Journal Cover JAMA The Journal of the American Medical Association
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   Full-text available via subscription Subscription journal
   ISSN (Print) 0098-7484 - ISSN (Online) 1538-3598
   Published by American Medical Association Homepage  [13 journals]
  • Highlights for May 16, 2017
    • PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Reassessing the Data on Whether a Physician Shortage Exists
    • Authors: Gudbranson E; Glickman A, Emanuel EJ.
      Abstract: This Viewpoint argues that there are sufficient numbers of primary care physicians in the United States and that any appearance of a shortage is attributable to factors such as unequal geographic distribution and management inefficiencies.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Addressing the Physician Shortage
    • Authors: Kirch DG; Petelle K.
      Abstract: This Viewpoint argues that the United States faces a serious physician shortage that is likely to worsen in the coming decades.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • USPSTF Draft Recommendation on Prostate Cancer Screening
    • Authors: Bibbins-Domingo K; Grossman DC, Curry SJ.
      Abstract: This Viewpoint from the US Preventive Services Task Force (USPSTF) introduces their 2017 draft recommendation statement on screening for prostate cancer, explains how it differs from their 2012 recommendation, and invites public comment.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Replacing the Affordable Care Act
    • Authors: Skinner JS; Volpp KG.
      Abstract: This Viewpoint draws on 4 general behavioral economics principles to apply to health care insurance reform.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Determination
    • Authors: Campbell BH.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Geographic Differences in Cardiovascular Mortality
    • Authors: Mensah GA; Goff DC, Gibbons GH.
      Abstract: The substantial decline in death rates from cardiovascular diseases (CVD) in the United States represents one of the greatest biomedical research and public health achievements of the 20th century. For example, the age-adjusted death rate for heart disease in 2015 (168.5 per 100 000) represented a nearly 70% reduction compared with rates 50 years earlier (542.5 per 100 000).
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Oral Iron for Heart Failure
    • Authors: Lewis GD; Malhotra R, Hernandez AF, et al.
      Abstract: This randomized clinical trial investigates the efficacy of oral iron supplementation for improvement of exercise capacity in adult patients with heart failure with reduced left ventricular ejection fraction.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Comparison of Intra-articular Triamcinolone vs Saline for Knee
           Osteoarthritis
    • Authors: McAlindon TE; LaValley MP, Harvey WF, et al.
      Abstract: This randomized trial compares the effects of intra-articular triamcinolone vs saline injected every 3 months for 2 years on changes in cartilage volume and pain in older adult patients with knee osteoarthritis.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Geographic Variation in Cardiovascular Mortality Among US Counties
    • Authors: Roth GA; Dwyer-Lindgren L, Bertozzi-Villa A, et al.
      Abstract: This population epidemiology study uses national death record and Census Bureau data to estimate trends in age-standardized cardiovascular disease mortality rates by US county between 1980 and 2014.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Intraocular vs Systemic Therapy for Uveitis
    • Authors: ; Kempen JH, Altaweel MM, et al.
      Abstract: This study reports 7-year outcomes data for patients with uveitis randomized in the Multicenter Uveitis Steroid Treatment trial to receive an intravitreous fluocinolone acetonide implant vs prednisone or other immunosuppressant therapy.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Trends in Use of Sedation for Low-Risk Endoscopy
    • Authors: Leung FW.
      Abstract: This commentary discusses a study published in JAMA Internal Medicine that assessed trends in the use of monitored anesthesia care for outpatient gastrointestinal endoscopy in the Veterans Health Administration from 2000 to 2013.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • 2016 ACCP Guideline on Antithrombotic Therapy for VTE
    • Authors: Jain A; Cifu AS.
      Abstract: This JAMA Clinical Guidelines Synopsis summarizes the American College of Chest Physicians’ 2016 recommendations on antithrombotic therapy for venous thromboembolism (VTE).
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Drugs for Head Lice
    • Abstract: This Medical Letter review summarizes commercially available head lice treatments, including prescribing information for pyrethrins, permethrin 1%, malathion, benzyl alcohol, spinosad, ivermectin, and manual treatment alternatives.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Postoperative Opioid Prescribing and Patient Satisfaction Survey Scores
    • Authors: Lee JS; Hu HM, Brummett CM, et al.
      Abstract: This study uses insurance claims and HCAHPS data to investigate correlations between measures of pain and patient satisfaction after hospital discharge and postoperative opioid prescriptions.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Hospital Characteristics and CMS Quality Measure Reporting and Star Rating
    • Authors: DeLancey JO; Softcheck J, Chung JW, et al.
      Abstract: This study uses CMS Overall Hospital Quality Star Rating data to estimate associations between hospital characteristics, number and types of measures reported, and the CMS Hospital Quality Star Ratings.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Global Burden of Disease Attributable to Hypertension
    • Authors: Cooper RS; Kaufman JS, Bovet P.
      Abstract: To the Editor The Global Burden of Disease (GBD) project has made important contributions to the field of public health surveillance. However, when providing cause-specific data, the limitations inherent in global estimates become apparent. In the article on the global burden of hypertension, an anomaly is the large number of disability-adjusted life-years from coronary heart disease assigned to sub-Saharan Africa and many parts of Asia. It is well established that coronary heart disease remains infrequent to rare in sub-Saharan Africa and much of Asia. In the supplemental material, the authors stated that the process of risk estimation was “standardized to enhance the comparability of results across risks, outcomes, populations and time,” which implies that the same risk coefficients were used for calculations in all geographic regions. This method will provide biased estimates of cardiovascular outcomes; although the relative risks may be similar across populations, the background of other risk factors, such as smoking and hyperlipidemia, vary and will influence the event rate and the number of deaths from coronary heart disease. In populations like those in sub-Saharan Africa and much of Asia, serum lipids remain low and, in Africa at least, smoking is uncommon. The large population-attributable fractions for these regions are therefore likely to be overestimates.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Global Burden of Disease Attributable to Hypertension—Reply
    • Authors: Roth GA; Murray CL.
      Abstract: In Reply Dr Cooper and colleagues suggest that coronary heart disease remains infrequent to rare in sub-Saharan Africa and Asia. We disagree. The empirical evidence behind their claim is unclear as they only cite a few older studies.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Intubation During In-Hospital Cardiac Arrest
    • Authors: Wilt JL; Lee D.
      Abstract: To the Editor In a large retrospective evaluation of intubation during cardiac arrest, Dr Andersen and colleagues suggested that intubation during the first 15 minutes of in-hospital cardiac arrest was associated with decreased survival. Although the authors tried to balance the distribution of groups with statistical analysis, the original groups were significantly different, preventing like groups from being analyzed.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Intubation During In-Hospital Cardiac Arrest—Reply
    • Authors: Andersen LW; Donnino MW.
      Abstract: In Reply Dr Wilt and Ms Lee question the validity of our results due to between-group differences in baseline characteristics before propensity matching, specifically mentioning differences in noninvasive ventilation and the initial rhythm. As noted in Table 2 in the article, these characteristics were well matched in the propensity score–matched cohort. Therefore, these variables cannot confound the adjusted results. Furthermore, in our subgroup analysis according to initial rhythm, intubation was associated with poor outcomes in both those with initial shockable and nonshockable rhythms. As noted in the article, there might be unmeasured confounders we were unable to adjust for.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Legal Ramifications of Ambiguous Clinical Guidelines
    • Authors: Kels CG; Kels LH.
      Abstract: To the Editor In their Viewpoint on clinical practice guidelines, Drs Klasco and Glinert highlighted the impracticality of ambiguous recommendations and issued a much-needed call for clarity. Clinicians making real-world decisions in an uncertain environment require actionable guidance, not equivocation. However, we are concerned that the authors’ analysis of the problem overlooked the use (and misuse) of clinical guidelines in medical malpractice litigation.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Legal Ramifications of Ambiguous Clinical Guidelines—Reply
    • Authors: Klasco RS; Glinert LH.
      Abstract: In Reply In highlighting the potential misuse of practice guidelines in litigation, Mr Kels and Dr Kels draw attention to one of the many unintended consequences of intermediate-grade recommendations; that is, that the authority of a professional society’s imprimatur and the appearance of quantitation inherent in an alphanumeric rating system may convey the impression of an action that is thoroughly evidence-based and ought to be performed, despite any number of layers of equivocation that might be deployed as a hedge against that impression.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Data Error
    • Abstract: In the Rational Clinical Examination Article entitled “Will Neuroimaging Reveal a Severe Intracranial Injury in This Adult With Minor Head Trauma' The Rational Clinical Examination Systematic Review” in the December 22/29, 2015, issue of JAMA, there were data errors in the GCS (Glasgow Coma Score) section “
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Omission in Text
    • Abstract: In the Capitol Health Call brief entitled “Vets Still Face Challenges in Receiving Timely Medical Care,” published in the April 11, 2017 issue of JAMA, there was an omission in the text. The last paragraph should have read, “Sen John McCain (R, Arizona), cosponsor of a bill to extend the Choice Program until its money runs out, projected to be in early 2018, said if the program is not extended, ‘more than a million veterans will lose their ability to visit a community provider, the VA system will once again become overwhelmed, and veterans will go back to the prescandal days of unending wait times for much-needed care.’” This article was corrected online.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • A Day in the Life: Dina El-Metwally, MD
    • Authors: Abbasi J.
      Abstract: This Medical News article profiles a NICU medical director in Baltimore.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Hunger, Health, and Compassion
    • Authors: Gostin LO.
      Abstract: The juxtaposition of headlines must have sent shivers down the spines of the global humanitarian and human rights communities. Even as headlines warned of 20 million people in Africa and the Mideast facing starvation, the Trump administration was proposing unprecedented cuts in foreign assistance.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Freeze-dried Rotavirus Vaccine Shows Promise
    • Authors: Friedrich MJ.
      Abstract: Three doses of a live, oral bovine rotavirus pentavalent vaccine (BRV-PV) protected healthy infants in Niger from severe rotavirus gastroenteritis, reported a team of international investigators in the New England Journal of Medicine.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Polio Vaccination Drive in African Nations
    • Authors: Friedrich MJ.
      Abstract: Efforts to vaccinate 116 million children against polio in 13 western and central African countries, led by the World Health Organization and the United Nations Children’s Fund, were carried out at the end of March. The polio eradication effort was prompted by the identification of 4 cases of polio in northeastern Nigeria in August of 2016. These polio cases were the first to occur in the region in more than 2 years. Although no additional cases have been reported since last August in Nigeria, the virus may still be circulating, and this synchronized campaign is intended to protect children throughout Africa.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Water Scarcity a Looming Threat to Children
    • Authors: Friedrich MJ.
      Abstract: A lack of access to safe water will impact almost 600 million children around the world over the next 2 decades, according to a UNICEF report, Thirsting for a Future: Water and Children in a Changing Climate. The report details how a depletion in sources of safe water increases the risk of death, disease, and malnutrition among children and how climate change will escalate these health risks in years ahead.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • A First in HCV Drugs for Youths
    • Authors: Voelker R.
      Abstract: Children and teens aged 12 to 17 years who have hepatitis C virus (HCV) infection will have access to the same antiviral medications that are known to eliminate HCV infections in adults.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Digitized Surgical Slides
    • Authors: Voelker R.
      Abstract: The FDA has cleared the way for pathologists to use whole-slide imaging when they view and interpret digital surgical pathology slides prepared from biopsied tissue. The Philips IntelliSite Pathology Solution is the first such system to receive the agency’s approval for primary diagnostic use.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Tardive Dyskinesia Drug Approved
    • Authors: Voelker R.
      Abstract: The first drug for adults with tardive dyskinesia (TD) has received FDA approval.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Musician’s Focal Dystonia
    • Authors: White J.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • The Supply of Doctors
    • Abstract: Recently a national periodical—Collier’s—published a misleading article by Albert Maisel entitled “So You Can’t Get a Doctor!” This long and somewhat confused statement purports to demonstrate that there is an acute shortage of doctors in this country and that deans of medical schools are callous to this alleged need, as shown by termination of the accelerated program in most schools and the reduction in freshmen enrolments to prewar levels.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • Reducing Risk of Dementia in Older Age
    • Authors: Sabayan B; Sorond F.
      PubDate: Tue, 16 May 2017 00:00:00 GMT
       
  • JAMA
    • PubDate: Tue, 16 May 2017 00:00:00 GMT
       
 
 
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