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
Treating Attention-Deficit/Hyperactivity Disorder Matters
This study used electronic health records (EHRs) data in a way that approximates a randomized clinical trial (RCT) to assess mortality rates by ADHD medication status over time. Individuals consistently treated with ADHD medication were compared with those who did not receive ADHD medication on 3 outcomes over a 2-year follow-up period: all-cause mortality, natural-cause mortality (eg, medical conditions), and unnatural-cause mortality (eg, accidental injuries, accidental poisoning, and suicide). Overall, those who initiated ADHD medication had a reduced risk for all-cause mortality and unnatural-cause mortality (but not n...
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
The Public Health Challenge of Δ 8 -THC and Derived Psychoactive Cannabis Products
This study is a reminder that there is a diverse set of cannabis products on the market that vary in their legal and regulatory status and potential for harm. Δ8-THC is a psychoactive cannabinoid that can be derived fr om hemp. It was introduced to the retail market in 2018 and there are indications that its use is on the rise. There is little regulatory oversight of production and sales of Δ8-THC and some evidence of adverse outcomes after use. (Source: JAMA)
Source: JAMA - March 12, 2024 Category: General Medicine Source Type: research
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(Source: JAMA)
Source: JAMA - March 5, 2024 Category: General Medicine Source Type: research
Cardiac Amyloidosis Due to Transthyretin Protein
This Review summarizes the clinical presentation, diagnosis, and treatment of amyloidosis from transthyretin (ATTR) protein cardiomyopathy. (Source: JAMA)
Source: JAMA - March 5, 2024 Category: General Medicine Source Type: research
Congenital Diaphragmatic Hernia
Of course death can happen at any hour. Like this: after birth, at dawn, the sun pressing through thick hospital windows, climbing peach walls of the delivery room, ending the long labor in the operating room. Cutting the baby from where she would not come. My snug gloves, warmth and wetness of birth, every single one. Except she was to die; hole at her center, bowel peristalsing her chest. Months you knew too, carrying her, she moved inside, so different from your miscarriages. Placental separation, inarched to the heart-lung machine, floors junked with effort. Luminescent skin of lanugo, newborn hirsutism; lovely photogr...
Source: JAMA - March 5, 2024 Category: General Medicine Source Type: research
Pharmacotherapy for Alcohol Use Disorder —Reply
In Reply We appreciate the thoughtful letter by Dr Shi regarding our systematic review and meta-analysis of pharmacotherapies for alcohol use disorder. Regarding the meta-analyses that included multiple doses, the analyses were stratified by dose whenever possible (eg, 50-mg oral naltrexone and 100-mg oral naltrexone). More details are provided in the full evidence report. (Source: JAMA)
Source: JAMA - March 5, 2024 Category: General Medicine Source Type: research
Medical Student Intent to Practice in Underserved Areas —Reply
In Reply We appreciate the thoughtful comments from Mr Akimoto and colleagues and Dr Soh regarding our recently published study. We wish to clarify that we did not state nor did we intend to imply that any specific demographic of physicians is uniquely responsible for caring for patients in underserved areas. (Source: JAMA)
Source: JAMA - March 5, 2024 Category: General Medicine Source Type: research
Treatment for Hyperthyroidism During Pregnancy —Reply
In Reply We agree that overt Graves disease hyperthyroidism requires treatment during pregnancy. As described in our review, risks for preeclampsia, low birth weight, miscarriage, and preterm delivery are increased without therapy, and as noted by Dr Watkins and colleagues, congenital anomaly risk is higher without treatment than when propylthiouracil is taken. For individuals who need treatment with antithyroid drugs during pregnancy, propylthiouracil is preferred over methimazole during the period of organogenesis. (Source: JAMA)
Source: JAMA - March 5, 2024 Category: General Medicine Source Type: research
Pharmacotherapy for Alcohol Use Disorder
To the Editor In a recent systematic review and meta-analysis, McPheeters and colleagues compared the efficacy and comparative efficacy of 9 therapies for alcohol use disorder from 118 clinical trials including 20 976 adults. The findings support the use of 50 mg/d of oral naltrexone and acamprosate as first-line pharmacotherapies for alcohol use disorder. However, I have several concerns about this article. (Source: JAMA)
Source: JAMA - March 5, 2024 Category: General Medicine Source Type: research
Medical Student Intent to Practice in Underserved Areas
To the Editor The research letter by Dyrbye and colleagues explored US medical student plans to practice in underserved areas and further disaggregated how racially and ethnically minoritized medical students might address the physician workforce shortage in these areas. (Source: JAMA)
Source: JAMA - March 5, 2024 Category: General Medicine Source Type: research
Medical Student Intent to Practice in Underserved Areas
To the Editor A recent research letter by Dyrbye and colleagues evaluated medical students ’ intent to practice in underserved areas by race, ethnicity, sex, and sexual orientation between 2019 and 2021. Dyrbye and colleagues found that American Indian or Alaska Native; Black or African American; Hispanic, Latino, or of Spanish origin; and Native Hawaiian or Other Pacific Islander medic al students were significantly more likely to report intent to practice in underserved areas. As Native Hawaiian or Other Pacific Islander physicians and researchers, we commend the authors on abiding by federal race standards, including ...
Source: JAMA - March 5, 2024 Category: General Medicine Source Type: research
Treatment for Hyperthyroidism During Pregnancy
To the Editor Although the recent review of hyperthyroidism by Lee and Pearce was comprehensive, as specialists in maternal-fetal medicine, we have concerns regarding the authors ’ overview of antithyroid medications during pregnancy. (Source: JAMA)
Source: JAMA - March 5, 2024 Category: General Medicine Source Type: research
Brain Work
As long ago as the eighteenth century, it was noticed by Lavoisier that exercise leads to an increased consumption of oxygen. Ever since that period, evidence has been accumulating to establish the fact that the bodily activities are attended with chemical changes. The liberation of energy proceeds through the transformation of matter stored in the organism. Every type of muscular work adds to the need of food to replace what has been expended in maintaining those inevitable functions that are classed in the expression basal metabolism. The increment of loss through vigorous exercise may amount, in terms of energy, to seve...
Source: JAMA - March 5, 2024 Category: General Medicine Source Type: research
