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This Week in JAMA
JAMA. 2008;300(4):363.
Sildenafil for SRI-Associated Sexual Dysfunction
Patients who take selective and nonselective serotonin reuptake inhibitors (SRIs) for depression often report treatment-related sexual dysfunction. Selective phosphodiesterase type 5 inhibitors, such as sildenafil, have proven efficacy in the treatment of sexual dysfunction in men, including men with depression, but these agents have received limited study in women. To evaluate the efficacy of sildenafil among women with SRI-associated sexual dysfunction, Nurnberg and colleagues randomly assigned 98 premenopausal women, whose depression was remitted by SRIs but who were experiencing sexual dysfunction since the onset of their depression or antidepressant treatment, to take either sildenafil or placebo before sexual activity. The authors found that compared with those receiving placebo, women who were treated with sildenafil had significant improvement in sexual function during the 8-week trial.
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Tuberculosis Among Foreign-Born Persons in the US
Foreign-born persons accounted for 57% of all tuberculosis (TB) cases in the United States in 2006. To assess the risk of TB and characteristics associated with the diagnosis among foreign-born populations in the United States, Cain and colleagues analyzed 2001-2006 data from 2 national data sets, the US National TB Surveillance System database and the American Community Survey. The authors report that 46 970 cases of TB disease were documented in foreign-born persons in 2001-2006. Higher rates of disease were associated with recent (within 2 years) entry into the United States, migration from sub-Saharan Africa and Southeast Asia, and increasing age at arrival in the United States.
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CMV Reactivation in Critically Ill Patients
Cytomegalovirus (CMV) infection is associated with an increased risk of adverse events among immunocompromised patients. Whether CMV reactivation is associated with adverse outcomes in immunocompetent patients is not clear. Limaye and colleagues prospectively assessed CMV plasma DNAemia and clinical outcomes in 120 CMV seropositive and immunocompetent adult patients admitted to an intensive care unit at 1 tertiary care medical center. They found that CMV viremia occurred in 33% of patients that was independently associated with prolonged hospitalization or death.
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Intersection of TB and HIV Epidemics
Tuberculosis (TB) is a leading cause of death among HIV-infected persons, and progress in reducing the burden of TB in the HIV population has not kept pace with global TB reduction goals. Havlir and colleagues discuss opportunities and challenges for HIV care and treatment programs to intensify TB case finding, treatment, and prevention.
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CLINICIAN'S CORNER
Heart Failure With Preserved Ejection Fraction
Patients with heart failure with a preserved ejection fraction have high rates of morbidity and mortality. Shah and Gheorghiade discuss the evidence that supports identification and treatment of common cardiovascular and noncardiovascular comorbidities to improve the quality and quantity of life for patients with heart failure and preserved ejection fraction.
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A Piece of My Mind
"About 3 months ago, I noticed that Tiger had developed excessive thirst and frequent urination. I was concerned that he may be developing diabetes." From "Baby Food."
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Medical News & Perspectives
The US Food and Drug Administration warns that antipsychotic drugs, which are often prescribed off-label for elderly patients with dementia, can increase the risk of death in this population.
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Commentaries
Obesity prevention in the information age
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Guideline development and patient preferences
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JAMA Classics
Crohn disease
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Diabetes Mellitus
Call for Papers
Authors are invited to submit manuscripts for an upcoming JAMA theme issue.
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Author in the Room Teleconference
Join Beverly Beth Green, MD, MPH, August 20 from 2 to 3 PM eastern time to discuss home blood pressure monitoring and Web and pharmacist care for hypertension control. To register, go to http://www.ihi.org/AuthorintheRoom.
JAMA Patient Page
For your patients: Information about tuberculosis.
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