This Viewpoint discusses the COVID-19 pandemic, community–law enforcement tensions, and social and structural factors that have potentially contributed to increased risks for homicide and suicide in the US.
The US isn’t the only place where primary care practice is on the ropes. About 33% of nearly 2300 general practitioners (GPs) in England said they were planning to quit direct patient care within 5 years, according to a University of Manchester survey.
A World Health Organization program launched in 1996 to eliminate active trachoma by 2020 did not reach its goal. However, the number of people at risk of trachoma blindness declined by 90% between 2002 and 2018, and the risk may yet be eliminated by 2030, according to analysis of data from 38 countries published in The Lancet Global Health.
These international, consensus-based, patient-reported outcomes (PRO)–specific guidelines aim to lay out the ethical considerations that researchers, research ethics committees, and funders should take into account when conducting or reviewing PRO clinical research.
Like Christiansen’s hound who wanders between two stark peaks to track the meal-marking blare of trumpets, my mind moves between trying to ignore the present and feeling sick about ignoring it. I kneel by a pond of orange koi that spark like hope against the algae-slick edges of stones, as an aging surgeon tucks in a packet of delicate nerves, then stitches up the fabric of my daughter’s back like the popped seam of a teddy bear. A reverent couple, white sunlight in their faces, casts twin shadows across the bulk of a red wagon. Читать дальше...
This JAMA Patient Page describes the skin condition psoriasis and its diagnosis, risk factors, and treatment.
This randomized clinical trial assesses whether transcatheter aortic valve implantation (TAVI) is noninferior to surgical aortic valve replacement in patients at moderately increased operative risk.
This randomized clinical trial examines the effect of oral methylprednisolone on the risk of major kidney outcomes, including 40% decline in eGFR, kidney failure (dialysis, transplant), or death due to kidney disease, and adverse effects in individuals with IgA nephropathy and proteinuria.
In Reply We disagree with Drs Pappalardo and Montisci that patients included in the hypothermia group of the HYPO-ECMO trial did not receive hypothermia induction. First, core temperature had to be monitored through an esophageal or bladder probe, which was not available in all patients immediately following randomization, and explains why patients in the hypothermia group were already in a hypothermic state at the first temperature measurement.
In Reply Regarding our recent article, Ms Bastarache and Dr Peterson suggest that identification of cases using EHR data may lead to lower estimates of penetrance. While they raise relevant points, we would like to provide clarification. First, Bastarache and Peterson state that a substantial fraction of individuals with disease lack the relevant ICD diagnosis codes used to estimate penetrance in our study; however, they provide limited evidence for this. The study mentioned is for AATD, a disease that was not included in our study. Читать дальше...
In Reply In response to the request by Dr Bezerra for additional details about the COVID-19 tests used in our study, there were 1322 presumptive positive results out of 903 408 rapid antigen tests. Of these, 92 504 were performed using BD Veritor tests (which had 125 presumptive positive results) and 810 904 using Abbott Panbio tests (which had 1197 presumptive positive results). Of the 462 presumptive positive results that were false-positives, 278 came from the same lot of Panbio rapid antigen... Читать дальше...
To the Editor I have several concerns about the recently published HYPO-ECMO trial. First, I wonder whether this trial’s exclusion of 72 patients who underwent cardiopulmonary resuscitation (CPR) for more than 45 minutes before initiation of ECMO was appropriate. In a previous trial comparing extracorporeal CPR with conventional treatment for patients with refractory ventricular fibrillation and out-of-hospital cardiac arrest, the average time from 911 call to initiation of ECMO in the extracorporeal CPR group was 59 minutes... Читать дальше...
To the Editor A recent study highlighted how electronic health record (EHR)–linked biobanks can be used to investigate penetrance in a diverse population and concluded that most pathogenic variants have low penetrance, using data from 2 large biobanks—BioMe and UK Biobank.
To the Editor In the recent study using data from a large COVID-19 rapid testing program that took place in working environments across Canada, the authors reported a low incidence of false-positive test results (0.05%) with rapid antigen testing, which is in accordance with previous smaller cohorts. These findings support the use of the antigen tests for screening asymptomatic individuals as an important tool to mitigate viral spread in work communities, without overwhelming polymerase chain reaction (PCR)–based diagnostic laboratories.
This cross-sectional study using NHANES data assesses the proportion of asymptomatic US adults eligible for screening based on new vs current US Preventive Services Task Force and American Diabetes Association screening guidelines, overall and among those with prediabetes or undiagnosed diabetes.
A. E. Rockey, M.D., Portland, Ore.
The FDA and the US Drug Enforcement Administration (DEA) recently issued joint warning letters to the operators of 2 websites illegally selling amphetamine drug products marketed as Adderall, a Schedule II stimulant, without a prescription.
The first test that uses breath samples to diagnose COVID-19 recently received Emergency Use Authorization from the FDA.
The FDA recently issued a new draft guidance for industry about improving the enrollment of clinical trial participants from underrepresented racial and ethnic populations, many of whom are part of medically underserved communities.
End-stage valvular aortic stenosis obstructs blood flow from the left ventricle into the aorta. Prior to development of the heart-lung machine in 1953, other than a few reports of direct fracture of the stenosed valve on a beating heart or with hypothermic cardiac arrest, there were no effective treatments for relief of outflow obstruction. Starting in the 1960s, the use of mechanical and then bioprosthetic heart valves led to a substantial improvement in survival for patients with severe aortic stenosis. Читать дальше...
IgA nephropathy is the most common primary glomerulonephritis in the world, with an estimated annual incidence of at least 2.5 per 100 000 persons. The pathogenesis of IgA nephropathy is thought to involve 4 factors (or “hits”). First, elevated levels of mucosal circulating galactose-deficient IgA1 (hit 1) are recognized by IgG or IgA autoantibodies (hit 2). Pathogenic galactose-deficient IgA1–auto-Ab immune complexes form (hit 3) that are deposited in the mesangium, causing glomerular injury (hit 4). Читать дальше...
This Arts and Medicine essay reviews how 21st-century evidence-based approaches to the use of psychedelic medicine replicate the ancient practices of Asclepian medicine.
Today, reports have confirmed that CityFibre has overtaken Virgin Media O2 as the second largest provider of FTTP services in the UK. According to Think Broadband, CityFibre’s most recent audit shows the company to have reached a total of 1,083,888 premises passed…
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Two of the most innovative companies in global ICT – Ericsson (NASDAQ: ERIC) and Intel – are pooling R&D excellence to create high-performing Cloud RAN solutions. The companies have launched a tech hub in California, USA. It focuses on the benefits that Ericsson Cloud RAN and Intel technology can bring to: improving energy efficiency and network performance, reducing time to market…
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This week, the Indian government has outlined plans to see domestically developed 6G deployed by 2030, with Prime Minister Modi saying that the country would accelerate its technological development to match those international rivals. Speaking at Telecom Regulatory Authority of India (TRAI) event this week, Modi announced that work on 6G was already underway, having created an industry taskforce to focus on the new technology…
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