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In This Issue of JAMA |

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JAMA. 2015;314(3):203-205. doi:10.1001/jama.2014.11865.
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RESEARCH

In a phase 2 trial that enrolled 980 US adults, Jackson and colleagues assessed immunogenicity and safety of an inactivated avian influenza A H7N9 vaccine in varying doses and with and without AS03 and MF59 adjuvant. Among the authors’ findings was that the AS03 and MF59 adjuvants augmented the immune response to 2 doses of the vaccine, with vaccine formulations with AS03 adjuvant formulations inducing the highest antibody titers.

To examine the association between prehospital interventions by bystanders—chest compressions and use of a public-access automated external defibrillator—and neurologically intact survival after out-of-hospital cardiac arrest, Nakahara and colleagues analyzed registry data from 167 912 patients who experienced a bystander-witnessed out-of-hospital cardiac arrest in Japan in 2005-2012. The authors report that during the years of study, rates of bystander chest compression and bystander defibrillation increased and were associated with an increased likelihood of neurologically intact survival after out-of-hospital cardiac arrest. In an Editorial, Nichol and Kim discuss strategies to improve patient survival after out-of-hospital cardiac arrest.

Editorial and Related Article

In an analysis of registry data from 4961 North Carolina patients who experienced an out-of-hospital cardiac arrest in 2010-2013—a time frame that included statewide efforts to improve bystander and first-responder resuscitation interventions—Malta Hansen and colleagues found that the proportion of patients who received bystander-initiated cardiopulmonary resuscitation (CPR) and defibrillation by first responders increased and was associated with a greater likelihood of survival. Bystander-initiated CPR was associated with a greater likelihood of survival with favorable neurological outcome.

Editorial and Related Article

Some studies suggest that pioglitazone use may increase risk of cancer. In analyses of data from 2 prospective cohorts of patients with diabetes—193 099 in a bladder cancer cohort and 236 507 in a study of 10 additional cancers—and a case-control study (464 cases and 464 matched controls), Lewis and colleagues found no statistically significant association between pioglitazone use and bladder cancer. Increased risks of prostate and pancreatic cancers associated with pioglitazone use merit further investigation. In an Editorial, Sharfstein and Kesselheim discuss the safety of prescription drugs. An Editorial by Fontanarosa and colleagues discusses journal policies regarding research on the safety of medical therapies and responsibilities of journals to the health of the public.

CLINICAL REVIEW & EDUCATION

Prystowsky and colleagues report results of a comprehensive search and systematic review of the current literature relating to the treatment of atrial fibrillation (5044 references identified, with an emphasis on the last 5 years). The authors discuss mechanisms of atrial fibrillation, prevention and modification of inciting causes, rate and rhythm control strategies, and appropriate anticoagulation therapy.

An article in JAMA Surgery reported that implementation of a multidisciplinary surgical site infection (SSI) prevention care bundle was associated with a substantial reduction in superficial SSIs after colorectal surgery. In this From the JAMA Network article, Itani discusses efforts to reduce SSIs.

This JAMA Clinical Guidelines Synopsis by Moss and Cifu summarizes the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation (Section on Prevention of Thrombosis). The authors consider the quality of the evidence base, highlight major guideline recommendations for patients in specific risk categories, and discuss areas in need of future study or ongoing research.

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