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This Week in JAMA
February 17, 2010

This Week in JAMA

JAMA. 2010;303(7):587. doi:10.1001/jama.2010.148

Van Cleave and colleagues Article analyzed data from 3 nationally representative cohorts of children who were aged 2 through 8 years at the beginning of each study period (1988, 1994, and 2000) and were followed up for 6 years to assess changes in the prevalence of chronic health conditions among children and youth—specifically, obesity, asthma, other physical conditions, and behavior or learning difficulties—that limited activities or schooling or that required medicine, special equipment, or specialized health services. The authors found that the prevalence of chronic conditions increased in each successive cohort of children and that the presence of these conditions was dynamic over time, with substantial variation in persistence. In an editorial, Halfon and Newacheck Article discuss the changing epidemiology of child health and childhood chronic disease.

Multiple genetic markers associated with cardiovascular disease (CVD) have been identified, but their contribution to cardiovascular risk assessment is uncertain—particularly among women. In a comprehensive review of genome-wide association study results, Paynter and colleagues identified 101 single-nucleotide polymorphisms associated with CVD or an intermediate phenotype and incorporated these in a CVD genetic risk score. The authors assessed the predictive ability of the genetic risk score in a prospective cohort of 19 313 white women who were healthy at study enrollment and had a median follow-up of 12.3 years. In analyses adjusted for traditional cardiovascular risk factors, the authors found that the genetic risk score did not improve CVD risk prediction.

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King Tutankhamun, perhaps the most famous of the Egyptian pharaohs, died in the ninth year of his reign (circa 1324 BC), at the age of 19. To explore kinship, putative familial diseases, and causes of death in Tutankhamun's immediate lineage, Hawass and colleagues Article performed detailed radiological, genetic, and anthropological studies on 11 mummies suspected of being kindred of King Tutankhamun and 5 mummies dating to an earlier period. The genetic data allowed construction of a 5-generation kindred of Tutankhamun's immediate lineage. The authors also report DNA evidence of malaria tropica infection and radiological evidence of bony abnormalities of the feet that may have contributed to Tutankhamun's death. In an editorial, Markel Article discusses the use of medical science to elucidate human history.

In a systematic literature review and meta-analysis, Palomaki and colleagues assessed the strength of the association between chromosome 9p21 single-nucleotide polymorphisms (SNPs) and heart disease and examined the potential clinical utility of testing for these genetic markers. The authors report a statistically significant—but small magnitude—association between 9p21 SNPs and heart disease that varied by age at disease onset.

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“These have been years in which my brain's comfort with the humanities has suffered the consequences of my heart's desire to become a healer.” From “Lonely.”

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Radiologists and nonradiologists may disagree about who is best suited to perform diagnostic and interventional imaging, but evidence-based studies to resolve this dispute are lacking.

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An article in the February Archives of Ophthalmology describes development of a rat model of age-related macular degeneration. Campochiaro discusses using animal models to investigate the pathogenesis and treatment of complex, multigenic diseases.

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Individual-level data from genome-wide aggregate results

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Skiers, snowboarders, and safety helmets

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Aligning rewards with population-based improvement

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Join Frank Davidoff, MD, Wednesday, March 17, from 2 to 3 PM eastern time to discuss how insights from health care improvement initiatives can reduce the ambivalence about heterogeneity in determining efficacy of treatment. To register, go to http://www.ihi.org/AuthorintheRoom.

For your patients: Information about chronic diseases of childhood.

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