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Journal Cover JAMA The Journal of the American Medical Association
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     ISSN (Print) 0098-7484 - ISSN (Online) 1538-3598
     Published by American Medical Association Homepage  [11 journals]   [SJR: 4.843]   [H-I: 456]
  • Physical Therapy and Hip Osteoarthritis
    • Authors: White DM; Cibulka MT, Woehrle J.
      Abstract: To the Editor Dr Bennell and colleagues examined some interventions used by physical therapists in the management of patients with hip osteoarthritis. Fifty-one percent of the patients in the active intervention group had moderate to severe hip osteoarthritis. In our experience, this subset of patients typically is less likely to respond favorably to most conservative treatment, particularly given the low dose and types of interventions in the study.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Physical Therapy and Hip Osteoarthritis—Reply
    • Authors: Bennell K; Abbott J.
      Abstract: In Reply Dr White and colleagues raise 4 issues. First, they are concerned about differential treatment effects according to disease severity given that half of our participants had moderate to severe hip osteoarthritis and that their experience shows that those with moderate to severe hip osteoarthritis do not respond as favorably to most conservative treatment. This is a possibility although an exploratory post hoc analysis of the data showed no significant differences in the amount of improvement in pain (P = .76) and function (P = .38) comparing disease severity subgroups with active and sham treatment.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • PET Screening for Metastatic Colorectal Adenocarcinoma
    • Authors: Wong C; Jolepalem P.
      Abstract: To the Editor Dr Moulton and colleagues concluded that positron emission tomography (PET) combined with computed tomography (CT) compared with diagnostic CT alone did not significantly change the management of patients with potentially resectable metastatic colorectal adenocarcinoma. However, we are concerned about some issues related to the use of PET-CT.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • PET Screening for Metastatic Colorectal Adenocarcinoma—Reply
    • Authors: Moulton C; Gulenchyn K, Levine MN.
      Abstract: In Reply Drs Wong and Jolepalem and Dr Hofman and colleagues question the value of PET after preoperative chemotherapy. In our trial, a baseline CT was used to decide if the patient was a candidate for hepatic surgery. Most patients (70%) had received prior chemotherapy, usually adjuvant, for their primary treatment and often at a time and place remote from study enrollment. Patients were considered eligible 4 weeks after their last chemotherapy dose. This was a real-life study and reflects standard referral patterns. It does not seem in a patient’s best interest to delay a PET-CT for many months to achieve better resolution of the test.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Uterine Pathology in Women Undergoing Minimally Invasive Hysterectomy
           Using Morcellation
    • Authors: Wright JD; Tergas AI, Burke WM, et al.
      Abstract: Even though minimally invasive surgery has improved outcomes for hysterectomy, the procedure requires removal of the uterus through small incisions. Morcellation, or fragmentation of the uterus into smaller pieces, is one method to remove the uterus. Recently, concern has been raised that morcellation may result in the spread of undetected malignancies.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • PET Screening for Metastatic Colorectal Adenocarcinoma
    • Authors: Hofman MS; Ware RE, Thomson BN.
      Abstract: To the Editor We dispute the conclusion that fluorodeoxyglucose (FDG) PET-CT is of questionable value to patients with hepatic metastases from colorectal cancer being evaluated for curative intent surgery. When current best surgical practice infrequently leads to cure and has associated morbidity and cost, is a 9% improvement in surgical management of questionable value to patients'
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Nasal Erythema and Crusting After a Trip to the Venezuelan Rainforest
    • Authors: Downing CP; Woc-Colburn L, Tyring SK.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Lung Cancer Screening
    • Authors: Davis AM; Cifu AS.
      Abstract: Guideline title Screening for Lung CancerDeveloper US Preventive Services Task Force (USPSTF)Release date 12/31/2013 (online); 3/4/2014 (print)Prior version 5/4/2004Funding source US federal government (Agency for Healthcare Research and Quality)Target population Asymptomatic adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit smoking within the past 15 yearsMajor recommendation and rating Screen annually for lung cancer with low-dose computed tomography in adults. Discontinue screening when the patient has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. (B recommendation)Related guidelines and other resourcesAmerican College of Chest Physicians. Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer' Diagnosis and Management of Lung Cancer: Evidence-Based Clinical Practice Guidelines. 2013. http://journal.publications.chestnet.org/data/Journals/CHEST/926876/chest_143_5_suppl_e93S.pdfThe American Association for Thoracic Surgery Guidelines for Lung Cancer Screening Using Low-Dose Computed Tomography Scans for Lung Cancer Survivors and Other High-Risk Groups. 2012. http://aats.org/multimedia/files/Guidelines/Lung-Cancer-Screening-Using-low-dose-computed-tomography-scans.pdfUS Preventive Services Task Force. Counseling and Interventions to Prevent Tobacco Use and Tobacco-Caused Disease in Adults and Pregnant Women. 2009. http://annals.org/data/Journals/AIM/20180/0000605-200904210-00009.pdf
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Electronic Medication Packaging Devices and Medication Adherence A
           Systematic Review
    • Authors: Checchi KD; Huybrechts KF, Avorn J, et al.
      Abstract: ImportanceMedication nonadherence, which has been estimated to affect 28% to 31% of US patients with hypertension, hyperlipidemia, and diabetes, may be improved by electronic medication packaging (EMP) devices (adherence-monitoring devices incorporated into the packaging of a prescription medication).ObjectivesTo investigate whether EMP devices are associated with improved adherence and to identify and describe common features of EMP devices.Evidence ReviewSystematic review of peer-reviewed studies testing the effectiveness of EMP systems in the MEDLINE, EMBASE, PsycINFO, CINAHL, International Pharmaceutical Abstracts, and Sociological Abstracts databases from searches conducted to June 13, 2014, with extraction of associations between the interventions and adherence, as well as other key findings. Each study was assessed for bias using the Cochrane Handbook for Systematic Reviews of Interventions; features of EMP devices and interventions were qualitatively assessed.FindingsThirty-seven studies (32 randomized and 5 nonrandomized) including 4326 patients met inclusion criteria (10 patient interface–only “simple” interventions and 29 “complex” interventions integrated into the health care system [2 qualified for both categories]). Overall, the effect estimates for differences in mean adherence ranged from a decrease of 2.9% to an increase of 34.0%, and the those for differences in the proportion of patients defined as adherent ranged from a decrease of 8.0% to an increase of 49.5%. We identified 5 common EMP characteristics: recorded dosing events and stored records of adherence, audiovisual reminders to cue dosing, digital displays, real-time monitoring, and feedback on adherence performance.Conclusions and RelevanceMany varieties of EMP devices exist. However, data supporting their use are limited, with variability in the quality of studies testing EMP devices. Devices integrated into the care delivery system and designed to record dosing events are most frequently associated with improved adherence, compared with other devices. Higher-quality evidence is needed to determine the effect, if any, of these low-cost interventions on medication nonadherence and to identify their most useful components.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Accuracy of FDG-PET to Diagnose Lung Cancer in Areas With Infectious Lung
           Disease A Meta-analysis
    • Authors: Deppen SA; Blume JD, Kensinger CD, et al.
      Abstract: ImportancePositron emission tomography (PET) combined with fludeoxyglucose F 18 (FDG) is recommended for the noninvasive diagnosis of pulmonary nodules suspicious for lung cancer. In populations with endemic infectious lung disease, FDG-PET may not accurately identify malignant lesions.ObjectivesTo estimate the diagnostic accuracy of FDG-PET for pulmonary nodules suspicious for lung cancer in regions where infectious lung disease is endemic and compare the test accuracy in regions where infectious lung disease is rare.Data Sources and Study SelectionDatabases of MEDLINE, EMBASE, and the Web of Science were searched from October 1, 2000, through April 28, 2014. Articles reporting information sufficient to calculate sensitivity and specificity of FDG-PET to diagnose lung cancer were included. Only studies that enrolled more than 10 participants with benign and malignant lesions were included. Database searches yielded 1923 articles, of which 257 were assessed for eligibility. Seventy studies were included in the analysis. Studies reported on a total of 8511 nodules; 5105 (60%) were malignant.Data Extraction and SynthesisAbstracts meeting eligibility criteria were collected by a research librarian and reviewed by 2 independent reviewers. Hierarchical summary receiver operating characteristic curves were constructed. A random-effects logistic regression model was used to summarize and assess the effect of endemic infectious lung disease on test performance.Main Outcome and MeasuresThe sensitivity and specificity for FDG-PET test performance.ResultsHeterogeneity for sensitivity (I2 = 87%) and specificity (I2 = 82%) was observed across studies. The pooled (unadjusted) sensitivity was 89% (95% CI, 86%-91%) and specificity was 75% (95% CI, 71%-79%). There was a 16% lower average adjusted specificity in regions with endemic infectious lung disease (61% [95% CI, 49%-72%]) compared with nonendemic regions (77% [95% CI, 73%-80%]). Lower specificity was observed when the analysis was limited to rigorously conducted and well-controlled studies. In general, sensitivity did not change appreciably by endemic infection status, even after adjusting for relevant factors.Conclusions and RelevanceThe accuracy of FDG-PET for diagnosing lung nodules was extremely heterogeneous. Use of FDG-PET combined with computed tomography was less specific in diagnosing malignancy in populations with endemic infectious lung disease compared with nonendemic regions. These data do not support the use of FDG-PET to diagnose lung cancer in endemic regions unless an institution achieves test performance accuracy similar to that found in nonendemic regions.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Prevalence and Incidence Trends for Diagnosed Diabetes Among Adults Aged
           20 to 79 Years, United States, 1980-2012
    • Authors: Geiss LS; Wang J, Cheng YJ, et al.
      Abstract: ImportanceAlthough the prevalence and incidence of diabetes have increased in the United States in recent decades, no studies have systematically examined long-term, national trends in the prevalence and incidence of diagnosed diabetes.ObjectiveTo examine long-term trends in the prevalence and incidence of diagnosed diabetes to determine whether there have been periods of acceleration or deceleration in rates.Design, Setting, and ParticipantsWe analyzed 1980-2012 data for 664 969 adults aged 20 to 79 years from the National Health Interview Survey (NHIS) to estimate incidence and prevalence rates for the overall civilian, noninstitutionalized, US population and by demographic subgroups (age group, sex, race/ethnicity, and educational level).Main Outcomes and MeasuresThe annual percentage change (APC) in rates of the prevalence and incidence of diagnosed diabetes (type 1 and type 2 combined).ResultsThe APC for age-adjusted prevalence and incidence of diagnosed diabetes did not change significantly during the 1980s (for prevalence, 0.2% [95% CI, −0.9% to 1.4%], P = .69; for incidence, −0.1% [95% CI, −2.5% to 2.4%], P = .93), but each increased sharply during 1990-2008 (for prevalence, 4.5% [95% CI, 4.1% to 4.9%], P 
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Implementing Lung Cancer Screening Under Medicare The Last Chance to Get
           It Right'
    • Authors: Sox HC.
      Abstract: In 2010, the investigators of the randomized National Lung Screening Trial (NLST) reported that annual screening with low-dose computed tomography (CT) reduced lung cancer mortality by 20% compared with screening with chest radiographs. Subsequently, several clinical practice guidelines recommended annual screening, and many insurers agreed to cover screening. Most recently, the US Preventive Services Task Force (USPSTF) recommended annual screening for 55- to 80-year-old individuals who had smoked at least 30 pack-years.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Introducing JAMA Clinical Guidelines Synopsis
    • Authors: Cifu AS; Davis AM, Livingston EH.
      Abstract: Physicians are busy and often do not have the time to review a single topic in enough depth to successfully aggregate and synthesize current research into a single coherent theme that can guide practice, and they may not have the expertise to critically appraise complex primary research studies and apply the results to determine how best to deliver medical care. The purpose of clinical guidelines is to accomplish these tasks for physicians. However, committees that prepare guidelines often fail to produce a document that most physicians can use. Guideline documents are often hundreds of pages long, making them difficult and time-consuming to read and digest. The deployment of guidelines through electronic medical record decision support tools or applications on handheld electronic devices can be helpful, but these tools cannot assist with the nuanced decision making required for providing care to individual patients.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Effect of Enhanced Information, Values Clarification, and Removal of
           Financial Barriers on Use of Prenatal Genetic Testing A Randomized
           Clinical Trial
    • Authors: Kuppermann M; Pena S, Bishop JT, et al.
      Abstract: ImportancePrenatal genetic testing guidelines recommend providing patients with detailed information to allow informed, preference-based screening and diagnostic testing decisions. The effect of implementing these guidelines is not well understood.ObjectiveTo analyze the effect of a decision-support guide and elimination of financial barriers to testing on use of prenatal genetic testing and decision making among pregnant women of varying literacy and numeracy levels.Design, Setting, and ParticipantsRandomized trial conducted from 2010-2013 at prenatal clinics at 3 county hospitals, 1 community clinic, 1 academic center, and 3 medical centers of an integrated health care delivery system in the San Francisco Bay area. Participants were English- or Spanish-speaking women who had not yet undergone screening or diagnostic testing and remained pregnant at 11 weeks’ gestation (n = 710).InterventionsA computerized, interactive decision-support guide and access to prenatal testing with no out-of-pocket expense (n = 357) or usual care as per current guidelines (n = 353).Main Outcomes and MeasuresThe primary outcome was invasive diagnostic test use, obtained via medical record review. Secondary outcomes included testing strategy undergone, and knowledge about testing, risk comprehension, and decisional conflict and regret at 24 to 36 weeks’ gestation.ResultsWomen randomized to the intervention group, compared with those randomized to the control group, were less likely to have invasive diagnostic testing (5.9% vs 12.3%; odds ratio [OR], 0.45 [95% CI, 0.25-0.80]) and more likely to forgo testing altogether (25.6% vs 20.4%; OR, 3.30 [95% CI, 1.43-7.64], reference group screening followed by invasive testing). Women randomized to the intervention group also had higher knowledge scores (9.4 vs 8.6 on a 15-point scale; mean group difference, 0.82 [95% CI, 0.34-1.31]) and were more likely to correctly estimate the amniocentesis-related miscarriage risk (73.8% vs 59.0%; OR, 1.95 [95% CI, 1.39-2.75]) and their estimated age-adjusted chance of carrying a fetus with trisomy 21 (58.7% vs 46.1%; OR, 1.66 [95% CI, 1.22-2.28]). Significant differences did not emerge in decisional conflict or regret.Conclusions and RelevanceFull implementation of prenatal testing guidelines using a computerized, interactive decision-support guide in the absence of financial barriers to testing resulted in less test use and more informed choices. If validated in additional populations, this approach may result in more informed and preference-based prenatal testing decision making and fewer women undergoing testing.Trial Registrationclinicaltrials.gov Identifier: NCT00505596
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Personalized Genomic Medicine and Prenatal Genetic Testing
    • Authors: Dolan SM.
      Abstract: Just 30 years ago, Merkatz et al reported an association between low maternal serum alpha-fetoprotein and trisomy 18, proving in principal that information about a fetus could be learned prenatally. Today, genetic testing directly on fetal cells can provide a complete karyotype, and use of chromosomal microarray analysis (CMA) can generate information regarding more than 80 syndromes caused by microdeletions and microduplications. Noninvasive prenatal testing on cell-free fetal DNA in maternal serum is also being integrated into prenatal care, providing, as early as the first trimester, highly sensitive screening for the common trisomies, sex chromosome aneuploidies, and syndromes such as velocardiofacial syndrome (22q11 deletion).
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Code Green
    • Authors: Wellbery C.
      Abstract: More than 40 years ago I had a dream: the earth was getting warmer and warmer, and people lay prostrate on the streets, lethargic from thirst and heat. That dream I recite only from memory, but here is another one I recorded in a diary I kept in those days: “I found myself in a house with many people. Suddenly I looked outside and saw that we were surrounded by sea. Huge waves crashed in the distance. The end of the world! Water was seeping through the windows. A girl was using a cup to scoop out the water. ‘Is the house sinking'’ I asked. While we were trying to stay afloat, I was rescued by the alarm clock.” And lest my theme here isn’t yet clear, another dream I wrote down, dated March 7, 1969: “I dreamt there was a huge fire; the flames were everywhere, destroying everything. That is not the first time I have dreamt of fire. Always the hot flames. … ”
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Optimizing Health for Persons With Multiple Chronic Conditions
    • Authors: Parekh AK; Kronick R, Tavenner M.
      Abstract: The challenges for the US health care system of high health care costs and poor health outcomes in individuals with multiple (2 or more) concurrent, chronic conditions have been well documented. Estimates are that more than one-quarter of all adults have multiple chronic conditions; in addition, more than two-thirds of Medicare fee-for-service beneficiaries have multiple chronic conditions, with 14% having 6 or more common conditions. Recently, the Centers for Medicare & Medicaid Services (CMS) released new data resources on chronic conditions among Medicare fee-for-service beneficiaries to better define the burden of chronic conditions among beneficiaries and the implications for the US health care system.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Prevention of Gastric Cancer
    • Authors: Herrero R; Parsonnet J, Greenberg E.
      Abstract: This year, it is estimated that more than 700 000 people will die of gastric cancer, making this disease the third most common cause of cancer death globally. Although gastric cancer rates have been declining by approximately 2% per year, the numbers of cases and deaths are expected to increase in coming years, reflecting increasing numbers of older (and thus, higher-risk) individuals in the world. Despite its importance, gastric cancer receives little attention from research funding agencies or public health organizations. For example, the National Cancer Institute annually spends approximately $12 million on programs directly related to gastric cancer, just 0.2% of its budget, and only 10% of this amount is allocated for prevention research. In contrast, the annual cost of treating gastric cancer in the United States, a lower-risk country, is estimated at approximately $2 billion.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Highlights
    • PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Should CMS Cover Lung Cancer Screening for the Fully Informed Patient'
    • Authors: Volk RJ; Hawk E, Bevers TB.
      Abstract: This Viewpoint discusses whether the Centers for Medicare & Medicaid Services should offer coverage for the fully informed patient who elects lung cancer screening.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • JAMA
    • PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Pavilion Street, Mount Adams Frances Farrand Dodge
    • Authors: Smith JM.
      Abstract: As the 1920s came roaring into their lives, Americans beheld the unfolding of a new age that was resplendent with movies, mass-produced automobiles, and shiny appliances that made running a household easier for Mom. The antics of Charlie Chaplin and Buster Keaton entertained many, and availability of cars, especially the tin lizzie, encouraged the exploration of distant horizons. Selected work of the era by Frances Farrand Dodge (1878-1969) acknowledges the evolving modern age but seems set against a backdrop of nostalgia for simpler times.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Vladimir and Anita
    • Authors: Coulehan J.
      Abstract: Anita, whose course of radiation hasn’t sprung the tiniest leakin her character, tells me the bluesthat crawl each morning into her bedare masculine. The icicle jitters that slip under her skin each eveningare feminine. She gets rid of the menby belting What a Friend We Have in Jesus until the nurses comeand shush her. She relies on the Spiritto hustle those petulant womenout of the room. Anita’s calm.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • A Physician’s Personal Hobbies and Prescriptions
    • Abstract: Every physician who has been actively engaged in his profession finds that there is a wide range of remedies that are valuable only in the secondary list, and that after all his main reliance in routine work is upon a few well known and long tried remedies. Oliver W. Holmes says: “Give me opium, wine and milk and I will cure all diseases to which flesh is heir.” Now while this is hyperbolic, it appeals to the experience of all as a terse statement of fact. Just as a mechanic will fashion a wide variety of articles with a few simple tools so the physician with a few good remedies mastered in their every detail, will meet the varying exigencies of his daily round, successfully. But this very knowledge has its dangers. It is characteristic of mental action that it repeats itself the more easily with each repetition—and we are but human. It is less labor to use the old formula again than to devise new. One man runs largely to bismuth, another to iron, another to hypophosphites. Again what is still worse routine is to treat all maladies in one line, to see nothing but disinfection for instance, or to see but one organ of the body at fault, and make the womb, or ovary, or kidney or whatnot, depending upon the individual’s specialty, the offender.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Editorial Notes
    • Abstract: A Thought From Dr. O. W. Holmes.—“When the hospitals are invaded by the novelist, he should learn something from the physician as well as the patients.” This is the appropriately genial and wholesome sentiment offered by Dr. Holmes in the April number of the AtlanticMonthly. It will fit into many another situation in life in addition to that for which it is immediately designed. It might be concentrated so as to read: “Don't be too morbid.”
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Suicide Runs in Families With ADHD
    • Authors: Slomski A.
      Abstract: Shared genetic factors may partly explain the increased risk of suicide among persons with attention-deficit/hyperactivity disorder (ADHD), found a longitudinal study of 51 707 Swedish patients with ADHD and their families (Ljung T et al. JAMA Psychiatry. 2014;71[8]:958-964). Heritable traits such as impulsivity play a large role in both ADHD and suicidal behavior and may explain the pattern of familial susceptibility to both, the authors said.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • AHRQ: Little Evidence for Opioids in Managing Long-term Chronic Pain
    • Authors: Kuehn BM.
      Abstract: Patients taking opioid medications for chronic pain over the long-term have an increased risk of serious dose-dependent harms, according to a review of the evidence on long-term opioid use by the Agency for Healthcare Research and Quality (AHRQ) (http://1.usa.gov/1pAbUwU). In addition, AHRQ found little evidence supporting the benefits of long-term use of opioids for chronic pain.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • DEA Tightens Restrictions on Hydrocodone Combination Products
    • Authors: Kuehn BM.
      Abstract: The US Drug Enforcement Administration (DEA) is tightening restrictions on the prescribing of hydrocodone combination products.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • FDA Warning: Phony Ebola Treatments Being Sold Online
    • Authors: Kuehn BM.
      Abstract: The US Food and Drug Administration (FDA) is warning consumers that fraudulent treatments for Ebola virus disease are being marketed online.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • NIH Outlines Needs for Ongoing Care of Longer-Living Patients With HIV
    • Authors: Kuehn BM.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • More Fruit, Less Fruit Juice
    • Abstract: Children in the United States are eating more fruit and drinking less fruit juice, which investigators said are “encouraging patterns.”
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Preventive Care Linked With Income, Health Insurance Status
    • Abstract: By reducing costs and expanding access to health insurance, the Affordable Care Act may help more US residents receive certain clinical preventive services proven to save lives.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Progress in Treating Cystic Fibrosis Means That Many Patients May Now
           Reach Midlife and Beyond
    • Authors: Kuehn BM.
      Abstract: In the not-too-distant past, parents were counseled that children with cystic fibrosis were unlikely to live past their teenage years. But a new estimate of patients’ life spans suggests that many can now expect to live into their 40s and beyond.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • From JAMA’s Daily News Site
    • PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Digoxin Linked to Higher Mortality in Some Patients With Atrial
           Fibrillation
    • Authors: Slomski A.
      Abstract: Digoxin was associated with increased mortality risk in US veterans newly diagnosed with atrial fibrillation/atrial flutter (AF) independent of drug adherence, kidney function, cardiovascular comorbidities, or concomitant therapies with β-blockers or amiodarone, according to a retrospective cohort study of 122 465 individuals with 353 168 person-years of follow-up (Turakhia M et al. J Am Coll Cardiol. 2014;64[7]:660-668).
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Exercise May Extend Life in Patients With High Serum Uric Acid
    • Authors: Slomski A.
      Abstract: People with asymptomatic hyperuricemia who engaged in moderate exercise experienced a 4- to 6-year increase in life expectancy and elimination of the mortality risks of high uric acid compared with inactive individuals with normal uric acid levels, found an observational study of 467 976 Taiwanese adults (Chen J-H et al. Ann Rheum Dis. doi:10.1136/annrheumdis-2014-205312 [published online July 22, 2014]).
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Overweight Preschoolers Headed for Cardiometabolic Problems
    • Authors: Slomski A.
      Abstract: Metabolic abnormalities, reduced insulin sensitivity, and nonalcoholic fatty liver disease (NAFLD) are present in children as young as 2 years old, found a study of 219 children whose body mass index had changed from normal to overweight or obese in the prior 12 months (Shashaj B et al. JAMA Pediatr. doi:10.1001/jamapediatrics.2014.900 [published online August 11, 2014]).
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Euthanasia for Minors in Belgium
    • Authors: Rietjens JC; Robijn L, van der Heide A.
      Abstract: To the Editor Dr Siegel and colleagues commented on the recent approval of the Belgian Act on Euthanasia to allow euthanasia for chronically ill children. We would like to enrich this commentary with findings from research in the Netherlands, a country where the law, since 2002, allows euthanasia for patients who are at least 12 years old, provided that a number of specific criteria are met.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Euthanasia for Minors in Belgium
    • Authors: Chambaere K; Roelands M, Deliens L.
      Abstract: To the Editor In their Viewpoint, Dr Siegel and colleagues reflected on the recent extension of the Belgian euthanasia law to include competent minors. As members of the Belgian End-of-Life Care Research Group, we think it is necessary to respond to their views to provide a more nuanced context and explain the prevailing perspective in Belgium.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Euthanasia for Minors in Belgium—Reply
    • Authors: Siegel AM; Sisti DA, Caplan AL.
      Abstract: In Reply Dr Chambaere and colleagues present a thoughtful response to our Viewpoint. However, we disagree that any age restriction on the availability of euthanasia is arbitrary.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Missing Author Contributions Statement
    • Abstract: In the Original Investigation entitled “Newborn Screening for Severe Combined Immunodeficiency in 11 Screening Programs in the United States,” published in the August 20, 2014, issue of JAMA (2014;312[7]:729-738. doi:10.1001/jama.2014.9132), there was a statement missing from the Author Contributions section. The statement should have read, “Drs Kwan and Abraham contributed equally to this work.” This article was corrected online.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
  • Fixing the Troubled Mental Health System
    • Authors: Sederer LI; Sharfstein SS.
      Abstract: Untreated and poorly treated serious mental illness affects the lives of individuals, families, and communities every day. Each year, approximately 39 000 people commit suicide, and the majority of them have acute mental illness. More than half of suicides are the result of a self-inflicted gunshot wound. Many other persons with serious mental illness have lives of isolation, are homeless, or are incarcerated. Because of the stigma of mental illness, an inability to know that they are ill, or troubling experiences with mental health services, people with mental illness often do not seek or follow through with treatment.
      PubDate: Wed, 24 Sep 2014 00:00:00 GMT
       
 
 
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