EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, January 17, 2005
To contact corresponding author Nira A. Goldstein, M.D., call Ellen Watson at 718-270-1176.

BEHAVIOR AND QUALITY OF LIFE IMPROVE FOR CHILDREN WHO RECEIVE TREATMENT FOR OBSTRUCTIVE SLEEP APNEA

CHICAGO—Behavioral and emotional difficulties are found in children with obstructive sleep apnea, but they improve after treatment, according to a study in the January issue of Archives of Otolaryngology—Head & Neck Surgery, one of the JAMA/Archives journals.

"Sleep-disordered breathing in children is most commonly caused by adenotonsillar hypertrophy [enlarged adenoids and tonsils], and tonsillectomy and adenoidectomy (T & A) is curative in 85 percent to 95 percent of cases," according to background information in the article. "Sleep-disordered breathing is viewed as a continuum of severity, from partial obstruction of the upper airway, producing snoring, to increased upper airway resistance to continuous episodes of complete upper airway obstruction or obstructive sleep apnea (OSA). Although the prevalence of primary snoring in children is 12 percent, the prevalence of OSA is one percent to three percent."

Khoa D. Tran, M.D., and colleagues from the State University of New York Downstate Medical Center, Brooklyn, assessed child behavior and quality of life by using standardized surveys completed by parents of children with OSA (n = 42) before and after T & A, compared with 41 children in the control group with no history of snoring undergoing unrelated elective surgery.

"In this study of 42 children with documented OSA undergoing T & A for treatment and 41 children without OSA undergoing elective surgery, a high prevalence of behavioral and emotional problems was found in the OSA group (29 percent vs. 10 percent)," the researchers report. "A significant improvement was found in the total problem score classification after T & A: only 12 percent of patients scored in the abnormal or borderline range compared with 20 percent of the control children." Large improvements in quality of life measures were also found by the researchers.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, January 17, 2005
To contact Harold Bohman, M.D., call Samuel Valliere at 760-725-5044.

MOBILE SURGICAL UNITS PREVENT DELAYS IN TREATING WOUNDED COMBAT PATIENTS IN IRAQ

CHICAGO—The use of new mobile surgical teams resulted in the faster treatment of injured U.S. Marines and Iraqi patients, according to an article in the January issue of Archives of Surgery, one of the JAMA/Archives journals.

Warfare used by the U.S. Marine Corps (U.S.M.C.) involves moving rapidly to reach military targets. Although effective, these tactics often result in traveling hundreds of miles away from surgical units, according to background information in the article. To avoid severe delays in critically injured Marines reaching surgical aid, the U.S.M.C. and U.S. Navy developed the Forward Resuscitative Surgery System (FRSS), small, mobile trauma surgical teams.

Lowell W. Chambers, M.D., of the First Medical Battalion/Naval Hospital Camp Pendleton, Calif., and colleagues examined the effectiveness of the FRSS during the invasion phase of the war. Ninety patients-30 U.S.M.C. and 60 Iraqis-were treated in the FRSS between March 21 and April 22, 2003. The FRSS was composed of two surgeons, an anesthesiologist, a critical care nurse, two surgical technicians, an independent duty corpsman or physician's assistant, and a basic corpsman. Only those requiring immediate care of life- or limb-threatening injuries were initially taken into the FRSS.

For Marines, the median [half-way] time from wounding to arrival at the FRSS was one hour, with a range of 15 minutes to 40 hours. Time of wounding was known in 35 of the 60 Iraqi patients, and they had a median time from wounding to arrival of two hours, with a range of 30 minutes to five days. A total of 149 procedures were performed by the six FRSS teams, with 21 patients identified as critical. Of treated injuries, 77 percent were penetrating and 64 percent occurred in patients' extremities. Seven U.S.M.C. patients developed complications due to their injuries; three confirmed deaths occurred in Iraqi patients treated in the FRSS.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, January 17, 2005
To contact Julie Ann Freischlag, M.D., call Trent Stockton at 410-955-8665.

NEW EDITOR APPOINTED FOR ARCHIVES OF SURGERY

CHICAGO—Julie Ann Freischlag, M.D., The William Stewart Halsted Professor and chair of the Department of Surgery at The Johns Hopkins University School of Medicine, Baltimore, Md., has been appointed as the eighth editor of the Archives of Surgery, one of the JAMA/Archives journals.

Dr. Freischlag is a graduate of the University of Illinois and received her medical degree from Rush University in Chicago. She completed a surgical residency and fellowship at the UCLA Medical Center. She has had faculty appointments at University of California, San Diego; UCLA; Medical College of Wisconsin in Milwaukee; and most recently at Johns Hopkins since 2003. She has served on the editorial boards of six surgical journals. She is also a researcher and has more than 125 publications in peer-reviewed journals and 27 book chapters.

She succeeds Claude H. Organ, Jr., M.D., who served as editor of the Archives of Surgery from 1989-2004 and is now Editor Emeritus.

For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.