The latest research you need to know

CLINICAL SHORTS

INCREASED CANCER RISKS ASSOCIATED WITH EZETIMIBE UNLIKELY

Due to the concern of increased incidence of cancer among patients taking ezetimibe, data from two other much larger trials (SHARP, IMPROVE-IT) were analyzed and negated the possible link with cancer.

Citation: Peto R, Emberson J, Landray M, et al. Analyses of cancer data from three ezetimibe trials. N Eng J Med. 2008;359:1357-1366.

OUT-OF-HOSPITAL TERMINATION-OF-RESUSCITATION RULES VALIDATED

Retrospective cohort study validates BLS and ALS termination-of-resuscitation rules in identifying patients with out-of-hospital cardiac arrests with little or no chance of survival.

Citation: Sasson C, Hegg AJ, Macy M, et al. Prehospital termination of resuscitation in cases of refractory out-of-hospital cardiac arrest. JAMA 2008;300(12):1432-1438.

CT COLONOGRAPHY CAN BE AN ALTERNATIVE TO COLONOSCOPY

In an observational cohort study of 2,531 asymptomatic patients 50 or older, CT colonography identified 90% of adenomas or cancers 10 mm or more in diameter compared to colonoscopy.

Citation: Johnson CD, Chen M, Toledano AY, et al. Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med. 2008;259:1207-1217.

IMPRESSIVE REGIONAL VARIATIONS IN OUT-OF-HOSPITAL ARREST OUTCOMES

Prospective, observational study in North America demonstrated the surprising wide variations in incidence and survival from a cardiac arrest, with Seattle having the best results and Alabama the worst of 10 study sites.

Citation: Nichol G, Thomas E, Callaway C. Regional variations in out-of-hospital cardiac arrest incidence and outcome. JAMA. 2008;300(12):1423-1431.

A RANDOMIZED TRIAL OF ARTHROSCOPIC SURGERY FOR OSTEOARTHRITIS OF THE KNEE

The trial was a single-center, single-blinded trial comparing arthroscopic knee surgery to medical and physical therapy alone. It concluded surgical intervention made no difference in quality of life or symptoms after two years of follow up.

Citation: Kirkley A, Birmingham TB, Litchfield RB, et al. A randomized control trial of arthroscopic surgery for osteoarthritis of the knee. N Eng J Med. 2008;359(11):1097-1107.

STATIN AND CANCER RISK NEGATED

A systematic review with meta-regression analysis of 15 randomized control trials did not demonstrate increased cancer risk with statin use.

Citation: Alsheikh-Ali AA, Trikalinos TA, Kent DM, et al. Statins, low-density lipoprotein cholesterol, and risk of cancer. J Am Coll Cardiol. 2008;52(14);1141-1147.

INCREASED MORTALITY WITH HIGH PSEUDOMONAS AERUGINOSA COLONIZATION, BUT WITHOUT VAP

A prospective, single-center, observational study unexpectedly demonstrated patients with high burden Pseudomonas aeruginosa colonization, but without clear signs of ventilator-associated pneumonia, were at higher risk of death.

Citation: Zhuo H, Yang K, Lynch S, et al. Increased mortality of ventilated patients with endotracheal Pseudomonas aeruginosa without clinical signs of infection. Crit Care Med. 2008;36(9); 2495-2503.

INFLUENCES OF MEDICAL STUDENTS’ CHOICE OF A CAREER IN INTERNAL MEDICINE

A Web-based, cross-sectional survey of fourth-year medical students from 11 medical schools found the quality of the students’ medicine rotation, a favorable impression of patients cared for by internists, and a favorable impression of internist lifestyle influenced their career decision.

Citation: Hauer K, During S, Kernan W, et al. Factors associated with medical students’ career choices regarding internal medicine. JAMA. 2008;300(10):1154-1164.

UNINTENDED WORKLOAD EFFECTS DUE TO WORK-HOUR RESTRICTIONS

In this cohort study of medical interns, there was less attendance in educational activities, less sleep on-call, and longer shift duration as a consequence of ACGME work-hour regulations.

Citation: Arora VM, Georgitis E, Siddique J, et al. Association of workload of on-call medical interns with on-call sleep duration, shift duration, and participation in educational activities. JAMA. 2008; 300(10);1146-1153.