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WHAT'S HOT IN... MEDICINE - 2009

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 Clarivate Analytics 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.


November/December 2009

KRAS Research Harbingers Personalized Cancer Care
by David W. Sharp

Recent research into mutations of the KRAS gene in metastatic colorectal cancer demonstrates that the presence of wild-type (non-mutated) KRAS in tumors is correlated with more-effective treatment with the anticancer agent panitumumab. Similar results have been obtained with the drug cetuximab. Such findings hasten the promise of personalizing cancer treatments for specific tumor types.
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September/October 2009

Examining HPV’s Role in Head and Neck Cancer
by David W. Sharp

With the role of human papillomavirus (HPV) in cervical cancer firmly established, researchers are now exploring HPV’s possible causative action in cancers of the head and neck. One study comparing histories of patients with oropharyngeal cancer against controls suggested a strong association between the cancer and HPV infection, with factors such as sexual behavior and the number of sexual partners exerting an apparent influence. Specifics, such as the precise means of oral transmission, are still being elucidated."
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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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