Today’s high-fidelity phonograph systems owe their existence to a discovery by Thomas A. Edison, who in 1876 hit on a method that permitted both recording and reproduction of sound from a rotating cylinder. After a number of attempts had been made to convert his machine from a cylinder into a standard phonograph, the phonograph industry was born at the turn of the century.
Science Journals
To the Editor Dr Short and colleagues provided a timely and clinically meaningful update on perinatal HIV management, including the expanded role of shared decision-making for breastfeeding among individuals with sustained viral suppression receiving antiretroviral therapy (ART). As these recommendations are increasingly incorporated into US clinical practice, an additional consideration is the dynamic nature of virologic control in the postpartum period.
Every clinician recalls moments during patient care when time seems to have stopped. Such stunning events, most typically at crucial junctures in patients’ lives—a child’s birth, a final breath—are indelibly part of medicine. Poetry is also notable for its ability to seemingly suspend time, making it suitable for marking such momentous life changes. The poem “Post Code” demonstrates several techniques that give poetry its time-stopping powers, highlighted by its medical context. It is first and foremost a lyric, the poetic genre typically composed in a kind of eternal present tense, even when referring to past events. When John Keats wrote to the figures on his Grecian urn, he addressed them as permanently alive—“Bold Lover, never, never canst thou kiss”—freezing them (and us) in a moment that never arrives and never passes. We find ourselves similarly frozen in “Post Code,” transfixed by the code room’s smells of “pennies and plastic” while the patient’s daughter’s hands forever grip the bed rail. Poetry also forces slowed-down reading, with its interceding line breaks and freighted punctuation; we linger over such arresting lines as “Outside, the hallway laughs—/a coffee joke, a shift trade—,” set off by cliffhanging dashes, or (more literally perhaps) “waiting for the monitor to change its mind.” Finally, poetry’s capacity for expressing epiphanies, those timeless, exalted realizations made possible by art’s existence outside of time, also occurs here, as in the poem’s final line: “and the day keeps walking past this door,” reminding us that the clinician’s healing work transcendently continues.
To the Editor The Special Communication from ESGO provided an important and timely synthesis of the evidence supporting opportunistic salpingectomy for tubo-ovarian carcinoma prevention. The biological rationale is compelling, and observational data consistently demonstrate substantial relative risk reduction, which justifies inclusion of salpingectomy in preoperative counseling for eligible women. However, counseling must remain broader than a single preventive surgical intervention.
This Viewpoint discusses the reasons why it is important for individuals to continue to receive the tetanus vaccine.
To the Editor Dr Harris and colleagues presented a timely and comprehensive Review of pharmacological treatments for opioid use disorder. The section on overdose management is detailed and well structured, placing appropriate emphasis on naloxone and summarizing the most recent evidence supporting its effectiveness. However, despite the broad scope of the Review, nalmefene was not discussed. Nalmefene is an opioid antagonist approved for alcohol use disorder and, more recently, for the reversal of opioid overdose. It first received US Food and Drug Administration (FDA) approval in 1995 as an injectable agent for overdose reversal but was withdrawn from the market approximately a decade later. A new approval was granted in 2023, when the FDA authorized an intranasal formulation for opioid overdose. Subsequently, in 2024, an autoinjector formulation (for subcutaneous or intramuscular administration) was also approved for the same indication.
In Reply We thank Dr Palma-Álvarez for his thoughtful Letter regarding our Review of medications for opioid use disorder, withdrawal, and overdose. He appropriately highlights the pharmacological properties of the opioid antagonist nalmefene and raises an important point about the evolving availability of opioid antagonists.
In this narrative medicine essay, a facial plastic surgeon who specializes in treating rare and complex operations, so-called zebras, describes how the excruciating pain in his right leg turned out to be a zebra.
This JAMA Patient Page describes how Ebola is transmitted, how common the infection is and where outbreaks have occurred, risk factors and symptoms, and how it is diagnosed and treated.
Blood-based multicancer detection (MCD) technologies have been touted as a revolution in early-stage population screening and testing for a wide range of cancers. MCDs (often called liquid biopsies) look for fragments of DNA and other biomarkers in the blood, which may indicate the presence of cancer and predict where it originated. The seductive premise has been clear: detecting cancer earlier and intervening at an earlier stage will cure more patients. Given this promise, the commercial market has grown to more than 24 companies, and the annual global market for these MCD technologies is estimated to reach US $2.9 billion by 2030.
This Viewpoint discusses some specific challenges in defining estimands for cluster randomized trials and illustrates how the CRT-Estimands Framework can be applied to improve the interpretation of trial results.
The study aimed to determine whether treatment with teriparatide, a parathyroid hormone analogue, followed by zoledronic acid, lowers the risk of fractures in adults with osteogenesis imperfecta compared with standard therapy.
The American College of Physicians (ACP) released a statement expressing concern about an executive order directing the US Centers for Disease Control and Prevention (CDC) to alter the childhood vaccine schedule.
This Medical News article discusses a new American Heart Association scientific statement on the role of physical activity in obesity care.
In Reply We thank Dr Yu and colleagues for their thoughtful commentary on our recent article addressing perinatal HIV management and infant feeding. Their emphasis on the postpartum period as an evolving and clinically distinct phase is both timely and important, and we appreciate the opportunity to expand on this critical aspect of care.
The conduct of randomized clinical trials (RCTs) is often a large-scale endeavor, with the potential to impact patients, clinicians, health care systems, and even the communities in which they are carried out. The effects of trials on participants may flow through the randomized study treatments or through other pathways, for example, by inducing changes to aspects of care separate from the randomized treatments. These effects may be beneficial (eg, participants may receive more careful evaluation, additional diagnostic studies, closer follow-up, or earlier detection of complications) or they may be harmful (eg, inconvenience or financial costs).
The room smells like pennies and plastic. Someone wipes gel from his ribs while his daughter still stands with hands on the rail, waiting for the monitor to change its mind. Outside, the hallway laughs— a coffee joke, a shift trade— and the day keeps walking past this door.
A new diffusion MRI approach offers a glimpse of the anomalies of cellular architecture underlying basal ganglia degeneration in Huntington’s disease.
The US Food and Drug Administration (FDA) released a warning advising consumers against using over-the-counter skin lightening products, which may contain high levels of mercury or hydroquinone.
This Perspective discusses female biology and resilience regarding Alzheimer disease despite pathologic risk.
This randomized clinical trial compares whether the addition of zoledronic acid to teriparatide compared with standard treatment reduces fractures among adults with osteogenesis imperfecta.
This JAMA Insights discusses the clinical presentation, diagnosis, and treatment of exocrine pancreatic insufficiency.
To the Editor The Special Communication from the European Society of Gynaecological Oncology (ESGO) about opportunistic salpingectomy for ovarian cancer prevention provided a timely and comprehensive synthesis of the biological rationale, safety profile, and growing consensus supporting this intervention.
In Reply Dr Meyer and colleagues and Drs Afors and Saridogan provide thoughtful comments on our Special Communication about opportunistic salpingectomy for prevention of tubo-ovarian carcinoma.
JAMA+ AI Associate Editor Yulin Hswen, ScD, MPH, spoke with Nigam Shah, MBBS, PhD, a professor of medicine at Stanford University and chief data scientist at Stanford Health Care, about the integration of AI into electronic health records for JAMA+ AI Conversations.