Standard treatment of chronic neuropathy often fails to provide
adequate pain relief and may be associated with intolerable adverse
effects, especially in elderly patients. Backonja and colleaguesArticle
conducted a multicenter trial of gabapentin, an anticonvulsant, for the
treatment of painful diabetic neuropathy and Rowbotham and colleaguesArticle
conducted a similar trial for the treatment of postherpetic neuralgia.
In both studies, the researchers found that patients treated with
gabapentin had significant improvement in measures of pain
severity, sleep interference, and quality of life compared with those
who received placebo. Adverse effects associated with gabapentin
therapy included somnolence and dizziness. In a related editorial, Low
and DotsonArticle conclude that gabapentin may be the drug of first choice for
the treatment of postherpetic neuralgia and for some patients with
painful diabetic neuropathy.
Abdominal obesity has been associated with an increased risk of
coronary heart disease (CHD), but whether this risk is independent of
total obesity has been controversial. Using data from more than
40,000 women prospectively followed up for 8 years in the
Nurses' Health Study, Rexrode and colleagues found that increased
abdominal adiposity measured by waist-hip ratio and waist circumference
was associated with a significantly increased risk of nonfatal
myocardial infarction and death from CHD in both obese and nonobese
According to population-based data, the incidence of preterm births has
been increasing, but this trend has been unexplained. Kramer and
colleagues analyzed data from all 65,574 nonreferred births at a
tertiary care hospital in Canada between 1978 and 1996. They found that
the increased incidence of preterm births at this hospital was largely
explained by increases in the rates of preterm induction of labor and
preterm cesarean delivery without labor for complications of pregnancy
and was also in part an artifact of the increased use of early
ultrasound to estimate gestational age.
In a review of 166 studies published between 1985 and 1997 on the
sexual abuse of boys, Holmes and SlapArticle found that estimates of the
prevalence of sexual abuse of boys ranged from 4% to 76%, depending
on the study population sampled and the definition of sexual abuse, and
that the methodologic quality of the studies was generally poor. In a
related editorial, FinkelhorArticle outlines a research agenda for child
sexual abuse that would inform public policy by emphasizing accurate
surveillance and evaluation of treatment interventions.
An interview with pediatrician Selma Deitch, MD, MPH, who "for much
of the latter half of this century has devoted her training, her
energies, and her personality to improving the health of children."
Charles Burchfield, The Mysterious Bird, 1917, American.
With World AIDS Day near, Mark Wainberg, PhD, president of the
International AIDS Society, discusses the spread of HIV in the
Preventing osteoporosis in postmenopausal women.
"The last known house call still surviving in captivity
languishes in a managed care arena near Chattanooga." From "Medical
Practices Disappearing in the South."
Original research, reviews, and commentaries are invited for the
JAMA theme issue on health promotion and obesity research
scheduled for the fall of 1999.
See editorial Article
Increasing medical student indebtedness is influencing students'
choice of specialty and career path.
See MS/JAMA section.
For your patients: Preventing and managing sexual abuse of children.
This Week in JAMA. JAMA. 1998;280(21):1809. doi:10.1001/jama.280.21.1809