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This Week in JAMA |

This Week in JAMA FREE

JAMA. 2009;302(6):599. doi:10.1001/jama.2009.1175.
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LIFESTYLE FACTORS AND RISK OF DEMENTIA

Consumption of a Mediterranean-type diet may be associated with a reduced risk of Alzheimer disease (AD), and new data on this relationship are reported in 2 articles in this issue. Scarmeas and colleagues Article investigated the association of diet and exercise with incident AD in a prospective cohort study of community-dwelling elderly persons and found that both higher adherence to a Mediterranean-type diet and increased physical activity were independently associated with a reduced risk of incident AD. In a prospective cohort study, Féart and colleagues Article examined the relationship between consumption of a Mediterranean diet and change in cognitive performance and risk of incident dementia. At a 5-year follow-up, the authors found that greater adherence to a Mediterranean diet was associated with higher Mini-Mental State Examination scores but not associated with other measures of cognitive function or risk of incident dementia. In an editorial, Knopman Article discusses the contributions of diet and other lifestyle choices to late-life cognitive function.

ASPIRIN USE AND COLORECTAL CANCER SURVIVAL

Aspirin use is associated with a reduced risk of colorectal cancer; however, the relationship between aspirin use and survival after colorectal cancer is not known. In a prospective cohort study that included 1279 men and women who were diagnosed with nonmetastatic colorectal cancer and followed up for a median 11.8 years, Chan and colleagues Article found that initiation of regular aspirin use after diagnosis was associated with a significantly lower risk of colorectal cancer–specific and overall mortality, particularly among patients whose tumors overexpress cyclooxygenase 2 (COX-2) on immunohistochemical assessment. In an editorial, Neugut Article discusses aspirin as an adjuvant therapy for colorectal cancer.

DELIVERY-RELATED DEATHS AMONG TERM INFANTS

Decreased rates of perinatal mortality in industrialized countries have been reported during the last 2 decades, with much of the reduction attributed to improvements in the management of infants delivered preterm. In an assessment of trends in delivery-related perinatal deaths among singleton term infants with cephalic presentation in Scotland, Pasupathy and colleagues found that the incidence of intrapartum stillbirth and neonatal death decreased 38% (95% confidence interval, −51% to −21%) between 1988 and 2007. The authors report a significant decline in deaths ascribed to intrapartum anoxia but no significant change in deaths ascribed to other causes.

CLINICIAN'S CORNER
A WOMAN WHO EXPERIENCED WRONG-SITE SURGERY
CLINICAL CROSSROADS

Ms W is a 62-year-old woman who underwent surgery to remove a squamous cell carcinoma from her face. When she removed the bandage, Ms W discovered that the surgery had been performed on an area to the right of the lesion, which she believes resulted from incorrect marking of the skin before surgery. Ms W had a second surgical procedure to remove the lesion. Gallagher discusses communicating with patients about medical errors, institutional responsibilities for error disclosure, and the relationship between disclosure and quality improvement.

A PIECE OF MY MIND

“It is well known that physicians are reluctant patients, and my experience certainly bears that out.” From “A Paucity of Physicians.”

MEDICAL NEWS & PERSPECTIVES

A new study links the use of stimulant medications with increased risk of sudden unexplained death, a very rare adverse event, in children and adolescents without a history of heart problems.

COMMENTARIES

Understanding influenza backward

Tobacco control's unfinished business

Interventions for chronic health problems

AUTHOR IN THE ROOM TELECONFERENCE

Join John Forman, MD, MSc, Wednesday, August 19, from 2 to 3 PM eastern time to discuss diet and lifestyle risk factors and incident hypertension in women. Register at http://www.ihi.org/AuthorintheRoom. Send questions toreplies@jama-archives.org.

READERS RESPOND

How would you manage a 52-year-old woman with morbid obesity? Go to www.jama.com to read the case, and submit your response, which may be selected for online publication. Submission deadline is September 6.

JAMA PATIENT PAGE

For your patients: Information about dementia.

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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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