Routine use of intraoperative cholangiography to identify the common
bile duct during cholecystectomy and prevent common bile duct injury is controversial.
In this nationwide cohort analysis of data from Medicare patients undergoing
cholecystectomy, Flum and colleaguesArticlefound that
the rate of common bile duct injury was significantly higher when intraoperative
cholangiography was not performed. In an editorial, TalaminiArticledescribes
the ongoing debate about routine vs selective use of intraoperative cholangiography
In the Multicenter Study of Hydroxyurea in Sickle Cell Anemia (MSH),
a placebo-controlled trial among adults with moderate to severe sickle cell
anemia, the rate of vaso-occlusive events over 2.5 years was significantly
reduced among patients who received hydroxyurea. In this follow-up study of
up to 9 years of observation, in which MSH participants could continue, start,
or stop treatment with hydroxyurea, Steinberg and colleaguesArticlefound
that mortality was reduced 40% during 3-month intervals when patients were
taking hydroxyurea. In an editorial, Weiner and BrugnaraArticleencourage
expanded use of hydroxyurea for patients with sickle cell disease.
Drug-drug interactions are a potentially preventable cause of adverse
drug events. In this series of 3 population-based case-control studies, Juurlink
and colleagues found that elderly patients treated with glyburide, digoxin,
or an angiotensin-converting enzyme inhibitor who were admitted to the hospital
for drug-related toxicity were significantly more likely to have used an interacting
drug in the week prior to admission than were matched control patients.
Dietary fiber consumption has been associated with reduced risk of cardiovascular
disease (CVD) in predominantly middle-aged populations. Mozaffarian and colleagues
analyzed data from adults aged 65 years or older enrolled in the Cardiovascular
Health Study to determine whether consumption of fiber from fruit, vegetables,
and cereals is associated with CVD risk in elderly persons, a population in
which atherosclerosis is more advanced. Higher cereal fiber intake was associated
with a lower risk of incident CVD, but not fruit or vegetable fiber intake.
Exposure to the neurotoxin methylmercury, which is especially toxic
to the developing human fetus, occurs primarily through consumption of fish
and shellfish. Schober and colleagues analyzed 1999-2000 data from the National
Health and Nutrition Examination Survey, a cross-sectional survey of the noninstitutionalized
US population, to describe the distribution of blood mercury levels in young
children and women of childbearing age and evaluate the association between
blood mercury levels and fish consumption. Blood mercury levels in women aged
16 to 49 years and children aged 1 to 5 years were generally below the recommended
reference dose and were 3 times higher in women than in young children. Blood
mercury levels were strongly associated with self-reported fish consumption
in the past 30 days in both children and women, and among women, increased
with the number of fish meals consumed.
Lactation mastitis: diagnosis, epidemiology, and treatment.
What are the possible health effects of weapons containing "depleted"
uranium? More than a decade after the battlefield debut of such weapons, consensus
on this issue remains elusive.
Results of this preliminary study suggest that levels of nitrotyrosine—a
marker specific for protein modification by nitric oxide–derived oxidants—are
associated with coronary artery disease (CAD) and are modulated by statin
A review of muscle complaints associated with statin use and discussion
of possible mechanisms of statin-induced muscle injury.
Legal, psychological, and visual dimensions of the maternal-fetal relationship.
For your patients: Information about mastitis.
This Week in JAMA. JAMA. 2003;289(13):1599. doi:10.1001/jama.289.13.1599