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Drug Approved for Rare Muscle Weakening Syndrome

Mar, 22/01/2019 - 01:00
More than 3 decades after its clinical use was first described, amifampridine has received approval for adults with rare, debilitating Lambert-Eaton myasthenic syndrome (LEMS).

Clinical Considerations for Aspirin Use for Primary Prevention in 2019

Mar, 22/01/2019 - 01:00
Reducing platelet activity with aspirin and other antiplatelet agents is an important factor in the prevention and management of atherothrombotic vascular events. For this indication, aspirin has both beneficial and potentially harmful effects; it can diminish or reverse thrombus formation (eg, in the setting of acute myocardial infarction or stroke), but it also increases the risk of bleeding.

Matched-Sibling Stem Cell Transplantation and Stroke in Children With SCA

Mar, 22/01/2019 - 01:00
Stroke is one of the most devastating complications of sickle cell anemia (SCA), and risk of stroke starts very early in life. Before screening techniques were available, 11% of children with homozygous SCA had ischemic stroke by their 20th birthday. Although most children with SCA will have neurologic recovery after stroke, approximately one-third will have long-term neurologic sequelae, including motor impairment. Moreover, children with SCA who have had a stroke often have neurocognitive impairment and difficulties with academic performance.

Addiction 101, in Technicolor

Mar, 22/01/2019 - 01:00
The Arts and Medicine feature reviews the film Beautiful Boy, a dramatization of journalist David Sheff’s 2008 memoir about his son’s descent into methamphetamine addiction and his tentative recovery.

Curbing Unnecessary and Wasted Diagnostic Imaging

Mar, 22/01/2019 - 01:00
In this Viewpoint, Ioannidis and coauthors compare overuse of computed tomography and magnetic resonance image scanning with large-scale haphazard population screening for disease and call for dedicated investigations to understand how to reduce unnecessary and wasteful diagnostic imaging.

Medicaid Expansion After the 2018 US Midterm Election

Mar, 22/01/2019 - 01:00
This Viewpoint discusses the likelihood of Medicaid expansion in Maine, Wisconsin, Utah, and Kansas, where 2018 midterm voters elected candidates supportive of expansion or voted for it in ballot initiatives, and reviews evidence on associations between state Medicaid expansion and improved health outcomes for beneficiaries.

For Women, Sexual Harassment and Assault Is Associated with Poorer Health Years Later

Mar, 22/01/2019 - 01:00
This Medical News article is an interview with Rebecca Thurston, PhD, about her recent study published in JAMA Internal Medicine that found sexual harassment and assault was associated with poorer midlife health in women.

Title X: Moving Forward or Backward on Women’s Health?

Mar, 22/01/2019 - 01:00
Twenty years ago, the Centers for Disease Control and Prevention (CDC) declared family planning and contraception services as 1 of 10 great public health achievements in the United States in the 20th century. Access to contraception is associated with reductions in teen pregnancy rates, improved health outcomes for women and their children, increased educational levels for women, enhanced economic security for women and their families, and other benefits that have led the US Agency for International Development (USAID) to declare family planning as a “best buy” for achieving the United Nations’ Sustainable Development Goals.

Malar Rash and Polyarthritis

Mar, 22/01/2019 - 01:00
A 58-year-old woman had a 2-week history of right knee, right ankle, and bilateral finger joint pain with a facial rash after a febrile illness in her daughter and preschool grandchildren, and an ANA level elevated to 1:160 (homogeneous pattern; negative <1:80 serum dilution. What would you do next?

Friendships Across Cultural Barriers—We Are All the Same

Mar, 22/01/2019 - 01:00
In this narrative medicine essay, a family practitioner tells the story of how her relationship with an old order Mennonite woman whose newborn son she examined and took to the hospital for cardiac surgery one Christmas day turns to friendship and a relationship with her broader community when the woman stays with her during her newborn daughter’s cardiac surgery.

Social Determinants of Health in the Digital Age

Mar, 22/01/2019 - 01:00
In this Viewpoint, Harlan Krumholz and colleagues discuss the promise that social media data hold for helping researchers better understand social determinants of health, and the challenges that must be overcome to reliably link social network data to clinical and health outcomes.

Random-Effects Meta-analysis

Mar, 22/01/2019 - 01:00
This JAMA Guide to Statistics and Methods explains the difference between fixed and random effects in treatment effect estimates, and the rationale for using random-effects meta-analysis to determine treatment effects across randomized trials conducted in heterogeneous patients and settings.

Ebola and War in the Democratic Republic of Congo

Mar, 22/01/2019 - 01:00
In this Viewpoint, Gostin and colleagues review recommendations developed by experts convened by Georgetown University on how the international community can respond to the 2018 Ebola outbreak in the Democratic Republic of Congo (DRC) in the midst of active conflict and insecurity from armed rebels.

Youth e-Cigarette Use

Mar, 15/01/2019 - 01:00
One in 5 high school students and 1 in 20 middle school students reported using e-cigarettes in the past 30 days in 2018, according to data from the CDC’s National Youth Tobacco Survey.

Tickborne Diseases Increasing

Mar, 15/01/2019 - 01:00
A recent data summary from the CDC shows that 2017 was a record-breaking year for tickborne diseases in the United States. Officials are also concerned about the arrival of a prolific species of disease-carrying tick.

JAMA

Mar, 15/01/2019 - 01:00

Evaluation and Management of Penicillin Allergy

Mar, 15/01/2019 - 01:00
This narrative review summarizes the epidemiology of penicillin allergy and the clinical consequences of misattributing adverse drug events to ?-lactam allergy, including development of antimicrobial resistance and adverse events associated with alternative antibiotics, and proposes an algorithm to facilitate evaluation of true penicillin allergy.

The Unicorn of Health Care: Black Male Physician

Mar, 15/01/2019 - 01:00
In this narrative medicine essay, a black physician relates the surprise and joy a black patient has when a he meets a black doctor in the examination room and comments on the need for medical schools to step up recruitment and training of a diverse physician workforce.

At the Line in the Sand, On the Bridge in the Rain, On The Borders That Do Not Exist

Mar, 15/01/2019 - 01:00
I have closed the book of my mind.Sometimes it is the only way to readsounds, air, light, the memories of rainand wind, the touch of rocks climbingand pools of water forming and drying.

Am I Allergic to Penicillin?

Mar, 15/01/2019 - 01:00
This JAMA Patient Page describes evaluation for and diagnosis of penicillin allergy.

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