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In This Issue of JAMA
April 18, 2017

Highlights

JAMA. 2017;317(15):1493-1495. doi:10.1001/jama.2016.13086
Research

A symptomatic therapy for acute sore throat might decrease the inappropriate prescribing of antibiotics; oral steroids can reduce inflammation in other upper respiratory tract infections such as acute sinusitis and croup. In a randomized clinical trial by Hayward and colleagues of 565 adults presenting to primary care with acute sore throat, a single oral dose of dexamethasone, compared with placebo, did not increase the proportion of patients with symptom resolution at 24 hours. There was a significant difference at 48 hours.

Author Video Interview and CME

Previous studies may have misattributed the reported association of autism spectrum disorder and maternal use of selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy. In a retrospective cohort study of 35 906 singleton births designed to control for confounding, Brown and colleagues did not find an association of SSRI use by expectant mothers and autism spectrum disorder in their exposed children. In an Editorial, Oberlander and Zwaigenbaum discuss distentangling maternal mood disorders and antidepressant use during pregnancy as risks for autism in children.

Editorial and Related Article

Prenatal antidepressant exposure has been reported to be associated with adverse birth outcomes, but the actual risk may be related to maternal depression rather than its treatment. In a retrospective cohort study of 1 580 629 offspring born to 943 776 mothers, Sujan and colleagues found that first-trimester antidepressant exposure, compared with no exposure, was associated with a small increased risk of preterm birth but no increased risk of small for gestational age, autism spectrum disorder, or attention-deficit/hyperactivity disorder.

Editorial and Related Article

Guidelines from the American College of Cardiology (ACC)/American Heart Association (AHA) and the US Preventive Services Task Force (USPSTF) have different criteria for the initiation of primary prevention statin treatment. To compare the proportions of individuals in the United States who would be eligible for treatment by these criteria, Pagidipati and colleagues studied a nationally representative sample of 3416 adults and found that adherence to the 2016 USPSTF recommendations for statin therapy, compared with the 2013 ACC/AHA guidelines, could lead to a lower number of individuals recommended for primary prevention statin therapy.

CME

Clinical Review & Education

An article in JAMA Pediatrics reported an increased risk of autism spectrum disorder among children whose mothers used SSRI antidepressants during pregnancy. In a From The JAMA Network article, King discusses the risks of untreated depression and places the findings of this study in the context of other research.

Aging physicians may have diminished abilities that could affect patient care. This article by Levinson and Ginsburg from the JAMA Professionalism series discusses a senior physician who was uncertain whether he was maintaining professional competence. He sought objective feedback on his performance from his medical director and participated in a continuing medical education program that included a chart audit and quality improvement plan.

CME

Helicobacter pylori infection is a cause of peptic ulcers, chronic gastritis, dyspepsia, gastric adenocarcinoma, and lymphoma. In a JAMA Clinical Guidelines Synopsis article, Kavitt and Cifu discuss the fifth iteration of the Maastricht/Florence consensus report, which builds on the recommendations of the 2015 Kyoto guidelines for the clinical management of H pylori gastritis.

This JAMA Clinical Challenge article by Wang and colleagues presents a woman with yellow-orange pigmentation of her palms and soles and normal levels of total and direct bilirubin. What would you do next?

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