ShortCuts: This Week in the Journals

October 6, 2008

fall.jpgCommentary by Jon-Emile Kenny MD, PGY-2 

Those crazy Canadians. My Grandmother would have liked new research from Canada demonstrating that honey is very effective in killing drug-resistant biofilms found in human nares. This adaptive virulence factor seen in Pseudomonas aeruginosa, and MRSA has made treating chronic rhinosinusitis difficult for Otolaryngologists. Honey had significantly more bacteriocidal activity compared with commonly used antibiotics. This research will be presented during the 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting in Chicago.

Bare Metal vs. Drug-Eluting. A retrospective analysis by Harvard Researchers published in the New England Journal of Medicine found that those who received drug eluting stents were slightly but significantly less likely to die over the next two years than those who received bare metal stents.  This held true even after correcting for baseline differences in the patients who received these interventions.  Drug-eluting stents were better for those with STEMI and NSTEMI and were associated with fewer revascularizations and fewer repeat MIs.

Obama, McCain and Traffic fatalities.  University of Toronto researcher Donald Redelmeiner and Stanford Statistician Robert Tibshirani have shown an 18% increase in traffic fatalities using data on all U.S. presidential election days for the past 32 years.  Their control group was the Tuesday before and after each election.  Explanations include: speed, distance, distraction, emotions, unfamiliar pathways traveling to polls and mobilization of unfit drivers.  Their research is published in the most recent Journal of the American Medical Association.

GAIT Trial.  This two-year randomized, blinded controlled trial in the Journal of Arthritis and Rheumatism has shown no difference in the progression of joint space narrowing in patients taking the following: glucosamine, chondroitn, celecoxib, placebo, or glucosamine plus chondroitin.

Clot-Busters.  Thrombolytics have 1.5 additional hours to restore cerebral circulation according to the ECASS 3 study group.   Evidence presented in the New England Journal of Medicine showed that while earlier is better, infusion of alteplase between 3 and 4.5 hours after the onset of ischemic stroke demonstrated an absolute risk reduction of 7%.

Prescribing Ipods?  Despite concern over premature presbycusis, research published in the U.S. Periodical Journal of Sport and Exercise Psychology has shown that listening to carefully-selected, motivational music can increase exercise endurance by 15%.  While exercising on a treadmill, participants in the study were asked to keep in strict time to tracks by Queen, the Red Hot Chili Peppers and Madonna.  Hopefully we’ll be hearing Freddie Mercury at the RUSK Institute shortly.

Beta-blockers: the wonder drug.  With recent evidence suggesting ipratropium increases mortality in those with COPD, the medical field is once again turned upside down with research published in The American Journal of Respiratory and Critical Care Medicine.  Cardioselective beta-blockers significantly reduced mortality in COPD patients in the perioperative period post-vascular surgery.  This is likely due to the fact that most patients with COPD also have coronary artery disease. Cardioselective beta-blockers reduce myocardial oxygen demand without causing untoward bronchospasm.

Novel Viagra Compound!  Researchers in Italy have isolated a more potent and selective  phophodiasterase 5 inhibitor than sildenafil.  This compound called icariin was isolated from a Chinese Herb called ‘Horny Goat Weed’ known for centuries as a remedy for erectile dysfunction.  This research is published in the Journal of Natural Products.

PPI & PNA.  A nested case-control study published by UK researchers in the Annals of Internal Medicine has shown that proton-pump inhibitor therapy started within the past 30 days was associated with an increased risk for community acquired pneumonia, whereas longer-term use was not.

Light Cigarettes still Rewarding.  Nicotine binds to nicotinic acetylcholine receptors in the brain that are tightly linked to dopaminergic pathways projecting to the nucleus accumbens (the reward center).  New PET research from UCLA published in the Journal of Neuropsychopharmacology has shown that smoking ‘light’ cigarettes still causes substantial occupancy of the brain’s nicotinic receptors compared to regular cigarettes (79% vs. 88%).

Work hours working?  Research in the September issue of the Archives of Surgery has compared complication rates in cholecystecomties in over 1000 patients before and after the implementation of the 80-hour work week at a major public teaching hospital in Los Angeles. After the restrictions, fewer patients experienced bile duct injury (0.4 percent vs. 1 percent) or any complication (2 percent vs. 5 percent).

Image courtesy of Wikimedia Commons