Author Interviews, BMJ, Nutrition, Weight Research / 29.01.2016
Dietary Flavenoids May Help Prevent Weight Gain
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Dr. Monica Bertoia[/caption]
MedicalResearch.com Interview with:
Monica L. Bertoia, MPH, PhD
Instructor in Medicine, Channing Division of Network Medicine
Brigham and Women’s Hospital & Harvard Medical School
Research Associate, Department of Nutrition
Harvard T. H. Chan School of Public Health
Boston, MA 02115
Medical Research: What is the background for this study? What are the main findings?
Response: Most weight loss studies have focused on one type of flavonoid, the flavan-3-ols found in green tea, and are limited to small numbers of overweight and obese study participants. We examined 7 subclasses of flavonoids and weight change in 124,086 healthy adults who reported their diet and weight repeatedly over up to 24 years.
Dr. Monica Bertoia[/caption]
MedicalResearch.com Interview with:
Monica L. Bertoia, MPH, PhD
Instructor in Medicine, Channing Division of Network Medicine
Brigham and Women’s Hospital & Harvard Medical School
Research Associate, Department of Nutrition
Harvard T. H. Chan School of Public Health
Boston, MA 02115
Medical Research: What is the background for this study? What are the main findings?
Response: Most weight loss studies have focused on one type of flavonoid, the flavan-3-ols found in green tea, and are limited to small numbers of overweight and obese study participants. We examined 7 subclasses of flavonoids and weight change in 124,086 healthy adults who reported their diet and weight repeatedly over up to 24 years.









Dr. Lazovich[/caption]
MedicalResearch.com Interview with:
DeAnn Lazovich, Ph.D.
Associate Professor
Division of Epidemiology and Community Health
University of Minnesota
Minneapolis, MN 55454
Medical Research: What is the background for this study? What are the main findings?
Dr. Lazovich: In Minnesota, as well as nationally, melanoma rates have been increasing more steeply in women than men younger than age 50 years since about the mid-1990s. Some have speculated that this could be due to women's indoor tanning use, as women use indoor tanning much more than men do. We had data on indoor 

Prof. Bisgaard[/caption]
MedicalResearch.com Interview with:
Hans Bisgaard, MD, DMSc
Professor of Pediatrics
The Faculty of Health Sciences
University of Copenhagen
Head of the Copenhagen Prospective Studies on Asthma in Childhood
University of Copenhagen and Naestved Hospital
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Bisgaard: Vitamin D deficiency has become a common health problem in westernized societies, possibly caused by a more sedentary indoor lifestyle and decreased intake of vitamin D containing foods. Vitamin D possesses a range of immune regulatory properties, and it has been speculated that vitamin D deficiency during pregnancy may affect fetal immune programming and contribute to asthma pathogenesis. Asthma often begins in early childhood and is the most common chronic childhood disorder. Observational studies have suggested that increased dietary vitamin D intake during pregnancy may protect against wheezing in the offspring, but the preventive effect of 
Dr. Augusto Litonjua[/caption]
MedicalResearch.com Interview with:
Augusto A. Litonjua, MD, MPH
Associate Professor
Channing Division of Network Medicine
and Division of Pulmonary and Critical Care Medicine
Department of Medicine
Brigham and Women's Hospital
Harvard Medical School
Boston, MA 02115 USA
Medical Research: What is the background for this study? What are the main findings?
Response: Vitamin D deficiency has been hypothesized to contribute to the asthma and allergy epidemic. Vitamin D has been shown to affect lung development in utero. However, observational studies have shown mixed results when studying asthma development in young children. Since most asthma cases start out as wheezing illnesses in very young children, we hypothesized that vitamin D supplementation in pregnant mothers might prevent the development of asthma and wheezing illnesses in their offspring. We randomly assigned 881 pregnant women at 10 to 18 weeks' gestation and at high risk of having children with asthma to receive daily 4,000 IU vitamin D plus a prenatal vitamin containing 400 IU vitamin D (n = 440), or a placebo plus a prenatal vitamin containing 400 IU vitamin D (n = 436). Eight hundred ten infants were born during the study period, and 806 were included in the analyses for the 3-year outcomes. The children born to mothers in the 4,400 IU group had a 20% reduction in the development of asthma or recurrent wheeze compared to the children born to mothers in the 400 IU group (24% vs 30%, respectively; an absolute reduction of 6%). However, this reduction did not reach statistical significance (p=0.051).
Dr. Richard Deth[/caption]
MedicalResearch.com Interview with:
Dr. Richard Deth PhD
Professor of Pharmacology
Department of Pharmaceutical Sciences
Nova Southeastern University
Medical Research: What is the background for this study?
Dr. Deth: Vitamin B12 plays a crucial role in regulating and promoting methylation reactions (the attachment of a carbon atom to molecules), including DNA methylation. Recent research has identified methylation of DNA and consequential changes in gene expression as crucial factors in brain development, as well as in memory formation and maintenance of brain function during aging. More specifically, the cause(s) of neurodevelopmental disorders such as autism remain obscure, although numerous studies have demonstrated oxidative stress and low plasma levels of the antioxidant glutathione (GSH) in autism.
Medical Research: What are the main findings?
Dr. Deth: We found that brain levels of vitamin B12, especially the methylation-regulating form known as methylB12, decrease significantly with age, even though blood levels don’t show a similar decrease. Importantly, much lower levels of methylB12 were found in subjects with autism and schizophrenia compared to normal subjects of a similar age. Animal studies showed that impaired GSH formation is associated with decreased brain B12 levels.
Prof. Ian Wong[/caption]
MedicalResearch.com Interview with:
Professor Ian C K Wong
Fellow of Royal Pharmaceutical Society
Fellow of Royal College of Paediatrics and Child Health (Honorary)
Fellow of the Higher Education Academy
Chair in Pharmacy Practice
Head of Research Department of Practice and Policy
UCL School of Pharmacy
London
Medical Research: What is the background for this study? What are the main findings?
Dr. Wong: Previous studies had showed an increased cardiovascular risk associated with clarithromycin (a widely used antibiotic) but the duration of effect remained unclear. Therefore, we conducted this study to investigate the duration of cardiovascular adverse effect provided that the risk exists after patients receiving clarithromycin in Hong Kong. We used three study designs to examine the association (temporal relationship) between clarithromycin and cardiovascular adverse outcomes such as myocardial infarction, arrhythmia, stroke, cardiac mortality at different time points.
Dr. Firas Abdollah[/caption]
MedicalResearch.com Interview with:
Firas Abdollah, M.D., F.E.B.U.
(Fellow of European Board of Urology) Urology Fellow with the Center for Outcomes Research, Analytics and Evaluation
Vattikuti Urology Institute at Henry Ford Hospital in Detroit
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Abdollah: Cancer screening aims to detect tumors early, before they become symptomatic. Evidence suggests that detection and treatment of early-stage tumors may reduce cancer mortality among screened individuals. Despite this potential benefit, screening programs may also cause harm. Notably, screening may identify low-risk indolent tumors that would never become clinically evident in the absence of screening (overdiagnosis), subjecting patients to the harms of unnecessary treatment. Such considerations are central to screening for prostate and breast cancers, the most prevalent solid tumors in men and women, respectively. These tumors are often slow growing, and guidelines recommend against screening (non-recommended screening) for these tumors in individuals with limited life expectancy, i.e. those with a life expectancy less than 10 years. Unfortunately, our study found that this practice is not uncommon in the US. Using a nationwide representative survey conducted in 2012, we found that among 149,514 individuals 65 years or older, 76,419 (51.1%) received any prostate/breast screening. Among these, 23,532 (30.8%) individuals had a life expectancy of less than 10 years. These numbers imply that among the screened population over 65 years old, almost one in three individuals received a non-recommended screening. This corresponds to an overall rate of non-recommended screening of 15.7% (23,532 of 149,514 individuals).
Another important finding of our study was that there were important variations in the rate of non-recommended screening from state to state; i.e. the chance of an individual older than 65 to receive a non-recommended screening varies based on his/her geographical location in United States.
Finally, on a state-by-state level, there was a correlation (40%) between non-recommended screening for prostate and breast cancer, i.e. states that are more likely to offer non-recommended screening for
Dr. Frank Rybicki[/caption]
MedicalResearch.com Interview with:
Frank J. Rybicki, MD, PhD
Professor, Chair and Chief, Department of Radiology
The University of Ottawa, Faculty of Medicine and
The Ottawa Hospital
Editor-in-Chief, 3D Printing in Medicine
Medical Research: What is the background for this document?
Dr. Rybicki: This document represents a conglomeration of the approach to appropriateness of three large medical professional groups. The American College of Radiology Appropriateness Criteria® are evidence based guidelines to assist referring physicians to order the most appropriate imaging test for a wide range of clinical scenarios. The Appropriateness Criteria are divided by organ section, and while they include emergent imaging studies, there is not a single publication to provide imaging guidance for patients who present to the emergency room with chest pain. The American College of Cardiology Appropriate Use Criteria provides evidence based data for a very large gamut of cardiovascular conditions. These guidelines include emergent cardiovascular imaging; however the Appropriate Use Criteria are divided by modality and like the ACR have not specially addressed this important, high risk patient population. The American College of Emergency Physicians, a key stakeholder group that represents referring physicians, has developed a large number of guidelines but also has not organized this group of imaging recommendations. Thus, the background of this document was a joint effort among all three societies to update, harmonize, and publish contemporary guidelines that can be readily incorporated into clinical practice but also provide standards for a large fraction of patients who come to the emergency room with chest pain who require imaging to evaluate for a life threatening diagnosis.
Medical Research: What types of chest pain conditions are covered by these guidelines?
Dr. Rybicki: Based on the background as noted above, the Writing Group for this important document included cardiologists, emergency physicians, and radiologists. Since the group was charged with describing common clinical scenarios seen in contemporary practice, there are four entry points for chest pain conditions. They are as follows:
Acupuncture Presure[/caption]
MedicalResearch.com Interview with:
Carolyn Ee, MBBS
Department of General Practice
University of Melbourne
Carlton, Victoria, Australia
Medical Research: What is the background for this study? What are the main findings?
Response: Hot flushes affect up to 90% of women during the menopause and beyond, and women are turning to complementary therapies. Our randomised sham-controlled trial found no difference between real and sham acupuncture (given with a blunt needle) for hot flushes, with both groups improving by around 40% at the end of treatment.
Dr. Rachael Callcut[/caption]
MedicalResearch.com Interview with:
Dr. Rachael Callcut M.D., M.S.P.H
Dr. Ilir Agalliu[/caption]
Dr. Murchison[/caption]
MedicalResearch.com Interview with:
Dr. Elizabeth Murchison
Menzies Institute for Medical Research
University of Tasmania
Save the Tasmanian Devil Program
Tasmanian Department of Primary Industries, Parks, Water and the Environment
Hobart Australia
Department of Veterinary Medicine
University of Cambridge, Cambridge UK
Medical Research: What is the background for this study?
Dr. Murchison: Transmissible cancers are cancers that can be transmitted between individuals by the transfer of living cancer cells. Transmissible cancers emerge only very rarely in nature, and until now only three examples were known. One of the three known naturally occurring transmissible cancers affects Tasmanian devils, the world’s largest carnivorous marsupial. This disease, which causes disfiguring facial tumours, was first observed in the late 1990s, and since then the disease has spread widely through the Tasmanian devil population. This transmissible cancer first emerged as a cancer in a single individual Tasmanian devil that probably lived about 30 years ago; this devil’s cancer cells have continued to survive by transmitting between hosts by biting.
Medical Research: What are the main findings?
Dr. Murchison: In late 2014, routine monitoring of the Tasmanian devil population led to the discovery of a male devil with facial tumours that resembled the known Tasmanian devil transmissible facial cancer. However, genetic analysis of this tumour indicated that the tumour in this devil was derived from a second transmissible cancer that was genetically unrelated to the first transmissible cancer in this species. Indeed, the genetic profile of this second cancer indicated that it had originally emerged from a male animal. This second cancer has subsequently been found in nine additional devils in the same part of Tasmania.
Dr. Jeffrey Silber[/caption]
Jeffrey H. Silber, M.D., Ph.D.
The Nancy Abramson Wolfson Professor of Health Services Research
Professor of Pediatrics and Anesthesiology & Critical Care, The University of Pennsylvania Perelman School of Medicine
Professor of Health Care Management
The Wharton School
Director, Center for Outcomes Research
The Children's Hospital of Philadelphia
Philadelphia, PA 19104
Medical Research: What is the background for this study?
Response: We wanted to test whether hospitals with better nursing work environments displayed better outcomes and value than those with worse nursing environments, and to determine whether these results depended on how sick patients were when first admitted to the hospital.
Medical Research: What are the main findings?
Response: Hospitals with better nursing work environments (defined by Magnet status), and staffing that was above average (a nurse-to-bed ratio greater than or equal to 1), had lower mortality than those hospitals with worse nursing environments and below average staffing levels. The mortality rate in Medicare patients undergoing general surgery was 4.8% in the hospitals with the better nursing environments versus 5.8% in those hospitals with worse nursing environments. Furthermore, cost per patient was similar. We found that better nursing environments were also associated with lower need to use the Intensive Care Unit. The greatest mortality benefit occurred in patients in the highest risk groups.
Dr. Daniel McIsaac[/caption]
Dr. Daniel I McIsaac, MD, MPH, FRCPC
Assistant Professor of Anesthesiology
Department of Anesthesiology
The Ottawa Hospital, Civic Campus
Ottawa, ON
Medical Research: What is the background for this study?
Dr. McIsaac: Older age is a well-known risk factor for adverse outcomes after surgery, however, many older patients have positive surgical outcomes. Frailty is a syndrome that encompasses the negative health attributes and comorbidities that accumulate across the lifespan, and is a strong discriminating factor between high- and low-risk older surgical patients. By definition, frail patients are “sicker” than non-frail patients, so their higher rates of morbidity and mortality after surgery aren’t surprising. However, frailty increases in prevalence with increasing age, so as our population ages we expect to see more frail people presenting for surgery. Our goal was to evaluate the impact of frailty on postoperative mortality at a population-level, and over the first year after surgery to provide insights that aren’t available in the current literature, which largely consists of single center studies limited to in-hospital and 30-day outcome windows.
Prof. Carl Clarke[/caption]