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This Week in JAMA
November 18, 1998

This Week in JAMA

JAMA. 1998;280(19):1643. doi:10.1001/jama.280.19.1643
Improving the Course of Chronic Depression

In an 18-month randomized controlled trial, Keller and colleagues studied the efficacy and safety of maintenance therapy with sertraline for patients with chronic depression at high risk of recurrence who had responded to initial sertraline treatment. Sertraline was well tolerated and the recurrence rate of depressive symptoms was significantly less in patients treated with sertraline than in those who received placebo.

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Cigarette Smoking Increases Among College Students

Between 1993 and 1997, the prevalence of current cigarette smoking among college students increased 28% according to a nationwide survey at 116 colleges. Wechsler and colleagues report that current smoking increased in both public and private colleges and among all student demographic groups and that more than one fourth of current smokers in the 1997 survey began smoking regularly while in college.

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Tuberculosis Control Beyond DOT

The incidence of tuberculosis has declined sharply in Baltimore since the introduction of directly observed therapy (DOT) programs in 1981. Still, according to the intensive epidemiologic investigation by Bishai and colleaguesArticle recent transmission of tuberculosis accounts for about one third of incident cases and appears to occur in low socioeconomic populations in specific geographic locations. In a related editorial, BarnesArticle discusses measures needed to reduce the ongoing transmission of tuberculosis.

Toward a Better Meningococcal C Vaccine

MacDonald and coworkers report that toddlers immunized with conjugated meningococcal C vaccine had significantly higher antibody titers after each of 2 primary vaccine doses and 12 months later than those immunized with plain polysaccharide vaccine. Toddlers immunized with polysaccharide vaccine had a poorer antibody response to a booster polysaccharide vaccine 1 year after the primary series compared with toddlers immunized with conjugated vaccine and compared with toddlers who had not received any prior meningococcal vaccine.

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Advances and Issues in Heart Transplantation

Hunt reviews the progress in cardiac allotransplantation and reports that recipient survival has been stable since immunosuppressive therapy with cyclosporine came into use in the 1980s. Major hurdles in heart transplantation remain, including limited donor supply, the development of graft coronary arteriopathy, and achieving optimal immunosuppression.

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Testing for HIV at Home

Based on postmarketing data from almost 175,000 home sample collection (HSC) tests for HIV during the first year of test availability, Branson found that individuals who used HSC tests were at high risk of HIV infection and almost 60% of test users had not had prior HIV testing. Most of the HIV-positive individuals who used the test either already had a source of medical care or accepted a medical referral at the time of telephone follow-up.

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The Cover

Theodor Rombouts, The Backgammon Players, Flemish, 1634.

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Medical News & Perspectives

US military physicians take care of troops and attempt to aid local populations under difficult conditions in the former Yugoslavia.

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Contempo 1998

Parkinson disease—improving diagnostic accuracy for early treatment and better outcomes.

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A Piece of My Mind

"The dean's world is bizarre but escape is possible." From "Tales of the Unnatural: Return From the Dean(d)."

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The Patient-Physician Relationship

The influence of health care payment mechanisms on patient trust and physician behavior.

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Call for Papers: New Technologies

More than 80 biomedical journals are planning to participate in a Global Theme Issue on new technologies in medicine scheduled for November 1999.

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JAMA Patient Page

For your patients: A primer on tuberculosis.

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