Premenopausal women with breast cancer who receive systemic chemotherapy are at risk of premature ovarian failure. In a randomized trial of premenopausal breast cancer patients undergoing adjuvant or neoadjuvant chemotherapy, Del Mastro and colleagues Article assessed the effect of temporary ovarian suppression on the incidence of early menopause. Patients were randomly assigned to receive chemotherapy alone or in combination with triptorelin, a gonadotropin releasing-hormone (GnRH) agonist. The authors found that triptorelin-induced temporary ovarian suppression during chemotherapy was associated with a reduced rate of chemotherapy-associated early menopause. In an editorial, Rugo and Rosen Article discuss the use of GnRH agonists to preserve ovarian function among women receiving chemotherapy for breast cancer.
Stress cardiomyopathy—a transient form of acute heart failure—is reportedly associated with acute emotional or physical stress and a distinctive left ventricular contraction pattern. Eitel and colleagues report results of a prospective, multicenter study that was designed to more fully define the clinical spectrum and evolution of stress cardiomyopathy. Patients enrolled in the study underwent an electrocardiogram, echocardiogram, coronary angiography, cardiovascular magnetic resonance imaging, and blood sample analysis at presentation to the hospital. Among the authors' findings was that stress cardiomyopathy appears to have a broader clinical profile than previously reported—including younger patients and patients without an identifiable stressful trigger—and may be associated with 4 distinct patterns of regional ventricular ballooning.
Foods purchased in restaurants are estimated to account for approximately 35% of daily energy intake, but the accuracy of menu information on the energy content of restaurant foods is unknown. Urban and colleagues Article obtained food samples from 42 randomly selected quick-serve and sit-down restaurants in 3 states and determined the difference between menu-stated and laboratory-measured energy values for 242 unique foods. The authors report that, overall, the restaurant-stated energy contents of the tested foods were not significantly different from measured values. However, for some individual foods there was substantial inaccuracy, with understatement of energy values for foods with lower energy content. In an editorial, Van Horn Article discusses the importance of accuracy in food labeling for long-term weight control.
Hadigan and Kottilil discuss challenges and advances in the management of patients who are coinfected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The authors discuss patient and virus predictors of poor response to interferon-based HCV therapy, increased rates of disease progression and treatment toxicities associated with HIV/HCV coinfection, and new developments in HCV therapeutics and treatment regimens.
Join Ross Zafonte, DO, Wednesday, August 17, from 2 to 3 PM eastern time to discuss the diagnosis and management of a 15-year-old athlete who experienced a concussion after falling while skiing without a helmet. To register, go to http://www.ihi.org/AuthorintheRoom.
“The truth of the matter is that patients tell physicians their secrets all the time. At my clinic, I am amazed by what people reveal if you only ask.” From “The Patient's Patients.”
AIDS drug assistance programs face funding shortfalls.
Melanoma prevention with regular sunscreen use
Clinical implementation of pharmacogenomics
Genetics and drug response
Assessing liability for catastrophic emergencies
Importance of health delivery research
Should a healthy 42-year-old man at low risk of HIV infection undergo screening? Go to www.jama.com to read the case. Submit your response by August 7 for possible online posting.
For your patients: Information about hyperthyroidism.
This Week in JAMA. JAMA. 2011;306(3):237. doi:10.1001/jama.2011.1024