Journal of American medical association, ces 60 derniers jours

Site du Journal of American medical association (JAMA)



mardi 16 juillet 2019

  • Growing Global Alcohol Use
    Increasing alcohol use worldwide threatens to derail the World Health Organization’s (WHO’s) goal of cutting alcohol use by 10% by 2025, according to a study in The Lancet.

  • Reducing Cervical Cancer Deaths
    A combination of increased cervical cancer screening, better coverage with the human papillomavirus (HPV) vaccine, and better access to radiotherapy will be needed to cut global cervical cancer incidence and deaths, according to a pair of studies in The Lancet (...)

  • Containing Nipah Virus Infection
    Isolating adults with respiratory symptoms resulting from Nipah virus infection may help stem the spread of the virus, a New England Journal of Medicinestudy suggests.

  • JAMA
  • What’s in a Name or Title?
    In this narrative medicine essay, an associate director of an internal medicine residency program describes when a student addressed her in an email by her first name but at the same time the student addressed a male colleague as “Doctor” and explains how she decided to handle the (...)

  • Jacqui’s Comet
    The steadfast stars I expected to navigate this new course all scroll their screens instead,

  • Steroid Side Effects
    This JAMA Patient Page describes use of steroid medications and the side effects that can result.

  • Effect of an ICU Diary on PTSD Symptoms Among Patients Receiving Mechanical Ventilation
    This randomized clinical trial compared the effects of a diary filled out by clinicians and family members during an intensive care unit (ICU) stay to ground their memory of events after discharge vs usual care on symptoms of posttraumatic stress disorder, anxiety, and depression in patients (...)

  • Association Between State-Mandated Protocolized Sepsis Care and In-hospital Adult Sepsis Mortality
    This cohort study uses hospital discharge data to compare 30-day in-hospital mortality of patients with sepsis in New York State before vs after implementation of regulations mandating rapid administration of antibiotics and fluid resuscitation and compares those data with mortality in 4 (...)

  • Effect of Flexible Family Visitation on Delirium Among Patients in the Intensive Care Unit
    This cluster-crossover randomized clinical trial compares the effects of a flexible visitation policy (up to 12 hours per day) vs a standard visitation policy (up to 4.5 hours per day) on delirium incidence among ICU patients.

  • Endovascular Reperfusion Therapy and Acute Ischemic Stroke Outcomes
    This cohort study uses data from the Get With the Guidelines-Stroke registry to report associations between time to treatment and functional outcomes among patients in clinical practice with acute ischemic stroke treated with endovascular (...)

  • Outcomes Associated With Overlapping Surgery—Reply
    In Reply Drs Urwin and Emanuel raise 2 concerns with our study on overlapping surgery. First, they note that the reported surgical times may not be representative, as the mean surgical times in the study are longer than times from other sources. These differences may stem from the fact that the (...)

  • Cannabis as a Substitute for Opioids—Reply
    In Reply Dr Gonzalez and colleagues provide detail regarding the New York State Medical Marijuana Program, noting that dispensaries overseen by pharmacists sell regulated products and that certifying practitioners must consult a prescription monitoring program. Some regulation of putatively (...)

  • Intravenous Acetaminophen for Postoperative Delirium—Reply
    In Reply We agree with Dr Wanek that the fentanyl conversion factor for morphine equivalents was incorrect. A conversion factor of 2.4 was used per current recommendations for conversion of fentanyl transdermal patch dosage in micrograms per hour to morphine equivalents in milligrams per day. (...)

  • Outcomes Associated With Overlapping Surgery
    To the Editor Dr Sun and colleagues performed a large database analysis of 66 430 overlapping surgical procedures. However, the challenges of large database studies include insufficiently granular data that may affect interpretation of the (...)

  • Outcomes Associated With Overlapping Surgery
    To the Editor In their study of overlapping surgery, Dr Sun and colleagues concluded that “among adults undergoing common operations, overlapping surgery was not significantly associated with differences in in-hospital mortality or postoperative complication rates but was significantly (...)

  • Cannabis as a Substitute for Opioids
    To the Editor In their critique of the availability of medical marijuana for patients suffering from chronic pain or struggling with opioid use disorder, Drs Humphreys and Saitz omitted important facts about the New York State Medical Marijuana Program, the limited availability of medication (...)

  • Intravenous Acetaminophen for Postoperative Delirium
    To the Editor The DEXACET trial found a decreased incidence of postoperative delirium in older patients after cardiac surgery who received intravenous (IV) acetaminophen vs placebo combined with propofol or dexmedetomidine. Dr Subramaniam and colleagues suggested that the difference in the (...)

  • Association Between Hurricane Declarations and Survival of Patients With Lung Cancer Undergoing Radiation
    This study uses National Cancer Database data to estimate associations between hurricane disaster declarations, which could disrupt electrical power, and survival of patients undergoing radiotherapy for nonoperative locally advanced non–small cell lung cancer between 2004 and (...)

  • Price Increases of Protected Class Drugs in Medicare Part D Relative to Inflation, 2012-2017
    This study characterizes price increases exceeding inflation between 2012 and 2017 for protected-class drugs (antineoplastics, antiretrovirals, antidepressants, antipsychotics, anticonvulsants, and immunosuppressants for transplant patients) that would lead to their exclusion from Medicare Part (...)

  • About Foot Wear
    “How beautiful are thy feet, with shoes, O! Prince’s daughter,” says the Song of Solomon, and it must be confessed as a fact true of our time that modern feet must be hidden by shoes to give an approach in appearance to a perfect classic standard. Toes twisted out of shape, thick projections at (...)

  • Highlights for July 16, 2019
  • Chemoimmunotherapy for Lymphoma
    A novel antibody-drug conjugate (ADC) for adults with refractory or relapsing diffuse large B-cell lymphoma (DLBCL), the most common form of non-Hodgkin lymphoma, has received accelerated FDA approval. Up to 40% of patients with DLBCL will (...)

  • Episodic Cluster Headache Antibody Therapy
    A monoclonal antibody that the FDA approved last year to prevent chronic and episodic migraine has now received approval to treat episodic cluster headache in adults. The drug blocks calcitonin gene-related peptide ligand—a potent vasodilator that modulates nociceptive trigeminal neurons (...)

  • Cranial Nerve Stimulator for Adolescents With IBS
    The FDA has authorized marketing of the first medical device for adolescents with abdominal pain associated with irritable bowel syndrome (IBS). The device, which is available by prescription only, is indicated for patients aged 11 through 18 (...)

  • Government Regulation of Sepsis Care
    Sepsis is estimated to affect more than 30 million people and cause an estimated 6 million deaths worldwide every year. Although new medical treatments are continually being proposed and tested, the greatest reduction in sepsis-related deaths over the past few decades has come from the early (...)

  • Endovascular Therapy for Acute Ischemic Stroke Treated in Clinical Practice
    Five randomized clinical trials, published in 2015, demonstrated the benefit of endovascular therapy in appropriately selected patients with acute ischemic stroke due to large vessel occlusion, and a subsequent individual patient data meta-analysis of these trials indicated that the benefit (...)

  • Psychological Consequences of Admission to the ICU
    For most patients and their families, admission to the intensive care unit (ICU) is an unanticipated event that causes substantial psychological distress. For patients, short- and long-term consequences include delirium, anxiety, depression, and acute and posttraumatic stress disorder (PTSD). (...)

  • Addition of Funding Source
    In the Viewpoint entitled “The True Cost of Measles Outbreaks During the Postelimination Era,” published in the March 26, 2019, issue of JAMA, an additional funding source is being added. In the Funding/Support section, at the end of the section, the following should appear “; and by grant (...)

  • Incorrect Data Due to Incorrect Conversion Factor
    In the Original Investigation entitled “Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery: The DEXACET Randomized Clinical Trial,” published in the February 19, 2019, issue of JAMA, an (...)

  • The Bleeding Edge
    This Arts and Medicine essay reviews The Bleeding Edge, a Netflix documentary about the medical device industry and the harms that can come to patients when innovation, regulatory approval, and adoption of devices in practice outpace evidence of their safety and (...)

  • Building a Better Death, One Conversation at a Time
    In this Medical News article, experts discuss how—or whether—the United States should have a national conversation about death and dying.

  • New Guidelines: Expand Palliative Care Beyond Specialists
    This Medical News article discusses how all physicians who treat seriously ill patients can integrate palliative care into their practices.

  • Preserving Civility in Vaccine Policy Discourse
    This Viewpoint calls out the threat to vaccine policy posed by a very small number of antivaccine (“antivax”) advocates who disrupt attempts to engage vaccine-hesitant persons in public hearings about risks and benefits of vaccination and, acknowledging the concerns of a skeptical public, calls (...)

  • Dilated Pupil in a Patient With Hyperhidrosis
    A 39-year-old woman with a history of palmar and axillary hyperhidrosis had anisocoria more pronounced in bright lighting conditions. She appeared well; denied double vision, ptosis, headache, or weakness; had normal visual acuity; and her neurologic examination was unremarkable. What is the (...)

  • The Academic Medical Center Value Debate—Are Teaching Hospitals Worth It?
    This Viewpoint reviews evidence about the outcomes and costs of health care at teaching vs nonteaching hospitals in an attempt to answer the question of whether the costs of academic medical centers are defensible and whether they deliver value for their (...)

  • Academic Medical Centers—Too Large for Their Own Good?
    This Viewpoint discusses the conflict between the role of academic medical centers as providers of complex uncompensated care, and the large profit margins they realize from expensive fee-for-service clinical activity that puts them at odds with attempts to reorganize medicine to provide (...)

  • Employ Cybersecurity Techniques Against Medical Misinformation
    This Viewpoint discusses the rapidly growing threat to public health that the dissemination of medical misinformation enables and the active measures that must be taken to stop it.

  • State Efforts to Lower Health Care Prices Paid by Private Insurers
    This Viewpoint proposes an array of approaches state governments might take to lower health care prices paid by private insurance, including rate setting using reference pricing; scrutiny of hospital mergers; expanding scope-of-practice laws to increase workforce; and investing in alternative (...)

mardi 9 juillet 2019

  • Medical Tourism–Linked Infections
    Twelve US patients have been diagnosed with Verona integron-encoded metallo-β-lactamase–producing carbapenem-resistant Pseudomonas aeruginosa (VIM-CRPA), after undergoing invasive medical procedures in Mexico, according to a CDC (...)

  • Diabetes Incidence Decreases
    The number of people newly diagnosed with diabetes decreased substantially between 2009 and 2017, while the number of people living with the disease in the United States has leveled off, according to a study by CDC scientists published in British Medical Journals Open Diabetes Care and (...)

  • JAMA
  • Subclinical Hypothyroidism—A Review
    This narrative review summarizes causes of subclinical hyperthyroidism, reviews controversies related to its clinical significance as a risk factor for heart failure, ischemic heart disease, and dementia, and discusses management considerations, including indications for observation vs thyroid (...)

  • The Sound of Silence—When There Are No Words
    In this narrative medicine essay, a surgeon and palliative care physician describes the isolating silence that she felt her after the slaying of her father in Egypt when she was 18 years old and how that lingering silence has come to guide her when sitting with patients, when there are no (...)

  • Triptych
    At seven weeks you are little more than a heartbeat four weeks four chambers is the mnemonic I’ve stored away along with an image of a tube twisting upon itself like a pair of jeans in the wash when you leave us in the middle of the day forgive me— it feels like losing something I didn’t know I (...)

  • Subclinical Hypothyroidism
    This JAMA Patient Page describes subclinical hypothyroidism and its causes, symptoms, and treatment.

  • Effect of Recombinant Zoster Vaccine on Herpes Zoster After Autologous Stem Cell Transplantation
    This randomized trial compares the effects of 2 doses of nonlive adjuvanted recombinant zoster vaccine vs placebo on incidence of herpes zoster in adults who had undergone autologous hematopoietic stem cell transplantation.

  • Peroral Endoscopic Myotomy vs Pneumatic Dilation for Treatment-Naive Patients With Achalasia
    This randomized clinical trial compares the effects on symptoms and recurrence of peroral endoscopic myotomy (POEM) vs pneumatic dilation for the initial treatment of idiopathic achalasia.

  • Resuscitation Strategies Using Peripheral Perfusion vs Serum Lactate Levels—Reply
    In Reply We agree with Drs Patel and Bergl that many studies of septic shock have overestimated control group mortality and effect size. However, in the ANDROMEDA-SHOCK trial, the delta for mortality in the control group was only 1.6% (expected 45% minus actual 43.4%). This is lower than (...)

  • Limiting Opioid Prescribing—Reply
    In Reply We agree with Dr Daoust that individualized opioid prescribing and co-analgesic prescribing should be considered. We also agree that preventing excessive opioid prescribing for acute pain is important to reduce misuse of unused opioids. In our Viewpoint, we questioned whether policy (...)

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