Sugar-sweetened beverages are a leading source of added dietary sugars,
and their consumption has been associated with obesity in children. Whether
sugar-sweetened drinks contribute to weight gain and type 2 diabetes in adults
is not known. Schulze and colleaguesArticleused dietary data
collected in a large prospective study to assess the association between consumption
of sugar-sweetened beverages and weight change and risk of type 2 diabetes
in women. During 8 years of follow-up, the authors found that higher consumption
of sugar-sweetened beverages was associated with greater weight gain and risk
of type 2 diabetes. In an editorial, ApovianArticlediscusses
the contribution of sugared drinks to the obesity epidemic and related health
Prior studies suggest that many patients with depression fail to receive
effective levels of pharmacotherapy or psychotherapy, and alternative models
of care deserve study. In a randomized trial of primary care patients with
depression, Simon and colleagues investigated the effects of usual care plus
a telephone care management program—with or without telephone psychotherapy—compared
with usual care alone on depression severity and patient-rated improvement
and satisfaction with treatment. They found that patients who received telephone
care management with telephone psychotherapy had signficantly greater improvement
in depression severity scores and that patients receiving either telephone
program reported significant improvement in their symptoms and greater satisfaction
with their treatment than patients receiving usual care alone.
Recent identification of mutations in the genes encoding succinate dehydrogenase
subunits D (SDHD) and B (SDHB)
distinguish paraganglioma syndromes type 1 (PGL-1) and 4 (PGL-4). Neumann
and colleagues performed genetic screening and neck, thoracic, and abdomen
imaging in patients with pheochromocytomas or head and neck paragangliomas
to determine differences in clinical features in carriers of the 2-gene mutation.
They found that head and neck paragangliomas and multifocal tumors occurred
more frequently in carriers of SDHD mutations (PGL-1)
than in carriers of SDHB mutations and that individuals
with SDHB mutations (PGL-4) had a higher frequency
of malignant disease than carriers of SDHD mutations.
Many Medicare beneficiaries experience temporary gaps in drug benefits
when they exceed annual dollar limits or caps. Tseng and colleagues surveyed
Medicare + Choice beneficiaries to determine the strategies they adopt if
they exceed annual drug benefits. They found that persons who exceeded their
drug benefit cap were more likely to use less of their prescribed and essential
medications, to call multiple pharmacies for the best price, to switch medications,
and to use samples compared with patients who did not exceed their drug benefit
Family caregivers of patients with dementia report high levels of psychiatric
and physical symptoms, but whether these symptoms abate after institutionalization
of the patient is not known. Schulz and colleagues collected data on caregiver
well-being before and after placement of a relative with dementia in long-term
care facilities. They found that symptoms of depression and anxiety did not
diminish after institutional placement, that use of anxiolytic medications
increased, and that nearly half the caregivers were at risk for clinical depression
following placement of their relative in long-term care facilities.
"During my training and subsequent practice in a community hospital,
I confirmed the value of being prepared and having a backup plan." From "The
Researchers are using neuroimaging and genetic studies to explore the
biological underpinnings of Tourette syndrome.
Attendance at Head Start significantly increased when primary care clinics
mailed a physician referral packet to the Head Start program.
Therapeutic potential of promoting and interrupting angiogenesis.
For your patients: Information about weight gain and diabetes.
This Week in JAMA . JAMA. 2004;292(8):895. doi:10.1001/jama.292.8.895