technician taking specimen out of freezer

    AUDIO
    VO
    Administration of non-toxigenic strains did not result in any severe side effects compared with placebo.

    AUDIO
    SOT/FULL Super@1:47 Dale N. Gerding, M.D., Edward Hines Jr. VA Hospital Runs:08
    “It’s the first time that we’ve taken a strain of the same bacteria that causes the disease and actually used it as a preventive measure.”

    VIDEO
    Cheryl walking, sitting outside talking on phone

    AUDIO
    VO
    Luckily Cheryl did not have a recurrence of c-diff.  Her health is back to normal and she is looking forward to…

    AUDIO
    SOT/FULL Super@2:02 Cheryl O’Riordan – C. difficile Patient Runs:02
    “My next trip.”…(laugh)

    VIDEO
    Pic of Cheryl on vacation

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The non-toxigenic c-diff bacteria only stays in the g-i tract temporarily.  Study authors say this corresponds to when a patient’s normal bacteria is recovered, which pushes out the non-toxigenic strain.

  • April 28, 2015

    Emergency Department Intervention Improves Rate of Treatment for Opioid Dependence

    Emergency Department Intervention Improves Rate of Treatment for Opioid Dependence

    INTRO:Those struggling with addictions to prescription drugs and heroin often seek care in hospital emergency departments. However, the primary option available for emergency department staff is referral to addiction treatment services. A new study evaluated whether these patients would be more successful in seeking and staying in addiction treatment if they began effective treatment in the emergency department. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Michael walking into hospital emergency department

    AUDIO
    VO
    Like others who have struggled with drug addiction, Michael McCrorken was no stranger to hospital emergency departments.

    AUDIO
    SOT/FULL Super@:07 Michael McCrorken Runs:07
    “I was literally just enslaved to my addiction and it was awful.”

    AUDIO
    SOT/FULL Super@:14 Gail D’Onofrio, M.D., M.S., – Yale School of Medicine Runs:09
    “These patients often seek care in the emergency department and often are just turned away and not directed to treatment.”

    VIDEO
    B-ROLL
    Dr. D’Onfrio, Dr. Fiellin and another doctor walking down hallway in ED, EMT’s walking with gurney, staff treating patient, wide shot of emergency department desk, pan of medication buprenorphine, cu of person getting blood pressure taken

    AUDIO
    VO
    Doctors Gail D’Onofrio (dah-naw-free-oh) and David Fiellin (feh-leen) from the Yale School of Medicine and co-authors enrolled 329 patients with opioid dependence from the emergency department at Yale-New Haven Hospital. One group received a referral to drug treatment. The second group underwent a brief intervention and referral to treatment.  The third group was started on buprenorphine (bew-puh-nor-feen), a medication that helps ease withdrawal symptoms and drug cravings. This group also followed up in primary care for maintenance therapy.

    AUDIO
    SOT/FULL Super@:49 David A. Fiellin, M.D., – Yale School of Medicine Runs:10
    “Once they came to the primary care center we organized their treatment and provided them that treatment for at least a 10 week period of time.”
    AUDIO
    SOT/FULL Super@:58 Gail D’Onofrio, M.D., M.S., – Yale School of Medicine Runs:06
    “Those patients that were randomized to the buprenorphine group, almost 80 percent of them were in treatment at 30 days.”

    AUDIO
    SOT/FULL Super@1:04 David A. Fiellin, M.D., – Yale School of Medicine Runs:07
    “And this is twice the number who will be engaged in treatment if they simply receive a referral to treatment.”

    GXF FULL
    JAMA COVER

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL Super@1:15 Gail D’Onofrio, M.D., M.S., – Yale School of Medicine Runs:07
    “We also found that those patients that were assigned to the buprenorphine group used less illicit opiates.”

    (Video covering 2nd half of bite: medication box)

    VIDEO
    B-ROLL
    Michael walking with ED nurse

    AUDIO
    VO
    Michael says one of the biggest concerns he and others faced was waiting to get into treatment.

    AUDIO
    SOT/FULL Super@1:27 Michael McCrorken Runs:07
    “If you go to the emergency room and they’ll treat you immediately versus waiting then it’s an asset.”

    (Video covering bite: Michael and doctors talking)

    VIDEO
    Michael walking outside

    AUDIO
    VO
    Michael has been in recovery for six years and is now studying business management.

    AUDIO
    SOT/FULL Super@1:39 Michael McCrorken Runs:05
    “I’ve never seen such a bright future and I never knew that I had it in me.”

    VIDEO
    Michael on camera

    AUDIO
    Catherine Dolf, the JAMA Report.
    Tag:In order to provide buprenorphine, emergency room physicians must complete extra training on opioid dependence and receive a special wavier from the Federal Drug Enforcement Agency.

     

  • April 21, 2015

    No Association Found Between Measles, Mumps, Rubella Vaccine and Autism, even among Children at Higher Risk

    No Association Found Between Measles, Mumps, Rubella Vaccine and Autism, even among Children at Higher Risk

    INTRO:Although multiple studies over the past 15 years have shown no link between the measles-mumps-rubella (or M-M-R) vaccine and autism spectrum disorders, parents and others continue to associate the vaccine with autism. A new study examined whether or not the M-M-R vaccine was associated with an increased risk of autism spectrum disorders especially in children whose older sibling already had an autism diagnosis. Catherine Dolf has more in this week’s JAMA Report.

    NATSO/FULL
    Runs:03
    “…waaaaaah…all done…”

    VIDEO
    B-ROLL
    Child getting vaccinated, vaccine in refrigerator, children in park

    AUDIO
    VO
    Receiving the measles-mumps-rubella or m-m-r vaccine has been a sometimes painful but routine part of a young child’s visit to the doctor. However, there have been questions about the safety of the MMR vaccine especially from parents who have children diagnosed with autism spectrum disorders or A-S-D.

    AUDIO
    SOT/FULL Super@:19 Anjali Jain, M.D., – The Lewin Group Runs:14
    “Many of them attribute their child’s autism spectrum disorders to the MMR vaccine. As a result they’re not always vaccinating those kids and their siblings as readily as other parents.”

    (Video covering 2nd part of bite: child getting vaccinated)

    VIDEO
    B-ROLL
    Dr. Jain walking outside, dissolve to her in office, cu of her on computer, various shots of children in park, family walking

    AUDIO
    VO
    Dr. Anjali (un-juh-lee) Jain (Jan) from the Lewin (LOO-WIN) Group and co-authors studied more than 95 thousand children enrolled in a large commercial health plan, following them from birth to at least five years of age. These children all had an older sibling enrolled in the plan. Researchers were particularly interested in children whose older sibling had an A-S-D diagnosis since that puts the younger child at a higher risk for A-S-D.

    AUDIO
    SOT/FULL Super@:54 Anjali Jain, M.D., – The Lewin Group Runs:18
    “We found no evidence of a harmful association between the MMR vaccine and autism spectrum disorders. This was true even among those children who were at an increased risk of having autism spectrum disorders by virtue of having an older sibling with ASD.”

    (Video covering middle of bite: vial of MMR vaccine)

    GXF FULL
    JAMA COVER

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIOSuper@1:16 Anjali Jain, M.D., – The Lewin Group Runs:12
    SOT/FULL
    “We found parents who have a child with an autism spectrum disorder already are vaccinating about 10 percent less than the parents of children who have unaffected siblings.”

    VIDEO
    B-ROLL
    Various shots of children walking outside

    AUDIO
    VO
    Dr. Jain (jan) says among the 95 thousand children just under a thousand were diagnosed with A-S-D, about one percent, similar to the prevalence in the general population.

    AUDIO
    SOT/FULL Super@1:37 Voice of:Anjali Jain, M.D., – The Lewin Group Runs:12
    “This study confirms the safety of the MMR vaccine using recent objective data in a very large data set. We hope that this reassures parents when they are making healthcare decisions for their children.”

    (Video covering first part of bite:  MMR vaccine in boxes, nurse showing mom information, mom holding child)

    VIDEO
    B-ROLL
    Mom holding child

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:Using a very large objective data base is important when looking at autism spectrum disorders because the condition varies so much from child to child.

  • April 14, 2015

    Intrauterine Exposure to Maternal Gestational Diabetes Associated With Increased Risk of Autism

    Intrauterine Exposure to Maternal Gestational Diabetes Associated With Increased Risk of Autism

    INTRO: When a fetus is exposed to high blood glucose because of maternal diabetes, this can have long-lasting effects on development. A new study examined whether exposure to maternal diabetes during pregnancy is associated with an increased risk of autism spectrum disorders in children. Catherine Dolf has more in this week’s JAMA Report.

    NATSO/FULL
    Runs:05
    “…wow, look at you…say yay…”

    VIDEO
    B-ROLL
    Megan clapping and hugging Levi, Levi working with therapist, Megan watching Levi and the therapist

    AUDIO
    VO
    2 year-old Levi Dahlberg was only recently diagnosed with autism but his mom Megan knew there was something different about him before that.

    AUDIO
    SOT/FULL Super@:11 Megan Dahlberg – Levi’s Mother Runs:11
    “Levi was saying hi and bye, kitty and tree and right about the same time he started walking he just stopped. Any sort of communication just went away around 16 months.”

    (Video covering end of bite: Levi walking to mom)

    AUDIO
    SOT/FULL Super@:23 Edward S. Curry, M.D., – Kaiser Permanente Southern California Runs:13
    “Early in pregnancy that first and second trimester is where the fetal brain is developing That’s a period of time where the brain is most susceptible to insults, so having an elevated blood sugar is an insult to that fetus.”

    (Video covering middle of bite: woman getting ultrasound)

    VIDEO
    B-ROLL

    AUDIO
    VO
    Doctors Edward Curry and Anny (Eh-knee) Xiang (She-ong) from Kaiser Permanente Southern California and co-authors reviewed the medical records of more than 322 thousand children, born at Kaiser Permanente hospitals between 1995 and 2009. They identified the mothers’ diabetes status during pregnancy and also examined how many children were diagnosed with autism spectrum disorders.

    AUDIO
    SOT/FULL Super@:54 Anny H. Xiang, Ph.D., – Kaiser Permanente Southern California Runs:13
    “Exposure to gestational diabetes diagnosed before 26 weeks gestation was associated with increased risk of autism spectrum disorders in the offspring.”

    GXF FULL
    JAMA COVER

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL Super@1:15 Anny H. Xiang, Ph.D., – Kaiser Permanente Southern California Runs:09
    “For the children of mothers diagnosed after 26 weeks of gestation, there was no increased risk of having autism spectrum disorders.”

    (Video covering 1st part of bite: pregnant women walking)

    VIDEO
    B-ROLL
    Pregnant women walking and sitting

    AUDIO
    VO
    There was also no increased risk of autism spectrum disorders observed in children of mothers diagnosed with diabetes before pregnancy as well as those without diabetes.

    AUDIO
    SOT/FULL Super@1:32 Edward S. Curry, M.D., – Kaiser Permanente Southern California Runs:13
    “Early pre-natal care is vitally important for mothers. You want the mothers to come in not only to check for diabetes but also to be on their pre-natal vitamins, those things that can have a positive impact on the developing fetus.”

    (Video covering middle and end of bite: ultra sound screen pan down to mother’s belly)

    VIDEO
    B-ROLL
    Megan watching Levi working with therapist

    AUDIO
    VO
    While Megan did not have diabetes during her pregnancy, she is grateful for ongoing autism research.

    AUDIO
    SOT/FULL Super@1:50 Megan Dahlberg – Levi’s Mother Runs:11
    “I hope that one day he does not have a diagnosis, that it can be cured.  You just want them to be able to thrive both socially and intellectually and that’s my hope.”

    (Video covering end of bite: Levi working with therapist on mini-trampoline)

    VIDEO
    B-ROLL
    Levi smiling at therapist

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The study authors note that this was an observational study and further studies are needed to confirm the findings and better understand the nature of this association.

  • December 22, 2015

    New Research Suggests Increased Number of I-V-F Cycles Can Be Beneficial

    New Research Suggests Increased Number of I-V-F Cycles Can Be Beneficial

    INTRO:Women facing infertility often turn to in vitro fertilization or I-V-F.  Although I-V-F technology has improved, there is still a widely held belief that if a woman doesn’t experience a successful live birth after three or four I-V-F cycles her chances of a successful live birth going forward are very low.  A new study looked at I-V-F success rates after repeated treatment cycles well beyond the third or fourth attempts.  Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Babies in nursery, cu of babies hand

    AUDIO
    VO
    Having a healthy baby is the goal of every woman trying to conceive, including those seeking the help of in vitro fertilization, or I-V-F.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@:07
    Runs:07
    “When you first embark on IVF treatment you should not be put off if you don’t have success after the first, the second, the third cycle.”

    VIDEO
    B-ROLL
    Various shots of technicians in lab

    AUDIO
    VO
    I-V-F technology has improved over recent years. One treatment cycle includes ovarian stimulation, transfer of a fresh embryo and any subsequent frozen embryos from that same ovarian stimulation.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@:26
    Runs:08
    “Once that you’ve exhausted the stores of frozen embryos would be then starting another treatment cycle.”

    VIDEO
    B-ROLL
    Dr. Lawlor walking down hallway, to her computer, IVF procedure, baby crying

    IVF video
    Mandatory Courtesy:
    University of Glasgow

    AUDIO
    VO
    Dr. Debbie Lawlor from the University of Bristol, in England, says no one has really looked at the success rate when you define an I-V-F cycle in that way. She and her co-authors studied almost 160 thousand women in the United Kingdom who underwent nearly 260 thousand full i-v-f cycles between 2003 and 2010. They examined live birth rates among these women thru 2012.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@ 1:00
    Runs:18
    “Women who are under 40 and using their own eggs within the first cycle, the success rate was 33 percent, it remained over 20 percent by their 6th cycle, they’d a cumulative live birth rate of 68 percent.”

    (Video covering 1st part of bite: baby being rocked)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The Study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@ 1:18
    Runs:17
    “You continue to increase your chances of success right up to the 9th cycle. You’re gaining similar levels of success at around 5 or 6 cycles which takes around two years to what couples naturally conceiving would reach in about a year.”

    VIDEO
    B-ROLL
    Women pushing baby strollers, cells dividing under microscope

    Mandatory Courtesy:
    University of Glasgow

    AUDIO
    VO
    Dr. Lawlor says women between 40 and 42 also increased their success rates right up until the ninth cycle. There was also encouraging news for women who produced no eggs or a very small number during a single ovarian stimulation.

    AUDIO
    SOT/FULL
    Debbie A. Lawlor, Ph.D., – University of Bristol, United Kingdom
    Super@ 1:47
    Runs:17
    “That importantly didn’t relate to the success with your next cycle of treatment. When you first embark on IVF treatment, I think you have to think about it as a set of repeated treatments and a longish term intervention.”
    (Video covering last part of bite: egg being injected)

    Mandatory Courtesy:
    University of Glasgow

    VIDEO
    B-ROLL
    Egg being injected

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:In women 42 and over success rates were very low across all cycles and the study authors did not see increases in live-birth rates.

  • December 15, 2015

    New Technology Improves Survival In Patients With Aggressive Type Of Brain Cancer

    New Technology Improves Survival In Patients With Aggressive Type Of Brain Cancer

    INTRO:It’s the most aggressive kind of brain cancer in adults. Most patients with glioblastoma (glee-oh-blastoma) die within 1 to 2 years of diagnosis. A new study examined whether treating this type of brain cancer with a new technology, using focused electrical currents, could help prolong survival in patients with the disease. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Roland walking thru hospital doors

    AUDIO
    VO
    Roland Frischherz (Free-shh-herts) was diagnosed with glioblastoma, (glee-oh-blastoma) an aggressive type of brain cancer, more than a year ago.

    AUDIO
    SOT/FULL
    Roland Frischherz – Glioblastoma Patient
    Super@:09
    Runs:13
    “It was a very tough time. I’m married. I have two daughters, so it was a very moving, moving period. Your life you lived before is closed.”

    VIDEO
    Roland and Dr. Stupp talking, technician applying electrodes to mannequin, cu of Roland’s backpack, Roland on floor wiring up his backpack with electrodes on his head

    AUDIO
    VO
    After completing standard chemotherapy and radiation treatments, he began additional therapy using something called tumor treating fields. The device is carried in a special backpack. Inside is a battery that powers electrodes, which are attached to his head.

    AUDIO
    SOT/FULL
    Roger Stupp, M.D., – University Hospital Zurich
    Super@:33
    Runs:19
    “The purpose is to keep the tumor from growing. The machine is applying an electrical field at a certain frequency and strength with alternating current. It will perturb, during cell division, the dividing glioblastoma cells while it will hardly affect any of the normal cells.”

    (Video covering middle of bite: technician showing battery connected to mannequin, cu of battery, connection cable)

    VIDEO
    B-ROLL
    Dr. Stupp at desk, brain image on computer, Roland zipping up backpack and putting it on

    AUDIO
    VO
    Dr. Roger Stupp from University Hospital in Zurich, Switzerland and co-authors are conducting a worldwide trial with 695 glioblastoma patients, all of whom completed standard courses of radiation and chemotherapy. One out of three received a maintenance course of chemotherapy, while the other two, received maintenance therapy plus the electrical tumor treating fields for up to two years.  The current results are for the first 315 patients.

    AUDIO
    SOT/FULL
    Roger Stupp, M.D., – University Hospital Zurich
    Super@ 1:17
    Runs:10
    “Both progression free survival, so the time until the tumor comes back, as well as overall survival is prolonged by a median of 3 months.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The Study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Roger Stupp, M.D., – University Hospital Zurich
    Super@ 1:36
    Runs:11
    “At two years the overall survival is prolonged by about 14 percent which means 14 percent more patients are alive at two years when they got the device.”

    (Video covering 1st part of bite: technician applying electrodes to mannequin)

    VIDEO
    B-ROLL
    Roland and Dr. Stupp talking

    AUDIO
    VO
    Roland continues to receive therapy with the tumor treating fields.

    AUDIO
    SOT/FULL
    Roland Frischherz – Glioblastoma Patient
    Super@ 1:46
    Runs:06
    “If this helps me, well I will continue like this as long as I can.”

    AUDIO
    SOT/FULL
    Roger Stupp, M.D., – University Hospital Zurich
    Super@ 1:52
    Runs:08
    “It’s far from being a cure. But it is another step in the right direction and some patients truly benefit from it.”

    (Video covering last part of bite: Roland walking out of hospital)

    VIDEO
    B-ROLL
    Roland walking out of hospital

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Because the initials results of the trial were so compelling, the International Data Monitoring Committee decided the findings should be made public so that other patients could be offered this treatment.

  • December 08, 2015

    Depression In Medical Residents, A Growing Problem

    Depression In Medical Residents, A Growing Problem

    INTRO:Even in the general population, people don’t want to talk about depression, which is one of the major reasons it isn’t always treated properly.  Depression is also a concern in the medical community, particularly affecting physicians in training known as medical residents.  A considerable number of medical residents suffer significant depressive symptoms at various times during their training.  What should be done to address the problem? Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Group of residents walking down hospital hallway, cu of feet walking down hallway, patient with IV pole walking into room

    AUDIO
    VO
    After medical school, the next step for a physician in training is residency. A growing number of these residents are not only dealing with long hours and the pressure of patient care but also with depression.

    AUDIO
    VO
    SOT/FULL
    Thomas L. Schwenk, M.D., – University of Nevada School of Medicine
    Super@:12
    Runs:27
    “A quarter to a third of the residents are suffering either specific diagnoses or significant symptom burden, I mean that’s, that’s an endemic, that is such a high prevalence of such a serious problem that we all should be extraordinarily worried. It doesn’t really matter whether it’s an actual diagnosis or just significant symptoms it means that they’re suffering. They’re not functioning well in their personal roles, they’re not functioning well in their professional roles.”

    (Video covering middle of bite: resident walking down hallway)

    VIDEO
    B-ROLL
    Dr. Schwenk sitting at table looking at papers, cu of Dr. Schwenk pan down to papers on table, people walking on the street, resident looking at computer screen,GXF FULL JAMA LOGO

    AUDIO
    VO
    Dr. Thomas Schwenk (shwank), Dean of the University of Nevada School of Medicine says while medical students and practicing physicians have a prevalence for depression roughly similar to the general population, the diagnosis is much more common in residents and also carries a great deal of stigma.  Dr. Schwenk discusses this issue in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Thomas L. Schwenk, M.D., – University of Nevada Medical School
    Super@:58
    Runs:23
    “We want people who are confident and strong and have shown great energy and decision making and have taken charge of situations in their undergraduate preparation. So it’s not surprising that these same people are going, to have a hard time admitting vulnerability or that they need help. When residents apply for jobs they do not want a hint that they’ve suffered from mental illness.”

    (Video covering middle of bite: Resident working on computer, cu of computer, resident going into patient exam room)

    VIDEO
    B-ROLL
    Resident walking outside patient rooms, resident talking with patient, resident going into on-call room

    AUDIO
    VO
    There have been several efforts to address this problem.  Confidential mental health care is now more easily available and mental health records are not included in academic records.  Resident duty hours have also been scaled back in recent years.

    AUDIO
    SOT/FULL
    Thomas L. Schwenk, M.D., – University of Nevada School of Medicine
    Super@ 1:36
    Runs:23
    “The reduction in hours, probably because it still is an incredibly high level of work load, hasn’t really improved residents’ quality of life and it seems to have caused some problems in performance and in the quality of care. The world is just so dramatically different, yet we’re still training residents the same way. It looks exactly like it looked in the 1950’s and 1960’s.

    VIDEO
    B-ROLL
    Dr. Schwenk walking in library

    AUDIO
    VO
    Dr. Schwenk is calling for even better mental health care and a national conversation about today’s medical education system.

    AUDIO
    SOT/FULL
    Thomas L. Schwenk, M.D., – University of Nevada School of Medicine
    Super@2:05
    Runs:37
    “What I would really like to see is the accrediting bodies, the residency review committees, the accreditation counsel for GME, ACGME, really take this to a high level. What if we built teaching programs from the ground up for teaching and clinical care was actually a secondary objective. Right now, what happens is the teaching in many regards kind of gets added on to an extremely high powered, high intensity, high productivity, very busy clinical system. And it makes it hard for residents I think, to really process everything that’s going on.”

    VIDEO
    B-ROLL

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Dr. Schwenk also says residents should be encouraged to take care of themselves so they can take care of others.

  • December 01, 2015

    Cesarean Section Rates And Health Outcomes For Mothers And Babies

    Cesarean Section Rates And Health Outcomes For Mothers And Babies

    INTRO:The most common operation done worldwide is the cesarean or C-section. In order to see better health outcomes, in the mid-1980s, the World Health Organization recommended that member countries C-section rates shouldn’t exceed 10 to 15 percent.  A new study evaluated the relationship between current cesarean section rates around the world and key health outcomes for mothers and babies.  Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Babies in nursery, cu of babies hand

    AUDIO
    VO
    Chances are the mothers of many of these babies underwent a cesarean or C-section birth.

    AUDIO
    SOT/FULL
    Alex B. Haynes, M.D., M.P.H., – Ariadne Labs
    Super@:06
    Runs:04
    “Almost one out of every 5 births on the planet, occur via cesarean section.”

    AUDIO
    SOT/FULL
    George Molina, M.D., M-P.H., – Ariadne Labs
    Super@:10
    Runs:07
    “Poorer countries were actually doing more C-sections as a proportion of all the care that they were providing, compared to wealthier countries.”

    VIDEO
    B-ROLL
    Cu of Dr. Haynes, wide shot of Dr. Molina and Dr. Haynes standing at white board, Graphic: Globe with 194 Member Countries, 2012 C-Section Rates, woman having ultrasound

    AUDIO
    VO
    Doctors Alex Haynes and George Molina from Ariadne (Air-ee-ahd-nee) Labs at Brigham and Women’s Hospital and co-authors gathered publicly available data from the 194 World Health Organization member countries. Using this information, they estimated two thousand and twelve C-section rates worldwide and examined how those rates affected maternal and neonatal health outcomes.

    AUDIO
    SOT/FULL
    George Molina, M.D., M-P.H., – Ariadne Labs
    Super@:35
    Runs:08
    “Up to a rate of about 19 C-sections per 100 live births we see reductions in maternal and neonatal mortality.”

    AUDIO
    SOT/FULL
    Alex B. Haynes, M.D., M.P.H., – Ariadne Labs
    Super@:43
    Runs:13
    “Across the world the average cesarean section rate is over 19 percent. Going from 19 to 25 to 30 percent did not result in improvements in neonatal or maternal mortality on a nationwide level.”

    (Video covering middle of bite: surgery video)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Alex B. Haynes, M.D., M.P.H., – Ariadne Labs
    Super@1:00
    Runs:17
    “There are many countries where not enough cesarean sections are being performed, meaning there is inadequate access to safe and timely emergency obstetric care and conversely, that there are some countries where probably more cesarean sections are being performed than yield health benefits.”

    VIDEO
    B-ROLL
    Dr. Haynes and Dr. Molina sitting at computer talking, woman walking with baby in hospital

    AUDIO
    VO
    The authors caution that these findings do not apply to any individual patients, facilities or hospitals.

    AUDIO
    SOT/FULL
    George Molina, M.D., M-P.H., – Ariadne Labs
    Super@1:25
    Runs:09
    “Our research can give some guidance for why countries should make their healthcare systems stronger so that they can provide safe, reliable and timely C-sections.”

    (Video covering 1st part of bite: mother walking with baby and video covering last part of bite: baby in nursery)

    VIDEO
    B-ROLL
    Baby in nursery

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study suggests that W-H-O target rates for cesarean section may be too low and need to be re-examined.

  • November 17, 2015

    Early Antibiotic Use May Halt Progression of Severe Respiratory Illness in Young Children

    Early Antibiotic Use May Halt Progression of Severe Respiratory Illness in Young Children

    INTRO: Preschool children who experience repeated episodes of severe lower respiratory tract infections often present with symptoms like wheezing and difficulty breathing.  A new study looked at whether a common antibiotic given early in these episodes could prevent the illness from getting worse. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of children in preschool class

    AUDIO
    VO
    When pre-school children experience repeated lower respiratory infections, It’s much more than just a simple cold.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@:06
    Runs:09
    “A lower respiratory tract illness is a cold that ends up going to the chest and that causes substantial coughing, wheezing, shortness of breath.

    VIDEO
    B-ROLL
    Steroid medication being poured out onto table

    AUDIO
    VO
    The usual treatment often includes steroids like prednisone.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@:18
    Runs:06
    “We wanted to provide a safe alternative that allows these children to experience fewer episodes.”

    VIDEO
    B-ROLL
    Dr. Bacharier walking down hallway, various shots of children, azithromycin medication

    AUDIO
    VO
    Dr. Leonard Bacharier (bah-CARE-ee-er) from Washington University in St. Louis and co-authors studied more than 600 children, from one to six years old, with a history of repeated episodes of severe  respiratory illness.  Children were randomly assigned to either receive the antibiotic azithromycin or a placebo early in these episodes.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@:41
    Runs:10
    “The parents were to have this medicine at home and were to start it at the very earliest signs of an illness in an effort to try to prevent the progression of the episodes.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@ :55
    Runs:10
    “The children in the azithromycin group were significantly less likely to have progression of their episodes to the point where prednisone would have been required.”

    VIDEO
    B-ROLL
    Azithromycin medication, children playing

    AUDIO
    VO
    Researchers also looked at whether increased antibiotic use could result in more bacterial resistance.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@ 1:16
    Runs:13
    “There was a slight increase in the number of children who had resistant organisms at the end of the study among those who received azithromycin compared to those who received placebo, but the numbers were relatively small.”

    (Video covering 1st part of bite: various shots of children)

    VIDEO
    B-ROLL
    Dr. Bacharier at his desk, looking at computer

    AUDIO
    VO
    Dr. Bacharier says further research is needed to understand how often these resistant organisms will emerge.

    AUDIO
    SOT/FULL
    Leonard B. Bacharier, M.D., – Washington University in St. Louis School of Medicine
    Super@1:29
    Runs:21
    “How to put this strategy into clinical practice is going to take some time. This requires a proactive discussion with the child’s health care provider in advance so that if this strategy is to be undertaken, it is available at home, with the parent well instructed as to the earliest signs of illness and knows when to start this.”

    (Video covering middle of bite: children playing)

    VIDEO
    B-ROLL
    Children playing

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Dr. Bacharier says even when used perfectly, there are many children who will develop severe illness despite these therapies.

  • November 13, 2015

    An Alternative Treatment For Diabetic Eye Disease

    An Alternative Treatment For Diabetic Eye Disease

    INTRO: Vision loss is one of the most feared complications of diabetes.  If not diagnosed and treated early, diabetic retinopathy can lead to blindness.  For decades, laser therapy has been used to treat this complication.  However this procedure can come with some important side effects.  A new study tested a different kind of treatment using an injectable medication called ranibizumab, to see if it would be as effective as laser therapy. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    People walking on the street, pictures get blurred, graphic: fade in words: Diabetic Retinopathy

    AUDIO
    VO
    Imagine your vision going from this…to this. These changes can happen slowly or all at once. It’s called diabetic retinopathy and it’s the leading cause of vision loss in patients with diabetes.

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@:11
    Runs:10
    “The most severe form of diabetic retinopathy is called proliferative diabetic retinopathy. There’s a development of abnormal scar tissue and blood vessels that are tugging on the retina.”

    VIDEO
    B-ROLL
    Graphic: pic of eye leaking vessels circled on left in red, blood vessels on right not leaking and circled in green

    AUDIO
    VO
    This eye, injected with dye, shows abnormal blood vessels that are leaking.  This often causes bleeding or even a detached retina. Healthy blood vessels are very tight and don’t leak. Laser therapy is the standard treatment to stop the vessels from leaking.

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@:34
    Runs:09
    “It’s not an ideal treatment because it can affect your side vision. It can affect your adjustment to dark and in some cases can make your vision worse.”

    VIDEO
    B-ROLL
    Dr. Jampol walking into exam room, sitting down and examining patients eyes, medication vial with syringe, various pictures of eye on computer

    AUDIO
    VO
    Dr. Lee Jampol from Northwestern University and co-authors studied more than 300 patients with this severe form of diabetic retinopathy.  Patients either received standard laser therapy or treatment with a newer medication called ranibizumab (ran-e-biz-u-mab), which was injected directly into the eye. In total, researchers treated almost 400 eyes.  Outcomes, especially vision loss, were compared at two years.

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@1:04
    Runs:07
    “Over the course of the two years the patients receiving the injections of the medication did somewhat better than the ones that got the laser.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@1:15
    Runs:18
    “It had less side effects. The peripheral vision stayed about the same in the medication group but it was diminished in the patients that had the laser treatment. There are other changes that occur in the retina with swelling of the back of the retina and we know that the injections help to prevent that better than the laser treatment.”

    (Video covering middle of bite: pic of eye)

    VIDEO
    B-ROLL
    Dr. Jampol examining Michael’s eyes

    AUDIO
    VO
    Routine eye exams helped identify Michael Graff’s retinopathy.  Today, he sees his ophthalmologist regularly because maintaining his vision is vital.

    AUDIO
    Michael Graff – Retinopathy Patient
    Super@1:41
    Runs:06
    “I’m an artist…it’s very important. I couldn’t imagine being without it.”

    (Video covering end of bite: Michael being examined by Dr. Jampol)

    AUDIO
    SOT/FULL
    Lee M. Jampol, M.D., – Northwestern University
    Super@1:49
    Runs:07
    “So when the patient goes in now to their doctor with proliferative diabetic retinopathy there’s two choices, where before there was only one.”

    (Video covering end of bite: Dr. Jampol and Michael talking)

    VIDEO
    B-ROLL
    Dr. Jampol and Michael talking

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The injectable medication, ranibizumab, had a low complication rate and showed good safety.

  • November 08, 2015

    Shared Financial Incentives For Physicians And Patients Helped Improve Cholesterol Levels

    Shared Financial Incentives For Physicians And Patients Helped Improve Cholesterol Levels

    INTRO: Financial incentives for physicians or patients are one way healthcare organizations are trying to improve health outcomes.  A new study examined whether providing financial incentives would help improve L-D-L or the “bad” cholesterol level in people at high-risk for cardiovascular disease. Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:01
    “…I’m going to get your vital signs this morning…”

    VIDEO
    B-ROLL
    Nurse getting ready to take patients temperature, cu of patient with thermometer in mouth, blood pressure being checked

    AUDIO
    VO
    In addition to vital signs, a visit to the doctors office often includes a discussion about cholesterol levels, especially if a patient is at high-risk for cardiovascular disease.

    AUDIO
    SOT/FULL
    David A. Asch, M.D., – University of Pennsylvania
    Super@:10
    Runs:11
    “You can substantially reduce that risk if you take statins or other medications to lower your cholesterol.  Many patients aren’t taking statins or if they are they stop them after a few months.”

    (Video covering  middle of bite: statin medication)

    AUDIO
    SOT/FULL
    Kevin G. Volpp, M.D., Ph.D., – University of Pennsylvania
    Super@:22
    Runs:09
    “And what we did in this study was to test a variety of strategies to try to help patients and their doctors get their cholesterol under better control.”

    VIDEO
    B-ROLL
    Dr. Volpp and Dr. Asch walking down hallway with colleague, colleague and doctors at white board, writing on white board while Dr. Asch and Dr. Volpp look on, doctor examining patient and doing different tests in exam room, patient and doctor talking

    AUDIO
    VO
    Doctors Kevin Volpp and David Asch from the University of Pennsylvania and co-authors studied the effect of different financial incentives on cholesterol levels in more than 15 hundred patients at high risk for cardiovascular disease.  The researchers randomly assigned 340 doctors to one of four groups. One group didn’t receive any financial incentives.  in another group, financial incentives were given only to the patients who showed improvements in their cholesterol.

    AUDIO
    SOT/FULL
    David A. Asch, M.D., – University of Pennsylvania
    Super@:53
    Runs:09
    “We also tried different approaches including giving financial incentives to physicians or giving financial incentives in a shared way to both patients and physicians.”

    AUDIO
    SOT/FULL
    Kevin G. Volpp, M.D., Ph.D., – University of Pennsylvania
    Super@ 1:03
    Runs:07
    “The most effective way of improving cholesterol control was a shared incentive between patients and providers.”

    (Video covering end of bite: doctor and patient talking)

    AUDIO
    SOT/FULL
    David A. Asch, M.D., – University of Pennsylvania
    Super@ 1:11
    Runs:03
    “They had the greatest reduction in their LDL cholesterol.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Kevin G. Volpp, M.D., Ph.D., – University of Pennsylvania
    Super@ 1:21
    Runs:15
    “If patients weren’t on statins, they were started on statins Having both the provider intensify therapy as appropriate and having the patients take those medications once prescribed, and that’s really why we think the shared incentive group was the most effective.”

    (Video covering  1st part of bite: statin medications)

    AUDIO
    SOT/FULL
    David A. Asch, M.D., – University of Pennsylvania
    Super@ 1:32
    Runs:12
    “We shouldn’t just think of these as mechanical economic transactions. Getting your cholesterol down is a team effort. It requires physicians to prescribe the medications and it requires patients to take the medications.”

    (Video covering middle of bite: patient getting blood drawn)

    AUDIO
    SOT/FULL
    Kevin G. Volpp, M.D., Ph.D., – University of Pennsylvania
    Super@ 1:45
    Runs:07
    “Both of those are critically important to the end goal of improving LDL cholesterol and reducing cardiovascular risk.”

    (Video covering end of bite: doctor and patient talking)

    VIDEO
    B-ROLL
    Dr. and patient talking

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:L-D-Llevels improved 25 points in the group receiving no financial incentives. Incentives given to physicians only and patients only did not work as well as when incentives were given to both physicians and patients.

  • November 03, 2015

    Prescription Drug Use Continues To Rise In The U.S.

    Prescription Drug Use Continues To Rise In The U.S.

    INTRO: Prescription drugs represent a major healthcare expense and the number of adults in the U-S taking prescription medications is increasing. A new study examined trends in prescription drug use from 1999 to 2012 among U-S adults. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various pharmacy signage, people walking on street, various pharmacy signage

    AUDIO
    VO
    Today there seems to be a pharmacy on almost every street corner. With hundreds of different drugs coming and going from the market, It’s not surprising that prescription drug use is on the rise.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@:09
    Runs:14
    “We observed an overall increase in prescription drug use. In 1999-2000 51 percent of all U-S adults age 20 and older reported any use of prescription medications and this increased to 59 percent in 2011-12.”

    (Video covering 2nd half of bite: people walking, Graphic: 1999-2000
    51% U.S. ADULTS 20+ YEARS
    59% 2011-2012)

    VIDEO
    B-ROLL
    Dr. Kantor walking down hallway, people outside walking, sitting at desk looking at charts on computer, Graphic:
    5 or More Prescription Drugs
    8.2 % in 1999-2000
    15 % in 2011-20012

    AUDIO
    VO
    Dr. Elizabeth Kantor from Memorial Sloan Kettering Cancer Center and co-authors examined more than a decade data from nearly 40 thousand U-S adults, 20 years and older, participating in the National Health and Nutrition Examination Survey or N-HANES. The number taking five or more prescription drugs almost doubled from 8 point 2 percent in 19-99 to two thousand to 15 percent in two thousand-11 to two thousand 12.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@:46
    Runs:12
    “This is particularly notable among older adults, ages 65 and older. When we account for age we find that the trends persist, suggesting that there are factors other than the aging of the population driving this increase.”

    (Video covering middle of bite: older people exercising)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@1:02
    Runs:13
    “When we look at drugs taken to control high-blood pressure, diabetes, high cholesterol, depression we see increases in all of those drug classes.  We also see increases in some less commonly used drug classes such as muscle relaxants.”

    (Video covering 2nd part of bite: various prescription medications)

    VIDEO
    B-ROLL
    Graphic:
    2011-2012
    SIMVASTATIN
    NEARLY 8% OF ALL ADULTS

    AUDIO
    VO
    Simvastatin, used to treat high cholesterol, was the most commonly used prescription drug in 2011-12, taken by nearly 8 percent of all U-S adults.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@1:23
    Runs:12
    “And when we look at the 10 most commonly used drugs in 2011-12, most of these drugs are taken for conditions associated with cardiovascular disease as well as the factors contributing to cardiovascular disease, such as obesity.”

    (Video covering 2nd part of bite: overweight man getting blood pressure checked)

    VIDEO
    B-ROLL
    Pills being counted

    AUDIO
    VO
    The sharpest increases in prescription drug use occurred in the early two thousands.

    AUDIO
    SOT/FULL
    Elizabeth D. Kantor, Ph.D., M.P.H., – Memorial Sloan Kettering Cancer Center
    Super@1:40
    Runs:06
    “Within the later 2000’s we actually saw that some drug classes remained stable and some modestly decreased.”

    (Video covering 2nd half of bite: pills being counted)

    VIDEO
    B-ROLL
    Pills being counted

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Prior studies about prescription drug use were limited in scope and often restricted to certain populations.

  • October 27, 2015

    Death Rates In U.S. Continue To Decrease

    Death Rates In U.S. Continue To Decrease

    INTRO: Are Americans living longer and what are they dying from? In a new study, researchers from the American Cancer Society reviewed changes in the overall U-S death rate as well as trends in the six leading causes of death. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    People outside

    AUDIO
    VO
    Americans are living longer.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@:03
    Runs:07
    “We are making progress in reducing death rate from all-causes and leading causes of death.”

    VIDEO
    B-ROLL
    Dr. Jemal walking down hallway with colleague, Dr. Jemal in his office looking at graphs on a computer, walking down hall

    AUDIO
    VO
    Dr. Ahmedin (Ah-meh-deen) Jemal along with colleagues from the American Cancer Society used data from the National Center for Health Statistics to examine trends in the overall death rate in the U-S from 1969 to 2013.  They also looked specifically at the six leading causes of death.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@:24
    Runs:06
    “Overall death rates have decreased by 42 or 43 percent.”

    VIDEO
    B-ROLL
    Graphic:
    1969-2013
    HEART DISEASE
    CANCER
    STROKE
    INJURIES
    DIABETES
    Arrows next to each point down,
    Three arrows down for heart disease, stroke, diabetes

    AUDIO
    VO
    During this time period, death rates continued to decrease for heart disease, cancer, stroke, injuries and diabetes.
    Although the decrease has slowed during the last five years for heart disease, stroke and diabetes.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@:45
    Runs:09
    “The slow-down could be due to the obesity epidemic that has unfolded over the last three decades.”

    (Video covering 1st part of bite: obese people)

    VIDEO
    B-ROLL
    X-rays of lungs

    AUDIO
    VO
    On the other hand, deaths from chronic obstructive pulmonary disease, or C-O-P-D, doubled.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@:55
    Runs:11
    “COPD rates in men increased through the early 1990s, now it is decreasing but in women, the COPD rates continue to increase since 1969.”

    (Video covering middle of bite: male patient being examined)

    VIDEO
    B-ROLL
    Various people smoking

    AUDIO
    VO
    Dr. Jemal says this difference may result from women starting and stopping smoking later than men.

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@1:15
    Runs:16
    “Cancer has been increasing from 1969 thru 1990 when it peaked and since 1990 it has been steadily decreasing because of a reduction of tobacco use as well as improvements in early detection.”

    VIDEO
    B-ROLL
    People outside, people smoking, obese people

    AUDIO
    VO
    Although death rates are down, there is still room for improvement.  One in five U-S adults still smoke and one in three are obese.

    AUDIO
    SOT/FULL
    Voice of:
    Ahmedin Jemal, D.V.M., Ph.D., – American Cancer Society
    Super@1:37
    Runs:09
    “Smoking, obesity, physical inactivity and bad diet account for about half of the total deaths in the U-S.

    (Video covering entire bite: various shots of people smoking, eating and obese people)

    VIDEO
    B-ROLL
    Woman walking across street

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Unintentional injuries such as accidents or drowning increased until the mid-1990s but have been decreasing during the most recent time period.

  • October 20, 2015

    New Recommendations For Breast Cancer Screening In Women With Average Cancer Risk

    New Recommendations For Breast Cancer Screening In Women With Average Cancer Risk

    INTRO: Breast cancer is the second leading cause of cancer deaths among American women. Early detection remains the best way to prevent breast cancer related deaths.  Many experts have tried to understand how to best balance potential benefits and harms of breast cancer screening. The American Cancer Society reviewed existing research and updated its recommendations for women who are at average risk for breast cancer. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@:02
    Runs:08
    “Mammography does save lives. It’s the single best tool that we have for preventing a premature death from breast cancer in a woman.”

    VIDEO
    B-ROLL
    Dr. Oeffinger at his desk, looking at mammograms, Graphic: several studies piled on top of one another, American Cancer Society logo

    AUDIO
    VO
    Dr. Kevin Oeffinger (EH-fen-jur) from Memorial Sloan Kettering Cancer Center along with a panel of other experts examined decades of research to update the American Cancer Society’s recommendations for breast cancer screening.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@:19
    Runs:21
    “What we realize is that there’s areas that the evidence is very clear and there’s other areas that there may be a trade-off. We recommend starting regular screening at age 45. The evidence clearly shows that there is substantial magnitude of benefit, life saved, compared to the risks of having a false-positive biopsy, false-positive additional images or over diagnosis.”

    (Video covering middle of bite: woman getting a mammogram)

    VIDEO
    B-ROLL
    Screening Mammography

    START YEARLY SCREENING
    AGE 45

    EVERY TWO YEARS
    AGE 55

    AUDIO
    VO
    In addition to starting yearly screening at 45, the American Cancer Society recommends that women transition to screening every two years at age 55.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@:50
    Runs:12
    “Women age 40 to 44 will benefit from screening mammography. We recommend that women have a visit with their health care professional and discuss their risk and benefits and then weigh how they look at false-positive testing.”

    (Video covering middle of bite: doctor talking with patient)

    VIDEO
    B-ROLL
    Screening Mammography

    INFORMED DECISION MAKING

    WOMEN 40-44
    OPTION TO SCREEN EARLY

    WOMEN 55+
    OPTION TO CONTINUE YEARLY SCREENING

    AUDIO
    VO
    For the first time, the guideline supports informed decision making, saying some women ages 40 to 44 should have the option to screen early and women 55 and older have the opportunity to continue yearly screening if they choose.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@1:24
    Runs:15
    “We do not recommend a particular age to stop screening. There is definitely benefit into the mid-70’s, and we think benefit beyond that in women who are active and have a ten year life expectancy of reasonably good health.”

    (Video covering middle of bite: older woman having mammogram)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D., – Memorial Sloan Kettering Cancer Center
    Super@1:34
    Runs:06
    “We no longer recommend doing clinical breast examinations for women in the United States.”

    VIDEO
    B-ROLL
    Doctor talking with patient

    AUDIO
    Dr. Oeffinger says this time could be better spent counseling women about individual screening preferences.

    AUDIO
    SOT/FULL
    Kevin C. Oeffinger, M.D. – Memorial Sloan Kettering Cancer Center
    Super@1:45
    Runs:12
    “This guideline however, is not a ‘one-size-fits-all.’ It’s very key that a woman is able to express her beliefs, her own values and preferences to her health care professional in making that shared and informed decision.”

    (Doctor walking with woman, sitting and talking in exam room)

    VIDEO
    B-ROLL
    Woman talking with doctor

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:About 8 to 10 percent of women are at high risk for breast cancer, the rest of women are at average risk.  Only 65 percent of U-S women are getting screened within a two-year time period.

  • October 19, 2015

    Seizures from Solving Sudoku Puzzles

  • October 06, 2015

    Minimally Invasive Approach Not as Effective as Standard Operation For Rectal Cancer

    Minimally Invasive Approach Not as Effective as Standard Operation For Rectal Cancer

    INTRO:The usual treatment of stage 2 or 3 rectal cancer includes surgery to remove the tumor. Traditionally, patients have undergone a major, “open” operation to remove the cancer. A new study compared whether a minimally invasive approach would be as good as an open or full operation.  Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    Various shots of laparoscopic procedure

    AUDIO
    VO
    This patient is undergoing a laparoscopy. This operation is done with small incisions, smaller instruments, and a fiber optic scope to see inside the abdomen. Most times the patient has less pain and a quicker recovery compared to a traditional open procedure that involves making a large incision. This technique works well for treating colon cancer.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@:17
    Runs:21
    “Rectal cancer which is at the other end of the G-I tract at the very bottom of the colon, is a different ballgame. There is a high risk of local recurrence of the tumor in the pelvis after an operation no matter whether you do it open or anything else.”

    VIDEO
    B-ROLL
    Dr. Fleshman walking down hallway, looking at computer with colleague

    AUDIO
    VO
    Dr. James Fleshman from Baylor University Medical Center and co-authors wanted to know if a minimally invasive approach was as good as an open procedure for patients with stage two or three rectal cancer.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@:48
    Runs:12
    “We wanted to make sure that we were giving our patients the best chance for curing their cancer not just giving them the advantage of a small incision and a minimally invasive approach.”

    VIDEO
    B-ROLL
    Computer screen showing various views of rectal area, cu of image, surgical team working in OR, various shots of staff examining slides with microscope

    AUDIO
    VO
    486 patients were randomly assigned to receive a standard, open operation or the minimally invasive, laparoscopic approach. All the procedures were done by 46 highly trained surgeons. Specimens from each procedure were examined under a microscope to see whether the entire tumor was removed, known as a “complete” resection.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@ 1:17
    Runs:15
    “Patients who underwent an open operation, 90 percent of all the patients had the complete resection. In the laparoscopy group only 81.7 percent of patients ended up with a complete resection.”

    (Video covering middle of bite: staff looking at slides)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@1:36
    Runs:10
    “That told us that laparoscopy for rectal cancer was not as good as open operation for rectal cancer.”

    VIDEO
    B-ROLL
    Dr. Fleshman scrubbing

    AUDIO
    VO
    Dr. Fleshman also says tumor location is important.

    AUDIO
    SOT/FULL
    James Fleshman, M.D. – Baylor University Medical Center
    Super@1:49
    Runs:25
    “So, if this is a very straightforward small tumor and the surgeon is comfortable in stating that this will be able to be done perfectly then laparoscopy may be the appropriate way to go. In a tumor that’s very deep in the pelvis and very large laparoscopy may not be the right way to treat this anymore.”

    (Video covering 2nd half of bite: Dr. Fleshman in surgery)

    VIDEO
    B-ROLL
    Dr. Fleshman in surgery

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study is one of the first trials to evaluate surgical techniques for treating rectal cancer.

  • October 05, 2015

    Flu Vaccine Reduces Hospitalizations For Pneumonia

    Flu Vaccine Reduces Hospitalizations For Pneumonia

    INTRO:Influenza or the flu, is a viral infection affecting the respiratory system. Pneumonia is a serious complication of influenza.  A new study examined whether getting a flu shot can help reduce hospitalizations due to influenza pneumonia. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Children in doctor’s office with nurse

    AUDIO
    VO
    For many people, getting a flu shot is an annual tradition.

    AUDIO
    NATSO/FULL
    Runs:04
    …what happened punkin’…whaaaa….whaaa.. that’s it…”

    VIDEO
    B-ROLL
    Baby crying after getting flu shot

    AUDIO
    VO
    Pneumonia is one of the most serious complications of influenza…

    AUDIO
    SOT/FULL
    Kathryn M. Edwards, M.D. – Vanderbilt University Medical Center
    Super@:11
    Runs:06
    “Pneumonia means an infection, deep down in your lungs.”

    (Vide covering 2nd part of bite: cu of chest x-ray)

    VIDEO
    B-ROLL
    Chest x-ray

    AUDIO
    VO
    …often requiring hospitalization.

    AUDIO
    SOT/FULL
    Carlos G. Grijalva, M.D., M.P.H. -Vanderbilt University Medical Center
    Super@:18
    Runs:05
    “The most effective way to prevent some of the influenza infections is vaccination.”

    VIDEO
    B-ROLL
    Dr. Grijalva and Dr. Edwards walking outside, looking at chest x-rays on computer, EMT’s taking patient into hospital

    AUDIO
    VO
    Doctors Carlos Grijalva (Gree-hahl-BAH) and Kathryn Edwards from Vanderbilt University Medical Center and co-authors evaluated more than 27 hundred patients over three consecutive flu seasons. All patients were admitted to the hospital from the emergency department at four sites around the U.S.

    AUDIO
    SOT/FULL
    Kathryn M. Edwards, M.D. – Vanderbilt University Medical Center
    Super@:38
    Runs:05
    “Everyone had the pneumonia but one group had flu and one group did not.”

    AUDIO
    SOT/FULL
    Carlos G. Grijalva, M.D., M.P.H. -Vanderbilt University Medical Center
    Super@:43
    Runs:05
    “About 6 percent of those patients had pneumonias  due to influenza.”

    VIDEO
    B-ROLL
    Nurse preparing flu vaccine, patient getting shot

    AUDIO
    VO
    Next the researchers determined how many patients with pneumonia had been vaccinated against influenza.

    AUDIO
    SOT/FULL
    Kathryn M. Edwards, M.D. – Vanderbilt University Medical Center
    Super@:53
    Runs:13
    “The people that had received vaccine had 57 percent less chance of getting hospitalized with flu-pneumonia than those patients that were not vaccinated.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Carlos G. Grijalva, M.D., M.P.H. -Vanderbilt University Medical Center
    Super@1:11
    Runs:11
    “The effectiveness of the vaccines seems to be a little lower for older subjects and for patients with underlying immunosuppressive conditions.”

    AUDIO
    SOT/FULL
    Kathryn M. Edwards, M.D. – Vanderbilt University Medical Center
    Super@1:25
    Runs:07
    “The vaccine seemed to work very well in young children and in individuals less than 65.”

    (Video covering 1st half of bite: young girl getting nasal flu vaccine)

    VIDEO
    B-ROLL
    Nurse preparing to give a flu shot to young boy

    AUDIO
    VO
    The study’s results provide one more reason to get a flu shot this fall.

    AUDIO
    NATSO/FULL
    Runs:05
    “Ouch…she’s all done…that hurt a little…a little?”

    VIDEO
    B-ROLL
    Child after he gets his shot

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The study was sponsored by the Centers for Disease Control and Prevention.

  • September 22, 2015

    Combination Drug Treatment Reduces Agitation in Patients With Alzheimer’s Disease

    Combination Drug Treatment Reduces Agitation in Patients With Alzheimer’s Disease

    INTRO:Agitation and aggression are common in patients with Alzheimer’s dementia and are a source of distress for caregivers. Patients may shout, curse or even become violent. Currently available medications have lots of side effects and are only modestly effective for treating agitation.  A new study tested a combination of two existing medications and whether this would help control agitation in patients with Alzheimer’s. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Laurie walking into hospital, pictures of her mother and father

    AUDIO
    VO
    Laurie Gabello is very familiar with hospitals and doctor’s offices. Her father has Alzheimer’s disease and her mother, dementia. But it wasn’t always that way.

    AUDIO
    SOT/FULL
    Laurie Gabello – Caregiver
    Super@:09
    Runs:05
    “They were extremely active. They traveled a lot.  They were extremely social.”
    (Video covering 1st part of bite: picture of parents)

    VIDEO
    B-ROLL
    Pictures of Laurie’s parents

    AUDIO
    VO
    Now in full time care, both of Laurie’s parents have frequent bouts of agitation.

    AUDIO
    SOT/FULL
    Laurie Gabello – Caregiver
    Super@:18
    Runs:14
    “When people do come in to help him with his showers or his daily care and stuff he does get extremely agitated. She gets very upset and very agitated, no matter what it is. What they’re serving for dinner, the fact that they play the same music over and over.”

    (Video covering middle of bite: pictures)

    AUDIO
    SOT/FULL
    Jeffrey L. Cummings, M.D., Sc.D. – Cleveland Clinic Lou Ruvo Center for Brain Health
    Super@:32
    Runs:08
    “These are things that make caregiving so extremely difficult, when there is a violent or aggressive reaction by the patient.”

    VIDEO
    B-ROLL
    Dr. Cummings walking down hallway, older people in the community, Dr. Cummings looking at brain images on computer, graphic

    AUDIO
    VO
    Dr. Jeffrey Cummings from the Cleveland Clinic and co-authors recruited 220 patients with Alzheimer’s dementia and agitation. During a preliminary 10-week trial, participants were randomly assigned to receive either the combination of dextromethorphan and quinidine or a placebo.

    AUDIO
    SOT/FULL
    Jeffrey L. Cummings, M.D., Sc.D. – Cleveland Clinic Lou Ruvo Center for Brain Health
    Super@:55
    Runs:10
    “The dextromethorphan-quinidine combination had a substantial effect in reducing agitation and far greater than was seen in the placebo treated patients.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Jeffrey L. Cummings, M.D., Sc.D. – Cleveland Clinic Lou Ruvo Center for Brain Health
    Super@:55
    Runs:03
    “And we showed that the drug was safe and effective.”

    VIDEO
    B-ROLL
    Laurie talking with a staff person

    AUDIO
    VO
    Dr. Cummings says there also appeared to be benefit for the caregivers of these patients.

    AUDIO
    SOT/FULL
    Jeffrey L. Cummings, M.D., Sc.D. – Cleveland Clinic Lou Ruvo Center for Brain Health
    Super@1:18
    Runs:09
    “There was a reduction in the stress experienced for caregivers of the patients who were treated with the dextromethorphan-quinidine combination.”

    VIDEO
    B-ROLL
    Photos of Laurie with her parents

    AUDIO
    VO
    Although caring for her parents is sometimes overwhelming, Laurie takes comfort in knowing they have lived full lives.

    AUDIO
    SOT/FULL
    Laurie Gabello – Caregiver
    Super@1:32
    Runs:06
    “They didn’t not do anything they set their heart out to do, that was on their bucket list, they did all of it.”

    (Video covering 2nd half of bite: various pictures of Laurie’s parents)

    VIDEO
    B-ROLL
    Various pictures of Laurie’s parents

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The combination of these two medications is not yet available for patients. More studies are needed before the results can be presented to the F-D-A for approval.

  • September 14, 2015

    Low Vitamin D Levels Associated with More Rapid Cognitive Decline in Older Adults

    Low Vitamin D Levels Associated with More Rapid Cognitive Decline in Older Adults

    INTRO: About 42 percent of the general U-S adult population has low vitamin D levels. That number is even higher among Hispanics and African-Americans. Besides promoting calcium absorption and bone health, vitamin D may also affect the brain and cognitive function. A new study looked at the association between baseline vitamin D levels and the rate of cognitive decline in a group of ethnically diverse older adults. Catherine Dolf has more this week’s JAMA Report.
    VIDEO B-ROLL Sun through the clouds, woman drinking milk, vitamin D bottles, older people walking AUDIO
    VO
    Sunlight and diet are the two main sources of vitamin D. Many people also take vitamin D supplements. However, having a low vitamin D level is still very common.

    AUDIO
    SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@:16 Runs:15
    “As the population ages, the fastest growing segment are the old and the oldest of old and with that, is an increase in the risk of cognitive dysfunction and outright Alzheimer’s disease and dementia.”
    VIDEO
    B-ROLL Dr. Miller walking, Graphic:382 Older Adults 75 Years of Age 61% Women 41 % White 30 % African-American 25 % Hispanic
    AUDIO
    VO
    Dr. Joshua Miller from Rutgers University, along with colleagues from the University of California Davis, studied 382 older adults with an average age of 75. 61 percent were women, 41 percent White, about 30 percent African-American and 25 percent Hispanic.

    AUDIO
    SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@:41 Runs:08
    “Some of the subjects had outright dementia, some had mild cognitive impairment and some had what we would call normal cognitive function.”
    VIDEO
    B-ROLL Dr. Miller in lab, person taking cognitive test

    AUDIO
    VO
    Vitamin D levels and cognitive function were measured at baseline. Cognitive function was also followed in 318 of the participants for an average of 5 years.

    AUDIO
    SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@:58 Runs:08
    “About 60 percent of the group, regardless of their race or ethnicity, was low in vitamin D.”
    GXF FULL JAMA LOGO

    AUDIO
    VO The study appears in JAMA, Neurology.

    AUDIO SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@ 1:09 Runs:09
    “Those who had dementia also had lower vitamin D status than those who had mild cognitive impairment or who had normal cognitive function.”
    VIDEO
    B-ROLL Vitamin D capsules, graphic:Episodic Memory Executive Function AUDIO
    VO
    Those low in vitamin D declined more in short term memory, known as episodic memory, as well as more complex cognitive tasks, known as executive function.

    AUDIO
    SOT/FULL Joshua W. Miller, Ph.D., – Rutgers University Super@1:26 Runs:06
    “They were declining about two and a half times faster than those who had adequate vitamin D.” (Video covering 2nd half of bite: Vitamin D capsules)
    VIDEO
    B-ROLL Vitamin D capsules

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study is observational. Future studies are needed to determine whether vitamin D supplements can slow cognitive decline.

  • September 08, 2015

    Diabetes Continues To Rise In U.S. Population

    Diabetes Continues To Rise In U.S. Population

    INTRO:If left untreated, diabetes can cause many serious health-related complications including kidney failure and blindness.  The total estimated cost of diabetes in the U.S. was $245 billion in 2012, which includes both health care costs and lost productivity. A new study examined the prevalence of diabetes in the U.S., including undiagnosed diabetes, and pre-diabetes. Catherine Dolf has details in this week’s JAMA Report.

    VIDEO
    B-ROLL
    People sitting and walking outside

    AUDIO
    VO
    DIABETES CONTINUES TO RISE IN THE U-S.

    AUDIO
    SOT/FULL
    Andy Menke, Ph.D., – Social & Scientific Systems Inc.
    Super@:05
    Runs:07
    (graphic lower third: wipes in 14% DIABETES)
    “14 percent of the people in the United States have diabetes and this is even higher in Asians and Blacks and Hispanics.”

    AUDIO
    SOT/FULL
    Catherine C. Cowie, Ph.D., – National Institutes of Health
    Super@:09
    Runs:10
    (graphic lower third: wipe in1988-2012 ADULTS 20+)
    “And we specifically looked at data from 1988 until 2012 in adults age 20 and above.”

    VIDEO
    B-ROLL
    Dr. Cowie and Dr. Menke walking outside, various shots of people outside

    AUDIO
    VO
    Dr. Catherine Cowie from the National Institutes of Health and Dr. Andy Menke from Social and Scientific Systems Incorporated along with their co-authors used data from a long running national survey of american adults known as N-HANES. About 26 thousand people were evaluated to determine prevalence and trends in diabetes.

    AUDIO
    Catherine C. Cowie, Ph.D., – National Institutes of Health
    Super@:36
    Runs:11
    (Graphic lower third: wipe in
    1/3 DIABETES IS UNDIAGNOSED
    1/3 POPULATION HAS PRE-DIABETES)
    “One third of diabetes is undiagnosed and we also found that one third of the population has pre-diabetes.”

    AUDIO
    SOT/FULL
    Andy Menke, Ph.D., – Social & Scientific Systems Inc.
    Super@:47
    Runs:05
    (Graphics lower third: wipe in
    ABOUT HALF THE POPULATION HAS DIABETES OR PRE-DIABETES)
    “This means half of people in the United States have either diabetes or pre-diabetes.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    SOT/FULL
    Catherine C. Cowie, Ph.D., – National Institutes of Health
    Super@:56
    Runs:16
    “For the first time in 2011-2012 we had data on Asian-Americans. Their prevalence of diabetes was as high as it is in the Blacks and Hispanics, around 20 percent of the population.”

    AUDIO
    SOT/FULL
    Andy Menke, Ph.D., – Social & Scientific Systems Inc.
    Super@1:13
    Runs:05
    “Up to 50 percent of Asians and Hispanics with diabetes were unaware that they had the condition.”

    VIDEO
    B-ROLL
    Man getting blood glucose test

    AUDIO
    VO
    That’s compared to about a third with undiagnosed diabetes in the White and Black populations.

    AUDIO
    SOT/FULL
    Catherine C. Cowie, Ph.D., – National Institutes of Health
    Super@1:22
    Runs:09
    “Diabetes continues to rise and it continues to rise in all age and sex, race, ethnic groups and in groups according to education and income.”

    (Video covering 2nd part of bite: people eating outside)

    VIDEO
    B-ROLL
    People eating outside

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say the high rate of diabetes in Asian Americans is occurring despite the fact that their body mass index or B-M-I is lower than the B-M-I in the general population.

  • September 01, 2015

    Genetic Testing in Children with Autism Spectrum Disorder

    Genetic Testing in Children with Autism Spectrum Disorder

    INTRO:Autism spectrum disorder or A-S-D represents a diverse group of conditions. If researchers can better understand the genetics of A-S-D, it may be possible to identify and diagnose at-risk children sooner.  A new study examined the results of two kinds of genetic tests in children diagnosed with A-S-D. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Owen walking with his mom and Dr. Fernandez

    AUDIO
    VO
    Owen was diagnosed with autism at two and half.

    AUDIO
    SOT/FULL
    Melissa Blundon  – Owen’s Mother
    Super@:03
    Runs:03
    “He wasn’t walking, he didn’t talk.”

    VIDEO
    B-ROLL
    Various shots of Owen sitting and talking with his mom and Dr. Fernandez

    AUDIO
    VO
    He’s much different today. Almost 13, Owen attends school, has plenty of friends and talks a lot. Even surprising his mom with a new word now and then.

    AUDIO
    SOT/FULL
    Owen Blundon – Study Participant
    Super@:14
    Runs:04
    “A brain and a heart. They’re squeezable.”

    AUDIO
    SOT/FULL
    Melissa Blundon – Owen’s Mother
    Super@:19
    Runs:03    “I’ve never heard him say squeezable before.”

    VIDE0
    B-ROLL
    Owen, his mom and Dr. Fernandez coming down stairs, Dr. Fernandez walking in the building, Graphic; names of two tests and number of children who received them

    AUDIO
    VO
    Owen participated in a study with more than 250 other children diagnosed with autism spectrum disorder. Dr. Bridget Fernandez from Memorial University in Newfoundland and co-authors used two newer genetic tests.  The first, chromosomal microarray analysis, was performed on each child.  The second, whole-exome sequencing, on 95 randomly selected children.

    AUDIO
    SOT/FULL
    Bridget A. Fernandez, M.D., Memorial University Hospital, Newfoundland
    Super@:42
    Runs:10
    “16 percent of the children had an ASD related genetic finding on either the microarray or the whole-exome sequencing.”

    VIDEO
    B-ROLL
    Researcher looking at genetic readouts on computer, various shots of people working in lab

    AUDIO
    VO
    The children were also closely examined for subtle physical differences and screened for birth defects. They were put into three groups based on the severity of these physical differences.

    AUDIO
    SOT/FULL
    Bridget A. Fernandez, M.D., Memorial University Hospital, Newfoundland
    Super@1:01
    Runs:09
    “And when we did that, the children in the morphologically complex group, 35 percent of them had a positive genetic test.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Bridget A. Fernandez, M.D., Memorial University Hospital, Newfoundland
    Super@1:14
    Runs:15
    “In that complex group, the diagnosis of autism was even more delayed than in the children without those types of problems. Sometimes there are other problems that are detracting from the fact that they have these red flags for autism.”

    VIDEO
    B-ROLL
    Owen and Melissa in exam room, cu of Melissa

    AUDIO
    VO
    As part of the study, Owen’s I-Q testing was normal, prompting his mother to send him to school.

    AUDIO
    SOT/FULL
    Melissa Blundon – Owen’s Mother
    Super@1:34
    Runs:08
    “Because I knew that he was smart enough, I said you’re going but now he’s developed into a lovely young man.”

    AUDIO
    SOT/FULL
    Bridget A. Fernandez, M.D., Memorial University Hospital, Newfoundland
    Super@1:42
    Runs:14
    “If we can understand the underlying genetics more completely we’d have the possibility to actually identify at-risk children through genetic testing and get earlier diagnosis and improve the outcome.”

    (Video covering last part of bite: Owen and Dr. Fernandez doing hi-5)

    VIDEO
    B-ROLL
    Owen giving hi-5 to Dr. Fernandez and she smiles

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The chromosomal microarray analysis has been performed for more than five years. The whole-exome sequencing test, a way of scanning most of the coding parts of the genome for mutations, is just entering routine clinical practice.

  • August 25, 2015

    Does Exercise Improve Cognitive Function in Older Adults?

    Does Exercise Improve Cognitive Function in Older Adults?

    INTRO:The ability to process complex thoughts, learn things and retain things we’ve learned, are all aspects of cognitive function. As we age, many of these skills decline. Some older adults have reported improvement in cognitive function when they exercise regularly. A new study compared moderate exercise with a health education program to see which one would better preserve cognitive function in older adults. Catherine Dolf explains in this week’s JAMA Report.
    VIDEO B-ROLL Bobby walking on track AUDIO
    VO
    After Bobby Cox retired, he wasn’t doing much of anything.

    AUDIO
    SOT/FULL Bobby Cox – Study Participant Super@:03 Runs:02
    “Sometimes it was hard for me to get up and move.”
    VIDEO
    B-ROLL Carol sitting at table working with test giver
    AUDIO
    VO
    For Carol Miller, living alone means it’s especially important for her memory and thinking to remain clear.

    AUDIO
    SOT/FULL Carol Miller – Study Participant Super@:12 Runs:05
    “I have to be in charge of a household and an automobile and my health.”
    VIDEO
    Split screen of Carol and Bobby, various shots of seniors working out, Dr. Sink talking with staff member, more of Bobby walking on the track

    AUDIO
    VO
    They both participated in a two-year study that included more than 16 hundred sedentary adults, between the ages of 70 and 89. Dr. Kaycee Sink from Wake Forest Baptist Medical Center and co-authors divided the seniors into two groups. Bobby was in the physical activity group.

    AUDIO
    SOT/FULL Kaycee M. Sink, M.D., M.A.S., – Wake Forest Baptist Medical Center Super@:32 Runs:09
    “The goal was to get folks to walk at least 30 minutes at moderate intensity. We also did some lower extremity strength and some flexibility exercises.”
    (Video covering 2nd half of bite: Bobby using ankle weights and lifting his legs with trainer)

    VIDEO
    B-ROLL
    Carol at table with staff member, taking different cognitive tests

    AUDIO
    VO
    Instead of exercise, Carol’s group attended health education seminars on different topics of interest to seniors.

    AUDIO
    SOT/FULL Kaycee M. Sink, M.D., M.A.S., – Wake Forest Baptist Medical Center Super@:47 Runs:08
    “We measured how they were thinking with their memory and complex processing and language function at the very start of the study.”
    AUDIO
    NATSO/FULL Runs:07
    “…I want you to say the name of each picture… acorn…dominoes…”
    GXF FULL JAMA LOGO

    AUDIO
    VO The study appears in JAMA, Journal of the American Medical Association.

    AUDIO SOT/FULL Kaycee M. Sink, M.D., M.A.S., – Wake Forest Baptist Medical Center Super@1:09 Runs:11
    “Both groups preserved their cognitive function over the course of two years. They stayed the same which is really remarkable because we would have expected older adults in this age range to have declined at least some over two years.”
    VIDEO
    B-ROLL Bobby exercising and Carol split screen taking a test AUDIO
    VO
    Bobby is exercising almost every day and Carol stays active by spending time with her grandchildren.

    AUDIO
    SOT/FULL Kaycee M. Sink, M.D., M.A.S., – Wake Forest Baptist Medical Center Super@1:26 Runs:09
    “Older adults should stay active physically, cognitively and socially. All of those things are important to maintaining independence and cognitive function as you age.” (Video covering 2nd half of bite: Seniors exercising)
    VIDEO
    B-ROLL Seniors exercising

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Participants 80 years and older and those who had poorer baseline physical function appeared to get more cognitive benefit from exercise compared to health education.

  • August 18, 2015

    Teens Who Use E-Cigarettes More Likely to Start Smoking

    Teens Who Use E-Cigarettes More Likely to Start Smoking

    INTRO:Over the past several years, electronic or e-cigarettes have grown in popularity.  Today’s e-cigarette users include a growing number of teenagers, many who have never smoked tobacco. A new study looked at whether younger teens that begin using e-cigarettes might also be more likely to experiment with smokable tobacco products.  Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Man smoking e-cigarette, outside of vape shop

    AUDIO
    VO
    E-cigarettes first entered the market as an alternative for adults who wanted to quit smoking. But over the years, things have changed.

    AUDIO
    SOT/FULL
    SOT/FULL
    Adam M. Leventhal, Ph.D. – University of Southern California
    Super@:08
    Runs:09
    “They come in attractive flavors like cotton candy, bubble gum, they’re very hi-tech and you know, they’re modern and cool.”

    VIDEO
    B-ROLL
    Man holding e-cigarette, Michelle smoking cigarette, Michelle using vape pen

    AUDIO
    VO
    Which helps make them very popular with young people. Michelle Mercado, now in her 20’s, smokes regular cigarettes but also started using e-cigarettes in her teens.

    AUDIO
    SOT/FULL
    Michelle Mercado – E-cigarette and Tobacco User
    Super@:25
    Run:09
    “I do see a lot of people like high schoolers and like young adults getting into the whole vape pen and e-cigarette thing.”

    VIDEO
    B-ROLL
    Dr. Leventhal entering room and meeting with his staff, high school kids walking, teen smoking

    AUDIO
    VO
    Dr. Adam Leventhal from the University of Southern California, Keck School of Medicine and co-authors surveyed more than 23 hundred Los Angeles area high school students at the beginning of 9th grade. Students included in the survey all reported never using any smokable tobacco products.

    AUDIO
    SOT/FULL
    Adam M. Leventhal, Ph.D. – University of Southern California
    Super@:49
    Runs:13
    “We compared teens who had used e-cigarettes to teens who hadn’t and we looked to see whether there were differences between those two groups and the initiation of smoking of combustible tobacco products.”

    VIDEO
    B-ROLL
    People getting on bus

    AUDIO
    VO
    THESE STUDENTS WERE SURVEYED AGAIN SIX MONTHS LATER AND ALSO WHEN ENTERING 10TH GRADE.

    AUDIO
    SOT/FULL
    Adam M. Leventhal, Ph.D. – University of Southern California
    Super@1:06
    Runs:17
    “The teens who used e-cigarettes were more than four times more likely to start smoking than teens who hadn’t used e-cigarettes. The associations were consistent across all the different types of tobacco products, regular cigarettes, cigars or even hookah tobacco water pipe.”

    (Video covering 2nd part of bite: guy smoking cigarette)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Adam M. Leventhal, Ph.D. – University of Southern California
    Super@1:27
    Runs:10
    “They were more likely to use two or more products for the first time during high school in comparison to teens who hadn’t used e-cigarettes.”

    VIDEO
    B-ROLL
    Students walking and girl on bike, girl smoking cigarette

    AUDIO
    VO
    This trend continued as the students entered 10th grade. Even when adjusting for other factors like peer pressure, impulsive tendencies, and socio-economic status, all risk factors for starting smoking, these associations remained.

    AUDIO
    SOT/FULL
    Adam M. Leventhal, Ph.D., University of Southern California
    Super@1:50
    Runs:12
    “This uptick that we’re seeing in adolescent e-cigarette use could potentially down the road lead to a new generation of tobacco smokers.”

    (Video covering end of bite: man standing on street smoking cigarette

    VIDEO
    B-ROLL
    Man on the street smoking cigarette

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This was an observational study. Further research is needed to determine whether the association between e-cigarette use and subsequent smoking is causal.

  • August 11, 2015

    Testosterone Therapy Neither Advances or Slows Down Hardening of the Arteries in Older Men with Low or Low-Normal Testosterone Levels

    Testosterone Therapy Neither Advances or Slows Down Hardening of the Arteries in Older Men with Low or Low-Normal Testosterone Levels

    INTRO:As men age, some experience declining testosterone levels. This may affect sexual function, vitality and overall quality of life. The popularity of testosterone supplementation has increased substantially over the last decade, but the long-term effects remain unclear. A new study evaluated whether using testosterone had any effect on hardening of the arteries, which is linked to heart attack and stroke. Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Peter Nowak – Study Participant
    Super@:02
    Runs:10
    “The aging population, the baby boomers, we’re all getting up into our 60’s and so there’s a lot of men’s health issues around our generation.”

    VIDEO
    B-ROLL
    Peter walking out of elevator, testosterone supplements, still pic of clogged arteries

    AUDIO
    VO
    One issue for Peter Nowak and other older men is declining testosterone levels and whether testosterone supplementation has serious side effects like hardening of the arteries or atherosclerosis.

    AUDIO
    SOT/FULL
    Shalender Bhasin, M.B.B.S., – Brigham and Women’s Hospital
    Super@:22
    Runs:13
    “The hardening of the arteries can impair blood flow to the heart and can lead to heart attacks and hardening of the arteries that supply blood to the brain can lead to strokes.”

    VIDEO
    B-ROLL
    Dr. Bhasin walking with Peter, various shots of men walking outside, testosterone gel, Peter in exam room showing where he applied the gel, pic of dye being pumped through heart arteries

    AUDIO
    VO
    Dr. Shalender Bhasin (bah-seen) from Brigham and Women’s Hospital and co-authors studied more than three hundred men. They were 60 years and older, in relatively good health, with low or low-normal testosterone levels. Half the men applied a testosterone gel daily to the skin for three years. The other half applied a placebo gel. Hardening of the arteries was measured in the coronary and carotid arteries, which supply the heart and brain.

    AUDIO
    SOT/FULL
    Shalender Bhasin, M.B.B.S., – Brigham and Women’s Hospital
    Super@:56
    Runs:13
    “Testosterone did not affect the rate of hardening of arteries over the three years duration of the testosterone therapy compared with placebo.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Shalender Bhasin, M.B.B.S., – Brigham and Women’s Hospital
    Super@1:12
    Runs:11
    “Testosterone also did not improve either the sexual function or quality of life in these otherwise healthy men, who had low or low-normal testosterone levels.”

    VIDEO
    B-ROLL
    Various shots of Peter and Dr. Bhasin in exam room talking

    AUDIO
    VO
    The study was blinded so Peter still doesn’t know if he received testosterone or placebo. However, when he saw his doctor last winter, his overall health was stable.

    AUDIO
    SOT/FULL
    Peter Nowak – Study Participant
    Super@1:32
    Runs:05
    “I got a fine bill of health.  She said everything’s good.”

    VIDEO
    B-ROLL
    Peter on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors note that this trial only looked at hardening of the arteries.  Larger studies are needed to determine whether taking testosterone increases the risk of heart attacks, strokes or other cardiovascular events.

  • August 04, 2015

    MINDFULNESS-BASED THERAPY DECREASES POSTTRAUMATIC STRESS DISORDER SYMPTOMS FOR U-S VETERANS

    MINDFULNESS-BASED THERAPY DECREASES POSTTRAUMATIC STRESS DISORDER SYMPTOMS FOR U-S VETERANS

    INTRO:Almost a quarter of U-S Veterans returning from the wars in Iraq and Afghanistan are diagnosed with post-traumatic stress disorder or P-T-S-D. The Veterans Administration has invested heavily in first-line treatments but up to 60 percent of veterans either don’t begin these treatments or drop out early. A new study evaluated another intervention, mindfulness-based stress reduction, to see if it would help veterans improve their P-T-S-D symptoms. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:02
    “…ring…”

    VIDEO
    B-ROLL
    Various shots of Veterans meditating

    AUDIO
    VO
    These Veterans are using mindfulness-based meditation to help manage P-T-S-D symptoms.

    AUDIO
    NATSO/FULL
    Runs:04
    “…becoming aware of the wandering mind…”

    AUDIO
    SOT/FULL
    Kelvin O. Lim, M.D., – Minneapolis VA Medical Center
    Super@:16
    Runs:09
    “Mindfulness is a type of technique that allows one to be more aware of what one is experiencing.”

    (Video covering 1st half of bite: veteran meditating)

    AUDIO
    SOT/FULL
    Melissa A. Polusny, Ph.D., – Minneapolis VA Medical Center
    Super@:19
    Runs:07
    “To be present and aware of their thoughts, their feelings, their experiences in a non-judgmental and accepting way.”

    VIDEO
    B-ROLL
    Freeze shots of all three Veterans

    AUDIO
    VO
    For Veterans John, Jeff and Jeunai (Jeh-nay) this was an unfamiliar way to help with their
    P-T-S-D symptoms.

    AUDIO
    SOT/FULL
    John – U.S. Veteran
    Super@:32
    Runs:05
    “I was skeptical. I didn’t see how it could help me with my problems.”

    AUDIO
    SOT/FULL
    Jeff – U.S. Veteran
    Super@:38
    Runs:07
    “If you could envision a California freeway at night, that’s the type of traffic I had in my head.”

    AUDIO
    SOT/FULL
    Jeunai – U.S. Veteran
    Super@:44
    Runs:12
    “I thought it was hogwash to tell you the truth. I didn’t think it would be beneficial but obviously all the other stuff I was trying wasn’t really working.”

    VIDEO
    B-ROLL
    Dr. Polusny,Dr. Lim and Dr.Erbes walking down the hospital hallway, more group meditation and group therapy, various shots of program facilitators assessing Veterans

    AUDIO
    VO
    Doctors Melissa Polusny (puh-LEWS-knee),Kelvin Lim and their colleagues at the
    Minneapolis V-A Medical Center wanted to determine if the mindfulness intervention
    could help. 116 Veterans with a diagnosis of P-T-S-D participated in the trial. Half the group completed 9 weeks of mindfulness-based stress reduction therapy.The other had group therapy, focusing on current life problems. The Veterans were monitored before, during and after treatment…

    AUDIO
    NASOT/FULL
    Runs:03
    “…does he have any rituals at home, does he check the locks…”

    VIDEO
    B-ROLL
    Facilitators talking

    AUDIO
    VO
    …and also two months after completing therapy.

    AUDIO
    SOT/FULL
    Kelvin O. Lim, M.D., – Minneapolis VA Medical Center
    Super@1:23
    Runs:09
    “There was a greater improvement with the mindfulness
    or meditation intervention but this was a moderate change.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Melissa A. Polusny, Ph.D., – Minneapolis VA Medical Center
    Super@1:36
    Runs:10
    “Mindfulness skills were significantly associated with
    greater improvements in PTSD symptoms and quality-of-life at the two month follow up.”

    AUDIO
    SOT/FULL
    Jeunai – Study Participant
    Super@1:45
    Runs:09
    “I don’t feel like I am treading water anymore and I feel mindfulness has brought me back to who I am and who my family can enjoy again.”

    (Video covering 2nd half of bite: Jeunai talking and smiling)

    AUDIO
    SOT/FULL
    Jeff – Study Participant
    Super@1:55
    Runs:08
    “I wish I would have had this opportunity when I was a young man to be able to have this resource. I would have been a completely different person today.”

    (Video covering 2nd half of bite: Jeff listening to other Vets talking

    AUDIO
    SOT/FULL
    John – Study Participant
    Super@2:03
    Runs:11
    “I feel peace and that has been a situation that has escaped me in the, 40 years since I was last in combat.”

    (Video covering middle of bite: John talking in group session)

    VIDEO
    B-ROLL
    John on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: More studies are needed but study authors say mindfulness may offer a milder form of exposure to trauma then the first-line treatments currently available.

  • July 28, 2015

    Death Rates, Hospitalizations, and Costs Decrease for Medicare Patients

    Death Rates, Hospitalizations, and Costs Decrease for Medicare Patients

    INTRO:Improving the health of Americans and the U.S. health care system in general has been a large focus for Medicare in recent years.  With so many different efforts being undertaken, what exactly are the benefits? A new study examined key outcomes among the Medicare population over the last 15 years.  Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:04
    “…I was very impressed by the service at the hospital…”

    AUDIO
    NATSO/FULL
    Runs:02
    “…everyone was thinking very hard how to help you…”

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@:07
    Runs:07
    “We’re experiencing an unprecedented improvement in the experience of people in the Medicare program.”

    VIDEO
    B-ROLL
    Dr. Krumholz talking with nurses, Dr. Krumholz examining patient, patient’s wife, couple holding hands, Dr. Krumholz talking to patient

    AUDIO
    VO
    Dr. Harlan Krumholz from the Yale University School of Medicine and co-authors reviewed the records of nearly 70 million medicare beneficiaries during a 15 year period, from 1999 thru 2013.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@:28
    Runs:09
    “It’s really important to keep tabs on what we are achieving in health care. We spend a lot of time, a lot of effort, a lot of resources trying to make things better.”

    VIDEO
    Older people outside hospital in wheelchairs

    AUDIO
    VO
    The researchers first looked at improvements in both the Medicare Advantage and fee-for-service programs combined.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@:39
    Runs:07
    “The chance of dying each year has gone down. Almost a 20 percent reduction in the mortality rate on an annual basis.”

    VIDEO
    B-ROLL
    Patient being pushed in a wheelchair, older person walking with cane

    AUDIO
    Then they took a closer look at the fee-for-service group, representing about 75 percent of the overall medicare population.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@:54
    Runs:15
    “We saw for every 100 thousand people in Medicare about 10 thousand fewer hospitalizations. That translates into millions of people not hospitalized in 2013 who would have been hospitalized had those rates not declined.”

    (Video covering middle of bite: empty hospital room)

    VIDEO
    Out of focus shot of patient in hospital room

    AUDIO
    VO
    OTHER PATIENT OUTCOMES WERE ALSO BETTER.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@1:11
    Runs:06
    “The chance of dying after being hospitalized among Medicare beneficiaries dropped dramatically during this period.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@1:21
    Runs:11
    “Many more people were spending many fewer days in the hospital in the last six months of their life.  When you consider in hospital costs and at the end of life there were also fewer dollars being spent.”

    (Video covering 2nd half of bite: doctors in patient room talking, staff working)

    VIDEO
    B-ROLL
    Older people in the community

    AUDIO
    VO
    These improvements were seen across the nation in all populations, by age, gender, and race.

    AUDIO
    SOT/FULL
    Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine
    Super@1:40
    Runs:05
    “We just have to make sure to continue this trend so the next time we look we’re that much better than we are today.”

    (Video covering first half of bite: Doctor looking at monitor)

    VIDEO
    B-ROLL
    Dr. Krumholz on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Overall spending of Medicare patients in the hospital also declined over
    the study period.

  • July 21, 2015

    SURVIVAL AFTER CARDIAC ARREST IMPROVES WHEN MORE PATIENTS RECEIVE BYSTANDER C-P-R AND EXTERNAL DEFIBRILLATION

    SURVIVAL AFTER CARDIAC ARREST IMPROVES WHEN MORE PATIENTS RECEIVE BYSTANDER C-P-R AND EXTERNAL DEFIBRILLATION

    “SURVIVAL AFTER CARDIAC ARREST IMPROVES WHEN MORE PATIENTS RECEIVE BYSTANDER C-P-R AND EXTERNAL DEFIBRILLATION”

    INTRO:If a family member, someone at work, or even the person standing next to you experiences sudden cardiac arrest, would you be able to help? Performing C-P-R and using an automated external defibrillator can mean the difference between life and death. A new study examined what happens if more ordinary people in the community and first-responders, like police officers and firefighters, learn to use these two interventions—can survival for patients having cardiac arrest be improved? Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:03
    “…hey hey buddy, are you ok, are you ok?”

    VIDEO
    B-ROLL
    Volunteers practicing CPR, cu of instructor, volunteers doing CPR

    AUDIO
    VO
    These volunteers are learning about cardiac arrest and how to provide compression only c-p-r.

    AUDIO
    NATSO/FULL
    Runs:02
    “This is CPR without the breaths.”

    VIDEO
    B-ROLL
    Cu of defibrillator pads being fastened onto mannequin

    AUDIO
    VO
    They are also learning how to use an automated external defibrillator or A-E-D.

    AUDIO
    NATSO/FULL
    Runs:08
    “…open packet and apply pads onto patient’s bare skin… analyzing heart rhythm…shock advised…”

    AUDIO
    SOT/FULL
    Christopher B. Granger, M.D., -Duke Clinical Research Institute
    Super@:22
    Runs:08
    “It’s very important that people not be afraid to act when one sees a cardiac arrest.”

    VIDEO
    B-ROLL
    “Miracle Man” video, David at Duke game, getting CPR and defibrillation

    Mandatory Super@:30

    Courtesy: Contrast Creative
    “Miracle Man”

    AUDIO
    VO
    David Foster had a cardiac arrest while attending a Duke basketball game. First responders performed C-P-R and also used an A-E-D located in the arena.

    AUDIO
    SOT/FULL
    Carolina Malta Hansen, M.D., – Duke Clinical Research Institute
    Super@:39
    Runs:07    “We know that the chances of survival fall about 10 percent per minute without any intervention.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Christopher B. Granger, M.D., -Duke Clinical Research Institute
    Super@ 1:26
    Runs:15
    “The only improvement was when people got bystander CPR so this highlights the critical importance for people to learn how to do compression only CPR and then to do it and don’t be afraid to do it.”

    AUDIO
    SOT/FULL
    Carolina Malta Hansen, M.D., – Duke Clinical Research Institute
    Super@1:41
    Runs:12
    “Patients who received bystander or first responder interventions before arrival of the EMS were more likely to survive compared to those who received EMS interventions alone.”

    (Video covering 2nd half of bite: gurney being taking out of ambulance)

    VIDEO
    Newspaper article, pic of David with medical staff
    (Mandatory Super@ 1:53)

    AUDIO
    VO
    Often called the “Miracle Man”, David survived his cardiac arrest and is doing well today.

    AUDIO
    SOT/FULL
    Carolina Malta Hansen, M.D., – Duke Clinical Research Institute
    Super@1:58
    Runs@:06
    “Any intervention is better than no intervention when a person is having a cardiac arrest.”

    VIDEO
    B-ROLL
    David playing basketball with his children

    (Mandatory Super@ 2:04)

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study looked at counties in non-metropolitan areas with very diverse communities.

  • July 13, 2015

    UNDIAGNOSED MATERNAL CANCER MAY EXPLAIN SOME DISCREPANCIES IN PRENATAL TESTING RESULTS

    UNDIAGNOSED MATERNAL CANCER MAY EXPLAIN SOME DISCREPANCIES IN PRENATAL TESTING RESULTS

    INTRO:An increasing number of pregnant women are undergoing non-invasive pre-natal testing to help identify fetal genetic abnormalities. This is done using a blood test that looks at both the D-N-A of the mother and the fetus.  In a small percentage of these tests, the results appear abnormal but the baby’s genetics are actually normal.  A new study examined if the rare diagnosis of maternal cancer could be one cause of such discrepancies. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Pregnant women having blood drawn

    AUDIO
    VO
    This increasingly common blood test can help detect whether a woman is carrying a fetus with a genetic abnormality.

    AUDIO
    SOT/FULL
    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@:07
    Runs:12
    “The test analyzes not only the DNA fragments from the fetus and the placenta but it analyzes DNA fragments from the mother herself.”

    VIDEO
    B-ROLL
    Lab technician working, Dr. Bianchi in lab

    AUDIO
    VO
    For every one thousand women tested, about two will have an abnormal result. It’s recommended those women have additional diagnostic testing looking at only the fetal D-N-A.

    AUDIO
    SOT/FULL
    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@:27
    Runs:19
    “In a small minority of women the test showed that the fetal chromosomes were normal and that disagreed with the blood test. We were examining whether cancer could explain the discrepancy between these two test results.”

    VIDEO
    B-ROLL
    Dr. Bianchi talking in lab with colleagues, Graphic: over lab video
    NON-INVASIVE PRENATAL SCREENING TESTS
    125,426 Tests
    2 Years
    3,757 Abnormal Tests
    10 Diagnosed with Cancer

    AUDIO
    VO
    Dr. Diana W. Bianchi from Tuft’s Medical Center and co-authors examined more than 125 thousand non-invasive prenatal test results done over a two year period. 3,757 women had abnormal test results. 10 of those women were subsequently diagnosed with cancer.

    AUDIO
    SOT/FULL
    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@1:02
    Runs:08
    “If she does have cancer, there’s the possibility that she is shedding DNA from these tumors into her blood.”

    VIDEO
    B-ROLL
    Woman getting an ultrasound

    AUDIO
    VO
    Medical records and additional genetic information were examined in 8 of those women to look for patterns suggestive of an underlying cancer.

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@1:27
    Runs:16
    “There’s a very rare situation in which the mother has cancer, cancer DNA can cause a discrepancy between the prenatal fetal genetic screening test and the fetal chromosome test.”

    (Video covering middle of bite: Ultrasound of fetus)

    VIDEO
    B-ROLL
    Babies in nursery

    AUDIO
    VO
    All 10 women diagnosed with cancer delivered healthy babies.

    AUDIO
    SOT/FULL
    SOT/FULL
    Diana W. Bianchi, M.D., – Tufts Medical Center
    Super@1:46
    Runs:14
    “Even though the test was not designed to detect cancer, cancer is an incidental finding. If you recognize the proper signatures then you can go on and have further care.”

    (Video covering end of bite: Dr. Bianchi talking with colleagues)

    VIDEO
    B-ROLL
    Dr. Bianchi talking with colleagues

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This was a preliminary study.  There is currently no clear guidance about follow up testing when discrepancies are found.  Further research is needed.

  • July 07, 2015

    Stroke Associated with Both Immediate and Long-Term Declines in Cognitive Function

    Stroke Associated with Both Immediate and Long-Term Declines in Cognitive Function

    “Stroke Associated with Both Immediate and Long-Term Declines in Cognitive Function”

    INTRO:Each year in the United States nearly 800 thousand people experience a stroke. Stroke is associated with declines in cognitive function, including memory and thinking speed. Although many patients experience these declines immediately after a stroke, a new study looked at whether cognitive decline also continues and even accelerates years after the initial stroke. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    David and nurse leaving hospital waiting room

    AUDIO
    VO
    David Ramon (Rah-man) was at home watching T-V when he had his stroke.

    AUDIO
    SOT/FULL
    David Ramon – Stroke Survivor
    Super@:05
    Runs:05
    “I couldn’t close my hand, the right side of my face was numb.”

    VIDEO
    B-ROLL
    David walking to exam room with nurse

    AUDIO
    VO
    He knew something was very wrong and went to find his wife.

    AUDIO
    SOT/FULL
    David Ramon – Stroke Survivor
    Super@:13
    Runs:11
    “I opened the door and tried to tell her that she should call the doctor.  It was just babble. I couldn’t speak.”

    VIDEO
    B-ROLL
    Various shots of David and Dr. Levine talking in exam room

    AUDIO
    VO
    After his stroke, like many patients, David had immediate problems with memory and his ability to think clearly was impaired.

    AUDIO
    SOT/FULL
    Deborah A. Levine, M.D., M.P.H. – University of Michigan
    Super@:30
    Runs:15    “We have known that stroke is associated with cognitive decline over the short term we did not know whether stroke is associated with declines in thinking speed and memory over the years after the event.”

    VIDEO
    B-ROLL
    Dr. Levine walking down hallway, older people walking outside, computer showing brain images, Dr. Levine doing memory test with David, cu of test, pan from Dr. Levine to David, brain image

    AUDIO
    Dr. Deborah Levine (Lih-veen) from the University of Michigan and co-authors followed more than 23 thousand people, 45 years and older who participated in a national study. The participants were free of any cognitive impairment when they entered the study. Memory and other aspects of cognitive function were measured at the beginning and at regular intervals throughout a six-year follow up period. 515 people experienced a stroke during the study period. The rest remained stroke free.

    AUDIO
    SOT/FULL
    Deborah A. Levine, M.D., M.P.H. – University of Michigan
    Super@1:13
    Runs:15
    “Stroke is associated with significant long-term cognitive decline. Stroke survivors may experience decline in their memory and thinking speed over years after the event, not just right after the event.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Deborah A. Levine, M.D., M.P.H. – University of Michigan
    Super@1:31
    Runs:12
    “Our findings highlight why it’s so important for stroke survivors and people at high risk for stroke to control their risk factors and to make behavior changes.”

    VIDEO
    B-ROLL
    Various shots of Dr. Levine checking David’s heart, David using apps on phone

    AUDIO
    VO
    David is doing just that. He lost 61 pounds and continues to be monitored closely by his doctors. He also uses programs on his phone to help improve his memory and thinking speed.

    AUDIO
    SOT/FULL
    David Ramon – Stroke Survivor
    Super@1:58
    Runs:10
    “I feel more energetic, happier. I do want to live a long time and I’d like that to be as well as possible.”

    (Video covering 1st and last part of bite: various shots of David using apps on his phone)
    VIDEO
    B-ROLL
    David using apps on his phone

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Stroke survivors warrant close monitoring to help detect declines in cognition years after their stroke.

  • June 23, 2015

    Implantable Defibrillators Underused Among Older Patients After Heart Attack

    Implantable Defibrillators Underused Among Older Patients After Heart Attack

    INTRO:Each year more than 350 thousand people die from sudden cardiac death. Placement of an “implantable cardioverter-defibrillator” , or I-C-D, can prevent sudden cardiac death in patients who have weakened heart function, including those who have experienced a previous heart attack.  A new study examined older patients who had weakened heart function after a heart attack and whether or not they underwent placement of these defibrillators and also what portion of the patients were still alive 2 years later. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Paul sitting on exam table talking with Dr. Pokorney, Dr. Pokorney checking monitor

    AUDIO
    VO
    Paul Harrison is getting his defibrillator checked.  His heart was left weakened after three heart attacks and no longer pumps blood as effectively as it should.

    AUDIO
    SOT/FULL
    Paul Harrison – Heart Patient
    Super@ :07
    Runs:07
    “It gave me a warning that something was happening. When it went off my heart had spiked to a really high number.”

    (Video covering middle of bite: cu of monitor, Dr. Pokorney listening to Paul’s heart)

    AUDIO
    SOT/FULL
    Sean D. Pokorney, M.D., M.B.A., – Duke University
    Super@:17
    Runs:12
    “The implantable cardioverter defibrillator when it senses one of these fast life-threatening heart rhythms can deliver a shock to reset the heart and hopefully get the heart back into a regular rhythm.”

    (Video covering 1st part of bite: doctor listening to Paul’s heart)

    AUDIO
    SOT/FULL
    Paul Harrison – Heart Patient
    Super@ :27
    Runs:05
    “It’s happened three times since I’ve had it. It’s actually saved my life.”

    VIDEO
    B-ROLL
    Doctor implanting a defibrillator in patient, nurses monitoring patients vital signs, doctor implanting defibrillator

    AUDIO
    VO
    Guidelines recommend that patients with weakened heart function that qualify for defibrillator placement wait 40 days after a heart attack. This includes patients 65 years and older.

    AUDIO
    SOT/FULL
    Tracy Y. Wang, M.D., M.H.S, M.Sc., – Duke University
    Super@:41
    Runs:13
    “We wanted to see how many of these patients got a defibrillator within the next year after their heart attack and then we wanted to look at their outcomes to two years to see if their death rate was impacted by the defibrillator.”

    (Video covering end of bite: Dr. Pokorney showing Paul his defibrillator on computer screen)

    VIDEO
    B-ROLL
    Various shots of Dr. Wong and Dr. Pokorney looking at heart on computer screen, cu of screen, Dr. Pokorney talking with Paul, examining skin around defibrillator

    AUDIO
    VO
    Doctors Tracy Wang(Wong) and Sean Pokorney from Duke University along with their co-authors examined clinical information from more than 10 thousand Medicare beneficiaries who had had a heart attack from 2007 to 2010. These patients were treated at more than 4 hundred hospitals across the U-S.

    AUDIO
    SOT/FULL
    Sean D. Pokorney, M.D., M.B.A., – Duke University
    Super@1:09
    Runs:06
    “Less than one in ten patients received an ICD within one year of their heart attack.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Tracy Y. Wang, M.D., M.H.S, M.Sc., – Duke University
    Super@1:19
    Runs:11
    “Patients two years later were surviving longer with a defibrillator. The patients who are 80 years or older we found an association with better survival when a defibrillator was implanted.”

    Video covering 2nd half of bite: doctor implanting a defibrillator)

    VIDEO
    B-ROLL
    Various shouts of Dr. Pokorney showing Paul his defibrillator

    AUDIO
    VO
    Patients who followed up with their doctors within 2 weeks after hospital discharge were more likely to get a defibrillator as were patients who underwent previous heart bypass surgery.  Paul says he is grateful for this life-saving technology.

    SOT/FULL
    SOT/FULL
    Paul Harrison – Heart Patient
    Super@ 1:41
    Runs:11
    “You come to a crossroads in your life to where you either give up or make the most of what you have left. I felt like they gave me three chances and not many people get one or two.”

    (Paul and his wife walking out of hospital)

    VIDEO
    B-ROLL
    Paul and wife walking

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The study results found that larger hospitals also had low defibrillator implantation rates in this medicare population.

  • June 09, 2015

    New Control System Shows Potential to Improve Function of Motorized Prosthetic Legs

    New Control System Shows Potential to Improve Function of Motorized Prosthetic Legs

    INTRO:Bending an ankle or knee while walking is second nature to most of us. Tiny electrical signals contract the leg muscles helping the joints move. Currently, most prosthetic legs can’t move that way. A new study examined if using the electrical signals generated when muscles contract, which already help guide motorized prosthetic arms, can also make it easier for people to walk with a motorized prosthetic leg.  Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Split screen of Terry and Hailey walking with motorized leg, Terry going down step

    AUDIO
    VO
    Artist Terry Karpowicz (Car-pah-wits) and tri-athlete Hailey Danisewicz (dan-ih-seh-vich) are helping test the next generation of prosthetic legs. A motorized leg that bends at the knee and ankle.

    AUDIO
    SOT/FULL
    Terry Karpowicz – Study Participant
    Super@:10
    Runs:08
    “This one allows me the opportunity to flow down the stairs and not really think about the process of what the next step is.”

    (Video covering 2nd half of bite: Terry going walking down stairs)

    VIDEO
    B-ROLL
    SOT/FULL
    Hailey Danisewicz – Study Participant
    Super@:18
    Runs:04
    “It feels great, you know just being able to go down with that really natural movement.”

    VIDEO
    B-ROLL
    Hailey walking up ramp, cu of TV screen showing EMG signals

    AUDIO
    VO
    This motorized leg harnesses electrical signals generated by their upper leg muscles.These signals are known as E-M-G.

    AUDIO
    SOT/FULL
    SOT/FULL
    Levi J. Hargrove, Ph.D., – Rehabilitation Institute of Chicago
    Super@:29
    Runs:10
    “We pick them up with tiny antennas called electrodes. When the electrodes touch the skin you can detect the EMG signals and we pick those signals up and decode them.”

    (Video covering 2nd half of bite: woman sitting at desk looking at computer, reverse shot computer screen, cu of computer screen)

    VIDEO
    B-ROLL
    Hailey walking down ramp

    AUDIO
    VO
    These signals help tell the leg how to move.

    AUDIO
    NATSO/FULL
    Runs:03    “…looking good…”

    VIDEO
    B-ROLL
    Terry walking up stairs with current prosthetic leg

    AUDIO
    Traditional prosthetic legs are passive, functioning almost like a fancy walking stick.

    AUDIO
    SOT/FULL
    Levi J. Hargrove, Ph.D., – Rehabilitation Institute of Chicago
    Super@:48
    Runs:07
    “With this prosthetic leg the power pushes you along.  It can push you up and out of a seat.  It can push you up stairs or slopes.”

    (Video covering middle of bite: Hailey going up stairs with motorized leg)

    VIDEO
    B-ROLL
    Dr. Hargrove walking with Hailey as she comes down the ramp, team members sitting and standing near Hailey, Terry going up ramp, Hailey going up steps with therapist

    AUDIO
    VO
    Dr. Levi Hargrove from the Rehabilitation Institute of Chicago and co-authors tested two different ways to use the motorized leg in a group of 7 patients, all with lower limb amputations. One way incorporated E-M-G, the other way did not.  Each patient tested both methods but was not aware of which method was being used at a given time.

    AUDIO
    SOT/FULL
    Levi J. Hargrove, Ph.D., – Rehabilitation Institute of Chicago
    Super@1:14
    Runs:09
    “The system that did not incorporate neural signals, we noticed that it had a few more errors.  It’s like stubbing your toe or kicking the bottom of the stair.”

    (Video covering 2nd half of bite: Hailey hitting leg on step)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Levi J. Hargrove, Ph.D., – Rehabilitation Institute of Chicago
    Super@1:26
    Runs:11
    “Using EMG signals resulted in a leg that behaved better, made fewer mistakes and people liked to use it better. It reduced error rates by almost 50 percent.”

    (Video covering 2nd half of bite: Terry walking up stairs)

    AUDIO
    SOT/FULL
    Terry Karpowicz – Study Participant
    Super@ 1:38
    Runs:07
    “It allows me that freedom to just be who I am, not necessarily an amputee.”

    AUDIO
    SOT/FULL
    Hailey Danisewicz – Study Participant
    Super@1:44
    Runs:12
    “This is kind of the closest I’ve gotten to having, having two legs again. What we’re working on in this lab is eventually going to change the lives of amputees everywhere. I mean it’s great.”

    (Video covering middle of bite: Hailey walking with leg)

    VIDEO
    B-ROLL
    Hailey on camera

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:All the participants had above the knee or through the knee amputations.

  • June 02, 2015

    Antidepressants in Late Pregnancy May Be Associated with a Small Increase in Risk of Severe Breathing Disorder in Newborns

    Antidepressants in Late Pregnancy May Be Associated with a Small Increase in Risk of Severe Breathing Disorder in Newborns

    INTRO:A 2006 health advisory from the Food and Drug Administration alerted women that taking certain types of anti-depressants late in pregnancy could increase the risk of a severe and life-threatening breathing disorder in their newborns. In 2011, the F-D-A updated the advisory saying it was too early to reach firm conclusions about a possible link. A new study examines whether taking anti-depressants during late pregnancy increases the risk for this condition known as P-P-H-N. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Babies in nursery, babies feet and stomach going up and down

    AUDIO
    VO
    Babies breathe very differently before and after birth.

    AUDIO
    SOT/FULL
    Krista F. Huybrechts, M.S., Ph.D., – Brigham and Women’s Hospital
    Super@:05
    Runs:05
    “Before birth, the baby’s blood circulates differently while in the uterus.”

    VIDEO
    B-ROLL
    Various shots of pregnant woman getting ultrasound, graphic: full screen of incubator with PPHN sliding onto screen and highlighting first letters PPHN, Dr. Huybrechts walking in hospital, cu shots of antidepressant medications, Dr. Huybrechts talking with nurse, showing nurse the medication

    AUDIO
    VO
    The fetus gets oxygen from its mother. The developing lungs are not used for breathing.  After birth this should change. Persistent pulmonary hypertension or p-p-h-n occurs when the baby does not adapt to breathing outside the womb. Dr. Krista Huybrechts (Hau-brecks) from Brigham and Women’s Hospital in Boston and co-authors examined medical records of nearly 4 million publicly insured women, all diagnosed with depression, who filled a prescription for anti-depressants during the last 90 days of pregnancy.  The researchers were most interested in use of selective serotonin re-uptake inhibitor anti-depressants or S-S-R-Is.

    AUDIO
    SOT/FULL
    Krista F. Huybrechts, M.S., Ph.D., – Brigham and Women’s Hospital
    Super@:42
    Runs:08
    “The large majority of those women, around 80 percent, used an SSRI as opposed to a non-SSRI antidepressant.”

    VIDEO
    B-ROLL
    Pregnant women walking, baby in incubator with nurse and doctor around him

    AUDIO
    VO
    The records of women who did not take an antidepressant were also examined.  The number of babies born with P-P-H-N was compared in each group.

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Krista F. Huybrechts, M.S., Ph.D., – Brigham and Women’s Hospital
    Super@1:09
    Runs:17
    “Once we accounted for potential differences in the characteristics of women belonging to these different exposure groups we did not find an increase in the risk of PPHN associated with either SSRI antidepressants nor for non-SSRI antidepressants.”

    (Video covering middle of bite: babies in nursery)

    VIDEO
    B-ROLL
    Pregnant women, babies in nursery

    AUDIO
    VO
    Those characteristics included diabetes and obesity, both of which are known risk factors for P-P-H-N.

    AUDIO
    SOT/FULL
    SOT/FULL
    Krista F. Huybrechts, M.S., Ph.D., – Brigham and Women’s Hospital
    Super@1:33
    Runs:15    “This is important information for clinicians and their patients when they are weighing the risks and benefits of continuing antidepressant medication use during pregnancy or potentially initiating medication use during pregnancy.”

    (Video covering 2nd half of bite: antidepressant medications)

    VIDEO
    B-ROLL
    Antidepressant medications

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The risk of P-P-H-N in the study population ranged between 20 and 30 cases per ten thousand births.

  • May 26, 2015

    Mild Thyroid Overactivity Associated With Increased Risk of Fractures

    Mild Thyroid Overactivity Associated With Increased Risk of Fractures

    INTRO:The thyroid gland makes hormones that regulate metabolism.  The thyroid also has other important effects throughout the body.  An overactive thyroid can increase the risk of osteoporosis and fractures. A new study examined whether the risk of these fractures also increases among patients with only mild abnormalities of the thyroid, those who have not developed any physical symptoms as a result of having too much or too little thyroid hormone.  Catherine Dolf explains in this week’s JAMA Report.

    NATSO/FULL
    Runs:08
    “…the thyroid is a butterfly shaped gland and it sits right at the base of your neck…the thyroid can cause problems from overactivity or from underactivity…”

    VIDEO
    B-ROLL
    Graphic: Underactive/Overactive thyroid and symptoms, Dr. Cappola examining patient

    AUDIO
    VO
    An underactive thyroid can cause constipation, unexplained weight gain, or fatigue. An overactive thyroid can do the opposite; symptoms might include, weight loss, anxiety, and heart palpitations.  Too much thyroid hormone can also increase the risk for osteoporosis and fractures. But for people who only have mild abnormalities in thyroid activity and don’t have any of these symptoms, do they also increase their risk for fractures?

    AUDIO
    NATSO/FULL
    Runs:01
    “…can you swallow please…”

    VIDEO
    B-ROLL
    Dr. Cappola walking down hall into an exam room, looking at x-ray on the computer, people walking outside, technician doing testing, Dr. Cappola looking at x-rays

    AUDIO
    VO
    Dr. Anne Cappola from the University of Pennsylvania and co-authors examined the results of 13 individual research studies that included more than 70 thousand patients from all over the world. All patients had testing of their thyroid hormone levels and were followed for an average of 12 years to see whether or not they experienced fractures.

    AUDIO
    SOT/FULL
    Anne R. Cappola, M.D., Sc.M., – University of Pennsylvania, Perelman School of Medicine
    Super@:52
    Runs:06
    “We found that three percent had a slightly overactive thyroid, five percent had a slightly underactive thyroid.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Anne R. Cappola, M.D., Sc.M., – University of Pennsylvania, Perelman School of Medicine
    Super@1:01
    Runs:14
    “Those who had the slightly overactive thyroid were more likely to have hip fractures and more likely to have any kind of fracture. The people who had just a little bit underactive thyroid didn’t have any fracture risk at all from having that thyroid problem.”

    VIDEO
    B-ROLL
    Dr. Cappola and patient talking in exam room

    AUDIO
    VO
    Currently, routine thyroid screening is not recommended.

    AUDIO
    SOT/FULL
    Anne R. Cappola, M.D., Sc.M., – University of Pennsylvania, Perelman School of Medicine
    Super@1:18
    Runs:15
    “If someone has a slightly overactive thyroid that’s something that needs to be paid attention to. What it suggests is if somebody has increased risk of fracture from having a slightly overactive thyroid that perhaps if we were to correct that and treat that we could prevent fractures.”

    (Video covering last part of bite: Spinal x-ray on computer)

    VIDEO
    B-ROLL
    Spinal x-ray

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The average age of patients that underwent thyroid testing was 64 and 61 percent were women.

  • May 19, 2015

    Oral Steroids Do Not Improve Sciatica Pain

    Oral Steroids Do Not Improve Sciatica Pain

    INTRO: Steroids are commonly prescribed for patients who suffer from lower back and leg pain caused by a herniated disc. But how well do these anti-inflammatory medications actually work? A new study looked at a common oral steroid medication and its effectiveness in decreasing pain and improving function for patients with a herniated disc. Catherine Dolf has more in this week’s JAMA Report.

     

    VIDEO

    B-ROLL

    Various shots of people walking outside

     

    AUDIO

    VO

    Every day, thousands of people head to their doctor’s office looking for relief from a very common problem.

     

    AUDIO

    NATSO/FULL Runs:02

    “…if you have any discomfort you tell me…”

     

    VIDEO

    B-ROLL

    Dr. Goldberg examining patient

     

    AUDIO

    VO

    It’s called sciatica.

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern California

    Super@:16

    Runs:10

    “Acute sciatica is often disabling, extremely painful condition felt down the leg. It’s usually caused by a ruptured disc in the lumbar area.”

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@:20

    Runs:08

    “We’ve begun looking at other ways to decrease the pain and improve function more easily for patients with sciatica.”

    VIDEO

    B-ROLL

    Dr. Goldberg lifting patients leg, prednisone tablet poured out on table

     

    AUDIO

    VO

    There are limited options for treating this painful condition. One of the most common approaches is to prescribe the oral steroid medication called prednisone.

     

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@:36

    Runs:04

    “But it’s never been studied to see if in fact it makes a difference.”

    VIDEO

    B-ROLL

    Dr. Goldberg and Dr. Avins walking, looking at MRI, patient going into MRI machine, cu of prednisone tablets

    AUDIO

    Doctors Harley Goldberg and Andrew Avins from Kaiser Permanente Northern California and co-authors studied 269 patients with sciatica. All patients underwent an m-r-i to confirm that they had a herniated disc. Two-thirds were given oral prednisone and the other third got a placebo. Patients were assessed for pain and overall function after three weeks and again at one year.

     

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@1:01

    Runs:13

    “People got no better with the prednisone than they did with the placebo, that is to say, they both got better equally. There was actually a little bit of improved functional capacity for people that took prednisone.”

    GXF FULL

    JAMA LOGO

     

    AUDIO

    VO

    The study appears in JAMA, Journal of the American Medical Association.

     

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern

    Super@1:17

    Runs:10

    “We also found that patients who took steroids had more side effects than patients who took the placebo but most of those side effects were fairly mild and transient in nature.”

     

    VIDEO

    B-ROLL

    Dr. Goldberg raising patients leg

     

    AUDIO

    VO

    The authors say these results provide important evidence about the relative risks and benefits of steroid therapy.

     

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern

    Super@1:33

    Runs:15

    “We now have guidance, we have information and we can provide for our patients, true meaningful and informed discussions about the relative benefits and risks of this kind of therapy for this kind of condition.”

    VIDEO

    B-ROLL

    Cu on computer screen, pan up to Dr. Goldberg and Dr. Avins

     

    AUDIO

    Catherine Dolf, the JAMA Report.

     

     

    Tag:Study authors say, while these new data are important, additional studies are needed to evaluate other treatments that may be effective for this common condition.

  • May 19, 2015

    Oral Steroids Do Not Improve Sciatica Pain

    Oral Steroids Do Not Improve Sciatica Pain

    INTRO: Steroids are commonly prescribed for patients who suffer from lower back and leg pain caused by a herniated disc. But how well do these anti-inflammatory medications actually work? A new study looked at a common oral steroid medication and its effectiveness in decreasing pain and improving function for patients with a herniated disc. Catherine Dolf has more in this week’s JAMA Report.

     

    VIDEO

    B-ROLL

    Various shots of people walking outside

     

    AUDIO

    VO

    Every day, thousands of people head to their doctor’s office looking for relief from a very common problem.

     

    AUDIO

    NATSO/FULL Runs:02

    “…if you have any discomfort you tell me…”

     

    VIDEO

    B-ROLL

    Dr. Goldberg examining patient

     

    AUDIO

    VO

    It’s called sciatica.

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern California

    Super@:16

    Runs:10

    “Acute sciatica is often disabling, extremely painful condition felt down the leg. It’s usually caused by a ruptured disc in the lumbar area.”

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@:20

    Runs:08

    “We’ve begun looking at other ways to decrease the pain and improve function more easily for patients with sciatica.”

    VIDEO

    B-ROLL

    Dr. Goldberg lifting patients leg, prednisone tablet poured out on table

     

    AUDIO

    VO

    There are limited options for treating this painful condition. One of the most common approaches is to prescribe the oral steroid medication called prednisone.

     

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@:36

    Runs:04

    “But it’s never been studied to see if in fact it makes a difference.”

    VIDEO

    B-ROLL

    Dr. Goldberg and Dr. Avins walking, looking at MRI, patient going into MRI machine, cu of prednisone tablets

    AUDIO

    Doctors Harley Goldberg and Andrew Avins from Kaiser Permanente Northern California and co-authors studied 269 patients with sciatica. All patients underwent an m-r-i to confirm that they had a herniated disc. Two-thirds were given oral prednisone and the other third got a placebo. Patients were assessed for pain and overall function after three weeks and again at one year.

     

    AUDIO

    SOT/FULL

    Harley Goldberg, D.O., – Kaiser Permanente Northern California

    Super@1:01

    Runs:13

    “People got no better with the prednisone than they did with the placebo, that is to say, they both got better equally. There was actually a little bit of improved functional capacity for people that took prednisone.”

    GXF FULL

    JAMA LOGO

     

    AUDIO

    VO

    The study appears in JAMA, Journal of the American Medical Association.

     

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern

    Super@1:17

    Runs:10

    “We also found that patients who took steroids had more side effects than patients who took the placebo but most of those side effects were fairly mild and transient in nature.”

     

    VIDEO

    B-ROLL

    Dr. Goldberg raising patients leg

     

    AUDIO

    VO

    The authors say these results provide important evidence about the relative risks and benefits of steroid therapy.

     

    AUDIO

    SOT/FULL

    Andrew L. Avins, M.D., M.P.H., – Kaiser Permanente Northern

    Super@1:33

    Runs:15

    “We now have guidance, we have information and we can provide for our patients, true meaningful and informed discussions about the relative benefits and risks of this kind of therapy for this kind of condition.”

    VIDEO

    B-ROLL

    Cu on computer screen, pan up to Dr. Goldberg and Dr. Avins

     

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    Catherine Dolf, the JAMA Report.

     

     

    Tag:Study authors say, while these new data are important, additional studies are needed to evaluate other treatments that may be effective for this common condition.

  • May 05, 2015

    Non-Aggressive Strain of Bacteria Helps Reduce Recurrent C. difficile Infection

    Non-Aggressive Strain of Bacteria Helps Reduce Recurrent C. difficile Infection

    INTRO:C-difficile or C-diff., is a common and sometimes deadly health care-associated infection. Almost 500 thousand cases are diagnosed each year in the U.S., usually affecting hospitalized patients and others taking antibiotics. The symptoms include severe diarrhea and colitis. Even after treatment, C-diff. frequently returns. A new study examined a potential way to prevent the infection from coming back. Catherine Dolf has more this week’s JAMA Report.

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    Pics of Cheryl biking and traveling, pic of C diff

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    Cheryl O’Riordan loves to bike, travel and volunteer but a bout with this bacteria, c-difficile, changed her life.

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    SOT/FULL Super@:06 Cheryl O’Riordan – C. difficile Patient Runs:07
    “I felt like the lining of my colon was being ripped out.” “I needed to be near a washroom at all times.”

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    Dr. Johnson listening to Cheryl’s heart

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    VO
    Dr. Stuart Johnson from Loyola University Health System treated Cheryl for her c-diff infection.

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    SOT/FULL Super@:18 Stuart Johnson – Loyola University Health System Runs:11
    “C diff is an opportunistic bacteria.” It can travel down the gut, start to replicate, produce the toxins and cause the manifestations that we refer to as C diff.”

    (Video covering 2nd half of bite: technician looking at petri dish)

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    Graphic: pic of C diff , various lab shots, technician working with vials

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    VO
    About 25 to 30 percent of patients see a return of the infection. However, some patients carry strains of c-diff that do not make the toxins that are responsible for symptoms of infection, in this case, severe diarrhea; these are called non-toxigenic strains.

    AUDIO
    SOT/FULL Super@:42 Dale N. Gerding, M.D., – Edward Hines Jr. VA Hospital Runs:09
    “If that strain can be established in your gut it will keep out the toxigenic strains, in fact, it may even force out some of these toxigenic strains.”

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    Dr. Gerding walking in his lab, technician laying out several petri dishes, technician taking sample from petri dish

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    Dr. Dale Gerding from the Edward Hines V-A Hospital and co-authors looked at 168 patients who had been successfully treated for c-diff and randomly assigned them to four groups. Three of the groups received varying doses of the non-toxigenic c-diff strain. The fourth group received a placebo.

    AUDIO
    SOT/FULL Super@1:06 Dale N. Gerding, M.D., – Edward Hines Jr. VA Hospital Runs:16
    “The secret clearly was to get these patients to be colonized with this nontoxigenic strain, which just means that these strains set up housekeeping in the G-I tract. We got about 70 percent of patients to colonize with this strain after treatment.”

    (Video covering middle of bite: Dr. Gerding looking into microscope, cu of lens)

    GXF FULL
    JAMA COVER

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    VO
    The study appears in JAMA, Journal of the American Medical Association.

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    SOT/FULL Super@1:26 Dale N. Gerding, M.D., Edward Hines Jr. VA Hospital Runs:16
    “We were able to reduce the recurrence rate from 30 percent in the placebo group down to 11 percent for all patients who got the nontoxigenic strain and for the dose that worked the best the recurrence rate was 5 percent.”

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    Technician taking specimen out of freezer

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    Administration of non-toxigenic strains did not result in any severe side effects compared with placebo.

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    SOT/FULL Super@1:47 Dale N. Gerding, M.D., Edward Hines Jr. VA Hospital Runs:08
    “It’s the first time that we’ve taken a strain of the same bacteria that causes the disease and actually used it as a preventive measure.”

    VIDEO
    Cheryl walking, sitting outside talking on phone

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    VO
    Luckily Cheryl did not have a recurrence of c-diff.  Her health is back to normal and she is looking forward to…

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    SOT/FULL Super@2:02 Cheryl O’Riordan – C. difficile Patient Runs:02
    “My next trip.”…(laugh)

    VIDEO
    Pic of Cheryl on vacation

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The non-toxigenic c-diff bacteria only stays in the g-i tract temporarily.  Study authors say this corresponds to when a patient’s normal bacteria is recovered, which pushes out the non-toxigenic strain.

  • April 28, 2015

    Emergency Department Intervention Improves Rate of Treatment for Opioid Dependence

    Emergency Department Intervention Improves Rate of Treatment for Opioid Dependence

    INTRO:Those struggling with addictions to prescription drugs and heroin often seek care in hospital emergency departments. However, the primary option available for emergency department staff is referral to addiction treatment services. A new study evaluated whether these patients would be more successful in seeking and staying in addiction treatment if they began effective treatment in the emergency department. Catherine Dolf explains in this week’s JAMA Report.

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    Michael walking into hospital emergency department

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    Like others who have struggled with drug addiction, Michael McCrorken was no stranger to hospital emergency departments.

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    SOT/FULL Super@:07 Michael McCrorken Runs:07
    “I was literally just enslaved to my addiction and it was awful.”

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    SOT/FULL Super@:14 Gail D’Onofrio, M.D., M.S., – Yale School of Medicine Runs:09
    “These patients often seek care in the emergency department and often are just turned away and not directed to treatment.”

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    Dr. D’Onfrio, Dr. Fiellin and another doctor walking down hallway in ED, EMT’s walking with gurney, staff treating patient, wide shot of emergency department desk, pan of medication buprenorphine, cu of person getting blood pressure taken

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    VO
    Doctors Gail D’Onofrio (dah-naw-free-oh) and David Fiellin (feh-leen) from the Yale School of Medicine and co-authors enrolled 329 patients with opioid dependence from the emergency department at Yale-New Haven Hospital. One group received a referral to drug treatment. The second group underwent a brief intervention and referral to treatment.  The third group was started on buprenorphine (bew-puh-nor-feen), a medication that helps ease withdrawal symptoms and drug cravings. This group also followed up in primary care for maintenance therapy.

    AUDIO
    SOT/FULL Super@:49 David A. Fiellin, M.D., – Yale School of Medicine Runs:10
    “Once they came to the primary care center we organized their treatment and provided them that treatment for at least a 10 week period of time.”
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    SOT/FULL Super@:58 Gail D’Onofrio, M.D., M.S., – Yale School of Medicine Runs:06
    “Those patients that were randomized to the buprenorphine group, almost 80 percent of them were in treatment at 30 days.”

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    SOT/FULL Super@1:04 David A. Fiellin, M.D., – Yale School of Medicine Runs:07
    “And this is twice the number who will be engaged in treatment if they simply receive a referral to treatment.”

    GXF FULL
    JAMA COVER

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

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    SOT/FULL Super@1:15 Gail D’Onofrio, M.D., M.S., – Yale School of Medicine Runs:07
    “We also found that those patients that were assigned to the buprenorphine group used less illicit opiates.”

    (Video covering 2nd half of bite: medication box)

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    Michael walking with ED nurse

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    VO
    Michael says one of the biggest concerns he and others faced was waiting to get into treatment.

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    SOT/FULL Super@1:27 Michael McCrorken Runs:07
    “If you go to the emergency room and they’ll treat you immediately versus waiting then it’s an asset.”

    (Video covering bite: Michael and doctors talking)

    VIDEO
    Michael walking outside

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    VO
    Michael has been in recovery for six years and is now studying business management.

    AUDIO
    SOT/FULL Super@1:39 Michael McCrorken Runs:05
    “I’ve never seen such a bright future and I never knew that I had it in me.”

    VIDEO
    Michael on camera

    AUDIO
    Catherine Dolf, the JAMA Report.
    Tag:In order to provide buprenorphine, emergency room physicians must complete extra training on opioid dependence and receive a special wavier from the Federal Drug Enforcement Agency.

     

  • April 21, 2015

    No Association Found Between Measles, Mumps, Rubella Vaccine and Autism, even among Children at Higher Risk

    No Association Found Between Measles, Mumps, Rubella Vaccine and Autism, even among Children at Higher Risk

    INTRO:Although multiple studies over the past 15 years have shown no link between the measles-mumps-rubella (or M-M-R) vaccine and autism spectrum disorders, parents and others continue to associate the vaccine with autism. A new study examined whether or not the M-M-R vaccine was associated with an increased risk of autism spectrum disorders especially in children whose older sibling already had an autism diagnosis. Catherine Dolf has more in this week’s JAMA Report.

    NATSO/FULL
    Runs:03
    “…waaaaaah…all done…”

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    Child getting vaccinated, vaccine in refrigerator, children in park

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    VO
    Receiving the measles-mumps-rubella or m-m-r vaccine has been a sometimes painful but routine part of a young child’s visit to the doctor. However, there have been questions about the safety of the MMR vaccine especially from parents who have children diagnosed with autism spectrum disorders or A-S-D.

    AUDIO
    SOT/FULL Super@:19 Anjali Jain, M.D., – The Lewin Group Runs:14
    “Many of them attribute their child’s autism spectrum disorders to the MMR vaccine. As a result they’re not always vaccinating those kids and their siblings as readily as other parents.”

    (Video covering 2nd part of bite: child getting vaccinated)

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    Dr. Jain walking outside, dissolve to her in office, cu of her on computer, various shots of children in park, family walking

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    VO
    Dr. Anjali (un-juh-lee) Jain (Jan) from the Lewin (LOO-WIN) Group and co-authors studied more than 95 thousand children enrolled in a large commercial health plan, following them from birth to at least five years of age. These children all had an older sibling enrolled in the plan. Researchers were particularly interested in children whose older sibling had an A-S-D diagnosis since that puts the younger child at a higher risk for A-S-D.

    AUDIO
    SOT/FULL Super@:54 Anjali Jain, M.D., – The Lewin Group Runs:18
    “We found no evidence of a harmful association between the MMR vaccine and autism spectrum disorders. This was true even among those children who were at an increased risk of having autism spectrum disorders by virtue of having an older sibling with ASD.”

    (Video covering middle of bite: vial of MMR vaccine)

    GXF FULL
    JAMA COVER

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    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIOSuper@1:16 Anjali Jain, M.D., – The Lewin Group Runs:12
    SOT/FULL
    “We found parents who have a child with an autism spectrum disorder already are vaccinating about 10 percent less than the parents of children who have unaffected siblings.”

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    Various shots of children walking outside

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    VO
    Dr. Jain (jan) says among the 95 thousand children just under a thousand were diagnosed with A-S-D, about one percent, similar to the prevalence in the general population.

    AUDIO
    SOT/FULL Super@1:37 Voice of:Anjali Jain, M.D., – The Lewin Group Runs:12
    “This study confirms the safety of the MMR vaccine using recent objective data in a very large data set. We hope that this reassures parents when they are making healthcare decisions for their children.”

    (Video covering first part of bite:  MMR vaccine in boxes, nurse showing mom information, mom holding child)

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    Mom holding child

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:Using a very large objective data base is important when looking at autism spectrum disorders because the condition varies so much from child to child.

  • April 14, 2015

    Intrauterine Exposure to Maternal Gestational Diabetes Associated With Increased Risk of Autism

    Intrauterine Exposure to Maternal Gestational Diabetes Associated With Increased Risk of Autism

    INTRO: When a fetus is exposed to high blood glucose because of maternal diabetes, this can have long-lasting effects on development. A new study examined whether exposure to maternal diabetes during pregnancy is associated with an increased risk of autism spectrum disorders in children. Catherine Dolf has more in this week’s JAMA Report.

    NATSO/FULL
    Runs:05
    “…wow, look at you…say yay…”

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    Megan clapping and hugging Levi, Levi working with therapist, Megan watching Levi and the therapist

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    VO
    2 year-old Levi Dahlberg was only recently diagnosed with autism but his mom Megan knew there was something different about him before that.

    AUDIO
    SOT/FULL Super@:11 Megan Dahlberg – Levi’s Mother Runs:11
    “Levi was saying hi and bye, kitty and tree and right about the same time he started walking he just stopped. Any sort of communication just went away around 16 months.”

    (Video covering end of bite: Levi walking to mom)

    AUDIO
    SOT/FULL Super@:23 Edward S. Curry, M.D., – Kaiser Permanente Southern California Runs:13
    “Early in pregnancy that first and second trimester is where the fetal brain is developing That’s a period of time where the brain is most susceptible to insults, so having an elevated blood sugar is an insult to that fetus.”

    (Video covering middle of bite: woman getting ultrasound)

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    Doctors Edward Curry and Anny (Eh-knee) Xiang (She-ong) from Kaiser Permanente Southern California and co-authors reviewed the medical records of more than 322 thousand children, born at Kaiser Permanente hospitals between 1995 and 2009. They identified the mothers’ diabetes status during pregnancy and also examined how many children were diagnosed with autism spectrum disorders.

    AUDIO
    SOT/FULL Super@:54 Anny H. Xiang, Ph.D., – Kaiser Permanente Southern California Runs:13
    “Exposure to gestational diabetes diagnosed before 26 weeks gestation was associated with increased risk of autism spectrum disorders in the offspring.”

    GXF FULL
    JAMA COVER

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    VO
    The study appears in JAMA, Journal of the American Medical Association.

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    SOT/FULL Super@1:15 Anny H. Xiang, Ph.D., – Kaiser Permanente Southern California Runs:09
    “For the children of mothers diagnosed after 26 weeks of gestation, there was no increased risk of having autism spectrum disorders.”

    (Video covering 1st part of bite: pregnant women walking)

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    Pregnant women walking and sitting

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    VO
    There was also no increased risk of autism spectrum disorders observed in children of mothers diagnosed with diabetes before pregnancy as well as those without diabetes.

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    SOT/FULL Super@1:32 Edward S. Curry, M.D., – Kaiser Permanente Southern California Runs:13
    “Early pre-natal care is vitally important for mothers. You want the mothers to come in not only to check for diabetes but also to be on their pre-natal vitamins, those things that can have a positive impact on the developing fetus.”

    (Video covering middle and end of bite: ultra sound screen pan down to mother’s belly)

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    Megan watching Levi working with therapist

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    VO
    While Megan did not have diabetes during her pregnancy, she is grateful for ongoing autism research.

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    SOT/FULL Super@1:50 Megan Dahlberg – Levi’s Mother Runs:11
    “I hope that one day he does not have a diagnosis, that it can be cured.  You just want them to be able to thrive both socially and intellectually and that’s my hope.”

    (Video covering end of bite: Levi working with therapist on mini-trampoline)

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    Levi smiling at therapist

    AUDIO
    Catherine Dolf, the JAMA Report.

    Tag:The study authors note that this was an observational study and further studies are needed to confirm the findings and better understand the nature of this association.