From 2004 to 2012, the rate of investment in medical research in the U.S. declined, while there has been an increase in research investment globally, particularly in Asia, according to a study in the January 13 issue of JAMA.
In a rural Maine county, sustained, community-wide programs targeting cardiovascular risk factors and behavior changes were associated with reductions in hospitalization and death rates over a 40 year period (1970-2010) compared with the rest of the state, with substantial improvements seen for hypertension and cholesterol control and smoking cessation, according to a study in the January 13 issue of JAMA.
Among patients in England with gout, only a minority of those with indications to receive urate-lowering therapy were treated according to guideline recommendations, according to a study in the December 24/31 issue of JAMA.
In Bangladesh, daily maternal supplementation of multiple micronutrients compared to iron-folic acid before and after childbirth did not reduce all-cause infant mortality to age 6 months, but did result in significant reductions in preterm birth and low birth weight, according to a study in the December 24/31 issue of JAMA.
Among full-term newborns with moderate or severe hypoxic ischemic encephalopathy (damage to cells in the central nervous system from inadequate oxygen), receiving deeper or longer duration cooling did not reduce risk of neonatal intensive care unit death, compared to usual care, according to a study in the December 24/31 issue of JAMA.
Between 1999 and 2010, periods of extreme heat in the U.S. were associated with an increased risk of hospitalization for older adults for fluid and electrolyte disorders, kidney failure, urinary tract infections, septicemia and heat stroke, according to a study in the December 24/31 issue of JAMA. The authors note that the absolute risk increase was small and of uncertain clinical importance.
High-risk children with chronic illness who received care at a clinic that provided both primary and specialty care and features to promote prompt effective care had an increase in access to care and parent satisfaction and a reduction in serious illnesses and costs, according to a study in the December 24/31 issue of JAMA.
Among patients with lymphoma undergoing a certain type of chemotherapy, receiving the antiviral drug entecavir resulted in a lower incidence of hepatitis B virus (HBV)-related hepatitis and HBV reactivation, compared with the antiviral drug lamivudine, according to a study in the December 17 issue of JAMA.
In a study that included overweight and obese participants, those with diets with low glycemic index of dietary carbohydrate did not have improvements in insulin sensitivity, lipid levels, or systolic blood pressure, according to a study in the December 17 issue of JAMA.
In a sample of U.S. emergency departments, compared to attending physicians alone, supervised visits (involving both resident and attending physicians) were associated with a greater likelihood of hospital admission and use of advanced imaging and with longer emergency department stays, according to a study in the December 10 issue of JAMA, a theme issue on medical education.
There has been a doubling during the last decade in the number of U.S. medical schools that have student-run free clinics, with more than half of medical students involved with these clinics, according to a study in the December 10 issue of JAMA, a theme issue on medical education.
An analysis of the non-English-language skills of U.S. medical residency applicants finds that although they are linguistically diverse, most of their languages do not match the languages spoken by the U.S. population with limited English proficiency, according to a study in the December 10 issue of JAMA, a theme issue on medical education.
Among primary care physicians, the spending patterns in the regions in which their residency program was located were associated with expenditures for subsequent care they provided as practicing physicians, with those trained in lower-spending regions continuing to practice in a less costly manner, even when they moved to higher-spending regions, and vice versa, according to a study in the December 10 issue of JAMA, a theme issue on medical education.
Although some guidelines recommend use of bisphosphonates (a class of drugs used to strengthen bone) for men on androgen deprivation therapy, an analysis finds that prescriptions for these drugs remains low, even for those men at high risk of subsequent fractures, according to a study in the December 3 issue of JAMA.
An examination of the potential interaction between pharmaceutical companies and the U.S. Food and Drug Administration (FDA) to discuss future studies finds that one-quarter of recent new drug approvals occurred without any meeting, and when such meetings occurred, pharmaceutical companies did not comply with one-quarter of the recommendations made by the FDA regarding study design or primary outcome, according to a study in the November 26 issue of JAMA.
Children who attended a full-day preschool program had higher scores on measures of school readiness skills (language, math, socio-emotional development, and physical health), increased attendance, and reduced chronic absences compared to children who attended part-day preschool, according to a study in the November 26 issue of JAMA.
Joseph B. Muhlestein, M.D., of the Intermountain Medical Center Heart Institute, Murray, Utah, and colleagues examined whether screening patients with diabetes deemed to be at high cardiac risk with coronary computed tomographic angiography (CCTA) would result in a significant longterm reduction in death, heart attack, or hospitalization for unstable angina.
Yasuo Ikeda, M.D., of Waseda University, Tokyo, Japan, and colleagues examined whether once-daily, low-dose aspirin would reduce the total number of cardiovascular (CV) events (death from CV causes, nonfatal heart attack or stroke) compared with no aspirin in Japanese patients 60 years or older with hypertension, diabetes, or poor cholesterol or triglyceride levels.
Mikhail Kosiborod, M.D., of Saint Luke's Mid America Heart Institute, Kansas City, and colleagues evaluated the efficacy and safety of the drug zirconium cyclosilicate in patients with hyperkalemia (higher than normal potassium levels). The study appears in JAMA and is being released to coincide with its presentation at the American Heart Association’s Scientific Sessions 2014.
Duk-Woo Park, M.D., of the University of Ulsan College of Medicine, Seoul, Korea, and Manesh R. Patel, M.D., of the Duke Clinical Research Institute, Durham, N.C., and colleagues investigated the incidence, extent, and location of obstructive non-infarct-related artery (IRA) disease and compared 30-day mortality according to the presence of non-IRA disease in patients with ST-segment elevation myocardial infarction.
Lars H. Lund, M.D., Ph.D., of the Karolinska Institutet, Stockholm, Sweden, and colleagues conducted a study to examine whether beta-blockers are associated with reduced mortality in heart failure patients with preserved ejection fraction (a measure of how well the left ventricle of the heart pumps with each contraction).The study appears in the November 19 issue of JAMA, a cardiovascular disease theme issue.
Vivek Y. Reddy, M.D., of the Icahn School of Medicine at Mount Sinai, New York, and colleagues examined the long-term efficacy and safety, compared to warfarin, of a device to achieve left atrial appendage closure in patients with atrial fibrillation. The study appears in the November 19 issue of JAMA, a cardiovascular disease theme issue.
Matthew D. Ritchey, D.P.T., of the Centers for Disease Control and Prevention (CDC), Atlanta, and colleagues examined the contributions of heart disease subtypes to overall heart disease mortality trends during 2000-2010. The study appears in the November 19 issue of JAMA, a cardiovascular disease theme issue.
Prashant Kaul, M.D., of the University of North Carolina, Chapel Hill, and colleagues conducted a study to define the incidence and treatment and outcomes of patients who experience a certain type of heart attack during hospitalization for conditions other than acute coronary syndromes. The study appears in the November 19 issue of JAMA, a cardiovascular disease theme issue.
Among kidney transplant recipients, a 3-month course of the antibiotic levofloxacin following transplantation did not prevent the major complication known as BK virus from appearing in the urine. The intervention was associated with an increased risk of adverse events such as bacterial resistance, according to a study appearing in JAMA. The study is being released to coincide with its presentation at the American Society of Nephrology’s annual Kidney Week meeting.
In patients undergoing noncardiac surgery, neither aspirin nor clonidine (a medication primarily used to treat high blood pressure) taken before and after surgery reduced the risk of acute kidney injury, according to a study appearing in JAMA. The study is being released to coincide with its presentation at the American Society of Nephrology’s annual Kidney Week meeting.
Patients with chronic hepatitis C virus infection and advanced fibrosis or cirrhosis who attained sustained virological response (SVR) had survival comparable with that of the general population, whereas patients who did not attain SVR had reduced survival, according to a study in the November 12 issue of JAMA.
Medicare patients with poor prognosis cancers who received hospice care had significantly lower rates of hospitalization, intensive care unit (ICU) admissions and invasive procedures at the end of life, along with significantly lower health care expenditures during the last year of life, according to a study in the November 12 issue of JAMA.
Among approximately 26,000 women, receipt of the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine during pregnancy was not associated with increased risk of preterm delivery or small-for-gestational-age birth or with hypertensive disorders of pregnancy, although a small increased risk of being diagnosed with chorioamnionitis (an inflammation of the membranes that surround the fetus) was observed, according to a study in the November 12 issue of JAMA.
In an analysis that included approximately 35,000 participants, genetic predisposition to elevated low-density lipoprotein cholesterol (LDL-C) was associated with aortic valve calcium and narrowing of the aortic valve, findings that support a causal association between LDL-C and aortic valve disease, according to a study appearing in JAMA. The study is being released to coincide with its presentation at the Canadian Cardiovascular Congress.
About two-thirds of FDA recalled dietary supplements analyzed still contained banned drugs at least 6 months after being recalled, according to a study in the October 22/29 issue of JAMA.
From the perspective of the insurers and patients, between 2009 and 2012, hospital-owned physician organizations in California incurred higher expenditures for commercial health maintenance organization enrollees for professional, hospital, laboratory, pharmaceutical and ancillary services than did physician-owned organizations, according to a study in the October 22/29 issue of JAMA.
An examination of the relationship between physician competition and prices paid by private preferred provider organizations (PPOs) for common office visits finds that more competition is associated with lower prices paid to physicians in 10 large specialties, according to a study in the October 22/29 issue of JAMA.
Hospital conversion from nonprofit to for-profit status in the 2000s was associated with better subsequent financial health but had no relationship to the quality of care delivered, mortality rates, or the proportion of poor or minority patients receiving care, according to a study in the October 22/29 issue of JAMA.
Searching a health service pricing website before using the service was associated with lower payments for clinical services such as advanced imaging and laboratory tests, according to a study in the October 22/29 issue of JAMA.
A one-day prevalence survey of 183 hospitals found that approximately 50 percent of hospitalized patients included in the survey were receiving antimicrobial drugs, and that about half of these patients were receiving 2 or more antimicrobial drugs, according to a study in the October 8 JAMA, a theme issue on infectious disease. Most antimicrobial use was for infection treatment.
Two randomized trials in the October 8 issue of JAMA examine new vaccination strategies for the prevention and control of avian influenza, often referred to as “bird flu.” This is a theme issue on infectious disease.
Study participants who reported tobacco use or had higher levels of biomarkers of tobacco exposure had a higher prevalence of the sexually transmitted infection, oral human papillomavirus type 16 (HPV-16), according to a study in the October 8 JAMA, a theme issue on infectious disease.
Despite no lapses in the disinfection process recommended by the manufacturer being identified, specialized gastrointestinal endoscopes called duodenoscopes had bacterial contamination associated with an outbreak of a highly resistant strain of E coli at a hospital in Illinois, according to a study in the October 8 JAMA, a theme issue on infectious disease.
An analysis of liability claims related to esophageal cancer screening finds that the risks of claims arising from acts of commission (complications from screening procedure) as well as acts of omission (failure to screen) are similarly low, according to a study in the October 1 issue of JAMA.
Among patients ages 50 to 69 years who underwent aortic valve replacement with bioprosthetic (made primarily with tissue) compared with mechanical prosthetic valves, there was no significant difference in 15-year survival or stroke, although patients in the bioprosthetic valve group had a greater likelihood of reoperation but a lower likelihood of major bleeding, according to a study in the October 1 issue of JAMA.
In a trial involving patients at high risk of hospital readmission or death, use of a virtual ward model of care (using some elements of hospital care in the community) after hospital discharge did not significantly reduce the rate of readmission or death up to a year following discharge, according to a study in the October 1 issue of JAMA.
Among patients older than 50 years with moderate to severe chronic knee pain, neither laser nor needle acupuncture provided greater benefit on pain or function compared to sham laser acupuncture, according to a study in the October 1 issue of JAMA.
An analysis of 70 studies finds that use of the diagnostic imaging procedure of fludeoxyglucose F18 (FDG)-positron emission tomography (PET) combined with computed tomography (CT) may not reliably distinguish benign disease from lung cancer in populations with endemic (high prevalence) infectious lung disease compared with nonendemic regions, according to a study in the September 24 issue of JAMA.
An intervention for pregnant women that included a computerized, interactive decision-support guide regarding prenatal genetic testing, and no cost for testing, resulted in less prenatal test use and more informed choices, according to a study in the September 24 issue of JAMA.
Following a doubling of the incidence and prevalence of diabetes in the U.S. from 1990-2008, new data suggest a plateauing of the rate between 2008 and 2012 for adults, however the incidence continued to increase in Hispanic and non-Hispanic black adults, according to a study in the September 24 issue of JAMA.
Among older adults with chronic obstructive pulmonary disease (COPD), particularly those with asthma, newly prescribed long-acting beta-agonists (LABAs) and inhaled corticosteroid combination therapy, compared with newly prescribed LABAs alone, was associated with a lower risk of death or COPD hospitalization, according to a study in the September 17 issue of JAMA.
The prevalence of abdominal obesity and average waist circumference increased among U.S. adults from 1999 to 2012, according to a study in the September 17 issue of JAMA.
In an analysis of the results of nearly 50 randomized trials that examined treatments of venous thromboembolisms (blood clot in a vein), there were no significant differences in clinical and safety outcomes associated with most treatment strategies when compared with the low-molecular-weight heparin-vitamin K antagonist combination, according to a study in the September 17 issue of JAMA.
Magnesium sulfate given intravenously to pregnant women at risk of very preterm birth was not associated with benefit on neurological, behavioral, growth, or functional outcomes in their children at school age, according to a study in the September 17 issue of JAMA.
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