JAMA

Listen to a summary of the August JAMA Medical News.

edhub.ama-assn.org

Do US hospitals fall under the “sensitive places” exception to the Second Amendment, and what are the ethical and practical considerations that support advancing firearm regulations in health care settings? https://ja.ma/4g2PRxK

Call for Clinical Challenge images 🔔

We are seeking images with an accompanying patient case for JAMA Clinical Challenge articles.

For more information, visit: https://ja.ma/4cKb90j

Calling all attendees 🔔

We are always accepting image submissions for JAMA Clinical Challenges. If you have a case that you are interested in submitting, visit: https://ja.ma/4e6CIlH

Meta-analysis: Among adults in the ICU who had sepsis or septic shock, the use of prolonged β-lactam antibiotic infusions was associated with a reduced risk of 90-day mortality compared with intermittent infusions.

Prolonged vs Intermittent Infusions of β-Lactam Antibiotics in Adults With Sepsis or Septic Shock This systematic review and bayesian meta-analysis investigated whether administration of β-lactam antibiotics by prolonged infusion reduces 90-day mortality compared with intermittent infusion in adult patients with sepsis or septic shock.

In critically ill patients with sepsis, continuous vs intermittent β-lactam antibiotic infusions did not significantly reduce 90-day mortality.
https://ja.ma/3Z5CZAL

Relaxed potassium supplementation (threshold 3.6 mEq/L) post-CABG surgery is noninferior to tight control (4.5 mEq/L) in preventing atrial fibrillation after cardiac surgery, potentially reducing costs and patient risks. https://ja.ma/4g4F2eG

Have you ever considered submitting a JAMA Clinical Challenge? JAMA is accepting submissions for patient scenarios.

For criteria and information on Clinical Challenge submissions, visit: https://ja.ma/4e39m7o

Private equity acquisitions appear to have depleted, rather than augmented, hospital assets. After private equity acquisition, hospital assets decreased by 24% relative to that of controls during 2 years. https://ja.ma/3AQvrI1

Most viewed in the last 7 days from JAMA: What is the long-term prognosis of myocarditis after COVID-19 mRNA vaccination and do clinical outcomes and medical management differ from myocarditis of other origins?

https://ja.ma/3yOC0up

Among Black African adults with uncontrolled hypertension, a low-dose triple-pill protocol achieved better blood pressure lowering and control with good tolerability compared with the standard-care protocol.
https://ja.ma/4cLtQRg

We are seeking images for JAMA Clinical Challenges.

If you have a case that fits the criteria of a JAMA Clinical Challenge, learn how to submit yours: https://ja.ma/4g1SAYl

A new analysis by KFF, formerly the Kaiser Family Foundation, found that Medicare Advantage insurance plans denied 3.4 million, or 7.4%, of 46 million prior authorization requests in 2022. This Medical News article discusses care denials under Medicare Advantage plans and efforts to streamline the prior authorization process.

CMS and Lawmakers Take Action on Medicare Advantage Prior Authorization This Medical News article discusses care denials under Medicare Advantage plans and efforts to streamline the prior authorization process.

In the largest Medicaid managed care plans across 4 of the largest US cities, only 17.8% of psychiatric prescribing clinicians listed as in-network for Medicaid were reachable, accepted Medicaid, and could provide a new patient appointment. https://ja.ma/4e076hr

JAMA Data Brief discusses new data from the Medical Expenditure Panel Survey, or MEPS, Household Component, a household survey sponsored by the Agency for Healthcare Research and Quality. https://ja.ma/3Z1LkFT

JAMA Clinical Challenge update.

Read this article to learn the answer to yesterday's challenge.

https://ja.ma/4e2pm9O

We want your images:

JAMA Clinical Challenges offers unique learning opportunities for clinicians at any stage of their career.

For more information on submitting a Clinical Challenge of a case, visit:
https://ja.ma/3AV6TO4

Among patients who underwent major noncardiac surgery, renin-angiotensin system inhibitor continuation before surgery was not associated with a higher rate of postoperative complications than discontinuation. https://ja.ma/47novPb

Call for Images 🔔

We are accepting submissions of patient cases with an accompanying clinical image for JAMA Clinical Challenges.

Learn more:
https://ja.ma/4e4zZsG

Most viewed in the last 7 days from JAMA: Narrative review investigates the use of direct oral anticoagulants to treat patients undergoing surgical and nonsurgical procedures and the most effective management strategies for these medications.

https://ja.ma/4dS4ySo

Pertussis is a respiratory illness caused by the bacterium Bordetella pertussis. This JAMA Patient Page describes pertussis illness, its signs and symptoms, and its diagnosis, treatment, and prevention measures. https://ja.ma/3T74g29

Study highlights the magnitude of inhaler-related emissions in the US, as well as potential cost barriers to propellant-free inhaler substitutions. https://ja.ma/4dEeTBN

Take the JAMA Clinical Challenge

An 18-year-old male presented to the primary care physician with a 4-month history of a slowly progressive painless lateral neck mass on the right side. The mass moved with swallowing.

Patient denied history of dysphagia, dysphonia, drainage, previous neck surgery, trauma, or recent fever. Neck ultrasonography revealed a well-circumscribed anechoic lesion with a diameter of 5.9 cm in the right thyroid lobe without any internal solid nodularity or septation.

A neck CT scan revealed an intrathyroidal lesion extending inferiorly to 3 cm above the angle of Louis causing tracheal compression and displacement.

What is your diagnosis? Comment your answer below.

A. Benign thyroid nodule
B. Parathyroid cyst
C. Reactive viral lymphadenopathy
D. Thyroglossal duct cyst

Friday at 12 pm ET we’ll post the answer.

JAMA Clinical Guidelines Synopsis: the 2023 American Association for the Study of Liver Diseases practice guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. https://ja.ma/3TaIbzH

This JAMA Medical News article reports on why a staph vaccine may finally be possible.

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Perioperative mortality after living kidney donation declined substantially in the past decade compared with prior decades, to fewer than 1 event per 10 000 donations. Risk was higher for male donors and donors with a history of hypertension. https://ja.ma/4fZPVyj

Renal cell carcinoma (RCC) is a common cancer, with an estimated 434 840 incident cases worldwide in 2022. In the US, it is the sixth most common cancer among males and ninth among females. This review summarizes the epidemiology, clinical presentation, pathophysiology, and management of RCC. https://ja.ma/3z4Jidi

Ransomware strikes have been on the rise in recent years. This Medical News story discusses the increase in ransomware cyberattacks on health care, as well as new cybersecurity initiatives. https://ja.ma/4cHRH4b

Three trends—personal conscience, employment contracts, and laws—challenge physicians from putting their patients first. This Viewpoint offers ways to reverse these barriers. https://ja.ma/4cKzVgS