Friday, August 03, 2007

Journal Club

I led my journal club session today, and it was a fun discussion. Both of the articles (mine and the other student presenter's) were really interesting. I think I've already said that my article was on drug eluting stents. I had some extra data from the Cleveland Clinic interventional cardiology labs that the director allowed me to use. We didn't have as much time to look at it during class as I would have liked, but it was still neat to see some in-house data anyway. (It appears that implantation of drug eluting stents does not increase people's risk of dying in procedures performed at the Clinic.) The other paper was looking for an association between sugary drinks, obesity, and type II diabetes. Not surprisingly, the association was very strong. What is even more interesting is that even diet soft drinks are associated with higher levels of obesity and diabetes. But this is probably because people don't change their eating habits even when they switch drinks. In other words, if I still go to McDonald's and get a Big Mac, fries, and an apple pie, I am eating so many calories that it doesn't matter very much if I got a diet Coke to go with it!

I've already mentioned that this year's journal club is much less formal and a lot more fun than last year's was. I think it's partly because of the different style of the discussions, and partly just because I find the material so much more interesting. Each presenter has a faculty "content expert" whose job is to help us analyze the paper. My content expert was an interventional cardiologist since the paper was about stents. He also happens to be the person in charge of my MS program (Clinical Trials), so I already knew him from before. I also got help with the stats from the TA, because we haven't covered most of the stats they used in the paper in class yet.

After class, I was talking to the other content expert about what it means for family history to be a risk factor for diabetes. People tend to want to write it off as just being genetics (i.e., if your parents had diabetes, you'll be at a higher risk to get it too), but you also have to take into account that families share many lifestyle habits and living conditions as well. So if a person's parents become diabetic because they have horrible diets and lifestyles and they are obese, but that person watches his diet and exercises regularly, it's hard to say how much risk of becoming diabetic he has. Even if he's more genetically predisposed to get diabetes in comparison to people with no family history, he can still alter his risk by removing himself from the kind of environment (low exercise, high calorie, high sugar) that would tend to trigger development of diabetes. The problem, of course, is that temporary fixes like going on a diet don't cut the muster. You have to make a lifestyle change (ex. stop eating at McDonald's altogether) and follow it for the rest of your life.

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