PrimeCuts

ShortCuts-This Week in The Journals

June 25, 2007
ShortCuts-This Week in The Journals

Commentary By: Sean Cavanaugh MD, Associate Editor Clinical Correlations

Not much in the way of surprise, a lot of the articles in the press this past week focused on cardiovascular health.

In the Lancet, the results of the VALIDD trial (the acronyms are getting a bit ridiculous eh?) were published. Although it seems that valsartan was not more effective than other agents at improving diastolic dysfunction, it seems that lowering the blood pressure aggressively (using any agents) DID effectively improve diastolic functioning.…

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ShortCuts-This Week in The Journals

June 18, 2007
ShortCuts-This Week in The Journals

A study reported in this week’s issue of JAMA attempts to correlate preoperative hematocrit levels with postoperative outcomes in elderly veterans undergoing noncardiac surgery. Both 30-day postoperative mortality and cardiac event rates increased in patients with hematocrits either higher or lower than the normal range (39 to 53.9%). A 1.6% increase in mortality was associated with every percentage point positively or negatively deviating from the normal range. Although compelling, this study does not establish a causal relationship between hematocrit and postoperative complications, and…

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ShortCuts- This Week in the Journals

June 11, 2007
ShortCuts- This Week in the Journals

It has been a little while, but stem cells are back in the news. Congress has passed legislation to provide more money for stem cell research, but did not reach a veto-proof majority. Meanwhile, scientists at MIT have successfully transformed mice skin cells into the equivalent of embryonic stem cells. The presumption is that these cells, which are indistinguishable from embryonic stems cells can then be forced to develop into any tissue under the proper stimulation. While this approach might obviate the need to…

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ShortCuts-This Week in the Journals

June 4, 2007
ShortCuts-This Week in the Journals

Much of the week in the media was spent discussing XDR TB. Andrew Speaker, a man on his way to his wedding in Santorini Greece (the picture of his wedding is to the right) managed to evade US security multiple times. The story is convoluted with many people telling different versions. It appears that he has smear negative, culture positive XDR-TB. His now father-in-law is a TB researcher, who insists that his new son-in-law did not catch it from his lab. Most importantly, when officials…

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ShortCuts-This week in the Journals

May 29, 2007
ShortCuts-This week in the Journals

The big bomb this past week was the Rosiglitazone Effect. Resulting in front page news in various newspapers (on multiple days), the meta-analysis in last week’s NEJM is causing quite the stir. For more information, see the post.

What’s old is what’s new. An interesting editorial on Medpage reviewed the reason that HCTZ is the most commonly prescribed thiazide, and it’s not efficacy. HCTZ is 4 letters and takes a second to write on a pad, chlorthalidone is 14 letters and, while possibly the…

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ShortCuts-This Week in the Journals

May 21, 2007
ShortCuts-This Week in the Journals

This week’s review is a potpourri of interesting if not groundbreaking articles.

The pharmaceutical industry certainly got off easier this week (see last week’s shortcuts) and the New York Times focused instead on the “industrialization” of the art of medicine. A hospital group in central Pennsylvania is offering insurers and patients bypass surgery for a flat fee with a 90 day guarantee. They’ve put 40 measures in place to make sure patients receive evidenced based care. If the any of the 40 measure…

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ShortCuts-The War on the Pharmaceutical Industry Edition

May 14, 2007
ShortCuts-The War on the Pharmaceutical Industry Edition

Welcome to our first theme issue of ShortCuts. This week, we decided to focus on the tribulations of the pharmaceutical industry, which recently seems to be plagued by new FDA advisories and NY Times exposés.

The first bad news for pharmaceutical companies occurred on May 2nd when the FDA expanded its black box warning on antidepressant medications, stating that the drugs may have the potential to increase suicidal symptoms in young adults between the ages of 18 and 24. The warning, previously targeting…

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ShortCuts-This Week in the Journals

May 7, 2007
ShortCuts-This Week in the Journals

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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ShortCuts-This Week in the Journals

April 30, 2007
ShortCuts-This Week in the Journals

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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ShortCuts-This Week in the Journals

April 23, 2007
ShortCuts-This Week in the Journals

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.…

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ShortCuts: This Week in the Journals

April 16, 2007
ShortCuts: This Week in the Journals

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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ShortCuts-This Week in the Journals

April 9, 2007
ShortCuts-This Week in the Journals

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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