LAURA H. CYPHERS

This population-based cohort study examines the association between COVID-19 vaccination during pregnancy and maternal and neonatal peripartum outcomes just before, during, or after delivery.
Source: JAMA Online First

This Medical News article discusses studies examining associations of air pollution and cognitive health.
Source: JAMA Online First

This Medical News article discusses a large study that found brain structure and cognitive changes months after SARS-CoV-2 infection.
Source: JAMA Online First

Thrombotic complications of SARS-CoV-2 infection were recognized early in the pandemic, when infected patients often presented with abnormal coagulation findings and acute macrovascular obstruction, and evidence of pulmonary microvascular thrombosis was identified on autopsy. The inflammatory response to SARS-CoV-2 infection commonly results in marked activation of coagulation—the process of thromboinflammation—with evidence of systemic endothelial damage and a resultant loss of normal anticoagulant properties. In this milieu of acute endothelial dysfunction and coagulopathy, platelets are hyperreactive with increased responsiveness to activation stimuli, have altered gene expression profiles, and present phenotypic changes indicative of abnormal platelet-leukocyte interactions. Given this situation, multiple randomized trials were initiated early in the pandemic to address the platelet-mediated consequences of COVID-19. Yet, while the rationale for adding antiplatelet therapy to anticoagulation was compelling, 3 recent clinical trials that addressed the potential utility of aspirin or P2Y12 inhibitors among COVID-19 inpatients as well as 1 trial of COVID-19 outpatients do not support this approach.
Source: JAMA Online First

This randomized clinical trial assesses the effect of treatment with an antiplatelet agent vs no antiplatelet therapy on days alive and free of intensive care unit respiratory or cardiovascular organ support within 21 days among patients critically ill with COVID-19.
Source: JAMA Online First

A woman had a large, deep ulcer at an injection site on her thigh, with a dusky violaceous border extending 2 to 5 cm from the wound edge, fever to 39.8 °C, and elevated white blood cell count and procalcitonin level; histologic examination of excised tissue showed a dense pan-dermal neutrophilic infiltrate, and multiple blood and tissue cultures were negative. What is the diagnosis and what would you do next?
Source: JAMA Online First

This Viewpoint summarizes the reasons why clinicians should have the knowledge and skills to assess and determine the appropriate application of artificial intelligence and machine learning outputs and how these new technologies will create new roles and responsibilities for clinicians.
Source: JAMA Online First

This study uses mortality data from the National Center for Health Statistics to assess whether alcohol-related deaths increased during the COVID-19 pandemic.
Source: JAMA Online First

This Viewpoint discusses the 3 components—accuracy, clinical utility, and patient benefit—of assessing whether diagnostic tests are effective.
Source: JAMA Online First

A 63-year-old patient with arthritis and obstructive sleep apnea presented with worsening joint pain, with degenerative changes shown on x-ray. A nasal bridge deformity was revealed when she removed her face mask, along with slightly elevated creatinine and ESR; urinalysis revealed white and red blood cells and 2+ protein. What is the diagnosis and what do you do next?
Source: JAMA Online First