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WHAT'S HOT IN... MEDICINE

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

July/August 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.
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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.
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March/April 2009

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.
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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.
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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..
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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.
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July/August 2008

Staph Report: Assessing MRSA Infections in the ER
by David W. Sharp

The emergence of methicillin-resistant Staphylococcus aureus, or MRSA, has become a serious health issue. A 2006 study of patients appearing in emergency rooms with skin or soft-tissue infections indicated that 76% had S. aureus, with 78% of those bacterial isolates showing resistance to methicillin.
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May/June 2008

Genome-Wide Studies and Risk in Type 2 Diabetes
by David W. Sharp

Two papers in the current Medicine Top Ten discusses genome-wide association studies on type 2 diabetes and the genetic factors and processes associated with increased risk for the disease.
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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.
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January/February 2008

Bevacizumub: A Poke in the Eye for Macular Patients?
by David W. Sharp

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.
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