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JAMA. 2005;293:2441.

Coronary Angiography With Multislice CT
Hoffmann and colleagues (SEE ARTICLE) assessed the accuracy of noninvasive coronary angiography (CA) using multislice computed tomography (MSCT) compared with standard invasive CA to detect obstructive coronary artery disease in 103 consecutive patients who had both tests. The authors found that MSCT had reasonably high accuracy for detecting significant obstructive coronary artery disease compared with invasive CA. In an editorial, Garcia (SEE ARTICLE) discusses the promise and limitations of MSCT.

Physical Activity and Breast Cancer Survival
Women who engage in physical activity after a breast cancer diagnosis have improved quality of life, but whether regular physical activity confers a survival advantage is not known. Holmes and colleagues assessed breast cancer mortality in relation to reported physical activity a median of 38 months after diagnosis among participants in the Nurses’ Health Study. The authors found that physical activity was associated with improved survival, with greatest benefit observed in women whose activity was equivalent to walking 3 to 5 h/wk at an average pace.

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Trends in Suicide
Among adults 18 to 54 years of age, the prevalence of suicide has declined about 6% since the early 1990s, but whether suicide-related behaviors such as thoughts, plans, gestures, and attempts have also declined is not clear. To address these questions, Kessler and colleagues analyzed self-reported data on suicide-related behaviors and treatment from 2 nationally representative surveys conducted in 1990-1992 and 2001-2003. Comparing data from the 2 surveys, the authors found little change in the number of persons reporting suicide-related behaviors, despite a substantial increase in treatment for persons who made a suicide gesture or attempt.

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EBV Antibody Titers and Onset of Symptoms in MS
Elevated titers to Epstein-Barr virus (EBV) have been reported in persons with multiple sclerosis (MS), but the temporal relationship of EBV infection to onset of MS is not known. In this issue of JAMA, Levin and colleagues (SEE ARTICLE) report data on EBV antibody titers and disease onset derived from 69 case-control sets. Baseline antibody titers to several EBV antigens were significantly higher in cases than controls, and the mean onset of MS symptoms was 4.0 years after baseline blood collection. In an editorial, Fontanarosa and DeAngelis (SEE ARTICLE) explain the circumstances that led to a reanalysis and new report of these data.

CLINICIAN’S CORNER
International Adoptees’ Behavioral and Mental Health
Prior studies suggest that international adoptees have more behavioral and mental health problems than children adopted within their home country or nonadoptees. In a meta-analysis of studies addressing adoptee mental health and behavioral problems, Juffer and van IJzendoorn (SEE ARTICLE) found that adoptees in general had more behavioral problems and received more mental health services than nonadoptees. However, international adoptees had fewer behavioral problems and were less often referred to mental health services than local adoptees. In an editorial, Miller (SEE ARTICLE) discusses the study findings and directions for future research.

Medical News & Perspectives
As the US population ages, the cost of osteoporosis and its related fractures is expected to grow. But an increasing body of research is providing better tools for managing this condition.

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Hair Dyes and Cancer Risk
Meta-analysis of data from 79 cohort and case-control studies failed to find strong evidence of a marked increase in cancer risk from personal use of hair dyes.

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Psychiatric Diagnoses
A proposed schema for psychiatric diagnoses focused on cause rather than symptoms.

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Medical Burden in Bipolar Disorder
Persons with bipolar disorder are at increased risk of certain medical conditions.

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JAMA Patient Page
For your patients: Information about suicide.

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