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September 2022 - July 1883

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May 12, 2020, Vol 323, No. 18, Pages 1749-1862

In This Issue of JAMA

Audio Highlights

Abstract Full Text
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JAMA. 2020;323(18):e200020. doi:10.1001/jama.2020.0020
Original Investigation

Effect of Surgery vs Functional Bracing on Functional Outcome Among Patients With Closed Displaced Humeral Shaft Fractures: The FISH Randomized Clinical Trial

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JAMA. 2020;323(18):1792-1801. doi:10.1001/jama.2020.3182

This randomized trial compares the effects of open reduction and internal fixation vs functional bracing for treating patients with closed displaced humeral shaft fractures.

Effect of Biomechanical Footwear on Knee Pain in People With Knee Osteoarthritis: The BIOTOK Randomized Clinical Trial

Abstract Full Text
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JAMA. 2020;323(18):1802-1812. doi:10.1001/jama.2020.3565

This randomized trial compares the effect of shoes with adjustable external convex pods attached to the outsole vs usual footwear on knee pain over 24 weeks in patients with symptomatic, radiologically confirmed knee osteoarthritis.

Association Between Initiation of Pulmonary Rehabilitation After Hospitalization for COPD and 1-Year Survival Among Medicare Beneficiaries

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JAMA. 2020;323(18):1813-1823. doi:10.1001/jama.2020.4437

This inception cohort study uses Medicare fee-for-service claims data to assess the association between initiation of pulmonary rehabilitation within 90 days of hospital discharge and 1-year survival among US patients hospitalized for chronic obstructive pulmonary disease in 2014.

Research Letter

Detection of SARS-CoV-2 in Different Types of Clinical Specimens

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JAMA. 2020;323(18):1843-1844. doi:10.1001/jama.2020.3786

This study describes results of PCR and viral RNA testing for SARS-CoV-2 in bronchoalveolar fluid, sputum, feces, blood, and urine specimens from patients with COVID-19 infection in China to identify possible means of non-respiratory transmission.

Ethics Committee Reviews of Applications for Research Studies at 1 Hospital in China During the 2019 Novel Coronavirus Epidemic

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JAMA. 2020;323(18):1844-1846. doi:10.1001/jama.2020.4362

This study reviews research ethics committee applications for COVID-19–related research at a Chinese hospital in February 2020 to characterize study type, approval rate and review time, reason for revision or denial, and issues with informed consent.

Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn

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JAMA. 2020;323(18):1846-1848. doi:10.1001/jama.2020.4621

This case report describes birth of an infant with elevated anti–SARS-CoV-2 IgM antibodies and cytokine levels to a mother with polymerase chain reaction–confirmed coronavirus disease 2019 (COVID-19) despite no physical contact.

Antibodies in Infants Born to Mothers With COVID-19 Pneumonia

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JAMA. 2020;323(18):1848-1849. doi:10.1001/jama.2020.4861

This study describes results of IgM and IgG antibody testing from throat swabs of newborns born to mothers with COVID-19 pneumonia.

Training and Fit Testing of Health Care Personnel for Reusable Elastomeric Half-Mask Respirators Compared With Disposable N95 Respirators

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JAMA. 2020;323(18):1849-1852. doi:10.1001/jama.2020.4806

This study examines the feasibility of rapidly training and fit testing health care workers to use elastomeric half-mask respirators (EHMRs), widely used in construction and manufacturing, as an alternative to N95 respirators during periods of shortage.

Rural-Urban Differences in Cardiovascular Mortality in the US, 1999-2017

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JAMA. 2020;323(18):1852-1854. doi:10.1001/jama.2020.2047

This study used data from the US Centers for Disease Control and Prevention WONDER database to examined temporal trends in cardiovascular disease age-adjusted mortality rates overall and across subgroups stratified by rural-urban area designation in the US.

Viewpoint

The COVID-19 Pandemic in the US: A Clinical Update

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JAMA. 2020;323(18):1767-1768. doi:10.1001/jama.2020.5788

This Viewpoint provides a summary update of coronavirus disease 2019 (COVID-19) in the US, discussing case-fatality rates, interpretation of polymerase chain reaction test results, duration of immunity, reinfection, and more.

COVID-19 and Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: What Is the Evidence?

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JAMA. 2020;323(18):1769-1770. doi:10.1001/jama.2020.4812

This Viewpoint reviews the pathophysiological and observational basis for speculating that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) might worsen clinical outcomes for patients with COVID-19, and summarizes guidance from specialty societies to continue the drugs in patients who need them pending more definitive evidence of harm.

The Importance of Addressing Advance Care Planning and Decisions About Do-Not-Resuscitate Orders During Novel Coronavirus 2019 (COVID-19)

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JAMA. 2020;323(18):1771-1772. doi:10.1001/jama.2020.4894

This Viewpoint emphasizes the importance of advanced care planning and goals-of-care discussions with older patients and those with chronic disease during the spread of coronavirus disease (COVID-19), given the likelihood these patients could become critically ill and require resuscitation and advanced life support if they became infected with SARS-CoV-2.

A Framework for Rationing Ventilators and Critical Care Beds During the COVID-19 Pandemic

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JAMA. 2020;323(18):1773-1774. doi:10.1001/jama.2020.5046

This Viewpoint describes a framework for rationing ventilators during the COVID-19 pandemic should intensive care units find themselves with more patients than they can care for, using a score-based system that incorporates patients’ likelihood of surviving to hospital discharge and beyond and their role in the public health response to the outbreak.

Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy

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JAMA. 2020;323(18):1775-1776. doi:10.1001/jama.2020.4683

This Viewpoint from physicians with the Italian National Institute of Health confirms a higher case-fatality rate from coronavirus disease 2019 (COVID-19) in Italy compared with China and explains possible reasons, including age, cause of death definitions, and testing strategy.

Older Clinicians and the Surge in Novel Coronavirus Disease 2019 (COVID-19)

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JAMA. 2020;323(18):1777-1778. doi:10.1001/jama.2020.4978

This Viewpoint summarizes the distribution of physicians and registered nurses aged 55 years and older in US cities caring for COVID-19 patients and proposes roles they can play in health systems that preserve their ability to apply their experience over the long-term course of the pandemic.

Delayed Antibiotic Prescriptions in Ambulatory Care: Reconsidering a Problematic Practice

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JAMA. 2020;323(18):1779-1780. doi:10.1001/jama.2020.2325

This Viewpoint discusses the unintended adverse consequences of delayed antibiotic prescribing—provision of an antibiotic prescription to be filled at a later date if a patient’s condition has not improved—and calls on clinicians to avoid the practice in patients who have self-limited conditions with likely viral etiologies.

A Piece of My Mind

Cultivating Hope

Abstract Full Text
JAMA. 2020;323(18):1781-1782. doi:10.1001/jama.2020.4508

In this narrative medicine essay, a pediatric psychiatrist relates how her younger sister with Down syndrome and congenital heart disease has lived well beyond expectation inspired her to help children cultivate hope through love and resilience.

Editorial

Pulmonary Rehabilitation and Improved Survival for Patients With COPD

Abstract Full Text
JAMA. 2020;323(18):1783-1785. doi:10.1001/jama.2020.4436

Toward Universal Deployable Guidelines for the Care of Patients With COVID-19

Abstract Full Text
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JAMA. 2020;323(18):1786-1787. doi:10.1001/jama.2020.5110

Can SARS-CoV-2 Infection Be Acquired In Utero?More Definitive Evidence Is Needed

Abstract Full Text
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JAMA. 2020;323(18):1788-1789. doi:10.1001/jama.2020.4868

A Bold Response to the COVID-19 Pandemic: Medical Students, National Service, and Public Health

Abstract Full Text
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JAMA. 2020;323(18):1790-1791. doi:10.1001/jama.2020.6166
Review

Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review

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JAMA. 2020;323(18):1824-1836. doi:10.1001/jama.2020.6019

This narrative review summarizes what is currently known about how SARS-CoV-2 infects cells and causes disease as a basis for considering whether chloroquine, remdisivir and other antivirals, or other existing drugs might be effective treatment for coronavirus disease 2019 (COVID-19).

JAMA Insights

Turbulent Gas Clouds and Respiratory Pathogen Emissions: Potential Implications for Reducing Transmission of COVID-19

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JAMA. 2020;323(18):1837-1838. doi:10.1001/jama.2020.4756

This JAMA Insights Clinical Update discusses the need to better understand the dynamics of respiratory disease transmission by better characterizing transmission routes, the role of patient physiology in shaping them, and best approaches for source control in the context of the COVID-19 outbreak.

JAMA Clinical Guidelines Synopsis

Management of Critically Ill Adults With COVID-19

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JAMA. 2020;323(18):1839-1841. doi:10.1001/jama.2020.4914

This JAMA Clinical Guidelines Synopsis summarizes the 2020 Surviving Sepsis Campaign guidelines on the treatment of critically ill adults with coronavirus disease 2019 (COVID-19).

Medical News & Perspectives

The Challenge of Preventing COVID-19 Spread in Correctional Facilities

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JAMA. 2020;323(18):1760-1761. doi:10.1001/jama.2020.5427

This Medical News feature examines steps that correctional facilities are taking to minimize the spread of COVID-19.

The JAMA Forum

The Case for Remedial Germline Editing—The Long-term View

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JAMA. 2020;323(18):1762-1763. doi:10.1001/jama.2020.6099
News From the Centers for Disease Control and Prevention

Despite Gains, Progress Toward TB Elimination Has Slowed

Abstract Full Text
JAMA. 2020;323(18):1765. doi:10.1001/jama.2020.6569

Discovering Why Some Infants Have Delayed Hearing Loss Detection

Abstract Full Text
JAMA. 2020;323(18):1765. doi:10.1001/jama.2020.5825
Biotech Innovations

PET-CT Improved High-risk Prostate Cancer Staging in Trial

Abstract Full Text
JAMA. 2020;323(18):1764. doi:10.1001/jama.2020.6994

Ankle Robots Could Make Running Easier, Encourage Exercise

Abstract Full Text
JAMA. 2020;323(18):1764. doi:10.1001/jama.2020.6501

Soy Scaffoldings Poised to Make Cultured Meat More Affordable

Abstract Full Text
JAMA. 2020;323(18):1764. doi:10.1001/jama.2020.7000
The Arts and Medicine

King Lear Under COVID-19 Lockdown

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JAMA. 2020;323(18):1758-1759. doi:10.1001/jama.2020.6186

This Arts and Medicine feature draws lessons from William Shakespeare’s King Lear about our collective disorientation and obligations to each other in the midst of the first-wave coronavirus (COVID-19) pandemic.

Poetry and Medicine

Truth Machine

Abstract Full Text
JAMA. 2020;323(18):1857. doi:10.1001/jama.2020.1210
JAMA Revisited

Serums and Vaccines in Influenza

Abstract Full Text
JAMA. 2020;323(18):1858. doi:10.1001/jama.2020.6524
JAMA Patient Page

Hepatitis E

Abstract Full Text
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JAMA. 2020;323(18):1862. doi:10.1001/jama.2019.21495

This JAMA Patient Page describes the symptoms, prevention, diagnosis, and treatment of hepatitis E.

Comment & Response

Delivery of Talc for Pleurodesis of Malignant Pleural Effusions

Abstract Full Text
JAMA. 2020;323(18):1855. doi:10.1001/jama.2020.3265

Delivery of Talc for Pleurodesis of Malignant Pleural Effusions—Reply

Abstract Full Text
JAMA. 2020;323(18):1855-1856. doi:10.1001/jama.2020.3268
JAMA Masthead

JAMA

Abstract Full Text
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JAMA. 2020;323(18):1749-1750. doi:10.1001/jama.2019.13426
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