Since 1991, California has prohibited the purchase or possession of
handguns by persons convicted of violent misdemeanor crimes for 10 years following
the conviction. Wintemute and colleaguesArticle report that misdemeanants who purchased
a handgun in 1989-1990 were more likely to be arrested for new gun-related
or violent crimes during a 3-year follow-up period than misdemeanants who
were denied the purchase of a gun in 1991. In an editorial, ColeArticle discusses
how combining different approaches to firearm injury prevention—strategies
that target high-risk individuals, population-based strategies, and strategies
that decrease supply of guns or demand—may reduce the incidence of firearm
In the United States, only 13% to 17% of adult patients with end-stage
renal disease receiving dialysis are treated with peritoneal dialysis, whereas
45% to 65% of children and adolescents receiving dialysis are treated with
this dialysis method. Using case vignettes in a survey of adult and pediatric
nephrologists, Furth and colleagues found that pediatric nephrologists were
60% more likely than adult nephrologists to recommend peritoneal dialysis
rather than hemodialysis for identical hypothetical patients with renal failure.
Prior to stem cell transplantation for hematologic diseases, Lee and
colleagues measured patient and physician estimates of the chance of cure
with and without transplantation and treatment-related mortality, and compared
these estimates with each other and with actual treatment-related mortality
and disease-free survival after transplantation. Patients were significantly
more optimistic than physicians on all measures. When actual mortality was
less than 30%, both patients and physicians were fairly accurate in estimating
treatment-related mortality; but when mortality was higher than 30%, physician
expectations were lower while patients remained optimistic.
Culture of Tropheryma whippelii, the bacterium
that causes Whipple disease, has been established only once, from a heart
valve inoculum. Raoult and colleagues report the isolation and genotyping
of a second strain of T whippelii from the duodenal
biopsy specimen of a patient with typical relapsing Whipple disease with intestinal
involvement using a novel method for culture and detection.
Hepatitis C and alcoholic liver disease are the leading causes of liver
transplantation in the United States. In this survey of adult US liver transplantation
programs that belong to the United Network of Organ Sharing, Koch and Banys
found that all responding programs accept applicants with a history of alcoholism
or other drug addictions, including heroin. Most programs require at least
6 months of abstinence. Patients receiving methadone maintenance are accepted
by 56% of the responding programs, but 32% require that methadone be discontinued.
Choosing a revascularization method for treatment of patients with coronary
Former injection drug users receiving methadone maintenance therapy
who are infected with hepatitis C virus face barriers to getting treatment
for their illness.
Meta-analysis of data from 56 articles indicates that second-trimester
ultrasonographic markers are not sufficiently sensitive for detection of fetuses
with Down syndrome to be useful as a screening test.
This fourth article in a series of consensus statements from the Working
Group on Civilian Biodefense discusses medical and public health management
following the use of botulinum toxin as a bioweapon.
JAMA acknowledges with gratitudeArticle the authors of the 4366 manuscripts
received in 2000 and the scholarly contributions of the 3613 peer reviewersArticle.
For your patients: Information about Down syndrome.
This Week in JAMA . JAMA. 2001;285(8):979. doi:10.1001/jama.285.8.979