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In This Issue of JAMA
October 22/29, 2019


JAMA. 2019;322(16):1527-1529. doi:10.1001/jama.2018.15564


Autism spectrum disorders are characterized, in part, by restricted and repetitive behaviors that can interfere with everyday functioning. Reddihough and colleagues randomized 146 children and adolescents with autism spectrum disorder and found that fluoxetine, compared with placebo, resulted in significantly lower scores for obsessive-compulsive behaviors at 16 weeks. In an Editorial, King emphasizes that unwelcome repetitive behaviors should be differentiated from repetitive behaviors that may be adaptive or pleasurable.


Visual Abstract and CME

For women in resource-limited settings who have cervical intraepithelial neoplasia (CIN) and HIV, cryotherapy is a feasible treatment option, but it may be less effective than the loop electrosurgical excision procedure (LEEP). Greene and colleagues randomized 400 women with histologically confirmed CIN and HIV infection and found that treatment with LEEP, compared with cryotherapy, resulted in a lower rate of cervical neoplasia recurrence over 24 months. In an Editorial, Chibwesha and Stringer suggest that the findings from this study, when combined with other research, position LEEP as the preferred treatment for CIN2/3 among women living with HIV in settings that can safely perform the procedure, but also point out that its role as first-line treatment for cervical precancer in low- and middle-income countries will likely remain limited in the near term.


In developed countries, more than 95% of infants born preterm survive into adulthood. Crump and colleagues conducted a national cohort study of 2 566 699 persons born in Sweden between 1973 and 1997 and found that most preterm infants survived to early to mid-adulthood without major comorbidities.


Clinical Review & Education

Dementia is an acquired loss of cognition in multiple cognitive domains sufficiently severe to affect social or occupational function. Arvanitakis and colleagues review the evaluation and clinical management of patients with signs and symptoms of dementia.

Symptoms of lactose malabsorption result from fluid shifts into the intestinal lumen and fermentation of residual lactose by gastrointestinal bacteria. This JAMA Insights article by Micic and colleagues discusses the pathophysiology and clinical management of patients with lactose intolerance.

JAMA Patient Page

In this JAMA Clinical Guidelines Synopsis of a 2018 guideline developed by the American Society of Hematology and the McMaster University GRADE Centre, Paul and Cifu discuss the prophylaxis and treatment of venous thromboembolism.