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Journal Cover JAMA The Journal of the American Medical Association
  [SJR: 6.44]   [H-I: 549]   [1256 followers]  Follow
    
   Full-text available via subscription Subscription journal  (Not entitled to full-text)
   ISSN (Print) 0098-7484 - ISSN (Online) 1538-3598
   Published by American Medical Association Homepage  [13 journals]
  • JAMA
    • PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Extremis
    • Authors: Buchbinder M.
      Abstract: This Arts and Medicine essay reviews Extremis, a 2016 short documentary streaming on Netflix, which addresses the challenges of end-of-life communication and decision-making in the ICU by following the work and patients of a critical and palliative care physician at Highland Hospital in Oakland, California.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Section
    • Authors: Uzumcu Z.
      Abstract: I watch the night snow streamby the radius of the courtyard’s lamp:it all gestures downward, and this snow looks how snow has always looked, billowed by the wind.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Dust And Its Dangers
    • Abstract: In the clinic of occupational diseases it is well recognized that dust of various sorts is a menace to the health of a large number of wage earners. For 1915 it has been estimated by Frederick L. Hoffman that at least 10 per cent. of workers labored under conditions more or less detrimental to health and life on account of atmospheric pollution commonly classed as dust. This impurity may be of the most diverse sorts. There are insoluble inorganic dusts, including metals in a state of fine division, silica, sand, coal, marble and similar powders. Potter’s asthma, grinder’s phthisis, and the siderosis among metal polishers and others engaged in metal working are familiar illustrations of the harm done by this class of dusts, which usually produce irritation through being inhaled. Others represent soluble inorganic impurities which are more readily absorbed after being swallowed, and are dangerous because of their inherently poisonous qualities. A third class, the organic dusts, comprises such widely varying materials as “sawdust, fur, skins, feathers, broom and straw, grains and flours, jute, flax, hemp, cotton, wool, carpet dust, street sweepings, tobacco-box dust, hides and leather, felts, rags, paper, horsehair, etc. Typical of the diseases caused by organic dusts are: flax dressers’ disease, a kind of pneumonia due to the inhalation of particles of flax; alkaloidal poisoning from African boxwood by workmen engaged in shuttle making, and malignant pustule and a febrile disease among rag sorters.”
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Stem Cell Treatments
    • Authors: Jin J.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Impact of Air Pollution on Children
    • Authors: Friedrich MJ.
      Abstract: Almost 300 million children around the world are exposed to toxic levels of outdoor air pollution, and those growing up in low- and middle-income countries are most at risk, according to a new report from the United Nations Children’s Fund (UNICEF), Clear the Air for Children.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • WHO Calls Off Global Zika Emergency
    • Authors: Friedrich MJ.
      Abstract: The Zika virus no longer represents a Public Health Emergency of International Concern (PHEIC), according to a World Health Organization declaration made after a November meeting of its Emergency Committee on Zika.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Diabetes Drug Gains New Indication
    • Authors: Voelker R.
      Abstract: The FDA has approved a new indication for the diabetes drug empagliflozin to reduce the risk of cardiovascular death in adult patients with type 2 diabetes and cardiovascular disease.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Salmonella -Tainted Milk Products Seized
    • Authors: Voelker R.
      Abstract: Acting on a complaint filed on the FDA’s behalf, the US Marshals Service seized more than 4 million pounds of dry nonfat milk powder and buttermilk powder that may have been contaminated because of Federal Food, Drug, and Cosmetic Act violations.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Relief for Ureteral Obstruction
    • Authors: Voelker R.
      Abstract: A new stent system that could help patients avoid a second invasive procedure to treat severe ureteral obstruction has received FDA approval, according to the device’s manufacturer, BrightWater Medical Inc, Mountain View, California.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Repeal and Replace Obamacare: What Could It Mean'
    • Authors: Butler SM.
      Abstract: Donald Trump’s pledge to “repeal and replace Obamacare” was one of his biggest crowd pleasers. It’s been noted, of course, that “repeal and replacing” is easier said than done, and indeed the President-elect has already begun to fudge. But moving forward on his broad replacement themes—expanding health savings accounts (HSAs) and state flexibility—could lead to some surprising and intriguing reforms.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Hypertension Shift From Rich to Poor Nations
    • Authors: Friedrich MJ.
      Abstract: In the last 40 years, the number of people with high blood pressure has almost doubled, with the increase occurring primarily in low- and middle-income countries. Meanwhile, blood pressure levels have declined in high-income countries, according to a report from the NCD (noncommunicable diseases) Risk Factor Collaboration, an international group of hundreds of investigators.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Underperforming Big Ideas in Biomedical Research—Reply
    • Authors: Joyner MJ; Paneth N, Ioannidis JA.
      Abstract: In Reply Drs Miller and Sittig challenge our claim that the big ideas that have long dominated biomedical research have underperformed. Interestingly, they admit that morbidity and mortality can be reduced by “getting the general population to eat less and exercise more; reducing the incidence of drunk driving; increasing the use of seat belts, child restraints, and bicycle helmets; and reducing cardiovascular disease risk through aspirin, blood pressure control, cholesterol reduction, and smoking cessation.” Indeed, these interventions constitute a terrific research agenda! Why not devote more research funds to finding out how to make these interventions more efficient'
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • NIH Charts a Path for Nutrition Science
    • Authors: Abbasi J.
      Abstract: This Medical News article discusses the new NIH Nutrition Research Task Force.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Postmortem Genetic Testing for Sudden Unexpected Death
    • Authors: Schrodi SJ.
      Abstract: To the Editor The various pathologies comprising sudden unexpected death are of considerable clinical priority, the etiologies of which may be amenable to interrogation by sequencing approaches. As pointed out by Dr Torkamani and colleagues, identifying causal genetic variants by postmortem genetic testing affects family members and may suggest treatments for similar carriers. Clinical genetic testing using next-generation sequencing technologies has spurred advances in the molecular diagnosis of numerous rare diseases.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Postmortem Genetic Testing for Sudden Unexpected Death—Reply
    • Authors: Torkamani A.
      Abstract: In Reply I agree in principle with the comments from Dr Schrodi that there remains a large degree of uncertainty between the observation of rare pathogenic variants for rare diseases and their ultimate attribution as the cause of sudden death. In the study, these potential connections were labeled as “speculative”; therefore, they should not be interpreted as the genetic cause of death with any degree of certainty, and accordingly, were not included in the summary discussion of the likely or plausible diagnostic yield of the study. Rather, the intent was to highlight potential expansions derived from exome sequencing to genetic causes of sudden death beyond the usual suspects (genes related to sudden cardiac death) that are typically included in clinical panel–based testing.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Underperforming Big Ideas in Biomedical Research
    • Authors: Miller DG; Sittig DF.
      Abstract: To the Editor In a Viewpoint, Dr Joyner and colleagues claimed that decades of research spending has been misguided by focusing on big ideas such as personalized medicine, stem cell therapy, and electronic health records (EHRs). Their definition of personalized medicine relied on 6 themes proposed by Collins that attempted to predict the value of focusing on genetics and subcellular biology at the start of the Human Genome Project in 1999. Although we agree that progress in subcellular biology (especially genetics) and health information technology (especially EHRs) has not yet achieved the anticipated promise, we believe that it is too early to judge the success or failure of these 8 big ideas on the basis of whether they have achieved “measurable reductions in mortality and morbidity.” If one were to judge all biological or information technology–related research using these criteria, researchers would be limited to studying ways to increase adoption of known public health interventions including: getting the general population to eat less and exercise more; reducing the incidence of drunk driving; increasing the use of seat belts, child restraints, and bicycle helmets; and reducing cardiovascular disease risk through aspirin, blood pressure control, cholesterol reduction, and smoking cessation.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Wearable Technology and Long-term Weight Loss
    • Authors: Voils CI; Shaw RJ.
      Abstract: To the Editor Dr Jakicic and colleagues examined whether a weight loss intervention enhanced with wearable technology would improve weight loss relative to a standard behavioral intervention. Contrary to their hypothesis, the enhanced technology group lost less weight. There were no group differences on other physical indices of weight, physical activity, or diet.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Wearable Technology and Long-term Weight Loss
    • Authors: Plante TB; Martin SS.
      Abstract: To the Editor After successful weight loss with weekly group sessions over the initial 6 months of the IDEA trial, individuals randomized to an enhanced intervention group using a physical activity tracking device regained more weight over the subsequent 18 months compared with participants randomized to a standard intervention not including use of this device. The results seem counterintuitive and remain insufficiently explained. We have a few questions that may lead to better understanding of the IDEA trial results.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Wearable Technology and Long-term Weight Loss
    • Authors: Kulick D.
      Abstract: To the Editor A randomized clinical trial of lifestyle interventions in overweight and obese adults concluded, contrary to the hypothesis, that the addition of wearable technology devices to a standard behavioral intervention resulted in less weight loss over 24 months. At the same time, the study found no significant differences between the 2 groups regarding physical activity, calorie intake, and diet.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Wearable Technology and Long-term Weight Loss—Reply
    • Authors: Jakicic JM; Belle SH.
      Abstract: In Reply We agree with Drs Klasnja and Hekler and Drs Voils and Shaw about the importance of considering the mechanisms of action, in particular the specific behavior change techniques used within interventions that focus on behavior change. The IDEA study was 1 of 7 controlled clinical trials independently testing interventions focused on weight gain prevention or weight loss in young adults. We are interested in what aspects of the interventions are associated with outcomes across the various studies and have obtained additional funding to examine this issue. In particular, we are identifying the behavior change techniques used by each of the interventions, including the interventions reported in our study, using the taxonomy proposed by Michie et al.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Management of Patient With a Latex Allergy
    • Authors: Minami CA; Barnard C, Bilimoria KY.
      Abstract: This JAMA Performance Improvement article explores the case of a patient with latex allergy who had a latex catheter placed and how the health care team should handle the situation both during surgery and postoperatively.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Antifungal Treatments for Critically Ill Patients Without Neutropenia
    • Authors: Cortegiani A; Russotto V, Giarratano A.
      Abstract: This Clinical Evidence Synopsis summarizes a 2016 update of a Cochrane review of clinical trials comparing the effects of antifungal drugs on prevention of mortality and invasive fungal infection in critically ill patients without neutropenia.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Epinephrine Auto-Injectors for Anaphylaxis
    • Abstract: This Medical Letter review summarizes available generic and brand-name epinephrine auto-injectors in the wake of recent EpiPen price increases.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Variation in the Ratio of Physician Charges to Medicare by Specialty and
           Region
    • Authors: Bai G; Anderson GF.
      Abstract: This study uses data from the Centers for Medicare & Medicaid Services to understand the extent and variation of physician excess charges by specialty and geographic region.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Wearable Technology and Long-term Weight Loss
    • Authors: Klasnja P; Hekler EB.
      Abstract: To the Editor Clinical trials can contribute knowledge about both efficacy and mechanisms of action. Efficacy concerns whether the intervention is “better” than a control, such as standard of care; mechanisms concern how the intervention produces desired outcomes—its hypothesized causal pathways. For pharmacotherapies, after years of bench research, a new drug’s action pathways are typically understood well enough that a clinical trial can both test efficacy and generate evidence about causal mechanisms.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Reevaluation of Asthma Diagnosis in Adults With Previously Diagnosed
           Asthma
    • Authors: Aaron SD; Vandemheen KL, FitzGerald J, et al.
      Abstract: This cohort study investigates the proportion of adults who were diagnosed with asthma by a physician within the previous 5 years and no longer met clinical criteria for the diagnosis.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Diabetes and Mortality in Rural and Urban Areas of China
    • Authors: Bragg F; Holmes MV, Iona A, et al.
      Abstract: This population epidemiology study uses national survey data to compare the prevalence of diabetes and to provide estimates of the diabetes-related absolute excess mortality for adults living in rural and urban areas of China.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Prognostic Accuracy of SIRS Criteria and SOFA and qSOFA Scores Among ICU
           Patients With Suspected Infection
    • Authors: Raith EP; Udy AA, Bailey M, et al.
      Abstract: This cohort study compares the accuracy of the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score, quick SOFA score, and Systemic Inflammatory Response Syndrome criteria for predicting in-hospital mortality or prolonged length of stay among adults admitted to the ICU with suspected infection in Australia and New Zealand.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Evaluating the Validity of Sepsis-3 Criteria in the Emergency Department
    • Authors: Freund Y; Lemachatti N, Krastinova E, et al.
      Abstract: This cohort study compares the ability of the quick Sequential Organ Failure Assessment score vs systemic inflammatory response syndrome and severe sepsis criteria for a in-hospital mortality risk among adult patients presenting to the emergency department with suspected infection.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • China’s Burgeoning Epidemic of Diabetes-Associated Mortality
    • Authors: Chan M.
      Abstract: Diabetes was not a health priority in China as recently as the 1980s, when prevalence in the adult population was estimated at only 1%. The first evidence that Asia’s rapidly developing economies might be poised for the epidemics of obesity, diabetes, and associated complications appeared in the mid-1990s, when Pan et al documented a 3-fold increase in the prevalence of diabetes among adults aged 25 to 74 years within 1 decade. The authors associated the increasing prevalence of diabetes in China with economic development, arguing that higher body mass index, a family history of diabetes, hypertension, a sedentary lifestyle, and higher annual income were independent risk factors.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • qSOFA for Identifying Sepsis Among Patients With Infection
    • Authors: Lamontagne F; Harrison DA, Rowan KM.
      Abstract: The identification of patients with possible sepsis is vitally important because timely recognition and appropriate, effective treatment substantially improves survival. Unlike some other life-threatening conditions (such as myocardial infarction), for which highly accurate diagnostic tests are available, no rapid diagnostic tests are currently available to accurately identify patients with sepsis (or those at high risk of developing sepsis) to help clinicians determine the best course of action. Development of such tests for sepsis will involve consideration of a number of key issues, such as whether sepsis is just one or, rather, multiple entities; whether degrees of having sepsis exist; which test is the gold standard (an accepted benchmark against which similar tests can be compared and diagnostic accuracy assessed); what levels of accuracy are sufficient for use in clinical practice; and which tests based on what markers are the most cost-effective. In the meantime, however, clinicians must rely on clinical judgment, potentially augmented by clinical criteria validated to identify sepsis among patients with infection.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Using the Electronic Health Record to Understand and Minimize Overuse
    • Authors: Rumball-Smith J; Shekelle PG, Bates DW.
      Abstract: This Viewpoint proposes ways in which electronic health record (EHR) systems might be configured to reduce health service overuse, improve health care quality, and control costs.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Ensuring and Improving Drug-Development Research for Children
    • Authors: Bourgeois FT; Hwang TJ.
      Abstract: This Viewpoint discusses the Pediatric Research Equity Act, a 2003 law authorizing the US Food and Drug Administration to require the study of new therapies for pediatric populations, and proposes improvements to the law as it comes up for reauthorization in 2017.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • A Mind-Body Duelist
    • Authors: Barbey; MA C.
      Abstract: Nine months after I was born, my pediatrician noticed something was wrong. Diagnosed with ectodermal dysplasia, I began my life with a disability. Medically, it has not been unmanageable. Emotionally, it has been a difficult journey.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Asthma—Here Today, Gone Tomorrow'
    • Authors: Hollingsworth HM; O’Connor GT.
      Abstract: Childhood asthma is a chronic health condition that often improves or resolves during adolescence or adulthood. Prospective cohort studies have indicated that as many as 75% of school-aged children with asthma “outgrow” this condition by some point in adulthood, although children with more severe symptoms, more impaired pulmonary function, and a higher degree of allergic sensitization to common aeroallergens are less likely to experience resolution of asthma. There is less evidence, however, about the rate of remission of asthma among adults, and the available data suggest a lower remission rate than among children.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Disseminating Clinical Best Practices in the VA Health System
    • Authors: Elnahal SM; Clancy CM, Shulkin DJ.
      Abstract: In this Viewpoint, the Under Secretary for Health of the Veterans Health Administration and colleagues describe the agency’s Diffusion of Excellence program, a learning health system approach to aligning best practices and agency system assets for rapid dissemination of clinical best practices.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Highlights for January 17, 2017
    • PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
  • Osteoporosis and Fracture Risk Evaluation and Management
    • Authors: Watts NB; Manson JE.
      Abstract: This Viewpoint outlines the diagnostic approaches and treatment options to reduce risk of fracture among patients with osteoporosis.
      PubDate: Tue, 17 Jan 2017 00:00:00 GMT
       
 
 
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