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In This Issue of JAMA
July 17, 2013


Author Affiliations

Copyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2013;310(3):223-225. doi:10.1001/jama.2013.5209

In a randomized trial that enrolled 268 consecutive patients with in-hospital cardiac arrest requiring epinephrine, Mentzelopoulos and colleagues compared combined vasopressin-epinephrine during cardiopulmonary resuscitation (CPR) and corticosteroid supplementation during and after CPR with saline placebo plus epinephrine during CPR and saline placebo for postresuscitation shock. The authors found that vasopressin-epinephrine and methylprednisolone during cardiopulmonary resuscitation and stress-dose hydrocortisone in postresuscitation shock resulted in improved survival to hospital discharge with favorable neurological status.

To assess whether the duration of obesity is associated with the presence and progression of coronary artery calcified plaque (CAC), Reis and colleagues analyzed data from 3275 participants in a longitudinal study of cardiovascular disease development who at baseline were not obese and were aged 18 to 30 years and who underwent computed tomography scanning to identify CAC during follow-up. The authors report that obesity developed in 40% of the participants and that a longer duration of obesity was associated with CAC presence and progression independent of the degree of adiposity.

Author Audio Interview

Androgen deprivation therapy (ADT) and the resulting hypogonadal condition may have detrimental effects on renal function. In a nested case-control study that involved 10 250 men newly diagnosed with nonmetastatic prostate cancer, Lapi and colleagues found that use of ADT was significantly associated with an increased risk of acute kidney injury.

After progressive declines in recent years, the prevalence of West Nile virus resurged in 2012 with the greatest number of cases centered in Dallas County, Texas. To guide future prevention efforts, Chung and colleagues analyzed epidemiologic, meteorologic, and geospatial features of the Dallas County epidemic. They found that the 2012 epidemic began early and after an unusually warm winter; followed increasing infection trends in mosquitoes; and cases clustered in areas with high housing density. In an Editorial, Ostroff discusses the history of West Nile virus in the United States and the importance of effective vector surveillance and control programs for mosquito-borne diseases.

Related Editorial, Related Article

Author Audio Interview

Clinical Review & Education

West Nile virus—introduced in North America in 1999 and now endemic throughout the contiguous United States— is associated with the 3 largest arboviral neuroinvasive disease outbreaks ever recorded in the United States. To provide a general overview of West Nile virus for practicing physicians and public health practitioners, Petersen and colleagues reviewed the literature and national surveillance data (1999 through 2012) from patients with West Nile virus–associated disease. The authors estimate that more than 780 000 West Nile virus–associated illnesses have occurred since 1999. They summarize their findings regarding virus ecology and virology; epidemiology, risk factors for West Nile virus infection and illness; diagnosis and clinical features; treatment of infection; and preventive strategies.

Related Editorial, Related Article

Continuing Medical Education

Timing of prophylactic antibiotic administration for surgical procedures is a quality measure in the Centers for Medicare & Medicaid Services Surgical Care Improvement Project and is linked to hospital performance pay initiatives. However, an analysis of patient-level data on prophylactic antibiotic timing for 32 459 surgical procedures that was published recently in JAMASurgery found no significant association between timing of antibiotic administration and surgical site infection occurrence. In this From The JAMA Network article, Seabrook discusses the need to align health care quality measures with desired clinical outcomes and provides a reminder that compliance with process standards reporting does not necessarily guarantee quality health care.