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In an 18-month randomized controlled trial, Keller and colleagues studied
the efficacy and safety of maintenance therapy with sertraline for patients
with chronic depression at high risk of recurrence who had responded to initial
sertraline treatment. Sertraline was well tolerated and the recurrence rate
of depressive symptoms was significantly less in patients treated with sertraline
than in those who received placebo.
Between 1993 and 1997, the prevalence of current cigarette smoking among
college students increased 28% according to a nationwide survey at 116 colleges.
Wechsler and colleagues report that current smoking increased in both public
and private colleges and among all student demographic groups and that more
than one fourth of current smokers in the 1997 survey began smoking regularly
while in college.
The incidence of tuberculosis has declined sharply in Baltimore since
the introduction of directly observed therapy (DOT) programs in 1981. Still,
according to the intensive epidemiologic investigation by Bishai and colleaguesArticle
recent transmission of tuberculosis accounts for about one third of incident
cases and appears to occur in low socioeconomic populations in specific geographic
locations. In a related editorial, BarnesArticle discusses measures needed to reduce
the ongoing transmission of tuberculosis.
MacDonald and coworkers report that toddlers immunized with conjugated
meningococcal C vaccine had significantly higher antibody titers after each
of 2 primary vaccine doses and 12 months later than those immunized with plain
polysaccharide vaccine. Toddlers immunized with polysaccharide vaccine had
a poorer antibody response to a booster polysaccharide vaccine 1 year after
the primary series compared with toddlers immunized with conjugated vaccine
and compared with toddlers who had not received any prior meningococcal vaccine.
Hunt reviews the progress in cardiac allotransplantation and reports
that recipient survival has been stable since immunosuppressive therapy with
cyclosporine came into use in the 1980s. Major hurdles in heart transplantation
remain, including limited donor supply, the development of graft coronary
arteriopathy, and achieving optimal immunosuppression.
Based on postmarketing data from almost 175,000 home sample collection
(HSC) tests for HIV during the first year of test availability, Branson found
that individuals who used HSC tests were at high risk of HIV infection and
almost 60% of test users had not had prior HIV testing. Most of the HIV-positive
individuals who used the test either already had a source of medical care
or accepted a medical referral at the time of telephone follow-up.
Theodor Rombouts, The Backgammon Players, Flemish,
US military physicians take care of troops and attempt to aid local
populations under difficult conditions in the former Yugoslavia.
Parkinson disease—improving diagnostic accuracy for early treatment
and better outcomes.
"The dean's world is bizarre but escape is possible." From "Tales of
the Unnatural: Return From the Dean(d)."
The influence of health care payment mechanisms on patient trust and
See Article and editorial Article
More than 80 biomedical journals are planning to participate in a Global
Theme Issue on new technologies in medicine scheduled for November 1999.
For your patients: A primer on tuberculosis.
This Week in JAMA. JAMA. 1998;280(19):1643. doi:10.1001/jama.280.19.1643