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Monday 23 February 2009 |
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| Faculty of 1000 is proud to present F1000 Medicine Reports, a new online journal featuring short commentaries by the world's top experts on the hottest topics in clinical medicine. |
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Our Advisory Board identifies these areas on the basis of trends amongst the papers evaluated by Faculty of 1000. F1000 Medicine Reports works in conjunction with the evaluations on F1000 to constitute a resource that not only identifies the major advances in medicine, but also puts them in context and summarises their importance for clinicians.
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Fresh fruit and vegetables are not shown to cause harm in patients with acute leukemia
 Changes Clinical Practice: Patients with acute leukemia undergoing induction chemotherapy may eat a diet with fresh fruits and vegetables.
A prominent recommendation for patients undergoing chemotherapy is a neutropenic diet, which avoids foods known to contain a higher level of bacteria. This is because during chemotherapy a patient's ability to fight off infections is reduced due to a decreasing number of neutrophils in the blood.
A recent article, highlighted by Karen Ballen of the Hematology Faculty randomised 153 patients with acute myeloid leukaemia (AML) receiving induction therapy "to a typical neutropenic cooked diet with no fresh fruits and vegetables or to a more liberalized diet with fresh fruit and vegetables." The authors "found no difference in rates of infection, fever, or survival between the two groups."
Dr Ballen explains how "the study questions a long held belief that patients with AML need to be maintained on a special neutropenic diet" and "indicates that patient outcome is not affected by a more liberal diet, which is likely to be more pleasing to patients."
In Dr Ballen's experience "compliance is often difficult with a cooked diet and patients miss the fruits and vegetables, another "loss" at a difficult time. Thus, the ability to liberalize diet would make a major improvement in quality of life."
The results of this study must be welcomed by all AML patients undergoing chemotherapy, who can now enjoy some of the finer things in life, without feeling guilty.
Read the evaluation in full here.
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An important new application for statins?
The authors of this paper, evaluated by Charles Feldman of the Respiratory Disorders Faculty and his Associate Faculty Member, Erica Shaddock, use a prospective observational study to determine whether prior statin use in community-acquired pneumonia patients leads to an improved outcome in these individuals, compared with the normal expectations for sufferers of the disease - and make an intriguing discovery.
Charles writes "patients with prior statin use had lower 30-day mortality (adjusted odds ratio (AOR) 0.46, 95% CI: 0.25-0.85, p=0.01) and developed complicated pneumonia less frequently (AOR 0.44, 95% CI: 0.25-0.76, p=0.0060)." and notes that "Also of interest is that those patients who had previously been prescribed statins had more severe pneumonia, as indicated by a higher Pneumonia Severity Index (PSI) score (PSI 4 compared with PSI 3). This makes the improved outcome seen in those patients with prior statin use even more relevant."
He believes that this study "adds to the growing evidence that the use of statins belongs to all physicians, not just cardiologists, and now it is the turn of the pulmonologist/intensivist to reap the benefits."
[See full evaluation]
The Hidden Jewels lists are one of the most popular features on the Faculty of 1000 Medicine site as they bring to scientists' attention papers they otherwise might have missed (especially in fields adjacent to their own). This list is compiled daily and includes highly viewed papers evaluated within the previous month.
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Happiness is contagious!
Happiness is an important element of health, and is particularly important in a palliative care setting. In this Exceptional article, highlighted by Marcin Chwistek from the Oncology Faculty, the authors look at the spread of happiness in social networks.
Marcin explains "The results revealed that happy people tend to be connected to one another, which results from the spread of happiness, not from a tendency of people to associate with similar individuals. Moreover, this association proved to be significant for up to three degrees of separation. It diminished with time and geographical distance and did not show to be significant for co-workers."
He believes that "The goal of palliative care is to improve the wellbeing and quality of life of patients, which is a major component of their happiness. This in turn contributes to happiness of others, making palliative care an element of public health."
However, as Marcin says in his comments, the mechanism for the spread of happiness is unknown and future research should investigate this.
You can read the complete evaluation of this article here.
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