Moderate lifestyle physical activity may provide long-term health
benefits comparable with those of vigorous structured exercise. Dunn
and colleaguesArticle found that after 6 months, sedentary adults randomly
assigned to a traditional exercise program had greater improvements in
cardiorespiratory fitness than subjects in a lifestyle physical
activity program. However, the subsequent decline in fitness in the 2
groups was greater in the traditional exercise group, and at 24 months,
fitness was similar in both groups. Andersen and colleaguesArticle report that
weight loss and improvement in fitness at 1 year were similar in obese
women treated with a low-fat diet and structured aerobic exercise and
those treated with diet plus moderate lifestyle activity. In an
editorial, PrattArticle comments that many physical activity options that
would benefit health are available to patients.
To evaluate the role of genetic factors in Parkinson disease, Tanner
and colleaguesArticle screened more than 19,000 twins aged 65 years and
older enrolled in a US twin registry. Overall, pairwise concordance for
Parkinson disease was low in both monozygotic and dizygotic twin pairs,
suggesting that genetic factors do not play an important role in the
etiology of Parkinson disease. However, pairwise concordance was
observed in all 4 monozygotic twin pairs and in only 2 of 12 dizygotic
twin pairs with Parkinson disease diagnosed before age 51 years. In an
editorial, CummingsArticle suggests that future research should focus on
environmental triggers for typical Parkinson disease and on genetic
factors for early-onset Parkinson disease.
ThinPrep, AutoPap, and Papnet are new technologies that increase the
sensitivity of the Papanicolaou (Pap) test for cervical cancer, but at
an increased cost. Brown and Garber estimated the cost-effectiveness of
these technologies in a hypothetical screening program with varying
screening frequency. They found that these 3 new technologies are not
cost-effective when added to annual conventional Pap testing, but are
more cost-effective when added to less frequent screening.
Health-related quality of life is reduced in survivors of acute
respiratory distress syndrome (ARDS), but the specific influences of
ARDS on quality-of-life outcomes, distinct from those of other aspects
of critical illnesses, are not known. Davidson and coworkers found that
quality-of-life outcomes were significantly worse in survivors of ARDS
with a diagnosis of sepsis or trauma than in severity- and diagnosis-matched controls without ARDS. Hospitalization was longer in
survivors of ARDS than in matched controls; however, among survivors of
ARDS, length of mechanical ventilation and of hospitalization were not
associated with differences in most quality-of-life outcomes.
Ms V reports that since menarche she has had serious, recurrent
symptoms of depression, anxiety, and irritability associated with her
menstrual cycle, consistent with a diagnosis of premenstrual dysphoric
disorder (PMDD). Parry discusses therapeutic options for PMDD and
points out that failure to treat PMDD may increase the severity and
frequency of PMDD episodes, the risk of treatment resistance, and the
risk of other mood disorders.
Glaucomatous damage leads to a loss of neural tissue in the optic
nerve and enlargement of the optic cup. Advances in the
understanding of the pathogenesis of glaucoma may change the approach
New assays test whether a strain of HIV is resistant to anti-HIV drugs.
Economic factors limit access to effective medications and vaccines
in developing countries, compromising the health of populations
Direct-to-consumer advertising of prescription drugs: informingArticle or
For your patients: Health benefits of physical activity.
This Week in JAMA. JAMA. 1999;281(4):301. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-4-jtw80037