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In This Issue of JAMA
November 28, 2017


JAMA. 2017;318(20):1955-1957. doi:10.1001/jama.2016.13410

Fecal microbiota transplantation (FMT) is the most effective therapy for recurrent Clostridium difficile infection. In a randomized trial by Kao and colleagues of 116 adult patients with recurrent Clostridium difficile infection, FMT via oral capsule was not inferior to FMT by colonoscopy for preventing recurrent infection. In an Editorial, Rao and colleagues discuss which components of donor stool are most likely to be beneficial.


Guidelines from the United States and Canada recommend surgery within 48 hours after hip fracture to prevent complications and avoid prolonged hospitalization. Pincus and colleagues conducted a population-based, retrospective cohort study of 42 230 adults undergoing hip fracture surgery at 72 hospitals and found that increased wait time was associated with a greater risk of 30-day mortality. In an Editorial, Vrahas and Sax note that at 24 hours after injury, the risk of complications began to increase, suggesting that surgical repair should be performed as soon as it is feasible.


Selective androgen receptor modulators (SARMs), which can be purchased as “dietary supplements” from internet sites without a prescription, are used to build muscle and modify body contours. Van Wagoner and colleagues analyzed 44 products marketed as SARMs on the internet and found that most were mislabeled and many contained untested compounds. In an Editorial, Auchus and Brower suggest that the widespread use of androgenic substances is an emerging epidemic analogous to the opioid crisis.



Publicly available data sets, such as the National Inpatient Sample (NIS), are often used for research on patterns and outcomes of health care. In a review of a representative sample of 120 recent published studies using data from the NIS, Khera and colleagues found that most lacked essential research elements.

Clinical Review & Education

Hidradenitis suppurativa is an inflammatory skin disorder with recurrent, painful, suppurating lesions found predominantly in intertriginous areas. Saunte and Jemec review the clinical treatment of patients with this disabling and stigmatizing disease.


This article in the JAMA Performance Improvement series explores the case of a patient with 2 breast masses (1 of which was malignant) whose benign mass was excised by mistake. Engelhardt and colleagues discuss the clinical management of wrong-site surgery.

Author Audio Interview and CME 1 and 2

In this JAMA Clinical Guidelines Synopsis of a 2017 guideline developed by the American Academy of Sleep Medicine, Mokhlesi and Cifu discuss the use of polysomnography and home sleep apnea testing for the diagnosis of obstructive sleep apnea.