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 |

In This Issue of JAMA FREE

JAMA. 2015;314(24):2591-2593. doi:10.1001/jama.2014.12159.
Text Size: A A A
Published online


Lambertini and colleagues report results of a median 7.3 years’ follow-up of 281 premenopausal women with stage I to III breast cancer who were randomly assigned to receive adjuvant chemotherapy alone or combined with the luteinizing hormone-releasing hormone analogue triptorelin. The authors found that compared with chemotherapy alone, women who received concurrent chemotherapy and triptorelin had a higher long-term probability of ovarian function recovery without a statistically significant difference in pregnancy rate or disease-free survival. In an Editorial, Partridge discusses prevention of premature menopause and fertility impairment in young cancer survivors.

Rahman and colleagues examined the effects of analgesic choice (nonsteroidal anti-inflammatory drugs [NSAIDs] vs opiates) and chest tube size (24F vs 12F) on chest tube–related pain and efficacy of pleurodesis for malignant pleural effusion in a randomized trial involving 320 patients. The authors report that pain scores did not differ between NSAIDs and opiates and that NSAIDs compared with opiate use resulted in noninferior rates of pleurodesis efficacy at 3 months. Small chest tubes were associated with lower pain scores but did not meet noninferiority criteria for pleurodesis efficacy.

The likelihood of achieving a live birth with repeated cycles of in vitro fertilization (IVF) is unclear. In an analysis of data from 156 947 women who underwent 257 398 IVF ovarian stimulation cycles, Smith and colleagues found that the live-birth rate for the first cycle of IVF was 29.5% and the cumulative prognosis-adjusted live-birth rate after 6 cycles was 65.3%. In an Editorial, Myers discusses factors that may influence live birth rates after multiple cycles of IVF.

Several cases of acute flaccid paralysis of unknown etiology were reported in California in 2012, prompting voluntary statewide disease surveillance. In a review of 59 reported cases (June 2012 to July 2015), Van Haren and colleagues found that most patients were children or young adults who experienced prolonged motor weakness. The etiology remains undetermined.


Easter and colleagues report results of a systematic review (14 studies identified; 23 079 patients total) to determine whether individual findings or a combination of findings can accurately distinguish patients with minor head trauma who are at high or low risk of severe intracranial injury. The authors found that certain risk factors (pedestrians struck by motor vehicles), symptoms (repetitive vomiting or posttraumatic seizures), and signs (suggesting possible skull fracture) were associated with a high risk of severe intracranial injury. In an Editorial, Rivara and colleagues discuss use of clinical prediction rules to guide computed tomography use after blunt head trauma.

An article in JAMA Ophthalmology reported results of a study to develop and validate a smartphone-based technique for measuring visual acuity. In this From the JAMA Network article, Brady and colleagues discuss visual acuity measurement and practical considerations in the use of mobile phone technology in clinical assessment.

This JAMA Clinical Guidelines Synopsis by Rao and colleagues summarizes the 2014 American Gastroenterological Association Institute Guideline on the Pharmacologic Management of Irritable Bowel Syndrome (IBS). High-quality evidence supports use of linactolide in constipation-predominant IBS. Lubiprostone, polyethylene glycol, rifaximin, alosteron, loperamide, tricyclic antidepressants, and antispasmodics received conditional recommendations. Use of these medications should be individualized.



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.