Новости за 17.09.2024

The inflammatory bowel diseases of ulcerative colitis and Crohn disease are chronic inflammatory conditions of the intestine. The estimated incidence of ulcerative colitis is 15 per 100 000 person-years and the prevalence is 400 per 100 000 in North America. Despite advances to medical management, nearly 1 in 5 patients with ulcerative colitis will be hospitalized and approximately 7% will require a colectomy within 5 years of diagnosis. The health care cost of ulcerative colitis has steadily risen over the past 2 decades... Читать дальше...

This Viewpoint explores partisan attitudes toward Medicaid in the 2024 US election and the implications for access to care and health equity if a Republican proposal that includes work requirements and block grants moves forward.

In the Medical News in Brief article titled “Adding Salt to Food at Mealtime Associated With Stomach Cancer Risk,” published on July 2, 2024, the absolute risk of cancer among those who salt their meals at the table was omitted. This article was corrected online.

In Reply Although the available data suggest that, in patients with atrial fibrillation, sex is not associated with serious oral anticoagulant-related bleeding, as suggested by Dr Samuelson Bannow and colleagues, we analyzed the interaction between diltiazem and apixaban/rivaroxaban according to sex. The cohort included 107 652 females with a mean age of 77.8 (SD, 7.2) years and 96 503 males with a mean age of 75.9 (SD, 6.6) years. The outcome was the composite of bleeding-related hospitalization or death with recent evidence of bleeding... Читать дальше...

To the Editor A recent study reported a higher incidence of serious bleeding in patients using diltiazem, compared with metoprolol, in conjunction with apixaban or rivaroxaban for the treatment of atrial fibrillation. The authors also reported a higher proportion of women in the diltiazem group (59.3% vs 50.4%). We read this study with particular interest given postmarketing data on uterine bleeding in women taking various direct oral anticoagulants, with rates of abnormal uterine bleeding as high as 67%. Читать дальше...

This study estimates the association between Florida’s red flag law enactment and firearm and nonfirearm homicide and suicide rates.

This 2024 Recommendation Statement from the US Preventive Services Task Force concludes that current evidence is insufficient to assess the balance of benefits and harms of screening and routine supplementation for iron deficiency and iron deficiency anemia in pregnant persons to prevent adverse maternal and infant health outcomes (I statement).

This systematic review to support a 2024 US Preventive Services Task Force Recommendation Statement summarizes published evidence on the benefits and harms of iron supplementation, and screening for iron deficiency and iron deficiency anemia, during pregnancy.

This JAMA Patient Page discusses the pros and cons of screening for iron deficiency and iron deficiency anemia during pregnancy.

The US Preventive Services Task Force (USPSTF) recently released a Recommendation Statement examining the data to support screening for iron deficiency anemia in pregnancy and finding them lacking. It also found insufficient evidence to make a clear recommendation for or against preventive iron supplementation in pregnancy, which has been a routine practice for decades, with up to 77% to 89% of patients reporting supplement use. As highlighted previously by the USPSTF and others, there is an urgent... Читать дальше...

The Original Investigation titled “Effect of Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Initiation on Organ Support–Free Days in Patients Hospitalized With COVID-19: A Randomized Clinical Trial,” published on April 11, 2023, has been updated to fix the name of Matteo Aldo Bonizzoni in a supplement. This article was corrected online.

The Original Investigation titled “Intravenous Vitamin C for Patients Hospitalized With COVID-19: Two Harmonized Randomized Clinical Trials,” published on November 14, 2023, has been updated to fix the name of Matteo Aldo Bonizzoni in a supplement. This article was corrected online.

This Viewpoint examines physician licensure requirements administered by state medical boards and 2 lawsuits challenging the restrictions placed on interstate telemedicine.

I saw an aged woman adorned by those she loved and my heart wondered. She couldn’t tell if she was dying or perhaps had died already but she knew about journeys— that we are only borne far by those we hold.

In Reply Dr Siegel and colleagues at the FDA raise concerns that our article incorrectly indicated that the FDA relies only on meta-analyses to establish surrogacy and “incorrectly identifies the evidence the FDA used to conclude that these biomarkers can serve as surrogate end points.” However, nowhere in the article did we state that the FDA relies only on meta-analyses to establish the surrogacy of a biomarker for a clinical outcome.

To the Editor Dr Wallach and colleagues evaluated the association between surrogate markers listed in the FDA surrogate end point table and clinical outcomes for 32 chronic diseases, including gout. In accordance with 2 published meta-analyses, the authors concluded urate levels are a weak surrogate marker for gout flares. They also indicated that reducing urate levels may worsen pain in people with gout. An explanation of these findings is needed to avoid confusion in gout management.

This JAMA Insights explores the differences between in-person and telehealth encounters between patients and clinicians and offers clinicians guidance on how to improve communication with patients when meeting virtually.

This Viewpoint explores the shift from fee-for-service to value-based payment models and the resulting trend of physician employment moving away from independent practices toward corporate health institutions.

In this narrative medicine essay, a pediatric infectious disease physician relates how he has learned to understand the protective role of code-shifting in his life and how that understanding has aided him in promoting an inclusive environment in academic medicine.

The modern hospital has evolved from a publicly supported institution which gave institutional and domiciliary care to the poor and unfortunate when they were sick to a complex intricate organization which serves a variety of purposes in the field of health. The hospital has evolved from an institution usually supported by the community or government to one maintained by private agencies and philanthropies and by the fees of persons in the community with the greatest financial resources.…Modern medicine... Читать дальше...

This Medical News article discusses the World Health Organization’s emergency declaration related to an mpox outbreak in Africa and the emergence of a new virus strain spread by sexual contact.

This Medical News article discusses terbinafine-resistant tinea, or ringworm, caused by the recently identified fungal species Trichophyton indotineae.

More adults in the US walk for recreation than walk to work or to a specific destination, a data brief from the National Center for Healthcare Statistics found. The data, which were based on results from the 2022 National Health Interview Survey, also showed demographic and socioeconomic differences.

The US Department of Health and Human Services (HHS) announced it will award about $45 million in grants to improve mental health and overdose crisis services in the US.

Infants born to birthing parents with obesity could be at a higher risk of sudden unexpected infant death (SUID), according to a cohort study in JAMA Pediatrics.