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. 2016;315(10):957-959. doi:10.1001/jama.2015.14149.
Text Size: A A A
Published online


Two previously marketed obesity drugs—fenfluramine and sibutramine—were withdrawn after evidence of cardiovascular harm emerged. Nissen and colleagues assessed whether obesity treatment with naltrexone-bupropion increases major adverse cardiovascular events (MACE) in a randomized, placebo-controlled noninferiority trial that enrolled 8910 overweight or obese patients. The authors report results of interim analyses performed after accrual of 25% and 50% of expected MACE, which found that the risk estimate for MACE did not exceed the prespecified noninferiority boundary; however, because of unanticipated early termination of the trial, the cardiovascular safety of the treatment remains uncertain. In an Editorial, Sharfstein and Psaty discuss the evaluation of the cardiovascular safety of naltrexone-bupropion treatment of obesity.

Editorial and Related Article

Observational studies suggest vitamin D supplementation is associated with beneficial effects on knee osteoarthritis (OA). In a randomized, double-blind trial that enrolled 413 patients with symptomatic knee OA and low serum 25-hydroxyvitamin D levels, Jin and colleagues found that compared with placebo, vitamin D supplementation did not result in significant differences in the change in tibial cartilage volume or knee pain score over 2 years.

Persistent postconcussion symptoms (PPCS) occur in approximately one-third of children who experience a concussion. In an analysis of data from 3063 children aged 5 up to 18 years who presented to an emergency department with acute concussion, Zemek and colleagues derived and validated a clinical risk score for PPCS. The authors report the risk score had modest discrimination to stratify patients at risk of PPCS 28 days after head injury. In an Editorial, Babcock and Kurowski discuss identification of childre at risk fro PPCS.

Hypertensive disorders of pregnancy, particularly preeclampsia, are associated with an increased risk of cardiomyopathy during the peripartum period—from the last month of pregnancy through 5 months after delivery. In a cohort study involving more than 1 million Danish women, Behrens and colleagues found that women with a history of hypertensive disorders of pregnancy, compared with women without such a history, have a small increased risk of cardiomyopathy, which persists beyond the peripartum period.


Few older adults with type 2 diabetes are enrolled in randomized trials of glucose-lowering medications, leading to substantial uncertainty about optimal glycemic control for this patient population. Lipska and colleagues reviewed the existing evidence on the benefits and harms of intensive vs standard glycemic control targets for older patients. The authors present an approach to help patients and clinicians reach individualized treatment goals.

In many clinical studies, an outcome of interest is the time interval between the initiation of treatment and the occurrence of an adverse event. This JAMA Guide to Statistics and Methods article by Tolles and Lewis discusses the use of time-to-event analysis in clinical trials, statistical methods for analyses, and considerations for interpreting results.

Related Article

Postthrombotic syndrome (PTS) may occur in 20% to 50% of patients with a deep venous thrombosis. This JAMA Clinical Guidelines Synopsis by Jain and Cifu summarizes an American Heart Association scientific statement: The Postthrombotic Syndrome: Evidence-Based Prevention, Diagnosis, and Treatment Strategies. Prevention and treatment strategies considered in the evidence review include elastic compression stockings, low-molecular-weight heparin, new oral anticoagulants, and compression dressings and pentoxifylline for treatment of venous ulcers.



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.