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In This Issue of JAMA
January 15, 2019

Highlights

JAMA. 2019;321(2):119-121. doi:10.1001/jama.2018.15146

Research

Preserving the viability of oxygen-sensitive bacteria may enhance the clinical effect of fecal microbiota transplantation (FMT) for patients with ulcerative colitis. Costello and colleagues randomized 73 adults with mild to moderately active ulcerative colitis and found that treatment with anaerobically prepared donor FMT compared with autologous FMT resulted in a higher likelihood of remission at 8 weeks. In an Editorial, Kelly and Ananthakrishnan suggest that manipulation of the microbiome may be most effective when used in combination with agents that target immune dysregulation.

Editorial

Summary Video and Visual Abstract

Many patients with relapsing-remitting multiple sclerosis have incomplete responses to disease-modifying therapy. Burt and colleagues randomized 110 patients with relapsing-remitting multiple sclerosis and found that nonmyeloablative hematopoietic stem cell transplantation (HSCT), compared with disease-modifying therapy, resulted in prolonged time to disease progression. In an Editorial, Atkins recommends further study to determine when in the course of multiple sclerosis HSCT is most likely to be beneficial.

Editorial and Related Article

CME and Visual Abstract

It is unknown whether choice of therapy is associated with the rate of progression from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive multiple sclerosis (SPMS). In a cohort study with prospective data collection for 1555 patients, Brown and colleagues for the MSBase Study Group found that initial treatment with fingolimod, natalizumab, or alemtuzumab was associated with a lower risk of conversion from RRMS to SPMS compared with initial treatment with β-interferon or glatiramer acetate.

Editorial and Related Article

Clinical Review & Education

More than 95% of patients labeled as having a penicillin allergy are able to tolerate this class of drugs. Shenoy and colleagues review the clinical evaluation of reported penicillin allergy.

JAMA Patient Page

CME, Summary Video, and Author Audio Interview

In this JAMA Clinical Guidelines Synopsis of a 2017 guideline developed by the US Department of Veterans Affairs and the US Department of Defense, Ostacher and Cifu discuss the clinical management of adults with exposure to traumatic events who are suspected of having posttraumatic stress disorder or acute stress disorder.

This JAMA Diagnostic Test Interpretation article by Nagpal and Chari presents a 67-year-old man with weight loss, diffuse enlargement of the pancreas, and an elevated level of IgG subgroup 4. How would you interpret this test result?

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