 |
|
This Week in JAMA
JAMA. 1998;280:863.
Controlling Recurrent Genital Herpes
Patients may find that episodic treatment with oral antiviral agents is unsatisfactory for frequent recurrences of genital herpes. Diaz-Mitoma and colleagues (SEE ARTICLE) report the results of a multicenter trial in which the preventive use of daily oral famciclovir for 1 year significantly decreased the time to the first recurrence of genital herpes and the number of recurrences. In an editorial, Engel (SEE ARTICLE) cautions that successful suppression of genital herpes does not eliminate asymptomatic viral shedding or the possibility of disease transmission.
When Tobacco Control Programs Fail
Following the introduction of a community-wide comprehensive tobacco control program in California in 1989, the per capita consumption of cigarettes in California declined more rapidly than before the program and more rapidly than in the rest of the United States. But from 1994 through 1996, the program was curtailed and its effects began to dwindle. Pierce and coworkers analyze the economic, political, and tobacco industry factors that might explain the loss of effectiveness of this program.
(SEE ARTICLE)
Curbside Consulting
Two surveys conducted independently in Massachusetts (SEE ARTICLE) and Rhode Island (SEE ARTICLE) indicate that physicians in group practice, particularly those in managed care settings, are more likely to seek informal "curbside" consultations than physicians in solo practice. Generalist physicians perceived informal consultations to be of higher overall quality than did subspecialists. In an editorial, Golub (SEE ARTICLE) describes the communication errors that might undermine the quality of informal consultations. He recommends that physicians appraise informal consultations critically, like other sources of information, and that curbside consulting be evaluated by rigorous empirical study.
Cancer Mortality After Nonmelanoma Skin Cancer
In a prospective study of more than 1 million participants, Kahn and coworkers found that a history of nonmelanoma skin cancer was associated with an increased risk of mortality from other cancers after 12 years of follow-up. The highest cancer mortality risks in men and women were associated with melanoma, pharyngeal cancer, lung cancer, and non-Hodgkin lymphoma. This epidemiologic study underscores the complex association between environmental exposures, inherited and acquired genetic susceptibilities, and the risk of cancer.
(SEE ARTICLE)
Imaging Studies and Coronary Artery Disease
Individual comparative studies have had limited power to detect differences in the performance of exercise echocardiography and exercise single-photon emission computed tomography for the detection and evaluation of coronary artery disease. In a meta-analysis that pooled data from 44 published studies, Fleischmann and colleagues show that both diagnostic tests have similar sensitivities, but exercise echocardiography has better specificity and higher overall discriminatory power.
(SEE ARTICLE)
The Cover
"While man and machine may be in opposition, man is clearly master." George Ault, The Mill Room, 1923, American.
(SEE ARTICLE)
A Piece of My Mind
"I know of physicians who have avoided treatment—perhaps because of fear of the lack of privacy afforded to other patients—and later committed suicide." From "A Challenge to Licensing Boards: The Stigma of Mental Health."
(SEE ARTICLE)
Medical News & Perspectives
From sexual partners' viewpoint, is the new virility pill proving to be a pleasure or a problem?
(SEE ARTICLE)
Contempo 1998
Reevaluating the role of antisecretory therapy in the treatment of bleeding peptic ulcer.
(SEE ARTICLE)
Policy Perspectives
When ethical health care for the individual is unethical public policy.
(SEE ARTICLE)
JAMA Patient Page
For your patients: Treatment of genital herpes.
(SEE ARTICLE)
|
