RSS Medical Articles

Body Iron Stores and the Gender Gap in Risk of Incident MI
Σάβατο, 04.01.2017, 03:00am
To the EditorIn a recent issue ofJAMA Internal Medicine, Albrektsen and colleagues in a large population-based prospective study found that the risk of myocardial infarction (MI) increased with age in both sexes, with lowest risk for women. This gender gap persisted throughout life, with a diminution of relative risk with age. Furthermore, the female advantage could not be explained by difference in the levels of traditional risk factors for coronary heart disease. However, the role of different body iron stores between sexes was not considered.
Body Iron Stores and the Gender Gap in Risk of Incident MI—Reply
Σάβατο, 04.01.2017, 03:00am
In ReplyWe have read with interest the letter by Mascitelli and Goldstein regarding sex differences in body iron stores as a possible explanation for the gender gap in risk of incident myocardial infarction (MI). Serum ferritin levels have been found to correlate with traditional coronary heart disease (CHD) risk factors, but no consistent relation with the risk of CHD has been found. Thus, in our study we did not think about ferritin level as a potential confounder. An important interpretation of our results is that the risk in women seems to be unrelated to menopausal status or to any factors related to menopausal status. There appears to be no protection of being premenopausal vs postmenopausal above what can be explained by a difference in age. The declining relative risk for sex with increasing age seems to be a consequence of a more pronounced flattening of risk level changes in middle-aged men, approaching the risk level for women. This is in contrast to previous beliefs that the risk in women approximate the risk level for men at a certain age. As Mascitelli and Goldstein point out, the absolute risk of MI in women increases about a decade after normal menopausal age. However, an even steeper increase in risk is seen in men, leading to increasing sex differences in absolute risk with increasing age. It is thus difficult to explain the age incidence patterns in view of sex differences in ferritin levels. In a Danish population study with follow-up through 1991, standardized age incidence curves were rather parallel for men and women (log-linear scale), in apparent contrast to the age- and sex-related changes in body iron stores.
Lingering Questions Concerning Specific Dietary Fats and Mortality
Σάβατο, 04.01.2017, 03:00am
To the EditorIn a recent issue ofJAMA Internal Medicine, Wang et al, in their Letter in Reply to a Letter to the Editor by Ravnskov et al, reiterate that their analysis is superior to that of other epidemiologists who find no correlation between saturated fat and mortality. However, there remain some serious questions about their study that it would help to have answered.
Lingering Questions Concerning Specific Dietary Fats and Mortality—Reply
Σάβατο, 04.01.2017, 03:00am
In ReplySchofield and Henderson cited the lower energy intake measured by food frequency questionnaires (FFQs) to question the validity of our findings. It is well known that energy intake is underestimated by FFQs due to a limited number of foods. However, owing to correlated errors between intakes of energy and macronutrients, calculating fatty acid intake as percent of energy will largely cancel out the errors. Furthermore, the validity and reliability of FFQ-measured dietary fatty acids (as percent of energy) have been extensively documented.
Incorrect Conclusions Concerning Antibiotics and Asthma Exacerbation
Σάβατο, 04.01.2017, 03:00am
To the EditorWe strongly support antibiotic stewardship, but we disagree with the statement, “Johnston and colleagues demonstrate that antibiotics for asthma exacerbation do not improve outcomes,”(p1649)from an Invited Commentary by Mehrotra and Linder in a recent issue ofJAMA Internal Medicine. It is true that the AZALEA study showed no benefit in primary or secondary outcomes; however, the statement by Mehrotra and Linder is not supported by the data we reported.
Incorrect Conclusions Concerning Antibiotics and Asthma Exacerbation—Reply
Σάβατο, 04.01.2017, 03:00am
In ReplyThe focus of our Invited Commentary was on antibiotic stewardship and we did not go into either the details of the AZALEA trial nor its generalizability. The single sentence summary of the AZALEA trial in our article potentially oversimplifies the findings of the study by Johnston and colleagues. However, we respectfully disagree with Johnston and colleagues that our interpretation of their trial was inaccurate. Our summary of the AZALEA trial was consistent with the brief summary provided byJAMA Internal Medicinethat stated, “This randomized clinical trial found no statistically or clinically significant benefit in symptoms, lung function, or speed of recovery.” Brusselle and Van Braeckel stated, “...addition of azithromycin to standard medical care for acute asthma exacerbations did not result in a statistically or clinically significant benefit.”(p1637)
Blood Donor Characteristics on Transfusion Outcomes
Σάβατο, 04.01.2017, 03:00am
To the EditorThe work of Chassé and colleagues in a recent issue ofJAMA Internal Medicinereported that blood donor (BD) characteristics may affect red blood cell (RBC) transfusion outcomes and describes a higher risk of death for recipients of RBC transfusions from young donors and female donors independently of recipient age, sex, and comorbidities. The authors discuss these results, mentioning the healthy donor phenomenon and the blood composition in female sex, not ruling out unknown biological and/or environmental factors.
Blood Donor Characteristics On Transfusion Outcomes—Reply
Σάβατο, 04.01.2017, 03:00am
In ReplyLeite and colleagues raise the hypothesis that part of the observed effect in the cohort in our study may be due to donor obesity. This hypothesis is interesting and potentially important at a population level. Although the reporting of body mass index is currently not available in our donor cohort, we obtained the prevalence of obesity estimates from Statistics Canada to evaluate how obesity could influence our results.
Incorrect Conflict of Interest Disclosure and Incorrect Author Affiliation
Σάβατο, 04.01.2017, 03:00am
In the article titled “Effect of Testosterone Treatment on Volumetric Bone Density and Strength in Older Men With Low Testosterone: A Controlled Clinical Trial,” the conflict of interest disclosures and author affiliation were incorrect for Dr Keaveny. This article has been corrected online.
Missing Conflict of Interest Disclosure
Σάβατο, 04.01.2017, 03:00am
In the article titled “Health and Health Care Use Among Individuals at Risk to Lose Health Insurance With Repeal of the Affordable Care Act,” a conflict of interest disclosure was missing for Dr Karaca-Mandic. This article has been corrected online.
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