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October 9, 2018, Vol 320, No. 14, Pages 1401-1506

In This Issue of JAMA

Highlights

Abstract Full Text
free access has audio
JAMA. 2018;320(14):1401-1403. doi:10.1001/jama.2017.12581
  • Audio Summary: Spontaneous vs Delayed Pushing During Labor, Polymyxin B Hemoperfusion for Septic Shock, Chronic Wound Management Review, and more
Viewpoint

Eliminating Poverty in the 21st CenturyThe Role of Health and Human Capital

Jim Yong Kim, MD, PhD
Abstract Full Text
JAMA. 2018;320(14):1427-1428. doi:10.1001/jama.2018.13709

In this Viewpoint, World Bank President Jim Yong Kim explains the World Bank’s Human Capital Index, which uses data on each country’s level of education and indicators of health status to answer a simple but powerful question: how productive will children born today be as members of the future workforce, relative to what is possible if they were in full health and had complete education?

Potential Benefits and Risks of High-Nicotine e-Cigarettes

Robin Koval, MBA; Jeffrey Willett, PhD; Jodie Briggs, MA
Abstract Full Text
JAMA. 2018;320(14):1429-1430. doi:10.1001/jama.2018.12328

This Viewpoint discusses how e-cigarettes have the potential to attract young users, and that stronger regulatory actions are needed to stop e-cigarette use among this group.

Substantial Shifts in Supreme Court Health Law Jurisprudence

Lawrence O. Gostin, JD; James G. Hodge Jr, JD, LLM
Abstract Full Text
JAMA. 2018;320(14):1431-1432. doi:10.1001/jama.2018.12331

This Viewpoint reviews what little is known about US Supreme Court nominee Judge Brett Kavanaugh’s jurisprudence on issues related to health care and health law in cases that could come before the US Supreme Court nominee in coming sessions.

Antibiotics for Sepsis—Finding the Equilibrium

Michael Klompas, MD, MPH; Thierry Calandra, MD, PhD; Mervyn Singer, MD, FRCP
Abstract Full Text
JAMA. 2018;320(14):1433-1434. doi:10.1001/jama.2018.12179

This Viewpoint makes the case that the importance of early detection of sepsis and the need for rapid antibiotics in patients with definite infection and possible septic shock has likely led to overuse of antibiotics in patients who might not need them, and argues for testing to confirm infection in non-shock patients in place of rapid empirical antimicrobial treatment.

A Piece of My Mind

The Giving Body

Adam Philip Stern, MD
Abstract Full Text
free access
JAMA. 2018;320(14):1435-1436. doi:10.1001/jama.2018.13844

In this narrative medicine essay, a young physician diagnosed with stage III kidney cancer realized with the progressive loss of systems and organs through treatment that he grew to identify with Shel Silverstein’s The Giving Tree, about a tree who gives the boy it loves every part of itself until as a stump all it can offer the now old man is a seat.

Editorial

Politics and Health Care

Donald M. Berwick, MD, MPP
Abstract Full Text
JAMA. 2018;320(14):1437-1438. doi:10.1001/jama.2018.12566

Immediate vs Delayed Pushing During the Second Stage of Labor

Jeffrey D. Sperling, MD, MS; Dana R. Gossett, MD, MSCI
Abstract Full Text
JAMA. 2018;320(14):1439-1440. doi:10.1001/jama.2018.12877

The Evolving Epidemiology and Management of Spontaneous Pneumothorax

Eric Savitsky, MD; Scott S. Oh, DO; Jay M. Lee, MD
Abstract Full Text
JAMA. 2018;320(14):1441-1443. doi:10.1001/jama.2018.12878
Original Investigation

Effect of Immediate vs Delayed Pushing on Rates of Spontaneous Vaginal Delivery Among Nulliparous Women Receiving Neuraxial AnalgesiaA Randomized Clinical Trial

Alison G. Cahill, MD, MSCI; Sindhu K. Srinivas, MD, MSCE; Alan T. N. Tita, MD, PhD; et al.
Abstract Full Text
has active quiz has multimedia
JAMA. 2018;320(14):1444-1454. doi:10.1001/jama.2018.13986

This randomized clinical trial compares the effects of immediate vs delayed pushing on spontaneous vaginal delivery and maternal and neonatal morbidities among nulliparous women at or beyond 37 weeks’ gestation admitted for spontaneous or induced labor.

Caring for the Critically Ill Patient

Effect of Targeted Polymyxin B Hemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin LevelThe EUPHRATES Randomized Clinical Trial

R. Phillip Dellinger, MD, MSc; Sean M. Bagshaw, MD, MSc; Massimo Antonelli, MD; et al.
Abstract Full Text
JAMA. 2018;320(14):1455-1463. doi:10.1001/jama.2018.14618

This clinical trial involving patients with septic shock and high endotoxin activity compares the effect of treatment with polymyxin B hemoperfusion vs sham therapy and usual care on mortality.

Association Between Third-Trimester Tdap Immunization and Neonatal Pertussis Antibody Concentration

C. Mary Healy, MD; Marcia A. Rench, BSN; Laurie S. Swaim, MD; et al.
Abstract Full Text
has active quiz
JAMA. 2018;320(14):1464-1470. doi:10.1001/jama.2018.14298

This prospective cohort study assesses whether maternal immunization with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine, compared with no immunization, is associated with high concentrations of pertussis toxin antibodies at birth and if there is an optimal gestational age for maternal immunization.

Trends in the Incidence and Recurrence of Inpatient-Treated Spontaneous Pneumothorax, 1968-2016

Rob J. Hallifax, PhD; Raph Goldacre, MSc; Martin J. Landray, PhD; et al.
Abstract Full Text
has active quiz
JAMA. 2018;320(14):1471-1480. doi:10.1001/jama.2018.14299

This population epidemiological study uses English national hospital data sets to characterize trends in the incidence and recurrence of hospital admissions for spontaneous pneumothorax to identify risk factors for recurrence.

JAMA Insights

Clinical Update

Management of Chronic Wounds—2018

Ruth Ellen Jones, MD; Deshka S. Foster, MD, MA; Michael T. Longaker, MD, MBA
Abstract Full Text
JAMA. 2018;320(14):1481-1482. doi:10.1001/jama.2018.12426

This Clinical Update summarizes options for chronic wound management in ambulatory settings, including use of standard gauze, negative-pressure wound therapy, advanced dressings (alginates, foams, hydrocolloids, and hydrogels), and adjuvant wound therapies.

JAMA Clinical Evidence Synopsis

Bisphosphonates for Patients Diagnosed With Multiple Myeloma

Rahul Mhaskar, PhD; Benjamin Djulbegovic, MD, PhD
Abstract Full Text
JAMA. 2018;320(14):1483-1484. doi:10.1001/jama.2018.13773

This Clinical Evidence Synopsis summarizes a Cochrane review of randomized trials comparing the effects of bisphosphonate therapy vs placebo or no treatment on mortality, vertebral fractures, nonvertebral fractures, and skeletal-related events among patients with multiple myeloma.

JAMA Diagnostic Test Interpretation

Coagulation Test Interpretation in a Patient Taking Direct Oral Anticoagulant Therapy

Michelle Sholzberg, MDCM, MSc; Yan Xu, MD
Abstract Full Text
JAMA. 2018;320(14):1485-1486. doi:10.1001/jama.2018.13998

A 74-year-old man taking rivaroxaban for atrial fibrillation developed a subdural hematoma and had an elevated prothrombin time (PT) with normal activated partial thromboplastin time (aPTT) and platelets prior to planned surgical evacuation. How do you interpret the results?

Research Letter

Campaign Contributions From Political Action Committees to Members of Congressional Committees Responding to the Opioid Crisis

Matthew S. McCoy, PhD; Genevieve P. Kanter, PhD
Abstract Full Text
JAMA. 2018;320(14):1489-1491. doi:10.1001/jama.2018.11338

This study examines recent campaign contributions to members of US congressional committees responsible for legislating on the opioid crisis by political action committees (PACs) associated with firms under investigation for having contributed to the crisis.

Use of Death Counts From Vital Statistics to Calculate Excess Deaths in Puerto Rico Following Hurricane Maria

Alexis R. Santos-Lozada, PhD; Jeffrey T. Howard, PhD
Abstract Full Text
JAMA. 2018;320(14):1491-1493. doi:10.1001/jama.2018.10929

This study calculates the number of excess deaths following Hurricane Maria through December 2017, using death counts from vital statistics records, to update a previous estimate.

Medical News & Perspectives

Unproven but Profitable: The Boom in US Stem Cell Clinics

Rita Rubin, MA
Abstract Full Text
free access
JAMA. 2018;320(14):1421-1423. doi:10.1001/jama.2018.13861

This Medical News & Perspectives article examines the proliferation of US clinics offering unproven stem cell therapies.

The JAMA Forum

The Surprising Resiliency of the Affordable Care Act

Gail Wilensky, PhD
Abstract Full Text
free access
JAMA. 2018;320(14):1423-1424. doi:10.1001/jama.2018.14134
News From the Centers for Disease Control and Prevention

More Youth Vaccinated for HPV

Bridget Kuehn, MSJ
Abstract Full Text
free access
JAMA. 2018;320(14):1426. doi:10.1001/jama.2018.14296

Breastfeeding Report Card

Bridget Kuehn, MSJ
Abstract Full Text
free access
JAMA. 2018;320(14):1426. doi:10.1001/jama.2018.14608
Biotech Innovations

Researchers Test New Techniques to Rule Out and Predict Heart Attacks

Jennifer Abbasi
Abstract Full Text
free access
JAMA. 2018;320(14):1425. doi:10.1001/jama.2018.14749

In-home Robots Improve Social Skills in Children With Autism

Jennifer Abbasi
Abstract Full Text
free access
JAMA. 2018;320(14):1425. doi:10.1001/jama.2018.14385
Comment & Response

Meta-analysis of LDL-C Lowering and Mortality

Edward K. Duran, MD; Nancy R. Cook, ScD; Paul M. Ridker, MD
Abstract Full Text
JAMA. 2018;320(14):1493. doi:10.1001/jama.2018.11202

Meta-analysis of LDL-C Lowering and Mortality—Reply

Jennifer G. Robinson, MD, MPH; Eliano P. Navarese, MD, PhD; Felicita Andreotti, MD, PhD
Abstract Full Text
JAMA. 2018;320(14):1493-1494. doi:10.1001/jama.2018.11198

Biological, Legal, and Moral Definitions of Brain Death

Brian Dewar, MLIS; Mark Fedyk, PhD; Michel C. F. Shamy, MD, MA, FRCPC
Abstract Full Text
JAMA. 2018;320(14):1494. doi:10.1001/jama.2018.10980

Biological, Legal, and Moral Definitions of Brain Death—Reply

Robert D. Truog, MD, MA
Abstract Full Text
JAMA. 2018;320(14):1494-1495. doi:10.1001/jama.2018.10984

Using Big Data to Determine Reference Values for Laboratory Tests

Amrom E. Obstfeld, MD, PhD; Stephen R. Master, MD, PhD; W. Greg Miller, PhD
Abstract Full Text
JAMA. 2018;320(14):1495-1496. doi:10.1001/jama.2018.10952

Using Big Data to Determine Reference Values for Laboratory Tests—Reply

Arjun K. Manrai, PhD; Chirag J. Patel, PhD; John P. A. Ioannidis, MD, DSc
Abstract Full Text
JAMA. 2018;320(14):1496. doi:10.1001/jama.2018.10956
The Arts and Medicine

In Memoriam—Honoring the Victims of Opioid Addiction

Christopher C. Muth, MD
Abstract Full Text
free access has multimedia
JAMA. 2018;320(14):1418-1419. doi:10.1001/jama.2018.13658

This Arts and Medicine essay reviews a traveling US exhibit created by the US National Safety Council that honors the human costs of the opioid addiction crisis and engages visitors in strategies to manage opioid use and prevent future deaths.

Poetry and Medicine

Return

Joan Michelson
Abstract Full Text
free access
JAMA. 2018;320(14):1498. doi:10.1001/jama.2018.7129
JAMA Revisited

Adequate Supply of Physicians Makes Lower Educational Standards Unnecessary

Abstract Full Text
JAMA. 2018;320(14):1499. doi:10.1001/jama.2017.12611
JAMA Patient Page

Choledocholithiasis

Ioana Baiu, MD, MPH; Mary T. Hawn, MD, MPH
Abstract Full Text
free access
JAMA. 2018;320(14):1506. doi:10.1001/jama.2018.11812

This JAMA Patient Page describes the symptoms, diagnosis, and treatment of choledocholithiasis.

JAMA Masthead

JAMA

Abstract Full Text
free access
JAMA. 2018;320(14):1405-1406. doi:10.1001/jama.2017.12582

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