In this Viewpoint, Anthony Fauci and colleagues at NIAID emphasize the continued importance of low-tech public health practices, such as wearing masks, limiting large gatherings, hand washing, and physical distancing, to help control the COVID-19 pandemic even after safe and effective vaccines become available until distribution and uptake of vaccines confer herd immunity on a population level.
This Viewpoint discusses the importance of understanding how next-generation genomic sequencing is being implemented—for whom noninvasive prenatal testing, whole-exome and -genome sequencing for suspected genetic disorders, and tumor sequencing is being used and who is paying for it—as precondition for knowing how the technologies can best serve patients.
This randomized clinical trial compares the effect of regional citrate vs systemic heparin anticoagulation on dialysis filter life span and 90-day mortality among critically ill adults with acute kidney injury (AKI) receiving continuous kidney replacement therapy.
This Viewpoint summarizes the principles guiding coronavirus disease 2019 (COVID-19) vaccine recommendations made by the Advisory Committee on Immunization Practices (ACIP), a nongovernment advisory standing committee that counsels the Centers for Disease Control and Prevention on US population vaccine use, emphasizing that any final recommendations await phase 3 safety and efficacy data from ongoing trials.
A 70-year-old man with a 2-year history of nasal congestion, rhinorrhea, and chronic cough developed yellow discoloration and thickening of his fingernails and toenails and progressive exertional dyspnea and edema of both lower extremities. ANA was positive (1:160, nucleolar pattern), a chest radiograph was unrevealing, and sinus CT showed bilateral maxillary and posterior ethmoidal sinusitis. What is the diagnosis and what would you do next?
This Medical News feature examines the debate about the value of frequent testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
This JAMA Insights Clinical Update discusses herd immunity in the context of the COVID-19 pandemic and explains the herd immunity threshold as a function of transmissibility (R0), the role of an effective vaccine and vaccination program in sustaining herd immunity, and the risks of an infection-based herd immunity approach.
This JAMA Patient Page describes what herd immunity is, how it limits disease spread, and how it is achieved in a population either by vaccination or by infection and recovery from a disease.
This Viewpoint offers provisional answers to common questions the public will have about approved COVID-19 vaccines, including what they can expect regarding its effectiveness and safety, trustworthiness of the approval process, and whether society can return to normal once sufficient numbers of people are immunized.
This Viewpoint explains the “test-negative” modified case-control design commonly used for evaluating vaccine effectiveness, describes why it may be lead to biased estimates of COVID-19 vaccine effectiveness in patients with severe illness more likely to test negative, and proposes potential approaches to correcting the bias, including incorporation of clinical assessment of cases.
This Viewpoint reviews systems in place to monitor postlicensure vaccine safety, and recommends harmonizing end points and protocols across vaccine trials and surveillance systems to enable timely identification and reliable evaluation of potential adverse events.
This Viewpoint discusses the tensions between rapid adoption of interventions for coronavirus disease 2019 (COVID-19) before adequate evidence justifies their use and therapeutic nihilism, and argues for sensible medicine between the 2, which favors usual care, disfavors unnecessary interventions, but embraces rapid scientific evaluation with clinical translation of options proven effective.
This Medical News article is an interview with nutrition expert Barry Popkin, PhD, lead author of a new systematic review and meta-analysis of studies on coronavirus disease 2019 among individuals who are obese.
This guideline from the International Antiviral (formerly AIDS) Society–USA updates practice recommendations for managing HIV infection including when to initiate antiviral therapy, how to monitor patients’ response, when to change antiviral regimens, and use of preexposure prophylaxis (PrEP) to prevent infection in those at risk.
This Viewpoint considers how COVID-19 vaccines can be distributed strategically, ethically, and legally given conflicts between consensus public health recommendations to prioritize allocation to disadvantaged racial and ethnic minorities and laws discouraging explicit consideration of race in policy decisions.
This Viewpoint compares the COVID-19 per capita overall and excess mortality rates in the US vs that of 18 OECD countries and the timing of any increases in excess mortality between February and September 2020.
In the context of declining state Medicaid revenues and rising enrollment related due to coronavirus disease 2019, this Viewpoint proposes policy and payment reforms related to mandated drug coverage and manufacturer rebates that could assist states financially while maintaining patient access to life-saving medications.
A woman who had immigrated from Guatemala 1 year prior developed headache, photophobia, vomiting, somnolence, and confusion but no focal neurologic deficits. Brain CT showed ventriculomegaly, hydrocephalus, and cerebral edema, while brain MRI showed a nonenhancing lesion obstructing the aqueduct of Sylvius that moved to the fourth ventricle with hydrocephalus resolution on repeat imaging 5 days later. What is the diagnosis and what would you do next?
This Viewpoint summarizes the report of the International Commission on the Clinical Use of Human Germline Genome Editing sponsored by the US National Academy of Medicine and the UK Royal Society, enumerating technical, regulatory, and ethical standards that need to be met before HHGE can be used on human embryos.
This Viewpoint discusses how disruptions from the coronavirus disease 2019 (COVID-19) pandemic can set the stage for beneficial personal and organizational change, and proposes steps that can be taken to catalyze the posttraumatic growth process.
This Viewpoint from the US Surgeon General’s office announces the 2020 release of the Surgeon General’s Call to Action to Control Hypertension and summarizes its key goals and recommendations aimed at making hypertension control a national public health priority and ensuring communities and patients have the resources to achieve it.
This Medical News article describes the use of telephone visits to deliver care during the pandemic.
This Viewpoint discusses the long-term symptoms and sequelae of COVID-19 infection, including physical manifestations and mental health consequences, and calls for observational studies and clinical trials to better understand the disease after the acute phase.
This Viewpoint describes the temporary halting of elective surgery as a consequence of the COVID-19 pandemic and discusses the implications of it that may inform future approaches during crisis and uncertainty.
This Viewpoint proposes that varying combinations of evidence, physician influence, and economics guide the continuation or de-adoption of low-value health services and can help organize and prioritize policy initiatives to drive down the prevalence of wasteful care.
This Medical Letter review summarizes available influenza vaccine formulations for use during the 2020-2021 flu season, with guidance on which to choose for specific age groups and populations.
This Viewpoint argues for inclusion of simply worded nutrition warnings on foods with excessive levels of sugar, sodium, and saturated fat, discussing international experience with the practice and its potential to incentivize healthier food products and reduce health inequities.
This JAMA Patient Page describes the risk of acquiring the COVID-19 virus associated with air travel, steps that airlines and airports are taking to mitigate risk, and steps that passengers can take to reduce their risk.
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