Curated News: JAMA

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16-Mar-2015 4:00 PM EDT
Are Antipsychotic Drugs More Dangerous to Dementia Patients Than We Think?
Michigan Medicine - University of Michigan

Drugs aimed at quelling the behavior problems of dementia patients may also hasten their deaths more than previously realized, a new study finds. The research adds more troubling evidence to the case against antipsychotic drugs as a treatment for the delusions, hallucinations and aggression that many people with Alzheimer’s disease experience.

Released: 17-Mar-2015 11:05 AM EDT
Genetic Markers Play Role in Who Benefits From Aspirin, NSAIDs to Lower Colon Cancer Risk
Indiana University

An Indiana University cancer researcher and her colleagues have identified genetic markers that may help determine who benefits from regular use of aspirin and other nonsteroidal anti-inflammatory drugs for lowering one’s risk of developing colorectal cancer.

13-Mar-2015 12:05 PM EDT
Effect of Aspirin, NSAIDs on Colorectal Cancer Risk May Differ From Genetic Variations
JAMA - Journal of the American Medical Association

Among approximately 19,000 individuals, the use of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with an overall lower risk of colorectal cancer, although this association differed according to certain genetic variations, according to a study in the March 17 issue of JAMA.

13-Mar-2015 12:05 PM EDT
Study Examines Diagnostic Accuracy of Pathologists Interpreting Breast Biopsies
JAMA - Journal of the American Medical Association

In a study in which pathologists provided diagnostic interpretation of breast biopsy slides, overall agreement between the individual pathologists' interpretations and that of an expert consensus panel was 75 percent, with the highest level of concordance for invasive breast cancer and lower levels of concordance for ductal carcinoma in situ and atypical hyperplasia, according to a study in the March 17 issue of JAMA.

13-Mar-2015 12:05 PM EDT
Early Imaging for Back Pain in Older Adults Not Associated With Better Outcomes
JAMA - Journal of the American Medical Association

Older adults who had spine imaging within 6 weeks of a new primary care visit for back pain had pain and disability over the following year that was not different from similar patients who did not undergo early imaging, according to a study in the March 17 issue of JAMA.

13-Mar-2015 12:05 PM EDT
Duration of Antiplatelet Therapy Following PCI, Risk of Adverse Events
JAMA - Journal of the American Medical Association

An additional 18 months of dual antiplatelet therapy among patients who received a bare metal coronary stent did not result in significant differences in rates of stent thrombosis (formation of a blood clot), major adverse cardiac and cerebrovascular events, or moderate or severe bleeding, compared to patients who received placebo, according to a study in the March 17 issue of JAMA. The authors note that limitations in sample size may make definitive conclusions regarding these findings difficult.

13-Mar-2015 12:05 PM EDT
Study Raises Concerns About Reporting of Noninferiority Trials
JAMA - Journal of the American Medical Association

An examination of the reporting of noninferiority clinical trials raises questions about the adequacy of their registration and results reporting within publicly accessible trial registries, according to a study in the March 17 issue of JAMA.

13-Mar-2015 1:05 PM EDT
The Link Between Aspirin, NSAIDs and Colon Cancer Prevention May Hinge on Genetic Variations
Fred Hutchinson Cancer Center

The link between taking aspirin, non-steroidal anti-inflammatory drugs, or NSAIDS, and colorectal cancer prevention is well established, but the mechanisms behind the protective effect have not been understood. A new study, co-led by investigators at Fred Hutchinson Cancer Research Center and published March 17 in JAMA, suggests this protection differs according to variations in DNA.

Released: 17-Mar-2015 10:05 AM EDT
Doctors Don't Always Agree on Breast Biopsies; Say Women with Aytpia or DCIS Should Seek Second Opinions
Norris Cotton Cancer Center Dartmouth-Hitchcock Medical Center

While doctors almost always agree on a pathological diagnosis of invasive breast cancer, there is room for improvement when diagnosing atypia (or atypical ductal hyperplasia-ADH) and DCIS (ductal carcinoma in-situ).

13-Mar-2015 12:05 PM EDT
Folic Acid Supplementation Among Adults with Hypertension Reduces Risk of Stroke
JAMA - Journal of the American Medical Association

In a study that included more than 20,000 adults in China with high blood pressure but without a history of stroke or heart attack, the combined use of the hypertension medication enalapril and folic acid, compared with enalapril alone, significantly reduced the risk of first stroke, according to a study appearing in JAMA. The study is being released to coincide with its presentation at the American College of Cardiology Annual Scientific Session.

10-Mar-2015 9:05 AM EDT
Geography Matters: Imaging Overuse Seen for Breast, Prostate Cancer in Certain Regions Across the U.S.
NYU Langone Health

Researchers from NYU Langone Medical Center conclude that patients with low-risk prostate or breast cancer were more likely to receive inappropriate imaging during treatment, based on the region of the country in which they received medical care.

12-Mar-2015 9:00 AM EDT
Harder-to-Abuse OxyContin Doesn’t Stop Illicit Use
Washington University in St. Louis

A reformulation of OxyContin that makes it less likely to be abused than the older formulation has curtailed the drug’s illicit use. But researchers at Washington University School of Medicine in St. Louis have found that a significant percentage still abuse the drug despite package labeling that emphasizes its abuse-deterrent properties.

5-Mar-2015 10:05 PM EST
Hospital Readmissions Following Severe Sepsis Often Preventable
JAMA - Journal of the American Medical Association

In an analysis of about 2,600 hospitalizations for severe sepsis, readmissions within 90 days were common, and approximately 40 percent occurred for diagnoses that could potentially be prevented or treated early to avoid hospitalization, according to a study in the March 10 issue of JAMA.

5-Mar-2015 10:05 PM EST
Lower Prevalence of Diabetes Found Among Patients With Inherited High Cholesterol Disorder
JAMA - Journal of the American Medical Association

The prevalence of type 2 diabetes among 25,000 patients with familial hypercholesterolemia (a genetic disorder characterized by high low-density lipoprotein [LDL] cholesterol levels) was significantly lower than among unaffected relatives, with the prevalence varying by the type of gene mutation, according to a study in the March 10 issue of JAMA.

5-Mar-2015 10:05 PM EST
Study Examines Outcomes for Patients One Year After Transcatheter Aortic Valve Replacement
JAMA - Journal of the American Medical Association

In an analysis of outcomes of about 12,000 patients who underwent transcatheter aortic valve replacement, death rate after one year was nearly one in four; of those alive at 12 months, almost half had not been rehospitalized and approximately 25 percent had only one hospitalization, according to a study in the March 10 issue of JAMA.

5-Mar-2015 10:05 PM EST
Study Compares Outcomes for Surgical vs Non-Surgical Treatment of Broken Shoulder
JAMA - Journal of the American Medical Association

Among patients with a displaced fracture in the upper arm near the shoulder (proximal humeral), there was no significant difference between surgical treatment and nonsurgical treatment in patient-reported outcomes over two years following the fracture, results that do not support the trend of increased surgery for patients with this type of fracture, according to a study in the March 10 issue of JAMA.

Released: 10-Mar-2015 11:00 AM EDT
Stopping the Revolving Door: Study Finds Sepsis Survivors Return to Hospital for Preventable Reasons
Michigan Medicine - University of Michigan

They’re alive thanks to the most advanced care modern hospitals can provide. But for survivors of sepsis, the hospital door often looks like a revolving one, a new study shows. And many of the conditions that send them back to a hospital bed should be preventable.

Released: 9-Mar-2015 2:05 PM EDT
Mood, Anxiety Disorders Common in Tourette Patients, Emerge at a Young Age
University of California, San Francisco (UCSF)

A new study of Tourette syndrome led by researchers from UC San Francisco and Massachusetts General Hospital has found that nearly 86 percent of patients who seek treatment for TS will be diagnosed with a second psychiatric disorder during their lifetimes, and that nearly 58 percent will receive two or more such diagnoses.

Released: 9-Mar-2015 12:05 PM EDT
Blood-Based Genetic Biomarkers Identify Young Boys with Autism
UC San Diego Health

In a study published in the current online issue of JAMA Psychiatry, an international team of scientists, led by researchers at the University of California, San Diego School of Medicine, report finding a highly accurate blood-based measure that could lead to development of a clinical test for autism spectrum disorder (ASD) risk in males as young as one to two years old. The test could be done in community pediatric settings.

Released: 9-Mar-2015 11:05 AM EDT
Two-Step Treatment Improved Function and Decreased Pain Severity in Veterans
Indiana University

A new study by researchers from the Richard L. Roudebush VA Medical Center in Indianapolis, the Regenstrief Institute and the Indiana University School of Medicine reports that a stepped-care strategy improved function and decreased pain severity, producing at least a 30 percent improvement in pain-related disability.

6-Mar-2015 11:00 AM EST
Youth Suicide Rate in Rural Areas Is Nearly Double the Rate in Cities
Ohio State University

The adolescent and young-adult suicide rate in the United States was almost twice as high in rural settings than in urban areas between 1996 and 2010, and new research suggests that the gap appears to be widening.

26-Feb-2015 3:05 PM EST
Intervention Results in More Stable Housing for Homeless Adults
JAMA - Journal of the American Medical Association

A program that included scattered-site supportive housing using rent supplements and case management services led to more stable housing for homeless adults with mental illness in four cities in Canada, compared with usual access to existing housing and community services, but the intervention did not result in significant improvements in health-related quality of life, according to a study in the March 3 issue of JAMA.

26-Feb-2015 3:05 PM EST
Administering Sedatives for Patients Receiving General Anesthesia Questioned
JAMA - Journal of the American Medical Association

Although sedatives are often administered before surgery, a randomized trial finds that among patients undergoing elective surgery under general anesthesia, receiving the sedative lorazepam before surgery, compared with placebo or no premedication, did not improve the self-reported patient experience the day after surgery, but was associated with longer time till removal off a breathing tube (extubation) and a lower rate of early cognitive recovery, according to a study in the March 3 issue of JAMA.

26-Feb-2015 3:05 PM EST
Long-Term Follow-Up of Benign Thyroid Nodules Shows Favorable Prognosis
JAMA - Journal of the American Medical Association

After five years of follow-up, a majority of asymptomatic, benign thyroid nodules exhibited no significant change in size, or actually decreased in size, and diagnoses of thyroid cancer were rare, according to a study in the March 3 issue of JAMA.

26-Feb-2015 3:05 PM EST
Examination of Prior Authorization Policies for Antipsychotic Prescribing to Children
JAMA - Journal of the American Medical Association

With a concern about inappropriate prescribing of antipsychotic medications to children, 31 states have implemented prior authorization policies for atypical antipsychotic prescribing, mostly within the past 5 years, and with most states applying their policies to children younger than 7 years of age, according to a study in the March 3 issue of JAMA.

26-Feb-2015 3:05 PM EST
Outcomes of Lung Transplantations Since Implementation of Need-Based Allocation System
JAMA - Journal of the American Medical Association

Since implementation of a medical need-based allocation system of donor lungs in 2005, double-lung transplantation has been associated with better graft survival than single-lung transplantation in patients with idiopathic pulmonary fibrosis (IPF); at 5 years, there has been no survival difference between single- and double-lung transplant recipients in patients with chronic obstructive pulmonary disease (COPD), according to a study in the March 3 issue of JAMA.

24-Feb-2015 11:40 AM EST
Published Outcomes Announced From Study on Adolescent Bariatric Surgery Safety
Nationwide Children's Hospital

Cardiovascular risks of severe pediatric obesity, assessed among adolescents participating in the “Teen Longitudinal Assessment of Bariatric Surgery” (Teen-LABS) study, were published this week in JAMA Pediatrics.

26-Feb-2015 12:05 PM EST
Guidelines Suggest Blood Thinners For More Women, Seniors With AFib
Duke Health

Nearly all women and people over 65 in the U.S. with atrial fibrillation are advised to take blood thinners under new guidelines based on an analysis from the Duke Clinical Research Institute.

2-Mar-2015 9:05 AM EST
Peanut Consumption Associated with Decreased Total Mortality and Mortality from Cardiovascular Diseases
Vanderbilt University Medical Center

Researchers at Vanderbilt University and the Shanghai Cancer Institute examined the association of nut consumption with mortality among low-income and racially diverse populations and found that intake of peanuts was associated with fewer deaths, especially from heart disease.

24-Feb-2015 5:00 PM EST
Study Linking Suicidal Behavior, Psychotic Experiences May Yield Strategies to Help Prevent Suicide Attempts
University of Maryland, Baltimore

A study published in JAMA Psychiatry examines suicidal ideation and psychotic experiences among more than 11,000 adults who were 18 and older. The data were drawn from a large general-population based sample of U. S. households households identified through the Collaborative Psychiatric Epidemiology Surveys (2001-2003).

19-Feb-2015 5:00 PM EST
Taking NSAIDs With Anti-Clotting Medications And Risk of Bleeding, CV Events
JAMA - Journal of the American Medical Association

Among patients receiving antithrombotic therapy (to prevent the formation of blood clots) after a heart attack, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with an increased risk of bleeding and events such as heart attack, stroke or cardiovascular death, even after short-term treatment, according to a study in the February 24 issue of JAMA.

19-Feb-2015 5:15 PM EST
Gene Variant and Risk and Severity of Nerve Disorder Linked to Cancer Drug
JAMA - Journal of the American Medical Association

Children with acute lymphoblastic leukemia who had a certain gene variant experienced a higher incidence and severity of peripheral neuropathy after receiving treatment with the cancer drug vincristine, according to a study in the February 24 issue of JAMA.

19-Feb-2015 5:00 PM EST
Study Suggests Need for More Sensitive Lung Cancer Screening Criteria
JAMA - Journal of the American Medical Association

An analysis of lung cancer incidence and screening found a decline in the proportion of patients with lung cancer meeting high-risk screening criteria, suggesting that an increasing number of patients with lung cancer would not have been candidates for screening, according to a study in the February 24 issue of JAMA.

19-Feb-2015 5:00 PM EST
Findings May Help With the Management of Anticoagulant-Related Bleeding Within the Brain
JAMA - Journal of the American Medical Association

Among patients with oral anticoagulation-associated intracerebral hemorrhage (bleeding within the brain), reversal of international normalized ratio below a certain level within 4 hours and systolic blood pressure less than 160 mm Hg at 4 hours were associated with lower rates of hematoma (a localized swelling filled with blood) enlargement, and resumption of anticoagulant therapy was associated with a lower risk of ischemic events without increased bleeding complications, according to a study in the February 24 issue of JAMA.

23-Feb-2015 4:00 PM EST
Decline in Smoking Rates May Increase Lung Cancer Mortality Due to Inadequate Screening Guidelines
Mayo Clinic

A decline in smoking rates may mean that many people who could have benefited from early detection of lung cancer are dying because they don’t qualify for low-dose CT scans, according to a group of Mayo Clinic researchers. Their research appears in the Feb. 24 issue of JAMA, the journal of the American Medical Association.

Released: 24-Feb-2015 11:00 AM EST
Inherited Gene Variation Leaves Young Leukemia Patients at Risk for Peripheral Neuropathy
St. Jude Children's Research Hospital

Researchers have identified the first genetic variation that is associated with increased risk and severity of peripheral neuropathy following treatment with a widely used anti-cancer drug. Investigators also found evidence of how it may be possible to protect young leukemia patients without jeopardizing cures. St. Jude Children’s Research Hospital scientists led the study, which appears today in the Journal of the American Medical Association.

Released: 19-Feb-2015 2:45 PM EST
New Study by UCLA Researchers Could Lead the Way for Better Assessment of Treatment Options for Men with Prostate Cancer
University of California, Los Angeles (UCLA), Health Sciences

UCLA researchers have found that radiation therapy is the most common treatment for men with prostate cancer regardless of the aggressiveness of the tumor, risk to the patient and overall patient prognosis. These findings lay the groundwork for improved treatment assessment by physicians and to better inform men fighting the disease.

12-Feb-2015 4:00 PM EST
Medication Therapy Can Increase Long-Term Success For Smokers Who Want to Cut Back First, Study Finds
Mayo Clinic

A study of more than 1,500 cigarette smokers who were not ready to quit smoking but were willing to cut back on cigarette consumption and combine their approach with varenicline (Chantix) increased their long-term success of quitting smoking. The multinational study is published in the February issue of the Journal of the American Medical Association.

12-Feb-2015 4:45 PM EST
Medication Effective in Helping Smokers Quit Gradually
JAMA - Journal of the American Medical Association

Among cigarette smokers not willing or able to quit smoking in the next month but willing to reduce with the goal of quitting in the next 3 months, use of the nicotine addiction medication varenicline for 24 weeks compared with placebo produced greater reductions in smoking prior to quitting and increased smoking cessation rates at the end of treatment and at 1 year, according to a study in the February 17 issue of JAMA.

12-Feb-2015 4:00 PM EST
Anticoagulant Linked With Lower Risk of Death Following Heart Attack Compared to Heparin
JAMA - Journal of the American Medical Association

Patients who experienced a certain type of heart attack who received the anticoagulant fondaparinux had a lower risk of major bleeding events and death both in the hospital and after six months compared to patients who received low-molecular-weight heparin (LMWH), although both groups had similar rates of subsequent heart attack or stroke, according to a study in the February 17 issue of JAMA.

12-Feb-2015 4:00 PM EST
Treatment for Severe Community-Acquired Pneumonia and High Inflammatory Response
JAMA - Journal of the American Medical Association

Among patients with severe community-acquired pneumonia and high initial inflammatory response, the use of the corticosteroid methylprednisolone decreased treatment failure, compared with placebo, according to a study in the February 17 issue of JAMA.

12-Feb-2015 4:00 PM EST
Study Shows Beneficial Effect of Electric Fans in Extreme Heat and Humidity
JAMA - Journal of the American Medical Association

Although some public health organizations advise against the use of electric fans in severe heat, a new study published in the February 17 issue of JAMA demonstrated that electric fans prevent heat-related elevations in heart rate and core body temperature.

12-Feb-2015 4:00 PM EST
Drug Improves Measures of Genetic Disease That Affects Liver, Spleen
JAMA - Journal of the American Medical Association

Among previously untreated adults with Gaucher disease type 1, a genetic disease in which there is improper metabolism due to a defect in an enzyme, treatment with the drug eliglustat resulted in significant improvements in liver and spleen size hemoglobin level, and platelet count, according to a study in the February 17 issue of JAMA.

Released: 16-Feb-2015 4:30 PM EST
Organizational Culture and Climate Predicts Use of Evidence-based Practices in the Treatment of Youth with Psychiatric Disorders
Perelman School of Medicine at the University of Pennsylvania

Many mental health therapists use treatments that have little evidence to support them. A new multi-institution study led by Penn Medicine has found that an organization’s culture and climate are better predictors of the use of evidence-based practices than an individual therapist’s characteristics in the treatment of children and adolescents with psychiatric disorders.

10-Feb-2015 12:00 PM EST
Cancer Patients Rarely Demand Unnecessary Tests and Treatments
Perelman School of Medicine at the University of Pennsylvania

Physicians often blame patient demands for contributing to high medical costs, however, a new Penn Medicine study involving more than 5,000 patient-clinician visits indicates that cancer patients rarely push for unnecessary tests and treatments from their health care providers.

5-Feb-2015 4:00 PM EST
BP-Lowering Treatment For Type 2 Diabetes Linked to Longer Survival
JAMA - Journal of the American Medical Association

Blood pressure-lowering treatment among patients with type 2 diabetes is associated with a lower risk of cardiovascular disease (CVD) and heart disease events and improved mortality, according to a study in the February 10 issue of JAMA.

5-Feb-2015 4:00 PM EST
Iron Supplementation Improves Hemoglobin Recovery Time Following Blood Donation
JAMA - Journal of the American Medical Association

Among blood donors with normal hemoglobin levels, low-dose oral iron supplementation, compared with no supplementation, reduced the time to recovery of the postdonation decrease in hemoglobin concentration in donors with low or higher levels of a marker of overall iron storage (ferritin), according to a study in the February 10 issue of JAMA.

5-Feb-2015 4:20 PM EST
Smartphone Applications, Wearable Devices Appear to be Accurate in Tracking Step Counts
JAMA - Journal of the American Medical Association

The testing of 10 smartphone applications and wearable devices intended to track physical activity found that most were accurate in tracking step counts, according to a study in the February 10 issue of JAMA.

5-Feb-2015 4:00 PM EST
Creatine Does Not Slow Rate of Parkinson Disease Progression
JAMA - Journal of the American Medical Association

Treatment with creatine monohydrate for at least 5 years for patients with early and treated Parkinson disease failed to slow clinical progression of the disease, compared with placebo, according to a study in the February 10 issue of JAMA.

5-Feb-2015 4:00 PM EST
Size of Biomarker Associated With Improved Survival Following Transplantation
JAMA - Journal of the American Medical Association

Among patients with severe aplastic anemia who received stem cell transplant from an unrelated donor, longer leukocyte (white blood cells) telomere length (a structure at the end of a chromosome) was associated with increased overall survival at 5 years, according to a study in the February 10 issue of JAMA.



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