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This Week in JAMA |

This Week in JAMA FREE

JAMA. 2012;307(6):539. doi:10.1001/jama.2012.107.
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MENINGOCOCCAL VACCINE WITH ROUTINE VACCINATIONS

Serogroup B Neisseria meningitidis (MenB) is a major cause of disease in early childhood. Gossger and colleagues assessed the immunogenicity of a multicomponent MenB (4CMenB) vaccine—given either separately or concomitantly with routine infant vaccines—in a randomized trial that enrolled 1885 infants. The authors report that the 4CMenB vaccine was immunogenic when administered with routine vaccines at 2, 4, and 6 or 2, 3, and 4 months of age and interfered minimally with the response to concomitantly administered infant vaccinations. In an editorial, Messonnier and Cohn discuss progress toward an infant MenB vaccine.

SHORT-COURSE CEFPODOXIME FOR CYSTITIS

Fluoroquinolones are efficacious for uncomplicated cystitis, but increasing rates of fluoroquinolone resistance are a concern. In a clinical trial that enrolled 300 women with acute uncomplicated cystitis, Hooten and colleagues assessed 30-day clinical cure rates among women randomly assigned to a 3-day regimen of cefpodoxime—a broad-spectrum, third-generation cephalosporin—or a 3-day regimen of ciprofloxacin. The authors report that compared with ciprofloxacin, cefpodoxime did not meet prespecified noninferiority criteria for achieving clinical cure of acute uncomplicated cystitis in women.

AGE AT DIAGNOSIS AND BREAST CANCER MORTALITY

In an analysis of data from 9766 postmenopausal women with hormone receptor− positive breast cancer, van de Water and colleagues examined the association between age at diagnosis and breast cancer outcomes. Among their findings was that increasing age at diagnosis was associated with higher breast cancer–specific mortality.

INTUSSUSCEPTION FOLLOWING ROTAVIRUS VACCINE

Pentavalent rotavirus (RV5) vaccines were not associated with intussusception in prelicensure clinical trials. However, recent examination of international postlicensure data suggested a possible increased risk of intussusception in the first week following the initial vaccine dose. In an analysis of data from 786 725 RV5 doses (309 844 first doses) administered to US infants aged 4 to 34 weeks, Shui and colleagues found no increased risk of intussusception 1 to 7 days and 1 to 30 days following RV5 vaccination.

CLINICIAN'S CORNER
DOES THIS PATIENT HAVE AN INFECTED CHRONIC WOUND?

An elderly nursing home resident presents with an increasingly painful pressure ulcer. Reddy and colleagues analyzed data from 15 studies (representing 985 patients and 1056 chronic wounds) to assess the accuracy of clinical signs and symptoms and the utility of noninvasive wound cultures in the diagnosis of chronic wound infections. They found that the presence of increasing pain may make infection of a chronic wound more likely; however, its absence does not rule out infection. Further evidence is needed to determine which, if any, wound swab culture has diagnostic utility.

JAMA CLINICAL CHALLENGE

Several weeks after initiating chemotherapy with tretinoin, cytarabine, and daunorubicin, a patient with acute promyelocytic leukemia developed a low-grade fever and purple rash. What would you do next?

MEDICAL NEWS & PERSPECTIVES

An NIH program helps scientists and pharmaceutical companies develop promising compounds to reach clinical trials.

VIEWPOINTS

Harms of screening

Nocebo effects, communication, and therapeutic outcomes

Integrating technology in health care

A PIECE OF MY MIND

“When I was a third-year medical student, my surgery clerkship director told me on my first day, “It won't affect your grade, but I want you to know that I don't think women should be doctors.” From “What Would Patsy Mink Think?”

MEDICAL EDUCATION 2012

Call for Papers

Authors are invited to submit manuscripts for an upcoming JAMA theme issue.

AUTHOR IN THE ROOM TELECONFERENCE

Join George A. Bray, MD, Wednesday, February 15, from 2 to 3 PM eastern time to discuss dietary protein and weight. To register, go to http://www.ihi.org/AuthorintheRoom.

READERS RESPOND

Dr A, a 30-year veteran physician, moved to a large practice. How would you address his frustration about quality improvement that focuses on populations instead of individuals? Go to www.jama.com, read the case, and submit your response by March 4.

JAMA PATIENT PAGE

For your patients: Information about intussusception.

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