JAMA Clinical Reviews

Mpox is an evolving global health threat, and clinicians should be aware of characteristic signs and symptoms to ensure timely diagnosis and appropriate management. Author Jason Zucker, MD, MS, of Columbia University Irving Medical Center speaks with JAMA Deputy Editor Preeti Malani, MD, MSJ, about the transmission, diagnosis, management, and prevention of mpox. Related Content: Mpox Clinical Presentation, Diagnostic Approaches, and Treatment Strategies The Resurgence of Mpox in Africa Decline of Mpox Antibody Responses After Modified Vaccinia Ankara–Bavarian Nordic Vaccination WHO Announces Mpox Global Plan, Appeals for Funding

Calcific aortic stenosis affects approximately 12% of people >75 years in the US and worldwide leads to more than 100 000 deaths each year. Catherine M. Otto, MD, PhD, of the University of Washington School of Medicine, Seattle, discusses the symptoms, diagnosis, and treatment of aortic stenosis with JAMA Deputy Editor Kristin L. Walter, MD, MS. Related Content: Calcific Aortic Stenosis

Jennifer N. Brudno, an Associate Research Physician at the National Cancer Institute, shares her expertise on CAR T-cell therapy. The discussion highlights how genetically engineered T cells specifically target and kill tumor cells, showing promise against various B cell malignancies. Brudno also delves into the side effects, like cytokine release syndrome and neurological toxicities, while addressing FDA concerns over secondary malignancies. Plus, logistical challenges and advancements in making these therapies more accessible are explored, painting a comprehensive picture of CAR T-cell therapy's impact.

In this insightful discussion, Nimish Vakil, a clinical professor and gastroenterologist from the University of Wisconsin, delves into the complexities of peptic ulcer disease. He outlines how H. pylori and NSAIDs are principal culprits, shedding light on recommended treatment regimens. Vakil clarifies misconceptions about diet and stress, noting their impact on symptoms but not on causing ulcers. He also addresses a troubling rise in non-H pylori cases among younger adults, emphasizing the need for targeted research and management.

Hussain S. Lalani, a primary care physician at Brigham and Women's Hospital and Harvard instructor, joins to tackle the critical issue of high prescription drug costs. He discusses effective strategies for patients to cut down expenses, including the use of copayment cards and patient assistance programs. The conversation also introduces a tailored algorithm for clinicians, emphasizing patient-centered approaches. Additionally, Lalani warns about online pharmacy scams and shares tips for navigating the complex landscape of medication affordability.

Monica Gandhi, an infectious diseases specialist and professor at UCSF, dives into the world of preexposure prophylaxis (PrEP) for HIV. She discusses the alarming rate of new HIV infections globally and the innovative therapies available, including oral medications and the dapivirine ring, which empowers women in HIV prevention. Gandhi emphasizes the critical role of adherence in maximizing PrEP's effectiveness and shares strategies to improve it. She also advocates for primary care doctors to more widely prescribe PrEP, likening it to the adoption of contraception in healthcare.

In July 2023, the US Food and Drug Administration (FDA) approved Opill, a daily progestin-only oral contraceptive for over-the-counter sale to people of all ages. Daniel Grossman, MD, discusses this and more with JAMA Associate Editor Melissa A. Simon, MD, MPH. Related Content: Over-the-Counter Oral Contraceptives Over-the-Counter Oral Contraceptive Pills Over-the-Counter Progestin-Only Oral Contraceptives

Jennifer E. Flythe, MD, MPH, a dialysis expert from the University of North Carolina, joins Kristin L. Walter, MD, MS, JAMA's Deputy Editor. They delve into the crucial decision-making process behind choosing hemodialysis or peritoneal dialysis based on patient symptoms and preferences. The discussion highlights the ineffectiveness of statins and ICDs for cardiovascular prevention in dialysis patients. They also explore managing common symptoms like pruritus and depression, while shedding light on the high mortality risk within the first six months of treatment.

Pavel Kolkhir, MD, an expert in chronic spontaneous urticaria, teams up with Karen E. Lasser, MD, MPH, a JAMA Senior Editor, to unpack this puzzling condition. They delve into its prevalence and varied symptoms, from itchy wheals to angioedema. The conversation touches on crucial distinctions between autoimmune and autoinflammatory diseases. They also reveal effective treatment strategies, emphasizing the importance of second-generation antihistamines and advanced options like Omalizumab. The impact on patients' quality of life, including psychological challenges, is also explored.

Scott A. Flanders, MD, an expert on community-acquired pneumonia, and Valerie M. Vaughn, MD, MSc, discuss key insights into its diagnosis and treatment with Mary McGrae McDermott, MD. They explore the evolving definitions and classifications of CAP. Signs, symptoms, and the impact of the lung microbiome are emphasized. The conversation also covers emerging challenges in diagnosing mycoplasma and Legionella infections, antibiotic stewardship, and the importance of personalized therapy, especially in light of the COVID-19 pandemic.