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This Week in JAMA
January 2, 2002

This Week in JAMA

JAMA. 2002;287(1):9. doi:10.1001/jama.287.1.9
Hip Fracture Risk Associated With Vitamin A Intake

Chronic high-dose intake of vitamin A has been shown to have adverse effects on bone. In this analysis of data from postmenopausal women enrolled in the Nurses' Health Study, a prospective cohort study with 18 years of follow-up, Feskanich and colleaguesArticle found that the risk of hip fracture was significantly higher among women who had the highest total vitamin A intake compared with women with the lowest intake. This increased risk was attributable primarily to dietary retinol intake rather than to intake of beta carotene. In an editorial, DenkeArticle reviews the sources and functions of dietary vitamin A and discusses new recommendations for vitamin A intake.

Acupuncture for Treatment of Cocaine Addiction

Auricular acupuncture is one of the most widely used treatments for cocaine addiction. In this randomized trial, however, Margolin and colleagues found that reduction in cocaine use, as measured by urine screening, and retention in treatment were not significantly different among patients with cocaine addiction who received auricular acupuncture compared with those who received a needle-insertion control treatment condition or a no-needle relaxation control treatment condition.

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Acetaminophen vs NSAIDs for Osteoarthritis Treatment

Current guidelines recommend acetaminophen as first-line therapy for treatment of osteoarthritis rather than nonsteroidal anti-inflammatory drugs (NSAIDs) because of concerns about adverse effects associated with NSAIDs and the absence of evidence of their superior efficacy compared with simple analgesics. In this randomized trial, Geba and colleagues compared the efficacy of acetaminophen 4000 mg/d, celecoxib 200 mg/d, and rofecoxib 12.5 or 25 mg/d for the relief of symptoms of osteoarthritis of the knee. In general, patients who received rofecoxib 25 mg/d experienced more improvement in symptoms of pain and stiffness after both 6 days and 6 weeks of treatment and were more likely to report a good or excellent global assessment of response to therapy compared with the other treatment groups.

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Issues in Biomedical Research

In this issue of THE JOURNAL, 3 articles address critical questions related to the conduct of biomedical research. Gelijns and ThierArticle examine the dynamics of medical innovation and the relationship between university and industry research. Morin and colleaguesArticle discuss differences between the roles of clinical practitioners and research scientists and potential conflicts of interest when a physician is caring for patients who are eligible to participate in research in which the physician is an investigator. Kalb and KoehlerArticle review legal issues in 3 areas of scientific research—the process of seeking reimbursement for research costs, the process of performing clinical research, and the potential improper remuneration of researchers or research subjects.

Medical News & Perspectives

Although basic research has suggested mechanisms by which estrogen contributes to brain functioning, clinical studies have produced conflicting results. Many questions about estrogen's effects on cognition remain unresolved, and answers are being sought through ongoing laboratory and clinical studies.

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The Rational Clinical Examination

A review of the accuracy of history, physical examination, and erythrocyte sedimentation rate for the diagnosis of temporal arteritis.

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Clinician's Corner

Beginning in this issue, the weekly Clinician's Corner will feature articles that provide up-to-date, practical clinical information directly relevant to patient care.

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Health care resources and delivery in rural United States.

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JAMA Patient Page

For your patients: Information about cocaine addiction.

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