A summary of current articles that pile on your desk

August 1, 2008

A summary of current articles that pile on your desk

Little Effect of Medicare Changes on Chemotherapy

JAMA. 2008;300:189-196 [July 9, 2008]

For elderly patients receiving chemotherapy, the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 hasn't greatly affected wait times and travel distances for treatment. Comparing patient wait times and travel distances before and after the MMA was enacted, Duke researchers found that in 2006 versus 2003, average wait times were only .88 days longer, while average travel distances were 1.30 miles longer.

JAMA. 2008;300:182-188 [July 9, 2008]

A University of California San Diego study showed that high blood levels of fetuin-A are associated with a higher risk of developing diabetes mellitus in healthy elderly individuals. Researchers measured serum levels of fetuin-A in 406 healthy individuals without diabetes. During six years of follow-up, the researchers found that 135 individuals developed diabetes mellitus.

Beta-Blocker Reduces Death After Heart Failure

J Am Coll Cardiol. 2008;52:190-199 [July 15, 2008]

Patients hospitalized for heart failure who continue to receive beta-blocker therapy after discharge have a lower risk of death than patients who withdraw from treatment or do not receive treatment, researchers reported. The California study examined outcomes in patients hospitalized with systolic heart failure. After 60 to 90 days of follow-up, continuing beta-blocker treatment significantly lowered the risk of post-discharge death and death or rehospitalization compared with no beta-blocker treatment.

Insulin Resistance Linked to Peripheral Arterial Disease

Circulation. 118:33-41 [June 16, 2008]

Insulin resistance is strongly associated with peripheral arterial disease and modifies the relationship between markers of inflammation and peripheral arterial disease, according to researchers at Brigham and Women's Hospital in Boston. Study subjects with a C-reactive protein (CRP) level greater than 3 mg/L were found to be far more likely to have peripheral arterial disease.

Slowed Aging Seen as Key to Future Longevity Gains

BMJ. 2008;337:a339 [July 8,2008]

Researchers at the International Longevity Center in New York have identified interventions that can postpone nearly all the diseases and disabilities that affect older people for increasing life expectancy, including initial mortality reductions in infants, children and mothers, and subsequent mortality reductions in middle-aged and older people. But the researchers state that the disease-specific model is unlikely to produce similar gains in the 21st century.

Wellness Programs May Cross Ethical, Legal Boundaries

N Engl J Med. 359:192-199 [July 10, 2008]

Wellness programs provided by employers and health plan providers with incentives for participation may be pushing the limits of legality, according to a study by the Harvard School of Public Health. In 2006, 19 percent of employers with at least 500 employees offered wellness program incentives to staff, up from 7 percent of companies in 2004.

Physical Activity Falls Sharply During Adolescence

JAMA. 2008;300(3):295-305 [July 16, 2008]

Between the ages of 9 and 15, physical activity fell steeply for American boys and girls in a geographically diverse sample, say University of California San Diego researchers. By age 15, participants only engaged in moderate-to-vigorous activity 49 minutes on weekdays and 35 minutes on weekend days. While boys were found to be more active than girls, boys and girls showed the same rate of decrease.

Prehypertension Increases Coronary Calcium Later in Life

Ann Intern Med 2008;149(2):91-99 [July 15, 2008]

There is a strong association between prehypertension in young adults and coronary calcium later in life, University of California San Francisco researchers report. The investigators found that 635 of the 3,560 participants (18 percent) in the Coronary Artery Risk Development in Young Adults (CARDIA) study had prehypertension before age 35. Participants with prehypertension before age 35 were more likely to be black, male, overweight, and of lower socioeconomic status.

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