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This Week in JAMA
JAMA. 1998;279:1145.
The Haitian Diethylene Glycol Poisoning Epidemic
A 1995-1996 epidemic of acute renal failure among Haitian children was traced to locally produced acetaminophen syrups tainted with diethylene glycol. A public health warning and product recall resolved the problem, but only after 88 children had died. Dr O'Brien and colleagues (SEE ARTICLE) conducted both a case-control study and prospective cohort study to investigate toxic doses of this contaminant and other risk factors for development of poisoning. Their work underscores the need for strict quality control by all pharmaceutical makers and for low-cost methods of adequate safety testing.
related editorial (SEE ARTICLE)
Montelukast for Chronic Asthma in Children
The US Food and Drug Administration recently approved the first in a new class of asthma medications, leukotriene inhibitors. In this randomized, double-blind study, Dr Knorr and colleagues evaluated another such agent, montelukast, among 6- to 14-year-olds with mild to moderate asthma. After 8 weeks, the predefined primary outcome measure, forced expiratory volume in 1 second (FEV1), improved significantly in the montelukast group, as did several secondary outcomes.
(SEE ARTICLE)
Predicting Mortality in Hospitalized Elderly Patients
Functional status is a powerful predictor of survival in older adults. However, several burdens of illness indices often used to predict mortality in populations of hospitalized patients, such as APACHE and the Charlson index, do not include functional status. Dr Inouye and colleagues add functional status to these indices to determine how well they predict 90-day and 2-year mortality in 2 populations of elderly patients.
(SEE ARTICLE)
Serious and Fatal Drug Reactions in US Hospitals
Medications, potentially life-saving when used against illness, also can be dangerous and sometimes lethal. In this meta-analysis, Dr Lazarou and colleagues (SEE ARTICLE) determine the proportion of patients hospitalized in the United States who are affected by serious or fatal drug reactions defined as a noxious, unintended, or undesired effect of a drug that occurs at therapeutic doses.
related editorial (SEE ARTICLE)
Prophylaxis for Invasive Streptococcal Disease
Given the severity of invasive group A streptococcal infection, health professionals often face difficult questions about patient management and protection of the public. In this consensus statement, a national multidisciplinary working group critically examines the existing data on the risk of transmission of invasive group A streptococcal infection to personal contacts of affected patients. The group also tries to determine whether antimicrobial prophylaxis should be recommended to reduce that risk for household contacts of patients.
(SEE ARTICLE)
Preventing Relapse for Recovering Substance Abusers
Patients recovering from alcohol abuse or other substance abuse disorders face daily challenges in remaining substance free. Dr Friedmann and colleagues emphasize the importance of a supportive relationship between the recovering patient and the primary care physician. Their report also presents practical strategies for helping patients decrease susceptibility to relapse, manage situations at high risk for relapse, and use available self-help and specialty resources.
(SEE ARTICLE)
The Cover
". . . it also extends a sympathetic and human view of city dwellers as they negotiate the city's canyons." Paul Cornoyer, The Plaza After Rain, c1910, American.
(SEE ARTICLE)
Medical News & Perspectives
The first report from the group Physician Leadership on National Drug Policy says addiction can be treated as successfully as other chronic diseases and costs less than incarceration.
(SEE ARTICLE)
A Piece of My Mind
"Jinx put on no airs and suffered none either. He clearly was not a doctor for the faint of heart, delicate of virtue, pompous, pious, or humorless. . . . He was a blue collar doc, a presence with an attitude." From "Remembering Jinx."
(SEE ARTICLE)
JAMA NetSight
Spam, bread crumbs, and cookies. Lunch leftovers? No, just some of the terms used in discussing privacy issues on the Internet. In our guide to interactive medicine.
(SEE ARTICLE)
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