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This Week in JAMA
JAMA. 1998;279:1051.
Can Johnnie and Janie Hear?
Parents, pediatricians, and teachers all are concerned with a child's ability to hear. Using data from a 1988-1994 survey of US children aged 6 to 19 years, Dr Niskar and colleagues found that approximately 1 in 7 children had evidence of low- or high-frequency hearing loss at 16 dB or greater. The study suggests that school hearing screening be expanded to cover a wider age range and both high and low frequencies.
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Preempting Postoperative Pain
Clinicians caring for patients facing surgery should be concerned by the possibility that patients adequately anesthetized by volatile anesthetics may experience lasting central sensitization as a result of surgical trauma. This randomized trial by Dr Gottschalk and colleagues shows that preemptive analgesia improves patients' pain control following prostatectomy.
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Looking for Impairment in Older Drivers
Medical conditions that can impair driving ability become more common with advancing age, although most older people can and do drive safely. Identifying which older drivers are at risk for crashes is key for targeting those who might need retraining, therapy, or driving restrictions. Dr Owsley and colleagues found that a measure of visual processing ability can identify potential problem drivers.
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Does This Patient Have DVT?
Signs and symptoms do not reliably predict which patients have deep vein thrombosis, but noninvasive testing cannot be performed on every patient with leg pain or swelling. In this Rational Clinical Exam article, Dr Anand and colleagues show how signs and symptoms can be combined to reliably stratify patients into groups with a high, low, or intermediate pretest probability of having DVT.
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More Attention to Attention-Deficit/Hyperactivity Disorder
Few neuropsychiatric syndromes among children and adolescents generate as much professional, parental, and public concern as has attention-deficit/hyperactivity disorder. In this report from the AMA Council on Scientific Affairs, Dr Goldman and colleagues present a thorough evaluation of the epidemiology, diagnostic criteria, clinical course, and pharmacologic treatment of this relatively common yet controversial syndrome.
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AIDS and HIV Infection in the Courts
Balancing patients' rights against the collective rights of the public for health protection is just one example of how the HIV/AIDS epidemic has tested the legal system. This article examines HIV/AIDS-related litigation in the health care system reported in US federal and state courts. As the authors demonstrate, courts and lawmakers already have tackled many challenging issues—including voluntary testing, mandatory reporting, duty to warn, duty to treat, and discrimination—with many more sure to come.
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The Cover
"Ironically, now, in the autumn of the millennium, there are signs of rebirth: Artists throughout Russia are once again beginning to create the porcelain eggs, combining all the heritage of the past with the newness of the future."— Imperial Porcelain Manufactory, Spring Flowers in Two Panels, mid-19th century.
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Medical News & Perspectives
Highlights from the first International Conference on Emerging Infectious Diseases.
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A Piece of My Mind
"I soon realized my patient was one who had been just that—a patient—for most of his 48 years." From "The Teaching Case."
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New Feature: Profiles in Primary Care
In this issue, we launch Profiles in Primary Care. Drawn from the oral histories of dozens of general practitioners interviewed by Fitzhugh Mullan, MD, the series makes an "eloquent case that medical generalism is a fascinating, important, and precious calling."
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To Our Peer Reviewers—Thank You
Peer review is essential to biomedical publication. We extend our sincere thanks to the 3276 JAMA peer reviewers for their thoughtful, scholarly, and timely reviews in 1997.
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