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JAMA. 1998;280:309.

Are All Infants Getting "Back to Sleep"?
Infants placed on their back to sleep are at decreased risk of sudden infant death syndrome (SIDS). In a nationally representative survey, Dr Willinger and colleagues (SEE ARTICLE) found that the prevalence of prone infant sleep position declined from 70% in 1992 to 24% in 1996. However, Dr Lesko and colleagues (SEE ARTICLE) report that prone infant sleep position increased from 18% to 29% between 1 month and 3 months of age. In a study of low-income, inner-city mothers, Dr Brenner and colleagues (SEE ARTICLE) found that 40% of infants aged 3 to 7 months were placed for sleep in the prone position. As Dr Malloy (SEE ARTICLE) discusses in an accompanying editorial, public health messages generally have been successful, but should now focus on low-income mothers of black or Hispanic racial/ethnic background.

Radioiodine Treatment and Cancer Mortality
Although radioiodine (¹³¹I) is an effective treatment for hyperthyroidism, whether the radiation involved increases the risk of cancer remains undefined. In this long-term cohort study, Dr Ron and colleagues (SEE ARTICLE) found a slight elevation in risk of thyroid cancer; the absolute risk was very low and underlying thyroid disease appeared to contribute to the risk. As Dr Cooper (SEE ARTICLE) explains in a related editorial, ¹³¹I remains a safe first-line treatment for hyperthyroidism.

Socioeconomic Status and Cardiovascular Risk Factors
Black and Mexican American women have higher rates of obesity, diabetes, and hypertension than do white women. Dr Winkleby and colleagues evaluated the independent relationships of ethnicity and socioeconomic status, as measured by education and poverty income ratio, along with the traditional risk factors of blood pressure, cigarette smoking, body mass index, physical inactivity, non–insulin-dependent diabetes, and cholesterol level. The rates of cardiovascular risk factors differed by socioeconomic status, but these factors did not explain all the differences among racial and ethnic groups.

(SEE ARTICLE)

Assessing Cure in H Pylori Infection
Serologic testing for anti–Helicobacter pylori antibodies is less invasive for patients than endoscopy, although its usefulness in assessing cure is unknown. Dr Feldman and colleagues find that all 15 patients they studied who were cured of H pylori infection (as assessed by gastric mucosal biopsy) had undetectable antibody titers at 18 months, whereas the 8 patients who were not cured had persistent antibodies.

(SEE ARTICLE)

A 75-Year-Old Woman With an Abdominal Aortic Aneurysm
Determining when the risk of abdominal aortic aneurysm rupture exceeds the risk from the patient's other medical conditions is a vexing clinical issue. In this Clinical Crossroads, Dr Goldman discusses the approach to assessing Mrs H's risk of aneurysmal rupture, her potential risk from elective surgery, and her risk of death and major morbidity from her severe emphysema.

(SEE ARTICLE)

The Cover
Vincent van Gogh, Vineyards at Auvers, 1890, Dutch.

(SEE ARTICLE)

Medical News & Perspectives
Older people with chronic pain are best treated with a combination of pharmacologic therapy and nonpharmacologic strategies such as education, cognitive-behavioral therapy, and exercise, according to new clinical practice guidelines from the American Geriatrics Society.

(SEE ARTICLE)

A Piece of My Mind
"If there is no greater joy than watching the birth of your first child, then there is no greater sadness than watching your child delivered, knowing she is already dead." From "A Visit From My Daughter."

(SEE ARTICLE)

Contempo 1998
Early diagnosis and prompt treatment of giant cell arteritis may prevent the onset or alter the progression of visual loss. Immunologic research is clarifying the pathogenesis, but more clinical data on the effectiveness of treatment are needed.

(SEE ARTICLE)

JAMA Patient Page
For your patients: Information about sudden infant death syndrome (SIDS).

(SEE ARTICLE)

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