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 OTOLARYNGOLOGY—HEAD & NECK SURGERY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, July 21, 2008)
MEMORY IMPAIRMENT ASSOCIATED WITH SOUND PROCESSING DISORDER
ARCHIVES OF DERMATOLOGY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, July 21, 2008)
STUDY EXAMINES MOTIVATIONS FOR TATTOO REMOVAL
ARCHIVES OF SURGERY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, July 21, 2008)
OLDER LIVER DONORS NOT ASSOCIATED WITH NEGATIVE OUTCOMES IN TRANSPLANT RECIPIENTS WITH HEPATITIS C
CANCER CENTERS AND HIGH-VOLUME HOSPITALS MAY EXAMINE MORE LYMPH NODES IN PATIENTS WITH GASTRIC AND PANCREATIC CANCER
ARCHIVES OF FACIAL PLASTIC SURGERY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, July 21, 2008)
CARBON DIOXIDE LASER RESURFACING MAY REDUCE WRINKLES OVER LONG TERM
INFORMATION CONTAINED IN THESE NEWS RELEASES IS PROTECTED BY COPYRIGHT. JOURNAL ATTRIBUTION IS REQUIRED.
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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, July 21, 2008
Media Advisory: To contact George A. Gates, M.D., call Mary Guiden at 206-616-3192.
MEMORY IMPAIRMENT ASSOCIATED WITH SOUND PROCESSING DISORDER
CHICAGO—Mild memory impairment may be associated with central auditory processing dysfunction, or difficulty hearing in complex situations with competing noise, such as hearing a single conversation amid several other conversations, according to a report in the July issue of Archives of Otolaryngology—Head & Neck Surgery, one of the JAMA/Archives journals.
“Central auditory processing dysfunction is a general term that is applied to persons whose hearing in quiet settings is normal or near normal yet who have substantial hearing difficulty in the presence of auditory stressors such as competing noise and other difficult listening situations,” the authors write as background information in the article. “Central auditory testing is important in evaluating individuals with hearing difficulty, because poor central auditory ability, per se, is not helped by amplification and requires alternative rehabilitation strategies.” Previous studies have shown that central auditory processing is impaired in individuals with Alzheimer’s disease and other types of dementia.
George A. Gates, M.D., of the University of Washington, Seattle, and colleagues assessed 313 individuals (average age 80 years) participating in a dementia surveillance program that began in 1994. These included 17 individuals who had been diagnosed with dementia, 64 with mild memory impairment but without a dementia diagnosis and 232 controls without memory loss.
Participants completed three tests designed to gauge central auditory processing: one in which nonsense sentences are read over the background of an interesting narrative and two in which separate sentences or numbers are read into each ear simultaneously. “These central auditory processing test paradigms evaluate how well an individual manages competing signals, a task that requires adequate short-term memory and the ability to shift attention rapidly,” the authors write.
Average scores on central auditory processing tests were significantly lower in the group with dementia and in the group with mild memory impairment than in the control group without memory problems. The association remained significant following adjustment for age and hearing status.
“Central auditory function was affected by even mild memory impairment,” the authors write. “We recommend that central auditory testing be considered in the evaluation of older persons with hearing complaints as part of a comprehensive, individualized program to assist their needs in both the aural rehabilitative and the cognitive domains.”
(Arch Otolaryngol Head Neck Surg. 2008;134[7]:771-777. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This research project was supported by a grant form the National Institute of Deafness and Other Communication Disorders and by a grant from the National Institute on Aging. 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, July 21, 2008
Media Advisory: To contact Myrna L. Armstrong, Ed.D., R.N., F.A.A.N., call Suzanna Cisneros Martinez at 806-743-2143.
STUDY EXAMINES MOTIVATIONS FOR TATTOO REMOVAL
CHICAGO—Individuals who visit dermatology clinics for tattoo removal are more likely to be women than men, and may be motivated by the social stigma associated with tattoos and negative comments by others, according to a report in the July issue of Archives of Dermatology, one of the JAMA/Archives journals.
About one-fourth of adults age 18 to 30 have a tattoo, according to background information in the article. “While the vast majority of individuals who are tattooed are pleased with their skin markings (up to 83 percent), the popularity and prevalence of tattoos often mean that dermatologists are increasingly hearing stories of regrets and requests for tattoo removal,” the authors write. About one-fifth of tattoo wearers are estimated to be dissatisfied with their tattoo, although only about 6 percent seek removal.
Myrna L. Armstrong, Ed.D., R.N., F.A.A.N., of the Texas Tech University Health Sciences Center, Marble Falls, Texas, conducted a survey of 196 individuals who visited one of four dermatology clinics for tattoo removal in 2006. The 66 men and 130 women (average age 30) answered 127 questions about demographics, obtaining their tattoo and their motivations for seeking removal. Their answers were compared with responses to a similar survey conducted in 1996.
“In both the 1996 and the 2006 studies, a shift in identity occurred, and removal centered around dissociating from the past,” the authors write. In 2006, participants reported they had gotten a tattoo to feel unique (44 percent), independent (33 percent) or to make life experiences stand out (28 percent). The main reasons listed for seeking tattoo removal included just deciding to remove it (58 percent), suffering embarrassment (57 percent), lowering of body image (38 percent), getting a new job or career (38 percent), having problems with clothes (37 percent), experiencing stigma (25 percent) or marking an occasion, such as a birthday, marriage or newly found independence (21 percent).
The 2006 survey also found that participants were more likely to be women (69 percent vs. 31 percent men) who were white, single, college-educated and between the ages of 24 and 39. They reported being risk takers, having stable families and were moderately to strongly religious.
While the women were pleased with their tattoos when they got them, they reported changes in their feelings over the following one to five years. “While men also reported some of these same tattoo problems leading to removal, there seemed to be more societal fallout for women with tattoos, as the tattoos began to cause embarrassment, negative comments and clothes problems and no longer satisfied the need for uniqueness,” the authors write.
“Societal support for women with tattoos may not be as strong as for men,” they conclude. “Rather than having visible tattoos, women may still want to choose self-controlled body site placement, even in our contemporary society.”
(Arch Dermatol. 2008;144[7]:879-884. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This work was supported in part by the Research and Practice Committee of the School of Nursing, Texas Tech University Health Sciences Center. 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, July 21, 2008
Media Advisory: To contact corresponding author William C. Chapman, M.D., call Caroline Arbanas at 314-286-0109.
OLDER LIVER DONORS NOT ASSOCIATED WITH NEGATIVE OUTCOMES IN TRANSPLANT RECIPIENTS WITH HEPATITIS C
CHICAGO—Receiving a liver from a donor older than age 60 does not appear to be associated with transplant failure, death or recurrent disease in the next five years among transplant patients with the hepatitis C virus, according to a report in the July issue of Archives of Surgery, one of the JAMA/Archives journals.
Hepatitis C virus infection is the most common cause of the liver disease cirrhosis and the most common indication for liver transplant for U.S. adults, according to background information in the article. Currently, about 17,000 patients are on the waiting list for a liver transplant. Many medical centers have expanded donor criteria, including increasing age limits, to increase the pool of available organs. “There are concerning reports, however, in recipients with hepatitis C virus that extended criteria donors, particularly older donors, are associated with poorer outcome, especially with early and severe hepatitis C virus recurrence in the donor graft,” the authors write.
M.B. Majella Doyle, M.D., and colleagues at Washington University School of Medicine, St. Louis, analyzed data from 489 adult liver transplants performed at the school between 1997 and 2006. Of these patients, 187 (38.2 percent) were infected with the hepatitis C virus and 302 (61.8 percent) had other indications for liver transplant.
Of patients with the hepatitis C virus, 88.1 percent were alive after one year, 78.3 percent survived three years and 69.2 percent survived five years. Donor livers were still functioning in 85.6 percent of hepatitis C virus–positive recipients after one year, 75.6 percent after three years and 65.6 percent after five years. There were no differences in rates of survival and graft (organ) survival between patients with and without hepatitis C in the short or medium term (at one, three or five years). “However, similar to other long-term transplant centers, we observed a negative effect from recurrent hepatitis C virus with a trend toward worsened long-term survival between years five and 10,” the authors write.
A total of 72 patients received organs from donors age 60 and older, including 24 (12.8 percent) with hepatitis C virus and 48 (15.9 percent) without the virus. There were no differences in one-, three- or five-year patient or graft survival rates when these patients—or those who received organs from donors age 65 and older—were compared with those who received organs from younger donors. Because the use of older donors has primarily occurred in the past five years, long-term comparisons were not possible. However, the early results suggest the practice is safe, the authors note.
“In conclusion, overall patient and graft survival in hepatitis C virus-positive recipients is comparable with that in hepatitis C virus-negative patients, and there seems to be little, if any, adverse effect on short- and medium-term follow-up with the use of carefully selected older donor grafts in recipients with hepatitis C virus,” they conclude. “Data from this series suggest that the continued use of selected older donors is a safe method of expanding the liver donor pool, even for hepatitis C-positive recipients.”
(Arch Surg. 2008;143[7]:679-685. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: 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, July 21, 2008
Media Advisory: To contact Karl Y. Bilimoria, M.D., M.S., call Marla Paul at 312-503-8928.
CANCER CENTERS AND HIGH-VOLUME HOSPITALS MAY EXAMINE MORE LYMPH NODES IN PATIENTS WITH GASTRIC AND PANCREATIC CANCER
CHICAGO—Patients with gastric or pancreatic cancer appear to have more lymph nodes examined for the spread of their disease if they are treated at hospitals performing more cancer surgeries or those designated as comprehensive cancer centers, according to a report in the July issue of Archives of Surgery, one of the JAMA/Archives journals.
Lymph node metastases (indicating the spread of cancer) have been shown to predict patients’ prognosis after cancer tissue is removed from the stomach or pancreas, according to background information in the article. If too few lymph nodes are examined for malignant cells, a patient’s cancer may be incorrectly classified, altering prognosis, treatment decisions and eligibility for clinical trials. “Although the precise number varies, current guidelines recommend resection and pathologic evaluation of at least 15 regional lymph nodes for gastric and pancreatic cancer,” the authors write.
Karl Y. Bilimoria, M.D., M.S., of the American College of Surgeons and Feinberg School of Medicine, Northwestern University, Chicago, and colleagues used records from the National Cancer Data Base (NCDB) to identify patients who had surgery for gastric or pancreatic cancer that was diagnosed in 2003 or 2004. Hospitals at which patients had surgery were classified based on case volume and also based on access to cancer-related services and specialists.
Of 3,088 patients with gastric cancer, 11.6 percent had surgery at a hospital designated as a National Cancer Institute (NCI) comprehensive cancer center or as part of the National Comprehensive Cancer Network (NCCN-NCI hospitals), 34 percent at other academic hospitals (affiliated with a medical school but not designated as NCCN-NCI facilities) and 54.4 percent at community hospitals. Nineteen percent of 1,130 pancreatic cancer patients had surgery at NCCN-NCI hospitals, 43.3 percent at other academic hospitals and 37.7 percent at community hospitals.
“Patients undergoing surgery had more lymph nodes examined at NCCN-NCI hospitals than at community hospitals (median [midpoint], 12 vs. six for gastric cancer and nine vs. six for pancreatic cancer),” the authors write. “Patients at highest-volume hospitals had more lymph nodes examined than patients at low-volume hospitals (median, 10 vs. six for gastric cancer and eight vs. six for pancreatic cancer).” Overall, 23.2 percent of patients with gastric cancer and 16.4 percent of patients with pancreatic cancer had at least 15 lymph nodes evaluated. Patients at high-volume or NCCN-NCI hospitals were more likely to have at least 15 lymph nodes evaluated than patients undergoing surgery at community or low-volume hospitals.
“Nodal status is a powerful predictor of outcome, and every reasonable attempt should be made to assess the optimal number of lymph nodes to accurately stage disease in patients with gastric and pancreatic cancer,” the authors write. “Moreover, differences in nodal evaluation may contribute to improved long-term outcomes at NCCN-NCI centers and high-volume hospitals for patients with gastric and pancreatic cancer.”
(Arch Surg. 2008;143[7]:671-678. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported in part by the American College of Surgeons Clinical Scholars in Residence program and by a grant from the Goldberg Family Charitable Trust. The NCDB is supported by the American College of Surgeons, the Commission on Cancer and the American Cancer Society. 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, July 21, 2008
Media Advisory: To contact P. Daniel Ward, M.D., M.S., call Katie Vloet at 734-764-2220. To contact editorialist Paul J. Carniol, M.D., call 908-598-1400.
CARBON DIOXIDE LASER RESURFACING MAY REDUCE WRINKLES OVER LONG TERM
CHICAGO—Carbon dioxide laser resurfacing appears to be an effective long-term treatment for facial wrinkles, according to a report in the July/August issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals.
The carbon dioxide laser vaporizes water molecules inside and outside of cells, causing thermal damage to the surrounding tissue, the authors write as background information in the article. In response to this insult, the skin produces more of the protein collagen, which fills in wrinkles. “In addition to structural changes, the healing process frequently leads to pigmentary [coloring] changes,” the authors write. “These changes in skin pigmentation may be desirable, such as when patients wish to remove solar evidence of aging; however, changes in pigmentation after treatment can often be a troubling adverse effect.”
P. Daniel Ward, M.D., M.S., and Shan R. Baker, M.D., of the University of Michigan, Ann Arbor, assessed 47 patients (42 women and five men, average age 52) who underwent carbon dioxide laser resurfacing on their entire face between 1996 and 2004.
Twenty-one patients (45 percent) had no complications following the procedure; of those who did, 14 (30 percent) had milia (small, white cysts) or acne; eight (17 percent) had hyperpigmentation (darkening of the skin); six (13 percent) had hypopigmentation (lightening of the skin); one (2 percent) developed an infection; and one (2 percent) developed sagging of the eyelids.
After an average of 2.3 years of follow-up, most of these complications had resolved. Patients’ scores on a scale measuring facial wrinkles improved 45 percent, and were consistent over all areas of the face. “With the exception of one case of hyperpigmentation, which resolved within two years of treatment, hypopigmentation was the only long-term adverse effect,” the authors write. “This complication was present in six patients (13 percent). The patients who developed hypopigmentation were more likely to have a greater response to treatment.”
“The efficacy of treating facial rhytids [wrinkles] with the carbon dioxide laser is well established, and the short- and long-term utility of the carbon dioxide laser in treating solar facial aging has previously been documented,” they conclude. “Our results verify those of previous studies that found that carbon dioxide laser resurfacing leads to long-term improvement in facial rhytidosis.”
(Arch Facial Plast Surg. 2008;10[4]:238-243. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.
COMMENTARY: CARBON DIOXIDE LASER RESURFACING STILL PROVIDES RESULTS
“In terms of results, carbon dioxide laser resurfacing remains the gold standard,” writes Paul J. Carnoil, M.D., of Summit, N.J., in an accompanying commentary.
“The number of patients who undergo carbon dioxide laser resurfacing has decreased since the 1990s,” Dr. Carnoil writes. “Some of the factors contributing to this decrease include the risk of delayed permanent hypopigmentation, prolonged recovery with associated erythema [redness] and the associated risks of other complications.”
“Overall, approximately 26 patients (55 percent) in Ward and Baker’s study had some type of complication. This relatively high complication rate means that attentive post-operative treatment by experienced physicians is important to minimize potential long-term problems. It has also led to an ongoing search for methods of treating facial aging and scarring with lower complication rates.” Other treatments have been developed with shorter recovery periods and lower complication rates, but may not yield results equal to carbon dioxide laser resurfacing, Dr. Carnoil notes.
(Arch Facial Plast Surg. 2008;10[4]:244-245. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including 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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