Curated News: JAMA

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State mandates requiring commercial health plans to cover the cost of services for children with autism spectrum disorder (ASD) have resulted in an increased number of children being diagnosed and treated for ASD, according to new research from the Perelman School of Medicine at the University of Pennsylvania. The findings will be published in the July 11th issue of JAMA Pediatrics.

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Acupressure helped reduce persistent fatigue in women who had been treated for breast cancer, a new study finds.

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Most people would get a little ‘rush’ out of the idea that they’re about to win some money. In fact, if you could look into their brain at that very moment, you’d see activity in the part of the brain that responds to rewards. But for marijuana users, that rush just isn’t as big – and gets smaller over time, a new study finds. And that may open them up to more risk of addiction.

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Despite increasing legalization of euthanasia and physician-assisted suicide (PAS) worldwide, the practice remains relatively rare and, when carried out, is primarily motivated by psychological factors such as loss of autonomy or enjoyment of life, rather than physical pain. A new comprehensive assessment of data from around the world shows that in areas where they are legal, only 0.3 to 4.6 percent of deaths result from euthanasia or PAS, with more than 70 percent of cases involving patients with cancer. The study also shows that the majority of patients requesting euthanasia or PAS are older, white and well-educated.

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Women who carry the BRCA1 gene mutation that dramatically increases their risk of breast and ovarian cancers are also at higher risk for a lethal form of uterine cancer, according to a study led by a Duke Cancer Institute researcher.

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In a surprising about-face, researchers have determined that a protocol providing physical therapy to ICU patients did not shorten hospital length of stay. The study, which is the largest to-date, reversed the findings from earlier pilot studies.

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Using so-called next-generation genome sequencing, researchers at Johns Hopkins have identified 84 potential inherited gene mutations that may contribute to the most severe forms of bipolar disorder. About 5.6 million Americans are estimated to have bipolar disorder.

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Even if you have what you might think of as good health insurance, your next hospital stay could cost you more than $1,000 out of your own pocket. And that amount has gone up sharply in recent years – a rise of more than 37 percent just for straightforward hospital stays for common conditions.

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Military members who visited a primary care clinic while suffering from post-traumatic stress disorder and depression reported fewer symptoms and better mental health functioning a year after enrolling in a treatment program that included specially trained care managers and telephone therapy options, according to a new study conducted by RTI International, RAND and the Department of Defense Deployment Health Clinical Center.

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Since gun law reform and the Firearms Buyback program 20 years ago, Australia has seen an accelerating decline in intentional firearm deaths and an absence of fatal mass shootings, the Journal of the American Medical Association (JAMA) reports today in a landmark study.

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A UCLA-led study estimates that almost 28,500 deaths could be prevented each year in the U.S. through use of a new FDA-approved class of cardiovascular medication that helps reduce mortality in patients diagnosed with heart failure and reduced ejection fraction, the percentage of blood pumped from the heart with each contraction.

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It happened fast. It happened in nearly every hospital in the state. And it didn’t come with dreaded side effects. The proportion of hospitalized patients who lacked insurance dropped by nearly four percentage points, and the proportion covered by Medicaid rose more than 6 points, in the state of Michigan within three months of the expansion of Medicaid.

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An analysis of more than 60 studies suggests that some plant-based therapies are associated with modest reductions in the frequency of hot flashes and vaginal dryness but no significant reduction in night sweats, according to a study appearing in the June 21 issue of JAMA.

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In a study appearing in the June 21 issue of JAMA, Matthew M. Davis, M.D., M.A.P.P., of the University of Michigan, Ann Arbor, and colleagues examined changes in insurance coverage among hospitalized nonelderly adults after Michigan expanded Medicaid coverage in 2014 under the Affordable Care Act (ACA).

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In a study appearing in the June 21 issue of JAMA, Peter Ganz, M.D., of the University of California-San Francisco, and colleagues conducted a study to develop and validate a score to predict risk of cardiovascular outcomes among patients with coronary heart disease using analysis of circulating proteins.

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Low dose aspirin is recommended by clinicians as a preventive measure for patients who have already had a heart attack or stroke, but the risk of taking low-dose aspirin to prevent or delay a first heart attack or stroke is less clear, as the benefit for reducing the risk of cardiovascular disease (CVD) must be balanced with the increased risk of gastrointestinal or other bleeding. To help clinicians and patients make informed decisions about aspirin use, researchers at Brigham and Women's Hospital have developed a new, free, mobile app, "Aspirin-Guide" that calculates both the CVD risk score and the bleeding risk score for the individual patient, and helps clinicians decide which patients are appropriate candidates for the use of low-dose aspirin (75 to 81 mg daily).

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A UAB study in the Journal of the American Medical Association shows patients’ mobility while hospitalized helps maintain daily activity in older adults.

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In the midst of an epidemic of prescription painkiller addiction and overdose deaths, a new Johns Hopkins Bloomberg School of Public Health survey suggests that more than half of patients prescribed opioids have leftover pills – and many save them to use later.

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Researchers have found that spending a week longer in the womb may give babies a tiny leg up on cognitive ability. The trade-off, however, seems to be a slight increase in the chance of having a physical disability.

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A single exposure to general anesthesia poses no cognitive risk to healthy children under age three, a critical time in brain development, according to a multicenter study led by Columbia University Medical Center and NewYork-Presbyterian/Morgan Stanley Children’s Hospital.

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In a meta-analysis of hundreds of clinical trials involving thousands of patients, researchers at University of California San Diego School of Medicine report that therapeutic approaches using precision medicine, which emphasizes the use of individual genetics to refine cancer treatment, showed improved response and longer periods of disease remission, even in phase I trials.

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Nearly 1 in 3 American senior citizens choose to get their government-funded Medicare health coverage through plans run by health insurance companies. The rest get it straight from the federal government. But if health policy decision-makers assume the two groups are the same, they’re mistaken, a new study finds.

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A significant proportion of lung cancer patients also have autoimmune disease, which may make them unsuitable for increasingly popular immunotherapy treatments, a team of researchers at UT Southwestern Medical Center’s Harold C. Simmons Comprehensive Cancer Center has found.

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This story looks at the use of opioids to recover from surgeries, while examining patient expectations and current practices. This story also covers an initiative entitled "Opioids for Pain: Be Smart. Be Safe. Be Sure."

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Researchers suggest that the number of child and youth concussions may be vastly underestimated in the U.S. A single-center study in a large pediatric network found that four out of five children diagnosed with concussion were seen at primary care practices, not in an emergency department (ED). However, most national counts of pediatric concussion rely solely on ED visits or school athletics data.

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On May 31st, the World Health Organization hopes to spur the nearly one billion smokers worldwide to put down their cigarettes for World No Tobacco Day. While this annual event generates media attention and is a potential starting point for many quit attempts, without a sustained effort these smokers will likely be puffing away again in a matter of weeks. Researchers say that one way to keep the momentum going after this once-a-year push to get smokers’ attention, is to use every Monday as a weekly opportunity to support smokers in their efforts to quit and stay quit.

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Women with a high risk of developing breast cancer based on family history and genetic risk can still reduce the chance they will develop the disease in their lifetimes by following a healthy lifestyle, new research led by the Johns Hopkins Bloomberg School of Public Health suggests.

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Additional immune-system-modulatory approaches may help reduce risk of cardiovascular disease.

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Suicide attempts, like suicides, have increased in the U.S. Army over the last decade. To better understand and prevent suicidal behavior, researchers from the Uniformed Services University of the Health Sciences (USU), the University of California, San Diego, Harvard Medical School, and the University of Michigan examined timing and risk factors for suicide attempts among U.S. Army enlisted Soldiers. They found the highest risk was among those who never deployed, and those who never deployed were at greatest risk during their second month of service.

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Chatting on the phone with a “sleep coach” and keeping a nightly sleep diary significantly improve sleep quality and reduce insomnia in women through all stages of menopause, according to a new study published in JAMA Internal Medicine. The study also found that such phone-based cognitive behavioral therapy significantly reduced the degree to which hot flashes interfered with daily functioning.

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Extremely low birth weight (ELBW) babies who survive are more likely to be disadvantaged in employment, income, self-esteem, marriage and more by the time they reach their 30s. A longitudinal study has followed the ELBW survivors born between 1977 and 1982.

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The number of people with visual impairment or blindness in the United States is expected to double to more than 8 million by 2050, according to projections based on the most recent census data and from studies funded by the National Eye Institute, part of the National Institutes of Health. Another 16.4 million Americans are expected to have difficulty seeing due to correctable refractive errors that can be fixed with glasses, contacts or surgery.

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Intensive therapies to reduce high blood pressure can cut the risk of heart disease in older adults without increasing the risk for falls, according to doctors at Wake Forest Baptist Medical Center.

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A study published today by researchers at the University of Southern California (USC) Roski Eye Institute in JAMA Ophthalmology found that the U.S. prevalence in visual impairment (VI) and blindness is expected to double over the next 35 years. By 2050, the number of Americans with a variety of eye disease and impairment issues, including age-related macular degeneration (AMD), glaucoma, diabetic retinopathy (DR) and cataracts, will dramatically increase impacting both individuals and society.

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Researchers repurposing E-Vac procedure to treat issues in the gastrointestinal tract.

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In a survey of high-achieving physician-scientists, nearly a third of women reported experiencing sexual harassment.

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In a survey of high-achieving physician-scientists, nearly a third of women reported experiencing sexual harassment.

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They may be small. They may be in rural towns. They may only have a couple of surgeons. But for common operations, critical access hospitals may be safer and less expensive than their larger cousins, a new study finds.

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In a massive analysis of DNA samples from more than 13,000 U.S. soldiers, scientists have identified two statistically significant genetic variants that may be associated with an increased risk of post-traumatic stress disorder (PTSD), an often serious mental illness linked to earlier exposure to a traumatic event, such as combat and an act of violence.

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A new study has found there is no decline over time in the accuracy of medical staff who analyse mammogram scans for indications of breast cancer. Research conducted at the University of Warwick investigated whether detection rates dropped towards the end of each batch of mammogram readings.

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A new study from researchers at the Perelman School of Medicine at the University of Pennsylvania, found that a simple change to prescription default options in electronic medical records immediately increased generic prescribing rates from 75 percent to 98 percent.

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ALS is a debilitating, progressive disease without a cure. Researchers now find pesticides and other environmental toxins could play a part in the disease’s onset.

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Offering virtual dermatology care significantly improved access to specialized skin care for a group of patients that traditionally has limited options, according to an independent study led by researchers at the RAND Corporation and Harvard Medical School’s Department of Health. The findings appear in a JAMA Dermatology article published online May 4.

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Miriam Hospital researcher leads effort to identify alternative ways to stop weight gain.

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On April 18, the National Institute on Minority Health and Health Disparities (NIMHD), part of the National Institutes of Health (NIH), announced the launch of an initiative to support research to better understand and address disparities in surgical care and outcomes for disadvantaged populations.

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An analysis by a University of North Carolina at Chapel Hill researcher reports in JAMA Oncology that a month of treatment with orally-administered cancer drugs introduced in 2014 were, on average, six times more expensive at launch than cancer drugs introduced in 2000 after adjusting for medical inflation. Drugs approved in 2000 cost an average of $1,869 per month compared to $11,325 for those approved in 2014.

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Among female registered nurses, working a rotating night shift for 5 years or more was associated with a small increase in the risk of coronary heart disease, according to a study appearing in the April 26 issue of JAMA.

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The addition of a house dust mite (HDM) sublingual allergen immunotherapy (SLIT) tablet to maintenance medications improved time to first moderate or severe asthma exacerbation during a period of inhaled corticosteroid (ICS) reduction among adults with HDM allergy-related asthma not well controlled by ICS, according to a study appearing in the April 26 issue of JAMA.

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In a study appearing in the April 26 issue of JAMA, Elizabeth A. Rafferty, M.D., formerly of Massachusetts General Hospital, Boston, and colleagues evaluated the screening performance of digital mammography combined with tomosynthesis (a type of imaging) compared with digital mammography alone for women with varying levels of breast density.

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In a study appearing in the April 26 issue of JAMA, Nancy R. Kressin, Ph.D., of the Veterans Affairs Boston Healthcare System, Boston University School of Medicine, and colleagues examined the content, readability, and understandability of dense breast notifications sent to women following screening mammography.