The optimal balance of macronutrients to prevent weight gain is not known, and the chance that low-fat, high-carbohydrate diets may cause weight gain has been raised. Howard and
colleaguesArticle assessed this possibility using data on weight change from baseline among women in the Women's Health Initiative Dietary Modification Trial, in which postmenopausal participants were randomly assigned to either a diet plan low in fat (target 20% fat) and high in vegetable, fruit, and grain intake or a self-selected diet control group. The authors found that the low-fat, high-carbohydrate diet was not associated with weight gain during a mean 7.5 years of follow-up. In an editorial, Dansinger and SchaeferArticle discuss the importance of adherence to lifestyle modifications to achieve long-term weight loss.
Although age-related differences in cardiac arrest etiology, pathophysiology, and survival have been described, data from in-hospital arrests are limited. Nadkarni and colleaguesArticle used data from a national registry of in-hospital cardiac arrests to assess the type of cardiac arrest and survival to hospital discharge for 37 782 adults and children. The investigators hypothesized that compared with adults, children would have worse survival and fewer arrests associated with ventricular fibrillation or pulseless ventricular tachycardia. They found that children had better survival to hospital discharge than adults, and the first documented rhythm was typically asystole or pulseless electrical activity at all ages. In an editorial, QuanArticle discusses the implications of these findings for resuscitation protocols.
Prior clinical studies have suggested that L-arginine, a popular health supplement, may reduce vascular stiffness and improve endothelial function in older patients. Schulman and colleagues conducted a randomized, placebo-controlled trial to assess whether adding L-arginine to standard therapy reduces vascular stiffness and improves ejection fraction in patients 6 months after a first ST-segment elevation myocardial infarction. The authors found that compared with placebo, L-arginine did not improve vascular stiffness measures or ejection fraction and may be associated with a higher risk of post-infarction death.
Serum hepatitis B virus (HBV) DNA level is a marker of viral replication and efficacy of antiviral therapy in patients with chronic hepatitis B. Chen and colleagues assessed the incidence of hepatocellular carcinoma in relation to serum HBV DNA level in a prospective cohort of patients who were seropositive for hepatitis B surface antigen. During a mean follow-up of 11.4 years, the authors found that an elevated serum HBV DNA level is a strong and independent predictor of hepatocellular carcinoma risk.
Several retrospective analyses suggest that cholesterol-lowering statin drugs reduce the risk of cancer. To investigate the impact of statins on cancer incidence or death, Dale and colleagues conducted a meta-analysis of data from clinical trials of statins for prevention of coronary artery disease, for which follow-up was at least 1 year and data on incident cancer diagnoses or death were collected. The authors found no reductions in cancer incidence or cancer deaths among patients receiving statin therapy.
New research using advanced imaging tools and genome-mining techniques are helping researchers better understand autism and identify its genetic basis.
Sedlak and Snyder describe several messenger systems involved in cell survival and programmed cell death, offering novel therapeutic possibilities.
Garfield describes the history and meaning of scientific journal impact factors.
Join Sandra Dial, MD, in a teleconference on January 18, 2006, to discuss new research on the use of gastric acid–suppressive agents and risk of community-acquired Clostridium difficile.
For more information and to register for “Author in the Room,” please visit http://www.ihi.org/authorintheroom.
For your patients: Information about cardiac arrest.
This article was corrected on 1/4/2006, prior to publication of the correction in print.
This Week in JAMA . JAMA. 2006;295(1):9. doi:10.1001/jama.295.1.9