JAMA Clinical Reviews

Neelima Tummala, an ear, nose, and throat specialist at NYU Langone Health, discusses the alarming impact of climate change on allergic rhinitis and sinusitis. She highlights how rising temperatures and CO2 levels are extending allergy seasons and increasing pollen production. Tummala shares practical strategies for patients, such as using purifiers and optimizing medication timing to align with pollen shifts. She emphasizes the importance of education and advocacy for public health in the face of climate challenges.

In a thought-provoking discussion, Kevin Hill, an addiction specialist and Associate Professor at Harvard Medical School, dives into the therapeutic applications of cannabis and cannabinoids. He highlights the critical balance clinicians must find between the benefits and risks of use. Hill shares data on the prevalence of medical cannabis, explains FDA-approved formulations, and addresses acute and chronic risks associated with THC. He also discusses strategies for harm reduction and voices concerns about adolescent use impacting cognitive health.

Dr. Michelle Mauermann, a professor of neurology and chair at the Mayo Clinic, shares insights on peripheral neuropathy, a condition affecting 1% of adults globally. She discusses its common causes like diabetes and B12 deficiency, the mechanisms behind its debilitating symptoms, and the importance of early diagnosis through EMG testing. Treatment strategies range from conservative measures to tailored medications like gabapentinoids. Mauermann also highlights the role of physical therapy in managing symptoms and preventing falls.

Norbert Stefan, MD, a leading endocrinologist and MASLD researcher, discusses metabolic dysfunction-associated steatotic liver disease. He reveals alarming global prevalence rates, especially in obesity and diabetes. Geographic variations in MASLD highlight rising incidences in Asia and harsher impacts in Eastern Europe. Stefan explains the role of diet, alcohol, and exercise in managing MASLD and outlines the diagnosis process through ultrasound and advanced imaging. He also covers innovative treatments, including medication and lifestyle changes to combat this growing health concern.

Frederick P. Rivara, a pediatrician and firearms injury prevention expert at the University of Washington, joins host Kirsten Bibbins-Domingo to discuss the recent JAMA Summit on reducing firearm violence. They explore the public health crisis of firearm deaths and outline a ambitious roadmap for a safer future by 2040. Rivara shares insights from a diverse group of 60 experts, highlighting five strategic steps to reduce firearm harms, and emphasizes the importance of community-based interventions and systems change in tackling violence.

Mackenzie R. Wehner, an Assistant Professor of Dermatology at MD Anderson Cancer Center, dives into the world of keratinocyte carcinomas, a prevalent form of skin cancer. She discusses risk factors like UV exposure and the impact of childhood sunburns. Indoor tanning's contribution to cancer risk reveals alarming truths, while sunscreen advice highlights the importance of SPF 30+. Wehner clarifies how to distinguish actinic keratoses from more serious conditions, and emphasizes the need for regular skin exams and careful monitoring to minimize recurrence.

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.