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 - February 27, 2024 Category: General Medicine Source Type: research
Bariatric Surgery Produces Long-term Benefits in Patients with Type 2 Diabetes
Nearly 30 years ago, Pories and colleagues published a landmark case series provocatively titled “Who Would Have Thought It? An Operation Proves to Be the Most Effective Therapy for Adult-Onset Diabetes Mellitus.” The operation was the gastric bypass for obesity. The excellent well-controlled study published in this issue of JAMA by Courcoulas and colleagues provides the most robust evidenc e to date of the long-term efficacy of bariatric surgery for improving control of type 2 diabetes. Effective therapies are critically needed for this disease, which affects more than 14% of adults in the US, is associated with a hig...
Source: JAMA - February 27, 2024 Category: General Medicine Source Type: research
Trickle-Down Medicaid
The Affordable Care Act (ACA) sought to expand Medicaid to all adults with incomes less than 138% of the federal poverty level. However, because Medicaid is a partnership between states and the federal government, some states sued in response to this unilateral federal change. A 2012 Supreme Court decision allowed states to opt out of the Medicaid expansion, and many did so. For the states that did expand, the federal government pays 90% of the $155 billion required to cover the expansion population, which totaled 19 million people in fiscal year 2022. What are the effects of all that money flowing into the health care system? (Source: JAMA)
Source: JAMA - February 27, 2024 Category: General Medicine Source Type: research
Jama
(Source: JAMA)
Source: JAMA - February 20, 2024 Category: General Medicine Source Type: research
Diagnosis and Management of Paroxysmal Supraventricular Tachycardia
This Review summarizes current evidence regarding the diagnosis and treatment of paroxysmal supraventricular tachycardia. (Source: JAMA)
Source: JAMA - February 20, 2024 Category: General Medicine Source Type: research
Tenderness
A sign the clinician elicits —importantly distinct from pain, which is concerned with feeling— my textbook insists. (Source: JAMA)
Source: JAMA - February 20, 2024 Category: General Medicine Source Type: research
Excess Mortality Associated With Eviction During the Pandemic
This cohort study of renters who received eviction filings, similar renters who did not, and the general population across the study area compares rates of excess mortality associated with the COVID-19 pandemic. (Source: JAMA)
Source: JAMA - February 20, 2024 Category: General Medicine Source Type: research
Early Metformin Treatment for Gestational Diabetes —Reply
In Reply We thank Mr Meng and colleagues and Dr Park and colleagues for their comments about the EMERGE trial. We agree with using caution in the interpretation of the trial, as the primary outcome did not reach the prespecified level of statistical significance. However, the constituents of the primary outcome (insulin initiation or a mean fasting glucose level of ≥5.1 mmol/L at weeks 32 and 38) were significantly improved in those randomized to metformin. In addition, secondary outcomes of maternal insulin dose, weight gain, and satisfaction with treatment also favored metformin. The rates of large for gestational age ...
Source: JAMA - February 20, 2024 Category: General Medicine Source Type: research
Survival of Childhood Cancer and Subsequent Clinical Care —Reply
In Reply Dr Boull and colleagues raise important points in their Letter. Our recent Review noted the absence of randomized clinical trials testing the efficacy of the Children ’s Oncology Group Long-Term Follow-Up Guidelines (COG LTFU Guidelines) in mitigating the risk of adverse treatment-related outcomes. The lack of randomized clinical trials is not limited to skin cancer but applies to all recommendations within the COG LTFU Guidelines. Given the relatively small ab solute numbers of childhood cancer survivors who experience specific adverse outcomes, and the long latency of complications, the plausibility of obtaini...
Source: JAMA - February 20, 2024 Category: General Medicine Source Type: research
Early Metformin Treatment for Gestational Diabetes
To the Editor We have some concerns about the recent article that tested whether early initiation of metformin reduced insulin initiation or improved fasting hyperglycemia at gestation weeks 32 or 38. First, since larger infants tend to be born to larger mothers, it would be helpful to know the distribution of maternal size (ie, height) in both groups. Second, it is important to clarify whether the large-for-gestational-age ratio was the same in both groups at the time of randomization, specifically at the time of gestational diabetes diagnosis. Third, I would like to inquire about the complete composition of the placebo d...
Source: JAMA - February 20, 2024 Category: General Medicine Source Type: research
Early Metformin Treatment for Gestational Diabetes
To the Editor A recent study concluded that early metformin treatment for gestational diabetes was not superior to placebo for the composite primary outcome. However, we have several concerns. First, the authors defined the primary outcome as a composite of insulin initiation before delivery or fasting blood glucose exceeding 5.1 mmol/L at week 32 or week 38 of gestation. Some studies have used different criteria, including new insulin initiation, increased use of glucose-lowering medications, or specific blood glucose measurements. We would like to know if there is an internationally recognized standard for these criteria...
Source: JAMA - February 20, 2024 Category: General Medicine Source Type: research
Survival of Childhood Cancer and Subsequent Clinical Care
To the Editor We read with interest the Review that detailed common subsequent health complications in childhood cancer survivors. The authors accurately highlighted basal cell carcinoma as an important secondary neoplasm in recipients of radiation therapy; however, childhood cancer survivors are also at risk of melanoma and squamous cell carcinoma, which, unlike basal cell carcinoma, can become invasive and metastasize. Chemotherapy alone and primary diagnoses of leukemia or lymphoma have been associated with increased risk of melanoma. Prolonged immunosuppression and chronic exposure to photosensitizing drugs such as vor...
Source: JAMA - February 20, 2024 Category: General Medicine Source Type: research
The Future of Medicine in Times of War
Jules Voncken, M.D., Li ége, Belgium (Source: JAMA)
Source: JAMA - February 20, 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 - February 20, 2024 Category: General Medicine Source Type: research
Theorizing Pathways Between Eviction Filings and Increased Mortality Risk
Evictions have become recognized as important social determinants of individual and community health, largely due to the revelatory work of Desmond in the past decade. During the COVID-19 pandemic, evictions became a major public health topic as the Centers for Disease Control and Prevention (CDC) issued a federal moratorium on evictions that lasted from September 4, 2020, through August 26, 2021. The moratorium was instituted with the intention to limit COVID-19 transmission by preventing homelessness and overcrowded housing conditions. Many local and regional jurisdictions also issued their own eviction moratoria that ov...
Source: JAMA - February 20, 2024 Category: General Medicine Source Type: research
