Journal Cover
JAMA Internal Medicine
Journal Prestige (SJR): 8.032
Citation Impact (citeScore): 4
Number of Followers: 327  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 2168-6106 - ISSN (Online) 2168-6114
Published by American Medical Association Homepage  [14 journals]
  • November 2019 Issue Highlights
    • Pages: 1453 - 1455
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.5521
      Issue No: Vol. 179, No. 11 (2019)
       
  • JAMA Internal Medicine
    • Pages: 1456 - 1456
      Abstract: Mission Statement: To promote the art and science of medicine and the betterment of human health by publishing manuscripts of interest and relevance to internists practicing as generalists or as medical subspecialists.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.5522
      Issue No: Vol. 179, No. 11 (2019)
       
  • Surprise Medical Bills, Cost of Care, and Effects on Patients
    • Authors: Kliff S.
      Pages: 1457 - 1458
      Abstract: This Viewpoint examines the high unexpected costs of emergency department visits and cites several pieces of journalism that reported on exorbitant, unexpected bills and led to cancellations of debt and potential broader health care policy changes.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3448
      Issue No: Vol. 179, No. 11 (2019)
       
  • The Public Health Urgency of a Temporary FDA Moratorium on New Opioid
           Approvals
    • Authors: Wolfe SM.
      Pages: 1459 - 1460
      Abstract: This Viewpoint suggests the US Food and Drug Administration (FDA) halt approval of new opioids until the agency adopts a more rigorous framework for opioid review, providing 2 examples of new opioids that were approved by the FDA but had high rates of abuse after entering the drug market.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3846
      Issue No: Vol. 179, No. 11 (2019)
       
  • Improving Adverse Event Reporting for Compounded Drugs
    • Authors: Dohm J; Kim J, Woodcock J.
      Pages: 1461 - 1462
      Abstract: This Viewpoint examines the weak points in adverse event reporting requirements for producers of compounded drugs and offers solutions to improve adverse event reporting and analysis.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3830
      Issue No: Vol. 179, No. 11 (2019)
       
  • Medical Discharge Summary—“Disposition: To the Street”
    • Authors: Goldberg S.
      Pages: 1463 - 1464
      Abstract: In this essay, an internal medicine physician describes caring for a patient who became one of the city’s top medical care users after becoming homeless.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3603
      Issue No: Vol. 179, No. 11 (2019)
       
  • Ending Surprise Medical Bills
    • Authors: Steinbrook R.
      Pages: 1465 - 1466
      Abstract: A surprise medical bill refers to unexpected charges incurred when a patient with health insurance receives care from a physician, hospital, or medical transport service that is not part of the insurer’s network. These charges can arise in an emergency, when a patient may not have the ability to choose the emergency department, the physicians, or the ambulance service. Or they can arise as part of otherwise routine in-network care, such as when a patient is treated at an in-network hospital or outpatient facility. A common reason is that certain physicians, such as an anesthesiologist, an emergency department physician, a pathologist, or a radiologist, may not participate in a health insurer’s network and bill the patient directly. Depending on the circumstances, patients may be responsible for the entire bill or the difference between the amount allowed under their health insurance and the amount billed, which is known as balance billing. Surprise medical bills frustrate and enrage insured patients, defeat the purpose of being insured, and they may cause financial hardship. They are also 1 of the few aspects of the fractured, expensive, and sometimes dysfunctional US health care system that Congress may soon address with bipartisan legislation.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3382
      Issue No: Vol. 179, No. 11 (2019)
       
  • De-adoption of Routine Urine Culture Testing—A Call to Action
    • Authors: Leis JA; Soong C.
      Pages: 1466 - 1468
      Abstract: Prescriptions for urinary tract infection (UTI) rank among the top indications for antibiotics worldwide. Although true UTI does occur frequently, overdiagnosis and overtreatment are also well-recognized problems. Because clinicians often obtain urine cultures in patients without localizing urinary symptoms, positive culture results, by definition, will reflect asymptomatic bacteriuria rather than infection. About 5% of young adults have asymptomatic bacteriuria at any time, and the prevalence is higher among patients with diabetes (10%-20%), spinal cord injury (30%), and urinary catheters (50%-70%), as well as among those living in long-term care facilities (30%-50%). In many populations, asymptomatic bacteriuria may be protective, and antibiotics can paradoxically increase the risk of developing UTI while selecting for antimicrobial resistance and increasing the risk of Clostridioides difficile infection.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4515
      Issue No: Vol. 179, No. 11 (2019)
       
  • Perioperative Management of Patients With Atrial Fibrillation Receiving a
           Direct Oral Anticoagulant
    • Authors: Douketis JD; Spyropoulos AC, Duncan J, et al.
      Pages: 1469 - 1478
      Abstract: This cohort study examines the risk of bleeding and stroke associated with surgical procedures and the value of perioperative management among patients with atrial fibrillation who use anticoagulants.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2431
      Issue No: Vol. 179, No. 11 (2019)
       
  • Association Between Soft Drink Consumption and Mortality in Europe
    • Authors: Mullee A; Romaguera D, Pearson-Stuttard J, et al.
      Pages: 1479 - 1490
      Abstract: This cohort study examines whether soft drink consumption is associated with all-cause and cause-specific mortality in a large cohort of European adults.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2478
      Issue No: Vol. 179, No. 11 (2019)
       
  • Association Between Drug Treatments for Patients With Osteoporosis and
           Overall Mortality Rates
    • Authors: Cummings SR; Lui L, Eastell R, et al.
      Pages: 1491 - 1500
      Abstract: This meta-analysis examines randomized placebo-controlled clinical trials of drug treatments, particularly treatment with bisphosphonates, for the prevention of fracture in patients with osteoporosis to assess whether these treatments are associated with reduced overall mortality rates.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2779
      Issue No: Vol. 179, No. 11 (2019)
       
  • Time-Series Analysis of Health Care–Associated Infections in a New
           Hospital With All Private Rooms
    • Authors: McDonald EG; Dendukuri N, Frenette C, et al.
      Pages: 1501 - 1506
      Abstract: This time-series analysis examines the changes in the rates of multidrug-resistant organisms and nosocomial infections after patients were moved from a hospital with ward-type rooms to one with 100% single-patient rooms.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2798
      Issue No: Vol. 179, No. 11 (2019)
       
  • The Evidence-Based Hospital—A Case for Single-Patient Rooms
    • Authors: Hamilton D.
      Pages: 1507 - 1508
      Abstract: Since the 1980s there has been growing recognition that the design of the physical environment of a hospital has an effect on clinical outcomes. Consistent with the movement toward evidence-based medicine, health care architecture has sought to develop an evidence-based design process.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2797
      Issue No: Vol. 179, No. 11 (2019)
       
  • Animal and Plant Protein Intake and Mortality in a Japanese Cohort
    • Authors: Budhathoki S; Sawada N, Iwasaki M, et al.
      Pages: 1509 - 1518
      Abstract: This cohort study evaluates the associations between animal and plant protein intake and all-cause and cause-specific mortality among Japanese adults.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2806
      Issue No: Vol. 179, No. 11 (2019)
       
  • Risk Factors and Outcomes Associated With Treatment of Asymptomatic
           Bacteriuria in Hospitalized Patients
    • Authors: Petty LA; Vaughn VM, Flanders SA, et al.
      Pages: 1519 - 1527
      Abstract: This cohort study examines the outcomes of treatment of asymptomatic bacteriuria in hospitalized patients.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2871
      Issue No: Vol. 179, No. 11 (2019)
       
  • Outcomes of Intensifying Older Adults’ Antihypertensive Regimens at
           Hospital Discharge
    • Authors: Anderson TS; Jing B, Auerbach A, et al.
      Pages: 1528 - 1536
      Abstract: This cohort study investigates the association between intensification of antihypertensive regimens at hospital discharge and clinical outcomes after discharge.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3007
      Issue No: Vol. 179, No. 11 (2019)
       
  • Large-scale Expansion of Peritoneal Dialysis Within an Integrated Care
           Delivery Model
    • Authors: Pravoverov LV; Zheng S, Parikh R, et al.
      Pages: 1537 - 1542
      Abstract: This cohort study describes a system-level approach to expansion of peritoneal dialysis use and temporal trends in initiation, persistence, and associated mortality among adult patients with advanced kidney disease in an integrated health care plan delivery system.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3155
      Issue No: Vol. 179, No. 11 (2019)
       
  • Out-of-Network Billing for Privately Insured Patients in In-Network
           Hospitals
    • Authors: Sun EC; Mello MM, Moshfegh J, et al.
      Pages: 1543 - 1550
      Abstract: This analysis of health insurance claims data assesses out-of-network billing for patients treated through in-network hospital admissions and emergency department visits.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3451
      Issue No: Vol. 179, No. 11 (2019)
       
  • Association Between Forced Sexual Initiation and Health Outcomes Among US
           Women
    • Authors: Hawks L; Woolhandler S, Himmelstein DU, et al.
      Pages: 1551 - 1558
      Abstract: This cross-sectional study estimates the health outcomes associated with forced sexual initiation in girls and women in the United States.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3500
      Issue No: Vol. 179, No. 11 (2019)
       
  • Forced and Coerced Sexual Initiation in Women
    • Authors: Huang AJ; Gibson CJ.
      Pages: 1558 - 1560
      Abstract: The #MeToo movement has opened a national conversation about nonconsensual sexual experiences among women, highlighting the prevalence of problematic sexual behaviors that have historically been normalized or not discussed. More women are now speaking openly about forced or coerced sexual activity, but there is much we still do not know about the long-term effect of these experiences on women’s health. As screening and recognition of the range of situations and interactions that encompass sexual assault expand, we also should determine the consequences of these experiences for women across their lifespan.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3467
      Issue No: Vol. 179, No. 11 (2019)
       
  • Acute Care for Patients Who Are Incarcerated
    • Authors: Haber LA; Erickson HP, Ranji SR, et al.
      Pages: 1561 - 1567
      Abstract: This review considers the legal precedents, terminology, characteristics, clinical management, and challenges during transitions of care for patients who are incarcerated and in need of short-term medical care.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3881
      Issue No: Vol. 179, No. 11 (2019)
       
  • 2019 Update on Medical Overuse
    • Authors: Morgan DJ; Dhruva SS, Coon ER, et al.
      Pages: 1568 - 1574
      Abstract: This review assesses articles published in 2018 related to medical overuse with the goal of improving patient care.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3842
      Issue No: Vol. 179, No. 11 (2019)
       
  • de Winter ECG Pattern—An Unusual ST-Segment Elevation Myocardial
           Infarction Equivalent Pattern
    • Authors: Xu W; Lu L, Jin M.
      Pages: 1575 - 1577
      Abstract: This case report presents the electrocardiographic findings of a man in his 60s with no history of cardiovascular disease who presented to the emergency department with chest pain of 1 hour’s duration.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4127
      Issue No: Vol. 179, No. 11 (2019)
       
  • Interpreting CD4 Counts in a Patient With HIV
    • Authors: Nath S; Nath S, Lazarte S.
      Pages: 1578 - 1579
      Abstract: This Teachable Moment describes a man in his 40s with human immunodeficiency virus infection being treated with combination antiretroviral therapy, cutaneous Kaposi sarcoma in remission, and lymphedema of both legs who presented with acute-onset right lower extremity pain, swelling, and erythema.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3642
      Issue No: Vol. 179, No. 11 (2019)
       
  • Deprescription Mosaic—The Art of Geriatrics
    • Pages: 1579 - 1579
      Abstract: Less is More
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4314
      Issue No: Vol. 179, No. 11 (2019)
       
  • Association Between Broadband Internet and Telemedicine Use
    • Authors: Wilcock AD; Rose S, Busch AB, et al.
      Pages: 1580 - 1582
      Abstract: This population-based study examines the availability of broadband in local communities for telemedicine.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2234
      Issue No: Vol. 179, No. 11 (2019)
       
  • Use of “Doctor” Badges for Physician Role Identification
           During Clinical Training
    • Authors: Foote MB; DeFilippis EM, Rome BN, et al.
      Pages: 1582 - 1584
      Abstract: This survey-based pilot study explores the frequency and implications of role misidentification experienced by residents at a large academic medical center and evaluates the use of a simple, low-cost method for distinguishing physicians from other members of the health care team.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2416
      Issue No: Vol. 179, No. 11 (2019)
       
  • Dual Use of VA and Part D Drug Benefits and Potentially Unsafe Prescribing
    • Authors: Thorpe JM; Thorpe CT, Schleiden L, et al.
      Pages: 1584 - 1586
      Abstract: This observational study evaluates the association of dual prescribing for Veterans Affairs and Medicare Part D benefits with unsafe prescription exposure in a national cohort of older veterans.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2788
      Issue No: Vol. 179, No. 11 (2019)
       
  • Implications for Veterans’ Health Care
    • Authors: Shulkin D.
      Pages: 1586 - 1587
      Abstract: Health Care Policy
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2996
      Issue No: Vol. 179, No. 11 (2019)
       
  • SGLT-2 Inhibitors and Risk of Hospitalization for Fournier Gangrene Among
           Men
    • Authors: Dave CV; Schneeweiss S, Patorno E.
      Pages: 1587 - 1590
      Abstract: This cohort study assesses the association between initiation of sodium-glucose cotransporter 2 (SGLT-2) inhibitor treatment and the risk of hospitalization for Fournier gangrene among men.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2813
      Issue No: Vol. 179, No. 11 (2019)
       
  • Association Between Data Sources and FDA Drug Safety Communications
    • Authors: Tau N; Shochat T, Gafter-Gvili A, et al.
      Pages: 1590 - 1592
      Abstract: This study describes sources of initial safety signals that that preceded US Food and Drug Administration (FDA) drug safety communications and examines their associations with drug characteristics and subsequent label changes.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3066
      Issue No: Vol. 179, No. 11 (2019)
       
  • Evidence Supporting US Food and Drug Administration Drug Safety
           Communications
    • Authors: Ross JS.
      Pages: 1592 - 1592
      Abstract: The US Food and Drug Administration (FDA) is responsible for ensuring that approved drugs are safe and effective. However, the clinical trials that form the basis for FDA approval typically enroll fewer than 1000 patients and have follow-up durations of 6 months or fewer. Thus, most serious safety risks may only become evident after FDA approval. In fact, for approximately one-third of new drug approvals, the FDA issues a new safety communication or warning after initial approval.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3065
      Issue No: Vol. 179, No. 11 (2019)
       
  • Assessment of Publication Trends of Systematic Reviews and Randomized
           Clinical Trials, 1995 to 2017
    • Authors: Niforatos JD; Weaver M, Johansen ME.
      Pages: 1593 - 1594
      Abstract: This cross-sectional study assesses the growth in the number of systematic reviews and meta-analyses vs randomized clinical trials from 1995 to 2017.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3013
      Issue No: Vol. 179, No. 11 (2019)
       
  • Meta-analysis Metastasis
    • Authors: Wallach JD.
      Pages: 1594 - 1595
      Abstract: In 2016, following an evaluation of publication trends over the last few decades, Ioannidis declared that “the production of systematic reviews and meta-analyses has reached epidemic proportions.” In particular, he estimated that the annual number of published systematic reviews and meta-analyses increased approximately 2700% from 1991 to 2014. Systematic reviews and meta-analyses, which are fundamental tools of evidence-based medicine, aim to accumulate, synthesize, and evaluate evidence across individual studies, with the goal of resolving uncertainties, reducing biases, and informing practice. However, the production of reviews has far outpaced the 150% increase in annual publications across all PubMed–indexed article types between 1991 and 2014. These recent trends have led to questions about the purpose, quality, and credibility of most reviews as well as calls to abandon systematic reviews and meta-analyses altogether.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.2999
      Issue No: Vol. 179, No. 11 (2019)
       
  • Industry Payments to Physician Directors of NCI-Designated Cancer Centers
    • Authors: Carr D; Welch H.
      Pages: 1595 - 1597
      Abstract: This study examines industry payments made to physician directors of National Cancer Institute–designated cancer centers from 2015 through 2017.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.3098
      Issue No: Vol. 179, No. 11 (2019)
       
  • Reevaluating the Use of the NIS to Identify Incident Cases of AF After AVR
    • Authors: Malik AH; Yandrapalli S, Tang GL.
      Pages: 1597 - 1598
      Abstract: To the Editor Kalra et al used the Nationwide Inpatient Sample (NIS) to estimate the incidence of new-onset atrial fibrillation (AF) after transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (AVR) and reported that 50% of patients develop AF after TAVI or AVR. We are concerned about the accuracy of the study results based on the methods used.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4409
      Issue No: Vol. 179, No. 11 (2019)
       
  • Reevaluating the Use of the NIS to Identify Incident Cases of AF After
           AVR—Reply
    • Authors: Kalra R; Patel N, Arora P.
      Pages: 1598 - 1598
      Abstract: In Reply We thank Malik et al for their interest in our article and their comments. We agree with the authors regarding the difficulty of differentiating between incident and prevalent atrial fibrillation (AF) in the Nationwide Inpatient Sample (NIS) database. We noted this in the article’s Limitations section. Furthermore, we also stated in our Methods section that the reported rates of AF from the NIS assumed that all secondary discharge field disease coding was for new diagnoses of AF. We realized this assumption or approach may not be completely accurate, but it has been previously published using the NIS database. We were cognizant of the limitations with the NIS database that Malik et al highlighted, so we attempted to combat them using the additional analyses involving a validation cohort from the New York state inpatient database. This database has a unique patient identifier, and prior data have confirmed correct estimates of incident AF.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4412
      Issue No: Vol. 179, No. 11 (2019)
       
  • More Considerations on Both Model Assumptions and Results
           Interpretations—Evaluating Readmission—Reply
    • Authors: Joshi S; Nuckols T, Sood N.
      Pages: 1599 - 1600
      Abstract: In Reply Du et al raise 3 issues with our study. First, in one analysis, we use methods described by Linden and Davis to estimate the extent to which regression to the mean (RTM) explains changes in excess readmissions after implementation of the Hospital Readmission Reduction Program (HRRP). As noted by Du et al, this analysis assumes that excess readmission ratios (ERRs) follow a gaussian distribution, but this assumption is violated for 2 of 3 conditions analyzed. Second, they question our choice to analyze RTM in ERRs rather than risk-adjusted readmissions. Finally, they question whether our estimates establish that RTM causally led to a decline in excess readmissions. Below, we respond to each of these concerns.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4721
      Issue No: Vol. 179, No. 11 (2019)
       
  • More Considerations on Both Model Assumptions and Results
           Interpretations—Evaluating Readmission
    • Authors: Du C; Zhou G, Li S.
      Pages: 1599 - 1599
      Abstract: To the Editor Joshi et al claim that for the 3 target conditions of acute myocardial infarction, heart failure, and pneumonia, most of the decline in excess readmissions is due to regression to the mean (RTM) when applying the statistical model described by Linden and Davis to the excess readmission ratios (ERRs). Unfortunately, Joshi et al did not assess the plausibility of the underlying model assumptions. Davis pointed out that the underlying statistical model to estimate the effects of RTM requires that the distributions of the ERRs during the 2 evaluation periods be gaussian with equal means and variances. To check this assumption, we ran the Levene test for the equality of variances for each of the 3 conditions and found that the P values for both pneumonia and acute myocardial infarction were less than .01. This suggests that the model assumptions underlying the RTM effects estimation by Joshi et al for these 2 conditions are violated. Consequently, the magnitude of RTM’s effects reported by Joshi et al may be inaccurate.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4688
      Issue No: Vol. 179, No. 11 (2019)
       
  • Alternative to Sodium Polystyrene Sulfonate and Patiromer for the
           Treatment of Hyperkalemia—Reply
    • Authors: Grady D; Parks M.
      Pages: 1600 - 1601
      Abstract: In Reply We thank Dr Sabir for his comments on our article and for bringing attention to another recent US Food and Drug Administration–approved medication for lowering serum potassium in outpatients with nonemergent hyperkalemia. In 2 late phase trials, patients with mild hyperkalemia (serum potassium ≥5.1 mEq/L) were treated with relatively high-dose, open-label oral sodium zirconium cyclosilicate 3 times per day for 48 hours. In both trials, most patients achieved normokalemia, though the reduction in serum potassium was on average small—depending on the dose, between 0.2 and 0.7 mEq/L. In both trials, patients who achieved normokalemia were randomized to receive various once-daily doses of sodium zirconium cyclosilicate for an additional 12 or 28 days of treatment. During randomized treatment, most patients maintained normal serum potassium levels, but differences compared with placebo were small—depending on the dose, between 0.3 and 0.7 mEq/L. A third unblinded trial enrolled patients with hyperkalemia who were treated with high-dose sodium zirconium cyclosilicate for 48 to 72 hours, then with maintenance daily doses for up to 1 year. In this trial, potassium levels averaged 4.7 mmol/L in those who continued in the study for 12 months, but 40% were lost to follow-up before the end of the trial. The main reported adverse effects of treatment with sodium zirconium cyclosilicate have been edema and hypokalemia, especially at higher doses. The rates of gastrointestinal adverse effects in these trials were no different in treated and placebo groups, and there were no reported cases of intestinal necrosis.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4685
      Issue No: Vol. 179, No. 11 (2019)
       
  • An Alternative to Sodium Polystyrene Sulfonate and Patiromer for the
           Treatment of Hyperkalemia
    • Authors: Sabir I.
      Pages: 1600 - 1600
      Abstract: To the Editor I am writing in relation to the Editorial by Parks and Grady recently published in JAMA Internal Medicine. In this article, a clear overview is provided of the current understanding of the efficacy and safety of sodium polystyrene sulfonate. In addition, a potassium binder, patiromer, is suggested as a possible alternative option for the long-term treatment of hyperkalemia.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4698
      Issue No: Vol. 179, No. 11 (2019)
       
  • Is 4400 Steps per Day the New 10 000 Steps per Day'
    • Authors: Aguiar EJ; Ducharme SW, Thomas DM.
      Pages: 1601 - 1601
      Abstract: To the Editor We read with interest the recently published Original Investigation by Lee and colleagues regarding the association of step volume and intensity with all-cause mortality using data from the Women’s Health Study. We commend the authors on their pursuit of this question, particularly given the recently identified dearth of longitudinal evidence related to steps per day and risk of mortality. The findings of Lee and colleagues provide further empirical evidence toward the question of how many steps per day are enough to improve health in adults.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4704
      Issue No: Vol. 179, No. 11 (2019)
       
  • Is 4400 Steps per Day the New 10 000 Steps per Day'—Reply
    • Authors: Lee I; Shiroma EJ.
      Pages: 1602 - 1602
      Abstract: In Reply We thank Aguiar and colleagues for their letter and very much agree that “Although it is still premature to provide empirically supported step-based recommendations, it is important to consider the implications of [available] findings for public health, physical activity guideline development, and individual goal setting.” It is encouraging to note a congruence between our findings of decreasing mortality rates with more steps taken a day until approximately 7500 steps/d when rates leveled and findings of a study by Tudor-Locke and colleagues showing approximately 7000 to 8000 steps/d being equivalent to meeting physical activity guidelines. Our study addressed all-cause mortality (and not other health outcomes) among older women (and not other age groups); thus, additional data are needed to obtain a full picture of the associations between physical activity and health. These data are forthcoming: in recent years, an exciting development in the field of physical activity research is the emergence of several prospective cohort studies that collect detailed information on physical activity using devices instead of relying on self-reports, as was traditionally completed. These studies are able to provide novel information, such as that related to light-intensity physical activity, which is not well reported, to inform future physical activity guidelines.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4701
      Issue No: Vol. 179, No. 11 (2019)
       
  • Age-Related Bias in Total Step Count Recorded by Wearable Devices
    • Authors: Kuo P; Urbanek JK, Schrack JA.
      Pages: 1602 - 1602
      Abstract: To the Editor Wearable devices provide clinicians and researchers the opportunity to better understand the health benefits of physical activity at the individual and population levels. Lee and colleagues recently analyzed the association between steps and all-cause mortality in a large cohort of older women and found that mortality rates gradually declined with increasing step volumes up to approximately 7500 steps/d. We appreciate the importance of this work to establish recommendations for improving health through daily physical activity; however, there are problems with the underlying methodology that may inadvertently understate the recommended amount of daily steps needed for health benefits.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4707
      Issue No: Vol. 179, No. 11 (2019)
       
  • Age-Related Bias in Total Step Count Recorded By Wearable
           Devices—Reply
    • Authors: Lee I; Shiroma EJ.
      Pages: 1603 - 1603
      Abstract: In Reply We thank Kuo and colleagues for their letter regarding our Original Investigation and agree that physical inactivity is a major public health problem in the United States and worldwide, which contributes to much ill health. Our main goal in conducting a study of step volume and intensity and their association with all-cause mortality was to provide information potentially useful for future physical activity guidelines. Current guidelines are couched in terms of recommended time spent in physical activity of moderate-to-vigorous intensity. This can be easily gauged by persons who purposefully exercise or walk for transportation; however, for those who may be active in their daily life (eg, someone who might actively play with children or grandchildren, or walk to the store to buy a replacement light bulb) but who do not intentionally exercise, it can be challenging to assess whether they are active enough to fulfill recommendations. Step counts may thus be a useful alternate metric, given the current ubiquity of step counters. Prior to our study, a widespread belief was that one needed 10 000 steps/d to achieve health benefit, which can be discouraging to inactive persons. Our findings indicated that 10 000 steps/d was not needed for lower mortality rates among older women who were not particularly active (mean step count of approximately 5500 steps/d).
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4691
      Issue No: Vol. 179, No. 11 (2019)
       
  • Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes
    • Authors: Deng X; Niu W.
      Pages: 1603 - 1604
      Abstract: To the Editor In their recently published systematic review and meta-analysis of 9 prospective studies totaling 307 099 participants, Qian and colleagues found benefits of plant-based dietary patterns in the primary prevention of type 2 diabetes. These findings carry the potential to create a healthier food environment for persons at a higher risk of developing diabetes via well-planned dietary interventions. However, we are concerned about 2 methodological aspects of this systematic review and meta-analysis.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4860
      Issue No: Vol. 179, No. 11 (2019)
       
  • Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes—Reply
    • Authors: Qian F; Sun Q.
      Pages: 1604 - 1605
      Abstract: In Reply We echo Gómez-Donoso and colleagues’ perspectives that plant-based diets or provegetarian diets can probably confer the same cardiometabolic health benefits as strict vegetarian or vegan diets. The favorable association of provegetarian diets with long-term weight control observed in the SUN cohort is in line with our results from a secondary analysis, in which a large part of the beneficial association between plant-based diets and type 2 diabetes was attributable to body mass index, calculated as weight in kilograms divided by height in meters squared. It is worth noting, though, that the inverse association persisted after accounting for body mass index in our analysis, which suggests that weight control may not be the sole pathway mediating the health benefits of eating plant-based diets.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4874
      Issue No: Vol. 179, No. 11 (2019)
       
  • Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes
    • Authors: Gómez-Donoso C; Bes-Rastrollo M, Martínez-González MA.
      Pages: 1604 - 1604
      Abstract: To the Editor Plant-based diets, which include strict vegan and vegetarian diets as well as more gentle approaches as proposed by formal operational scores assessing a provegetarian diet, have gained attention as a dietary strategy that can confer both health and environmental advantages. They are sometimes informally referred to as plant-forward, flexitarian, or semivegetarian diets.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4863
      Issue No: Vol. 179, No. 11 (2019)
       
  • Vitamin B 12 Therapy in Older Adults and Misconception of Its
           Inappropriateness
    • Authors: Arendt J; Nexo E.
      Pages: 1605 - 1605
      Abstract: To the Editor: Based on their study combining registry data of serum B12 measurements and prescriptions of B12 injections, Silverstein and colleagues recently claimed that 64% of elderly patients receive inappropriate B12 injection treatment. Their article presents a general misconception of B12 deficiency and its treatment. The study included 146 850 patients with a prescription of B12 injections; B12 deficiency was defined as serum B12 221 pmol/L or less, but the authors fail to acknowledge the well-documented limitations in the use of this biomarker for diagnosing B12 deficiency.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4899
      Issue No: Vol. 179, No. 11 (2019)
       
  • Vitamin B 12 Therapy in Older Adults and Misconception of Its
           Inappropriateness—Reply
    • Authors: Silverstein WK; Lin Y, Cheung MC.
      Pages: 1606 - 1607
      Abstract: In Reply We thank Arendt and colleagues and Stall and colleagues for their letters on our study. We agree that diagnosing vitamin B12 deficiency can be challenging in elderly patients. To mitigate this, we used a threshold of 221 pmol/L, the least restrictive value for B12 deficiency according to the National Health and Nutrition Examination Survey. It is also in keeping with Canadian practice guidelines on B12 deficiency, which suggest that symptoms of deficiency are rare with a serum B12 221 pmol/L or greater. We also believe that using methylmalonic acid and homocysteine levels as surrogates for deficiency does not reflect real-world practice, given their limited availability, cost, and poor sensitivity with increasing age.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4902
      Issue No: Vol. 179, No. 11 (2019)
       
  • Vitamin B 12 Therapy in Older Adults and Misconception of Its
           Inappropriateness
    • Authors: Stall NM; Goldlist BJ, Alibhai SH.
      Pages: 1606 - 1606
      Abstract: To the Editor We commend Silverstein and colleagues for examining the appropriateness of vitamin B12 therapy among older adults (study population was restricted to persons ≥65 years of age). However, we would be cautious about classifying vitamin B12 supplementation as inappropriate on the basis of either a serum B12 level below the normal limit or the absence of a serum B12 level in the 12 months prior to a prescription.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.4926
      Issue No: Vol. 179, No. 11 (2019)
       
  • Error in Figure 3
    • Pages: 1607 - 1607
      Abstract: In the Original Investigation titled “Association of 30-Day Mortality With Oral Step-Down vs Continued Intravenous Therapy in Patients Hospitalized With Enterobacteriaceae Bacteremia,” published online on January 22, 2019, and in print on March 4, 2019, the y-axis in Figure 3 was incorrect. This article has been corrected online.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.5480
      Issue No: Vol. 179, No. 11 (2019)
       
  • Correction to Open Access Status
    • Pages: 1607 - 1607
      Abstract: In the Original Investigation titled “Association Between Soft Drink Consumption and Mortality in 10 European Countries,” published online September 3, 2019, corrections were made to make the article available as open access. This article was corrected online.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.5327
      Issue No: Vol. 179, No. 11 (2019)
       
  • I’m Worried About Depression—What Should I Know'
    • Authors: Incze MA.
      Pages: 1612 - 1612
      Abstract: This JAMA Patient Page describes depression, its diagnosis, and its treatment.
      PubDate: Fri, 01 Nov 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0637
      Issue No: Vol. 179, No. 11 (2019)
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
Home (Search)
Subjects A-Z
Publishers A-Z
Customise
APIs
Your IP address: 34.231.21.123
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-