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This Week in JAMA
October 26, 2005

This Week in JAMA

JAMA. 2005;294(16):1993. doi:10.1001/jama.294.16.1993
Supplemental Oxygen and Surgical Infection

Results of previous studies assessing the effects of perioperative supplemental oxygen on surgical wound infection rates have been inconclusive. Belda and colleaguesArticle conducted a randomized trial in which patients having colorectal surgery were randomly assigned to either 30% or 80% fraction of inspired oxygen (FIO2) intraoperatively and for 6 hours after surgery. The wound sites were examined through the 14th postoperative day for signs of superficial or deep infection. The authors found that patients administered 80% FIO2 had a significantly lower risk of wound infections. In an editorial, DellingerArticle discusses the results of this and other investigations of supplemental oxygen and surgical infections and discusses the importance of implementing all measures known to reduce surgical site infections.

Invasive Pneumococcal Disease Among Older Adults

A pneumococcal conjugate vaccine (PCV-7), which reduces pneumococcal carriage, was licensed for use in infants and young children in 2000. In a population-based prospective study of adults 50 years of age and older, Lexau and colleagues sought to determine whether the incidence of invasive pneumococcal disease, disease characteristics, or spectrum of patients acquiring these illnesses has changed since the vaccine licensure. The authors found that invasive pneumococcal disease incidence declined by 28% in this population of adults. Cases increased among persons with certain comorbid conditions, such as human immunodeficiency virus infection, recent immunosuppressive therapy, diabetes, and chronic obstructive pulmonary disease.

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Urine Telomerase in Bladder Cancer

Currently available noninvasive tests for early detection of bladder cancer lack sufficient sensitivity and specificity for routine use. Sanchini and colleagues conducted a case-control study to test the utility of an enzyme assay for urine telomerase activity for identifying patients with early bladder cancer. Confirming results from a pilot study, the authors found that a urine telomerase activity of 50 arbitrary enzymatic units accurately detects bladder tumors in men.

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Paraganglioma Syndrome With

In patients enrolled in an international pheochromocytoma registry, Schiavi and colleagues conducted genetic screening for mutations in the SDHC, SDHB, and SDHD pheochromocytoma susceptibility genes to determine the prevalence and clinical characteristics of SDHC mutation–associated head and neck paragangliomas (HNPs) vs those with SDHB and SDHD mutations or sporadic cases. They found a 4% prevalence of SDHC carriers in HNP cases and 0% prevalence in pheochromocytoma index cases. Patients with the SDHC mutation had no signs of pheochromocytoma and had unique clinical characteristics, including age of onset, tumor location, and absence of multiple or malignant tumors compared with patients with other mutations or sporadic cases.

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Medical News & Perspectives

Burn units in US hospitals are increasingly treating a new type of patient—methamphetamine users who are injured in fires and explosions while producing the drug at improvised covert laboratories.

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Educating physicians to recognize and treat depression and restricting population access to lethal means have the greatest efficacy to prevent suicide.

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Patents-Based Drug Development

Barton and Emanuel discuss problems with the current patents-based drug development process and potential economic and procedural solutions.

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Physician-Attorney Relations

A focus on shared values may help diminish antipathy between physicians and attorneys.

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Growth Hormone for “Antiaging”

Clinical and legal issues in the marketing, distribution, and administration of growth hormone for antiaging purposes.

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JAMA Patient Page

For your patients: Information about wound infections.

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