Bilateral Renal Agenesis —Interpreting the RAFT Trial
Bilateral renal agenesis is historically considered to be universally fatal, due to pulmonary hypoplasia resulting from failure to maintain adequate amniotic fluid from fetal urine production in the first half of pregnancy. This fundamental dictum from perinatal-neonatal medicine has been challenged by the RAFT trial in this issue of JAMA. The authors performed a multicenter nonrandomized clinical trial of pregnancies complicated by bilateral renal agenesis and anhydramnios due to fetal anuria to assess whether the infants of participants who agreed to serial amnioinfusions initiated prior to 26 weeks ’ gestation to prom...
Source: JAMA - December 5, 2023 Category: General Medicine Source Type: research
Adenotonsillectomy or Watchful Waiting for Pediatric Sleep-Disordered Breathing
Habitual snoring and sleep-disordered breathing (SDB) are remarkably common conditions in children. Poor sleep has a significant effect on the neurobehavior and quality of life (QOL) of the child and therefore on the parent-child dyad, which exceeds the effect of a prevalent and treatable disease. When surgery is considered as treatment, the surgeon and family balance the potential benefit to the child, associated morbidity, related financial burden, and the cost-effectiveness of surgery compared with medical management or watchful waiting. When there is a choice, the collaborative process of shared decision-making between...
Source: JAMA - December 5, 2023 Category: General Medicine Source Type: research
Jama
(Source: JAMA)
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
Review of Obesity Management in Adults
This Review summarizes current evidence regarding the pathophysiology, diagnosis, and treatment of obesity. (Source: JAMA)
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
Made of Flower and Flame: Poetry and Climate Change
The natural world, long a source of delight and repose and so often celebrated in poetry, is changing. As the impact of human activity harmful to the earth ’s climate and global health continues to be documented, so too has contemporary poetry responded in its own terms in the work of poets like Gary Snyder and Terry Tempest Williams, and in this issue’s “Persephone Explains Global Warming.” Florid, overheated language evokes the globe’s asto nishing variety of biota and the threat posed by rising temperatures. “Unphas[ed] tides” and “blister[ed] trees” are metaphors for nature gone awry. The poem’s ver...
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
Persephone Explains Global Warming
She has realized: all these years in Hell have made her powerful. She whirls back from the underworld, skirts made of flowers but also, now, flame. She dares the sun to come closer, flirts with the moon, unphasing the tides. She offers fruit to passersby, out of season: mango, blood orange, avocado, overripe pineapple. She blisters the trees with her passing. It ’s not enough to bring back spring: hurricanes, volcanoes, tornadoes, wildfires, tsunamis in her dance. If the poles switch polarity, if the icecaps are melting, she’ll be singing: “Put the blame on Mame, boys,” in a satin dress, a film-noir femme fatale in...
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
Self-Sampling Strategy to Increase Cervical Cancer Screening
This randomized clinical trial assessed rates of adherence to undergo cervical cancer screening by comparing response rates to various outreach strategies among individuals who were due or overdue for screening and who had unknown screening history. (Source: JAMA)
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
Toripalimab Plus Chemotherapy for Recurrent or Metastatic Nasopharyngeal Carcinoma
This multicenter, double-blind, randomized trial conducted in nasopharyngeal cancer (NPC) –endemic regions assesses whether toripalimab in combination with gemcitabine-cisplatin as first-line treatment for recurrent or metastatic NPC, compared with gemcitabine-cisplatin alone, will significantly improve progression-free survival and overall survival among chemotherapy-naive patients wi th recurrent or metastatic NPC. (Source: JAMA)
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
USPSTF Recommendation on Screening for Lipid Disorders in Children and Adolescents —Reply
In Reply The USPSTF appreciates the viewpoints expressed in the Letters to the Editor regarding the Recommendation Statement on screening for lipid disorders in children and adolescents. (Source: JAMA)
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
Treatment of SARS-CoV-2 Infection in US Nursing Homes —Reply
In Reply Dr Bergman highlights a number of important potential barriers to COVID-19 antiviral treatment use in nursing homes, including rapidly evolving guidelines concerning the use of monoclonal antibodies, insufficient supply of recommended monoclonal antibodies, and high staffing needs to administer monoclonal antibodies intravenously. These factors likely contributed to the low antiviral treatment rates observed in our study, when monoclonal antibodies were the only treatment available. (Source: JAMA)
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
USPSTF Recommendation on Screening for Lipid Disorders in Children and Adolescents
To the Editor We disagree with the recent recommendation from the US Preventive Services Task Force (USPSTF) against lipid screening in the pediatric population. If misinterpreted, this statement could have widespread implications that adversely affect the health of youths with familial hypercholesterolemia (FH). Familial hypercholesterolemia is a relatively common semidominant genetic condition that, if untreated, leads to cumulative exposure to low-density lipoprotein cholesterol (LDL-C) and premature atherosclerotic cardiovascular disease (ASCVD). (Source: JAMA)
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
USPSTF Recommendation on Screening for Lipid Disorders in Children and Adolescents
To the Editor The preamble to the USPSTF Recommendation Statement on screening for lipid disorders in children and adolescents states that the USPSTF is committed to mitigating the health inequities that prevent people from fully benefiting from preventive services. However, the conclusion of that Recommendation Statement that there is insufficient evidence to recommend screening for lipid disorders in children and adolescents may contribute to inequities in the prevention of heart disease later in life. (Source: JAMA)
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
USPSTF Recommendation on Screening for Lipid Disorders in Children and Adolescents
To the Editor The Agency for Healthcare Research and Quality describes the USPSTF as follows: “The USPSTF works to improve the health of people nationwide by making evidenced-based recommendations on effective ways to prevent disease and prolong life.” This is a serious and important mandate. (Source: JAMA)
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
Treatment of SARS-CoV-2 Infection in US Nursing Homes
To the Editor A recent Research Letter examined COVID-19 treatment rates in US nursing homes from May 31, 2021, through December 25, 2022, and found that only 1 in 4 nursing home residents with COVID-19 had been treated with antiviral treatments and that more than 40% of nursing homes reported never administering any oral antiviral or monoclonal antibody treatment in the 19-month study window. As a practicing nursing home attending physician and medical director, I wish to elaborate on some of the barriers to treatment in nursing homes to highlight policy changes that could improve treatment rates in future pandemics. (Source: JAMA)
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
The Foundation of Ethics, The Public Service of Professions
(Source: JAMA)
Source: JAMA - November 28, 2023 Category: General Medicine Source Type: research
