This randomized clinical trial compares effectiveness and adverse events of transvaginal mesh–augmented hysteropexy vs vaginal hysterectomy with suture apical uterosacral ligament suspension in postmenopausal women with symptomatic uterovaginal prolapse.
This superiority trial compared behavioral and pelvic floor muscle therapy plus midurethral sling surgery with midurethral sling surgery alone in treating women with mixed urinary incontinence.
This randomized trial compares the effects of sacubitril-valsartan vs enalapril on central aortic stiffness and other physiologic indexes in patients with heart failure and reduced ejection fraction.
This exploratory cohort study of patients with heart failure with reduced ejection fraction (HFrEF) assesses the association between change in N-terminal pro–B-type natriuretic peptide (NT-proBNP) after starting sacubitril-valsartan and changes in left ventricular ejection fraction, diastolic volume, and other measures of physiologic cardiac function.
This study describes health services offered by USNWR “best hospitals” in executive physical packages, daylong comprehensive evaluations offering testing and screening of wealthy individuals and corporate leaders.
This Viewpoint reviews evidence of the effects of screening for social determinants of health and emphasizes the need to assess if screening leads to improvements in case finding, referral to and receipt of social services, and patient outcomes without patient harms.
In 2019, the US Food and Drug Administration approved esketamine for treatment of major depressive disorder unresponsive to other therapies when given in a health care facility because of its transient effects on vital signs and feelings of dissociation it can produce acutely. This Viewpoint discusses likely barriers to use of the new treatment option given that the drug is expensive, many psychiatrists work in solo or small group settings, do not accept commercial insurance, and may be reluctant to invest in the costly infrastructure necessary to provide it and monitor patients as required after its administration.
In this Viewpoint, Drs Anthony Fauci and Andrea Lerner discuss the rise of injection of opioids in the rural US as an emerging risk factor for HIV infection among traditionally low-risk communities, and calls for interventions to prevent IDU-related HIV transmission—needle-exchange programs, opioid use disorder treatment programs, and increased availability of preexposure prophylaxis (PrEP)—as a means to end the HIV epidemic in the US.
This Viewpoint summarizes what is known about greenhouse gas emissions and pollution generated by health care activities in high-income countries, calls for cooperation between stakeholders (physicians, hospital administrators, regulatory bodies, specialty societies, policy makers, industry) to reduce the environmental footprint of their collective activities, and calls for funding of environmental sustainability science to inform the effort and optimize resource and waste management.
In this narrative medicine essay, an obstetrician-gynecologist struggles with the overwhelming strains of her profession, family obligations, and struggling marriage that together buried her sense of empathy until a grateful patient hugs her, an expression that reaches what she feared had been long extinguished.
This JAMA Insights Clinical Update reviews updates in 2019 to the Advisory Committee on Immunization Practices (ACIP) adult immunization schedule, including recommendations for the Shingrix vaccine for prevention of zoster and of the Heplisav-B vaccine for prevention of hepatitis B virus infection.
A 67-year-old white female patient with metastatic breast cancer presented with 2 weeks of painless reduced vision in her right eye (OD), without headache, photophobia, diplopia, or eye pain, with placoid yellow choroidal lesions with ill-defined borders and subretinal fluid in each eye (OU). What is the diagnosis and what would you do next?
This Medical News story discusses the use of telemedicine to treat opioid use disorder in rural areas.
This Medical News feature discusses research into the cardiometabolic benefits of a modest reduction in calorie intake.
This JAMA Patient Page describes the causes of testosterone deficiency as well as testing and treatment for it.
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