Chronic stable angina reduces quality of life and only rarely leads to acute coronary syndrome (ACS). Treatment is lifestyle modification to manage atherosclerotic risk factors, with revascularization (eg, PCI or CABG) indicated to reduce symptoms and improve quality of life only once medical therapy is maximized. James De Lemos, MD, professor of medicine in the division of cardiology at UT Southwestern Medical Center, summarizes these and other aspects of chronic stable angina management.
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Interview with John B. Wong, MD, USPSTF member and coauthor of USPSTF Recommendation: Screening for Hypertension in Adults
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Dual antiplatelet therapy, typically aspirin and an oral P2Y12 receptor inhibitor (clopidogrel, prasugrel, ticagrelor, cangrelor), reduces adverse events after acute coronary syndrome (ACS) but choice of agent and optimal duration may be patient-specific. Umair Khalid, MD, a cardiologist at the Baylor School of Medicine in Houston, discusses how to use these agents in management of ACS.
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Interest in space travel has increased since SpaceX’s first commercial launch to the International Space Station (ISS) in May 2020 and with efforts to send humans to Mars. Serena Auñón-Chancellor, MD, MPH, a physician-astronaut who completed a 6-month mission to the ISS in 2018 and is associate professor of clinical medicine at LSU Health Sciences Center in Baton Rouge and associate program director for the Aerospace Medicine Residency Program at University of Texas Medical Branch (UTMB) in Galveston, discusses how the human body and mind adapt to life in space.
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Space Travel and Human Health, Part 1
Do Apollo Astronaut Deaths Shine a Light on Deep Space Radiation and Cardiovascular Disease?
Association of Structural Changes in the Brain and Retina After Long-Duration Spaceflight
Interest in space travel has increased since SpaceX’s first commercial launch to the International Space Station in May 2020 and with efforts to send humans to Mars. Jim Bagian, MD, a physician-astronaut who logged 337 hours in space between 1989 and 1991, is director of the Center for Healthcare Engineering and Patient Safety at the University of Michigan and discusses the effects of space travel on the human body and physiologic readjustments on return to earth.
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Do Apollo Astronaut Deaths Shine a Light on Deep Space Radiation and Cardiovascular Disease?
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.
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Diagnosis and Management of Transient Ischemic Attack and Acute Ischemic Stroke
Semaglutide has recently been shown to induce clinically significant weight loss in patients with obesity that is sustained for as long as the drug is given. Tom Wadden, PhD, from the University of Pennsylvania, discusses results from the series of recent STEP trials and how they compare to the effects of other medications used to treat obesity.
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Authors have declared conflicts of interest related to the article discussed in this podcast. Visit the article on jama.com for the complete disclosure.
Performing repeated statistical comparisons on data can result in false-positive findings. Jing Cao, PhD, associate professor of statistics at Southern Methodist University, explains problems that can arise from multiple testing procedures and how to avoid making false conclusions.
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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.
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The Pfizer-BioNTech and Moderna COVID-19 mRNA vaccines are the first of many being tested for widespread use. Buddy Creech, MD, MPH, director of the Vanderbilt Vaccine Research Program, reviews these and other vaccines likely to become available, including products that use inactivated, protein subunit, and viral vector immunization strategies.
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Advance directives (ADs) allow patients to express their medical treatment preferences. Patients with ADs are more likely to receive medical care concordant with their wishes and are less likely to die in the hospital than patients without them, but use remains low in the US. Maria Silvera, MD, a palliative care physician and associate professor of medicine at the University of Michigan, and Catherine Auriemma, MD, a fellow in pulmonary/critical care medicine at the University of Pennsylvania, discuss the importance of ADs and strategies to increase their uptake.
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The CDC coordinated a massive effort to immunize nearly all nursing home and long-term care facility residents in the US against COVID-19 infection in the month after vaccine approval. Ruth Link-Gelles, PhD, MPH, CDC staff epidemiologist and Lieutenant Commander of the US Public Health Service Commissioned Corps, describes how.
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This is Dr Howard Bauchner, Editor in Chief of JAMA and the JAMA Network.
The podcast on structural racism based on the discussion between Dr Ed Livingston and Dr Mitch Katz has been withdrawn. Comments made in the podcast were inaccurate, offensive, hurtful, and inconsistent with the standards of JAMA. Racism and structural racism exist in the US and in health care. After careful consideration, I determined that the harms caused by the podcast outweighed any reason for the podcast to remain available on the JAMA Network. I once again apologize for the harms caused by this podcast and the tweet about the podcast. We are instituting changes that will address and prevent such failures from happening again.
Highly effective B-cell therapies like rituximab and ofatumumab have changed the outlook for patients with multiple sclerosis (MS). Alexander Rae-Grant, MD, emeritus professor of neurology at the Cleveland Clinic Lerner College of Medicine, discusses recent advances in the diagnosis and treatment of MS.
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Natural experiments comparing coronavirus spread on ships and in hair salons with vs without face masks point to the importance of wearing masks for curbing SARS-CoV-2 spread. John T. Brooks, MD, chief medical officer of the CDC’s COVID-19 response team, reviews recently published epidemiologic data that reinforce the role of mask use for pandemic control.
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Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2
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.
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Immune checkpoint inhibitors have been a major breakthrough in cancer treatment but can have many serious adverse effects. Pankti Reid, MD, MPH, assistant professor of medicine in rheumatology at the University of Chicago, discusses the pathogenesis, diagnosis, and treatment of toxicities from immune checkpoint inhibitors as outlined by the 2019 NCCN guidelines.
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Howard Reber, MD, emeritus professor of surgery at UCLA, discusses how to treat acute pancreatitis.
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Howard Reber, MD, emeritus professor of surgery at UCLA, discusses how to diagnose acute pancreatitis.
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Ethnic and racial minorities have been particularly hard hit with COVID-19 in some communities. Mitchell Katz, MD, president and chief executive officer of New York City Health + Hospitals, and former Los Angeles County health agency director, discusses this problem and what has been learned from COVID-19 that can help resolve the general problem of health care disparities.
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Tobacco use is the leading cause of preventable disease and death in the world, but most attempts to quit are unsuccessful. Atul Jain, MD, assistant professor of medicine at Mayo College of Medicine, discusses new guidelines from the American Thoracic Society on pharmacologic management of tobacco cessation, including target population and deciding when to initiate.
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Initiating Pharmacologic Treatment in Tobacco-Dependent Adults
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.
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Modernize Medical Licensing, and Credentialing, Too—Lessons From the COVID-19 Pandemic
Glaucoma is the most common cause of irreversible blindness in the world. Joshua Stein, MD, MS, associate professor of ophthalmology at the University of Michigan, reviews the diagnosis and treatment of glaucoma.
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A new trial reports that a third of emergency department patients presenting with appendicitis admitted for oral antibiotic treatment had outcomes no different from those admitted for intravenous antibiotic treatment. Paulina Salminen, MD, PhD, professor of surgery at the University of Turku in Finland, discusses the findings.
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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.
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