This Week in JAMA FREE

A JAMA THEME ISSUE

Edited by Catherine D. DeAngelis, MD, MPH, and Richard M. Glass, MD

In 300 breast cancer patients with a family history of 4 or more cases of breast or ovarian cancer and who had negative genetic test results for BRCA1 and BRCA2, Walsh and colleagues assessed the frequency and types of undetected cancer-predisposing mutations in BRACA1, BRACA2, CHEK2, TP53, and PTEN. The authors identified previously undetected mutations in 52 of the women. Thirty-five women had rare mutations in BRCA1 and BRCA2, 14 had a mutation in CHEK2, and 3 had a mutation in TP53.

Children of depressed parents have high rates of mental disorders. Whether treatment of parental depression reduces psychopathology in their children is not known. Weissman and colleagues studied 151 mother-child pairs and found that treatment and remission of maternal depression was associated with reduced symptoms and diagnoses in their children. Conversely, among mothers with unremitting depression, symptoms and diagnoses in their children increased.

Two articles in this issue examine the relationships of physical activity and body mass index (BMI) to heart disease in women. First, Whang and colleaguesArticle assessed the association of moderate to vigorous exercise with sudden cardiac death and found an exceedingly low risk of sudden cardiac death, which could be reduced further with regular exercise. In a second article, Mora and colleaguesArticle examined the associations of physical activity and BMI with lipid and inflammatory biomarkers of cardiac health. They found that lower levels of physical activity and, in particular, higher levels of BMI were independently associated with adverse levels of most cardiovascular biomarkers. Within BMI categories, physically active women had more favorable levels compared with inactive women.

Hemingway and colleagues analyzed data from a prospective cohort study in Finland to determine sex differences in the incidence and prognosis of chronic stable angina. The authors found a similar angina incidence and rates of coronary mortality and fatal and nonfatal myocardial infarction in women and men.

Some studies suggest low-dose aspirin may not have similar cardioprotective benefit in women and men. To examine these sex differences, Becker and colleagues investigated the effects of aspirin, 81 mg/d for 2 weeks, on platelet function tests. The authors found that women had slightly greater platelet reactivity compared with men following aspirin therapy. However, women had total suppression of the direct cyclooxygenase 1 pathway, the likely mechanism for aspirin's cardioprotective effect.

Migeon discusses the contributions of X inactivation and cellular mosaicism to sex-specific diseases, disease heterogeneity, and physiologic diversity.

“[My mother] was like an actor who feels joy in performing a play despite knowing that the fleeting beauty she creates will find refuge only in her audience's fragile memory.” From “Hauntings.”

Disturbed sleep during pregnancy is so common that it is often overlooked as a cause of significant morbidity.

Ms T, 62, was diagnosed with stage I infiltrating lobular carcinoma and treated with lumpectomy and radiation. Come discusses the epidemiology and prognosis of breast cancer and adjuvant endocrine therapy.

The Archives of Dermatology includes 2 articles on sex differences in disease risk and manifestations. Robinson reviews women's susceptibility to sexually transmitted diseases and prevalence of autoimmune diseases.

Pregnant women should be entitled to fetal karyotype determination.

DeAngelis and Glass discuss advances in women's health.

For your patients: Information about women's health.