Curated News: JAMA

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A new study to be published online June 25 in JAMA Internal Medicine reports that hospital at home (HaH) care provides a shorter length of stay; reductions in hospital readmissions, emergency department visits, and transfers to skilled nursing facilities; and, improved patient experience versus traditional inpatient care. The study, which spans nearly three years, includes patients with the broadest set of admitting diagnoses ever to be researched, thus strengthening the evidence base for hospital at home care.

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Health care insurers including Medicare, Medicaid and major private insurers have not done enough to combat the opioid epidemic, suggests a study led by researchers at Johns Hopkins Bloomberg School of Public Health.

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In the first 90 days of concurrent opioid and benzodiazepine use, the risk of opioid-related overdose increases five-fold compared to opioid-only use among Medicare recipients, according to a new study from the University of Pittsburgh School of Pharmacy.

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Dr. Kyran Quinlan and colleagues at Rush issue an urgent call for prevention strategies for sleep-related infant deaths in his viewpoint, “Protecting Infants From Sleep-Related Deaths” published in the June 18 online issue of JAMA Pediatrics.

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Seis genes contêm mutações que podem ser transmitidas entre familiares, o que aumenta substancialmente o risco de uma pessoa ter câncer de pâncreas, de acordo com a pesquisa da Mayo Clinic publicada na edição de 19 de junho da JAMA. Contudo, como os pesquisadores descobriram essas mutações genéticas em pacientes sem histórico familiar de câncer de pâncreas, eles recomendam testes genéticos para todos os pacientes com câncer de pâncreas como o novo padrão de tratamento.

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根据6月19日在《美国医学会杂志》（JAMA.）上发表的一项Mayo Clinic的研究报告，六个基因含有可能在家系中传递的突变，这大大增加了一个人患pancreatic cancer的风险。 然而，由于研究人员在没有胰腺癌家族史的患者中也发现了这些基因突变，他们建议新的医疗标准来对所有胰腺癌患者进行基因检测。

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In a new study of breast cancer patients who had breast reconstruction, researchers examine complications across the different types of surgeries. For many women facing treatment for breast cancer, breast reconstruction after mastectomy is a quality of life issue. It is linked with feeling more feminine, or “whole again” after surgery.

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Rutgers Professor Stephen Crystal, who co-authored a pioneering study showing that U.S. survivors of opioid overdoses are highly likely to die within a year from drug use–related causes, suicide and wide-ranging diseases, is available for interviews. The study was published online in JAMA Psychiatry today.

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ROCHESTER, Minn. — Six genes contain mutations that may be passed down in families, substantially increasing a person’s risk for pancreatic cancer. That's according to Mayo Clinic research published in the June 19 edition of the JAMA. However, because researchers found these genetic mutations in patients with no family history of pancreatic cancer, they are recommending genetic testing for all pancreatic cancer patients as the new standard of care.

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A JAMA Pediatrics study shows that since 2003, the use of alternative medicines among children has doubled. Increased use of Omega-3 fatty acids and melatonin among adolescents ages 13 to 18 drives the change.

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A pair of recent studies performed by researchers at Children’s Hospital of Philadelphia (CHOP) and the University of Pennsylvania represents a significant step forward in understanding the role of the brain’s “reward circuit” and certain hallmarks of autism spectrum disorder (ASD), namely difficulty interpreting or engaging in typical social behavior and restricted or repetitive interests or behaviors.

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Research published in JAMA Internal Medicine found that tamsulosin does not significantly effect patient-reported passage or capture of kidney stones.

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A new Food-PRICE study finds persistent nutritional disparities within the food choices of those receiving assistance under the Supplemental Nutrition Assistance Program (SNAP) compared to those not receiving SNAP assistance.

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A study is the first to use gold-standard methods to test the hypothesis that antipsychotic treatment in youths adversely increases body fat and decreases insulin sensitivity. All three antipsychotics tested – oral aripiprazole, olanzapine, and risperidone, which are common first line use medications for children with nonpsychotic behavior disorders – increased not only total body fat, but also visceral and subcutaneous abdominal fat, associated with long-term risk for cardiovascular disease, high blood pressure and type 2 diabetes.

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A new study from University of Illinois at Chicago researchers suggests that more than one-third of U.S. adults may be using prescription medications that have the potential to cause depression or increase the risk of suicide.

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During 325 observations, researchers at the University of Utah and University of Michigan identified 283 protocol violations, which could increase the risk of self-contamination of health care personnel and transmission of antibiotic-resistant organisms to patients.

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Results of a large-scale study suggest that the oral diabetes drug metformin is safe for most diabetics who also have chronic kidney disease (CKD). The study of more than 150,000 adults by Johns Hopkins Medicine investigators found that metformin’s association with the development of a life-threatening condition called lactic acidosis was seen only among patients with severely decreased kidney function.

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Rutgers Global Health Institute’s director discusses how rejecting scientific facts can undermine progress in public health – and how the medical profession can further public understanding of science

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A new study shows a rapid rise in the percentage of hospitals that require their workers to be vaccinated against influenza – except among hospitals that focus on treating the nation’s military veterans. The percentage of Veterans Affairs hospitals that have a flu vaccine mandate rose from 1 percent in 2013 to 4 percent in 2017. But at the same time, the percentage of non-VA hospitals requiring shots rose from 44 percent to nearly 70 percent.

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Cancer is one of the leading causes of death among Americans. At least 10 percent of cancers are caused by inherited mutations in genes such as BRCA1 and BRCA2. Parents with the cancer gene mutation have a 50 percent chance of passing it on to a son or daughter. It’s well-known that women with BRCA are at a very high risk for breast and ovarian cancer.

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Persistent pain and recurrent episodes of pain are common for those who are living with cancer, or for those undergoing cancer treatment. When used properly, prescription opioids have long been known to help combat pain experienced by people with cancer.

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Results of a study of nearly 2,000 U.S. citizen children and their mothers add to growing evidence of the multigenerational, beneficial effects of the Deferred Action for Childhood Arrivals (DACA) immigration policy on children who are citizens, illustrating increased participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) among citizen children whose mothers are likely eligible for DACA.

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Addressing a critical issue for people with a genetic disorder called tuberous sclerosis complex (TSC), doctors at The University of Texas Health Science Center at Houston (UTHealth) reported that a skin cream containing rapamycin significantly reduced the disfiguring facial tumors affecting more than 90 percent of people with the condition.

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Each year in the U.S., more than 300,000 people have heart surgery. To reduce risk of stroke for their patients, surgeons often will close the left atrial appendage, which is a small sac in the left side of the heart where many blood clots form, during these surgeries. Mayo Clinic researchers report today in JAMA that adding this procedure is likely the right choice for certain patients but not all.

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a new study from researchers at Nationwide Children’s Hospital and collaborators published today in JAMA Pediatrics shows that racial disparities in suicide rates are age-related. Specifically, suicide rates for black children aged 5-12 were roughly two times higher than those of similarly-aged white children.

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Researchers have developed updated guidelines for classifying a serious form of skin cancer called invasive melanoma.

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A software tool to automatically calculate how extensively bones have been infiltrated by prostate cancer is both accurate and speedy, capturing key prognostic information related to survival and the development of symptoms over time.

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Children who underwent cardiac surgery were less likely to develop acute kidney injury if they had been treated with acetaminophen in the first 48 hours after their procedures, according to a Vanderbilt study just published in JAMA Pediatrics.

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A meditation and stress reduction program may be as effective at getting people to move as structured exercise programs, according to a study led by an Iowa State researcher. Jacob Meyer is part of another study that found resistance training reduces symptoms of depression.

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Researchers from the Smith Center for Outcomes Research in Cardiology at Beth Israel Deaconess Medical Center (BIDMC) provide a closer look at physicians’ knowledge, attitudes and beliefs about PCI public reporting.

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Very few depression patients receive the treatment once known as ‘shock therapy’. But a new cost-effectiveness study suggests that the modern form of the approach, called ECT, should be made more available to patients who fail to get relief from two other types of treatment.

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When the Centers for Medicare and Medicaid Services (CMS) announced controversial policies inviting states to establish work requirements as a condition to receive Medicaid, many in the medical community opposed it. If these measures continue to be approved – as is the case in Kentucky, Indiana, and Arkansas – CMS should act to minimize the potential harms they could cause to Medicaid recipients, two Penn Medicine experts in law and ethics argue in a new JAMA Viewpoint published this week, that lays out basic safeguards to help guide the states. “Promoting health, after all,” the authors note, “is the goal of Medicaid.”

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The APOE gene, the strongest genetic risk factor for Alzheimer’s disease, may play a more prominent role in disease development among women than men, according to new research from the Vanderbilt Memory and Alzheimer’s Center.

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Eye inflammation and uveal effusion develop among patients taking anti-cancer immune checkpoint inhibitor therapy.

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Researchers at Memorial Sloan Kettering (MSK) report that firefighters at the World Trade Center (WTC) scene in September 2001 were nearly twice as likely as the general population to have a multiple myeloma precursor condition called monoclonal gammopathy of undetermined significance (MGUS).

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Effect is greatest among those with highest illness burden

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They cost thousands of dollars, and insurance almost never covers them. But hearing aids may hold the potential to cut older adults’ visits to the hospital or emergency room, according to a new study. That could mean lower costs in the long run, though more research is needed to see if this is true. The study arrives at a time when discussion about adding Medicare coverage for hearing aids is rising.

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Research led by UNC School of Medicine student Wesley Stepp, PhD, shows how more detailed genetic testing of head and neck tumors could lead to more personalized treatments for patients.

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Study shows potential link between Parkinson’s disease and inflammatory bowel disease, suggests anti-TNFα therapy may reduce the risk of developing Parkinson’s disease

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Soldiers who deploy twice in one year, with six months or less between each deployment, could be at an increased risk for attempted suicide during or after their second deployment, according to a study published April 18.

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PAs increasingly used in dermatology to cut costs and improve access, but are less likely than dermatologists to accurately diagnose early stage skin cancers, according to new research.

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Are indoor tanners taking measures to prevent skin cancer? A researcher from Rutgers Cancer Institute of New Jersey and colleagues at Fox Chase Cancer Center found a majority of the indoor tanners analyzed in this study are not taking part in skin cancer screening.

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Colon polyps from patients with Lynch syndrome, a hereditary condition that raises colorectal cancer risk, display immune system activation well before cancer development, according to research from The University of Texas MD Anderson Cancer Center. The preclinical research challenges traditional models of cancer immune activation and suggests immunotherapy may be useful for colorectal cancer prevention in certain high-risk groups.

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Studying data from more than 125,000 individuals, an international team of researchers led by scientists at Washington University School of Medicine in St. Louis has identified genetic links between amyotrophic lateral sclerosis (ALS) and frontotemporal dementia. The link between the seemingly unrelated disorders suggests that some drugs developed to treat ALS also may work against frontotemporal dementia and vice versa.

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A new smartphone app allows Parkinson's disease patients and their doctors to better track the progression of symptoms, such as tremors and walking difficulties, that can vary dramatically over days, or even hours.

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People have a 50 percent higher risk of death if they suffer a shocking financial loss

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超过一半的美国医生表示他们在工作中曾经有过度劳累的问题。 今天，Mayo Clinic和其他领先的医疗中心发表了“医生健康章程”，作为医疗机构的一个 预期模型不仅要最大限度地减少和管理医生的劳累过度，而且还要促进医生的健康福利。 《美国医学会杂志》（JAMA）在线发表了该章程。该章程已经得到许多主要医疗机构（包括美国医学协会和美国医学院协会）的赞成或支持。

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MRIs show that babies with fragile X syndrome had less-developed white matter compared to infants that did not develop the condition. Imaging various sections of white matter from different angles can help researchers focus on the brain circuitry important for proper neuron communication.

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Hospital payment experiment in Maryland failed to deliver on the promise of shifting care from hospitals toward less expensive outpatient and primary care settings. Researchers say that weak incentives for physicians may have limited the program’s effectiveness.