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This Week in JAMA |

This Week in JAMA FREE

JAMA. 1998;280(21):1809. doi:10.1001/jama.280.21.1809.
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GABAPENTIN REDUCES PAIN OF CHRONIC NEUROPATHY

Standard treatment of chronic neuropathy often fails to provide adequate pain relief and may be associated with intolerable adverse effects, especially in elderly patients. Backonja and colleaguesArticle conducted a multicenter trial of gabapentin, an anticonvulsant, for the treatment of painful diabetic neuropathy and Rowbotham and colleaguesArticle conducted a similar trial for the treatment of postherpetic neuralgia. In both studies, the researchers found that patients treated with gabapentin had significant improvement in measures of pain severity, sleep interference, and quality of life compared with those who received placebo. Adverse effects associated with gabapentin therapy included somnolence and dizziness. In a related editorial, Low and DotsonArticle conclude that gabapentin may be the drug of first choice for the treatment of postherpetic neuralgia and for some patients with painful diabetic neuropathy.

ABDOMINAL ADIPOSITY INCREASES RISK OF CHD IN WOMEN

Abdominal obesity has been associated with an increased risk of coronary heart disease (CHD), but whether this risk is independent of total obesity has been controversial. Using data from more than 40,000 women prospectively followed up for 8 years in the Nurses' Health Study, Rexrode and colleagues found that increased abdominal adiposity measured by waist-hip ratio and waist circumference was associated with a significantly increased risk of nonfatal myocardial infarction and death from CHD in both obese and nonobese women.

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EXPLAINING THE INCREASE IN PRETERM BIRTHS

According to population-based data, the incidence of preterm births has been increasing, but this trend has been unexplained. Kramer and colleagues analyzed data from all 65,574 nonreferred births at a tertiary care hospital in Canada between 1978 and 1996. They found that the increased incidence of preterm births at this hospital was largely explained by increases in the rates of preterm induction of labor and preterm cesarean delivery without labor for complications of pregnancy and was also in part an artifact of the increased use of early ultrasound to estimate gestational age.

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RESEARCH INADEQUATE ON SEXUAL ABUSE OF BOYS

In a review of 166 studies published between 1985 and 1997 on the sexual abuse of boys, Holmes and SlapArticle found that estimates of the prevalence of sexual abuse of boys ranged from 4% to 76%, depending on the study population sampled and the definition of sexual abuse, and that the methodologic quality of the studies was generally poor. In a related editorial, FinkelhorArticle outlines a research agenda for child sexual abuse that would inform public policy by emphasizing accurate surveillance and evaluation of treatment interventions.

PROFILES IN PRIMARY CARE

An interview with pediatrician Selma Deitch, MD, MPH, who "for much of the latter half of this century has devoted her training, her energies, and her personality to improving the health of children."

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THE COVER

Charles Burchfield, The Mysterious Bird, 1917, American.

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MEDICAL NEWS & PERSPECTIVES

With World AIDS Day near, Mark Wainberg, PhD, president of the International AIDS Society, discusses the spread of HIV in the developing world.

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CONTEMPO 1998

Preventing osteoporosis in postmenopausal women.

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A PIECE OF MY MIND

"The last known house call still surviving in captivity languishes in a managed care arena near Chattanooga." From "Medical Practices Disappearing in the South."

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CALL FOR PAPERS: HEALTH PROMOTION

Original research, reviews, and commentaries are invited for the JAMA theme issue on health promotion and obesity research scheduled for the fall of 1999.

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Increasing medical student indebtedness is influencing students' choice of specialty and career path.

See MS/JAMA section.

PATIENT PAGE

For your patients: Preventing and managing sexual abuse of children.

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