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 Showing 21-40 of 71 Articles
Research Letter 
Christina C. Melon, BA, MSc; Panteha Eshtiaghi; Warren J. Luksun, MD, FRCPC; Duminda N. Wijeysundera, MD, PhD, FRCPC
Assessment of exercise capacity is critical to preoperative evaluation. Practice guidelines recommend that patients proceed to noncardiac surgery without further testing if their exercise capacity exceeds 4 metabolic equivalent tasks (METs).1 This assumption that good exercise capacity indicates low perioperative risk is largely extrapolated from studies involving objective exercise testing. ...
Research Letter 
German Morís, MD; Juan Carlos Garcia-Monco, MD
Cases of drug-induced aseptic meningitis (DIAM) are likely underreported, and only a few reviews of the literature have been performed. We have updated (to February 2014) a previous review (1999)1 to identify newer agents associated with DIAM, as well as distinctive new features.
Research Letter 
Analía R. Stormo, BS; Mona Saraiya, MD, MPH; Esther Hing, MPH; Jillian T. Henderson, PhD; George F. Sawaya, MD
A well-woman preventive care visit is a core service supported by the Human Resources and Services Administration,1 yet it is unclear which preventive services are provided by primary care physicians (PCPs) and which are provided by obstetrician/gynecologists (OB/GYNs).2,3 We examined patterns of selected age-appropriate preventive care visits across a woman’s ...
Viewpoint 
Maura Calsyn, JD; Ezekiel J. Emanuel, MD, PhD
Medicare’s Acute Care Episode (ACE) demonstration bundled hospital and physician payments for 37 inpatient cardiac and orthopedic procedures. This payment structure improved coordination between physicians and hospitals and motivated hospitals to negotiate lower prices with device manufacturers, in most instances saving money without evidence of stinting on care. The program ...
Topics: medicare; acute care
Invited Commentary 
Margot Kushel, MD
In the United States, an estimated 2 million people are addicted to heroin or opioid analgesics, 80% of whom are not in treatment.1 Rates of addiction have increased during the past 20 years, following increased misuse of prescription opioid analgesics, resulting in large increases in opioid-related emergency department visits, hospitalizations, ...
Invited Commentary 
Wayne B. Jonas, MD, LTC (Ret); Eric B. Schoomaker, MD, PhD, LTG (Ret)
In the documentary movie Escape Fire,1 a battle-weary and combat-wounded soldier falls out of his bunk during a medical evacuation flight from Afghanistan to Washington, DC. Disoriented from an overdose of opioid and psychoactive medications previously prescribed for his wounds, pain, and loss, he later embarks on a journey of ...
Research Letter 
Robin L. Toblin, PhD, MPH; Phillip J. Quartana, PhD; Lyndon A. Riviere, PhD; Kristina Clarke Walper, MPH; Charles W. Hoge, MD
Chronic pain affects a quarter of people seeking primary health care.1,2 Opioid medications are prescribed for chronic pain, but recently, rates of opioid use and misuse have ballooned, leading to significant numbers of overdose-related hospitalizations and deaths.3 The prevalence of chronic pain and opioid use associated with deployment is not ...
Research Letter 
Nareg H. Roubinian, MD, MPHTM; Gabriel J. Escobar, MD; Vincent Liu, MD; Marla N. Gardner, BS; Jeffrey L. Carson, MD; Steven H. Kleinman, MD; Edward L. Murphy, MD; for the NHLBI Recipient Epidemiology and Donor Evaluation Study (REDS-III)
Blood conservation strategies effectively decrease red blood cell (RBC) use in specific patient groups.1- 3 However, the impact of RBC transfusion reduction on mortality in a diverse inpatient population remains poorly described. We detail the impact of declining RBC use on 30-day mortality within Kaiser Permanente Northern California (KPNC), an ...
Research Letter 
Maria Stepanova, PhD; Homan Wai, MD; Sammy Saab, MD; Alita Mishra, MD; Chapy Venkatesan, MD; Zobair M. Younossi, MD, MPH
Since the first liver transplant, tremendous advances in organ preservation, surgical techniques and postoperative management have occurred. These advances have made liver transplantation the standard of care for patients with end-stage liver disease.1- 3 In this study, we describe how the clinicodemographic portrait of adult liver transplant recipients has changed ...
Original Investigation 
Jane M. Liebschutz, MD, MPH; Denise Crooks, MPH; Debra Herman, PhD; Bradley Anderson, PhD; Judith Tsui, MD, MPH; Lidia Z. Meshesha, BA; Shernaz Dossabhoy, BA; Michael Stein, MD

Importance  Buprenorphine opioid agonist treatment (OAT) has established efficacy for treating opioid dependency among persons seeking addiction treatment. However, effectiveness for out-of-treatment, hospitalized patients is not known.

Objective  To determine whether buprenorphine administration during medical hospitalization and linkage to office-based buprenorphine OAT after discharge increase entry ...

Original Investigation 
Sandeep Vijan, MD, MS; Jeremy B. Sussman, MD, MS; John S. Yudkin, MD, FRCP; Rodney A. Hayward, MD
Includes: Supplemental Content

Importance  Type 2 diabetes mellitus is common, and treatment to correct blood glucose levels is standard. However, treatment burden starts years before treatment benefits accrue. Because guidelines often ignore treatment burden, many patients with diabetes may be overtreated.

Objective  To examine how treatment burden affects the ...

Invited Commentary 
C. Noel Bairey Merz, MD; Vera Regitz-Zagrosek, MD
There are numerous differences in cardiovascular disease (CVD) between men and women. Women have a higher prevalence of coronary microvascular dysfunction, heart failure with preserved ejection fraction, Tako-Tsubo syndrome (also known as stress-induced cardiomyopathy), and post–myocardial infarction depression than men. Women also have a greater sensitivity to QT-prolonging medications and ...
Topics: gender
Invited Commentary 
Fred C. Ko, MD, MS; R. Sean Morrison, MD
Hip fracture most commonly affects older adults and causes devastating consequences including pain, immobilization, functional decline, delirium, and death. Among those in the Medicare population who sustain hip fractures, 13% die within 3 months and 24% die within 12 months.1 Of those who survive to 6 months, only 50% recover ...
Invited Commentary 
Aseem Malhotra, MBChB, MRCP
Given its cost and commonality, the appropriate application of percutaneous coronary intervention (PCI) in treating coronary artery disease is justifiably a health care policy priority. Understanding the limitations of the subjective assessment and treatment of coronary stenosis through coronary angiography alone has led to many changes, including greater incorporation of ...
Invited Commentary 
Richard J. Baron, MD
In this issue of JAMA Internal Medicine, Nelson et al1 provide an informative study of a large-scale implementation of the patient-centered medical home (PCMH) model within the Veteran’s Health Administration (VHA), looking at important outcomes of hospitalization and emergency department use, patient satisfaction, and staff burnout. The scale of the ...
Original Investigation 
Georg M. Fröhlich, MD; Simon Redwood, MD; Roby Rakhit, MD; Philip A. MacCarthy, MD; Pitt Lim, MD; Tom Crake, MD; Steven K. White, MD; Charles J. Knight, MD; Christoph Kustosz, MSc; Guido Knapp, PhD; Miles C. Dalby, MD; Iqbal S. Mali, MD; Andrew Archbold, MD; Andrew Wragg, MD; Adam D. Timmis, MD; Pascal Meier, MD
Includes: Supplemental Content

Importance  Intracoronary pressure wire–derived measurements of fractional flow reserve (FFR) and intravascular ultrasonography (IVUS) provide functional and anatomical information that can be used to guide coronary stent implantation. Although these devices are widely used and recommended by guidelines, limited data exist about their effect on clinical end ...

Original Investigation 
Mark D. Neuman, MD, MSc; Jeffrey H. Silber, MD, PhD; Jay S. Magaziner, PhD; Molly A. Passarella, MS; Samir Mehta, MD; Rachel M. Werner, MD, PhD
Includes: Supplemental Content

Importance  Little is known regarding outcomes after hip fracture among long-term nursing home residents.

Objective  To describe patterns and predictors of mortality and functional decline in activities of daily living (ADLs) among nursing home residents after hip fracture.

Design, Setting, and Participants  Retrospective cohort study ...

Original Investigation 
Karin M. Nelson, MD, MSHS; Christian Helfrich, MPH, PhD; Haili Sun, PhD; Paul L. Hebert, PhD; Chuan-Fen Liu, MPH, PhD; Emily Dolan, PhD; Leslie Taylor, PhD; Edwin Wong, PhD; Charles Maynard, PhD; Susan E. Hernandez, MPA; William Sanders, AA, AS; Ian Randall, MHSA; Idamay Curtis, BA; Gordon Schectman, MD; Richard Stark, MD; Stephan D. Fihn, MD, MPH
Includes: Supplemental Content

Importance  In 2010, the Veterans Health Administration (VHA) began implementing the patient-centered medical home (PCMH) model. The Patient Aligned Care Team (PACT) initiative aims to improve health outcomes through team-based care, improved access, and care management. To track progress and evaluate outcomes at all VHA primary care ...

Original Investigation 
Robbert Zusterzeel, MD; Kimberly A. Selzman, MD, MPH; William E. Sanders, MD, MBA; Daniel A. Caños, PhD, MPH; Kathryn M. O’Callaghan, BSE; Jamie L. Carpenter, MSPH; Ileana L. Piña, MD, MPH; David G. Strauss, MD, PhD
Includes: Supplemental Content

Importance  Women were underrepresented in cardiac resynchronization therapy (CRT) trials for heart failure (making up about 20% of enrollees). Combining individual patient data from multiple clinical trials would enable assessment of CRT benefit in women.

Objective  To evaluate whether women with left bundle branch block (LBBB) ...

Viewpoint 
Jon D. Duke, MD, MS; Aaron S. Kesselheim, MD, JD
The product information for a prescription drug—commonly called its label—is the full description of the drug’s indications for use, method of administration, warnings, contraindications, and potential adverse events. It is written by the manufacturer of the brand-name drug, approved by the US Food and Drug Administration (FDA), and published when ...
Topics: generic drugs; food

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