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 |

This Week in JAMA FREE

JAMA. 2002;287(11):1359. doi:10.1001/jama.2012.345.
Text Size: A A A
Published online

COGNITIVE OUTCOMES AFTER ON- VS OFF-PUMP CABG SURGERY

Cerebral morbidity, including cognitive decline and stroke, has been associated with coronary artery bypass graft (CABG) surgery using cardiopulmonary bypass (on-pump surgery). In this randomized trial, Van Dijk and colleaguesArticle found that 3 months after a first CABG surgery, the incidence of cognitive decline was not significantly different between patients who received on-pump CABG surgery and those who received CABG surgery using cardiac stabilizers (off-pump surgery group), but overall improvement in cognitive outcomes was greater in the off-pump group compared with the on-pump group. At 12 months, however, differences in improvements in cognitive outcomes between the 2 groups were not statistically significant. In an editorial, Mark and NewmanArticle discuss the possible mechanisms of cognitive dysfunction after CABG surgery and emphasize the importance of additional research on neuroprotective strategies.

RISK OF NON-HODGKIN LYMPHOMA IN CELIAC DISEASE

To estimate the risk of non-Hodgkin lymphoma associated with celiac disease, Catassi and colleagues evaluated patients with newly diagnosed non-Hodgkin lymphoma (cases) and healthy adults (controls) for celiac disease using measurement of IgA class serum antiendomysial antibody level as a screening test. Celiac disease was associated with a significantly increased risk of non-Hodgkin lymphoma, especially of the T-cell type and with a primary site in the gut, although the magnitude of increased risk was lower than previous estimates.

See Article

NITRIC OXIDE SYNTHASE INHIBITOR AND INSULIN RESISTANCE

Increased levels of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, are associated with endothelial dysfunction, an abnormality that may be part of the link between insulin resistance, a feature of the metabolic syndrome, and coronary heart disease risk. In this cross-sectional study, Stühlinger and colleaguesArticle found that plasma ADMA concentrations were positively correlated with insulin resistance, as measured by steady-state plasma glucose concentrations, in both normotensive and hypertensive nondiabetic volunteers. In a subset of insulin-resistant hypertensive volunteers, insulin sensitivity improved and ADMA levels decreased after treatment for 12 weeks with rosiglitazone, an insulin-sensitizing agent. In an editorial, NashArticle discusses the complex relationship among insulin resistance, ADMA levels, and cardiovascular disease.

BIOCHEMICAL DIAGNOSIS OF PHEOCHROMOCYTOMA

The diagnosis of pheochromocytoma depends on biochemical evidence of excessive production of catecholamines by the tumor. Lenders and colleagues evaluated the diagnostic performance of several biochemical tests in a cohort of patients tested for pheochromocytoma. Plasma free metanephrines or urinary fractionated metanephrines were more sensitive diagnostic tests than measurements of plasma or urinary catecholamines or of urinary metanephrines or urinary vanillylmandelic acid. Based on receiver operating characteristic curves, measurement of plasma free metanephrines was the best test for confirming or excluding pheochromocytoma.

See Article

MEDICAL NEWS & PERSPECTIVES

The serendipitous discovery of harmless particles that exactly mimic the Ebola virus promises to speed basic research on that virulent pathogen and, possibly, the development of vaccines and drug therapies.

See Article

CLINICIAN'S CORNER

Part 1Article reviews clinical trials evaluating the efficacy of perioperative β-blocker therapy for reduction of adverse cardiac events and mortality in patients undergoing noncardiac surgery. Hypothetical cases in part 2Article illustrate clinical decision-making for perioperative β-blocker use despite limitations of the current evidence base.

ROTAVIRUS VACCINE IN THE NEWS MEDIA

An analysis of how the news media portrayed the rotavirus vaccine before and after reports of intussusception in vaccine recipients.

See Article

JAMA PATIENT PAGE

For your patients: Information about celiac disease.

See Article

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.