This Week in JAMA FREE

Whether there are clinical consequences such as nosocomial infection, organ dysfunction, and death associated with prolonged storage of red blood cells for transfusion is not clear. In a randomized trial involving 377 premature infants who had birth weights of less than 1250 g and who required transfusion, Fergusson and colleagues found that compared with standard-issue red blood cells (mean age, 14.6 days), transfusion of fresh red blood cells (mean age, 5.1 days) was not associated with improvement in a composite outcome that included major neonatal morbidities and death.

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Vigorous physical activity is thought to increase the risk of bleeding events in children with hemophilia. Broderick and colleagues assessed the risk in a case-crossover study that involved 104 children with moderate or severe hemophilia. The authors report that vigorous physical activity was associated with a moderate and transient relative increase in bleeding risk in the 8 hours following the activity; however, the absolute increase in bleeding risk is likely to be small. In an editorial, Manco-Johnson discusses risks and risk-reduction strategies for children with hemophilia who participate in vigorous, contact-related sports activities.

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There is concern that public reporting of patient outcomes of percutaneous coronary intervention (PCI) could result in lower rates of PCI for patients with acute myocardial infarction (MI) or with higher acute MI mortality. In an analysis of 2002-2010 Medicare data from 3 states with public reporting (49 660 patients) and 7 regional, nonreporting states (48 142 patients), Joynt and colleagues found that compared with nonreporting states, rates of PCI in states with public reporting were lower and overall acute MI mortality rates were comparable. In an editorial, Moscucci discusses public reporting of PCI outcomes and quality of care.

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Neurotensin—a peptide expressed in the central nervous system and gastrointestinal tract—regulates satiety and has trophic effects on normal and neoplastic tissues. In an analysis of data from 4632 participants in a population-based prospective cohort study, Melander and colleagues found that the baseline fasting level of the neurotensin precursor hormone proneurotensin was associated with subsequent development of diabetes, cardiovascular disease, and breast cancer and was associated with total and cardiovascular-specific mortality.

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A 61-year-old man presents with progressive chronic pain in his lower extremities and episodes of dysthesia of his left foot. On examination, he is noted to have bowing of his extremities and prominent bony masses on both legs. He reports that his father and sister have similar lesions. What would you do next?

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Using genomic technologies and standard tools for infection control, physicians are combating antibiotic-resistant Klebsiella pneumoniae infections in US hospitals.

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CT screening for lung cancer and other diseases

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Medication use in preterm infants: improving the evidence base

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US FDA Safety and Innovation Act

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Lowering health care spending through innovations in care delivery

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“Urubamba had safe streets, Internet access, many loose dogs, rare cats, good food, no obvious beggars or homeless persons, rare cigarettes.” From “Big Hearts.”

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Dr Bauchner summarizes and comments on this week's issue. Go to http://jama.jamanetwork.com/multimedia.aspx#Weekly

Join Robert W. Haley, MD, Wednesday October 10, from 2 to 3 PM eastern time to discuss controlling urban epidemics of West Nile virus infection. To register, go to http://www.ihi.org/AuthorintheRoom.

For your patients: Information about bleeding disorders.

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