The Top Ten lists in Medicine feature papers published during the last
two years (excluding review articles) that were most cited in current
journal articles indexed by
Thomson Reuters
during a recent two-month period. Papers are ranked according to the
latest bimonthly citation count. The articles below are accompanied by
expert discussion and analysis (including comments from the
papers’ authors) written by one of four veteran
scientist-journalists and longtime ScienceWatch.com
contributors.
2009
Obesity
Surgery: Weighing The Effects on Mortality
by David W. Sharp
Recent studies have assessed the effects of anti-obesity
surgery on mortality, comparing obese subjects who underwent
gastric bypass and other procedures against obese controls who
did not have surgery. Results indicated that surgery improved
mortality rates and quality of life, with improvement
apparently related to quantity of weight lost. Given the
refinements in surgical techniques since these studies were
initially launched in the 1980s, the current advantages are
likely to be even greater.
View
Article
May/June 2009
2008/09
Trials Ignite Debate about Regimen for Type 2
Diabetes
by David W. Sharp
Medicine’s most-cited papers are currently dominated by
studies pertaining to type 2 diabetes and its management. In
particular, recent trials have examined the effects of intensive
blood-glucose lowering in the treatment of type 2 diabetes.
Meta-analysis has suggested that this course of therapy is
connected with a higher incidence of cardiovascular events and
higher mortality rates, although further investigation is needed to
clarify this matter and others related to treatment.
View Article
The
Intensive Insulin/Intensive Care Debate Waits for
NICE-SUGAR
by David W. Sharp
Recent studies have examined the use of tight glycemic
control—specifically, intense insulin therapy—for
patients with severe sepsis in intensive-care units. Although
earlier trials suggested that such therapy improved mortality
as compared with conventional intensive care, later studies
indicated no significant difference and also suggested that low
glycemic levels present a threat of their own. Clinicians will
look to ongoing trials to clarify these matters.
View
Article
January/February 2009
Colon Cancer Stem Cells Causing "Breathless
Excitement"
by David W. Sharp
Recent highly cited papers in medicine investigate the increasing
evidence pertaining to cancer stem cells. In one paper, for example, a
team of researchers discusses a particular cell capable of initiating
colon cancer. A deeper knowledge of these kinds of cells—how they
behave, how they differ from one another, and how they interact with
such factors as the cell-surface marker CD133—will add to the
understanding of oncogenesis and help point the way toward improved
treatment strategies.
View Article
2008
November/December 2008
Cancer
Screening—When Will It Be the Lung’s
Turn?
by David W. Sharp
A paper in the New England Journal of Medicine reports on a
study of outcome following screening for lung cancer by spiral computed
tomography. After screening individuals who were at risk for lung
cancer due to smoking or occupational exposure to carcinogens, the
researchers determined that those diagnosed with stage 1 lung cancer
demonstrated substantial survival benefit from early treatment,
demonstrating the effectiveness of annual screening..
View Article
September/October 2008
In
Two Different Cancers, Success with Drugs New and
Old
by David W. Sharp
Recent cancer therapy has shown progress on two fronts: in chronic
myeloid leukemia, the drug dasatinib has shown benefit in patients
who are resistant to imatinib, while in gastric cancer,
perioperative chemotherapy with the older agents epirubicin,
cisplatin, and fluorouracil has been shown to improve survival when
compared to surgery alone.
View Article
March/April 2008
Investigating
Angiogenesis Inhibitors and Other Drugs in Kidney
Cancer
by David W. Sharp
A comparatively recent treatment for renal-cell carcinoma involves
tyrosine-kinase-inhibiting agents, including sunitinib, bevacizumab,
and temsirolimus, to block angiogenesis and tumor-cell proliferation.
Studies suggest that, compared to interferon, these agents improved
survival.
View Article
Injection of the vascular endothelial growth-factor inhibitor bevacizumab,
normally used in cancer, has been effective in treating the eye disorder
known as age-related macular degeneration, but, in view of safety concerns
that are currently under study, the manufacturer has curtailed its
availability for this application.
View Article
