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This Week in JAMA
March 12, 2003

This Week in JAMA

JAMA. 2003;289(10):1205. doi:10.1001/jama.289.10.1205
Homocysteine Levels and Congestive Heart Failure Risk

Elevated plasma homocysteine levels have been shown to be a risk factor for vascular disease. To study whether homocysteine levels are associated with risk of congestive heart failure, Vasan and colleagues analyzed 8-year follow-up data from adults who participated in the Framingham Heart Study during the 1979-1982 and 1986-1990 examinations and who were free of congestive heart failure or prior myocardial infarction at baseline. Plasma homocysteine levels higher than the sex-specific median value were associated with a significantly increased risk of incident heart failure in both men and women.

Article
Passive Smoking and Risk of Pediatric Dental Caries

Dental caries disproportionately affect children living in poverty. Experimental evidence suggests that environmental tobacco smoke may have a causal role in caries formation. In this analysis of data from children aged 4 to 11 years who participated in the Third National Health and Nutrition Examination Survey (1988-1994), Aligne and colleagues found that passive smoking as indicated by serum cotinine levels of 0.2 to 10 ng/mL was significantly associated with decayed and filled tooth surfaces in deciduous but not in permanent teeth.

Article
Hidden Epidemic of Chlamydial Infection in China

The prevalence of sexually transmitted diseases in China has increased rapidly during the last 2 decades. Between August 1999 and August 2000, Parish and colleaguesArticle conducted a national population-based study of Chinese adults aged 20 to 64 years to estimate the prevalence of genital chlamydial infections, which is not tracked in China's public health reporting system, and the prevalence of gonorrheal infections. The overall prevalence of chlamydial infection per 100 population was 2.1 among men and 2.6 among women; and of gonorrheal infection, 0.02 among men and 0.08 among women. Risk of chlamydial infection among men was significantly associated with unprotected sex with a commercial sex worker. The risk of chlamydial infection among women was largely associated with behaviors of their spouse or steady sexual partner. In an editorial, BeyrerArticle discusses China's current vulnerability to a widespread heterosexual HIV epidemic and interventions that target commercial sex networks.

Hand Hygiene Agents Against a

Current guidelines for handwashing and hand antisepsis recommend hand hygiene with nonantimicrobial soap and water or with antimicrobial soap and water if exposure to Bacillus anthracis is suspected or proven, but only limited data are available on the susceptibility of B anthracis to antiseptics. Weber and colleagues used the Standard Test Method for Evaluation of the Effectiveness of Health Care Professional Handwash Formulations to evaluate the efficacy of several hand antiseptics and nonantimicrobial soap and water against B atrophaeus, a surrogate of B anthracis, at wash times of 10, 30, and 60 seconds. Handwashing for 10 seconds with nonantimicrobial soap under running water or with 2% chlorhexidine gluconate was very effective in reducing the amount of B atrophaeus spore contamination on hands. Handwashing with chlorine-containing microfiber towels was increasingly effective as wash time increased, but a waterless rub containing 61% ethyl alcohol was ineffective in eliminating B atrophaeus spores at all wash times.

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Medical News & Perspectives

Only one man died during Lewis and Clark's 8000-mile expedition across western North America. During the bicentennial of this grand enterprise, a new exhibit at the College of Physicians of Philadelphia explores the expedition's medical adventures.

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Crisis in Bench to Bedside Research

Obstacles to the translation of basic science research into clinical studiesArticle and from clinical studies into clinical practice and health decision making: analysis and call to actionArticle.

CLINICIAN'S CORNER

Scientific Review/Clinical Applications

Part 1Article of this 2-part article assesses the evidence on the efficacy of colorectal screening tests for prevention of colorectal cancer. Part 2Article summarizes available evidence to answer commonly asked clinical questions about colorectal cancer screening.

Contempo Updates

Management of conjoined twins.

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JAMA Patient Page

For your patients: Information about colon cancer screening.

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