JAMA : the journal of the American Medical Association
-
Comparative Study
Morbidity and mortality associated with the July 1980 heat wave in St Louis and Kansas City, Mo.
The morbidity and mortality associated with the 1980 heat wave in St Louis and Kansas City, Mo, were assessed retrospectively. Heat-related illness and deaths were identified by review of death certificates and hospital, emergency room, and medical examiners' records in the two cities. Data from the July 1980 heat wave were compared with data from July 1978 and 1979, when there were no heat waves. ⋯ Heatstroke rates were ten to 12 times higher for persons aged 65 years or older than for those younger than 65 years. The ratios of age-adjusted heatstroke rates were approximately 3:1 for nonwhite v white persons and about 6:1 for low v high socioeconomic status. Public health preventive measures in future heat waves should be directed toward the urban poor, the elderly, and persons of other-than-white races.
-
The risk of epithelial ovarian cancer in relation to the use of combination oral contraceptives was evaluated in a case-control study of women younger than 60 years. Combination oral contraceptives were used by 35 (26%) of 136 cases and 187 (35%) of 539 controls. ⋯ The findings were not explained by parity or by other identified potential confounding factors. The results suggest that the use of combination oral contraceptives protects against epithelial ovarian cancer.
-
Comparative Study
Subclavian vein catheterization during cardiopulmonary resuscitation. A prospective comparison of the supraclavicular and infraclavicular percutaneous approaches.
Percutaneous access to the central venous circulation is indicated in the management of some cardiopulmonary arrests. We prospectively studied 89 attempted subclavian vein catheterizations in a total of 76 patients. ⋯ We found that the percutaneous SC route provides a better technique than the IC approach: it is associated with fewer failures, less difficulty in the mechanics of line insertion, a higher incidence of proper catheter tip location, and much less interference with cardiopulmonary resuscitation in normal, obese, and cachectic patient subgroups. Successful performance occurred despite a documented lack of physician experience with the SC technique, indicating that it should be taught during advanced cardiac life support training courses.