Humans

The rate of severe maternal morbidity in US hospitals increased 45% between 2006 and 2015, according to a recent report from the Agency for Healthcare Research and Quality (AHRQ). During that 10-year period, the severe maternal morbidity rate increased from 101 per 10 000 delivery hospitalizations to 147 per 10 000, the authors found, noting that previous
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Hurricane Florence made landfall as a Category 1 storm near Wrightsville Beach, North Carolina, on Friday, September 14, 2018, with 90-mph winds. At the same time, 3 other named storms—Helene, Isaac, and Joyce—roamed the Atlantic; Tropical Storm Olivia had just passed over Hawaii; and “Super Typhoon” Mangkhut, the strongest tropical cyclone of 2018, was hours
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In the Original Investigation entitled “Five-Year Follow-up of Antibiotic Therapy for Uncomplicated Acute Appendicitis in the APPAC Randomized Clinical Trial,” published in the September 25, 2018, issue of JAMA,1 the box in Figure 1 describing 5-year follow-up for patients who were randomized to receive antibiotic therapy should have shown that all of the 30 patients
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To the Editor Dr Costa and colleagues for the UK WOLLF Collaborators found no improvement in disability at 12 months in patients with severe open fractures of the lower limb who received negative pressure wound therapy (NPWT) vs standard wound management.1 I would like to address some issues in the study. First, differences between NPWT
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Surgical fellowships have proliferated over the last 2 decades. Recent data suggest that the application process has become inefficient and costly, especially for candidates and programs in competitive surgical specialties.1 Although the Accreditation Council for Graduate Medical Education (ACGME) accredits many programs, other organizations, such as the Foundation for Surgical Fellowships, the Society of Surgical
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Supplementing diets with n-3 (omega-3) fatty acids did not prevent serious vascular events in patients with diabetes mellitus, found a trial in the New England Journal of Medicine. The 15 480 trial participants with diabetes but no atherosclerotic cardiovascular disease were randomly assigned to receive 1-g capsules of either n −3 fatty acids or an olive-oil
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Patients with hypertension may benefit from antihypertensive treatment with a calcium channel blocker and a lipid-lowering statin years after taking the medications, reported a long-term follow-up study in the Lancet. Patients who received amlodipine-based antihypertensive treatment had fewer stroke deaths—independent of blood pressure levels—and patients taking lipid-lowering atorvastatin had fewer cardiovascular deaths. In the original
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The US Preventive Services Task Force (USPSTF) has recently published recommendations on screening for intimate partner violence, elder abuse, and abuse of vulnerable adults. The Problem of Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults Intimate partner violence, also called domestic or dating violence, can be physical, sexual, or psychological (for example, stalking).
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Since the passage of the Affordable Care Act, there has been an unprecedented pace of testing new payment models to increase health care value. These models have been directed across the continuum of health care professionals and organizations, including physicians, hospitals, and post-acute care facilities. Collectively, these models aim to combine financial incentives for efficient
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Trial Design and Population This randomized, double-blind, placebo-controlled, phase 3 trial was conducted at 16 medical centers in the United States. Before we randomly assigned the patients to receive a trial drug or placebo, we obtained written informed consent from the patients or their authorized representatives. The institutional review board at each participating center approved
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Perhaps the most vexing problem in a patient in an intensive care unit (ICU) is an unexpected change in mental status. Historically, “acute encephalopathy” was the term used to encompass such alterations, but “delirium” is now used to describe this state. The Oxford English Dictionary defines delirium as “an acutely disturbed state of mind characterized
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Clinical heterogeneity is a hallmark of many autoimmune disorders, and clinical or subclinical pulmonary involvement is a common extraarticular feature of the rheumatoid arthritis (RA) phenotype. High-resolution computed tomography reveals evidence of pulmonary abnormalities in more than half of patients with RA, and clinically significant interstitial lung disease (ILD) will develop in approximately 10% of
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From Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Bichat–Claude Bernard, Departments of Rheumatology (P.-A.J., E.E., S. Ottaviani, P.D.), Genetics (C.K., C. Boileau), Pulmonology A (R.B., B.C.), Pulmonology B (G.T.), and Radiology (M.-P.D.), Département Hospitalo-Universitaire Fibrose Inflammation Remodelage, INSERM Unité Mixte de Recherche (UMR) 1152, Université Paris Diderot (P.-A.J., C.K., R.B., G.T., B.C., P.D.), Arthritis Recherche et
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Patients and Trial Interventions Figure 1. Figure 1. Randomization, Trial Populations, and Follow-up. Triple-negative breast cancer is breast cancer that does not express estrogen, progesterone, or human epidermal growth factor 2 (HER2) receptors. Patients may have been ineligible for inclusion in the trial for multiple reasons; the most common reasons are shown. The numbers of
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Patients A total of 521 patients were enrolled between October 7, 2013, and August 26, 2014 (Fig. S1 in the Supplementary Appendix, available at NEJM.org). A total of 347 patients were randomly assigned to the palbociclib–fulvestrant group and 174 to the placebo–fulvestrant group (intention-to-treat population). A total of 345 patients in the palbociclib–fulvestrant group and
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Preclinical Development The in vitro pharmacologic characteristics of VX-659 were evaluated in biochemical and functional studies alone and in dual and triple combination with tezacaftor–ivacaftor with the use of human bronchial epithelial cells derived from patients with cystic fibrosis and Phe508del–MF genotypes (four donors) or the Phe508del–Phe508del genotype (three donors). For details, see the Methods
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Cystic fibrosis is one of the most common life-threatening autosomal recessive disorders, affecting approximately 80,000 children and adults worldwide.1 It is caused by mutations that result in deficient or defective function of the cystic fibrosis transmembrane conductance regulator (CFTR), an anion channel that is normally present in epithelial membranes.2 In addition to the standard symptomatic
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VX-445–Tezacaftor–Ivacaftor In Vitro Figure 1. Figure 1. In Vitro Effects of VX-445 Alone or in Combination with TEZ, IVA, or TEZ–IVA. Panel A shows the results of immunoblotting from three independent experiments involving human bronchial epithelial (HBE) cells. (HBE cells for all experiments are from four Phe508del-MF donors and three Phe508del–Phe508del donors.) Panel B shows
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In the issues of June 7, 2001, and January 3, 2002, we published articles1,2 from the laboratory of Dr. Piero Anversa; at that time, the laboratory was located at the New York Medical College. In 2007, Anversa moved his laboratory to Brigham and Women’s Hospital, a major teaching hospital of Harvard Medical School. An institutional
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Unassuming farmland in Østfold County, Norway, was hiding a secret for centuries – and now it’s been rumbled. Using high-resolution ground-penetrating radar, archaeologists have found an ancient Viking cemetery, complete with what appears to be a well-preserved ship burial. A popular mode of interment among the Norse Vikings, ship burials consisting of a longboat covered
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To the Editor The Bougie Use in Emergency Airway Management (BEAM) trial demonstrated significantly higher first-pass intubation success with elective use of a bougie vs an endotracheal tube plus stylet in the emergency department (ED).1 In their discussion, Dr Driver and colleagues stated that prior to commencement of the trial, the majority of ED intubations
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In 2005, a trial supported by the National Institutes of Health (NIH) that included patients with a mean age of 60 years demonstrated that implantable cardioverter-defibrillators had improved survival rates over amiodarone in patients with congestive heart failure.1 This study and another that examined cardioverter-defibrillator therapy contributed to change in clinical practice.2 However, 40% of
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Biliary colic is the pain caused by gallstones. The gallbladder is a pouch the size of a lime that sits under the liver and stores bile. Bile is a dark green liquid composed of water, bile salts, and cholesterol that helps with digestion of food and absorption of fat and fat-soluble nutrients and vitamins. The
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In the Letter to the Editor entitled “Comparing Spending on Medical Care in the United States and Other Countries,” published in the August 28, 2018, issue of JAMA,1 the author affiliation for Louis J. Goodman, PhD, should have been the Physicians Foundation, Austin, Texas. In addition, the Conflict of Interest Disclosures should have read “Drs
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Dengue fever cases dropped in an Australian city after scientists joined with townspeople to release mosquitoes that were modified to prevent them from transmitting dengue virus and other disease-causing arboviruses. The results, posted to the Gates Open Research platform, indicate that releasing mosquitoes infected with the Wolbachia bacterium could be a cost-effective arbovirus control intervention
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Making sense of race is a difficult challenge for biomedicine. Should medicine focus on shared humanity or recognize the salience of racial and ethnic divisions? While physicians and patients continue to hope for a future free of racial animus, the unfortunate reality is that race continues to adversely affect the health and well-being of millions
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The FDA has approved a new treatment for adults with hairy cell leukemia who have received at least 2 prior systemic therapies, including a purine nucleoside analog. sciencesource.com Richard Pazdur, MD, director of the FDA’s Oncology Center of Excellence, noted that the newly approved drug, moxetumomab pasudotox-tdfk, “is the result of important research conducted by
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The complexities of social identity and genetic ancestry have led to confusion and consternation related to the use and interpretation of race, ethnicity, and ancestry data in biomedical research. These discussions and overt debates have intensified with advances in genomics and knowledge about how social factors interact with biology. As more information about genomic diversity
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A revolution in genomics is creeping into economics. It allows us to say something we might have suspected, but could never confirm: money trumps genes. Using one new, genome-based measure, economists found genetic endowments are distributed almost equally among children in low-income and high-income families. Success is not. The least-gifted children of high-income parents graduate
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