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A summary of the "must-read" articles from the journals in that pile on your desk.

HRT After Hysterectomy Does Not Raise Breast Cancer RiskJAMA. 2006;295:1647-1657 [April 12, 2006]

That's the conclusion reached by researchers at Stanford University who studied 10,739 postmenopausal women with prior hysterectomy. The women were randomized to receive conjugated equine estrogens (CEE) or a placebo at 40 US clinical trial centers from 1993 to 1998. Women underwent mammography at baseline and annually for a mean follow-up of 7.1 years.

Glucose Swings May Be Worse Than Chronic HyperglycemiaJAMA. 2006;295:1681-1687 [April 12, 2006]

Sleep Apnea Therapy Reverses Cardiac Structure ChangesJ Am Coll Cardiol. 2006;47:1433-1439 [April 4, 2006]

Six months of treatment with continuous positive airway pressure improved symptoms, hemodynamics, and left and right ventricular morphology and function in patients with severe obstructive sleep apnea, according to Belgian researchers.

Cardiac Medications Help in Peripheral Arterial DiseaseJ Am Coll Cardiol. 2006;47:1182-1187 [March 21, 2006]

Statins, beta-blockers, aspirin and ACE inhibitors reduce the long-term risk of death in patients with peripheral arterial disease, according to Dutch researchers who screened 2,420 PAD patients for clinical risk factors and cardiac medication and followed them for a median of eight years.

Prevnar Cuts Antibiotic Resistant S. pneumoniae RatesN Eng J Med. 2006;354:1455-1463 [April 6, 2006]

The incidence of antibiotic-resistant invasive Streptococcus pneumoniae declined significantly in the US, both in vaccinated and in unvaccinated individuals, after the introduction of the 7-valent pneumococcal conjugate vaccine (Prevnar) in 2000, according to investigators at the CDC. In children under 2 years of age, infection dropped by 81 percent. Rates of invasive disease caused by penicillin- and multiantibiotic- resistant strains at any age dropped 57 percent and 59 percent by 2004, respectively, with adults 65 years or older showing a 49 percent decline, suggesting the vaccination is promoting herd immunity.

HPV Vaccine Shows Long-Term Protection Against InfectionThe Lancet. 2006;online April 6, 2006

A follow-up of a human papillomavirus (HPV) vaccine trial first reported in 2004 shows that the therapy could protect women against infection for up to 4.5 years, according to a report from researchers at Dartmouth Medical School. The vaccine was well tolerated, and protected against persistent and new infections of HPV-16/HPV-18 as well as the next two most common forms of oncogenic HPV, types 45 and 31. The study was funded by GlaxoSmithKline Biologicals, which prepared the report, used for regulatory purposes.

ACE Inhibitors Can Reduce Coronary Artery Disease RisksArch Intern Med. 2006;166:787-796 [April 10, 2006]

Investigators in Paris analyzed seven randomized, controlled trials that included five different ACE inhibitors and 33,960 patients with coronary artery disease, but without heart failure or left ventricular dysfunction. They found that, in an average follow-up of 4.4 years, ACE inhibitors decreased overall mortality by 14 percent, cardiovascular mortality by 19 percent, myocardial infarction by 18 percent and stroke by 23 percent.

Estrogen Increases Risk of Venous ThromboembolismArch Intern Med. 2006;166:772-780 [April 10, 2006]

Postmenopausal women lacking a uterus are at increased risk of developing venous thromboembolism-including DVT and PE-after estrogen therapy, particularly in the first two years, according to a study by researchers at the University of Hawaii in Honolulu.

Long-Term Etanercept Use Safe for Elderly with RAAnn Rheum Dis. 2006;65:379-384 [March 2006]

Long-term use of etanercept to treat elderly patients with rheumatoid arthritis is safe, the drug is well-tolerated, and the risk of adverse events, infections, or malignancies is no greater than in younger patients, according to investigators at the University of Texas Southwestern Medical Center at Dallas. The study was supported by Immunex Corporation, a subsidiary of Amgen Inc., and by Wyeth.

Prepared jointly by the editors of Medical Economics and HealthDay's Physicians' Briefing ( http://www.physiciansbriefing.com).

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