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This Week in JAMA
September 23/30, 1998

This Week in JAMA

JAMA. 1998;280(12):1033. doi:10.1001/jama.280.12.1033

Using positron emission tomography, Grubb and colleaguesArticle evaluated the cerebral hemodynamics of patients with internal carotid artery occlusion and a history of transient ischemic neurologic symptoms or ischemic stroke. A significantly higher incidence of subsequent stroke was observed in patients with increased cerebral oxygen extraction distal to the occlusion than in patients with normal cerebral oxygen extraction. In an editorial, AdamsArticle suggests that patients with carotid artery occlusion and highly compromised cerebral hemodynamics be considered for a new trial of extracranial-intracranial bypass surgery.

McKenzie and coworkersArticle conducted a 12-week trial of daily low-dose hydrocortisone vs placebo in 70 patients with chronic fatigue syndrome (CFS). The treatment group had slight improvements in symptoms measured by one of several self-rating scales compared with the placebo group, but hydrocortisone treatment was significantly associated with biochemical evidence of adrenal suppression. In an editorial, StreetenArticle considers factors that may mediate fatigue in CFS.