Vitamin D has been associated with beneficial effects on cardiovascular-related morbidity and mortality, possibly through modification of cardiac structure and function. In a randomized, placebo-controlled trial that enrolled 227 patients with chronic kidney disease (CKD) (increasing their risk of vitamin D deficiency) and mild to moderate left ventricular hypertrophy, Thadhani and colleagues assessed the effects of an active vitamin D compound (paricalcitol) on change in left ventricular mass. The authors report that compared with placebo, 48-weeks' therapy with paricalcitol did not reduce ventricular mass index or improve measures of diastolic dysfunction. In an editorial, Anker and von Haehling discuss the lack of evidence that vitamin D supplementation benefits patients with CKD.
Antibiotics are commonly prescribed for acute rhinosinusitis despite limited evidence to support their effectiveness. In a randomized trial that enrolled 166 adults, Garbutt and colleagues assessed the incremental effect of amoxicillin over symptomatic treatment alone on disease-specific quality of life. Patients received either a 10-day course of amoxicillin or placebo in addition to standard treatments for pain, fever, cough, and nasal congestion to use as needed. The authors found no significant difference in symptom scores on day 3 or day 10 among patients who received amoxicillin compared with patients who received placebo.
Article AND VIDEO INTERVIEW
Human papillomavirus (HPV)–positive oropharyngeal tumors are increasing in incidence in the United States, but little is known about the epidemiology of oral HPV infection. In an analysis of data from 5579 participants (aged 14 to 69 years) in the 2009-2010 National Health and Nutrition Examination Survey, Gillison and colleagues found the overall prevalence of oral HPV infection was 6.9%. Prevalence was higher among men than women, with current smoking and more lifetime sexual partners among the risk factors for infection. In an editorial, Schlecht discusses HPV infection and the risks of intimacy.
Little is known about the combined associations between physical activity and sedentary time with cardiometabolic risk factors in healthy children. To address this question, Ekelund and colleagues analyzed pooled data from 14 studies (comprising 20 871 participants aged 4 to 18 years) that used accelerometry to measure participants' time spent in moderate- or vigorous-intensity physical activity and sedentary time. The authors report that higher levels of time spent in moderate- and vigorous-intensity physical activity were associated with better cardiometabolic risk factors regardless of the amount of time spent sedentary.
Article AND AUDIO INTERVIEW
Epidemiological studies have suggested an association between air pollution levels and cardiovascular mortality. However, the association between air pollution and risk of myocardial infarction (MI) remains controversial. In a systematic review and meta-analysis of data from 34 studies, Mustafić and colleagues found that all main air pollutants, with the exception of ozone, were associated with an increase in MI risk.
Two new analyses indicate that many researchers are failing to report their study results in ClinicalTrials.gov.
Global surgical initiatives
Unintended consequences of conflict of interest disclosure
Health care cost and value
“[Diane’s] comments about me made it apparent that I was not the psychotherapist she had envisioned.” From “A Perfect Match.”
Call for Papers
Investigators are invited to submit abstracts for the Seventh International Congress on Peer Review and Biomedical Publication.
Join David S. Ludwig, MD, PhD, March 21, from 2 to 3 PM eastern time to discuss weight loss strategies for adolescents. To register, go to http://www.ihi.org/AuthorintheRoom.
Dr Bauchner summarizes and comments on this week's issue. Go to http://jama.ama-assn.org/misc/audiocommentary.dtl.
Dr A, a senior physician, in a small practice moved to a large practice. How would you address his frustration about quality improvement that focuses on populations instead of individuals? Go to www.jama.com, read the case, and submit your response by March 4.
For your patients: Information about Henoch-Schönlein purpura.
This Week in JAMA. JAMA. 2012;307(7):637. doi:10.1001/jama.2012.151