Left ventricular hypertrophy (LVH) is associated with increased blood
pressure, and prior studies have documented regression of LVH in patients
receiving antihypertensive therapy. However, whether reduction in LVH is associated
with improved cardiac outcomes is not clear. Results from the Losartan Intervention
For Endpoint Reduction in Hypertension (LIFE) study, which randomized patients
with hypertension and LVH to losartan- or atenolol-based treatment regimens,
address this question and are reported in 2 articles ArticleArticle in this issue of JAMA. After a mean follow-up of 4.8 years, the LIFE investigators found
that hypertension treatment-related reductions in LVH, assessed by electrocardiogram
and echocardiogram, were correlated with reductions in cardiovascular morbidity
and mortality. In an editorial,Article Gardin and Lauer
discuss the importance of evaluating for LVH at the time of hypertension diagnosis
and in considering changes in left ventricular mass when adjusting long-term
Infections are common complications in the care of extremely low-birth-weight
(ELBW) neonates. Whether early childhood neurodevelopment and growth are compromised
by these infections is not known. Stoll and colleaguesArticle analyzed
data from a national registry of very low-birth-weight infants to assess neurodevelopmental
and growth outcomes in early childhood in relation to neonatal infection.
They found that ELBW infants with a history of neonatal infection were more
likely to have adverse neurodevelopmental outcomes and impaired head growth
compared with those not infected. In an editorial,Article Msall
discusses the challenges of preventing adverse neurodevelopmental outcomes
in ELBW infants.
Prior studies document an increase in influenza and pneumococcal vaccination
rates with computerized reminder systems. Potential benefits from a computerized
standing order system have not been evaluated. Dexter and colleagues conducted
a randomized trial that enrolled hospital inpatients eligible to receive influenza
and/or pneumococcal vaccine. The authors compared vaccination rates for patients
with computerized standing orders—directing a nurse to administer the
vaccine at time of discharge—with those for patients whose physicians
received computerized vaccination reminders during routine order entry. They
found that patients with a standing order were significantly more likely to
receive the needed vaccine than were patients with a physician reminder.
Exposure to ozone has been associated with a number of adverse health
effects, but the relationship of ozone exposure to mortality is inconclusive.
Bell and colleagues used national air quality and mortality data of 95 large
urban areas from 1987 through 2000 to investigate whether daily and weekly
exposure to ambient ozone is associated with mortality. In analyses adjusted
for particulate matter, weather, seasonality, and long-term trends, they found
that a 10-ppb increase in daily ozone levels for the previous week was associated
with a 0.52% increase in daily mortality or an estimated 3767 additional deaths
annually for the 95 communities studied.
A federal task force is recommending that all states screen newborns
for 29 treatable inherited disorders that can be detected through blood analysis.
Patients with hypoxemic acute respiratory failure (ARF) placed in the
prone position had improved oxygenation and less ventilator-associated pneumonia
but similar mortality outcomes as patients in the supine position.
Clinical ReviewPharmacological and nonpharmacological
interventions that benefit patients with fibromyalgia syndrome.
For your patients: Information about left ventricular hypertrophy.
This Week in JAMA . JAMA. 2004;292(19):2311. doi:10.1001/jama.292.19.2311