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JAMA. 2005;294:9.

JAMA-EXPRESS
Aspirin and Vitamin E for Cancer and CVD Prevention
Results from the Women’s Health Study, a randomized 2 x 2 factorial trial evaluating the benefits and risks of taking aspirin every other day (100 mg) and natural-source vitamin E (600 IU) vs placebo in the primary prevention of cardiovascular disease (CVD) and cancer, are reported in 2 articles (SEE ARTICLE) (SEE ARTICLE) in this issue of JAMA. The investigators found that compared with placebo, neither aspirin nor vitamin E was associated with reductions in overall or site-specific cancer incidence, cancer mortality, major cardiovascular events, or cardiovascular and total mortality. In editorials, Jacobs and Thun (SEE ARTICLE) discuss the challenges of cancer chemoprevention and Redberg (SEE ARTICLE) discusses CVD prevention strategies for women.

Performance Characteristics of PSA Screening
The utility of the prostate-specific antigen (PSA) test to identify men with prostate cancer is controversial. Thompson and colleagues (SEE ARTICLE) assessed the performance characteristics of PSA screening in men who had PSA values of 3.0 ng/mL or less at baseline, who had annual PSA measurement through 7 years of follow-up, and who underwent an end-of-study prostate biopsy. The authors found that no specific value of PSA had both high sensitivity and specificity for prostate cancer. Rather, there was a continuum of cancer risk at all values of PSA and no definitive PSA level at which to recommend prostate biopsy.

Mortality Associated With Treated Hyperthyroidism
Some evidence suggests an increased risk of mortality in patients with hyperthyroidism, but whether this risk derives from the effects of excess thyroid hormone, the hypothyroid state following treatment, or its reversal with thyroid hormone (thyroxine [T₄]) therapy is not clear. To address this question, Franklyn and colleagues (SEE ARTICLE) investigated mortality in a cohort of individuals treated with radioiodine for overt hyperthyroidism. They found an increased risk of all-cause and circulatory deaths during follow-up in patients who did not require or had not yet started T₄ therapy. There was no increased risk of mortality during follow-up among patients who received T₄ for radioiodine-induced hypothyroidism.

Arginine Metabolism in Sickle Cell Disease
Elevated arginase activity has been reported in sickle cell disease. Morris and colleagues (SEE ARTICLE) hypothesized that increased arginase activity and dysregulated arginine metabolism contribute to sickle cell disease pathogenesis, morbidity, and mortality and tested their hypothesis in 228 patients with sickle cell disease and 36 African American controls. They found that plasma arginase levels were significantly higher in patients compared with controls and that lower levels of plasma arginine were associated with a greater severity of pulmonary hypertension and higher mortality.

A Piece of My Mind
"Darkness, both physical and spiritual, descends upon our unit. Many, both physician and nurse, have never seen anything like this." From "Death and Life in Iraq."

(SEE ARTICLE)

Medical News & Perspectives
Interest in discovering compounds that reduce cancer risk has never been higher, but identifying safe and effective chemopreventive agents has proved expectedly difficult.

(SEE ARTICLE)

Androgens and Female Sexual Function
Measures of serum testosterone, free testosterone, androstenedione, or dehydroepiandrosterone sulfate do not correlate with self-reports of low sexual function in women.

(SEE ARTICLE)

CLINICIAN’S CORNER
Coffee and Type 2 Diabetes
Individuals consuming at least 4 to 6 cups of coffee daily may have a reduced risk of type 2 diabetes.

(SEE ARTICLE)

Reporting Conflicts of Interest in Research
A review and update of JAMA policies regarding authors’ conflicts of interest, disclosures of financial, material, or other paid support of their research, and requirements for reporting industry-sponsored studies.

(SEE ARTICLE)

JAMA Patient Page
For your patients: Information about hyperthyroidism.

(SEE ARTICLE)

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