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To the Editor. —We cannot agree with the JAMA editorial by Trimble1 that phenytoin produces greater impairment of cognitive functions than either carbamazepine or valproate sodium. The studies cited by Trimble have both methodological and statistical shortcomings that limit the confidence with which conclusions can be drawn, and his literature review selectively omits contradictory results.Thompson et al2,3 examined the effects of phenytoin and valproate on healthy subjects in separate studies and concluded that phenytoin produces greater functional impairment. However, results from these reports cannot be compared directly since they were not derived using identical approaches to data analysis (ie, treatment minus baseline difference scores for phenytoin2 and drug vs placebo contrasts for valproate3).To directly compare results from these studies, we calculated the Student t tests from their data. Comparing phenytoin with valproate treatment, we observed significant differences for both color (P<.01) and category
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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