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US Surgeon General Vivek Murthy: Firearm Violence Is a Public Health Crisis JAMA (IF 63.1) Pub Date : 2024-07-19 Jennifer Abbasi, Yulin Hswen
This Medical News article is an interview with US Surgeon General, Vivek Murthy, MD, MBA, and JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, about a new advisory that declares gun violence a public health crisis.
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A 25-Year-Old With an Incidentally Detected Ascending Thoracic Aortic Aneurysm and Bicuspid Aortic Valve JAMA (IF 63.1) Pub Date : 2024-07-18 Nicholas Oh, Eric E. Roselli, Patrick R. Vargo
A woman with shortness of breath underwent imaging that showed an isolated dilatation in the mid ascending aorta and a bicuspid aortic valve but no pulmonary infiltrates, effusion, or embolism and no aortic stenosis or regurgitation; her family history is notable for aortic dissection. What would you do next?
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Someone Has to Be Around to Put Out the Lights JAMA (IF 63.1) Pub Date : 2024-07-18 Joel Yager
In this narrative medicine essay, a retired psychiatrist emulates his father who in his sunset years helped many of his friends, family members, and loved ones navigate end-of-life illnesses and death.
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Toward a Comprehensive Measure of Drug-Attributable Harm JAMA (IF 63.1) Pub Date : 2024-07-18 Vaughan W. Rees, Connor Kubeisy, Howard K. Koh
This Viewpoint from authors at the Harvard T.H. Chan School of Public Health summarizes approaches to addressing substance use in the US; challenges posed by metrics such as overdose deaths; and more informative metrics, such as quality-adjusted life-years, to promote health equity and improve length and quality of life and health outcomes at all levels.
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Medical Practice and the Climate Crisis JAMA (IF 63.1) Pub Date : 2024-07-17 Wendy Levinson
This JAMA Insights discusses the significant role that health care plays in the climate crisis and provides strategies to assist clinicians with improving patient care while also protecting the environment.
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Endometriosis Typology and Ovarian Cancer Risk JAMA (IF 63.1) Pub Date : 2024-07-17 Mollie E. Barnard, Leslie V. Farland, Bin Yan, Jing Wang, Britton Trabert, Jennifer A. Doherty, Huong D. Meeks, Myke Madsen, Emily Guinto, Lindsay J. Collin, Kathryn A. Maurer, Jessica M. Page, Amber C. Kiser, Michael W. Varner, Kristina Allen-Brady, Anna Z. Pollack, Kurt R. Peterson, C. Matthew Peterson, Karen C. Schliep
ImportanceEndometriosis has been associated with an increased risk of ovarian cancer; however, the associations between endometriosis subtypes and ovarian cancer histotypes have not been well-described.ObjectiveTo evaluate the associations of endometriosis subtypes with incidence of ovarian cancer, both overall and by histotype.Design, Setting, and ParticipantsPopulation-based cohort study using data
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New Reproductive Privacy Rule to Protect Both Patients and Physicians JAMA (IF 63.1) Pub Date : 2024-07-17 Carmel Shachar
This Viewpoint describes the newly finalized Reproductive Privacy Rule, a HIPAA regulatory update intended to prevent law enforcement in abortion-restrictive states from obtaining reproductive care medical records to prosecute patients and physicians.
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The Supreme Court Decision on Firearm Ownership for People Subject to Restraining Orders JAMA (IF 63.1) Pub Date : 2024-07-15 Lawrence O. Gostin, Stephen I. Vladeck
This Viewpoint explicates the complex reasoning the US Supreme Court has used in rulings on gun control and raises concerns that the recent Rahimi decision poses more questions than it settled on the future of the Second Amendment.
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International Medical Graduates and the Physician Workforce JAMA (IF 63.1) Pub Date : 2024-07-15 Oliver J. McElvaney, Graham T. McMahon
ImportancePhysician shortages and the geographic maldistribution of general and specialist physicians impair health care delivery and worsen health inequity in the US. International medical graduates (IMGs) represent a potential solution given their ready supply.ObservationsDespite extensive clinical experience, evidence of competence, and willingness to practice in underserved communities, IMGs experience
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The Biden Administration’s Push to Lower Drug Prices Through March-In Rights JAMA (IF 63.1) Pub Date : 2024-07-15 Daniel G. Aaron, J. Jonas Anderson
This Viewpoint explores a 2023 Biden administration proposal for US agencies to use their march-in rights and the impact this proposed framework could have on drug prices.
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Refining Colon Cancer Screening, Antibody Therapy for Lung Cancer, and More—Highlights From ASCO 2024 JAMA (IF 63.1) Pub Date : 2024-07-12 Jennifer Abbasi
This Medical News article is an interview about JAMA Network highlights from the American Society of Clinical Oncology’s annual meeting, hosted by Nora Disis, MD, editor in chief of JAMA Oncology and a JAMA deputy editor.
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Smallpox Readiness JAMA (IF 63.1) Pub Date : 2024-07-11 Lawrence O. Gostin, Shalini Singaravelu, Noreen Hynes
This Viewpoint highlights the potential for unintentional or deliberate release of variola virus (smallpox), discusses current medical countermeasures for smallpox, and calls for greater flexibility from the US and its partners in developing safe, reliable, affordable, and equitable countermeasures.
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Treatment Approaches for Opioid Use Disorder Offered in US Substance Use Treatment Facilities JAMA (IF 63.1) Pub Date : 2024-07-11 Tae Woo Park, Bryant Shuey, Jane Liebschutz, Jonathan Cantor, Timothy S. Anderson
This study compares medication and psychosocial treatments for opioid use disorder, as well as treatments offered at opioid and nonopioid treatment program facilities for commonly co-occurring substance use disorders and mental disorders.
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Wildfires and Human Health JAMA (IF 63.1) Pub Date : 2024-07-10 Raj P. Fadadu, Gina Solomon, John R. Balmes
This JAMA Insights explores the adverse effects of wildfires on human health and health care systems and offers suggestions on how clinicians can help mitigate the health threats posed by wildfires.
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Prevalence of Nicotine Pouch Use Among US Adults JAMA (IF 63.1) Pub Date : 2024-07-10 Hongying Daisy Dai, Adam M. Leventhal
This cross-sectional study uses data from the 2022 Tobacco Use Supplement of the Current Population Survey to estimate the prevalence of adult US nicotine pouch use and the characteristics of the individuals using pouches.
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Rebuilding the Relative Value Unit–Based Physician Payment System JAMA (IF 63.1) Pub Date : 2024-07-10 Laurence F. McMahon, Zirui Song
This Viewpoint explores the use of relative value units assigned by the Resource-Based Relative Value Scale in US physician payment systems and the need to rebuild this scale to reflect changes in modern clinical practice.
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Acceptability of Hospital-at-Home Care and Capacity for Caregiver Burden JAMA (IF 63.1) Pub Date : 2024-07-08 Melissa A. Frasco, Erin L. Duffy, Erin Trish
This study surveys a representative US population about aspects of hospital-at-home care, including acceptability and willingness to perform caregiving tasks.
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The Tobacco Industry Has No Business Funding Continuing Medical Education JAMA (IF 63.1) Pub Date : 2024-07-08 Robert K. Jackler, Pamela M. Ling
This Viewpoint explores tobacco industry–funded continuing medical education and concerns regarding the precedents this funding sets in relation to commercial bias and influence and conflicts of interest.
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Essential Tremor JAMA (IF 63.1) Pub Date : 2024-07-08 W. Jeffrey Elias, Binit B. Shah
This JAMA Insights discusses the diagnostic evaluation and treatment, including pharmacological, nonpharmacological, and surgical options, of essential tremor.
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Tapping AI’s Strengths—From Operating Room Safety to Wearable Device Interpretation JAMA (IF 63.1) Pub Date : 2024-07-05 Jennifer Abbasi, Yulin Hswen
In this Medical News interview, Sachin Kheterpal, the University of Michigan Medical School’s associate dean for research information technology, joins JAMA Editor in Chief Kirsten Bibbins-Domingo to discuss AI’s number-crunching potential for improving patient care.
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Where Are All the Pediatricians? JAMA (IF 63.1) Pub Date : 2024-07-03 Katherine A. Jordan, Priyanka Rao, Julie S. Byerley
This Viewpoint highlights the current decline in US medical graduates choosing pediatrics as a specialty; discusses some reasons for, and the long-term ramifications of, this decline; and suggests measures that could be taken to reverse the decline and ensure that children receive excellent care.
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The Human Cost of Politicizing Immigration: Migration Stigma, US Politics, and Health JAMA (IF 63.1) Pub Date : 2024-07-01 Lawrence H. Yang, Maureen A. Eger, Bruce G. Link
This Viewpoint discusses stigma and health consequences associated with migration in the context of the US election and identifies ways to develop structural competencies for physicians and future research.
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A Patient With Proteinuria, Myalgias, and Decreased Pigmentation of Facial Skin JAMA (IF 63.1) Pub Date : 2024-07-01 Shan Wu, Bo Han, Xishan Xiong
A patient had bilateral leg edema, insomnia, myalgias, paresthesias in the fingertips, lighter pigmentation of the facial skin compared with other areas of the body, proteinuria, and an elevated creatinine level. What is the diagnosis and what would you do next?
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Embedding Patient and Health Care Professional Voices in Clinical Trials JAMA (IF 63.1) Pub Date : 2024-07-01 Stuart G. Nicholls, Marion K. Campbell
This Viewpoint discusses the need to include patient and health care professional perspectives in the design of clinical trials to improve trial features and implementation.
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Why Evidence Generation Should Matter to Payers and How They Can Help JAMA (IF 63.1) Pub Date : 2024-07-01 Ali B. Abbasi, Lesley H. Curtis, Lee A. Fleisher, Robert M. Califf
ImportanceThe US leads the world in bringing new medical products to market, but the ability to generate evidence to inform clinical practice in postmarket settings needs improvement. Although a diverse group of stakeholders is working to improve postmarket evidence generation, the role of private payers has been underappreciated.ObservationsPayers are crucial allies in improving evidence generation
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Cardiovascular Clinical Trials in the Asia-Pacific Region JAMA (IF 63.1) Pub Date : 2024-07-01 Stephen J. Nicholls, Carolyn S. P. Lam, Adam J. Nelson
This Viewpoint discusses the potential challenges to the operational conduct of clinical trials in the Asia-Pacific region, where there is a high rate of cardiovascular disease, and provides possible solutions.
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Major Gaps in the Cascade of Care for Opioid Use Disorder JAMA (IF 63.1) Pub Date : 2024-06-27 M. Allison Arwady, Miriam Delphin-Rittmon, Nora D. Volkow
This Viewpoint examines a recent report that used data from the 2022 National Survey on Drug Use and Health to estimate the opioid cascade of care, a framework to characterize the adult US populations who needed and received opioid use disorder (OUD) treatment, as well as discusses ways in which clinicians can close gaps in care.
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A More Selective vs a Standard Risk-Stratified, Heparin-Based, Obstetric Thromboprophylaxis Protocol JAMA (IF 63.1) Pub Date : 2024-06-27 Macie L. Champion, Christina T. Blanchard, Michelle Y. Lu, Ashley E. Shea, Anna I. Lively, J. Morgan Jenkins, Samantha E. Howell, Grace M. Lee, Brian M. Casey, Ashley N. Battarbee, Akila Subramaniam
ImportanceIn 2016, our institution adopted a pregnancy-related venous thromboembolism (VTE) prophylaxis protocol based on American College of Obstetricians and Gynecologists guidelines that recommended postpartum heparin-based chemoprophylaxis (enoxaparin) based on a risk-stratified algorithm. In response to increased wound hematomas without significant reduction in VTE using this protocol, a more
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Misaligned Pharmacy Incentives in Value-Based Care JAMA (IF 63.1) Pub Date : 2024-06-27 Nina Jain, Benjamin N. Rome, Mallika L. Mendu
This Viewpoint explains some ways in which the alignment of incentives between payers and clinicians in value-based care (VBC) arrangements can be interrupted and proposes a multifaceted approach to realigning incentives for drug spending within VBC contracts to better provide value-based care and improve patient outcomes.
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Even Better JAMA (IF 63.1) Pub Date : 2024-06-27 Lydia Henderson
In this narrative medicine essay, a physical medicine and rehabilitation resident’s understanding of and empathy for patients reaches new heights following her diagnosis of and treatment for breast cancer during residency.
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Diagnosis and Management of Celiac Disease JAMA (IF 63.1) Pub Date : 2024-06-26 Kerstin Austin, Nimrod Deiss-Yehiely, Jason T. Alexander
This JAMA Clinical Guidelines Synopsis summarizes the American College of Gastroenterology’s 2023 guideline update on diagnosis and management of celiac disease.
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Firearm Policy in the Hospital Setting—Recognizing Health Care as a “Sensitive Place” JAMA (IF 63.1) Pub Date : 2024-06-26 Joshua B. Romero, Daniel G. Aaron, Richard S. Saver, Joseph Blocher
ImportanceHospitals are hot zones of the US gun injury epidemic. To shelter these facilities from the dangers of gun violence, state legislatures have enacted laws to reduce the carrying of firearms on hospital premises. However, these efforts currently face serious Second Amendment challenges in federal courts. The ongoing legal battles, which have wide-ranging implications for patient and clinician
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LGBTQI+ Data Collection in Medicaid to Advance Health Equity JAMA (IF 63.1) Pub Date : 2024-06-26 Nathaniel M. Tran, Kevin H. Nguyen
This Viewpoint explores Centers for Medicare & Medicaid Services guidance on the collection of sexual orientation and gender identity data and how these data could be used to advance health equity for LGBTQI+ people.
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Addressing Ableism in Physician Well-Being Planning JAMA (IF 63.1) Pub Date : 2024-06-24 Michael Quon
This Viewpoint discusses the importance of physician well-being for optimizing patient care and current efforts to improve physician well-being, describes how structural ableism affects the well-being of physicians with disabilities, and calls for further efforts to address ableism in the health care workforce.
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Food and Drug Administration v Alliance for Hippocratic Medicine—A Cautious Win for Reproductive Health Care and FDA Authority JAMA (IF 63.1) Pub Date : 2024-06-24 Michele B. Goodwin, Allison M. Whelan, Lawrence O. Gostin
This Viewpoint discusses the recent US Supreme Court ruling allowing mifepristone—a drug used in medication abortion—to be widely available in the US, summarizes the history of challenges to the availability of mifepristone, and highlights reasons for concerns that remain after the Court’s current ruling.
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Trail Magic JAMA (IF 63.1) Pub Date : 2024-06-24 Beverly Gray
In this narrative medicine essay, an obstetrician-gynecologist describes a day in her life of crossing state lines to provide abortion care for people from all over the Southeast US in the post-Dobbs era.
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Supporting OB-GYNs in Abortion-Restrictive States—A Playbook for Institutions JAMA (IF 63.1) Pub Date : 2024-06-24 Erika L. Sabbath, Kavita S. Arora, Mara Buchbinder
This Viewpoint provides proposed institutional practices, such as medicolegal collaboration and providing materials and resources, to support obstetrician-gynecologists (OB-GYNs) in abortion-restrictive states.
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Comparison of No-Test Telehealth and In-Person Medication Abortion JAMA (IF 63.1) Pub Date : 2024-06-24 Lauren J. Ralph, C. Finley Baba, M. Antonia Biggs, Colleen McNicholas, Amy Hagstrom Miller, Daniel Grossman
ImportanceIn the US, access to medication abortion using history-based (no-test) eligibility assessment, including through telehealth and mailing of mifepristone, has grown rapidly. Additional evidence on the effectiveness and safety of these models is needed.ObjectiveTo evaluate whether medication abortion with no-test eligibility assessment and mailing of medications is as effective as in-person
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New Cardiovascular Disease Risk Calculator Could Eliminate the Need for Statins for Millions JAMA (IF 63.1) Pub Date : 2024-06-21 Howard Larkin
This Medical News article discusses a recent study in JAMA Internal Medicine that estimated statin eligibility using the new PREVENT equations compared with the older equations.
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Use of a Financial Incentive Code for In-Home COVID-19 Vaccination of Homebound Older Adults JAMA (IF 63.1) Pub Date : 2024-06-20 Robert M. Zimbroff, W. James Deardorff, Sujin Song, Margaret C. Nikolov, Matthew E. Growdon
This study evaluated the uptake of Healthcare Common Procedure Coding System code M0201 after initial implementation to inform future policy related to in-home preventive care.
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Perioperative Management of Antithrombotic Therapy JAMA (IF 63.1) Pub Date : 2024-06-20 Maureen D. Lyons, Bailey Pope, Jason Alexander
This JAMA Clinical Guidelines Synopsis summarizes the American College of Chest Physicians’ 2022 guideline on perioperative management of patients taking oral anticoagulation or antiplatelet therapy who are undergoing an elective surgery or procedure.
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Questioning the Impossible JAMA (IF 63.1) Pub Date : 2024-06-20 Rachel Gallant
In this narrative medicine essay, a pediatric oncologist gains new insight into the decision to transition from cancer-directed therapy to comfort-focused care when roles are reversed and she experiences end-of-life decision-making as a caregiver.
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Proposed Increases in Government Authority Over Research Misconduct Proceedings JAMA (IF 63.1) Pub Date : 2024-06-20 Minal M. Caron, Mark Barnes, Barbara E. Bierer
This Viewpoint discusses changes proposed by the US Department of Health and Human Services’ Office of Research Integrity that would shift control of research misconduct proceedings from institutional oversight to federal authority.
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Protecting Participants Is Not the Top Priority in Clinical Research JAMA (IF 63.1) Pub Date : 2024-06-20 Jerry Menikoff
This Viewpoint discusses the need to protect participants in clinical research and the opportunity to address this issue as the World Medical Association works to revise its Declaration of Helsinki, which governs medical research ethics.
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A Clinical Diagnostic Test for Calcium Release Deficiency Syndrome JAMA (IF 63.1) Pub Date : 2024-06-20 Mingke Ni, Ziv Dadon, Julian O. M. Ormerod, Johan Saenen, Wiert F. Hoeksema, Pavel Antiperovitch, Rafik Tadros, Morten K. Christiansen, Christian Steinberg, Marine Arnaud, Shanshan Tian, Bo Sun, John Paul Estillore, Ruiwu Wang, Habib R. Khan, Thomas M. Roston, Andrea Mazzanti, John R. Giudicessi, Konstantinos C. Siontis, Aiman Alak, J. Gabriel Acosta, Syamkumar M. Divakara Menon, Nigel S. Tan, Christian
ImportanceSudden death and cardiac arrest frequently occur without explanation, even after a thorough clinical evaluation. Calcium release deficiency syndrome (CRDS), a life-threatening genetic arrhythmia syndrome, is undetectable with standard testing and leads to unexplained cardiac arrest.ObjectiveTo explore the cardiac repolarization response on an electrocardiogram after brief tachycardia and
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Interventions for Weight Management in Children and Adolescents JAMA (IF 63.1) Pub Date : 2024-06-18 Elizabeth A. O’Connor, Corinne V. Evans, Michelle Henninger, Nadia Redmond, Caitlyn A. Senger
ImportanceBody mass index (BMI) of the 95th or greater percentile for age and sex is common among young people, and its prevalence has increased in recent decades.ObjectiveTo examine the benefits and harms of weight management interventions initiated in health care settings among children and adolescents with high BMI.Data SourcesMEDLINE via Ovid, PsycINFO via Ovid, and the Cochrane Central Registry
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Checks and Balances on FDA’s Authority JAMA (IF 63.1) Pub Date : 2024-06-18 Holly Fernandez Lynch, Peter Lurie, I. Glenn Cohen
In this Viewpoint, the authors refute recent suggestions that the US Food and Drug Administration (FDA) is not accountable for its decisions, pointing out the legal, legislative, and executive checks and balances on the agency.
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Interventions for High BMI in Children and Teenagers JAMA (IF 63.1) Pub Date : 2024-06-18 Jill Jin
This JAMA Patient Page describes intensive behavioral interventions for high body mass index (BMI) in children and teenagers and the US Preventive Services Task Force (USPSTF) recommendation for provision of such interventions.
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Povidone Iodine vs Chlorhexidine Gluconate in Alcohol for Preoperative Skin Antisepsis JAMA (IF 63.1) Pub Date : 2024-06-17 Andreas F. Widmer, Andrew Atkinson, Stefan P. Kuster, Aline Wolfensberger, Steffi Klimke, Rami Sommerstein, Friedrich S. Eckstein, Florian Schoenhoff, Guido Beldi, Christian A. Gutschow, Jonas Marschall, Alexander Schweiger, Philipp Jent
ImportancePreoperative skin antisepsis is an established procedure to prevent surgical site infections (SSIs). The choice of antiseptic agent, povidone iodine or chlorhexidine gluconate, remains debated.ObjectiveTo determine whether povidone iodine in alcohol is noninferior to chlorhexidine gluconate in alcohol to prevent SSIs after cardiac or abdominal surgery.Design, Setting, and ParticipantsMulticenter
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Two-Stage Syphilis Testing JAMA (IF 63.1) Pub Date : 2024-06-14 Lais Lopes Almeida Gomes, Caroline J. Stone, Katharina S. Shaw
A 54-year-old woman presented with erythematous annular and indurated plaques on her face, trunk, and extremities and had false-positive syphilis test results during 2 pregnancies 25 and 22 years prior. What would you do next?
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Germline CDH1 Variants and Lifetime Cancer Risk JAMA (IF 63.1) Pub Date : 2024-06-14 Carrie E. Ryan, Grace-Ann Fasaye, Amber F. Gallanis, Lauren A. Gamble, Paul H. McClelland, Anna Duemler, Sarah G. Samaranayake, Andrew M. Blakely, Christine M. Drogan, Kerry Kingham, Devanshi Patel, Linda Rodgers-Fouche, Ava Siegel, Sonia S. Kupfer, James M. Ford, Daniel C. Chung, James G. Dowty, Joshua Sampson, Jeremy L. Davis
ImportanceApproximately 1% to 3% of gastric cancers and 5% of lobular breast cancers are hereditary. Loss of function CDH1 gene variants are the most common gene variants associated with hereditary diffuse gastric cancer and lobular breast cancer. Previously, the lifetime risk of gastric cancer was estimated to be approximately 25% to 83% and for breast cancer it was estimated to be approximately 39%
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Association Between Cost Sharing and Naloxone Prescription Dispensing JAMA (IF 63.1) Pub Date : 2024-06-13 Kao-Ping Chua, Rena M. Conti, Pooja Lagisetty, Amy S. Bohnert, Sijia He, Thuy D. Nguyen
ImportanceIncreasing access to naloxone (an opioid antagonist that can reverse overdose) could slow the US opioid epidemic. Prior studies suggest cost sharing may be a barrier to dispensing of naloxone prescriptions, but these studies were limited by their cross-sectional designs and use of databases that do not capture prescriptions that are not filled (abandoned).ObjectiveTo evaluate the association
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Trends in Naloxone Dispensing From Retail Pharmacies in the US JAMA (IF 63.1) Pub Date : 2024-06-13 S. Michaela Rikard, Andrea E. Strahan, Lyna Z. Schieber, Gery P. Guy
This cross-sectional study examines trends in naloxone dispensing by US retail pharmacies from 2019 to 2023, including prescriber specialty and product brand.
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The Weight of a Differential JAMA (IF 63.1) Pub Date : 2024-06-13 Maren E. Olson
In this narrative medicine essay, when a physician’s mother begins experiencing postmenopausal bleeding, the author wonders what it would be like to hear someone’s signs and symptoms and not automatically begin to build a differential.
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Upholding Standards for Qualified Bilingual Staff JAMA (IF 63.1) Pub Date : 2024-06-13 Adaugo Amobi
This Viewpoint discusses ways to ensure the proficiency of bilingual communication among health care staff in patient-clinician encounters, such as language testing and use of professional interpreters.
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Test-Negative Study Designs for Evaluating Vaccine Effectiveness JAMA (IF 63.1) Pub Date : 2024-06-12 Natalie Dean, Avnika B. Amin
This JAMA Guide to Statistics and Methods article explains the test-negative study design, an observational study design routinely used to estimate vaccine effectiveness, and examines its use in a study that estimated the performance of messenger RNA boosters against the Omicron variant.
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Prolonged vs Intermittent Infusions of β-Lactam Antibiotics in Adults With Sepsis or Septic Shock JAMA (IF 63.1) Pub Date : 2024-06-12 Mohd H. Abdul-Aziz, Naomi E. Hammond, Stephen J. Brett, Menino O. Cotta, Jan J. De Waele, Anthony Devaux, Gian Luca Di Tanna, Joel M. Dulhunty, Hatem Elkady, Lars Eriksson, M. Shahnaz Hasan, Ayesha Bibi Khan, Jeffrey Lipman, Xiaoqiu Liu, Giacomo Monti, John Myburgh, Emmanuel Novy, Shahed Omar, Dorrilyn Rajbhandari, Claire Roger, Fredrik Sjövall, Irene Zaghi, Alberto Zangrillo, Anthony Delaney, Jason
ImportanceThere is uncertainty about whether prolonged infusions of β-lactam antibiotics improve clinically important outcomes in critically ill adults with sepsis or septic shock.ObjectiveTo determine whether prolonged β-lactam antibiotic infusions are associated with a reduced risk of death in critically ill adults with sepsis or septic shock compared with intermittent infusions.Data SourcesThe primary
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Low-Dose Corticosteroids for Critically Ill Adults With Severe Pulmonary Infections JAMA (IF 63.1) Pub Date : 2024-06-12 Romain Pirracchio, Balasubramanian Venkatesh, Matthieu Legrand
ImportanceSevere pulmonary infections, including COVID-19, community-acquired pneumonia, influenza, and Pneumocystis pneumonia, are a leading cause of death among adults worldwide. Pulmonary infections in critically ill patients may cause septic shock, acute respiratory distress syndrome, or both, which are associated with mortality rates ranging between 30% and 50%.ObservationsCorticosteroids mitigate
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The Unmet Health Care Needs of Indigenous People Incarcerated in Tribal Jails JAMA (IF 63.1) Pub Date : 2024-06-12 Carolyn Camplain, Ricky Camplain
This Viewpoint investigates the poor quality of health care provided to Indigenous peoples incarcerated in US tribal jails and proposes solutions to address health disparities and strengthen tribal sovereignty.
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Management of Depression in Adults JAMA (IF 63.1) Pub Date : 2024-06-10 Gregory E. Simon, Nathalie Moise, David C. Mohr
ImportanceApproximately 9% of US adults experience major depression each year, with a lifetime prevalence of approximately 17% for men and 30% for women.ObservationsMajor depression is defined by depressed mood, loss of interest in activities, and associated psychological and somatic symptoms lasting at least 2 weeks. Evaluation should include structured assessment of severity as well as risk of self-harm