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. 2006;296(17):2059. doi:10.1001/jama.296.17.2059.
Text Size: A A A
Published online

CONSTRAINT-INDUCED MOVEMENT THERAPY AFTER STROKE

Despite traditional rehabilitation, a high percentage of stroke survivors have persistent functional limitations of affected extremities. The multicenter randomized Extremity Constraint Induced Therapy Evaluation (EXCITE) trial compared the effects of 2 weeks of constraint-induced movement therapy (CIMT) vs usual care for patients who had upper extremity paresis and had experienced a stroke 3 to 9 months before trial entry. Wolf and colleaguesArticle, writing for the EXCITE investigators, report that compared with patients who had received usual care, patients randomly assigned to CIMT had significantly greater improvements in arm motor function. These improvements persisted for up to 1 year and were not influenced by age, sex, or arm function at trial enrollment. In an editorial, Luft and HanleyArticle discuss the EXCITE trial results and directions for future research in stroke rehabilitation.

STATIN THERAPY AND ADVERSE EVENTS IN HEART FAILURE

Epidemiological studies have suggested that a link exists between low lipoprotein levels and an increased risk of adverse events in individuals with heart failure. Go and colleagues evaluated the association between initiation of statin therapy and risks of death and hospitalization in a cohort of adults with heart failure who were eligible for lipid-lowering therapy. The authors found that statin therapy was independently associated with lower risks of death and hospitalization among patients with heart failure whether or not they had coronary artery disease.

RISK OF SUICIDE ATTEMPTS AMONG BLACKS

Interventions to reduce suicide among black Americans are limited by a lack of data on suicide prevalence and risks in this population. Joe and colleagues analyzed data from a nationally representative survey to assess the prevalence and correlates of suicide ideation, planning, and attempts among blacks of African American and Caribbean ethnicity. The authors found a lifetime prevalence of 11.7% for suicide ideation and 4.1% for suicide attempts, levels that are comparable with the general population. Caribbean black men had the highest prevalence of attempts. Other factors associated with suicide attempts included younger age, lower education, Midwest residence, and having 1 or more psychiatric disorders.

SEROTONERGIC BRAINSTEM ABNORMALITIES IN SIDS

Serotonergic (5-HT) neurons in the medulla oblongata project to respiratory and autonomic nuclei in the brainstem and spinal cord, and previous studies identified abnormalities in medullary 5-HT receptor binding in a subset of cases of sudden infant death syndrome (SIDS). Paterson and colleaguesArticle investigated cellular defects associated with altered 5-HT receptor binding in autopsy samples obtained from 31 SIDS cases and 10 infant controls. The authors report that compared with control infants, SIDS cases had a higher number and density of 5-HT neurons and lower density of binding sites in regions of the medulla involved in homeostatic functions. In an editorial, Weese-MayerArticle discusses the neuropathology of SIDS and the importance of confirming these findings in autopsy studies reflecting the ethnic diversity of SIDS.

A PIECE OF MY MIND

“The hospital bond feels deeper than 2 people sharing the patient's dramatic story of recovery from illness.” From “The Hospitalist's Story.”

MEDICAL NEWS & PERSPECTIVES

An Institute of Medicine committee is calling for sweeping improvements in the Food and Drug Administration’s efforts to ensure drug safety, particularly measures that increase the agency’s postmarket safety monitoring activities and expand its regulatory authority.

CLINICIAN'S CORNER

Ms K is a 47-year-old woman who was recently diagnosed with sarcoidosis. Weinberger discusses the diagnosis, pathophysiology, treatment, and prognosis of sarcoidosis.

AUTHOR IN THE ROOM TELECONFERENCE

Join Dariush Mozaffarian, MD, DrPH, Wednesday, November 15, 2006, from 2 to 3 PM eastern time to discuss the risks and benefits of eating fish. To register, go to http://www.ihi.org/AuthorintheRoom.

AUDIO COMMENTARY

Dr DeAngelis summarizes and comments on this week's issue. Go to http://jama.ama-assn.org/misc/audiocommentary.dtl.

JAMA PATIENT PAGE

For your patients: Information about sarcoidosis.

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.