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
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
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..
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.
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.
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.
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
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.