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August 2019 - July 1883

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Issue

March 5, 2019, Vol 321, No. 9, Pages 815-910

In This Issue of JAMA

Highlights

Abstract Full Text
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JAMA. 2019;321(9):815-817. doi:10.1001/jama.2018.15223
Original Investigation

Caring for the Critically Ill Patient

Effect of Titrating Positive End-Expiratory Pressure (PEEP) With an Esophageal Pressure–Guided Strategy vs an Empirical High PEEP-Fio2 Strategy on Death and Days Free From Mechanical Ventilation Among Patients With Acute Respiratory Distress Syndrome: A Randomized Clinical Trial

Abstract Full Text
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JAMA. 2019;321(9):846-857. doi:10.1001/jama.2019.0555

This randomized trial compares the effect of guiding PEEP titration using esophageal pressure vs empirical high PEEP–fraction of inspired oxygen (Fio2) on a composite of death and days free from mechanical ventilation at 28 days in patients with moderate to severe acute respiratory distress syndrome (ARDS).

Effect of Multinutrient Supplementation and Food-Related Behavioral Activation Therapy on Prevention of Major Depressive Disorder Among Overweight or Obese Adults With Subsyndromal Depressive Symptoms: The MooDFOOD Randomized Clinical Trial

Abstract Full Text
has active quiz
JAMA. 2019;321(9):858-868. doi:10.1001/jama.2019.0556

This 2 × 2 factorial randomized clinical trial tests 2 nutritional strategies—multinutrient supplementation and food-related behavioral activation therapy—reduces major depressive disorder (MDD) over a year among overweight or obese European adults with elevated symptoms but without an MDD episode found neither approach reduced the number of episodes.

Effect of Integrated Behavioral Weight Loss Treatment and Problem-Solving Therapy on Body Mass Index and Depressive Symptoms Among Patients With Obesity and Depression: The RAINBOW Randomized Clinical Trial

Abstract Full Text
has active quiz
JAMA. 2019;321(9):869-879. doi:10.1001/jama.2019.0557

This randomized clinical trial tests the hypothesis that an integrated collaborative care intervention would significantly improve both obesity and depression at 12 months compared with usual care in adults with body mass indices of 30 or greater (≥27 for Asian adults) and 9-item Patient Health Questionnaire scores of 10 or greater.

Effect of a Behavioral Intervention Strategy on Sustained Change in Physical Activity and Sedentary Behavior in Patients With Type 2 Diabetes: The IDES_2 Randomized Clinical Trial

Abstract Full Text
JAMA. 2019;321(9):880-890. doi:10.1001/jama.2019.0922

This open-label, randomized clinical trial examined the effect of a behavioral intervention that included theoretical and practical counseling sessions vs general physician recommendations to increase physical activity on physical activity and sedentary time in participants with type 2 diabetes.

Research Letter

Comparison of National Institutes of Health Grant Amounts to First-Time Male and Female Principal Investigators

Abstract Full Text
JAMA. 2019;321(9):898-900. doi:10.1001/jama.2018.21944

This Research Letter examines differences in the size of National Institutes of Health (NIH) grants awarded to first-time male and female principal investigators at top research institutions, including the Big Ten and Ivy League universities.

Viewpoint

Evolving Issues in Oncology

Patients and Physicians in the Era of Modern Cancer Care

Abstract Full Text
JAMA. 2019;321(9):829-830. doi:10.1001/jama.2018.17334

This Viewpoint discusses the evolving nature of the oncologist-patient relationship given the growth in complexity of information available to both, the costs of cancer care, and the long-term relationships that are newly developing as cancer treatments become more effective, and it calls for support systems that will facilitate informed conversations and clinical decisions.

Enterovirus D68–Associated Acute Flaccid Myelitis: Rising to the Clinical and Research Challenges

Abstract Full Text
JAMA. 2019;321(9):831-832. doi:10.1001/jama.2019.1016

This Viewpoint reviews the epidemiology and clinical presentation of acute flaccid myelitis (AFM) in the United States, highlighting evidence that enterovirus D68 is associated with seasonal biennial upsurges in AFM cases, and calls for support for virology research, studies to develop prevention and treatment strategies, and enhanced epidemiologic surveillance to contain future outbreaks.

The Orphan Drug Act Revisited

Abstract Full Text
JAMA. 2019;321(9):833-834. doi:10.1001/jama.2019.0290

This Viewpoint reviews unintended consequences of the 1983 Orphan Drug Act, which incentivized development of drugs for rare diseases, including abbreviated approval processes for manufacturers and surges in drug costs, and calls for revision of the “orphan drug” definition in an era where precision medicine will narrow patient populations sufficiently to make any drug qualify for an “orphan” designation.

The 2018 Farm Bill—Implications and Opportunities for Public Health

Abstract Full Text
JAMA. 2019;321(9):835-836. doi:10.1001/jama.2019.0317

This Viewpoint explains how the 2018 Farm Bill, legislation that authorizes an array of major food and agriculture programs in the United States, is a powerful but underutilized tool for promoting public health, reducing health care spending, and addressing disparities by improving access to better nutrition and reducing the prevalence of diet-related diseases.

A Piece of My Mind

Hard Times and Hard Stops

Abstract Full Text
JAMA. 2019;321(9):837-838. doi:10.1001/jama.2019.1208

This narrative medicine essay uses an instance when the physician-author’s elderly mother was screened for intimate partner violence to discuss electronic health record (EHR) ‘hard stops,’ an EHR function that forces a response before a visit can proceed as an implementation of CMS ‘meaningful use’ that, the author claims, is neither meaningful nor useful and possibly harmful.

Editorial

The Elusive Search for “Best PEEP” and Whether Esophageal Pressure Monitoring Helps

Abstract Full Text
JAMA. 2019;321(9):839-841. doi:10.1001/jama.2019.0267

Diet and Depression—From Confirmation to Implementation

Abstract Full Text
JAMA. 2019;321(9):842-843. doi:10.1001/jama.2019.0273

Ending the HIV Epidemic: A Plan for the United States

Abstract Full Text
free access
JAMA. 2019;321(9):844-845. doi:10.1001/jama.2019.1343
JAMA Insights

Genomics and Precision Health

Next-Generation Sequencing of Infectious Pathogens

Abstract Full Text
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JAMA. 2019;321(9):893-894. doi:10.1001/jama.2018.21669

This JAMA Genomics and Precision Health article explains how next-generation sequencing can be used to identify pathogens and provide insights into disease transmission, virulence, and antimicrobial resistance.

JAMA Clinical Guidelines Synopsis

Diagnosis and Management of Infectious Diarrhea

Abstract Full Text
JAMA. 2019;321(9):891-892. doi:10.1001/jama.2018.21974

This JAMA Clinical Guidelines Synopsis summarizes the Infectious Diseases Society of America’s (IDSA’s) 2017 guideline on diagnosis and management of infectious diarrhea in children and adults.

JAMA Clinical Challenge

A 54-Year-Old Man With Pancytopenia

Abstract Full Text
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JAMA. 2019;321(9):895-896. doi:10.1001/jama.2018.21899

A 54-year-old man who had undergone Roux-en-Y gastric bypass 12 years ago presented for evaluation of new-onset pancytopenia. Histopathologic examination of bone marrow aspirate showed normocellular marrow, dyserythropoiesis with vacuolized and dysplastic erythroid precursors, left-shifted granulocytic maturation, ring sideroblasts with no increase in blasts, and no cytogenic abnormalities. What would you do next?

Medical News & Perspectives

Hospitals Turn to Housing to Help Homeless Patients

Abstract Full Text
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JAMA. 2019;321(9):822-824. doi:10.1001/jama.2018.21476

This Medical News story discusses hospital-led initiatives aimed at providing housing for homeless people to improve their health and well-being.

Quick Uptakes: Sex-Specific Tumor Signatures Help Explain Differences in Glioblastoma Survival

Abstract Full Text
JAMA. 2019;321(9):824-825. doi:10.1001/jama.2019.0432

This Medical News feature summarizes a recent study exploring how tumor biology contributes to sex differences in glioblastoma survival.

News From the Food and Drug Administration

A Record Year for Device Approvals

Abstract Full Text
JAMA. 2019;321(9):827. doi:10.1001/jama.2019.1144

New Diagnostic Test for Sexually Transmitted Infection

Abstract Full Text
JAMA. 2019;321(9):827. doi:10.1001/jama.2019.1169

Generic Seizure Drug Wins Approval

Abstract Full Text
JAMA. 2019;321(9):827. doi:10.1001/jama.2019.1172
Bench to Bedside

Vaccine Protects Mice From Emerging Tick-Borne Flaviviruses

Abstract Full Text
JAMA. 2019;321(9):825-826. doi:10.1001/jama.2019.0920
Poetry and Medicine

A-Fib: An Irregular Sonnet

Abstract Full Text
JAMA. 2019;321(9):904. doi:10.1001/jama.2018.16397
JAMA Revisited

The Contribution of Holidays to National Vigor

Abstract Full Text
JAMA. 2019;321(9):905. doi:10.1001/jama.2018.15231
JAMA Patient Page

What Is a Pandemic?

Abstract Full Text
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JAMA. 2019;321(9):910. doi:10.1001/jama.2019.0700

PRECIS HERE

Comment & Response

Weight Loss Interventions in Adults

Abstract Full Text
JAMA. 2019;321(9):900. doi:10.1001/jama.2018.20287

Weight Loss Interventions in Adults—Reply

Abstract Full Text
JAMA. 2019;321(9):900-901. doi:10.1001/jama.2018.20291

Therapeutic Approaches to Aging

Abstract Full Text
JAMA. 2019;321(9):901. doi:10.1001/jama.2018.20550

Therapeutic Approaches to Aging—Reply

Abstract Full Text
JAMA. 2019;321(9):901-902. doi:10.1001/jama.2018.20554

The Role of Endotoxin in Septic Shock

Abstract Full Text
JAMA. 2019;321(9):902-903. doi:10.1001/jama.2018.20874

The Role of Endotoxin in Septic Shock—Reply

Abstract Full Text
JAMA. 2019;321(9):903. doi:10.1001/jama.2018.20882
JAMA Masthead

JAMA

Abstract Full Text
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JAMA. 2019;321(9):819-820. doi:10.1001/jama.2018.15224
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