This crossover randomized clinical trial aims to determine the effect of different arm positions on blood pressure readings.

On June 25, 2024, the US Surgeon General released an advisory describing the public health crisis of firearm violence in the US. The public statement recounted some horrific statistics: firearm violence is the leading cause of death for US children and adolescents; between 2012 and 2022, firearm suicide increased by 20% across the US population; between 1999 and 2020, an estimated 434 000 youth experienced the death of a parent due to firearms. In the face of a problem this immense, multifaceted, and often politicized, it can feel hard to know where to start.

In Reply We thank Lisi for contributing a Letter to the Editor regarding our recent Patient Page about edible cannabis. Lisi emphasized the potential harms of edible cannabis products, including their unpredictable effects, the risk for accidental exposure and intoxication leading to emergency department visits, and the lack of strong unifying regulatory and oversight frameworks for medical cannabis at the national level. We completely agree, specifically highlighting each of these potential harms in the Patient Page along with other established risks such as impaired driving, cognitive effects, and interactions with commonly prescribed medications. Emphasizing these risks is a crucial part of patient counseling, and we thank Lisi for providing additional information to guide this practice.

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This Viewpoint describes allowing for hospital staff discretion regarding strict adherence to policy vs best interest of the patient.

This cross-sectional study examines the wastage observed with the use of weight-based dosing of lecanemab in treatment of Alzheimer disease and proposes alternative vial sizes to reduce wastage.

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To the Editor The randomized clinical trial by Tuisku et al evaluating electronic cigarettes vs varenicline for smoking cessation in adults lacked relevant data that were important for interpreting the study’s results. The article did not report the number of participants who continued to use electronic cigarettes or other noncigarette nicotine products, or individuals who used both combustible and electronic cigarettes (ie, dual use), at follow-up. Although 12 weeks of treatment were prescribed, the main article did not report actual product use. A single point estimate at week 4 was reported in eTable 3 in Supplement 2. The outcome reported was combustible cigarette use at follow-up, as measuring exhaled carbon monoxide to confirm abstinence would only detect the use of combustible products. Furthermore, although the Results section in the main article reported superior sustained smoking cessation at 52 weeks in the varenicline group compared to the electronic cigarette group, the article’s abstract does not address this.

This cohort study examined whether the Medicare Competitive Bidding Program is associated with oxygen use, outcomes, and spending among patients with chronic obstructive pulmonary disease (COPD).

This Teachable Moment discusses guideline-directed medical therapy intolerance in a woman in her 80s with heart failure with reduced ejection fraction and transthyretin amyloid cardiomyopathy.

This randomized clinical trial evaluates whether vitamin K2 is better than placebo in managing nocturnal leg cramps.

To the Editor We read with interest the article by Advani et al on recurrent urinary tract infections (UTIs) in older women and would like to contribute to the discussion on the prevention of future UTI episodes in this population. Specifically, we would like to address the authors’ suggestion of consulting a physician before consuming cranberries because they have not been proven to reduce the incidence of infections.

The incidence of chronic obstructive pulmonary disease (COPD) has been increasing among all ages and particularly among older individuals in the US (aged ≥65 years). Despite this rising incidence, long-term oxygen therapy (LTOT) prescription rates have declined for unknown reasons. The decline in use of oxygen has been especially marked for the liquid form of oxygen. Advocacy organizations have cited an approximately 70% decline in liquid oxygen prescriptions between 2017 and 2021, which they claim is “more significant” than drops in prescriptions for other types of oxygen. Patients tend to prefer liquid oxygen because it is physically lighter and lasts longer, even though there is little evidence of enhanced clinical benefit compared with other home oxygen modalities and liquid oxygen is more costly.

This Viewpoint discusses the lack of gun violence education in medical school curricula despite the high prevalence of firearm-related deaths and injuries in the US.

In Reply We appreciate the Letter to the Editor from Farber regarding our randomized clinical trial on the effectiveness of electronic cigarettes in smoking cessation. Data presentation plays an important role in medical publications. Guidelines such as the Consolidated Standards of Reporting Trials (CONSORT) reporting guideline with its extensions provide a useful framework for presenting the main findings of a randomized clinical trial. We have adhered to these guidelines. For clinical trials published in JAMA Internal Medicine, study results must be reported consistently with what was prespecified in their trial design, as documented in the trial registration, protocol, and statistical analysis plan. In our article, the prespecified primary outcome (confirmed 7-day combustible cigarette smoking abstinence on week 26) took priority and precedence over all other data presentations.

This case report describes the electrocardiagram findings of a patient in their 60s with chest tightness and dyspnea, left ventricular systolic impairment, and elevated troponin I levels.

This randomized clinical trial evaluates the effect of a patient/caregiver and prescriber-mailed educational intervention on potentially inappropriate prescribing to patients with Alzheimer disease or Alzheimer disease–related dementias.

This cross-sectional study reports the prevalence and odds of physical and/or sexual violence among unhoused adults in California.

This case report describes a 57-year-old man with end-stage kidney disease who was receiving hemodialysis through a tunneled central venous catheter and had severe hyperkalemia that prompted admission for emergent hemodialysis.

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This Viewpoint discusses how the lack of agreement governing in-network and out-of-network care can harm patients and benefit aggressive pricing strategies.

This multicenter randomized clinical trial investigates the efficacy and safety of acupuncture compared with sham acupuncture in patients with chronic sciatica from herniated disk.

This Viewpoint details the previous lack of dental coverage under Medicare and what the new expansion could provide for patients now and in the future.

In 2000, the US Food and Drug Administration (FDA) approved the medication mifepristone, an antiprogesterone oral medication used with misoprostol to induce abortion. Before mifepristone, most abortions that occurred within the medical system in the US were done using either procedural abortion or medication abortion that used methotrexate or misoprostol only, both of which can have higher adverse event profiles and lower efficacy rates than the mifepristone-misoprostol combined regimen. Mifepristone’s approval advanced treatment options for patients needing abortion care and those undergoing miscarriage management, improved the efficacy and availability of medication abortion, and increased the power of patients to manage their own abortions in the place and time of their choosing.