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Cellular Telephones Not Associated With Brain Cancer
The health effects of exposure to the radiofrequency signals from handheld
cellular telephones are not known. Muscat and colleagues evaluated handheld
cellular telephone use among patients with primary brain cancer and matched
controls without brain cancer between 1994 and 1998. Risk of brain cancer
was not associated with monthly hours of cellular telephone use, number of
years of use, or lifetime cumulative hours of use.
Psychosocial Stress and Prognosis in Women With CHD
Psychosocial stress, particularly work stress, has been associated with
an increased incidence of coronary heart disease (CHD) in men, and with a
poorer prognosis. To assess whether stress is a determinant of cardiovascular
health in women, Orth-Gomér and colleagues followed up 292 women who
were hospitalized for acute myocardial infarction or unstable angina pectoris.
Among women who were married or cohabiting with a man, those who reported
severe marital stress at baseline had a 3-fold increased risk of recurrent
coronary events after a median follow-up of 4.8 years compared with women
without marital stress. Work stress, however, was not predictive of recurrent
Weight Change and Sleep-Disordered Breathing
Obesity is strongly correlated with sleep-disordered breathing, but
the association between change in weight and sleep-disordered breathing is
not known. In this prospective study, Peppard and colleagues evaluated 690
adults for sleep-disordered breathing at baseline and again 4 years later.
Change in the apnea-hypopnea index (AHI, apnea events + hypopnea events per
hour of sleep) was related in a dose-response fashion to change in weight.
A 10% weight gain predicted an approximate 32% increase in the AHI and was
associated with a 6-fold increase in the risk of developing moderate-to-severe
sleep-disordered breathing. A 10% weight loss predicted a 26% decrease in
Gender Disparities in Home Care Among Elderly
Using data from respondents in a national survey of noninstitutionalized
elderly people who reported any activity of daily living or instrumental activity
of daily living impairment, Katz and colleagues found that elderly women with
disabilities received fewer hours per week of informal home care than elderly
disabled men. Married disabled women received many fewer hours of informal
home care per week than married disabled men. Differences in the number of
hours per week of formal home care were small.
Survival After Colon Cancer Surgery
To determine whether hospital volume of colon cancer resections predicts
survival after colon cancer surgery, Schrag and colleagues analyzed Surveillance,
Epidemiology, and End Results (SEER)–Medicare data from patients who
had surgical resection for primary colon adenocarcinoma diagnosed between
1991 and 1996. Thirty-day postoperative mortality was 5.5% for patients treated
at low-volume hospitals and 3.5% for patients treated at high-volume hospitals,
a small but statistically significant difference. Overall survival and cancer-specific
survival were directly correlated with hospital procedure volume, but the
magnitude of these associations was also small.
Contraindicated Drug Use Continues After Warnings
In June 1998, the US Food and Drug Administration issued a press release
announcing contraindications added to the label of cisapride, a gastrointestinal
tract promotility agent, that could predispose to serious cardiac arrhythmias,
and the manufacturer issued warning letters to inform practitioners. Smalley
and colleaguesArticle found that contraindicated use of cisapride continued at almost
the same rate despite these actions. In a related commentary, WoosleyArticle considers
new ways to promote safe use of medications.
A Piece of My Mind
"How could someone awarded bachelor's, master's, and PhD degrees possibly
be so lost?" From "Lost by Degrees."
Declaration of Helsinki
The fifth revision of the Declaration of Helsinki on ethical principles
for medical research involving human subjects was adopted by the World Medical
Association in October 2000. Medical News & PerspectivesArticle reports reactions
of the research community to new provisions in the fifth revisionArticle, particularly
regarding constraints on the use of placebo in clinical trials. In a commentary,
RiisArticle provides an international perspective on the revision.
Hepatitis B Vaccine and Hepatocellular Cancer
In Taiwan, the incidence of childhood hepatocellular carcinoma decreased
among boys after initiation of a universal hepatitis B virus vaccination program,
but not among girls.
Communication Skills in End-of-Life Care
A 7-step approach for structuring communication about care at the end
of life with patients and their families.
JAMA Patient Page
For your patients: Information about colon cancer.
This Week in JAMA. JAMA. 2000;284(23):2971. doi:10.1001/jama.284.23.2971
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