We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
In This Issue of JAMA |

Highlights FREE

JAMA. 2014;311(7):647-649. doi:10.1001/jama.2013.279332.
Text Size: A A A
Published online


Agitation is common, persistent, and difficult to treat in patients with Alzheimer disease. In a randomized trial involving 186 patients with probable Alzheimer disease and clinically significant agitation, Porsteinsson and colleagues assessed the effects of a psychosocial intervention plus either citalopram or placebo for 9 weeks. The authors report that patients who received citalopram had significantly reduced agitation and caregiver distress; however, citalopram at the target dose of 30 mg/d was associated with worsening of cognitive score and adverse cardiac effects. In an Editorial, Small discusses the treatment of agitation in patients with dementia.

Related Editorial

Radiofrequency catheter ablation is an accepted second-line therapy in patients with paroxysmal atrial fibrillation (AF) who do not respond to antiarrhythmic drug therapy. Morillo and colleagues assessed whether the ablation procedure is superior to antiarrhythmic drug therapy as first-line therapy in a randomized trial that enrolled 127 treatment-naive patients with paroxysmal AF. The authors report that compared with drug treatment, ablation resulted in a lower rate of recurrent atrial tachyarrhythmias at 2 years. In an Editorial, Calkins discusses implications of the study findings for patient care.

Related Editorial

In a randomized trial that enrolled 232 functionally limited older adults who had completed traditional rehabilitation after a hip fracture, Latham and colleagues assessed whether a home exercise program that included functionally oriented exercises and minimal contact with a physical therapist would improve patients’ physical function. The authors report that compared with the control group patients (who received in-home and telephone-based nutrition education), intervention group patients had improved physical function 6 and 9 months after randomization.

To assess the incidence of clinically significant surgical site infections following ambulatory surgery, Owens and colleagues analyzed 2010 data from 8 states (284 098 procedures). The authors report that rates of clinically significant surgical site infections were relative low—approximately 3.0 per 1000 procedures at postsurgical day 14—however, given the large number of ambulatory procedures performed annually, the absolute number of infections may be substantial.


Wells and colleagues report results of a systematic review examining the etiology and treatment of venous thromboembolism (VTE). The authors consider the risks and benefits of treatment and summarize treatment recommendations during 3 phases of VTE—acute (first 5-10 days), long-term (the end of acute treatment through 3-6 months), and extended treatment—and by VTE etiology—whether provoked (by transient risk factors), unprovoked, or associated with malignancy.

Related Articles 1 and 2

Di Nisio and Middeldorp summarize a 2013 Cochrane review of 30 randomized trials (6462 patients) that examined the safety and efficacy of treatments for lower extremity superficial thrombophlebitis. Among the findings was that compared with placebo, fondaparinux, 2.5 mg subcutaneously once daily for 45 days, is associated with fewer symptomatic venous thromboembolic events and no increase in major bleeding.

Related Articles 1 and 2

This Medical Letter article reviews the clinical data on the safety and efficacy of 4 new oral anticoagulants for acute venous thrombosis: rivaroxaban, dabigatran etexilate, apixaban, and edoxaban. All appear to be effective and safe; however, data in older and sicker patients are limited.

Related Articles 1 and 2



Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.