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Journal Cover JAMA The Journal of the American Medical Association
  [SJR: 6.44]   [H-I: 549]   [1173 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]
  • Abdominal Wall Hernias
    • Authors: Livingston EH.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Two Gratitudes
    • Authors: Adrian CD.
      Abstract: In this essay, novelist Chris Adrian reviews Oliver Sacks' final 'Gratitude' essays and Jenny Diski's end of life memoir, "In Gratitude."
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Reading Bly in the Waiting Room
    • Authors: Christianson B.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • The Falling Death Rate and Lengthening of Life
    • Abstract: The baby of today has the prospect of a much longer average lifetime than did the baby of two generations ago. The average duration of life and the death rate are two complementary magnitudes. If the death rate could be accurately established for any period, it would be an easy matter to calculate the span of life in a population in which the annual number of deaths equals the annual number of births, and without emigration or immigration. Such equalities exist in few countries, least of all in the United States. It was calculated by Willcox some years ago that the annual death rate in the United States was about 18 per thousand. On this basis the average length of life would be fifty-five years, obviously a rather high estimate for this country, involving errors of assumption which cannot readily be eliminated from the statistical calculations. For this reason it is ordinarily preferable to be satisfied with a statement of the “crude death rate,” or the quotient of the number of deaths in the year divided by the population. Such figures are easier to obtain.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Breastfeeding Practices Slow to Improve
    • Authors: Friedrich MJ.
      Abstract: Evidence for the importance of breastfeeding from the first hour of life and beyond is strong, but too few infants and young children around the world are benefitting from appropriate breastfeeding practices, according to a recent report from the United Nations International Children’s Emergency Fund (UNICEF).
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Ovarian Cancer Screening Tests Don’t Pass Muster
    • Authors: Voelker R.
      Abstract: Physicians and their women patients shouldn’t use screening tests that claim to detect ovarian cancer, the FDA has cautioned.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Reducing Stroke Disability
    • Authors: Voelker R.
      Abstract: The FDA has expanded indications for 2 blood clot retrieval devices as first-line treatment for ischemic stroke when used with a clot-dissolving drug within 6 hours of symptom onset.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Say Goodbye to Some Antibacterials
    • Authors: Voelker R.
      Abstract: Over-the-counter antibacterial soaps and washes that contain triclosan, triclocarban, or any of 17 other specific active ingredients will soon come off store shelves in response to a recently issued FDA rule.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Time to Hit the Pause Button on Medicare’s Payment Demonstration
    • Authors: Wilensky G.
      Abstract: After a slow start in 2011, the Center for Medicare & Medicaid Innovation (CMMI) at the Centers of Medicare & Medicaid Services (CMS) seems to have gone into overdrive. As part of the Department of Health and Human Services’ pledge to move the majority of Medicare payments away from undifferentiated fee-for-service payments to some type of value-based care, CMMI has been sponsoring a wide variety of models. These include models that feature fee-for-service payments with incentives added, bundled or episode-based payments, and population-based payments.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Brain Abnormalities From Zika Infection
    • Authors: Friedrich MJ.
      Abstract: A range of brain abnormalities that can arise in fetuses and newborns from congenital infection with the Zika virus are illustrated in series of radiographs in a recent report from Brazilian and US researchers published in Radiology.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Mosquito Traps Reduce Malaria in Kenya
    • Authors: Friedrich MJ.
      Abstract: Solar-powered mosquito traps that emit human odor as bait reduced the Anopheles funestus mosquito population by nearly 70% on the Kenyan island of Rusinga, in Lake Victoria, according to a recent report from an international group of researchers published in The Lancet.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Data Error in Figure
    • Abstract: In the Original Investigation entitled “Temporal Trends in Late Preterm and Early Term Birth Rates in 6 High-Income Countries in North America and Europe and Association With Clinician-Initiated Obstetric Interventions,” published in the September 12, 2016, issue of JAMA, the data for the Norwegian labor inductions and prelabor cesarean deliveries were incorrect due to a copy and paste error in creating the Figure from the raw data. This article was corrected online.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Pharmacogenomics Into the Clinic
    • Authors: Abbasi J.
      Abstract: This Medical News article discusses barriers to widespread implementation of genotype-guided prescribing.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Euthanasia and Physician-Assisted Suicide—In Reply
    • Authors: Emanuel EJ; Onwuteaka-Philipsen BD, Cohen J.
      Abstract: In Reply Drs Stevens and Toffler raise concerns about the lack of data on complications and abuse with the performance of PAS in Oregon and Washington. We agree there is a dearth of data, and we advocated for more research on problems and complications of euthanasia and PAS. Two types of research studies should be conducted. One would enhance official reporting forms requiring information on specific types of complications, such as vomiting of medications, prolonged time to death (>1 hour), and regaining consciousness. It is true that in completing these forms, physicians would be reporting on their own practices and may be reluctant to disclose complications. However, they may still be willing to provide information about unanticipated problems, and such reporting provides a minimum frequency of complications. All jurisdictions also should routinely conduct death certificate studies in which death certificates are randomly selected and the signing physicians contacted to complete a survey about the circumstances of the death. Such surveys have been performed in Belgium and the Netherlands. Although rarely used, surveys of bereaved family members identified from death certificates could also uncover practices that physicians might not know about or disclose.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Euthanasia and Physician-Assisted Suicide
    • Authors: Stevens KR; Jr, Toffler WL.
      Abstract: To the Editor Dr Emanuel and colleagues, in their article on attitudes and practices of euthanasia and physician-assisted suicide (PAS), documented the failure in Oregon and Washington to track data regarding abuses and complications. With the prescribing physician rarely present when the drugs were taken, how can complications or the rate at which they occurred be determined?
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Euthanasia and Physician-Assisted Suicide
    • Authors: Sulmasy DP; Ely E, Sprung CL.
      Abstract: To the Editor The article by Dr Emanuel and colleagues reporting no widespread violation of regulations concerning euthanasia and PAS might suggest that legalizing PAS has no untoward consequences. Because many physicians support PAS but consider euthanasia wrong, an important question is whether legalization of PAS will inevitably lead to euthanasia. As the World Medical Organization and American Medical Association consider whether to withdraw their opposition to legalization of PAS, we argue that the distinction between euthanasia and PAS cannot hold based on 5 reasons.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Longitudinal Evaluation of Work Status and Productivity After Bariatric
    • Authors: Alfonso-Cristancho R; King WC, Mitchell JE, et al.
      Abstract: This study assesses working status and productivity change in the first 3 years following surgery for severe obesity.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Palliative Care–Led Meetings for Families of ICU Patients
    • Authors: Remy AM; Remy KE, Rosenbaum JL.
      Abstract: To the Editor In a multicenter randomized clinical trial, Dr Carson and colleagues found that among 365 surrogate decision makers of patients with chronic critical illness, the use of 2 structured palliative care–led informational and emotional support meetings compared with usual care did not reduce anxiety or depression symptoms and may have increased posttraumatic stress disorder symptoms at 3-month follow-up. The results may be influenced by a number of aspects of the study design.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Palliative Care–Led Meetings for Families of ICU Patients
    • Authors: Martin EW.
      Abstract: To the Editor Dr Carson and colleagues reported on a palliative care–led goals of care intervention for families of ICU patients with chronic critical illness. In my view, the null findings were not surprising. Although the researchers suggested that their intervention offered “more intensive informational and emotional support,” the intervention content fell far short of the support provided by a palliative care consultation. In many cases, family meetings occurred only once during a hospitalization that was often weeks long. It appears that treatment recommendations were not made by palliative care clinicians and the patients were not seen or examined.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Palliative Care–Led Meetings for Families of ICU Patients
    • Authors: Danis M; Carson SS, Hanson LC.
      Abstract: In Reply Ms Remy and colleagues suggest that the intervention of 1 or 2 palliative care–led meetings to inform and support families of patients with chronic critical illness had little effect because it does not replicate the intensive and comprehensive intervention that palliative care consultations provide. Both Remy and colleagues and Dr Martin point out that in full palliative care consultations, patients are seen, examined, assessed, and offered a range of approaches to meet their needs as well as their families’ needs. They also note that palliative care, at its best, includes follow-up bereavement support for families of patients who die.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • The Ethics of Behavioral Health Information Technology
    • Authors: Joy M; Clement T, Sisti D.
      Abstract: This Viewpoint discusses the ethics of using an icon in electronic health records to designate patients who have frequent visits.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Highlights for October 18, 2016
    • PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Recurrence and Complications After Elective Incisional Hernia Repair
    • Authors: Kokotovic D; Bisgaard T, Helgstrand F.
      Abstract: This Danish cohort study investigates the risks of long-term recurrence and mesh-related complications among patients undergoing incisional hernia repair with open mesh, laparoscopic mesh, and open nonmesh surgical techniques.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Conservative vs Conventional Oxygen and ICU Mortality
    • Authors: Girardis M; Busani S, Damiani E, et al.
      Abstract: This randomized clinical trial compares a conservative oxygen protocol vs standard oxygen delivery on the outcomes of mortality, organ failure, and infection in adult patients admitted to a medical-surgical intensive care unit (ICU).
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Management of an Unprovoked First Seizure in Adults
    • Authors: Tao JX; Davis AM.
      Abstract: This JAMA Clinical Guidelines Synopsis summarizes the American Academy of Neurology’s and American Epilepsy Society’s 2015 guideline on management of an unprovoked first seizure in adults.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Thyroid-Stimulating Hormone in the Evaluation of Subclinical
    • Authors: Papaleontiou M; Cappola AR.
      Abstract: A 62-year-old woman presented with a 6-month history of hair thinning, itchy scalp, and cold sensitivity, has a mild elevation of her thyroid-stimulating hormone level (4.88 mIU/L) and elevated levels of low-density lipoprotein (155 mg/dL) and total cholesterol (257 mg/dL). How do you interpret the test results?
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Oxygen in the ICU
    • Authors: Ferguson ND.
      Abstract: Oxygen gas was discovered and described in the 1770s by Scheele, Priestley, and Lavoisier and shortly thereafter its therapeutic potential for patients with respiratory illness was appreciated. Oxygen has become a mainstay of treatment for acutely ill patients, with emphasis frequently placed on the importance of avoiding hypoxemia. Modern clinical practice guidelines for critically ill patients generally target the normal levels for the partial pressure of arterial oxygen (Pao2) and the oxyhemoglobin saturation in arterial blood (Sao2), which range from 89 through 100 mm Hg and 95% through 97%, respectively, depending on patient age.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Empirical Micafungin Treatment and Invasive Fungal Infection–Free
    • Authors: Timsit J; Azoulay E, Schwebel C, et al.
      Abstract: This randomized clinical trial compares the effects of micafungin vs placebo on 28-day fungal infection–free survival among nonneutropenic critically ill patients with ICU-acquired sepsis, Candida species colonization at multiple sites, and multiple organ failure.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Effect of Postextubation High-Flow Nasal Cannula vs NIV on Reintubation
    • Authors: Hernández G; Vaquero C, Colinas L, et al.
      Abstract: This randomized clinical trial compares the effects of high-flow conditioned oxygen therapy vs noninvasive ventilation (NIV) on postextubation respiratory failure and reintubation among critically ill adult patients.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • New Findings in Ventral Incisional Hernia Repair
    • Authors: Itani KF.
      Abstract: At a time when joints are successfully replaced with full restoration of function and cataracts are removed and replaced with multifocal intraocular lenses and full recovery of vision, the surgical community continues to struggle to find the best approach to repair ventral hernias. Current issues include the best anatomical approach; the best material, if any, to use to reinforce the repair; and the best location for the surgical mesh when it is used. Hernia repairs are common, with about 348 000 ventral hernia repairs in the United States in 2006 at a cost of $3.2 billion.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • The EMPIRICUS Trial Antifungal Therapy in Critically Ill Patients With
    • Authors: Siddharthan T; Karakousis PC, Checkley W.
      Abstract: Candida species are the most common cause of invasive fungal infections, accounting for 70% to 90% of hospital cases. Although the overall US incidence of candidemia is low among nonneutropenic, critically ill adults (approximately 2/1000 intensive care unit [ICU] admissions), candidemia results in a longer length of stay (≤1 month), costs in excess of $40 000 per case, and a 30-day mortality greater than 50%. Moreover, mortality from invasive fungal infection has been increasing over the past decade, suggesting that advances in the management for invasive fungal infection have lagged behind those for bacterial septic shock. In light of the high mortality associated with invasive fungal infection, particularly among critically ill patients, a number of guidelines have focused on empirical treatment with antifungal echinocandins and surveillance for Candida either through culture or diagnostic biomarkers. Accordingly, the use of echinocandins has increased from 4.6% to 48.5% in some settings. Yet little was previously known about mortality benefits from prophylactic antifungal therapy.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Warning Notices on Advertisements for Sugary Drinks
    • Authors: Schillinger D; Jacobson MF.
      Abstract: This Viewpoint discusses the trial of American Beverage Association (ABA) et al v City & County of San Francisco over the ordinance requiring billboards advertising sugar-sweetened beverages to include a warning notice.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • The Face That Thinks
    • Authors: Patel JJ.
      Abstract: During my second year of residency, I was confident in my presentation skills. I had a routine before presenting new patients. Just before morning rounds, I printed out all of my notes and highlighted the important features of the patient’s history, my examination findings, and my assessment and plan. I folded each note long-ways for easy retrieval from my coat pocket, and when it came time to present, I pulled out my papers and recited, nearly word-for-word, what I had typed out earlier. If I could read directly from my neatly folded papers, the chances of fumbling information were reduced. I thought this made rounding easier for the team: it kept rounds moving. There was no second-guessing information, because it was all right there, typed out nicely on a crisp, white sheet of paper, in 10-point Times New Roman font. And if we needed additional data, someone had a computer on wheels handy, ready to retrieve information. I was convinced my routine was benefiting me as much as it was my team.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Reassessing Cancer Compendia for Off-Label Oncology Prescribing
    • Authors: Green AK; Wood WA, Basch EM.
      Abstract: This Viewpoint argues that the current model of payment coverage decisions for oncology drugs based on third-party drug compendia is outdated and should be abandoned for a new approach.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
  • Investing Wisely in Health Care Capital
    • Authors: Klein DJ; Brown AD, Detsky AS.
      Abstract: This Viewpoint emphasizes the contribution of capital spending to escalating health care costs, and argues for improved understanding of the ways capital spending planning and investment can deliver important gains in health care value and population health.
      PubDate: Tue, 18 Oct 2016 00:00:00 GMT
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