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This Week in JAMA
JAMA. 1998;280:1809.
Gabapentin Reduces Pain of Chronic Neuropathy
Standard treatment of chronic neuropathy often fails to provide adequate pain relief and may be associated with intolerable adverse effects, especially in elderly patients. Backonja and colleagues conducted a multicenter trial of gabapentin, an anticonvulsant, for the treatment of painful diabetic neuropathy and Rowbotham and colleagues conducted a similar trial for the treatment of postherpetic neuralgia. In both studies, the researchers found that patients treated with gabapentin had significant improvement in measures of pain severity, sleep interference, and quality of life compared with those who received placebo. Adverse effects associated with gabapentin therapy included somnolence and dizziness. In a related editorial, Low and Dotson conclude that gabapentin may be the drug of first choice for the treatment of postherpetic neuralgia and for some patients with painful diabetic neuropathy.
(SEE ARTICLE) and (SEE ARTICLE) , and editorial (SEE ARTICLE)
Abdominal Adiposity Increases Risk of CHD in Women
Abdominal obesity has been associated with an increased risk of coronary heart disease (CHD), but whether this risk is independent of total obesity has been controversial. Using data from more than 40,000 women prospectively followed up for 8 years in the Nurses' Health Study, Rexrode and colleagues found that increased abdominal adiposity measured by waist-hip ratio and waist circumference was associated with a significantly increased risk of nonfatal myocardial infarction and death from CHD in both obese and nonobese women.
(SEE ARTICLE)
Explaining the Increase in Preterm Births
According to population-based data, the incidence of preterm births has been increasing, but this trend has been unexplained. Kramer and colleagues analyzed data from all 65,574 nonreferred births at a tertiary care hospital in Canada between 1978 and 1996. They found that the increased incidence of preterm births at this hospital was largely explained by increases in the rates of preterm induction of labor and preterm cesarean delivery without labor for complications of pregnancy and was also in part an artifact of the increased use of early ultrasound to estimate gestational age.
(SEE ARTICLE)
Research Inadequate on Sexual Abuse of Boys
In a review of 166 studies published between 1985 and 1997 on the sexual abuse of boys, Holmes and Slap found that estimates of the prevalence of sexual abuse of boys ranged from 4% to 76%, depending on the study population sampled and the definition of sexual abuse, and that the methodologic quality of the studies was generally poor. In a related editorial, Finkelhor outlines a research agenda for child sexual abuse that would inform public policy by emphasizing accurate surveillance and evaluation of treatment interventions.
(SEE ARTICLE) and editorial (SEE ARTICLE)
Profiles in Primary Care
An interview with pediatrician Selma Deitch, MD, MPH, who "for much of the latter half of this century has devoted her training, her energies, and her personality to improving the health of children."
(SEE ARTICLE)
The Cover
Charles Burchfield, The Mysterious Bird, 1917, American.
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Medical News & Perspectives
With World AIDS Day near, Mark Wainberg, PhD, president of the International AIDS Society, discusses the spread of HIV in the developing world.
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Contempo 1998
Preventing osteoporosis in postmenopausal women.
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A Piece of My Mind
"The last known house call still surviving in captivity languishes in a managed care arena near Chattanooga." From "Medical Practices Disappearing in the South."
(SEE ARTICLE)
Call for Papers: Health Promotion
Original research, reviews, and commentaries are invited for the JAMA theme issue on health promotion and obesity research scheduled for the fall of 1999.
editorial (SEE ARTICLE)
MS/JAMA
Increasing medical student indebtedness is influencing students' choice of specialty and career path.
MS/JAMA section.
JAMA Patient Page
For your patients: Preventing and managing sexual abuse of children.
(SEE ARTICLE)
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