April 4, 2017, Vol 317, No. 13, Pages 1291-1388

In This Issue of JAMA

Highlights

Abstract Full Text

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JAMA. 2017;317(13):1291-1293. doi:10.1001/jama.2016.13064

Audio Editors' Summary: Dexmedetomidine in the ICU, trends in thyroid cancer, OCD diagnosis and treatment, and more

Original Investigation

Caring for the Critically Ill Patient

Effect of Dexmedetomidine on Mortality and Ventilator-Free Days in Patients Requiring Mechanical Ventilation With Sepsis: A Randomized Clinical Trial

Yu Kawazoe, MD, PhD; Kyohei Miyamoto, MD; Takeshi Morimoto, MD, PhD, MPH; et al.

Abstract Full Text

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JAMA. 2017;317(13):1321-1328. doi:10.1001/jama.2017.2088

This randomized clinical trial compares the effects of sedation with vs without dexmedetomidine on mortality and ventilator-free days in patients with sepsis.

Association Between Early Low-Dose Hydrocortisone Therapy in Extremely Preterm Neonates and Neurodevelopmental Outcomes at 2 Years of Age

Olivier Baud, MD, PhD; Clémence Trousson, MSc; Valérie Biran, MD, PhD; et al.

Abstract Full Text

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JAMA. 2017;317(13):1329-1337. doi:10.1001/jama.2017.2692

This secondary analysis of outcomes from the PREMILOC (Early Low-Dose Hydrocortisone to Improve Survival without Bronchopulmonary Dysplasia in Extremely Preterm Infants) trial compares neurodevelopmental impairment in neonates given hydrocortisone vs placebo.

Editorial
Reevaluating Postnatal Steroids for Extremely Preterm Infants to Prevent Lung Disease
Neil Marlow, DM, FMedSci

JAMA

Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013

Hyeyeun Lim, PhD; Susan S. Devesa, PhD; Julie A. Sosa, MD; et al.

Abstract Full Text

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JAMA. 2017;317(13):1338-1348. doi:10.1001/jama.2017.2719

This study uses SEER database data to compare thyroid cancer incidence and mortality rates in the United States by cancer type and stage between 1974 and 2013.

Preliminary Communication

Effect of Moderate-Intensity Exercise Training on Peak Oxygen Consumption in Patients With Hypertrophic Cardiomyopathy: A Randomized Clinical Trial

Sara Saberi, MD, MS; Matthew Wheeler, MD, PhD; Jennifer Bragg-Gresham, MS, PhD; et al.

Abstract Full Text

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JAMA. 2017;317(13):1349-1357. doi:10.1001/jama.2017.2503

This randomized clinical trial assesses whether moderate-intensity exercise training, compared with usual activity, improves exercise capacity in adults with hypertrophic cardiomyopathy.

Editorial
Recreational Exercise in Hypertrophic Cardiomyopathy
Anjali T. Owens, MD; Thomas P. Cappola, MD, ScM

JAMA

Research Letter

Rates of Cortical Atrophy in Adults 80 Years and Older With Superior vs Average Episodic Memory

Amanda H. Cook, MA; Jaiashre Sridhar, MS; Daniel Ohm, BS; et al.

Abstract Full Text

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JAMA. 2017;317(13):1373-1375. doi:10.1001/jama.2017.0627

This cohort study compares cortical volume change over 18 months among adults 80 years and older with memory at least as good as middle-aged adults (SuperAgers) vs cognitively average elderly peers.

Viewpoint

Prime Time for Shared Decision Making

Erica S. Spatz, MD, MHS; Harlan M. Krumholz, MD, SM; Benjamin W. Moulton, JD, MPH

Abstract Full Text

JAMA. 2017;317(13):1309-1310. doi:10.1001/jama.2017.0616

This Viewpoint proposes steps that policy makers and health systems can take to make high-quality shared decision making more routine in clinical practice.

Medical Liability Reform in a New Political Environment

Anand Parekh, MD, MPH; G. William Hoagland, MS

Abstract Full Text

JAMA. 2017;317(13):1311-1312. doi:10.1001/jama.2017.1405

This Viewpoint proposes newly conceivable federal policy options under a Republican president and Congress that may offer a more bipartisan and comprehensive approach to medical liability reform.

Making Health Care Markets Work: Competition Policy for Health Care

Martin Gaynor, PhD; Farzad Mostashari, MD, ScM; Paul B. Ginsburg, PhD

Abstract Full Text

JAMA. 2017;317(13):1313-1314. doi:10.1001/jama.2017.1173

With increasing consolidation of US physician practices and hospitals into health care systems, this Viewpoint discusses the negative effects on quality of patient care and health care costs, and it proposes potential solutions.

A Piece of My Mind

The Prescriptions I Write

Norah Neylon, MBBS

Abstract Full Text

JAMA. 2017;317(13):1315-1316. doi:10.1001/jama.2016.16796

Editorial

Reevaluating Postnatal Steroids for Extremely Preterm Infants to Prevent Lung Disease

Neil Marlow, DM, FMedSci

Abstract Full Text

JAMA. 2017;317(13):1317-1318. doi:10.1001/jama.2017.2725

Recreational Exercise in Hypertrophic Cardiomyopathy

Anjali T. Owens, MD; Thomas P. Cappola, MD, ScM

Abstract Full Text

JAMA. 2017;317(13):1319-1320. doi:10.1001/jama.2017.2584

Review

Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment

Matthew E. Hirschtritt, MD, MPH; Michael H. Bloch, MD, MS; Carol A. Mathews, MD

Abstract Full Text

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JAMA. 2017;317(13):1358-1367. doi:10.1001/jama.2017.2200

This narrative review summarizes screening, diagnosis, and treatment options for patients with obsessive-compulsive disorder.

Audio: Complications From SSRIs

From the JAMA Network

Congenital Zika Syndrome in 2017

Daniel Lucey, MD, MPH; Hannah Cummins, MS; Sabrina Sholts, PhD

Abstract Full Text

JAMA. 2017;317(13):1368-1369. doi:10.1001/jama.2017.1553

This commentary discusses a case series of infants with congenital Zika virus infection published in JAMA Neurology that described developmental abnormalities more severe than had been previously reported.

JAMA Clinical Challenge

Fever in a Traveler Returning From Africa

Erica S. Herc, MD; David Manthei, MD, PhD; James Riddell IV, MD

Abstract Full Text

JAMA. 2017;317(13):1370-1371. doi:10.1001/jama.2016.19729

A 35-year- old man had 4 days of fever, confusion, and jaundice after travel to Sierra Leone, where he did not take malaria prophylaxis or use insect repellent. His blood smear showed Plasmodium falciparum ring forms. What would you do next?

Medical News & Perspectives

Resetting the Circadian Clock Might Boost Metabolic Health

Bridget M. Kuehn

Abstract Full Text

JAMA. 2017;317(13):1303-1305. doi:10.1001/jama.2017.0653

This Medical News feature discusses the role of circadian clock in regulating metabolism.

News From the Food and Drug Administration

Biologic Medication for Psoriasis

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2017;317(13):1308. doi:10.1001/jama.2017.2408

Detecting Bacteremia Pathogens

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2017;317(13):1308. doi:10.1001/jama.2017.2683

Test Aids Antibiotic Decisions

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2017;317(13):1308. doi:10.1001/jama.2017.2685

The JAMA Forum

Vaccines and the Trump Administration

Joshua M. Sharfstein, MD

Abstract Full Text

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JAMA. 2017;317(13):1305-1306. doi:10.1001/jama.2017.2311

Lab Reports

Allele-Specific Gene Expression May Influence Mental Health

Tracy Hampton, PhD

Abstract Full Text

JAMA. 2017;317(13):1307. doi:10.1001/jama.2017.2529

Circadian Clock Boosts Stress-Response Genes During Aging

Tracy Hampton, PhD

Abstract Full Text

JAMA. 2017;317(13):1307. doi:10.1001/jama.2017.3108

Skin’s Natural Bacteria May Protect Against Pathogens

Tracy Hampton, PhD

Abstract Full Text

JAMA. 2017;317(13):1307. doi:10.1001/jama.2017.3111

The Arts and Medicine

How to Survive a Plague: The Next Great HIV/AIDS History

Paul A. Volberding, MD

Abstract Full Text

JAMA. 2017;317(13):1298-1299. doi:10.1001/jama.2017.1325

This Arts and Medicine essay reviews David Frances’s book, How to Survive a Plague, an extensive account of the AIDS activists in the 1980s and 1990s who effectively mobilized to provide medical treatment and support for those suffering from the disease.

Poetry and Medicine