Optimizing Beneficence and Justice in Heart Transplant Allocation
Over the last 5 decades, heart transplant has emerged as the preferred therapy for select patients with advanced heart failure, with a 1-year survival of 90% and conditional half-life of 13 years, far better than that of end-stage heart disease. Yet demand for donor hearts far exceeds supply, and more than one-third of candidates die or are removed from the waiting list without receiving a transplant. Thus, equitable allocation of this scarce resource to those of the highest medical urgency remains a major challenge. (Source: JAMA)
Source: JAMA - February 13, 2024 Category: General Medicine Source Type: research
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(Source: JAMA)
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Thyroid Cancer —A Review
This narrative review summarizes current evidence regarding the pathophysiology, diagnosis, and management of early-stage and advanced thyroid cancer. (Source: JAMA)
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Hospital Fugue
A dark-haired girl in a bed across from mine had inhaled a chunk of apple —lodging it like a runaway kite in the papery tree of her lung. Then it was fished out, in surgery, with a thin tube, like the red magnet my father lowered on a string—after the baby, jowled and mad as Potemkin, hurled the house keys down the grate, thrilling to their metal music, their jangled fall, their echo of heavy doors, strained tones, the adult voice of fate. (Source: JAMA)
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Effectiveness of Bivalent mRNA Vaccines in Preventing SARS-CoV-2 Infection in Children
This study uses data from 3 prospective cohort studies conducted in the US to assess vaccine effectiveness of bivalent COVID-19 vaccines against SARS-CoV-2 infection and symptomatic COVID-19 among children and adolescents. (Source: JAMA)
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Neonatal Outcomes After COVID-19 Vaccination in Pregnancy
This cohort study evaluates the risks of neonatal adverse events after exposure to COVID-19 vaccination during pregnancy. (Source: JAMA)
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Serum Urate and Recurrent Gout
This retrospective study of patients with gout examines whether serum urate levels are associated with subsequent risk of gout flares and hospitalization for gout. (Source: JAMA)
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Sedentary Behavior and Dementia —Reply
In Reply We thank Dr Hecht for his comment on our recent research article examining sedentary behavior and incident dementia. We agree that the possibility of ascertainment bias is an important issue that warrants careful consideration. As we discussed in the Limitations section of our article, the use of hospital records and death registry data for dementia diagnoses may provide less accurate diagnoses or may underestimate cases in this cohort, leading to the potential for ascertainment bias related to links between physical activity and overall health. To help address this limitation, we included presence of chronic dise...
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Rh Sensitization and Induced Abortion —Reply
In Reply In response to our recent article, Mr Uzoigwe and Dr Ali comment that the 1965 study by Zipursky et al, which we used to calculate a threshold for significant fRBC allosensitization, is unethical. These ethical flaws highlight that decades have elapsed since there has been adequate scientific study of Rh sensitization in early pregnancy and underscore the need to design new studies that address research gaps while protecting human participants, as we did. Second, while we agree that the threshold of 0.1 mL of fRBCs may be arbitrary, this threshold led to sensitization in only 4 of 15 participants in the study by Z...
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Sedentary Behavior and Dementia
To the Editor A recent study on physical activity and risk of dementia has several strengths, including the large population and an objective measure of physical activity. There is an important limitation that the authors do not appear to fully address, however: ascertainment bias. As the diagnosis of dementia depended on either having a death certificate or hospitalization (in which inpatient diagnostic codes would be assigned), the outcome could be ascertained only in participants with these health outcomes. Participants without either of these 2 health events could not be classified as having dementia regardless of actu...
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Rh Sensitization and Induced Abortion
To the Editor A recent study posited that analysis of fRBCs in pregnant individuals who had previous induced abortions at less than 12 weeks ’ gestational age could be used to recommend discontinuation of Rh immunoglobulin prophylaxis in a subset of patients. While this research provides valuable insights into the complex issue of maternal alloimmunization, it does not establish a clear link between fRBC levels and the most important o utcome—hemolytic disease of the fetus and newborn (HDFN). First, the study’s premise relied on the establishment of a specific threshold of fRBC transfer required to induce alloimmuniz...
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Rh Sensitization and Induced Abortion
This study reported that the inoculum of RBC Rh-positive antigens following abortions at less than 12 weeks’ gestation was below the threshold supposedly required for sensitization. The authors concluded that abandoning Rh immunoglobulin could save effort and resources. Prior to this study, 2 prospective studies published in 1972 supported Rh immunoglobulin use in this circumstance. In 2022, the World Health Organization recommended abandoning first-trimester Rh immunoglobulin (still in draft); the grade of evidence was “very low.” (Source: JAMA)
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Rh Sensitization and Induced Abortion
To the Editor A recent study engaged an important topic; however, it is premature to conclude, contrary to national guidelines, that Rh testing and immunoglobulin are no longer indicated following first-trimester termination of pregnancy. (Source: JAMA)
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Infection and Rickets
“Rickets is indeed a price paid by man for his abandonment of a life out-of-doors and a natural diet for a life in houses and a diet of denatured foodstuffs; it is a sign of the operation of the immutable law of nature that nothing out of accord with her shall flourish.” These are the words with which Professor Park of Yale University has summarized his conclusions. They indicate a reconciliation between the long contending views regarding the etiology of rickets. There can no longer be any doubt that dietary factors may assume a determining rôle; but it is equally evident that such envir onmental conditions as are re...
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
Audio Highlights
Listen to the JAMA Editor ’s Audio Summary for an overview and discussion of the important articles appearing in this week’s issue of JAMA. (Source: JAMA)
Source: JAMA - February 6, 2024 Category: General Medicine Source Type: research
