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This Week in JAMA
July 12, 2006

This Week in JAMA

JAMA. 2006;296(2):141. doi:10.1001/jama.296.2.141
Energy Expenditure and Mortality Among Older Adults

Exercise is known to confer longevity benefits, but whether energy expenditure through any activity offers similar benefit is not known. Manini and colleaguesArticle measured total energy expenditure, resting metabolic rate, and thermic effect of food in 302 high-functioning community-dwelling older adults (ages 70-82 years at baseline). From these measures, they calculated free-living activity energy expenditure of each participant. During a mean 6 years of follow-up, the authors found that higher free-living activity energy expenditure was associated with lower mortality risk in the study participants. In an editorial, Blair and HaskellArticle discuss the contributions of physical activity and nonexercise activity thermogenesis to daily energy expenditure and the need for objective measurements of the amount and intensity of physical activity.

Tobacco Carcinogens and Lung Cancer in Women

Previously, the International Early Lung Cancer Action Program InvestigatorsArticle reported that women have a higher risk of lung cancer compared with men of similar age and smoking history. They now report results of a prospective, international study of asymptomatic volunteers who had computer tomographic screening for lung cancer. Results of this study confirmed that among asymptomatic smokers, women have a higher risk of lung cancer than men. The authors also found that compared with men of similar age and smoking history, women have a lower rate of lung cancer–related mortality. In an editorial, Neugut and JacobsonArticle discuss how sex might influence carcinogenesis and survival after a cancer diagnosis.

Mutations, Salpingo-oophorectomy, and Cancer

Questionnaire data collected by Finch and colleagues were used to assess the effect of prophylactic bilateral salpingo-oophorectomy on ovarian, fallopian tube, and primary peritoneal cancers in women with deleterious BRCA1 or BRCA2 mutations. After an average follow-up period of 3.5 years, there were 50 incident cancers, of which 32 were diagnosed in women with intact ovaries. The authors estimate that prophylactic salpingo-oophorectomy is associated with an approximate 80% reduction in peritoneal cancer risk.

Weight Change and Postmenopausal Breast Cancer

To test the hypothesis that adiposity is a modifiable risk factor for breast cancer, Eliassen and colleagues assessed the relationship of weight change since age 18 years and since menopause to postmenopausal breast cancer in a large prospective cohort of women. They found that weight gain in adulthood, particularly since menopause, is associated with an increased risk of postmenopausal breast cancer and that weight loss after menopause is associated with a decreased risk.

Bacterial Biofilms in Chronic Otitis Media

Bacterial biofilms have been implicated in several chronic bacterial infections. Hall-Stoodley and colleagues tested the hypothesis that chronic otitis media with effusion and recurrent otitis media may be biofilm-related diseases by examining middle-ear mucosa biopsy specimens from children having tympanostomy tube placement and uninfected control patients having cochlear implantation. The authors found mucosal biofilms of common middle-ear pathogens on 92% of the mucosa biopsy specimens from children with otitis media and none of the control biopsy specimens.

A Piece of My Mind

“‘Dad, do I have leukemia?’ This is a question I have not been trained to respond to during nearly 2 decades as a physician, nor during 16 years as a parent.” From “The CBC.”

Medical News & Perspectives

Results from phase 3 clinical trials of targeted therapies for metastatic renal cell carcinoma may prompt changes in the standard of care for this disease.


Genome-scale screening tests that are likely to yield unexpected findings or “incidentalomes” of unknown significance, may undermine the promise of genomic medicine.

Conflict of Interest

An update to JAMA's policy on authors' reports of conflicts of interest.

Author in the Room Teleconference

Join Victor Vogel, MD, on Wednesday, July 19, 2006, from 2 to 3 PM eastern time to discuss tamoxifen vs raloxifen and risk of breast cancer. To register, go to http://www.ihi.org/AuthorintheRoom.

Audio Commentary

Dr DeAngelis summarizes and comments on this week's issue. Go to http://jama.ama-assn.org/misc/audiocommentary.dtl.

JAMA Patient Page

For your patients: Information about fitness for older adults.