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In This Issue of JAMA
June 19, 2018


JAMA. 2018;319(23):2349-2351. doi:10.1001/jama.2017.12416


Posttraumatic stress disorder and other stress-related illnesses may affect immune function by disrupting the hypothalamic-pituitary-adrenal axis and autonomic nervous system. In a retrospective cohort study of 106 464 participants with stress-related disorders, 126 652 siblings, and 1 064 640 unaffected participants selected randomly from the general population, Song and colleagues found that a diagnosis of stress-related disorder was associated with an increased risk of autoimmune disease.

Cancer predisposition gene testing can identify individuals who may benefit from screening, prevention, and early detection of disease. In a case-control study of 3030 adults diagnosed as having pancreatic cancer and 176 241controls, Hu and colleagues identified mutations in 6 genes associated with pancreatic cancer. An Editorial by Syngal and Furniss suggests that genetic screening at the time of diagnosis could have therapeutic implications for patients with pancreatic cancer and their families.



Obesity rates may vary by time, person, and place. In a cross-sectional analysis of nationally representative survey data from 6863 respondents, Ogden and colleagues found that the prevalence of severe obesity in US children and adolescents was inversely associated with urbanization.

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Differences in chronic disease risk factors, such as obesity, have been reported for adults living in rural vs urban areas. Hales and colleagues analyzed nationally representative surveys of 10 792 US adults and found that in 2013-2016, the prevalence of obesity was greatest for those living in nonmetropolitan areas.

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Clinical Review & Education

In this JAMA Clinical Guidelines Synopsis of a 2018 guideline developed by the American College of Physicians, Tung and colleagues discuss the potential harms and uncertain benefits of intensive glycemic control.

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Audio Interview

This JAMA Clinical Challenge by Jain and colleagues presents an 18-year-old college student with weight loss, lymphadenopathy, and an anterior mediastinal mass. What would you do next?

Sodium-glucose co-transporter 2 inhibitors reduce blood glucose levels by decreasing glucose reabsorption and increasing glucose excretion. This Medical Letter on Drugs and Therapeutics discusses the clinical indications for treatment with the sodium-glucose cotransporter 2 inhibitor ertugliflozin in adults with type 2 diabetes.