9p21. More than just three numbers and one letter, this stretch of DNA, which is present in 1 out of five Caucasians, results in a 64% increase in the risk of myocardial infarction. Two groups, performing genome-wide association studies, made this discovery, which would not have been possible before the work of the Human Genome Project. It should be noted that this mutation is not present in Africans and does not confer an increased risk in African Americans. This stretch of DNA is also…

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In the present era of almost daily “landmark trial” publications, the literature this past week took a slightly more introspective turn. Two separate journals turned the spotlight back on the uneasy relationship between commerce and science – and well written and thoughtful editorials accompany each.

An analysis in the week before last’s BMJ called attention to the increasing trend toward designing trials with composite endpoints – and suggested that this tendency is potentially misleading. In a sample of 114 cardiovascular trials with composite primary end…

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I think an unfortunate result of the ACC meetings is the feeling that if a study is not released early and does not make the front page of the New York Times then it is not relevant or worth talking about. We’ll save the debate about releasing results early for another time (although it frequently seems to be a self-serving public relations move by the journal publishing the article) …let’s march forward with several articles that were released this week with little fanfare.…

Overall, it seemed like a relatively quiet week in the news world. Winter weather perseveres, Larry Birkhead is the father, and Sanjaya is still singing (or trying to). A perusal of the week’s medicine journals, however, is somewhat uplifting as it reminds us of the expansive scope of medicine.

Beginning on the broad public health front, the CDC announced this week that it was changing its recommendations for the treatment of gonorrhea due to increasing drug resistance. Fluoroquinolones, once recommended as first-line treatment…

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The April 3rd issue of the Annals provides guidelines for screening mammography in women age 40-49. In the article and an accompanying editorial, the authors suggest that in women younger than age 50, the possible modest benefit of routine mammography screening for women in their 40s may be outweighed by the risk of false-positive results and the resultant repeated exams, biopsies, etc. As always, we should individualize our recommendations to our patients. Annals Link

As long as we are discussing mammography,…

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JAMA reported on two important “negative” trials: The results of the EVEREST trial, comparing tolvaptan (a novel vasopressin V2 receptor blocker) to placebo for the treatment of acute CHF exacerbation, indicate that this agent had no effect on the primary endpoint of all-cause mortality or the composite endpoint of cardiovascular death, hospitalization for heart failure; secondary endpoints were also not effected. The TRIUMPH trial looked at the effect of tilarginine (an isoform-nonselective NOS inhibitor) in patients with MI and refractory cardiogenic shock and…

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It seemed to be a slow week in the medical literature, but that will likely change as the 2007 American College of Cardiology Scientific Session is now underway. Theheart.org has an excellent summary about what to expect from the meetings. (free registration required).

The annals has an interesting prospective observational study that looks at a prediction rule to determine whether a patient with a minor head injury with or without loss of consciousness should have a catscan done. The prediction rule includes age,…

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Welcome to ShortCuts, yet another new feature of Clinical Correlations. Every week we will post what we feelare the 5 most interesting articles from the news and literature with links. We’re not attempting to digest any of this for you or to be all-inclusive, but rather make you aware of some of the more important articles that have been published that we simply do not have time to fully review here at Clinical Correlations. Please let us know your thoughts on this format at…

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