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.
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.
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
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.
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.
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.
"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.
Highlights from the first International Conference on Emerging Infectious
"I soon realized my patient was one who had been just that—a patient—for
most of his 48 years." From "The Teaching Case."
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."
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.
This Week in JAMA. JAMA. 1998;279(14):1051. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-14-jtw80000