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 Showing 21-40 of 76 Articles
Original Investigation 
Elyn H. Wang, BA; Cary P. Gross, MD; Jon C. Tilburt, MD, MPH; James B. Yu, MD, MHS; Paul L. Nguyen, MD; Marc C. Smaldone, MD, MSHP; Nilay D. Shah, PhD; Robert Abouassally, MD; Maxine Sun, PhD; Simon P. Kim, MD, MPH
Includes: Supplemental Content

Importance  The current attitudes of prostate cancer specialists toward decision aids and their use in clinical practice to facilitate shared decision making are poorly understood.

Objective  To assess attitudes toward decision aids and their dissemination in clinical practice.

Design, Setting, and Participants  A survey was ...

Invited Commentary: Decision Aid Paradox; Michael J. Barry, MD
Original Investigation  FREE
Matthew J. Bair, MD, MS; Dennis Ang, MD; Jingwei Wu, MS; Samantha D. Outcalt, PhD; Christy Sargent, BS; Carol Kempf, RN; Amanda Froman, BS; Arlene A. Schmid, PhD, OTR; Teresa M. Damush, PhD; Zhangsheng Yu, PhD; Louanne W. Davis, PsyD; Kurt Kroenke, MD
Includes: Supplemental Content

Importance  Despite the prevalence and the functional, psychological, and economic impact of chronic pain, few intervention studies of treatment of chronic pain in veterans have been performed.

Objective  To determine whether a stepped-care intervention is more effective than usual care, as hypothesized, in reducing pain-related disability, ...

Invited Commentary 
Michael J. Barry, MD
For most medical treatment decisions, there is more than one reasonable choice. Although bacterial meningitis needs antibiotics, decisions about treatments for conditions such as clinically localized prostate cancer have many options, including observation, radiation therapy, and surgery. In turn, each of these broad treatment categories has variants: watchful waiting, active ...
Editor's Note 
Joseph S. Ross, MD, MHS
Musculoskeletal pain is one of the most common reasons adults visit their primary care physician, an office encounter that typically starts with a discussion of the patient’s symptoms and physical function, continues with advice from the physician to lose weight and engage in rehabilitation exercises, and concludes with a prescription, ...
Challenges in Clinical Electrocardiography 
Arjun Sinha, MD, MS; Jasmine Rassiwala, MD, MPH; Nora Goldschlager, MD
A woman in her 60s with hypertension and hyperlipidemia presented with chest pain for 3 days. She denied any cardiac history but reported intermittent substernal chest pain for the past few months that had worsened in the past week. She denied associated symptoms. Her vital signs and cardiopulmonary examination results ...
Challenges in Clinical Electrocardiography 
Zaid Aziz, MD; Peter Mikolajczak, MD; Paul J. Hauptman, MD
A man in his 90s with a history of hypertension, hypercholesterolemia, sinus node dysfunction, and prior dual-chamber pacemaker implantation presented with 1 month of abdominal pain radiating to his back. The initial chest radiograph demonstrated a dual-chamber permanent pacemaker with an atrial lead in the right atrial appendage and ventricular ...
Research Letter 
Jonathan Michael Pell, MD; Mary Mancuso, MA; Shelly Limon, BSN, MS, CNRN; Kathy Oman, RN, PhD; Chen-Tan Lin, MD
In 2001, the Institute of Medicine1 recommended improving patient engagement by providing continuous care, allowing patients to be the source of control and fostering transparency with patients and families. Electronic health records (EHRs) facilitate these objectives via the use of patient portals.2 Giving outpatients direct access to their health information ...
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

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