A Case of S1Q3T3 —A Classic Nonspecific Electrocardiogram Finding
This case report describes a patient in their 40s with a history of end-stage kidney disease secondary to hypertension and diabetes who presented with fatigue, cough, weakness, and dyspnea on exertion and was subsequently diagnosed with acute disseminated cryptococcal infection. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 30, 2023 Category: Internal Medicine Source Type: research
Treating Climate and Nature Crisis as a Global Health Emergency
Over 200 health journals call on the United Nations, political leaders, and health professionals to recognize that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 25, 2023 Category: Internal Medicine Source Type: research
Endogenous and Exogenous Thyrotoxicosis and Risk of Incident Cognitive Disorders in Older Adults
This cohort study assesses whether endogenous and exogenous thyrotoxicosis is associated with higher risk of cognitive disorders in adults 65 years and older. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 23, 2023 Category: Internal Medicine Source Type: research
Homelessness and Incidence and Causes of Sudden Death
This cohort study compares incidence and causes of sudden death by autopsy among housed and unhoused individuals in San Francisco County, California. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 23, 2023 Category: Internal Medicine Source Type: research
Thinking Differently —on Solitude and Productivism—Reply
In Reply Sue-Chue-Lam writes that The Thinker “may not be the ideal (or at least not the only) role model for the thoughtful clinician.” He offers a series of examples as to what the “best of critical thought” usually looks like—emphasizing that it is rarely achieved in private and advocating for a collective form of dialogue. However , just as solitude should not be interpreted as a necessary condition for productive thinking (a position not directly adopted in the original Perspective), we should similarly not feel compelled to see collective dialogue as the ideal or at least not the only solution. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 23, 2023 Category: Internal Medicine Source Type: research
Thinking Differently —on Solitude and Productivism
To the Editor Taran asks us to see Rodin ’s The Thinker as a reminder to clinicians to take the time to think deeply about their careers. This is an important provocation for what it says about how thinking ought to look, and how we ought to spend our time alone. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 23, 2023 Category: Internal Medicine Source Type: research
Nirmatrelvir and Molnupiravir and Post –COVID-19 Condition in Older Patients
This observational cohort study assesses the occurrence of post –COVID-19 condition symptoms in Medicare enrollees prescribed nirmatrelvir and molnupiravir. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 23, 2023 Category: Internal Medicine Source Type: research
Disentangling the Association Between Excess Thyroid Hormone and Cognition in Older Adults
Several large cohort studies have shown an association between exogenous thyrotoxicosis and cognitive impairment or dementia. In contrast, a recent multicohort individual participant data analysis of more than 74 000 adults did not demonstrate consistent associations between thyroid dysfunction and scores on tests of executive function, memory, or risk of dementia. However, while not statistically significant, individuals with overt hyperthyroidism in this study had about a 50% increased risk of dementia compared with those with normal thyroid function. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 23, 2023 Category: Internal Medicine Source Type: research
Intermittent Negative Deflections Preceding the QRS Complexes
This case report describes a patient in their 60s who developed apparent abnormal Q waves and severe hypomagnesemia while receiving chemotherapy for metastatic rectal carcinoma. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 23, 2023 Category: Internal Medicine Source Type: research
Waiting for a Heart Valve
This essay describes a family of physicians waiting for a heart valve for their vivacious 95-year-old aunt. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 16, 2023 Category: Internal Medicine Source Type: research
Changes in Care Use and Financial Status Associated With Dementia in Older Adults
This cohort study aims to determine the incremental changes associated with dementia in regard to older adults ’ care use as well as assess financial consequences for individuals, families, and society. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 16, 2023 Category: Internal Medicine Source Type: research
Anchoring to a Diagnosis? —Reply
In Reply We agree with Aberegg and Graham that earlier studies of anchoring bias focused on a numerical anchor. We also agree that experiments in a controlled setting would be useful in assessing the hypothesized phenomenon of anchoring to a categorical diagnosis. However, in the absence of these experiments, we believe that our study is among the first to provide empirical support for this phenomenon in a clinical setting. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 16, 2023 Category: Internal Medicine Source Type: research
Anchoring to a Diagnosis?
To the Editor Using a database of Veterans Affairs emergency department visits, Ly et al analyzed patients with a history of congestive heart failure (CHF) presenting with shortness of breath. They found that if the triage nurse had entered CHF on the intake form (occurring in 4.1% of visits), physicians were less likely to order testing for pulmonary embolism (PE) and took longer to do so. The authors proposed that these findings constitute evidence of an anchoring bias. Several issues relevant to the study and its interpretation warrant expostulation. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 16, 2023 Category: Internal Medicine Source Type: research
Variations in State Laws on Mental Health –Related Firearm Prohibition
This quality improvement study assesses heterogeneity in state rules regarding reporting of mental health conditions to the National Instant Criminal Background Check System when individuals seek to acquire firearms. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 16, 2023 Category: Internal Medicine Source Type: research
Introducing the Guide to Statistics and Methods
The advancement of science and medicine depends on the publication of credible, peer-reviewed evidence. As an integral part of our effort to provide trustworthy evidence, JAMA Internal Medicine is committed to improving the methodological rigor of its publications. As a key part of this effort, every manuscript reporting original research will undergo statistical review before acceptance. In addition, we are introducing a new series, the Guide to Statistics and Methods, intended to help clinician readers more fully understand and interpret scientific articles. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - October 16, 2023 Category: Internal Medicine Source Type: research
