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.
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
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.
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.
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
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.
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.
Management of conjoined twins.
For your patients: Information about colon cancer screening.
This Week in JAMA . JAMA. 2003;289(10):1205. doi:10.1001/jama.289.10.1205