tbuckley/cabot-search huggingface dataset:
Abstract 20554: Post-Discharge PharmD Medication Reconciliation and Uptitration Heart Failure Clinic Reduces 30-Day and 90-Day Readmission Rates Compared to Usual Care: An Innovative Approach to the Readmission Dilemma
Authors: Rasha Al-Bawardy, Samvit Tandan, Angela Cheng, Lendita Prlesi, Jason Slyer, Edward Borukhov, Ileana L Piña
Journal: Circulation (2014)

Heart failure (HF) remains the most common reason for 30-day readmissions despite financial penalties enacted by CMS. Joint Commission requires medication reconciliation (MedRec) at discharge. However, discharge MedRec does not include review of medications (Rx) taken by patient (pt) at home. We set up a 7-10 day post discharge Brown Bag Clinic (BBC) (HFrEF and HFpEF=EF≤40%), where pts bring Rx from home and PharmD trained in HF Rx provides education and performs MedRec and uptitration of GDMT. Demographics, Rx, doses and labs were collected at BBC and from the EMR. We hypothesized that pts who came to BBC would have a lower 30- and 90-day readmission rate and significantly different 90-day mortality compared to a control. GDMT presented only for HFrEF pts. Data are means ± SD. Comparisons between two groups were performed using a Student’s t-test. Of 176 pts scheduled, 103 (59%) were no-shows (group “C”) vs. 73 who attended BBC (group “BBCpts”) (See Table). Age, EF, Cr were similar for BBCpts vs. C, but ...
Abstract 14895: Predictors of Six-Month Mortality for Older Medicare Beneficiaries Hospitalized for Heart Failure: Plans for the Development and Validation of University of Alabama at Birmingham Heart Failure Model to Optimize Discharge Hospice Referral
Authors: Sula Mazimba, Raya Kheirbek, Nawar M Shara, Charity Morgan, Marie Bakitas, Orna Intrator, Monika Safford, Prakash Deedwania, Gregg Fonarow, Wilbert S Aronow, Ross D Fletcher, Richard M Allman, Ali Ahmed
Journal: Circulation (2014)

Introduction:  Reduction of hospital readmission to reduce the cost of Medicare is an Affordable Care Act priority and over the next 10 years hospitals are projected to lose over $7 billion in Medicare payments due to above-average 30-day all-cause readmission, for which heart failure (HF) is the leading cause. Findings from the Alabama HF Project demonstrated that among those who did not receive a discharge hospice referral, 20% died within 6-month of discharge and compared with these patients, those receiving a discharge hospice referral had a significant lower risk of 30-day all-cause readmissions. The objective of the current study is to develop a model to identify HF patients at risk for 6-month mortality so that the discharge hospice referral process may be optimized.   Methods:  In the Alabama HF Project, of the 8032 Medicare beneficiaries hospitalized for decompensated HF in 103 U.S. hospitals between 1999 and 2001, 7042 were aged ≥65 years. Of these, 170 (2.4%) received discharge hospice referral and were excluded. Of the remaining 6872 patients, 1492 (22%) died within six months and were considered hospice-eligible. Multivariable-adjusted Cox regression model was used to identify baseline characteristics significantly associated with 6-month post-discharge mortality.   Results:  Patients had a mean age of 78 (±8) years, 60% were women, 22% African American. 30-day all cause hospital readmission occurred in 37% of patients who died and 17% who did not die within 6 months post-discharge (p  Table  below. Race, Left ventricular ejection function, serum potassium, intensive care stay or cardiology care had no significant association with 6-month mortality. The model had a c-statistic of 0.73 (95% CI, 0.71-0.74).   Conclusions:  Several routinely available clinical and laboratory characteristics can reliably predict 6-month mortality in patients with HF.
Anxiety Disorders Affect 4.3 Million Working US Adults
Authors: Julie Jacob
Journal: JAMA (2015)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Changes in plasma biomarkers over time in patients (pts) with advanced biliary tract cancer (ABC) treated in the UK ABC-03 randomized phase II trial.
Authors: Alison Catherine Backen, Mairead G McNamara, Andre Lopes, Harpreet Wasan, Daniel H. Palmer, Marian Duggan, David Cunningham, Alan Anthoney, Philippa Corrie, Srinivasan Madhusudan, Anthony Maraveyas, Paul J. Ross, Justin S. Waters, William P. Steward, Charlotte Rees, Sandy Beare, John A. Bridgewater, Caroline Dive, Juan W. Valle
Journal: Journal of Clinical Oncology (2015)

4085 Background: ABC-03 was a randomized phase II trial of cediranib (C; AZD2171) [inhibitor of VEGFR-1, -2 and -3 tyrosine kinase and VEGF-induced signaling] or placebo (P) in combination with cisplatin/gemcitabine for pts with ABC. Changes in plasma biomarkers including angiogenic proteins and a marker of cell death (CK18) have not been reported in ABC. Methods: ELISA was performed for 15 angiogenesis or inflammatory-related proteins and CK18 in plasma of pts with repeated sampling during treatment and at disease progression. Tumor markers were also evaluated. Overall survival (OS) was analyzed using Cox model for baseline (BL) biomarkers and time-varying covariate Cox model (TVC) for biomarkers with serial measurements. Results: Plasma samples were available from 117 of 124 pts (59 in C arm, 58 in P). After adjusting for treatment and pt characteristics, higher BL VEGFR2 (p = 0.02), CK18 (p = 0.005), CEA (p < 0.001), CA19-9 (p = 0.03) and CA125 (p = 0.001) correlated with shorter OS, as did incremental increases in CK18 (HR 1.08, 95%CI 1.05-1.11, p < 0.001) and IL-6 (HR 1.02, 95%CI 1.00-1.03, p = 0.008) using TVC. There was evidence for interaction between treatment and BL CA19-9 and PDGFbb for OS: incremental increases in CA19-9 were associated with an increased risk of death (C: HR 1.44, 95%CI 1.16-1.80; P: HR 1.03, 95%CI 1.00-1.05, p = 0.001) and higher values of PDGFbb were associated with a decreased risk of death with C (HR 0.82, 95%CI 0.68-1.00) and an increased risk of death with P (HR 1.15, 95%CI 0.99-1.34, p = 0.01). In TVC, there was evidence of interaction between treatment and VEGFA (p = 0.03), PDGFbb (p = 0.08), VEGFC (p = 0.06) and SDF1b (p = 0.06). Higher values of VEGFA were associated with increased risk of death with P (HR 1.31, 95%CI 1.06-1.62) but not with C (HR 0.99, 95%CI 0.86-1.15) (p = 0.03). Conclusions: High BL VEGFR2, CK18 and tumor markers are associated with a poor outcome in pts with ABC. Increasing levels of CA19-9 and PDGFbb from BL were associated with increased and decreased risk of death, respectively, in C-treated pts. Changes in VEGFA correlated with OS for pts on P but not C. These findings may inform future clinical trial stratification and design. Clinical trial information: NCT00939848.
Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome
Authors: Timothy King
Journal: JAMA (2004)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 18459: CT-guided Planar Imaging for the Assessment of Right Ventricular Myocardial Perfusion: a Novel, Noninvasive Monitoring Tool for Patients With Pulmonary Hypertension
Authors: Ken Kato, Hideyuki Miyauchi, Takashi Iimori, Koichi Sawada, Yoichi Kuwabara, Seichiro Sakao, Koichiro Tatsumi, Yoshio Kobayashi
Journal: Circulation (2014)

Introduction: In patients with pulmonary hypertension (PH), right ventricular (RV) dysfunction as a consequence of increased RV pressure may result in RV enlargement and hypertrophy, which also increases the RV myocardial perfusion. Hypothesis: We assessed the hypothesis that RV myocardial perfusion detected by planar thallium-201 (201Tl) imaging is useful for quantitative evaluation for RV dysfunction in PH patients. Method: The study groups included 16 PH patients with chronic thromboembolic pulmonary hypertension (CTEPH) and 24 healthy controls. All subjects underwent myocardial perfusion SPECT/CT. Cardiac CT was used to obtain the optimal angle to differentiate the RV from the left ventricle (LV). Forty minutes after intravenously administration of 111 MBq of 201Tl, planar acquisition from the optimal angle was performed. In the planar image, we measured the total counts of 201Tl in the RV and LV. The relative count of the RV to LV (HR/HL) was calculated as RV myocardial perfusion indicator for this study. Mean pulmonary artery pressure (mPAP) by cardiac catheterization was obtained in all PH patients to estimate the severity. Results: HR/HL was significantly elevated in the PH group compared with control (0.57 ± 0.13 vs. 0.36 ± 0.07, p &lt;0.01). In the PH group, average mPAP was 42.2 ± 8.84mmHg, which was significantly correlated with HR/HL (r=0.70, p&lt;0.01). In 7 patients with CTEPH who underwent pulmonary endarterectomy (PEA), HR/HL significantly decreased after PEA (from 0.57±0.16 to 0.42±0.07, p&lt;0.05). The decrease of HR/HL was significantly associated with the decrease of mPAP after PEA (r=0.78, p&lt;0.05). Conclusion: Relative RV accumulation in CT-guided 201Tl planar imaging by SPECT/CT was associated with the severity of PH in CTEPH patients and decreased after surgical treatment of CTEPH in parallel with the reduction of mPAP. This method may represent a novel, noninvasive monitoring tool for PH patients.
Abstract P145: Circulating and Dietary Trans-Fatty Acids and Incident Type-2 Diabetes Mellitus in Older Adults: The Cardiovascular Health Study
Authors: Qianyi Wang, Fumiaki Imamura, Wenjie Ma, Rozenn N Lemaitre, Irena B King, Xiaoling Song, Mary L Biggs, Joseph A Delaney, Kenneth J Mukamal, Luc Djousse, David Siscovick, Dariush Mozaffarian
Journal: Circulation (2014)

Background: While trans-fatty acids (TFA) influence CHD, their effects on type 2 diabetes mellitus (DM) are not established, with mixed findings of experimental, short-term intervention, and observational studies. Effects may vary depending on specific TFA subtype or method of assessment (circulating biomarkers vs. diet). Objectives: To examine prospective associations of circulating and estimated dietary TFA with risk of incident DM in older adults. Methods: Plasma phospholipid trans-(t-)16:1n9, total t-18:1, and cis/trans-(c/t-), t/c- and t/t-18:2(n6,9) were measured in blood stored among 3,076 adults in the Cardiovascular Health Study (CHS), aged 74±5y and free of prevalent DM in 1992. Dietary TFA was estimated among 4,246 adults free of prevalent DM when dietary questionnaires were initially administered in 1989 (n=3,917) or in 1996 (n=329). Incident DM up to 2009 was defined as new use of insulin or hypoglycemic drugs, fasting glucose≥126 mg/dL, nonfasting glucose≥200 mg/dL, or 2-hour post-challenge glucose≥200 mg/dL. The relative risk of incident DM associated with each TFA subtype was assessed using multivariate Cox proportional hazards regression. Results: Levels of each circulating TFA subtype varied from 2.00±0.73 (% of fatty acids) for t-18:1 to 0.05±0.02 for t/t-18:2. TFA subtypes were moderately to highly intercorrelated (r=0.4 to 0.8), except for t/t-18:2 which weakly correlated with all other TFAs (r&lt;0.1). During 30,927 person-years, 364 DM cases occurred among participants with plasma phospholipid TFA measures. Adjusting for demographics, lifestyle factors, and medical history, lower DM risk was associated with higher levels of t-16:1n9 (Quartile 4 vs. Quartile 1 HR=0.76, p trend=0.03), total t-18:1 (HR=0.71, p trend=0.02) and t/t-18:2 (HR=0.73, p trend=0.04). However, further mutual adjustment for the different TFA subtypes attenuated these inverse associations, and none of the 5 circulating TFA biomarkers were independently related to incident DM (p trend≥0.14 for all). During 50,508 person-years in the dietary analyses, 453 DM cases occurred. Adjusting for demographics, lifestyle, medical history, and other dietary habits, increased DM risk was observed among participants with higher consumption of total TFA (Quartile 4 vs. Quartile 1 HR=1.40, p trend=0.04) and t-18:2 (HR=1.49, p trend=0.006), and t-18:1 consumption (HR=1.32, p trend=0.08), although the latter was not statistically significant. Conclusions: Plasma phospholipid TFA subtypes were not associated, whereas dietary total TFA and t-18:2 were positively associated, with incident DM among older adults. These findings highlight the need to understand how dietary TFA may influence DM and why associations may differ for circulating versus dietary TFAs.
Abstract 12510: Volume of Myocardial Delayed Contrast Enhancement is a Strong Predictor of Cardiac Outcomes in Patients with Pulmonary Hypertension
Authors: Teruo Noguchi, Yosuke Nishihata, Masahito Sakuma, Norifumi Nakanishi, Naoaki Yamada
Journal: Circulation (2010)

Background: Delayed myocardial enhancement (DE) on cardiac magnetic resonance (CMR) in patients with pulmonary hypertension (PH) correlates with disease severity and right ventricular (RV) systolic function. However, the correlation of DE with overall prognosis is unknown. Hypothesis: We hypothesized that the DE volume on CMR correlates with cardiovascular events in patients with PH. Methods: CMR was performed using a 1.5T MR system on 26 consecutive PH patients (15 idiopathic PH, 11 chronic thromboembolic PH; CTEPH) within 1 week following cardiac catheterization. A multi-slice, breath-hold, inversion recovery true-FISP sequence was performed 20 min after Gadolinium injection. Pulmonary arterial pressure (PAP), pulmonary vascular resistance index (PVRI), and cardiac index (CI) were measured by cardiac catheterization. Univariate and multivariate Cox regression analyses were used to identify predictors of cardiac events defined as death or heart failure. Results: DE was seen in all patients at the inserti...
Wayne Katon, MD
Authors: Stephan Heckers
Journal: JAMA Psychiatry (2015)

Wayne Katon, MD; Henrik Sondergaard Pedersen, MSc; Anette Riisgaard Ribe, MD; Morten Fenger-Grøn, MSc; Dimitry Davydow, MD, MPH; Frans Boch Waldorff, MD, PhD; Mogens Vestergaard, MD, PhD
Important Clarifications About Treating Indeterminate Vascular Injuries to the Neck
Authors: Jason T. Lee
Journal: JAMA Surgery (2015)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
208. Regenerative Properties of Retinoic Acid Receptor β2 in Rat Model of Dorsal Rhizotomy
Authors: Liang-Fong Wong, Ping K. Yip, Anna Battaglia, John Grist, Lucy E. Walmsley, Malcolm Maden, Susan M. Kingsman, Alan J. Kingsman, Stephen B. McMahon, Nicholas D. Mazarakis
Journal: Molecular Therapy (2004)

After rhizotomy, axonal regeneration in the dorsal root is arrested in the transition zone between the peripheral and central nervous system. The damaged sensory axons have been shown to grow across this inhibitory dorsal root entry zone (DREZ) with the provision of neurotrophic factors1. In this study we present a novel approach to stimulating axonal growth across this barrier via the use of an equine infectious anaemia virus (EIAV)-based lentiviral vector expressing a novel regenerative molecule. Retinoic acid receptor β2 (RARβ2) is a transcription factor activated by retinoic acid, a biologically active metabolite of Vitamin A, and has been shown to induce neurite outgrowth in adult spinal cord explants2. An EIAV-based lentiviral vector expressing RARβ2 was delivered to sensory neurones via injection into dorsal spinal cord. In control animals that received an EIAV vector expressing β-galactosidase (LacZ), dorsal rhizotomy resulted in the loss of peripheral sensory axons innervating the spinal cord corresponding to the injured roots. In contrast, injured primary sensory afferents were found to regenerate across the DREZ in RARβ2 animals. Furthermore RARβ2-treated animals exhibited improvement in performance in behavioural tasks assessing for sensory and motor functions. These results suggest that lentiviral-mediated delivery of RARβ2 promoted the regeneration of injured sensory axons into the inhibitory DREZ after rhizotomy and promoted functional recovery. Hence this novel approach shows potential for therapeutic applications in the treatment of dorsal root avulsion injuries.
Abstract 18682: Inflammatory Biomarkers for Prognostication of Outcomes in Stable Coronary Artery Disease - Experiences From the STABILITY Trial
Authors: Claes Held, Harvey D White, Ralph A Stewart, Andrzej Budaj, Christopher P Cannon, Robert A Harrington, Wolfgang Koenig, Sue Krug-Gourley, Agneta Siegbahn, Philippe Gabriel Steg, Elizabeth Tarka, Olof Petter Östlund, Lars Wallentin
Journal: Circulation (2014)

Introduction: Prognostication of outcome in patients with stable coronary artery disease (CAD) is currently based on clinical characteristics and biomarkers indicating dysglycemia, dyslipidemia, renal dysfunction and possibly cardiac biomarkers. Hypothesis: We assessed the incremental prognostic value of biomarkers of inflammation in the Stabilization of Atherosclerotic Plaque By Initiation of Darapladib Therapy (STABILITY) trial. Methods: In STABILITY, 15,828 patients with chronic CAD on optimal medical treatment were randomized to treatment with darapladib or placebo. Serum levels of hs-C-reactive protein (CRP) and Interleukin (IL)-6 were measured at randomization in 14,373 and 4733 patients, respectively. Centrally adjudicated outcome events were accumulated during a median of 3.7 years follow-up. The associations between levels of the biomarkers and outcomes were evaluated by multivariable Cox regression. Results: The impact of biomarker levels at baseline in relation to the composite endpoint, MACE (major adverse cardiovascular event), of cardiovascular (CV) death, myocardial infarction (MI) and stroke, and its individual components are presented in the Table. Both hs-CRP and IL-6 provided strong prognostic information in addition to clinical predictors for outcomes of MACE, CV death and MI, but not for stroke. Conclusions: In conclusion, the cardiac biomarkers hs-CRP and IL-6, provided important complementary prognostic information on the risk of CV mortality and MI, but not for stroke in patients with stable CAD on optimal medical treatment.
Celebrating the ACP Centennial: From the <i>Annals</i> Archive—Ebola Virus Disease
Authors: Deborah Cotton
Journal: Annals of Internal Medicine (2015)

Editorials2 June 2015Celebrating the ACP Centennial: From the Annals Archive—Ebola Virus DiseaseDeborah Cotton, MD, MPH, Deputy EditorDeborah Cotton, MD, MPH, Deputy EditorSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-2866 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail During the 2015 centennial year of the American College of Physicians, publisher of Annals of Internal Medicine, Annals editors will link an article in each issue with an earlier paper from our archives addressing the same disease or clinical question. We hope our readers find this interesting and we welcome comments, especially from physicians who were practicing at the time of publication of the original paper who might offer insight into the impact of the earlier paper on their knowledge or practice.The Ebola virus disease epidemic in western Africa has been catastrophic in its magnitude and loss of life. ...References1. Boggild AK, Esposito DH, Kozarsky PE, Ansdell V, Beeching NJ, Campion D, et al. Differential diagnosis of illness in travelers arriving from Sierra Leone, Liberia, or Guinea: a cross-sectional study from the GeoSentinel Surveillance Network. Ann Intern Med. 2015;162:757-64. doi:10.7326/M15-0074 LinkGoogle Scholar2. Viral hemorrhagic fever: initial management of suspected and confirmed cases. Ann Intern Med. 1984;101:73-81. doi:10.7326/0003-4819-101-1-73 LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Deborah Cotton, MD, MPH, Deputy Editor PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoViral Hemorrhagic FeverDifferential Diagnosis of Illness in Travelers Arriving From Sierra Leone, Liberia, or Guinea: A Cross-sectional Study From the GeoSentinel Surveillance Network Andrea K. Boggild , Douglas H. Esposito , Phyllis E. Kozarsky , Vernon Ansdell , Nicholas J. Beeching , Daniel Campion , Francesco Castelli , Eric Caumes , Francois Chappuis , Jakob P. Cramer , Effrossyni Gkrania-Klotsas , Martin P. Grobusch , Stefan H.F. Hagmann , Noreen A. Hynes , Poh Lian Lim , Rogelio López-Vélez , Denis J.M. Malvy , Marc Mendelson , Philippe Parola , Mark J. Sotir , Henry M. Wu , and Davidson H. Hamer , for the GeoSentinel Surveillance Network* Metrics 2 June 2015Volume 162, Issue 11Page: 792KeywordsArchivesEbola virusMetastasisSigns and symptomsViral diseasesViral hemorrhagic fevers ePublished: 2 June 2015 Issue Published: 2 June 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...