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Cathelijne H. van der Wouden, BSc; Deanna Alexis Carere, ScD, CGC; Anke H. Maitland-van der Zee, PharmD, PhD; Mack T. Ruffin IV, MD, MPH; J. Scott Roberts, PhD; Robert C. Green, MD, MPH, for the Impact of Personal Genomics Study Group†
Includes: Audio/Video

Patients may share the results of direct-to-consumer personal genomic testing with their primary care provider. This study describes a group of consumers who shared their results with their primary care provider and whether they were satisfied or dissatisfied with the experience.

Topics: primary care physicians, follow-up, genome, perception, primary health care, genetics, primary care ...
  
Iris M. Markusse, MD, PhD; Gülşah Akdemir, MD; Linda Dirven, PhD; Yvonne P.M. Goekoop-Ruiterman, MD, PhD; Johannes H.L.M. van Groenendael, MD; K. Huub Han, MD; T.H. Esmeralda Molenaar, MD, PhD; Saskia Le Cessie, PhD; Willem F. Lems, MD, PhD; Peter A.H.M. van der Lubbe, MD, PhD; Pit J.S.M. Kerstens, MD, PhD; André J. Peeters, MD, PhD; H. Karel Ronday, MD, PhD; Peter B.J. de Sonnaville, MD; Irene Speyer, MD; Theo Stijnen, PhD; Saskia ten Wolde, MD, PhD; Tom W.J. Huizinga, MD, PhD; and Cornelia F. Allaart, MD, PhD

Studies have shown that a “treat-to-target” strategy results in improved clinical outcomes among patients with early active rheumatoid arthritis, but long-term data on this approach are lacking. The authors present outcomes among patients treated with this approach for 10 years as part of a trial that examined 4 treat-to-target strategies for rheumatoid arthritis.

Topics: rheumatoid arthritis, combined modality therapy, follow-up, therapeutics, symptom onset, disease remission, infliximab, ...
  

Studies have documented a relationship between increased body mass index (BMI) and improved survival, but BMI is an imperfect measure of adiposity. This population-based cohort study examined the relationship of BMI and body fat percentage with all-cause mortality among middle-aged and older adults who underwent bone mineral density testing.

Topics: body mass index procedure, mortality, body fat, obesity
  

This synopsis of the 2016 American Diabetes Association Standards of Medical Care in Diabetes focuses on key areas necessary for managing the disease, preventing complications, and improving outcomes.

Topics: diabetes mellitus, diabetes mellitus, type 2, insulin, hypoglycemia, american diabetes association, hemoglobin ...
  

On 7 January 2016, the U.S. Department of Health and Human Services and Department of Agriculture released the Dietary Guidelines for Americans 2015–2020. This commentary discusses the new guidelines and the strength of the scientific evidence supporting them.

Topics: nutrition guidelines, diet, coronary heart disease
  
Jacob West, MPP; and Ateev Mehrotra, MD, MPH

In 1961, an article with a similar title changed our understanding about who receives medical care. This article updates our understanding since then, describes the trends changing the ecology of care, and reviews the implications for the health care system.

Topics: ecology
  

Evidence-based medicine and big data are very different approaches to producing evidence. In this commentary, the author posits that “combining these 2 ways of knowing offers the best path for enlarging and strengthening the knowledge base of clinical medicine.”

Topics: evidence-based medicine
  

Discussions of past scandals have become an obligatory part of bioethics courses in undergraduate, graduate, medical, and other health professional schools. This paper revisits several scandals that are typically discussed in bioethics education and training to generate a more historically informed assessment of immoral behavior.

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According to van der Wouden and colleagues' study, consumers who purchase direct-to-consumer genetic tests find the marketing message compelling. The editorialists discuss the findings and why they believe that marketing these tests creates consumer expectations that cannot—and perhaps should not—be met by the health care system.

Topics: genetics, genetic screening
  
Christopher Moriates, MD
Includes: Audio/Video

“Do you have any questions?” I asked. My brain immediately began chanting, “Please don't, please don't, please don't.” I thought the chant was quiet enough that only I could hear it, but my patient seemed to read my mind.

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Marisa A. Montecalvo, MD
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Alexander T. Sandhu, MD; R. Adams Dudley, MD, MBA; and Dhruv S. Kazi, MD, MSc, MS
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Patrick L. Remington, MD, MPH; Anastassios G. Pittas, MD, MS; and Ethan M. Balk, MD, MPH
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Steffie Woolhandler, MD, MPH; and David U. Himmelstein, MD
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Ana Marina Moreira, MD; Thizá M. Londero, MD; Iuri M. Goemann, MD; and Beatriz D. Schaan, MD, PhD
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Topics: costa rica, internship and residency, travel, medical residencies, zika virus disease
  
Laura Sherwood, BS, BA
Includes: Audio/Video
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Amy Ship, MD
Includes: Audio/Video
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Richard Bronson, MD
Includes: Audio/Video
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Topics: mammography, mortality, breast cancer
  
Topics: breast neoplasm screening
  
Topics: colonoscopy, adenoma detection rate
  
Topics: heart failure, hospitalization, nurses, mortality, titration method, heart failure with reduced ejection ...
  
Topics: statins, dementia, cognitive impairment, elderly
  
Topics: smoking cessation, inpatient, varenicline, follow-up
  
Topics: chronic lymphocytic leukemia, chronic b-cell leukemias, elderly, ibrutinib, chlorambucil, follow-up
  
Topics: cancer, computed tomography/positron emission tomography imaging, venous thromboembolism, follow-up
  
Topics: cardiopulmonary resuscitation, out-of-hospital cardiac arrest
  
Topics: atherosclerosis, primary prevention, cardiovascular diseases, statins
  

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: anticoagulation, consultation, hematoma, subdural, headache
  
Topics: rheumatoid arthritis, diabetes mellitus, type 2, genome, methotrexate, symptom onset, primary care ...
  
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