Management of back pain appears to be variable, despite numerous published clinical guidelines, according to a report published by JAMA Internal Medicine, a JAMA Network publication.
The encouraging observation in this study is that the incidence of T1D in Finnish children younger than 15 years has ceased to increase after a period of accelerated increase.
An analysis of data from three studies that involved a total of more than 240,000 participants found that a self-reported history of kidney stones was associated with a statistically significant increased risk of coronary heart disease among women but no significant association was evident for men, according to a study in the July 24/31 issue of JAMA.
In a survey of about 2,500 U. S. physicians on their perceived role in addressing health care costs, they reported having some responsibility to address health care costs in their practice and expressed general agreement with quality initiatives that may also reduce cost, but expressed less enthusiasm for cost containment involving changes in payment models, according to a study in the July 24/31 issue of JAMA.
An investigation into the source of a fatal case of raccoon rabies virus exposure indicates the individual received the virus via a kidney transplant 18 months earlier, findings suggesting that rabies transmitted by this route may have a long incubation period, and that although solid organ transplant transmission of infectious encephalitis is rare, further education to increase awareness is needed, according to a study in the July 24/31 issue of JAMA.
In an analysis of 5-year survival rates among black and white women diagnosed with breast cancer between 1991 and 2005, black women continued to have a lower rate of survival, with most of the difference related to factors including poorer health of black patients at diagnosis and more advanced disease, rather than treatment differences, according to a study in the July 24/31 issue of JAMA.
A case series by researchers at Vanderbilt University, Nashville, Tenn., examined three patients with ischemic stroke who later received a diagnosis of fungal meningitis attributed to epidural injections of contaminated methylprednisolone for low back pain.
Parents who had established relationships with pediatricians still accessed care for their children at retail clinics (RCs), typically located in large chain drugstores, mostly because the clinics were convenient, according to a study published by JAMA Pediatrics, a JAMA Network publication.
A study of the use of transthoracic echocardiography (TTE) at an academic medical center suggests that although 9 in 10 of the procedures were appropriate under 2011 appropriate use criteria, less than 1 in 3 of the TTEs resulted in an active change in care, according to a report of the research by Susan Matulevicius, M.D., and colleagues at the University of Texas Southwestern Medical Center, Dallas.
A study in Norway suggests echocardiographic screening in the general public for structural and valvular heart disease was not associated with benefit for reducing the risk of death, myocardial infarction (heart attack) or stroke, according to a report published by JAMA Internal Medicine, a JAMA Network publication.
“Multiple hospitalizations for complications from a terminal illness may be burdensome for elderly patients and reflect poor quality care,” write Joan M. Teno, M.D., M.S., of the Warren Alpert School of Medicine of Brown University, Providence, R.I., and colleagues, who conducted a study to examine whether the occurrence of multiple hospitalizations for the complications of infections or dehydration was associated with survival.
In a study that included more than 10,000 men with nonmetastatic prostate cancer, use of androgen deprivation therapy (ADT) was associated with a significantly increased risk of acute kidney injury, with variations observed with certain types of ADTs, according to a study in the July 17 issue of JAMA.
Among patients who experienced in-hospital cardiac arrest requiring vasopressors (drugs that increase blood pressure), use of a combination therapy during cardiopulmonary resuscitation resulted in improved survival to hospital discharge with favorable neurological status, according to a study in the July 17 issue of JAMA.
Lyle R. Petersen, M.D., M.P.H., of the Centers for Disease Control and Prevention, U.S. Public Health Service, Department of Health and Human Services, Fort Collins, Colo., and colleagues conducted a review of the medical literature and national surveillance data to examine the ecology, virology, epidemiology, clinical characteristics, diagnosis, prevention, and control of West Nile virus.
An analysis of West Nile virus epidemics in Dallas County in 2012 and previous years finds that the epidemics begin early, after unusually warm winters; are often in similar geographical locations; and are predicted by the mosquito vector index (an estimate of the average number of West Nile virus-infected mosquitoes collected per trap-night), information that may help prevent future outbreaks of West Nile virus-associated illness, according to a study in the July 17 issue of JAMA.
In a study of adults recruited and followed up over the past 3 decades in the United States, longer duration of overall and abdominal obesity beginning in young adulthood was associated with higher rates of coronary artery calcification, a subclinical predictor of coronary heart disease, according to a study in the July 17 issue of JAMA.
Prosthetic valve endocarditis (inflammation and infection involving the heart valves and lining of the heart chambers) remains associated with a high one-year mortality rate and early valve replacement does not appear to be associated with lower mortality compared with medical therapy.
“In 2007, Congress passed the Food and Drug Administration Amendments Act (FDAAA), which authorized the FDA to require postmarketing studies for a prescription drug's approval and mandate adherence to study deadlines. We examined how fulfillment of these postmarketing studies has changed over time.”
Emmanouil S. Brilakis, M.D., Ph.D., of the VA North Texas Health Care System and University of Texas Southwestern Medical Center at Dallas, and colleagues conducted a review of medical literature regarding optimal medical therapy after percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries).
The increased use of cardiac catheterization in New York relative to Ontario appears related to selecting more patients at low risk of obstructive coronary artery disease, with the subsequent diagnostic yield (i.e., the proportion of tested patients in whom disease was diagnosed) of this procedure in New York significantly lower than in Ontario, according to a study in the July 10 issue of JAMA.
Among men who had undergone radical prostatectomy, daily consumption of a beverage powder supplement containing soy protein isolate for 2 years did not reduce or delay development of biochemical recurrence of prostate cancer compared to men who received placebo, according to a study in the July 10 issue of JAMA.
In a study that included nearly 6 million Medicare Advantage and Medicare fee-for-service beneficiaries from 12 states, rates of angiography and percutaneous coronary interventions were significantly lower among Medicare Advantage beneficiaries and geographic variation in procedure rates was substantial for both payment types, according to a study in the July 10 issue of JAMA.
In a multiethnic group of adults, low serum 25-hydroxyvitamin D concentration was associated with increased risk of coronary heart disease events among white or Chinese participants but not among black or Hispanic participants, results that suggest that the risks and benefits of vitamin D supplementation should be evaluated carefully across race and ethnicity, according to a study in the July 10 issue of JAMA.
The authors used data from the Women's Health Initiative (WHI) to assess the association between smoking cessation, weight gain, and subsequent coronary heart disease (CHD) risk among postmenopausal women with and without diabetes.
Harvey V. Fineberg, M.D., Ph.D., of the Institute of Medicine, Washington, D.C., examines a number of the reasons that disease prevention in clinical medicine and public health is often resisted, and suggests and discusses the following strategies for overcoming these obstacles.
In a trial that included nearly 200 participants with peripheral artery disease (PAD), a home-based exercise intervention with a group-mediated cognitive behavioral intervention component improved walking performance and physical activity in patients with PAD, according to a study in the July 3 issue of JAMA.
Among patients at risk of heart failure, collaborative care based on screening for certain levels of brain-type natriuretic peptide reduced the combined rates of left ventricular systolic dysfunction, diastolic dysfunction, and heart failure as well as emergency cardiovascular hospitalizations, according to a study in the July 3 issue of JAMA.
In a study that included more than 2.5 million children born in Sweden, compared with spontaneous conception, any in vitro fertilization (IVF) treatment was not associated with autistic disorder but was associated with a small but statistically significantly increased risk of mental retardation, according to a study in the July 3 issue of JAMA. The authors note that the prevalence of these disorders was low, and the increase in absolute risk associated with IVF was small.
An intervention that consisted of home blood pressure (BP) telemonitoring with pharmacist management resulted in improvements in BP control and decreases in BP during 12 months, compared with usual care, and improvement in BP that was maintained for 6 months following the intervention, according to a study in the July 3 issue of JAMA.
Implementing an out-of hospital stroke policy in some Chicago hospitals was associated with significant improvements in emergency medical services use and increased intravenous tissue plasminogen activator (tPA) use at primary stroke centers, according to a study published by JAMA Neurology.
Respiratory infections in early childhood may be a potential risk factor for developing type 1 diabetes mellitus (T1D), according to a study published by JAMA Pediatrics, a JAMA Network publication.
Nighttime frequency of vital signs monitoring for low-risk medical inpatients might be reduced, according to a research letter by Jordan C. Yoder, B.A. and colleagues at the University of Chicago.
Exercise-induced improvements in glycemic control are dependent on the pre-training glycemic level, and although moderate-intensity aerobic exercise can improve glycemic control, individuals with ambient hyperglycemia (high blood glucose) are more likely to be nonresponders, according to a research letter by Thomas P. J. Solomon, Ph.D. of the Centre of Inflammation and Metabolism, Copenhagen, Denmark, and colleagues.
Treatment with a biological agent was not superior to conventional treatment in terms of the effect on work loss over 21 months in patients with early rheumatoid arthritis (RA) who responded insufficiently to methotrexate, according to a report published by JAMA Internal Medicine, a JAMA Network publication.
An analysis of patients with coronary heart disease (CHD) who attained low-density lipoprotein cholesterol (LDL-C) goals with no treatment intensification suggests that about one-third of them underwent repeat testing, according to a report published by JAMA Internal Medicine, a JAMA Network publication.
Use of advanced treatment technologies for prostate cancer, such as intensity-modulated radiotherapy and robotic prostatectomy, has increased among men with low-risk disease, high risk of noncancer mortality, or both, a population of patients who are unlikely to benefit from these treatments, according to a study in the June 26 issue of JAMA.
In 2 large studies, the association between aspirin use and risk of colorectal cancer was affected by mutation of the gene BRAF, with regular aspirin use associated with a lower risk of BRAF-wild-type colorectal cancer but not with risk of BRAF-mutated cancer, findings that suggest that BRAF-mutant colon tumor cells may be less sensitive to the effect of aspirin, according to a study in the June 26 issue of JAMA.
Gabriela Ilie, Ph.D., of St. Michael's Hospital, Toronto, Canada, and colleagues, examined the prevalence of TBI, mechanisms of injury, and adverse correlates in a large representative sample of adolescents living in Ontario, Canada.
Postmenopausal hormone therapy with conjugated equine estrogens (CEEs) was not associated with overall sustained benefit or risk to cognitive function when given to women ages 50 to 55 years, according to a report published Online First by JAMA Internal Medicine, a JAMA Network publication.
Hospital performance on publicly reported conditions (acute myocardial infarction [heart attack], congestive heart failure, and pneumonia), may potentially be used as a signal of overall hospital mortality rates, according to a study by Marta L. McCrum, M.D., of Harvard School of Public Health, Boston, and colleagues.
Conversations between parents and adolescents that focus on weight and size are associated with an increased risk for unhealthy adolescent weight-control behaviors, according to a study published Online First by JAMA Pediatrics, a JAMA Network publication.
The excess risk of death from ischemic (due to reduced blood flow), but not hemorrhagic (due to bleeding), stroke in US black children has decreased over the past decade, according to a study by Laura L. Lehman, M.D., of Boston Children’s Hospital, and colleagues.
In an analysis that included a sample of patients in the top portion of Medicare spending, only a small percentage of their costs appeared to be related to preventable emergency department visits and hospitalizations, limiting the ability to lower costs for these patients through better outpatient care, according to a study in the June 26 issue of JAMA.
Compared with adults already enrolled in Medicaid, low-income uninsured adults who may be eligible for Medicaid under the Affordable Care Act were less likely to have chronic conditions such as hypertension, diabetes, and hypercholesterolemia, although those with 1 of these conditions were less likely to be aware they had it or to have the disease controlled, according to a study in the June 26 issue of JAMA.
Greater relevance to patients could be realized by focusing information on services that are predictable, nonurgent, and subject to deductibles (e.g., routine outpatient care for chronic diseases) rather than services that are unpredictable, emergent, or would exceed most deductibles (e.g., hospitalizations for life-threatening conditions).
Among patients with suspected stage I/II pulmonary sarcoidosis who were undergoing confirmation of the condition via tissue sampling, the use of the procedure known as endosonographic nodal aspiration compared with bronchoscopic biopsy, the current diagnostic standard, resulted in greater diagnostic yield, according to a study in the June 19 issue of JAMA.
The majority of children at risk of type 1 diabetes who developed 2 or more diabetes-related autoantibodies developed type 1 diabetes within 15 years, findings that highlight the need for research into finding interventions to stop the development of multiple islet autoantibodies, according to a study in the June 19 issue of JAMA.
Magnetic resonance imaging (MRI) at the site of injection of a contaminated lot of a steroid drug to treat symptoms such as back pain resulted in earlier identification of patients with probable or confirmed fungal spinal or paraspinal infection, allowing early initiation of medical and surgical treatment, according to a study in the June 19 issue of JAMA.
In a study that included nearly 60,000 patients with acute ischemic stroke, thrombolytic treatment (to help dissolve a blood clot) that was started more rapidly after symptom onset was associated with reduced in-hospital mortality and intracranial hemorrhage and higher rates of independent walking ability at discharge and discharge to home, according to a study in the June 19 issue of JAMA.
Among children with juvenile idiopathic arthritis (JIA) who had undergone primary immunization, the use of a measles-mumps-rubella (MMR) booster compared with no booster did not result in worse JIA disease activity, according to a study in the June 19 issue of JAMA.
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