JAMA Clinical Reviews

A Patient's Perspective on Nonoperative Treatment of Appendicitis

11 Aug 2020

Contributed by Lukas

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 mo...

Updated Pulmonary Embolism Guidelines

11 Aug 2020

Contributed by Lukas

The European Society of Cardiology updated its guidelines for pulmonary embolism in 2019. Jonathan Paul, MD, from the University of Chicago discusses ...

The Importance of Minimal Clinically Important Differences in Research Studies

06 Aug 2020

Contributed by Lukas

Before a study is carried out, it is important to define what is an important difference between groups. This is often not done correctly. Anna McGlot...

Update on Dexamethasone for the Treatment of COVID-19

05 Aug 2020

Contributed by Lukas

Few treatments have proven to be effective for treating COVID-19. Recently, a clinical trial reporting the results of dexamethasone for treating COVID...

Update on Congestive Heart Failure

04 Aug 2020

Contributed by Lukas

Congestive heart failure is common and can have devastating effects on patients' quality of life. Until recently few treatments were available, but th...

Treating Pediatric Appendicitis Nonoperatively

27 Jul 2020

Contributed by Lukas

Accumulating evidence in adults has shown that nonoperative treatment of appendicitis is an acceptable means for treatment. A recent prospective study...

Perioperative Risk Assessment

21 Jul 2020

Contributed by Lukas

Jeffrey Berger, MD, from the Center for the Prevention of Cardiovascular Disease at the New York University School of Medicine, explains the ins and o...

Drug Treatment for Primary Prevention of Breast Cancer

21 Jul 2020

Contributed by Lukas

Some of the nearly 40 000 deaths each year in the US from breast cancer might be avoided through use of medications to prevent breast cancer in high-r...

Remdesivir and Dexamethasone for the Treatment of COVID-19

20 Jul 2020

Contributed by Lukas

Both remdesivir and dexamethasone have been promoted as effective treatments for COVID-19. JAMA Deputy Editor Greg Curfman, MD, and Professor Rachel S...

How Is COVID-19 Transmitted?

13 Jul 2020

Contributed by Lukas

Whether the SARS-CoV-2 virus is transmitted by droplets or aerosol influences which public health interventions might slow its spread. Michael Klompas...

Complications From SSRIs

10 Jul 2020

Contributed by Lukas

SSRIs are a commonly used medication. Although complications from them are not common because so many people take these medications, physicians will i...

Acute Kidney Injury Caused by Proton Pump Inhibitors

08 Jul 2020

Contributed by Lukas

Proton pump inhibitors are among the most commonly used medicines by patients. They're generally safe, but they can cause acute kidney injury, and it'...

Diagnosis and Management of Amyloidosis

07 Jul 2020

Contributed by Lukas

Although there are only about 4000 new cases of amyloidosis in the US per year, it can cause preserved ejection fraction heart failure, kidney and liv...

A Clinical Pharmacologist's Perspective on Penicillin Allergy

06 Jul 2020

Contributed by Lukas

Although frequently reported, penicillin allergy is actually uncommon. Penicillins are very effective against a wide variety of infections, and when t...

Sample Size Calculation for a Hypothesis Test

02 Jul 2020

Contributed by Lukas

One of the most common causes for problems we see in manuscripts at JAMA is an inappropriately calculated study sample size. This seemingly mysterious...

Understanding Pragmatic Trials

25 Jun 2020

Contributed by Lukas

Generalizability of randomized trials is always limited because of the super-selectivity of the patients enrolled in these trials and the very control...

Overview of Depression

02 Jun 2020

Contributed by Lukas

Nearly 10% of all patients seen in primary care have depression. Although usually mild, when depression is severe the consequences can be serious. Tom...

The Effect of Hearing Loss on Cognitive Decline

19 May 2020

Contributed by Lukas

Even limited hearing loss might be associated with cognitive decline. If true, early intervention with hearing aids might help people have better cogn...

My Father Was Murdered by Terrorists: Recollections of a Trauma Surgeon

05 May 2020

Contributed by Lukas

When she was a teenager Melissa Red Hoffman's father was killed by terrorists. Dr Hoffman recalls her father's death and how that has influenced her c...

Coronavirus (COVID-19) Update: Ventilatory Management for COVID-Related Respiratory Failure

24 Apr 2020

Contributed by Lukas

Management of COVID-19-related respiratory failure differs from what is necessary for ARDS. Rather than having alveolar edema, COVID-19 patients have ...

Parkinson Disease Information for Patients

14 Apr 2020

Contributed by Lukas

More than 6 million people worldwide have Parkinson disease. Even though it is classically associated with tremors, the disease has many manifestation...

Coronavirus (COVID-19) Update: Reusing Face Masks and N95 Respirators

08 Apr 2020

Contributed by Lukas

Shortages of face masks and N95 respirators have forced clinicians and hospitals to reuse these normally disposable items. Ron Shaffer, PhD, former CD...

Treating Pediatric Eczema

07 Apr 2020

Contributed by Lukas

Eczema is extremely common in children. Most the time it is easily treated with topical steroids but on occasion it requires systemic therapies. JAMA ...

Coronavirus (COVID-19) Update: Safe Shopping at Stores and Pharmacies

03 Apr 2020

Contributed by Lukas

Food and medicine shopping is essential during the COVID-19 pandemic, but requires getting out and standing close to strangers at a time when social d...

Coronavirus Disease 2019 (COVID-19) Update: PCR Testing and Shortages

27 Mar 2020

Contributed by Lukas

The lack of availability of COVID-19 testing has interfered with the ability to contain the spread of disease. Omai Garner, PhD, laboratory director f...

Coronavirus Disease 2019 (COVID-19) Update: How the VA Is Preparing

25 Mar 2020

Contributed by Lukas

As COVID-19 spreads, clinicians and health systems are struggling to prepare for a surge of patients. Richard Stone, MD, the US Veterans Health Admini...

Coronavirus (COVID-19) Update: Lessons Learned From The 2003 SARS Outbreak

25 Mar 2020

Contributed by Lukas

In 2003, Toronto was the North American center for Severe Acute Respiratory Syndrome (SARS). The disease spread through the city's hospitals before an...

Coronavirus (COVID-19) Update: Chloroquine/Hydroxychloroquine and Azithromycin

24 Mar 2020

Contributed by Lukas

Chloroquine was shown in 2004 to be active in vitro against SARS coronavirus but is of unproven efficacy and safety in patients infected with SARS-CoV...

Nonalcoholic Steatohepatitis: The Primary Care Perspective

24 Mar 2020

Contributed by Lukas

Nonalcoholic steatohepatitis (NASH) is becoming more frequent as the population becomes more obese. This is not a benign problem, and NASH can ultimat...

The Diagnosis and Management of Primary Hyperparathyroidism

24 Mar 2020

Contributed by Lukas

Hyperparathyroidism is a fairly common disease that causes elevated calcium levels and bone depletion, resulting in fractures and kidney problems. The...

Coronavirus (COVID-19) Update: Early Safety Signals Around Ibuprofen and Renin-Angiotensin Inhibitors

20 Mar 2020

Contributed by Lukas

Emerging information about how SARS-CoV-2 virus infects cells has led to speculation that NSAIDs and ACE inhibitors/angiotensin receptor blockers (ARB...

Nathan Pritikin and His Diet

17 Mar 2020

Contributed by Lukas

Nathan Pritikin was a college dropout who became an entrepreneur. While doing research for the government during World War II, he observed that popula...

Who Was Nathan Pritikin and Why Is There a Diet Named After Him?

17 Mar 2020

Contributed by Lukas

This podcast explains the Pritikin diet to patients. Nathan Pritikin was a college dropout who became an entrepreneur. While doing research for the go...

COVID-19 in Seattle: Clinical Features and Managing the Outbreak

15 Mar 2020

Contributed by Lukas

Seattle was one of the first US cities to have a COVID-19 outbreak, with a cluster of nursing home-related deaths. However, many people who tested pos...

The Effect of the COVID-19 Pandemic on Clinic Operations

13 Mar 2020

Contributed by Lukas

Seattle has been a focal point for the US in the coronavirus pandemic. Doug Paauw, MD, professor of medicine at the University of Washington, in Seatt...

Update on Coronavirus: March 6, 2020, by NIAID's Anthony Fauci, MD

09 Mar 2020

Contributed by Lukas

Coronovirus (the virus SARS-CoV-2) continues to spread throughout the world. In recent weeks, there has been an increasing number of cases and deaths ...

Unprofessional Behavior Leads to Complications

25 Feb 2020

Contributed by Lukas

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...

The 2020 Influenza Epidemic—More Serious Than Coronavirus in the US

18 Feb 2020

Contributed by Lukas

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 i...

AIDS-Related Chronic Inflammation Leading to Chronic Disease

18 Feb 2020

Contributed by Lukas

Great strides have been made in treating HIV, as Anthony Fauci, MD, discusses in this podcast episode. But even substantial viral suppression leaves s...

Testing for Breast Cancer Susceptibility Genes

11 Feb 2020

Contributed by Lukas

Breast cancer is a leading cause of death in women. Some women have a cancer susceptibility gene known as BRCA, and women should be tested for BRCA un...

Parkinson Disease

11 Feb 2020

Contributed by Lukas

More than 6 million people worldwide have Parkinson disease. Even though it is classically associated with tremors, the disease has many manifestation...

Management of Chronic Stable Angina in 2020

04 Feb 2020

Contributed by Lukas

Controversy exists regarding how to best manage chronic stable angina. Intuitively, it seems that because it is usually caused by coronary artery lesi...

Treating Conjunctivitis and Dry Eye Disease

04 Feb 2020

Contributed by Lukas

Conjunctivitis and dry eye disease are some of the most common conditions patients present with. They are usually benign entities that respond well to...

2019 Novel Coronavirus: An Update From NIAID Director Anthony Fauci, MD

30 Jan 2020

Contributed by Lukas

A new virus known as the 2019 novel coronavirus (2019-nCoV) is rapidly spreading through China. The rapid spread and severity of this illness are worr...

Football Players and Erectile Dysfunction Associated With Repetitive Head Injury

29 Jan 2020

Contributed by Lukas

American football is a dangerous sport and is characterized by violent contact between people that often leads to repetitive head injury. A multitude ...

The Keto, Atkins, and Pritikin Diets

28 Jan 2020

Contributed by Lukas

There are many named diets that receive a great deal of attention. But what are they and do they work? David Heber, MD, PhD, from the UCLA Center for ...

The Keto Diet: Advice for Patients

28 Jan 2020

Contributed by Lukas

The keto diet is very popular and involves eating very few carbohydrates, a fair amount of fat, and normal amounts of protein. It is one of many ways ...

The American Heart Association Takes a Stance Against e-Cigarettes

21 Jan 2020

Contributed by Lukas

e-Cigarettes are dangerous, but the public has been falsely led to believe that they are safe. Because of this misconception and the inherent dangers,...

An Inconvenient Tooth

14 Jan 2020

Contributed by Lukas

Animal bites can be a cause of significant injury and on occasion, fatalities. In this episode, JAMA Fishbein Fellow Angel Desai, MD, MPH discusses th...

NICE Guidelines for Heavy Menstrual Bleeding: What to Make of Them

19 Dec 2019

Contributed by Lukas

The UK's National Institute for Health and Care Excellence (NICE) recently issued guidelines for how to manage heavy menstrual bleeding. Guidelines on...

The Medical and Political Response to the 2019 Christchurch Mosque Mass Shooting

10 Dec 2019

Contributed by Lukas

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 w...

What Do I Need to Know About e-Cigarettes and If They Help People Stop Smoking?

25 Nov 2019

Contributed by Lukas

Electronic cigarette (e-cigarette) use, otherwise known as "vaping," has been increasing since 2010. This podcast reviews research on the epidemiology...

The Underappreciated Problem of Cardiac Disease in Women

18 Nov 2019

Contributed by Lukas

Barbra Streisand and Noel Bairey Merz, MD, director of the Streisand Women's Heart Center at Cedars-Sinai in Los Angeles, California, discuss the prob...

Review of Atrial Fibrillation Treatment

12 Nov 2019

Contributed by Lukas

Atrial fibrillation is a very common problem that is treated with a variety of medications and interventions. Sandip Mukherjee, MD, a contributing edi...

Influenza Vaccination in 2019-2020

06 Nov 2019

Contributed by Lukas

Winter is coming…and with it, the onset of flu season. In this episode, Jean-Marie Pflomm, PharmD, Editor in Chief of The Medical Letter, decodes fl...

How Adolescent Boys' Need for Friendship Affects Their Mental Health

05 Nov 2019

Contributed by Lukas

Adolescent boys are notoriously difficult to deal with. However, some of their behaviors mask a need they have for developing intimate friendships. Be...

Emerging Applications for Ketamine

22 Oct 2019

Contributed by Lukas

Even though it gained notoriety for recreational uses, Ketamine is experiencing a resurgence in clinical settings given its versatility and potential ...

Understanding Lipids and Cardiovascular Risk Through Mendelian Randomization

08 Oct 2019

Contributed by Lukas

Mendelian randomization is a powerful technique that enables investigators to mimic randomized clinical trials by characterizing genetic differences b...

Pancreatic Cancer

08 Oct 2019

Contributed by Lukas

Pancreatic cancer is the third most common cause of cancer death in the United States. Timothy Donohue, MD, chief of surgical oncology at the Universi...

Personal Protective Equipment for Health Care Infection Control

07 Oct 2019

Contributed by Lukas

Personal protective equipment comprises gloves, gowns, masks, regular respirators, and powered air purifying respirators (PAPRs). In this Clinical Rev...

Improving Uptake of Preexposure Prophylaxis (PrEP) for HIV in Primary Care

06 Oct 2019

Contributed by Lukas

JAMA Fishbein Fellow Angel Desai, MD interviews Douglas S. Krakower, MD at the IDWeek 2019 conference in Washington, D.C. Related article: Rising PrEP...

Update in Clinical Infectious Diseases 2019-2020

06 Oct 2019

Contributed by Lukas

This Clinical Review podcast reviews some of the most important advances in clinical infectious diseases presented at IDWeek 2019 including data on ra...

A New Path for Gun Research Funding

10 Sep 2019

Contributed by Lukas

Since the passage of the Dickey Amendment in 1996, federal funding for gun violence research has been withheld from the CDC and other federal agencies...

Bariatric Surgery and Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity

03 Sep 2019

Contributed by Lukas

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

Management of Heart Failure in 2019-2020, Part 2

02 Sep 2019

Contributed by Lukas

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

Management of Heart Failure in 2019-2020, Part 1

02 Sep 2019

Contributed by Lukas

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

The Influence of Obesity on Cancer

20 Aug 2019

Contributed by Lukas

Jennifer A. Ligibel, MD, from the Dana-Farber Cancer Institute and Harvard Medical School, Boston, explains how obesity influences the risk of develop...

Responsible Use of Opioids to Treat Cancer Pain

06 Aug 2019

Contributed by Lukas

Dr. Eduardo Bruera, Chair of the Department of Palliative Care at MD Anderson, discusses how to responsibly manage cancer pain using opioids.

Diagnosing Menopause

22 Jul 2019

Contributed by Lukas

Menopause is inevitable for women. It symptoms are uncomfortable and distressing. For women to best cope with menopause, it is useful to firmly establ...

Guns and Suicide

16 Jul 2019

Contributed by Lukas

Using firearms to commit suicide is one of the most common causes of firearm related deaths. This can happen even in families where it seems highly un...

Subclinical Hypothyroidism

09 Jul 2019

Contributed by Lukas

Subclinical hypothyroidism is common, but it is not clear how best to treat it. Anne R. Cappola, MD, ScM, professor of medicine at the University of P...

The Clinical Ramifications of Dense Breasts

02 Jul 2019

Contributed by Lukas

There are now 36 states and recent federal legislation that require that clinicians inform women about breast density results from mammography. Conseq...

California's Attempt to Improve Measles Vaccination Rates

02 Jul 2019

Contributed by Lukas

California enacted 3 aggressive laws between 2014 and 2016 in an effort to improve measles vaccination rates. To a large extent these laws were effect...

Reducing the Intensity of Antiplatelet Therapy Following Coronary Stent Procedures

25 Jun 2019

Contributed by Lukas

A conversation with Greg Curfman, MD, JAMA Deputy Editor and a cardiologist, who reviews 2 new studies showing that a short duration of dual antiplate...

The Gabby Giffords Shooting

11 Jun 2019

Contributed by Lukas

Over the span of less than a minute, a gunman with a history of mental health issues turned a Safeway parking lot into the scene of a mass shooting, k...

Abnormal Uterine Bleeding

04 Jun 2019

Contributed by Lukas

Andrew M. Kaunitz, MD, from the Department of Obstetrics and Gynecology at the University of Florida, Jacksonville, explains how to diagnose and treat...

Menopausal Hormone Therapy

30 May 2019

Contributed by Lukas

Jan L. Shifren, MD, from the department of obstetrics and gynecology, Massachusetts General Hospital, and Harvard Medical School discusses menopausal ...

Cervical Cancer Screening

28 May 2019

Contributed by Lukas

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

Treating Nonmetastatic Breast Cancer in 2019

07 May 2019

Contributed by Lukas

Breast cancer outcomes continue to improve. Treatments for the disease are very effective and continually evolving. We spoke with Patricia A. Ganz, MD...

JAMA Women's Health Series Introduction by Dr Carolyn Crandall

07 May 2019

Contributed by Lukas

Dr Carolyn Crandall, professor of medicine at the David Geffen School of Medicine at UCLA and JAMA Associate Editor, introduces JAMA's new series of a...

Beyond the Rhetoric: Gun Control That Works, Part 3

09 Apr 2019

Contributed by Lukas

Congressman Mike Thompson chairs the US House Gun Violence Prevention Taskforce. He spoke with us about what the House has done to address gun violenc...

How to Reduce Maternal Mortality Rates in the United States

02 Apr 2019

Contributed by Lukas

Maternal mortality rates in most of the United States are high. These rates were successfully lowered in the United Kingdom and also in California. Ma...

Beyond the Rhetoric: Gun Control That Works, Part 2

26 Mar 2019

Contributed by Lukas

Almost nothing is more controversial than gun control in the United States. Yet while passions flare and legislators posture but do little, deaths fro...

Update on Atrial Fibrillation: Review of the New AHA/ACC/HRS Treatment Guidelines

15 Mar 2019

Contributed by Lukas

Cardiologist and JAMA Deputy Editor Greg Curfman, MD, discusses the many changes in the new AHA/ACC/HRS atrial fibrillation guidelines with University...

Beyond the Rhetoric: Gun Control That Works, Part 1

12 Mar 2019

Contributed by Lukas

Almost nothing is more controversial than gun control in the United States. Yet while passions flare and legislators posture but do little, deaths fro...

Is It Safe? What Happens When Your Surgeon Is Not Actually Doing Some of Your Operation?

26 Feb 2019

Contributed by Lukas

Great controversy exists regarding the safety of surgery when the attending surgeon allows someone else to perform parts of the operation. These pract...

COPD: All You Need to Know in 20 Minutes

26 Feb 2019

Contributed by Lukas

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 t...

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

14 Feb 2019

Contributed by Lukas

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 se...

Can I Believe the Results From Observational Studies? Using E-Values That Anyone Can Calculate for Evaluating the Risk of Confounding

12 Feb 2019

Contributed by Lukas

E-values are a new tool that enables investigators to estimate the likelihood that some unmeasured confounder might overcome seemingly positive result...

Finding a Serious Arrhythmia Using a Watch

29 Jan 2019

Contributed by Lukas

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 lon...

Screening for Breast Cancer: Is It Worth It?

22 Jan 2019

Contributed by Lukas

Breast cancer screening is debated passionately among those who advocate for very aggressive screening and other experts who believe that screening ca...

Major Societies Agree – A New Approach to Penicillin Allergy Is Needed

15 Jan 2019

Contributed by Lukas

Very few people who think they are allergic to penicillin actually are. Yet, even if someone reports a remote and vague history of penicillin allergy,...

Medical Emergencies While Flying

21 Dec 2018

Contributed by Lukas

When flying and they call "Is there a licensed medical professional on board," should physicians respond? If so, what should they do? Are they liable ...

Bayes for Clinicians Who Need to Know but Don't Like Math

11 Dec 2018

Contributed by Lukas

The statistical concept of Bayes comes up in clinical medicine all the time. It simply means that what you know about something factors into how you a...

Battle of the Heart Societies, Part 2: Who Is Right – the US or Europe Regarding How to Manage Hypertension? Their Differences

20 Nov 2018

Contributed by Lukas

Within the last 2 years, major guidelines have been issued from US-based and European organizations that differ in their recommendations for the diagn...

A Family's Struggle With Alcoholism

13 Nov 2018

Contributed by Lukas

What is it like to go through alcohol withdrawal at home? What is it like for a mother to sit by her son's side while he goes through withdrawal and s...

Observations From ICU Patients We Thought Were Asleep, but Were Not

23 Oct 2018

Contributed by Lukas

What if the patient you are managing in the ICU is not asleep when you thought they were? Patients relate their very disturbing stories about what the...

An Update on the Diagnosis and Treatment of Venous Thromboembolic Disease

16 Oct 2018

Contributed by Lukas

Venous thromboembolic disease is common. There are many steps necessary to establish a diagnosis or treat this disease. These are summarized in this J...

Alcohol Withdrawal Syndrome

02 Oct 2018

Contributed by Lukas

Alcohol withdrawal is a serious problem that can lead to mortality. How to predict if it will occur when a patient who is misusing alcohol is admitted...

Treating Appendicitis Without Surgery – 5-Year Follow-up From a Randomized Clinical Trial of Antibiotic Treatment

25 Sep 2018

Contributed by Lukas

In 2015, JAMA published results of a randomized clinical trial showing that antibiotic treatment for acute appendicitis was feasible. Doubters of the ...