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In This Issue of JAMA |

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JAMA. 2015;313(1):3-5. doi:10.1001/jama.2014.11497.
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Historically, type 1 diabetes mellitus has been associated with large reductions in life expectancy. Livingstone and colleagues assessed life expectancy in a contemporary cohort of 24 691 Scottish patients with type 1 diabetes and found that compared with the general population, subsequent life expectancy at age 20 years for patients with diabetes was approximately 11 years less for men and 13 years less for women. In an Editorial, Katz and Laffel discuss prevention of diabetes complications to improve patient survival.

Editorial and Related Article

In an observational follow-up of participants in the Diabetes Control and Complications Trial, which involved random assignment to intensive treatment (n=711) or conventional treatment (n=730) for a mean 6.5 years and intensive treatment for all participants recommended thereafter, Orchard and colleagues found that mortality risk was modestly lower among individuals in the initial intensive therapy group after a mean 27 years’ follow-up.

Editorial and Related Article

Case reports have suggested a link between human papillomavirus (HPV) vaccination and development of demyelinating diseases. In an analysis of nationwide registry data from Denmark and Sweden—representing nearly 4 million girls and women, among whom approximately 800 000 received the quadrivalent HPV vaccine—Scheller and colleagues found no association between quadrivalent HPV vaccination and development of multiple sclerosis or other demyelinating diseases.

In a retrospective cohort study involving 2500 veterans who underwent bariatric surgery and 7462 who did not have surgery and were matched on relevant variables including age, sex, body mass index, and diabetes, Arterburn and colleagues found that patients who underwent surgery had lower rates of all-cause mortality at 5 years and up to 10 years after the procedure.


Acute diarrhea is the most common illness among travelers to low-income regions of the world. Based on a review of 122 articles (37 published since 2012), Steffen and colleagues discuss the etiology, risk factors, prevention, and management of traveler’s diarrhea. The authors report a declining incidence of traveler’s diarrhea—likely related to food safety improvements—discuss antibiotic prophylaxis, and summarize data regarding treatment choice and efficacy.

An article in JAMA Pediatrics reported that a brief cognitive behavioral intervention decreased parenting stress and maternal depressive symptoms in the period immediately following a child’s diagnosis of autism spectrum disorder. In this From The JAMA Network article, Karp and Kuo discuss extended support for parents as a component of treatment of children with autism spectrum disorder.

A 38-year-old morbidly obese man had a 1-month history of a papular rash on the extensor surfaces of his extremities, which was associated with a burning sensation. Skin examination revealed numerous bright pink papules with a central yellow hue. What would you do next?

This JAMA Diagnostic Test Interpretation article by Paul and Roland presents the case of a 35-year-old woman with progressive right-sided hearing loss—without tinnitus, vertigo, otorrhea, otalgia, or facial weakness. The patient’s history was negative for ear infections, excessive noise exposure, or ear or head trauma. Otoscopic examination was normal. Tuning fork examination revealed left-sided lateralization and air greater than bone conduction, bilaterally. How would you interpret the audiogram results?



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