In a previously published trial among patients with unstable angina
and non–ST-segment elevation myocardial infarction (UA/NSTEMI), early
invasive treatment was associated with a significantly reduced risk of death,
nonfatal myocardial infarction, or rehospitalization compared with conservative
treatment. Morrow and colleaguesArticle, in this secondary analysis, found that the
benefit of early invasive treatment was significantly increased among patients
with elevated cardiac troponin levels compared with patients with negative
troponin test results. In an editorial, Quinn and MoliternoArticle discuss problems
with currently available troponin assays, including lack of standardization
and poor precision, and suggest that results of these assays be applied with
caution in the clinical setting.
Formula feeding in developing countries has been associated with increased
mortality risk from diarrheal disease and malnutrition. The possible benefit
of formula feeding by women infected with HIV in resource-poor settings, however,
was suggested by a previously published trial comparing breastfeeding and
formula feeding by women infected with HIV in Nairobi, Kenya, in which formula
feeding was associated with a decreased risk of maternal-to-infant HIV transmission
and no increase in mortality risk. In further analyses of 2-year outcomes
in this trial, Mbori-Ngacha and colleaguesArticle found no significant difference
in 2-year mortality rates and no difference in the incidence of diarrhea,
pneumonia, or other illnesses. Nutritional status was better among breastfed
infants. In an editorial, Guay and RuffArticle discuss the limited generalizability
of the results of this trial and identify factors that complicate public health
policy on infant feeding by HIV-positive women in resource-poor settings.
In cross-sectional studies, long or highly irregular menstrual cycles
have been associated with insulin resistance and glucose intolerance. Solomon
and colleagues, in this analysis of data from women enrolled in the prospective
Nurses' Health Study II, found that the risk of developing type 2 diabetes
mellitus was significantly higher among women with cycle lengths of 40 days
or more at baseline (age 18 to 22 years) compared with women with a usual
cycle length of 26 to 31 days.
Among nursing home residents, lower respiratory tract infections (LRIs)
are a leading cause of mortality and hospitalization. Mehr and colleagues
conducted a prospective study of lower respiratory tract illness episodes
among residents of 36 nursing homes and report on the development and validation
of a new risk-prediction model to identify nursing home residents at relatively
low risk of mortality due to LRI.
Oculopharyngeal muscular dystrophy (OPMD) is a rare late-onset hereditary
myopathy caused by polyalanine triplet repeat expansion in the gene for poly(A)
binding protein 2. The 2 largest OPMD populations are of French descendants
in Quebec and Bukara Jews in Israel. Becher and colleagues identified an OPMD
population of 216 Hispanic New Mexicans from 39 different kindreds over a
4-generation period and describe the clinical, genetic, and demographic features
of this OPMD population.
"It may seem bizarre to look at a life-threatening disease as an opportunity
for growth and learning, but it is almost inevitable that growth and learning
will occur." From "Live and Learn."
Difficulty in providing medical care, food, and shelter to the displaced,
impoverished population in Afghanistan is leaving aid workers frustrated and
A review of studies on the expression of Fhit protein in malignant or
premalignant lesions and preclinical studies of FHIT
Case presentation and discussion of Pneumocystis carinii pneumonia, including recent advances in diagnosis, treatment, and
A new JAMA feature presenting commentaries on selected articles from
the Archives Journals begins with a discussion of
2 major clinical trials evaluating the effect of nutritional supplementation
on age-related eye disease.
For your patients: Information about selecting a nursing home.
This Week in JAMA. JAMA. 2001;286(19):2363. doi:10.1001/jama.286.19.2363