We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
In This Issue of JAMA |

Highlights FREE

JAMA. 2014;312(11):1073-1075. doi:10.1001/jama.2013.279725.
Text Size: A A A
Published online


Antenatal magnesium sulfate given to women at imminent risk of very preterm delivery reduces the risk of cerebral palsy in early childhood. In a follow-up study of 867 school-aged children born very preterm and whose mothers had been randomly assigned to receive antenatal magnesium sulfate or placebo, Doyle and colleagues found that maternal treatment with magnesium sulfate was not associated with neurological, cognitive, behavioral, growth, or functional outcomes in the children at ages 6 to 11 years. A mortality advantage of magnesium sulfate treatment could not be excluded.

Randomized, placebo-controlled studies of patients with chronic obstructive pulmonary disease (COPD) have demonstrated that combination therapy, consisting of long-acting β-agonists (LABA) and inhaled corticosteroids, decreases disease exacerbations and possibly mortality. Gershon and colleagues assessed the comparative effectiveness of newly prescribed combination therapy vs LABA alone in a propensity score–matched cohort of 11 872 patients with COPD. The authors found that combination therapy was associated with a lower risk of a composite outcome of death or COPD hospitalization—particularly among patients with asthma and those not receiving inhaled long-acting anticholinergic medication. In an Editorial, Calverley discusses the value of administrative data analyses to inform patient care.

There are many treatment strategies for acute venous thromboembolism (VTE), but little guidance as to which drug is most effective and safe. In a network meta-analysis of data from 45 randomized trials (44 989 patients) examining 8 anticoagulation options, Castellucci and colleagues found no significant differences in clinical and safety outcomes associated with most treatment strategies compared with the low-molecular-weight heparin and vitamin K antagonist combination. However, the unfractionated heparin and vitamin K antagonist combination may be the least effective strategy and rivaroxaban and apixaban may be associated with the lowest risk of bleeding.


Older adults’ physiological and functional heterogeneity adds complexity to treatment decisions for hypercholesterolemia. Strandberg and colleagues present 3 illustrative cases of older patients with hypercholesterolemia and report results of a literature review on the role of statins in primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in older patients. Based on their review of the evidence (26 articles and recent cholesterol treatment guidelines), the authors conclude that ideally, treatment of hypercholesterolemia for patients at risk of ASCVD should start before age 80 years. Because no randomized clinical trial evidence exists to guide statin initiation after age 80 years, decisions to use statins in older patients must be individualized.

An article in JAMA Psychiatry reported that among patients with prescription opioid dependence, a treatment regimen involving a 4-week buprenorphine taper and subsequent naltrexone maintenance therapy resulted in higher rates of opioid abstinence at 12 weeks than a 2- or 1-week buprenorphine taper regimen. In this From the JAMA Network article, Ruetsch discusses treatment of opioid use disorder.

This JAMA Diagnostic Test Interpretation article by Neuner and Carnahan presents the case of a 69-year-old white woman who had a screening dual-energy x-ray absorptiometry (DXA) scan that showed low bone mineral density of the spine. Menopause began at age 39 years, the patient has never smoked, and she has no history of fractures or falls. How would you interpret the DXA scan results?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.