Ethnic and racial minorities have been particularly hard hit with COVID-19 in some communities. Mitchell Katz, MD, president and chief executive officer of New York City Health + Hospitals, and former Los Angeles County health agency director, discusses this problem and what has been learned from COVID-19 that can help resolve the general problem of health care disparities.
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Tobacco use is the leading cause of preventable disease and death in the world, but most attempts to quit are unsuccessful. Atul Jain, MD, assistant professor of medicine at Mayo College of Medicine, discusses new guidelines from the American Thoracic Society on pharmacologic management of tobacco cessation, including target population and deciding when to initiate.
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Initiating Pharmacologic Treatment in Tobacco-Dependent Adults
Mitchell Katz, MD, president and chief executive officer of New York City Health + Hospitals, and former Los Angeles County health agency director, discusses causes, similarities, and differences between the spike of COVID-19 cases, hospitalizations, and deaths in the 2 cities.
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Modernize Medical Licensing, and Credentialing, Too—Lessons From the COVID-19 Pandemic
Glaucoma is the most common cause of irreversible blindness in the world. Joshua Stein, MD, MS, associate professor of ophthalmology at the University of Michigan, reviews the diagnosis and treatment of glaucoma.
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A new trial reports that a third of emergency department patients presenting with appendicitis admitted for oral antibiotic treatment had outcomes no different from those admitted for intravenous antibiotic treatment. Paulina Salminen, MD, PhD, professor of surgery at the University of Turku in Finland, discusses the findings.
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Gregory Armstrong, MD, director of the Advanced Molecular Detection Program for the CDC, explains what is currently known about the new mutations of SARS-CoV-2.
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Genetic Variants of SARS-CoV-2—What Do They Mean?
Next-Generation Sequencing of Infectious Pathogens
Next Generation Sequencing of Infectious Pathogens in Public Health and Clinical Practice
Next-generation sequencing is a catchall term for new, high-throughput technologies that allow rapid sequencing of a full genome. It can be used to sequence a patient’s DNA in diagnosing a genetic disorder or characterizing a cancer, but it can also be used to sequence the genome of a pathogenic bacteria, virus, fungi, or parasites. In this JAMA clinical review podcast, we talk with authors Marta Gwinn, MD, MPH, and Gregory L. Armstrong, MD, from the CDC, about how next-generation sequencing of infectious pathogens is being implemented in clinical practice and in public health surveillance for infectious disease.
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Next-Generation Sequencing of Infectious Pathogens
Podcast originally published 2/14/19.
Tom Shimabukuro, MD, MPH, MBA, and Sara Mbaeyi, MD, MPH, from the CDC discuss rare allergic complications in patients who received the first dose of the Pfizer-BioNTech vaccine between December 14-23, 2020.
Patent foramen ovale (PFO) is an often overlooked cause of acute ischemic stroke. JAMA Associate Editor Jeffrey Saver, MD, professor of neurology at UCLA, discusses new recommendations from a 2020 AAN Practice Advisory about use of mechanical PFO closure and anticoagulant vs antiplatelet therapy to prevent subsequent strokes in patients with a PFO and an initial event.
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Management of Patients With a Patent Foramen Ovale With History of Stroke or TIA
New therapies have greatly improved outcomes for patients with Crohn disease. Peter Higgins, MD, from the University of Michigan, discusses advances in management and treatment protocols.
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Management of Crohn Disease
Adam Lauring, MD, PhD, from the University of Michigan Division of Infectious Diseases, an expert on the evolutionary biology of RNA viruses, explains the new genetic variants recently found in SARS-CoV-2 and their importance.
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Genetic Variants of SARS-CoV-2—What Do They Mean?
Elderly persons and residents of nursing homes have been the hardest hit in the COVID-19 pandemic. Harvard geriatrician Sharon Inouye, MD, discusses the effect COVID-19 has had on nursing homes and what should be done about it.
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Homeless patients with chronic medical conditions who need long-term care often repeatedly present to emergency departments to receive treatment. Following a performance improvement analysis, clinicians at UCSF developed an emergency department–based team who work with the community to provide care for this challenging population. Hemal Kanzaria, MD, and Jack Chase, MD, discuss how UCSF has addressed this clinical problem.
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Caring for Emergency Department Patients With Complex Medical, Behavioral Health, and Social Needs
JAMA Fishbein Fellow Kristin Walter, MD, interviews Craig Garfield, MD and Richard Weissbourd, EdD, about parental relationships during the COVID-19 pandemic.
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Considerations for Young Children and Those With Special Needs as COVID-19 Continues
Lockdowns resulting from COVID-19 have had a devastating effect on everyone’s personal lives and the economy. What factors in people’s daily lives are most associated with SARS-CoV-2 transmission between people? Manish Patel, MD, team lead of the CDC’s Influenza Prevention & Control Team, discusses a study they conducted examining what sorts of activities might be associated with COVID-19 disease transmission.
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Community Outbreak Investigation of SARS-CoV-2 Transmission Among Bus Riders in Eastern China
It is well known that alcohol use severely affects driving ability, but does cannabis? There are many fewer traffic crashes related to cannabis than alcohol intoxication. Johannes Ramaekers, PhD, of the University of Maastricht in the Netherlands, discusses his study examining the relationship between vaping THC and driving safety.
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Effect of Cannabidiol and Δ-Tetrahydrocannabinol on Driving Performance
Driving Under the Influence of CBD or THC—Is There a Difference?
Closing businesses during the COVID-19 pandemic has had devastating consequences for individuals and the economy in general. Proper air handling combined with the use of masks and physical distancing can greatly improve the safety of indoor spaces. Joseph Allen, DSc, MPH, assistant professor of exposure assessment science at Harvard T.H. Chan School of Public Health, and Andrew Ibrahim, MD, assistant professor of surgery and architecture and urban planning at the University of Michigan, discuss air conditioning standards that can substantially reduce the risk of disease transmission in indoor spaces.
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Roger J. Lewis, MD, PhD, discusses Randomization in Clinical Trials from the JAMA Guide to Statistics and Methods
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Judith Lieu, MD, from the Department of Otolaryngology–Head & Neck Surgery at Washington University in St Louis, discusses the need for screening young children for hearing loss and the importance of treating hearing loss as early in life as is possible.
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Certificates of Need are regulations required by some states before any construction or expansion of services at medical facilities are undertaken. Originally developed to prevent excessive construction of expensive health care facilities, these rules have distorted health care markets and probably should be repealed. Karl Bilimoria, MD, from Northwestern University, Tarik K Yuce, MD, and JAMA Associate Editor Karen Joynt Maddox, MD, from Washington University, discuss the current status of these regulations and their effect on health care markets.
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Mark Litwin, MD, chair of Urology at the UCLA School of Medicine, discusses the evaluation of hematuria and also the presentation, diagnosis, and treatment of bladder cancer.
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There are hundreds of thousands of liver transplant patients, all of whom will be seen in general clinical practices. It is common for them to develop elevated liver enzymes--a potentially serious problem that may be a sign that the transplanted liver is failing. Traditionally, patients with these findings are sent to a liver transplant center for an inpatient workup. A new protocol facilitating management of most of these patients in routine outpatient clinics has been developed, greatly improving the efficiency of managing patients with this clinical problem. Fady Kaldas, MD, director of the Dumont-UCLA transplant center, discusses how to manage elevated liver function results in liver transplant patients on an outpatient basis.
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Outpatient Management of Liver Function Test Abnormalities in Patients With a Liver Transplant
Are e-cigarettes helpful or harmful as a tool to help people stop smoking? Mark J. Eisenberg, MD, MPH, from the Jewish General Hospital and McGill University in Montreal, Canada, discuss a recent clinical trial he reported in the November 10, 2020, issue of JAMA examining the efficacy of e-cigarettes as a smoking cessation aid.
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Effect of e-Cigarettes Plus Counseling vs Counseling Alone on Smoking Cessation
A new multisociety guideline was recently released suggesting that for many patients, the interval between colonoscopies following polyp resection is less than previously recommended. Cecelia Zhang, MD, Duke University, and Maylyn Martinez, MD, University of Chicago, discuss the new guideline.
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Tim Uyeki, MD, chief medical officer for the Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), discusses how the COVID-19 pandemic may affect the 2020-2021 influenza season.
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