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 | December 26, 2012|

This Week in JAMA FREE

JAMA. 2012;308(24):2541. doi:10.1001/jama.2012.3408.
Text Size: A A A
Published online

ATHEROSCLEROSIS AMONG US SERVICE MEMBERS

Autopsies of US service members killed in the Korean and Vietnam wars demonstrated that subclinical coronary atherosclerosis was present in the second and third decades of life. To estimate the current prevalence of coronary and aortic atherosclerosis in members of the US armed forces, Webber and colleagues reviewed cardiovascular autopsy reports from 3832 individuals who died of combat or unintentional injuries during military deployment, October 2001-August 2011. The authors report that the mean prevalence of any coronary atherosclerosis was 8.5% and varied by age and cardiovascular risk factors. In an editorial, Levy discusses trends in cardiovascular health and implications for prevention of heart disease.

SEE Article and Article and

HCV INFECTION, INTERFERON RESPONSE, AND MORTALITY

Patients with chronic hepatitis C virus (HCV) infection who receive interferon-based therapy and achieve a sustained virological response—defined as absence of viremia 24 weeks after cessation of all antiviral medication—have lower risks of liver failure and liver-related death. In long-term follow-up of 530 patients with chronic HCV infection who initiated interferon-based treatment between 1990 and 2003, van der Meer and colleagues found that a sustained virological response to interferon-based therapy was associated with lower all-cause mortality.

SEE Article

NONINFERIORITY AND EQUIVALENCE TRIALS

Guidelines for authors reporting findings from noninferiority and equivalence trials and guidance for clinicians applying results from noninferiority trials are the focus of 2 articles in this issue. In the first article, Piaggio and colleagues present an updated extension of the CONSORT (Consolidated Standards of Reporting Trials) 2010 statement to include noninferiority and equivalence trials. The authors discuss the rationale for noninferiority and equivalence trials, provide empirical evidence of trial quality, describe the CONSORT updating process, and provide examples of changes to the CONSORT checklist for reporting noninferiority and equivalence trials. In the second article—a Users' Guides to the Medical Literature—Mulla and colleagues highlight issues related to the validity and interpretation of noninferiority trials and the applicability of trial results to individual patients.

CLINICIAN'S CORNER VARICOSE VEINS AND VENOUS INSUFFICIENCY

Varicose veins and other manifestations of chronic venous insufficiency are common in middle-aged and older adults, and signs and symptoms can range from cosmetic to clinically significant. Treatment may be conservative—such as compression stockings, lifestyle changes, and medications—or involve minimally invasive or invasive surgical procedures. In a discussion of the case of a 68-year-old woman with recurrent varicose veins, Hamdan reviews the epidemiology, pathophysiology, and natural history of varicose veins; typical symptoms; patient evaluation; and treatment options.

SEE Article

JAMA CLINICAL CHALLENGE

A 31-year-old woman with a family history of recurrent pneumothorax presents with a 10-year history of facial and upper body papules. Her brother and father have similar skin lesions. Skin biopsy confirms fibrofolliculomas. What would you do next?

SEE Article

MEDICAL NEWS & PERSPECTIVES

Over the past decade, failure to adhere to safe injection practices, particularly at outpatient facilities, has led to at least 48 outbreaks of infectious diseases and placed many thousands of patients at risk.

SEE Article

VIEWPOINTS

Restructuring SNAP to reduce child hunger and obesity

SEE Article

Emergency preparedness: lessons of Hurricane Sandy

SEE Article

Mental health effects of Hurricane Sandy

SEE Article

Mobility to prevent falls in older patients

SEE Article

A PIECE OF MY MIND

“Bravo, Doctor. You knocked it out of the ballpark.” From “Warning Shot.”

SEE Article

EDITOR'S AUDIO SUMMARY

Dr Bauchner summarizes and comments on this week's issue. Go to www.jama.com.

AUTHOR IN THE ROOM TELECONFERENCE

Join Robert H. Shmerling, MD, January 16, from 2 to 3 PM eastern time to discuss the management of gout. To register, go to http://www.ihi.org/AuthorintheRoom.

JAMA PATIENT PAGE

For your patients: Information about varicose veins.

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.