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This Week in JAMA
January 7, 2009

This Week in JAMA

JAMA. 2009;301(1):9. doi:10.1001/jama.2008.952

Some studies have suggested that antioxidant supplements may prevent cancer or reduce cancer mortality; however, the data are not definitive. The results of 2 large clinical trials that assessed the effects of antioxidant supplementation on cancer in men are reported in this issue. In the first article, Lippman and colleagues Article report results from the Selenium and Vitamin E Cancer Prevention Trial, in which men aged 50 years or older were randomly assigned to 4 treatments: selenium, vitamin E, selenium plus vitamin E, or placebo. After a median follow-up of 5.46 years (range, 4.17-7.33 years), the investigators found that selenium or vitamin E, alone or in combination, did not prevent prostate cancer. In the second article, which is based on an analysis of data from the Physicians' Health Study II, Gaziano and colleagues Article report that compared with placebo, neither vitamin E nor vitamin C supplementation reduced the risk of prostate or total cancer during a mean follow-up of 8.0 years. In an editorial, Gann Article discusses lessons learned in clinical trials of nutritional prevention of prostate cancer.

Deep brain stimulation is an accepted treatment for advanced Parkinson disease. However, whether deep brain stimulation is more effective than optimal medical management is not clear. To address this question, Weaver and colleagues Article randomly assigned 255 patients with advanced Parkinson disease to receive either deep brain stimulation or best medical therapy. At a 6-month assessment, the investigators found that deep brain stimulation was more effective than best medical therapy in improving “on” time (good motor control with unimpeded motor function), motor function, and quality of life but was associated with an increased risk of serious adverse events. In an editorial, Deuschl Article discusses the pathology of Parkinson disease and the treatment of advanced disease with deep brain stimulation.

In the first in a series of 3 Users’ Guides to the Medical Literature on genetic association studies, Attia and colleagues use the APOE polymorphism and its association with dementia to review the terminology and key concepts in genetics that are essential to reading and understanding this literature. The evaluation of study validity and applicability in genetic association studies will be the focus of the second and third articles, which will be published in the next 2 issues of JAMA.

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Ms P is a 41-year-old woman with recurrent uterine fibroids, menorrhagia, anemia, and fatigue. She had a myomectomy via laparotomy in her 30s. Ms P would like to avoid another surgical procedure and retain her fertility. Van Voorhis discusses the treatment of uterine fibroids.

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“Comfort with uncertainty is essential to all competent care—and particularly to the daily demands of primary care.” From “Drama in Medicine?”

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Scientists have demonstrated that a new primary prevention strategy may reduce cardiovascular events in certain patients at risk of cardiovascular disease.

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Americans with Disabilities Act: shattered aspirations and new hope

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The other medical home

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Roentgenologic examination of the gallbladder

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Join David J. A. Jenkins, MD, PhD, January 21 from 2 to 3 PM eastern time to discuss low–glycemic index or high–cereal fiber diets and type 2 diabetes. To register, go to http://www.ihi.org/AuthorintheRoom.

How would you manage smoking cessation treatment in a 51-year-old woman with a history of bipolar disorder and tobacco use for more than 35 years? Go to www.jama.com to read the case and submit your response, which may be selected for online publication. Submission deadline is January 28.

For your patients: Information about uterine fibroids.

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