Preexposure prophylaxis (PrEP) involves use of antiviral medication for HIV prevention in HIV-negative adults or adolescents at risk for HIV through sex or injection drug use. The United Nations Programme on HIV/AIDS (UNAIDS) recently set a goal for 95% of people at risk of HIV (approximately 10...
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Update on Over-the-Counter (OTC) Contraception
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.
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Dialysis for Chronic Kidney Failure
Selection of hemodialysis or peritoneal dialysis and timing of dialysis initiation are influenced by patient symptoms, laboratory trajectories, patient preferences, and therapy cost and availability; shared decision-making is key. Jennifer E. Flythe, MD, MPH, from the University of North...
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Dialysis for Chronic Kidney Failure: A Review
Importance: More than 3.5 million people worldwide and 540 000 individuals in the US receive maintenance hemodialysis or peritoneal dialysis for the treatment of chronic kidney failure. The 5-year survival rate is approximately 40% after initiation of maintenance dialysis.
Observations:...
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Diagnosis and Treatment of Chronic Spontaneous Urticaria
Chronic spontaneous urticaria affects approximately 1% of the general population worldwide, impairs patients’ quality of life, and is associated with multiple comorbidities. Pavel Kolkhir, MD, discusses the current evidence on the epidemiology, pathophysiology, diagnosis, and treatment of...
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Long-Term Use of Muscle Relaxant Medications for Chronic Pain: A Systematic Review
Importance: Stricter opioid prescribing guidelines have increased prescriptions of skeletal muscle relaxants (SMRs) for chronic pain, but the efficacy of long-term use of SMRs for chronic pain is unknown.
Objective: To systematically review the effectiveness or efficacy of long-term use...
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Mineralocorticoid receptor antagonists in heart failure: an individual patient level meta-analysis
Background: Mineralocorticoid receptor antagonists (MRAs) reduce hospitalisations and death in patients with heart failure and reduced ejection fraction (HFrEF), but the benefit in patients with heart failure and mildly reduced ejection fraction (HFmrEF) or heart failure and preserved ejection...
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Diagnosis and Treatment of Community-Acquired Pneumonia (CAP)
Community-acquired pneumonia is associated with approximately 740 000 hospitalizations and 41 000 deaths in the US annually. JAMA Review authors Scott A. Flanders, MD, and Valerie M. Vaughn, MD, MSc, discuss diagnosis and treatment of community-acquired pneumonia with JAMA Deputy Editor Mary...
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Community-Acquired Pneumonia: A Review
Importance: Community-acquired pneumonia (CAP) results in approximately 1.4 million emergency department visits, 740 000 hospitalizations, and 41 000 deaths in the US annually.
Observations: Community-acquired pneumonia can be diagnosed in a patient with 2 or more signs (eg, temperature...
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Evaluation of Suspected Antibiotic Allergies
Antibiotic-associated adverse drug reactions are often mild (eg, nausea or diarrhea) and typically occur 1 to 6 hours after drug exposure. IgE-mediated reactions cause urticaria, angioedema, bronchospasm, or, in severe cases, anaphylaxis. Cell-mediated delayed hypersensitivity can occur over...
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