JAMA Clinical Reviews is a podcast series produced by the Journal of the American Medical Association. It provides expert discussions on current clinical topics across a broad range of medical specialties.
Childhood obesity is defined by BMI at or above the 95th percentile, but genetic susceptibility and environmental influences shape risk. Intensive family-based treatment is foundational, while additional interventions and meaningful treatment outcomes depend on age and disease severity.
Advanced heart failure prompts specialist evaluation for transplantation or ventricular assistance alongside assessment of reversible contributors. After transplantation, immunosuppression brings interaction risks, while rejection and coronary allograft vasculopathy require continuing surveillance.
Narcolepsy assessment starts by distinguishing true involuntary sleepiness from fatigue and asking specifically about cataplexy. Overnight polysomnography followed by multiple sleep latency testing supports diagnosis, while planned naps and medication address persistent sleepiness and cataplexy.
Respiratory-virus vaccine evidence needs careful interpretation of population, comparator and outcome. Influenza effectiveness is relative to standard-dose vaccination, RSV protection may wane without yet supporting repeat dosing, and COVID-19 safety findings depend on the dosing schedules actually studied.
Therapeutic cancer vaccines aim to generate antitumour immunity using tumour antigens, adjuvants and different delivery technologies, while mutation-derived targets, cytotoxic T-cell responses, tumour burden and intratumoural approaches all influence their potential effectiveness.
Progressive gait change, cognitive decline and urinary dysfunction in older adults can signal idiopathic normal pressure hydrocephalus, but ventricular enlargement alone is insufficient; timed gait assessment before and after cerebrospinal fluid drainage, including delayed response, helps select patients for shunting.
Rheumatoid arthritis can begin with only a few inflamed joints and negative serology, so diagnosis remains clinical; early disease-modifying treatment, structured disease-activity targets and coordinated primary care–rheumatology follow-up aim to prevent progressive joint and systemic damage.
Chronic symptoms that worsen upright and improve supine should prompt structured heart-rate and blood-pressure measurement through ten minutes of standing. Diagnosis also requires exclusion of mimics, while treatment begins with volume expansion, compression and recumbent exercise.
Treatment goals, opioid exposure, kidney and liver function, comorbidity and likely adherence determine medication choice for alcohol use disorder. Naltrexone, acamprosate, supervised disulfiram and topiramate offer different mechanisms, limitations and opportunities for treatment during hospital admission.
Circulating tumour DNA can identify actionable mutations in metastatic cancer or signal molecular residual disease after curative-intent treatment. Tumour-informed assays offer high specificity for the original cancer, but negative results can miss low-shedding disease and do not justify unsupported treatment de-escalation or exclude a new primary cancer.
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