Pediatrics and COVID-19
In this Viewpoint, the editor of JAMA Pediatrics summarizes the effect on children of the first 6 months of the COVID-19 pandemic, reviewing evidence for why they seem not to become ill or as sick as adults and discussing the pandemic ’s likely long-term effects on child development and psychological health. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Cardiology and COVID-19
In this Viewpoint, JAMA Cardiology editors review the journal's more inportant articles advancing the scientific understanding of COVID-19 and the heart in the first 6 months of the pandemic, including evidence of direct myocardial injury and indirect effects of the pandemic on outcomes for patients with CVD postponing care for fear of contracting the virus. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Internal Medicine and COVID-19
In this Viewpoint, JAMA Internal Medicine editors offer a broad review of the clinical science emerging from the first 6 months of the coronavirus disease 2019 (COVID-19) pandemic, including epidemiology of the infection, evidence that has influenced clinical care, and a discussion of workforce and supply chain issues and health inequities affecting patients and essential workers. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Surgery and COVID-19
In this Viewpoint JAMA Surgery ’s editor reviews how the COVID-19 pandemic has affected the practice of general surgery in its first 6 months, including the need for universal precautions to mitigate the risks of infection transmission, the cessation and resumption of elective procedures, and adverse effects on educational expe riences of students aspiring to the specialty. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

JAMA Network Open and COVID-19
In this Viewpoint, JAMA Network Open editors review the journal's more important articles advancing scientific understanding of COVID-19 in the first 6 months of the pandemic, and discuss the importance of a global open access journal to meeting the public health challenge. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Dermatology and COVID-19
In this Viewpoint, JAMA Dermatology editors review the skin findings seen in association with coronavirus disease 2019 (COVID-19), how best to respond to those manifestations, and ways the pandemic has affected the practice of dermatology, including reassignment of specialists to COVID-19 care and the transition to teledermatology. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Otolaryngology and COVID-19
In this Viewpoint, JAMA Otolaryngology –Head& Neck Surgery ’s editor in chief reviews how the COVID-19 pandemic has affected the practice of otolaryngology–head and neck surgery in its first 6 months, including through a shift away from procedural management of head and neck disease toward medical and noninvasive management to mitigate risk of infection transmission, and through the acute rise in incidence of patients with olfactory dysunction requiring consultation and follow-up. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Nephrology and COVID-19
In this Viewpoint, JAMA ’s nephrology associate editor and colleagues review how COVID-19 has affected the practice of nephrology, including the rise in incidence of acute kidney injury (AKI) in patients with more severe disease, shortages of supplies and staff to care for AKI patients, effects on kidney transplantation, and implementation of telehealth. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Oncology and COVID-19
This Viewpoint summarizes the clinical characteristics of patients with cancer as associated with increased mortality risk from COVID-19, and it highlights important areas where more research is needed. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Ophthalmology and COVID-19
In this Viewpoint, JAMA Ophthalmology ’s editor reviews the known eye manifestations of COVID-19, the potential for ocular transmission of illness, and the effects of the pandemic on ophthalmologic practice and research. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Health Policy and COVID-19
In this Viewpoint, JAMA Health Forum ’s editor reviews important policy issues that characterized the first 6 months of the COVID-19 pandemic, including personal protective equipment (PPE) shortages, health inequities among vulnerable populations, requests from patients for medical exemptions from face mask requirements, and the bene fits and risks of school reopenings. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Hand Sanitizer Poisoning and Deaths Reported in 2 States
Fifteen people were hospitalized in Arizona and New Mexico after they drank hand sanitizer containing methanol. Four of the patients died and 3 experienced vision loss, according to a report from CDC investigators and state public health officials. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Pandemic ’s Mental Health Toll Grows
Considerable increases in mental health disorders since coronavirus disease 2019 (COVID-19) emerged demonstrate the need for specific screening tools to detect pandemic-related trauma and stress, according to a recent study. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Association of Nursing Home Ratings and COVID-19 Cases
This study evaluates COVID-19 case rates between high- and low-performing nursing homes based on CMS quality measures. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Point Prevalence of SARS-CoV-2 Infection Among Residents of Connecticut Nursing Homes
This study describes the point prevalence of polymerase chain reaction tests positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among residents of a sample of Connecticut nursing homes in the first half of May 2020. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Incorrect Axis Alignment in Figure
This article was corrected online. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Challenging the “Scoop and Run” Model for Management of Out-of-Hospital Cardiac Arrest
Adult out-of-hospital cardiac arrest (OHCA) represents an enormous public health challenge in the US, with an estimated incidence of 140.7 per 100  000 persons per year. Of the 347 322 cases of OHCA assessed by emergency medical services (EMS) in 2015, 52% underwent resuscitation efforts with 10.4% of these surviving to hospital discharge. There is, however, significant regional variation in the incidence of, mortality due to, and survival to discharge associated with OHCA. Historically, management of OHCA in the US was guided by the model of rapidly transporting the patient to a hospital, in contrast to the model used...
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Phasing Out Potentially Hazardous Food Packaging
Three manufacturers agreed to a 3-year phaseout of certain perfluoroalkyl and polyfluoroalkyl substances (PFAS) that are used to prevent grease from penetrating food packaging such as fast-food wrappers and takeout boxes, the FDA announced. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

CBD Drug Is Approved for a Third Form of Epilepsy
A drug containing the marijuana derivative cannabidiol (CBD) was approved to treat seizures associated with tuberous sclerosis complex (TSC) in patients aged 1 year or older. TSC is a genetic disease that causes benign tumors to grow throughout the body. It affects 1 in 6000 people. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Oral Drug Approved for Spinal Muscular Atrophy
The first oral therapy for adults and children aged 2 months or older who have spinal muscular atrophy (SMA) has received FDA approval. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Estimating Risk Ratios and Risk Differences
This JAMA Guide to Statistics and Methods explains the differences between risk ratios and odds ratios and when each is the more appropriate statistic to estimate measures of effect or association in research findings. (Source: JAMA)
Source: JAMA - September 15, 2020 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 - September 15, 2020 Category: General Medicine Source Type: research

New Rules for the Pandemic Era
Coronavirus disease 2019 (COVID-19) is not the world ’s first pandemic, and it is unlikely to be the last. In recent years, there have been actual or potential pandemics in 2002 (severe acute respiratory syndrome coronavirus), 2009 (H1N1 influenza), 2012 (Middle East respiratory syndrome coronavirus), and 2014 (Ebola). The new normal seems to be an actual or potential epidemic every 2 to 3 years. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Occultism and Insanity
William House, M.D., Portland, Ore. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Policies Among US Pediatricians for Dismissing Patients for Delaying or Refusing Vaccination
This survey study assesses US pediatrician practices and office policies in response to parents who either refuse primary vaccinations or request to spread out individual vaccines in the primary series. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Benefits of Treating Obstructive Sleep Apnea
To the Editor Drs Gottlieb and Punjabi, in their Review on obstructive sleep apnea (OSA), stated that “current evidence suggests that treatment does not reduce the risk of cardiovascular disease, stroke, or metabolic abnormalities in asymptomatic patients.” Even though studies have failed to find a decrease in cardiovascular mortality in patients using continuous positive airway pressure (PAP), they have had significant methodological flaws, such as excluding patients with excessive sleepiness—precisely the patients who need continuous PAP therapy. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Pharmacologic Treatments for Tinnitus
To the Editor The Clinical Update on tinnitus by Dr Piccirillo and colleagues described the marked heterogeneity of this disorder associated with a number of different conditions, such as acoustic trauma, hearing loss, and emotional stressors. This heterogeneity may be the reason that successful treatment is frequently elusive. The authors reviewed only nonpharmacological approaches to treating tinnitus, such as psychoeducation, tinnitus retraining, and behavioral therapies. Although these treatments are effective for some patients, they are ineffective or partially effective for many. Thus, the need for alternative or add...
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Preemptive Therapy vs Antiviral Prophylaxis in Cytomegalovirus-Seronegative Liver Transplant Recipients With Seropositive Donors
To the Editor Dr Singh and colleagues reported that within the first 12 months after liver transplantation, preemptive therapy resulted in significantly lower rates of cytomegalovirus (CMV) disease compared with primary valganciclovir prophylaxis in 205 CMV-seronegative recipients from seropositive donors. The authors noted that a 1-patient difference in each group would have nullified this outcome. The study reported 2 cases of CMV disease in the prophylaxis group (usually rare), potentially due to inadequate kidney dosing; while this highlights the importance of appropriate dosing, would the outcome have been different h...
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Benefits of Treating Obstructive Sleep Apnea —Reply
In Reply We agree with Dr Hunasikatti that the exclusion of excessively sleepy patients from randomized trials of the management of OSA for secondary prevention of cardiovascular disease may well have contributed to the null findings of these studies, as mentioned in our Review. Although it is not known whether treatment of sleepy patients with OSA reduces cardiovascular risk, control of symptoms is a sufficient rationale for treatment of these patients, whether the treatment is PAP or any of the variety of alternative treatment options. These alternatives include weight loss and exercise, which have known cardiovascular a...
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Preemptive Therapy vs Antiviral Prophylaxis in Cytomegalovirus-Seronegative Liver Transplant Recipients With Seropositive Donors —Reply
In Reply The observed rate of breakthrough disease (2%) during prophylaxis in our study is consistent with the rate in other clinical studies (1%-4%). Both CMV disease cases in the prophylaxis group were receiving intermittent hemodialysis and kidney-adjusted parenteral ganciclovir per manufacturer ’s instructions. Inadequate dosing is unlikely given data showing that in solid organ transplant recipients with advanced kidney dysfunction, manufacturer’s recommended dosing results in relative drug overexposure, not underexposure. Excluding these 2 cases, the odds of CMV disease by 12 months (0.46 [95% CI, 0.191-1...
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Pharmacologic Treatments for Tinnitus —Reply
In Reply Dr Asnis emphasizes the importance of pharmacological treatments for tinnitus, which were not addressed in our Clinical Update. Although we disagree with his assertion that nonpharmacological treatments are ineffective in many, his letter does raise several good points about the comorbid conditions of insomnia and depression and the role that pharmacotherapy, especially hypnotics and antidepressants, may play. Unfortunately, no drug has “demonstrated replicable, long-term reduction of tinnitus impact in excess of placebo effects,” and there is no drug approved by the US Food and Drug Administration for...
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Telehealth Success Spurs a Call for Greater Post –COVID-19 License Portability
This Medical News article examines the pros and cons of national medical licensure as physicians have grappled with seeing out-of-state patients via telemedicine during the coronavirus disease 2019 pandemic. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Association of Routine Infant Vaccinations With Antibody Levels Among Preterm Infants
This cohort study evaluates IgG antibody concentrations in preterm infants after administration of combination diphtheria –tetanus toxoids–acellular pertussis–inactivated poliomyelitis–Haemophilus influenza type b–and hepatitis B (DTaP-IPV-Hib-HepB) and pneumococcal conjugate vaccines. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Intra-arrest Transport vs Continued On-Scene Resuscitation and Survival in Patients With Out-of-Hospital Cardiac Arrest
This study of adult patients with out-of-hospital cardiac arrest compares rates of survival to hospital discharge for those receiving EMS transport vs continued on-scene resuscitation . (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Patient Information: Brain Death
This JAMA Patient Page explains the current definition of brain death, characteristic causes, and the conditions under which the diagnosis can be made. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Buoyancy
Your scars remind me of the silvery bottom of fish before they turn upwards. When I was younger, you took me fishing. The solution, you said, was not to build more lakes. Instead, you gently unhooked the smallest of fish before letting them wiggle away. So easy to forget the crimson. Slowly dissipating in the cool, still water and the budding morning light. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Finding His Voice —A Mother Learns to Let Go
In this narrative medicine essay, a psychologist recounts how she found her voice through writing and in patient care advocacy and research and how she helped her son, who has Schwartz-Jampel syndrome, find his voice when young, but now he is taking over his own narrative as a young adult. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

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(Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Addressing Influenza Vaccination Disparities During the COVID-19 Pandemic
In this Viewpoint, CDC scientists discuss the public health urgency of increasing influenza vaccination uptake early in the 2020-2021 season to ameliorate the threat to patients and hospitals of overlapping outbreaks, and urges clinicians to strongly recommend the vaccine and administer it to patients whenever and wherever possible. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Honoring the Legacy of Henrietta Lacks: The Need for a Biospecimen Consent Policy
In this Viewpoint, the NIH director and acting chief of staff discuss how Henrietta Lacks ’ cervical cancer cells (HeLa) were used without her consent to create an immortal cell line used widely in modern medical research, and argue for development of policies to prevent unauthorized use of biological specimens to prevent the same thing from happening again. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Nearly Half of Dementia Cases Could Be Prevented or Delayed
International dementia experts have expanded their list of risk factors that, if reduced or eliminated, could prevent or delay 40% of dementia cases worldwide. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Interest in Global COVID-19 Vaccine Alliance Grows
More than 150 countries may join a global alliance to ensure rapid and equitable access to an eventual coronavirus disease 2019 (COVID-19) vaccine. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Routine Vaccinations Decline During Pandemic
An alarming decline in routine vaccinations among children and adolescents has occurred since the coronavirus disease 2019 (COVID-19) pandemic began, according to a survey led by the United Nations Children ’s Fund (UNICEF), the World Health Organization (WHO), and Gavi, the Vaccine Alliance. (Source: JAMA)
Source: JAMA - September 15, 2020 Category: General Medicine Source Type: research

Unwavering Regulatory Safeguards for COVID-19 Vaccines
This Viewpoint from the FDA reviews the minimum safety and efficacy standards COVID-19 vaccine candidates would need to meet to be considered for approval, and affirms its commitments to evaluating both in diverse populations and to postmarketing surveillance as means to ensure that approval will meet the highest safety and regulatory standards based on science and evidence, not politics. (Source: JAMA)
Source: JAMA - September 8, 2020 Category: General Medicine Source Type: research

Dance for Respiratory Patients in Low-Resource Settings
This Arts and Medicine feature describes the integration of local dance traditions into pulmonary rehabilitation programs for COPD and tuberculosis patients in low- and middle-income countries. (Source: JAMA)
Source: JAMA - September 8, 2020 Category: General Medicine Source Type: research

Drug Repurposing Study Pinpoints Potential COVID-19 Antivirals
In the race to put existing drugs to the test for coronavirus disease 2019 (COVID-19), a National Institutes of Health –funded team winnowed down about 12 000 approved and investigational drugs to 13 promising candidates against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). (Source: JAMA)
Source: JAMA - September 8, 2020 Category: General Medicine Source Type: research

Antibiotic-Sparing Gonorrhea Diagnostic Wins Federal Funding
Physician offices could one day have a point-of-care gonorrhea test that not only delivers results within 30 minutes but also indicates the infecting strain ’s susceptibility to ciprofloxacin. In August, San Jose, California, startup Visby Medical, Inc won a $19 million federal prize to develop its prototype device, which could help thwart antimicrobial resistance by reducing unnecessary antibiotic use. (Source: JAMA)
Source: JAMA - September 8, 2020 Category: General Medicine Source Type: research

New T-Cell Therapy Tested for Multiple Myeloma
Scientists safely demonstrated a new immunotherapy approach in a recent small trial of patients with multiple myeloma. The technique, described in Science Translational Medicine, involves isolating patients ’ own T cells that target a spectrum of tumor cell antigens, expanding them outside the body, and then infusing them back into the body. (Source: JAMA)
Source: JAMA - September 8, 2020 Category: General Medicine Source Type: research

Correction to Affiliations in Arts and Medicine Feature
This article was corrected online. (Source: JAMA)
Source: JAMA - September 8, 2020 Category: General Medicine Source Type: research

Out-of-Hospital Tranexamic Acid for Traumatic Brain Injury
In this issue of JAMA, Rowell and colleagues from the Resuscitation Outcomes Consortium report findings from a randomized clinical trial of out-of-hospital administration of the antifibrinolytic agent tranexamic acid for patients with moderate or severe traumatic brain injury (TBI; defined as out-of-hospital Glasgow Coma Scale [GCS] score ≤12) and systolic blood pressure of at least 90 mm Hg. The study randomized patients to 3 treatment groups in which patients received either a 1-g tranexamic acid out-of-hospital bolus and 1-g in-hospital infusion over 8 hours (bolus maintenance group), a 2-g tranexamic acid out-of-hos...
Source: JAMA - September 8, 2020 Category: General Medicine Source Type: research