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A summary of the "must-read" articles from the journals in that pile on your desk.

Community-Acquired MRSA Seen as Emerging ThreatAnn Intern Med. 2006;144:309-317 and 318-325 [March 7, 2006]

Methicillin-resistant strains of S. aureus (MRSA) are rapidly becoming a community-acquired pathogen, according to studies in Boulder, CO, and New York City. In the latter, MRSA colonization was most common in those 65 or older, women, diabetics, and those recently in long-term care.

Risk Affects Cost-Effectiveness of Aspirin, Statins to Prevent CHDAnn Intern Med. 2006;144:326-336 [March 7, 2006]

Questionnaire Tags High Risk in Heart Failure PatientsJ Am Coll Cardiol. 2006;47:752-756 [Feb. 21, 2006]

A low score on the 100-point Kansas City Cardiomyopathy Questionnaire (KCCQ) is a predictor of a poor prognosis in outpatients with heart failure, investigators with the Cardiovascular Outcomes Research Consortium report. Of 505 outpatients with heart failure and ejection fractions below 40 percent, nine percent had KCCQ scores below 25. During one year of follow-up, 37 percent of those patients had been hospitalized for heart failure and 20 percent had died.

Cocoa Associated with Lower BP in the ElderlyArch Intern Med. 2006;166:411-417 [Feb. 27, 2006]

Over a 15-year period, high cocoa intake-mostly chocolate and chocolate bars-was found to be associated with lower blood pressure and a reduced risk of death in elderly men, say researchers from the Netherlands.

Iraq War Takes Mental Toll on Returning Service MembersJAMA. 2006;295:1023-1032 [March 1, 2006]

About 20 percent of US service members returning from Iraq report mental health problems, a greater percentage than those serving in Afghanistan (11.3 percent) or those serving in other areas (8.5 percent), say researchers at Walter Reed Army Institute of Research. They also found that 35 percent of Iraq war veterans used mental health services in the year after returning home and 12 percent a year were diagnosed with a mental health problem.

Natalizumab Shown Effective for Multiple SclerosisN Engl J Med. 2006;354:899-910 and 911-923 [March 2, 2006]

Natalizumab, the first alpha-4 integrin antagonist, reduces the risk of relapse and disability in MS, according to two new studies. Researchers in the Netherlands found that the drug, which is given in a monthly infusion, reduced the risk of sustained progression at two years by 42 percent and the rate of relapse at one year by 68 percent. Researchers at the Cleveland Clinic found that combination therapy with interferon was associated with a lower annualized rate of relapse over a two-year period than was interferon alone (0.34 vs 0.75).

Hepatitis B Patients Have Good Response to EntecavirN Engl J Med. 2006;354:1001-1010 and 1011-1020 [March 9, 2006]

Two studies confirm that hepatitis B patients taking entecavir show significantly improved outcomes. Taiwan researchers found histologic improvement in 72 percent of patients on the drug and undetectable serum HBV DNA levels in 67 percent. Hong Kong investigators found undetectable HBV DNA levels in 90 percent of the entecavir group. The latter study was supported by Bristol-Myers Squibb; researchers in both studies have received compensation from drug companies.

Gatifloxacin Linked to Severe Changes in Blood SugarN Engl J Med. 2006;354 [published online]

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