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Evolution of research on the effect of unemployment on acute myocardial infarction risk. 失业对急性心肌梗死风险影响的研究进展。
Pub Date : 2012-12-10 DOI: 10.1001/jamainternmed.2013.1835
William T Gallo
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引用次数: 11
Fasting for lipid testing: is it worth the trouble?: comment on "fasting time and lipid levels in a community-based population". 空腹做血脂测试:值得这么麻烦吗?对“社区人群禁食时间和血脂水平”的评论。
Pub Date : 2012-12-10 DOI: 10.1001/2013.jamainternmed.263
Amit V Khera, Samia Mora
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引用次数: 24
Is hypertension overtreatment a silent epidemic?-Reply. 高血压过度治疗是一种无声的流行病吗?
Pub Date : 2012-12-10 DOI: 10.1001/2013.jamainternmed.317
Eve A Kerr, Timothy P Hofer
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引用次数: 0
About this journal. 关于这本日记。
Pub Date : 2012-12-10 DOI: 10.1001/archinte.172.22.1699
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引用次数: 0
Using health information technology to improve health care: emphasizing speed to value. 利用卫生信息技术改善卫生保健:强调速度与价值。
Pub Date : 2012-12-10 DOI: 10.1001/2013.jamainternmed.607
Walter H Ettinger
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引用次数: 4
Body mass index vs cholesterol in cardiovascular disease risk prediction models. 体重指数与胆固醇在心血管疾病风险预测模型中的关系
Pub Date : 2012-12-10 DOI: 10.1001/2013.jamainternmed.327
David Faeh, Julia Braun, Matthias Bopp
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引用次数: 22
Acupuncture for dyspnea on exertion in chronic obstructive pulmonary disease: no blindness-reply. 针刺治疗慢性阻塞性肺疾病用力时呼吸困难:无盲应答。
Pub Date : 2012-12-10 DOI: 10.1001/jamainternmed.2013.1285
Masao Suzuki, Naoto Ishizaki
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引用次数: 0
Community health workers combat readmission. 社区卫生工作者打击再入院。
Pub Date : 2012-12-10 DOI: 10.1001/2013.jamainternmed.82
Shreya Kangovi, Judith A Long, Ezekiel Emanuel
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引用次数: 25
Cost control in a parallel universe: Medicare spending in the United States and Canada. 平行宇宙中的成本控制:美国和加拿大的医疗保险支出。
Pub Date : 2012-12-10 DOI: 10.1001/2013.jamainternmed.272
David U Himmelstein, Steffie Woolhandler
1. Joint Commission. Improving America’s Hospitals: The Joint Commission Annual Report on Quality and Safety, 2007. http://www.jointcommission .org/Improving_Americas_Hospitals_The_Joint_Commissions_Annual _Report_on_Quality_and_Safety_-_2007/. Accessed September 6, 2012. 2. Cohen MD, Hilligoss PB. The published literature on handoffs in hospitals: deficiencies identified in an extensive review. Qual Saf Health Care. 2010; 19(6):493-497. 3. Arora VM, Johnson JK, Meltzer DO, Humphrey HJ. A theoretical framework and competency-based approach to improving handoffs. Qual Saf Health Care. 2008;17(1):11-14. 4. Horwitz LI, Moin T, Green ML. Development and implementation of an oral sign-out skills curriculum. J Gen Intern Med. 2007;22(10):1470-1474. 5. Riesenberg LA, Leitzsch J, Little BW. Systematic review of handoff mnemonics literature. Am J Med Qual. 2009;24(3):196-204. 6. Hilligoss PB, Cohen MD. Hospital handoffs as multifunctional situated routines: implications for researchers and administrators. In: Blair JD, Fottler M, Savage G, Friedman LH, eds. Biennial Review of Health Care Management (Advances in Health Care Management). Vol 11. Bingley, England: Emerald Group Publishing; 2011:91-132. 7. Manly BFJ. Randomization, Bootstrap and Monte Carlo Methods in Biology. Boca Raton, FL: Chapman & Hall/CRC; 2007. 8. De Leeuw J, Hornik K, Mair P. Isotone optimization in R: pool-adjacentviolators algorithm (PAVA) and active set methods. J Stat Softw. 2009; 32(5):1-24. 9. Robertson T, Wright FT, Dykstra R. Order Restricted Statistical Inference. Chichester, NY: Wiley; 1988. 10. Sanghavi D. The phantom menace of sleep-deprived doctors. New York Times Magazine. 2011. http://www.nytimes.com/2011/08/07/magazine /the-phantom-menace-of-sleep-deprived-doctors.html. Accessed January 15, 2012.
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引用次数: 22
Supratherapeutic dosing of acetaminophen among hospitalized patients. 对乙酰氨基酚在住院患者中的超治疗剂量。
Pub Date : 2012-12-10 DOI: 10.1001/2013.jamainternmed.438
Li Zhou, Saverio M Maviglia, Lisa M Mahoney, Frank Chang, E John Orav, Joseph Plasek, Laura J Boulware, David W Bates, Roberto A Rocha

Background: We investigated acetaminophen use and identify factors contributing to supratherapeutic dosing of acetaminophen in hospitalized patients.

Methods: We retrospectively reviewed the electronic health records of adult patients who were admitted to 2 academic tertiary care hospitals (hospital A amd hospital B) from June 1, 2010, to August 31, 2010, and who received acetaminophen during their hospitalization. Patients' acetaminophen administration records (including drug name, dose, administration time, hospital units, etc), demographic data, diagnoses, and results from liver function tests were obtained. The main outcome measures included acetaminophen exposure rate and supratherapeutic dosing rate among hospitalized patients, hazard ratios (HRs) and 95% confidence intervals (CIs) for risk factors for supratherapeutic dosing, and changes in liver function test before and after supratherapeutic dosing.

Results: A total of 14 411 patients (60.7%) were exposed to acetaminophen, of whom 955 (6.6%) exceeded the 4 g per day maximum recommended dose. In addition, 22.3% of patients who were 65 years or older and 17.6% of patients with chronic liver diseases exceeded the recommended limit of 3 g per day. Patients receiving excessive doses of acetaminophen tended to have significant alkaline phosphatase elevations, although causal relationship cannot be concluded. A significantly higher risk of supratherapeutic dosing was observed in hospital A (HR, 1.6 [95% CI, 1.4-1.8]), white patients (HR, 1.5 [95% CI, 1.3-1.7]), patients diagnosed as having osteoarthritis (HR, 1.4 [95% CI, 1.3-1.6]), and those who received scheduled administrations (HR, 16.6 [95% CI, 13.5-20.6]), multiple product formulations (HR, 2.4 [95% CI 2.0-2.9]), or the 500-mg strength formulation (HR, 1.9 [95% CI, 1.5-2.3]). A lower risk was found for pro re nata (as needed) administrations (HR, 0.7 [95% CI, 0.6-0.9]) and in nonsurgical and non–intensive care units (HR, 0.6 [95% CI, 0.5-0.7]).

Conclusions: Supratherapeutic dosing of acetaminophen was significantly associated with multiple factors. Interventions to reduce the incidence of some risk factors may prevent supratherapeutic acetaminophen dosing in hospitalized patients.

背景:我们调查了住院患者对乙酰氨基酚的使用情况,并确定了影响对乙酰氨基酚超治疗剂量的因素。方法:回顾性分析2010年6月1日至2010年8月31日在2家三级专科医院(A医院和B医院)住院并在住院期间服用对乙酰氨基酚的成年患者的电子健康记录。获得患者对乙酰氨基酚给药记录(包括药名、剂量、给药时间、医院单位等)、人口学资料、诊断及肝功能检查结果。主要结局指标包括住院患者对乙酰氨基酚暴露率和超治疗给药率,超治疗给药危险因素的危险比(hr)和95%可信区间(ci),以及超治疗给药前后肝功能检查的变化。结果:共有14411例患者(60.7%)暴露于对乙酰氨基酚,其中955例(6.6%)超过每日最大推荐剂量4 g。此外,22.3%的65岁及以上的患者和17.6%的慢性肝病患者超过了建议的每天3克的限制。过量服用对乙酰氨基酚的患者往往有明显的碱性磷酸酶升高,但因果关系尚不能确定。在A医院(HR, 1.6 [95% CI, 1.4-1.8])、白人患者(HR, 1.5 [95% CI, 1.3-1.7])、诊断为骨关节炎的患者(HR, 1.4 [95% CI, 1.3-1.6])和接受预定给药(HR, 16.6 [95% CI, 13.5-20.6])、多种制剂(HR, 2.4 [95% CI 2.0-2.9])或500 mg强度制剂(HR, 1.9 [95% CI, 1.5-2.3])的患者中观察到超治疗剂量的风险显著较高。根据需要给药的风险较低(风险比为0.7 [95% CI, 0.6-0.9]),非手术和非重症监护病房的风险比为0.6 [95% CI, 0.5-0.7])。结论:对乙酰氨基酚超治疗剂量与多种因素显著相关。减少某些危险因素发生率的干预措施可能会阻止住院患者使用超治疗性对乙酰氨基酚。
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引用次数: 24
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Archives of internal medicine
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