Purified poloxamer 188 (PP188) is a nonionic surfactant that improves
microvascular blood flow by reducing blood viscosity and adhesive frictional
forces. In this randomized controlled trial, Orringer and colleaguesArticle found
that the duration of acute vaso-occlusive crises among patients with sickle
cell disease who received PP188 was decreased compared with the placebo group,
especially among children, and the proportion of patients able to achieve
crisis resolution was increased. In an editorial, NagelArticle discusses current
research on innovative strategies to inhibit vaso-occlusion in sickle cell
disease and stresses the importance of providing prompt, effective pain management
for patients with acute sickle cell crisis.
Recent evidence suggests that atherosclerosis is a chronic inflammatory
condition involving the vessel wall and circulating inflammatory cells. Two
studies in this issue of THE JOURNAL investigate the association between markers
of inflammation and coronary artery disease (CAD). In an analysis of data
from a prospective clinical trial that compared invasive and noninvasive therapies
for patients with unstable CAD, Lindmark and colleaguesArticle found that interleukin
6 level was an independent predictor of mortality over 6 to 12 months. Zhang
and colleaguesArticle, in a case-control study, found that elevated levels of myeloperoxidase,
an enzyme that promotes oxidation of lipoproteins in atheroma, was associated
with the presence of CAD. In an editorial, Vorchheimer and FusterArticle note that
it is premature to incorporate measurement of inflammatory markers into the
routine assessment of patients with CAD and emphasize the importance of treating
these patients with medications that have documented efficacy.
To determine whether dry eye syndrome is associated with postmenopausal
hormone replacement therapy, Schaumberg and colleagues analyzed data from
postmenopausal women enrolled in the Women's Health Study. At the 4-year follow-up
visit, the prevalence of dry eye syndrome was significantly higher among women
who used hormone replacement therapy, especially estrogen alone, compared
Previous studies have found that early stages of neurodegenerative diseases,
including Alzheimer disease, can produce alterations in brain metabolism that
are detectable with positron emission tomography (PET). Silverman and colleagues
followed up patients for an average of 3 years who underwent PET evaluation
for symptoms of dementia. Overall, the initial PET pattern of cerebral metabolism
was significantly associated with the subsequent course of dementia, and the
likelihood of progressive dementia after a single initial negative PET scan
Small-area variations in surgical rates have been documented for many
surgical procedures. In the 49 counties of Ontario, Coyte and colleagues found
almost a 10-fold difference between areas with the highest and lowest rates
of myringotomy with insertion of tympanostomy tubes. The dominant modifiable
determinant of area variation was the propensity of primary care physicians
to refer for this surgical procedure.
"I soon realized she was saying that I had the power in my hands to
determine when she would die." From "You Have the Power."
From the Centers for Disease Control and Prevention: Guidelines for
recognizing and responding to anthrax threats and other illnesses such as
plague and smallpox that might result from a bioterrorist attack.
A review of recent epidemiologic studies indicate that alcohol consumption
is associated with increased risk of breast cancer; experimental studies suggest
several mechanisms by which alcohol may affect breast carcinogenesis.
Cosmetic and reconstructive surgery, body image, and health: how medicine
For your patients: Information about Alzheimer disease.
This Week in JAMA. JAMA. 2001;286(17):2061. doi:10.1001/jama.286.17.2061