Journal of American medical association, ces 60 derniers jours

Site du Journal of American medical association (JAMA)



mardi 16 avril 2019

  • Antimicrobial Resistance on the Rise in Zoonotic Bacteria in Europe
    Experts continue to find zoonotic bacteria with high levels of antimicrobial resistance in humans, animals, and food, according to a new report from the European Food Safety Authority and the European Centre for Disease Prevention and (...)

  • Cancer Goes Undiagnosed in Almost Half the World’s Children
    Almost half of all children around the world with cancer—the vast majority of whom live in low- and middle-income countries—are not diagnosed or treated, US researchers have reported.

  • Monster 2015-2016 El Niño Event Triggered Infectious Diseases
    An intense El Niño event in 2015-2016 fueled outbreaks of chikungunya, hantavirus, Rift Valley fever, cholera, and plague around the world, according to a new report from US investigators. The National Oceanic and Atmospheric Administration ranked this El Niño among the top 3 strongest events in (...)

  • USPSTF Recommendation: Screening for Elevated Blood Lead Levels in Children and Pregnancy
    This 2019 Recommendation Statement from the US Preventive Services Task Force concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic children (I statement) and asymptomatic pregnant persons (I (...)

  • USPSTF Evidence Report: Screening for Elevated Blood Lead Levels in Childhood and Pregnancy
    This systematic review to support the 2019 US Preventive Services Task Force Recommendation Statement on screening for elevated blood lead levels in childhood and pregnancy summarizes published evidence on the benefits and harms of screening and intervention for elevated blood lead levels in (...)

  • JAMA
  • Central Casting: The Hospital Team as Grey’s Anatomy Characters
    In this narrative medicine essay an otolaryngologist remembers a patient who identifies her physicians as characters in the television show Grey’s Anatomy, a playful reference that makes her advanced cancer hospitalizations bearable and disarms her physicians through diversion and (...)

  • The MRI
    You take off your jewels and your watch,lie down head first, prepare to enter the cavern.A nurse, kind and young, arranges youwith a pillow and warm blanket.She asks are you comfortable?

  • Screening for High Blood Lead Levels in Children and Pregnant Women
    This JAMA Patient Page describes the US Preventive Services Task Force’s recent recommendations on screening for high blood lead levels in children and pregnant women.

  • Doxepin Mouthwash or Diphenhydramine-Lidocaine-Antacid Mouthwash vs Placebo for Oral Mucositis Pain
    This phase 3 randomized trial compares the effect of doxepin mouthwash or diphenhydramine-lidocaine-antacid mouthwash on oral mucositis–related pain among patients who underwent definitive head and neck radiotherapy.

  • Effect of a Workplace Wellness Program on Employee Health and Economic Outcomes
    This cluster randomized clinical trial evaluates the effects of a workplace wellness program comprising nutrition, physical activity, and stress reduction modules on self-reported lifestyle outcomes (exercise, diet, smoking, alcohol use), clinical measures (eg, cholesterol, blood pressure, body (...)

  • Evaluation for Fibrosis After Cure of Hepatitis C—Reply
    In Reply Dr Fischer and colleagues highlight 2 important points regarding the decision to perform VCTE. We agree that specificity describes the accuracy of a test in the absence of disease and defines the ability of a test to correctly classify an individual as disease free. We obtained our (...)

  • Lowering the P Value Threshold—Reply
    In Reply Mr Adibi and colleagues raise salient points about the prior probability of replication of late-phase RCTs and the increased sample size requirements necessary for a P value threshold of .005. Although we agree that the .005 threshold would require adjustments to funding strategies and (...)

  • Evaluation for Fibrosis After Cure of Hepatitis C
    To the Editor Dr Wilder et al described a patient treated and cured of HCV who subsequently underwent VCTE to restage his liver disease. Vibration-controlled transient elastography or routine monitoring of fibrosis regression is not currently recommended after HCV (...)

  • Evaluation for Fibrosis After Cure of Hepatitis C
    To the Editor We are concerned about 2 comments that Dr Wilder and colleagues made in their discussion of a patient with cured chronic hepatitis C virus (HCV) infection who underwent vibration-controlled transient elastography (VCTE) (...)

  • Lowering the P Value Threshold
    To the Editor Mr Wayant and colleagues evaluated the effect of lowering the significance threshold from .05 to .005 on major randomized clinical trials (RCTs) published in 2017. The authors reported that 70.7% of primary end points remained significant and suggested that lowering the threshold (...)

  • App-Based Decision Support and Alerts for Blood Glucose Self-management in Type 2 Diabetes
    This study characterizes the proportion of apps available in 2018 for self-management of type 2 diabetes that included goal-setting features, reminders to measure blood glucose, hypoglycemia and hyperglycemia alerts, and action (...)

  • The Foxhall Fossil Human Jawbone
    In our Correspondence Department this week we publish a letter from J. Reid Moir of Ipswich, England, in regard to a fossil human jawbone found at Foxhall. As will be noticed, the object of Mr. Moir’s communication to The Journal is to secure, if possible, some trace of the jawbone, which Mr. (...)

  • Making Amends for the Opioid Epidemic
    With the opioid epidemic now claiming nearly 2000 lives from overdose in the United States each month, the medical profession is increasingly accepting the assessment of noted surgeon and writer Atul Gawande, MD: “We started it.” Specialty societies such as the American Academy of Family (...)

  • Highlights for April 16, 2019
  • Robotically Assisted Surgical Devices Raise Caution
    The FDA has warned that robotically assisted surgical devices haven’t been established as safe and effective to treat or prevent breast or cervical cancers.

  • Agreement to Regulate Cell-Based Meat Products
    As lab-to-table beef and poultry products inch closer to reality, the FDA announced a formal agreement to jointly regulate them.

  • New Therapy for Treatment-Resistant Depression
    The FDA has approved esketamine nasal spray as an adjunctive therapy for adults with treatment-resistant depression (TRD), which affects approximately 30% of patients with major depressive disorder. It’s the first regulatory approval of esketamine, the s-enantiomer of ketamine, for any (...)

  • Employer Wellness Programs—A Work in Progress
    Approximately 4 of 5 large US employers offer a wellness program as part of their employees’ health benefits. Workplace wellness programs include a coordinated set of activities that support employees in making changes to health behaviors that may reduce their risk for certain chronic conditions (...)

  • The Search for an Effective Therapy and Pain Relief for Oral Mucositis
    Oral mucositis is a significant complication of cancer therapy because of the associated pain and negative effects on the ability to eat, drink, and swallow and on the quality of life. Furthermore, oral mucositis increases the risk of systemic infection, and may interrupt cancer therapy. Oral (...)

  • Screening for Elevated Blood Lead Levels in Children and Pregnant Women
    In this issue of JAMA, the US Preventive Services Task Force (USPSTF) presents its recommendation on screening for elevated blood lead levels in children and pregnant women, along with the evidence summary supporting this recommendation—a reevaluation of the 2006 recommendations. Lead exposure (...)

  • Incorrect Numeric Value
    In the Diagnostic Test Interpretation entitled “Vibration-Controlled Transient Elastography for Diagnosing Cirrhosis and Staging Hepatic Fibrosis,” published in the November 20, 2018, issue of JAMA, a value reported in the Application to This Patient section was incorrect. The third sentence (...)

  • Error in JAMA Forum Article on Pelvic Examination Under Anesthesia
    In the JAMA Forum article titled “Teaching Pelvic Examination Under Anesthesia Without Patient Consent,” published in the February 26, 2019, issue of JAMA, there was an error in the sentence “The Association of American Medical Colleges, reversing its prior policy position, offered that (...)

  • A Model for Public Access to Trustworthy and Comprehensive Reporting of Research
    This Viewpoint describes the peer review processes of the Patient-Centered Outcomes Research Institute, the yield since 2010 of publicly posted final reports of funded comparative effectiveness studies, and speculates that the benefits of the legislatively mandated process may someday outweigh (...)

  • Dr Schrier Goes to Congress as Second Woman Physician
    This Medical News article is an interview with the first pediatrician and second woman physician to serve in Congress.

  • Childhood Lead Exposure May Affect Personality, Mental Health in Adulthood
    This Medical News feature summarizes a recent study exploring the link between childhood lead exposure and mental health and personality in adulthood.

  • The Uncertain Effect of Financial Incentives to Improve Health Behaviors
    Given considerable empirical support for using financial incentives to motivate desired behaviors, this Viewpoint reviews behavioral economics principles and methodological reasons that might explain the absence of an effect of financial rewards on medication adherence and health outcomes in (...)

  • Management of Patients With Severe Aortic Stenosis With Transcatheter Valve Replacement
    This JAMA Clinical Guidelines Synopsis summarizes the 2017 focused update of the American College of Cardiology/American Heart Association (AHA/ACC) guideline on management of patients with severe aortic stenosis focusing on surgical vs transcatheter valve replacement (...)

  • Effect of Add-on Oral Semaglutide vs Sitagliptin on HbA 1c in Type 2 Diabetes Uncontrolled With Metformin
    This randomized clinical trial compares the effects of 3-, 7-, and 14-mg/d of oral semaglutide vs sitagliptin on glycated hemoglobin in patients with type 2 diabetes uncontrolled with metformin alone or with sulfonylurea.

  • The Future of the GLP-1 Receptor Agonists
    The discovery of the enteric hormone glucagon-like peptide 1 (GLP-1), and subsequent demonstration that its physiologic actions to lower blood glucose levels can be extended to the treatment of type 2 diabetes, have been important therapeutic advances. The approval of exenatide for clinical use (...)

mardi 9 avril 2019

  • Vaping and Pregnancy
    Use of e-cigarettes during pregnancy may be common despite the potential risks, according to a CDC report. It found that 10% of women reported use of these devices shortly before pregnancy, 7% reported use around the time of pregnancy, and 1.4% reported use during the last 3 months of pregnancy (...)

  • Measles Vaccine Exemptions
    A 2018 outbreak of measles in California that infected 6 people may have been driven in part by children who received broad medical exemptions to measles vaccination, according to a CDC report.

  • JAMA
  • Having the Conversation I Encourage Others to Have About End-of-Life Care
    In this narrative medicine essay, a palliative care physician with breast cancer talks about the end-of-life conversations she and her husband have, recalling how her priorities have changed through life stages and how she uses her experiences to inform her interactions with her own cancer (...)

  • Oximetry
    She’s lost the manual, misplacedThe map, tossed out directions.She’s solo, no navigator,No trial in the simulator,Rising, finding her zenith.

  • Eosinophilic Esophagitis
    This JAMA Patient Page describes the symptoms, diagnosis, and treatment of eosinophilic esophagitis.

  • Association of Patient Characteristics and Tumor Genomics With Non–Small Cell Lung Cancer Outcomes
    This cancer epidemiology study links electronic health record (EHR) data with comprehensive genomic profiling to identify patient characteristics and gene alterations associated with overall survival, response to targeted and immune therapies, and other clinical outcomes in patients non–small (...)

  • Association of HIV Preexposure Prophylaxis With Incidence of STIs
    To evaluate the possibility that HIV preexposure prophylaxis (PrEP) might lead to behavioral changes that increase risk of non-HIV sexually transmitted infections (STIs), this cohort study investigates the incidence of chlamydia, gonorrhea, and syphilis among a population of Australian gay and (...)

  • Effect of High- vs Standard-Dose Vitamin D 3 on Progression-Free Survival of Colorectal Cancer
    This phase 2 randomized clinical trial compares the effects of high-dose vs standard-dose vitamin D3 added to standard chemotherapy on progression-free survival among patients with metastatic colorectal cancer.

  • Effect of Vitamin D Supplementation on Relapse-Free Survival in Patients With Digestive Tract Cancers
    This randomized clinical trial compares the effects of vitamin D supplementation vs placebo on 5-year relapse-free survival after surgical resection of stage I-III esophageal, gastric, small bowel, and colorectal cancers.

  • Multifaceted Program to Reduce Job Strain in ICU Nurses—Reply
    In Reply Dr Lesage and colleagues highlighted 3 important aspects of the SISTRESSREA study. Although we agree that the intervention tested was aimed at developing individual skills, it also was dedicated to the improvement of teamwork. Therefore, the intervention may have triggered an (...)

  • Decontamination Strategies for Critically Ill Patients—Reply
    In Reply As mentioned by Ms Taylor and colleagues, the SDD strategy did not include systemic cephalosporins, as this was considered inappropriate in settings that were selected for having a high prevalence of multidrug-resistant gram-negative bacteria. We acknowledge that this may have reduced (...)

  • Multifaceted Program to Reduce Job Strain in ICU Nurses
    To the Editor Ms El Khamali and colleagues found that, among nurses working in an intensive care unit (ICU), those who participated in a multifaceted skills enhancement program had a lower prevalence of job strain after 6 months compared with those who did not participate in the program. (...)

  • Decontamination Strategies for Critically Ill Patients
    To the Editor Dr Wittekamp and colleagues concluded that the use of selective digestive tract decontamination (SDD), compared with standard care, did not lead to a reduction in bloodstream infections acquired in the intensive care unit (ICU) caused by multidrug-resistant gram-negative bacteria. (...)

  • Decontamination Strategies for Critically Ill Patients
    To the Editor A randomized clinical trial investigated the incidence of bloodstream infections with antibiotic-resistant microorganisms in ventilated patients with sequential phases of chlorhexidine 2% mouthwash, selective oral decontamination, and SDD. The SDD strategy is aimed at the (...)

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