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This Week in JAMA |

This Week in JAMA FREE

JAMA. 2008;299(15):1745. doi:10.1001/jama.299.15.1745.
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JAMA-EXPRESS
MC-1 IN HIGH-RISK CABG SURGERY

Ischemia-reperfusion injury is a significant factor contributing to morbidity and mortality following coronary artery bypass graft (CABG) surgery. Pyridoxal 5′-phosphate monohydrate (MC-1), a naturally occurring pyridoxine metabolite, prevents cellular calcium overload, and some data suggest it may reduce ischemia-reperfusion injury. In the MC-1 to Eliminate Necrosis and Damage in Coronary Artery Bypass Graft Surgery II Trial (MEND-CABG II), intermediate- to high-risk patients undergoing CABG with cardiopulmonary bypass were randomly assigned to receive 250 mg/d of MC-1 or placebo immediately before and for 30 days after surgery. The MEND-CABG II investigators found no difference in the composite outcome of cardiovascular death or nonfatal myocardial infarction among patients who received MC-1 vs placebo during the 30-day follow-up.

JAMA-EXPRESS
STRATEGIES TO IMPROVE ANGIOPLASTY OUTCOMES

Valgimigli and colleagues report results of the MULTISTRATEGY randomized trial, in which patients presenting with ST-elevation myocardial infarction or new left bundle-branch block were assigned to 1 of 4 strategies of percutaneous coronary intervention: abciximab with an uncoated stent, abciximab with a sirolimus-eluting stent, tirofiban with an uncoated stent, or tirofiban with a sirolimus-eluting stent. The investigators found that tirofiban was noninferior to abciximab for achieving at least 50% resolution of ST-segment elevation at 90 minutes after the intervention. During 8 months of follow-up, patients who received sirolimus-eluting stents had a significantly lower risk of major adverse cardiac events compared with patients who received uncoated stents.

INDUSTRY MANIPULATION OF MEDICAL SCIENCE

CLINICIAN'S CORNER
PALLIATIVE CARE IN HEAD AND NECK CANCER
PERSPECTIVES ON CARE AT THE CLOSE OF LIFE

A comprehensive and multidisciplinary approach to patients with head and neck cancers, to address the physical and psychological effects associated with treatment.

A PIECE OF MY MIND

“Nearly four years since completing my residency, . . . I returned to my home country for the first time as a full-fledged internist and accidental tourist.” From “Rediscovery.”

MEDICAL NEWS & PERSPECTIVES

Critics charge that proposed federal guidelines for distributing reprints of journal articles that discuss off-label uses of drugs and devices would allow companies to continue to use the reprints as marketing tools.

COMMENTARIES

International recruitment of nurses: justice and human rights

“Gizmo idolatry” in medicine

AUTHOR IN THE ROOM TELECONFERENCE

Join Barbara Howard, PhD, and William Howard, MD, on May 21, 2008, from 2 to 3 PM eastern time to discuss lower blood pressure and cholesterol targets in diabetes. 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

READERS RESPOND

How would you manage a 50-year-old man with chronic low back pain? Go to www.jama.com to read the case and submit your response. Your response may be selected for online publication. Submission deadline is April 30.

JAMA PATIENT PAGE

For your patients: Information about coronary artery bypass grafting.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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