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;316(3):241-243. doi:10.1001/jama.2015.14380.
Text Size: A A A
Published online


The effectiveness of buprenorphine to treat opioid dependence can be limited by suboptimal adherence to treatment. Rosenthal and colleagues assessed whether a buprenorphine-containing implant is noninferior to daily sublingual buprenorphine in a double-blind, double-dummy randomized trial that enrolled 177 adults with opioid dependence who were abstinent on a stable dose of sublingual buprenorphine. The authors report that 6 months’ use of buprenorphine implants compared with continued sublingual buprenorphine did not result in an inferior likelihood of remaining a responder. In an Editorial, Compton and Volkow discuss interventions to improve outcomes among persons with opioid use disorders.

In 1996, Australia enacted major gun law reforms including a ban on semiautomatic rifles. In an analysis of Australian government statistics on deaths caused by firearms (1970-2013) and news reports of mass shootings in Australia (1979-2016), Chapman and colleagues found that following enactment of the gun law reforms in 1996, no mass firearm killings have occurred in Australia. Firearm deaths declined more rapidly between 1997 and 2013 compared with the trend in firearm deaths before 1997. In an Editorial, Webster discusses gun policy and firearm-related fatalities.

Hormonal treatment in preparation for vitro fertilization (IVF) procedures causes temporary decreased and elevated levels of estradiol and progesterone, which may influence breast cancer risk. van den Belt-Dusebout and colleagues assessed the association of IVF with breast cancer risk in an analysis of data from 25 108 women treated for infertility between 1980 and 1995 and cancer registry data. The authors report that among women undergoing fertility treatment, IVF-treatment compared with non-IVF treatment was not associated with an elevated risk of breast cancer after a median 21 years’ follow-up.


Numerous glucose-lowering drugs—from 9 drug classes—are approved for treatment of type 2 diabetes. Palmer and colleagues assessed the relative efficacy and safety of these drugs in a review and network meta-analysis of data from 301 randomized trials (1.4 million patient-months of treatment). The authors found no significant differences between any of the 9 classes of glucose-lowering drugs—used either alone or in combination—and the risk of cardiovascular or all-cause mortality. Metformin was associated with lower or comparable hemoglobin A1c levels compared with the other drug classes given as monotherapy.


Cellulitis can be a diagnostic and therapeutic challenge. Based on a systematic review that identified 123 pertinent articles, Raff and Kroshinsky summarize the evidence relating to the epidemiology, pathophysiology, microbiology, diagnosis, and treatment of cellulitis. Cellulitis is common and the diagnosis is based primarily on patient history and physical examination findings. Antibiotic treatment of uncomplicated cellulitis should be directed against Streptococcus and methicillin-sensitive Staphylcoccus aureus. Methicillin-resistant S aureus should be considered in high-risk patient populations.


This JAMA Clinical Guideline Synopsis article provides a summary of A Guideline for the Clinical Management of Opioid Addiction developed by a multidisciplinary group in British Columbia. Withdrawal alone is not recommended; rather, patients should be offered medically supervised opioid agonist treatment. High-quality evidence supports buprenorphine-naloxone as first line treatment.

This JAMA Diagnostic Test Interpretation article by Patel and Muir presents the case of a woman in her 60s with new-onset ascites. She has undifferentiated connective tissue disease and longstanding pulmonary hypertension. She reports no alcohol or illicit drug use and no personal or family history of liver disease. Physical examination findings include jugular venous distension and a bulging abdomen with flank dullness. A diagnostic paracentesis was performed. How would you interpret the 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.