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This Week in JAMA
JAMA. 1998;279:1675.
Socioeconomic Status, Health Behaviors, and Mortality
Low socioeconomic status is associated with higher mortality, but also with such health risk behaviors as smoking, alcohol use, sedentary lifestyle, and increased body weight, which are known to contribute to increased mortality. Dr Lantz and colleagues (SEE ARTICLE) found that these 4 risk behaviors combined accounted for only 12% to 13% of the predictive effect of income level on mortality. A related editorial (SEE ARTICLE) suggests that psychosocial factors might account for the remaining increased risk.
Patients Who Think They'll Live Longer Want More Aggressive Care
If cancer patients understand their prognosis, will they choose comfort care over life-extending measures? In this study by Dr Weeks and colleagues (SEE ARTICLE) , patients with advanced lung cancer and colon cancer were asked to estimate their chance of surviving 6 months and whether they favored potentially life-extending therapy or comfort measures. Those who believed they had 6 months to live more often chose more aggressive treatment than those who believed they would not, although there was no favorable impact on survival.
related editorial (SEE ARTICLE)
Another Reason Not to Smoke: Hearing Loss
Cigarette smoking has been associated with age-related hearing loss in some but not all reports. Dr Cruickshanks and colleagues found that people who smoked were 1.7 times more likely to have hearing loss compared with nonsmokers, even after excluding individuals with occupational noise exposure. Nonsmokers exposed to environmental tobacco smoke also were more likely to have hearing problems than individuals not exposed.
(SEE ARTICLE)
Depression Predicts Physical Decline in Older People
Many physicians and family members report that depressed mood appears to contribute to physical decline among the elderly. In a 4-year prospective study of a large cohort of people aged 71 years and older, Dr Penninx and colleagues found that depression predicts functional decline, even among those with the highest levels of physical functioning at baseline.
(SEE ARTICLE)
In-Hospital Death Rates Inadequate Measure of Trauma Mortality
In this retrospective cohort study, Dr Mullins and colleagues found in-hospital death rates an incomplete measure of trauma-related mortality. Currently used measures don't account for injured patients who died of nontraumatic causes (eg, underlying cardiac disease) and fail to capture deaths among patients hospitalized for trauma that occur within 30 days of discharge.
(SEE ARTICLE)
Short-Course Antibiotics for Acute Otitis Media
In this meta-analysis, Dr Kozyrskyj and colleagues (SEE ARTICLE) pooled data from randomized controlled trials that compared different durations of antibiotic treatment for acute otitis media in children aged 1 month to 18 years. Their analysis supports the use of 5 days of oral antibiotics to treat uncomplicated acute otitis media in children.
related editorial (SEE ARTICLE)
The Cover
"Campendonk destroyed much of his own work until then, perhaps recognizing that he must now go forward on his own, ‘putting away the things of childhood,' so to speak." Heinrich Campendonk, Bucolic Landscape, 1913, German.
(SEE ARTICLE)
Medical News & Perspectives
As research on snakes, frogs, and sea snails yields new pharmacologic knowledge, scientists unite to preserve natural biodiversity.
(SEE ARTICLE)
A Piece of My Mind
". . . overdose attempts, intentional car crashes, self-inflicted wounds, and threats of suicide." From "God Save the Child."
(SEE ARTICLE)
Contempo 1998
When is memory loss in the elderly Alzheimer disease?
(SEE ARTICLE)
JAMA Patient Page
Depression in the elderly.
(SEE ARTICLE)
On the Web
Full text of US government guidelines for antiretroviral therapy in HIV infection. In the JAMA HIV/AIDS Information Center. http://www.ama-assn.org/aids
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