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This Week in JAMA
JAMA. 2005;293:135.
Drug-Eluting Stents vs Angioplasty for Restenosis
Drug-eluting stents are more effective than balloon angioplasty in reducing coronary restenosis in patients with de novo lesions, but the optimal treatment of in-stent restenosis is not clear. Kastrati and colleagues conducted a randomized trial to assess whether drug-eluting stents are more effective than balloon angioplasty and to compare the relative efficacy of sirolimus-eluting vs paclitaxel-eluting stents in treating in-stent restenosis. Angiograms obtained at a 6-month follow-up revealed that drug-eluting stents are superior to balloon angioplasty in preventing recurrent restenosis and that the sirolimus-eluting stent may be superior to the paclitaxel-eluting stent.
(SEE ARTICLE)
Diet and Cancer Risk
Many studies have assessed possible associations of dietary components with cancer risk, often with inconclusive results. Two articles in this issue of JAMA add additional insight. First, Chao and colleagues (SEE ARTICLE) examined the association of recent and long-term meat consumption and risk of incident colon and rectal cancer in a large cohort of US adults. They found that prolonged high consumption of red and processed meat is associated with an increased risk of cancer in the distal colon. In a second article, van Gils and colleagues (SEE ARTICLE) examined the relationship between total and specific vegetable and fruit intake and the incidence of breast cancer in a large cohort of European women. During a median 5.4 years of follow-up, the authors found no association between vegetable and fruit intake and incident breast cancer. In an editorial, Willett (SEE ARTICLE) discusses these findings and the benefits of a healthful diet.
Fasting Serum Glucose and Cancer Risk
Several studies suggest an association between diabetes and increased cancer risk. To further investigate this association, Jee and colleagues (SEE ARTICLE) analyzed data on fasting serum glucose, diabetes, and incident cancers and cancer deaths from a prospective cohort study of nearly 1.3 million Korean adults. They found dose-response relationships between fasting serum glucose levels and rates of overall cancer mortality and cancer incidence. Mortality and incidence risks were higher for persons with diabetes compared with persons without, and adjustment for body mass index did not alter the findings. In an editorial, Cooney and Gruber (SEE ARTICLE) discuss how hyperglycemia and diabetes may influence cancer incidence and mortality and the public health significance of this association.
Mortality and BMI in Pediatric AML
Clinical experience suggesting that overweight children with acute myeloid leukemia (AML) experienced more treatment-related toxic effects and death than patients not overweight led Lange and colleagues to conduct a retrospective review of body mass index (BMI) and survival in pediatric AML. After adjustment for potential sociodemographic and clinical variables, they found that compared with middleweight patients, underweight and overweight children had lower overall survival and a higher risk of treatment-related mortality.
(SEE ARTICLE)
Malaria in Soldiers Returning From Afghanistan
Malaria is seasonally endemic in Afghanistan and Iraq, and soldiers returning to the United States may import malaria. Kotwal and colleagues investigated a malaria outbreak among a 725-man Army Ranger Task Force deployed to Afghanistan in 2002. They identified 38 cases of malaria, often associated with vague symptoms and diagnosed a mean of 233 days after the soldiers’ return to the United States. The authors also documented poor compliance with preventive measures, including chemoprophylaxis, use of insect repellent, and application of permethrin on uniforms.
(SEE ARTICLE)
Medical News & Perspectives
An effort to reveal the complete genetic blueprints of thousands of known human and avian influenza viruses is expected to help researchers monitor global influenza-related activity for vaccine planning and enhance pandemic preparedness efforts.
(SEE ARTICLE)
CLINICIAN’S CORNER
Preventing Diabetic Foot Ulcers
Clinical Review
The efficacy of interventions to prevent diabetic foot ulcers.
(SEE ARTICLE)
Influenza Prevention
Strategies to maximize use of inactivated and intranasal live, attenuated influenza vaccines.
(SEE ARTICLE)
JAMA Patient Page
For your patients: Information about diabetic foot ulcers.
(SEE ARTICLE)
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