Chronic high-dose intake of vitamin A has been shown to have adverse
effects on bone. In this analysis of data from postmenopausal women enrolled
in the Nurses' Health Study, a prospective cohort study with 18 years of follow-up,
Feskanich and colleaguesArticle found that the risk of hip fracture was significantly
higher among women who had the highest total vitamin A intake compared with
women with the lowest intake. This increased risk was attributable primarily
to dietary retinol intake rather than to intake of beta carotene. In an editorial,
DenkeArticle reviews the sources and functions of dietary vitamin A and discusses
new recommendations for vitamin A intake.
Auricular acupuncture is one of the most widely used treatments for
cocaine addiction. In this randomized trial, however, Margolin and colleagues
found that reduction in cocaine use, as measured by urine screening, and retention
in treatment were not significantly different among patients with cocaine
addiction who received auricular acupuncture compared with those who received
a needle-insertion control treatment condition or a no-needle relaxation control
Current guidelines recommend acetaminophen as first-line therapy for
treatment of osteoarthritis rather than nonsteroidal anti-inflammatory drugs
(NSAIDs) because of concerns about adverse effects associated with NSAIDs
and the absence of evidence of their superior efficacy compared with simple
analgesics. In this randomized trial, Geba and colleagues compared the efficacy
of acetaminophen 4000 mg/d, celecoxib 200 mg/d, and rofecoxib 12.5 or 25 mg/d
for the relief of symptoms of osteoarthritis of the knee. In general, patients
who received rofecoxib 25 mg/d experienced more improvement in symptoms of
pain and stiffness after both 6 days and 6 weeks of treatment and were more
likely to report a good or excellent global assessment of response to therapy
compared with the other treatment groups.
In this issue of THE JOURNAL, 3 articles address critical questions
related to the conduct of biomedical research. Gelijns and ThierArticle examine the
dynamics of medical innovation and the relationship between university and
industry research. Morin and colleaguesArticle discuss differences between the roles
of clinical practitioners and research scientists and potential conflicts
of interest when a physician is caring for patients who are eligible to participate
in research in which the physician is an investigator. Kalb and KoehlerArticle review
legal issues in 3 areas of scientific research—the process of seeking
reimbursement for research costs, the process of performing clinical research,
and the potential improper remuneration of researchers or research subjects.
Although basic research has suggested mechanisms by which estrogen contributes
to brain functioning, clinical studies have produced conflicting results.
Many questions about estrogen's effects on cognition remain unresolved, and
answers are being sought through ongoing laboratory and clinical studies.
A review of the accuracy of history, physical examination, and erythrocyte
sedimentation rate for the diagnosis of temporal arteritis.
Beginning in this issue, the weekly Clinician's Corner will feature
articles that provide up-to-date, practical clinical information directly
relevant to patient care.
Health care resources and delivery in rural United States.
For your patients: Information about cocaine addiction.
This Week in JAMA. JAMA. 2002;287(1):9. doi:10.1001/jama.287.1.9