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 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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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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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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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The podcast on structural racism based on the discussion between Dr Ed Livingston and Dr Mitch Katz has been withdrawn.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.
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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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
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.
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Next-Generation Sequencing of Infectious Pathogens
Podcast originally published 2/14/19.
Tom Shimabukuro, MD, MPH, MBA, and Sara Mbaeyi, MD, MPH, from the CDC discuss rare allergic complications in patients who received the first dose of the Pfizer-BioNTech vaccine between December 14-23, 2020.
Patent foramen ovale (PFO) is an often overlooked cause of acute ischemic stroke. JAMA Associate Editor Jeffrey Saver, MD, professor of neurology at UCLA, discusses new recommendations from a 2020 AAN Practice Advisory about use of mechanical PFO closure and anticoagulant vs antiplatelet therapy to prevent subsequent strokes in patients with a PFO and an initial event.
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Management of Patients With a Patent Foramen Ovale With History of Stroke or TIA
New therapies have greatly improved outcomes for patients with Crohn disease. Peter Higgins, MD, from the University of Michigan, discusses advances in management and treatment protocols.
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Management of Crohn Disease
Adam Lauring, MD, PhD, from the University of Michigan Division of Infectious Diseases, an expert on the evolutionary biology of RNA viruses, explains the new genetic variants recently found in SARS-CoV-2 and their importance.
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Genetic Variants of SARS-CoV-2—What Do They Mean?
Elderly persons and residents of nursing homes have been the hardest hit in the COVID-19 pandemic. Harvard geriatrician Sharon Inouye, MD, discusses the effect COVID-19 has had on nursing homes and what should be done about it.
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Homeless patients with chronic medical conditions who need long-term care often repeatedly present to emergency departments to receive treatment. Following a performance improvement analysis, clinicians at UCSF developed an emergency department–based team who work with the community to provide care for this challenging population. Hemal Kanzaria, MD, and Jack Chase, MD, discuss how UCSF has addressed this clinical problem.
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Caring for Emergency Department Patients With Complex Medical, Behavioral Health, and Social Needs
JAMA Fishbein Fellow Kristin Walter, MD, interviews Craig Garfield, MD and Richard Weissbourd, EdD, about parental relationships during the COVID-19 pandemic.
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Considerations for Young Children and Those With Special Needs as COVID-19 Continues
Lockdowns resulting from COVID-19 have had a devastating effect on everyone’s personal lives and the economy. What factors in people’s daily lives are most associated with SARS-CoV-2 transmission between people? Manish Patel, MD, team lead of the CDC’s Influenza Prevention & Control Team, discusses a study they conducted examining what sorts of activities might be associated with COVID-19 disease transmission.
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Community Outbreak Investigation of SARS-CoV-2 Transmission Among Bus Riders in Eastern China