David R. Vinson, MD; Dustin G. Mark, MD; Uli K. Chettipally, MD, MPH; Jie Huang, PhD; Adina S. Rauchwerger, MPH; Mary E. Reed, DrPH; James S. Lin, MD; Mamata V. Kene, MD, MPH; David H. Wang, MD; Dana R. Sax, MD, MPH; Tamara S. Pleshakov, DO; Ian D. McLachlan, MD, MPH; Cyrus K. Yamin, MD; Andrew R. Elms, MD; Hilary R. Iskin, BA; Ridhima Vemula, BA; Donald M. Yealy, MD; Dustin W. Ballard, MD, MBE; for the eSPEED Investigators of the KP CREST Network
Despite the well-established safety of outpatient treatment for pulmonary embolism in appropriately selected, low-risk patients, most continue to be hospitalized for initiation of treatment. This multicenter clinical trial tested whether delivery of a focused clinical decision support system could safely increase the number of patients with acute pulmonary embolism who are discharged to home from the emergency department.
Katherine G. Hastings, MPH; Derek B. Boothroyd, PhD; Kristopher Kapphahn, MS; Jiaqi Hu, MPH; David H. Rehkopf, ScD, MPH; Mark R. Cullen, MD; Latha Palaniappan, MD, MS
Recent studies of state-level data suggest that the United States is experiencing a transition from heart disease to cancer as the leading cause of death. This analysis provides data on this “new epidemiologic transition” at the county level and by socioeconomic characteristics.
Lilia M. Cortina, PhD; Reshma Jagsi, MD, DPhil
The medical profession is not immune from sexual harassment, and culture change is needed. The authors discuss taxonomies and findings from the social sciences that merit consideration by the medical profession as it strives to change culture to prevent sexual harassment.
Paul D. Stein, MD; Mary J. Hughes, DO
In their article, Vinson and colleagues add to mounting evidence for the safety of home treatment of selected patients with pulmonary embolism. The editorialists discuss the findings and speculate why few stable patients receive home treatment despite evidence of its safety in selected patients and cost-effectiveness.
Silvia Stringhini, PhD; Idris Guessous, MD, PhD
A combination of increased prevention and improved medical treatment of cardiovascular disease has allowed cancer to gradually replace heart disease as the leading cause of death in high-income countries over the past decade. The study by Hastings and colleagues in this issue provides a lens for interpreting the population dynamics related to the epidemiologic transition. The editorialists discuss the findings from a social epidemiology perspective.
Muhammad Hammadah, MD; Jeong Hwan Kim, MD; Ayman Samman Tahhan, MD; Bryan Kindya, MD; Chang Liu, MPH; Yi-An Ko, PhD; Ibhar Al Mheid, MD; Kobina Wilmot, MD; Ronnie Ramadan, MD; Ayman Alkhoder, MD; Fahad Choudhary, MD; Mohamad Mazen Gafeer, MD; Naser Abdelhadi, MD; Pratik Pimple, MBBS, MPH; Pratik Sandesara, MD; Bruno B. Lima, MD; Amit J. Shah, MD; Laura Ward, MPH; Michael Kutner, PhD; J. Douglas Bremner, MD; David S. Sheps, MD; Paolo Raggi, MD; Laurence S. Sperling, MD; Viola Vaccarino, MD, PhD; Arshed A. Quyyumi, MD
Although guidelines recommend against routine surveillance cardiac stress testing for patients with known, stable ischemic heart disease, such testing is frequently performed. This study evaluated whether blood levels of high-sensitivity cardiac troponin can rule out inducible myocardial ischemia in patients with stable coronary artery disease.
Mark Levine, MD; Michael Fraser, PhD, MS
The U.S. Centers for Disease Control and Prevention's report of 116 overdose deaths a day from prescription and illicit opioids in 2016 underscores the need for urgent action to prevent overdose deaths, promote evidence-based programs for treatment and recovery, and implement programs and policies that support the primary prevention of addiction. The authors of this commentary recognize the desire policymakers and practitioners have for a “silver bullet” to address pressing public health problems. However, no single public health tactic or policy will end the opioid crisis.
Anjali B. Thakkar, MD, MBA; Sukumar P. Desai, MD
Jeremy Swan and William Ganz developed their eponymous pulmonary artery catheter in the 1970s, and its use came to define critical care medicine in the late 20th century. This article describes the natural life cycle of this catheter as new, less invasive technology arrived to replace it.
P.J. Devereaux, MD, PhD
Hammadah and colleagues explored whether a high-sensitivity cardiac troponin I measurement could exclude inducible ischemia. The editorialist discusses why their observations are an important contribution to the area of prognostication in patients with stable coronary artery disease.
Peter Louis Loper Jr., MD
How might we be delivered from both this fast-food addiction and the addictions promoted by our health care system?
Darren B. Taichman, MD, PhD
Xiao Jing Wang, MD; Harmeet Malhi, MD
Robert M. Centor, MD; Rodney A. Hayward, MD
In this episode of Annals On Call, Dr. Centor discusses an update of the pooled cohort equations used to estimate atherosclerotic cardiovascular disease risk with Dr. Rodney Hayward. Dr. Hayward was a co-investigator on a recent study that updated the equations to improve prediction in sex and race subgroups.
Emily Steinberg, MFA
Annals Graphic Medicine brings together original graphic narratives, comics, animation/video, and other creative forms by those who provide or receive health care. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.
David Arterburn, MD, MPH; Robert Wellman, MS; Ana Emiliano, MD; Steven R. Smith, MD; Andrew O. Odegaard, PhD, MPH; Sameer Murali, MD; Neely Williams, MDiv; Karen J. Coleman, PhD; Anita Courcoulas, MD, MPH; R. Yates Coley, PhD; Jane Anau, BS; Roy Pardee, JD, MA; Sengwee Toh, ScD; Cheri Janning, RN, BSN, MS; Andrea Cook, PhD; Jessica Sturtevant, MS; Casie Horgan, MPH; Kathleen M. McTigue, MD, MPH, MS; for the PCORnet Bariatric Study Collaborative
To compare weight loss at 1, 3, and 5 years after bariatric procedures and adverse events within 30 days, this study analyzed data from 41 health systems in the National Patient-Centered Clinical Research Network. The researchers compared outcomes in patients who had Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding procedures.
Matthieu Roustit, PharmD, PhD; Joris Giai, MD, MSc; Olivier Gaget, MD; Charles Khouri, PharmD; Myriam Mouhib, PharmD; Adrien Lotito, PharmD; Sophie Blaise, MD, PhD; Christophe Seinturier, MD; Fabien Subtil, PhD; Adeline Paris, PharmD, PhD; Claire Cracowski, MD; Bernard Imbert, MD; Patrick Carpentier, MD, PhD; Sunita Vohra, MD, PhD; Jean-Luc Cracowski, MD, PhD
Raynaud phenomenon characteristically occurs during exposure to cold. Using a series of randomized, double-blind, n-of-1 trials, the authors assessed the efficacy and safety of on-demand sildenafil as an alternative to daily treatment for RP.
Angela Lowenstern, MD; Sana M. Al-Khatib, MD, MHS; Lauren Sharan, MD; Ranee Chatterjee, MD, MPH; Nancy M. Allen LaPointe, PharmD, MHS; Bimal Shah, MD, MBA; Ethan D. Borre, BA; Giselle Raitz, MD; Adam Goode, DPT, PhD; Roshini Yapa, MBBS; J. Kelly Davis, BA; Kathryn Lallinger, MSLS; Robyn Schmidt, BA; Andrzej S. Kosinski, PhD; Gillian D. Sanders, PhD
This systematic review of 220 comparative studies examines the effectiveness of medical and procedural treatments for patients with nonvalvular atrial fibrillation.
Renee Butkus, BA; Robert Doherty, BA; Sue S. Bornstein, MD; for the Health and Public Policy Committee of the American College of Physicians
Firearm-related injuries continue to threaten public health in the United States. This position paper provides policy recommendations from the American College of Physicians that are aimed at reducing firearm-related morbidity and mortality.
Philip J. Cook, PhD
The editorialist discusses the American College of Physicians' position paper on reducing the public health crisis of firearm-related injury and how the focus and efforts of physicians and others should consider additional factors to help address the crisis.
Nancy Puzziferri, MD, MSCS; Bruce M. Wolfe, MD
In this issue, a study done in the National Patient-Centered Clinical Research Network compares weight loss outcomes up to 5 years after Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding. The editorialists discuss the ways in which the findings should affect decisions about bariatric treatment and questions future studies should aim to answer.
James S. Kahn, MD
This issue includes a position paper from the American College of Physicians on the health care crisis of firearm-related injury and a research study assessing perceptions of the problem among physicians and the public. The editorialist describes how and why he asks his patients about firearm safety in his medical practice.
Marc Righini, MD; Helia Robert-Ebadi, MD; Antoine Elias, MD, PhD; Olivier Sanchez, MD, PhD; Emmanuelle Le Moigne, MD; Jeannot Schmidt, MD; Catherine Le Gall, MD; Jacques Cornuz, MD, PhD; Drahomir Aujesky, MD, MSc; Pierre-Marie Roy, MD, PhD; Céline Chauleur, MD, PhD; Olivier T. Rutschmann, MD; Pierre-Alexandre Poletti, MD; Grégoire Le Gal, MD, PhD; for the CT-PE-Pregnancy Group
Pregnant women are at increased risk for venous thromboembolism, and pulmonary embolism (PE) is among the most common causes of maternal death. Yet, evidence on the evaluation of suspected PE during pregnancy is limited, prospective management studies have not been reported, and guidelines are highly variable. This prospective multicenter study validated a diagnostic strategy in pregnant women with suspected PE.
Anne Marie Valente, MD; Katherine E. Economy, MD
In this issue, Righini and colleagues report the results of a large prospective study of an algorithm for the evaluation of pregnant women with suspected pulmonary embolism. The editorialists discuss the important lessons learned and how they should inform clinical practice and future study.
Maria Salgado, PhD; Mi Kwon, MD; Cristina Gálvez, MS; Jon Badiola, MD; Monique Nijhuis, PhD; Alessandra Bandera, MD, PhD; Pascual Balsalobre, PhD; Pilar Miralles, MD; Ismael Buño, PhD; Carolina Martinez-Laperche, PhD; Cristina Vilaplana, MD, PhD; Manuel Jurado, MD, PhD; Bonaventura Clotet, MD, PhD; Annemarie Wensing, MD; Javier Martinez-Picado, PhD; Jose Luis Diez-Martin, MD, PhD; for the IciStem Consortium
The multifactorial mechanisms associated with radical reductions in HIV-1 reservoirs after allogeneic hematopoietic stem cell transplant (allo-HSCT) are not fully understood. In this nested case series within an observational cohort, the authors investigate the mechanism of HIV-1 eradication associated with allo-HSCT.
Brian T. Bateman, MD, MSc; Uffe Heide-Jørgensen, MSc, PhD; Kristjana Einarsdóttir, PhD; Anders Engeland, MSc, PhD; Kari Furu, MScPharm, MPH, PhD; Mika Gissler, PhD; Sonia Hernandez-Diaz, MD, DrPH; Helle Kieler, MD, PhD; Anna-Maria Lahesmaa-Korpinen, PhD; Helen Mogun, MS; Mette Nørgaard, MD, PhD; Johan Reutfors, MD, PhD; Randi Selmer, MSc, PhD; Krista F. Huybrechts, MS, PhD; Helga Zoega, MA, PhD
β-Blockers are among the most commonly used antihypertensive medications during pregnancy, but concerns have been raised about their potential teratogenic effects. These authors analyzed data from nationwide health registries in 5 Nordic countries and the U.S. Medicaid population to examine the risk for congenital malformations in offspring of women with hypertension who were exposed to β-blockers during the first trimester of pregnancy.
Richard D'Aquila, MD
An allogeneic hematopoietic stem cell transplant (allo-HSCT) cured Timothy Ray Brown of HIV and cancer, adding more “known unknowns” to the HIV cure research agenda. How are latent HIV reservoirs so radically depleted by allo-HSCT? In this issue, Salgado and colleagues report on the largest number of HIV-infected patients receiving allo-HSCT with CCR5 wild-type donor cells for hematologic disease who have been studied to date and begin to address this question. The editorialist discusses the implications of the findings.
Joel G. Ray, MD, MSc
In their article, Bateman and colleagues report a study that provides reassurance regarding the safety of β-blocker use during pregnancy. The editorialist discusses the findings and their clinical implications for caring for pregnant women who have hypertension or other conditions that require the use of β-blockers.
Jihyoun Jeon, PhD; Theodore R. Holford, PhD; David T. Levy, PhD; Eric J. Feuer, PhD; Pianpian Cao, MPH; Jamie Tam, PhD; Lauren Clarke, MSc; John Clarke, MSc; Chung Yin Kong, PhD; Rafael Meza, PhD
Although lung cancer mortality has decreased since the 1990s, lung cancer remains the leading cause of cancer death in the United States. This study used 4 simulation models of the natural history of lung cancer to project the effect of existing tobacco control efforts on lung cancer and mortality rates from 2015 to 2065.
Y. Tony Yang, ScD, LLM, MPH; Stanton Glantz, PhD
In June 2018, voters in San Francisco, California, supported implementation of a law prohibiting the sale of flavored tobacco products, including menthol cigarettes and flavored vaping liquids, despite a $12 million campaign funded almost entirely by the R.J. Reynolds Tobacco Company to oppose the law. The vote showed that with appropriate support for public health campaigns, it is possible to overcome heavily financed efforts by Big Tobacco if there is enough funding to spread the message.
Steven A. Schroeder, MD
In response to mounting concern about the use of electronic cigarettes by young people, the commissioner of the FDA recently released an action plan together with a demand that manufacturers report how they will address the problem and a threat to accelerate regulations. The author discusses the potential consequences of such actions, as well as inaction, and the potential risks and benefits involved.
Anne N. Thorndike, MD, MPH
Mirbolouk and colleagues report the prevalence of e-cigarette use by adults without a history of combustible cigarette smoking. The editorialist discusses how these findings highlight why the medical and public health communities must begin to address e-cigarette use by young adult never-smokers through screening, education, and treatment and pursue research to understand the risks of long-term exposure to e-cigarettes.
Gerard A. Silvestri, MD, MS; Matthew J. Carpenter, PhD
In this issue, Jeon and colleagues report computer models that project future lung cancer mortality among U.S. adults. The editorialists discuss the important messages about smoking, screening, and lung cancer that these projections provide.
Douglas C. Throckmorton, MD; Janet Woodcock, MD
Gomes and colleagues explore the trends and consequences of the recent and striking increase in prescribing of gabapentinoids, particularly in combination with opioids. The editorialists discuss these findings and the need to carefully investigate the consequences of combined use of all central nervous system–active drugs.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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