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JAMA Internal Medicine - recientes

December 2017 Issue Highlights
1/12/2017
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Evolution of Procedural Competency in Internal Medicine Training
1/12/2017
Sacks CA, Alba GA, Miloslavsky EM.
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This Viewpoint examines the implications of changing the scope of procedural training for general practitioners in internal medicine.

Clinical Care of Lesbian, Gay, Bisexual, and Transgender Older Adults
1/12/2017
Torke AM, Carnahan JL.
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This Viewpoint suggests several recommendations for quality care for lesbian, gay, bisexual, and transgender older adults that are informed by research evidence and expert opinion.

The Road to Zero Deaths From Motor Vehicle Crashes
1/12/2017
Hersman DP, Rosekind MR.
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This Viewpoint highlights the role of the health care community in reducing the number of deaths from motor vehicle crashes.

Compounded Bioidentical Hormone Therapy
1/12/2017
Stuenkel CA, Manson JE.
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This Viewpoint discusses the potential harms of perimenopausal and postmenopausal women taking compounded bioidentical hormone therapy not approved by the US Food and Drug Administration.

Music and Medicine: Something Important
1/12/2017
Fitzgibbons S.
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“You got any Gershwin?”

Residency Evaluations—Where Is the Patient Voice?
1/12/2017
Tummalapalli S.
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This Perspective discusses the importance of patient feedback during residency training and proposes how to include it.

The Epidemic of Guns
1/12/2017
Bauchner H, Rivara FP, Bonow RO, et al.
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The shooting in Las Vegas, Nevada, that left 59 people dead, 10 times that number wounded, and thousands of people with the psychological distress from being present at the scene during and after the massacre has once again raised the issue of what we as a nation can and should do about guns. The solution lies in not just focusing on Las Vegas and the hundreds of other mass shootings that have occurred in the United States in the last 14 months, but rather to underscore that on average almost 100 people die each day in the United States from gun violence. The 36 252 deaths from firearms in the United States in 2015 exceeded the number of deaths from motor vehicle traffic crashes that year (36 161). That same year, the US Centers for Disease Control and Prevention reported that 5 people died from terrorism. Since 1968, more individuals in the United States have died from gun violence than in battle during all the wars the country has fought since its inception.

Cancer Survivorship Care in Advanced Primary Care Practices
1/12/2017
Rubinstein EB, Miller WL, Hudson SV, et al.
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This case study of 12 advanced primary care practices investigates why primary care has not begun to integrate comprehensive cancer survivorship services.

Gestational Diabetes and Long-term Cardiovascular Disease Risk
1/12/2017
Tobias DK, Stuart JJ, Li S, et al.
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This cohort study of US women participating in the Nurses’ Health Study II prospectively evaluates the association of a history of gestational diabetes with incident cardiovascular risk.

Wealth-Associated Disparities in Death and Disability in the United States and England
1/12/2017
Makaroun LK, Brown RT, Diaz-Ramirez L, et al.
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This cohort study evaluates the association between wealth, mortality, and disability among older adults in both the United States and England.

Cost-effectiveness of Testing and Treatment for Latent Tuberculosis
1/12/2017
Tasillo A, Salomon JA, Trikalinos TA, et al.
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This cohort simulation model evaluates the use of tests and treatment of latent tuberculosis infection in residents born outside the United States.

Work-Family Conflict and Depression Among Male and Female Interns
1/12/2017
Guille C, Frank E, Zhao Z, et al.
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This prospective longitudinal study examines the increase in depressive symptoms during physicians’ internship year, its potentially disproportionate effect on women, and work-family conflict as a risk factor.

Warfarin Use and Lower Cancer Incidence Among Older Patients
1/12/2017
Haaland GS, Falk RS, Straume O, et al.
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This population-based cohort study uses the Norwegian national registries to determine the association between warfarin use and cancer incidence among persons aged 52 to 82 years.

Hospital Resource Use and Outcomes of Hospitalists vs PCPs vs Generalists
1/12/2017
Stevens JP, Nyweide DJ, Maresh S, et al.
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This cohort study uses Medicare claims data to examine differences in health care resource use and outcomes among hospitalized Medicare beneficiaries cared for by hospitalists, their own primary care physicians, or other generalists.

Cessation Advice Plus Active Referral for Smokers
1/12/2017
Wang M, Suen Y, Li W, et al.
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This pragmatic cluster randomized clinical trial evaluates the effectiveness of advice plus referral to smoking cessation services in individuals with varying levels and lengths of smoking.

Patient Navigation and Financial Incentives on Smoking Cessation
1/12/2017
Lasser KE, Quintiliani LM, Truong V, et al.
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This randomized clinical trial evaluates a multicomponent intervention to promote smoking cessation among smokers with low socioeconomic status and smokers who are minorities.

Long-term Sustainability of Diabetes Prevention
1/12/2017
Haw J, Galaviz KI, Straus AN, et al.
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This meta-analysis examines the use of medications and lifestyle modifications to reduce the progression to diabetes in persons with diabetes risks.

Integration of Cancer Survivorship Care and Primary Care Practice
1/12/2017
Tonorezos ES, Conigliaro J.
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More than 10 years ago, the Institute of Medicine (IOM) released a seminal report, From Cancer Patient to Cancer Survivor: Lost in Transition. In this publication, the IOM highlighted the now more than 15 million US adults with a history of cancer and outlined necessary components of high-quality survivorship care. Not unexpectedly, implementation of the IOM recommendations relied on the availability of well-informed and responsive primary care survivorship clinicians. Yet, in the time since that report, the primary care and oncology workforce has shrunk (and will continue to do so), while clinician uncertainty and survivorship knowledge gaps persist. Therefore, although oncologists, patients, and other stakeholders are looking toward a primary care context for high-quality and life-sustaining survivorship care, uneven survivorship care delivery has continued. Unfortunately, failure to meet the health care needs of cancer survivors seems to result in adverse outcomes.

Pregnancy and Glucose Intolerance in Women of Childbearing Age
1/12/2017
Gunderson EP, Jaffe MG.
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The increased physiologic and metabolic demands of pregnancy act as a “stress test” that may reveal underlying subclinical disease or provide insight into future chronic disease. Pregnancy complications, such as gestational diabetes (GD) and hypertensive disorders, are “early warning” signs for chronic disease in women decades before the menopausal transition. More than 50 years ago, O’Sullivan and Mahan developed criteria for the diagnosis of GD, glucose intolerance first recognized during pregnancy, based solely on observed higher rates of progression to diabetes in women many years postdelivery. A history of GD confers a 7-fold higher risk of type 2 diabetes mellitus and 3-fold higher cardiometabolic risk for women. In 2011, the American Heart Association added GD history to its CVD risk assessment for women based on the strong link to overt diabetes. Until recently, evidence was insufficient to determine whether a history of GD elevated CVD risk independent of its association with overt diabetes and metabolic disease.







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