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%).
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.
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.
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.
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.
Dermatologists debated the value of sentinel node biopsy, safety of
liposuction, and use of prophylactic antibiotics at their annual meeting.
Proposed criteria to determine when quality improvement (QI) initiatives
should be reviewed and regulated as research to protect the rights and interests
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
New diagnostic and therapeutic technologies in medicine.
For your patients: Alcohol and driving.
The Plight of Academic Health Centers
This Week in JAMA. JAMA. 2000;283(17):2207. doi:10.1001/jama.283.17.2207