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The authors analyzed data from state and national health surveys from 2009 to 2010 to describe the preventable fractions of cardiovascular mortality associated with either complete elimination or reduction to best achieved levels in hypercholesterolemia, diabetes, hypertension, obesity, and smoking.

Topics: cardiovascular death
Shauna Onofrey, MPH; Jasneet Aneja, MPH; Gillian A. Haney, MPH; Ellen H. Nagami, MPH; Alfred DeMaria Jr., MD; Georg M. Lauer, MD, PhD; Kelsey Hills-Evans, MD; Kerri Barton, MPH; Stephanie Kulaga, BA; Melinda J. Bowen, RN; Noelle Cocoros, DSc, MPH; Barbara H. McGovern, MD; Daniel R. Church, MPH; and Arthur Y. Kim, MD

This study aimed to validate estimates of the incidence of acute hepatitis C virus (HCV) infection in Massachusetts. The authors found that acute HCV infection may be underreported when current methods of surveillance are used.

Topics: hepatitis c, surveillance, medical, acute hepatitis c
Meenakshi Bewtra, MD, MPH, PhD; Craig W. Newcomb, MS; Qufei Wu, MS; Lang Chen, PhD; Fenglong Xie, MS; Jason A. Roy, PhD; Cary B. Aarons, MD; Mark T. Osterman, MD, MSCE; Kimberly A. Forde, MD, MHS; Jeffrey R. Curtis, MD, MS, MPH; and James D. Lewis, MD, MSCE

The authors analyzed Medicare and Medicaid data from 2000 to 2011 to compare the survival of patients who had either elective colectomy or medical therapy for advanced ulcerative colitis.

Topics: colectomy, ulcerative colitis, medical management, mortality, surgical procedures, elective
Deborah Cook, MD; Marilyn Swinton, MSc; Feli Toledo, MDiv; France Clarke, RRT; Trudy Rose, BA, MTS; Tracey Hand-Breckenridge, MDiv; Anne Boyle, BScN, MD; Anne Woods, MD, MDiv; Nicole Zytaruk, RN; Diane Heels-Ansdell, MSc; and Robert Sheppard, MD

This article describes the efforts of a multidisciplinary team to humanize a difficult process by eliciting and fulfilling some simple wishes of dying patients and their families.

Topics: intensive care unit, terminally ill, end-of-life care

This paper summarizes a conference during which a cardiologist and internists discuss how they would treat an individual patient whose risk factors and individual characteristics place them in a gray area of recent guidelines.

Topics: atherosclerosis, statins, cardiovascular diseases, cholesterol, risk reduction, therapeutics, cardiovascular disease risk factors ...

In December 2014, a joint clinical practice guideline was approved for management of dyslipidemia to reduce cardiovascular risk in adults. This synopsis summarizes key features of the guideline.

Topics: dyslipidemias, statins, cardiovascular disease risk factors, united states department of veterans affairs, ...

Behavioral health care encompasses care for mental health and substance abuse conditions, health behavior change, life stresses and crises, and stress-related physical symptoms. This American College of Physicians position paper offers a series of policy recommendations on better integrating behavioral health into the primary care setting.

Topics: mental health, primary health care, behavioral medicine, substance abuse, behavioral health care, ...

The Institute of Medicine convened a panel to develop recommendations relevant to the public health aspects of cognitive aging and define actions required to better maintain the cognitive health of older adults. This commentary highlights key aspects for clinicians.

Topics: aging, institute of medicine (u.s.)
James V. Hennessey, MD; Irwin Klein, MD; Kenneth A. Woeber, MD; Rhoda Cobin, MD; and Jeffrey R. Garber, MD

Over the past decade, several professional organizations have given guidance on how and when to use thyroidstimulating hormone testing for persons with undiagnosed thyroid dysfunction in the general population. The authors discuss a different approach, aggressive case finding, in which only selected persons with certain clinical conditions or characteristics are tested for thyroid dysfunction.

Topics: thyroid diseases

This commentary focuses on the Middle East respiratory syndrome.

Topics: middle east respiratory syndrome coronavirus, middle east respiratory syndrome, severe acute respiratory ...

This article divides the ways providers can be paid into 8 methods. Understanding this distribution helps explain trends in payment reform, conflicts that occur between providers and payers, and the reasons for some professional norms and business practices.

Topics: capitation payment system, incentives, spending, hospitals, healthcare payer, trend, medicare, accountable care ...

Non-A, non-B hepatitis is the topic of this issue's discussion from the Annals archive.

Topics: hepatitis c

In this issue, Bewtra and colleagues report a study that compared the outcomes of medical versus surgical treatment of ulcerative colitis.

Topics: ulcerative colitis

In this issue, Cook and colleagues report their experience with an approach to humanize terminal care by identifying and implementing final wishes for dying patients.

Topics: death, intensive care unit
Christine Laine, MD, MPH; Darren B. Taichman, MD, PhD; and Michael A. LaCombe, MD

In this issue, an anonymous author describes 2 incidents in which physicians acted disrespectfully toward unconscious patients. The Editors explain why they chose to publish this essay and explore strategies for handling inappropriate behavior in colleagues and superiors.

Topics: unconscious (psychology), unconsciousness, anesthesiologist, hemorrhage, anesthesia, general, uterine inertia, ambiguity, hysterectomy, vaginal, ...

Do any of you have someone to forgive from your clinical experiences? Did anything ever happen that you need to forgive or perhaps still can't forgive?

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David S.H. Bell, MD
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Sandeep Vijan, MD, MS
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Steven E. Weinberger, MD; David B. Hoyt, MD; Hal C. Lawrence III, MD; Saul Levin, MD, MPA; Douglas E. Henley, MD; Errol R. Alden, MD; Dean Wilkerson, JD, MBA; Georges C. Benjamin, MD; and William C. Hubbard, JD
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Charles Jessee, PhD
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Christine Laine, MD, MPH; and Darren B. Taichman, MD, PhD
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Irving Kushner, MD; and Maria J. Antonelli, MD
Topics: c-reactive protein measurement
Charlene A. Wong, MD, MSHP; Gabbie Nirenburg, JD, MS; Daniel Polsky, PhD; Robert Town, PhD; and Tom Baker, JD
Topics: insurance, internet, patient protection and affordable care act
Jack Coulehan, MD, MPH
Includes: Audio/Video
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Andrew Thurston, MD
Includes: Audio/Video
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Topics: evidence-based medicine, health services, medical literature, mentoring
Topics: aortic valve stenosis, aortic valve replacement, mortality, follow-up, transcatheter aortic-valve implantation
Topics: aortic valve stenosis, transcatheter aortic-valve implantation, mortality, follow-up
Topics: ischemic stroke, alteplase, thrombectomy, disability, follow-up
Topics: antiplatelet agents, infarction, lacunar, ischemic stroke
Topics: statins, palliative care, mortality, follow-up
Topics: weight reduction
Topics: antirheumatic drugs, disease-modifying, disability, tumor necrosis factor blockers, follow-up
Topics: septic shock, follow-up, mortality, goal-directed therapy
Topics: follow-up, cardiovascular event
Topics: myocardial infarction, acute, cardiac troponin measurement
Topics: hospitals, rehabilitation, fall prevention, follow-up
Topics: blood pressure monitoring, ambulatory, cardiovascular event

The Consult Guys bring a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations.

Topics: aortic valve stenosis, consultation, hip region, hip joint
Topics: ulcerative colitis, mortality, medical management
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