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This Week in JAMA
August 14, 2002

This Week in JAMA

JAMA. 2002;288(6):671. doi:10.1001/jama.288.6.671

Sertraline for MDD After Acute Coronary Syndromes

Major depressive disorder (MDD) is a risk factor for mortality after acute myocardial infarction (MI), but only a minority of patients with depression after an MI receive antidepressant treatment. In contrast to the cardiotoxic effects of older antidepressants, Glassman and colleaguesArticle, for the Sertraline Antidepressant Heart Attack Randomized Trial (SADHART) group, found that cardiovascular safety outcomes among patients with MDD after hospitalization for acute MI or unstable angina were not significantly different in the sertraline and placebo groups. In an editorial, Carney and JaffeArticle discuss important directions for future trials of treatment of depression following acute coronary syndromes.

Parental Notification and Use of Teen Sexual Health Care

Legislation has recently been introduced in 10 states and the US Congress that would prohibit prescribed contraceptives for adolescents without parental involvement. To determine the effect of mandatory parental notification for precribed contraceptives on the use of sexual health services by adolescent girls, Reddy and colleaguesArticle surveyed girls younger than 18 years seeking services at Planned Parenthood family planning clinics in Wisconsin. More than half of those surveyed indicated that they would stop using all sexual health care services, delay testing or treatment for HIV or other sexually transmitted diseases, or discontinue use of specific sexual health services if their parents were informed that they were seeking prescribed contraceptives. In an editorial, Ford and EnglishArticle discuss risks of limiting confidentiality of adolescent health services.

Diet Supplements and Respiratory Infections in Elderly

Graat and colleagues conducted a randomized controlled trial to evaluate the effect of long-term daily multivitamin-mineral and vitamin E supplementation on the incidence and severity of acute respiratory tract infection in elderly individuals. The incidence of acute respiratory tract infection in the multivitamin-mineral, multivitamin-mineral and vitamin E, and vitamin E alone supplementation groups did not differ significantly from the incidence in the placebo group. Severity of illness was worse in vitamin E vs no vitamin E groups.

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Hand-Cleansing Protocols and Surgical Site Infections

Surgical site infections are among the leading nosocomial causes of morbidity and a source of excess medical costs. In this randomized crossover trial, Parienti and colleagues compared 30-day surgical site infection rates using 2 hand-cleansing protocols for hand antisepsis before surgery—a hand-rubbing cleansing protocol using an aqueous alcoholic solution and a traditional hand-scrubbing protocol with an antiseptic preparation. Hand-rubbing was as effective as hand-scrubbing in preventing surgical site infections. Compliance with recommended duration of hand antisepsis was better and skin dryness and irritation were less with the hand-rubbing protocol than with the hand-scrubbing protocol.

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Cognitive Outcomes, Behaviors of Children Born Preterm

Estimates of the effect of preterm birth on cognitive and behavioral outcomes at school age are extremely variable. In this meta-analysis of case-control studies of children born preterm that reported cognitive and/or behavioral outcomes after age 5 years, Bhutta and colleagues found that preterm birth was associated with lower cognitive scores and increased risks for attention-deficit/hyperactivity disorder and other behavioral problems. Mean cognitive scores of preterm-born cases and term-born controls were directly proportional to birth weight and gestational age.

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A Piece of My Mind

"The vanity of life lasts until death, whose arrival is certain but almost always surprising. We all look for signs and hints, of change, of decline, intimations of the end." From "Vanity."

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Medical News & Perspectives

At the XIV International AIDS Conference in Barcelona, delegates were confronted with sobering news about the growing epidemic, some good and bad news from biomedical researchers, and hopeful signs of a growing global commitment to help poor nations cope with HIV/AIDS.

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Tobacco, Pharmaceutical Company Ties

Three case studies illustrate how financial ties between tobacco and pharmaceutical companies have created conflicts of interest that influence the development and marketing of nicotine replacement therapies.

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Clinician's corner

Childhood asthma: epidemiology, clinical course, and treatment.

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Violation of Journal Embargo

Fontanarosa and DeAngelis denounce the recent break of the JAMA embargo and discuss the rationale for THE JOURNAL's embargo policy.

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Physician Gender and Communication

In this meta-analysis of studies that evaluated the relationship between physician gender and physician communication during medical visits, female primary care physicians engaged in more patient-centered communication and had longer visits than male physicians.

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JAMA Patient Page

For your patients: Information about depression and the heart.

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