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 Showing 1-20 of 73 Articles
Viewpoint  FREE
Ronald M. Witteles, MD; Abraham Verghese, MD, MACP

This Viewpoint advocates simplifying the Accreditation Council for Graduate Medical Education Milestones.

Viewpoint  FREE
Eric S. Holmboe, MD; Stephanie Call, MD; Robert D. Ficalora, MD

This Viewpoint discusses the positive effect of the ACGME Milestones initiative on preparing residents for unsupervised practice while also recognizing challenges.

Mitsuru Mukaigawara, MD

After I had worked a daylong outpatient clinic, a nurse told me that a hospitalized patient of mine had gone home. She was very ill with uremia and septic shock. “Her blood pressure was not measurable; the last intravenous line collapsed,” the nurse told me. She rushed home, ...

Original Investigation  FREE
Stefanie N. Hinkle, PhD; Sunni L. Mumford, PhD; Katherine L. Grantz, MD, MS; Robert M. Silver, MD; Emily M. Mitchell, PhD; Lindsey A. Sjaarda, PhD; Rose G. Radin, PhD; Neil J. Perkins, PhD; Noya Galai, PhD; Enrique F. Schisterman, PhD
Includes: Supplemental Content

Importance  Nausea and vomiting during pregnancy have been associated with a reduced risk for pregnancy loss. However, most prior studies enrolled women with clinically recognized pregnancies, thereby missing early losses.

Objective  To examine the association of nausea and vomiting during pregnancy with pregnancy loss.

Design, Setting, ...

Invited Commentary: Understanding of Nausea, Vomiting, and Pregnancy Loss; Siripanth Nippita, MD, MS; Laura E. Dodge, ScD, MPH
Invited Commentary 
Siripanth Nippita, MD, MS; Laura E. Dodge, ScD, MPH

Scientists and the medical community have advanced our understanding of the natural history of nausea and vomiting in pregnancy (NVP), which affects 50% to 80% of pregnant women.1 In the early 20th century, physicians recognized the association between NVP and carbohydrate metabolism,2 but some also ascribed ...

Editor's Note 
Fiona Clement, PhD

Possible health consequences related to chemical exposure through common items, such as plastic, fruits, and furniture, are receiving increased attention. In the current Evidence to Practice article, Gore1 summarizes the evidence supporting the Endocrine Society’s Scientific Statement on endocrine-disrupting chemicals, such as polychlorinated biphenyls; dioxins; pesticides, plastics, ...

Editor's Note 
Adam J. Schoenfeld, MD; Patrick G. O’Malley, MD, MPH

Primary care physicians and their clinic staff face a considerable workload burden. One study1 estimated that it would require primary care physicians 21.7 hours of their day to complete all acute, chronic, and preventive care duties for a typical patient population. It is therefore no surprise that ...

Evidence to Practice 
Andrea C. Gore, PhD

This review describes research from the past 5 years demonstrating significant advances in understanding the actions of endocrine-disrupting chemicals on endocrine health and disease.

Teachable Moment 
Avash Das, MBBS; Abhishek Maiti, MBBS; Shirshendu Sinha, MBBS

This case report examines the risks associated with antidepressant use in the elderly population.

Challenges in Clinical Electrocardiography 
Shannon Ruzycki, MD; Robert Jack Henry Miller, MD; Tyrone Harrison, MD

A man in his 60s presented with dull, right-sided shoulder pain of 12 hours’ duration relieved by nitroglycerin. He reported escalating exertional chest discomfort with dyspnea over the preceding weeks. Medical history included a provoked deep vein thrombosis and chronic obstructive pulmonary disease. He took no new medications ...

Research Letter 
James L. Wofford, MD, MS; Melanie J. Martin, MD; Claudia L. Campos, MD

This study assesses the changes in the number of glucometer readings in a clinical setting after a policy change was implemented that made glucometer readings optional.

Original Investigation 
Lisa Harnack, DrPH; J. Michael Oakes, PhD; Brian Elbel, PhD; Timothy Beatty, PhD; Sarah Rydell, MPH; Simone French, PhD
Includes: Supplemental Content

Importance  Strategies to improve the nutritional status of those participating in the Supplemental Nutrition Assistance Program (SNAP) are of interest to policymakers.

Objective  To evaluate whether the proposed policy of incentivizing the purchase of fruits and vegetables and prohibiting the purchase of less nutritious foods in ...

Original Investigation 
James Baggs, PhD; Scott K. Fridkin, MD, MPH; Lori A. Pollack, MD, MPH; Arjun Srinivasan, MD, MPH; John A. Jernigan, MD, MS
Includes: Supplemental Content

Importance  The rising threat of antibiotic resistance and other adverse consequences resulting from the misuse of antibiotics requires a better understanding of antibiotic use in hospitals in the United States.

Objective  To use proprietary administrative data to estimate patterns of US inpatient antibiotic use in recent ...

Invited Commentary: Tipping the Balance Towards Fewer Antibiotics; Ateev Mehrotra, MD, MPH; Jeffrey A. Linder, MD, MPH
Original Investigation 
Sebastian L. Johnston, MBBS, PhD; Matyas Szigeti, MSc; Mary Cross, BA (Hons); Christopher Brightling, MBBS, PhD; Rekha Chaudhuri, MBBS, MD; Timothy Harrison, MBBS, PhD; Adel Mansur, MBBS, PhD; Laura Robison, BSc; Zahid Sattar, BSc, PhD; David Jackson, MBBS, PhD; Patrick Mallia, MBBS, PhD; Ernie Wong, MBBS, BSc; Christopher Corrigan, MA, PhD; Bernard Higgins, MBBS; Philip Ind, MB, BChir, PhD; Dave Singh, MB, BChir, MD; Neil C. Thomson, MBChB, MD; Deborah Ashby, PhD, CStat; Anoop Chauhan, MBBS, PhD; For the AZALEA Trial Team
Includes: Supplemental Content

Importance  Guidelines recommend against antibiotic use to treat asthma attacks. A study with telithromycin reported benefit, but adverse reactions limit its use.

Objective  To determine whether azithromycin added to standard care for asthma attacks in adults results in clinical benefit.

Design, Setting, and Participants  The ...

Invited Commentaries: AZALEA Trial Highlights Antibiotic Overuse in Acute Asthma Attacks; Guy G. Brusselle, MD, PhD; Eva Van Braeckel, MD, PhD Tipping the Balance Towards Fewer Antibiotics; Ateev Mehrotra, MD, MPH; Jeffrey A. Linder, MD, MPH
Invited Commentary 
Guy G. Brusselle, MD, PhD; Eva Van Braeckel, MD, PhD

Asthma affects more than 300 million people worldwide, causing variable symptoms of cough, chest tightness, and exertional or nocturnal dyspnea due to chronic inflammation of the lower airways and bronchial hyperresponsiveness. Acute episodes of worsening respiratory symptoms, called acute exacerbations or asthma attacks, can be life-threatening, and induce ...

Invited Commentary 
Marlene B. Schwartz, PhD

The Supplemental Nutrition Assistance Program (SNAP) is the largest federal food assistance program and a critical component of the social safety net. The primary purpose of SNAP is to alleviate hunger. A body of research indicates that the program succeeds in this key mission and may also help ...

Invited Commentary 
Ateev Mehrotra, MD, MPH; Jeffrey A. Linder, MD, MPH

News of patients with broadly resistant “superbugs” have recently raised public awareness of the risks of antibiotic overuse. But unnecessary antibiotic use is not a new problem; it has been a public health priority for decades and 2 new articles1,2 in the current issue of ...

Daniel J. Morgan, MD, MS; Sanket S. Dhruva, MD; Scott M. Wright, MD; Deborah Korenstein, MD
Includes: Supplemental Content

Importance  Overuse of medical care is an increasingly recognized problem in clinical medicine.

Objective  To identify and highlight original research articles published in 2015 that are most likely to reduce overuse of medical care, organized into 3 categories: overuse of testing, overtreatment, and questionable use of ...

Teachable Moment 
Jana Bregman, MD; Wade Iams, MD; Cecelia Theobald, MD, MPH

This Teachable Moment discusses the need to recognize the risks of catheter-associated trauma as an impetus for reducing the frequency of unnecessary urinary catheterization.

Challenges in Clinical Electrocardiography 
Thomas Nguyen, MD; Amina Khaldi, MD; Ruben Casado-Arroyo, MD, PhD

A man in his 60s presented for shortness of breath on exertion for several months. The patient denied any chest pain or palpitations. Medical history included liver transplantation for hepatocarcinoma and chronic kidney disease. Physical examination findings were normal except for tachycardia at 114 bpm. An electrocardiogram (ECG) ...

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