JAMA Clinical Reviews

For many years guidelines have recommended against obtaining ECGs for low-risk patients undergoing routine health examinations. Yet about a fifth of all patients having these exams get an ECG. Why? Are clinicians just stubborn or uninformed or are the guidelines missing something clinicians are concerned about? Read the article: The Screening ECG and Cardiac Risks  

Many attempts to replace the trachea have failed in the past. The most spectacular failure was fraudulent research done in Europe by a high-profile surgeon who was eventually charged with scientific misconduct. JAMA now reports a clinical series of successful tracheal transplants done in France. How do we know the procedures described in JAMA really worked? The answer is provided in this podcast.

The controversy continues about the efficacy of PSA screening for prostate cancer. New recommendations were just issued from the USPSTF about who should be screened for prostate cancer and when. But not everyone agrees with these recommendations. Ballentine Carter, MD, from the Department of Urology at the Johns Hopkins School of Medicine, discusses the new recommendations and provides an expert urologist's perspective on PSA screening for prostate cancer. Related article

Peanut allergy is common. But it is more common in countries that delay the introduction of peanuts into the diets of infants. Guidelines in the United States previously recommended delayed introduction of peanuts for infants, which resulted in an increased prevalence of peanut allergy. New recommendations now recommend early introduction of peanuts into infants’ diets to minimize the risk of developing peanut allergy. Read the article: Peanut Allergy Prevention

Acute respiratory disease syndrome is characterized by respiratory failure that occurs after someone is acutely ill, usually from a disease that does not primarily involve the lungs. Its cause, diagnosis, and treatment are reviewed in this JAMA Clinical Reviews Podcast for the February 20, 2018 issue

Douglas H. Smith, MD, of the University of Pennsylvania's Department of Neurosurgery and Center for Brain Injury and Repair, and Randel Swanson II, DO, PhD, of the University of Pennsylvania's Physical Medicine and Rehabilitation department, summarize findings from a clinical evaluation of US government personnel reporting neurologic symptoms after exposure to directional auditory and sensory phenomena during their official postings in Havana, Cuba.  

The health risks associated with participation in American football have garnered increasing attention over the past several years. Particular focus has been on concussion and the association of repeated head trauma with chronic traumatic encephalopathy (CTE). However, other factors related to participation in professional football might be associated with better or worse health throughout life. Dr Ann McKee discusses the occurrence of CTE in a case series of deceased football players who donated their brains for research. Former National Football League (NFL) player Mike Adamle shares his story including his symptoms and suspected diagnosis of CTE. Dr Atheendar Venkataramani discusses a recent study about the association between playing in the NFL and all-cause mortality. Read the articles: Association Between American Football in the NFL and Long-term Mortality in Retirement Evaluation of Chronic Traumatic Encephalopathy in American Football Players JAMA Patient Page: Sport-Related Concussion  

Why is two-thirds of the US population overweight or obese? Obesity began to increase in 1980, and its incidence is still rising. One reason for this might be that the population has become tolerant of obesity and accepted it as the normal state. On the other end of the spectrum, some people desire to lose weight but, in general, diets and medications are not very effective. The most effective way to lose weight is with bariatric surgery. A relatively new procedure, the gastric sleeve resection, has been introduced. However, most new bariatric operations fail; think of the jejunoileal bypass, vertical banded gastroplasty, and laparoscopic adjustable gastric banding procedures. Has the gastric sleeve resection been successful? A series of articles providing definitive outcomes for these procedures have been published in JAMA and their results are summarized in this podcast. Interviewees: David E. Arterburn, MD, MPH Kaiser Permanente Washington Health Research Institute, Seattle, WA Anirban Gupta, MD Washington Permanente Medical Group, Bellevue, WA Read the article: Comparing the Outcomes of Sleeve Gastrectomy

The incidence of thyroid cancer is increasing. Like so many cancers, it is being diagnosed at earlier stages because of more aggressive screening and diagnostic testing. The aggressiveness of very early stage thyroid cancer is unknown and some of these tumors may be managed by active surveillance instead of surgery. In this podcast, Dr Sally Carty, Professor of Surgery at the University of Pittsburgh, reviews how to manage thyroid cancer. Natural History and Tumor Volume Kinetics of Papillary Thyroid Cancers Patient-Guided Decision Making in Papillary Thyroid Cancer Active Surveillance for Thyroid Cancer

Sinusitis is one of the most common conditions seen by clinicians. Despite its frequency, it is often misdiagnosed. In this podcast, we review the proper way to establish a diagnosis and treat both acute and chronic sinusitis. Related article