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In This Issue of Archives of Internal Medicine
Arch Intern Med. 2008;168(5):448.
Development and Validation of an All-Cause Mortality Risk Score in Type 2 Diabetes
It remains uncertain whether death can be predicted in type 2 diabetes mellitus. A prospective cohort study of 7583 patients with type 2 diabetes with 5.5 years of follow-up and a split-half approach was conducted to develop and validate a death risk score. Age, sex, peripheral arterial disease, cancer history, insulin use, blood hemoglobin and body mass index, urinary albumin-creatinine ratio, and estimated glomerular filtration rate were used in the risk score, which achieved good calibration and discrimination (area under the receiver operating characteristic curve, 0.85). The study concludes that death in patients with type 2 diabetes can be predicted using a risk score.
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The Representation of Women on the Editorial Boards of Major Medical Journals
Despite the dramatic increase in women entering the medical profession over the past several decades, women have remained underrepresented in certain senior leadership positions in academic medicine. Because editorial positions at major medical journals are prestigious and influential, Jagsi et al sought to examine the representation of women on editorial boards as well as in the role of editor-in-chief. In their study, they examined the editorial membership of 16 major biomedical journals in 1970 and every 5 years thereafter through 2005. They found that the representation of women on the editorial boards of major medical journals has increased over the past 35 years. Nevertheless, women still composed a minority of the membership of the editorial boards for each journal considered in their study, and substantially so for some.
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Association of Early Follow-up After Acute Myocardial Infarction With Higher Rates of Medication Use
In this study of 1516 patients from the Prospective Registry Evaluating Outcomes After Myocardial Infarction: Events and Recovery (PREMIER) registry, Daugherty et al found that, in general, evidence-based medication use at 6 months was greater in patients receiving any form of early follow-up after acute myocardial infarction. Furthermore, collaborative follow-up care between a primary care provider and a cardiologist revealed a trend toward improved medication use compared with either alone. These results support current guideline recommendations for early follow-up after hospitalization for acute myocardial infarction and suggest a structure for this follow-up.
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Geographic Variation and Risk of Skin Cancer in US Women
Qureshi et al evaluated the differences in risk for melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) in a prospective study of 84 836 female nurses living at varying geographic locations as assessed by the UV index in the United States. They found that the risk for SCC was independently affected by residence in medium and high UV index locations, the gradient of risk was weaker for BCC, and risk for melanoma did not change significantly across this UV gradient. For women who reported living in high UV index locations consistently, the multivariate risk for SCC was highest. These findings suggest that residence in high UV index locations is not associated with a uniformly elevated risk of all 3 skin cancers and that SCC seems to be the most UV-associated cancer. Recommendations for sun protection behaviors for skin cancer prevention should also promote vitamin D supplementation.
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Ongoing Improvement in Outcomes for Patients Diagnosed as Having Non-Hodgkin Lymphoma From the 1990s to the Early 21st Century
In this study, Pulte et al used period analysis to estimate trends in 5- and 10-year relative survival on a population level for patients diagnosed as having non-Hodgkin lymphoma (NHL) between 1990-1992 and 2002-2004, using data from the Surveillance, Epidemiology, and End Results database. Improvement was most pronounced for younger patients and patients with extranodal disease, but increases in 5- and 10-year relative survival rates were seen in all age groups, both sexes, nodal and extranodal disease, and both high- and low-grade NHL. When survival was examined by ethnicity, a greater increase was seen for white patients than for black patients, although survival improved in both groups. Improvements in treatment, including the addition of antibody therapy to chemotherapy, better supportive care, and a decrease in human immunodeficiency virus–related NHL may have led to the increases in survival observed.
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