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 Showing 1-20 of 49 Articles
Paul Rousseau, MD
The attending physician was trailed by 5 trainees: 2 medical students, 1 intern, a resident, and a fellow. As they stopped at the door to the patient's room, the attending physician spoke.
Original Investigation 
Enrico Mossello, MD, PhD; Mariachiara Pieraccioli, MD; Nicola Nesti, MD; Matteo Bulgaresi, MD; Chiara Lorenzi, MD; Veronica Caleri, MD, PhD; Elisabetta Tonon, MD, PhD; M. Chiara Cavallini, MD, PhD; Caterina Baroncini, MD; Mauro Di Bari, MD, PhD; Samuele Baldasseroni, MD, PhD; Claudia Cantini, MD, PhD; Carlo A. Biagini, MD; Niccolò Marchionni, MD; Andrea Ungar, MD, PhD

Importance  The prognostic role of high blood pressure and the aggressiveness of blood pressure lowering in dementia are not well characterized.

Objective  To assess whether office blood pressure, ambulatory blood pressure monitoring, or the use of antihypertensive drugs (AHDs) predict the progression of cognitive decline in ...

Invited Commentary: Blood Pressure Control and Cognitive Impairment; Behnam Sabayan, MD, PhD; Rudi G. J. Westendorp, MD, PhD
Original Investigation 
Hung N. Luu, MD, PhD; William J. Blot, PhD; Yong-Bing Xiang, MD, MPH; Hui Cai, MD, PhD; Margaret K. Hargreaves, PhD; Honglan Li, MD, MPH; Gong Yang, MD, MPH; Lisa Signorello, ScD; Yu-Tang Gao, MD; Wei Zheng, MD, PhD; Xiao-Ou Shu, MD, PhD
Includes: Supplemental Content

Importance  High intake of nuts has been linked to a reduced risk of mortality. Previous studies, however, were primarily conducted among people of European descent, particularly those of high socioeconomic status.

Objective  To examine the association of nut consumption with total and cause-specific mortality in Americans ...

Original Investigation 
Emily G. McDonald, MD; Jonathon Milligan, MD; Charles Frenette, MD; Todd C. Lee, MD, MPH
Includes: Supplemental Content

Importance  Clostridium difficile infection (CDI) is associated with significant morbidity, mortality, and a high risk of recurrence. Proton pump inhibitor (PPI) use is associated with an initial episode of CDI, and PPIs are frequently overprescribed. For many, the use of PPIs could likely be discontinued before CDI ...

Invited Commentary 
Behnam Sabayan, MD, PhD; Rudi G. J. Westendorp, MD, PhD
The link between blood pressure and cognitive impairment is a complex beast. Several observational investigations have studied the association between blood pressure and cognitive function and yielded mixed results.1 Various explanations such as heterogeneity in demographic and clinical characteristics of study populations have been proposed for such discrepancies. Methodological limitations ...
Invited Commentary 
Margaret C. Fang, MD, MPH
The recent 2014 American Heart Association, American College of Cardiology, and Heart Rhythm Society guideline for the management of patients with atrial fibrillation (AF) recommends using the CHA2DS2-VASc stroke risk score instead of the older CHADS2 score when deciding whether to recommend anticoagulant therapy, in essence lowering the threshold at ...
Editor's Note 
Mitchell H. Katz, MD
Multiple studies have demonstrated the beneficial effects of eating nuts. Nonetheless, the editors felt it was worth publishing another such study for 2 reasons. First, this study1 combined 3 cohorts to produce a large and diverse sample, including a predominately low socioeconomic cohort of Americans and 2 Chinese cohorts. The ...
Research Letter 
Emily C. O’Brien, PhD; Sunghee Kim, PhD; Paul L. Hess, MD; Peter R. Kowey, MD; Gregg C. Fonarow, MD; Jonathan P. Piccini, MD, MHS; Eric D. Peterson, MD, MPH
In 2014, the American Heart Association, American College of Cardiology, and Heart Rhythm Society published a revised guideline for atrial fibrillation (AF) treatment recommending use of a refined stroke risk score and revised threshold for oral anticoagulation (OAC) initiation.1 We assessed the potential effect of this new guideline by comparing ...
Invited Commentary: New Atrial Fibrillation Guideline; Margaret C. Fang, MD, MPH
Research Letter 
Mallika L. Mendu, MD, MBA; Andrew Lundquist, MD; Ayal A. Aizer, MD, MHS; David E. Leaf, MD, MMSc; Emily Robinson, MD, MPH; David J. R. Steele, MD; Sushrut S. Waikar, MD, MPH
Chronic kidney disease (CKD) affects approximately 13% of adults in the United States and is associated with significant morbidity, mortality, and costs.1- 3 There is a broad differential for CKD, including diabetes mellitus, hypertension, glomerulonephritis, tubulointerstitial disease, urologic causes, and unknown causes.2 To our knowledge, a comprehensive assessment of the ...
Original Investigation 
Jacek Skarbinski, MD; Eli Rosenberg, PhD; Gabriela Paz-Bailey, MD, MSc, PhD; H. Irene Hall, PhD; Charles E. Rose, PhD; Abigail H. Viall, MA; Jennifer L. Fagan, MA; Amy Lansky, PhD; Jonathan H. Mermin, MD, MPH
Includes: Supplemental Content

Importance  Human immunodeficiency virus (HIV) transmission risk is primarily dependent on behavior (sexual and injection drug use) and HIV viral load. National goals emphasize maximizing coverage along the HIV care continuum, but the effect on HIV prevention is unknown.

Objectives  To estimate the rate and number ...

Invited Commentary: The HIV Treatment Cascade; Thomas P. Giordano, MD, MPH
Original Investigation 
Tanjaniina Laukkanen, MSc; Hassan Khan, MD, PhD; Francesco Zaccardi, MD; Jari A. Laukkanen, MD, PhD
Includes: Supplemental Content

Importance  Sauna bathing is a health habit associated with better hemodynamic function; however, the association of sauna bathing with cardiovascular and all-cause mortality is not known.

Objective  To investigate the association of frequency and duration of sauna bathing with the risk of sudden cardiac death (SCD), ...

Original Investigation 
Kevin Brown, PhD; Kim Valenta, PhD; David Fisman, MD, MSc; Andrew Simor, MD; Nick Daneman, MD, MSc

Importance  Only a portion of hospital-acquired Clostridium difficile infections can be traced back to source patients identified as having symptomatic disease. Antibiotic exposure is the main risk factor for C difficile infection for individual patients and is also associated with increased asymptomatic shedding. Contact with patients taking ...

Invited Commentary: Antibiotics and Multidrug-Resistant Organisms; L. Clifford McDonald, MD
Original Investigation 
Robert A. Schnoll, PhD; Patricia M. Goelz, MPH; Anna Veluz-Wilkins, MA; Sonja Blazekovic, BA; Lindsay Powers, MA; Frank T. Leone, MD; Peter Gariti, PhD; E. Paul Wileyto, PhD; Brian Hitsman, PhD
Includes: Supplemental Content

Importance  The US Food and Drug Administration adopted labeling for nicotine patches to allow use beyond the standard 8 weeks. This decision was based in part on data showing increased efficacy for 24 weeks of treatment. Few studies have examined whether the use of nicotine patches beyond ...

Invited Commentary 
Thomas P. Giordano, MD, MPH
The human immunodeficiency virus (HIV) treatment cascade provides a snapshot of the effectiveness of the health care system in diagnosing and treating the estimated 1.2 million persons living with HIV infection in the United States.1 Like many concepts in health care, the cascade developed and evolved over time.
Invited Commentary 
Fiona Clement, PhD; Blake Charlton, MD
In the short time since its April 2012 launch by the American Board of Internal Medicine Foundation, the Choosing Wisely campaign has affected more than 60 US specialty societies. Now the campaign is becoming an international phenomenon, as evidenced by Selby et al1 and Gupta and Detsky2 in this issue. ...
Invited Commentary 
L. Clifford McDonald, MD
Conventional wisdom has suggested 2 distinct categories of epidemiologic risk factors in the development of Clostridium difficile infection (CDI): factors that increase the risk of transmission of C difficile and factors that disrupt the patient’s lower intestinal microbiota, a major host defense against infection. This host defense function may be ...
Editor's Note 
Rita F. Redberg, MD, MSc
Often I have advised a patient who was considering an unnecessary test, such as a coronary artery calcium test or carotid ultrasonography from a mobile van, to forgo that test and instead spend the money on something that he or she would actually enjoy, such as a massage or spa ...
Research Letter 
Shlok Gupta, MD; Allan S. Detsky, MD, PhD, FRCPC
As part of the American Board of Internal Medicine Foundation’s Choosing Wisely campaign,1 more than 60 specialty societies have published lists of 5 tests, procedures, or treatments that physicians and patients should question. Recognizing the opportunity for the provision of higher-value care in our own setting, we developed a Choosing ...
Invited Commentary: Challenges in Choosing Wisely’s Future; Fiona Clement, PhD; Blake Charlton, MD
Research Letter 
Kevin Selby, MD; Jean-Michel Gaspoz, MD, MPH; Nicolas Rodondi, MD, MAS; Stefan Neuner-Jehle, MD, MPH; Arnaud Perrier, MD; Andreas Zeller, MD; Jacques Cornuz, MD, MPH
In 2010, the idea emerged of creating lists of low-value health care activities as a way to confront rising medical costs and encourage cost-conscious care. The Good Stewardship Working Group1 and Brody2 pioneered the idea of “top 5” lists, leading to the Choosing Wisely campaign.3 Building on this momentum, there ...
Invited Commentary: Challenges in Choosing Wisely’s Future; Fiona Clement, PhD; Blake Charlton, MD

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