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 Showing 41-60 of 86 Articles
Teachable Moment 
Stephanie E. Rogers, MD, MS, MPH, PA; Liviu Klein, MD, MS; Carla Maria Perissinotto, MD, MHS
Original Investigation 
Matthew A. Davis, DC, MPH, PhD; Julie P. W. Bynum, MD, MPH; Brenda E. Sirovich, MD, MS
Includes: Supplemental Content

Importance  Fruit consumption is believed to have beneficial health effects, and some claim, “An apple a day keeps the doctor away.”

Objective  To examine the relationship between eating an apple a day and keeping the doctor away.

Design, Setting, and Participants  A cross-sectional study of ...

Editor's Note: The Prescription Is Laughter; Rita F. Redberg, MD, MSc
Original Investigation 
Rohan Khera, MD; Peter Cram, MD, MBA; Xin Lu, MS; Ankur Vyas, MD, MS; Alicia Gerke, MD, MS; Gary E. Rosenthal, MD; Phillip A. Horwitz, MD; Saket Girotra, MD, SM
Includes: Supplemental Content

Importance  Percutaneous ventricular assist devices (PVADs) provide robust hemodynamic support compared with intra-aortic balloon pumps (IABPs), but clinical use patterns are unknown.

Objective  To examine contemporary patterns in PVAD use in the United States and compare them with use of IABPs.

Design, Setting, and Participants  ...

Editor's Note: High-Risk Medical Devices; Joseph S. Ross, MD, MHS
Original Investigation 
David B. Bekelman, MD, MPH; Mary E. Plomondon, PhD, MSPH; Evan P. Carey, MS; Mark D. Sullivan, MD, PhD; Karin M. Nelson, MD, MSHS; Brack Hattler, MD; Connor F. McBryde, MD; Kenneth G. Lehmann, MD; Katherine Gianola, MD; Paul A. Heidenreich, MD; John S. Rumsfeld, MD, PhD
Includes: Supplemental Content

Importance  Heart failure (HF) has a major effect on patients’ health status, including their symptom burden, functional status, and health-related quality of life.

Objective  To determine the effectiveness of a collaborative care patient-centered disease management (PCDM) intervention to improve the health status of patients with HF....

Original Investigation 
Joanna L. Hart, MD, MSHP; Michael O. Harhay, MPH, MBE; Nicole B. Gabler, PhD, MHA; Sarah J. Ratcliffe, PhD; Caroline M. Quill, MD, MSHP; Scott D. Halpern, MD, PhD
Includes: Supplemental Content

Importance  Although the end-of-life care patients receive is known to vary across nations, regions, and centers, these differences are best explored within a group of patients with presumably similar care preferences.

Objective  To examine the proportions of patients admitted to the intensive care unit (ICU) with ...

Invited Commentary: ICU Treatment Escalation Despite Preexisting Limitations; Amber E. Barnato, MD, MPH, MS; Elizabeth Dzeng, MD, MPH, MPhil, MS
Original Investigation 
Marius Henriksen, PT, MSc, PhD; Robin Christensen, PhD; Louise Klokker, MSc; Cecilie Bartholdy, MSc; Elisabeth Bandak, MSc; Karen Ellegaard, PhD; Mikael P. Boesen, PhD; Robert G. Coumine Riis, MD; Else M. Bartels, PhD; Henning Bliddal, DMSc
Includes: Supplemental Content

Importance  Osteoarthritis (OA) of the knee is the most frequent form of arthritis and a cause of pain and disability. Combined nonpharmacologic and pharmacologic treatments are recommended as the optimal treatment approach, but no evidence supports the recommendation.

Objective  To assess the clinical benefits of an ...

Original Investigation 
Yousif Ahmad, MRCP; Sayan Sen, PhD; Matthew J. Shun-Shin, MRCP; Jing Ouyang, BA; Judith A. Finegold, MRCP; Rasha K. Al-Lamee, MRCP; Justin E. R. Davies, PhD; Graham D. Cole, MRCP; Darrel P. Francis, MD
Includes: Supplemental Content

Importance  Intra-aortic balloon pump (IABP) therapy is a widely used intervention for acute myocardial infarction with cardiogenic shock. Guidelines, which previously strongly recommended it, have recently undergone substantial change.

Objective  To assess IABP efficacy in acute myocardial infarction.

Data Sources  Human studies found in Pubmed, ...

Editor's Note: High-Risk Medical Devices; Joseph S. Ross, MD, MHS
Invited Commentary 
Amber E. Barnato, MD, MPH, MS; Elizabeth Dzeng, MD, MPH, MPhil, MS
In this issue of JAMA Internal Medicine, Hart and colleagues 1 provide, to our knowledge, the first known epidemiologic data on treatment patterns among patients admitted to the intensive care unit (ICU) with preexisting treatment limitations. Treatment limitations are explicit statements by the patient, documented in the medical record, refusing ...
Editor's Note 
Rita F. Redberg, MD, MSc
Although we take seriously the statement, “An apple a day keeps the doctor away”1 (and the importance of a good parachute), these articles launch our first April Fool’s issue. At least once per year, and more is likely better (but needs to be tested), laughter is the best medicine. We ...
Editor's Note 
Joseph S. Ross, MD, MHS
The intra-aortic balloon pump (IABP), a mechanical device designed to increase both myocardial perfusion and cardiac output, was pioneered in the 1960s to treat patients in cardiogenic shock. An innovation at the time, the device was made available for use prior to passage of the 1976 Medical Device Amendments, which ...
Research Letter 
Paul F. Pinsky, PhD; Robert E. Schoen, MD, MPH
A recent study from the Kaiser Permanente–Southern California region reported that, among patients undergoing surveillance colonoscopy, the rate of subsequent colorectal cancer (CRC) diagnosis was significantly lower for those aged 75 years or older than for those aged 50 to 74 years.1 The CRC incidence was 0.24 per 1000 person-years ...
Original Investigation 
Adrian C. Traeger, MPhty; Markus Hübscher, PhD; Nicholas Henschke, PhD; G. Lorimer Moseley, PhD; Hopin Lee, MPhty; James H. McAuley, PhD
Includes: Supplemental Content

Importance  Reassurance is a core aspect of daily medical practice, yet little is known on how it can be achieved.

Objective  To determine whether patient education in primary care increases reassurance in patients with acute or subacute low back pain (LBP).

Data Sources  Medline, EMBASE, ...

Invited Commentary: Reassuring Patients About Low Back Pain; Roger Chou, MD
Original Investigation 
Kirsti Uusi-Rasi, PhD; Radhika Patil, MSc; Saija Karinkanta, PhD; Pekka Kannus, MD, PhD; Kari Tokola, MSc; Christel Lamberg-Allardt, PhD; Harri Sievänen, DSc
Includes: Supplemental Content

Importance  While vitamin D supplementation and exercise are recommended for prevention of falls for older people, results regarding these 2 factors are contradictory.

Objective  To determine the effectiveness of targeted exercise training and vitamin D supplementation in reducing falls and injurious falls among older women.

Design, ...

Invited Commentary: Vitamin D and Falls; Erin S. LeBlanc, MD, MPH; Roger Chou, MD
Original Investigation 
Jean S. Kutner, MD, MSPH; Patrick J. Blatchford, PhD; Donald H. Taylor Jr, PhD; Christine S. Ritchie, MD; Janet H. Bull, MD; Diane L. Fairclough, DrPH; Laura C. Hanson, MD; Thomas W. LeBlanc, MD; Greg P. Samsa, PhD; Steven Wolf, MS; Noreen M. Aziz, MD, PhD; David C. Currow, BMed; Betty Ferrell, PhD; Nina Wagner-Johnston, MD; S. Yousuf Zafar, MD; James F. Cleary, MD; Sandesh Dev, MD; Patricia S. Goode, MD; Arif H. Kamal, MD; Cordt Kassner, PhD; Elizabeth A. Kvale, MD; Janelle G. McCallum, RN, MSN; Adeboye B. Ogunseitan, MD; Steven Z. Pantilat, MD; Russell K. Portenoy, MD; Maryjo Prince-Paul, PhD; Jeff A. Sloan, PhD; Keith M. Swetz, MD; Charles F. Von Gunten, MD, PhD; Amy P. Abernethy, MD, PhD
Includes: Supplemental Content

Importance  For patients with limited prognosis, some medication risks may outweigh the benefits, particularly when benefits take years to accrue; statins are one example. Data are lacking regarding the risks and benefits of discontinuing statin therapy for patients with limited life expectancy.

Objective  To evaluate the ...

Invited Commentary: Deprescribing of Statins; Holly M. Holmes, MD, MS; Adam Todd, PhD, MPharm
Case Report/Case Series 
Kashish Goel, MBBS; Marysia Tweet, MD; Timothy M. Olson, MD; Joseph J. Maleszewski, MD; Rajiv Gulati, MD, PhD; Sharonne N. Hayes, MD

Importance  Spontaneous coronary artery dissection (SCAD) is a major cause of acute coronary syndrome in young women, especially among those without traditional cardiovascular risk factors. Prior efforts to study SCAD have been hampered by underrecognition and lack of registry-based studies. Risk factors and pathogenesis remain largely undefined, ...

Invited Commentary 
Erin S. LeBlanc, MD, MPH; Roger Chou, MD
Vitamin D is of great interest to the medical and lay communities. Numerous observational studies (often cross-sectional) have examined the association between serum levels of 25-hydroxyvitamin D (25[OH]D) and various conditions. Low levels of 25(OH)D have been associated with increased risk of falls, fractures, cardiovascular disease, colorectal cancer, type 2 ...
Invited Commentary 
Roger Chou, MD
Low back pain is one of the most commonly encountered conditions in clinical practice. Despite trends showing increasing use of advanced imaging tests, opioids, and invasive surgical and interventional procedures, with attendant increases in costs, the prevalence and burdens associated with low back pain appear to be on the rise.1 ...
Invited Commentary 
Holly M. Holmes, MD, MS; Adam Todd, PhD, MPharm
Along with acknowledgment of the many advantages of statins, increasing focus has been placed on diminishing benefits and, in some cases, harms of this drug class when used in patients with limited life expectancy. Statins are prescribed for only preventive purposes, without symptomatic benefit to patients. As such, in some ...
Special Communication 
Ian A. Scott, MBBS, FRACP, MHA, MEd; Sarah N. Hilmer, MBBS, FRACP, PhD; Emily Reeve, BPharm (Hons), PhD; Kathleen Potter, PhD, FRACGP; David Le Couteur, PhD, FRACP; Deborah Rigby, BPharm, GradDipClinPharm, FASCP, FACP, FAICD; Danijela Gnjidic, PhD; Christopher B. Del Mar, MB, BChir, MD, FRACGP; Elizabeth E. Roughead, PhD; Amy Page, MClinPharm; Jesse Jansen, MPsych, PhD; Jennifer H. Martin, MB, ChB, FRACP, PhD

Inappropriate polypharmacy, especially in older people, imposes a substantial burden of adverse drug events, ill health, disability, hospitalization, and even death. The single most important predictor of inappropriate prescribing and risk of adverse drug events in older patients is the number of prescribed drugs. Deprescribing is the process ...

Invited Commentary: Deprescribing of Statins; Holly M. Holmes, MD, MS; Adam Todd, PhD, MPharm
Original Investigation 
Lona Mody, MD; Sarah L. Krein, PhD; Sanjay K. Saint, MD; Lillian C. Min, MD; Ana Montoya, MD; Bonnie Lansing, LPN; Sara E. McNamara, MPH; Kathleen Symons, BA; Jay Fisch, BS; Evonne Koo, MPH; Ruth Anne Rye, BS; Andrzej Galecki, MD, PhD; Mohammed U. Kabeto, MS; James T. Fitzgerald, PhD; Russell N. Olmsted, MPH; Carol A. Kauffman, MD; Suzanne F. Bradley, MD
Includes: Supplemental Content

Importance  Indwelling devices (eg, urinary catheters and feeding tubes) are often used in nursing homes (NHs). Inadequate care of residents with these devices contributes to high rates of multidrug-resistant organisms (MDROs) and device-related infections in NHs.

Objective  To test whether a multimodal targeted infection program (TIP) ...

Invited Commentary: Reducing Antimicrobial Resistance in Nursing Homes; Nimalie D. Stone, MD, MS

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