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 - December 19, 2023 Category: General Medicine Source Type: research
Making Sense of Individual Responses to Sodium Reduction
More than 130 million adults in the US have hypertension, and national rates of blood pressure (BP) control have declined in recent years. This high burden of hypertension is driven in part by the US diet. The average US adult consumes 3.4 g of sodium daily, approximately 70% of which comes from the packaged and pre-prepared foods that define much of our culinary culture. Several randomized clinical trials have demonstrated that lowering sodium intake leads to lower BP, particularly among individuals with higher baseline BP. Population-level randomized interventions have shown that sodium restriction with potassium-based s...
Source: JAMA - December 19, 2023 Category: General Medicine Source Type: research
Risk of Harm From AI-Driven Clinical Decision Support
At the point of care, artificial intelligence (AI) algorithms have been developed to augment diagnostic decisions and suggest appropriate care pathways, by leveraging complex information in a patient ’s electronic health record, such as imaging, documentation, and diagnostic testing. With an increasing number of technologies integrated into the diagnosis, management, and even treatment of patients, the promise of AI to enhance accuracy, reduce errors, reduce clinician burnout, and improve clin ical workflows may appear imminent. (Source: JAMA)
Source: JAMA - December 19, 2023 Category: General Medicine Source Type: research
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(Source: JAMA)
Source: JAMA - December 12, 2023 Category: General Medicine Source Type: research
Cover Me With Words —Expressing Pain in Poetry
Elaine Scarry, author of the influential book The Body in Pain, argues that pain is essentially unshareable; that its unshareability derives from its “resistance to language”; and that “physical pain does not simply resist language but actively destroys it.” (Source: JAMA)
Source: JAMA - December 12, 2023 Category: General Medicine Source Type: research
O.r. 34
don ’t look at me cover me with words (Source: JAMA)
Source: JAMA - December 12, 2023 Category: General Medicine Source Type: research
Metformin Plus Insulin for Preexisting Diabetes or Gestational Diabetes in Early Pregnancy
This randomized clinical trial compares the effect of insulin plus metformin vs insulin and placebo in reducing the odds of adverse neonatal outcomes in pregnant adults with preexisting type 2 diabetes or diabetes identified in early pregnancy. (Source: JAMA)
Source: JAMA - December 12, 2023 Category: General Medicine Source Type: research
Cannabis Exposure and Adverse Pregnancy Outcomes Related to Placental Function
This observational analysis evaluates the association between maternal cannabis use and adverse pregnancy outcomes known to be related to placental function among nulliparous individuals treated at US medical centers with stored urine samples and available pregnancy outcome data. (Source: JAMA)
Source: JAMA - December 12, 2023 Category: General Medicine Source Type: research
Sugar-Sweetened Beverages and Risk of Liver Disease —Reply
In Reply We appreciate the comments by Dr Ayada and colleagues. We agree that sugar-sweetened beverages might partially impact the risk of liver cancer through their potential effect on NAFLD. We also hypothesize that sugar-sweetened beverages could affect liver carcinogenesis directly or via other mechanisms. For example, various additives, colorings, and preservatives that are commonly used in sugar-sweetened beverages could increase the expression of genes related to inflammatory processes in the liver. Additionally, sugar-sweetened beverages could induce changes in gut microbiota, which may increase intestinal permeabi...
Source: JAMA - December 12, 2023 Category: General Medicine Source Type: research
Clinical Guidelines for Priapism —Reply
In Reply We appreciate the Letter to the Editor from Dr Holzman noting the potential value of ketamine in the therapy of priapism. This therapy was not discussed in the recent American Urological Association priapism guidelines; the evidence is limited and based on case reports mentioned by Holzman as well as others. Zipper et al presented a series of 4 pediatric patients and reported priapism resolution in each of 3 patients with a priapism event of less than 12 hours ’ duration. However, other reports on ketamine are mixed, even in the perioperative setting, where its use was first reported, and standard treatment prot...
Source: JAMA - December 12, 2023 Category: General Medicine Source Type: research
Medicare Advantage Disenrollment Among Beneficiaries With Chronic Conditions —Reply
In Reply In our recent Research Letter, we found that the number of chronic conditions was not associated with disenrollment from MA to FFS or from FFS to MA between 2010 and 2019. Dr Burke uses our study findings to discuss the MA program as a whole and raises concern that some individuals may not completely understand MA plans ’ utilization management tools and subsequently find it difficult to switch to FFS because they cannot find a generous Medigap policy at an affordable price. As the MA program is rapidly expanding among Medicare beneficiaries, Burke’s concerns are valid. However, our study did not examine any o...
Source: JAMA - December 12, 2023 Category: General Medicine Source Type: research
Sugar-Sweetened Beverages and Risk of Liver Disease
To the Editor A recent study investigated associations between sugar-sweetened and artificially sweetened beverages and risk of chronic liver disease and liver cancer in women. Compared with intake of 3 or fewer sugar-sweetened beverages per month, individuals who consumed 1 or more sugar-sweetened beverages per day had a significantly higher risk of developing liver cancer. The same association for artificial sweeteners did not show statistical significance, although the hazard ratio was 1.17. The World Health Organization recently identified artificial sweeteners as possible carcinogens in high dosage, although this is s...
Source: JAMA - December 12, 2023 Category: General Medicine Source Type: research
Clinical Guidelines for Priapism
To the Editor A recent Clinical Guidelines Synopsis reviewed diagnosis and management of priapism as a medical emergency. Unwanted tumescence may also occur intraoperatively under anesthesia regardless of anesthetic technique (general vs regional, such as spinal) and can interfere with cystoscopy and other surgical procedures. (Source: JAMA)
Source: JAMA - December 12, 2023 Category: General Medicine Source Type: research
Medicare Advantage Disenrollment Among Beneficiaries With Chronic Conditions
To the Editor A recently published Research Letter on Medicare Advantage (MA) disenrollment patterns is misleading about the harms of MA to vulnerable patients enrolled in MA, which is not Medicare but a private, for-profit insurance plan. (Source: JAMA)
Source: JAMA - December 12, 2023 Category: General Medicine Source Type: research
Disease as an Aftermath of War
When the war trumpets blow, the peoples must dance. No place so remote, no family so isolated that it may not be affected by a conflict seemingly as outside its sphere of interest as the planet Saturn. War, famine and pestilence ride together as well chosen comrades. Disease is a consequence of modern war as direct and inevitable as bullet wounds. (Source: JAMA)
Source: JAMA - December 12, 2023 Category: General Medicine Source Type: research
