In this analysis of quality-of-life outcomes from the Clinical Outcomes
of Surgical Therapy trial, an ongoing trial comparing laparoscopic-assisted
colectomy (LAC) with open colectomy for resection of colon adenocarcinoma,
Weeks and colleaguesArticle found that symptoms or quality of life in the immediate
postoperative period or during 2 months of follow-up were not statistically
significantly different after LAC than after open colectomy. Duration of postoperative
in-hospital analgesia and length of hospital stay were slightly reduced in
the LAC group. In an editorial, PetrelliArticle emphasizes that curative resection
of colon cancer by LAC should not be performed outside of randomized controlled
trials until the efficacy and safety of the procedure have been definitively
Risk factors for Alzheimer disease (AD) have been well established in
white populations, but evidence suggests that risk factors for AD may vary
considerably in other populations. Green and colleagues conducted a risk analysis
based on data collected at 17 medical centers from white and African American
probands meeting criteria for definite or probable AD and from their families.
First-degree biological relatives of African Americans with AD had a significantly
higher cumulative risk of dementia by age 85 years than did relatives of whites
with AD. The additional risk of dementia conferred by being a first-degree
biological relative, by being female, or by the probability of having an APOE ∊4 allele was similar in African American and
To assess the use of prescription and over-the-counter drugs in the
United States, Kaufman and colleagues are conducting an ongoing telephone
survey of a population-based sample of noninstitutionalized US adults. In
this report of data collected in 1998 and 1999, 81% of respondents used at
least 1 medication (prescription or over-the-counter drug, vitamin/mineral,
or herbal/supplement) during the week preceding the survey. Fifty percent
of respondents took at least 1 prescription drug, and 7% took 5 or more prescription
drugs. Forty percent of the survey population took at least 1 vitamin/mineral,
and 14% took at least 1 herbal/supplement.
Factors that influence the survival of patients receiving mechanical
ventilation have been identified in previous studies, but most of these studies
have included patients receiving mechanical ventilation for a specific medical
indication. To assess the relative importance of multiple factors that might
influence survival, Esteban and colleagues conducted a multicenter, prospective
study in a heterogeneous population of adult patients who received mechanical
ventilation for more than 12 hours. Survival of patients who received mechanical
ventilation was 69%. Factors associated with increased mortality included
factors present at the start of mechanical ventilation, factors related to
patient management, and clinical complications during the course of mechanical
Based on an analysis of data from the Third National Health and Nutrition
Examination Survey (1988-1994), an estimated 22% of US adults have the metabolic
syndrome, a group of clinical features associated with increased risk of developing
diabetes mellitus and cardiovascular disease and of cardiovascular and all-cause
"There are certain potent experiences in life that become prisms through
which our past and future are filtered and redefined, turning points according
to which our lives are permanently rearranged in a before-and-after era."
From "The Body Politic."
In the first large-scale attempt to determine whether US physicians'
working conditions may contribute to the frequency and severity of medical
errors, 2 forthcoming studies will gather systematic data on fatigue in medical
Part 1 of this 2-part article, first in the new JAMA series "Scientific
Review and Clinical Applications,"Article systematically reviews recent evidence
on the efficacy of oral hypoglycemic agents for the treatment of type 2 diabetes
mellitus. In part 2Article, 4 clinical scenarios illustrate important considerations
when choosing a specific antidiabetic pharmacological treatment regimen.
In this issue, JAMA begins a new series of articles designed to provide
physicians with the best available information and resources to guide clinical
care. Part 1 of each article reviews and synthesizes the most recent evidence
on a common clinical topic. In the second part, typical patient cases illustrate
the application of this information in clinical practice.
For your patients: Information about laparoscopy.
This Week in JAMA. JAMA. 2002;287(3):279. doi:10.1001/jama.287.3.279