Bmj Usa: Journal Rack

Journal rack

BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E200

From BMJ USA 2003;Mar:171

This section calls attention to new studies and systematic reviews selected by the Editor from journals published just as this issue went into production (approximately 2 months before publication). Studies are noted that might directly influence clinical practice decisions in primary care. Journals hand-searched for the Journal rack are: American Journal of Medicine, American Journal of Preventive Medicine, Annals of Internal Medicine, Circulation, JAMA, Journal of General Internal Medicine, Journal of the American Board of Family Practice, JNCI, Lancet, New England Journal of Medicine, Obstetrics and Gynecology, Pediatrics

Cardiovascular—A prospective cohort study of 38 077 male health professionals reported an inverse association between alcohol consumption (at least 3 to 4 times per week) and the risk of myocardial infarction. (Mukamal et al. N Engl J Med Jan 9, 2003;348:109–118.)

Cardiovascular—Data from the Framingham Heart Study indicate that a 20 mm Hg elevation in systolic blood pressure conferred a 56% increase in the risk of congestive heart failure. (Haider et al. Ann Intern Med Jan 7, 2003;138:10–16.)

Cardiovascular—A Danish trial involving 160 patients with type 2 diabetes found that an intensive multifactorial intervention aimed at glycemic control and cardiovascular risk modification resulted in a 53% reduction in the incidence of cardiovascular disease over a mean follow-up period of about 8 years. (GØde et al. N Engl J Med Jan 30, 2003;348:383–393.)

Endocrinologic—Data from the Behavioral Risk Factor Surveillance System indicate that the prevalence of obesity and diabetes in the United States increased between 2000 and 2001 (from 19.8% to 20.9% and from 7.3% to 7.9%, respectively). (Mokdad et al. JAMA Jan 1, 2003;289:76–79.)

Endocrinologic—A randomized trial involving 2763 postmenopausal women with coronary heart disease found that hormone therapy reduced the incidence of diabetes by 35%, but the authors cautioned that this evidence is insufficient to recommend its use for secondary prevention of heart disease. (Kanaya et al. Ann Intern Med Jan 7, 2003;138:1–9.)

Endocrinologic—Analysis of survey and actuarial data revealed that white men aged 20 to 30 years with severe obesity (body mass index > 45) lost an average of 13 years of life, or incurred a 22% reduction in remaining life-span. The corresponding value for women was 8 years of life lost. (Fontaine et al. JAMA Jan 8, 2003;289:187–193.)

Health promotion—A review of 21 trials for the United States Preventive Services Task Force found that dietary counseling produced modest changes in self-reported consumption of saturated fat, fruits and vegetables, and possibly, dietary fiber. More intensive interventions yielded more substantial results. (Pignone et al. Am J Prev Med Jan 2003;24:75–92.)

Infectious diseases—A modeling study of the risks and benefits of smallpox vaccination concluded that vaccinating health care workers would not save lives unless the probability of a building or high-impact airport terrorist attack exceeded 22% and 0.2%, respectively. The probabilities would have to be much higher for vaccination of the public to be life-saving. (Bozzette et al. N Engl J Med Jan 30, 2003;348:416–425.)

Mental health—A prospective cohort study of 448 Seattle women who had experienced intimate partner violence found that a civil protection order was associated with decreased risk of contact by the abuser, weapon threats, injury, and abuse-related medical care. (Holt et al. Am J Prev Med Jan 2003;24:16–21.)

Neurologic—A randomized trial involving 60 patients with 2 to 6 migraine attacks per month found that 16 mg of candesartan (an angiotensin II receptor blocker) taken prophylactically for 12 weeks reduced the mean number of days with headache from 18.5 to 13.6. (Tronvik et al. JAMA Jan 1, 2003;289:65–69.)

Neurologic—A Dutch randomized trial involving 83 patients with lumbosacral radicular pain found no benefit from radiofrequency lesioning of dorsal root ganglia compared with a sham procedure. (Geurts et al. Lancet Jan 4, 2003;361:21–26.)

Neurologic—A survey of Cincinnati residents found that knowledge of stroke warning signs, but not of stroke risk factors, increased between 1995 and 2000; knowledge was lowest, however, among those at highest risk: the elderly, African Americans, and men. (Schneider et al. JAMA Jan 15, 2003;289:343–346.)

Neurologic—A meta-analysis of three trials of carotid endarterectomy for symptomatic stenosis found that surgery increased the 5-year risk of ipsilateral ischemic stroke in patients with less than 30% stenosis, had no effect in patients with 30–49% stenosis, was of marginal benefit in those with 50–69% stenosis, and was highly beneficial (absolute risk improvement of 16%) in those with 70% stenosis or greater. (Rothwell et al. Lancet Jan 11, 2003;361:107–116.)

Oncologic—Given a variety of assumptions, a modeling study concluded that helical computed tomography screening for lung cancer among current smokers would cost $116 300 per quality-adjusted life year gained and would cost much more if former smokers were screened. The authors noted that the efficacy of such screening is yet to be proven in any population. (Mahadevia et al. JAMA Jan 15, 2003;289:313–322.)

Oncologic—A meta-analysis of updated data from five trials concluded that tamoxifen or raloxifene reduced the incidence of breast cancer by more than one third but tamoxifen increased the risk of endometrial cancer, and both drugs increased the risk of venous thromboembolic events. (Cuzick et al. Lancet Jan 25, 2003;361:296–300.)

Ophthalmologic—Data from 20 570 eye examinations of British patients with type 2 diabetes suggest that patients with no retinopathy can be safely screened at 3-year intervals but that yearly or more frequent screening is needed for patients with higher grades of retinopathy. (Younis et al. Lancet Jan 18, 2003;361:195–200.)

Pediatric—A prospective study of 309 children aged 1 to 24 months with a first febrile urinary tract infection found that ultrasound was not useful—it was normal in 88% of cases and did not affect management when abnormal—but voiding cystourethrograms identified vesicoureteral reflux in 39% of cases. Repeated scans were performed in 89% of the children and identified renal scarring in 10% of cases. (Hoberman et al. N Engl J Med Jan 16, 2003;348:195–202.)

Substance abuse—Data from states in the Behavioral Risk Factor Surveillance System indicate that approximately 2 million smokers and 2 million binge drinkers with a routine checkup in the past 12 months were not advised to quit smoking or counseled about their alcohol use. (Denny et al. Am J Prev Med Jan 2003;24:71–74.)

Substance abuse—Data from population surveys of 115 000 women indicate that approximately half of women who quit smoking during pregnancy resumed smoking within 6 months postpartum. (Colman and Joyce. Am J Prev Med Jan 2003;24:29–35.)

Substance abuse—Data from the Behavioral Risk Factor Surveillance System indicate that binge drinking episodes (5 or more alcoholic drinks on 1 occasion) per person per year underwent a relative increase of 17% from 1993 to 2001, with 73% of all binge drinkers being moderate drinkers. (Naimi et al. JAMA Jan 1, 2003;289:70–75.)

Substance abuse—A survey of 311 Australian twin pairs—in which one twin had used marijuana before age 17 and the other had not—found that the odds of other drug use, alcohol dependence, and drug abuse/dependence were 2 to 5 times higher among the twins who used cannabis. (Lynskey et al. JAMA Jan 22–29, 2003;289:427–433.)

Urologic—A randomized trial involving 90 men with sexual dysfunction due to treatment of depression with serotonin reuptake inhibitors found that a 6-week course of sildenafil significantly improved sexual function. (Nurnberg et al. JAMA Jan 1, 2003;289:56–64.)

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