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This Week in JAMA
October 3, 2001

This Week in JAMA

JAMA. 2001;286(13):1545. doi:10.1001/jama.286.13.1545
Use of Antenatal Corticosteroids for Preterm Delivery

A single course of antenatal corticosteroids for women at risk for preterm delivery has been shown to reduce the incidence of neonatal complications associated with preterm birth. In clinical practice, however, repeated weekly courses of antenatal corticosteroids are often used despite the lack of evidence on the efficacy of this therapy and some indication that weekly administration is associated with adverse effects on infant growth and development. In this randomized trial, Guinn and colleaguesArticle found that weekly courses of antenatal corticosteroids for women at risk for preterm delivery did not reduce neonatal morbidity compared with a single course. In an editorial, LawsonArticle identifies important areas of future research on the antenatal use of corticosteroids.

Driver Licensing Systems and Teenage Crash Risk

Graduated driver licensing (GDL) systems, which have been adopted in many states in the United States, limit initial driving privileges for teenage drivers to low-risk conditions. Two studies in this issue—one by Foss and colleaguesArticle on the North Carolina GDL system and the other by Shope and colleaguesArticle on the Michigan system—found that motor vehicle crashes among 16-year-old drivers were substantially reduced after implementation of GDL systems. In an editorial, McCarttArticle considers which elements of GDL systems reduce the risk of motor vehicle crashes among teenage drivers.

Symptoms and Function in Patients With PAD

Intermittent claudication is considered a classic symptom of peripheral arterial disease (PAD). In this study of clinical characteristics and functional limitations associated with PAD, McDermott and colleagues found that leg symptoms other than intermittent claudication commonly occur in patients with PAD and are also associated with serious functional impairment.

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Codispensing of Cisapride and Contraindicated Drugs

Cisapride, an agent for the treatment of gastroesophageal reflux disease, was removed from the market because of serious cardiac arrhythmias and deaths associated with its use in combination with other drugs. Drug label changes and physician notification letters issued before removal of cisapride identified drugs that interact with cisapride and predispose to adverse reactions if coadministered. Jones and colleagues report that when a cisapride prescription overlapped with a contraindicated drug, 89% were dispensed in the same pharmacies, 50% were prescribed by the same physicians, and 17% were dispensed on the same days.

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The Rational Clinical Examination

How to assess whether a patient with knee complaints has a torn meniscus or ligament injury.

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Medical News & Perspectives

As deadlines draw near for implementation of the Health Insurance Portability and Accountability Act, experts consider how to comply with this federal legislation.

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Post-MI Depression: Grand Rounds at the Johns Hopkins Hospital

Ziegelstein discusses the case of a 56-year-old man with symptoms of depression after experiencing a first myocardial infarction (MI) and the possible association between post-MI depression and increased mortality risk.

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MSJAMA

Genetic information and disease prevention.

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JAMA Patient Page

For your patients: Information about teenage drivers and automobile safety.

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