JAMA internal medicine
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JAMA internal medicine · May 2018
Multicenter Study Observational StudySex Differences in Outcomes After STEMI: Effect Modification by Treatment Strategy and Age.
Previous works have shown that women hospitalized with ST-segment elevation myocardial infarction (STEMI) have higher short-term mortality rates than men. However, it is unclear if these differences persist among patients undergoing contemporary primary percutaneous coronary intervention (PCI). ⋯ Younger age was associated with higher 30-day mortality rates in women with STEMI even after adjustment for medications, primary PCI, and other coexisting comorbidities. This difference declines after age 60 and is no longer observed in oldest women.
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JAMA internal medicine · May 2018
Association of Medical and Adult-Use Marijuana Laws With Opioid Prescribing for Medicaid Enrollees.
Overprescribing of opioids is considered a major driving force behind the opioid epidemic in the United States. Marijuana is one of the potential nonopioid alternatives that can relieve pain at a relatively lower risk of addiction and virtually no risk of overdose. Marijuana liberalization, including medical and adult-use marijuana laws, has made marijuana available to more Americans. ⋯ The potential of marijuana liberalization to reduce the use and consequences of prescription opioids among Medicaid enrollees deserves consideration during the policy discussions about marijuana reform and the opioid epidemic.
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JAMA internal medicine · Apr 2018
Randomized Controlled Trial Comparative StudyEffect of a Collaborative Care Intervention vs Usual Care on Health Status of Patients With Chronic Heart Failure: The CASA Randomized Clinical Trial.
Many patients with chronic heart failure experience reduced health status despite receiving conventional therapy. ⋯ This multisite randomized clinical trial of the CASA intervention did not demonstrate improved heart failure-specific health status. Secondary outcomes of depression and fatigue, both difficult symptoms to treat in heart failure, improved.
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JAMA internal medicine · Apr 2018
Association of Cigarette, Cigar, and Pipe Use With Mortality Risk in the US Population.
Tobacco products have changed in recent years. Contemporary mortality risk estimates of combustible tobacco product use are needed. ⋯ This study provides further evidence that exclusive use of cigar, pipes, and cigarettes each confers significant mortality risks.
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JAMA internal medicine · Mar 2018
Observational StudyPrevalence of Pulmonary Embolism in Patients With Syncope.
Sparse data and conflicting evidence exist on the prevalence of pulmonary embolism (PE) in patients with syncope. ⋯ Pulmonary embolism was rarely identified in patients with syncope. Although PE should be considered in every patient, not all patients should undergo evaluation for PE.