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5 May 2009 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians on the first and third Tuesday of every month. These highlights are not intended to substitute for articles as sources of information. For a copy of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656, or visit Past highlights are accessible as well.

1. Molecular Markers May Help Predict Which Patients Are Likely to Die from Prostate Cancer

Prostate cancer is one of the most common types of cancer, affecting about one in six men in the United States. The severity of prostate cancer varies widely, ranging from relatively benign to very aggressive. Patients with a slow growing form of the disease have a normal life-expectancy, which makes clinicians question whether the benefits of therapy outweigh the potential risks. However, it can be difficult to determine a patient's prognosis, especially in those newly-diagnosed with the disease. For this reason, it is important to identify men whose early-stage prostate cancer is destined to be fatal and who may benefit from early aggressive therapy. Researchers reviewed health records for 1,313 U.S. veterans with prostate cancer who were at least 50 years old to determine whether certain molecular factors are associated independently with death from the disease. The researchers found that BCL2, p53, or high microvessel density in prostate cancer biopsies is associated with increased risk for death in these patients.

2. News Reports Often Exaggerate the Importance of Medical Research

The news media is often criticized for exaggerating science stories and deliberately sensationalizing the news. However, researchers argue that sensationalism may begin with the journalistsí sources. The researchers reviewed 200 press releases from 20 academic medical centers. They concluded that academic press releases often promote research with uncertain relevance to human health without acknowledging important cautions or limitations. However, since the researchers did not analyze news coverage stemming from the press releases, they could not directly link problems with press releases with exaggerated or sensational reporting. The study authors suggest that academic centers issue fewer releases about preliminary research, especially unpublished scientific meeting presentations. By issuing fewer press releases, academic centers could help reduce the chance that journalists and the public are misled about the importance or implications of medical research.

3. The USPSTF Reaffirms its Recommendations on Folic Acid for the Prevention of Neural Tube Defects

Neural tube defects (NTDs) are one of the most common birth defects, occurring in approximately one in 1,000 live births in the United States. An NTD is an opening in the spinal cord or brain that occurs very early in human development, often before a woman even knows she is pregnant. The most common NTD is spina bifida, which can cause permanent mild or severe defects. Women who take folic acid supplements before and during early pregnancy are less likely to have babies with NTDs than women who do not take folic acid. In 1996, the U.S. Preventive Services Task Force (USPSTF) recommended that all women who could become pregnant should take a multivitamin supplement containing folic acid. The USPSTF recently reviewed literature published since its last recommendation and concluded that folic acid supplementation clearly reduces NTDs. While many foods are now fortified with folic acid, it is not known whether women can get enough folic acid through their diet to prevent NTDs.

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