Highlights of this issue

Erythropoietin use in critically ill patients

Erythropoietin is used off label to treat anemia in critically ill patients; however, the clinical benefits of such use are uncertain. In a meta-analysis of 9 randomized controlled trials, Zarychanski and colleagues found that erythropoietin confers no significant mortality benefit and only a minor reduction in transfusions among critically ill patients. They conclude that existing evidence is insufficient to support the general use of erythropoietin in this population. In a related commentary, Corwin reviews the evidence of decreased mortality associated with erythropoietin use in a subgroup of trauma patients. This issue's editorial criticizes the pharmaceutical industry's encouragement of off-label use of medications.

See pages 697, 725 and 747

Static magnets for reducing pain

Static magnets are widely marketed to the public for pain relief, despite little scientific basis for this use. In their meta-analysis of 9 randomized trials, Pittler and colleagues found no effect of magnets on pain scores and conclude that the evidence does not support the use of magnets for pain relief.

See page 736

Obstructive sleep apnea in familial partial lipodystrophy

Hegele and colleagues describe 2 cases of obstructive sleep apnea in nonobese women. Both women had familial partial lipodystrophy type 2, which causes markedly increased fat deposition in the neck. The physiologic consequences of this rare syndrome highlight the importance of considering obstructive sleep apnea even in the absence of obesity when other anatomic or clinical risk factors are present.

See page 743

Practice

Bhat and Dawson describe a unique constellation of symptoms involving 4 systems in a patient with a Crohn's disease flare-up. They stress the importance of considering tracheobronchitis and airway stenosis in patients with inflammatory bowel disease who present with persistent respiratory symptoms (page 715).

In Clinical Vistas, Szakacs and colleagues present a case of nosocomial myiasis in an intensive care unit (page 719).

In this issue's Public Health column, Weir and colleagues describe the health concerns of raw milk and outline how the public health system would respond to a case of raw milk exposure (page 721).

In Health and Drug Alerts, Meymeh and Wooltorton comment on a recent advisory concerning pioglitazone use for diabetes and the risk of fracture (page 723).