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This Week in JAMA
November 21, 2001

This Week in JAMA

JAMA. 2001;286(19):2363. doi:10.1001/jama.286.19.2363
Troponin Levels and Treatment Outcome in UA/NSTEMI

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.

Infant Feeding and Maternal-Infant HIV Transmission

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.

Oligomenorrhea and Risk of Type 2 Diabetes Mellitus

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.

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Mortality Risk From LRIs in Nursing Home Residents

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.

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Oculopharyngeal Muscular Dystrophy in New Mexico

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.

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A Piece of My Mind

"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."

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Medical News & Perspectives

Difficulty in providing medical care, food, and shelter to the displaced, impoverished population in Afghanistan is leaving aid workers frustrated and Afghans distressed.

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Potential Gene Therapy for Cancer

A review of studies on the expression of Fhit protein in malignant or premalignant lesions and preclinical studies of FHIT gene therapy.

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Case presentation and discussion of Pneumocystis carinii pneumonia, including recent advances in diagnosis, treatment, and prevention.

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From the Archives Journals

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.

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JAMA Patient Page

For your patients: Information about selecting a nursing home.

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