Jama
(Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

COVID-19 Precautions Hamper Breastfeeding Support
Nearly 1 in 5 hospitals reduced in-person lactation support and nearly three-quarters discharged new mothers in less than 48 hours to lessen the risk of contracting severe acute respiratory syndrome coronavirus 2, according to a CDC report. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Health Workers ’ Antibody Levels Wane After SARS-CoV-2 Infection
Antibodies to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) decline during the weeks after infection, in some cases falling below the threshold for seropositivity within 2 months, according to a national study of health care workers. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Could Baking Soda Fight Leukemia Relapse After Stem Cell Transplant?
For patients with leukemia and other hematological malignancies, donor hematopoietic stem cells can recognize and attack remaining cancer cells after chemotherapy. But residual cancer cells ’ immune-suppressing effects can thwart these transplants and lead to eventual relapse, requiring a donor lymphocyte infusion. A new study suggests that a treatment as simple as sodium bicarbonate—better known as baking soda—can potentially boost donor lymphocytes’ ability to overcome relaps e after stem cell transplants. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Incorrect Data in Table and in Results Section
This article was corrected online. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Diversity in Medical Schools —Need for a New Bold Approach
In this issue of JAMA, Montgomery Rice details the wrenching history of Black men and women and medical education and the many challenges still thwarting the long-standing goal of increasing diversity in US medical schools. From her purview as dean at Morehouse School of Medicine, she offers unique insights and specifically illuminates the failure to increase the enrollment of Black medical students, especially at new medical schools, many of which have explicitly adopted diversity as a foundational pillar of contemporary mission statements. As a consequence, the medical schools serving historically Black colleges and univ...
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

First Progeria Drug Is Approved
A new medication intended to reduce the risk of death from a genetic disease that causes premature aging has been approved for patients 1 year or older. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Antiviral Drug Approved for Postexposure Flu Prevention
The approved indication for baloxavir marboxil has been expanded to include postexposure influenza prevention for patients 12 years or older. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

New Tool Offers Faster Notice of Foodborne Illness Outbreaks
The FDA has created a new way to inform the public about foodborne illness outbreaks before health advisories or product recalls are issued. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Management of Patients With a Patent Foramen Ovale With History of Stroke or TIA
This Clinical Guidelines Synopsis summarizes the American Academy of Neurology ’s practice advisory update on management of patients with a patent foramen ovale who have a history of stroke or transient ischemic attack. (Source: JAMA)
Source: JAMA - January 5, 2021 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 - January 5, 2021 Category: General Medicine Source Type: research

A 7-Point Action Agenda to End the COVID-19 Pandemic for President-elect Biden
President-elect Joseph Biden has a historic opportunity to reset the US response to coronavirus disease 2019 (COVID-19), but it is unrealistic to expect a sharp turnaround, given steep spikes in cases and deaths. Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the US, the federal government has undermined science, conveyed confusing health messages, politicized public health agencies, and sowed distrust. Despite being ranked by the Global Health Security Index as first in pandemic preparedness before COVID-19, the US has been among the world ’s worst performers, with the most ca...
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Current Comment
(Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Postexercise Ankle-Brachial Index Testing to Diagnose Peripheral Artery Disease
To the Editor Dr Mehta and colleagues presented the advantages and drawbacks of postexercise ankle-brachial index (ABI) testing based on a clinical case. However, several concerns about the postexercise criteria were not mentioned in the article. Postexercise ABI criteria to diagnose peripheral artery disease (PAD) are debated. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Postexercise Ankle-Brachial Index Testing to Diagnose Peripheral Artery Disease —Reply
In Reply Dr Mah é and colleagues are concerned about the sensitivity and specificity of the thresholds used for diagnosing PAD in patients with normal (1.00-1.40) or borderline (0.91-0.99) resting ABI and exertional non–joint-related leg pain. The diagnostic threshold of either a postexercise ABI decrease of mor e than 20% or a postexercise ankle systolic pressure decrease of more than 30 mm Hg were suggested by Aboyans et al as a reasonable diagnostic criterion for PAD (recommendation class IIa; level of evidence A) in the 2012 American Heart Association scientific statement on measurement and interpretati on...
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Pulmonary Embolism Prevalence Among Patients With COPD With Acutely Worsening Respiratory Symptoms
This cross-sectional study characterizes the prevalence of pulmonary embolism defined by a uniform diagnostic algorithm in patients in France with COPD hospitalized with acutely worsening respiratory symptoms. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Patient Information: Bisphosphonates for Postmenopausal Osteoporosis
This JAMA Patient Page summarizes the benefits and possible harms of taking bisphosphonates for postmenopausal osteoporosis (age-related thinning of bones). (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Sewing a Mask
The first effort is lopsided. Dark thread on light fabric shows every knotted stitch and wandering line. Thread bunches up at corners on the underside, the bobbin was pulled too tight, the settings wrong. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Highest Bidder —Creativity
In this narrative medicine essay, a physician explores a persistent memory of a high school peer who staked all on creativity as a value that physicians and future physicians ought to tap into to resolve today ’s strife as healers. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Management of Crohn Disease
This review discusses the diagnosis and management of Crohn disease, including the importance of disease severity and risk stratification when determining a treatment strategy, the importance of maintenance therapy, and the adverse effects of treatment options. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Jama
(Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Diversity in Medical Schools —A Much-Needed New Beginning
This Viewpoint reviews the many factors contributing to underrepresentation of Black physicians in US medical training pipelines and the health care workforce, and urges actions to dismantle structural barriers to Black medical school enrollment and achieve racial parity in the profession. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Two Decades Since To Err Is Human
It has been more than 2 decades since the Institute of Medicine (IOM; now the National Academy of Medicine [NAM]) published To Err Is Human in 2000, which concluded that up to an estimated 98  000 deaths each year may result from preventable medical errors. In 2020, as a host of articles appeared to celebrate the anniversary of the report, the COVID-19 pandemic cruelly illustrated the ways in which the US health system has still fallen far short of the goal of providing safe, high-qual ity care. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Incorporating the Risk for Subsequent Primary Cancers Into the Care of Adult Cancer Survivors
A diagnosis of cancer is a feared and often unexpected event, affecting an estimated 1.8 million individuals annually in the US. Hereditary cancers are rare, accounting for approximately 10% of all incident cancers. The majority of adult-onset cancers are sporadic, increase with advancing age, and are associated with lifestyle behaviors, obesity, and infections that lead to acquired somatic mutations that eventuate in cancer, accounting for an estimated 50% to 60% of incident cancers. Cancer is often diagnosed early with screening tests, or when more advanced, is identified because of clinical symptoms or findings on physi...
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Digitalis Glycosides for Heart Rate Control in Atrial Fibrillation
Digitalis glycosides were first introduced into clinical use in 1785 by William Withering, a physician in Birmingham, England. A new study published in JAMA, also conducted by physicians in Birmingham, provides novel information on the use of digoxin for heart rate control in patients with atrial fibrillation (AF). (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

More Transparency Needed for COVID-19 Emergency Authorizations
To improve public trust, the US Food and Drug Administration (FDA) should be more transparent in publicly disclosing its reviews of safety and effectiveness data leading to Emergency Use Authorization (EUA) of coronavirus disease 2019 (COVID-19) vaccines and treatments, according to a recent report from the US Government Accountability Office (GAO). (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Postpartum Depression Persists Longer Than Previously Thought
Postpartum depression might persist for up to 3 years after giving birth, according to a recent study conducted by researchers from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Pharmacies Partner With HHS to Provide COVID-19 Vaccines
Chain and independent pharmacies have partnered with the federal government to maximize access to coronavirus disease 2019 vaccines at no cost when they ’re available, the US Department of Health and Human Services (HHS) recently announced. (Source: JAMA)
Source: JAMA - December 22, 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 - December 22, 2020 Category: General Medicine Source Type: research

A British Tribute to the American Physician
In the London Lancet for October 20, page 507, an anonymous writer ventures a few reminiscent thoughts relative to the association of the British physicians with their American colleagues during the period of the war. It is a charming statement in which every medical reader should take pleasure. The statement follows: (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Uptake and Accuracy of the ICD-10-CM Diagnosis Code for COVID-19 Among US Hospitalizations
This study uses administrative claims data to describe trends in use of ICD-10-CM diagnosis codes for novel coronavirus patients in January-May 2020, before and afer the April 1 release of the U07.1 code to facilitate billing for and case monitoring of COVID-19. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Cross-Training in Neurology and Psychiatry
To the Editor In their Viewpoint on training in neurology and psychiatry, Dr Keshavan and colleagues, argued that the interface between the mind and the brain is neglected in training; the addition of residency training in clinical neuroscience may allow physicians to better address those diseases that cause neurological and psychiatric symptoms. However, by suggesting that all trainees in neurology and psychiatry focus more heavily on the neurosciences, I believe that they went too far. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Cross-Training in Neurology and Psychiatry —Reply
In Reply Mr Butchart agrees that the interface between the brain and the mind has been neglected by the fields of both neurology and psychiatry. However, he also suggests that our proposal of increased neuroscience training for all trainees in neurology and psychiatry goes too far. We would like to emphasize some key aspects of our Viewpoint that may place this issue in a clearer context. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Exercise Intensity Unrelated to Older Adults ’ Mortality Risk
Researchers in Norway found no significant difference in all-cause mortality among older adults following standard exercise guidelines or supervised high- or moderate-intensity exercise regimens, a trial published in the BMJ reported. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Empagliflozin Cuts Cardiovascular Deaths in Advanced Heart Failure
Patients treated for advanced but stable heart failure, including those with diabetes, had a 25% lower risk of cardiovascular death or hospitalization for heart failure when they received empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, according to an international trial in the New England Journal of Medicine. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

High-Calorie Treatment Leads to Faster Gains in Anorexia Nervosa
Adolescents and young adults hospitalized with anorexia nervosa became medically stable more quickly with higher-calorie foods reintroduced to their diet compared with standard lower-calorie refeeding (LCR), according to short-term outcomes published in JAMA Pediatrics. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Reliving Childhood Trauma Details Isn ’t Needed to Treat PTSD
Two treatments that don ’t require lengthy recollection of traumatic memories were equally effective for adults with posttraumatic stress disorder (PTSD) arising from childhood experiences, an international trial in the British Journal of Psychiatry reported. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Early Physical Therapy Relieves Sciatica Disability and Pain
A primary care clinician ’s referral to physical therapy within 90 days of sciatica symptom onset improved pain and functional capabilities compared with usual care, a trial in the Annals of Internal Medicine found. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Association of First Primary Cancer With Risk of Subsequent Primary Cancer in US Adults
This cohort study uses SEER registry data to estimate overall and cancer-specific risk for secondary primary cancers among US adults with first primary cancers who lived at least 5 years past their initial diagnosis. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Effect of Digoxin vs Bisoprolol for Heart Rate Control in Patients With Permanent Atrial Fibrillation
This randomized trial compares the effect of low-dose digoxin vs bisoprolol for heart rate control on quality of life in patients aged 60 years or older with permanent atrial fibrillation and dyspnea. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Patient Information: Peyronie Disease
This JAMA Patient Page describes Peyronie disease, a scarring of tissue in the penis that may affect sexual function, and available procedural treatment options. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Patient Information: Gastroesophageal Reflux Disease (GERD)
This JAMA Patient Page describes the causes, symptoms and signs, and treatments, including medication (eg, proton pump inhibitors) and surgery (eg, fundoplication), for gastroesophageal reflux disease (GERD). (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

A Social Medicine Team for Emergency Department Patients With High Psychosocial Burden
This JAMA Performance Improvement article describes experience at Zuckerberg San Francisco General Hospital with an emergency department social medicine (EDSM) team to facilitate care of ED patients with low-acuity medical illnesses and complex psychosocial comorbidities (homelessness, mental illness, substance use, poverty). (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

An Essential Worker ’s List of Pandemic Chores for the Kids
Sorry I had to leave before you woke up. You ’re right, it isn’t fair. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

The Light Princess —Pregnancy Loss
In this narrative medicine essay a family physician recalls her bereavement after a pregnancy loss and her slow process of healing through mentoring and lasting relationships with premed students, following their lives and careers with the same pride as a parent. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Gastroesophageal Reflux Disease
This narrative review summarizes recent advances in the diagnosis and management of gastroesophageal reflux disease (GERD), including updates on pharmacologic options and surgical approaches. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Jama
(Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Assessing Progress in Health Care Quality Through the Lens of COVID-19
This Viewpoint describes US health system performance during the COVID-19 pandemic using the National Academy of Medicine's 2001 Quality Chasm framework, focusing on system cohesion, organizational capabilities, and environment of care. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Accelerating Global Improvements in Health Care Quality
This Viewpoint proposes a policy framework for thinking about health care quality in low- and middle-income countries, emphasizing the importance of infrastructure, enforceable quality standards, safety practices, guideline-directed clinical care, and patient and family involvement. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

A Roadmap to Advance Patient Safety in Ambulatory Care
This Viewpoint emphasizes the need for research and initiatives related to patient safety in outpatient settings and proposes practice, policy, and patient and caregiver milestones to give patient harm reduction in ambulatory care settings the same priority as in inpatient settings. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research