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JAMA. 2003;289:9.

Prevalence of Autism in a US Metropolitan Area
Recent epidemiological studies, particularly those conducted outside the United States, suggest that the prevalence of autism is increasing. Yeargin-Allsopp and colleagues (SEE ARTICLE) studied the prevalence of autism among 289 456 children aged 3 to 10 years in metropolitan Atlanta in 1996. Cases were identified through screening and abstracting records at medical and educational sources, and case status was determined by expert review. The prevalence of autism was 3.4 per 1000 children, higher than rates from US studies conducted during the 1980s and early 1990s, but consistent with more recent studies. In an editorial, Fombonne (SEE ARTICLE) critiques the debate about a possible epidemic of autism.

Sildenafil for Sexual Dysfunction From Antidepressants
Sexual dysfunction is a common adverse effect of antidepressant therapy. In this randomized placebo-controlled trial, Nurnberg and colleagues assessed the efficacy of sildenafil citrate in men with major depression in remission and sexual dysfunction associated with serotonin reuptake inhibitor antidepressant therapy. Improvement in sexual function was achieved by a significantly greater proportion of men in the sildenafil group than in the placebo group.

(SEE ARTICLE)

Angiotensin II Receptor Blocker for Migraine Prophylaxis
Few well-tolerated drugs are available for the prophylaxis of migraine headaches. In this randomized placebo-controlled crossover study, Tronvik and colleagues assessed the efficacy of the angiotensin II receptor blocker candesartan for migraine prophylaxis. Over 12 weeks, the mean number of days with headache was significantly lower in the candesartan group than in the placebo group. Other secondary end points were also reduced in the candesartan group, including hours with headache, days with migraine, and hours with migraine.

(SEE ARTICLE)

Binge Drinking Among US Adults
Binge drinking, defined as consuming 5 or more alcoholic drinks on 1 occasion, generally results in acute impairment and may result in other adverse health consequences. In this analysis of data from the Behavioral Risk Factor Surveillance System, Naimi and colleagues found that the total number of binge-drinking episodes among US adults increased from approximately 1.2 billion in 1993 to 1.5 billion in 2001. Binge-drinking episodes per person per year increased from 6.3 to 7.4.

(SEE ARTICLE)

Obesity and Diabetes Prevalences Increasing
Mokdad and colleagues previously reported that the prevalence of obesity and diabetes among US adults increased substantially from 1990 to 2000. In this analysis of data from the 2001 Behavioral Risk Factor Surveillance System, Mokdad and colleagues found that the prevalence of obesity continued to increase from 19.8% in 2000 to 20.9% in 2001, and the prevalence of diabetes from 7.3% to 7.9%.

(SEE ARTICLE)

A Piece of My Mind
"Time was when the doctor could diagnose and treat a pneumonia, hydrate the patient, and correct an arrhythmia. Multiconsultism has changed all that." From "Will the Real Doctor Please Stand Up?"

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Medical News & Perspectives
Not only is HIV/AIDS affecting ever greater numbers of people—an estimated 42 million are now infected—but about half of those living with HIV are now women. A new report, AIDS Epidemic Update 2002, adds that the epidemic is rapidly expanding in Eastern Europe and Asia and is fueling a famine in southern Africa.

(SEE ARTICLE)

CLINICIAN'S CORNER
Acute Cholecystitis
The Rational Clinical Examination A systematic review of studies of the diagnostic performance of clinical and laboratory findings for detection of acute cholecystitis.

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Reporting Studies of Diagnostic Tests
Rennie discusses new guidelines to improve reports of studies of diagnostic tests developed by the Standards for Reporting of Diagnostic Accuracy (STARD) group.

(SEE ARTICLE)

MSJAMA
Teaching and assessment of communication skills during medical training and issues in patient-physician communication in medical practice.

See (SEE ARTICLE)

JAMA Patient Page
For your patients: Information about acute cholecystitis.

(SEE ARTICLE)

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