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This Week in JAMA
JAMA. 1999;281:1773.
Intranasal Soluble ICAM-1 Reduces Cold Symptoms
Blocking the cellular attachment of infecting viruses is a promising research strategy for prevention of viral illnesses. Turner and colleagues report that after experimental rhinovirus infection, subjects who were treated for 7 days with intranasal tremacamra, a recombinant soluble intercellular adhesion molecule 1 (ICAM-1), had significantly lower symptom scores (Figure) and lower nasal mucus weights and reported fewer colds than subjects who received placebo. In an editorial, McIntosh discusses key features of prospective cures for the common cold.
(SEE ARTICLE) and editorial (SEE ARTICLE)
Raw-Milk Cheese Source of Salmonella Outbreaks
Investigations of 2 outbreaks of multidrug-resistant Salmonella Typhimurium DT104 infection in northern California by Cody and coworkers and of another outbreak in Washington State by Villar and colleagues identified cheese made from unpasteurized milk as the source of infection. In an editorial, Keene highlights the type of information that is provided by investigations of disease outbreaks and discusses the educational and regulatory efforts required to reduce the incidence of foodborne illnesses.
(SEE ARTICLE) and (SEE ARTICLE) and editorial (SEE ARTICLE)
Homocysteine and Risk of Cardiovascular Disease
Retrospective and cross-sectional studies suggest an association between plasma homocysteine level and atherothrombotic disease, whereas in prospective studies, an elevated homocysteine level has not consistently been predictive of cardiovascular events. In this prospective case-control study of 28,263 healthy postmenopausal women in the Women's Health Study followed up for a mean of 3 years, Ridker and colleagues found that women with elevated baseline homocysteine levels were at increased risk of cardiovascular events, especially those with the highest baseline levels. The increase in risk associated with elevated homocysteine levels was moderate and less than that associated with other previously identified cardiovascular disease risk factors.
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Screening for Anal Squamous Cell Carcinoma
Anal squamous cell carcinoma may be preventable in high-risk populations if precursor high-grade squamous intraepithelial lesions are detected by routine screening. Based on estimates derived from a model using a hypothetical cohort of homosexual and bisexual men infected with the human immunodeficiency virus, Goldie and colleagues conclude that routine screening with an anal Papanicolaou test would prolong quality-adjusted life expectancy in this population at a cost comparable with that of other preventive interventions.
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Stroke Prevention in Patients With Atrial Fibrillation
In this review of trials of warfarin, aspirin, or both for the prevention of stroke in patients with atrial fibrillation, Ezekowitz and Levine suggest that optimal stroke prevention therapy may vary depending on the coexistence of other risk factors. For persons older than 65 years with other stroke risk factors, such as high blood pressure, diabetes mellitus, or prior stroke, warfarin therapy was associated with a much greater reduction in stroke risk than was aspirin therapy. However, for patients between 65 and 75 years without other stroke risk factors, aspirin therapy achieved a similar reduction in stroke risk as warfarin.
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A Piece of My Mind
"It is perfectly fine to glory in our successes, but we must also confront our failures." From "Saying Good-bye."
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Medical News & Perspectives
The myriad ways in which the arts and the environment can improve health and healing were discussed at the first World Symposium on Culture, Health, and the Arts.
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Users' Guides to the Medical Literature
How to evaluate the usefulness of treatment recommendations.
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Letter From Hong Kong
Impact of US tobacco control legislation on smoking in developing countries.
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JAMA Patient Page
For your patients: Facts about Salmonella infection from contaminated foods.
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