Journal Watch, a medical literature news service, uses physician-editors to report on important new clinical studies in a core group of over 20 journals. Journal Watch surveys a broad range of biomedical literature; it is not intended to substitute for reading the orginal publications.
The following alphabetical list provides the two-letter label, the relevant alias, and an example for each Journal Watch field.
===== ============ Label Name/Example ===== ============ an Accession Number [Phrase Indexed] example: 941014001.an. hl Headline [Word Indexed] example: vascular restenosis.hl. ns News Summary [Word Indexed] example: oral contraceptives.ns. so Source [Word Indexed] example 1: jama 1994 sep 14.so. example 2: gurwitz jh.so. example 3: drug therapy.so. up Update Code [Phrase Indexed] example: 9610.up.
The following limit is available from the Limit menu on the Main Search Screen:
Update Code Sentence Syntax: limit 3 to latest update Command Syntax: ..l/3 up=9610
Command Syntax: ..c/jwat Sentence Syntax: use jwat
<1> Accession Number 970325001. Headline INHALED STEROIDS REDUCE HOSPITALIZATION FOR ASTHMA. Source Donahue JG et al. Inhaled steroids and the risk of hospitalization for asthma. JAMA 1997 Mar 19; 277:887-91. News Summary Inhaled steroids improve pulmonary physiology and symptoms in patients with asthma, but do they reduce the rate of hospitalization? This analysis of medication and hospitalization data from a large health maintenance organization assessed the relation between inhaled steroid use and hospital admissions in 16,941 patients with asthma. Over a median of three years, beta-agonists were dispensed to 86 percent of the patients, while inhaled steroids were also dispensed in rates ranging from 11 percent of children to 28 percent of adults over age 45. In general, asthma drug prescriptions were associated with higher rates of hospitalization. However, patients taking inhaled steroids had a 50 percent decrease in adjusted risk for hospitalization compared with patients not taking them. There was no evidence of a dose-response relationship. Beta-agonist use was not associated with reduced hospitalization rates. Comment: This important study confirms evidence from smaller investigations that have suggested that inhaled steroids can improve outcomes and lower costs. Many managed care organizations are now pushing to increase use of these medications. --TH Lee. Update Code 9703 <2> Accession Number 970321006. Headline PREHOSPITAL ECG: THE NEXT ADVANCE IN CORONARY CARE?. Source Canto JG; et al. The prehospital electrocardiogram in acute myocardial infarction: Is its full potential being realized?. J Am Coll Cardiol 1997 Mar 1; 29:498-505. News Summary Advancement in medicine usually comes in the form of new tests or treatments, but this study makes the case that changing the timing of a familiar test -- the electrocardiogram -- might improve outcomes for patients with acute myocardial infarction. The analysis compared 3768 patients who had a prehospital ECG and 66,995 patients who did not. The data were taken from a U.S. MI registry from 1994 to 1996. The researchers did not distinguish between prehospital ECGs given by paramedics in the field versus those given in physician offices. All patients presented within 12 hours of initial symptoms. Having a prehospital ECG was associated with a longer interval between symptom onset and hospital arrival, but once in the hospital, the prehospital-ECG group had a shorter median time to initiation of thrombolysis (30 vs. 40 minutes) or primary angioplasty (92 vs. 115 minutes). Both of these revascularization therapies were more likely to be given if patients had had a prehospital ECG. Inhospital mortality was 8 percent among those with a prehospital ECG versus 12 percent in the other patients. Multivariate analysis showed that, after adjusting for other data, prehospital ECG was associated with a 17 percent reduction in mortality. Comment: This study is not a randomized trial, and does not prove that the prehospital ECG was responsible for better outcomes. However, the data are consistent with the hypothesis that the early availability of ECG data leads to faster and greater use of revascularization therapies. --TH Lee. Update Code 9703
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Revised 3 March, 1997