 |
|
This Week in JAMA
JAMA. 2007;298:257.
Dietary Pattern and Prognosis After Breast Cancer
Some evidence suggests that a diet high in vegetables and fruit reduces breast cancer risk and that a diet high in fat increases risk. However, the effect of these and other dietary factors on cancer progression is not clear. Pierce and colleagues (SEE ARTICLE) report results from the Women's Healthy Eating and Living (WHEL) Study, a randomized trial that assessed the risks of breast cancer recurrence or new primary breast cancer and all-cause mortality among women who had been treated for early stage (stage I-IIIa) breast cancer and who were randomly assigned to either an intervention to promote a dietary pattern very high in vegetables, fruit, and fiber and low in fat or a comparison dietary pattern ("5-A-Day"). Over a mean 7.3-year follow-up, the authors found no differences in breast cancer events or all-cause mortality between women in the 2 groups. In an editorial, Gapstur and Khan (SEE ARTICLE) discuss current data relating to dietary intake and its relationship to cancer progression and survival.
Triglycerides and Risk of Heart Disease
The relationship between nonfasting hypertriglyceridemia and incident cardiovascular disease is addressed in 2 articles in this issue. In a prospective cohort study with 26 years of follow-up, Nordestgaard and colleagues (SEE ARTICLE) tested the hypothesis that very high levels of nonfasting triglycerides are associated with an increased risk of myocardial infarction, ischemic heart disease, and death. The authors found that nonfasting triglycerides higher than 5 mmol/L (>442.5 mg/dL) predicted increased risks of the 3 study outcomes, particularly in women. Bansal and colleagues (SEE ARTICLE) analyzed data from the prospective Women's Health Study to assess the association between fasting vs nonfasting triglyceride levels and risk of future cardiovascular events. They found that nonfasting triglyceride levels were associated with increased risks of future cardiovascular events, independent of baseline cardiac risk factors, other lipids, and markers of insulin resistance, whereas fasting triglyceride levels were not. In an editorial, McBride (SEE ARTICLE) discusses the role of triglycerides in lipid metabolism and implications of the study results for patient care.
Cancer Risk Associated With CT Coronary Angiography
With increasing use of computed tomography coronary angiography (CTCA), concerns about radiation exposure and a possible increased risk of cancer must be addressed. In computer simulations, Einstein and colleagues determined the lifetime attributable risk of cancer associated with a single 64-slice CTCA study, in models adjusted for age, sex, and scan protocol. The authors' analyses revealed estimated lifetime attributable risks for cancer that are not negligible, particularly for persons who are young and female.
(SEE ARTICLE)
CLINICIAN'S CORNER
Emotional Stress and Cardiac Arrhythmias
Grand Rounds
Ziegelstein discusses the pathophysiology and effects of acute emotional distress on cardiac function and the treatment of patients who survive an episode of serious cardiac arrhythmia in the setting of acute emotional distress.
(SEE ARTICLE)
A Piece of My Mind
"[U]ntil I was a good long way into all that debt and sleep deprivation, I had not understood very well what it meant to be human." From "Life Math."
(SEE ARTICLE)
Medical News & Perspectives
Experts are developing a more complete picture of the feasibility of maintaining weight loss and a more hopeful message for millions who are overweight or obese.
(SEE ARTICLE)
Electroconvulsive Therapy
Progress and challenges in electroconvulsive therapy for depression.
(SEE ARTICLE)
Adverse Drug Event Monitoring
Advantages of computer-based pharmacoepidemiology for postmarketing surveillance of drug safety.
(SEE ARTICLE)
Author in the Room Teleconference
Join Roy C. Ziegelstein, MD, August 15, 2007, from 2 to 3 PM eastern time to discuss acute emotional stress and cardiac arrhythmias. To register, go to http://www.ihi.org/AuthorintheRoom.
Audio Commentary
Dr DeAngelis summarizes and comments on this week's issue. Go to http://jama.ama-assn.org/misc/audiocommentary.dtl
JAMA Patient Page
For your patients: Information about acute emotional stress and the heart.
(SEE ARTICLE)
|
