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JAMA Clinical Reviews

Interviews about ideas & innovations in medicine, science & clinical practice. Listen & earn CME credit
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Now displaying: Page 1

In-depth interviews about current ideas and innovation in medicine, science, and clinical practice.

Aug 6, 2020

Before a study is carried out, it is important to define what is an important difference between groups. This is often not done correctly. Anna McGlothlin, PhD, from Berry Consultants discusses how to assess the minimal clinically important difference in research studies.

Aug 5, 2020

Few treatments have proven to be effective for treating COVID-19. Recently, a clinical trial reporting the results of dexamethasone for treating COVID-19 was published and has received a great deal of attention in the popular media. Greg Curfman, MD, JAMA Deputy Editor, reviews the study and discusses what the findings do or do not reveal about the efficacy of dexamethasone for treating COVID-19.

Related Article(s):

Missed Opportunities on Emergency Remdesivir Use

Aug 4, 2020

Congestive heart failure is common and can have devastating effects on patients' quality of life. Until recently few treatments were available, but that has changed. Congestive heart failure management has substantially improved. Hutter Family Professor of Medicine at Harvard Medical School James L. Januzzi Jr, MD, reviews the diagnosis and treatment of congestive heart failure.

Related Article(s):

Heart Failure With Reduced Ejection Fraction

Jul 27, 2020

Accumulating evidence in adults has shown that nonoperative treatment of appendicitis is an acceptable means for treatment. A recent prospective study published in JAMA has shown the same is true for children. Most children who are treated with antibiotics instead of surgery for appendicitis do just fine. The lead author for this study, Peter Minneci, MD, from the Nationwide Children’s Hospital of the Ohio State Medical School, discusses his work in investigating alternative ways to treat appendicitis.

Related Article:

Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated Appendicitis

Jul 21, 2020

Jeffrey Berger, MD, from the Center for the Prevention of Cardiovascular Disease at the New York University School of Medicine, explains the ins and outs of perioperative cardiovascular risk assessment and management for noncardiac surgery.

Related Article(s):

Perioperative Cardiovascular Risk Assessment and Management for Noncardiac Surgery

Jul 21, 2020

Some of the nearly 40 000 deaths each year in the US from breast cancer might be avoided through use of medications to prevent breast cancer in high-risk women. Patricia Ganz, MD, Distinguished Professor of Medicine and Public Health at UCLA, reviews the evidence underlying chemoprevention of breast cancer and which women might benefit from the drugs.

Related Article(s):

Medications for Primary Prevention of Breast Cancer

Breast Cancer Risk Calculators:

https://bcrisktool.cancer.gov/calculator.html
https://tools.bcsc-scc.org/BC5yearRisk/intro.htm
https://ibis.ikonopedia.com/

 

Jul 20, 2020

Both remdesivir and dexamethasone have been promoted as effective treatments for COVID-19. JAMA Deputy Editor Greg Curfman, MD, and Professor Rachel Sachs, JD, from the Washington University School of Law discuss the science and health policy aspects of these COVID-19 treatments.

Related Article(s):

Missed Opportunities on Emergency Remdesivir Use

Jul 13, 2020

Whether the SARS-CoV-2 virus is transmitted by droplets or aerosol influences which public health interventions might slow its spread. Michael Klompas, MD, professor of medicine at Harvard Medical School, explains evidence to date about mechanisms of coronavirus transmission and implications for pandemic containment and mitigation efforts.

Related:

Airborne Transmission of SARS-CoV-2: Theoretical Considerations and Available Evidence

Jul 10, 2020

SSRIs are a commonly used medication. Although complications from them are not common because so many people take these medications, physicians will inevitably see problems such as dependence and withdrawal, hyponatremia, bleeding disorders, and even the uncommon but severe SSRI syndrome. To learn about these potential complications, we spoke with David Juurlink, MD, PhD, an internist and clinical pharmacologist at the University of Toronto.

Jul 8, 2020

Proton pump inhibitors are among the most commonly used medicines by patients. They’re generally safe, but they can cause acute kidney injury, and it’s important for clinicians to be aware of this potential complication. David Juurlink, MD, PhD, internist and clinical pharmacologist from the University of Toronto, discusses this important potential complication.

Related Article: 

An Evidence-Based Approach to the Treatment of Gastroesophageal Reflux Disease

Jul 7, 2020

Although there are only about 4000 new cases of amyloidosis in the US per year, it can cause preserved ejection fraction heart failure, kidney and liver failure, and neuropathy. Amyloidosis is easily diagnosed and treatable, and it should be considered in the differential diagnosis for these diseases. Morie A. Gertz, MD, from the Mayo Clinic in Rochester, Minnesota, talks with JAMA Clinical Reviews about amyloidosis.

Related:

Systemic Amyloidosis Recognition, Prognosis, and Therapy

Jul 6, 2020

Although frequently reported, penicillin allergy is actually uncommon. Penicillins are very effective against a wide variety of infections, and when they can't be used, problems arise. We discussed the problem of penicillin allergy with David Juurlink, MD, PhD, internist and clinical pharmacologist from the University of Toronto.

Related Article(s):

Evaluation and Management of Penicillin Allergy

Jul 2, 2020

One of the most common causes for problems we see in manuscripts at JAMA is an inappropriately calculated study sample size. This seemingly mysterious process is explained by Lynne Stokes, PhD, professor of Statistical Science at Southern Methodist University in Dallas, Texas.

Jun 25, 2020

Generalizability of randomized trials is always limited because of the super-selectivity of the patients enrolled in these trials and the very controlled conditions in which clinical care is delivered. Pragmatic trials are performed in order to provide guidance for how to best deliver clinical care in situations that more closely resemble actual clinical scenarios. Hal Sox, MD, director of peer review for the Patient-Centered Outcomes Research Institute (PCORI), explains how these trials work and what clinical questions they answer.

Related:

Pragmatic Trials: Practical Answers to “Real-world” Questions

Jun 2, 2020

Nearly 10% of all patients seen in primary care have depression. Although usually mild, when depression is severe the consequences can be serious. Tom Garrick, MD, professor of Psychiatry at the University of Southern California, discusses the diagnosis and treatment of depression.

Related:

Drugs for Depression

May 19, 2020

Even limited hearing loss might be associated with cognitive decline. If true, early intervention with hearing aids might help people have better cognitive performance. Michael Johns III, MD, online editor for JAMA Otolaryngology, speaks with Justin Golub, MD, assistant professor of otolaryngology at Columbia University, whose research has shown that very mild hearing loss can be associated with cognitive disability.

Related Article 

May 5, 2020

When she was a teenager Melissa Red Hoffman's father was killed by terrorists. Dr Hoffman recalls her father's death and how that has influenced her career and how she can identify with patients and their families at the most difficult moments.

Read the story:

The Sound of Silence—When There Are No Words

Apr 24, 2020

Management of COVID-19-related respiratory failure differs from what is necessary for ARDS. Rather than having alveolar edema, COVID-19 patients have pulmonary vascular dysregulation. Gas exchange is severely compromised with little reduction in lung compliance. Ventilatory support for COVID-19 patients requires higher than normal tidal volumes with minimal PEEP and allowance for higher than usual serum CO2 levels. How the unique pathophysiology of respiratory failure should be treated is discussed by John J. Marini, MD, professor of medicine at the University of Minnesota.

Apr 14, 2020

More than 6 million people worldwide have Parkinson disease. Even though it is classically associated with tremors, the disease has many manifestations and is very treatable for most patients. Michael S. Okun, MD, from the Department of Neurology at the University of Florida, Gainesville, discusses the pathophysiology, clinical presentation, diagnosis, and treatment of Parkinson disease.

Related:

Choosing a Parkinson Disease Treatment

Apr 8, 2020

Shortages of face masks and N95 respirators have forced clinicians and hospitals to reuse these normally disposable items. Ron Shaffer, PhD, former CDC PPE Research Branch Chief, discusses effective sterilization techniques and how to test that the equipment stays protective after sterilization.

Apr 7, 2020

Eczema is extremely common in children. Most the time it is easily treated with topical steroids but on occasion it requires systemic therapies. JAMA Pediatrics Editor Dimitri Christakis, MD, MPH, and JAMA Network Open Editor Frederick Rivara, MD, MPH, discuss the results of a clinical trial of a new monoclonal antibody intended to improve eczema in children that was published in the January 2020 issue of JAMA Pediatrics.

Related:

Are Bacteria Transplants the Future of Eczema Therapy?

Effect of an Intervention to Promote Breastfeeding on Asthma, Lung Function, and Atopic Eczema at Age 16 Years: Follow-up of the PROBIT Randomized Trial

Persistence of Childhood Eczema Into Adulthood

Association Between Eczema and Stature in 9 US Population-Based Studies

Healthcare Utilization, Patient Costs, and Access to Care in US Adults With Eczema: A Population-Based Study

Management of Atopic Dermatitis

Anti-IgE Medication Lessens Pediatric Atopic Dermatitis Severity

Atopic Eczema

Apr 3, 2020

Food and medicine shopping is essential during the COVID-19 pandemic, but requires getting out and standing close to strangers at a time when social distancing and sheltering-in-place are recommended to slow spread of disease. David Aronoff, MD, director of the Division of Infectious Diseases at Vanderbilt University in Nashville, explains how to minimize COVID-19 risk while shopping.

Mar 27, 2020

The lack of availability of COVID-19 testing has interfered with the ability to contain the spread of disease. Omai Garner, PhD, laboratory director for Clinical Microbiology in the UCLA health system, explains how PCR testing for COVID-19 works and why testing is in short supply.

Mar 25, 2020

In 2003, Toronto was the North American center for Severe Acute Respiratory Syndrome (SARS). The disease spread through the city’s hospitals before anyone knew what was happening. Dr Allison McGeer was a clinician caring for SARS patients and ultimately was infected herself. She describes her experience as a patient and provider and reviews lessons learned that might help others manage their regional COVID-19 outbreaks.

Related:

Supporting the Health Care Workforce During the COVID-19 Global Epidemic

Mar 25, 2020

As COVID-19 spreads, clinicians and health systems are struggling to prepare for a surge of patients. Richard Stone, MD, the US Veterans Health Administration's Executive in Charge, spoke with JAMA about how the VA health system is preparing for this public health emergency.

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