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Intensive Lifestyle Intervention for Type 2 Diabetes

Mar, 26/12/2017 - 01:00
To the Editor The study by Ms Johansen and colleagues found that an intensive lifestyle intervention compared with standard care resulted in a modest benefit in glycemic control in patients with type 2 diabetes diagnosed for less than 10 years, which did not meet the criteria of equivalence. More participants in the lifestyle group (56.3%) eliminated the use of glucose-lowering medication than in the standard care group (14.7%) at the end of the study in a post hoc analysis.

Intensive Lifestyle Intervention for Type 2 Diabetes—Reply

Mar, 26/12/2017 - 01:00
In Reply Dr Giugliano and colleagues raise concerns about the lack of information on type 2 diabetes remission as an outcome in our trial, which complicates comparisons with other lifestyle intervention studies. Moreover, the authors suggest that the lower HbA1c levels at entry to the study may have been responsible for the modest reduction in HbA1c and that physical activity is of lesser importance compared with different dietary components in the care of patients with type 2 diabetes.

Spiritual Care in Medicine

Mar, 26/12/2017 - 01:00
To the Editor Dr VanderWeele and colleagues addressed spirituality and health in a Viewpoint. They highlighted a gap between current evidence and clinical practice. Almost half of physicians do not desire spiritual care training, and more than one-quarter believe spirituality is personally unimportant, suggesting reasons why spiritual care is sparse.

Spiritual Care in Medicine—Reply

Mar, 26/12/2017 - 01:00
In Reply We agree with Dr Liao that philosophical ideas have influenced the nature and practice of medicine. We agree also that philosophical discussion of the “truth claims” of world religions and spiritual entities is important, albeit challenging. Although we further agree that materialist presuppositions have led to a neglect of spiritual care, we do not believe that materialist or atheist perspectives necessarily preclude the provision of such care. There is now robust data demonstrating its importance.

Error in Figure Title

Mar, 26/12/2017 - 01:00
In the Research Letter entitled “Trends in Emergency Department Visits for Nonfatal Self-inflicted Injuries Among Youth Aged 10 to 24 Years in the United States, 2001-2015,” published in the November 21, 2017, issue of JAMA, there was an error in the Figure title. The date in the title reads “2001-2005.” It should read “2001-2015.” This article was corrected online.

FDA Tries to Change the Tobacco Landscape

Mar, 26/12/2017 - 01:00
In this Medical News article, experts discuss the FDA’s strategy to reduce nicotine in cigarettes to nonaddictive levels.

Youth Increasingly Diagnosed With Opioid Misuse In EDs

Mar, 26/12/2017 - 01:00
This Medical News article discusses trends in opioid misuse and dependence in adolescents and young adults.

Gamification Motivates Physical Activity

Mar, 26/12/2017 - 01:00
A game-based intervention using social incentives to reward behaviors increased physical activity, according to a study published in JAMA Internal Medicine.

Prochlorperazine Superior to Hydromorphone for Migraine

Mar, 26/12/2017 - 01:00
Intravenous (IV) hydromorphone, commonly used as first-line therapy to treat acute migraine in the emergency department (ED), is substantially less effective than IV prochlorperazine, according to a trial published in Neurology.

Recumbent Delivery with Epidural and Spontaneous Vaginal Births

Mar, 26/12/2017 - 01:00
Nulliparous women who received low-dose epidural anesthesia during delivery were more likely to have spontaneous vaginal births when they were lying down during later stages of labor compared with women who were in an upright position, reported a study in the BMJ.

Stenting Does Not Relieve Stable Angina Symptoms

Mar, 26/12/2017 - 01:00
Patients with stable angina who underwent percutaneous coronary intervention (PCI) had no significant symptom relief or improvement in quality of life compared with patients who had a placebo procedure, found a trial in the Lancet. The observation that PCI leads to improvement in angina symptoms may involve a large placebo effect, suggested the authors.

Surgery Improves Seizures in Children With Drug-Resistant Epilepsy

Mar, 26/12/2017 - 01:00
Children with drug-resistant epilepsy who underwent surgery had greater freedom from seizures at 1 year than children who received only medical therapy, reported a study in the New England Journal of Medicine.

CMS Vows to Overhaul Medicaid

Mar, 26/12/2017 - 01:00
The Centers for Medicare & Medicaid Services (CMS) has announced a plan to overhaul Medicaid that would grant states more flexibility in how they administer the program.

Crowdsourcing Pregnancy Data

Mar, 26/12/2017 - 01:00
A new NIH research project aims to crowdsource data from pregnant women to answer long-standing questions about normal pregnancy and how the experiences of women with chronic conditions or disabilities may differ.

NIH Strategy to Combat Opioid Crisis

Mar, 26/12/2017 - 01:00
On the same day that the opioid crisis was declared a public health emergency, the National Institutes of Health (NIH) Director Francis Collins, MD, PhD, announced an approach to the opioid crisis that addresses the twin epidemics of addiction and chronic pain.

Opioid Emergency Declared

Mar, 26/12/2017 - 01:00
President Trump designated the ongoing opioid epidemic a public health emergency October 26, 2017. At his request, the Acting Secretary of the Department of Health and Human Services (HHS) Eric Hargan issued a declaration that provides additional flexibility for the Department and other federal and state health agencies in responding to the crisis.

Lyme Disease Spreading to More States

Mar, 26/12/2017 - 01:00
Lyme disease, spread via the bite of an infected tick, has expanded into states that border those with a historically high incidence, according to a recent CDC report on surveillance data for 2008-2015.

Most Drinking Water–Associated Outbreaks Linked to Legionella

Mar, 26/12/2017 - 01:00
During 2013-2014, the CDC received 42 reports of disease outbreaks in the United States related to drinking water, with 57% of them linked to Legionella, the bacterium that causes legionnaires disease, according to recent findings.

Movie Review of The Immortal Life of Henrietta Lacks

Mar, 26/12/2017 - 01:00
This Arts and Medicine essay reviews the HBO adaptation of The Immortal Life of Henrietta Lacks, produced by Oprah Winfrey, and the ongoing relevance of the story to life sciences research ethics.


Mar, 26/12/2017 - 01:00
as doctor-son to weekly visit the onegrilling nurses on leg swells and missed meds the other kneeling chair-side in the dayroom corner she nodding at phone pixof grands and great-grands speaking only to ask PLEASE let me go home and after my 3rd THIS is your home closing her eyes as if streaming the unimaginable everything seen loved feared mourned in all but 3 weeks of 99 years shaking her head as if thinking No not this then 10 hours later

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