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This Week in JAMA
JAMA. 2002;287:1079.
Nonoxynol-9 Gel as a Vaginal Microbicide
In in vitro and animal studies, nonoxynol-9, a commonly used spermicide, was found to inactivate various sexually transmitted pathogens, but results of clinical trials testing its effectiveness as a vaginal microbicide have been inconsistent. In this randomized controlled trial, Roddy and colleagues (SEE ARTICLE) compared nonoxynol-9 gel and condom use with condom use alone for the prevention of male-to-female transmission of urogenital gonococcal and chlamydial infection. The rate of new urogenital infections in the gel plus condom group was not significantly different from that in the condom group. In an editorial, Richardson (SEE ARTICLE) urges continued research on other vaginal microbicides.
Long-term Cannabis Use and Cognitive Function
To determine whether long-term cannabis use is associated with cognitive impairments, Solowij and colleagues (SEE ARTICLE) assessed the neuropsychological performance of long- and shorter-term cannabis users seeking treatment for cannabis dependence and of nonusers. Cannabis users were tested a median of 17 hours after last cannabis use. Long-term users performed significantly less well than shorter-term users and nonusers on measures of memory and attention. Performance on some tests worsened as a function of increasing years of cannabis use. In an editorial, Pope (SEE ARTICLE) evaluates possible confounding in this and other studies of cannabis use, observing that available evidence is not sufficient to know with certainty whether cognitive deficits persist after long-term cannabis use.
Exposure to Fine Particulate Air Pollution and Mortality
Short-term exposure to particulate air pollution has been associated with adverse health outcomes, but evidence suggesting an association between long-term exposure to particulate air pollution and adverse health outcomes is less conclusive. Pope and colleagues analyzed 1982 mortality risk factor data combined with vital status and cause of death data through 1998 from participants in the prospective Cancer Prevention Study II linked with air pollution data for metropolitan areas throughout the United States. Long-term exposure to fine particulate air pollution was associated with elevated risks of all-cause, cardiopulmonary, and lung cancer mortality.
(SEE ARTICLE)
Characteristics of Events Leading to Commotio Cordis
Commotio cordis—sudden cardiac arrest from blunt, nonpenetrating blows to the chest—has been associated with competitive sports. In this analysis of data from 128 cases of commotio cordis in the US Commotio Cordis Registry, Maron and colleagues found that most reported commotio cordis events occurred during organized sports, but many events also occurred during routine daily and recreational activities.
(SEE ARTICLE)
Injury Risk in Compact Extended-Cab Pickup Trucks
Compact extended-cab pickup trucks typically have small rear occupant compartments with auxiliary, nonstandard seats that are exempt from regulatory safety testing. In this cross-sectional study of motor vehicle crashes involving children aged 15 years and younger, Winston and colleagues found that children in compact extended-cab pickup trucks were at greater risk of injury than children in other vehicles. The overall increased risk of injury was primarily due to the substantial increase in risk of injury of children seated in the rear seats of compact pickup trucks compared with that of children seated in the rear seats of other vehicles.
(SEE ARTICLE)
Medical News & Perspectives
Throughout the country, medical schools are finding meaningful ways to incorporate education about dealing with terrorism into their curricula.
(SEE ARTICLE)
Retinal Arteriolar Narrowing and CHD Risk
In this prospective cohort study, retinal arteriolar narrowing was associated with an increased risk of incident coronary heart disease (CHD) in women but not in men.
(SEE ARTICLE)
CLINICIAN'S CORNER
The Rational Clinical Examination
A review of the accuracy and precision of case-finding questionnaires and clinical interview strategies for the diagnosis of clinical depression.
(SEE ARTICLE)
MSJAMA
Gross anatomy: ritual, learning, art.
(SEE ARTICLE)
JAMA Patient Page
For your patients: Information about child car safety seats.
(SEE ARTICLE)
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