A summary of current clinical articles from that pile on your desk
* Suicide Risk Greater Following Post-Traumatic Stress
Arch Gen Psychiatry. 2009;66305-311. [March 2009]
Post-traumatic stress disorder after a traumatic event in childhood can independently predict attempted suicide risk, although trauma alone cannot, according to researchers at the Johns Hopkins University School of Medicine in Baltimore. A large proportion (81 percent) of the participants was found to have been exposed to at least one traumatic event in their lifetime; of these, 8 percent developed PTSD. A strong and significant association was found between an individual having PTSD following a traumatic event and their likelihood to have a subsequent suicide attempt (2.7-fold increased risk after adjusting for other factors). Trauma not accompanied by PTSD was not associated with an increased risk of suicide attempt.
* Anger Induces Heart Instability and Arrhythmias
J Am Coll Cardiol. 2009;53:774-778. [March 3, 2009]
Anger-induced T-wave alternane, a marker of repolarization instability, predicts ventricular arrhythmias in patients with implantable cardioverter- defibrillatore, providing a link between stress and sudden death, according to researchers from Yale University School of Medicine in New Haven, Connecticut. During a followup of at least one year, 10 patients with ICD-terminated arrhythmias had significantly higher anger-induced T-wave alternons. Arrhythmias were more common in patients in the highest quartile of anger-induced T-wave alternane on extended follow-up.
* Variables Predicting Cancer After Mammography Identified
Radiology. 2009;250:648-657. [March 2009]
Among women who develop invasive breast cancer after abnormal mammographie findings, the best predictors of cancer are masses and calcifications, with asymmetry and architectural distortions having much lower positive predictive value, according to researchers at the University of California in San Francisco. Most invasive cancers were identified with a mass (68 percent), followed by calcifications (21 percent), architectural distortions (6 percent), and asymmetry (5 percent).
* Metabolic Syndrome Linked to Distinct Liver Cancers
Hepatology. 2009:49:851-859. [March 2009]
A French study found that in patients with hepatocellular carcinoma, whose only risk factor for liver disease is evidence of metabolic syndrome, the cancer typically occurs without significant fibrosis in the surrounding liver. Patients with metabolic syndrome were more likely to have background liver that was free of significant fibrosis, compared with the overt-cause group. In addition, the HCCs were more often well-differentiated in the metabolic syndrome group compared with the overt-cause group.
* Racial Disparities Seen in Post-Heart Attack Outcomes
Ann Intern Med. 2009;150:314-324. [March 3, 2009]
In patients with myocardial infarction, overall outcomes are significantly worse in blacks than whites. But the differences are attenuated after adjustment for patient characteristics that differ by race such as socioeconomic status and co-morbid conditions, researchers from the Mid America Heart Institute in Kansas City, Missouri, report. Researchers found that black patients had higher rates of mortality and rehospitalization, and a lower quality of life compared with whites. But after adjusting for patient characteristics, researchers found that these differences mostly disappeared and that black patients actually showed a trend toward lower rehospitalization.
* Topical Cyclosporine Beneficial in Dry Eye Syndrome
Arch Ophthalmol. 2009:127:146-152. [February 2009]
In patients with moderate to severe dry eye syndrome who don't respond to conventional lubricant therapy, treatment with topical cyclosporine emulsion improves quality of life and is cost-effective, researchers from the University of Pennsylvania School of Medicine in Philadelphia report. …