Big Issues in Patient Care: Mediterranean Diet Yes, Testosterone No, and More Topics

The editors of the prestigious New England Journal of Medicine (NEJM) recently issued a report, “2013 Year in Review.” The collection of articles summarizes what these deep medical thinkers believe are the most relevant clinical topics in general medicine, focusing on primary care, landmark studies, media coverage and public awareness.

The report is directed toward medical professionals, but the topic choices are pertinent to our readers because they reflect information clinicians believe is key to giving patients the best care.

One must have a subscription to read the report’s individual articles. But many concern topics we have covered recently. Following are excerpts from the report, and links to our coverage.

  • New Cholesterol Guidelines Spur Debate:

    “Two new guidelines from the American Heart Association and American College of Cardiology – one on cardiovascular risk assessment, the other on cholesterol management – spurred considerable controversy [toward] the end of 2013.”

    See our newsletter, “Spotlight on Statins: Controversy over New Drug Guidelines.”

  • Questions About Risks and Benefits of Testosterone Therapy:

    “We know very little about risks associated with testosterone therapy, but that fact doesn’t seem to be inhibiting its vigorous promotion by pharmaceutical companies and some physicians who serve as spokespeople for those companies. For now, clinicians are confronted regularly with the need to balance demands of men who seek to improve their strength, energy, and appearance with theoretical (and now, empirical) concerns about long-term risks of testosterone therapy.”

    See our blogs, “Marketing the Latest Drug Fad, Testosterone” and “Testosterone Therapy Might Carry Heart Risks.”

  • Lung Cancer Screening with Computed Tomography – Now Recommended:

    “In the end, benefits of screening will outweigh harms only if patients are selected carefully for screening and if screen-positive patients are managed in centers where expert multidisciplinary follow-up is available.”

    See our blog, “Federal Panel Recommends Annual CT Scans for Some Smokers.”

  • Ongoing Battles with ICU Infections:

    “Eliminating hospital-acquired, antibiotic-resistant infections has long bedeviled epidemiologists, especially in the close quarters of intensive care units (ICUs). Several studies in 2013 emphasized the elusiveness of this goal.”

    See our blog, “Controlling Staph Infections in the ICU.”

  • Mediterranean Diet Test in a Randomized Trial:

    “Until now, most of the evidence favoring the Mediterranean diet was observational. We now have randomized-trial-level evidence that this diet – along with generous intake of extra-virgin olive oil and nuts – lowers cardiovascular risk to some extent.”

    See our blog, “Eating Nuts and Plotting Forests” and our newsletter, “You Can Do This Now: Simple Steps to More Healthful Living in 2014.”

  • Electronic Cigarettes: Increasingly Used, Still Unregulated, Poorly Understood:

    “Electronic cigarettes (e-cigarettes) – cigarette-shaped, battery-powered, nicotine-vapor delivery devices – are growing rapidly in popularity. They have been promoted as smoking-cessation aids, but we know little about their risks and benefits.

    “… E-cigarettes are currently classified as a tobacco product, but the FDA has not yet exercised its authority to regulate their marketing. Reportedly, it will issue preliminary rules soon. Clearly, we need more research to inform such regulations.”

    See our blog, “We Don’t Know Enough about Electronic Cigarettes.”

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