This randomized trial compares the effect of guiding PEEP titration using esophageal pressure vs empirical high PEEP–fraction of inspired oxygen (Fio2) on a composite of death and days free from mechanical ventilation at 28 days in patients with moderate to severe acute respiratory distress syndrome (ARDS).
This 2 × 2 factorial randomized clinical trial tests 2 nutritional strategies—multinutrient supplementation and food-related behavioral activation therapy—reduces major depressive disorder (MDD) over a year among overweight or obese European adults with elevated symptoms but without an MDD episode found neither approach reduced the number of episodes.
This randomized clinical trial tests the hypothesis that an integrated collaborative care intervention would significantly improve both obesity and depression at 12 months compared with usual care in adults with body mass indices of 30 or greater (≥27 for Asian adults) and 9-item Patient Health Questionnaire scores of 10 or greater.
This open-label, randomized clinical trial examined the effect of a behavioral intervention that included theoretical and practical counseling sessions vs general physician recommendations to increase physical activity on physical activity and sedentary time in participants with type 2 diabetes.
This Research Letter examines differences in the size of National Institutes of Health (NIH) grants awarded to first-time male and female principal investigators at top research institutions, including the Big Ten and Ivy League universities.
This Viewpoint discusses the evolving nature of the oncologist-patient relationship given the growth in complexity of information available to both, the costs of cancer care, and the long-term relationships that are newly developing as cancer treatments become more effective, and it calls for support systems that will facilitate informed conversations and clinical decisions.
This Viewpoint reviews the epidemiology and clinical presentation of acute flaccid myelitis (AFM) in the United States, highlighting evidence that enterovirus D68 is associated with seasonal biennial upsurges in AFM cases, and calls for support for virology research, studies to develop prevention and treatment strategies, and enhanced epidemiologic surveillance to contain future outbreaks.
This Viewpoint reviews unintended consequences of the 1983 Orphan Drug Act, which incentivized development of drugs for rare diseases, including abbreviated approval processes for manufacturers and surges in drug costs, and calls for revision of the “orphan drug” definition in an era where precision medicine will narrow patient populations sufficiently to make any drug qualify for an “orphan” designation.
This Viewpoint explains how the 2018 Farm Bill, legislation that authorizes an array of major food and agriculture programs in the United States, is a powerful but underutilized tool for promoting public health, reducing health care spending, and addressing disparities by improving access to better nutrition and reducing the prevalence of diet-related diseases.
This narrative medicine essay uses an instance when the physician-author’s elderly mother was screened for intimate partner violence to discuss electronic health record (EHR) ‘hard stops,’ an EHR function that forces a response before a visit can proceed as an implementation of CMS ‘meaningful use’ that, the author claims, is neither meaningful nor useful and possibly harmful.
This JAMA Genomics and Precision Health article explains how next-generation sequencing can be used to identify pathogens and provide insights into disease transmission, virulence, and antimicrobial resistance.
This JAMA Clinical Guidelines Synopsis summarizes the Infectious Diseases Society of America’s (IDSA’s) 2017 guideline on diagnosis and management of infectious diarrhea in children and adults.
A 54-year-old man who had undergone Roux-en-Y gastric bypass 12 years ago presented for evaluation of new-onset pancytopenia. Histopathologic examination of bone marrow aspirate showed normocellular marrow, dyserythropoiesis with vacuolized and dysplastic erythroid precursors, left-shifted granulocytic maturation, ring sideroblasts with no increase in blasts, and no cytogenic abnormalities. What would you do next?
This Medical News story discusses hospital-led initiatives aimed at providing housing for homeless people to improve their health and well-being.
This Medical News feature summarizes a recent study exploring how tumor biology contributes to sex differences in glioblastoma survival.
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