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This Week in JAMA
December 10, 2003

This Week in JAMA

JAMA. 2003;290(22):2907. doi:10.1001/jama.290.22.2907
Inflammation and Hypertension Risk

Investigators have hypothesized that inflammation may have a role in the development of hypertension. Sesso and colleaguesArticle report results of a prospective cohort study of women whose blood pressure was in the normal range at enrollment and who had no history of hypertension or antihypertensive therapy. Levels of C-reactive protein were measured at baseline and served as a marker of systemic inflammation. After an average of 7.8 years of follow-up, women whose baseline C-reactive protein levels were elevated had a higher likelihood of a new diagnosis of hypertension. In an editorial, GrundyArticle discusses the relationship of inflammation to hypertension and the potential pathologic processes that could contribute to the observed association.

Combined T

Some patients with hypothyroidism who receive thyroxine (T4) replacement continue to report hypothyroid symptoms. Clyde and colleaguesArticle report results of a randomized trial comparing T4 therapy alone with therapy with a reduced dose of T4 and the addition of liothyronine, the biologically active form of thyroid hormone, triiodothyronine (T3). Both treatment regimens resulted in normal serum thyrotropin levels. There were no significant differences in body weight, blood pressure, or serum lipid levels between the 2 groups or compared with baseline. Both groups reported improved quality of life, but neither treatment regimen demonstrated superiority. In an editorial, CooperArticle discusses the ongoing challenge of providing thyroid replacement that mimics normal physiology.

Colon Polyps and Advanced Colon Cancer Risk Factors

Identification of risk factors for colon polyps and advanced colon cancer in asymptomatic individuals could facilitate identification of individuals at highest risk. Lieberman and colleagues conducted a prospective, cross-sectional study to assess the association of heredity and a number of lifestyle variables on disease risk among patients who had undergone colonoscopy. Colon cancer in a first-degree relative and current cigarette and alcohol use were positively associated with advanced colon cancer, but higher cereal fiber and vitamin D intake and daily use of nonsteroidal anti-inflammatory drugs were not. Only current or past smoking distinguished participants with hyperplastic polyps from those without.

Infant Pertussis

The incidence of reported cases of pertussis has increased since the 1980s, but it is unclear whether this is a result of an increase in disease or improved recognition or surveillance. Tanaka and colleagues reviewed data from 2 US databases to describe characteristics and incidence of infant pertussis between 1980 and 1999. They report an increase in incidence in the 1990s, particularly among infants younger than 4 months, and little change in disease severity or the number of cases requiring hospitalization compared with cases reported in the 1980s.


Methicillin-resistant Staphylococcus aureus (MRSA) infections are no longer limited to patients with a history of hospitalization or long-term care residence. Little is known about potential molecular differences between community-associated and health care–associated infections. Naimi and colleagues report demographic and clinical features and isolate microbiological and molecular characteristics from patients diagnosed with MRSA infections. Patients with community-associated MRSA infections were significantly younger and more likely to have skin and soft tissue infections and less likely to have respiratory and urinary tract infections than patients with health care–associated infections. Isolates from the 2 types of MRSA infection could be distinguished by their unique antibiotic sensitivities and molecular characteristics.

Medical News & Perspectives

Tensions between health authorities on both sides of the US-Canadian border are mounting as consumers in the United States increasingly turn to Canadian pharmacies for low-cost prescription medications.

Benefits of Noninvasive Ventilation

Reductions in ICU morality and nosocomial infections were documented in critically ill patients with acute exacerbations of COPD and pulmonary edema.

Physician Shortages

Cooper and colleagues surveyed medical school deans and medical society executives regarding their perceptions of physician shortage and the effect of these on medical education.

Clinician's corner

Effects and prevention of fetal alcohol spectrum disorder.

JAMA Patient Page

For your patients: Information about hypothyroidism.