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This Week in JAMA
JAMA. 2004;292:895.
Sugared Drinks, Weight Gain, and Diabetes in Women
Sugar-sweetened beverages are a leading source of added dietary sugars, and their consumption has been associated with obesity in children. Whether sugar-sweetened drinks contribute to weight gain and type 2 diabetes in adults is not known. Schulze and colleagues (SEE ARTICLE) used dietary data collected in a large prospective study to assess the association between consumption of sugar-sweetened beverages and weight change and risk of type 2 diabetes in women. During 8 years of follow-up, the authors found that higher consumption of sugar-sweetened beverages was associated with greater weight gain and risk of type 2 diabetes. In an editorial, Apovian (SEE ARTICLE) discusses the contribution of sugared drinks to the obesity epidemic and related health consequences.
Telephone Outreach for Patients With Depression
Prior studies suggest that many patients with depression fail to receive effective levels of pharmacotherapy or psychotherapy, and alternative models of care deserve study. In a randomized trial of primary care patients with depression, Simon and colleagues investigated the effects of usual care plus a telephone care management program—with or without telephone psychotherapy—compared with usual care alone on depression severity and patient-rated improvement and satisfaction with treatment. They found that patients who received telephone care management with telephone psychotherapy had signficantly greater improvement in depression severity scores and that patients receiving either telephone program reported significant improvement in their symptoms and greater satisfaction with their treatment than patients receiving usual care alone.
(SEE ARTICLE)
Clinical Features of Paraganglioma Syndromes
Recent identification of mutations in the genes encoding succinate dehydrogenase subunits D (SDHD) and B (SDHB) distinguish paraganglioma syndromes type 1 (PGL-1) and 4 (PGL-4). Neumann and colleagues performed genetic screening and neck, thoracic, and abdomen imaging in patients with pheochromocytomas or head and neck paragangliomas to determine differences in clinical features in carriers of the 2-gene mutation. They found that head and neck paragangliomas and multifocal tumors occurred more frequently in carriers of SDHD mutations (PGL-1) than in carriers of SDHB mutations and that individuals with SDHB mutations (PGL-4) had a higher frequency of malignant disease than carriers of SDHD mutations.
(SEE ARTICLE)
Cost-Lowering Strategies by Medicare Beneficiaries
Many Medicare beneficiaries experience temporary gaps in drug benefits when they exceed annual dollar limits or caps. Tseng and colleagues surveyed Medicare + Choice beneficiaries to determine the strategies they adopt if they exceed annual drug benefits. They found that persons who exceeded their drug benefit cap were more likely to use less of their prescribed and essential medications, to call multiple pharmacies for the best price, to switch medications, and to use samples compared with patients who did not exceed their drug benefit cap.
(SEE ARTICLE)
Health and Well-being of Caregivers
Family caregivers of patients with dementia report high levels of psychiatric and physical symptoms, but whether these symptoms abate after institutionalization of the patient is not known. Schulz and colleagues collected data on caregiver well-being before and after placement of a relative with dementia in long-term care facilities. They found that symptoms of depression and anxiety did not diminish after institutional placement, that use of anxiolytic medications increased, and that nearly half the caregivers were at risk for clinical depression following placement of their relative in long-term care facilities.
(SEE ARTICLE)
A Piece of My Mind
"During my training and subsequent practice in a community hospital, I confirmed the value of being prepared and having a backup plan." From "The Fix-It Man."
(SEE ARTICLE)
Medical News & Perspectives
Researchers are using neuroimaging and genetic studies to explore the biological underpinnings of Tourette syndrome.
(SEE ARTICLE)
Clinic Referral to Head Start
Attendance at Head Start significantly increased when primary care clinics mailed a physician referral packet to the Head Start program.
(SEE ARTICLE)
CLINICIAN'S CORNER
Contempo Updates
Therapeutic potential of promoting and interrupting angiogenesis.
(SEE ARTICLE)
JAMA Patient Page
For your patients: Information about weight gain and diabetes.
(SEE ARTICLE)
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