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This Week in JAMA | December 19, 2012|

This Week in JAMA FREE

JAMA. 2012;308(23):2429. doi:10.1001/jama.2012.3393.
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ASPIRIN AND AGE-RELATED MACULAR DEGENERATION

Klein and colleagues examined the relationship between aspirin use and age-related macular degeneration (AMD) in a longitudinal, population-based study that enrolled 4926 individuals aged 43 to 86 years. At clinical eye examinations—performed every 5 years over a 20-year period—study participants were asked whether they had regularly used aspirin at least twice a week for more than 3 months. The authors found that regular aspirin use 10 years prior was associated with a small but statistically significant increase in the risk of incident late and neovascular AMD.

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WORLD TRADE CENTER EXPOSURE AND CANCER RISK

There has been concern that potentially toxic materials and emissions at the World Trade Center (WTC) site may be associated with cancer risk in exposed individuals. In an analysis of data from the WTC Health Registry—including 21 850 rescue/recovery workers and 33 928 individuals not involved in WTC rescue/recovery operations—and 11 state cancer registries, Li and colleagues found that compared with New York State residents overall, WTC rescue/recovery workers were at excess risk of prostate cancer, thyroid cancer, and myeloma. Risk was unrelated to the intensity of WTC exposure.

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DIABETES REMISSION AFTER WEIGHT LOSS INTERVENTION

In an exploratory analysis of data from 4503 participants in the Look AHEAD study—a randomized controlled trial investigating the effect of an intensive lifestyle-based weight loss intervention vs diabetes education and support on cardiovascular disease incidence in adults with type 2 diabetes—Gregg and colleagues examined the association of the lifestyle intervention with remission to prediabetes or normoglycemia. The authors report the lifestyle intervention was associated with a greater likelihood of remission of type 2 diabetes; however, the absolute remission rates were modest and complete remission was rare. In an editorial, Arterburn and O’Connor discuss the future of diabetes prevention and treatment.

PCSK9 ANTIBODY IN STATIN-INTOLERANT PATIENTS

In a 12-week randomized trial that enrolled 160 adult patients with hypercholesterolemia and statin intolerance due to adverse muscle-related effects, Sullivan and colleagues found that a subcutaneously administered human monoclonal antibody to proprotein convertase subtilisin/kexin type 9 (PCSK9)—a plasma proprotein that mediates binding and trafficking of low-density lipoprotein (LDL) cholesterol receptors—significantly reduced LDL cholesterol levels.

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CLINICIAN'S CORNERCLOPIDOGREL PRETREATMENT IN PATIENTS UNDERGOING PCI

Pretreatment with clopidogrel is recommended for patients with acute coronary syndromes or stable coronary artery disease who are scheduled for percutaneous coronary intervention (PCI); however, effects of clopidogrel pretreatment on important clinical outcomes are not clear. In a systematic review and meta-analysis of data from 15 studies (37 814 patients), Bellemain-Appaix and colleagues found that compared with no pretreatment, receipt of clopidogrel was not associated with a lower risk of mortality or major bleeding but was associated with a reduction in major adverse cardiac events.

MEDICAL NEWS & PERSPECTIVES

Psychoactive designer street drugs known as “bath salts” may have potentially dangerous and long-lasting adverse effects, and their varied composition can confound clinicians.

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VIEWPOINTS

Fungal meningitis: a compounding problem

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Iodine supplementation during pregnancy and lactation

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Making health care reform work

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A PIECE OF MY MIND

"We [physicians] tend to imagine ourselves a class apart where health is concerned, and might drift to extremes in our own care, caring either too much or too little." From "A Pain in the Tuches."

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EDITOR'S AUDIO SUMMARY

Dr Bauchner summarizes and comments on this week's issue. Go to http://jama.ama-assn.org/misc/audiocommentary.dtl

AUTHOR IN THE ROOM TELECONFERENCE

Join Robert H. Shmerling, MD, January 16 from 2 to 3 PM eastern time to discuss management of gout. To register, go to http://www.ihi.org/AuthorintheRoom.

JAMA PATIENT PAGE

For your patients: Information about venous embolism during air travel.

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