Sundaravadielu, S., author

Interview with Henry M. Blumberg, MD, author of Update on the Treatment of Tuberculosis and Latent Tuberculosis Infection, published in the June 8 issue of JAMA, the Journal of the American Medical Association. Summary Points: 1. Tuberculosis is a public health problem. The responsibility for prescribing an appropriate regimen and assuring that treatment is completed is assigned to the public health program or the treating physician, not the patient. 2. Directly observed therapy is recommended for all patients being treated for active TB, this will necessitate the need for greater collaboration between the treating physician and the public health department. 3. Initial therapy for newly diagnosed patients with tuberculosis consists of a 4-drug regimen including isoniazid, rifampin, pyrazinamide and ethambutol. 4. Testing for latent TB infection should be targeted at those who are at increased risk of progression to active TB. 5. Despite its limitations, the tuberculin skin test remains the most commonly used test for the diagnosis of latent TB infection; newer diagnostic tests for latent TB infection are on the horizon. 6. Active tuberculosis should be excluded before beginning treatment for latent tuberculosis infection. 7. Nine months of isoniazid is the preferred therapy for the treatment of latent TB infection.

Interview with Michael E. Pichichero, MD, author of Combined Tetanus, Diphtheria, and 5-Component Pertussis Vaccine for Use in Adolescents and Adults, published in the June 22/29 issue of JAMA, the Journal of the American Medical Association. Summary Points: 1. Need: The combined tetanus-diphtheria 5-component pertussis vaccine is needed; There has been a 300% increase of pertussis among US adolescents in the last three years. 2. Safety: The combined tetanus-diphtheria 5-component pertussis vaccine is safe, as the reactions are the same as the tetanus vaccine. 3. Universal: On June 30, 2005, the American Academy of Pediatrics (ASAP), America Academy of Family Physicians (AFAR), and the Advisory Committee on Immunization Practices (ACID) all recommended the universal use of the combined tetanus-diphtheria 5-component pertussis vaccine or its competitor vaccine for adolescents.

Interview with Matthew H. Samore, MD, author of Clinical Decision Support and Appropriateness of Antimicrobial Prescribing: A Randomized Trial, published in the November 9 issue of JAMA, the Journal of the American Medical Association. Summary points: 1. Repetitive use of a diagnostic and treatment algorithm to ingrain new prescribing habits was a valuable part of this practice change intervention. 2. Clinical decision support systems (CDSS) are feasibly implemented in practice settings that lack electronic medical records, including rural communities. 3. CDSS needs to be integrated with tools that save clinicians' time to be sustainable.

This Viewpoint proposes a framework for international cooperation among governments and organizations to replace competition and hoarding with equitable global distribution of COVID-19 therapeutics and vaccines as they are developed.

This population epidemiology study characterizes trends in polymerase chain reaction (PCR) test positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Washington State and the Seattle area between March 1 and April 16, 2020, before and after statewide physical distancing guidelines and stay-at-home orders.

In this narrative medicine essay, a psychiatrist used her residency to avoid grieving the loss of her brother to suicide but through participation in a grief support group during training she began to thaw enough to remember her brother, watch videos of ephemeral moments like celebrating his fourth birthday, an act that allowed her to see him and her family again.

In this narrative medicine essay, a physician finds in the motion of diastole, the process of letting go and filling up, an apt metaphor for how to handle the burnout, anxiety, and depression of medical training.