Highlights

Handgrip strength and mortality

Handgrip strength is a predictor of all-cause mortality among the oldest old, and may serve as a tool to prognosticate risk of mortality. Ling and colleagues come to this conclusion based on their research involving 555 participants from the prospective Leiden 85-plus study. Those with the lowest handgrip strength at ages 85 and 89 years had the highest risk of all-cause mortality. See Research, page 429

The findings of Ling and colleagues suggest that measurement of handgrip strength may constitute a new tool for assessing the capacity of elderly patients to live with disease or undergo certain treatments, says Huang. See Commentary, page 423

Kidney damage in children exposed to melamine

Children who consumed dairy products contaminated with melamine had an overall prevalence of renal abnormalities of 0.61%, a study by Liu and colleagues found. The authors conducted ultrasonographic screening and follow-up of nearly 8000 children in an area of China where dairy products with the highest levels of contamination had been sold. The abnormalities persisted in 12% of affected children. See Research, page 439

Tang highlights the continuing barriers to research in China, particularly the methods by which researchers are evaluated, compared and rewarded. See Commentary, page 424

Care and computer reminders

Computer reminders to physicians at the point of care resulted in only small to modest improvements in processes of care. Shojania and colleagues come to this conclusion from their systematic review, which included 28 trials. The improvements in care were no larger than those achieved with paper reminders, say the authors. See Research, page E216

Delirium in hospital

Multicomponent interventions, which combine comprehensive assessment and strategies targeting risk factors, appear to be effective in preventing delirium in older patients in hospitals. However, they may not decrease mortality or duration of stay in hospital. See Reviews, page 465

Making food safer

Education and training in handling food and its preparation must continue to be high priority as most food-borne illnesses are acquired after eating food prepared in restaurants and at home, says Holley. See Analysis, page 471

Screening for severe cutaneous adverse drug reactions

The association of certain genotypes with severe cutaneous adverse drug reactions makes pretreatment screening advisable. Human leukocyte antigen (HLA) allele-B*1502, for instance, confers a very high risk of Stevens-Johnson syndrome induced by carbamazepine in patients of Southeastern Asian ethnicity. See Practice, page 476

Hypersensitivity syndrome after taking sulfasalazine

A teenaged boy who presented with fever and macropapular rash was found to have a drug reaction with eosinophilia and systemic symptoms caused by sulfasalazine. See Clinical images, page 481

Canadian nuclear woes prompt US scramble for secure isotope supply

Buffeted by geopolitics from afar and the needs of patients at home, the United States is moving on two fronts to secure the supply of isotopes that is vital in medical imaging but dangerous in the wrong hands. See News, page 427