Silver and colleagues conducted a longitudinal study of acute responses
to the terrorist attacks against the United States on September 11, 2001,
using Web-based surveys of a national probability sample of adults residing
outside New York City 9 to 23 days (wave 1) and approximately 2 (wave 2) and
6 (wave 3) months after the attacks. Two months after the attacks, 17% of
the US population outside New York City reported symptoms of September 11–related
posttraumatic stress, and 5.8% reported posttraumatic stress symptoms 6 months
after the attacks. Coping strategies assessed shortly after the attacks in
wave 1 were the strongest predictors of posttraumatic stress symptoms over
Evidence evaluating conservative and surgical treatments for carpal
tunnel syndrome is limited. Gerritsen and colleagues conducted a randomized
controlled trial among patients with clinically and electrophysiologically
confirmed carpal tunnel syndrome to compare short-term and long-term efficacy
of wrist splinting and open carpal tunnel release surgery for relieving symptoms
of carpal tunnel syndrome. Outcomes after 1 month of treatment were generally
better in the splinting group than in the surgery group, but longer-term outcomes
at 3, 6, 12, and 18 months were better in the surgery group. In an editorial,
Wilgis discusses when to consider surgery for patients with carpal tunnel
Left ventricular systolic dysfunction (LVSD) and left ventricular (LV)
hypertrophy have been associated with elevations of plasma natriuretic peptides.
Prior research has suggested that measurement of plasma brain natriuretic
peptide (BNP) and the N-terminal component of proatrial natriuretic peptide
(NT-ANP) may be useful as a mass screening tool to detect asymptomatic LV
hypertrophy and LVSD in the general population. In this analysis of data from
the Framingham Heart Study, however, Vasan and colleagues found that performance
of both BNP and NT-ANP for detection of elevated LV mass and LVSD was only
fair in men, and poor in women. Overall, areas under the receiver operating
characteristic curves for elevated LV mass or LVSD were at or below 0.75 for
Many smokers in the United States attempt smoking cessation each year,
but the success rate per attempt is low. Pierce and Gilpin analyzed data from
the large population-based California Tobacco Surveys of 1992, 1996, and 1999
to examine trends in smoking cessation, use of pharmaceutical cessation aids,
and success in cessation in the general California population. Cessation attempts
among California smokers increased from 38.1% in 1992 to 61.5% in 1999. Use
of nicotine replacement therapy increased short-term cessation success in
moderate to heavy smokers in each survey year, but a long-term cessation advantage
was observed only before nicotine replacement therapy became widely available
over the counter in August 1996.
In this analysis of data from the 1994-1995 National Health Interview
Survey, Weil and colleagues found that obesity was more prevalent among adults
with disabling sensory, physical, and mental health conditions than among
adults without disabilities. Most adults with disabilities were as likely
to attempt weight loss and report exercise counseling as those without disabilities.
"I am humbled by the convincing demonstration that even in the unlikeliest
of places, where faith fuels it, there will be life." From "Beyond Hope?"
Efforts are under way to assess the health consequences of exposure
to airborne contaminants resulting from the destruction of the World Trade
Center. Innovations in accessing and using DNA evidence are helping forensic
scientists and genetics experts identify victims of the disaster.
Excerpts from an interview with Robert, a 14-year-old adolescent whose
mother died of breast cancer, illustrate the adaptive challenges posed by
the terminal phase of a parent's illness and death, and how health care professionals
can help parents support an adolescent through this process.
A cross-sectional survey indicates that women in the Herat Province
of Afghanistan have a high risk of mortality during pregnancy and childbirth.
Human rights factors identified during the survey may contribute to preventable
maternal deaths in that region.
For your patients: Information about carpal tunnel syndrome.
This Week in JAMA. JAMA. 2002;288(10):1197. doi:10.1001/jama.288.10.1197