Struggling to Stem the Tide of Child Maltreatment
Many JAMA readers understand that child maltreatment is a pervasive public health and costly societal problem with devastating consequences to the long-term physical health, mental health, and well-being of surviors. But few have witnessed what we see on a regular basis: the lost futures of chronically neglected children who have never experienced the stability and safety of a nurturing family; the mental health challenges of adolescents who have been sexually abused and assaulted for years by their caregivers; the permanent neurologic injuries of infants who have survived abusive head trauma; and the battered bodies of mu...
Source: JAMA - March 19, 2024 Category: General Medicine Source Type: research
Postmarketing Vaccine Safety Assessments
After the initial randomized clinical trials and emergency use authorization of the COVID-19 vaccines by the US Food and Drug Administration (FDA) during the COVID-19 pandemic, the US Centers for Disease Control and Prevention (CDC) and the FDA undertook extensive postmarketing vaccine safety surveillance activities in the US, with close monitoring by an independent safety committee. Analysis of surveillance data identified several important adverse events associated with receipt of the COVID-19 vaccines. (Source: JAMA)
Source: JAMA - March 19, 2024 Category: General Medicine Source Type: research
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(Source: JAMA)
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
Allergic Rhinitis
This narrative review discusses the pathogenesis, differential diagnosis, treatments, and prognosis for patients with allergic rhinitis. (Source: JAMA)
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
Suicide and Poetry
With the US suicide rate reaching a new high in 2022, poetry —especially that of John Berryman, Sylvia Plath, Anne Sexton, and other confessional poets who wrestled with intense emotion before ending their lives—seems ever more relevant. In “Aftermath,” the speaker describes the harrowing suicide of a patient in the hospital, her matter-of-fact tone b elying the shock of self-harm happening in the very place devoted to care and healing. The middle-stanza lyrical dream wishes somehow to reverse the mortal injury. It comprises long lines and extended between-stanzas silences, which seem to provide breathing room for ...
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
Aftermath
Asters reach from paper cups across the nurses ’ desk. When the petals fall we fold them in a book. This is how we fix it when he shoots himself in the face after night rounds. * I dream I draw his pain into a 10-mL syringe. Gray matter leaps from the wall back into his brain. The bullet blows back inside his gun and his children come— * Aft er three days the room is scrubbed clean. Some of us cry. All of us get back to work. (Source: JAMA)
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
Adolescent Δ 8 -THC and Marijuana Use in the US
This cross-sectional nationally representative classroom-based survey of US 12th-grade students examines the self-reported prevalence of and sociodemographic and policy factors associated with Δ8-THC and marijuana use during a 12-month period. (Source: JAMA)
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
Pharmacotherapy and Mortality in Individuals With ADHD
This cohort study investigates whether the initiation of medication to treat patients with attention-deficit/hyperactivity disorder (ADHD) was associated with mortality. (Source: JAMA)
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
Vitamin C for Patients Hospitalized With COVID-19 —Reply
In Reply Dr McKenzie and colleagues raise concerns regarding the safety of bundling thiamine with other vitamins into a product primarily prescribed for thiamine replacement in patients with or at risk of alcohol withdrawal. This formulation consists of 2 ampules (thiamine, riboflavin, and pyridoxine in ampule 1; ascorbic acid, nicotinamide, and glucose in ampule 2) that are intended to be diluted together in normal saline or 5% dextrose and infused. We are aware of a similar bundled injectable vitamin solution in other countries. (Source: JAMA)
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
GLP-1 Receptor Agonists and Gastrointestinal Adverse Events —Reply
In Reply We thank Dr Suissa and colleagues for their critical review of our report. They question whether diabetes was adequately excluded in our study beyond the 90-day period. We agree that diabetes requires a stricter exclusion. As such, we ensured that study participants had not received an antihyperglycemic drug or a diabetes code for at least 1 year prior to cohort entry (date of the first prescription of a study drug) before the obesity restriction was applied. This detail was not included in our article due to space limitations. (Source: JAMA)
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
Vitamin C for Patients Hospitalized With COVID-19
To the Editor The recently published REMAP-CAP and LOVIT-COVID studies tested the hypothesis that the administration of high-dose vitamin C (ascorbic acid) increases the number of days patients are alive and free from organ support. However, these studies were terminated early when statistical triggers for harm and futility were met. In addition, the earlier LOVIT study found harm from high-dose vitamin C and a higher risk of death or persistent organ dysfunction at 28 days. The dose of vitamin C given to the 1476 patients with critical illness in the 3 studies was 50 mg/kg of body weight administered 4 times daily. For a ...
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
Sigh Breaths in Patients With Trauma Receiving Mechanical Ventilation
To the Editor We recently published a study showing that sigh breaths added to usual care of trauma patients receiving ventilation did not significantly increase the primary end point of ventilator-free days. However, the prespecified secondary and post hoc tertiary end points indicated that sighs were safe, shortened time with the ventilator, and may substantially decrease mortality. We linked these findings to the rationale that surfactant needs to be continuously secreted to prevent ventilator-induced lung injury and that stretching the lung is the strongest stimulus for secretion of surfactant from type II pneumocytes. (Source: JAMA)
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
GLP-1 Receptor Agonists and Gastrointestinal Adverse Events
To the Editor A recent Research Letter examined the risk of gastrointestinal adverse events associated with use of glucagon-like peptide-1 (GLP-1) receptor agonists for weight loss. The authors reported a 9-fold increase in the risk of pancreatitis (adjusted hazard ratio [HR], 9.09; 95% CI, 1.25-66.00), a 4-fold increase in bowel obstruction (adjusted HR, 4.22; 95% CI, 1.02-17.40), a 3-fold increase in gastroparesis (adjusted HR, 3.67; 95% CI, 1.15-11.90), and a numerical increase in biliary disease (adjusted HR, 1.50; 95% CI, 0.89-2.53). Such extreme findings raise clinical concerns that may not be justified in view of se...
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
Constitution and Fitness
The equipment of man to combat adverse influences that may confront him from time to time is evidently made up of various factors, some of which are inborn, whereas others are the product of environmental influences. To what extent these factors enter into what is popularly termed human constitution or, by medical writers, diathesis, remains for the most part the subject of rather personal speculation. “Constitution” has been defined lately as that aggregate of hereditarial characters, influenced more or less by environment, which determines the individual’s reaction, successful or unsuccessful, to the stress of envi...
Source: JAMA - March 12, 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 - March 12, 2024 Category: General Medicine Source Type: research
