This study screens more than 50 000 youths in diverse populations of Colorado and Bavaria to assess whether previous SARS-CoV-2 infection was associated with autoimmunity, which predicts future type 1 diabetes.
This observational follow-up study of patients from the MOMENTUM 3 randomized trial compares outcomes and overall survival in individuals who received a fully magnetically levitated centrifugal-flow vs an axial-flow left ventricular assist device.
Workplace COVID-19 outbreaks were about 5 times more common and nearly twice as deadly in the bus and urban transit industry than all industries combined in California, found an analysis led by the California Department of Public Health.
An investigation by CDC and state health authorities in Utah found monkeypox virus on many frequently used household surfaces, blankets, furniture, and other objects in a home where residents had been isolating for weeks. Although monkeypox is mainly spread through skin-to-skin contact in the current outbreak, the authors noted that “transmission via contaminated objects or surfaces is also possible.”
This Viewpoint reports the disproportionate rate of firearm-related deaths in US Black communities; emphasizes the urgency of addressing this issue; and details the causes of these deaths in the context of community, law enforcement, and in custody.
This Viewpoint discusses the history and current status of assault weapons bans in the US, provides evidence of the potential effectiveness of a US ban and information regarding the Australian ban, and explores potential next steps.
This Viewpoint summarizes current data on firearm injuries in the US, discusses the limitations of available data sources, and proposes measures for a comprehensive system to track firearm injury and death
This Viewpoint highlights the challenges to passing federal legislation that limits gun ownership and accessibility and summarizes some of the state laws used to successfully lower rates of firearm-related death and injury.
This Viewpoint discusses homicide rates among American Indian and Alaska Native individuals and the importance of utilizing existing strategies tailored to the needs of American Indian and Alaska Native communities to prevent violence and reduce these rates.
This Viewpoint discusses violence-related US public health concerns and suggests creating a federal Office of National Violence Prevention to develop a comprehensive, coordinated, and sustained effort to address all aspects of violence in the US.
In this narrative medicine essay, a third-year family medicine resident on the threshold of his career meditates on the systemic racial inequities that stymie his ability to heal his most vulnerable and oppressed patients.
This JAMA Patient Page summarizes the US Preventive Services Task Force’s recent recommendations on screening for syphilis infection in adults and adolescents who are at increased risk for syphilis infection.
This randomized clinical trial evaluates the efficacy and adverse event profile of serplulimab plus chemotherapy compared with placebo plus chemotherapy as first-line treatment in patients with extensive-stage small cell lung cancer.
This randomized clinical trial compares the efficacy of high-flow nasal cannula oxygen vs standard oxygen therapy in reducing the rate of mortality at day 28 in patients with respiratory failure due to COVID-19 admitted in intensive care units.
Researchers found that mepolizumab, a humanized monoclonal antibody, significantly reduced the number of asthma exacerbations in urban Black and Hispanic children, a population that has the highest risk of asthma-related morbidity and mortality. Therapy directed at the eosinophilic phenotype of asthma has proved to be successful in adults but hasn’t been well studied in children and diverse populations.
A noninferiority trial found no difference in satisfaction between women who underwent sedation with intravenous (IV) ketamine or IV fentanyl during first-trimester surgical abortion. The current opioid crisis has prompted interest in finding a nonopioid agent for pain control during outpatient surgical abortion. Although IV fentanyl is the current standard sedation, ketamine is frequently used in trauma and for acute pain crises and is favored in outpatient settings because it does not cause respiratory and cardiovascular depression.
Office-based workers typically spend 73% of their workday and 66% of their waking day sitting. In a recent trial workers who used a standing desk cut the amount of time they spent sitting by an hour per day.
A trial that evaluated 3 existing generic medications—metformin, ivermectin, and fluvoxamine—for early outpatient treatment of SARS-CoV-2 infection among adults with overweight and obesity did not prevent progression to severe COVID-19.
In Reply In their Letter about our recent study of patients with asymptomatic severe carotid stenosis, Dr Sterpetti and colleagues highlight the short life expectancy of the cohort and state that only 43 patients were alive at the end of the study. We would like to clarify that this number applies only to the small subgroup of patients who experienced an ipsilateral stroke and survived through the observation period. Overall mortality of the cohort was 51.4% during the study period. We agree with Sterpetti and colleagues that surgically and medically treated patients were likely not comparable; indeed, we specifically avoided any such comparison in this descriptive study and cautioned against extrapolating our findings in an attempt to make this association.
To the Editor We would like to raise several points about the recent study that estimated stroke outcomes among patients with asymptomatic severe carotid stenosis without surgical intervention. First, the standard-of-care medical treatment of asymptomatic carotid artery stenosis has made great advances recently and includes use of statins, antiplatelet agents, anticoagulants, and antihypertensives. Therefore, we believe that this study would benefit from a subgroup analysis of medication use in these patients. In addition, higher rates of medication adherence have been observed in patients with previous arterial surgical intervention due to regular postoperative follow-up visits and improved insight into their illness. Therefore, we think a sensitivity test that separates patients whose care was managed medically from those who underwent surgery would be informative when examining medication adherence.
To the Editor In a recent study of the clinical outcomes of 3737 adults with asymptomatic severe carotid stenosis who did not undergo carotid revascularization, the 5-year ipsilateral stroke rate was 4.7%. The authors concluded that “these findings may inform decision-making regarding surgical and medical treatment for patients with asymptomatic severe carotid artery stenosis.” A multicenter randomized prospective trial from 2021 reported similar 5-year stroke rates for 3625 patients with asymptomatic severe carotid stenosis who underwent carotid endarterectomy. Based on these studies, one could come to the conclusion that results of medical and surgical therapy for patients with severe carotid stenosis are similar.
To the Editor In a recent study, the authors reported 133 ipsilateral ischemic strokes among patients with medically treated asymptomatic severe carotid stenosis who did not undergo surgical intervention after a mean follow-up of 4.1 years. During this follow-up period, 55.6% of the 3737 patients died; however, cause of death was not reported in this study. Could some of these deaths have been caused by major strokes, and is it possible that these events were missed?
This systematic review to support the 2022 US Preventive Services Task Force Recommendation Statement on screening for syphilis infection summarizes published evidence on the benefits and harms of screening for syphilis infection in asymptomatic, nonpregnant adults and adolescents at increased risk for syphilis infection.
Workers who cleaned up the 2010 Deepwater Horizon oil spill had an increased risk of asthma 1 to 3 years after the incident, according to research led by the National Institute of Environmental Health Sciences. Environment International published the results.
Poverty combined with crowded housing or parental separation was associated with higher risk of premature death from adolescence into adulthood in a study of adverse childhood experiences (ACEs) by researchers at the National Institute of Child Health and Human Development. The results were published in The Lancet Regional Health.
Firearm violence in the US is an unrelenting clinical, public health, societal, and political concern of major proportion. The morbidity and mortality attributed to firearms have continued to increase; have adversely and profoundly affected individuals, families, and communities; and have exceedingly important consequences for all of society. The frequent occurrence of firearm violence and the repetitive episodes of mass shootings highlight the pervasiveness of firearms and the accessibility of assault weapons and serve as grim reminders that every person in the US is potentially vulnerable to firearm violence.
Small cell lung cancer (SCLC) is difficult to control with available treatments, particularly for patients with extensive-stage disease. For decades, there were no improvements in standard platinum-based chemotherapy for initial management of disease that cannot be treated within a single radiation field. Although SCLC is highly responsive to initial platinum chemotherapy in most cases, disease recurrence is nearly universal and has a median survival of less than 1 year from diagnosis.
COVID-19 infection commonly causes pneumonitis, which can result in acute hypoxemic respiratory failure (AHRF). While many hospitalized patients recover after only requiring conventional oxygen therapy (typically nasal cannula or face mask oxygen), a number of patients require additional noninvasive respiratory support, such as high-flow nasal oxygen (HFNO), continuous positive airway pressure (CPAP), and noninvasive ventilation (NIV). Despite this support, however, a significant proportion of patients experience clinical deterioration necessitating invasive mechanical ventilation and these patients are at high risk of death and significant morbidity.
In 2020, the rate of infectious (ie, primary and secondary) syphilis in the US was 12.6 per 100 000 and preliminary data from 2021 suggest even higher rates, estimated at 15.8 per 100 000. These rates have increased unabated since 2001 and are related to ongoing syphilis epidemics involving 2 populations: men who have sex with men (MSM) and heterosexual men and women. The latter epidemic has resulted in substantial increases in rates of syphilis among pregnant persons and, consequently, in the rate of congenital syphilis. The national congenital syphilis rate of 57.3 cases per 100 000 live births in 2020 is a 254% increase relative to the rate in 2016 and represents a serious failure of the US public health system.
In a 1953 report, Bagratuni described 7 older patients with symptoms of “generalized aching, especially in the shoulders and cervical region,” combined with fever, weight loss, elevated erythrocyte sedimentation rate, and anemia, a syndrome that was likely first reported 2 years earlier by Kersley. Bagratuni noted that this entity was similar to rheumatoid arthritis (RA), but without the typical articular manifestations of stiffness, pain, and swelling in the peripheral joints associated with RA. He suggested that the phrase rheumatoid disease be applied to such patients. Four years later, Barber first coined the term polymyalgia rheumatica in a description of 12 patients who had symptoms of pain and systemic inflammation, but lacked tender, swollen, or deformed peripheral joints, which are classic features of RA. In this report, Barber recognized the importance of differentiating this novel disease from other inflammatory conditions, such as RA and polymyositis.