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581. Does this patient with diabetes have large-fiber peripheral neuropathy?
Diabetic peripheral neuropathy predisposes patients to foot ulceration that heals poorly and too often leads to amputation. Large-fiber peripheral neuropathy (LFPN), one common form of diabetic neuropathy, when detected early prompts aggressive measures to prevent progression to foot ulceration and its associated morbidity and mortality.
582. Will this patient develop persistent disabling low back pain?
Low back pain is extremely common. Early identification of patients more likely to develop persistent disabling symptoms could help guide decisions regarding follow-up and management.
583. Stopping randomized trials early for benefit and estimation of treatment effects: systematic review and meta-regression analysis.
作者: Dirk Bassler.;Matthias Briel.;Victor M Montori.;Melanie Lane.;Paul Glasziou.;Qi Zhou.;Diane Heels-Ansdell.;Stephen D Walter.;Gordon H Guyatt.; .;David N Flynn.;Mohamed B Elamin.;Mohammad Hassan Murad.;Nisrin O Abu Elnour.;Julianna F Lampropulos.;Amit Sood.;Rebecca J Mullan.;Patricia J Erwin.;Clare R Bankhead.;Rafael Perera.;Carolina Ruiz Culebro.;John J You.;Sohail M Mulla.;Jagdeep Kaur.;Kara A Nerenberg.;Holger Schünemann.;Deborah J Cook.;Kristina Lutz.;Christine M Ribic.;Noah Vale.;German Malaga.;Elie A Akl.;Ignacio Ferreira-Gonzalez.;Pablo Alonso-Coello.;Gerard Urrutia.;Regina Kunz.;Heiner C Bucher.;Alain J Nordmann.;Heike Raatz.;Suzana Alves da Silva.;Fabio Tuche.;Brigitte Strahm.;Benjamin Djulbegovic.;Neill K J Adhikari.;Edward J Mills.;Femida Gwadry-Sridhar.;Haresh Kirpalani.;Heloisa P Soares.;Paul J Karanicolas.;Karen E A Burns.;Per Olav Vandvik.;Fernando Coto-Yglesias.;Pedro Paulo M Chrispim.;Tim Ramsay.
来源: JAMA. 2010年303卷12期1180-7页
Theory and simulation suggest that randomized controlled trials (RCTs) stopped early for benefit (truncated RCTs) systematically overestimate treatment effects for the outcome that precipitated early stopping.
584. Vitamin B6 and risk of colorectal cancer: a meta-analysis of prospective studies.
Mounting evidence indicates that vitamin B(6), a coenzyme involved in nearly 100 enzymatic reactions, may reduce the risk of colorectal cancer.
585. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis.
作者: Matthias Briel.;Maureen Meade.;Alain Mercat.;Roy G Brower.;Daniel Talmor.;Stephen D Walter.;Arthur S Slutsky.;Eleanor Pullenayegum.;Qi Zhou.;Deborah Cook.;Laurent Brochard.;Jean-Christophe M Richard.;Francois Lamontagne.;Neera Bhatnagar.;Thomas E Stewart.;Gordon Guyatt.
来源: JAMA. 2010年303卷9期865-73页
Trials comparing higher vs lower levels of positive end-expiratory pressure (PEEP) in adults with acute lung injury or acute respiratory distress syndrome (ARDS) have been underpowered to detect small but potentially important effects on mortality or to explore subgroup differences.
586. Association between 9p21 genomic markers and heart disease: a meta-analysis.
Associations between chromosome 9p21 single-nucleotide polymorphisms (SNPs) and heart disease have been reported and replicated. If testing improves risk assessments using traditional factors, it may provide opportunities to improve public health.
587. Risk of deep vein thrombosis following a single negative whole-leg compression ultrasound: a systematic review and meta-analysis.
作者: Stacy A Johnson.;Scott M Stevens.;Scott C Woller.;Erica Lake.;Marco Donadini.;Ji Cheng.;José Labarère.;James D Douketis.
来源: JAMA. 2010年303卷5期438-45页
In patients with suspected lower extremity deep vein thrombosis (DVT), compression ultrasound (CUS) is typically the initial test to confirm or exclude DVT. Patients with an initial negative CUS result often require repeat CUS after 5 to 7 days. Whole-leg CUS may exclude proximal and distal DVT in a single evaluation.
588. Antidepressant drug effects and depression severity: a patient-level meta-analysis.
作者: Jay C Fournier.;Robert J DeRubeis.;Steven D Hollon.;Sona Dimidjian.;Jay D Amsterdam.;Richard C Shelton.;Jan Fawcett.
来源: JAMA. 2010年303卷1期47-53页
Antidepressant medications represent the best established treatment for major depressive disorder, but there is little evidence that they have a specific pharmacological effect relative to pill placebo for patients with less severe depression.
589. Strength of study evidence examined by the FDA in premarket approval of cardiovascular devices.
Medical devices are common in clinical practice and have important effects on morbidity and mortality, yet there has not been a systematic examination of evidence used by the US Food and Drug Administration (FDA) for device approval.
590. Assessment of claims of improved prediction beyond the Framingham risk score.
With heightened interest in predictive medicine, many studies try to document information that can improve prediction of major clinical outcomes.
591. Acute-onset floaters and flashes: is this patient at risk for retinal detachment?
作者: Hussein Hollands.;Davin Johnson.;Anya C Brox.;David Almeida.;David L Simel.;Sanjay Sharma.
来源: JAMA. 2009年302卷20期2243-9页
Acute onset of monocular floaters and/or flashes represents a common presentation to primary care physicians, and the most likely diagnosis is posterior vitreous detachment (PVD). A significant proportion of patients with acute PVD develop an associated retinal tear that can lead to retinal detachment and permanent vision loss if left untreated.
592. Does this patient with palpitations have a cardiac arrhythmia?
作者: Paaladinesh Thavendiranathan.;Akshay Bagai.;Clarence Khoo.;Paul Dorian.;Niteesh K Choudhry.
来源: JAMA. 2009年302卷19期2135-43页
Many patients have palpitations and seek advice from general practitioners. Differentiating benign causes from those resulting from clinically significant cardiac arrhythmia can be challenging and the clinical examination may aid in this process.
593. Tools for direct observation and assessment of clinical skills of medical trainees: a systematic review.
Direct observation of medical trainees with actual patients is important for performance-based clinical skills assessment. Multiple tools for direct observation are available, but their characteristics and outcomes have not been compared systematically.
594. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis.
作者: John R de Almeida.;Murtadha Al Khabori.;Gordon H Guyatt.;Ian J Witterick.;Vincent Y W Lin.;Julian M Nedzelski.;Joseph M Chen.
来源: JAMA. 2009年302卷9期985-93页
New evidence has emerged regarding the use of corticosteroids and antiviral agents in Bell palsy.
595. Sexual abuse and lifetime diagnosis of somatic disorders: a systematic review and meta-analysis.
作者: Molly L Paras.;Mohammad Hassan Murad.;Laura P Chen.;Erin N Goranson.;Amelia L Sattler.;Kristina M Colbenson.;Mohamed B Elamin.;Richard J Seime.;Larry J Prokop.;Ali Zirakzadeh.
来源: JAMA. 2009年302卷5期550-61页
Many patients presenting for general medical care have a history of sexual abuse. The literature suggests an association between a history of sexual abuse and somatic sequelae.
596. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis.
作者: Zachary Steel.;Tien Chey.;Derrick Silove.;Claire Marnane.;Richard A Bryant.;Mark van Ommeren.
来源: JAMA. 2009年302卷5期537-49页
Uncertainties continue about the roles that methodological factors and key risk factors, particularly torture and other potentially traumatic events (PTEs), play in the variation of reported prevalence rates of posttraumatic stress disorder (PTSD) and depression across epidemiologic surveys among postconflict populations worldwide.
597. Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality.
作者: .;Sebhat Erqou.;Stephen Kaptoge.;Philip L Perry.;Emanuele Di Angelantonio.;Alexander Thompson.;Ian R White.;Santica M Marcovina.;Rory Collins.;Simon G Thompson.;John Danesh.
来源: JAMA. 2009年302卷4期412-23页
Circulating concentration of lipoprotein(a) (Lp[a]), a large glycoprotein attached to a low-density lipoprotein-like particle, may be associated with risk of coronary heart disease (CHD) and stroke.
598. Adiponectin levels and risk of type 2 diabetes: a systematic review and meta-analysis.
The association of obesity with development of type 2 diabetes may be partly mediated by altered secretion of adipokines by adipose tissue. Greater adiposity down-regulates secretion of adiponectin, an adipokine with anti-inflammatory and insulin-sensitizing properties. The strength and consistency of the relation between plasma adiponectin and risk of type 2 diabetes is unclear.
599. Predictive value of factor V Leiden and prothrombin G20210A in adults with venous thromboembolism and in family members of those with a mutation: a systematic review.
作者: Jodi B Segal.;Daniel J Brotman.;Alejandro J Necochea.;Ashkan Emadi.;Lipika Samal.;Lisa M Wilson.;Matthew T Crim.;Eric B Bass.
来源: JAMA. 2009年301卷23期2472-85页
Testing for genetic risks for venous thromboembolism (VTE) is common, but the safety and utility of such testing need review.
600. Corticosteroids in the treatment of severe sepsis and septic shock in adults: a systematic review.
作者: Djillali Annane.;Eric Bellissant.;Pierre-Edouard Bollaert.;Josef Briegel.;Marco Confalonieri.;Raffaele De Gaudio.;Didier Keh.;Yizhak Kupfer.;Michael Oppert.;G Umberto Meduri.
来源: JAMA. 2009年301卷22期2362-75页
The benefit of corticosteroids in severe sepsis and septic shock remains controversial.
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