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This Week in JAMA
JAMA. 2000;284:2971.
Cellular Telephones Not Associated With Brain Cancer
The health effects of exposure to the radiofrequency signals from handheld cellular telephones are not known. Muscat and colleagues evaluated handheld cellular telephone use among patients with primary brain cancer and matched controls without brain cancer between 1994 and 1998. Risk of brain cancer was not associated with monthly hours of cellular telephone use, number of years of use, or lifetime cumulative hours of use.
(SEE ARTICLE)
Psychosocial Stress and Prognosis in Women With CHD
Psychosocial stress, particularly work stress, has been associated with an increased incidence of coronary heart disease (CHD) in men, and with a poorer prognosis. To assess whether stress is a determinant of cardiovascular health in women, Orth-Gomér and colleagues followed up 292 women who were hospitalized for acute myocardial infarction or unstable angina pectoris. Among women who were married or cohabiting with a man, those who reported severe marital stress at baseline had a 3-fold increased risk of recurrent coronary events after a median follow-up of 4.8 years compared with women without marital stress. Work stress, however, was not predictive of recurrent coronary events.
(SEE ARTICLE)
Weight Change and Sleep-Disordered Breathing
Obesity is strongly correlated with sleep-disordered breathing, but the association between change in weight and sleep-disordered breathing is not known. In this prospective study, Peppard and colleagues evaluated 690 adults for sleep-disordered breathing at baseline and again 4 years later. Change in the apnea-hypopnea index (AHI, apnea events + hypopnea events per hour of sleep) was related in a dose-response fashion to change in weight. A 10% weight gain predicted an approximate 32% increase in the AHI and was associated with a 6-fold increase in the risk of developing moderate-to-severe sleep-disordered breathing. A 10% weight loss predicted a 26% decrease in the AHI.
(SEE ARTICLE)
Gender Disparities in Home Care Among Elderly
Using data from respondents in a national survey of noninstitutionalized elderly people who reported any activity of daily living or instrumental activity of daily living impairment, Katz and colleagues found that elderly women with disabilities received fewer hours per week of informal home care than elderly disabled men. Married disabled women received many fewer hours of informal home care per week than married disabled men. Differences in the number of hours per week of formal home care were small.
(SEE ARTICLE)
Survival After Colon Cancer Surgery
To determine whether hospital volume of colon cancer resections predicts survival after colon cancer surgery, Schrag and colleagues analyzed Surveillance, Epidemiology, and End Results (SEER)–Medicare data from patients who had surgical resection for primary colon adenocarcinoma diagnosed between 1991 and 1996. Thirty-day postoperative mortality was 5.5% for patients treated at low-volume hospitals and 3.5% for patients treated at high-volume hospitals, a small but statistically significant difference. Overall survival and cancer-specific survival were directly correlated with hospital procedure volume, but the magnitude of these associations was also small.
(SEE ARTICLE)
Contraindicated Drug Use Continues After Warnings
In June 1998, the US Food and Drug Administration issued a press release announcing contraindications added to the label of cisapride, a gastrointestinal tract promotility agent, that could predispose to serious cardiac arrhythmias, and the manufacturer issued warning letters to inform practitioners. Smalley and colleagues (SEE ARTICLE) found that contraindicated use of cisapride continued at almost the same rate despite these actions. In a related commentary, Woosley (SEE ARTICLE) considers new ways to promote safe use of medications.
A Piece of My Mind
"How could someone awarded bachelor's, master's, and PhD degrees possibly be so lost?" From "Lost by Degrees."
(SEE ARTICLE)
Declaration of Helsinki
The fifth revision of the Declaration of Helsinki on ethical principles for medical research involving human subjects was adopted by the World Medical Association in October 2000. Medical News & Perspectives (SEE ARTICLE) reports reactions of the research community to new provisions in the fifth revision (SEE ARTICLE) , particularly regarding constraints on the use of placebo in clinical trials. In a commentary, Riis (SEE ARTICLE) provides an international perspective on the revision.
Hepatitis B Vaccine and Hepatocellular Cancer
In Taiwan, the incidence of childhood hepatocellular carcinoma decreased among boys after initiation of a universal hepatitis B virus vaccination program, but not among girls.
(SEE ARTICLE)
Communication Skills in End-of-Life Care
A 7-step approach for structuring communication about care at the end of life with patients and their families.
(SEE ARTICLE)
JAMA Patient Page
For your patients: Information about colon cancer.
(SEE ARTICLE)
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