Новости за 20.02.2024

This Viewpoint discusses 4 defining health issues that will likely influence not only the 2024 presidential election but also congressional and state races.

This study examines prevalence of use of complementary health approaches overall and for pain management among US adults.

This Arts and Medicine feature coauthored by a patient and her hospital clinicians describes the use of hand-drawn window art in hospital rooms as a way to bring color and creativity into inpatient settings and build community among hospital staff and patients.

In this narrative medicine essay, an internal medicince resident grapples with the question of “How much is enough?” when treating someone with terminal cancer.

This JAMA Patient Page describes the condition of uterine prolapse and its risk factors, symptoms, and treatment options.

This randomized clinical trial compares the effect of donor human milk on neurodevelopmental outcomes at 22 to 26 months’ corrected age compared with preterm infant formula among extremely preterm infants who received minimal maternal milk.

In 2024, more than 50 countries representing more than half of the world’s population have gone or will go to the polls to elect their leaders. Through their health, science, economic, and social policies, governments exert extraordinary influence on the health and health care of those within their jurisdiction and on regional and global health. 2024 provides an opportunity to highlight the critical health issues faced across the globe and in particular national contexts.

From the moment of birth, infants born extremely preterm or at an extremely low birth weight (<1000 g) face critical illness due to multiorgan system immaturity, typically requiring hospitalization in the neonatal intensive care unit (NICU) for several months. Medical interventions now allow most of these infants to survive to hospital discharge, and the focus has shifted to identifying interventions that reduce adverse health and developmental consequences during childhood and beyond. With this goal in mind... Читать дальше...

This Medical News story examines the latest information about rebound, treatment eligibility, optimal dosing, and other questions related to nirmatrelvir-ritonavir for treating COVID-19.

There’s not much evidence on the risk of birth defects with medications used to treat opioid use disorder (OUD) during pregnancy. But a recent study found that treating OUD with buprenorphine during the first trimester was linked with an 18% lower relative risk and about a 1% lower absolute risk of congenital malformations compared with methadone treatment. The analysis, published in JAMA Internal Medicine, was based on data from more than 13 000 pregnancies.

Even small increases in out-of-pocket costs for preexposure prophylaxis (PrEP), a medication that can prevent people from being infected with HIV, could result in patients not filling their prescriptions, a recent study in Health Affairs projected.

Being diagnosed with depression during or after pregnancy was associated with an increased risk of death up to 18 years later from any cause, according to data from more than 86 000 Swedish women with the condition.

People in the UK who did not receive all the doses of the vaccine for which they were eligible had up to 4 times the risk of being hospitalized or dying from COVID-19 compared with those who were fully vaccinated, according to electronic health record data taken from the entire population aged 5 years or older. Rates of undervaccination ranged from about 33% to almost 50% across the UK, with the highest rates in Northern Ireland.

Researchers have turned to machine learning algorithms to help find biomarkers that could identify people with major depressive disorder (MDD). But these algorithms were only able to accurately identify up to 62% of people with MDD using neuroimaging data, a study involving more than 1800 participants aged 18 to 65 years found.

Poll results from more than 2600 respondents found that about 8% of adults aged 50 to 80 years reported using an online-only direct-to-consumer health care service. This may increase though. About one-third of the respondents expressed interest in using these services in the future, the University of Michigan’s National Poll on Healthy Aging found.

People who spent much of their day at work sitting had a 16% higher risk of dying from any cause and a 34% higher mortality risk from cardiovascular disease compared with those who didn’t spend as much time sitting on the job, according to a cohort study in JAMA Network Open. After the study’s roughly 13-year surveillance of about 480 000 participants, researchers also found that people who mostly sat during the day but increased their physical activity by an extra 15 to 30 minutes had a similar... Читать дальше...

A new rule finalized by the US Centers for Medicare & Medicaid Services (CMS) streamlines the prior authorization process, which requires clinicians to seek permission from insurers before prescribing certain treatments to patients. The rule applies to insurance providers including Medicare Advantage organizations and Medicaid programs, which have until January 1, 2027, to implement the requirements.

This clinical trial compares the effectiveness of anticoagulation vs antiplatelet therapy for secondary stroke prevention in patients with cryptogenic stroke and evidence of atrial cardiopathy.

It can be counterintuitive for patients with atrial fibrillation (AF) to understand the evidence-based recommendation to receive anticoagulation therapy despite successful suppression of their arrhythmia with an antiarrhythmic drug. After all, the general teaching is that the heightened risk of stroke and systemic thromboemboli occurs due to the stasis of blood in the left atrial appendage produced during rapid and disorganized fibrillation of atrial tissue. And yet, randomized clinical trial data... Читать дальше...

This Review summarizes current evidence regarding the diagnosis and treatment of paroxysmal supraventricular tachycardia.

A sign the clinician elicits —importantly distinct from pain, which is concerned with feeling— my textbook insists.

This cohort study of renters who received eviction filings, similar renters who did not, and the general population across the study area compares rates of excess mortality associated with the COVID-19 pandemic.

In Reply We thank Mr Meng and colleagues and Dr Park and colleagues for their comments about the EMERGE trial. We agree with using caution in the interpretation of the trial, as the primary outcome did not reach the prespecified level of statistical significance. However, the constituents of the primary outcome (insulin initiation or a mean fasting glucose level of ≥5.1 mmol/L at weeks 32 and 38) were significantly improved in those randomized to metformin. In addition, secondary outcomes of maternal insulin dose... Читать дальше...

In Reply Dr Boull and colleagues raise important points in their Letter. Our recent Review noted the absence of randomized clinical trials testing the efficacy of the Children’s Oncology Group Long-Term Follow-Up Guidelines (COG LTFU Guidelines) in mitigating the risk of adverse treatment-related outcomes. The lack of randomized clinical trials is not limited to skin cancer but applies to all recommendations within the COG LTFU Guidelines. Given the relatively small absolute numbers of childhood... Читать дальше...

To the Editor A recent study concluded that early metformin treatment for gestational diabetes was not superior to placebo for the composite primary outcome. However, we have several concerns. First, the authors defined the primary outcome as a composite of insulin initiation before delivery or fasting blood glucose exceeding 5.1 mmol/L at week 32 or week 38 of gestation. Some studies have used different criteria, including new insulin initiation, increased use of glucose-lowering medications, or specific blood glucose measurements. Читать дальше...