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Manson JE, Bassuk SS.
This Viewpoint reviews the evidence supporting use of specific vitamin and mineral supplements in healthy and high-risk populations, and provides general guidance about appropriate and inappropriate use of such supplements in generally healthy people.
This Medical News article discusses clinical use of a very-low-carb, high-fat diet for weight loss and type 2 diabetes treatment.
In this essay, a critical care pediatric hospitalist finds herself on the other side of the office table advocating for the specific medical care needed to address her son’s rare skeletal dysplasia and her search for a pediatric specialist with whom to travel on this quest.
Emanuel EJ, Gudbranson E.
In this Viewpoint, Ezekiel Emanuel argues that emotional intelligence (EQ) is as important as IQ for the effective practice of medicine and calls for medical schools to evaluate the EQ of applicants and provide opportunities to enhance EQ among medical students.
Clinical Findings and Outcomes in US Government Personnel Reporting Directional Sensory Phenomena in Cuba15/2/2018
Swanson RL, II, Hampton S, Green-McKenzie J, et al.
This case series describes findings from the clinical evaluation of US government personnel reporting symptoms after exposure to directional audible and sensory phenomena during their postings in Havana, Cuba, and their clinical outcomes after rehabilitation.
Inohara T, Xian Y, Liang L, et al.
This cohort study compares the association between use of warfarin vs non–vitamin K oral anticoagulants (NOACs) and in-hospital mortality among patients with intracerebral hemorrhage.
Singer M, Deutschman CS, Seymour C, et al.
This article presents updated definitions of and clinical criteria for diagnosing sepsis and septic shock based on recommendations from an expert task force.
In this essay, a young medical student describes her struggle with depression and how the experience of vulnerability has bred a deep compassion for her patients and peers.
James PA, Oparil S, Carter BL, et al.
In the report from the panel members appointed to the Eighth Joint National Committee (JNC 8), the guideline authors provide evidence-based recommendations for the management of hypertension including specific goals by age, race, and comorbidities.
In this Medical News story, physicians discuss their efforts aimed at addressing gun violence and injury.
In this essay, the author shows moments when the words he and other physicians used alienated his patient and family, interfered with fully understanding a patient’s medical needs, and impaired clinical judgment.
Mez J, Daneshvar DH, Kiernan PT, et al.
This case series investigated the neuropathological and clinical features of deceased football players with chronic traumatic encephalopathy whose brains were donated for research.
Freund Y, Cachanado M, Aubry A, et al.
This crossover cluster–randomized clinical noninferiority trial compared the safety of using pulmonary embolism rule-out criteria (PERC) vs a conventional strategy (D-dimer and CTPA) for excluding the diagnosis of pulmonary embolism (PE) among emergency department patients with low clinical probability of PE.
Venkataramani AS, Gandhavadi M, Jena AB.
This cohort study examines the association between career participation in professional American football and mortality risk in retirement, and it compares causes of death among career vs replacement players.
Muth CC, Lewis SL.
The primary value of publishing case reports and case series in the medical literature involves the documentation of symptoms, signs, and clinical data in a unique group of individuals. Often at the time of initial report, the fundamental etiology and pathophysiologic mechanism underlying the clinical phenomena are not yet fully understood, but the clear description of potentially pertinent data serves as a foundation on which other clinicians and investigators can build.
Choi H, Sell RL, Lenert L, et al.
ContextPatients with pharmacoresistant epilepsy have increased mortality compared with the general population, but patients with pharmacoresistant temporal lobe epilepsy who meet criteria for surgery and who become seizure-free after anterior temporal lobe resection have reduced excess mortality vs those with persistent seizures.
ObjectiveTo quantify the potential survival benefit of anterior temporal lobe resection for patients with pharmacoresistant temporal lobe epilepsy vs continued medical management.
DesignMonte Carlo simulation model that incorporates possible surgical complications and seizure status, with 10 000 runs. The model was populated with health-related quality-of-life data obtained directly from patients and data from the medical literature. Insufficient data were available to assess gamma-knife radiosurgery or vagal nerve stimulation.
Main Outcome MeasuresLife expectancy and quality-adjusted life expectancy.
ResultsCompared with medical management, anterior temporal lobe resection for a 35-year-old patient with an epileptogenic zone identified in the anterior temporal lobe would increase survival by 5.0 years (95% CI, 2.1-9.2) with surgery preferred in 100% of the simulations. Anterior temporal lobe resection would increase quality-adjusted life expectancy by 7.5 quality-adjusted life-years (95%, CI, −0.8 to 17.4) with surgery preferred in 96.5% of the simulations, primarily due to increased years spent without disabling seizures, thereby reducing seizure-related excess mortality and improving quality of life. The results were robust to sensitivity analyses.
ConclusionThe decision analysis model suggests that on average anterior temporal lobe resection should provide substantial gains in life expectancy and quality-adjusted life expectancy for surgically eligible patients with pharmacoresistant temporal lobe epilepsy compared with medical management.
Chapman S, Alpers P, Jones M.
This population epidemiology study uses government statistics to compare the number of mass fatal shootings, firearm deaths, and firearm-related and all-cause homicide and suicides before and after enactment of gun law reforms in Australia in 1996.
As overdose deaths mount, leading to a decline in US life expectancy 2 years in a row, my New Year’s wish is for more people to appreciate this statement: Not all well-intentioned approaches to addressing the opioid epidemic are good ideas. Some are based on evidence and experience, others on misunderstanding, blame, fear, or frustration. What’s needed in 2018 is the wisdom—and the courage—to tell the difference.
This Medical News article discusses whether all patients really need β-blockers after a heart attack.
Micha R, Peñalvo JL, Cudhea F, et al.
This nutritional epidemiology study uses NHANES data to estimate associations between dietary components and mortality due to heart disease, stroke, and type 2 diabetes among US adults between 2002 and 2012.
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