Charité Clinical Journal Club (English) by Fred Luft - 24.10.2018

The N Engl J Med image of the week shows a 35-year-old man who presented to the emergency psychiatry service with paranoid delusions and was found to have patchy, irregular alopecia of the scalp. What is the most likely diagnosis? You are offered androgenic alopecia, central centrifugal cicatricial alopecia, syphilitic alopecia, trichotillomania, and hypothyroidism. We review these hairy conditions. Acetosalicylic acid (aspirin) is advised for secondary prevention after heart attacks and strokes and in the US has also been advocated in primary prevention in patients at risk. Also, aspirin is said to reduce the risk of colon cancer. But will aspirin help old persons (those 70 years) from developing heart attacks and stroke? From 2010 through 2014, investigators enrolled community-dwelling persons in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics in the United States) and did not have cardiovascular disease, dementia, or physical disability. Participants were randomly assigned to receive 100 mg per day of enteric-coated aspirin or placebo orally. The primary end point was a composite of death, dementia, or persistent physical disability.