Somnolence is a known adverse effect of antiparkinson medications, and
2 new dopamine agonists have been reported to cause episodes of sudden-onset
sleep in patients with Parkinson disease while they were driving. In this
prospective survey of patients with Parkinson disease without dementia, however,
Hobson and colleaguesArticle found that excessive daytime sleepiness, although frequent,
was not associated with any particular antiparkinson medication. Only 3 of
the 420 drivers among the study participants reported sudden onset of sleep
without warning while driving. In an editorial, ComellaArticle considers several
factors in addition to medication use that might contribute to excessive daytime
sleepiness in patients with Parkinson disease.
To evaluate the current epidemiology of rubella and congenital rubella
syndrome in the United States, Reef and colleaguesArticle analyzed reported rubella
cases from 1990 through 1999 and performed molecular typing of virus isolates.
The incidence of rubella and congenital rubella syndrome decreased during
the 1990s. Characteristics of rubella cases shifted—the proportion of
cases among adults increased, fewer cases were reported among women than among
men, and most cases occurred among persons of Hispanic ethnicity, most of
whom were born outside the United States. Molecular typing identified 3 statistically
distinct genotypic groups, all of which were involved in clusters and outbreaks.
In a commentary, Abramson and PickeringArticle discuss the achievements of the US
childhood immunization program and consider challenges to its continued success.
Sharing of published scientific information and resources is essential
to the advancement of scientific research and education, but instances of
data withholding have been reported. Campbell and colleagues conducted a national
survey of geneticists and other life scientists in US universities. While
only 12% of geneticists reported denying requests from other researchers for
information, data, and materials related to published research, almost 50%
of geneticists who had made a request reported that at least 1 of their requests
had been denied. Other life scientists reported similar experiences, but were
less likely to report that data withholding had a negative impact on their
own research or in their field of research.
Chelation therapy with EDTA is a commonly used alternative therapy for
the treatment of ischemic heart disease, but its efficacy has not been demonstrated.
In this randomized, placebo-controlled trial among patients with stable ischemic
heart disease, Knudtson and colleagues found that changes in exercise time
to ischemia, functional reserve for exercise, and quality of life from baseline
to 27-week follow-up were not significantly different in the chelation therapy
group compared with the placebo group.
Mrs G, a 70-year-old woman who moved to the United States from Vietnam
7 years ago, is currently receiving care for hypertension and diabetes, as
well as preventive care, from a Vietnamese American primary care physician.
McPhee discusses cultural issues that influence health care, medical problems
with higher risk in Vietnamese patients, and approaches to care that address
the special needs of Vietnamese patients.
"Each morning we say good-bye to our children, fully expecting that,
come evening, they will be safe at home. And so it was for Eric and his parents."
From "The Knapsack."
A review of the major mycotoxins that affect human health.
Sports medicine specialists caution players and coaches that even so-called
"mild" concussions can lead to long-term problems—and they want the
National Football League to set a better example in dealing with such injuries.
A review of studies evaluating hospitalist programs and discussion of
issues facing the growing hospitalist movement.
A cross-sectional survey of internally displaced women in Sierra Leone
conducted in 2001 indicates that sexual violence committed by combatants in
Sierra Leone was widespread and occurred in the context of other human rights
abuses against the civilian population.
For your patients: Information about rubella.
This Week in JAMA. JAMA. 2002;287(4):411. doi:10.1001/jama.287.4.411