In a retrospective cohort study of 227 521 Medicare beneficiaries who initiated treatment with rosiglitazone or pioglitazone from July 2006 to June 2009, Graham and colleagues Article found that compared with pioglitazone, prescription of rosiglitazone was associated with an increased risk of stroke, heart failure, and all-cause mortality and the composite of acute myocardial infarction, stroke, heart failure, and all-cause mortality. In an editorial, Juurlink Article discusses the evidence relating to the safety and efficacy of rosiglitazone.
Investigators from the Consortium on Safe Labor—a geographically representative consortium of 12 urban US medical centers—analyzed obstetric and neonatal data from 233 844 deliveries occurring between 2002 and 2008 to assess short-term respiratory morbidity in late preterm births (340/7 to 366/7 weeks' gestational age). The investigators report that compared with term births, late preterm births were associated with an increased risk of respiratory distress syndrome and other respiratory morbidity that decreased with each advancing week of gestation.
Reeves and colleagues analyzed data from women enrolled in the prospective Million Women Study to assess breast cancer risk—overall and by tumor subtype—associated with 14 single-nucleotide polymorphisms (SNPs) and in relation to a polygenic risk score based on the 7 most strongly associated SNPs. Among the authors' findings was that the polygenic risk score was significantly associated with breast cancer risk and was highly predictive of estrogen receptor–positive disease.
In an analysis of data from a voluntary consortium involving 25 Michigan hospitals and 62 surgeons who perform bariatric surgery procedures, Birkmeyer and colleagues examined the complication rates of different bariatric surgery procedures and variability across hospitals, including variability by procedure volume and center of excellence status. The authors report that among 15 275 patients who underwent 1 of 3 common bariatric surgery procedures between 2005 and 2009, 7.3% experienced perioperative complications, the majority of which were minor. Rates of serious complications were inversely associated with hospital and surgeon procedure volume and unrelated to center of excellence accreditation.
Witlox and colleagues assessed the association between delirium and long-term outcomes among elderly patients in a systematic review and meta-analysis of data from observational studies. The authors found that delirium was associated with increased risks of death, institutionalization, and dementia and was independent of age, sex, comorbid illness or illness severity, and presence of dementia at baseline.
In a systematic review of topical and systemic medications prescribed to treat the main clinical manifestations of primary Sjögren syndrome, Ramos-Casals and colleagues found empirical support for the use of pilocarpine and cevimeline for sicca features and topical cyclosporine for moderate and severe dry eye, but limited evidence to support the use of many drugs frequently prescribed.
“Some of my pandas are people. There's the aunt who housed me one summer. And the professor who wordlessly handed me $50 when I mentioned that I was traveling with $8 in my pocket. Two pandas.” From “A Panda Story.”
Unrecognized delirium in intensive care patients can cause lasting disability, yet screening tools and promising preventive strategies are underused.
Colonoscopy vs sigmoidoscopy for colorectal cancer screening
Patient-centered medical home: reducing diagnostic error
Medical leadership in a complex world
Miracles, choices, and justice: health care's future
How would you manage a 29-year-old woman with flulike symptoms? Go to www.jama.com to read the case, and submit your response, which may be selected for online publication. Submission deadline is August 8.
Theme Issue on Violence and Human Rights
For your patients: Information about Sjögren syndrome.
This Week in JAMA . JAMA. 2010;304(4):377. doi:10.1001/jama.2010.1043