4041. Uninsured children and adolescents with insured parents.
Millions of US children and adolescents lack health insurance coverage. Efforts to expand their insurance often focus on extending public coverage to uninsured parents. Less is known about the uninsured whose parents already have coverage.
4042. High-dose B vitamin supplementation and cognitive decline in Alzheimer disease: a randomized controlled trial.
作者: Paul S Aisen.;Lon S Schneider.;Mary Sano.;Ramon Diaz-Arrastia.;Christopher H van Dyck.;Myron F Weiner.;Teodoro Bottiglieri.;Shelia Jin.;Karen T Stokes.;Ronald G Thomas.;Leon J Thal.; .
来源: JAMA. 2008年300卷15期1774-83页
Blood levels of homocysteine may be increased in Alzheimer disease (AD) and hyperhomocysteinemia may contribute to disease pathophysiology by vascular and direct neurotoxic mechanisms. Even in the absence of vitamin deficiency, homocysteine levels can be reduced by administration of high-dose supplements of folic acid and vitamins B(6) and B(12). Prior studies of B vitamins to reduce homocysteine in AD have not had sufficient size or duration to assess their effect on cognitive decline.
4043. Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment.
作者: Alexi A Wright.;Baohui Zhang.;Alaka Ray.;Jennifer W Mack.;Elizabeth Trice.;Tracy Balboni.;Susan L Mitchell.;Vicki A Jackson.;Susan D Block.;Paul K Maciejewski.;Holly G Prigerson.
来源: JAMA. 2008年300卷14期1665-73页
Talking about death can be difficult. Without evidence that end-of-life discussions improve patient outcomes, physicians must balance their desire to honor patient autonomy against a concern of inflicting psychological harm.
4044. Variants of the adiponectin (ADIPOQ) and adiponectin receptor 1 (ADIPOR1) genes and colorectal cancer risk.
作者: Virginia G Kaklamani.;Kari B Wisinski.;Maureen Sadim.;Cassandra Gulden.;Albert Do.;Kenneth Offit.;John A Baron.;Habibul Ahsan.;Christos Mantzoros.;Boris Pasche.
来源: JAMA. 2008年300卷13期1523-31页
Current epidemiological evidence suggests an association between obesity, hyperinsulinemia, and colorectal cancer risk. Adiponectin is a hormone secreted by the adipose tissue, and serum levels are inversely correlated with obesity and hyperinsulinemia. While there is evidence of an association between circulating adiponectin levels and colorectal cancer risk, no association between genes of the adiponectin pathway and colorectal cancer have been reported to date.
4047. Regional variation in out-of-hospital cardiac arrest incidence and outcome.
作者: Graham Nichol.;Elizabeth Thomas.;Clifton W Callaway.;Jerris Hedges.;Judy L Powell.;Tom P Aufderheide.;Tom Rea.;Robert Lowe.;Todd Brown.;John Dreyer.;Dan Davis.;Ahamed Idris.;Ian Stiell.; .
来源: JAMA. 2008年300卷12期1423-31页
The health and policy implications of regional variation in incidence and outcome of out-of-hospital cardiac arrest remain to be determined.
4048. Prevalence of colon polyps detected by colonoscopy screening in asymptomatic black and white patients.
作者: David A Lieberman.;Jennifer L Holub.;Matthew D Moravec.;Glenn M Eisen.;Dawn Peters.;Cynthia D Morris.
来源: JAMA. 2008年300卷12期1417-22页
Compared with white individuals, black men and women have a higher incidence and mortality from colorectal cancer and may develop cancer at a younger age. Colorectal cancer screening might be less effective in black individuals, if there are racial differences in the age-adjusted prevalence and location of cancer precursor lesions.
4050. Neurologic manifestations of von Hippel-Lindau disease.
von Hippel-Lindau disease (VHL) is an autosomal-dominant neoplasia syndrome that is the result of a germline mutation of the VHL tumor suppressor gene on the short arm of chromosome 3. Patients with VHL are predisposed to develop lesions of the central nervous system and viscera. Central nervous system lesions include hemangioblastomas (the most common tumor in VHL) and endolymphatic sac tumors (ELSTs). Visceral manifestations include renal carcinomas and cysts, pancreatic neuroendocrine tumors and cysts, pheochromocytomas, and cystadenomas of the reproductive adnexal organs. Despite their benign pathology, hemangioblastomas and ELSTs are a frequent cause of morbidity and mortality in patients with VHL. Recent molecular biologic investigations into these VHL-associated central nervous system lesions provide new insight into their origin and development. Emerging data from serial imaging and clinical surveillance protocols provide insight into the natural history of these lesions. Because of the dissimilar pathobiology and clinical course between hemangioblastomas and ELSTs, the optimal management strategies for these neurologic manifestations of VHL are very different.
4051. Prevalence of symptomatic pelvic floor disorders in US women.
作者: Ingrid Nygaard.;Matthew D Barber.;Kathryn L Burgio.;Kimberly Kenton.;Susan Meikle.;Joseph Schaffer.;Cathie Spino.;William E Whitehead.;Jennifer Wu.;Debra J Brody.; .
来源: JAMA. 2008年300卷11期1311-6页
Pelvic floor disorders (urinary incontinence, fecal incontinence, and pelvic organ prolapse) affect many women. No national prevalence estimates derived from the same population-based sample exists for multiple pelvic floor disorders in women in the United States.
4052. Awareness and use of California's Paid Family Leave Insurance among parents of chronically ill children.
作者: Mark A Schuster.;Paul J Chung.;Marc N Elliott.;Craig F Garfield.;Katherine D Vestal.;David J Klein.
来源: JAMA. 2008年300卷9期1047-55页
In 2004, California's Paid Family Leave Insurance Program (PFLI) became the first state program to provide paid leave to care for an ill family member.
4054. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial.
Hyperuricemia is a predictor for the development of hypertension and is commonly present in new-onset essential hypertension. Experimentally increasing uric acid levels using a uricase inhibitor causes systemic hypertension in animal models.
4055. Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet.
作者: Robert B Saper.;Russell S Phillips.;Anusha Sehgal.;Nadia Khouri.;Roger B Davis.;Janet Paquin.;Venkatesh Thuppil.;Stefanos N Kales.
来源: JAMA. 2008年300卷8期915-23页
Lead, mercury, and arsenic have been detected in a substantial proportion of Indian-manufactured traditional Ayurvedic medicines. Metals may be present due to the practice of rasa shastra (combining herbs with metals, minerals, and gems). Whether toxic metals are present in both US- and Indian-manufactured Ayurvedic medicines is unknown.
4056. Nut, corn, and popcorn consumption and the incidence of diverticular disease.
作者: Lisa L Strate.;Yan L Liu.;Sapna Syngal.;Walid H Aldoori.;Edward L Giovannucci.
来源: JAMA. 2008年300卷8期907-14页
Patients with diverticular disease are frequently advised to avoid eating nuts, corn, popcorn, and seeds to reduce the risk of complications. However, there is little evidence to support this recommendation.
4058. Within-person across-neuropsychological test variability and incident dementia.
作者: Roee Holtzer.;Joe Verghese.;Cuiling Wang.;Charles B Hall.;Richard B Lipton.
来源: JAMA. 2008年300卷7期823-30页
Neuropsychological tests are used to predict and diagnose dementia. However, to our knowledge, no studies to date have examined whether within-person across-neuropsychological test variability predicts dementia.
4060. Comparison of mental health between former child soldiers and children never conscripted by armed groups in Nepal.
作者: Brandon A Kohrt.;Mark J D Jordans.;Wietse A Tol.;Rebecca A Speckman.;Sujen M Maharjan.;Carol M Worthman.;Ivan H Komproe.
来源: JAMA. 2008年300卷6期691-702页
Former child soldiers are considered in need of special mental health interventions. However, there is a lack of studies investigating the mental health of child soldiers compared with civilian children in armed conflicts.
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