Jama Clinical Reviews: Interviews About Ideas & Innovations In Medicine, Science & Clinical Practice. Listen & Earn Cme Credi

Interest in space travel has increased since SpaceX’s first commercial launch to the International Space Station in May 2020 and with efforts to send humans to Mars. Jim Bagian, MD, a physician-astronaut who logged 337 hours in space between 1989 and 1991, is director of the Center for Healthcare Engineering and Patient Safety at the University of Michigan and discusses the effects of space travel on the human body and physiologic readjustments on return to earth. Related Content: Do Apollo Astronaut Deaths Shine a Light on Deep Space Radiation and Cardiovascular Disease?

Shyam Prabhakaran, MD, chairman of neurology at the University of Chicago, discusses the diagnosis and evaluation of patients who present with transient ischemic attack (TIA) and stroke. Related Article: Diagnosis and Management of Transient Ischemic Attack and Acute Ischemic Stroke

Semaglutide has recently been shown to induce clinically significant weight loss in patients with obesity that is sustained for as long as the drug is given. Tom Wadden, PhD, from the University of Pennsylvania, discusses results from the series of recent STEP trials and how they compare to the effects of other medications used to treat obesity. Related Articles: Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity Authors have declared conflicts of interest related to the article discussed in this podcast. Visit the article on jama.com for the complete disclosure.

Performing repeated statistical comparisons on data can result in false-positive findings. Jing Cao, PhD, associate professor of statistics at Southern Methodist University, explains problems that can arise from multiple testing procedures and how to avoid making false conclusions. Related Article: Multiple Comparison Procedures

Irritable bowel syndrome (IBS) is a clinical syndrome of vague abdominal pain and cramping associated with diarrhea or constipation. IBS is a diagnosis of exclusion, and a variety of treatments can improve its symptoms. Michael Camilleri, MD, professor of medicine at the Mayo Clinic, discusses recent advances in the diagnosis and management of IBS. Related Content: Diagnosis and Treatment of Irritable Bowel Syndrome

The Pfizer-BioNTech and Moderna COVID-19 mRNA vaccines are the first of many being tested for widespread use. Buddy Creech, MD, MPH, director of the Vanderbilt Vaccine Research Program, reviews these and other vaccines likely to become available, including products that use inactivated, protein subunit, and viral vector immunization strategies. Related Content: SARS-CoV-2 Vaccines

Advance directives (ADs) allow patients to express their medical treatment preferences. Patients with ADs are more likely to receive medical care concordant with their wishes and are less likely to die in the hospital than patients without them, but use remains low in the US. Maria Silvera, MD, a palliative care physician and associate professor of medicine at the University of Michigan, and Catherine Auriemma, MD, a fellow in pulmonary/critical care medicine at the University of Pennsylvania, discuss the importance of ADs and strategies to increase their uptake. Related Article: Completion of Advance Directives and Documented Care Preferences During the Coronavirus Disease 2019 (COVID-19) Pandemic

The CDC coordinated a massive effort to immunize nearly all nursing home and long-term care facility residents in the US against COVID-19 infection in the month after vaccine approval. Ruth Link-Gelles, PhD, MPH, CDC staff epidemiologist and Lieutenant Commander of the US Public Health Service Commissioned Corps, describes how. Related Article(s): First-Dose COVID-19 Vaccination Coverage Among Skilled Nursing Facility Residents and Staff Nursing Homes’ Next Test—Vaccinating Workers Against COVID-19

This is Dr Howard Bauchner, Editor in Chief of JAMA and the JAMA Network. The podcast on structural racism based on the discussion between Dr Ed Livingston and Dr Mitch Katz has been withdrawn.  Comments made in the podcast were inaccurate, offensive, hurtful, and inconsistent with the standards of JAMA.  Racism and structural racism exist in the US and in health care.  After careful consideration, I determined that the harms caused by the podcast outweighed any reason for the podcast to remain available on the JAMA Network.  I once again apologize for the harms caused by this podcast and the tweet about the podcast.  We are instituting changes that will address and prevent such failures from happening again.

Highly effective B-cell therapies like rituximab and ofatumumab have changed the outlook for patients with multiple sclerosis (MS). Alexander Rae-Grant, MD, emeritus professor of neurology at the Cleveland Clinic Lerner College of Medicine, discusses recent advances in the diagnosis and treatment of MS. Related Article(s): Diagnosis and Treatment of Multiple Sclerosis Progress in Multiple Sclerosis Research

Natural experiments comparing coronavirus spread on ships and in hair salons with vs without face masks point to the importance of wearing masks for curbing SARS-CoV-2 spread. John T. Brooks, MD, chief medical officer of the CDC’s COVID-19 response team, reviews recently published epidemiologic data that reinforce the role of mask use for pandemic control. Related Article: Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2

Philip Cohen, MD, associate clinical professor of internal medicine at UCLA, a primary care internist who also specializes in sports medicine, discusses the primary care management of osteoarthritis. Related Articles: Drugs for Osteoarthritis Diagnosis and Treatment of Hip and Knee Osteoarthritis

Immune checkpoint inhibitors have been a major breakthrough in cancer treatment but can have many serious adverse effects. Pankti Reid, MD, MPH, assistant professor of medicine in rheumatology at the University of Chicago, discusses the pathogenesis, diagnosis, and treatment of toxicities from immune checkpoint inhibitors as outlined by the 2019 NCCN guidelines. Related Article: Management of Immunotherapy-Related Toxicities in Patients Treated With Immune Checkpoint Inhibitor Therapy

Howard Reber, MD, emeritus professor of surgery at UCLA, discusses how to treat acute pancreatitis. Related Article(s): Acute Pancreatitis

Howard Reber, MD, emeritus professor of surgery at UCLA, discusses how to diagnose acute pancreatitis. Related Article(s): Acute Pancreatitis

Ethnic and racial minorities have been particularly hard hit with COVID-19 in some communities. Mitchell Katz, MD, president and chief executive officer of New York City Health + Hospitals, and former Los Angeles County health agency director, discusses this problem and what has been learned from COVID-19 that can help resolve the general problem of health care disparities. Related Article: Racial and Ethnic Health Disparities Related to COVID-19

Tobacco use is the leading cause of preventable disease and death in the world, but most attempts to quit are unsuccessful. Atul Jain, MD, assistant professor of medicine at Mayo College of Medicine, discusses new guidelines from the American Thoracic Society on pharmacologic management of tobacco cessation, including target population and deciding when to initiate. Related Article(s): Initiating Pharmacologic Treatment in Tobacco-Dependent Adults

Mitchell Katz, MD, president and chief executive officer of New York City Health + Hospitals, and former Los Angeles County health agency director, discusses causes, similarities, and differences between the spike of COVID-19 cases, hospitalizations, and deaths in the 2 cities. Related Article: Modernize Medical Licensing, and Credentialing, Too—Lessons From the COVID-19 Pandemic

Glaucoma is the most common cause of irreversible blindness in the world. Joshua Stein, MD, MS, associate professor of ophthalmology at the University of Michigan, reviews the diagnosis and treatment of glaucoma. Related Article: Glaucoma in Adults—Screening, Diagnosis, and Management

A new trial reports that a third of emergency department patients presenting with appendicitis admitted for oral antibiotic treatment had outcomes no different from those admitted for intravenous antibiotic treatment. Paulina Salminen, MD, PhD, professor of surgery at the University of Turku in Finland, discusses the findings. Related Article(s): Effect of Oral Moxifloxacin vs Intravenous Ertapenem Plus Oral Levofloxacin for Treatment of Uncomplicated Acute Appendicitis