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Results from the Women’s Health Study, a randomized 2 × 2
factorial trial evaluating the benefits and risks of taking aspirin every
other day (100 mg) and natural-source vitamin E (600 IU) vs placebo in the
primary prevention of cardiovascular disease (CVD) and cancer, are reported
in 2 articles ArticleArticle in
this issue of JAMA. The investigators found that
compared with placebo, neither aspirin nor vitamin E was associated with reductions
in overall or site-specific cancer incidence, cancer mortality, major cardiovascular
events, or cardiovascular and total mortality. In editorials, Jacobs and Thun Article discuss the challenges of cancer chemoprevention and Redberg Article discusses CVD prevention strategies
Performance Characteristics of PSA Screening
The utility of the prostate-specific antigen (PSA) test to identify
men with prostate cancer is controversial. Thompson and colleagues Article assessed
the performance characteristics of PSA screening in men who had PSA values
of 3.0 ng/mL or less at baseline, who had annual PSA measurement through 7
years of follow-up, and who underwent an end-of-study prostate biopsy. The
authors found that no specific value of PSA had both high sensitivity and
specificity for prostate cancer. Rather, there was a continuum of cancer risk
at all values of PSA and no definitive PSA level at which to recommend prostate
Mortality Associated With Treated Hyperthyroidism
Some evidence suggests an increased risk of mortality in patients with
hyperthyroidism, but whether this risk derives from the effects of excess
thyroid hormone, the hypothyroid state following treatment, or its reversal
with thyroid hormone (thyroxine [T4]) therapy is not clear. To
address this question, Franklyn and colleagues Article investigated
mortality in a cohort of individuals treated with radioiodine for overt hyperthyroidism.
They found an increased risk of all-cause and circulatory deaths during follow-up
in patients who did not require or had not yet started T4 therapy.
There was no increased risk of mortality during follow-up among patients who
received T4 for radioiodine-induced hypothyroidism.
Arginine Metabolism in Sickle Cell Disease
Elevated arginase activity has been reported in sickle cell disease.
Morris and colleagues Article hypothesized that increased
arginase activity and dysregulated arginine metabolism contribute to sickle
cell disease pathogenesis, morbidity, and mortality and tested their hypothesis
in 228 patients with sickle cell disease and 36 African American controls.
They found that plasma arginase levels were significantly higher in patients
compared with controls and that lower levels of plasma arginine were associated
with a greater severity of pulmonary hypertension and higher mortality.
A Piece of My Mind
“Darkness, both physical and spiritual, descends upon our unit.
Many, both physician and nurse, have never seen anything like this.”
From “Death and Life in Iraq.”
Medical News & Perspectives
Interest in discovering compounds that reduce cancer risk has never
been higher, but identifying safe and effective chemopreventive agents has
proved expectedly difficult.
Androgens and Female Sexual Function
Measures of serum testosterone, free testosterone, androstenedione,
or dehydroepiandrosterone sulfate do not correlate with self-reports of low
sexual function in women.
Individuals consuming at least 4 to 6 cups of coffee daily may have
a reduced risk of type 2 diabetes.
Reporting Conflicts of Interest in Research
A review and update of JAMA policies regarding
authors’ conflicts of interest, disclosures of financial, material,
or other paid support of their research, and requirements for reporting industry-sponsored
JAMA Patient Page
For your patients: Information about hyperthyroidism.
This Week in JAMA . JAMA. 2005;294(1):9. doi:10.1001/jama.294.1.9