Hospitals that were penalized more frequently in the Hospital-Acquired Condition (HAC) Reduction Program offered advanced services, were major teaching institutions and had better performance on other publicly reported process-of-care and outcome measures, according to a study in the July 28 issue of JAMA, a theme issue on Medicare and Medicaid at 50.
Researchers have found an association between treatment with the antibiotic dicloxacillin and a decrease in international normalized ratio (INR; a measure of blood coagulation) levels among patients taking the vitamin K antagonists warfarin or phenprocoumon, according to a study in the July 21 issue of JAMA.
In a phase 2 trial that included nearly 1,000 adults, the AS03 and MF59 adjuvants (a component that improves immune response of inactivated influenza vaccines) increased the immune responses to two doses of an inactivated H7N9 influenza vaccine, with AS03-adjuvanted formulations inducing the highest amount of antibody response, according to a study in the July 21 issue of JAMA.
Although some previous studies have suggested an increased risk of bladder cancer with use of the diabetes drug pioglitazone, analyses that included nearly 200,000 patients found no statistically significant increased risk, however a small increased risk could not be excluded, according to a study in the July 21 issue of JAMA.
Two studies in the July 21 issue of JAMA find that use of interventions such as cardiopulmonary resuscitation and automated external defibrillators by bystanders and first responders have increased and were associated with improved survival and neurological outcomes for persons who experienced an out-of-hospital cardiac arrest.
An examination of state vaccination requirements for adolescents finds that the human papillomavirus (HPV) vaccine is currently required in only two states, many fewer than another vaccine associated with sexual transmission (hepatitis B) and another primarily recommended for adolescents (meningococcal conjugate), according to a study in the July 14 issue of JAMA.
Among patients with diabetic kidney disease and hyperkalemia (elevated potassium levels in the blood), a potentially life-threatening condition, those who received the new drug patiromer, twice daily for four weeks, had significant decreases in potassium levels which lasted through one year, according to a study in the July 14 issue of JAMA.
An examination of the 2013 guidelines for determining statin eligibility, compared to guidelines from 2004, indicates that they are associated with greater accuracy and efficiency in identifying increased risk of cardiovascular disease (CVD) events and presence of subclinical coronary artery disease, particularly in individuals at intermediate risk, according to a study in the July 14 issue of JAMA.
For women with Lynch syndrome, an association was found between the risk of endometrial cancer and the age of first menstrual cycle, having given birth, and hormonal contraceptive use, according to a study in the July 7 issue of JAMA. Lynch syndrome is a genetic condition that increases the risk for various cancers.
After years of overtreatment for patients with low-risk prostate cancer, rates of active surveillance/ watchful waiting increased sharply in 2010 through 2013, and high-risk disease was more often treated appropriately with potentially curative local treatment rather than androgen deprivation alone, according to a study in the July 7 issue of JAMA.
Among patients with a first episode of pulmonary embolism (the obstruction of the pulmonary artery or a branch of it leading to the lungs by a blood clot) who received 6 months of anticoagulant treatment, an additional 18 months of treatment with warfarin reduced the risk of additional blood clots and major bleeding, however, the benefit was not maintained after discontinuation of anticoagulation therapy, according to a study in the July 7 issue of JAMA.
In an analysis that included nearly 1.2 million participants and more than 135,000 deaths, mortality associated with a history of diabetes, stroke, or heart attack was similar for each condition, and the risk of death increased substantially with each additional condition a patient had, according to a study in the July 7 issue of JAMA.
In a study that included nearly 24,000 participants, those who experienced a stroke had an acute decline in cognitive function and also accelerated and persistent cognitive decline over 6 years, according to an article in the July 7 issue of JAMA.
An analysis of edible medical marijuana products from 3 major metropolitan areas found that many had lower amounts of key substances than labeled, which may not produce the desired medical benefit, while others contained significantly more of a certain substance than labeled, placing patients at risk of experiencing adverse effects, according to a study in the June 23/30 issue of JAMA.
In an analysis of the findings of nearly 80 randomized trials that included about 6,500 participants, there was moderate-quality evidence to support the use of cannabinoids (chemical compounds that are the active principles in cannabis or marijuana) for the treatment of chronic pain and lower-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, sleep disorders, and Tourette syndrome, according to a study in the June 23/30 issue of JAMA.
Among extremely preterm infants, early screening for the vascular disorder patent ductus arteriosus before day 3 of life was associated with a lower risk of in-hospital death and pulmonary hemorrhage, but not with differences in other severe complications, according to a study in the June 23/30 issue of JAMA.
Among men in Sweden, use of erectile dysfunctions drugs with phosphodiesterase type 5 inhibitors was associated with a modest but significant increased risk of malignant melanoma, although the pattern of association raises questions about whether this association is causal, according to a study in the June 23/30 issue of JAMA.
Among Medicare patients who experienced a heart attack from 2007 to 2010, fewer than 1 in 10 eligible patients with low ejection fraction (a measure of how well the left ventricle of the heart pumps blood with each beat) received an implantable cardioverter-defibrillator (ICD) within 1 year after the heart attack, even though ICD implantation was associated with a lower risk of death at 2 years after implantation, according to a study in the June 23/30 issue of JAMA.
Among patients with uncomplicated appendicitis, antibiotic treatment did not meet a prespecified level of effectiveness compared with appendectomy, although most patients who received antibiotic therapy did not require an appendectomy, and for those who did, they did not experience significant complications, according to a study in the June 16 issue of JAMA.
An analysis that included information from more than 57,000 screening colonoscopies suggests that higher adenoma detection rates may be associated with up to 50 percent to 60 percent lower lifetime colorectal cancer incidence and death without higher overall costs, despite a higher number of colonoscopies and potential complications, according to a study in the June 16 issue of JAMA.
In a group of more than 5,000 extremely preterm infants, important in-hospital outcomes were neither better nor worse in infants enrolled in randomized clinical trials (RCTs) compared with eligible but nonenrolled infants, findings that may provide reassurance regarding concerns about performing RCTs in this vulnerable population, according to a study in the June 16 issue of JAMA.
Funding for health in developing countries has increased substantially since 1990, with a focus on HIV/AIDS, maternal health, and newborn and child health, and limited funding for noncommunicable diseases, according to a study in the June 16 issue of JAMA.
Following implementation of rotavirus vaccination in 2006, all-cause acute gastroenteritis hospitalization rates among U.S. children younger than 5 years of age declined by 31 percent - 55 percent in each of the post-vaccine years from 2008 through 2012, according to a study in the June 9 issue of JAMA.
Among applicants to U.S. medical schools, those with disabilities who obtained extra test administration time for the Medical College Admission Test in use from 1991 to January 2015 had no significant difference in rate of medical school admission but had lower rates of passing the United States Medical Licensing Examination Step examinations and of medical school graduation, according to a study in the June 9 issue of JAMA, a theme issue on the Americans with Disabilities Act.
A control system that incorporated electrical signals generated during muscle contractions and gait information resulted in improved real-time control of a powered prosthetic leg for different modes of walking (such as on level ground or descending stairs), according to a study in the June 9 issue of JAMA, a theme issue on the Americans with Disabilities Act.
Between 1993 and 2012, the incidence rate of acute traumatic spinal cord injury remained relatively stable in the U.S., although there was an increase among older adults, mostly associated with an increase in falls, according to a study in the June 9 issue of JAMA, a theme issue on the Americans with Disabilities Act.
An analysis of the use of computerized clinical decision support systems regarding orders for advanced diagnostic imaging found that the systems failed to identify relevant appropriateness criteria for the majority of orders, according to a study in the June 2 issue of JAMA.
An analysis of approximately 3.8 million pregnancies finds that use of antidepressants late in pregnancy may be associated with an increased risk of persistent pulmonary hypertension of the newborn (PPHN), according to a study in the June 2 issue of JAMA. However, the absolute risk was small and the risk increase appears more modest than suggested in previous studies. PPHN is a rare but life-threatening condition that occurs when a newborn's circulation system doesn't adapt to breathing outside the womb.
Implementation of a pre-surgical intervention that included screening for the bacteria Staphylococcus aureus, treating patients who were positive for this bacteria, and the administration of antibiotics based on these culture results was associated with a modest reduction in S aureus surgical site infections, according to a study in the June 2 issue of JAMA.
Although some data have suggested that supplementation with soy isoflavone may be an effective treatment for patients with poor asthma control, a randomized trial that included nearly 400 children and adults found that use of the supplement did not result in improved lung function or clinical outcomes, including asthma symptoms and episodes of poor asthma control, according to a study in the May 26 issue of JAMA. Soy isoflavones are plant (soybean) derived chemicals that have anti-oxidant effects.
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