This randomized trial compares the effects of low vs intermediate tidal volumes on ventilator-free days and mortality among intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS).
This randomized trial compares the effects of protocolized weaning via early extubation to noninvasive ventilation vs standard weaning from invasive ventilation on time to liberation from mechanical ventilation among adults with respiratory failure ready to wean but with an unsuccessful spontaneous breathing trial.
This cluster randomized trial investigates the effects on medication discontinuation of a program in which pharmacists educated older patients taking benzodiazepines, sedative-hypnotics, first-generation antihistamines, and selective NSAIDs about why the drugs are inappropriate for their age groups and offered potential alternative treatment options.
This study assesses the availability of pharmacist-furnished naloxone 2 years after implementation of legislation in California allowing provision of the drug without a physician’s prescription.
This study evaluated naloxone accessibility from chain pharmacies in Texas 32 months after state legislation allowing pharmacists to dispense naloxone under standing orders from authorizing prescribers.
This 2018 Recommendation Statement from the US Preventive Services Task Force recommends screening for unhealthy alcohol use in primary care settings in adults, including pregnant women, and providing brief behavioral counseling to reduce unhealthy alcohol use (B recommendation) and concludes that evidence is insufficient to assess balance of benefits and harms of screening and counseling for alcohol use in primary care settings in adolescents (I statement).
This systematic review to support the 2018 US Preventive Services Task Force Recommendation Statement on screening and behavioral counseling to reduce unhealthy alcohol use summarizes published evidence on the benefits and harms of screening and behavioral counseling to reduce unhealthy alcohol use among adults.
This Viewpoint discusses the retention of gadolinium, used in contrast-enhanced MRI, in skin and kidney tissue and the efforts of experts from radiological societies, the NIH, and the FDA to study the safety of this element in clinical use.
This Viewpoint discusses the use of quality improvement reviews to build consensus about when randomized trials of competing treatment strategies are indicated and to inform the design and conduct of comparative effectiveness trials in emergency trauma.
This Viewpoint describes the Million Hearts initiative, a US Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services program aimed at preventing 1 million acute cardiovascular (CV) events by improving key cardiovascular disease (CVD) risk factors, and summarizes two 2018 CDC reports describing the burden of preventable CVD deaths and the slow rate of improving population-level measures of CV health.
This Viewpoint explains how group purchasing organizations (GPOs) – companies that purchase devices, supplies, and medication from multiple manufacturers and serve as single supply sources for hospitals and medical centers – contribute to supply shortages, higher prices, and limited product selection, and proposes policy solutions to overcome the adverse effects of the arrangements.
In this narrative medicine essay, the author mourns the suicide of young adult of a friend and relives his brother’s suicide 30 years earlier in a stream of consiousness montage of grief and advice to succor for those left behind.
This Genomics and Precision Health article explains the use of genomic testing in clinical settings when a genetic basis for disease is suspected, but the evaluation has not provided enough specificity to guide selection of a single gene test or a gene panel test.
This Medical News article discusses why many patients have mistakenly been labeled as allergic to penicillin and the impact that can have on their health.
This Medical News article discusses a recently discovered association between time of year and cognitive performance even in people with Alzheimer disease.
This JAMA Patient Page describes the US Preventive Services Task Force’s recent recommendations on screening and counseling to reduce unhealthy alcohol use.
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