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  • JAMA October 2, 2013

    Figure: Smoothed Average Daily Morphine Equivalents Used Before and After Bariatric Surgery for Groups With Chronic, Some, or No Opioid Use Before Surgery

    Longitudinal trends were examined using fitted penalized b-spline curves of daily morphine equivalents used by each group before and after surgery. The tinted bands show 95% CIs for the fitted daily mean morphine equivalent estimates.
  • Oxycodone for Cancer Pain in Adult Patients

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    JAMA. 2015; 314(12):1282-1283. doi: 10.1001/jama.2015.8556

    This Clinical Evidence Synopsis summarizes a Cochrane review of trials comparing oxycodone with placebo and other opioids for treating cancer pain in adults.

  • A 93-Year-Old Man With Advanced Dementia and Eating Problems

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    JAMA. 2007; 298(21):2527-2536. doi: 10.1001/jama.298.17.jrr70001
  • JAMA June 14, 2016

    Figure: Mortality According to Study Drug Duration, Dose, and Baseline Use of Short-Acting Opioids

    An individual patient can be in multiple duration and dose categories during follow-up; thus, the numbers do not sum to the total cohort size. Adjusted hazard ratios and risk differences are shown for current use of long-acting opioids vs current use of analgesic anticonvulsants or cyclic antidepressants. The estimates according to duration of use and study drug dose during follow-up are adjusted for a time-dependent disease risk score; those for baseline use of short-acting opioids are adjusted for baseline propensity score and age and calendar year during follow-up. Cut points for low (≤cut point) vs high (>cut point) study drug dose were 60-mg/d morphine equivalents, 600-mg/d gabapentin equivalents, and 40-mg/d amitriptyline equivalents. For short-acting opioids, doses are in morphine equivalents.
  • JAMA October 11, 2017

    Figure: Opioid Use and Overdose and Fentanyl Drug Reports, 1999-2015

    aSource: National Center for Health Statistics at the US Centers for Disease Control and Prevention. WONDER online database: prescription opioid overdose deaths include fatal overdoses related to natural and semisynthetic opioids or methadone. Illicit opioid-related overdose deaths are related to heroin or synthetic nonmethadone opioids, and some overdose deaths are related to prescribed fentanyl or other prescribed synthetic opioids.bSource: Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health. https://www.samhsa.gov/data/population-data-nsduh/reports?tab=38.cSources: Dashed line from 1999 to 2005 (Drug Enforcement Administration. Automation of Reports and Consolidated Orders System: sales to pharmacies, hospitals, and practitioners for codeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, and oxycodone. Paulozzi LJ, et al. MMWR Morb Mortal Wkly Rep. 2011;60:1487-1492). Solid line from 2006 to 2015 (QuintilesIMS estimates of opioid prescriptions dispensed in the United States to 59 000 pharmacies, representing 88% of US prescriptions. Guy GP Jr, et al. MMWR Morb Mortal Wkly Rep. 2017;66:697-704).dSource: Drug Enforcement Administration. Fentanyl, 2001-2015. https://www.deadiversion.usdoj.gov/nflis/2017fentanyl.pdf. The number of fentanyl drug reports reflects the number of encounters by law enforcement that tested positive for fentanyl. Therefore, fentanyl drug reports provide an indication of the available supply of illicitly manufactured fentanyl.
  • JAMA April 6, 2011

    Figure 1: Percentage of Prescriptions Dispensed for Opioid Analgesics From Outpatient US Retail Pharmacies by Age and Physician Specialty, 2009

    These unprojected data include new and refill prescriptions. Top 5 prescribers for each age group are shown. Age groups for individuals 40 years and older were combined because they shared the same top 5 prescribers. Note that percentages in each group do not sum to 100 because prescriptions from specialties other than the main prescribers are not shown. Opioids included codeine and combination noninjectable (USC 02232), morphine and opium noninjectable (USC 02222), morphine and opium injectable (USC 02221), codeine and combination injectable (USC 02231). ENT indicates ear, nose and throat; GP/FM/DO, general practitioner/family medicine/osteopathic physicians; IM, internal medicine; and OB/GYN, obstetrics/gynecology. Included as primary care physicians are general practitioners, family practitioners, and osteopathic physicians; descriptors of the roles are those used by SDI Health.
  • JAMA June 17, 1998

    Figure: Management of Pain in Elderly Patients With Cancer

    Pharmacological treatment of cancer patients with pain according to the World Health Organization's (WHO's) 3-level ladder. The WHO's level 1 is nonnarcotic analgesics; level 2, weak opiates; and level 3, morphine or like substances.
  • Basal Muscle Amino Acid Kinetics and Protein Synthesis in Healthy Young and Older Men

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    JAMA. 2001; 286(10):1206-1212. doi: 10.1001/jama.286.10.1206
  • Glioblastoma and Other Malignant Gliomas: A Clinical Review

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    JAMA. 2013; 310(17):1842-1850. doi: 10.1001/jama.2013.280319

    Omuro and DeAngelis review the clinical management of malignant gliomas, including genetic and environmental risk factors such as cell phones, diagnostic pitfalls, symptom management, specific antitumor therapy, and common complications.

  • Chronic Use of Opioid Medications Before and After Bariatric Surgery

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    JAMA. 2013; 310(13):1369-1376. doi: 10.1001/jama.2013.278344

    Raebel and colleagues compare use of opioid medications for chronic pain 1 year before bariatric surgery vs 1 year after in a retrospective cohort study of 11 719 US patients from 2005 through 2009. In an Editorial, Alford discusses risks associated with opioid use and decreasing the need for chronic opioid therapy.

  • JAMA April 8, 1998

    Figure: Preemptive Epidural Analgesia and Recovery From Radical Prostatectomy: A Randomized Controlled Trial

    Figure 4.—Total postoperative analgesic use (mean ± SEM) during hospitalization for each patient group and route of administration. The epidural solution contained 0.01% preservative-free morphine sulfate and 0.05% bupivacaine. The morphine equivalent of opioids not administered through the epidural catheter was obtained by converting each dose to its equivalent of intravenous morphine. Although overall analgesic use did not differ between the preemptive and control groups (P=.18), a significant difference was present between the bupivacaine group and the control group (P=.05), but not between the bupivacaine group and the fentanyl group (P=.11).
  • Effect of Intravenous Paracetamol on Postoperative Morphine Requirements in Neonates and Infants Undergoing Major Noncardiac Surgery: A Randomized Controlled Trial

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    JAMA. 2013; 309(2):149-154. doi: 10.1001/jama.2012.148050
    To determine whether intravenous paracetamol would significantly (>30%) reduce morphine requirements in neonates and infants after major surgery, Ceelie and coauthors randomly assigned 71 infants younger than 1 year to receive paracetamol or morphine up to 48 hours following major surgery. Anand provides comment in the related Editorial.
  • Prescription of Long-Acting Opioids and Mortality in Patients With Chronic Noncancer Pain

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    JAMA. 2016; 315(22):2415-2423. doi: 10.1001/jama.2016.7789

    This retrospective study compared risk of death among Medicaid patients in Tennessee initiating long-acting opioid therapy for chronic noncancer pain with patients taking anticonvulsants or cyclic antidepressants.

  • Surgical vs Nonoperative Treatment for Lumbar Disk Herniation: The Spine Patient Outcomes Research Trial (SPORT) Observational Cohort

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    JAMA. 2006; 296(20):2451-2459. doi: 10.1001/jama.296.20.2451
  • Effect of Therapeutic Hypothermia Initiated After 6 Hours of Age on Death or Disability Among Newborns With Hypoxic-Ischemic Encephalopathy: A Randomized Clinical Trial

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    JAMA. 2017; 318(16):1550-1560. doi: 10.1001/jama.2017.14972

    This randomized clinical trial compares the effects of whole-body cooling vs usual care on death or disability at 18 to 22 months among infants with hypoxic-ischemic encephalopathy.

  • Potential Role of Pharmacogenomics in Reducing Adverse Drug Reactions: A Systematic Review

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    JAMA. 2001; 286(18):2270-2279. doi: 10.1001/jama.286.18.2270
  • Trends in Prescription Drug Use Among Adults in the United States From 1999-2012

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    JAMA. 2015; 314(17):1818-1830. doi: 10.1001/jama.2015.13766

    This pharmacoepidemiology study uses NHANES data to describe trends in prescription drug use among US adults between 1999 and 2012.

  • Effect of Dexmedetomidine on Mortality and Ventilator-Free Days in Patients Requiring Mechanical Ventilation With Sepsis: A Randomized Clinical Trial

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    JAMA. 2017; 317(13):1321-1328. doi: 10.1001/jama.2017.2088

    This randomized clinical trial compares the effects of sedation with vs without dexmedetomidine on mortality and ventilator-free days in patients with sepsis.

  • Naproxen With Cyclobenzaprine, Oxycodone/Acetaminophen, or Placebo for Treating Acute Low Back Pain: A Randomized Clinical Trial

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    JAMA. 2015; 314(15):1572-1580. doi: 10.1001/jama.2015.13043

    This randomized trial compared improvement in functional outcomes among patients with low back pain discharged from the emergency department and receiving naproxen with either placebo, cyclobenzaprine, or oxycodone/acetaminophen.

  • Effect of Corticosteroid Injection, Physiotherapy, or Both on Clinical Outcomes in Patients With Unilateral Lateral Epicondylalgia: A Randomized Controlled Trial

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    JAMA. 2013; 309(5):461-469. doi: 10.1001/jama.2013.129
    Coombes and coauthors report on the effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia.