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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Strategies to Help Patients Afford Their Medicines in the US
Many patients in the US struggle to afford their prescription drugs. The inability to take medications as prescribed can lead to worse health outcomes.
Below are 7 strategies that patients can use to respond to high prescription drug costs in the US.
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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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Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk: A Randomized Clinical Trial
Importance: Sciatica is commonly caused by herniated lumbar disc and contributes to severe pain and prolonged disability. Although acupuncture is widely used by patients with chronic sciatica, the evidence of its efficacy is scarce.
Objective: To investigate the efficacy and safety of...
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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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Arm Position and Blood Pressure Readings: The ARMS Crossover Randomized Clinical Trial
Importance: Guidelines for blood pressure (BP) measurement recommend arm support on a desk with the midcuff positioned at heart level. Still, nonstandard positions are used in clinical practice (eg, with arm resting on the lap or unsupported on the side).
Objective: To determine the...
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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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