 |
|
This Week in JAMA
JAMA. 2003;289:1205.
Homocysteine Levels and Congestive Heart Failure Risk
Elevated plasma homocysteine levels have been shown to be a risk factor for vascular disease. To study whether homocysteine levels are associated with risk of congestive heart failure, Vasan and colleagues analyzed 8-year follow-up data from adults who participated in the Framingham Heart Study during the 1979-1982 and 1986-1990 examinations and who were free of congestive heart failure or prior myocardial infarction at baseline. Plasma homocysteine levels higher than the sex-specific median value were associated with a significantly increased risk of incident heart failure in both men and women.
(SEE ARTICLE)
Passive Smoking and Risk of Pediatric Dental Caries
Dental caries disproportionately affect children living in poverty. Experimental evidence suggests that environmental tobacco smoke may have a causal role in caries formation. In this analysis of data from children aged 4 to 11 years who participated in the Third National Health and Nutrition Examination Survey (1988-1994), Aligne and colleagues found that passive smoking as indicated by serum cotinine levels of 0.2 to 10 ng/mL was significantly associated with decayed and filled tooth surfaces in deciduous but not in permanent teeth.
(SEE ARTICLE)
Hidden Epidemic of Chlamydial Infection in China
The prevalence of sexually transmitted diseases in China has increased rapidly during the last 2 decades. Between August 1999 and August 2000, Parish and colleagues (SEE ARTICLE) conducted a national population-based study of Chinese adults aged 20 to 64 years to estimate the prevalence of genital chlamydial infections, which is not tracked in China's public health reporting system, and the prevalence of gonorrheal infections. The overall prevalence of chlamydial infection per 100 population was 2.1 among men and 2.6 among women; and of gonorrheal infection, 0.02 among men and 0.08 among women. Risk of chlamydial infection among men was significantly associated with unprotected sex with a commercial sex worker. The risk of chlamydial infection among women was largely associated with behaviors of their spouse or steady sexual partner. In an editorial, Beyrer (SEE ARTICLE) discusses China's current vulnerability to a widespread heterosexual HIV epidemic and interventions that target commercial sex networks.
Hand Hygiene Agents Against a B anthracis Surrogate
Current guidelines for handwashing and hand antisepsis recommend hand hygiene with nonantimicrobial soap and water or with antimicrobial soap and water if exposure to Bacillus anthracis is suspected or proven, but only limited data are available on the susceptibility of B anthracis to antiseptics. Weber and colleagues used the Standard Test Method for Evaluation of the Effectiveness of Health Care Professional Handwash Formulations to evaluate the efficacy of several hand antiseptics and nonantimicrobial soap and water against B atrophaeus, a surrogate of B anthracis, at wash times of 10, 30, and 60 seconds. Handwashing for 10 seconds with nonantimicrobial soap under running water or with 2% chlorhexidine gluconate was very effective in reducing the amount of B atrophaeus spore contamination on hands. Handwashing with chlorine-containing microfiber towels was increasingly effective as wash time increased, but a waterless rub containing 61% ethyl alcohol was ineffective in eliminating B atrophaeus spores at all wash times.
(SEE ARTICLE)
Medical News & Perspectives
Only one man died during Lewis and Clark's 8000-mile expedition across western North America. During the bicentennial of this grand enterprise, a new exhibit at the College of Physicians of Philadelphia explores the expedition's medical adventures.
(SEE ARTICLE)
Crisis in Bench to Bedside Research
Obstacles to the translation of basic science research into clinical studies (SEE ARTICLE) and from clinical studies into clinical practice and health decision making: analysis and call to action (SEE ARTICLE) .
CLINICIAN'S CORNER
Colorectal Cancer Screening
Scientific Review/Clinical Applications
Part 1 (SEE ARTICLE) of this 2-part article assesses the evidence on the efficacy of colorectal screening tests for prevention of colorectal cancer. Part 2 (SEE ARTICLE) summarizes available evidence to answer commonly asked clinical questions about colorectal cancer screening.
Contempo Updates
Management of conjoined twins.
(SEE ARTICLE)
JAMA Patient Page
For your patients: Information about colon cancer screening.
(SEE ARTICLE)
|
