A summary of the "must-read" articles from the journals in that pile on your desk.
Meta-Analysis Finds COX-2 Inhibitors, NSAID Risk SimilarBMJ. 2006;332:1302-1305 (June 3, 2006)
A meta-analysis by British researchers found that studies comparing COX-2 inhibitors with NSAIDs found similar incidence rates for serious vascular events, typically MI, for the two types of drugs, although naproxen did not carry any additional risk.
COPD Patients Benefit From Inhaled CorticosteroidsAnn Fam Med. 2006;4:253-262 (May/June, 2006)
A meta-analysis of data from 13 studies shows that COPD patients treated with inhaled corticosteroids experienced fewer exacerbations than those treated with placebo. Mortality was unchanged and quality of life, functional capacity, and respiratory tract symptoms were mixed. The researchers, from the University of North Carolina at Chapel Hill, did note a dose-related risk of cataracts and open-angle glaucoma.
Radiation Does Not Improve Survival for Brain MetastasesJAMA. 2006;295:2483-2491 (June 7, 2006)
Adding whole-brain radiation to radiosurgery does not improve survival in patients with brain metastases, but if patients have radiosurgery alone, they experience higher tumor recurrence rates and more often need salvage brain treatment, say Japanese researchers.
Rise in BMI Aggravates Gastroesophageal RefluxNew Engl J Med. 2006;354:2340-2348 (June 1, 2006)
A higher body mass index is associated with more severe GERD symptoms, even in normal-weight women and those who experience a moderate weight gain, report researchers at Boston University School of Medicine. The risk of frequent reflux symptoms was lower in women with a BMI of less than 20. Even in women of normal weight at the outset, a BMI increase of 3.5 points was associated with a two to three times greater risk of more frequent symptoms compared to women with no weight gain.
Medicare Drug Benefit Limit Linked to Mortality RiskNew Engl J Med. 2006;354:2349-2359 (June 1, 2006)
A $1,000 annual limit for Medicare+Choice recipients' drug benefits in 2003 meant 31 percent lower drug costs but was associated with more emergency department and hospital visits and a higher mortality rate than among those with unlimited drug benefits funded by employers, according to a study done at Kaiser Permanente in Oakland, CA. The savings in drug costs were offset by increases in the costs of hospitalization and emergency department care, say the researchers.
Birth Defects Higher After ACE Inhibitor UseNew Engl J Med. 2006;354:2443-2451 (June 8, 2006)
Women who take ACE inhibitors during the first trimester of pregnancy have a greater risk of having an infant with cardiovascular and central nervous system defects than women who do not take the antihypertensives, according to researchers at Vanderbilt University School of Medicine. Exposure to other antihypertensives in early pregnancy was not associated with an increased risk of malformations.
Seven-Item Scale Can Help Diagnose Anxiety DisorderArch Int Med. 2006;166:1092-1097 (May 22, 2006)
Possible cases of generalized anxiety disorder can be screened using a self-administered, seven-item anxiety scale that can also be used to assess the severity of the condition, say Columbia University investigators.
Severe Chlamydia Effects Less Common Than ThoughtSex Transm Infec. 2006;82:212-218 (May, 2006)
The incidence of severe complications of genital chlamydia in women-including pelvic inflammatory disease, ectopic pregnancy, and infertility-turns out to be lower than expected, according to Swiss investigators. "Our results provide reassurance for patients, but mean that the benefits of chlamydia screening programs might have been overestimated," they conclude.
Prepared jointly by the editors of Medical Economics and HealthDay's Physicians' Briefing ( http://www.physiciansbriefing.com).