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This Week in JAMA
JAMA. 1999;281:301.
Moderate Physical Activity Improves Health, Fitness
Moderate lifestyle physical activity may provide long-term health benefits comparable with those of vigorous structured exercise. Dunn and colleagues found that after 6 months, sedentary adults randomly assigned to a traditional exercise program had greater improvements in cardiorespiratory fitness than subjects in a lifestyle physical activity program. However, the subsequent decline in fitness in the 2 groups was greater in the traditional exercise group, and at 24 months, fitness was similar in both groups. Andersen and colleagues report that weight loss and improvement in fitness at 1 year were similar in obese women treated with a low-fat diet and structured aerobic exercise and those treated with diet plus moderate lifestyle activity. In an editorial, Pratt comments that many physical activity options that would benefit health are available to patients.
(SEE ARTICLE) | (SEE ARTICLE) and editorial (SEE ARTICLE)
Genetic Factors in Parkinson Disease
To evaluate the role of genetic factors in Parkinson disease, Tanner and colleagues screened more than 19,000 twins aged 65 years and older enrolled in a US twin registry. Overall, pairwise concordance for Parkinson disease was low in both monozygotic and dizygotic twin pairs, suggesting that genetic factors do not play an important role in the etiology of Parkinson disease. However, pairwise concordance was observed in all 4 monozygotic twin pairs and in only 2 of 12 dizygotic twin pairs with Parkinson disease diagnosed before age 51 years. In an editorial, Cummings suggests that future research should focus on environmental triggers for typical Parkinson disease and on genetic factors for early-onset Parkinson disease.
(SEE ARTICLE) and editorial (SEE ARTICLE)
Cost-effectiveness of Screening for Cervical Cancer
ThinPrep, AutoPap, and Papnet are new technologies that increase the sensitivity of the Papanicolaou (Pap) test for cervical cancer, but at an increased cost. Brown and Garber estimated the cost-effectiveness of these technologies in a hypothetical screening program with varying screening frequency. They found that these 3 new technologies are not cost-effective when added to annual conventional Pap testing, but are more cost-effective when added to less frequent screening.
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Quality of Life of Survivors of ARDS
Health-related quality of life is reduced in survivors of acute respiratory distress syndrome (ARDS), but the specific influences of ARDS on quality-of-life outcomes, distinct from those of other aspects of critical illnesses, are not known. Davidson and coworkers found that quality-of-life outcomes were significantly worse in survivors of ARDS with a diagnosis of sepsis or trauma than in severity- and diagnosis-matched controls without ARDS. Hospitalization was longer in survivors of ARDS than in matched controls; however, among survivors of ARDS, length of mechanical ventilation and of hospitalization were not associated with differences in most quality-of-life outcomes.
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A Woman With Premenstrual Dysphoric Disorder
Ms V reports that since menarche she has had serious, recurrent symptoms of depression, anxiety, and irritability associated with her menstrual cycle, consistent with a diagnosis of premenstrual dysphoric disorder (PMDD). Parry discusses therapeutic options for PMDD and points out that failure to treat PMDD may increase the severity and frequency of PMDD episodes, the risk of treatment resistance, and the risk of other mood disorders.
(SEE ARTICLE)
Contempo 1999
Glaucomatous damage leads to a loss of neural tissue in the optic nerve and enlargement of the optic cup. Advances in the understanding of the pathogenesis of glaucoma may change the approach to therapy.
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Medical News & Perspectives
New assays test whether a strain of HIV is resistant to anti-HIV drugs.
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Special Communication
Economic factors limit access to effective medications and vaccines in developing countries, compromising the health of populations worldwide.
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Controversies
Direct-to-consumer advertising of prescription drugs: informing or misleading patients?
(SEE ARTICLE) and (SEE ARTICLE)
JAMA Patient Page
For your patients: Health benefits of physical activity.
(SEE ARTICLE)
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