Treatment of coronary artery restenosis within a previously implanted bare-metal stent is the subject of 2 articles in this issue of JAMA. First, Stone and colleaguesArticle report results of a randomized trial that assessed the safety and efficacy of angioplasty and placement of a paclitaxel-eluting stent vs vascular brachytherapy in patients with in-stent restenosis. At a 9-month assessment, the authors found that patients who received the paclitaxel-eluting stent had less clinical and angiographic restenosis and improved event-free survival compared with patients receiving brachytherapy. In a second article, Holmes and colleaguesArticle report results of a trial that assessed target vessel failure at 9 months' follow-up in patients who received a sirolimus-eluting stent vs brachytherapy. This study also demonstrated better clinical and angiographic outcomes in patients with the drug-eluting stent compared with patients having brachytherapy. In an editorial, Mukherjee and MoliternoArticle discuss the advantages of drug-eluting stents for the treatment of bare-metal stent restenosis.
Children with croup are often treated with humidity, although scientific evidence supporting this treatment strategy is lacking. To assess the efficacies of several different humidity treatments for croup, Scolnik and colleagues randomly assigned children with symptoms of moderate to severe croup, who were seen in the emergency department of a tertiary care children's hospital, to a 30-minute humidity treatment using the traditional blow-by technique, nebulizer-delivered 40% humidity, or nebulizer-delivered 100% humidity with water particles of optimal size. Before and after treatment measurements of the Westley croup score were compared. The authors found no statistically or clinically significant changes in the croup score for any of the humidity conditions tested.
Late-breaking trials sessions are becoming common at major scientific meetings. However, little is known about the publication fate and other characteristics of randomized controlled trials (RCTs) presented at late-breaking sessions vs other meeting sessions. Toma and colleagues identified the meeting abstracts and subsequent full-length articles for 86 late-breaking RCTs and for a randomly selected comparison group of RCTs presented at other sessions of American College of Cardiology (ACC) scientific meetings in 1999 through 2002. The authors found a number of differences between published late-breaking RCTs compared with RCTs presented at other meeting sessions, including that the late-breaking RCTs were significantly larger, were more likely to be preceded by a published study design paper and to be published, and were less likely to report results favorable to the intervention. Discrepancies between meeting abstracts and full-length articles were common for both late-breaking and regular-session RCTs.
Systematic review of prospective and cross-sectional studies assessing the relationship of endogenous sex hormone levels to risk of type 2 diabetes suggests differential relationships in men vs women, particularly with regard to testosterone levels.
Scientists are weighing the cost-effectiveness of current strategies to screen donated blood for the West Nile virus and are proposing approaches tied to the virus' seasonal and regional patterns.
Preventing osteoporosis in patients requiring chronic glucocorticosteroid therapy is the subject of several articles in the January 2006 issue of the Archives of Dermatology. Prescribing calcium, vitamin D, and a bisphosphonate when patients begin anticipated chronic glucocorticoid therapy or, alternatively, treating disease with steroid-sparing agents are 2 strategies addressed.
A gradient in health that parallels social status could help explain some health inequalities.
Join William C. Taylor, MD, on Wednesday, April 19, 2006, from 2 to 3 PM eastern time to discuss approaches to screening for colonoscopy.
To register, go to http://www.ihi.org/AuthorintheRoom.
For your patients: Information about weight and diabetes.
NEXT WEEK Theme Issue on Women’s Health
This Week in JAMA . JAMA. 2006;295(11):1219. doi:10.1001/jama.295.11.1219