Efficacy and Safety of Digitalis Glycosides in Heart Failure
https://jamanetwork.com/journals/jama/fullarticle/2848972
This meta-analysis assesses the association of digitalis glycosides treatment with risk of the composite outcome of cardiovascular death or first worsening heart failure events in patients with heart failure with mildly reduced ejection fraction or in those with heart failure with reduced ejection fraction.
https://jamanetwork.com/journals/jama/fullarticle/2848972
This meta-analysis assesses the association of digitalis glycosides treatment with risk of the composite outcome of cardiovascular death or first worsening heart failure events in patients with heart failure with mildly reduced ejection fraction or in those with heart failure with reduced ejection fraction.
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Digoxin in Patients With Symptomatic Rheumatic Heart Disease Research Summary
https://jamanetwork.com/journals/jama/fullarticle/2848971
This study evaluated whether digoxin, when added to usual care, reduced the risk of death or new-onset or worsening heart failure in patients with symptomatic rheumatic heart disease (RHD).
https://jamanetwork.com/journals/jama/fullarticle/2848971
This study evaluated whether digoxin, when added to usual care, reduced the risk of death or new-onset or worsening heart failure in patients with symptomatic rheumatic heart disease (RHD).
Comorbidities and Outcomes in People with Functional Neurological Disorder
https://jamanetwork.com/journals/jamaneurology/fullarticle/2848940
This cohort study compared the prevalence of neurological comorbidities among people with functional neurological disorder versus those with epilepsy and multiple sclerosis.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2848940
This cohort study compared the prevalence of neurological comorbidities among people with functional neurological disorder versus those with epilepsy and multiple sclerosis.
Genetic Testing in Parkinson Disease
https://jamanetwork.com/journals/jamaneurology/fullarticle/2848939
This cohort study evaluates the association between age at onset and family history of Parkinson disease in patients who carry pathogenic variants.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2848939
This cohort study evaluates the association between age at onset and family history of Parkinson disease in patients who carry pathogenic variants.
Incidence and Prevalence of Dementia With Lewy Bodies
https://jamanetwork.com/journals/jamaneurology/fullarticle/2848938
This study estimates pooled incidence and prevalence of dementia with Lewy bodies from population-based studies worldwide, overall and by age and sex.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2848938
This study estimates pooled incidence and prevalence of dementia with Lewy bodies from population-based studies worldwide, overall and by age and sex.
Safeguarding People With MS From Domestic Violence
https://jamanetwork.com/journals/jamaneurology/fullarticle/2848937
This Viewpoint examines the high prevalence, risk factors, health impacts, and underrecognition of domestic violence among people with multiple sclerosis and calls for improved clinician awareness, standardized research, and routine, trauma-informed safeguarding practices in neurology care.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2848937
This Viewpoint examines the high prevalence, risk factors, health impacts, and underrecognition of domestic violence among people with multiple sclerosis and calls for improved clinician awareness, standardized research, and routine, trauma-informed safeguarding practices in neurology care.
Amyotrophic Lateral Sclerosis: A Review
https://jamanetwork.com/journals/jama/fullarticle/2848974
This Review summarizes current evidence regarding the diagnosis and treatment of amyotrophic lateral sclerosis.
https://jamanetwork.com/journals/jama/fullarticle/2848974
This Review summarizes current evidence regarding the diagnosis and treatment of amyotrophic lateral sclerosis.
Patent Listing Challenges by the Federal Trade Commission
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2848544
The number of patents listed per brand-name drug is remarkable, with a recent analysis finding that the 10 top-selling drugs in 2021 had been issued a total of 742 patents. The number and timing of patents serve to shield these drugs from generic competition, hindering drug affordability. Drug manufacturers have applied various patent strategies to reduce competition. These include patent thickets, a complicated structure of overlapping and incremental patents, and evergreening, the addition of secondary patents for very minor alterations. To address these questionable patents, generic drug manufacturers are currently relied on to challenge them via litigation, but this approach has had variable success and leads to a cascade of further delayed generic competition and higher drug costs.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2848544
The number of patents listed per brand-name drug is remarkable, with a recent analysis finding that the 10 top-selling drugs in 2021 had been issued a total of 742 patents. The number and timing of patents serve to shield these drugs from generic competition, hindering drug affordability. Drug manufacturers have applied various patent strategies to reduce competition. These include patent thickets, a complicated structure of overlapping and incremental patents, and evergreening, the addition of secondary patents for very minor alterations. To address these questionable patents, generic drug manufacturers are currently relied on to challenge them via litigation, but this approach has had variable success and leads to a cascade of further delayed generic competition and higher drug costs.
Self-Collected HPV Screening for Cervical Cancer Screening
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2848534
This Viewpoint describes use of self-collected human papillomavirus (HPV) testing to increase screening access for patients who are unable or unwilling to undergo in-clinic screening and reduce the incidence of cervical cancer.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2848534
This Viewpoint describes use of self-collected human papillomavirus (HPV) testing to increase screening access for patients who are unable or unwilling to undergo in-clinic screening and reduce the incidence of cervical cancer.
Collaborating to Improve Quality of Life Among Prostate Cancer Survivors
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2848543
Ever since Huggins and Hodges demonstrated that prostate cancer was an androgen-dependent neoplasm, urologists and oncologists have explored various methods of suppressing testosterone. Orchidectomy gave way to diethylstilbestrol, which in turn gave way to luteinizing hormone-releasing hormone agonists and then antagonists. At one point, adrenalectomy was briefly performed. Success has been defined by castrate testosterone levels, and adverse effects are accepted, as prostate cancer can be lethal.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2848543
Ever since Huggins and Hodges demonstrated that prostate cancer was an androgen-dependent neoplasm, urologists and oncologists have explored various methods of suppressing testosterone. Orchidectomy gave way to diethylstilbestrol, which in turn gave way to luteinizing hormone-releasing hormone agonists and then antagonists. At one point, adrenalectomy was briefly performed. Success has been defined by castrate testosterone levels, and adverse effects are accepted, as prostate cancer can be lethal.
Contingency Management for the Treatment of Stimulant Use Disorder
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2848542
This Clinical Insights discusses the use of contingency management for the treatment of stimulant use disorder.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2848542
This Clinical Insights discusses the use of contingency management for the treatment of stimulant use disorder.
Delisting of Pharmaceutical Patents Challenged by the Federal Trade Commission
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2848541
This cohort study evaluates all products targeted by the Federal Trade Commission from 2023 to 2025 and analyzes how delistings have impacted periods of patent protection.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2848541
This cohort study evaluates all products targeted by the Federal Trade Commission from 2023 to 2025 and analyzes how delistings have impacted periods of patent protection.
Ovarian Cysts in Polycystic Ovary Syndrome
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2848540
This cross-sectional study examines ovarian morphology regarding polycystic ovary syndrome.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2848540
This cross-sectional study examines ovarian morphology regarding polycystic ovary syndrome.
Parental Support for Trainees—The Clock Is Ticking
https://jamanetwork.com/journals/jama/fullarticle/2849002
Graduate medical education looks very different in 2026 than it did in the early 1800s, with the many changes since that time including formalization and funding for teaching hospitals, efforts at work-hour limitations, and an emphasis on competency-based education. Yet, given the demands of the profession, graduate medical education remains a very challenging training—cognitively, physically, and emotionally.
https://jamanetwork.com/journals/jama/fullarticle/2849002
Graduate medical education looks very different in 2026 than it did in the early 1800s, with the many changes since that time including formalization and funding for teaching hospitals, efforts at work-hour limitations, and an emphasis on competency-based education. Yet, given the demands of the profession, graduate medical education remains a very challenging training—cognitively, physically, and emotionally.
Autoimmune Disease and Dancing With Oneself
https://jamanetwork.com/journals/jama/fullarticle/2848994
The rondeau is a 15-line fixed form in French lyric poetry that was popular during the 13th to 15th centuries and was often set to music like other received forms currently found in English, with regular rhyme schemes and repeated lines. The poem “Autoimmune Rondeau” draws on this history, creating a kind of healing music around the experience of autoimmune disease. The rhyme scheme and repeated line “It’s self on self” evoke the interplay between the disordered immune system and a patient’s own body. The references to mythological twins further deepen this comparison: Castor and Pollux, whose bond was famously strong and who battled alongside one another in the Trojan War, suggest periods when autoimmune disease abates, while Romulus and Remus, who fought over where to build Rome before Romulus killed his brother and then founded the great city, suggest autoimmune attacks so serious as to be fatal. Yet the speaker refuses to bow to pain and suffering: by choosing the rondeau form, with its soothing, musical beauty, we are reminded that although the songs and dances of its origins certainly addressed the mournful themes of unrequited love and separation from God in heaven, they ultimately celebrated life’s joys and pleasures. Thus the poem’s rhetorical question resonates: “Does [the] punishment match the crime?” Whether the speaker is allowing readers a moment of bemused irony or simply joining them in the human absurdity of fate, what is clearest is that even as we confront dire illness, poetry can still invite us to sing, dance, and even smile.
https://jamanetwork.com/journals/jama/fullarticle/2848994
The rondeau is a 15-line fixed form in French lyric poetry that was popular during the 13th to 15th centuries and was often set to music like other received forms currently found in English, with regular rhyme schemes and repeated lines. The poem “Autoimmune Rondeau” draws on this history, creating a kind of healing music around the experience of autoimmune disease. The rhyme scheme and repeated line “It’s self on self” evoke the interplay between the disordered immune system and a patient’s own body. The references to mythological twins further deepen this comparison: Castor and Pollux, whose bond was famously strong and who battled alongside one another in the Trojan War, suggest periods when autoimmune disease abates, while Romulus and Remus, who fought over where to build Rome before Romulus killed his brother and then founded the great city, suggest autoimmune attacks so serious as to be fatal. Yet the speaker refuses to bow to pain and suffering: by choosing the rondeau form, with its soothing, musical beauty, we are reminded that although the songs and dances of its origins certainly addressed the mournful themes of unrequited love and separation from God in heaven, they ultimately celebrated life’s joys and pleasures. Thus the poem’s rhetorical question resonates: “Does [the] punishment match the crime?” Whether the speaker is allowing readers a moment of bemused irony or simply joining them in the human absurdity of fate, what is clearest is that even as we confront dire illness, poetry can still invite us to sing, dance, and even smile.
A Pediatric Perspective on the 2025-2030 Dietary Guidelines
https://jamanetwork.com/journals/jama/fullarticle/2848992
This Viewpoint discusses the importance of evidence-based dietary guidelines for the health of children and adolescents, summarizes the strengths of the 2025-2030 Dietary Guidelines for Americans as well as concerns and challenges, and suggests government policy actions needed from the perspective of pediatric health care professionals and researchers.
https://jamanetwork.com/journals/jama/fullarticle/2848992
This Viewpoint discusses the importance of evidence-based dietary guidelines for the health of children and adolescents, summarizes the strengths of the 2025-2030 Dietary Guidelines for Americans as well as concerns and challenges, and suggests government policy actions needed from the perspective of pediatric health care professionals and researchers.
Antibiotics for Uncomplicated Acute Appendicitis
https://jamanetwork.com/journals/jama/fullarticle/2849000
To the Editor A recent study of 10-year follow-up results from the Appendicitis Acuta (APPAC) trial reported a 37.8% true appendicitis recurrence rate and a 44.3% cumulative appendectomy rate among patients initially treated with antibiotics for uncomplicated acute appendicitis. While the authors concluded that antibiotics remain a viable treatment option for uncomplicated appendicitis, we wish to highlight several concerns about the generalizability, safety, and practicality of this approach.
https://jamanetwork.com/journals/jama/fullarticle/2849000
To the Editor A recent study of 10-year follow-up results from the Appendicitis Acuta (APPAC) trial reported a 37.8% true appendicitis recurrence rate and a 44.3% cumulative appendectomy rate among patients initially treated with antibiotics for uncomplicated acute appendicitis. While the authors concluded that antibiotics remain a viable treatment option for uncomplicated appendicitis, we wish to highlight several concerns about the generalizability, safety, and practicality of this approach.
Antibiotics for Uncomplicated Acute Appendicitis
https://jamanetwork.com/journals/jama/fullarticle/2848999
To the Editor The 10-year follow-up of the APPAC trial provides valuable long-term data supporting antibiotics as a feasible treatment option for uncomplicated acute appendicitis. However, several aspects of the analysis and its interpretation warrant clarification.
https://jamanetwork.com/journals/jama/fullarticle/2848999
To the Editor The 10-year follow-up of the APPAC trial provides valuable long-term data supporting antibiotics as a feasible treatment option for uncomplicated acute appendicitis. However, several aspects of the analysis and its interpretation warrant clarification.
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Antibiotics for Uncomplicated Acute Appendicitis—Reply
https://jamanetwork.com/journals/jama/fullarticle/2848998
In Reply We appreciate the letters about our recent study. With currently available knowledge, treatment of uncomplicated acute appendicitis is no longer about correct vs incorrect management but rather a comprehensive assessment of 2 different treatment strategies, with implications ranging from patient-reported outcomes to health care cost savings. Similarly, for diagnosis of acute appendicitis—it is no longer yes or no—all outcomes, from treatment success to appendiceal tumor prevalence and resource savings, are closely related to the accurate diagnosis of appendicitis severity. The judicious use of CT advocated by Dr Dai and colleagues is important to limit unnecessary radiation exposure, especially because many patients with suspected acute appendicitis are young adults. However, imaging has been considered mandatory to achieve satisfactory accuracy in assessing appendicitis severity, which is achievable using low-dose CT with a marked radiation dose reduction without compromising diagnostic accuracy, underlining the importance of adapting these low-dose imaging protocols. Dai and colleagues also express concern about the use of broad-spectrum antibiotics. Ertapenem was initially selected to standardize the study group treatments for efficacy because ertapenem effectively covers all pathogens that can cause appendicitis. However, there is current evidence that some patients with uncomplicated acute appendicitis may have resolution of symptoms without antibiotic treatment, and most patients can be safely discharged from the emergency department. Therefore, future studies should examine the optimized nonoperative treatment of uncomplicated acute appendicitis in an outpatient setting.
https://jamanetwork.com/journals/jama/fullarticle/2848998
In Reply We appreciate the letters about our recent study. With currently available knowledge, treatment of uncomplicated acute appendicitis is no longer about correct vs incorrect management but rather a comprehensive assessment of 2 different treatment strategies, with implications ranging from patient-reported outcomes to health care cost savings. Similarly, for diagnosis of acute appendicitis—it is no longer yes or no—all outcomes, from treatment success to appendiceal tumor prevalence and resource savings, are closely related to the accurate diagnosis of appendicitis severity. The judicious use of CT advocated by Dr Dai and colleagues is important to limit unnecessary radiation exposure, especially because many patients with suspected acute appendicitis are young adults. However, imaging has been considered mandatory to achieve satisfactory accuracy in assessing appendicitis severity, which is achievable using low-dose CT with a marked radiation dose reduction without compromising diagnostic accuracy, underlining the importance of adapting these low-dose imaging protocols. Dai and colleagues also express concern about the use of broad-spectrum antibiotics. Ertapenem was initially selected to standardize the study group treatments for efficacy because ertapenem effectively covers all pathogens that can cause appendicitis. However, there is current evidence that some patients with uncomplicated acute appendicitis may have resolution of symptoms without antibiotic treatment, and most patients can be safely discharged from the emergency department. Therefore, future studies should examine the optimized nonoperative treatment of uncomplicated acute appendicitis in an outpatient setting.
Non-HDL Cholesterol and Apolipoprotein B Measures and Risk of Atherosclerotic Cardiovascular Disease
https://jamanetwork.com/journals/jamacardiology/fullarticle/2849115
This cohort study reports on whether non–high-density-lipoprotein levels provide information on risk of atherosclerotic cardiovascular disease beyond apolipoprotein B values and vice versa.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2849115
This cohort study reports on whether non–high-density-lipoprotein levels provide information on risk of atherosclerotic cardiovascular disease beyond apolipoprotein B values and vice versa.