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JAMA The Journal of the American Medical Association    [657 followers]  Follow    
  Full-text available via subscription Subscription journal
     ISSN (Print) 0098-7484 - ISSN (Online) 1538-3598
     Published by American Medical Association Homepage  [11 journals]   [SJR: 4.843]   [H-I: 456]
  • Fibromyalgia A Clinical Review
    • Authors: Clauw DJ.
      Abstract: ImportanceFibromyalgia is present in as much as 2% to 8% of the population, is characterized by widespread pain, and is often accompanied by fatigue, memory problems, and sleep disturbances.ObjectiveTo review the epidemiology, pathophysiology, diagnosis, and treatment of fibromyalgia.Evidence ReviewThe medical literature on fibromyalgia was reviewed from 1955 to March 2014 via MEDLINE and the Cochrane Central Registry of Controlled Trials, with an emphasis on meta-analyses and contemporary evidence-based treatment guidelines. Treatment recommendations are based on the most recent evidence-based guidelines from the Canadian Pain Society and graded from 1 to 5 based on the level of available evidence.FindingsNumerous treatments are available for managing fibromyalgia that are supported by high-quality evidence. These include nonpharmacological therapies (education, exercise, cognitive behavioral therapy) and pharmacological therapies (tricyclics, serotonin norepinephrine reuptake inhibitors, and gabapentinoids).Conclusions and RelevanceFibromyalgia and other “centralized” pain states are much better understood now than ever before. Fibromyalgia may be considered as a discrete diagnosis or as a constellation of symptoms characterized by central nervous system pain amplification with concomitant fatigue, memory problems, and sleep and mood disturbances. Effective treatment for fibromyalgia is now possible.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Maternal Body Mass Index and the Risk of Fetal Death, Stillbirth, and
           Infant Death A Systematic Review and Meta-analysis
    • Authors: Aune D; Saugstad O, Henriksen T, et al.
      Abstract: ImportanceEvidence suggests that maternal obesity increases the risk of fetal death, stillbirth, and infant death; however, the optimal body mass index (BMI) for prevention is not known.ObjectiveTo conduct a systematic review and meta-analysis of cohort studies of maternal BMI and risk of fetal death, stillbirth, and infant death.Data SourcesThe PubMed and Embase databases were searched from inception to January 23, 2014.Study SelectionCohort studies reporting adjusted relative risk (RR) estimates for fetal death, stillbirth, or infant death by at least 3 categories of maternal BMI were included.Data ExtractionData were extracted by 1 reviewer and checked by the remaining reviewers for accuracy. Summary RRs were estimated using a random-effects model.Main Outcomes and MeasuresFetal death, stillbirth, and neonatal, perinatal, and infant death.ResultsThirty eight studies (44 publications) with more than 10 147 fetal deaths, more than 16 274 stillbirths, more than 4311 perinatal deaths, 11 294 neonatal deaths, and 4983 infant deaths were included. The summary RR per 5-unit increase in maternal BMI for fetal death was 1.21 (95% CI, 1.09-1.35; I2 = 77.6%; n = 7 studies); for stillbirth, 1.24 (95% CI, 1.18-1.30; I2 = 80%; n = 18 studies); for perinatal death, 1.16 (95% CI, 1.00-1.35; I2 = 93.7%; n = 11 studies); for neonatal death, 1.15 (95% CI, 1.07-1.23; I2 = 78.5%; n = 12 studies); and for infant death, 1.18 (95% CI, 1.09-1.28; I2 = 79%; n = 4 studies). The test for nonlinearity was significant in all analyses but was most pronounced for fetal death. For women with a BMI of 20 (reference standard for all outcomes), 25, and 30, absolute risks per 10 000 pregnancies for fetal death were 76, 82 (95% CI, 76-88), and 102 (95% CI, 93-112); for stillbirth, 40, 48 (95% CI, 46-51), and 59 (95% CI, 55-63); for perinatal death, 66, 73 (95% CI, 67-81), and 86 (95% CI, 76-98); for neonatal death, 20, 21 (95% CI, 19-23), and 24 (95% CI, 22-27); and for infant death, 33, 37 (95% CI, 34-39), and 43 (95% CI, 40-47), respectively.Conclusions and RelevanceEven modest increases in maternal BMI were associated with increased risk of fetal death, stillbirth, and neonatal, perinatal, and infant death. Weight management guidelines for women who plan pregnancies should take these findings into consideration to reduce the burden of fetal death, stillbirth, and infant death.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Effect of Metformin on Left Ventricular Function After Acute Myocardial
           Infarction in Patients Without Diabetes The GIPS-III Randomized Clinical
           Trial
    • Authors: Lexis CH; van der Horst IC, Lipsic E, et al.
      Abstract: ImportanceMetformin treatment is associated with improved outcome after myocardial infarction in patients with diabetes. In animal experimental studies metformin preserves left ventricular function.ObjectiveTo evaluate the effect of metformin treatment on preservation of left ventricular function in patients without diabetes presenting with ST-segment elevation myocardial infarction (STEMI).Design, Setting, and ParticipantsDouble-blind, placebo-controlled study conducted among 380 patients who underwent primary percutaneous coronary intervention (PCI) for STEMI at the University Medical Center Groningen, the Netherlands, between January 1, 2011, and May 26, 2013.InterventionsMetformin hydrochloride (500 mg) (n = 191) or placebo (n = 189) twice daily for 4 months.Main Outcomes and MeasuresThe primary efficacy measure was left ventricular ejection fraction (LVEF) after 4 months, assessed by magnetic resonance imaging. A secondary efficacy measure was the N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration after 4 months. The incidence of major adverse cardiac events (MACE; the combined end point of death, reinfarction, or target-lesion revascularization) was recorded until 4 months as a secondary efficacy measure.ResultsAt 4 months, all patients were alive and none were lost to follow-up. LVEF was 53.1% (95% CI, 51.6%-54.6%) in the metformin group (n = 135), compared with 54.8% (95% CI, 53.5%-56.1%) (P = .10) in the placebo group (n = 136). NT-proBNP concentration was 167 ng/L in the metformin group (interquartile range [IQR], 65-393 ng/L) and 167 ng/L in the placebo group (IQR, 74-383 ng/L) (P = .66). MACE were observed in 6 patients (3.1%) in the metformin group and in 2 patients (1.1%) in the placebo group (P = .16). Creatinine concentration (79 µmol/L [IQR, 70-87 µmol/L] vs 79 µmol/L [IQR, 72-89 µmol/L], P = .61) and glycated hemoglobin (5.9% [IQR, 5.6%-6.1%] vs 5.9% [IQR, 5.7%-6.1%], P = .15) were not significantly different between both groups. No cases of lactic acidosis were observed.Conclusions and RelevanceAmong patients without diabetes presenting with STEMI and undergoing primary PCI, the use of metformin compared with placebo did not result in improved LVEF after 4 months. The present findings do not support the use of metformin in this setting.Trial Registrationclinicaltrials.gov Identifier: NCT01217307.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Effect of Aleglitazar on Cardiovascular Outcomes After Acute Coronary
           Syndrome in Patients With Type 2 Diabetes Mellitus The AleCardio
           Randomized Clinical Trial
    • Authors: Lincoff A; Tardif J, Schwartz GG, et al.
      Abstract: ImportanceNo therapy directed against diabetes has been shown to unequivocally reduce the excess risk of cardiovascular complications. Aleglitazar is a dual agonist of peroxisome proliferator–activated receptors with insulin-sensitizing and glucose-lowering actions and favorable effects on lipid profiles.ObjectiveTo determine whether the addition of aleglitazar to standard medical therapy reduces cardiovascular morbidity and mortality among patients with type 2 diabetes mellitus and a recent acute coronary syndrome (ACS).Design, Setting, and ParticipantsAleCardio was a phase 3, multicenter, randomized, double-blind, placebo-controlled trial conducted in 720 hospitals in 26 countries throughout North America, Latin America, Europe, and Asia-Pacific regions. The enrollment of 7226 patients hospitalized for ACS (myocardial infarction or unstable angina) with type 2 diabetes occurred between February 2010 and May 2012; treatment was planned to continue until patients were followed-up for at least 2.5 years and 950 primary end point events were positively adjudicated.InterventionsRandomized in a 1:1 ratio to receive aleglitazar 150 µg or placebo daily.Main Outcomes and MeasuresThe primary efficacy end point was time to cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Principal safety end points were hospitalization due to heart failure and changes in renal function.ResultsThe trial was terminated on July 2, 2013, after a median follow-up of 104 weeks, upon recommendation of the data and safety monitoring board due to futility for efficacy at an unplanned interim analysis and increased rates of safety end points. A total of 3.1% of patients were lost to follow-up and 3.2% of patients withdrew consent. The primary end point occurred in 344 patients (9.5%) in the aleglitazar group and 360 patients (10.0%) in the placebo group (hazard ratio, 0.96 [95% CI, 0.83-1.11]; P = .57). Rates of serious adverse events, including heart failure (3.4% for aleglitazar vs 2.8% for placebo, P = .14), gastrointestinal hemorrhages (2.4% for aleglitazar vs 1.7% for placebo, P = .03), and renal dysfunction (7.4% for aleglitazar vs 2.7% for placebo, P 
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Comparison of Balloon-Expandable vs Self-expandable Valves in Patients
           Undergoing Transcatheter Aortic Valve Replacement The CHOICE Randomized
           Clinical Trial
    • Authors: Abdel-Wahab M; Mehilli J, Frerker C, et al.
      Abstract: ImportanceTranscatheter aortic valve replacement (TAVR) is an effective treatment option for high-risk patients with severe aortic stenosis. Different from surgery, transcatheter deployment of valves requires either a balloon-expandable or self-expandable system. A randomized comparison of these 2 systems has not been performed.ObjectiveTo determine whether the balloon-expandable device is associated with a better success rate than the self-expandable device.Design, Setting, and PatientsThe CHOICE study was an investigator-initiated trial in high-risk patients with severe aortic stenosis and an anatomy suitable for the transfemoral TAVR procedure. One hundred twenty-one patients were randomly assigned to receive a balloon-expandable valve (Edwards Sapien XT) and 120 were assigned to receive a self-expandable valve (Medtronic CoreValve). Patients were enrolled between March 2012 and December 2013 at 5 centers in Germany.InterventionsTransfemoral TAVR with a balloon-expandable or self-expandable device.Main Outcomes and MeasuresThe primary end point was device success, which is a composite end point including successful vascular access and deployment of the device and retrieval of the delivery system, correct position of the device, intended performance of the heart valve without moderate or severe regurgitation, and only 1 valve implanted in the proper anatomical location. Secondary end points included cardiovascular mortality, bleeding and vascular complications, postprocedural pacemaker placement, and a combined safety end point at 30 days, including all-cause mortality, major stroke, and other serious complications.ResultsDevice success occurred in 116 of 121 patients (95.9%) in the balloon-expandable valve group and 93 of 120 patients (77.5%) in the self-expandable valve group (relative risk [RR], 1.24, 95% CI, 1.12-1.37, P 
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Ethics, Regulation, and Comparative Effectiveness Research Time for a
           Change
    • Authors: Platt R; Kass NE, McGraw D.
      Abstract: The US health care system is poised to learn more about preventing, diagnosing, and treating illness than has ever been possible. This change is powered by the increasing commitment to comparative effectiveness research, increases in practice-based research, and the increasing availability of data arising from electronic health information systems to help patients, clinicians, and others understand who benefits from which treatments. Much can be learned by observing the outcomes of the varied decisions that clinicians and hospitals make. However, for many health care questions, it is important to intervene by systematically varying care, for instance by randomly selecting the order in which a new practice is introduced into different parts of a system or by randomly assigning different commonly used treatments to patients who are good candidates for all of the approaches. Indeed, random assignment would be important to ascribe causality to the change.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Miracle
    • Authors: Glod SA.
      Abstract: ECMO row is lined with bodies.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Selection of Valves for TAVR Is the CHOICE Clear'
    • Authors: Tuzcu E; Kapadia SR.
      Abstract: Transcatheter aortic valve replacement (TAVR) was first performed in 2002. Since then, a tremendous amount of progress with this innovative technology has resulted in widespread adoption of this procedure for treatment of aortic valve disease. More than 10 000 TAVRs were performed in the United States alone since Food and Drug Administration (FDA) approval of the first device in 2011. Contrary to Europe, where 10 different valves have been approved by the European Union, in the United States all except a few hundred cases have been performed using only 2 valves. These 2 distinctly different transcatheter valve systems have gone through a series of developments. However, the fundamental characteristics of the valves remain unchanged.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Parental Perspectives on Adolescent Hearing Loss
    • Authors: Kesser BW.
      Abstract: JAMA Otolaryngology–Head and Neck SurgeryParental Perspectives on Adolescent Hearing Loss Risk and PreventionDeepa L. Sekhar, MD, MSc; Sarah J. Clark, MPH; Matthew M. Davis, MD, MAPP; Dianne C. Singer, MPH; Ian M. Paul, MD, MscImportance: Data indicate that 1 in 6 adolescents has high-frequency hearing loss, which is typically noise related and preventable. Parental participation improves the success of adolescent behavioral interventions, yet little is known about parental perspectives regarding adolescent noise-induced hearing loss.Objective: To perform a survey to determine parental knowledge of adolescent hearing loss and willingness to promote hearing conservation to discern information that is critical to design adolescent hearing loss prevention programs.Design, Setting, and Participants: A cross-sectional, Internet-based survey of a nationally representative online sample of parents of 13- to 17-year-olds.Interventions: A survey conducted with the C.S. Mott Children’s Hospital National Poll on Children’s Health, a recurring online survey.Main Outcomes and Measures: Parental knowledge of adolescent hearing loss and willingness to promote hearing conservation.Results: Of 716 eligible respondents, 96.3% of parents reported that their adolescent was slightly or not at all at risk of hearing problems from excessive noise, and 69.0% had not spoken with their adolescent about noise exposure, mainly because of the perceived low risk. Nonetheless, to protect their adolescents’ hearing, more than 65.0% of parents are either willing or very willing to consider limiting time listening to music, limiting access to excessively noisy situations, or insisting on the use of hearing protection (earplugs or earmuffs). Higher parental education increased the odds of promoting hearing-protective strategies. Parents were less likely to insist on hearing protection for older adolescents. Parents who understood that both volume and time of exposure affect hearing damage were more likely to have discussed hearing loss with their adolescent (odds ratio [OR], 1.98; 95% CI, 1.29-3.03). The odds of discussing hearing loss were also increased for those who were willing or very willing to limit time listening to music (OR, 1.88; 95% CI, 1.19-2.26) and to insist on hearing protection (OR, 1.92; 95% CI, 1.15-3.18) compared with parents who were very unwilling, unwilling, or neutral.Conclusions and Relevance: Despite the rising prevalence of acquired adolescent hearing loss, few parents believe their adolescent is at risk. Those with higher education are more willing to promote hearing conservation, especially with younger adolescents. To create effective hearing conservation programs, parents need better education on this subject as well as effective and acceptable strategies to prevent adolescent noise exposure.JAMA Otolaryngol Head Neck Surg. 2014;140(1):22-28. doi:10.1001/jamaoto.2013.5760.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Highlights
    • PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Sickle Cell Trait—Neglected Opportunities in the Era of Genomic
           Medicine
    • Authors: Taylor C; Kavanagh P, Zuckerman B.
      Abstract: The use of genomics to prevent and treat disease is considered an important cornerstone for the future of health care. While the potential of genomics must be acknowledged, use of currently available scientific data and technical advances to reduce the burden of sickle cell disease (SCD), one of the most common serious single-gene disorders, is past due. However, any discussion of SCD must consider the historical context of race, inequalities in care, and previous concerns about authoritarian eugenics. The goal of this Viewpoint is to call attention to the unfulfilled promise of genetic screening to prevent SCD and to recommend necessary steps to realize this promise.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Cost-Related Motivations for Conducting Research Participants Should Be
           Informed
    • Authors: Nayak RK; Pearson SD, Miller FG.
      Abstract: Many groups in the United States are concerned about the increasing cost of health services and have sought to reduce health care spending while maintaining the quality of care. A promising approach to this goal is to conduct more head-to-head clinical trials that compare the effectiveness of less expensive treatment options with that of more costly treatments. However, this type of research raises questions about how the purposes of the studies are presented to potential research participants.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Integrating Care at the End of Life Should Medicare Advantage Include
           Hospice'
    • Authors: Stevenson DG; Huskamp HA.
      Abstract: Since its creation in 1983, the Medicare hospice benefit has been “carved out” of Medicare’s managed care program, commonly known as Medicare Advantage. When a Medicare Advantage enrollee elects hospice, payments for both hospice and other services unrelated to the individual’s terminal condition revert to fee-for-service Medicare, and health plans remain liable only for the Part D or supplemental benefits they provide. Although the initial rationale for this approach is unclear, the policy has come to define end-of-life care for a substantial portion of Medicare beneficiaries. Approximately 417 000 Medicare Advantage enrollees died in 2011 (24% of Medicare deaths), almost half of whom used hospice (D.G.S., analysis of 2011 Medicare hospice claims and Master Beneficiary Summary File, unpublished data, 2014). Consistent with broader efforts to integrate health care services across the continuum, the Medicare Payment Advisory Commission (MedPAC) recently recommended ending the hospice carve-out.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • A Nodular Protuberance on the Hard Palate
    • Authors: Ladizinski B; Lee KC.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Variation in Rates of Autoimmune Thyroid Disease by Race/Ethnicity in US
           Military Personnel
    • Authors: McLeod DA; Caturegli P, Cooper DS, et al.
      Abstract: The relationship between Graves disease and race/ethnicity is undefined. Based on thyroid antibody prevalence, the rates of Hashimoto thyroiditis may be highest in whites and lowest in blacks.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Dopamine vs Nesiritide for Acute Heart Failure With Renal Dysfunction
    • Authors: Kumar S.
      Abstract: To the Editor Dr Chen and colleagues evaluated the role of low-dose dopamine and nesiritide as individual strategies in treating patients with acute decongested heart failure while attempting to preserve or improve renal function. The trial found no benefit from low-dose dopamine or nesiritide with standard diuretic therapy. Despite significant advances in understanding the pathophysiology of acute heart failure, contemporary therapies have failed to have an effect.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Dopamine vs Nesiritide for Acute Heart Failure With Renal
           Dysfunction—Reply
    • Authors: Chen HH; Redfield MM.
      Abstract: In Reply Dr Kumar brings up 3 relevant queries regarding the ROSE trial: (1) whether future clinical trials in acute heart failure should target heart failure with preserved ejection fraction and heart failure with reduced ejection fraction separately; (2) the relevance of cystatin C as a surrogate end point; and (3) whether the advanced renal disease in the study population makes them nonresponders to any therapeutic measure.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Lag Time to Benefit for Preventive Therapies
    • Authors: Braithwaite R.
      Abstract: To the Editor: In their Viewpoint, Dr Lee and colleagues explained why clinicians and guideline panels should move beyond age as a crude marker for life expectancy and compare life expectancy with the earliest time when benefits exceed harms. They also noted that “unlike magnitude of benefit, measures of lag time to benefit are rarely reported.”
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Lag Time to Benefit for Preventive Therapies
    • Authors: Holmes HM; Min L, Boyd C.
      Abstract: To the Editor Dr Lee and colleagues discussed using lag time to benefit along with magnitude of benefit when considering preventive therapies in older adults. However, using time-to-benefit information from randomized clinical trials (RCTs) entails a number of challenges that warrant discussion.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Lag Time to Benefit for Preventive Therapies—Reply
    • Authors: Lee SJ; Leipzig RM, Walter LC.
      Abstract: In Reply Dr Braithwaite notes the similarities between our proposed concept of lag time to benefit and the concept of payoff time. We absolutely agree.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Incorrect Unit of Measure and Omitted Grant
    • Abstract: In the Original Investigation entitled “Blood Pressure Trajectories in Early Adulthood and Subclinical Atherosclerosis in Middle Age” published in the February 5, 2014, issue of JAMA (2014;311[5]:490-497. doi:10.1001/jama.2013.285122), the wrong unit was provided for measurement of coronary artery calcification. Instead of Hounsfield units (HU), the correct unit of measure is Agatston units (AU). In the accompanying Editorial entitled “Early Patterns of Blood Pressure Change and Future Coronary Atherosclerosis” (2014;311[5]:471-472. doi:10.1001/jama.2013.285123), the same change applies. Additionally, in the Original Investigation, grant RO1 HL098445 from the National Heart, Lung, and Blood Institute was omitted from the Funding/Support section. These articles have been corrected online.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • CDC: Hospital Antibiotic Use Promotes Resistance Checklist Can Improve
           Practices
    • Authors: Kuehn BM.
      Abstract: Antibiotic prescribing in hospitals is inconsistent and often inappropriate—contributing to the emergence of antibiotic resistance, according to an analysis of hospital antibiotic prescribing by the US Centers for Disease Control and Prevention (CDC). But simple steps, such as implementing checklists, could help hospitals more wisely use these vital medications, the CDC says.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • WHO: More Than 7 Million Air Pollution Deaths Each Year
    • Authors: Kuehn BM.
      Abstract: Exposure to air pollution results in an estimated 7 million deaths each year, said the World Health Organization (WHO), double its previous estimate. This suggests that air pollution—indoor, outdoor, or both—caused 1 in 8 deaths worldwide in 2012.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • IOM: Military Psychological Interventions Lack Evidence
    • Authors: Slomski A.
      Abstract: The casualties of the Iraq and Afghanistan wars weren’t limited to soldiers returning home with broken bodies—or in body bags. The invisible wounds from psychological disorders among active-duty military personnel are even more pervasive, increasing 62% from 2000 to 2011, according to a new Institute of Medicine (IOM) report, Preventing Psychological Disorders in Service Members and Their Families: An Assessment of Programs.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Some Progress in Effort to Reduce Hospital-Acquired Infections
    • Authors: Kuehn BM.
      Abstract: Hospital-acquired infections remain a pressing public health threat, affecting 1 in 25 hospitalized patients in 2011, according to the US Centers for Disease Control and Prevention (CDC). But some progress has been made in reducing these infections.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • From JAMA’s Daily News Site
    • PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Community-Based Care and Treatment of Schizophrenia
    • Authors: Friedrich MJ.
      Abstract: Adding community-based care to facility-based care is an effective strategy for treating individuals with schizophrenia in India, according to a study by researchers from India and the United Kingdom (Chatterjee S et al. Lancet. doi:10.1016/S0140-6736[13]62629-X [published online March 5, 2014]).
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Dromedary Camels and MERS
    • Authors: Friedrich MJ.
      Abstract: The coronavirus responsible for several hundred cases of Middle East respiratory syndrome (MERS) in the Middle East since 2012, many of them fatal, has been found to be widespread in dromedary camels throughout the Kingdom of Saudi Arabia, and these animals are likely responsible for human transmission (Alagaili AN et al. mBio. 2014;5[2]:e00884-14).
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Effect of Warming Temperatures on Malaria Incidence
    • Authors: Friedrich MJ.
      Abstract: Warming temperatures at higher altitudes are leading to higher rates of malaria in the highlands of Ethiopia and Columbia, according to a report from an international team of researchers (Siraj AS et al. Science. 2014;343[6175]:1154-1158).
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • WHO Issues New Guidelines to Ensure Contraception as a Human Right
    • Authors: Friedrich MJ.
      Abstract: The World Health Organization (WHO) released a set of guidelines on how countries can provide better information on contraception and easier access to services in ways that ensure the respect and protection of women’s human rights (http://bit.ly/1qefpd2).
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Barriers Still Hold Back HIV Care From Sub-Saharan Africa’s Infants
    • Abstract: Even in one of sub-Saharan Africa’s most successful programs to prevent mother-to-child HIV transmission, one-third of infants born to infected mothers weren’t tested for HIV because of logistical challenges and other barriers.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Fungal Infections May Be Overlooked After Natural Disasters
    • Abstract: Survivors of natural disasters may develop fungal infections that aren’t properly treated because they’re clinically similar to bacterial infections, a recent report indicates.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Our English Coasts (Strayed Sheep) William Holman Hunt
    • Authors: Smith JM.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • A Long Shot
    • Authors: Coulehan J.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Fibromyalgia Syndrome An Emerging but Controversial Condition
    • Authors: Goldenberg DL.
      Abstract: The syndrome termed fibromyalgia or fibrositis has recently attracted the interest of investigators and become a subject of general medical interest. Although some authors believe that fibromyalgia is not a discrete condition, rheumatologists now report that fibromyalgia is one of the most common diagnoses in ambulatory practice. Recent estimates of the prevalence of fibromyalgia in the United States have ranged from 3 to 6 million.…
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • Fibromyalgia
    • Authors: Sugerman D.
      PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
  • JAMA
    • PubDate: Wed, 16 Apr 2014 00:00:00 GMT
       
 
 
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