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This Week in JAMA
January 19, 2000

This Week in JAMA

JAMA. 2000;283(3):297. doi:10.1001/jama.283.3.297
Natural Measles Infection and Risk of Atopic Disease

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.

Elevations of Creatine Kinase–MB and Mortality Risk

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.

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Outcomes of Radical Prostatectomy for Prostate Cancer

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.

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Smoking Trends Among Pregnant Women, 1987-1996

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.

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Reversal of Methadone-Induced Constipation

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 placebo group.

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A Piece of My Mind

"When good news is delivered with bad news, the good news is often submerged beneath the bad." From "A Fragile Commodity."

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From the

Genetic sequencing and phylogenetic analyses suggest that the Pan troglodytes troglodytes chimpanzee may be the primary reservoir for human immunodeficiency virus type 1.

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Medical News & Perspectives

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.

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Physicians and the Pharmaceutical Industry

A reviewArticle of studies on the frequency and influence of interactions between physicians and the pharmaceutical and health care technology industry.Article

Anti-HIV Therapy Update

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.

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Pregnancy Outcomes Among Refugees

Poor pregnancy outcomes among Burundian women in a refugee camp in Tanzania document risks to reproductive health in refugee settings.

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JAMA Patient Page

For your patients: A primer on allergies.

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