Interesting Articles: A Weekly Review of the "Big Five" Medical Journals

This is a collection of articles I have found interesting in the weekly editions of the "big five" medical journals: NEJM, JAMA, Annals, Lancet and BMJ (a few more journals are included occasionally). The review is a weekly feature of Clinical Cases and Images - Blog. Please see the end of the post for a suggested time-efficient way to stay up-to-date with the medical literature.


Alcohol Screening Scores and Medication Nonadherence
Chris L. Bryson, MD, MS; David H. Au, MD, MS; Haili Sun, PhD; Emily C. Williams, MPH; Daniel R. Kivlahan, PhD; and Katharine A. Bradley, MD, MPH, Annals of Int Med, 2 December 2008 | Volume 149 Issue 11 | Pages 795-803

Medication nonadherence is common and is associated with adverse outcomes. Patients completed the Alcohol Use Disorder Identification Test–Consumption (AUDIT-C) questionnaire, a validated 3-question alcohol misuse screening test.

AUDIT consumption questions (AUDIT-C):

1. How often did you have a drink containing alcohol in the past year?
2. How many drinks did you have on a typical day when you were drinking in the past year?
How often did you have 6 or more drinks on one occasion in the past year?

Alcohol misuse was associated with increased risk for medication nonadherence.


Prognostic Value of a T-Cell–Based, Interferon- Biomarker in Children with Tuberculosis Contact
Mustafa Bakir, MD; Kerry A. Millington, DPhil; Ahmet Soysal, MD; Jonathan J. Deeks, PhD; Serpil Efee; Yasemin Aslan, SRN; Davinder P.S. Dosanjh, DPhil; and Ajit Lalvani, DM. Annals of Int Med, 2 December 2008 | Volume 149 Issue 11 | Pages 777-786

Enzyme-linked immunospot (ELISpot) assay is an increasingly widely used, T-cell–based, interferon-–release assay for diagnosing tuberculosis infection. Positive ELISpot results predict subsequent development of active tuberculosis in recent tuberculosis contacts.


Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis.
Alexander C Ford et al. BMJ 2008;337:a2313

Fibre, antispasmodics, and peppermint oil were all more effective than placebo in the treatment of irritable bowel syndrome.


Hypersensitivity reactions to human papillomavirus vaccine in Australian schoolgirls: retrospective cohort study.
Liew Woei Kang et al. BMJ 2008;337:a2642

True hypersensitivity to the quadrivalent human papillomavirus vaccine in Australian schoolgirls was uncommon and most tolerated subsequent doses.


Screening for Prostate Cancer among Men 75 Years of Age or Older
Michael J. Barry, M.D. NEJM, Volume 359:2515-2516 December 11, 2008 Number 24

The new recommendations from the USPSTF should prompt clinicians to think twice before ordering PSA tests for cases in which screening is likely to do more harm than good.


JAMA Patient Page: Sickle Cell Vasculopathy
JAMA Vol. 300 No. 22, December 10, 2008

Sickle cell disease affects 70 000 people in the United States.


A time efficient way to stay up-to-date with medical literature

"How do you eat in elephant? In small bites." The same rule probably applies to staying current with the ever expanding avalanche of medical literature. One can try the following approach:

1. Subscribe to the RSS feeds of the 5 major medical journals (NEJM, JAMA, BMJ, Lancet and Annals) plus 2-3 subpecialty journals in your field of interest.

Medical Journals tab: A screenshot of iGoogle with RSS feeds from the major medical journals.

2. Read the journal on the day it is published online, for example, NEJM on Wednesdays.

3. Use text-to-speech to listen to the articles you do not have time to read.

4. Listen to journal podcasts. Click here to subscribe the podcasts of the 4 major journals in iGoogle.

University of Oxford Journal Watch: Lighthearted Review of Medical Journals
5 Tips to Stay Up-to-Date with Medical Literature
Make Your Own "Medical Journal" with iGoogle Personalized Page
Share iGoogle Tabs with Medical Journals, Podcasts and Gadgets
Text-to-Speech Programs and Continuous Medical Education
Image source: OpenClipArt, public domain.

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