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, the NEJM, this week, has released a study that shows that computer-aided detection used in the evaluation of mammograms actually resulted in a reduction of the accuracy of mammography, and that system-wide use would increase the annual cost of mammography by an estimated $550 million in the United States. NEJM Link
If all of this negative mammography news is giving you headaches, you will be happy to learn that JAMA reports that since migraines are thought to have both an inflammatory and vascular component, use of a tablet that combines sumatriptan and naproxen was superior to either alone and to placebo. JAMA Link
Sticking in the brain, but moving a bit to the basic science side of things, Nature Medicine has an article that suggests that the immune response is important in protection against Alzheimer disease. The authors showed that if you prevent immune cells from entering the brain in a mouse model of Alzheimer disease, by blocking the function if chemokines, the neurologic disease is exacerbated. Nature Medicine Link
The American Review of Respiratory and Critical Care Medicine has a very intriguing cohort study which showed a dose dependent decreased risk of lung cancer in copd patients who use inhaled corticosteroids. If this data can be replicated it could have definite implications when deciding which inhalers to put our copd patients on. American Review Link
–Michael Poles, MD Associate Editor Clinical Correlations
Image of Mountain Road in Spain, Courtesy of Wikimedia Commons