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This Week in JAMA
JAMA. 1999;281:1871.
Injuries and Deaths From Falls Among Older Adults
The risk of falling and the severity of associated complications increase with advancing age. To determine trends in the epidemiology of injuries and deaths secondary to falls among older adults, Kannus and colleagues analyzed data on individuals aged 50 years and older from the National Hospital Discharge Register and the Official Cause-of-Death Statistics of Finland. They found a marked increase in the age-adjusted incidence of fall-induced injuries for both men and women between 1970 and 1995, but the age-adjusted incidence of fall-induced deaths between 1971 and 1995 did not show an increasing trend.
(SEE ARTICLE)
Practice Guidelines Fail to Meet Standards
Shaneyfelt and colleagues evaluated clinical practice guidelines to assess how well they adhere to methodological standards. On average, clinical practice guidelines met fewer than half of the standards and were particularly deficient in reporting how evidence was identified, evaluated, and synthesized. In an editorial, Cook and Giacomini point out that the criteria used in this study may not be suitable for all guidelines and emphasize the importance of measuring the effect of guidelines on clinical and economic outcomes.
(SEE ARTICLE) and editorial (SEE ARTICLE)
Meningococcal Infection Among College-Aged Persons
The number of outbreaks of meningococcal infection on college campuses has increased recently, but in this study of cases of meningococcal infection among Maryland residents between 1992 and 1997, Harrison and coworkers found that the incidence of meningococcal infection in college students was similar to that in the general population of the same age. The incidence of meningococcal infection was significantly higher, however, among students at 4-year colleges living on campus compared with those living off campus.
(SEE ARTICLE)
Smoke-Free Restaurant Laws Do Not Hurt Tourism
The tobacco industry has argued that ordinances that prohibit smoking in restaurants adversely affect tourism. Glantz and Charlesworth, however, report that the rate of growth in hotel revenues as a marker of tourism increased or remained steady in 8 of 9 US study localities after passage of 100% smoke-free restaurant ordinances.
(SEE ARTICLE)
Drug Treatment of Stable Angina
In this meta-analysis of trials that compared the efficacy and safety of drugs for the treatment of stable angina, Heidenreich and colleagues found that the number of episodes of angina per week and discontinuation of treatment because of adverse events were less frequent with  -blockers than with calcium antagonists. Rates of cardiac death and myocardial infarction among patients treated with -blockers or calcium antagonists were similar, but most of the studies were short-term. There were no significant differences in outcomes in the few studies comparing long-acting nitrates with calcium antagonists or -blockers.
(SEE ARTICLE)
A 44-Year-Old Terminally Ill Woman With Severe Pain
During the 2-week hospitalization that ended with her death from metastatic lung cancer, Mrs L experienced severe back pain and headache despite different therapies for pain. Foley discusses effective pain management strategies for patients with end-stage cancer.
(SEE ARTICLE)
Contempo 1999
Genetic factors associated with alcohol abuse and dependence.
(SEE ARTICLE)
Medical News & Perspectives
Schizophrenia researchers hope that early detection and intervention will lead to a better prognosis for people with this mental disorder.
(SEE ARTICLE)
Quality of Genetics Research
Bogardus and colleagues examine the epidemiologic quality of molecular genetic research studies published in 4 major general medical journals.
(SEE ARTICLE)
Cesarean to Prevent HIV?
Stringer and colleagues argue that evidence is insufficient to support the use of cesarean delivery to prevent perinatal transmission of human immunodeficiency virus (HIV) in most circumstances.
(SEE ARTICLE)
JAMA Patient Page
For your patients: Preventing falls among the elderly.
(SEE ARTICLE)
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