JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. the Archives of Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENTS
ARCHIVES OF NEUROLOGY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, March 10, 2008)
OFFSPRING OF PARENTS WHO BOTH HAVE ALZHEIMER'S DISEASE MAY BE MORE LIKELY TO DEVELOP THE ILLNESS
CLOT-BUSTING THERAPY FOLLOWING STROKE OFFERS GREATER BENEFIT FOR PATIENTS ON ANTI-PLATELET MEDICATION
ARCHIVES OF INTERNAL MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, March 10, 2008)
OUTLOOK IMPROVES FOR PATIENTS WITH NON-HODGKIN LYMPHOMA OVER PAST DECADE
MAGNESIUM ASSOCIATED WITH LOWER RISK FOR SOME STROKES IN MALE SMOKERS
ARCHIVES OF OPHTHALMOLOGY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, March 10, 2008)
GLAUCOMA ASSOCIATED WITH INCREASED RISK OF CARDIOVASCULAR DEATH IN BLACK PATIENTS
INFORMATION CONTAINED IN THESE NEWS RELEASES IS PROTECTED BY COPYRIGHT. JOURNAL ATTRIBUTION IS REQUIRED.
JOURNALISTS CAN NOW ACCESS EMBARGOED JAMA/ARCHIVES STUDIES ON-LINE. Go to www.jamamedia.org for more information and to apply for access.
SAVE THE DATE: JAMA will hold a media briefing on Tuesday, March 18, from 10 a.m. – 12:15 p.m., at the National Press Club in Washington, D.C., on Genetics and Genomics.
The program will highlight new research on the identification of genes related to several major diseases and conditions that affect millions of men and women, as well as genomic medicine applications for common chronic diseases. A group of international researchers will present their papers published in this special theme issue of JAMA and Editor-in-Chief Dr. Catherine DeAngelis will moderate the program.
To register, go to www.jamamedia.org and click on the Events tab, or call 312-464-JAMA.
Archives of Dermatology, Archives of Neurology, Archives of Ophthalmology and Archives of Surgery also will feature research on genetics and genomics in the March issues.
Please Note: The FOR THE MEDIA website now has a search feature to enable media to find previous JAMA/Archives news releases on specific medical topics. This search feature link is located on the home page at www.jamamedia.org
EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 10, 2008
Media Advisory: To contact corresponding author Thomas D. Bird, M.D., call Justin Reedy at 206-685-0382.
OFFSPRING OF PARENTS WHO BOTH HAVE ALZHEIMER'S DISEASE MAY BE MORE LIKELY TO DEVELOP THE ILLNESS
CHICAGO—Adult-age offspring of parents who have both been diagnosed with Alzheimer's disease appear to have an increased risk of developing the disease compared with the general population, according to a report in the March issue of Archives of Neurology, one of the JAMA/Archives journals.
"Alzheimer's disease is a common cause of dementia in the U.S. population and the leading cause of cognitive impairment in the elderly population," according to background information in the article. Identifying genes in Alzheimer's disease patients can help detect others who are at risk for the condition. "Because Alzheimer's disease is so common in the general population, it is not uncommon for both spouses to develop the disease. Offspring of two such affected individuals would presumably carry a higher burden of these Alzheimer's disease-associated genes."
Suman Jayadev, M.D., of the University of Washington, Seattle, and colleagues studied the frequency of Alzheimer's disease in adult children of 111 families in which both parents had been clinically diagnosed with the disease. Ages at onset of dementia were also noted.
Of the 297 offspring who reached adulthood, 22.6 percent developed Alzheimer's disease compared with an estimated 6 percent to 13 percent of the general population. The average age at onset for children of couples with the illness was 66.3. The risk of developing the disease increased with age with 31 percent of those older than age 60 affected and 41.8 percent of those older than age 70 affected. "Of the 240 unaffected individuals, 189 (78.8 percent) had not yet reached age 70 years, suggesting that the incidence of Alzheimer's disease (22.6 percent) is an underestimation of the final incidence rate of Alzheimer's disease in this population," the authors write.
Having additional family members with Alzheimer's disease did not increase the risk of developing the disease, but was associated with a younger age at onset for those who did develop the illness. Children with no history of the disease beyond the parents had an older age at onset (72 years) compared with those who had one parent with family history of the disease (60 years) or both parents with family history of the illness (57 years).
"The role of family history and the specific genes involved in this phenomenon require a better definition," the authors conclude. "Families with a significant Alzheimer's disease history may be more likely to be referred to an Alzheimer's disease research center and, thus, the present patients may be 'enriched' for a particularly Alzheimer's disease-prone subgroup. Following these families as the offspring continue to age will provide increasingly informative data."
(Arch Neurol. 2008;65[3]:373-378.
Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by grants from the National Institute on Aging/National Institutes of Health and by Veterans Affairs research funds. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 10, 2008
Media Advisory: To contact Maarten Uyttenboogaart, M.D., e-mail: m.uyttenboogaart{at}neuro.umcg.nl.
CLOT-BUSTING THERAPY FOLLOWING STROKE OFFERS GREATER BENEFIT FOR PATIENTS ON ANTI-PLATELET MEDICATION
CHICAGO—Patients given a clot-busting drug following stroke appear to have better outcomes if they were already taking anti-platelet medications, despite an apparent increased risk for bleeding in the brain, according to an article posted online today that will appear in the May 2008 print issue of Archives of Neurology, one of the JAMA/Archives journals.
Dissolving blood clots by administering the drug tissue plasminogen activator (tPA) appears to improve outcomes in some patients with stroke, according to background information in the article. However, the medication is associated with a 10-fold increased risk of symptomatic brain hemorrhage (bleeding). Antiplatelet medications, such as aspirin, might further increase the risk for bleeding because these drugs impair the function of cells critical in forming blood clots.
Maarten Uyttenboogaart, M.D., and colleagues at the University of Groningen, Groningen, the Netherlands, studied 301 patients who received tPA following stroke between 2002 and 2006. Of those, 89 had used antiplatelet drugs prior to receiving tPA.
Symptomatic brain hemorrhages occurred in 12 patients who had received antiplatelet therapy (13.5 percent) and six patients who had not (2.8 percent). Patients who had been taking antiplatelet therapy had a higher risk for symptomatic brain hemorrhages. "Despite this increased risk, prior antiplatelet therapy increased the odds of a favorable outcome," defined as the ability to independently carry out activities of daily living after three months, the authors write. "Therefore, our study suggests that tPA treatment should not be withheld from patients receiving antiplatelet therapy."
Aspirin remains active for four to six days and might prevent an additional blood vessel blockage from occurring following tPA therapy, leading to the observed improved outcomes, the authors note. "Larger prospective studies are warranted to further investigate the influence of antiplatelet therapy on outcome after thrombolytic therapy for acute ischemic stroke," they conclude.
(Arch Neurol. 2008;65[5]:(doi:10.1001/archneur.65.5.noc70077).
Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by a grant from the Catharina Heerdt Foundation. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 10, 2008
Media Advisory: To contact corresponding author Hermann Brenner, M.D., M.P.H., e-mail: h.brenner{at}dkfz-heidelberg.de.
OUTLOOK IMPROVES FOR PATIENTS WITH NON-HODGKIN LYMPHOMA OVER PAST DECADE
CHICAGO—Five- and 10-year survival rates for patients with non-Hodgkin lymphoma appear to have increased from the 1990s to the early 21st century, according to a report in the March 10 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Non-Hodgkin lymphoma includes several cancers of the immune system that occur in approximately 20.4 of every 100,000 individuals, according to background information in the article. Treatment for the condition has evolved rapidly in recent years.
Dianne Pulte, M.D., of the German Cancer Research Center, Heidelberg, and colleagues analyzed data from the Surveillance, Epidemiology and End Results (SEER) Program of the U.S. National Cancer Institute. Survival rates were calculated based on two-year time periods between 1990 and 2004 within which patients were diagnosed with non-Hodgkin lymphoma, as well as by age group (15 to 44, 45 to 54, 55 to 64, 65 to 74 and 75 years or older), sex, race, tumor location (i.e. whether the disease was nodal [in the lymph nodes] or extranodal [in a site other than the lymph nodes]) and histologic subtype (to classify tumors as high-grade or low-grade).
"Overall, five-year relative survival increased from 50.4 percent to 66.8 percent, and 10-year relative survival increased from 39.4 percent to 56.3 percent between 1990 to 1992 and 2002 to 2004," the authors write. "Improvements were most pronounced in patients younger than 45 years (plus 26.8 and plus 27.1 percentage points for five- and 10-year survival, respectively), but improvements were seen in all age groups, in both sexes, in both nodal and extranodal disease and in both low-grade and high-grade disease. Improvements in prognosis were less in black patients than in white patients, especially in younger black patients."
Two factors may explain these improvements, the authors note. "One is advances in therapy that have occurred between 1990 and 2004, particularly the introduction of antibody therapy for non-Hodgkin lymphoma," they write. "Treatment with antibody therapy and chemotherapy has extended life expectancy in many cases, but whether and how often this extension represents a true cure is still unknown." In addition, improvements in the treatment of HIV have reduced the occurrence of HIV-related non-Hodgkin lymphomas and also made them easier to treat.
"Our estimates of long-term survival in patients with non-Hodgkin lymphoma obtained by the period analysis method for the 2002 to 2004 period are much higher than previously available survival estimates, which mostly pertain to patients diagnosed in the 1990s," the authors conclude. "Timely disclosure of the improvements in survival achieved in patients, clinicians, researchers and the public is essential."
(Arch Intern Med. 2008;168[5]:469-476. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: The work of Dr. Pulte was supported by a Faculty Research Visit Grant from the German Academic Exchange Service and a Merit Review Grant from the U.S. Department of Veterans Affairs. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 10, 2008
Media Advisory: To contact Susanna C. Larsson, Ph.D., e-mail: Susanna.Larsson{at}ki.se.
MAGNESIUM ASSOCIATED WITH LOWER RISK FOR SOME STROKES IN MALE SMOKERS
CHICAGO—Male smokers who consume more magnesium appear to have a lower risk for cerebral infarction, a type of stroke that occurs when blood flow to the brain is blocked, according to a report in the March 10 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Recent studies indicate that changes in diet may help prevent stroke, according to background information in the article. Hypertension, or high blood pressure, is a risk factor for stroke; therefore, dietary measures that reduce blood pressure may in turn affect stroke risk. Consuming more magnesium, calcium and potassium has been associated with lower blood pressure in previous studies, while sodium has been positively associated with hypertension.
Susanna C. Larsson, Ph.D., of the Karolinska Institutet, Stockholm, Sweden, and colleagues analyzed the diets of 26,556 Finnish male smokers age 50 to 69 years who had not previously had strokes. In addition to the types of food they ate, the men reported other characteristics including medical, smoking and physical activity histories. Their height, weight and blood pressure were recorded, and a blood sample was taken.
During an average of 13.6 years of follow-up, 2,702 of the men had cerebral infarctions; 383 had intracerebral hemorrhages, which involve bleeding into the brain tissue; 196 had subarachnoid hemorrhages, or bleeding between the brain and the thin tissues that cover it; and 84 had unspecified types of strokes.
After adjusting for age and cardiovascular risk factors, such as diabetes and cholesterol level, men who consumed the most magnesium (an average of 589 milligrams per day) had a 15 percent lower risk for cerebral infarction than those who consumed the least (an average of 373 milligrams per day). The association was stronger in men younger than 60 years. Magnesium intake was not associated with a lower risk of intracerebral or subarachnoid hemorrhage, and calcium, potassium and sodium intake were not associated with risk for any type of stroke.
"An inverse association between magnesium intake and cerebral infarction is biologically plausible," the authors write. In addition to lowering blood pressure, magnesium may influence cholesterol concentrations or the body's use of insulin to turn glucose into energy. Either of these mechanisms would affect the risk for cerebral infarction but not hemorrhage.
The results "suggest that a high consumption of magnesium-rich foods, such as whole-grain cereals, may play a role in the prevention of cerebral infarction," they write. "Whether magnesium supplementation lowers the risk of cerebral infarction needs to be assessed in large, long-term randomized trials."
(Arch Intern Med. 2008;168[5]:459-465. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: The ATBC Study was supported by Public Health Service contracts from the National Cancer Institute. Dr. Larsson's postdoctoral research at the National Public Health Institute was supported by a grant from the Swedish Council for Working Life and Social Research. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 10, 2008
Media Advisory: To contact Suh-Yuh Wu, M.A., call Greg Filiano at 631-444-9343.
GLAUCOMA ASSOCIATED WITH INCREASED RISK OF CARDIOVASCULAR DEATH IN BLACK PATIENTS
CHICAGO—Black patients with diagnosed and treated glaucoma and those with high pressure in their eyes appear to have an increased risk of death from cardiovascular causes, according to a report in the March issue of Archives of Ophthalmology, one of the JAMA/Archives journals.
"Glaucoma is one of the leading causes of visual impairment worldwide," the authors write as background information in the article. "The most common type, primary open-angle glaucoma, is especially prevalent in populations of African origin, in which it is the foremost cause of blindness." In addition to higher rates of open-angle glaucoma, black populations also tend to have higher rates of death from chronic disease and high pressure within their eyes (ocular hypertension) than white populations.
Suh-Yuh Wu, M.A., of Stony Brook University, Stony Brook, New York, and colleagues studied 4,092 participants age 40 to 84 (average age 58.6) in the Barbados Eye Studies, which assess a predominately black population with similar ancestry to African-Americans. Initial visits occurred between 1987 and 1992. Height, weight and blood pressure were recorded; interviews were conducted; and various eye measurements were taken. These included photographs of the retina and measurements of eye pressure.
At the beginning of the study, 300 participants had glaucoma, including 141 who had been diagnosed and treated. After nine years of follow-up, 764 (19 percent) of the participants had died. After adjusting for other factors, glaucoma was not associated with the risk of death overall. However, the risk of death from cardiovascular causes was 38 percent higher in individuals who had previously been diagnosed with or treated for open-angle glaucoma and 91 percent higher in those who had been treated with one particular agent, the beta-blocker timolol maleate. Cardiovascular deaths were also 28 percent higher in those with ocular hypertension at the beginning of the study.
"One explanation for the excess mortality [death] found in persons with previously diagnosed open-angle glaucoma could be their longer duration of disease compared with those with newly diagnosed disease," the authors write. "Another explanation for an increased mortality risk could be related to the open-angle glaucoma treatment received." Adverse effects or inappropriate use of beta-blockers and other medications used to treat glaucoma may harm the cardiovascular system and increase death risk.
Some evidence suggests that risk factors for ocular hypertension and cardiovascular disease are similar, potentially explaining the increased risk of death associated with ocular hypertension, the authors note. "These findings underscore the importance of close monitoring and controlling of adequate intraocular pressure levels in this and other high-risk populations," they conclude.
(Arch Ophthalmol. 2008;126[3]:365-370. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by grants from the National Eye Institute, Bethesda, Md. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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