April 12, 2016, Vol 315, No. 14, Pages 1425-1532

In This Issue of JAMA

Highlights

Abstract Full Text

free access has audio

JAMA. 2016;315(14):1425-1427. doi:10.1001/jama.2015.14201

Audio Editors' Summary: Managing agitation and infection in the ICU, does your patient have infectious mononucleosis?, and more

Original Investigation

Caring for the Critically Ill Patient

Incidence, Risk Factors, and Attributable Mortality of Secondary Infections in the Intensive Care Unit After Admission for Sepsis

Lonneke A. van Vught, MD; Peter M. C. Klein Klouwenberg, MD, PharmD, PhD; Cristian Spitoni, PhD; et al.

Abstract Full Text

free access

JAMA. 2016;315(14):1469-1479. doi:10.1001/jama.2016.2691

This prospective study sought to determine the incidence, risk factors, and attributable mortality of ICU-acquired infections in patients admitted with or without sepsis.

Editorial
Immunosuppression and Secondary Infection in Sepsis: Part, Not All, of the Story
Derek C. Angus, MD, MPH; Steven Opal, MD

Caring for the Critically Ill Patient

Effect of a Quality Improvement Intervention With Daily Round Checklists, Goal Setting, and Clinician Prompting on Mortality of Critically Ill Patients: A Randomized Clinical Trial

Writing Group for the CHECKLIST-ICU Investigators and the Brazilian Research in Intensive Care Network (BRICNet)

Abstract Full Text

free access

JAMA. 2016;315(14):1480-1490. doi:10.1001/jama.2016.3463

This cluster randomized trial investigated the effects of a quality improvement intervention comprising checklists, goal setting, and clinician follow-up vs routine care on mortality among adults in Brazilian intensive care units.

Association of Changes in Air Quality With Bronchitic Symptoms in Children in California, 1993-2012

Kiros Berhane, PhD; Chih-Chieh Chang, PhD; Rob McConnell, MD; et al.

Abstract Full Text

free access has multimedia has audio

JAMA. 2016;315(14):1491-1501. doi:10.1001/jama.2016.3444

This cohort study tracked children living in Southern California over 16 years to determine whether improvements in air quality were associated with reductions in bronchitic symptoms.

Audio Author Interview: Air Quality and Bronchitic Symptoms in Children

Preliminary Communication

Caring for the Critically Ill Patient

Effect of Dexmedetomidine Added to Standard Care on Ventilator-Free Time in Patients With Agitated Delirium: A Randomized Clinical Trial

Michael C. Reade, DPhil, FCICM; Glenn M. Eastwood, RN, PhD; Rinaldo Bellomo, MD, FCICM; et al.

Abstract Full Text

free access

JAMA. 2016;315(14):1460-1468. doi:10.1001/jama.2016.2707

This randomized clinical trial assesses the effectiveness of dexmedetomidine when added to standard care in patients with agitated delirium receiving mechanical ventilation.

Editorial
The Evolving Approach to Brain Dysfunction in Critically Ill Patients
E. Wesley Ely, MD, MPH; Pratik P. Pandharipande, MD, MSCI

Research Letter

Physicians’ Knowledge About FDA Approval Standards and Perceptions of the “Breakthrough Therapy” Designation

Aaron S. Kesselheim, MD, JD, MPH; Steven Woloshin, MD, MS; Wesley Eddings, PhD; et al.

Abstract Full Text

free access

JAMA. 2016;315(14):1516-1518. doi:10.1001/jama.2015.16984

This survey study examines how well physicians understand the US Food and Drug Administration’s (FDA’s) statutory definition of a “breakthrough” therapy, and whether the term breakthrough affects their perceptions of a drug’s efficacy.

Viewpoint

Innovations in Health Care Delivery

A Patient-Designed Do-It-Yourself Mobile Technology System for Diabetes: Promise and Challenges for a New Era in Medicine

Joyce M. Lee, MD, MPH; Emily Hirschfeld, BA; James Wedding, PE

Abstract Full Text

JAMA. 2016;315(14):1447-1448. doi:10.1001/jama.2016.1903

This Viewpoint uses the Nightscout Project, a patient-developed mobile technology system, to discuss safety, legal, and regulatory challenges to the broader use of mobile health technology.

Lifetime Perspectives on Primary Prevention of Atherosclerotic Cardiovascular Disease

Maarten J. G. Leening, MD, MSc; Jarett D. Berry, MD, MS; Norrina B. Allen, PhD, MPH

Abstract Full Text

JAMA. 2016;315(14):1449-1450. doi:10.1001/jama.2016.1654

This Viewpoint discusses the need for examination of long-term patterns across a broad range of risk factors in predicting patients’ lifetime risk of atherosclerotic cardiovascular disease.

Neglected Dimensions of Global Security: The Global Health Risk Framework Commission

Lawrence O. Gostin, JD; Carmen C. Mundaca-Shah, MD, DrPH; Patrick W. Kelley, MD, DrPH

Abstract Full Text

JAMA. 2016;315(14):1451-1452. doi:10.1001/jama.2016.1964

This Viewpoint discusses the Global Health Risk Framework Commission’s strategy to safeguard human and economic security from pandemic threats.

A Piece of My Mind

Mentorship Malpractice

Vineet Chopra, MD, MSc; Dana P. Edelson, MD, MS; Sanjay Saint, MD, MPH

Abstract Full Text

JAMA. 2016;315(14):1453-1454. doi:10.1001/jama.2015.18884

Editorial

The Evolving Approach to Brain Dysfunction in Critically Ill Patients

E. Wesley Ely, MD, MPH; Pratik P. Pandharipande, MD, MSCI

Abstract Full Text

JAMA. 2016;315(14):1455-1456. doi:10.1001/jama.2016.2708

Immunosuppression and Secondary Infection in Sepsis: Part, Not All, of the Story

Derek C. Angus, MD, MPH; Steven Opal, MD

Abstract Full Text

JAMA. 2016;315(14):1457-1459. doi:10.1001/jama.2016.2762

The Rational Clinical Examination

Does This Patient Have Infectious Mononucleosis?The Rational Clinical Examination Systematic Review

Mark H. Ebell, MD, MS; Marlene Call, RN, MPH; JoAnna Shinholser, MPH; et al.

Abstract Full Text

has audio

JAMA. 2016;315(14):1502-1509. doi:10.1001/jama.2016.2111

This Rational Clinical Examination systematic review summarizes the diagnostic accuracy of physical examination and laboratory findings for diagnosing infectious mononucleosis in adolescent and young adults.

Audio: Diagnosing Infectious Mononucleosis
JAMAevidence: Users' Guides to the Medical Literature: Measuring Agreement Beyond Chance With Dr Thomas McGinn

JAMA Clinical Guidelines Synopsis

Management of Atopic Dermatitis

Sarah L. Stein, MD; Adam S. Cifu, MD

Abstract Full Text

has audio

JAMA. 2016;315(14):1510-1511. doi:10.1001/jama.2016.1459

This JAMA Clinical Guidelines Synopsis summarizes the American Academy of Dermatology’s 2014 guideline on management of atopic dermatitis.

Audio Clinical Review: Treating Pediatric Eczema

From The Medical Letter on Drugs and Therapeutics

Safety of Testosterone Replacement Therapy

Abstract Full Text

JAMA. 2016;315(14):1512-1513. doi:10.1001/jama.2016.3450

This Medical Letter review summarizes the safety of testosterone therapy for the improvement of sexual function, physical function, and vitality in older men with low serum testosterone levels and symptoms suggesting hypoandrogenism.

Medical News & Perspectives

New Dietary Guidelines Place Added Sugars in the Crosshairs

Mike Mitka, MSJ

Abstract Full Text

JAMA. 2016;315(14):1440-1441. doi:10.1001/jama.2016.1321

This Medical News & Perspectives article discusses the recommendations on added sugar intake as part of the recent Dietary Guidelines released by the HHS and USDA.

The JAMA Forum