α-Lipoic Acid Is Ineffective for Diabetic Neuropathy
General Medicine
Summary and Comment
Objective improvement was borderline, and symptom relief was nil.
By Allan S. Brett, MD
October 13, 2011
Covering:
Ziegler D et al., Diabetes Care 2011 Sep; 34:2054
Spironolactone plus Trimethoprim Induces Hyperkalemia in Elders
General Medicine
Summary and Comment
Treatment with trimethoprim is associated with risk for hospitalization in spironolactone-treated patients.
Erectile Function After Prostate Cancer Therapy
Oncology and Hematology
Summary and Comment
Free
Two years after treatment, functional erections were reported by 48% of men with function before treatment.
By Robert Dreicer, MD, MS, FACP
October 11, 2011
Covering:
Alemozaffar M et al., JAMA 2011 Sep 21; 306:1205
Barry MJ., JAMA 2011 Sep 21; 306:1258
Treating Lower Urinary Tract Symptoms with Saw Palmetto
General Medicine
Summary and Comment
Free
Even at three times the usual dose, it was no better than placebo.
Xanthelasmata Signals Excess Risks for Ischemic Vascular Disease and Death
General Medicine
Summary and Comment
No such association was found for arcus senilis corneae.
Predicting Conversion from Mild Cognitive Impairment to Alzheimer Disease
Neurology
Summary and Comment
Cognitive and functional measures remain significant predictors of decline compared with other biomarkers.
A Systemic Factor Linked to Age-Related Neurogenesis: An Animal Study
Psychiatry
Summary and Comment
A blood-borne protein increases with aging and seems to decrease neurogenesis and cognitive performance in mice.
By Barbara Geller, MD
October 3, 2011
Covering:
Villeda SA et al., Nature 2011 Sep; 477:90
Medical Management Is Superior to Stenting for Intracranial Arterial Stenosis
General Medicine
Summary and Comment
The rate of postprocedural strokes was unacceptably high in patients who received stents.
By Allan S. Brett, MD
September 29, 2011
Covering:
Chimowitz MI et al., N Engl J Med 2011 Sep 15; 365:993
A Novel Tool Identifies Patients at Excess Risk for Venous Thromboembolism
General Medicine
Summary and Comment
Easily accessible clinical data on 11 variables can predict 1- and 5-year VTE risk.
Off-Label Use of Atypical Antipsychotics: Benefits Vary More Than Harms
Psychiatry
Summary and Comment
Free
This drug class can be modestly effective depending on the drug and condition, but adverse events are uniformly problematic.
By Peter Roy-Byrne, MD
September 27, 2011
Covering:
Maher AR et al., JAMA 2011 Sep 28; 306:1359
Mortality Rises with Greater Cognitive Impairment
General Medicine
Summary and Comment
A simple screening tool for cognitive impairment in older patients predicts mortality, but the value of screening is unclear.
Intensive Glucose-Lowering Treatment Does Not Lower 5-Year Mortality
General Medicine
Summary and Comment
In this meta-analysis, treatment did not lower risks for other adverse outcomes associated with type 2 diabetes.
Surgical Delay in Patients with Hip Fractures
General Medicine
Summary and Comment
Surgery within 5 days provided no clear benefit.
Clinical Diagnosis Remarkably Accurate in Early-Onset Dementias
Neurology
Summary and Comment
Free
Experts in dementia predicted neuropathology using only clinical history and neuropsychological screening exams.
Worsening Diastolic Function Predicts Heart Failure
Cardiology
Summary and Comment
Progression of diastolic dysfunction is an independent risk factor that warrants vigilance but not — at this point — screening or intervention.
Simvastatin Doesn't Benefit Patients with Alzheimer Disease
General Medicine
Summary and Comment
Randomized trials failed to show that statins can prevent or treat Alzheimer disease.
By Allan S. Brett, MD
August 30, 2011
Covering:
Sano M et al., Neurology 2011 Aug 9; 77:556
The Physiology of Memory Impairment: An Animal Study
Psychiatry
Summary and Comment
Neuronal firing rates decreased with age in monkeys during a working memory task and improved with chemical agents.
Valproate Does Not Prevent Agitation in Alzheimer Disease Patients
Psychiatry
Summary and Comment
On several measures, the drug performs worse than placebo.
By Steven Dubovsky, MD
August 29, 2011
Covering:
Tariot PN et al. for the Alzheimer's Disease Cooperative Study Group., Arch Gen Psychiatry 2011 Aug; 68:853
White-Matter Hyperintensities Linked to Brain Activations in Late-Life Depression
Psychiatry
Summary and Comment
Emotion-laden brain activation is high in patients with high levels of hyperintensities, but which comes first — the depression or the hyperintensities?
By Joel Yager, MD
August 29, 2011
Covering:
Aizenstein HJ et al., Am J Psychiatry 2011 Jul 28
Does Gabapentin Prevent Postherpetic Neuralgia?
General Medicine
Summary and Comment
Researchers believe so, but their uncontrolled trial doesn't prove it.
By Allan S. Brett, MD
August 25, 2011
Covering:
Lapolla W et al., Arch Dermatol 2011 Aug; 147:901
Follow-Up Chest X-Rays After Pneumonia?
General Medicine
Summary and Comment
Free
Follow-up imaging probably can be limited to older patients.
By Allan S. Brett, MD
August 23, 2011
Covering:
Tang KL et al., Arch Intern Med 2011 Jul 11; 171:1193
Soy Isoflavones and Menopause: No Benefit
General Medicine
Summary and Comment
Soy provided no improvement in bone density or hot flashes.
By Thomas L. Schwenk, MD
August 23, 2011
Covering:
Levis S et al., Arch Intern Med 2011 Aug 8/22; 171:1363
Newton KM and Grady D., Arch Intern Med 2011 Aug 8/22; 171:1369
Sleep-Disordered Breathing Raises Risk for Cognitive Decline in Older Women
General Medicine
Summary and Comment
Risk might be related to hypoxic episodes.
By Thomas L. Schwenk, MD
August 23, 2011
Covering:
Yaffe K et al., JAMA 2011 Aug 10; 306:613
Canessa N and Ferini-Strambi L., JAMA 2011 Aug 10; 306:654
Warfarin and Clopidogrel Are More Likely Than Aspirin to Cause Perioperative Bleeding
Dermatology
Summary and Comment
Free
But office surgery is still safe in patients on anticoagulants and antithrombotics.
By Murad Alam, MD, MSCI
August 19, 2011
Covering:
Bordeaux JS et al., J Am Acad Dermatol 2011 Sep; 65:576
Reviews of Note
Neurobiology of depression; treating refractory depression; adolescents with substance use disorders; gambling disorders; neurobiology of sleep and wakefulness; exercise to improve cognition; leptin, metabolism, and psychiatric disorders.