Pontus Henriksson, PhD; Hanna Henriksson, PhD; Per Tynelius, MSc; Daniel Berglind, PhD; Marie Löf, PhD; I-Min Lee, MBBS, ScD; Eric J. Shiroma, ScD; Francisco B. Ortega, PhD
The relationship between a healthy lifestyle during adolescence and chronic disease later in life is not well understood. This study, which involved a large cohort of male adolescents in Sweden, examined the relationship of cardiorespiratory fitness and obesity with receipt of a disability pension later in life.
Ian Barnett, PhD; John Torous, MD
Artificial intelligence and machine learning promise to improve health care and health itself, but potential pitfalls exist. A recent example is Facebook's efforts to screen users' posts to identify those at risk for suicide and alert emergency services.
K.M. Venkat Narayan, MD; Shivani A. Patel, PhD; Solveig A. Cunningham, PhD; James Curran, MD
This commentary describes the recent reversal of health gains in the United States due to increases in midlife mortality rates among many groups. The authors' solution is to equally emphasize research and allocate resources on biological, socioeconomic, and political determinants of health.
Rhanderson Cardoso, MD; Khurram Nasir, MD, MPH, MSc; Roger S. Blumenthal, MD; Michael J. Blaha, MD, MPH
This commentary addresses the 2018 American Heart Association and American College of Cardiology risk assessment and cholesterol management recommendations about “risk enhancers” and coronary artery calcium testing.
Christopher L. Bennett, MD, MA
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##mdash;whether they be poignant, thought-provoking, or just plain entertaining.
Robert E. Brutcher, PharmD, PhD; Connie Kurihara, RN; Mark C. Bicket, MD; Parvaneh Moussavian-Yousefi, PharmD; David E. Reece, MD; Lisa M. Solomon, BS; Scott R. Griffith, MD; David E. Jamison, MD; Steven P. Cohen, MD
The use of compounded topical pain creams has increased dramatically, yet their effectiveness has not been well evaluated. This trial assessed the effectiveness of compounded creams versus placebo for treating localized chronic pain.
Anjala Tess, MD; Steven D. Freedman, MD, PhD; Tara Kent, MD; Howard Libman, MD
Acute pancreatitis is a common reason for hospitalization. Here, 2 experts debate how they would apply an American Gastroenterological Association guideline addressing management of acute pancreatitis to a patient with recurrent episodes, focusing on initial management and timing of subsequent surgery.
David K. Kim, MD, MA; Paul Hunter, MD; on behalf of the Advisory Committee on Immunization Practices
This article provides immunization recommendations from the Advisory Committee on Immunization Practices (ACIP) for adults aged 19 years or older. The ACIP-recommended use of each vaccine is determined after in-depth reviews of vaccine-related data, including disease epidemiology and burden of disease, vaccine efficacy and effectiveness, vaccine safety, the quality of evidence, feasibility of program implementation, and economic analyses of immunization policy.
Katy J.L. Bell, MBChB, MMed(Clin Epi), PhD; Jenny Doust, BMBS, PhD; Paul Glasziou, MBBS, PhD; Louise Cullen, MBBS(Hon), PhD; Ian A. Harris, MBBS, MMed(Clin Epi), PhD; Leon Smith, MBBS; Rachelle Buchbinder, MBBS(Hons), MSc, PhD; Alexandra Barratt, MBBS, MPH, PhD
Overdiagnosis is commonly conceptualized as an unintended consequence of early disease detection in asymptomatic persons but can also occur in persons with symptoms. This commentary poses ways to identify this problem and examines the use of high-sensitivity cardiac troponin assays to diagnose type 1 myocardial infarction as an example of the potential for overdiagnosis.
The ever-growing popularity of Annals Graphic Medicine has prompted us to expand it to include regular monthly features from 2 talented physician artists. Look for a new installment of “Dr. Mom” on the first Tuesday of the month and “Progress Notes” on the third Tuesday.
Michael J. Green, MD, MS
This editorial discusses the 4 Annals Graphic Medicine comics published in this issue, which show the vulnerability that students feel during medical school.
Richard B. Weinberg, MD
“I have come to thank you, doctor. I thank you so much. God has sent you to me.”
Kelly E. Largent, MD
Alexandra Pârvan, PhD
Darren B. Taichman, MD, PhD
Elisabeth J. Woodhams, MD, MSc; Melissa Gilliam, MD, MPH
Robert M. Centor, MD; Nancy A. Rigotti, MD
In this episode of Annals On Call, Dr. Centor discusses electronic cigarette use with Dr. Nancy Rigotti of Massachusetts General Hospital.
Grace E. Farris, MD
“Dr. Mom” explores the challenges and ups and downs of juggling life as a hospitalist and mother. The feature appears monthly in Annals Graphic Medicine at Annals.org.
Mollie Kotzen, MD, MPH
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.
Michelle Sayad, MD
Shruti Sudhakar, MD
Gazi M. Rashid, BS
Christopher E. Cox, MD; Douglas B. White, MD; Catherine L. Hough, MD; Derek M. Jones, MDiv; Jeremy M. Kahn, MD; Maren K. Olsen, PhD; Carmen L. Lewis, MD; Laura C. Hanson, MD; Shannon S. Carson, MD
Patients requiring prolonged mechanical ventilation face high morbidity and mortality and frequently lack decisional capacity. Decision aids might help align surrogate decision makers and clinicians' understanding of patient prognosis to better inform discussions regarding plans of care. This randomized trial assessed whether a decision aid improved agreement between surrogates' and clinicians' assessments of patient prognoses.
Desiree Wussler, MD; Nikola Kozhuharov, MD; Zaid Sabti, MD; Joan Walter, MD; Ivo Strebel, MS; Letizia Scholl, MD; Oscar Miró, PhD; Xavier Rossello, MD, PhD; Francisco Javier Martín-Sánchez, MD, PhD; Stuart J. Pocock, PhD; Albina Nowak, MD; Patrick Badertscher, MD; Raphael Twerenbold, MD; Karin Wildi, MD; Christian Puelacher, MD; Jeanne du Fay de Lavallaz, MD; Samyut Shrestha, MD; Olivia Strauch; Dayana Flores, MD; Thomas Nestelberger, MD; Jasper Boeddinghaus, MD; Carmela Schumacher, MSc; Assen Goudev, PhD; Otmar Pfister, MD; Tobias Breidthardt, MD; Christian Mueller, MD
The MEESSI-AHF (Multiple Estimation of risk based on the Emergency department Spanish Score In patients with AHF) risk score was developed to predict 30-day mortality in patients presenting with acute heart failure (AHF) to emergency departments (EDs) in Spain. The performance of the score in other countries was unknown. In this study, the authors externally validated the MEESSI-AHF score in a cohort of unselected patients with AHF who presented to 4 EDs in Switzerland.
Aaron M. Tannenbaum, MD; Scott D. Halpern, MD, PhD
In their article, Cox and colleagues examine whether a surrogate-facing decision aid improves clinician–surrogate concordance on estimates of 1-year survival or any of several patient and surrogate outcomes for patients receiving prolonged mechanical ventilation and find no such benefits. The editorialists posit that interventions that merely enhance knowledge and induce deliberation may never promote better surrogate decision making.
April Jorge, MD; Zachary S. Wallace, MD, MSc; Na Lu, MPH; Yuqing Zhang, DSc; Hyon K. Choi, MD, DrPH
Renal transplantation is associated with increased survival among patients with end-stage renal disease (ESRD). However, the benefits of renal transplant in patients whose ESRD is due to lupus nephritis (LN-ESRD) is uncertain. This analysis compared survival among patients with LN-ESRD who did and did not have a kidney transplant.
Christina M. Yuan, MD
Last year, a “well-being survey” was added to the annual faculty survey from the Accreditation Council for Graduate Medical Education. A program director ponders its purpose and the possible ramifications for faculty who respond to it.
Nitender Goyal, MD; Daniel E. Weiner, MD, MS; Andrew S. Levey, MD
Jorge and colleagues examined data from 1995 to 2014 to assess outcomes of patients with lupus nephritis who initiated dialysis and were placed on the waitlist for a kidney transplant. The editorialists discuss the findings in light of slow progress in the treatment of lupus nephritis. Given higher patient and allograft survival with both preemptive and early kidney transplant, it is essential that transplant be considered as promptly as possible for patients with lupus nephritis.
Dhruv S. Kazi, MD, MSc, MS; Joanne Penko, MS, MPH; Pamela G. Coxson, PhD; David Guzman, MSPH; Pengxiao C. Wei, BS, MPH; Kirsten Bibbins-Domingo, PhD, MD, MAS
The high price of prescription drugs in the United States has been a barrier to adoption of potentially life-saving therapies. To address this issue, the authors propose that cost-effectiveness analyses be performed in a timely manner so that this information can help influence drug pricing shortly after approval. They illustrate how this process might work by describing their recent experience with PCSK9 (proprotein convertase subtilisin/kexin 9) inhibitors, monoclonal antibodies that lower cholesterol levels in the blood.
Mark A. Hlatky, MD
Proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors substantially reduce cholesterol levels, but the U.S. Food and Drug Administration–approved PCSK9 inhibitors, alirocumab and evolocumab, came to market priced at $14 000 per year—more than 100 times the cost of a generic statin. Kazi and colleagues performed a cost-effectiveness analysis of alirocumab in secondary prevention based on new trial results and updated pricing. The editorialist discusses the findings and what it takes for preventive therapies to be cost-effective.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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