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Robert M. Centor, MD; T. Prescott Atkinson, MD, PhD; Amy E. Ratliff, MLS; Li Xiao, PhD; Donna M. Crabb, MT (ASCP); Carlos A. Estrada, MD, MS; Michael B. Faircloth, MD; Lisa Oestreich, DO; Jeremy Hatchett, MD; Walid Khalife, PhD; and Ken B. Waites, MD
Includes: Audio/Video

European data suggest that Fusobacterium necrophorum causes at least 10% of cases of pharyngitis. In this cross-sectional study, the authors sought to estimate the prevalence of F. necrophorum, Mycoplasma pneumoniae, and group A or C/G β-hemolytic streptococcal pharyngitis in a university student health clinic.

Topics: pharyngitis, streptococcus, polymerase chain reaction, pharyngitis, bacterial, acute, health clinic, fusobacterium
Yunsheng Ma, MD, PhD; Barbara C. Olendzki, RD, MPH; Jinsong Wang, MD, PhD; Gioia M. Persuitte, MPA; Wenjun Li, PhD; Hua Fang, PhD; Philip A. Merriam, MSPH; Nicole M. Wedick, ScD; Ira S. Ockene, MD; Annie L. Culver, BPharm; Kristin L. Schneider, PhD; Gin-Fei Olendzki, MBA; James Carmody, PhD; Tingjian Ge, PhD; Zhiying Zhang, PhD; and Sherry L. Pagoto, PhD

This study randomly assigned adults with the metabolic syndrome to either a simple high-fiber diet or a more complex diet based on the multicomponent American Heart Association dietary guidelines. Although participants assigned to the multicomponent advice lost slightly more weight, participants in both groups lost weight, suggesting that simple dietary advice might be a reasonable option for those unable or unwilling to follow more complex dietary advice.

Topics: diet, metabolic syndrome x, weight reduction
Amanda H. Anderson, PhD, MPH; Wei Yang, PhD; Raymond R. Townsend, MD; Qiang Pan, MA; Glenn M. Chertow, MD, MPH; John W. Kusek, PhD; Jeanne Charleston, BSN, RN; Jiang He, MD, PhD; RadhaKrishna Kallem, MD, MPH; James P. Lash, MD; Edgar R. Miller III, MD, PhD; Mahboob Rahman, MD, MS; Susan Steigerwalt, MD; Matthew Weir, MD; Jackson T. Wright Jr., MD, PhD; Harold I. Feldman, MD, MSCE, for the Chronic Renal Insufficiency Cohort Study Investigators

Data to inform appropriate blood pressure (BP) targets for patients with chronic kidney disease (CKD) are incomplete. This study found that analyses using time-updated BP with adjustment for updated covariates showed stronger associations between elevated systolic BP and the progression of CKD than analyses based on baseline systolic BP.

Topics: kidney failure, chronic, kidney, surrogate endpoints, systolic blood pressure, blood pressure, diabetes ...
Andrew P. DeFilippis, MD, MSc; Rebekah Young, PhD; Christopher J. Carrubba, MD; John W. McEvoy, MB, BCh, BAO; Matthew J. Budoff, MD; Roger S. Blumenthal, MD; Richard A. Kronmal, PhD; Robyn L. McClelland, PhD; Khurram Nasir, MD, MPH; and Michael J. Blaha, MD, MPH

Accurate risk prediction is a vital component in the primary prevention of atherosclerotic cardiovascular disease. This study evaluated the performance of 4 commonly used risk prediction tools and found that all either over- or underestimated risk and performed differently in men and women.

Topics: atherosclerosis, cardiovascular diseases, calibration, cardiovascular disease risk factors, follow-up
Roger Chou, MD; Judith A. Turner, PhD; Emily B. Devine, PharmD, PhD, MBA; Ryan N. Hansen, PharmD, PhD; Sean D. Sullivan, PhD; Ian Blazina, MPH; Tracy Dana, MLS; Christina Bougatsos, MPH; and Richard A. Deyo, MD, MPH
Includes: CME

Prescriptions of opioid medications for chronic pain have increased dramatically, as have opioid overdoses, abuse, and other harms and uncertainty about long-term effectiveness. This review found scant and insufficient evidence that long-term opioid therapy for chronic pain improves function, quality of life, or pain outcomes.

Topics: risk, opioid abuse, chronic pain, opioids, effectiveness, chronic pain management, long-term treatment, ...
Tianjing Li, MD, MHS, PhD; S. Swaroop Vedula, MBBS, PhD; Nira Hadar, MS, PhD; Christopher Parkin, MS; Joseph Lau, MD; and Kay Dickersin, MA, PhD

The authors provide a step-by-step tutorial for selecting data collection tools; constructing forms; and abstracting, managing, and archiving data for systematic reviews.

Topics: institute of medicine (u.s.), internet, software, united states agency for healthcare research ...
David B. Reuben, MD; Anika A.H. Alvanzo, MD, MS; Takamaru Ashikaga, PhD; G. Anne Bogat, PhD; Christopher M. Callahan, MD; Victoria Ruffing, RN, CCRC; and David C. Steffens, MD, MHS

This abridged report from a National Institutes of Health workshop addresses the role of opioids in the treatment of chronic pain. It identifies several key evidence gaps and research priorities.

Topics: pain, risk, chronic pain, opioids, effectiveness, chronic pain management, long-term treatment, opioid ...
Thomson Kuhn, MA; Peter Basch, MD; Michael Barr, MD, MBA; Thomas Yackel, MD, MPH, MS,, for the Medical Informatics Committee of the American College of Physicians

In this position paper, the Medical Informatics Committee of the American College of Physicians reviews the current and emerging purposes of clinical documentation, the drivers that may influence or distract from these purposes, and the opportunities and challenges that have arisen from electronic health records.

Topics: medical records, medical informatics, electronic medical records, american college of physicians, policy ...

In this commentary, the authors discuss ethical issues in the provision of life-sustaining therapies, such as cardiopulmonary resuscitation and dialysis, to patients with Ebola being cared for in developed countries.

Topics: ethics, ebola virus, ebola virus disease, life sustaining treatment, developed countries
Michael Rosenblatt, MD; Sachin H. Jain, MD; and Matthew Cahill, BA

This commentary discusses the benefits and risks of data sharing from the perspective of persons with experience in academic medicine, government, and medical publishing, as well as the pharmaceutical industry.

Topics: institute of medicine (u.s.), incentives, data sharing

This commentary discusses the Institute of Medicine report on sharing clinical trial data and envisions a world with realigned incentives so that the maximum benefits can be derived from making more clinical trial data available.

Topics: drug industry, government, privacy, pharmaceutical company, data sharing
Deborah Cotton, MD, MPH, Deputy Editor

The Framingham Study is the topic of this issue’s discussion from the Annals archives.

Topics: framingham heart study, framingham risk calculator

In this issue, Centor and colleagues estimate the prevalence of F. necrophorum, M. pneumoniae, and group A or C/G β-hemolytic streptococcal pharyngitis in a university student health clinic. The editorialist cautions clinicians to be aware of the various organisms that cause pharyngitis but not to overcomplicate management.

Topics: sore throat, streptococcal infections, group a, pharyngitis, streptococcus pyogenes

In this issue, DeFilippis and colleagues examined several prominent risk prediction tools for cardiovascular disease in which they found cases of overestimation and underestimation. The editorialists believe that the study serves as a crucial test of external validation and demands the attention of both clinicians and policymakers.

Topics: cardiovascular disease risk factors, cardiovascular diseases

In this issue, the Medical Informatics Committee of the American College of Physicians reviews the current and emerging purposes of clinical documentation. The editorialist urges providers and other stakeholders to view such documentation as a fundamental tool for improving patient care.

Topics: medical records, medical informatics, electronic medical records, american college of physicians, chronic ...
Lenore M. Buckley, MD, MPH
Includes: Audio/Video
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Libing Jiang, MM; Yuefeng Ma, MD, PhD; and Mao Zhang, MD, PhD
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Bram Rochwerg, MD; Waleed Alhazzani, MD; Roman Jaeschke, MD; and Deborah J. Cook, MD
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Marc B. Garnick, MD; and Wendy Balter, MBA
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Kaenat Mulla; Adebusola Shonubi, iBSc; and Dev Katarey, BMBS, MSc
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Xiaomei Meng, MD, PhD; Suman Paul, MBBS, PhD; and Douglas J. Federman, MD
Topics: metabolic acidosis, accidental poisoning by isopropyl alcohol
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Gaetan Sgro, MD
Includes: Audio/Video
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Topics: angiotensins, enalapril, renin-angiotensin system, heart failure, hospitalization, neprilysin, mortality, follow-up, valsartan
Topics: exercise, nursing homes, wheelchair, elderly, follow-up
Topics: coronary angiography, statins, renal failure, acute
Topics: anticoagulation, aspirin, venous thromboembolism, follow-up
Topics: pregnancy, influenza, follow-up
Topics: antiviral agents, recurrent genital herpes
Topics: hip region, hip joint, knee region, knee joint, pain management, opioids, adverse ...
Topics: obesity, diabetes mellitus, type 2, weight reduction, hemoglobin a, glycosylated, duodenum, jejunum, ...
Topics: foot, sensory perception, touch sensation, diabetes mellitus
Topics: extrapulmonary tuberculosis, cerebrospinal fluid, lymph nodes, pleural fluid, tuberculosis
Topics: renal failure, acute, mortality, atypical antipsychotic
Topics: hypoglycemia, glipizide, glyburide, antimicrobials

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: torsades de pointes, consultation
Topics: weight reduction, diet, changes in diet
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