LAURA H. CYPHERS

The majority of pituitary microadenomas—tumors in the pituitary gland that measure less than 10 mm—either remained the same or decreased in size over time, according to magnetic resonance imaging (MRI) results from 177 patients during a study period spanning 2003 to 2021. Of the 28% of pituitary microadenomas that increased in size, their rate of growth was slow and only 1.7% grew to more than 10 mm.
Source: JAMA Online First

The Institute Pasteur in Dakar, Senegal, confirmed Equatorial Guinea’s first case of Marburg virus disease, which carries a case-fatality rate of up to 88%, on February 8. The person with the confirmed infection died, as did 8 of their contacts who had probable or suspected cases. Their symptoms included fever, vomiting, and bloody diarrhea. Two people also experienced skin lesions and bleeding from the ear.
Source: JAMA Online First

This Medical News feature examines the possible health consequences of making daylight saving time permanent.
Source: JAMA Online First

This cluster randomized clinical trial assesses the effect of a coordinated, multifaceted intervention of assessment, education, and feedback vs usual care on the prescribing of all 3 groups of recommended therapies (high-intensity statins, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and sodium-glucose cotransporter 2 inhibitors and/or glucagon-like peptide 1 receptor agonists) for adults with type 2 diabetes and atherosclerotic cardiovascular disease.
Source: JAMA Online First

In this issue of JAMA, Borlaug and colleagues report the results of a important clinical trial, which are likely to alter paradigms and clinical guidelines for heart failure with preserved ejection fraction (HFpEF). The prevalence of this syndrome has progressively increased, and HFpEF has become the most common form of heart failure, particularly in older persons, women, and Black individuals. It affects more than 3 million people in the US and is associated with severe symptoms of exertional dyspnea and fatigue (exercise intolerance), impaired health-related quality of life, severely reduced exercise capacity (the primary outcome in the current trial), and increased rates of rehospitalizations and death.
Source: JAMA Online First

This randomized crossover trial assessed if implanting and programming a pacemaker for rate-adaptive atrial pacing improved exercise performance in patients with heart failure with preserved ejection fraction and chronotropic incompetence at a single US tertiary referral center.
Source: JAMA Online First

Life expectancy in the US is now the lowest it has been since 1996, with young- and middle-aged adults seeing the most rapid declines. These declines began in 2014 and have accelerated over the past 3 years of the pandemic. While COVID-19 represents a significant proportion, increases in heart disease between 2020 and 2021 explain more than 4% of the most recent shortening in life expectancy. These increases in cardiovascular mortality reflect recent disturbing trends in cardiovascular risk determinants and events in younger adults. Although overall cardiovascular disease mortality declined until 2020, hospitalization and death rates flattened or in some cases increased among specific racial and ethnic subgroups of young adults during this time. In particular, hypertensive heart disease, heart failure, and endocarditis have increased in young adults, particularly among Black individuals, through 2018. Consequently, young adults make up a growing proportion of cardiovascular disease events, with the proportion of premature myocardial infarction among adults younger than 40 years increasing by 2% every year. The increasing event rates observed among younger adults can be attributed to the increasing prevalence and onset of risk factors such as obesity and hypertension at younger ages, which exacerbate cumulative exposure and cardiovascular disease risk over near- and long-term time horizons.
Source: JAMA Online First

This study assesses the prevalence rates of cardiovascular risk factors (hypertension, diabetes, hyperlipidemia, obesity, and tobacco use), treatment, and control among adults aged 20 to 44 years from 2009 through March 2020, overall and by sex and race and ethnicity.
Source: JAMA Online First

This article in the Women’s Health series discusses uterine perforation occurring during gynecological procedures, including prevention, identification of risk factors, recognition, management, and long-term outcomes.
Source: JAMA Online First

This JAMA Patient Page describes melanoma, its risk factors, diagnosis, treatment, and prognosis.
Source: JAMA Online First