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Journal Cover JAMA The Journal of the American Medical Association
  [SJR: 6.44]   [H-I: 549]   [1656 followers]  Follow
    
   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 December 5, 2017
    • PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • The 2017 Hypertension Guideline: What’s New and Different
    • Authors: Whelton PK; Carey RM.
      Abstract: This Viewpoint reviews key recommendations in the 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure authored by the AHA, ACC, and 9 other specialty organizations, and highlights differences from the 2003 JNC 7 guideline.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Responsible Care in the Face of Shifting CDC Zika Virus Recommendations
    • Authors: Goldfarb I; Jaffe E, Lyerly A.
      Abstract: This Viewpoint discusses clinical and public health challenges likely to arise from the 2017 change in Centers for Disease Control and Prevention (CDC) recommendations from serologic testing of all Zika-exposed pregnant women regardless of the timing and duration of exposure to testing only those pregnant women with symptoms consistent with infection or with ongoing exposure.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Cybersecurity Concerns and Medical Devices
    • Authors: Kramer DB Fu K.
      Abstract: This Viewpoint uses a 2017 US Food and Drug Administration (FDA) safety communication about the vulnerability of some cardiac pacemakers to malware to discuss medical device data security and patient safety more generally, and regulatory steps the FDA has and can take to combat the risks.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Making a Case for Sanctuary Hospitals
    • Authors: Saadi A; Ahmed S, Katz MH.
      Abstract: This Viewpoint discusses how current enforcement of US immigration policy has led to arrests and questioning of patients at health care facilities and argues that all health care settings should have legal sanctuary status to protect undocumented immigrants’ access to medical treatment.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Moral Choices for Today’s Physician
    • Authors: Berwick DM.
      Abstract: In this essay, Don Berwick considers moral choices physicians face personally, organizationally, and globally and exhorts them to understand that the health of humanity depends on their speaking out against the social injustice of overpricing drugs and services, mass incarceration, and the lack of environmental responsibility.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • The 2017 Hypertension Guideline: Highlights for Clinical Practice
    • Authors: Greenland P; Peterson E.
      Abstract: Hypertension, the world’s most common and modifiable cardiovascular risk factor, has been the focus of multiple clinical practice guidelines dating back to the first Joint National Committee in 1977. In 2014, a writing group commissioned by the National Heart, Lung, and Blood Institute focused on a few key treatment questions and used data only from randomized clinical trials (RCTs) to inform their recommendations. Based on a lack of RCT evidence, the writing group recommended relaxing some of the treatment goals for several subgroups, including patients aged 60 years or older and those with diabetes or kidney disease. Even before publication, these somewhat conservative recommendations were criticized and ultimately not endorsed either by major professional societies or by some of the original guideline writing group.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • High-Cutoff Hemodialysis in Myeloma Cast Nephropathy
    • Authors: Jhaveri KD; Niesvizky R.
      Abstract: Multiple myeloma accounts for approximately 13% of all hematologic malignancies and is characterized by the neoplastic proliferation of clonal plasma cells that usually produce unique immunoglobulins (either intact or immunoglobulin light chains). Light chains can lead to tubular, interstitial, and glomerular damage in the kidney. Among patients with multiple myeloma, reduced kidney function has been associated with poor prognosis and shorter survival. The most common form of kidney disease reported on biopsy among patients with multiple myeloma is cast nephropathy (CN), which is a tubular interstitial disorder. The type of acute kidney injury (AKI) seen with CN can be mild but in some cases it may be severe and require dialysis.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Newborn Screening Policies for Critical Congenital Heart Disease
    • Authors: Kemper AR; Lam WK, Bocchini JA, Jr.
      Abstract: Newborn screening was developed more than 50 years ago as a way to prevent developmental disability associated with untreated phenylketonuria through early detection and treatment. Since then, newborn screening has expanded to include dozens of conditions that, if not identified in early infancy, are associated with significant morbidity and mortality. In the United States, each state is responsible for determining which conditions should be included in screening. Adding a condition to a state newborn screening panel is challenging. Not only does the newborn screening program have to implement the screening test, but systems must be put into place to enable diagnostic confirmation, prompt treatment, and public health monitoring. The resources needed to expand newborn screening must be weighed against the expected benefit, and because virtually all newborns are screened, the potential harms (eg, false positives, overdiagnosis) must be carefully considered.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Effects of GM-CSF on Walking Performance in Patients With PAD
    • Authors: McDermott MM; Ferrucci L, Tian L, et al.
      Abstract: This 2 × 2 factorial trial compared the effects of granulocyte-macrophage colony-stimulating factor (GM-CSF) vs placebo and of supervised treadmill exercise vs education control on 6-minute walk distance at 12 weeks in patients with peripheral artery disease.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Effect of High-Cutoff vs Conventional Hemodialysis for Myeloma Cast
           Nephropathy
    • Authors: Bridoux F; Carron P, Pegourie B, et al.
      Abstract: This randomized clinical trial compares the effects of hemodialysis using a high-cutoff dialyzer (with very large membrane pores and high permeability to immunoglobulin light chains) vs a conventional high-flux dialyzer (with small pores and lower permeability) on hemodialysis independence among patients with biopsy-proven myeloma cast nephropathy requiring hemodialysis in France.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Newborn Screening for Congenital Heart Disease and Infant Cardiac Deaths
    • Authors: Abouk R; Grosse SD, Ailes EC, et al.
      Abstract: This observational study compares changes in infant cardiac death rates in US states that did and did not implement newborn screening policies for critical congenital heart disease.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Treatment by Locum Tenens Internal Medicine Physicians and 30-Day
           Mortality Among Medicare Beneficiaries
    • Authors: Blumenthal DM; Olenski AR, Tsugawa Y, et al.
      Abstract: This cohort study evaluates the differences in quality and costs of care related to locum tenens vs non–locum tenens physicians treating hospitalized Medicare beneficiaries.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Treating Specific Variants Causing Cystic Fibrosis
    • Authors: Cutting GR.
      Abstract: This JAMA Insights article explains how precision health, which uses mechanistic insights to treat individual patients based on their unique abnormalities, can treat variants causing cystic fibrosis.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • The 2017 Guideline on Management of High Blood Pressure in Adults
    • Authors: Cifu AS; Davis AM.
      Abstract: This JAMA Clinical Guidelines Synopsis summarizes the 2017 American College of Cardiology/American Heart Association guideline on prevention, detection, evaluation, and management of high blood pressure in adults.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • FDA Expedited Programs and Clinical Development Times for Novel
           Therapeutics, 2012-2016
    • Authors: Hwang TJ; Darrow JJ, Kesselheim AS.
      Abstract: This study uses the Drugs@FDA database to analyze clinical development times for drugs to treat serious diseases within the 4 FDA expedited programs intended to speed drug review and approval.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Vitamin D Supplementation and Upper Respiratory Tract Infections in
           Children
    • Authors: Davidson BL; Alansari K.
      Abstract: To the Editor Ms Aglipay and colleagues found that daily high-dose (2000 U) oral vitamin D was not superior to maintenance (400 U) doses for preventing winter season viral upper respiratory tract infections in healthy young children. They could not ethically use a placebo control. Although the mean baseline vitamin D level was approximately 36 ng/mL for both treatment groups, almost a third had baseline levels less than 30 ng/mL (to convert serum 25-hydroxyvitamin D from ng/mL to nmol/L, multiply by 2.4960). In another study that randomized children whose baseline levels were all lower than 26 ng/mL, children with the very lowest baseline levels (3-11 ng/mL) in the high-dose supplement group had significantly reduced moderate-severe asthma attacks during the first 3 months but no difference during the overall prolonged study period. Supplementation, high-dose or maintenance, likely exerts its effect on steady state within 8 weeks. After that, maintenance and high-dose treatment groups may not differ in clinical event rates.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Vitamin D Supplementation and Upper Respiratory Tract Infections in
           Children
    • Authors: Aglipay M; Maguire JL.
      Abstract: In Reply Drs Davidson and Alansari suggest that a difference between high-dose and standard-dose vitamin D supplementation may be found among children with lower baseline serum 25-hydroxyvitamin D concentration at a 90-day end point.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Length of Stay After Overlappin Surgery
    • Authors: Hyder JA; Habermann EB, Cima RR.
      Abstract: To the Editor The Viewpoint by Drs Mello and Livingston summarized knowledge regarding the practice of overlapping surgery and stated, “Another [study] reported longer length of stay for some types of overlapping cases,” referencing a study by us and other coauthors. We would like to clarify that statement as it is an incomplete representation of the findings.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Length of Stay After Overlappin Surgery
    • Authors: Livingston EH; Mello MM.
      Abstract: In Reply Dr Hyder and colleagues contend that we incompletely represented the findings of their study of the effect of overlapping surgery on clinical outcomes by stating that their study “reported longer length of stay for some types of overlapping cases.” They note that their primary analysis showed no difference in length of stay; the difference in length of stay occurred only in a preplanned secondary analysis. Our summary of their complex set of analyses was necessarily concise, but not inaccurate.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • The Future of Radiology
    • Authors: Branstetter BF; IV.
      Abstract: To the Editor Dr Hise bemoaned the culture shift in radiology precipitated by the picture archiving and computer system (PACS). Radiologists have used PACS to enable a centralized model of image interpretation, in which physical location has become unimportant to patient care contributions. In doing so, one of the key elements of effective radiology practice has been lost: face-to-face interactions with clinical colleagues.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • The Future of Radiology
    • Authors: Schick RM.
      Abstract: To the Editor In the A Piece of My Mind article, Dr Hise mourned the passing of the era before digital imaging systems, a time remembered fondly for the face-to-face interactions between radiologists and referring physicians that allowed exchange of information that significantly enhanced radiologic report quality. I have lived through the same transformation but come to an entirely opposite conclusion. Although it is true that clinicians rarely come to the radiology department, the explosion of powerful communication tools available today is superior to the old ways of communicating before cell phones, text messages, or internet chat tools. Now it is much easier to connect with clinical colleagues, and when conferring, clinicians and radiologist can be looking at the same image at the same time. With digital dictation, I can easily place a report in draft status and resume when the clinician responds at his or her convenience. In addition, the electronic health record (EHR) has transformed radiology. When I read a diagnostic study, I quickly scan notes from the emergency department physician, selected consultants, or past admissions. I can see recent laboratory values, pathology results, and all the previous imaging reports. My workflow now includes a step in which within 10 to 60 seconds—depending on case complexity—I have a trove of information to help focus my reporting. Furthermore, I can instantly refresh my knowledge with a quick internet search. When I do connect with a clinician to communicate a result or to clarify an order, the bolus of clinical information from the EHR makes that interaction richer and more efficient for both of us. When I look at the advent of PACS, there is no mourning here. Instead I thank the many engineers who have built these amazing systems of interphysician communication, image sharing, clinical data sharing, and online research. The reports generated in my practice are better than ever and patient care is improved.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • The Future of Radiology—Reply
    • Authors: Hise J.
      Abstract: In Reply I received dozens of emails from across the country in response to my A Piece of My Mind article on the loss of personal interactions between clinicians and radiologists. The majority of these emails echoed my sentiments. Dr Branstetter has offered a solution to this problem, which I had previously considered.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Missing Funding/Support, Role of the Funder/Sponsor, and Additional
           Contributions Statements
    • Abstract: The Research Letter article entitled “Labeling Accuracy of Cannabidiol Extracts Sold Online” published in the November 7, 2017, issue of JAMA, was missing the Funding/Support, Role of the Funder/Sponsor, and Additional Contributions statements. The full statements should read as follows: “Funding/Support: This project was funded by a grant from the Institute for Research on Cannabinoids (IROC), a 501(c)(3) nonprofit organization supported by individual donations. Role of the Funder/Sponsor: Although Drs Bonn-Miller, Thomas, and Vandrey serve as unpaid board members of IROC, the institution played no part in the design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. Additional Contributions: We thank the Realm of Caring Foundation for their facility and staff support for the execution of this project. They did not receive compensation for their contribution.” This article was corrected online.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Omitted Disclosures of Potential Conflicts of Interest
    • Abstract: In the Viewpoint entitled “The Misuse of Meta-analysis in Nutrition Research,” published in the October 17, 2017, issue of JAMA, the authors omitted disclosure of potential conflicts of interest.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • JAMA Network Articles of the Year
    • Authors: Abbasi J.
      Abstract: This Medical News article discusses the top-viewed article of the past year from each JAMA Network journal.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Body-on-a-Chip Reveals Multitissue Interactions During Drug Exposure
    • Authors: Hampton T.
      Abstract: By generating bioengineered organoids of the liver, heart, and lungs and connecting them in a closed system with a nutrient-rich liquid to mimic the body’s circulatory system, researchers have created a “body-on-a-chip” that may help reveal interorgan responses to drug or toxic chemical exposure. The potential to do so has implications for drug development, considering that many drugs have progressed through years of preclinical studies, clinical trials, and market availability before being recalled.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • A First in FDA’s Device Innovation Effort
    • Authors: Voelker R.
      Abstract: As part of a program to promote medical device innovation, the FDA has qualified its first medical device development tool—a patient survey that could lead to advances in improving quality of life among patients with heart failure.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Treating Opioid Addiction With Medication
    • Authors: Voelker R.
      Abstract: The FDA plans to convene an expert panel to examine the population-level effects of treating opioid addiction with medication in hopes of gaining wider acceptance of and insurance coverage for those medications.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Treatment for Aggressive Lymphoma
    • Authors: Voelker R.
      Abstract: A new medication for adults with mantle cell lymphoma has received FDA approval. Acalabrutinib is indicated for patients who haven’t responded to treatment or have relapsed.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Out of Place
    • Authors: Halberstadt C.
      Abstract: In the infusion space of curtained cubiclestime is measured by the silent dripof medicines, the comfort of the chair,an extra pillow, heated blanket,winter coat in chilly air,welcomed carts of snacks and lunch,the Reiki woman’s warming touchthat soothes a clouded mind.My tongue speaks haltingly to visitorsfrom care teams who I long to seeand tell them fluently just how dazed I am.Everyone is careful, competent, and kind,all questions answered:“How much time will this drip be'”“Two hours—let us know if anything feels wrong.”Time passes by the everyday outside—noncommittal roofs of city blocksin snow, then rain, gray skies,drops upon the glass and in my veins,which deep within may changereturning quietly to now or to beforeor to the not yet known—while I am here and out of place.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • “Hopefully . . .”
    • Abstract: A new plague is creeping over the land. The disease will probably not affect vital statistics in the immediate future, and therefore public health officials and epidemiologists will ignore it. It does, however, produce acute anxiety among all who preserve a sensitivity to language. I refer to the grim misuse of “hopefully” in our current speech and even in our writing.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • Active Surveillance for Prostate Cancer
    • Authors: Matulewicz RS; Weiner AB, Schaeffer EM.
      Abstract: This JAMA Patient Page describes active surveillance for management of prostate cancer and explains which patients are candidates for this treatment strategy.
      PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
  • JAMA
    • PubDate: Tue, 05 Dec 2017 00:00:00 GMT
       
 
 
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