Responding to reports of unintentional drug overdoses among children given over-the-counter (OTC) liquid medications, in November 2009, the US Food and Drug Administration (FDA) released new voluntary industry guidelines relating to consistency and clarity in OTC medication dosing directions and accompanying measuring devices. In an analysis of 200 pediatric OTC liquid medications—commonly available at the time of the FDA guidance release—Yin and colleagues Article found high levels of variability and inconsistency between dosing directions and measuring devices. In an editorial, DeWalt Article discusses the importance of clear communication to ensure safe and effective medication use.
Hankinson and colleagues evaluated the relationship between habitual activity levels and changes in body mass index (BMI) and waist circumference in a prospective cohort of individuals aged 18 to 30 years at baseline who were followed up for 20 years. In analyses that were adjusted for race, baseline BMI, age, energy intake, education, alcohol use, and smoking status, the authors found that participants—particularly women—who maintained higher levels of moderate and vigorous activity throughout young adulthood experienced smaller gains in BMI and waist circumference.
In an analysis of tissue samples from 990 ethnically diverse patients with pheochromocytomas and paragangliomas, Yao and colleagues assessed the prevalence and spectrum of mutations in the transmembrane coding gene FP/TMEM127, a recently identified pheochromocytoma susceptibility gene. The authors identified 44 distinct FP/TMEM127 variants, 19 of which were considered of potential pathogenic significance for pheochromocytomas but not paragangliomas. Clinical features of FP/TMEM127- mutant tumors are reported.
The ventilatory strategy used after brain death may affect the suitability of donor lungs for transplant. In a multicenter randomized trial of patients who were potential organ donors, Mascia and colleagues found that a lung protection strategy, which used lower tidal volumes and higher positive end-expiratory pressure levels than a conventional ventilatory strategy, increased the number of eligible and harvested lungs for transplantation. In an editorial, Roberts discusses strategies to improve the supply of deceased donor organs.
The clinical syndrome of lumbar spinal stenosis—which involves lower extremity pain, numbness, or weakness and is often accompanied by low back pain—is a common diagnosis among older adults presenting with lower extremity pain and requires both radiographic or anatomic evidence of spinal canal narrowing and characteristic symptoms and signs. In a systematic review of the literature, Suri and colleagues assessed the accuracy of the clinical examination for the diagnosis of the syndrome. They found that the most useful examination findings were absence of pain when seated, improvement of symptoms when bending forward, and a wide-based gait.
“So much to learn and so much to do in this all-too-short life—who has time to sleep?” From “Lullaby.”
New findings suggest that current strategies for preventing and treating herpes infections in neonates may need to be reconsidered and that additional risk factors for pediatric Clostridium difficile infection should be on clinicians' radar.
United States' engagement in global tobacco control
The right to health and health care reform
Call for Papers
Authors are invited to submit manuscripts for a JAMA theme issue.
Join Julia Howell Hayes, MD, Wednesday, January 19, 2011, from 2 to 3 PM eastern time to discuss active surveillance vs initial treatment for low-risk prostate cancer. To register, go to http://www.ihi.org/AuthorintheRoom.
Dr DeAngelis summarizes and comments on this week's issue. Go to http://jama.ama-assn.org/misc/audiocommentary.dtl.
For your patients: Information about lung transplants.
This Week in JAMA . JAMA. 2010;304(23):2559. doi:10.1001/jama.2010.1835