Новости за 11.07.2023

This Medical News article discusses new research presented at the American Society of Clinical Oncology’s 2023 annual meeting.

Infection with Fusobacterium bacteria was linked with endometriosis in some women, according to data from 155 participants in Japan. About 64% of patients with endometriosis compared with about 7% of those without the condition had evidence of Fusobacterium infiltration, mainly F nucleatum, in the endometrium.

A new US plan outlines approaches the federal government is taking to prevent and treat sexually transmitted infections (STIs), specifically chlamydia, gonorrhea, syphilis, and human papillomavirus, through 2025, the Department of Health and Human Services (HHS) announced.

The cumulative risk of dying within 5 years of an early invasive breast cancer diagnosis has declined from about 14% in the 1990s to about 5% for women diagnosed between 2010 and 2015, according to data from 512 447 women in England who were treated initially with surgery. Mortality rates were highest during the 5 years after diagnosis before declining with each following 5-year period.

Consistent with previous studies, patients at high risk of excessive bleeding after major trauma who received an injection of tranexamic acid before arriving at the hospital had a lower risk of death at 28 days than those who received a placebo. At 6 months after injury, however, both groups experienced similar rates of survival with moderate disability or better, according to results from 1310 adults across Australia, Germany, and New Zealand who received 2 total doses of the drug.

An analysis found that nursing home residents with Alzheimer disease or cognitive impairment had better outcomes when people with those conditions made up more than 90% of the facility’s population—which was the case for only a small proportion of nearly 14 000 facilities with 7.6 million residents. Improved outcomes included fewer hospital and emergency department admissions.

Paraguay is currently experiencing a large chikungunya outbreak, with more than 81 000 suspected, probable, or confirmed cases recorded from October 1, 2022, to March 11, 2023, researchers reported in MMWR in early June. There are currently no approved vaccines or treatments for the mosquito-borne virus, which is transmitted in parts of Africa, the Americas, and Asia, with occasional outbreaks in other areas.

A new US program will offer up to $100 000 of loan repayment to pediatric specialists in medicine and surgery as well as to clinicians who provide behavioral health care to children and adolescents, the Department of Health and Human Services said in a statement announcing the $15 million investment by the Health Resources and Services Administration (HRSA).

Some people with diabetes, including about 27% who were insured, used online crowdfunding to cover costs linked to their health, according to an analysis of 313 randomly selected GoFundMe campaigns from patients with type 1 and type 2 diabetes.

Starting in July 2024, the US Centers for Medicare & Medicaid Services (CMS) will begin piloting the Making Care Primary Model at organizations in 8 states—Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington. In addition to improving care coordination, helping primary care clinicians connect with specialists, and strengthening connections with community-based organizations, the approach will likely reduce health care costs, the agency said in a statement.

This Viewpoint examines Medicare physician payment flaws and needed reforms, including changes implemented by Congress, CMS, commercial payers, and physician employers.

This Viewpoint discusses the Medicare Physician Fee Schedule and its flaws, including how they might be remedied by severing CMS dependence on Relative Value Update Committee estimates of time and intensity.

This 32-country randomized clinical trial assesses the effects of bempedoic acid on cardiovascular outcomes in statin-intolerant patients receiving bempedoic acid vs placebo for primary prevention of a first major adverse cardiovascular event.

Statin therapy is the mainstay of lipid-lowering therapy for the primary prevention of atherosclerotic cardiovascular disease (ASCVD). But 5% to 10% of patients are unable to tolerate a statin at any dose or at a dose high enough to achieve patient-specific target levels of low-density lipoprotein cholesterol (LDL-C), most commonly due to muscle-related symptoms. Statin-intolerant patients have historically had few therapeutic options: ezetimibe produces only modest reductions in LDL-C levels, and... Читать дальше...

This study examines whether Medicare Advantage (MA) enrollees with more chronic conditions were more likely to disenroll when MA enrollment grew rapidly from 2009 to 2019.

This Viewpoint discusses the ramifications of the Dobbs v Jackson Women’s Health Organization decision by the US Supreme Court and the state of reproductive health care in the US.

In this narrative medicine essay, a resident otolaryngologist’s grief over the loss of his daughter at nearly 20 weeks’ gestation nearly crushes him until he finds relief hearing the stories of other parents at a hospital-sponsored rememberance celebration.

This JAMA Insights Clinical Update discusses current recommendations regarding prevention of Pneumocystis pneumonia in patients who are immunocompromised.

This review summarizes current evidence regarding diagnosis and treatment of Cushing syndrome due to endogenous overproduction of cortisol.

Mother and daughter, breast oncologist and patient: the poem “Thirty-Five” brims with loaded dualities that deftly illuminate the poet’s layered feelings about her increased risk of breast cancer. The alchemy of poetry allows her to inhabit 2 places at once, present and past, in the doctor’s office undergoing a clinical breast exam and at home with her mother as she helps her recover from having her “heavy breasts…cut away.” The poet’s unerring eye for detail communicates the particularly unnerving tension between risk and intimacy... Читать дальше...

My new oncologist asks about my family history as she kneads my breasts with her fingers, searching.

This randomized trial compares the efficacy and tolerability of 2 durations of cytisinicline treatment (6 or 12 weeks) vs placebo for smoking cessation in adults who smoked cigarettes daily.

This prospective multicenter study of 400 hospitalized infants with a suspected genetic disorder evaluated rates of molecular diagnostic yield, time to return of results, and clinical utility by comparing between genomic sequencing and targeted neonatal gene-sequencing testing.

In Reply We thank Dr Khaire and colleagues for their interest in our study, and for their agreement that the study provides strong evidence that the detection of persistent FLT3-ITD or NPM1 variants in the blood samples of adults during first remission from AML prior to allogeneic transplant is associated with increased posttransplant relapse and death, compared with those testing negative.

In Reply In response to our recent Review, Dr Wang raises several interesting points regarding the use of prophylaxis against P jirovecii pneumonia in patients with glioma, but conflates 2 different clinical scenarios. The first is P jirovecii pneumonia prophylaxis in the setting of long-term steroid use (>4 weeks), as discussed in our Review. The second scenario is empirical P jirovecii pneumonia prophylaxis in the setting of chemoradiation, which is the scenario addressed in the article cited by Wang.