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This Week in JAMA

This Week in JAMA Sleep Disorders in Police Officers Police officers—who often work extended shifts—may experience chronic sleep deficiency or have untreated sleep disorders, which may adversely affect their health and safety. In a cross-sectional survey of 4957 North American police officers and prospective follow-up surveys completed by 3545 officers, Rajaratnam and colleagues found that 40% of the respondents screened positive for a sleep disorder, which was associated with increased risk of self-reported adverse health and job-related administrative errors and safety violations. In an editorial, Grandner and Pack discuss health and safety implications of sleep deprivation and untreated sleep disorders for individuals and society. Article (AUTHOR VIDEO INTERVIEW) Heart Rate, Ischemic Heart Disease, and Mortality High resting heart rate is a recognized predictor of cardiovascular morbidity and mortality, but whether temporal changes in resting heart rate influence the risk of death from ischemic heart disease is not known. Nauman and colleagues analyzed data from a prospective cohort study of 29 325 apparently healthy individuals who had resting heart rate measured on 2 occasions approximately 10 years apart. The authors report that an increase in resting heart rate over the 10-year period was associated with an increased risk of ischemic heart disease–related death. Article Chlorthalidone Treatment and Long-term Survival In the Systolic Hypertension in the Elderly Program trial, in which 4736 older patients with isolated systolic hypertension were randomly assigned to chlorthalidone-based stepped-care therapy or placebo for 4.5 years, antihypertensive therapy resulted in a lower rate of cardiovascular events but effects on mortality were not significant. At a 22-year follow-up of the study participants, Kostis and colleagues found that 4.5 years' treatment with chlorthalidone-based therapy was associated with a gain in life expectancy free from cardiovascular death—corresponding to approximately 1 day gained for each month of treatment received. Article Immunosuppression in Sepsis Some evidence suggests that in severe sepsis, an early hyperinflammatory response is followed by immunosuppression. In a study that involved postmortem spleen and lung tissue harvested from 40 patients who died with sepsis, 29 control spleens from critically ill patients without sepsis, and 20 control lungs from transplant donors or lung cancer resections, Boomer and colleagues assessed the association of sepsis with changes in host immunity. The authors report biochemical, flow cytometric, and immunohistochemical findings consistent with immunosuppression in tissue obtained from the patients who died with sepsis that were not observed in the control tissues. In an editorial, Ward discusses evidence for the development of immunosuppression in patients with sepsis. In a commentary Angus calls for a reevaluation of current modes of treating sepsis. ArticleArticleArticle CLINICIAN'S CORNER JAMA Clinical Challenge A patient who experienced the sensation of an object striking his right eye, without acute pain or change in vision, presented to the emergency department 9 days later for evaluation of increasingly blurred vision. What would you do next? Article A Piece of My Mind “The central determinants of health care costs are physician habits, attitudes, and behaviors. In every clinical encounter, multiple decisions are made with significant financial consequences.” From “Fix It!” Article Medical News & Perspectives The recent recommendation by the US Preventive Services Task Force advising against prostate-specific antigen–based screening for prostate cancer has provoked considerable debate in the medical community. Article Commentaries Accelerating identification and approval of cancer drugs Article Homocysteine lowering: the role of subgroup analyses Article Placebo effect in clinical practice Article Author in the Room Teleconference Join Harold C. Sox, MD, on Wednesday, January 18, at 2 PM eastern time to discuss the new American Cancer Society process for creating trust-worthy cancer screening guidelines. To register, go to http://www.ihi.org/AuthorintheRoom. Editor's Audio Commentary Dr Bauchner summarizes and comments on this week's issue. Go to http://jama.ama-assn.org/misc/audiocommentary.dtl. Readers Respond How would you manage care for a house officer with a needlestick injury? Go to www.jama.com to read the case. Submit your response by January 1. JAMA Patient Page For your patients: Information about frostbite. Article http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

This Week in JAMA

JAMA , Volume 306 (23) – Dec 21, 2011

This Week in JAMA

Abstract

Sleep Disorders in Police Officers Police officers—who often work extended shifts—may experience chronic sleep deficiency or have untreated sleep disorders, which may adversely affect their health and safety. In a cross-sectional survey of 4957 North American police officers and prospective follow-up surveys completed by 3545 officers, Rajaratnam and colleagues found that 40% of the respondents screened positive for a sleep disorder, which was associated with increased risk of...
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Publisher
American Medical Association
Copyright
Copyright © 2011 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2011.1855
Publisher site
See Article on Publisher Site

Abstract

Sleep Disorders in Police Officers Police officers—who often work extended shifts—may experience chronic sleep deficiency or have untreated sleep disorders, which may adversely affect their health and safety. In a cross-sectional survey of 4957 North American police officers and prospective follow-up surveys completed by 3545 officers, Rajaratnam and colleagues found that 40% of the respondents screened positive for a sleep disorder, which was associated with increased risk of self-reported adverse health and job-related administrative errors and safety violations. In an editorial, Grandner and Pack discuss health and safety implications of sleep deprivation and untreated sleep disorders for individuals and society. Article (AUTHOR VIDEO INTERVIEW) Heart Rate, Ischemic Heart Disease, and Mortality High resting heart rate is a recognized predictor of cardiovascular morbidity and mortality, but whether temporal changes in resting heart rate influence the risk of death from ischemic heart disease is not known. Nauman and colleagues analyzed data from a prospective cohort study of 29 325 apparently healthy individuals who had resting heart rate measured on 2 occasions approximately 10 years apart. The authors report that an increase in resting heart rate over the 10-year period was associated with an increased risk of ischemic heart disease–related death. Article Chlorthalidone Treatment and Long-term Survival In the Systolic Hypertension in the Elderly Program trial, in which 4736 older patients with isolated systolic hypertension were randomly assigned to chlorthalidone-based stepped-care therapy or placebo for 4.5 years, antihypertensive therapy resulted in a lower rate of cardiovascular events but effects on mortality were not significant. At a 22-year follow-up of the study participants, Kostis and colleagues found that 4.5 years' treatment with chlorthalidone-based therapy was associated with a gain in life expectancy free from cardiovascular death—corresponding to approximately 1 day gained for each month of treatment received. Article Immunosuppression in Sepsis Some evidence suggests that in severe sepsis, an early hyperinflammatory response is followed by immunosuppression. In a study that involved postmortem spleen and lung tissue harvested from 40 patients who died with sepsis, 29 control spleens from critically ill patients without sepsis, and 20 control lungs from transplant donors or lung cancer resections, Boomer and colleagues assessed the association of sepsis with changes in host immunity. The authors report biochemical, flow cytometric, and immunohistochemical findings consistent with immunosuppression in tissue obtained from the patients who died with sepsis that were not observed in the control tissues. In an editorial, Ward discusses evidence for the development of immunosuppression in patients with sepsis. In a commentary Angus calls for a reevaluation of current modes of treating sepsis. ArticleArticleArticle CLINICIAN'S CORNER JAMA Clinical Challenge A patient who experienced the sensation of an object striking his right eye, without acute pain or change in vision, presented to the emergency department 9 days later for evaluation of increasingly blurred vision. What would you do next? Article A Piece of My Mind “The central determinants of health care costs are physician habits, attitudes, and behaviors. In every clinical encounter, multiple decisions are made with significant financial consequences.” From “Fix It!” Article Medical News & Perspectives The recent recommendation by the US Preventive Services Task Force advising against prostate-specific antigen–based screening for prostate cancer has provoked considerable debate in the medical community. Article Commentaries Accelerating identification and approval of cancer drugs Article Homocysteine lowering: the role of subgroup analyses Article Placebo effect in clinical practice Article Author in the Room Teleconference Join Harold C. Sox, MD, on Wednesday, January 18, at 2 PM eastern time to discuss the new American Cancer Society process for creating trust-worthy cancer screening guidelines. To register, go to http://www.ihi.org/AuthorintheRoom. Editor's Audio Commentary Dr Bauchner summarizes and comments on this week's issue. Go to http://jama.ama-assn.org/misc/audiocommentary.dtl. Readers Respond How would you manage care for a house officer with a needlestick injury? Go to www.jama.com to read the case. Submit your response by January 1. JAMA Patient Page For your patients: Information about frostbite. Article

Journal

JAMAAmerican Medical Association

Published: Dec 21, 2011

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