Infants placed on their back to sleep are at decreased risk of sudden
infant death syndrome (SIDS). In a nationally representative survey, Dr Willinger
and colleaguesArticle found that the prevalence of prone infant sleep position declined
from 70% in 1992 to 24% in 1996. However, Dr Lesko and colleaguesArticle report that
prone infant sleep position increased from 18% to 29% between 1 month and
3 months of age. In a study of low-income, inner-city mothers, Dr Brenner
and colleaguesArticle found that 40% of infants aged 3 to 7 months were placed for
sleep in the prone position. As Dr MalloyArticle discusses in an accompanying editorial,
public health messages generally have been successful, but should now focus
on low-income mothers of black or Hispanic racial/ethnic background.
Although radioiodine (131I) is an effective treatment for
hyperthyroidism, whether the radiation involved increases the risk of cancer
remains undefined. In this long-term cohort study, Dr Ron and colleaguesArticle found
a slight elevation in risk of thyroid cancer; the absolute risk was very low
and underlying thyroid disease appeared to contribute to the risk. As Dr CooperArticle explains in a related editorial, 131I remains a safe first-line
treatment for hyperthyroidism.
Black and Mexican American women have higher rates of obesity, diabetes,
and hypertension than do white women. Dr Winkleby and colleagues evaluated
the independent relationships of ethnicity and socioeconomic status, as measured
by education and poverty income ratio, along with the traditional risk factors
of blood pressure, cigarette smoking, body mass index, physical inactivity,
non–insulin-dependent diabetes, and cholesterol level. The rates of
cardiovascular risk factors differed by socioeconomic status, but these factors
did not explain all the differences among racial and ethnic groups.
Serologic testing for anti–Helicobacter pylori antibodies is less invasive for patients than endoscopy, although
its usefulness in assessing cure is unknown. Dr Feldman and colleagues find
that all 15 patients they studied who were cured of H pylori infection (as assessed by gastric mucosal biopsy) had undetectable
antibody titers at 18 months, whereas the 8 patients who were not cured had
Determining when the risk of abdominal aortic aneurysm rupture exceeds
the risk from the patient's other medical conditions is a vexing clinical
issue. In this Clinical Crossroads, Dr Goldman discusses the approach to assessing
Mrs H's risk of aneurysmal rupture, her potential risk from elective surgery,
and her risk of death and major morbidity from her severe emphysema.
Vincent van Gogh, Vineyards at Auvers, 1890,
Older people with chronic pain are best treated with a combination of
pharmacologic therapy and nonpharmacologic strategies such as education, cognitive-behavioral
therapy, and exercise, according to new clinical practice guidelines from
the American Geriatrics Society.
"If there is no greater joy than watching the birth of your first child,
then there is no greater sadness than watching your child delivered, knowing
she is already dead." From "A Visit From My Daughter."
Early diagnosis and prompt treatment of giant cell arteritis may prevent
the onset or alter the progression of visual loss. Immunologic research is
clarifying the pathogenesis, but more clinical data on the effectiveness of
treatment are needed.
For your patients: Information about sudden infant death syndrome (SIDS).
This Week in JAMA. JAMA. 1998;280(4):309. doi:10.1001/jama.280.4.309