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JAMA Clinical Reviews

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Mar 20, 2020 • 9min

Coronavirus (COVID-19) Update: Early Safety Signals Around Ibuprofen and Renin-Angiotensin Inhibitors

Emerging information about how SARS-CoV-2 virus infects cells has led to speculation that NSAIDs and ACE inhibitors/angiotensin receptor blockers (ARBs) may worsen clinical disease. Infectious disease physician Carlos del Rio, MD, of Emory University explains the concerns and their clinical implications.
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Mar 17, 2020 • 23min

Who Was Nathan Pritikin and Why Is There a Diet Named After Him?

This podcast explains the Pritikin diet to patients. Nathan Pritikin was a college dropout who became an entrepreneur. While doing research for the government during World War II, he observed that populations that had extremely limited food availability because of the war had substantially reduced mortality from cardiovascular disease—something unexpected at a time when cardiovascular disease was thought to be due to stress. After the war when food became more available CVD death rates went back up, resulting in Pritikin concluding that CVD was related to diet. Pritikin devised his own very low-fat diet that bears his name and the diet is still in use 65 years later. Related: The Pritikin Diet The Lost Lectures from Nathan Pritikin (drmcdougall.com)
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Mar 17, 2020 • 24min

Nathan Pritikin and His Diet

Nathan Pritikin was a college dropout who became an entrepreneur. While doing research for the government during World War II, he observed that populations that had extremely limited food availability because of the war had substantially reduced mortality from cardiovascular disease—something unexpected at a time when cardiovascular disease was thought to be due to stress. After the war when food became more available CVD death rates went back up, resulting in Pritikin concluding that CVD was related to diet. Pritikin devised his own very low-fat diet that bears his name and the diet is still in use 65 years later. Related: The Pritikin Diet The Lost Lectures from Nathan Pritikin (drmcdougall.com)
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Mar 15, 2020 • 24min

COVID-19 in Seattle: Clinical Features and Managing the Outbreak

Seattle was one of the first US cities to have a COVID-19 outbreak, with a cluster of nursing home-related deaths. However, many people who tested positive for the novel coronavirus never became ill, and in some the clinical illness was indistinguishable from influenza. John Lynch, MD, MPH, an infectious disease physician and medical director for infection prevention and control at the Harborview Medical Center, summarizes his hospital’s experience managing the patients and outbreak.
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Mar 13, 2020 • 21min

The Effect of the COVID-19 Pandemic on Clinic Operations

Seattle has been a focal point for the US in the coronavirus pandemic. Doug Paauw, MD, professor of medicine at the University of Washington, in Seattle, describes the UW primary care clinic experience as this pandemic evolved. Major lessons learned included accommodating for significant numbers of staff not available to work in the clinic because of school closures, change in workflow because of shortages of personal protective equipment, physicians having to accommodate very large numbers of patient queries via telephone, email, or electronic health record, and the importance of the rapid development of local ability to test for SARS-CoV-2 independent of public health agencies.
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Mar 9, 2020 • 33min

Update on Coronavirus: March 6, 2020, by NIAID’s Anthony Fauci, MD

Coronovirus (the virus SARS-CoV-2) continues to spread throughout the world. In recent weeks, there has been an increasing number of cases and deaths in the US. As concern about the virus increases, there is an increasing need for accurate information about the disease and how much concern we should have. Anthony Fauci, MD, is the director of the National Institute for Allergy and Infectious Diseases (NIAID) and has been the main spokesperson for the US government about coronavirus. Dr Fauci spoke with JAMA Editor in Chief Howard Bauchner, MD, about where we are as of today with the SARS-CoV-2 epidemic. JAMA Coronavirus Resource Center
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Feb 25, 2020 • 10min

Unprofessional Behavior Leads to Complications

Physicians who act out cause all sorts of problems. Fortunately, only a few clinicians have behavior problems and in the modern era, bad behaviors are not tolerated. Bad behaviors get reported these days and actions are taken against these sorts of clinicians. Clinicians who act out frequently say they are doing so to protect their patients. But are they? William Cooper, MD, MPH, and Gerald B. Hickson, MD, from Vanderbilt University Medical Center in Nashville, Tennessee, discuss a study they published in relating bad behaviors to having more complications of surgical care. Related article: Association of Coworker Reports About Unprofessional Behavior by Surgeons With Surgical Complications in Their Patients
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Feb 18, 2020 • 31min

The 2020 Influenza Epidemic—More Serious Than Coronavirus in the US

Although coronavirus disease 2019 (COVID-19) dominates the news in early 2020, it affects few people in the US. In contrast, at the same time the US is experiencing a severe influenza epidemic, which has caused an estimated 250 000 hospitalizations and 14 000 deaths. Timothy Uyeki, MD, lead for the CDC’s 2019 novel coronavirus response team and Chief Medical Officer of CDC’s influenza division, discusses influenza in the US, how it compares to coronavirus, and what both patients and clinicians should know about this year’s flu season. CDC's Influenza site CDC's Weekly U.S. Influenza Surveillance Report HealthMap Vaccine Finder
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Feb 18, 2020 • 9min

AIDS-Related Chronic Inflammation Leading to Chronic Disease

Great strides have been made in treating HIV, as Anthony Fauci, MD, discusses in this podcast episode. But even substantial viral suppression leaves some virus behind, causing chronic inflammation. Many chronic diseases, including atherosclerotic coronary vascular disease, are worsened by this chronic inflammatory state. Because HIV patients are now living very long lives, they are also developing chronic diseases at a more rapid rate than their non-HIV-infected peers because of this chronic inflammation.
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Feb 11, 2020 • 14min

Testing for Breast Cancer Susceptibility Genes

Breast cancer is a leading cause of death in women. Some women have a cancer susceptibility gene known as BRCA, and women should be tested for BRCA under some circumstances. Carol Mangione, MD, division chief of General Internal Medicine and Health Services Research at UCLA, discusses when testing is appropriate, and Ranjit Manchanda, MD, PhD, from Barts Cancer Institute in London, UK, discusses the cost-effectiveness of BRCA screening for women who have had breast cancer.

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