Jesse E. Ross, MD
This commentary discusses the value of residents during the coronavirus disease 2019 pandemic. The author also evaluates the role of program leadership and administration during this health crisis.
The Parkinson Study Group STEADY-PD III Investigators
Several studies have suggested that treatment with dihydropyridine calcium-channel blockers, such as isradipine, may be associated with a reduced risk for Parkinson disease. This randomized controlled trial examined the effect of isradipine on disease progression among patients with a relatively recent diagnosis of Parkinson disease.
Jinoos Yazdany, MD, MPH; Alfred H.J. Kim, MD, PhD
Two medications often used for treatment of immune-mediated conditions, hydroxychloroquine and chloroquine, have recently attracted widespread interest as potential therapies for coronavirus disease 2019. The authors of this commentary provide guidance for clinical decision making for patients with coronavirus disease 2019 as well as for patients with rheumatologic conditions, such as systemic lupus erythematosus and rheumatoid arthritis
Baijayanta Maiti, MD, PhD; Joel S. Perlmutter, MD
In their article, the Parkinson Study Group STEADY-PD III Investigators report the results of a randomized controlled trial evaluating the effect of isradipine, a dihydropyridine calcium-channel blocker, on clinical progression of Parkinson disease. The editorialists discuss the findings and the need for more reliable in vivo biomarkers of Parkinson disease progression and measures of specific target engagement.
Simone V. Benatti, MD
One of the most painful aspects of this pandemic is the irremediable separation of patients from their families at the end of their lives.
John H. Choe, MD, MPH
These 2 weeks of attending are ones that I will never forget, but I worry about what the next 2 weeks will bring.
Alex Thomas, MD
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.
Robert M. Centor, MD; Jeanne Marrazzo, MD, MPH
In this episode of Annals On Call, Dr. Centor discusses strategies to protect health care workers from COVID-19 with Dr. Jeanne Marrazzo.
Alfred H.J. Kim, MD, PhD*; Jeffrey A. Sparks, MD, MMSc*; Jean W. Liew, MD; Michael S. Putman, MD; Francis Berenbaum, MD, PhD; Alí Duarte-García, MD, MS; Elizabeth R. Graef, DO; Peter Korsten, MD; Sebastian E. Sattui, MD; Emily Sirotich, BSc; Manuel F. Ugarte-Gil, MD, MSc; Kate Webb, MBBCh, PhD; Rebecca Grainger, MBChB, PhD; for the COVID-19 Global Rheumatology Alliance†
Hydroxychloroquine, an essential treatment for many patients with rheumatologic conditions, has recently garnered widespread attention as a potential treatment for COVID-19 infection. The authors appraise the study generating this interest and highlight the potential consequences of rapid dissemination of overinterpreted data, particularly for people with conditions for which hydroxychloroquine has demonstrated benefits in preventing organ damage and life-threatening disease flares.
Alexander Kutikov, MD; David S. Weinberg, MD, MSc; Martin J. Edelman, MD; Eric M. Horwitz, MD; Robert G. Uzzo, MD, MBA; Richard I. Fisher, MD
Initial reports suggest that COVID-19 can be particularly lethal in patients with cancer. This commentary discusses how to balance a delay in cancer diagnosis or treatment against the risk for a potential COVID-19 exposure, mitigate the risks for significant care disruptions associated with social distancing behaviors, and manage the appropriate allocation of limited health care resources in this unprecedented time of health care crisis.
Mounica Vallurupalli, MD; Jean G. MacFadyen, BA; Robert J. Glynn, ScD; Tom Thuren, MD; Peter Libby, MD; Nancy Berliner, MD; Paul M Ridker, MD
These analyses of data from a randomized controlled trial explored whether interleukin-1β inhibition with canakinumab reduces incident anemia and improves hemoglobin levels among patients with prevalent anemia.
Emanuele Angelucci, MD; Junmin Li, MD; Peter Greenberg, MD; Depei Wu, MD; Ming Hou, MD; Efreen Horacio Montaňo Figueroa, MD; Maria Guadalupe Rodriguez, MD; Xunwei Dong, MD; Jagannath Ghosh, MS; Miguel Izquierdo, MD; Guillermo Garcia-Manero, MD; on behalf of the TELESTO Study Investigators
Iron overload in transfusion-dependent patients with myelodysplastic syndrome (MDS) can lead to poorer clinical outcomes. The effectiveness of iron chelation therapy in patients with lower-risk MDS is limited. This phase 2 clinical trial explores whether iron chelation is associated with clinical benefit in this group compared with placebo.
David E. Kloecker, MPhil; Melanie J. Davies, MD; Kamlesh Khunti, MD, PhD; Francesco Zaccardi, MD, PhD
This article describes an alternative to the hazard ratio for reporting effects of interventions in trials: the restricted mean survival time. By presenting examples from trials with cardiovascular outcomes in patients with type 2 diabetes, the authors illustrate the uses and limitations of the measure for researchers and clinicians.
Eileen Barrett, MD, MPH; Elizabeth Lawrence, MD; Daniel Waldman, MD; Heather Brislen, MD
State-based medical license applications often ask about mental health diagnoses and treatment in terms that stigmatize mental illness, which inadvertently discourages physicians from seeking care. In this article, the authors describe a recent collaboration that resulted in updated and destigmatized language on their state's medical license application.
A. Russell Localio, PhD; Anne R. Meibohm, PhD; Eliseo Guallar, MD, DrPH
This article summarizes the goals, assumptions, and challenges of mediation analysis, a rapidly developing statistical methodology, in medical and public health.
Mohamed Taha, MD
Charlene Dewey, MD, MEd; Susan Hingle, MD; Elizabeth Goelz, MD; Mark Linzer, MD
The COVID-19 pandemic has upended clinicians' sense of order and control, creating the potential for stress in the short term and burnout over the long term. This commentary offers suggestions to encourage a culture that will sustain the clinician workforce during the pandemic.
Safi U. Khan, MD; Mohammed Osman, MD; Muhammad U. Khan, MD; Muhammad Shahzeb Khan, MD; Di Zhao, PhD; Mamas A. Mamas, MB BCh, DPhil; Nazir Savji, MD; Ahmad Al-Abdouh, MD; Rani K. Hasan, MD, MHS; Erin D. Michos, MD, MHS
This meta-analysis of 4 large trials examines the potential benefits and harms of dual versus triple antithrombotic therapy for patients with atrial fibrillation who have had percutaneous coronary intervention to treat acute coronary syndrome.
Suresh T. Chari, MD; Ayush Sharma, MBBS; Anirban Maitra, MBBS
Pancreatic ductal adenocarcinoma (PDAC) is the fourth most common cause of cancer death, with more than 80% of patients diagnosed at advanced stages and a 5-year survival of only 9%. The best hope for improving the prognosis of PDAC is to detect the cancer at early stages when more patients can undergo maximal therapy (that is, chemotherapy and resective surgery). A sequential risk-tailored strategy for early detection of PDAC is being developed in a large prospective cohort of patients with new-onset diabetes.
Catharine B. Stack, PhD; Anne R. Meibohm, PhD; Joshua M. Liao, MD, MSc; Eliseo Guallar, MD, DrPH
Post hoc analyses of randomized trial data can help answer important questions by making use of valuable data collected in controlled settings. Using trial data to compare nonrandomized exposures requires care because the comparisons are not protected by randomization. This article helps readers understand the potential biases that need to be considered when evaluating such studies.
John U. Doherty, MD
In their article, Khan and colleagues report a meta-analysis that addresses the care of patients with atrial fibrillation after coronary stent placement who require anticoagulation to mitigate stroke risk and antiplatelet therapy to promote stent patency. The editorial discusses the findings and how to best balance the risks for bleeding and thrombosis that such patients face.
William J. Doan, BA, MFA, PhD
Michael Klompas, MD, MPH
Coronavirus disease 2019 (COVID-19) is optimized to spread widely: Its signs and symptoms are largely indistinguishable from those of other respiratory viruses. This commentary specifically addresses best ways to protect our hospitals against COVID-19.
Vineet Chopra, MD, MSc; Eric Toner, MD; Richard Waldhorn, MD; Laraine Washer, MD
Estimates suggest that COVID-19 will stress bed capacity, equipment, and health care personnel in U.S. hospitals in ways not previously experienced. How can health systems prepare to care for a large influx of patients with this disease?
Rochelle P. Walensky, MD, MPH; Tim Horn, MS; Nicole C. McCann, BA; Kenneth A. Freedberg, MD, MSc; A. David Paltiel, MBA, PhD
Recent trial data showed that tenofovir alafenamide–emtricitabine was noninferior to tenofovir disoproxil fumarate–emtricitabine for HIV preexposure prophylaxis among men who have sex with men and showed greater renal and bone safety. This analysis estimates the greatest possible clinical benefits and economic savings attributable to tenofovir alafenamide–emtricitabine and the maximum price that payers should be willing to pay for this treatment compared with generic tenofovir disoproxil fumarate–emtricitabine.
Michael Fralick, MD, PhD, SM; Michael Colacci, MD; Sebastian Schneeweiss, MD, ScD; Krista F. Huybrechts, MS, PhD; Kueiyu Joshua Lin, MD, ScD, MPH; Joshua J. Gagne, PharmD, ScD
Trials have compared the efficacy and safety of apixaban and rivaroxaban with warfarin in preventing stroke and systemic thromboembolism among patients with atrial fibrillation, but direct comparisons of these 2 treatments are currently lacking. This analysis of a nationwide health care claims database compares the effectiveness and safety of apixaban versus rivaroxaban among patients with nonvalvular atrial fibrillation.
Olga Pleguezuelos, PhD; Joep Dille; Sofie de Groen; Fredrik Oftung, PhD; Hubert G.M. Niesters, PhD; Md Atiqul Islam, MSc, PhD; Lisbeth Meyer Næss, PhD; Olav Hungnes, PhD; Nuhoda Aldarij, BSc; Demi L. Idema, BSc; Ana Fernandez Perez, BSc; Emma James, PhD; Henderik W. Frijlink, PhD; Gregory Stoloff; Paul Groeneveld, MD, PhD; Eelko Hak, PhD
In this randomized, double-blind, placebo-controlled, single-center phase 2b clinical trial, the authors compare the safety, immunogenicity, and exploratory efficacy of different formulations and dosing regimens of FLU-v, a broad-spectrum influenza vaccine that induces antibodies and cell-mediated immunity, versus placebo.
Stephen A. Lauer, MS, PhD; Kyra H. Grantz, BA; Qifang Bi, MHS; Forrest K. Jones, MPH; Qulu Zheng, MHS; Hannah R. Meredith, PhD; Andrew S. Azman, PhD; Nicholas G. Reich, PhD; Justin Lessler, PhD
Using news reports and press releases from provinces, regions, and countries outside Wuhan, Hubei province, China, this analysis estimates the length of the incubation period of coronavirus disease 2019 (COVID-19) and its public health implications.
Carlos del Rio, MD; Wendy S. Armstrong, MD
In this issue, Walensky and colleagues report a cost-effectiveness analysis that estimates the potential clinical benefits of tenofovir alafenamide–emtricitabine (F/TAF) and the resultant cost savings of lower risk for renal failure and fractures versus the increased cost of branded F/TAF compared with generic tenofovir disoproxil fumarate–emtricitabine for HIV preexposure prophylaxis (PrEP). The editorialists believe that the findings make it clear that shifting to F/TAF as first-line PrEP for all should not be universally recommended if the goal is to end AIDS in the United States.
Michael L. Anderson, PhD; Carlos Dobkin, PhD; Devon Gorry, PhD
When vaccinating against influenza, some countries focus on elderly persons because observational studies indicate that this practice decreases both population mortality and the frequency of hospitalization. This new study finds different results with a different research design that reduces the bias and confounding that might have affected other studies.
Trish M. Perl, MD, MSc; Connie Savor Price, MD
In the setting of emerging infections, such as COVID-19, this commentary argues that all members of the health care team need training on how to integrate key epidemiologic information, such as travel history, into their risk assessments in the same way they are trained to ask about tobacco exposure to assess cancer and heart disease risk.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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