This randomized clinical trial compares the effect of high-flow nasal oxygen with prophylactic noninvasive ventilation applied immediately after extubation vs high-flow nasal oxygen alone on the rate of reintubation in patients at high risk of extubation failure in the intensive care unit (ICU).
This phase 2b/3 randomized clinical trial compares the effects of selepressin, a selective vasopressin V1a receptor agonist and noncatecholaminergic vasopressor, vs placebo on ventilator- and vasopressor-free days within 30 days among adult patients with septic shock receiving norepinephrine.
This preliminary exploratory analysis of the ongoing PREDIMED-Plus randomized trial reports dietary adherence among Spanish community-dwelling participants with metabolic syndrome randomized to an energy-reduced Mediterranean diet, physical activity, and behavioral support vs an energy-unrestricted Mediterranean diet alone.
This cohort study uses Swedish Medical Birth Register data to investigate risk of birth defects in infants born to women who had Roux-en-Y bariatric surgery between 2007 and 2014.
This Special Communication uses a systematic literature review to update previous dollar estimates of waste in the US health care system attributable to failure of care delivery and coordination, low-value care, price inflation, fraud, and administrative complexity.
This Viewpoint proposes conditions under which physicians might sign on to deliver humane and ethical medical treatment of immigrants in US detention facilities while managing dual loyalty conflicts with immigration enforcement agencies, including exemption from nondisclosure agreements, use of 3rd-party hiring agencies, and establishment of independent health oversight committees.
This Viewpoint discusses the phenomenon of physicians talking about patients with their partners and spouses, and the tensions between balancing patient privacy with having a personal outlet and support for processing challenging clinical experiences.
In the wake of a 2019 executive order requiring hospitals to publicly post paid prices and requiring clinicians, insurers, and health plans to provide estimated out-of-pocket costs to patients, this Viewpoint reviews available evidence about the likelihood that price transparency might influence consumer choice, put downward pressure on prices, and influence insurers to incentivize patients to seek lower-cost care.
This Viewpoint characterizes the costs of medical supply acquisition and waste as an underrecognized contributor to health care expenditures and proposes policy and practice reforms, such as standardizing reuse of some supplies and extending expiration dates on others that could optimize supply availability and generate savings without adverse effects on patients.
In this narrative medicine essay, a married pair of pediatricians share the story of the loss of their first pregnancy, the compassionate care they received, the challenges those around them faced in offering consolation, and, ultimately, the successful pregnancies that brought children to their family.
This JAMA Insights Clinical Update reviews infection control and treatment strategies to manage Candida auris, a new drug-resistant fungal species that can cause severe invasive infection with high morbidity and mortality in patients with underlying comorbid illnesses.
A 66-year-old man had bilateral carpal tunnel syndrome and 6 years of chronic joint pain and stiffness of the shoulders, hips, and knees. He reported occasional bruising around his eyes; physical examination showed raised soft tissue masses around the sternoclavicular joints and scapulae, and laboratory examination was notable for significant levels of protein and albumin. What is the diagnosis and what would you do next?
This Medical News story discusses efforts to remove barriers faced by women seeking birth control pills and other hormonal contraceptives.
This Medical News article discusses a biomarker panel being developed to screen for war zone–related posttraumatic stress disorder.
This JAMA Patient Page describes causes, control, and prevention of infection with the yeast Candida auris.
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