0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
This Week in JAMA | November 14, 2012|

This Week in JAMA FREE

JAMA. 2012;308(18):1835. doi:10.1001/jama.2012.3318.
Text Size: A A A
Published online

MULTIVITAMINS IN THE PREVENTION OF CANCER IN MEN

In the Physicians' Health Study II, 14 641 male US physicians aged 50 years or older were randomly assigned to receive a daily multivitamin or placebo. During a median follow-up of 11.2 years, Gaziano and colleagues found that compared with men taking placebo, those taking a daily multivitamin had a modest but significantly reduced risk of total cancer. In an editorial, Bach and Lewis discuss a number of uncertainties regarding the effect of multivitamin supplementation on cancer risk in men.

SURGERY VS WATCHFUL WAITING IN LOW-GRADE GLIOMAS

Management of low-grade gliomas is controversial. In a retrospective cohort study of 153 Norwegian patients with diffuse low-grade gliomas who received care at 2 university hospitals with different treatment strategies, Jakola and colleagues found that treatment at a center that favored early surgical resection was associated with better overall survival than treatment at a hospital that favored biopsy and watchful waiting. In an editorial, Markert discusses treatment of low-grade gliomas.

STRUCTURAL BRAIN CHANGES IN PATIENTS WITH MIGRAINE

Migraine has been associated with a higher prevalence of magnetic resonance imaging (MRI)–detected lesions in the brain. Palm-Meinders and colleagues assessed progression of these lesions in a 9-year follow-up of 203 patients with migraine and 83 controls who participated in a population-based study of MRI-detected cerebral abnormalities in migraine. On MRI obtained during follow-up, the authors found that compared with controls, women with migraine had a higher prevalence and greater progression of deep white matter hyperintensities, but not progression of other brain lesions. In an editorial, Friedman and Dodick discuss implications for patients with migraine.

See related Article, Editorial, and

VITAMIN D CONCENTRATIONS AND CLINICAL OUTCOMES

In analyses of data from 4 independent prospective cohort studies—a discovery cohort involving 1514 participants and a replication meta-analysis across 3 cohorts involving 2727 participants—Levin and colleagues found that common variants of the vitamin D receptor gene modified the association of low serum vitamin D with a composite clinical outcome of hip fracture, myocardial infarction, cancer, and mortality.

SEE Article

ANTIVIRALS IN HBV-RELATED HEPATOCELLULAR CARCINOMA

Among patients with hepatitis B virus (HBV)–related hepatocellular carcinoma, higher HBV viral load is a risk factor for tumor recurrence following curative liver resection. In a cohort of 4569 newly diagnosed patients with HBV-related hepatocellular carcinoma who underwent curative liver resection, Wu and colleagues found that patients who received antiviral therapy—specifically nucleoside analogues—had a lower risk of tumor recurrence than patients who did not during 6 years' follow-up. In an editorial, Lok discusses the use of antiviral therapy in patients with HBV-related hepatocellular carcinoma.

CLINICIAN'S CORNER JAMA CLINICAL CHALLENGE

A patient with a 30-year history of an enlarging, painless wrist mass has functional limitation and hand swelling. Ultrasound examination shows a cystic-appearing mass with no arterialized flow and angiography reveals delayed contrast enhancement. What would you do next?

SEE Article

MEDICAL NEWS & PERSPECTIVES

Outdated treatment approaches are hampering the ability of the military health care system to treat patients who have substance abuse disorders.

SEE Article

VIEWPOINTS

Preventing fatal opioid overdose

SEE Article

Rethinking opioid prescribing

SEE Article

Promises and limitations of genome-wide association studies

SEE Article

A PIECE OF MY MIND

“I am quite certain that I would seem like an ordinary patient to most physicians.” From “The Unasked Question.”

SEE Article

EDITOR'S AUDIO SUMMARY

Dr Pasche summarizes and comments on this week's issue. Go to http://jama.jamanetwork.com/multimedia.aspx#Weekly

AUTHOR IN THE ROOM TELECONFERENCE

Join Nancy A. Rigotti, MD, Wednesday, November 14, from 2 to 3 PM eastern time to discuss strategies to help patients quit smoking. To register, go to http://www.ihi.org/Authorintheroom.

JAMA PATIENT PAGE

For your patients: Information about antibiotic resistance.

SEE Article

First Page Preview

View Large
First page PDF preview

Tables

References

Letters

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.