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Physicians report feeling moral distress over hospital policies that force inadequate care based on...

...has several limitations. First, the study was conducted in only two safety net systems, and it may not be applicable to other training environments. Furthermore, there may have been an inherent response bias from participants, where negative experiences and perceptions were minimized due to social desirability. Strengths of this study include that it looked to evaluate clinicians’ experiences with this policy, rather than only the patients’ experi...

Anti-HLA antibodies predict worse kidney-allograft survival

...the reference model improved risk stratification, as shown by a continuous net reclassification improvement of 0.75 (95% CI, 0.54 to 0.97). By Xiaozhou Liu and Adrienne Cheung More from this author: Nivolumab plus ipilimumab shows promise for metastatic melanoma, Prophylactic platelet transfusions prevent bleeding in hematologic cancers, Azithromycin is not associated with increased cardiovascular death in low-risk groups, Health education module...

Text messaging program for diabetes shows improved medication adherence

...mes, increases healthy behaviors, and decreases ED utilization in a safety net population. 128 adult patients with poorly controlled diabetes (glycosylated hemoglobin [Hb A1C] level ≥8%) in an urban, public ED were enrolled in the study and randomly assigned to receive either two daily text messages for six months in English or Spanish or no text messages. The primary outcome of interest was the change in Hb A1C at 6 months between groups. Seconda...

2 Minute Medicine Rewind October 20 – October 27, 2014

...o 4.5 million patients covered by HMO insurance plans in California between 2009 and 2012, and compared the total annual expenditures per patient (as determined by insurance payments and including payments to practicing physicians, hospitals, clinical laboratories, and pharmaceutical manufacturers for office visits, inpatient and outpatient procedures, diagnostics tests, and pharmaceuticals). The total expenditures were also adjusted for patient i...

2 Minute Medicine Rewind September 17, 2018

..., p=0. 0128). There were no differences in major adverse cardiovascular or net adverse clinical events between heparin and bivalirudin groups. This study therefore shows that in patients with acute coronary syndrome, radial access was associated with lower rates of adverse clinical events compared with femoral access, but not major adverse cardiovascular events at 1 year. Prevalence of cannabis use in electronic cigarettes among US youth The use o...

Support sheets for patients did not reduce low value screening tests

...ncurred by these services, many screening tests have been found to deliver net harm on a population-based level. Patient education is one potential site of intervention to decrease the prevalence of inappropriate testing. This study aimed to identify if a brief, evidence-based decision support sheet would alter patient intention to receive low-value testing. The study investigators used four types of single-page evidence-based decision support she...

#VisualAbstract: Personalized Prediction of Cardiovascular Benefits and Bleeding Harms From Aspirin for Primary Prevention

...hat when a CVD event was considered equivalent to 2 major bleeding events, net benefits of aspirin increased to 21% of women and 41% of men. Patients with more CVD risk factors (including hyperlipidemia, hypertension, diabetes, smokers) and those with lower bleeding risk factors benefited more from aspirin treatment. Despite the significance of these results, one limitation of this study was the generalizability of findings given that the study to...

2 Minute Medicine Rewind December 16-22, 2013

...rdiovascular events. Each increase in ambulatory activity, in increments of 2000 steps, was associated with a 10% decrease in risk for cardiovascular events (HR 0.90, 95%CI 0.84-0.96, p=0.0014). Likewise, each 2000-step increase in activity from baseline (measured at 12 months) was also associated with an 8% decrease in cardiovascular events (HR 0.92, 95%CI 0.86-0.99, p=0.0271), independent of the baseline number of steps (p=0.58 for interaction)....

#VisualAbstract: Neoadjuvant degarelix versus triptorelin in premenopausal patients who receive letrozole for locally advanced...

...s with breast cancer receiving letrozole as neoadjuvant endocrine therapy (NET). In this randomized controlled trial, 51 premenopausal women with stage cT2 to 4b, estrogen receptor and progesterone receptor greater than 50%, and human epidermal growth factor receptor 2-negative invasive breast cancer were randomized to receive triptorelin 3.75 mg (administered intramuscularly on day 1 of every cycle) or degarelix 240 mg (administered subcutaneousl...

Herpes zoster not significantly associated with subsequent increased incidence of cancer [CMAJ]

...ited applicability to Asian populations. For further reading regarding the link between herpes zoster and developing malignancy, please see the following studies: 1.     Ragozzino MW, Melton LJ III, Kurland LT, et al. Risk of cancer after herpes zoster: A population-based study. NEJM 1982;307:393-397. 2.     Buntinx F, Wachana R, Bartholomeeusen S, et al. Is herpes zoster a marker for occult or subsequent malignancy? Br J Gen Pract 2005;55:102-107...

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