JAMA Clinical Reviews

Benjamin Solomon, PhD, a medical oncologist from the Peter MacCallum Cancer Centre, discusses the troubling rise of lung cancer in nonsmoking individuals, accounting for 15-20% of cases globally. He highlights the influence of environmental factors like air pollution and the peculiar histological differences, with adenocarcinoma being prevalent in nonsmokers. Solomon also tackles the lack of screening guidelines for this demographic, the challenges in early detection, and the importance of targeted therapies, emphasizing the need for better understanding and support for these patients.

Franco Chevalier, an infectious disease physician and Deputy Medical Director at the San Francisco City Clinic, dives into the alarming rise of syphilis cases in the U.S. He discusses the serious complications of untreated syphilis, including potential blindness and dementia. Chevalier outlines effective serologic testing strategies, illuminates when to consider lumbar punctures for neurosyphilis, and talks about emerging rapid testing options. He emphasizes the importance of early treatment with penicillin and the latest prevention guidelines, reminding clinicians of syphilis's complex clinical presentations.

David Christiani, a Professor of Environmental Genetics at Harvard, explores the pressing issue of microplastic pollution. He reveals the shocking presence of microplastics in human tissues and their potential health risks, linking them to respiratory and cardiovascular issues. The conversation touches on how microplastics interact with harmful chemicals and their prevalence in everyday items. Christiani emphasizes the need for innovative policy measures to combat this man-made crisis and instills hope for a cleaner future.

Join Juan Carlos Cardet, an Associate Professor specializing in Allergy and Immunology, as he unpacks the complexities of managing severe refractory asthma. He explains the significance of Type 2 asthma and identifies key tests essential for accurate diagnosis. Dr. Cardet highlights the role of inhaled corticosteroids and outlines when to consider biologic therapies. He also discusses the promising impact of these therapies on reducing exacerbations and hospitalizations, while addressing disparities in access to specialized care.

Epidemiologist Brian Lee from Drexel University discusses his groundbreaking study on acetaminophen use in pregnancy and its potential link to autism and neurodevelopmental issues. He delves into the study's findings that suggest initial associations may vanish when sibling analyses are considered, challenging the notion of causality. Lee also addresses the rigorous design of the study, the importance of dose-response analysis, and how clinicians can effectively counsel expectant mothers amidst conflicting advice. This engaging conversation demystifies critical concerns for parents.

Angela Fagerlin, a leading researcher at the University of Utah, shares her insights on communicating medical numbers effectively. She emphasizes the importance of using numeric probabilities instead of vague terms, which can mislead patients. Fagerlin advocates for consistent denominators to simplify comparisons and prefers absolute differences over relative risks for clarity. Visual displays, like pictographs, enhance understanding, while providing context for unfamiliar biomarker numbers improves patient decision-making. Ultimately, informed choices hinge on clear numeric communication.

In this discussion, Behnood Bikdeli, a cardiologist at Brigham and Women’s Hospital, delves into the complexities of superficial vein thrombosis (SuVT). He outlines the pathophysiology, risk factors, and crucial symptoms associated with the condition. Bikdeli emphasizes the significance of Doppler ultrasound in diagnosis and the potential transition to deep vein thrombosis. Treatment strategies, including the use of warm compresses and the selective application of anticoagulation, are also thoroughly explored, highlighting tailored approaches for high-risk patients.

Dr. Maria Papaleontiou, an Associate Professor of Medicine at the University of Michigan specializing in hypothyroidism research, joins to illuminate this complex condition. She discusses the prevalence and risk factors associated with hypothyroidism, emphasizing geographic and demographic influences. The conversation highlights critical symptoms like fatigue and cognitive challenges, plus the severe consequences of untreated cases, including heart failure. Dr. Papaleontiou also stresses personalized treatment approaches and the importance of monitoring treatment to avoid complications.

In this engaging discussion, Alexander Chern, a neurotology fellow at Johns Hopkins, dives into the exciting world of over-the-counter hearing aid-enabled earbuds. He explains how these innovative devices, like Apple's AirPods Pro 2, merge hearing health with consumer technology. Chern highlights the potential for increased accessibility, while addressing the challenges of stigma linked to hearing aids. Listeners will learn about home testing methods for hearing assessments, making hearing health more approachable and affordable for everyone.

John Kirkwood, Co-director of the Melanoma and Skin Cancer Program at the University of Pittsburgh, joins Kristin Walter to discuss cutaneous melanoma. They cover the alarming rise in incidence and highlight risk factors like UV exposure and atypical moles. Screening guidelines are clarified, stressing the need for annual exams. Kirkwood also delves into advancements in treatment, including immunotherapy, which has notably improved patient survival rates. Tune in for crucial insights into prevention and management strategies!