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* This Week in the Journal
 August 2, 2007
 Audio Icon Audio Summary
*
Correspondence
* Reducing Asthma Treatment
* Beclomethasone and Albuterol in Mild Asthma
* A National Survey of Physician–Industry Relationships
* A Decline in Breast-Cancer Incidence
* Severe Cutaneous Reaction during Radiation Therapy with Concurrent Cetuximab
*
Book Reviews
* Prescribing by Numbers: Drugs and the Definition of Disease
* Patients with Substance Abuse Problems: Effective Identification, Diagnosis, and Treatment
* Diagnosing Genius: The Life and Death of Beethoven
*
Continuing Medical Examination
* Prevalence of Rheumatic Heart Disease Detected by Echocardiographic Screening
* Prevention of Preterm Delivery
* A Growing Problem
Original Articles
Genomewide Association Analysis of Coronary Artery Disease

Using the technique of genomewide association analysis, the authors found a locus on chromosome 9 (9p21.3) that is strongly associated with familial coronary artery disease. The precise gene that may be involved is not known and will require further study, but this type of genomic analysis is likely to lead to a deeper understanding of the pathogenesis of coronary artery disease and other chronic diseases.

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Original Articles
Progesterone for the Prevention of Preterm Delivery of Twins

Although 17 alpha-hydroxyprogesterone caproate (17P) has been shown to reduce the rate of recurrent preterm birth in singleton gestations, 17P did not reduce the risk of delivery or fetal death before 35 weeks of gestation in this randomized, placebo-controlled trial involving women with twin gestations. These data do not support the use of 17P to reduce the risk of preterm birth in twin gestations.

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Original Articles
Progesterone and Preterm Delivery among Women with a Short Cervix

Asymptomatic women who have a short cervix at midgestation are at increased risk for spontaneous early preterm delivery. In this randomized trial, women with a short cervix (15 mm or less in length) assigned to treatment with vaginal progesterone had a significantly lower rate of spontaneous delivery before 34 weeks of gestation than did women assigned to placebo. In contrast to another trial published in this issue of the Journal, which showed no reduction in the risk of preterm birth among women with twins treated with 17 alpha-hydroxyprogesterone caproate, this study indicates the efficacy of vaginal progesterone in reducing this risk among women with a short cervix.

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Original Articles
Prevalence of Rheumatic Heart Disease in Asia and Africa

Screening for rheumatic heart disease in children was undertaken in Cambodia and Mozambique. In both countries, echocardiographic screening showed a much higher prevalence of rheumatic heart disease in children than did clinical screening. The findings have important public health implications for secondary prevention of this serious disorder, which is particularly prevalent in the developing world.

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Review Article
Drug Therapy: Prevention of Preterm Delivery

Although preterm birth (at <37 weeks' gestation) is sometimes indicated for the health of the mother or her fetus, spontaneous preterm births occur as a consequence of spontaneous preterm labor or preterm rupture of fetal membranes before the onset of labor. This review focuses on therapeutic strategies for the prevention and treatment of spontaneous preterm labor and delivery.


Clinical Problem-Solving
A Growing Problem

A 36-year-old pregnant woman at 21 weeks' gestation presented with a 4-week history of a dry, nonproductive cough. She said she had no fever, chills, dyspnea, chest pain, or weight loss. She had no new pets, environmental exposures, or sick contacts.


Clinical Implications of Basic Research
Changing the Trajectory of Cognitive Decline?

Environmental enrichment or intracranial injection of a histone deacetylase inhibitor results in improved memory function in mice with neurodegeneration.


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