EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 13, 2004
To contact corresponding author Christoph R. Meier, Ph.D., M.Sc., e-mail: chMeier{at}uhbs.ch

RISK OF HEART ATTACK HIGHER FOR SEVERAL WEEKS AFTER STOPPING NSAID THERAPY

CHICAGO—The risk of having a heart attack is elevated in the weeks after stopping use of nonsteroidal anti-inflammatory drugs, according to an article in the December issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

According to the article, intravascular inflammation has been associated with an increased risk of acute myocardial infarction (AMI, or heart attack). Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the risk of AMI, the article states.

Lorenz M. Fischer, M.Sc., of University Hospital Basel, Basel, Switzerland, and colleagues investigated the risk of AMI during NSAID exposure and after stopping NSAID therapy. The researchers analyzed data from the British General Practice Research Database. They included 8,688 cases, who were patients with their first AMI between 1995 and 2001, and 33,923 age- and sex-matched controls without AMI.

The researchers found that after adjustment for various physiological and lifestyle factors (including high blood pressure, elevated blood lipid levels, diabetes, heart disease, smoking, body mass index and aspirin use), the risk of AMI was about 50 percent higher for patients who stopped taking NSAIDs one to 29 days prior to their first AMI, compared with patients who did not use NSAID therapy. The risk was highest in patients with rheumatoid arthritis or lupus (about three times higher) and for patients who stopped using NSAID therapy after previous long-term use (about two times higher). Current and past NSAID use (60 days or less before first AMI) was not associated with an increased risk of AMI.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 13, 2004
To contact Judy Illes, Ph.D., call Michelle Brandt at 650/723-0272. To contact editorialist Patrick G. O'Malley, M.D., P.H.D., call Public Affairs - Walter Reed Medical Center at 202/782-7177.

DIRECT-TO-CONSUMER MARKETING DOES NOT PROVIDE BALANCED INFORMATION

CHICAGO—Advertisements for body-imaging to screen for cancer, cardiac disease and other illnesses, do not provide adequate information to consumers, according to an article in the December issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

According to the article, self-referral to health care products and services has risen steadily since 1988, when direct-to-consumer (DTC) marketing of pharmaceuticals was authorized by the U.S. Federal Trade Commission (FTC). Self-referral for whole-body computed tomography (CT) scans and magnetic resonance imaging (MRI) for early detection of cancer, cardiovascular disease, and other diseases has also increased, the article states. These imaging procedures are marketed directly to consumers.

Judy Illes, Ph.D., of the Stanford Center for Biomedical Ethics, Palo Alto, Calif., and colleagues conducted a detailed analysis of print advertisements and informational brochures for self-referred imaging.

The researchers evaluated 40 print advertisements from U.S. newspapers and 20 informational brochures. The material was analyzed and grouped according to theme: health care technology, emotion, empowerment and assurance, incentives, limited supporting evidence, popular appeal, statistics and images.

The researchers found that "both the advertisements and the brochures emphasized health care and technology information and provided assurances of good health and incentives to self-refer." The researchers also found that the advertisements did not refer to noncompany sources of information or to potential risks of having a scan. Statements lacking clear scientific evidence were identified in 38 percent of the advertisements (n=15) and 25 percent of the brochures (n=5).

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 13, 2004
To contact Dag Aarsland, M.D., Ph.D., e-mail: daa{at}sir.no

RATE OF DECLINE IN COGNITIVE FUNCTIONING SIMILAR IN PATIENTS WITH PARKINSON DISEASE AND DEMENTIA AND PATIENTS WITH ALZHEIMER DISEASE

CHICAGO—The average annual decline in cognitive functioning is similar in patients with Parkinson disease (PD) and dementia and patients with Alzheimer disease (AD), according to an article in the December issue of the Archives of Neurology, one of the JAMA/Archives journals.

According to information in the article, dementia is common in patients with Parkinson disease and is associated with rapid motor and functional decline, higher death rates, and increased caregiver stress. However, few studies have focused on the rate of cognitive decline in PD, and the results vary considerably.

Dag Aarsland, M.D., Ph.D., of Rogaland Central Hospital, Hillevag, Norway, and colleagues measured the rate of change in score on the Mini-Mental State Examination (a test of cognitive functioning) in patients with PD and compared those changes to Mini-Mental State Examination changes of patients with AD and patients without dementia.

Patients with PD were selected from a community-based cohort in Rogaland County, Norway. Patients with no cognitive impairment at the onset of their disease and who participated in one or more assessments after their first visit were included and examined again after four years (visit two) and eight years (visit three). Motor, cognitive, and psychiatric symptoms were rated using standardized scales at visit one. Two population-based cohorts of patients with Alzheimer disease and patients without dementia were included for comparison.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 13, 2004
To contact Jeffrey J. Walline, O.D., Ph.D., call Karen Greene at 614/292-0818.

MYOPIA PROGRESSES MORE SLOWLY IN CHILDREN WHO WEAR HARD CONTACT LENSES

CHICAGO—Children who wear rigid gas-permeable contact lenses (RGPs) had slower progression of their myopia (nearsightedness) than patients who wear soft contact lenses (SCLs), according to an article in the December issue of the Archives of Ophthalmology, one of the JAMA/Archives journals.

According to the article, "myopia affects approximately 25 percent of the U.S. population, and it typically develops between eight and 16 years of age." Previous studies have reported that rigid contact lenses may slow myopia progression, but other studies have found that rigid contact lenses have no effect on myopia progression in children, the article states.

Jeffrey J. Walline, O.D., Ph.D., of The Ohio State University College of Optometry, Columbus, and colleagues randomly assigned 116 children (aged eight to 11 years old) to wear RGPs or SCLs as part of the Contact Lens and Myopia Progression (CLAMP) Study. Vision tests were administered at the beginning of the study, and at three years after randomization. All participants had 20/20 vision (with correction) at the beginning of the study and low to moderate myopia.

The researchers found that compared to children who wore SCLs, the children who wore RGPs had a slower progression of myopia. "Although results from the CLAMP Study indicate that RGPs significantly slow the progression of myopia in children, the slowed change in refractive error may not be overwhelming from the clinical perspective," the authors write.