JAMA Clinical Reviews (JAMA Network)

JAMA Senior Editor Kristin Walter, MD, MS, speaks with Fernando Zampieri, MD, PhD, assistant professor in the Department of Critical Care Medicine at the University of Alberta in Alberta, Canada, about fluid therapy in critically ill adults with sepsis.

Related Content:

• Fluid Therapy for Critically Ill Adults With Sepsis

Approximately 3 million people in the US have heart failure with preserved ejection fraction (HFpEF). JAMA Executive Editor Gregory Curfman, MD, discusses diagnosis and treatment of HFpEF with authors Margaret Redfield, MD, and Barry Borlaug, MD, both from Mayo Foundation for Medical Education and Research Division of Cardiovascular Diseases.

Related Content:

• Heart Failure With Preserved Ejection Fraction

Appendectomy remains the first-line therapy for acute appendicitis, but treatment with antibiotics rather than surgery is appropriate in selected patients with uncomplicated appendicitis. JAMA Associate Editor Anthony Charles, MD, MPH, from UNC School of Medicine summarizes this and other aspects of acute appendicitis in adults along with author Theodore N. Pappas, MD, from Duke University Medical Center.

Related Content:

Diagnosis and Management of Acute Appendicitis in Adults

Acute Appendicitis

Bariatric surgery is unequivocally the most effective means for inducing weight loss and managing diabetes for obese patients. There are numerous other benefits for these operations including improved long-term cardiovascular outcomes. David Arterburn, MD, MPH, a senior investigator from the Kaiser Permanente Washington Health Research Institute, discusses bariatric surgery outcomes.

Related Article(s):

Benefits and Risks of Bariatric Surgery in Adults

Interview with Wanda K. Nicholson, MD, MPH, MBA, USPSTF Chair and coauthor of Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS.

Related Content:

• Collaborative Modeling to Compare Different Breast Cancer Screening Strategies
• Screening for Breast Cancer
• Screening for Breast Cancer
• Screening for Breast Cancer
• Toward More Equitable Breast Cancer Outcomes

Genital herpes is a common sexually transmitted infection that is caused by HSV-1 or HSV-2 and may result in ulcers, neonatal herpes infection, and increased risk of HIV acquisition. Author Christine Johnston, MD, University of Washington, discusses herpes infection and more with JAMA Deputy Editor Preeti Malani, MD, MSJ.

Related Content:

• Genital Herpes

Even limited hearing loss might be associated with cognitive decline. If true, early intervention with hearing aids might help people have better cognitive performance. Michael Johns III, MD, online editor for JAMA Otolaryngology, speaks with Justin Golub, MD, assistant professor of otolaryngology at Columbia University, whose research has shown that very mild hearing loss can be associated with cognitive disability.

Related Article 

Health care spending in the United States is out of control. The most significant aspect of medical care driving this spending is pharmaceuticals; within pharmaceuticals the greatest increases have been in spending for diabetes medications. The cost of insulin analogs has increased 5- to 6-fold in the last 10 years for no particular reason. More than 90% of US patients who use insulin use these analogs, despite the fact that they have few if any clinical benefits relative to regular or NPH insulin, which cost 1/10 as much. Aside from the cost of insulin, diabetes is probably treated far more aggressively than necessary since clinical trials demonstrating the benefits of aggressive glucose control for type 2 diabetes demonstrated vanishingly small benefits of this form of treatment. In this podcast we discuss the perplexing case of spending too much money on diabetes treatment.

One of the most important things clinicians can do is help patients and their families deal with impending death. Despite its importance, this part of medical care is hardly covered in medical training. Clinicians have to learn this on their own. One of the most powerful ways to find out what it’s like is to go through it yourself. Martin F. Shapiro, MD, professor of medicine at the Weill Cornell School of Medicine, describes along with his sister, Lori Shapiro, what they went through in dealing with their mother’s death. Dr Shapiro relates what he learned to more effectively manage his patients and their families in coping with the end of life.

Related Article(s):

The Last Breath—Enriching End-of-Life Moments

JAMA Associate Editor Linda Brubaker, MD, MS, discusses medication abortion as an alternative to a procedural abortion to terminate a pregnancy in an interview with Stephanie Teal, MD, MPH, University Hospitals Cleveland Medical Center, and Rebecca Cohen, MD, OB/GYN, University of Colorado.

Related Content:

• Medication Abortion
• Contraception Selection, Effectiveness, and Adverse Effects

Conflict of Interest Disclosures:
Dr Cohen serves as an unpaid board member for Cobalt, a reproductive rights advocacy group. No other disclosures were reported.

A new clinical trial suggests that obstructive sleep apnea (in patients unable to tolerate treatment with CPAP or other devices) can be treated with airway surgery. The author of the study published in JAMA, Stuart MacKay, MBBS, from the University of Wollongong, Australia, discusses the study and treatments for obstructive sleep apnea.

Related Article:

Effect of Multilevel Upper Airway Surgery vs Medical Management on the Apnea-Hypopnea Index and Patient-Reported Daytime Sleepiness Among Patients With Moderate or Severe Obstructive Sleep Apnea

Each year approximately 100 000 people in the US are treated for cervical precancer, and about 4000 individuals die from cervical cancer. JAMA Senior Editor Melissa Simon, MD, MPH, and Rebecca B. Perkins, MD, MSc, Boston University School of Medicine, discuss the importance of HPV screening, genotyping and cytology testing, and HPV vaccination.

Related Content:

• Cervical Cancer Screening

Selection of hemodialysis or peritoneal dialysis and timing of dialysis initiation are influenced by patient symptoms, laboratory trajectories, patient preferences, and therapy cost and availability; shared decision-making is key. Jennifer E. Flythe, MD, MPH, from the University of North Carolina, discusses dialysis for chronic kidney failure with JAMA Deputy Editor Kristin L. Walter, MD, MS.

Related Content:

• Dialysis for Chronic Kidney Failure

David Juurlink, MD, PhD, a clinical pharmacologist and professor of internal medicine at Sunnybrook Health Sciences Centre and professor of medicine at the University of Toronto, discusses 10 things new doctors should know about drugs and thir complications as they start practicing medications in the the fourth and final episode of this series.

Even though highly effective medications are currently available to prevent HIV, there are about 1.3 million new infections worldwide each year. Monica Gandhi, MD, MPH, of the University of California San Francisco joins JAMA Senior Editor Karen E. Lasser, MD, MPH, to discuss preexposure prophylaxis (PrEP) for HIV.

Related Content:

• Preexposure Prophylaxis (PrEP) for HIV
• What Is Doxycycline Postexposure Prophylaxis?

Saved by a Fitbit. Technology is developing at a pace far exceeding its application in medical care. An exception is in consumer devices, which as long as they do not hold themselves out as diagnostic tools, can apply as many technologies to wearable devices as companies want to put into them. In this episode we discuss how a clinician used a wearable device to diagnose his father's rapid heart rates consistent with dangerous cardiac arrhythmias.

Read the article: Wearable Devices for Cardiac Rhythm Diagnosis and Management

The capabilities and risks of various types of artificial intelligence (AI) are markedly different. JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, interviews author Michael Howell, MD, MPH, chief clinical officer at Google, to discuss how AI has evolved and how to understand the problems and possibilities of each iteration.

Related Content:

• AI and Clinical Practice—AI Gaslighting, AI Hallucinations, and GenAI Potential
• Three Epochs of Artificial Intelligence in Health Care

Myelodysplastic neoplasms, or myelodysplastic syndromes, are diagnosed in approximately 4 of 100 000 people each year in the US and are associated with a 5-year survival rate of approximately 37%. In this JAMA podcast and author interview, JAMA Deputy Editor Mary M. McDermott, MD, discusses the diagnosis and treatment of myelodysplastic syndromes with Mikkael A. Sekeres, MD, MS, chief of hematology and professor of medicine of the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine.

Related Content:

Diagnosis and Treatment of Myelodysplastic Syndromes

Gregory Armstrong, MD, director of the Advanced Molecular Detection Program for the CDC, explains what is currently known about the new mutations of SARS-CoV-2.

Related Article(s):
Genetic Variants of SARS-CoV-2—What Do They Mean?

Next-Generation Sequencing of Infectious Pathogens

Next Generation Sequencing of Infectious Pathogens in Public Health and Clinical Practice

Understanding SARS-CoV-2 Genetic Variants

Next-generation sequencing is a catchall term for new, high-throughput technologies that allow rapid sequencing of a full genome. It can be used to sequence a patient’s DNA in diagnosing a genetic disorder or characterizing a cancer, but it can also be used to sequence the genome of a pathogenic bacteria, virus, fungi, or parasites. In this JAMA clinical review podcast, we talk with authors Marta Gwinn, MD, MPH, and Gregory L. Armstrong, MD, from the CDC, about how next-generation sequencing of infectious pathogens is being implemented in clinical practice and in public health surveillance for infectious disease.

Related Article(s):

Next-Generation Sequencing of Infectious Pathogens

Podcast originally published 2/14/19.

Syphilis is on the rise despite prior successful efforts to control it. Why is it coming back and what needs to be done about it? Dr Charles Hicks from UC San Diego explains. This podcast coincides with updated syphilis screening recommendations from the USPSTF that were published in the September 4, 2018 issue of JAMA.

Nearly all women experience some element of nausea and vomiting during their pregnancies. In this podcast we review the entire spectrum of disease all the way up to hyperemesis gravidarum and how to provide care for women experiencing these problems.

Article discussed in this episode:

Treatments for Hyperemesis Gravidarum and Nausea and Vomiting in Pregnancy

Transgender and gender diverse persons may desire gender-affirming medical and surgical treatment that can mitigate psychologic distress and reduce suicide risk. JAMA Associate Editor David L. Simel, MD, MHS, speaks with Andrew M. Davis, MD, MPH, University of Chicago, and Tonia Poteat, PhD, PA-C, MPH, University of North Carolina, Chapel Hill, about the Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 guidelines.

Related Content:

• Standards of Care for Transgender and Gender Diverse People

A JAMA Clinical Guidelines Synopsis summarizes the Endocrine Society’s most recent recommendations on vitamin D supplementation for disease prevention. Author Sherri-Ann M. Burnett-Bowie, MD, MPH, discusses this and more with JAMA Associate Editor David L. Simel, MD, MHS.

Related Content:

• Vitamin D for Prevention of Disease

Tim Uyeki, MD, chief medical officer for the Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), discusses how the COVID-19 pandemic may affect the 2020-2021 influenza season.

Related Article(s):

Preparing for the 2020-2021 Influenza Season

The Platelet Inhibition and Patient Outcomes (PLATO) trial showed that ticagrelor had better outcomes than clopidogrel for avoiding thrombotic complications following acute coronary syndrome. Subsequent trials suggested that the outcomes for the drugs were about the same. The effects of ticagrelor and clopidogrel were examined in a very large observational study performed by Harlan Krumholz, MD, and colleagues, published in the October 27, 2020, issue of JAMA. Dr Krumholz explains how his study was performed and what it showed.

Related Article:

Association of Ticagrelor vs Clopidogrel With Net Adverse Clinical Events in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

ohdsi.org

JAMA Deputy Editor Mary McDermott, MD, and JAMA Deputy Editor Kristin Walter, MD, MS, highlight their selections of top JAMA 2024 Clinical Reviews podcasts.

Related Content:

• Dialysis for Chronic Kidney Failure (podcast)
• Diagnosis and Treatment of Community-Acquired Pneumonia (CAP) (podcast)
• Obesity Medications (podcast)
• Dialysis for Chronic Kidney Failure
• Community-Acquired Pneumonia
• Medications for Obesity

Persistent diarrhea is a poorly recognized syndrome in all populations that requires proper assessment and diagnosis to ensure that affected individuals receive the treatment needed to experience improvement of clinical symptoms. Listen to Drs Herbert DuPont and Annie Feagins discuss how to diagnose and treat diarrhea. Related article: Persistent Diarrhea

Venous thromboembolic disease is common. There are many steps necessary to establish a diagnosis or treat this disease. These are summarized in this JAMA Clinical Reviews podcast and interview with Philip S. Wells, MD, from the Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada, and author of a recent JAMA review on the topic.

IgE-mediated food allergies can be life-threatening. JAMA Associate Editor David Simel, MD, MHS, discusses prevention and management of severe food allergies with authors Onyinye I. Iweala, MD, PhD, and Yamini V. Virkud, MD, of the University of North Carolina, Chapel Hill.

Related Content:

• Management of Food Allergies and Food-Related Anaphylaxis

Dislocated hips in newborns can lead to complex surgery, interruption to family life, and premature osteoarthritis. Daniel Perry, MBChb(Hons), PhD, of Alder Hey Children's Hospital, University of Liverpool, discusses the clinical diagnosis of dislocated hips in newborns with JAMA Associate Editor David Simel, MD, MHS.

Related Content:

• Does This Infant Have a Dislocated Hip?

During the transition to menopause, approximately 50%-75% of individuals experience vasomotor or genitourinary symptoms. JAMA Senior Editor Linda Brubaker, MD, and Carolyn Crandall MD, MS, of the University of California, Los Angeles, discuss hormonal and nonhormonal therapy for treatment of menopausal symptoms.

Related Content:

• Management of Menopausal Symptoms

The new American College of Gastroenterology guideline on ulcerative colitis is discussed by one of its authors, David T. Rubin, MD, from the Inflammatory Bowel Disease Center at the University of Chicago, and Maylyn Martinez, MD, also from the University of Chicago.

Related Article(s):

Ulcerative Colitis in Adults

On March 15, 2019, a lone gunman walked into 2 mosques within minutes of each other in Christchurch, New Zealand, and opened fire with semiautomatic weapons, killing 51 and wounding many more. We spoke to Greg Robertson, MB ChB, the surgeon who coordinated the medical response to this mass casualty event. Robertson talks about what his hospital had to do to manage all these casualties and also how New Zealand quickly changed its laws to restrict the availability of weapons used for these sorts of attacks.

In 2015, JAMA published results of a randomized clinical trial showing that antibiotic treatment for acute appendicitis was feasible. Doubters of the efficacy of antibiotics for treating appendicitis were concerned about what the long-term recurrence rate would be for those patients treated without surgery. The 5-year results of the study are now presented, showing that only about 40% of patients treated with antibiotics ultimately go on to have an appendectomy.

Read the article: Five-Year Follow-up of Antibiotic Therapy for Uncomplicated Acute Appendicitis in the APPAC Randomized Clinical Trial

JAMA Associate Editor Preeti Malani, MD, MSJ, discusses the transmission, diagnosis, and treatment of monkeypox and the 2022 outbreak with Jeannette Guarner, MD, and Carlos del Rio, MD, both of the Division of Infectious Diseases at Emory University’s School of Medicine. Recorded July 11, 2022.

Related Content:

• Monkeypox in 2022—What Clinicians Need to Know
• What Is Monkeypox?
• What to Know About Monkeypox
• Global Monkeypox Outbreaks Spur Drug Research for the Neglected Disease
• The WHO Declaration of Monkeypox as a Global Public Health Emergency
• Update on the Monkeypox Outbreak
• Update on Monkeypox (podcast)

E-values are a new tool that enables investigators to estimate the likelihood that some unmeasured confounder might overcome seemingly positive results. They are very easy to calculate and any reader of the medical literature can do this calculation to get a sense for how likely it is that there is some unmeasured factor in an observational study that might negate otherwise seemingly positive findings.

Read the article: Using the E-Value to Assess the Potential Effect of Unmeasured Confounding in Observational Studies

E-Value Calculator

Approximately one-third of all medical school graduates report having been abused as students. Medical student and resident abuse has long been considered unacceptable behavior but still persists in the teaching environment. In this podcast we discuss how students and residents might respond to these events. We interview Geoffrey Young, MD, from the Association of American Medical Colleges and Thomas J. Nasca, MD, from the Accreditation Council for Graduate Medical Education, who discuss how they expect medical schools to respond to abusive behaviors and what resources are available to students and residents who have been abused to report those experiences without fearing retribution.

Article discussed in this episode:

Medical Student Mistreatment

JAMA Deputy Editor Ed Livingston, MD, interviews Akshay Desai, MD, at the European Society of Cardiology's 2019 conference in Paris, France.

The US is a global leader in introducing new medical products, but the ability to generate evidence to inform clinical practice in postmarket settings must improve. Insurers may have an important role to play. Robert M. Califf, MD, of the US Food and Drug Administration, discusses why and how payers could support evidence generation with JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS.

Related Content:

• Why Evidence Generation Should Matter to Payers and How They Can Help

Allergy to penicillin is one of the most commonly reported allergies by patients. In reality, true penicillin allergy is uncommon. Dr. Elizabeth Phillips from Vanderbilt University discusses her experience with testing for penicillin allergy in patients who thought they had this problem.

Interview with Katrina E. Donahue, MD, MPH, USPSTF member and coauthor of Screening for Skin Cancer: US Preventive Services Task Force Recommendation Statement. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS.

Related Content:

• Skin Cancer Screening
• Screening and Prevention of Skin Cancer
• Screening for Skin Cancer
• What Is Mohs Surgery?
• Skin Cancer Screening

Breast cancer outcomes continue to improve. Treatments for the disease are very effective and continually evolving. We spoke with Patricia A. Ganz, MD, from UCLA about what is new in breast cancer treatment.

Read the article here.

There are new findings about another form of Borrelia: Borrelia miyamotoi. This form of Borrelia causes a relapsing fever but is spread in the same way that Lyme disease is. To help understand these new findings we spoke with Eugene Shapiro, MD, from the Department of Pediatrics and Department of Epidemiology of Microbial Diseases at Yale.

Maternal mortality rates in most of the United States are high. These rates were successfully lowered in the United Kingdom and also in California. Many of these deaths are preventable. In this podcast we interview Elizabeth A. Howell, MD, MPP, from the Icahn School of Medicine at Mt Sinai in New York, who explains the relatively simple ways to address this problem.

See related article.

The incidence of thyroid cancer is increasing. Like so many cancers, it is being diagnosed at earlier stages because of more aggressive screening and diagnostic testing. The aggressiveness of very early stage thyroid cancer is unknown and some of these tumors may be managed by active surveillance instead of surgery. In this podcast, Dr Sally Carty, Professor of Surgery at the University of Pittsburgh, reviews how to manage thyroid cancer.

Natural History and Tumor Volume Kinetics of Papillary Thyroid Cancers

Patient-Guided Decision Making in Papillary Thyroid Cancer

Active Surveillance for Thyroid Cancer

Interview with John M. Ruiz, PhD, USPSTF member and coauthor of Screening and Preventive Interventions for Oral Health in Children and Adolescents Aged 5 to 17 Years, and Screening and Preventive Interventions for Oral Health in Adults: US Preventive Services Task Force Recommendation Statements. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS.

Related Content:

• Screening, Referral, Behavioral Counseling, and Preventive Interventions for Oral Health in Children and Adolescents Aged 5 to 17 Years
• Screening and Preventive Interventions for Oral Health in Children and Adolescents Aged 5 to 17 Years
• Screening and Preventive Interventions for Oral Health in Adults
• A Call for More Oral Health Research in Primary Care
• Dental Caries in Adults, Adolescents, and Children
• Screening, Referral, Behavioral Counseling, and Preventive Interventions for Oral Health in Adults

Acute respiratory disease syndrome is characterized by respiratory failure that occurs after someone is acutely ill, usually from a disease that does not primarily involve the lungs. Its cause, diagnosis, and treatment are reviewed in this JAMA Clinical Reviews Podcast for the February 20, 2018 issue

COPD is common enough that it is responsible for 3% of all clinic visits in the United States. Clinicians will undoubtedly deal with this disease in their practice. How to diagnose and manage it is reviewed by Frank C. Sciurba, MD, a professor of medicine from the University of Pittsburgh, Pennsylvania.

Next-generation sequencing is a catchall term for new, high-throughput technologies that allow rapid sequencing of a full genome. It can be used to sequence a patient’s DNA in diagnosing a genetic disorder or characterizing a cancer, but can also be used to sequence the genome of a pathogenic bacteria, virus, fungi, or parasites. In this JAMA clinical review podcast, we talk with authors Marta Gwinn, MD, MPH, and Gregory L. Armstrong, MD, from the CDC, about how next-generation sequencing of infectious pathogens is being implemented in clinical practice and in public health surveillance for infectious disease.

Carpal tunnel syndrome and trigger finger are common hand conditions in primary care practice that are associated with pain and disability. In this JAMA podcast, JAMA Deputy Editor Mary M. McDermott, MD, and Kelly Currie, MD, assistant professor in the Washington University Division of Plastic & Reconstructive Surgery in St Louis, Missouri, discuss the diagnosis and treatment of these conditions and other hand problems that are commonly encountered in primary care.

Related Content:

Common Hand Conditions

Patient Information: Carpal Tunnel Syndrome

Bleeding is one of the most common preventable causes of death. It is common, yet most people don't know what to do about it when they see it. The Stop the Bleed campaign is an effort to educate the public should they encounter people who are bleeding. Simple maneuvers can have a great beneficial effect. In this JAMA Clinical Reviews podcast, we hear from people with substantial experience in managing bleeding in the field and what they recommend for managing this otherwise deadly problem.

Read the article: Stop the Bleeding: Educating the Public

In the 13 years since the American Thoracic Society and Infectious Diseases Society of America have issued guidelines for the treatment of community-acquired pneumonia much has changed, resulting in a new guideline with 16 major recommendations. These are reviewed by Maylyn Martinez, MD, from the Department of Medicine at the University of Chicago and JAMA Network Open Associate Editor Angel Desai, MD, from the Department of Medicine at the University of California at Davis.

Related Article:

Diagnosis and Treatment of Adults With Community-Acquired Pneumonia

Recognizing a potentially difficult intubation can help clinicians prepare for complications by getting assistance from colleagues with airway training and by ensuring advanced airway management equipment is available. Michael E. Detsky, MD, MSHP, assistant professor of medicine at the University of Toronto and the Mount Sinai Health System, discusses findings from a Rational Clinical Examination systematic review identifying physical findings and risk factors that can help predict difficult endotracheal intubation.

Related Content:

• Will This Patient Be Difficult to Intubate? The Rational Clinical Examination Systematic Review
• Will This Patient Be Difficult to Intubate? (video)

In 2017 the Society for Critical Care Medicine updated its guidelines for sepsis management. These new guidelines differ significantly from ones in the past in that they no longer recommend protocolized resuscitation and emphasize early and aggressive fluid resuscitation when patients present with septic shock. This is the first podcast in the Surviving Sepsis guideline series. The next episode discusses why the new sepsis guideline changed.

Article discussed in this episode: Management of Sepsis and Septic Shock

Speakers:

Laura Evans, MD, MSc, of Bellevue Hospital and NYU Medical Center

Andrew Rhodes, MBBS, MD, of St George’s University Hospitals NHS Trust and co-chair of the Surviving Sepsis guideline panel

Mitchell M. Levy, MD, of the Alpert Medical School of Brown University and Rhode Island Hospital

Dry mouth, oral candidiasis, and recurrent aphthous ulcers are common oral conditions that may be associated with patient discomfort, decreased quality of life, and in some cases, morbidity. Author Eric T. Stoopler, DMD, of Penn Dental Medicine, discusses these 3 common oral conditions with JAMA Associate Editor David L. Simel, MD, MHS.

Related Content:

• Common Oral Conditions

Irritable bowel syndrome (IBS) is a clinical syndrome of vague abdominal pain and cramping associated with diarrhea or constipation. IBS is a diagnosis of exclusion, and a variety of treatments can improve its symptoms. Michael Camilleri, MD, professor of medicine at the Mayo Clinic, discusses recent advances in the diagnosis and management of IBS.

Related Content:

Diagnosis and Treatment of Irritable Bowel Syndrome

Community acquired pneumonia accounts for 600,000 hospital admissions a year. Many patients with this disease are quite ill and have a very high mortality. To save lives, the appropriate antibiotics should be given in a timely basis, but it is not clear what the best antibiotics are and how long they should be given. In this podcast we interview the author of a JAMA review on community acquired pneumonia, Dr Jonathan Lee, author of Antibiotic Therapy for Adults Hospitalized With Community-Acquired Pneumonia, who performed a systematic review of the literature to determine the best way to treat community acquired pneumonia.

Interview with Kevin P. Hill, MD, MHS, author of Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems: A Clinical Review, and Deepak Cyril D'Souza, MBBS, MD, author of Medical Marijuana: Is the Cart Before the Horse?

Out-of-hospital cardiac arrest in apparently healthy adults younger than 40 years ranges from 4 to 14 per 100 000 person-years worldwide. Among young adults who have had cardiac arrest outside of a hospital, only 9% to 16% survive to hospital discharge. Author Zian Tseng, MD, MAS, University of California, San Francisco, discusses this and more with JAMA Associate Editor David L. Simel, MD, MHS.

Related Content:

• Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults

What are the common signs and symptoms of celiac disease and how is this disease diagnosed and managed? Author Kerstin Austin, MD, from the University of Wisconsin-Madison, discusses this and more with JAMA Associate Editor David L. Simel, MD, MHS.

Related Content:

• Diagnosis and Management of Celiac Disease

In 2003, Toronto was the North American center for Severe Acute Respiratory Syndrome (SARS). The disease spread through the city’s hospitals before anyone knew what was happening. Dr Allison McGeer was a clinician caring for SARS patients and ultimately was infected herself. She describes her experience as a patient and provider and reviews lessons learned that might help others manage their regional COVID-19 outbreaks.

Related:

Supporting the Health Care Workforce During the COVID-19 Global Epidemic

Chronic kidney disease develops among 30% to 40% of people with type 1 or type 2 diabetes during their lifetime. Author Ian H. de Boer, MD, MS, of the University of Washington Division of Nephrology, discusses the evaluation and treatment of chronic kidney disease in patients with type 1 and type 2 diabetes with JAMA Senior Editor Karen Lasser, MD, MPH.

Related Content:

• Diabetes and Chronic Kidney Disease

George F. Sawaya, MD, professor of obstetrics and gynecology at the University of California, San Francisco, discusses cervical cancer screening in the modern era.

Read the article: Cervical Cancer Screening: More Choices in 2019

Read the transcript

An increasing number of transgender patients are being seen in all care settings. Their medical needs are not too different from those for any primary care patient. New guidelines issued by the Endocrine Society in September 2017 are summarized in this podcast.

Approximately 9% of US adults experience major depression each year, with lifetime prevalence nearly 17% for men and 30% for women. Effective first-line depression treatments include forms of psychotherapy and medication. Close monitoring significantly improves likelihood of treatment success. Gregory E. Simon, MD, MPH, discusses depression treatment with JAMA Senior Editor Karen E. Lasser, MD, MPH.

Related Content:

• Management of Depression in Adults

Barbra Streisand and Noel Bairey Merz, MD, director of the Streisand Women’s Heart Center at Cedars-Sinai in Los Angeles, California, discuss the problem of cardiovascular disease in women and especially coronary microvascular disease, which causes an unusual presentation of cardiac ischemic disease in women.

In November 2017, new guidelines were issued for hypertension treatment. They are a comprehensive overhaul of recommendations for both the diagnosis and treatment of hypertension. Last week, we discussed the guidelines' specific recommendations with Dr Paul Whelton, professor of medicine at Tulane University, who chaired the guidelines-writing committee. We also spoke to Dr Phil Greenland from Northwestern University, who is one of the cardiology editors for JAMA. This week, in part 2 of this podcast, we discuss the controversies associated with the new hypertension guidelines.

Related articles: The 2017 Clinical Practice Guideline for High Blood Pressure Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults The New 2017 ACC/AHA Guidelines “Up the Pressure” on Diagnosis and Treatment of Hypertension

Lumbar spinal stenosis is a common cause of low back pain and disability in older people. Both nonoperative and operative therapies can improve symptoms from spinal stenosis. In this podcast, Jeffrey Katz, MD, MSc, from Harvard Medical School joins JAMA Deputy Editor Mary M. McDermott, MD, to discuss current evidence regarding diagnosis and optimal treatment of lumbar spinal stenosis, including when to consider invasive therapies for patients with symptoms of lumbar spinal stenosis.

Related Content:

Diagnosis and Management of Lumbar Spinal Stenosis

Within the last 2 years, major guidelines have been issued from US-based and European organizations that differ in their recommendations for the diagnosis and treatment of hypertension. Experts from both sides of the Atlantic--Paul Whelton, MD, from the United States and Bryan Williams, MD, from Europe--discuss the similarities and differences in these guidelines and the basis for the differences. They were interviewed by JAMA editors Greg Curfman, MD, and Ed Livingston, MD. Part 1 [LINK] of this 2-part series, reviewed the similarities between the 2 guidelines and discussed issues regarding how to best treat hypertension in elderly individuals. In this Part 2 episode, the differences between the guidelines are reviewed and how clinicians should use this information to treat patients is presented. See also the JAMA website on hypertension guidelines at https://sites.jamanetwork.com/jnc8/.

Alcoholic liver disease is increasing in incidence, especially in younger age groups. Ashwani Singal, MD, MS, professor of medicine at University of South Dakota, reviews the diagnosis, clinical presentation, and management of alcoholic liver disease, from acute alcoholic hepatitis to cirrhosis.

Related Content:

Diagnosis and Treatment of Alcohol-Associated Liver Disease

Although coronavirus disease 2019 (COVID-19) dominates the news in early 2020, it affects few people in the US. In contrast, at the same time the US is experiencing a severe influenza epidemic, which has caused an estimated 250 000 hospitalizations and 14 000 deaths. Timothy Uyeki, MD, lead for the CDC’s 2019 novel coronavirus response team and Chief Medical Officer of CDC’s influenza division, discusses influenza in the US, how it compares to coronavirus, and what both patients and clinicians should know about this year’s flu season.

CDC's Influenza site

CDC's Weekly U.S. Influenza Surveillance Report

HealthMap Vaccine Finder

There are now 36 states and recent federal legislation that require that clinicians inform women about breast density results from mammography. Consequently, clinicians must be aware of the clinical ramifications of dense breasts and what to do about them when found. Karla Kerlikowske, MD, from UCSF explains the risks associated with dense breasts and how to manage patients who have them. CME will be available on July 2 when the print/online issue of JAMA is published.

Mitchell Katz, MD, president and chief executive officer of New York City Health + Hospitals, and former Los Angeles County health agency director, discusses causes, similarities, and differences between the spike of COVID-19 cases, hospitalizations, and deaths in the 2 cities.

Related Article:

Modernize Medical Licensing, and Credentialing, Too—Lessons From the COVID-19 Pandemic

Interview with John B. Wong, MD, USPSTF member and coauthor of USPSTF Recommendation: Screening for Hypertension in Adults

Related Content:

• Screening for Hypertension in Adults
• The 2021 USPSTF Recommendation on Blood Pressure Screening
• USPSTF Recommendation: Screening for Hypertension in Adults
• USPSTF Recommendation Statement on Hypertension Screening in Adults
• Hypertension Screening Recommendation and Racial/Ethnic Disparities in Blood Pressure Control
• USPSTF Recommendations for Screening for Hypertension in Adults
• Patient Information: Screening for Hypertension in Adults
• The Surgeon General's Call to Action to Control Hypertension
• Hypertension, Obesity, and COVID-19

Minor head trauma usually does not cause significant brain injury. To be safe, clinicians often obtain head CT scans to ensure no major injury is present. For minor head trauma (Glascow coma scale 13-15), the risk to benefit ratio for head CT is usually not in favor of getting CT scans. When the Canadian head CT rule or New Orleans Criteria are negative, there is a very small risk for missing a significant brain injury. Joshua Easter, MD from the Department of Emergency Medicine at the University of Virginia who authored a JAMA Rational Clinical Examination article on this topic is interviewed as is Frederick Rivara, from the Department of Pediatrics at the University of Washington who wrote an accompanying editorial. Michelle Mello, a Law Professor at Stanford, discusses the medical liability associated with not obtaining neuroimaging for minor head trauma.

Philip Cohen, MD, associate clinical professor of internal medicine at UCLA, a primary care internist who also specializes in sports medicine, discusses the primary care management of osteoarthritis.

Related Articles:

• Drugs for Osteoarthritis
• Diagnosis and Treatment of Hip and Knee Osteoarthritis

Peripheral neuropathy is a highly prevalent and morbid condition affecting 2% to 7% of the population. Patients frequently experience pain and are at risk of falls, ulcerations, and amputations. It is most commonly occurs in patients with diabetes. For most cases, the diagnosis and treatment of neuropathy can be made without complex testing or referral to specialists. Drs. Eva Feldman and Brian Callaghan from the University of Michigan Department of Neurology, authors of Distal Symmetric Polyneuropathy and Electrodiagnostic Tests in Polyneuropathy and Radiculopathy, explain how to manage neuropathy.

Shyam Prabhakaran, MD, chairman of neurology at the University of Chicago, discusses the diagnosis and evaluation of patients who present with transient ischemic attack (TIA) and stroke.

Related Article:

Diagnosis and Management of Transient Ischemic Attack and Acute Ischemic Stroke

Interstitial lung disease (ILD), characterized by inflammation and fibrosis of the lungs, is associated with progressive dyspnea and results in approximately 25 000 to 30 000 deaths in the US each year. Toby M. Maher, MD, MSc, PhD, of Keck Medicine of USC, discusses the diagnosis and management of ILD with JAMA Deputy Editor Mary McGrae McDermott, MD.

Related Content:

• Interstitial Lung Disease

Chromosomal microarray technology (CMA) facilitates the genetic diagnosis of intellectual disabilities, autism spectrum disorder, and congenital abnormalities in children. Previously, G-band karyotyping was the test performed for this purpose but it could only identify very large chromosomal abnormalities and was not very sensitive. Being a molecular rather than microscopic technique, CMA is far more sensitive for identifying genetic abnormalities and is now the test of choice.

We interview David H. Ledbetter, MD, and Christa Lese Martin, PhD, from Geisinger Health System, authors of this JAMA Insights article.

Articles discussed in this episode:

Chromosomal Microarray Testing for Children With Unexplained Neurodevelopmental Disorders

New Approaches to Molecular Diagnosis

When managing septic shock, passive leg raising is the best test to determine if a patient is likely to respond to a fluid bolus, better than CVP lines or even bedside ultrasound. Dr Najib Ayas, Associate professor of Critical Care Medicine at the University of British Columbia, discusses shock management from the context of his Rational Clinical examination article in the September 27, 2016 issue of JAMA, entitled “Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids?”

Interview with John B. Wong, MD, USPSTF member and coauthor of Preexposure Prophylaxis to Prevent Acquisition of HIV: US Preventive Services Task Force Recommendation Statement. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS.

Related Content:

• Preexposure Prophylaxis for the Prevention of HIV
• New USPSTF Guidelines for HIV Preexposure Prophylaxis
• Preexposure Prophylaxis to Prevent Acquisition of HIV
• Preventing HIV With PrEP

JAMA Deputy Editor Ed Livingston, MD, interviews Steven Nissen, MD, at the European Society of Cardiology's 2019 conference in Paris, France.

Chronic pelvic pain is a challenging condition that affects an estimated 26% of the world’s female population. JAMA Associate Editor Linda Brubaker, MD, and Georgine Lamvu, MD, of the University of Central Florida, discuss recommendations from consensus guidelines intended to improve the care of women with chronic pelvic pain and to facilitate positive clinical experiences for them.

Related Articles:

• Chronic Pelvic Pain in Women
• I Have Chronic Pelvic Pain: What Should I Know?

JAMA Fishbein Fellow Kristin Walter, MD, interviews Craig Garfield, MD and Richard Weissbourd, EdD, about parental relationships during the COVID-19 pandemic.

Related Article(s):

Considerations for Young Children and Those With Special Needs as COVID-19 Continues

Physicians who act out cause all sorts of problems. Fortunately, only a few clinicians have behavior problems and in the modern era, bad behaviors are not tolerated. Bad behaviors get reported these days and actions are taken against these sorts of clinicians. Clinicians who act out frequently say they are doing so to protect their patients. But are they? William Cooper, MD, MPH, and Gerald B. Hickson, MD, from Vanderbilt University Medical Center in Nashville, Tennessee, discuss a study they published in relating bad behaviors to having more complications of surgical care.

Related article:

Association of Coworker Reports About Unprofessional Behavior by Surgeons With Surgical Complications in Their Patients

In the US, approximately 100 000 people have sickle cell disease, a chronic condition characterized by hemolytic anemia, acute and chronic pain, increased rates of stroke and nephropathy, and an average lifespan that is 20 years less than that of the general population. In this podcast, JAMA Deputy Editor Mary McDermott, MD, interviews review article author Patricia Kavanaugh, MD, on the diagnosis and management of sickle cell disease. Discussion includes a summary of 3 new therapies for sickle cell disease and some of the social, structural, and cultural challenges encountered by patients with sickle cell disease.

Related Content:

Sickle Cell Disease

Vasomotor symptoms are common during menopause and may have substantial negative effects on quality of life. JAMA Senior Editor Linda Brubaker, MD, MS, discusses nonhormonal therapies for menopausal vasomotor symptoms with Susan D. Reed, MD, MPH, MS, professor emeritus at the University of Washington and president and CEO of The North American Menopause Society.

Related Content:

• Nonhormonal Therapies for Menopausal Vasomotor Symptoms

Chronic myeloid leukemia is a myeloproliferative neoplasm that affects approximately 5 million people worldwide. Tyrosine kinase inhibitors, such as imatinib, have substantially improved survival in patients with chronic myeloid leukemia. In this podcast, author Elias J. Jabbour, MD, of the University of Texas MD Anderson Cancer Center, discusses diagnosis and treatment of chronic myeloid leukemia with JAMA Deputy Editor Mary McDermott, MD.

Related Content:

• Chronic Myeloid Leukemia

Hyperthyroidism affects 2.5% of adults worldwide and, if untreated, is associated with osteoporosis, heart rhythm abnormalities, heart failure, and increased mortality. JAMA Associate Editor Anne Cappola, MD, speaks with Elizabeth N. Pearce, MD, MSc, of Boston University, about the most common causes, symptoms, and first-line treatments for hyperthyroidism.

Related Content:

• Hyperthyroidism

Interview with Vanessa Northington Gamble, MD, PhD, author of Dr Herman A. Barnett, Black Civil Rights Activists, and the Desegregation of The University of Texas Medical Branch in 1949: “We Ought to Go in Texas and I Don’t Mean to a Segregated Medical School.” Hosted by Robert Steinbrook, MD, and Raegan W. Durant, MD, MPH.

Related Content:

• Dr Herman A. Barnett, Black Civil Rights Activists, and the Desegregation of The University of Texas Medical Branch in 1949

Allogeneic stem cell transplantation is a potentially life-saving therapy for some patients with hematologic and bone marrow cancers and certain nonmalignant conditions such as sickle cell disease. Hermioni L. Amonoo, MD, MPP, MPH, of Harvard Medical School and Dana-Farber Cancer Institute, joins JAMA Deputy Editor Kristin Walter, MD, MS, to discuss the process of allogeneic stem cell donation.

Related Content:

• Allogeneic Stem Cell Donation

Accumulating evidence in adults has shown that nonoperative treatment of appendicitis is an acceptable means for treatment. A recent prospective study published in JAMA has shown the same is true for children. Most children who are treated with antibiotics instead of surgery for appendicitis do just fine. The lead author for this study, Peter Minneci, MD, from the Nationwide Children’s Hospital of the Ohio State Medical School, discusses his work in investigating alternative ways to treat appendicitis.

Related Article:

Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated Appendicitis

Hyponatremia affects approximately 5% of adults and approximately 35% of hospitalized patients. Even mild hyponatremia can be associated with cognitive impairment; in hospitalized patients, hyponatremia is associated with longer hospital stays and increased mortality. In this podcast, JAMA Deputy Editor Mary M. McDermott, MD, interviews Nicolaos E. Madias, MD, a nephrologist and professor of medicine at Tufts University School of Medicine, about the clinical approach to diagnosing hyponatremia and management of both acute and chronic hyponatremia.

Related Content:

Diagnosis and Management of Hyponatremia

A major study recently published in JAMA showed that many children who have appendicitis do not need surgery and, if they undergo surgery, may have more disability than if they were treated with antibiotics alone. JAMA Clinical Reviews spoke with a patient in the study whose mother happens to be JAMA Associate Editor Preeti Malani, MD, JAMA’s infectious diseases editor and chief health officer for the University of Michigan. This patient initially was treated with antibiotics, later required appendectomy, and discussed the difficulties he experienced following laparoscopic appendectomy.

Related Article:

Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated Appendicitis

Community-acquired pneumonia is associated with approximately 740 000 hospitalizations and 41 000 deaths in the US annually. JAMA Review authors Scott A. Flanders, MD, and Valerie M. Vaughn, MD, MSc, discuss diagnosis and treatment of community-acquired pneumonia with JAMA Deputy Editor Mary McGrae McDermott, MD.

Related Content:

• Community-Acquired Pneumonia

About 1.2% of people in the United States will be diagnosed with thyroid cancer at some point during their lifetime. JAMA Senior Editor Karen E. Lasser, MD, MPH, speaks with author Laura Boucai, MD, associate professor of Medicine at the Weill Cornell Medical College and Memorial Sloan Kettering Cancer Center about thyroid cancer.

Related Content:

• Thyroid Cancer

Multiple myeloma is a hematologic malignancy characterized by abnormal plasma cells in the bone marrow, with potential uncontrolled growth causing destructive bone lesions, kidney injury, anemia, and hypercalcemia. Edward Libby, MD, of the University of Washington, joins JAMA Associate Editor Ethan Basch, MD, of the University of North Carolina, for a discussion of the diagnosis, complications, and management of myeloma, as well as the related conditions of monoclonal gammopathy of undetermined significance (MGUS) and smoldering myeloma.

Related Content:

• Diagnosis and Management of Multiple Myeloma
• Patient Information: Multiple Myeloma

Malignant primary brain tumors cause more than 15 000 deaths annually in the US. JAMA Fishbein Fellow Revital Marcus, MD, interviews Ingo Mellinghoff, MD, PhD, neuro-oncologist and chair of the department of neurology at Memorial Sloan Kettering Cancer Center in New York, about the epidemiology, diagnosis, and treatment of various primary malignant brain tumors in adults.

Related Content:

• Glioblastoma and Other Primary Brain Malignancies in Adults