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What Clinicians Need to Know About Vitamins and Mineral Supplements
Manson JE, Bassuk SS.
ver resumen
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.

Interest in the Ketogenic Diet Grows
Abbasi J.
ver resumen
This Medical News article discusses clinical use of a very-low-carb, high-fat diet for weight loss and type 2 diabetes treatment.

Physician-Parents Whose Children Have Rare Diseases
Rule AL.
ver resumen
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.

Does Medicine Overemphasize IQ?
Emanuel EJ, Gudbranson E.
ver resumen
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 Cuba
Swanson RL, II, Hampton S, Green-McKenzie J, et al.
ver resumen
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.

Intracerebral Hemorrhage in Patients Receiving Oral Anticoagulants
Inohara T, Xian Y, Liang L, et al.
ver resumen
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.

Consensus Definitions for Sepsis and Septic Shock
Singer M, Deutschman CS, Seymour C, et al.
ver resumen
This article presents updated definitions of and clinical criteria for diagnosing sepsis and septic shock based on recommendations from an expert task force.

A Medical Student Shares Her Struggle With Depression
Gupta R.
ver resumen
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.

2014 Guideline for Management of High Blood Pressure
James PA, Oparil S, Carter BL, et al.
ver resumen
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.

Physicians Join Efforts to Curb Gun Violence
Kuehn BM.
ver resumen
In this Medical News story, physicians discuss their efforts aimed at addressing gun violence and injury.

A Different Kind of Precision Medicine: Choosing Words Wisely
Patel JJ.
ver resumen
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.

Evaluation of Chronic Traumatic Encephalopathy in Football Players
Mez J, Daneshvar DH, Kiernan PT, et al.
ver resumen
This case series investigated the neuropathological and clinical features of deceased football players with chronic traumatic encephalopathy whose brains were donated for research.

Pulmonary Embolism Rule-Out Criteria and Subsequent Thromboembolic Events
Freund Y, Cachanado M, Aubry A, et al.
ver resumen
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.

Association Between Playing Football in the NFL and Long-term Mortality in Retirement
Venkataramani AS, Gandhavadi M, Jena AB.
ver resumen
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.

Neurological Symptoms Among US Diplomats in Cuba
Muth CC, Lewis SL.
ver resumen
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.

Epilepsy Surgery for Pharmacoresistant Temporal Lobe Epilepsy A Decision Analysis
Choi H, Sell RL, Lenert L, et al.
ver resumen
Patients 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.
To quantify the potential survival benefit of anterior temporal lobe resection for patients with pharmacoresistant temporal lobe epilepsy vs continued medical management.
Monte 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 Measures
Life expectancy and quality-adjusted life expectancy.
Compared 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.
The 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.

Gun Law Reforms and Firearm Deaths in Australia
Chapman S, Alpers P, Jones M.
ver resumen
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.

A New Year’s Wish on Opioids
Sharfstein JM.
ver resumen
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.

β-Blockers After a Heart Attack
Abbasi J.
ver resumen
This Medical News article discusses whether all patients really need β-blockers after a heart attack.

Association Between Diet and Cardiometabolic Mortality in the United States
Micha R, Peñalvo JL, Cudhea F, et al.
ver resumen
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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