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November 2019 - July 1883

Decade

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Issue

October 15, 2019, Vol 322, No. 15, Pages 1427-1526

In This Issue of JAMA

Highlights

Abstract Full Text
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JAMA. 2019;322(15):1427-1429. doi:10.1001/jama.2018.15553
Original Investigation

Caring for the Critically Ill Patient

Effect of Postextubation High-Flow Nasal Oxygen With Noninvasive Ventilation vs High-Flow Nasal Oxygen Alone on Reintubation Among Patients at High Risk of Extubation Failure: A Randomized Clinical Trial

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JAMA. 2019;322(15):1465-1475. doi:10.1001/jama.2019.14901

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).

Caring for the Critically Ill Patient

Effect of Selepressin vs Placebo on Ventilator- and Vasopressor-Free Days in Patients With Septic Shock: The SEPSIS-ACT Randomized Clinical Trial

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JAMA. 2019;322(15):1476-1485. doi:10.1001/jama.2019.14607

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.

Effect of a Nutritional and Behavioral Intervention on Energy-Reduced Mediterranean Diet Adherence Among Patients With Metabolic Syndrome: Interim Analysis of the PREDIMED-Plus Randomized Clinical Trial

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JAMA. 2019;322(15):1486-1499. doi:10.1001/jama.2019.14630

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.

Research Letter

Association of Maternal Gastric Bypass Surgery With Offspring Birth Defects

Abstract Full Text
JAMA. 2019;322(15):1515-1517. doi:10.1001/jama.2019.12925

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.

Special Communication

Waste in the US Health Care System: Estimated Costs and Potential for Savings

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JAMA. 2019;322(15):1501-1509. doi:10.1001/jama.2019.13978

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.

Viewpoint

Can Physicians Work in US Immigration Detention Facilities While Upholding Their Hippocratic Oath?

Abstract Full Text
JAMA. 2019;322(15):1445-1446. doi:10.1001/jama.2019.12567

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.

Physicians Talking With Their Partners About Patients

Abstract Full Text
JAMA. 2019;322(15):1447-1448. doi:10.1001/jama.2019.12293

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.

What Is the Value of Market-Wide Health Care Price Transparency?

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JAMA. 2019;322(15):1449-1450. doi:10.1001/jama.2019.11578

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.

Improving Value in Health Care Through Comprehensive Supply Optimization

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JAMA. 2019;322(15):1451-1452. doi:10.1001/jama.2019.15478

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.

A Piece of My Mind

When You Can’t Find a Heartbeat

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JAMA. 2019;322(15):1453-1454. doi:10.1001/jama.2019.15597

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.

Editorial

Added Benefit of Noninvasive Ventilation to High-Flow Nasal Oxygen to Prevent Reintubation in Higher-Risk Patients

Abstract Full Text
JAMA. 2019;322(15):1455-1457. doi:10.1001/jama.2019.14609

Elusive Waste: The Fermi Paradox in US Health Care

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JAMA. 2019;322(15):1458-1459. doi:10.1001/jama.2019.14610

Toward Evidence-Based Policy Making to Reduce Wasteful Health Care Spending

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JAMA. 2019;322(15):1460-1462. doi:10.1001/jama.2019.13977

Waste in the US Health Care System

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JAMA. 2019;322(15):1463-1464. doi:10.1001/jama.2019.15353
JAMA Insights

Clinical Update

What Is Known About Candida auris

Abstract Full Text
JAMA. 2019;322(15):1510-1511. doi:10.1001/jama.2019.13843

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.

JAMA Clinical Challenge

Joint Pain and Proteinuria

Abstract Full Text
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JAMA. 2019;322(15):1512-1513. doi:10.1001/jama.2019.12704

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?

Editor's Note

Dietary Adherence in a Clinical Trial of a Nutritional and Behavioral Intervention

Abstract Full Text
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JAMA. 2019;322(15):1500. doi:10.1001/jama.2019.15855
Medical News & Perspectives

High Unintended Pregnancy Rate Spurs Efforts to Ease Contraceptive Access

Abstract Full Text
JAMA. 2019;322(15):1434-1436. doi:10.1001/jama.2019.15237

This Medical News story discusses efforts to remove barriers faced by women seeking birth control pills and other hormonal contraceptives.

Quick Uptakes

First Biomarker-Based Screening Tool for PTSD

Abstract Full Text
JAMA. 2019;322(15):1437. doi:10.1001/jama.2019.15339

This Medical News article discusses a biomarker panel being developed to screen for war zone–related posttraumatic stress disorder.

News From the Food and Drug Administration

Device for Improving Heart Failure Symptoms

Abstract Full Text
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JAMA. 2019;322(15):1442. doi:10.1001/jama.2019.16026

First Treatment for Lung Disease Related to Scleroderma

Abstract Full Text
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JAMA. 2019;322(15):1442. doi:10.1001/jama.2019.16349

Tether Device for Treating Pediatric Idiopathic Scoliosis

Abstract Full Text
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JAMA. 2019;322(15):1442. doi:10.1001/jama.2019.16350
The JAMA Forum

Is Affording Undocumented Immigrants Health Coverage a Radical Proposal?

Abstract Full Text
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JAMA. 2019;322(15):1438-1439. doi:10.1001/jama.2019.15806
Global Health

Early Success in Ebola Trial

Abstract Full Text
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JAMA. 2019;322(15):1441. doi:10.1001/jama.2019.15760

Malaria Eradication Is Within Reach

Abstract Full Text
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JAMA. 2019;322(15):1441. doi:10.1001/jama.2019.16413

Improving Nutrition to Save Lives

Abstract Full Text
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JAMA. 2019;322(15):1441. doi:10.1001/jama.2019.16414
JAMA Infographic

Visualizing Health Policy

US Public’s Perspective on Prescription Drug Costs

Abstract Full Text
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JAMA. 2019;322(15):1440. doi:10.1001/jama.2019.15547
Poetry and Medicine

Unarranged

Abstract Full Text
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JAMA. 2019;322(15):1521. doi:10.1001/jama.2019.12547
JAMA Revisited

Current Comment

Abstract Full Text
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JAMA. 2019;322(15):1522. doi:10.1001/jama.2018.15561
JAMA Patient Page

Candida auris Infection

Abstract Full Text
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JAMA. 2019;322(15):1526. doi:10.1001/jama.2019.13857

This JAMA Patient Page describes causes, control, and prevention of infection with the yeast Candida auris.

Comment & Response

Development Assistance for Health in Low-Income Countries

Abstract Full Text
JAMA. 2019;322(15):1517-1518. doi:10.1001/jama.2019.12922

Development Assistance for Health in Low-Income Countries—Reply

Abstract Full Text
JAMA. 2019;322(15):1518. doi:10.1001/jama.2019.12929

Reasons for Increases in Complications of Diabetes

Abstract Full Text
JAMA. 2019;322(15):1518-1519. doi:10.1001/jama.2019.13036

Reasons for Increases in Complications of Diabetes—Reply

Abstract Full Text
JAMA. 2019;322(15):1519. doi:10.1001/jama.2019.13040

Challenges of Dual-Physician Couples

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JAMA. 2019;322(15):1519-1520. doi:10.1001/jama.2019.13153

Challenges of Dual-Physician Couples—Reply

Abstract Full Text
JAMA. 2019;322(15):1520. doi:10.1001/jama.2019.13156
JAMA Masthead

JAMA

Abstract Full Text
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JAMA. 2019;322(15):1431-1432. doi:10.1001/jama.2018.15554
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