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This Week in JAMA |

This Week in JAMA FREE

JAMA. 2008;300(18):2095. doi:10.1001/jama.2008.629.
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Published online

JAMA-EXPRESS
VITAMINS E AND C AND CVD PREVENTION

In the randomized and placebo-controlled Physicians' Health Study II, Sesso and colleagues assessed the individual effects of vitamin E (400 IU every other day) and vitamin C (500 mg daily) supplements on the risk of major cardiovascular disease (CVD) events among 14 641 male physicians who were 50 years or older and at low risk of CVD at baseline. The authors report that compared with placebo, neither vitamin E nor vitamin C supplementation reduced the risk of major cardiovascular events during a mean follow-up of 8 years.

JAMA-EXPRESS
ASPIRIN AND ATHEROSCLEROSIS IN TYPE 2 DIABETES

To assess the efficacy of low-dose aspirin for primary prevention of cardiovascular events among patients with type 2 diabetes, Ogawa and colleagues Article from 163 institutions in Japan randomly assigned patients with type 2 diabetes and no history of atherosclerotic disease either to low-dose aspirin therapy (81 or 100 mg/d) or to a nonaspirin control group. During a median 4.37 years of follow-up, the investigators found that low-dose aspirin therapy was not associated with a significant reduction in the risk of cardiovascular events. In an editorial, Nicolucci Article discusses the role of aspirin in the primary prevention of cardiovascular disease.

NONFASTING TRIGLYCERIDES AND ISCHEMIC STROKE

Elevated levels of nonfasting triglycerides are associated with an increased risk of ischemic heart disease. The role of triglycerides in the risk of ischemic stroke is not clear. Freiberg and colleagues hypothesized that increased levels of nonfasting triglycerides increase the risk of ischemic stroke and tested their hypothesis in analyses of data from a population-based cohort study of Danish adults. In prospective and cross-sectional analyses of the study data, the authors found that increased nonfasting triglyceride levels were associated with higher risks of ischemic stroke.

EXTENSIVELY DRUG-RESISTANT TB IN THE UNITED STATES

Emergence of extensively drug-resistant tuberculosis (XDR-TB) is a global public health concern. To examine the epidemiology and clinical course of XDR-TB, Shah and colleagues analyzed TB cases that were reported in the United States from 1993 to 2007. The authors report risk factors, clinical features, and survival rates for XDR-TB compared with multidrug-resistant TB and drug-susceptible TB cases. Among the authors' findings is that 83 cases of XDR-TB have occurred in the United States since 1993. Recent declines in annual cases parallel improvements in TB and HIV/AIDS control.

CLINICIAN'S CORNER
DEPRESSION SCREENING IN CARDIOVASCULAR CARE

Several practice guidelines recommend that patients with cardiovascular disease be evaluated for depression. However, whether depression screening benefits patients with cardiovascular disease is not known. To address this question, Thombs and colleagues systematically reviewed the literature on the accuracy of depression screening in cardiovascular care and the effects of depression treatment on cardiac outcomes. The authors found that depression screening tools have reasonable accuracy and that treatment of depression is associated with modest improvement in depressive symptoms but does not improve cardiac outcomes.

A PIECE OF MY MIND

“And then I see it. There is stool everywhere: on his sheets, his VA pajamas, even his socks.” From “A Lesson Learned by Accident.”

MEDICAL NEWS & PERSPECTIVES

Studies illuminating how a gene-regulating process called methylation can sometimes play a role in cancer are beginning to lead to clinical applications.

COMMENTARIES

Shifts in thinking about dementia

Human oocyte research: ethics of oocyte donation

Population-based outcome studies of new therapies

LITERATIM

The “discovery” of ether anesthesia, and its “re-discovery” by Hollywood

AUTHOR IN THE ROOM TELECONFERENCE

Join Rita F. Redberg, MD, MSc, November 19 from 2 to 3 PM eastern time to discuss stress testing to document ischemia before PCI. To register, go to http://www.ihi.org/AuthorintheRoom.

READERS RESPOND

How would you manage a 24-year-old woman with intractable seizures since age 10 years? Go to www.jama.com, read the case, and submit your response, which may be selected for online publication. Submission deadline is November 26.

JAMA PATIENT PAGE

For your patients: Information about depression.

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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.
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