In this narrative medicine essay, a neonatologist through the complex forces of intensive care physician, son, and ethicist grapples with the impending loss of his father and ultimately understanding his father’s demand for autonomy in deciding his care.
Cancer loves me, tho I’m not quite sure why. Is it the many
In Reply We agree with Dr Shontell and colleagues that collapsing racial and ethnic groups into broad categories can obscure disparities. Asian and Pacific Islander include more than 40 subgroups with cultural, linguistic, and socioeconomic diversity. Despite this diversity, for many years, race information on death certificates was collected in accordance with the 1977 OMB standards. Those standards included 4 race categories (American Indian or Alaska Native, Asian or Pacific Islander, Black, and White).
To the Editor A recent study evaluating differences in all-cause and cause-specific mortality in youth patients from different racial groups across the US highlighted subpopulations at the greatest risk of increased mortality, who therefore have the greatest need for targeted public health intervention. However, by aggregating the Native Hawaiian and Other Pacific Islander with Asian populations, the authors masked Native Hawaiian and Other Pacific Islander health disparities. As Native Hawaiian... Читать дальше...
This study evaluates the effectiveness of the respiratory syncytial virus vaccine against hospitalization for acute respiratory illness among US adults aged 60 years and older.
This JAMA Insights investigates the increased rates of climate change–related preventable injury and the importance of emergency and disaster preparedness as well as injury and violence prevention.
This work discusses initiatives designed to capture the value of public investment that will result in an accurate, comprehensive, and transparent paper trail of public funding.
This review summarizes current evidence on recommended treatments for acute pericarditis, its prognosis, and the diagnostic evaluation of individuals with suspected initial or recurrent pericarditis.
This JAMA Patient Page describes the condition of plantar fasciitis and its diagnosis and treatment.
This randomized clinical trial investigates the efficacy of balloon angioplasty plus aggressive medical management vs medical management alone in the treatment of patients with symptomatic intracranial atherosclerotic stenosis.
In Reply Alliance A011502, a randomized trial of aspirin 300 mg daily compared with placebo among 3020 survivors of high-risk nonmetastatic breast cancer, was terminated early due to lack of benefit from aspirin. Dr Thorat and colleagues note that for some cancers (eg, colorectal cancer) and different settings (eg, primary prevention), the time course of benefit can differ. However, in the adjuvant setting, it would still be most appropriate to use the standard stopping rules applied to adjuvant... Читать дальше...
To the Editor A recent study reported on the absence of a statistically significant benefit of aspirin at 300 mg/d for recurrence and survival in patients with breast cancer. In accordance with these findings, the authors advised against the routine use of aspirin as an adjunct treatment in breast cancer.
This study evaluates the accuracy of clinical staging in early-stage pancreatic ductal adenocarcinoma.
The progress of scientific investigation that leads to new discoveries or to the more rational application of knowledge already available often opens a pathway to useful therapeutic endeavor. As a consequence, the conscientious practitioner is frequently impelled to be alert to the novel contributions that may be applied in his professional work. An imperative sense of duty, not infrequently coupled with an inspiring enthusiasm for the promise of betterment, urges him to keep in touch with the items... Читать дальше...
Intracranial atherosclerotic arterial stenosis (ICAS) is one of the most common causes of stroke worldwide and is associated with a particularly high risk of recurrent stroke. The mechanisms by which ICAS causes transient ischemic attack (TIA) or stroke include acute occlusion or artery-to-artery embolization due to plaque rupture, branch atheromatous disease wherein the large artery plaque overgrows the ostium of a perforator artery, hypoperfusion of distal territory due to low flow, or a combination of these mechanisms. Читать дальше...
This randomized clinical trial compares the effectiveness and safety of a novel low-dose triple-pill protocol, compared with a standard-care protocol, for blood pressure lowering among Black African adults in Nigeria.
A sick man who eats many herbs does not know the one that made him well.Variation on an African proverb
This Medical News article is an interview with emergency management and medical experts from Oregon and Washington who experienced the record-breaking heat wave in June of 2021.
This Medical News article discusses the latest research about the use of nirmatrelvir-ritonavir, sold as Paxlovid, to treat COVID-19 and, possibly, to prevent or treat long COVID.
A diminished sense of purpose and personal growth may precede mild cognitive impairment (MCI) in older adults, according to research recently published in the Journal of Neurology, Neurosurgery & Psychiatry.
Although US federal law entitles children enrolled in Medicaid to vision services, adults depend on rules set at the state level. That can lead to major disparities in service coverage, a state-by-state analysis in Health Affairs found.
Symptoms such as abdominal bloating and pain have been a signal to UK and US clinicians to perform diagnostic tests for ovarian cancer. If the results are abnormal, patients in the UK may be fast-tracked for a referral within 2 weeks, despite a lack of clear evidence on how effective this is for women with aggressive ovarian cancer.
Since 2021, the US National Institutes of Health (NIH) has enrolled 90 000 people across more than 200 clinical sites as part of its RECOVER initiative to understand, identify, and treat post–COVID-19 condition, also known as long COVID. One goal of these studies has been to discover biomarkers that can help diagnose long COVID because symptoms are so wide-ranging. Recently, though, a study in the Annals of Internal Medicine found that routine laboratory tests are unlikely to help achieve that goal.
Pfizer’s ABRYSVO vaccine was safe and generated a strong immune response against respiratory syncytial virus (RSV) in immunocompromised adults aged 18 years or older, according to top-line clinical trial results announced in August. Last year, the US Food and Drug Administration approved ABRYVSO for use in people aged 60 years or older, but there is no RSV vaccine available for younger adults, even though immunocompromised individuals of any age have an increased risk of RSV complications, Pfizer noted in its news release.
Deaths from COVID-19 dropped by about 69% last year, decreasing from roughly 246 000 deaths in 2022 to 76 000 in 2023, according to provisional data released by the US Centers for Disease Control and Prevention (CDC). This shifted COVID-19 from the 4th leading cause of death in 2022 to the 10th, researchers noted in the Morbidity and Mortality Weekly Report.