People traveling to high altitude are at risk of developing acute altitude illnesses, including AMS, HACE, and HAPE. Incidence and risk are assessed by history of acute altitude illness, sleeping elevation above sea level on day 1 of travel, and rate of ascent. AMS incidence can range from...
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JAK 1-3 inhibitors and TYK-2 inhibitors in dermatology: Practical pearls for the primary care physician
Guidelines for primary care clinicians on monitoring and safety guidelines regarding Janus kinase and tyrosine kinase 2 inhibitors in the treatment of inflammatory skin conditions are often unclear. This review aims to provide the primary care physician with a review of clinically relevant and...
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Approach to otitis externa
Objective: To provide family physicians with a practical evidence-based approach to management of otitis externa.
Sources of information: The approach described is based on MEDLINE and PubMed literature published between 1993 and 2023.
Main message: Otitis externa is diffuse...
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Preexposure Prophylaxis (PrEP) for HIV
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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