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This Week in JAMA
August 12, 2009

This Week in JAMA

JAMA. 2009;302(6):599. doi:10.1001/jama.2009.1175

Consumption of a Mediterranean-type diet may be associated with a reduced risk of Alzheimer disease (AD), and new data on this relationship are reported in 2 articles in this issue. Scarmeas and colleagues Article investigated the association of diet and exercise with incident AD in a prospective cohort study of community-dwelling elderly persons and found that both higher adherence to a Mediterranean-type diet and increased physical activity were independently associated with a reduced risk of incident AD. In a prospective cohort study, Féart and colleagues Article examined the relationship between consumption of a Mediterranean diet and change in cognitive performance and risk of incident dementia. At a 5-year follow-up, the authors found that greater adherence to a Mediterranean diet was associated with higher Mini-Mental State Examination scores but not associated with other measures of cognitive function or risk of incident dementia. In an editorial, Knopman Article discusses the contributions of diet and other lifestyle choices to late-life cognitive function.

Aspirin use is associated with a reduced risk of colorectal cancer; however, the relationship between aspirin use and survival after colorectal cancer is not known. In a prospective cohort study that included 1279 men and women who were diagnosed with nonmetastatic colorectal cancer and followed up for a median 11.8 years, Chan and colleagues Article found that initiation of regular aspirin use after diagnosis was associated with a significantly lower risk of colorectal cancer–specific and overall mortality, particularly among patients whose tumors overexpress cyclooxygenase 2 (COX-2) on immunohistochemical assessment. In an editorial, Neugut Article discusses aspirin as an adjuvant therapy for colorectal cancer.

Decreased rates of perinatal mortality in industrialized countries have been reported during the last 2 decades, with much of the reduction attributed to improvements in the management of infants delivered preterm. In an assessment of trends in delivery-related perinatal deaths among singleton term infants with cephalic presentation in Scotland, Pasupathy and colleagues found that the incidence of intrapartum stillbirth and neonatal death decreased 38% (95% confidence interval, −51% to −21%) between 1988 and 2007. The authors report a significant decline in deaths ascribed to intrapartum anoxia but no significant change in deaths ascribed to other causes.

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Ms W is a 62-year-old woman who underwent surgery to remove a squamous cell carcinoma from her face. When she removed the bandage, Ms W discovered that the surgery had been performed on an area to the right of the lesion, which she believes resulted from incorrect marking of the skin before surgery. Ms W had a second surgical procedure to remove the lesion. Gallagher discusses communicating with patients about medical errors, institutional responsibilities for error disclosure, and the relationship between disclosure and quality improvement.

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“It is well known that physicians are reluctant patients, and my experience certainly bears that out.” From “A Paucity of Physicians.”

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A new study links the use of stimulant medications with increased risk of sudden unexplained death, a very rare adverse event, in children and adolescents without a history of heart problems.

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Understanding influenza backward

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Tobacco control's unfinished business

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Interventions for chronic health problems

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Join John Forman, MD, MSc, Wednesday, August 19, from 2 to 3 PM eastern time to discuss diet and lifestyle risk factors and incident hypertension in women. Register at http://www.ihi.org/AuthorintheRoom. Send questions toreplies@jama-archives.org.

How would you manage a 52-year-old woman with morbid obesity? Go to www.jama.com to read the case, and submit your response, which may be selected for online publication. Submission deadline is September 6.

For your patients: Information about dementia.

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