A summary of the "must-read" articles from the journals in thatpile on your desk.
Limited Benefit in Colonoscopy Screening of the ElderlyJAMA. 2006;295:2357-2365 (May 24/31, 2006)
Screening elderly individuals for colon cancer detects more cancers but does not increase life expectancy compared with younger individuals, according to researchers at the Virginia Mason Medical Center in Seattle who examined gains in life expectancy with screening colonoscopy in 1,034 asymptomatic individuals aged 50 to 54 years, 147 individuals aged 75 to 79 years, and 63 individuals at least 80 years old. Although more cancers were found in the oldest individuals, the gain in life expectancy was only 15 percent of the expected gain observed in younger patients.
Breast MRI Cost-Effective for Some High-Risk WomenJAMA. 2006;295:2374-2384 (May 24/31, 2006)
The addition of breast MRI to mammography screening is most cost-effective for women 35 to 54 years old who carry mutations in the BRCA1 or BRCA2 genes, according to researchers at Stanford University School of Medicine in Stanford, CA.
Aspirin and Dipyridamole Best Treatment After StrokeLancet. 2006;367:1665-1673 (May 20, 2006)
A combination of aspirin and dipyridamole works better than aspirin alone to prevent further circulatory problems after cerebral ischemia of arterial origin, say Dutch researchers involved in the European/Australasian Stroke Prevention in Reversible Ischemia Trial (ESPRIT). The combination therapy group had an absolute risk reduction ratio of 1.0 percent per year.
H5N1 Avian Flu Vaccine Shows Promise in TrialsLancet. 2006 (published online, May 11, 2006)
Phase I trials of a vaccine against the avian influenza A virus H5N1 have shown that it is well-tolerated and produces an immune response sufficient for it to meet European vaccine licensing requirements, according to French researchers.
Three Questions Can Identify Type of IncontinenceAnn Intern Med. 2006;144:715-723 (May 16, 2006)
You can distinguish between urge and stress incontinence in women by asking three questions-whether they leak urine, when, and when they leak most often-say researchers at the University of California San Francisco. Accuracy is high enough to make extensive, invasive evaluation unnecessary.
Higher Flu Vaccine Doses Safe and Effective in ElderlyArch Intern Med. 2006;166:1121-1127 (May 22, 2006)
Increasing the dosage of influenza vaccine-to as high as 60 μgrams of hemagglutinin per strain-for elderly patients may safely offer added protection without significant side effects, say researchers at Baylor College of Medicine.
Implantable Defibrillator Improves Survival with TimeJ Am Coll Cardiol. 2006;47:1811-1817 (May 5, 2006)
Researchers at the University of Rochester (NY) Medical Center found that an implantable cardioverter-defibrillator (ICD) improves survival in high-risk cardiac patients, but only when the device is implanted more than six months after a revascularization procedure.