October 1, 2019 Issue of JAMA

October 1, 2019, Vol 322, No. 13, Pages 1225-1322

This Week in JAMA

Highlights

Abstract Full Text

free access has audio

JAMA. 2019;322(13):1225-1227. doi:10.1001/jama.2018.15531

Podcast: Effect of Vitamin C in Sepsis, Anesthesia vs Sedation for Stroke Thrombectomy, CKD Review, and more

Original Investigation

Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity

Ali Aminian, MD; Alexander Zajichek, MS; David E. Arterburn, MD, MPH; et al.

Abstract Full Text

free access has audio

JAMA. 2019;322(13):1271-1282. doi:10.1001/jama.2019.14231

This matched-cohort study uses Cleveland Clinic Health System data to investigate the association between bariatric surgery and major adverse cardiovascular events (MACE), including mortality, coronary disease and stroke, in adult patients with type 2 diabetes and obesity.

Podcast: Bariatric Surgery and Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity
Podcast: Update on Bariatric Surgery鈥�2020

Editorial
The Role of Bariatric Surgery in Managing the Macrovascular Complications of Obesity-Related Type 2 Diabetes
Edward H. Livingston, MD

JAMA

Association of General Anesthesia vs Procedural Sedation With Functional Outcome Among Patients With Acute Ischemic Stroke Undergoing Thrombectomy: A Systematic Review and Meta-analysis

Silvia Schönenberger, MD; Pia Löwhagen Hendén, MD; Claus Z. Simonsen, MD; et al.

Abstract Full Text

free access

JAMA. 2019;322(13):1283-1293. doi:10.1001/jama.2019.11455

This meta-analysis pools individual patient data to estimate the association between receipt of general anesthesia vs procedural sedation and 3-month disability among patients with acute ischemic stroke undergoing mechanical thrombectomy from 3 randomized trials.

Preliminary Communication

Caring for the Critically Ill Patient

Effect of Vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe Acute Respiratory Failure: The CITRIS-ALI Randomized Clinical Trial

Alpha A. Fowler III, MD; Jonathon D. Truwit, MD; R. Duncan Hite, MD; et al.

Abstract Full Text

free access has multimedia

JAMA. 2019;322(13):1261-1270. doi:10.1001/jama.2019.11825

This randomized clinical trial compares the effects of high-dose vitamin C vs placebo on the incidence of organ failure and biomarkers of inflammation and vascular injury in patients in the intensive care unit (ICU) with sepsis and ARDS.

Video: Conference Interview: The Preclinical Basis for Testing the Effects of Vitamin C in Sepsis and ARDS
Video: Conference Presentation: Effect of Vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe ARDS: A Randomized Clinical Trial

Editorial
Is High-Dose Vitamin C Beneficial for Patients With Sepsis?
Emily B. Brant, MD; Derek C. Angus, MD, MPH

JAMA

Research Letter

Drive Times to Opioid Treatment Programs in Urban and Rural Counties in 5 US States

Paul J. Joudrey, MD, MPH; E. Jennifer Edelman, MD, MHS; Emily A. Wang, MD, MAS

Abstract Full Text

free access

JAMA. 2019;322(13):1310-1312. doi:10.1001/jama.2019.12562

This study characterizes driving distances to opioid treatment programs in urban vs rural counties in states with the highest rates of opioid mortality and compares them with distances to methadone-prescribing federally qualified health centers and dialysis centers.

Viewpoint

Discovery of 2 Distinctive Lineages of Lymphocytes, T Cells and B Cells, as the Basis of the Adaptive Immune System and Immunologic Function: 2019 Albert Lasker Basic Medical Research Award

Max Dale Cooper, MD; Jacques F. A. P. Miller, MD, PhD

Abstract Full Text

free access

JAMA. 2019;322(13):1247-1248. doi:10.1001/jama.2019.13815

In this Viewpoint, 2019 Albert Lasker Basic Medical Research Award winners Max Dale Cooper and Jacques F. A. P. Miller discuss their discovery of B and T cells, which provided the organizing principle of the adaptive immune system and launched the course of modern immunology.

Biomarker-Driven Drug Discovery in Cancer鈥擳rastuzumab Development: 2019 Lasker-DeBakey Clinical Medical Research Award

H. Michael Shepard, PhD

Abstract Full Text

free access

JAMA. 2019;322(13):1249-1250. doi:10.1001/jama.2019.13963

In this Viewpoint, 2019 Lasker-DeBakey Clinical Medical Research Award winner H. Michael Shepard discusses development of trastuzumab, the first fully humanized monoclonal antibody for solid tumor treatment and the first tyrosine kinase inhibitor, for treatment of breast cancer.

The Power of Vaccines and How Gavi Has Helped Make the World Healthier: 2019 Lasker-Bloomberg Public Service Award

Seth Berkley, MD

Abstract Full Text

free access

JAMA. 2019;322(13):1251-1252. doi:10.1001/jama.2019.13190

In this Viewpoint, the CEO of Lasker-Bloomberg Public Service Award winner Gavi, the Vaccine Alliance, describes its work improving access to affordable childhood vaccines in low-income countries.

Medicaid Expansion and Health: Assessing the Evidence After 5 Years

Heidi Allen, PhD, MSW; Benjamin D. Sommers, MD, PhD

Abstract Full Text

has audio

JAMA. 2019;322(13):1253-1254. doi:10.1001/jama.2019.12345

This Viewpoint reviews evidence for associations between Medicaid expansion under the Affordable Care Act and self-reported health outcomes, condition-specific outcome measures from administrative data, and state and national health indicators for low-income populations.

Conversations with Dr Bauchner: Medicaid Expansion and Health: Assessing the Evidence After Five Years

A Piece of My Mind

Driving in the Minivan鈥擫ife as a Pediatrician and Parent of a Child With Disabilities

Megan H. Pesch, MD

Abstract Full Text

JAMA. 2019;322(13):1255-1256. doi:10.1001/jama.2019.14889

In this narrative medicine essay, a developmental and behavioral pediatrician shares her experience parenting her youngest daughter, deaf from exposure to congenital cytomegalovirus (CMV) and the joys and struggles guiding the care and development of a child with hearing impairment.

Editorial

Is High-Dose Vitamin C Beneficial for Patients With Sepsis?

Emily B. Brant, MD; Derek C. Angus, MD, MPH

Abstract Full Text

JAMA. 2019;322(13):1257-1258. doi:10.1001/jama.2019.11643

The Role of Bariatric Surgery in Managing the Macrovascular Complications of Obesity-Related Type 2 Diabetes

Edward H. Livingston, MD

Abstract Full Text

JAMA. 2019;322(13):1259-1260. doi:10.1001/jama.2019.14577

Review

Chronic Kidney Disease Diagnosis and Management: A Review

Teresa K. Chen, MD, MHS; Daphne H. Knicely, MD; Morgan E. Grams, MD, PhD

Abstract Full Text

has audio

JAMA. 2019;322(13):1294-1304. doi:10.1001/jama.2019.14745

This narrative review discusses the diagnosis, evaluation, staging, and management of chronic kidney disease (CKD), including discussion of new calculators for determining risk of CKD progression, treatment of complications, and considerations for referral to a nephrologist and dialysis initiation.

Podcast: Acute Kidney Injury Caused by Proton Pump Inhibitors

JAMA Insights

Genomics and Precision Health

Improving the Understanding of Genetic Variants in Rare Disease With Large-scale Reference Populations

Nicola Whiffin, PhD; James S. Ware, PhD, MRCP; Anne O鈥橠onnell-Luria, MD, PhD

Abstract Full Text

JAMA. 2019;322(13):1305-1306. doi:10.1001/jama.2019.12891

This Genomics and Precision Health update explains the importance of large and diverse reference populations in human genome databases to more accurately report allele frequencies of rare variants.

JAMA Clinical Challenge

Breast Mass in an African American Man

Vanessa Buie, MD; April Swoboda, MD; Jean Bao, MD

Abstract Full Text

JAMA. 2019;322(13):1307-1308. doi:10.1001/jama.2019.12698

A 43-year-old African American man presented with a nontender, self-palpated mass in his left breast. Physical examination showed retraction of the nipple and a 3.5鈥壝椻€�3.0鈥揷m firm mass, with no axillary lymphadenopathy. Mammography showed a partially obscured left upper quadrant mass with extension to the nipple, and targeted ultrasound showed an irregular hypoechoic mass. What is the diagnosis and what would you do next?

Medical News & Perspectives

Quick Uptakes

How Old Is Too Old to Be President?

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2019;322(13):1240-1241. doi:10.1001/jama.2019.14329

This Medical News article reports on a recent analysis that concludes that older candidates鈥� ages shouldn鈥檛 be a concern in the 2020 presidential election.

Cardiovascular Corner: Prescription Omega-3s, Stroke Rehab, and Statins After Age 75

Jennifer Abbasi

Abstract Full Text

JAMA. 2019;322(13):1241-1243. doi:10.1001/jama.2019.14485

This Medical News article is an update on important clinical research in the world of heart disease and stroke.

News From the Food and Drug Administration

Contaminated Duodenoscope Saga Continues

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2019;322(13):1246. doi:10.1001/jama.2019.15402

New Antibiotic for Community-Acquired Pneumonia

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2019;322(13):1246. doi:10.1001/jama.2019.15179

Add-on Drug Approved for 鈥淥ff鈥� Episodes of Parkinson Disease

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2019;322(13):1246. doi:10.1001/jama.2019.15403

The JAMA Forum

Price Transparency in Health Care Has Been Disappointing, but It Doesn鈥檛 Have to Be

Gilbert Benavidez, MPH; Austin Frakt, PhD

Abstract Full Text

free access

JAMA. 2019;322(13):1243-1244. doi:10.1001/jama.2019.14603

Bench to Bedside

Autophagy Genes Linked to Sepsis Survival in Mice

Tracy Hampton, PhD

Abstract Full Text

JAMA. 2019;322(13):1244-1245. doi:10.1001/jama.2019.14766

The Arts and Medicine

Jamaica Kincaid鈥檚鈥淕irl鈥� and the Challenge of Growing Up in Medical Training

Naomi Rosenberg, MD; Michael Vitez, BA

Abstract Full Text

JAMA. 2019;322(13):1238-1239. doi:10.1001/jama.2019.14003

This Arts and Medicine feature describes use of author Jamaica Kincaid鈥檚 short story 鈥淕irl鈥� in narrative medicine workshops to help residents explore hierarchies and the challenges of growing up professionally in their medical training programs.

Poetry and Medicine