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. 2005;293(16):1949. doi:10.1001/jama.293.16.1949.
Text Size: A A A
Published online

GENETICS OF COLORECTAL CANCER

Identification and follow-up of patients at risk of familial colorectal cancer (CRC) are the subject of 2 articles in this issue of JAMA. First, Lindor and colleaguesArticle examined cancer incidence in persons with a family pedigree that suggests hereditary nonpolyposis colorectal cancer (HNPCC) but who lacked the characteristic DNA mismatch repair gene defect. They found that families without the DNA defect had a lower CRC risk, were diagnosed at a later age, and had a lower incidence of other malignancies associated with HNPCC than did families with the defect. In the second article, Piñol and colleaguesArticle assessed the accuracy of the revised Bethesda guidelines for identifying individuals at risk of HNPCC. They found that microsatellite instability testing and immunostaining are equivalent and effective in selecting patients for further genetic testing. In an editorial, Vasen and BolandArticle discuss the utility and application of molecular diagnostic tools for patients with CRC and their families.

PATIENT REQUESTS FOR ADVERTISED ANTIDEPRESSANTS

Direct-to-consumer advertising (DTCA) of prescription medications is controversial, with claims that it may cause overuse of unnecessary medication or prevent underuse of effective medication. In a randomized trial using standardized patients exhibiting symptoms of major depression or adjustment disorder, Kravitz and colleaguesArticle assessed the effects of patients’ DTCA-related requests on primary care physicians’ initial treatment decisions. For patients exhibiting signs of major depression, antidepressant prescribing rates were 76% for patients who made a general request for treatment, 53% for those who had asked for a specific brand, and 31% for patients who made no request. For patients exhibiting signs of adjustment disorder, antidepressant prescribing rates were 39% for those making a general request, 55% for those asking for a specific brand, and 10% for those who made no request. In an editorial, HollonArticle describes the relationship of DTCA to prescribing decisions and the need for evidence-based and regulated advertisements.

NEUROPROTECTIVE AND ANTIVIRAL EFFECTS OF MINOCYCLINE

Current antiretroviral drugs suppress human immunodeficiency virus (HIV) replication in peripheral blood, but effects on HIV sequestered in the central nervous system (CNS) are significantly less. With evidence that minocycline has anti-inflammatory and neuroprotective effects in animal models of disease, Zink and colleagues investigated whether it could prevent encephalitis and neurodegeneration in pigtailed macaques infected with simian immunodeficiency virus (SIV). In addition, they assessed the effect of minocycline on HIV and SIV replication in cultured lymphocytes and macrophages. They found that SIV-infected macaques treated with minocycline had less severe encephalitis and less virus replication in the CNS than did those not treated with minocycline and that minocycline suppressed HIV and SIV replication in cell cultures.

See Article

VALIDITY OF CT TO DETECT PULMONARY EMBOLISM

Computed tomography (CT) is increasingly used to assess patients with suspected pulmonary embolism, but the validity of a negative CT and the safety of withholding anticoagulant therapy are uncertain. Quiroz and colleagues analyzed pooled data from 3500 patients in studies that used CT to rule out the diagnosis of acute pulmonary embolism to calculate a negative likelihood ratio of venous thromboembolism after a negative chest CT. They found the negative predictive value for CT was comparable with pulmonary angiography and found no evidence of adverse clinical outcomes when anticoagulant therapy was withheld.

See Article

MEDICAL NEWS & PERSPECTIVES

Studies of the X chromosome reveal an unsuspected degree of genetic variation between the sexes and among women that may help explain some medically important differences between men and women.

See Article

CLINICIAN’S CORNER

Mrs H is a married and sexually active 80-year-old woman who reported recent symptoms of tissue coming out of her vagina. Cundiff discusses the pathophysiology, epidemiology, and assessment of vaginal prolapse and provides options for treatment.

See Article

JAMA PATIENT PAGE

For your patients: Information about uterine prolapse.

See Article

Tables

References

CME
Also 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.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
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.