Unlike results of previously published studies suggesting that natural
measles infection is associated with a reduced risk of atopic disease, Paunio
and colleaguesArticle report that the prevalence of eczema, allergic rhinitis, and
asthma in a cohort of 547,910 individuals aged 14 months to 19 years in Finland
was significantly higher among children who had had natural measles infection
compared with those who had not. Information about history of natural measles
infection and atopic diseases was collected by report at the time of measles-mumps-rubella
vaccination. In an editorial, Gern and WeissArticle discuss the theoretical relationship
between childhood infections, early development of the immune system, and
subsequent risk of atopic disease.
Using data from the Platelet Glycoprotein IIb/IIIa in Unstable Angina:
Receptor Suppression Using Integrilin Therapy (PURSUIT) trial, Alexander and
colleagues found that in patients with acute coronary syndromes without ST-segment
elevation, peak levels of the myocardium-specific creatine-kinase isoenzyme
(CK-MB) during hospitalization were predictive of 30-day and 6-month mortality.
Thirty-day and 6-month mortality rates associated with normal peak CK-MB levels
were 1.8% and 4.0%; for peak CK-MB levels 1 to 2 times normal, 3.3% and 6.2%;
for levels 3 to 5 times normal, 5.1% and 7.5%; and for peak CK-MB levels greater
than 10 times normal, 8.3% and 11%. Thirty-day mortality risk increased in
a stepwise fashion with increasing peak CK-MB level.
Information on outcomes of different therapies for clinically localized
prostate cancer is necessary for informed treatment choices, but population-based
data are limited. In this longitudinal study of 1291 men from 6 geographic
regions with clinically localized prostate cancer treated with radical prostatectomy,
Stanford and colleagues found that 8.4% of men were incontinent and 59.9%
were impotent at 18 months or more following surgery. Among men who were potent
before surgery, impotence at 18 months was less frequent among those who had
nerve-sparing surgery (56.0% to 58.6%) compared with non–nerve-sparing
surgery (65.6%). Rates of erectile dysfunction and urinary incontinence after
radical prostatectomy varied by age and sexual function also varied by race.
In this analysis of data from the Behavioral Risk Factor Surveillance
System from 33 US states collected between 1987 and 1996, Ebrahim and colleagues
found that smoking initiation rates among women aged 18 to 44 years decreased
from 44.1% to 38.2%. The prevalence of current smoking decreased among both
pregnant and nonpregnant women and was generally twice as high among nonpregnant
women compared with pregnant women. The percentage of pregnant women who had
quit smoking was similar in 1987 and 1996. The decline in prevalence of current
smoking over time among pregnant women was primarily due to decreased smoking
initiation rather than to increased smoking cessation related to pregnancy.
Constipation is a common adverse effect of long-term opioid administration.
Yuan and colleagues report that all patients with methadone-induced constipation
who were randomly assigned to receive methylnaltrexone, a peripheral opioid
receptor antagonist, had a laxation response after intravenous methylnaltrexone
administration whereas none of the patients who received placebo had a laxation
response. Average decrease in oral-cecal transit time was significantly greater
among patients who received methylnaltrexone compared with patients in the
"When good news is delivered with bad news, the good news is often submerged
beneath the bad." From "A Fragile Commodity."
Genetic sequencing and phylogenetic analyses suggest that the Pan troglodytes troglodytes chimpanzee may be the primary
reservoir for human immunodeficiency virus type 1.
A favorable early study of a new drug for chronic myelogenous leukemia
underscores the promise of tailoring therapy to the molecular abnormality
responsible for a disease.
A reviewArticle of studies on the frequency and influence of interactions between
physicians and the pharmaceutical and health care technology industry.Article
New recommendations for antiretroviral therapy for adults infected with
the human immunodeficiency virus type 1 (HIV-1) from an expert panel convened
by the International AIDS Society–USA.
Poor pregnancy outcomes among Burundian women in a refugee camp in Tanzania
document risks to reproductive health in refugee settings.
For your patients: A primer on allergies.
This Week in JAMA. JAMA. 2000;283(3):297. doi:10.1001/jama.283.3.297