This randomized trial compares the effects of resuscitation strategies targeting normalization of capillary refill time vs normalization or decrease of serum lactate levels on 28-day mortality among patients with septic shock.
This cluster-randomized clinical trial compares the effect of a nurse-led intervention intended to alleviate acute stress and memories of frightening intensive care unit (ICU) experiences vs usual care on patient-reported posttraumatic stress disorder (PTSD) symptom severity 6 months after ICU discharge.
This study uses FDA documents to describe transmucosal immediate-release fentanyl (TIRF) prescribing patterns after the agency’s 2011 REMS intended to reduce the rate of TIRF-related adverse outcomes, misuse, abuse, addiction, and overdose.
This randomized clinical trial compares the effects of postoperative intravenous acetaminophen vs placebo, combined with intravenous propofol vs dexmedetomidine, on postoperative in-hospital delirium among older patients undergoing cardiac surgery.
This cancer epidemiology study uses SEER data to examine US trends in use of active surveillance, watchful waiting, radiotherapy, and surgical management of localized prostate cancer among men with low-, intermediate-, and high-risk disease treated between 2010 and 2015.
This Viewpoint questions recent US state regulations authorizing the use of cannabis as a substitute for opioids in treatment of opioid addiction and chronic pain, citing the absence of evidence of cannabis equivalency, the risks of marijuana use, and ample evidence supporting the use of methadone and buprenorphine for management of opioid use disorder (OID).
This Viewpoint assesses the prospects for reform of maintenance of certification (MOC) programs administered by physician specialty boards, distinguishing between reforms in summative knowledge testing using formal examination and formative programs that support ongoing incremental and personalizable education.
This Viewpoint reviews potential adverse consequences of US state and insurer policy initiatives to limit opioid prescription duration for patients with acute pain and proposes that condition-specific prescribing guidelines and patient-centered approaches could maintain pain control while reducing the risk of diversion and misuse.
In this narrative medicine essay, a pediatrician recalls how her residency program and peers helped her through a challenging pregnancy and postpartum period, compares herself to women who are not so lucky, and calls on the physician community to advocate for a change in US policy to provide 12-week paid family leave.
This JAMA Guide to Statistics and Methods reviews the use of mediation analysis to evaluate possible mechanisms that the effects of interventions are presumed to work through.
A 26-year-old white man had recurrent episodes of ocular redness and blurry vision coincident with nodular skin elevation in a left-arm tattoo. Slit lamp examination revealed inflammatory cells in the anterior chamber of the left eye; punch biopsy of the tattooed skin revealed pigment-containing macrophages. What is the diagnosis and what would you do next?
A 5-year-old girl with a family history of cystic fibrosis presented with constipation, poor weight gain, and a BMI below the third percentile. Three sweat chloride tests were indeterminate, a CFTR analysis panel was negative, and whole-genome sequence analysis revealed 1 cystic fibrosis–causing mutation. What would you do next?
This Medical News article discusses recent studies that question the one-size-fits-all approach to probiotic supplementation for gastrointestinal health, arguing for a more personalized approach.
This Arts and Medicine feature reviews the American Ballet Theatre’s 2017 production of Richard Strauss’ Whipped Cream (Schlagobers), a collaboration between choreographer Alexei Ratmansky and pop surrealist Mark Ryden, which tells the story of a boy’s admission to and rescue from a nightmarish hospitalization.
This JAMA Patient Page explains aspects of decision making for older patients considering surgery.
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