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

Collaborative Care Benefits Alzheimer PatientsJAMA. 2006;295:2148-2157 (May 10, 2006)
Alzheimer patients cared for by an interdisciplinary team within their primary care setting are more likely to receive cholinesterase inhibitors and antidepressants and have fewer behavioral and psychological symptoms than other patients, according to researchers at the Indiana University Center for Aging Research.

Early Statin Therapy Does Not Cut Death Risk After ACSJAMA. 2006;295:2046-2056 (May 3, 2006)
Treatment with statins less than two weeks after the onset of acute coronary syndromes (ACS) does not significantly cut the risk of death, stroke, or another heart attack within four months, according to a meta-analysis done by Swiss investigators. They do suggest, though, that early statin therapy may reduce the occurrence of unstable angina.

Inhaled Corticosteroids Don't Prevent Asthma DevelopmentN Engl Med. 2006;354:1985-97 (May 11, 2006)
Researchers at the University of Tucson who studied infants and young children at high risk for asthma over a three year period found that inhaled corticosteroid therapy reduced symptoms and exacerbations during two years of treatment, but also temporarily slowed growth. The treatment did not change the development of asthma symptoms or lung function during a third, treatment-free year.

Pain Management Program Improves Pain AssessmentArch Intern Med. 2006;166:1033-1039 (May 8, 2006)
A pain management instrument that includes enhanced pain assessments and nursing staff updates improves some aspects of pain management in hospitalized adults, but not overall pain scores, according to one of the largest studies of its kind reported by investigators at Mount Sinai School of Medicine in New York City. They found that using both the enhanced pain scale and audit and feedback improved pain assessment rates to 64 percent and 85 percent, respectively, compared with 32 percent and 64 percent in controls. The enhanced pain scale also increased analgesic use.

Off-Label Prescribing Common in Doctors' OfficesArch Intern Med. 2006;166:1021-1026 (May 8, 2006)
About one-fifth of the drugs prescribed by office-based physicians are for off-label uses and almost three-quarters of off-label uses had little or no scientific support, say investigators at Dartmouth Medical School who defined prescribing patterns for 160 commonly prescribed drugs.

Higher Breast Cancer Risk for Long-Term Estrogen UsersArch Intern Med. 2006;166:1027-1032 (May 8, 2006)
Postmenopausal women with hysterectomies who undergo long-term estrogen use-15 years or more-have an increased risk of developing breast cancer, according to results of a study spanning more than 20 years and including 28,835 women. Women who had taken estrogen for less than 10 years did not have a statistically significant increased risk of developing breast cancer.

Ethnicity Has Role in Adverse Events in ACE Inhibitor TherapyBMJ. 2006. (Published online, May 5)
British investigators reviewing 564 studies discovered that black patients taking ACE inhibitors had three times the angioedema risk. East Asians taking ACE inhibitors had 2.7 times the risk of developing cough as whites.

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Emma Schuering: ©Polsinelli
Emma Schuering: ©Polsinelli