Despite the known health benefits of physical activity, how to best
counsel patients to increase physical activity is uncertain. In this randomized
trial that enrolled sedentary patients from 11 primary care facilities, the
Activity Counseling Trial Research GroupArticle compared the effectiveness of 3 physical
activity counseling interventions of varying intensity—a high-intensity
counseling intervention, an intermediate-intensity assistance intervention,
and an advice comparison intervention. After 24 months, there were no significant
overall differences in self-reported physical activity among the 3 groups.
Improvements in cardiorespiratory fitness among women in the counseling and
assistance groups were significantly greater than in the advice comparison
group, but there were no significant differences in cardiorespiratory fitness
among men. In an editorial, WeeArticle stresses the magnitude of the health risk
associated with sedentary lifestyle and low physical fitness and discusses
strategies that may improve adherence to physical activity recommendations.
Invasive meningococcal disease has increased among young adults during
the past decade. Bruce and colleaguesArticle conducted a prospective surveillance
study among US college students from September 1, 1998, to August 31, 1999,
to determine rates of and risk factors for meningococcal disease in this population.
The overall incidence rate for undergraduates was 0.7 per 100 000 persons,
lower than the rate of 1.4 per 100 000 in the general population of 18-
to 23-year-old nonstudents. However, the incidence rate was highest among
freshmen living in dormitories (5.1 per 100 000), and the risk of meningococcal
disease was significantly higher among freshmen living in dormitories compared
with other college students. In a population-based surveillance study from
January 1, 1990, through December 31, 1999, in Maryland, Harrison and colleaguesArticle
found that the incidence and proportion of cases of meningococcal infection
among persons aged 15 through 24 years initially increased and then markedly
decreased in 1998-1999. In an editorial, WengerArticle discusses immunization strategies
as a way to control meningococcal disease.
The choice of insertion site for central venous catheterization can
influence the frequency and type of associated complications. In this randomized
controlled trial among intensive care unit patients, Merrer and colleagues
found that catheterization of the femoral vein was associated with a significantly
higher risk of overall complications compared with catheterization of the
subclavian vein. The rates of mechanical complications did not differ between
the 2 sites, but the rates of infectious and thrombotic complications were
significantly higher for femoral venous catheterization.
More than one third of patients with myocardial infarction in the United
States are elderly persons, and more than 40% are women, but historically
these patient groups have been underenrolled in published cardiovascular clinical
trials relative to younger persons and men. In this review of randomized controlled
trials among patients with acute coronary syndromes published from January
1996 to March 2000, Lee and colleagues found that although enrollment of persons
aged 75 years or older and of women has increased, the proportion of elderly
persons and women enrolled in these trials remains well below their proportion
in the affected population.
"How can we be gentle on our patients if we are not gentle on ourselves?
How can we care for our patients if we do not care
for ourselves, if we do not care for one another?"
From "A Golden Rule: Remember the Gift."
A review of the epidemiology and clinical features of infections caused
by West Nile virus and strategies for prevention.
At the first conference to which both Chinese and US health care leaders
brought their unique perspectives on national health care, they shared experiences
to learn from each other and help find solutions to surprisingly similar problems.
Case presentation and discussion of a woman with mild macrocytic anemia,
leukopenia, and chronic fatigue.
For your patients: Information about beginning a physical activity program.
This Week in JAMA. JAMA. 2001;286(6):639. doi:10.1001/jama.286.6.639