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This Week in JAMA
May 3, 2000

This Week in JAMA

JAMA. 2000;283(17):2207. doi:10.1001/jama.283.17.2207
Drinking Drivers and Auto-Related Deaths of Children

Alcohol-impaired driving is the foremost single preventable cause of motor vehicle crash–related deaths. Using data for 1991 through 1996 from the Fatality Analysis Reporting System (FARS), Margolis and colleaguesArticle found that 3310 (19.9%) of 16676 motor vehicle crash–related deaths of children younger than 16 years involved a driver who had been drinking alcohol. About two thirds of children with alcohol-related deaths were passengers in the same car as the driver who had been using alcohol. In a second analysis of FARS data and data from the General Estimates System on nonfatal injuries, Quinlan and colleaguesArticle estimated that 5555 (28.1%) of 19768 passenger deaths of children aged 14 years and younger involved a drinking driver between 1985 and 1996 and 149,000 child passengers were nonfatally injured. Alcohol-related fatality rates for child passengers killed while being transported by a drinking driver declined from 1985 through 1990 but remained unchanged from 1991 through 1996. In an editorial, LiArticle advocates a zero-tolerance policy through federal legislation that makes it illegal for drivers of all ages to drive with a blood alcohol level above the minimum reliable detectable level (0.02%).

Incident Type 2 DM in African Americans and Whites

Using data from the prospective Atherosclerosis Risk in Communities Study on 12107 adults without type 2 diabetes mellitus (DM) at baseline, Brancati and colleagues found that the sex-specific incidence of diabetes during 9 years of follow-up was significantly higher among African Americans, especially African American women, compared with whites. In multivariate analyses, racial differences in potentially modifiable risk factors, particularly adiposity, explained 47.8% of the excess risk in African American women, but little or none of the excess risk in African American men.

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Hereditary and Sporadic Ovarian Cancer Compared

To determine whether clinical and pathological features of hereditary ovarian cancer differ from those of sporadic cases, Boyd and colleagues studied 189 women of Jewish origin with invasive epithelial ovarian carcinoma, comparing 88 cases associated with germline mutations in BRCA1 or BRCA2 with 101 cases without a BRCA mutation. The average age at diagnosis was significantly younger for the BRCA-associated cases, but histology, grade, stage, and success of cytoreductive surgery were similar. In survival analyses using 2 additional comparison groups from clinical trials, women with hereditary cancer had a longer disease-free interval following primary chemotherapy and better survival than women with nonhereditary ovarian cancer.

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Artificial Air-Pocket Device Extends Time of Snow Burial

Most deaths after avalanche burial are caused by asphyxia. In this study of a novel artificial air-pocket device built into a vest that is worn over other clothing, Grissom and colleaguesArticle found that during experimental snow burial, subjects were able to remain buried significantly longer with the device (mean burial time, 58 minutes) than with a 500-cm3 volume air pocket created in the snow (mean burial time, 10 minutes). In an editorial, Fontanarosa and RennieArticle explain JOURNAL policy regarding use of information published in JAMA to promote products.

Household Radiation Exposure After Outpatient

A recently revised rule of the US Nuclear Regulatory Commission (NRC) allows patients receiving sodium iodide 131I therapy to be released from isolation if the total effective dose equivalent to any other individual from exposure to the treated individual is not likely to exceed 5.0 mSv. Grigsby and colleagues found that in a series of 30 patients receiving outpatient 131I therapy following thyroidectomy for thyroid carcinoma, radiation exposure to household members, pets, and in 4 rooms in the home were well below the limit of 5.0 mSv mandated by NRC regulations.

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Medical News & Perspectives

Dermatologists debated the value of sentinel node biopsy, safety of liposuction, and use of prophylactic antibiotics at their annual meeting.

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QI Initiatives and Protection of Patients

Proposed criteria to determine when quality improvement (QI) initiatives should be reviewed and regulated as research to protect the rights and interests of participants.

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Plague as a Bioweapon

Medical and public health management following use of Yersinia pestis, the causative agent of plague, as a biological weapon: third in a series of consensus statements from the Working Group on Civilian Biodefense.

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MSJAMA

New diagnostic and therapeutic technologies in medicine.

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JAMA Patient Page

For your patients: Alcohol and driving.

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The Plight of Academic Health Centers

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