Interesting Articles: A Weekly Review of the "Big Five" Medical Journals

This is a collection of articles I have found interesting in the weekly editions of the "big five" medical journals: NEJM, JAMA, Annals, Lancet and BMJ (a few more journals are included occasionally). The review is a weekly feature of Clinical Cases and Images - Blog. Please see the end of the post for a suggested time-efficient way to stay up-to-date with the medical literature.

Venous Thromboembolism and Mortality Associated With Recombinant Erythropoietin and Darbepoetin Administration for the Treatment of Cancer-Associated Anemia. Charles L. Bennett at al. JAMA. 2008;299(8):914-924.

Erythropoiesis-stimulating agents (ESA) raise the risk of death among cancer patients by about 10%. The study also found a 57% increase in the risk of venous thromboembolism, a known side effect of ESAs. The findings raise concern about the safety of ESA administration to patients with cancer in addition to the concerns we already have about ESA use in CKD and ESRD patients.

Salivating for Knowledge: Potential Pharmacological Agents in Tick Saliva. Hovius JWR, Levi M, Fikrig E PLoS Medicine Vol. 5, No. 2, e43.

Tick saliva is a potential source for novel pharmacological agents that could be useful for clinical practice.

Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure. van Baal PHM, Polder JJ, de Wit GA, Hoogenveen RT, Feenstra TL, et al. PLoS Medicine Vol. 5, No. 2, e29.
Obesity prevention leads to a decrease in costs of obesity-related diseases but this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures. Bottom line: people living longer cost more to health insurers.

Vasopressin versus Norepinephrine Infusion in Patients with Septic Shock. NEJM, 02/2008.

Low-dose vasopressin did not reduce mortality rates as compared with norepinephrine among patients with septic shock.

Cumulative Association of Five Genetic Variants with Prostate Cancer. NEJM, 02/2008.

Five Single-nucleotide polymorphisms (SNPs) in this study and family history accounted for 46% of the cases of prostate cancer in the Swedish men studied. In conclusion, SNPs in 5 chromosomal regions plus a family history of prostate cancer have a cumulative and significant association with prostate cancer.

Survival after bilateral versus single lung transplantation for patients with chronic obstructive pulmonary disease: a retrospective analysis of registry data. The Lancet 2008; 371:744-751.

Bilateral lung transplantation leads to longer survival than single lung transplantation in patients with COPD.

Russia's next president needs to tackle health reforms. The Lancet 2008; 371:711-714.

Perspectives, Profile: Viktor Schultz: physician in a Russian municipal hospital. The Lancet 2008; 371:717.

A time efficient way to stay up-to-date with medical literature

"How do you eat in elephant? In small bites." The same rule probably applies to staying current with the ever expanding avalanche of medical literature. One can try the following approach:

1. Subscribe the to the RSS feeds of the 5 major medical journals (NEJM, JAMA, BMJ, Lancet and Annals) plus 2-3 subpecialty journals in your field of interest.


Medical Journals tab: A screenshot of iGoogle with RSS feeds from the major medical journals.

2. Read the journal on the day it is published online, for example, NEJM on Wednesdays.

3. Use text-to-speech to listen to articles you do not have time to read.

4. Listen to journal podcasts. Click here to subscribe the podcasts of the 4 major journals in iGoogle.

Related:
Make Your Own "Medical Journal" with iGoogle Personalized Page
Share iGoogle Tabs with Medical Journals, Podcasts and Gadgets
Annals of Internal Medicine Launches Podcast and Audio Summaries
Text-to-Speech Programs and Continuous Medical Education
Image source: OpenClipArt, public domain.