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Prevalence of HPV Infection Among Females in the US
A human papillomavirus (HPV) vaccine was licensed in June 2006 and is recommended for 11- to 12-year-old girls. To estimate the prevaccine prevalence of HPV among women in the United States, Dunne and colleaguesArticle analyzed data from 14- to 59-year-old female participants in the 2003-2004 National Health and Nutrition Examination Survey who provided a self-collected vaginal swab specimen that was analyzed for HPV DNA. The authors found an overall HPV prevalence of 26.8% (95% confidence interval, 23.3%-30.9%). Human papillomavirus vaccine types 6, 11, 16, or 18 were detected in 3.4% of women. In an editorial, Weller and StanberryArticle discuss the prevalence of HPV and implications for assessing vaccine efficacy and cost-effectiveness.
Cognitive Behavioral Therapy for PTSD in Women
Few studies have evaluated the treatment of posttraumatic stress disorder (PTSD) in women. In a randomized controlled trial of female military personnel with PTSD, Schnurr and colleagues compared PTSD symptom severity after 10 weekly sessions of a cognitive behavioral therapy, prolonged exposure, with present-centered therapy, a supportive intervention typically used by Veterans Affairs clinicians to address PTSD in female veterans. The authors found that prolonged exposure was more effective than present-centered therapy for treating PTSD.
Deficits in Physician Communication
Delays or inaccuracies in communication between hospital-based and outpatient primary care physicians could compromise patient care and the extent to which physicians successfully complete this information transfer is unknown. Kripalani and colleagues conducted a systematic literature review to assess the types and prevalence of deficits in communication and information transfer between hospitalists and primary care physicians, and identified interventions to improve the process. They found that delays and deficits in communication were common. Interventions, such as computer-generated discharge summaries and patients as couriers, may improve the physician-to-physician communication.
Antioxidants and Mortality
Antioxidants are believed to reduce the risk of several diseases. However, in a previously published article, Bjelakovic and colleagues reported that antioxidant supplements (with the potential exception of selenium) had no effect on gastrointestinal cancer and were associated with an increase in all-cause mortality. In this issue of JAMA, the investigators report results of a systematic literature review to assess the effects of beta carotene, vitamins A and E, ascorbic acid (vitamin C), and selenium on all-cause mortality among participants in primary and secondary disease prevention trials. The authors found that beta carotene, vitamin A, and vitamin E, taken singly or combined with other antioxidant supplements, were associated with increased all-cause mortality.
Mrs Z, a 47-year-old woman who has an 8-year history of infertility treatment, is scheduled for in vitro fertilization (IVF) using donor oocytes. Her physician recommends the transfer of a single embryo, but Mrs Z would like to conceive twins. Stillman discusses the current science of IVF, single-embryo transfer, and reasons patients prefer that multiple oocytes be transferred.
A Piece of My Mind
“Each time when a cheerful nurse telephones me, pleased to report that my latest test result is normal, my heart sinks. How can I expect her to understand that I don't want it to be normal?” From “The Need to Know.”
Medical News & Perspectives
Stem cells isolated from amniotic fluid can develop into various cell types, an accomplishment that scientists suggest offers the potential for stem cell-related therapies without the ethical issues raised by embryonic stem cell research.
Holes in Medicare Drug Plans
Helping patients navigate the “doughnut hole” coverage gap in Medicare prescription drug benefit plans.
Reducing “Waste” in Medicine
Methods to reduce waste and ensure safe, effective, efficient, patient-centered, timely, and equitable health care.
Appreciation for JAMA's peer reviewers and authors.
Dr DeAngelis summarizes and comments on this week's issue. Go to http://jama.ama-assn.org/misc/audiocommentary.dtl.
JAMA Patient Page
For your patients: Information about human papillomavirus infection.
This Week in JAMA . JAMA. 2007;297(8):779. doi:10.1001/jama.297.8.779
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