June 19, 2018 Issue of JAMA

June 19, 2018, Vol 319, No. 23, Pages 2349-2450

This Week in JAMA

Highlights

Abstract Full Text

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JAMA. 2018;319(23):2349-2351. doi:10.1001/jama.2017.12416

Podcast: Optimal Target HbA1c, Genetic Risks for Pancreatic Cancer, US Trends in Obesity, and more

Original Investigation

Association of Stress-Related Disorders With Subsequent Autoimmune Disease

Huan Song, MD, PhD; Fang Fang, MD, PhD; Gunnar Tomasson, MD, PhD; et al.

Abstract Full Text

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JAMA. 2018;319(23):2388-2400. doi:10.1001/jama.2018.7028

This cohort study uses Swedish national registry data to investigate associations between PTSD, stress reactions, and adjustment disorders and subsequent autoimmune disease.

Association Between Inherited Germline Mutations in Cancer Predisposition Genes and Risk of Pancreatic Cancer

Chunling Hu, MD, PhD; Steven N. Hart, PhD; Eric C. Polley, PhD; et al.

Abstract Full Text

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JAMA. 2018;319(23):2401-2409. doi:10.1001/jama.2018.6228

This case-control study uses Mayo Clinic registry data to assess associations between inherited germline mutations in 21 cancer predisposition genes and risk of pancreatic cancer.

Editorial
Germline Genetic Testing for Pancreatic Ductal Adenocarcinoma at Time of Diagnosis
Sapna Syngal, MD, MPH; C. Sloane Furniss, PhD

JAMA

Differences in Obesity Prevalence by Demographics and Urbanization in US Children and Adolescents, 2013-2016

Cynthia L. Ogden, PhD; Cheryl D. Fryar, MSPH; Craig M. Hales, MD; et al.

Abstract Full Text

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JAMA. 2018;319(23):2410-2418. doi:10.1001/jama.2018.5158

This national survey study uses NHANES data to examine trends in obesity and severe obesity among US youth aged 2 to 19 years by sex, age, race and ethnicity, education level, and urbanization from 2013 to 2016.

Differences in Obesity Prevalence by Demographic Characteristics and Urbanization Level Among Adults in the United States, 2013-2016

Craig M. Hales, MD; Cheryl D. Fryar, MSPH; Margaret D. Carroll, MSPH; et al.

Abstract Full Text

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JAMA. 2018;319(23):2419-2429. doi:10.1001/jama.2018.7270

This national survey study uses National Health and Nutrition Examination Survey data to examine trends in obesity and severe obesity among adults aged 20 years or older by age, sex, race, ethnicity, education level and urbanization level between 2001 and 2016.

Research Letter

Representation of Patients With Chronic Kidney Disease in Trials of Cancer Therapy

Abhijat Kitchlu, MD, FRCPC; Joshua Shapiro, BSc; Eitan Amir, MD, PhD; et al.

Abstract Full Text

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JAMA. 2018;319(23):2437-2439. doi:10.1001/jama.2018.7260

This study characterizes the exclusion of patients with chronic kidney disease (CKD) in randomized clinical trials of drug treatment for bladder, breast, colorectal, lung, and prostate cancer.

Viewpoint

An Incomplete Prescription: President Trump鈥檚 Plan to Address High Drug Prices

Ameet Sarpatwari, JD, PhD; Jerry Avorn, MD; Aaron S. Kesselheim, MD, JD, MPH

Abstract Full Text

JAMA. 2018;319(23):2373-2374. doi:10.1001/jama.2018.7424

This Viewpoint discusses missed opportunities in the 2018 White House blueprint to reduce prescription drug prices, including a proposal that would require CMS to negotiate prices with manufacturers and that would ban unfair practices companies use to extend brand exclusivity.

Banning Abortion in Cases of Down Syndrome: Important Lessons for Advances in Genetic Diagnosis

Rebecca B. Reingold, JD; Lawrence O. Gostin, JD

Abstract Full Text

JAMA. 2018;319(23):2375-2376. doi:10.1001/jama.2018.6118

This Viewpoint discusses legal and ethical issues raised by the 2017 Ohio law prohibiting physicians from performing abortions if the pregnant woman鈥檚 decision was influenced by her belief that the fetus has Down syndrome.

Direct-to-Consumer Genetic Testing: The Implications of the US FDA鈥檚 First Marketing Authorization for BRCA Mutation Testing

Jennifer Gill, MS; Adam J. Obley, MD; Vinay Prasad, MD, MPH

Abstract Full Text

JAMA. 2018;319(23):2377-2378. doi:10.1001/jama.2018.5330

This Viewpoint discusses the implications of the US FDA鈥檚 2018 marketing authorization permitting 23and Me to market BRCA mutation testing to the general public, including concern about overtesting, false assurance, and the ability of accessible testing to improve population health outcomes.

Evolving Payer Coverage Policies on Genomic Sequencing Tests: Beginning of the End or End of the Beginning?

Kathryn A. Phillips, PhD

Abstract Full Text

JAMA. 2018;319(23):2379-2380. doi:10.1001/jama.2018.4863

This Viewpoint discusses a 2018 Centers for Medicare & Medicaid Services national coverage determination on next-generation sequencing tests for patients with advanced cancer and suggests ways to ensure appropriate and equitable access to testing, resource efficiency, and improvement in patient and societal outcomes.

The Microbiome and Risk for Atherosclerosis

Anthony L. Komaroff, MD

Abstract Full Text

JAMA. 2018;319(23):2381-2382. doi:10.1001/jama.2018.5240

This Viewpoint discusses the role the human gut microbiome may play in the development and progression of atherosclerosis, both by influencing risk factors and by direct effects on the inflammation and vulnerability of endovascular plaques.

A Piece of My Mind

The Perfect Specialty

Gregory E. Brisson, MD

Abstract Full Text

JAMA. 2018;319(23):2386-2387. doi:10.1001/jama.2018.7132

In this narrative medicine essay, an internist speculates about the perfect specialty in moments of confusion over nonspecified illnesses and concludes that all specialties involve scientific imprecision.

Editorial

Germline Genetic Testing for Pancreatic Ductal Adenocarcinoma at Time of Diagnosis

Sapna Syngal, MD, MPH; C. Sloane Furniss, PhD

Abstract Full Text

JAMA. 2018;319(23):2383-2385. doi:10.1001/jama.2018.6227

JAMA Clinical Guidelines Synopsis

Glycemic Control in Nonpregnant Adults With Type 2 Diabetes

Elizabeth L. Tung, MD, MS; Andrew M. Davis, MD, MPH; Neda Laiteerapong, MD, MS

Abstract Full Text

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JAMA. 2018;319(23):2430-2431. doi:10.1001/jama.2018.6798

This JAMA Clinical Guidelines Synopsis summarizes the American College of Physicians鈥� (ACP鈥檚) 2018 guidance statement on hemoglobin A_1c goals in nonpregnant adults with type 2 diabetes.

Video: Hemoglobin A_1c Targets in Type 2 Diabetes

Podcast: A Goal Too Far: Rethinking HbA1c Targets for Diabetes Treatment

JAMA Clinical Challenge

A Mediastinal Mass in a Young Man

Snigdha Jain, MD; Arjun Gupta, MD; Srikanth Nagalla, MD

Abstract Full Text

JAMA. 2018;319(23):2432-2433. doi:10.1001/jama.2018.7107

A healthy young adult presented to the emergency department reporting 6 months of fatigue, dry cough, dyspnea, and weight loss. A chest x-ray showed opacification of the right lung field and a CT revealed a centrally necrotic mass in the right anterior mediastinum, right pleural effusion, and compression of the superior vena cava. What would you do next?

From The Medical Letter on Drugs and Therapeutics

Ertugliflozin for Type 2 Diabetes

Abstract Full Text

JAMA. 2018;319(23):2434-2435. doi:10.1001/jama.2018.5840

This Medical Letter review summarizes clinical study data, adverse effects, drug interactions, and dosage and administration of the sodium-glucose co-transporter 2 inhibitor ertugliflozin alone and in fixed-dose combinations with metformin for the treatment of adults with type 2 diabetes.

Medical News & Perspectives

A Day in the Life: Physician Cares for HIV-Positive Patients in Jail

Rita Rubin, MA

Abstract Full Text

JAMA. 2018;319(23):2365-2367. doi:10.1001/jama.2018.5315

This Medical News story describes a day in the life of an infectious disease specialist caring for incarcerated individuals living with HIV.

For Patients With Type 2 Diabetes, What鈥檚 the Best Target Hemoglobin A_1C?

Jennifer Abbasi

Abstract Full Text

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JAMA. 2018;319(23):2367-2369. doi:10.1001/jama.2018.5420

This Medical News article discusses new clinical guidance for blood glucose targets.

Video: Hemoglobin A_1c Targets in Type 2 Diabetes

News From the Food and Drug Administration

New Relief for Opioid Withdrawal

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2018;319(23):2372. doi:10.1001/jama.2018.7719

Neurovascular Stent Caution

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2018;319(23):2372. doi:10.1001/jama.2018.7721

Biosimilar Approved for Anemia

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2018;319(23):2372. doi:10.1001/jama.2018.7764

The JAMA Forum

The Need to Simplify Measuring Quality in Health Care

Gail Wilensky, PhD

Abstract Full Text

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JAMA. 2018;319(23):2369-2370. doi:10.1001/jama.2018.6858

Global Health

Ethical Guidelines for Genomic Research in Africa

M.J. Friedrich

Abstract Full Text

JAMA. 2018;319(23):2371. doi:10.1001/jama.2018.7241

New Platform Showcases Scientific Research From Africa

M.J. Friedrich

Abstract Full Text

JAMA. 2018;319(23):2371. doi:10.1001/jama.2018.7853

Preemptive Antibiotic Use Reduces Childhood Deaths

M.J. Friedrich

Abstract Full Text

JAMA. 2018;319(23):2371. doi:10.1001/jama.2018.7854

The Arts and Medicine

Pathogenesis: A New Deck-Building Game

Nicholas N. Zacharek; Preeti N. Malani, MD, MSJ

Abstract Full Text

JAMA. 2018;319(23):2364. doi:10.1001/jama.2018.1770

This Arts and Medicine essay reviews Pathogenesis, a deck-building card game in which players accumulate cards that represent the battle between microbial pathogens and the body鈥檚 physical defense barriers and adaptive and innate immune responses.

Poetry and Medicine