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This Week in JAMA
October 1, 2008

This Week in JAMA

JAMA. 2008;300(13):1489. doi:10.1001/jama.300.13.1489

Serum levels of adiponectin, a hormone secreted by adipose tissue, are inversely associated with colorectal cancer risk and several polymorphisms of adiponectin ligand and receptor genes have been shown to influence adiponectin levels. To examine the association of adiponectin polymorphisms with colorectal cancer risk, Kaklamani and colleagues conducted 2 case-control studies involving patients with colorectal cancer and appropriate controls. In their analyses of 10 common single haplotype-tagging single nucleotide polymorphisms (SNPs) of the adiponectin (ADIPOQ) and adiponectin type 1 receptor (ADIPOR1) genes, the authors identified one ADIPOQ SNP (rs266729) that was associated with a decreased risk of colorectal cancer.

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Marano and colleagues from the Anthrax Vaccine Research Program Working Group report results from the first 1005 enrollees in a randomized clinical trial assessing the immunogenicity and safety of receiving anthrax vaccine adsorbed in a reduced dose and by intramuscular (IM) injection compared with the licensed dose regimen administered subcutaneously. The investigators found that compared with the 4-dose subcutaneous licensed regimen, the experimental 4-dose or 3-dose IM regimens were associated with noninferior immunological outcomes at 7-months' follow-up and a significantly lower occurrence of adverse events at the injection site.

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The news media are a major source of information about medical research. How the media address potential sources of bias in research—such as funding source—has received little attention. In a review of 306 news articles that reported findings from medication research published in 5 prominent medical journals and from a survey of editors of 93 widely circulated US newspapers, Hochman and colleagues found that newspaper stories often failed to mention pharmaceutical company funding and frequently referred to medications by their brand names, despite newspaper editors' contention that this was not the case.

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The effectiveness of long-term psychodynamic psychotherapy for patients with complex mental disorders, including personality disorders and chronic and multiple mental disorders, is not clear. In a meta-analysis of data from 11 randomized controlled trials and 12 observational studies of long-term psychodynamic psychotherapy lasting for at least a year or 50 sessions, Leichsenring and Rabung Article found that long-term psychodynamic psychotherapy was effective and superior to shorter-term methods of psychotherapy for patients with complex mental disorders. In an editorial, Glass Article discusses challenges in the conduct of psychotherapy research and implications for the care of patients with complex mental disorders.

Ms E, a 60-year-old semiretired and active woman, had good cognitive health until 2005 when she experienced difficulty remembering conversations and encountered an increased need to rely on written reminders. Magnetic resonance imaging of the brain revealed white matter lesions. Ellison discusses the evaluation and treatment of mild cognitive impairment.

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“I really didn't think that I was immortal, but I thought I was close.” From “The Physician in Winter.”

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As companies market direct-to-consumer genome scans as a way for individuals to assess their future health risks, some are questioning the clinical value of these tests.

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Right to bear arms and public health

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Nosocomial infections and the Deficit Reduction Act

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Reductionism and complex systems

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Closed-chest cardiac massage

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JAMA's updated policy on release of information to the public.

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Join Ingrid Nygaard, MD, MS, October 15 from 2 to 3 PM eastern time to discuss symptomatic pelvic floor disorders in women. To register, go to http://www.ihi.org/AuthorintheRoom.

How would you manage an 82-year-old woman with hypertension and renal artery stenosis? Go to www.jama.com, read the case, and submit your response. Submission deadline is October 29.

For your patients: Information about mild cognitive impairment.

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