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This Week in JAMA
January 5, 2005

This Week in JAMA

JAMA. 2005;293(1):7. doi:10.1001/jama.293.1.7
Popular Diets, Weight Loss, and Cardiac Risk

Popular diets promise weight loss and disease risk reduction, but data to support their efficacy and health effects are limited. Dansinger and colleaguesArticle assessed adherence and 1-year changes in baseline weight and cardiac risk factors in overweight and obese patients who were randomly assigned to 1 of 4 diets (Atkins, Zone, Weight Watchers, and Ornish), with varying nutrient composition. Adherence to the assigned diets was low. Modest weight change from baseline was associated with diet adherence, not diet type, and participants adhering to their assigned diet achieved comparable, modest improvements in several cardiac risk factors. In an editorial,Article Eckel discusses the challenges of helping patients achieve and sustain a lower weight.

Pregnancies, STIs, and Emergency Contraception

Emergency contraception (EC) can reduce the number of unintended pregnancies, but there are concerns that easy availability will reduce regular contraceptive use or increase sexually transmitted infections (STIs). Raine and colleaguesArticle conducted a randomized trial to evaluate the effect of direct access to EC through pharmacies and advance provision vs clinic access on use of EC, pregnancy rate, and new STIs. They found that women in the advance provision group were almost twice as likely to use EC as women in the clinic access group. Pharmacy access did not increase use relative to clinic access. Rates of unprotected intercourse, pregnancy, and new STIs were similar across the groups. In an editorial,Article Litt discusses the importance of these findings to stimulate new initiatives for improving access to EC.

Retinopathy and Risk of Congestive Heart Failure

Microvascular disease has been suggested as a factor in the development of congestive heart failure (CHF). To investigate this possible association, Wong and colleagues examined the relationship of retinopathy to risk of incident CHF in a population-based cohort of middle-aged men and women who were followed up for 7 years. The authors found that retinopathy at baseline was an independent predictor of CHF, with a significantly elevated risk even in persons without preexisting coronary heart disease, diabetes, or hypertension.

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Quality of Life in Overweight and Obese Children

Previous studies have documented lower health-related quality of life (QOL) in selected samples of overweight and obese children, but population-based data are lacking. Williams and colleagues assessed health-related QOL in a representative sample of Australian children, 9 to 12 years of age. They found that health-related QOL declined with increasing weight, particularly in measures of physical and social functioning. Measures of emotional and school function did not differ significantly across weight categories.

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Urinary Placental Growth Factor and Preeclampsia Risk

Prior research by Levine and colleagues suggested that low serum levels of placental growth factor (PlGF) antedate the clinical signs of preeclampsia. In an extension of this work, they hypothesized that urinary levels of PlGF would be similarly reduced and would predict women who developed preeclampsia. They determined urinary PlGF levels in women who developed preeclampsia vs those who did not. The authors found that PlGF levels were significantly lower beginning at 25 to 28 weeks of gestation in women who developed preeclampsia compared with women who did not, particularly in women with early onset of preeclampsia or small-for-gestational-age infants.

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A Piece of My Mind

“Mrs Smyth . . . made it very clear to me that if she ever stopped breathing, she wanted no ‘so-called resuscitation.’” From “The Octogenarian’s Plan.”

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Medical News & Perspectives

The use of 3-dimensional ultrasound for the purpose of creating “keepsake” fetal images for parents rather than for medical purposes is generating a debate about the appropriateness of the practice.

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Magnesium and Colorectal Cancer Risk

In a prospective study of women, magnesium intake was inversely associated with colorectal cancer risk.

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Contempo Updates
Erythropoietin appears to have neuronal and vascular cytoprotective effects.

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JAMA Patient Page

For your patients: Information about retinopathy.

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