An analysis of nationally-representative data indicates that between 1988 and 2010 there has been a trend of declining average levels of total cholesterol, non-high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol for U.S. adults overall.
In a comparison of strategies to identify individuals with Lynch syndrome, the most common form of hereditary colorectal cancer (CRC), caused by mutations in certain genes (DNA mismatch repair [MMR] genes), universal tumor MMR testing among certain CRC patients had a greater sensitivity for the identification of Lynch syndrome compared with multiple alternative strategies, although the diagnostic improvement was modest.
In a pilot study assessing the effect of different levels of chloride in intravenous fluids administered to critically ill patients in an intensive care unit, restricting the amount of chloride administration was associated with a significant decrease in the incidence of acute kidney injury and the use of renal replacement therapy.
Plasma levels of proneurotensin are associated with the development of diabetes, cardiovascular disease, cardiovascular and total mortality, and breast cancer in women during long-term follow-up.
In an analysis that included nearly 100,000 Medicare patients who had experienced a heart attack, the use of a percutaneous coronary intervention was lower for patients treated in states with public reporting of PCI outcomes compared with patients treated in states without public reporting, with these differences being particularly large in the highest-risk patients
In children and adolescents with hemophilia, vigorous physical activity was associated with an elevated risk of bleeding, although it appears the absolute increase in risk may be small
Among premature, very low-birth-weight infants requiring a transfusion, use of fresh red blood cells (RBCs) compared with standard RBC transfusion practice did not improve clinical outcomes that included rates of complications or death.
Preliminary research finds that for patients with nondystrophic myotonias (NDMs), rare diseases that affect the skeletal muscle and cause functionally limiting stiffness and pain, use of the anti-arrhythmic medication mexiletine resulted in improvement in patient-reported stiffness.
A study that included more than 45,000 residents of Sweden with rheumatoid arthritis finds that individuals with this disease had an associated higher risk of venous thromboembolism (a blood clot that forms within a vein), and that this elevated risk was stable for 10 years after the time of diagnosis
Among patients with either coronary artery disease (CAD) risk factors only, known prior heart attack, or known CAD without heart attack, the use of beta-blockers was not associated with a lower risk of a composite of cardiovascular events that included cardiovascular death, nonfatal heart attack or nonfatal stroke
Although some data have suggested a possible inverse association between serum vitamin D levels and the incidence of upper respiratory tract infections (colds), participants in a randomized controlled trial who received a monthly dose of 100,000 IUs of vitamin D3 did not have a significantly reduced incidence or severity of colds.
Obese adults with excess visceral fat (fat located inside the abdominal cavity, around the body's internal organs) and biomarkers of insulin resistance had an associated increased risk for the development of type 2 diabetes mellitus, while obese individuals with higher amounts of total body fat and subcutaneous fat (underneath the skin) did not have this increased risk
Addressing the obesity epidemic by preventing excess calorie consumption with government regulation of portion sizes is justifiable and could be an effective measure to help prevent obesity-related health problems and deaths.
In a nationally representative sample of nearly 3,000 children and adolescents, those who had higher concentrations of urinary bisphenol A (BPA), a manufactured chemical found in consumer products, had significantly increased odds of being obese.
Severely obese patients who had Roux-en-Y gastric bypass surgery had significant weight loss that was sustained for an average of 6 years after the surgery and also experienced frequent remission and lower incidence of diabetes, hypertension, and abnormal cholesterol levels, compared to participants who did not have the surgery
In an analysis of the cost-savings achieved by an earlier pilot program, the Medicare Physician Group Practice Demonstration (PGPD), researchers found modest estimates of overall savings associated with the PGPD, but larger savings among the dually eligible patients (Medicare and Medicaid), with savings achieved in large part through reductions in hospitalizations, according to a study in the September 12 issue of JAMA.
Preoperative 3-dimensional visualization of sentinel lymph nodes (SLNs) with a technique known as single-photon emission computed tomography/computed tomography was associated with a higher rate of detection of positive SLNs and a higher rate of disease-free survival among patients with melanoma, according to a study in the September 12 issue of JAMA.
Among adults with asthma controlled with low-dose inhaled corticosteroid therapy, the time to treatment failure was not significantly different among patients who received corticosteroid dose adjustment based on physician assessment, a biomarker, or symptom occurrence, according to a study in the September 12 issue of JAMA.
In a study that included nearly 70,000 patients, supplementation with omega-3 polyunsaturated fatty acids was not associated with a lower risk of all-cause death, cardiac death, sudden death, heart attack, or stroke, according to an analysis of previous studies published in the September 12 issue of JAMA.
In a study that included more than 2,700 women receiving care in primary care clinics, those who were screened for partner violence and received a partner violence resource list did not experience significant differences for several outcomes, including overall quality of life, general health, and recurrence of partner violence, compared to women who just received a partner violence resource list
The results of two studies in the August 15 issue of JAMA report on the psychological status of workers at the Fukushima nuclear power plants in Japan several months after the earthquake and tsunami in March 2011, and the amount of internal radiation exposure among residents of a city north of the power plant that experienced a meltdown.
Among couples in which one partner was diagnosed as having posttraumatic stress disorder (PTSD), participation in disorder-specific couple therapy resulted in decreased PTSD symptom severity and increased patient relationship satisfaction, compared with couples who were placed on a wait list for the therapy.
Participants in a study who were normal weight at the time of a diagnosis of diabetes experienced higher rates of total and noncardiovascular death compared with those who were overweight or obese at diabetes diagnosis.
In a study involving more than 16,000 U.S. children and adolescents, there has been a decrease in average total cholesterol levels over the past 2 decades, although almost 1 in 10 had elevated total cholesterol in 2007-2010.
Although there have been questions regarding the safety and durability of endoscopic vein graft harvest for coronary artery bypass graft (CABG) surgery, an analysis of data of more than 200,000 patients who underwent CABG surgery found no evidence of a long-term increased risk of death with endoscopic vein graft harvesting compared to open vein-graft harvesting
Among patients with multiple colorectal polyps, the prevalence of certain gene mutations varied considerably by polyp count
Patients with chronic heart failure who participated in exercise training had modest reductions in symptoms of depression after 12 months, compared with usual care
Medicare patients 65 years and older who underwent cataract surgery had a lower odds of hip fracture 1 year after the procedure when compared with patients with cataract who did not have cataract surgery
Among patients with relapsing-remitting multiple sclerosis (MS), treatment with the widely-prescribed drug to treat MS, interferon beta, was not associated with less progression of disability
Physicians tend to share patients with colleagues who have similar personal traits and practice styles, and there is substantial variation in physician network characteristics across geographic areas
Use of the botanical product silymarin, an extract of milk thistle that is commonly used by some patients with chronic liver disease, did not provide greater benefit than placebo for patients with treatment-resistant chronic hepatitis C virus (HCV) infection
Adding stroke severity to a hospital 30-day mortality model based on claims data for Medicare beneficiaries with acute ischemic stroke was associated with improvement in predicting the risk of death at 30 days and changes in performance ranking regarding mortality for a considerable proportion of hospitals
In studies examining the risk of adverse outcomes after receipt of the influenza A(H1N1) vaccine, infants exposed to the vaccine in utero did not have a significantly increased risk of major birth defects, preterm birth, or fetal growth restriction; while in another, study researchers found a small increased risk in adults of the nervous system disorder, Guillain-Barre syndrome, during the 4 to 8 weeks after vaccination, according to 2 studies in the July 11 issue of JAMA.
In studies examining the risk of adverse outcomes after receipt of the influenza A(H1N1) vaccine, infants exposed to the vaccine in utero did not have a significantly increased risk of major birth defects, preterm birth, or fetal growth restriction; while in another, study researchers found a small increased risk in adults of the nervous system disorder, Guillain-Barre syndrome, during the 4 to 8 weeks after vaccination, according to 2 studies in the July 11 issue of JAMA.
Patients who had surgery for periampullary cancer (a variety of types of cancer that are located in and near the head of the pancreas, including an area called the ampulla where the bile duct joins up with the pancreatic duct to empty their secretions into the upper small intestine) and received chemotherapy had a statistically significant survival benefit, compared to patients who did not receive chemotherapy, after adjusting for prognostic variables, according to a study in the July 11 issue of JAMA.
Among intermediate- to high-risk patients undergoing coronary artery bypass graft surgery, administration of the agent acadesine to regulate adenosine (a naturally occurring chemical that dilates blood flow and can improve coronary blood flow and perfusion) did not reduce all-cause death, nonfatal stroke, or need for mechanical support for ventricular dysfunction, for approximately a month after surgery, according to a study in the July 11 issue of JAMA.
In analysis that included more than 9 million Department of Defense nonactive and active duty personnel, the rates of both community-onset and hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bacteremia decreased from 2005 to 2010, while the proportion of community-onset skin and soft tissue infections due to MRSA has more recently declined.
Although some have suggested that patients receiving medication for immune-mediated diseases such as rheumatoid arthritis or psoriasis may be at increased risk of herpes zoster (HZ; shingles) shortly after receipt of the vaccine, an analysis that included nearly 20,000 vaccinated Medicare beneficiaries finds that the live zoster vaccine is not associated with an increased risk of HZ shortly after vaccination in patients currently treated with biologics.
Among individuals without known cardiovascular disease (CVD), the addition of certain apolipoproteins and lipoproteins to risk scores containing total cholesterol and high-density lipoprotein cholesterol (HDL-C) was associated with slight improvement in CVD prediction, according to a study in the June 20 issue of JAMA.
In a study that included nearly 2 millions adults in Canada, the rate of progression to untreated kidney failure was considerably higher among older adults, compared to younger individuals, according to a study in the June 20 issue of JAMA.
Among patients who underwent bariatric surgery, there was a higher prevalence of alcohol use disorders in the second year after surgery, and specifically after Roux-en-Y gastric bypass, compared with the years immediately before and following surgery, according to a study in the June 20 issue of JAMA.
Among six large integrated health care systems between 1996 and 2010 there was a substantial increase in the use of advanced diagnostic imaging, including approximately a tripling of the use of computed tomography and nearly a quadrupling of the use of magnetic resonance imaging, as well as a substantial increase in estimated radiation exposure, according to a study in the June 13 issue of JAMA.
A survey of mid-career academic physician researchers finds that gender differences in salary exist, even after adjustment for differences in specialty, institutional characteristics, academic productivity, academic rank, work hours, and other factors, according to a study in the June 13 issue of JAMA.
Treatment with glucose-lowering thiazolidinedione drugs in patients with Type 2 diabetes appears to be associated with an increased risk of diabetic macular edema (a complication that may affect vision) at 1-year and 10-year follow-up evaluations, according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication.
A telephone intervention trial was associated with improvement in glaucoma medication adherence in both the treatment group and the control group but, when the two groups were compared, interactive telephone calls and tailored print materials did not significantly improve adherence, according to a report of a randomized controlled clinical trial published Online First by Archives of Ophthalmology, a JAMA Network publication.
Cerebral damage and retinopathy of prematurity appear to be independently associated with visual impairment among preschool children who were born extremely premature, according to a report published Online First by Archives of Ophthalmology, a JAMA Network publication.
An analysis of available medical literature suggests smoking was linked to increased mortality in older patients and that smoking cessation was associated with reduced mortality at an older age, according to a report published in the June 11 issue of Archives of Internal Medicine, a JAMA Network publication.
Two studies that included adults with obstructive sleep apnea examined the effectiveness of reducing the risk of cardiovascular outcomes, including high blood pressure, by treatment with continuous positive airway pressure (CPAP), according to the articles in the May 23/30 issue of JAMA.
Nursing homes that used a multicomponent intervention that included staff training and supportive materials for staff, residents and relatives had a lower rate of use of physical restraints such as bilateral bed rails and belts, according to a study in the May 23/30 issue of JAMA.
Treatment with bisphosphonate therapy appears to be associated with an increased risk of atypical fractures of the femur, according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication.
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