October 9, 2018 Issue of JAMA

October 9, 2018, Vol 320, No. 14, Pages 1401-1506

This Week in JAMA

Highlights

Abstract Full Text

free access has audio

JAMA. 2018;320(14):1401-1403. doi:10.1001/jama.2017.12581

Podcast: Spontaneous vs Delayed Pushing During Labor, Polymyxin B Hemoperfusion for Septic Shock, Chronic Wound Management Review, and more

Original Investigation

Effect of Immediate vs Delayed Pushing on Rates of Spontaneous Vaginal Delivery Among Nulliparous Women Receiving Neuraxial Analgesia: A Randomized Clinical Trial

Alison G. Cahill, MD, MSCI; Sindhu K. Srinivas, MD, MSCE; Alan T. N. Tita, MD, PhD; et al.

Abstract Full Text

free access has multimedia

JAMA. 2018;320(14):1444-1454. doi:10.1001/jama.2018.13986

This randomized clinical trial compares the effects of immediate vs delayed pushing on spontaneous vaginal delivery and maternal and neonatal morbidities among nulliparous women at or beyond 37 weeks鈥� gestation admitted for spontaneous or induced labor.

Video: Immediate vs Delayed Pushing During Second Stage of Labor

Editorial
Immediate vs Delayed Pushing During the Second Stage of Labor
Jeffrey D. Sperling, MD, MS; Dana R. Gossett, MD, MSCI

JAMA

Caring for the Critically Ill Patient

Effect of Targeted Polymyxin B Hemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level: The EUPHRATES Randomized Clinical Trial

R. Phillip Dellinger, MD, MSc; Sean M. Bagshaw, MD, MSc; Massimo Antonelli, MD; et al.

Abstract Full Text

free access has multimedia

JAMA. 2018;320(14):1455-1463. doi:10.1001/jama.2018.14618

This clinical trial involving patients with septic shock and high endotoxin activity compares the effect of treatment with polymyxin B hemoperfusion vs sham therapy and usual care on mortality.

Video: Conference Presentation: Effect of Targeted Polymyxin B Hemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level: The EUPHRATES Randomized Clinical Trial
Video: Conference Commentary: Effect of Targeted Polymyxin B Hemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level: The EUPHRATES Randomized Clinical Trial

Association Between Third-Trimester Tdap Immunization and Neonatal Pertussis Antibody Concentration

C. Mary Healy, MD; Marcia A. Rench, BSN; Laurie S. Swaim, MD; et al.

Abstract Full Text

free access

JAMA. 2018;320(14):1464-1470. doi:10.1001/jama.2018.14298

This prospective cohort study assesses whether maternal immunization with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine, compared with no immunization, is associated with high concentrations of pertussis toxin antibodies at birth and if there is an optimal gestational age for maternal immunization.

Trends in the Incidence and Recurrence of Inpatient-Treated Spontaneous Pneumothorax, 1968-2016

Rob J. Hallifax, PhD; Raph Goldacre, MSc; Martin J. Landray, PhD; et al.

Abstract Full Text

free access

JAMA. 2018;320(14):1471-1480. doi:10.1001/jama.2018.14299

This population epidemiological study uses English national hospital data sets to characterize trends in the incidence and recurrence of hospital admissions for spontaneous pneumothorax to identify risk factors for recurrence.

Editorial
The Evolving Epidemiology and Management of Spontaneous Pneumothorax
Eric Savitsky, MD; Scott S. Oh, DO; Jay M. Lee, MD

JAMA

Research Letter

Campaign Contributions From Political Action Committees to Members of Congressional Committees Responding to the Opioid Crisis

Matthew S. McCoy, PhD; Genevieve P. Kanter, PhD

Abstract Full Text

free access

JAMA. 2018;320(14):1489-1491. doi:10.1001/jama.2018.11338

This study examines recent campaign contributions to members of US congressional committees responsible for legislating on the opioid crisis by political action committees (PACs) associated with firms under investigation for having contributed to the crisis.

Editorial
Politics and Health Care
Donald M. Berwick, MD, MPP

JAMA

Use of Death Counts From Vital Statistics to Calculate Excess Deaths in Puerto Rico Following Hurricane Maria

Alexis R. Santos-Lozada, PhD; Jeffrey T. Howard, PhD

Abstract Full Text

free access

JAMA. 2018;320(14):1491-1493. doi:10.1001/jama.2018.10929

This study calculates the number of excess deaths following Hurricane Maria through December 2017, using death counts from vital statistics records, to update a previous estimate.

Viewpoint

Eliminating Poverty in the 21st Century: The Role of Health and Human Capital

Jim Yong Kim, MD, PhD

Abstract Full Text

JAMA. 2018;320(14):1427-1428. doi:10.1001/jama.2018.13709

In this Viewpoint, World Bank President Jim Yong Kim explains the World Bank鈥檚 Human Capital Index, which uses data on each country鈥檚 level of education and indicators of health status to answer a simple but powerful question: how productive will children born today be as members of the future workforce, relative to what is possible if they were in full health and had complete education?

Potential Benefits and Risks of High-Nicotine e-Cigarettes

Robin Koval, MBA; Jeffrey Willett, PhD; Jodie Briggs, MA

Abstract Full Text

JAMA. 2018;320(14):1429-1430. doi:10.1001/jama.2018.12328

This Viewpoint discusses how e-cigarettes have the potential to attract young users, and that stronger regulatory actions are needed to stop e-cigarette use among this group.

Substantial Shifts in Supreme Court Health Law Jurisprudence

Lawrence O. Gostin, JD; James G. Hodge Jr, JD, LLM

Abstract Full Text

JAMA. 2018;320(14):1431-1432. doi:10.1001/jama.2018.12331

This Viewpoint reviews what little is known about US Supreme Court nominee Judge Brett Kavanaugh鈥檚 jurisprudence on issues related to health care and health law in cases that could come before the US Supreme Court nominee in coming sessions.

Editorial
Politics and Health Care
Donald M. Berwick, MD, MPP

JAMA

Antibiotics for Sepsis鈥擣inding the Equilibrium

Michael Klompas, MD, MPH; Thierry Calandra, MD, PhD; Mervyn Singer, MD, FRCP

Abstract Full Text

JAMA. 2018;320(14):1433-1434. doi:10.1001/jama.2018.12179

This Viewpoint makes the case that the importance of early detection of sepsis and the need for rapid antibiotics in patients with definite infection and possible septic shock has likely led to overuse of antibiotics in patients who might not need them, and argues for testing to confirm infection in non-shock patients in place of rapid empirical antimicrobial treatment.

A Piece of My Mind

The Giving Body

Adam Philip Stern, MD

Abstract Full Text

JAMA. 2018;320(14):1435-1436. doi:10.1001/jama.2018.13844

In this narrative medicine essay, a young physician diagnosed with stage III kidney cancer realized with the progressive loss of systems and organs through treatment that he grew to identify with Shel Silverstein鈥檚 The Giving Tree, about a tree who gives the boy it loves every part of itself until as a stump all it can offer the now old man is a seat.

Editorial

Politics and Health Care

Donald M. Berwick, MD, MPP

Abstract Full Text

JAMA. 2018;320(14):1437-1438. doi:10.1001/jama.2018.12566

Immediate vs Delayed Pushing During the Second Stage of Labor

Jeffrey D. Sperling, MD, MS; Dana R. Gossett, MD, MSCI

Abstract Full Text

JAMA. 2018;320(14):1439-1440. doi:10.1001/jama.2018.12877

The Evolving Epidemiology and Management of Spontaneous Pneumothorax

Eric Savitsky, MD; Scott S. Oh, DO; Jay M. Lee, MD

Abstract Full Text

JAMA. 2018;320(14):1441-1443. doi:10.1001/jama.2018.12878

JAMA Insights

Clinical Update

Management of Chronic Wounds鈥�2018

Ruth Ellen Jones, MD; Deshka S. Foster, MD, MA; Michael T. Longaker, MD, MBA

Abstract Full Text

JAMA. 2018;320(14):1481-1482. doi:10.1001/jama.2018.12426

This Clinical Update summarizes options for chronic wound management in ambulatory settings, including use of standard gauze, negative-pressure wound therapy, advanced dressings (alginates, foams, hydrocolloids, and hydrogels), and adjuvant wound therapies.

JAMA Clinical Evidence Synopsis

Bisphosphonates for Patients Diagnosed With Multiple Myeloma

Rahul Mhaskar, PhD; Benjamin Djulbegovic, MD, PhD

Abstract Full Text

JAMA. 2018;320(14):1483-1484. doi:10.1001/jama.2018.13773

This Clinical Evidence Synopsis summarizes a Cochrane review of randomized trials comparing the effects of bisphosphonate therapy vs placebo or no treatment on mortality, vertebral fractures, nonvertebral fractures, and skeletal-related events among patients with multiple myeloma.

JAMA Diagnostic Test Interpretation

Coagulation Test Interpretation in a Patient Taking Direct Oral Anticoagulant Therapy

Michelle Sholzberg, MDCM, MSc; Yan Xu, MD

Abstract Full Text

JAMA. 2018;320(14):1485-1486. doi:10.1001/jama.2018.13998

A 74-year-old man taking rivaroxaban for atrial fibrillation developed a subdural hematoma and had an elevated prothrombin time (PT) with normal activated partial thromboplastin time (aPTT) and platelets prior to planned surgical evacuation. How do you interpret the results?

Medical News & Perspectives

Unproven but Profitable: The Boom in US Stem Cell Clinics

Rita Rubin, MA

Abstract Full Text

JAMA. 2018;320(14):1421-1423. doi:10.1001/jama.2018.13861

This Medical News & Perspectives article examines the proliferation of US clinics offering unproven stem cell therapies.

The JAMA Forum

The Surprising Resiliency of the Affordable Care Act

Gail Wilensky, PhD

Abstract Full Text

free access

JAMA. 2018;320(14):1423-1424. doi:10.1001/jama.2018.14134

News From the Centers for Disease Control and Prevention

More Youth Vaccinated for HPV

Bridget Kuehn, MSJ

Abstract Full Text

JAMA. 2018;320(14):1426. doi:10.1001/jama.2018.14296

Breastfeeding Report Card

Bridget Kuehn, MSJ

Abstract Full Text

JAMA. 2018;320(14):1426. doi:10.1001/jama.2018.14608

Biotech Innovations

Researchers Test New Techniques to Rule Out and Predict Heart Attacks

Jennifer Abbasi

Abstract Full Text

JAMA. 2018;320(14):1425. doi:10.1001/jama.2018.14749

In-home Robots Improve Social Skills in Children With Autism

Jennifer Abbasi

Abstract Full Text

JAMA. 2018;320(14):1425. doi:10.1001/jama.2018.14385

The Arts and Medicine

In Memoriam鈥擧onoring the Victims of Opioid Addiction

Christopher C. Muth, MD

Abstract Full Text

has multimedia

JAMA. 2018;320(14):1418-1419. doi:10.1001/jama.2018.13658

This Arts and Medicine essay reviews a traveling US exhibit created by the US National Safety Council that honors the human costs of the opioid addiction crisis and engages visitors in strategies to manage opioid use and prevent future deaths.