Reviews

From BMJ USA 2002;October:582

This section calls attention to new studies and systematic reviews, selected by the Editor from journals published just as this issue went into production (approximately 2 months before publication). The Journals hand-searched for the Journal Rack are: American Journal of Medicine, American Journal of Preventive Medicine, Annals of Internal Medicine, Circulation, JAMA, Journal of Family Practice, Journal of General Internal Medicine, Journal of the American Board of Family Practice, JNCI, Lancet, New England Journal of Medicine, and Pediatrics. Studies are noted that might directly influence clinical practice decisions in primary care and have been classified by type of problem addressed.

CardiovascularA Swiss randomized trial involving 553 angioplasty patients found that the composite end point (death, nonfatal myocardial infarction, and repeat revascularization) at year 1 was reduced by 32% among those who received 6 months of folic acid, vitamin B₁₂, and vitamin B_{6 (}Schnyder et al. JAMA Aug 28, 2002;288:973-979).

DermatologicIn a survey of 156,354 Americans, 58% of those age 18-29 reported having had a sunburn in the past year (Saraiya et al. Am J Prev Med Aug 2002;23:91-97).

GeriatricA randomized trial involving 230 community-dwelling adults age 60 and older found that use of ginkgo did not improve memory or cognitive function over 6 weeks (Solomon et al. JAMA Aug 21, 2002;288:835-840).

GeriatricIn a survey of 545 hospice nurses in Oregon, where physician-assisted suicide was legalized in 1997, 45% of the respondents reported that a patient had requested assistance with suicide (Ganzini et al. N Engl J Med Aug 22, 2002;347:582-588).

HematologicA Canadian randomized trial involving 51 patients with excessive warfarin anticoagulation found that oral vitamin K was 4 times more likely to correct the international normalized ratio within one day than was subcutaneous vitamin K (Crowther et al. Ann Intern Med Aug 20, 2002;137:251-254).

Infectious DiseasesA Dutch randomized trial involving 652 adults age 60 and older found that neither multivitamin-minerals at physiological doses nor 200 mg of vitamin E reduced acute respiratory tract infections, and the severity was worse in those taking vitamin E (Graat et al. JAMA Aug 14, 2002;288:715-721).

Infectious DiseasesA cost-benefit analysis found that the benefits of influenza vaccination and antiviral treatment of healthy working adults equaled or exceeded their costs (Lee et al. Ann Intern Med Aug 20, 2002;137:225-231).

Infectious DiseasesA French randomized trial involving 4387 patients found that surgical site infection rates were no higher when hands were rubbed with 75% aqueous alcohol solution (preceded by a 1-minute nonantiseptic hand wash) than when hands were scrubbed with antiseptic soap. See also BMJUSA p 572 (http://bmj.com/cgi/content/abstract/325/7360/362) (Parienti et al. JAMA Aug 14, 2002;288:722-727).

Infectious DiseasesA British case-control study found that patients with herpes zoster were less likely to report exposure to varicella or zoster within the past 10 years than were subjects without zoster. The authors speculated that varicella vaccination, by reducing the prevalence of childhood varicella, might promote adult zoster (Thomas et al. Lancet Aug 31, 2002;360:678-682).

Infectious DiseasesAn analysis of plasma obtained in 1995-2000 from 377 subjects with untreated HIV infection found that high-level drug resistance had increased from 3% to 12% (Little et al. N Engl J Med Aug 8, 2002;347:385-394).

Infectious DiseasesA French randomized trial involving 300 patients with septic shock found that mortality among those with documented adrenal insufficiency was 33% lower in the groups that received hydrocortisone (50 mg intravenous bolus every 6 hours) or fludrocortisone (50 µg tablet daily) than among those who received placebos (Annane et al. JAMA Aug 21, 2002;288:862-871).

Mental HealthA survey of 610 primary care physicians found that 19% reported screening new patients for domestic violence. Fewer than 70% said that they knew how to assess or intervene in domestic violence. See systematic review on p 561 (Gerbert et al. Am J Prev Med Aug 2002;23:82-90).

ObstetricAn examination of 81 obstetrical textbooks found that only 17% included a recommendation that pregnant women not drink alcohol; 53% contained a sentence condoning some level of drinking (Loop and Nettleman. Am J Prev Med Aug 2002;23:136-138).

OncologicNational tumor registry data suggest that up to 15% of prostate cancers detected by PSA screening in white men (37% in African American men) are unlikely to cause clinical symptoms and would only have been detected on autopsy (Etzioni et al. J Natl Cancer Inst July 3, 2002;94:981-990).

OphthalmologicA cohort study of 277 patients with cataracts found that the frequency of motor vehicle crashes over 4-6 years was reduced by 53% among those who underwent surgery (Owsley et al. JAMA Aug 21, 2002;288:841-849).

PediatricA cohort study of 42 newborns found that those born to mothers with diabetes, who underwent repeated heel lances in the first 24-36 hours, demonstrated more grimacing and crying with skin cleansing and venipuncture than did normal infants, suggesting that they were anticipating and experiencing more intense pain (Taddio et al. JAMA Aug 21, 2002;288:857-861).

PediatricA cohort study of 835 infants found that allergic sensitization at age 6-7 was 56% lower among children exposed to 2 or more dogs or cats during the first year of life (Ownby et al. JAMA Aug 28, 2002;288:963-972).

PediatricA British meta-analysis of 31 studies concluded that ear and rectal thermometers produce discordant results in children. A child with a rectal temperature of 38°C could have an ear temperature ranging from 37.04°C to 39.20°C (Craig et al. Lancet Aug 24, 2002;360:603-609).

PediatricA survey of 1118 female adolescents found that 59% would stop obtaining sexual care services if family planning clinics informed their parents that they wanted prescription contraceptives (Reddy et al. JAMA Aug 14, 2002;288:710-714).

Primary Care PracticeA study involving 685 primary care patients found that interest in taking aspirin for symptomatic carotid artery disease was reduced if the risks of aspirin were presented after the benefits as opposed to being presented first (Bergus et al. J Gen Intern Med Aug 2002;17:612-617).

Primary Care PracticeA meta-analysis of 32 studies found that female physicians have longer medical visits and speak in a more patient-centered style (eg, active partnership, positive talk, psychosocial content, emotional focus) than do male physicians (Roter et al. JAMA Aug 14, 2002;288:756-764).

Primary PreventionA systematic review found 8 trials of the effectiveness of clinician counseling to improve physical activity and concluded that the evidence is indecisive (Eden et al. Ann Intern Med Aug 6, 2002;137:208-215).

Primary PreventionA randomized trial involving 298 sedentary adults reported that an automated telephone-linked system for physical activity counseling resulted in increased moderate- and vigorous-intensity activity at 3 months but demonstrated no benefit at 6 months(Pinto et al. Am J Prev Med Aug 2002;23:113-120).

RheumatologicAn Italian study of 86 patients with suspected temporal arteritis found that physical examination was more sensitive and specific than arterial ultrasonography (Salvarani et al. Ann Intern Med Aug 20, 2002;137:232-238).