This study describes possible transmission of novel coronavirus disease 2019 (COVID-19) from an asymptomatic Wuhan resident to 5 family members in Anyang, a Chinese city in the neighboring province of Hubei.
This JAMA Insights Clinical Update summarizes current guidelines for prevention of surgical site infections and discusses emerging prevention strategies, such as preoperative bowel preparation and negative-pressure wound therapy, that are challenging longstanding surgical practices.
This randomized clinical trial compares the effects of 2 tenecteplase doses (0.40 vs 0.25 mg/kg) prior to endovascular thrombectomy on blood flow restoration to brain ischemic territory in patients with large vessel occlusion ischemic stroke.
This Viewpoint discusses public health measures implemented in Singapore to manage potential COVID-19 infection based on the country’s experience with SARS in 2003 and reviews critical information gaps necessary to help manage the outbreak, such as viral shedding patterns and optimal timing of antiviral treatment after exposure.
This Viewpoint summarizes current shortcomings in direct-to-consumer genetic tests, which often lack clinical utility for consumers, and explains how tests that encompass entire genes and include only genes with well-established risk estimates and medical management guidelines could provide more valuable insight into their disease risk.
This Viewpoint discusses the potential role of ECMO (extracorporeal membrane oxygenation) in the management of novel coronavirus disease 2019 (COVID-19) and cautions about the risk of overuse and the shortage of ECMO capability given the numbers of people infected if the technology is not appropriately utilized.
In this Medical News article, Tom Inglesby, MD, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, speaks about natural and deliberate biological threats to US national security.
This randomized trial compares the effects of intravenous interferon β-1a vs placebo on 28-day mortality and on ventilator-free days in patients with moderate to severe acute respiratory distress syndrome (ARDS).
This unblinded randomized trial compares the effect of a machine learning–derived system that uses arterial waveform information to predict cardiovascular decompensation vs standard monitoring by anesthesiologists on the depth and duration of intraoperative hypotension in patients undergoing elective noncardiac surgery.
This cohort study uses electronic health record (EHR) data to evaluate the association between Physician Orders for Life-Sustaining Treatment (POLST) and intensive care unit (ICU) admission and the incidence of and risk factors for POLST-discordant intensive care among adult patients hospitalized 6 months or less before death.
This study characterizes the demographic, epidemiologic, and clinical characteristics of hospitalized infants diagnosed with coronavirus disease 2019 infection between December 8, 2019, and February 6, 2020, in China.
This Genomics and Precision Health article explains how genetic testing is used to identify the probable geographic origins of one’s ancestors and how it can aid in risk assessment for some heritable conditions, and summarizes the contexts in which its information provides clinically relevant information.
This Viewpoint discusses the policy and legal ramifications of the national public health emergency declared by the US government in response the coronavirus disease 2019 (COVID-19) outbreak, and examines the lawfulness of quarantine and other compulsory measures.
This Viewpoint proposes the creation of a homelessness-focused special needs plan, a Medicare Advantage insurance plan aimed at meeting the unique care needs of specific populations, to help offer the intensive case management and care coordination necessary for providing health care to homeless individuals.
An 18-year-old man who recently emigrated from India presented with fever, malaise, and anorexia for 4 days. He was afebrile with scleral icterus and a palpable liver edge; had a white blood cell count of 3.9 × 103/μL with elevations in total and direct bilirubin, alkaline phosphatase, and liver enzymes; and laboratory test results were positive for HBsAg and HBV core IgG. What is the cause of his hepatitis, and what would you do next?
This randomized clinical trial compares the effect of vasopressors guided by a mean arterial pressure (MAP) target of 60 to 65 mm Hg with a MAP level determined by the treating physician on 90-day mortality among critically ill older patients with vasodilatory hypotension.
This Viewpoint discusses the concepts of transmissibility and severity as the critical factors that determine the extent of an epidemic, drawing on the previous pandemic of influenza A(H1N1) and epidemics of SARS and MERS to consider what the scope, morbidity, and mortality of the 2019 novel coronavirus (2019-nCoV) epidemic might be.
This study uses registry data to compare risk of in-hospital mortality and major bleeding among patients with acute coronary syndrome and cardiogenic shock managed with an intravascular microaxial left ventricular assist device (LVAD) vs intra-aortic balloon pulsation (IABP).
This single-center case series describes the demographics, symptoms, laboratory and imaging findings, treatment, and clinical course of 138 patients hospitalized with 2019 novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) in Wuhan, China, highlighting presumed human-to-human hospital-associated transmission in many cases.
This case series uses patient hospital data to summarize the clinical presentation and laboratory and imaging findings of 13 patients with confirmed 2019-nCoV infection admitted to hospitals in Beijing in January 2020.
This Viewpoint discusses the potential harms that can emerge from changing disease classifications, generally to broaden criteria for diagnosing greater numbers of patients, and calls for a balanced and systematic evaluation of the benefits and risks of shifting illness thresholds before formalizing changes.
This JAMA Insights article reviews the presentation and diagnostic workup of primary hyperparathyroidism, and indications for surgical vs surveillance management.
This Viewpoint summarizes recommendations made by National Academies of Sciences, Engineering, and Medicine (NASEM) experts to address the US health system’s preparedness for major threats, highlighting 5 principles to help regions prepare for specific threats as a prelude to partnerships that would facilitate more comprehensive national preparedness.
This JAMA Guidelines Synopsis summarizes the American Thoracic Society (ATS)/Infectious Diseases Society of America (IDSA) 2019 recommendations on diagnosis and treatment of adults with community-acquired pneumonia.
This Medical Letter review summarizes evidence underlying American Thoracic Society and Infectious Diseases Society of America guideline recommendations on the use of corticosteroids as an adjunct to antimicrobials for the treatment of community-acquired pneumonia
This Viewpoint summarizes the epidemiology and clinical features of 2019-nCoV infection and reviews CDC criteria to guide evaluation and management of patients with possible infection.
This Medical News feature discusses “street medicine,” the practice of caring for unsheltered homeless individuals.
This Viewpoint discusses the challenge prior medication authorization procedures presents for patients, physicians, and practices, and it proposes principles to guide “prior auth” reform, including focusing the procedures on the initial intended purpose of managing use of high-cost drugs that have equivalent lower-cost alternatives, protecting the continuity of medication for patients, and being transparent, efficient, and fair in their requirements.
In this Viewpoint, Berwick and colleagues review the evolution of prior authorization (“prior auth”) into a process where insurers deny previously approved coverage, patients receive surprise bills, and clinicians spend time appealing charges, and propose the introduction of legal provisions that make authorization decisions binding and absolve patients, clinicians, and organization of financial responsibility for previously approved services.
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