Новости за 18.07.2023

Exposure to wildfire smoke has increased in the US over the past decade, with more than 87% of the nation’s population experiencing an increase in the number of days of heavy smoke, according to an analysis of satellite-collected and census data and information about communities’ sociodemographic, economic, and cultural characteristics. On average, the number of person-days of heavy smoke exposure increased 350% between the first and the second 5 years of the study from about 310 million person-days... Читать дальше...

Losing weight boosted metabolic markers, such as insulin sensitivity, in people with obesity, but did not remedy their blunted brain responses to nutrient intake, according to functional magnetic resonance imaging results from 30 participants with obesity, or a body mass index of 30 or higher, and 28 participants without obesity.

Taking a 100-mg dose of aspirin each day was associated with a 20% higher risk of anemia compared with a placebo, according to a secondary analysis of results from the ASPREE (Aspirin in Reducing Events in the Elderly) randomized clinical trial that included 19 114 people aged 65 years or older. The incidence of anemia was about 51 events per 1000 person-years in the aspirin group and 43 events in the placebo group. Participants who received daily aspirin also tended to have a larger decrease in ferritin levels—a measure of overall iron stores... Читать дальше...

The country’s health care spending will grow an average of 5.4% per year between 2022 and 2031, accounting for about $1 out of every $5 spent in the US by the end of the period, according to new projections from the Centers for Medicare & Medicaid Services published in Health Affairs. The agency expects that recent legislative changes, such as the expiration of regulations surrounding the COVID-19 public health emergency and the implementation of the Inflation Reduction Act’s prescription drug provisions... Читать дальше...

This Viewpoint analyzes the scope and legal implications of tracking on hospital websites, including potential HIPAA and state privacy law violations, and suggests that hospitals limit such tracking.

This Viewpoint highlights several key steps that states could take to expand perinatal care coverage for noncitizens.

This study evaluates changes in the number of births in Texas after passage of Texas’ Senate Bill 8 (SB8), which bans abortions as early as 5 weeks’ gestation.

In this narrative medicine essay, an internist suffering from portal communication burnout explored several solutions, none of which sat well with him, so he decided to write a letter to his patients explaining his fatigue and asking them to abide by some usage guidelines.

A previously healthy individual in his 20s had 3 months of annular skin lesions, with numbness and paresthesia in the affected areas. Physical examination revealed multiple tattoos, bilateral palpable thickened auricular and ulnar nerves, and claw-hand deformity; test results for rapid plasma reagin, antinuclear antibodies, rheumatoid factor, acid-fast bacilli, mycobacteria, and fungi were negative, and biopsy did not identify Mycobacterium leprae. What is the diagnosis and what would you do next?

This Viewpoint discusses the amount of physical activity recommended by the Physical Activity Guidelines for Americans, 2nd Edition, and how clinicians should use these recommendations to personalize and set achievable physical activity goals for their patients.

This 2023 Recommendation Statement from the US Preventive Services Task Force concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for lipid disorders in children and adolescents 20 years or younger (I statement).

This systematic review to support the 2023 US Preventive Services Task Force Recommendation Statement on screening for lipid disorders in children and adolescents summarizes published evidence on the benefits and harms of screening for, and treatment of, dyslipidemia due to familial hypercholesterolemia and multifactorial dyslipidemia in children and adolescents 20 years and younger.

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This JAMA Patient Page describes lipid disorders, and the pros and cons of screening for them in children and adolescents.

This study examines associations between an accelerometer-derived “weekend warrior” pattern (ie, most moderate to vigorous physical activity achieved over 1-2 days) vs similar physical activity spread more evenly and the risk of incident cardiovascular events.

This study examines the association between state public insurance coverage and postpartum care among low-income immigrants and the differences in care received among immigrants relative to nonimmigrants.

In Reply We agree with Drs Gao and Zhang that understanding the effectiveness of IUDs to prevent pregnancy is important to adequately weigh the risks and benefits of early postpartum IUD placement. Although IUDs are well known to be highly effective, our study was not designed to adequately assess the effectiveness of early postpartum IUDs for pregnancy prevention. We did report all pregnancies in the trial; 2 pregnancies occurred during use of an IUD among the 294 participants who received an IUD... Читать дальше...

In Reply In their Letter about our recent Viewpoint, Dr Probst and colleagues rightly emphasize the health challenges facing rural youth in the US. Pediatric mortality rates in rural counties—already higher than in metropolitan areas—increased during the COVID-19 pandemic. Centers for Disease Control and Prevention (CDC) data indicate that between 2019 and 2021, all-cause mortality at ages 1 to 19 years increased by 14% in rural (nonmetropolitan, micropolitan, and noncore) counties. The primary cause was not COVID-19... Читать дальше...

In Reply We appreciate the opportunity to respond to Dr Oxman’s Letter about our Viewpoint. We agree with Oxman that the current use of algorithms to diagnose sepsis has caused unintended consequences. However, we would not classify the use of sepsis algorithms as a “systems approach.”

To the Editor A recent study found that the risk of complete intrauterine device (IUD) expulsion in individuals who underwent early postpartum IUD placement (2-4 weeks postpartum) was not inferior to that in individuals who underwent interval IUD placement (6-8 weeks postpartum). However, this conclusion must be viewed with cautious for several statistical reasons.

To the Editor As public health researchers, we applaud the recent Viewpoint that called attention to recent increases in child mortality. However, we believe that this Viewpoint did not acknowledge a child population that has been markedly underserved and generally understudied—rural children.

To the Editor I was pleased to read the recent Viewpoint highlighting the serious problem of diagnostic error—a crucial issue not just in emergency departments. I applaud the recommendations to move the focus away from individual physician failings and toward discussion of underlying causes.

This study examines the exposure of Medicare Part D beneficiaries to utilization management, such as prior authorization, for oral oncology drugs.

A press sheet just received, issued by the Publicity Bureau of the American Bottlers of Carbonated Beverages, is a plea for the giving of soft drinks to young children and an attempt to combat “a prejudice held by some persons” against this product:

One reason why the professional study of science in general, and medicine in particular, has failed to win public applause and gather popular support in larger measure than it does at present lies in the distortions and misrepresentations to which this department of learning has all too often been subjected. The quack and the impostor make no sincere pretense of adhering strictly to the known in heralding their claims; the pseudoscientist usually dresses his propaganda in a variety of raiment that may include ignorance... Читать дальше...