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This Week in JAMA
October 21, 2009

This Week in JAMA

JAMA. 2009;302(15):1621. doi:10.1001/jama.2009.1509

Some evidence has suggested that antidepressant efficacy is increased when augmented with an omega-3 fatty acid supplement. In a randomized placebo-controlled trial involving patients with depression and coronary heart disease (CHD), Carney and colleagues assessed whether augmentation with 2 g/d of omega-3 improves the response to sertraline. At a 10-week assessment, the authors found no evidence that sertraline plus omega-3 is superior to sertraline plus placebo capsule for the treatment of depression in patients with established CHD.

Aldosterone antagonists are recommended for patients with moderate to severe heart failure. In an analysis of data from patients with heart failure admitted to hospitals participating in a heart failure quality improvement program, Albert and colleagues examined the use of aldosterone antagonists. The authors report that less than one-third of eligible patients received aldosterone antagonist therapy.

Cardiovascular disease (CVD) and osteoporosis may have common etiologies. In a cohort study of 31 936 Swedish twins, Sennerby and colleagues found that the risk of hip fracture was significantly increased following a CVD diagnosis. The authors report that twins without heart failure or stroke had an increased risk of hip fracture after their co-twins were diagnosed with these diseases, which may suggest a genetic predisposition to the development of CVD and fractures.

Staiger and colleagues Article assessed current and future physician workforce estimates in 2 parallel retrospective cohort analyses of annual data (1978-2008) from the American Medical Association Physician Masterfile and the US Census Bureau Current Population Survey (CPS). The authors found that compared with estimates based on Masterfile data, CPS-based projections suggest more young physicians in the workforce and fewer older physicians remaining in active practice, resulting in a smaller and younger physician workforce now and in the future. In an editorial, Ricketts Article discusses the importance of accurate physician workforce estimates for public policy and health care reform.

Genetic disease transmission to offspring conceived with donated sperm has received scant attention by the medical community and regulatory agencies. Maron and colleagues Article report the case of an asymptomatic sperm donor who was found to carry a mutation that causes hypertrophic cardiomyopathy. Nine offspring with the mutation have been identified, 3 of whom have evidence of hypertrophic cardiomyopathy. In an editorial, Daar and Brzyski Article discuss ethical and policy implications of genetic screening of sperm and oocyte donors.

Esserman and colleagues review the effects of population-based screening for breast cancer and prostate cancer on the diagnosis of early and regional-stage cancers and cancer mortality and recommend new approaches for early detection and prevention of these diseases.

‘“[H]ow do you feel about the fact that Grandma may tell the doctors to do something you don't want?’” From “Can We Agree to Disagree?”

Homeopathic remedies may be sold over-the-counter alongside nonprescription drugs but are not held to the same regulatory standards, leaving questions about their safety.

Chew discusses the results of 2 clinical trials that assessed the safety and efficacy of intravitreal triamcinolone treatment of retinal vein occlusion.

Sex-related differences in colon carcinogenesis

Event rate variation in type 2 diabetes trials

Join Michael S. Krasner, MD, November 18, 2009, from 2 to 3 PM eastern time to discuss the association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. To register, go to http://www.ihi.org/AuthorintheRoom.

How would you care for a 66-year-old man with an abdominal aortic aneurysm? Go to www.jama.com to read the case, and submit your response, which may be selected for online publication. Submission deadline is November 8.

For your patients: Information about hypertrophic cardiomyopathy.