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1. Will Neuroimaging Reveal a Severe Intracranial Injury in This Adult With Minor Head Trauma?: The Rational Clinical Examination Systematic Review.
作者: Joshua S Easter.;Jason S Haukoos.;William P Meehan.;Victor Novack.;Jonathan A Edlow.
来源: JAMA. 2015年314卷24期2672-81页
Adults with apparently minor head trauma (Glasgow Coma Scale [GCS] scores ≥13 who appear well on examination) may have severe intracranial injuries requiring prompt intervention. Findings from clinical examination can aid in determining which adults with minor trauma have severe intracranial injuries visible on computed tomography (CT).
2. Management of Graves Disease: A Review.
Graves disease is the most common cause of persistent hyperthyroidism in adults. Approximately 3% of women and 0.5% of men will develop Graves disease during their lifetime.
3. Training Physicians to Provide High-Value, Cost-Conscious Care: A Systematic Review.
作者: Lorette A Stammen.;Renée E Stalmeijer.;Emma Paternotte.;Andrea Oudkerk Pool.;Erik W Driessen.;Fedde Scheele.;Laurents P S Stassen.
来源: JAMA. 2015年314卷22期2384-400页
Increasing health care expenditures are taxing the sustainability of the health care system. Physicians should be prepared to deliver high-value, cost-conscious care.
4. Prevalence of Depression and Depressive Symptoms Among Resident Physicians: A Systematic Review and Meta-analysis.
作者: Douglas A Mata.;Marco A Ramos.;Narinder Bansal.;Rida Khan.;Constance Guille.;Emanuele Di Angelantonio.;Srijan Sen.
来源: JAMA. 2015年314卷22期2373-83页
Physicians in training are at high risk for depression. However, the estimated prevalence of this disorder varies substantially between studies.
5. CPAP vs Mandibular Advancement Devices and Blood Pressure in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-analysis.
Obstructive sleep apnea is associated with higher levels of blood pressure (BP), which can lead to increased cardiovascular risk.
6. Distal Symmetric Polyneuropathy: A Review.
Peripheral neuropathy is a highly prevalent and morbid condition affecting 2% to 7% of the population. Patients frequently experience pain and are at risk of falls, ulcerations, and amputations. We aimed to review recent diagnostic and therapeutic advances in distal symmetric polyneuropathy, the most common subtype of peripheral neuropathy.
7. Does This Patient With Chest Pain Have Acute Coronary Syndrome?: The Rational Clinical Examination Systematic Review.
作者: Alexander C Fanaroff.;Jennifer A Rymer.;Sarah A Goldstein.;David L Simel.;L Kristin Newby.
来源: JAMA. 2015年314卷18期1955-65页
About 10% of patients with acute chest pain are ultimately diagnosed with acute coronary syndrome (ACS). Early, accurate estimation of the probability of ACS in these patients using the clinical examination could prevent many hospital admissions among low-risk patients and ensure that high-risk patients are promptly treated.
8. Benefits and Harms of Breast Cancer Screening: A Systematic Review.
作者: Evan R Myers.;Patricia Moorman.;Jennifer M Gierisch.;Laura J Havrilesky.;Lars J Grimm.;Sujata Ghate.;Brittany Davidson.;Ranee Chatterjee Mongtomery.;Matthew J Crowley.;Douglas C McCrory.;Amy Kendrick.;Gillian D Sanders.
来源: JAMA. 2015年314卷15期1615-34页
Patients need to consider both benefits and harms of breast cancer screening.
9. Evaluation and Treatment of Pericarditis: A Systematic Review.
Pericarditis is the most common form of pericardial disease and a relatively common cause of chest pain.
10. Diabetes: Advances in Diagnosis and Treatment.
Chronic diseases have overtaken acute diseases, such as infections, as the major cause of premature mortality worldwide. Diabetes mellitus, a chronic degenerative metabolic disease, has reached epidemic proportions in the past 30 years, with worldwide prevalence approaching 400 million people.
11. Medical Therapies for Adult Chronic Sinusitis: A Systematic Review.
Chronic sinusitis is a common inflammatory condition defined by persistent symptomatic inflammation of the sinonasal cavities lasting longer than 3 months. It accounts for 1% to 2% of total physician encounters and is associated with large health care expenditures. Appropriate use of medical therapies for chronic sinusitis is necessary to optimize patient quality of life (QOL) and daily functioning and minimize the risk of acute inflammatory exacerbations.
12. Septic Shock: Advances in Diagnosis and Treatment.
Septic shock is a clinical emergency that occurs in more than 230,000 US patients each year. OBSERVATIONS AND ADVANCES: In the setting of suspected or documented infection, septic shock is typically defined in a clinical setting by low systolic (≤90 mm Hg) or mean arterial blood pressure (≤65 mm Hg) accompanied by signs of hypoperfusion (eg, oliguria, hyperlactemia, poor peripheral perfusion, or altered mental status). Focused ultrasonography is recommended for the prompt recognition of complicating physiology (eg, hypovolemia or cardiogenic shock), while invasive hemodynamic monitoring is recommended only for select patients. In septic shock, 3 randomized clinical trials demonstrate that protocolized care offers little advantage compared with management without a protocol. Hydroxyethyl starch is no longer recommended, and debate continues about the role of various crystalloid solutions and albumin.
13. Does This Patient Have Posttraumatic Stress Disorder?: Rational Clinical Examination Systematic Review.
作者: Michele R Spoont.;John W Williams.;Shannon Kehle-Forbes.;Jason A Nieuwsma.;Monica C Mann-Wrobel.;Raz Gross.
来源: JAMA. 2015年314卷5期501-10页
Posttraumatic stress disorder (PTSD) is a relatively common mental health condition frequently seen, though often unrecognized, in primary care settings. Identifying and treating PTSD can greatly improve patient health and well-being.
14. Psychotherapy for Military-Related PTSD: A Review of Randomized Clinical Trials.
作者: Maria M Steenkamp.;Brett T Litz.;Charles W Hoge.;Charles R Marmar.
来源: JAMA. 2015年314卷5期489-500页
Posttraumatic stress disorder (PTSD) is a disabling psychiatric disorder common among military personnel and veterans. First-line psychotherapies most often recommended for PTSD consist mainly of "trauma-focused" psychotherapies that involve focusing on details of the trauma or associated cognitive and emotional effects.
15. Treatment of Atrial Fibrillation.
Atrial fibrillation is a common arrhythmia that affects more than 2.5 million people in the United States and causes substantial morbidity and mortality, especially regarding the increased risk of stroke.
16. Polypharmacy in the Aging Patient: Management of Hypertension in Octogenarians.
作者: Athanase Benetos.;Patrick Rossignol.;Antonio Cherubini.;Laure Joly.;Tomasz Grodzicki.;Chakravarthi Rajkumar.;Timo E Strandberg.;Mirko Petrovic.
来源: JAMA. 2015年314卷2期170-80页
Hypertension treatment is beneficial for most hypertensive patients. The benefits for patients who are very old and frail, especially those taking numerous medications, are less certain.
17. Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems: A Clinical Review.
As of March 2015, 23 states and the District of Columbia had medical marijuana laws in place. Physicians should know both the scientific rationale and the practical implications for medical marijuana laws.
18. Cannabinoids for Medical Use: A Systematic Review and Meta-analysis.
作者: Penny F Whiting.;Robert F Wolff.;Sohan Deshpande.;Marcello Di Nisio.;Steven Duffy.;Adrian V Hernandez.;J Christiaan Keurentjes.;Shona Lang.;Kate Misso.;Steve Ryder.;Simone Schmidlkofer.;Marie Westwood.;Jos Kleijnen.
来源: JAMA. 2015年313卷24期2456-73页
Cannabis and cannabinoid drugs are widely used to treat disease or alleviate symptoms, but their efficacy for specific indications is not clear.
19. Nonalcoholic fatty liver disease: a systematic review.
Nonalcoholic fatty liver disease and its subtype nonalcoholic steatohepatitis affect approximately 30% and 5%, respectively, of the US population. In patients with nonalcoholic steatohepatitis, half of deaths are due to cardiovascular disease and malignancy, yet awareness of this remains low. Cirrhosis, the third leading cause of death in patients with nonalcoholic fatty liver disease, is predicted to become the most common indication for liver transplantation.
20. Stroke prevention in atrial fibrillation: a systematic review.
Atrial fibrillation (AF) is associated with an increase in mortality and morbidity, with a substantial increase in stroke and systemic thromboembolism. Strokes related to AF are associated with higher mortality, greater disability, longer hospital stays, and lower chance of being discharged home than strokes unrelated to AF.
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