Новости за 23.07.2024

So strong is the association between rhyme and poetry that we often conflate the two. Yet rhyme has other applications, particularly in aiding memory. Children first learn their ABCs via a nursery rhyme, while many mnemonics (including those employed by medical students) rhyme. In the aptly titled “Memorial Day,” rhyme serves in both these capacities, as lyrical organizer of language and portal to remembering. The end-rhymes of the second and fourth lines of each stanza first become touchstones for... Читать дальше...

I hold it, feel its weight— a paper chart, a relic. She died six months before we went electronic.

This study examines prostate-specific antigen values among transgender women in the Veterans Health Administration receiving estrogen.

This Viewpoint explains some ways in which the alignment of incentives between payers and clinicians in value-based care (VBC) arrangements can be interrupted and proposes a multifaceted approach to realigning incentives for drug spending within VBC contracts to better provide value-based care and improve patient outcomes.

In this narrative medicine essay, a physical medicine and rehabilitation resident’s understanding of and empathy for patients reaches new heights following her diagnosis of and treatment for breast cancer during residency.

This JAMA Patient Page describes the types of thyroid cancer and its risk factors, diagnosis, monitoring, and treatment.

This observational study assesses incidence of wound hematoma diagnoses up to 6 weeks post partum among obstetric patients who received thromboprophylaxis according to less selective vs more selective hospital chemoprophylaxis protocols.

These are days of flux in matters pertaining to medical education. Commissions, foundations, societies, faculties and even legislatures are engaged in the investigation of the medical curriculums. We hear the old, familiar cry that “something is fundamentally wrong” in our current system; and the outsider, listening as an untutored observer unfamiliar with the history of science, may even begin to believe the old Latin proverb that there is more danger from the physician than from the disease. A generation or more ago... Читать дальше...

A patient had bilateral leg edema, insomnia, myalgias, paresthesias in the fingertips, lighter pigmentation of the facial skin compared with other areas of the body, proteinuria, and an elevated creatinine level. What is the diagnosis and what would you do next?

This Medical News article is an interview with retired neurologist Daniel Gibbs, who is living with Alzheimer disease.

Multiple days of high temperatures were associated with a slight uptick of preterm and early-term births—those that occur between 28 and 37 weeks’ gestation and between 37 and 39 weeks’ gestation, respectively—a recent study in JAMA Network Open found. The findings were based on data from more than 53 million births in the 50 most populated US cities between 1993 and 2017.

More than 180 million—or about 60%—of adults in the US will have some type of heart or vascular disease, including high blood pressure, by the year 2050, according to projections based on the National Health and Nutrition Examination Survey conducted between 2015 and 2020. In addition, the likely increase in disease–associated health care expenses and productivity losses will cost billions of dollars more each year, totaling about $1.8 trillion annually by 2050, an accompanying study published in Circulation found.

Military members and veterans with posttraumatic stress disorder (PTSD) who partnered with a psychiatric service dog in addition to receiving usual care for the condition had less severe symptoms after 3 months than those who received typical care only, according to results from a nonrandomized clinical trial involving 156 participants in the US.

As part of a comprehensive sexual health approach, clinicians should offer certain patients a prescription for doxycycline to take within 72 hours of oral, vaginal, or anal sex to prevent sexually transmitted infections (STIs), according to new guidelines from the US Centers for Disease Control and Prevention (CDC).

The Medical News & Perspectives article “Syphilis Has Surged for Reasons That Go Beyond the Pathogen That Causes It,” published on June 14, 2024, was updated to reflect the Centers for Disease Control and Prevention’s final clinical guidelines on the use of doxyPEP for preventing bacterial sexually transmitted infections such as syphilis. The guidelines were published on June 6, 2024. This article was updated online.

In Reply We are thankful for Dr Cramer’s keen interest in our publication, in which we concluded that there appears to be no causal link between use of acetaminophen during pregnancy and the risk of autism, ADHD, or intellectual disability in children. Dr Cramer raises several points, many of which we have addressed in another correspondence, which we believe deserve some contextualization.

In Reply In response to the Letter by Dr Tu and colleagues, our pooled analysis of patient-level data from 13 centers demonstrated that a higher level of TILs was strongly associated with lower recurrence risk and improved survival in patients with TNBC not receiving adjuvant/neoadjuvant systemic therapy. As noted in the Discussion section of our article, we acknowledged the limitations inherent to retrospective analyses and lack of data on germline cancer predisposition variants and race and ethnicity... Читать дальше...

To the Editor Using Swedish national databases involving children born from 1995 to 2019, Dr Ahlqvist and colleagues address maternal acetaminophen (paracetamol) use and neurodevelopmental disorders. In models without sibling controls, ever-use vs no acetaminophen use was associated with increased risk of autism, attention-deficit/hyperactivity disorder (ADHD), and intellectual disability. However, the authors found no associations using sibling controls and concluded that “acetaminophen use during... Читать дальше...

To the Editor A recent study presented intriguing findings on the prognostic value of tumor-infiltrating lymphocytes (TILs) in patients with early-stage triple-negative breast cancer (TNBC) not undergoing adjuvant or neoadjuvant chemotherapy. However, several important aspects warrant further discussion and clarification.

Polycystic ovary syndrome, or PCOS, is a common endocrine disorder characterized by elevated levels of male sex hormones, known as androgens, in females. In addition to irregular menstrual cycles, enlarged or cyst-filled ovaries, increased body hair, and acne, patients with PCOS might have problems with fertility and metabolic issues, such as insulin resistance. Current treatment options like birth control pills and metformin tend to target only specific symptoms of the condition.

Roughly one-third of patients experienced symptoms such as headaches, nausea, insomnia, and irritability after discontinuing their use of antidepressants, according to an analysis of 79 studies involving more than 21 000 participants. The symptoms were attributable to patient expectations about the adverse effects of stopping the drug in about 17% of participants. After accounting for this, roughly 1 in 7 people had antidepressant discontinuation symptoms, the researchers reported in The Lancet Psychiatry. Читать дальше...

Only about one-third of participants in trials evaluating medical devices were women, a new systematic review of 195 trials, the majority of which were conducted between 2013 and 2022, found. The researchers found no increase in the percentage of women included as participants over time, continuing a decades-long trend of women being underrepresented in clinical trials for devices.

About one-third of people with preexisting heart disease who were exposed to very high temperatures experienced asymptomatic heat–induced cardiac ischemia, or poor oxygen delivery to the heart, a recent study published in Annals of Internal Medicine found. The findings were based on data from 61 participants: 41 healthy young and older adults as well as 20 older people with coronary artery disease (CAD).

The US National Institutes of Health (NIH) recently announced that it would invest $30 million over the next 2 years to test the feasibility of a primary care research network, called the Communities Advancing Research Equity for Health. The network’s aim is to integrate clinical research into community–based primary care, particularly in underserved areas. This would mean expanding opportunities for people to participate in clinical trials and other research and using that evidence to inform better patient care and outcomes.