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This Week in JAMA
January 23/30, 2002

This Week in JAMA

JAMA. 2002;287(4):411. doi:10.1001/jama.287.4.411

Daytime Sleepiness in Parkinson Disease

Somnolence is a known adverse effect of antiparkinson medications, and 2 new dopamine agonists have been reported to cause episodes of sudden-onset sleep in patients with Parkinson disease while they were driving. In this prospective survey of patients with Parkinson disease without dementia, however, Hobson and colleaguesArticle found that excessive daytime sleepiness, although frequent, was not associated with any particular antiparkinson medication. Only 3 of the 420 drivers among the study participants reported sudden onset of sleep without warning while driving. In an editorial, ComellaArticle considers several factors in addition to medication use that might contribute to excessive daytime sleepiness in patients with Parkinson disease.

Changing Epidemiology of Rubella

To evaluate the current epidemiology of rubella and congenital rubella syndrome in the United States, Reef and colleaguesArticle analyzed reported rubella cases from 1990 through 1999 and performed molecular typing of virus isolates. The incidence of rubella and congenital rubella syndrome decreased during the 1990s. Characteristics of rubella cases shifted—the proportion of cases among adults increased, fewer cases were reported among women than among men, and most cases occurred among persons of Hispanic ethnicity, most of whom were born outside the United States. Molecular typing identified 3 statistically distinct genotypic groups, all of which were involved in clusters and outbreaks. In a commentary, Abramson and PickeringArticle discuss the achievements of the US childhood immunization program and consider challenges to its continued success.

Data Withholding in Academic Genetics

Sharing of published scientific information and resources is essential to the advancement of scientific research and education, but instances of data withholding have been reported. Campbell and colleagues conducted a national survey of geneticists and other life scientists in US universities. While only 12% of geneticists reported denying requests from other researchers for information, data, and materials related to published research, almost 50% of geneticists who had made a request reported that at least 1 of their requests had been denied. Other life scientists reported similar experiences, but were less likely to report that data withholding had a negative impact on their own research or in their field of research.

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Chelation Therapy for Ischemic Heart Disease

Chelation therapy with EDTA is a commonly used alternative therapy for the treatment of ischemic heart disease, but its efficacy has not been demonstrated. In this randomized, placebo-controlled trial among patients with stable ischemic heart disease, Knudtson and colleagues found that changes in exercise time to ischemia, functional reserve for exercise, and quality of life from baseline to 27-week follow-up were not significantly different in the chelation therapy group compared with the placebo group.

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Clinician's corner

Mrs G, a 70-year-old woman who moved to the United States from Vietnam 7 years ago, is currently receiving care for hypertension and diabetes, as well as preventive care, from a Vietnamese American primary care physician. McPhee discusses cultural issues that influence health care, medical problems with higher risk in Vietnamese patients, and approaches to care that address the special needs of Vietnamese patients.

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A Piece of My Mind

"Each morning we say good-bye to our children, fully expecting that, come evening, they will be safe at home. And so it was for Eric and his parents." From "The Knapsack."

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Contempo Updates

A review of the major mycotoxins that affect human health.

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Medical News & Perspectives

Sports medicine specialists caution players and coaches that even so-called "mild" concussions can lead to long-term problems—and they want the National Football League to set a better example in dealing with such injuries.

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Hospitalist Movement

A review of studies evaluating hospitalist programs and discussion of issues facing the growing hospitalist movement.

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War-Related Sexual Violence

A cross-sectional survey of internally displaced women in Sierra Leone conducted in 2001 indicates that sexual violence committed by combatants in Sierra Leone was widespread and occurred in the context of other human rights abuses against the civilian population.

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JAMA Patient Page

For your patients: Information about rubella.

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