News — Welcome to the February 2019 edition of Beth Israel Deaconess Medical Center’s (BIDMC) Research & Health 麻豆传媒 Digest.
This month’s update includes:
- Everything you need to know about the flu (Infectious Diseases)
- Fad diets: A dietitian’s perspective (Nutrition)
- A beginner’s guide to exercise (Wellness)
- Pregnancy and the environment (Obstetrics and Gynecology)
- Weight loss procedures: Comparing surgical and non-surgical options (Weight Loss Surgery)
- Protecting the heart from cancer treatments (Cardiology)
- Higher sodium intake associated with increased lightheadedness in the context of the DASH-sodium trial (General Medicine)
- Study finds no mortality effect with drug-coated devices for peripheral revascularization
(Cardiovascular/Outcomes) - Gerontologists find functional status after TAVR, SAVR, linked to pre-op fragility (Gerontology/Senior Health/Cardiovascular)
- Preventing postoperative delirium (Anesthesiology)
- Facebook’s innovative suicide algorithm lacks transparency (Digital Psychiatry)
- Still many questions surrounding therapeutic cannabis use (Addiction Psychiatry)
If any of these briefs pique your interest and you’d like to speak with one of our experts, please contact us at [email protected] or at 617-667-7300. You can also reach the BIDMC communications team member on call through the BIDMC page operator at (617) 667-4700 and asking for pager ID #33880.
BIDMC Research & Health 麻豆传媒 Digest: February 2019
Everything You Need To Know About the Flu
Seasonal flu is a serious illness causing approximately 200,000 hospitalizations and 36,000 deaths each year. Sharon Wright, MD, MPH, BIDMC’s Director of Infection Control/Hospital Epidemiology, shares everything you need to know about the flu – from how to prepare before you get sick to when to call a doctor.
Fad Diets: A Dietitian’s Perspective
Anyone considering a fad diet needs to be reminded that they’re called fad diets for a reason. At best, they’re not useful for long-term weight loss; at worst, they can severely jeopardize your health. Danelle Olson, RD, LDN, CNSC, a registered dietitian in the Weight Loss Surgery Center at BIDMC, explains the problems with fad diets.
A Beginner's Guide to Exercise
Linda Trainor, RN, BSN, who works in the Weight Loss Surgery Center at BIDMC, shares tips for adding exercise into your daily life. Some of her recommendations include setting goals and keeping a journal.
Pregnancy and the Environment
Blair Wylie, MD, MPH, Director of Maternal-Fetal Medicine at BIDMC, provides answers to commonly asked questions about potentially harmful exposures that might impact a pregnancy. While some environmental factors – like air pollution – may be out of your direct control, there are a few simple guidelines, Wylie says, that can help reduce your risk and protect your baby’s health.
Weight Loss Procedures: Comparing Surgical and Non-surgical Options
Weight loss surgery can have life-altering, even lifesaving, effects. If you are 100 pounds overweight (the equivalent of a body mass index, or BMI, of 40), you may be considering weight loss surgery. Non-surgical options may be the right choice if you need to lose less weight. Dan Jones, MD, Chief of Bariatric and Minimally Invasive Surgery at BIDMC, discusses which types of weight loss surgery are right for your health and lifestyle.
Protecting the Heart from Cancer Treatments
In recent years, highly effective treatments have led to a significant increase in the number of breast cancer survivors, today numbering nearly 3 million. BIDMC cardiologists Aarti Asnani, MD, Loryn Feinberg, MD, and James Chang, MD, want patients to be aware of a sometimes overlooked side effect of these otherwise successful treatments.
Higher Sodium Intake Associated with Increased Lightheadedness in the Context of the DASH-Sodium Trial
Lightheadedness with standing, otherwise known as postural lightheadedness, results from a gravitational drop in blood pressure and is common among adults. While mild in many adults, it has been cited as an important contributing factor in some harmful clinical events, such as falls. Greater sodium intake is widely viewed as an intervention for preventing lightheadedness when moving from seated to standing positions. However, contrary to this recommendation, a team of researchers led by Stephen Juraschek, MD, PhD, a primary care physician at BIDMC, found that higher sodium intake, when studied in the context of the DASH-Sodium trial (Dietary Approaches to Stop Hypertension), actually increases lightheadedness. These findings challenge traditional recommendations to increase sodium intake to prevent lightheadedness. The study appeared in the Journal of Clinical Hypertension.
Study Finds No Mortality Effect with Drug-Coated Devices for Peripheral Revascularization
In a study published in JAMA Cardiology, a team of researchers led by Eric Secemsky, MD, MSc, Interventional Cardiologist and Director of Vascular Intervention at BIDMC, found no difference in long-term mortality between patients treated for peripheral arterial disease with drug-coated stents and balloons compared with nondrug-coated devices. The study’s authors conducted their investigation in reaction to a December 2018 meta-analysis that, while demonstrating no difference in mortality between patients treated with drug-coated and nondrug-coated devices at one year after revascularization, found an increase in deaths among patients treated with drug-coated devices at two and five years post-procedure.
Gerontologists Find Functional Status after TAVR, SAVR Linked to Pre-Op Fragility
Expecting to improve longevity as well as restore quality of life, patients with aortic stenosis increasingly opt for one of two procedures to repair the aorta; surgical aortic valve replacement (SAVR), which requires opening up the chest cavity, or transcatheter aortic valve replacement (TAVR), an increasingly popular minimally-invasive procedure. However, while valve repair has been shown to increase longevity, many patients’ quality of life continues to decline. In a paper published in the Journal of the American Medical Association Internal Medicine, leading gerontologists at BIDMC assessed the change in patients’ functional status during the year following valve replacement procedure. The team, led by Dae Hyun Kim, MD, a gerontologist at BIDMC, demonstrated that patient outcomes were tightly linked to patients’ pre-operative health status, and were also associated with post-operative complications and delirium.
Preventing Postoperative Delirium
In a new study published in the Journal of the American Medical Association, a team of physician-researchers at BIDMC led by Balachundhar Subramainam, MD, PhD, Director of the Center for Anesthesia Research Excellence in the Department of Anesthesia, Critical Care and Pain Medicine at BIDMC, found that intravenous acetaminophen significantly reduced the incidence of postoperative delirium following coronary artery bypass procedures in patients over 60. The findings of this single-center trial may represent the first steps toward a therapeutic intervention for the prevention of postoperative delirium, a common and devastating complication in the often highly vulnerable older adults who undergo cardiac surgery.
Facebook’s Innovative Suicide Algorithm Lacks Transparency
Facebook deserves commendation for its recent efforts to prevent suicide, John Torous, MD, Director of the Digital Psychiatry Division in BIDMC’s Department of Psychiatry wrote in a recent Ideas and Opinions in the Annals of Internal Medicine. But Facebook’s lack of transparency and failure to adhere to research ethics make the benefits – and risks – of the company’s endeavors unclear, argues Torous. Using an algorithm to assess risk of suicide through users’ interactions on the social media platform, Facebook’s Community Operations team has made an estimated 3500 calls to local emergency services to date. What’s missing is a rigorous investigation of the algorithm’s accuracy and efficacy preventing suicide, as well as the mechanisms of patient protection, such as informed consent, that apply to most public health research endeavors.
Still Many Questions Surrounding Therapeutic Cannabis Use
As of November 2018, 30 nations have initiated policies to allow the use of cannabis or cannabinoids for the treatment of specific medical conditions, Kevin Hill, MD, wrote in The Lancet Psychiatry this month. But the scientific evidence to support its therapeutic use has not kept pace with the rapid growth of patient interest, argues Hill, Director of Addiction Psychiatry in BIDMC’s Department of Psychiatry. The body of research most strongly suggests cannabis may be effective treating chronic pain, neuropathic pain and muscle spasticity associated with multiple sclerosis; however, patients already use the substance on a wide-range of medical conditions not yet proven to respond to cannabis or cannabinoids. This sub-optimal scenario in which patients are resorting to treatments that are not evidence-based underscores the need for rigorous randomized trials of cannabis, as well as evidence-based guidelines for healthcare professionals about how to safely oversee medical cannabis pharmacotherapy.
Kevin Hill, MD, is an expert in addiction psychiatry and can speak further on this topic.
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