Tin tức y tế

New research has identified and described a cellular process that, despite what textbooks say, has remained elusive to scientists until now -- precisely how the copying of genetic material that, once started, is properly turned off.

Demystifying traditional Chinese medicine for conservationists could be the key to better protecting endangered species like pangolins, tigers and rhino, according to researchers. Efforts to shift entrenched values and beliefs about Chinese medicine are not achieving conservation gains in the short term.

Researchers have compiled the world's most comprehensive list of known plant species. It contains 1,315,562 names of vascular plants, thus extending the number by some 70,000 - equivalent to about 20%. The researchers have also succeeded in clarifying 181,000 hitherto unclear species names.

Scientists have developed a new gene therapy approach that offers promise for one day treating an eye disease that leads to a progressive loss of vision and affects thousands of people across the globe. The study also has implications for a much wider suite of neurological disorders associated with aging.

The health harms associated with prolonged sitting can be offset by exceeding weekly recommended physical activity levels, says the World Health Organization (WHO) in new global guidelines on physical activity and sedentary behavior.

CONCLUSIONS: The results presented here suggest that oral terbinafine can be proposed to treat severe onychomycosis with an acceptable tolerance profile in KTR with different ART such as tacrolimus and highlight the need of multicentric studies to establish guidelines for onychomycosis treatment in KTR.

CONCLUSIONS: Micronised progesterone improves various sleep outcomes in randomised controlled trials, predominantly in studies enrolling post-menopausal women. Further research could evaluate the efficacy of micronised progesterone monotherapy using polysomnography or validated questionnaires in larger cohorts.

Hypertension is a leading risk factor for cardiovascular events and death. Despite differences in clinical implications of hypertension between men and women, guidelines establishing optimal blood pressure (BP) targets are still debated. The aim of this study was to investigate sex differences in the BP level associated with increased risks of major adverse cardiac and cerebral events (MACCEs) among antihypertensive-treated patients. Using data from the Korean National Health Insurance...

CONCLUSION: Contrast-enhanced computed tomography (CT) and ultrasonography (US) are of major value in the diagnosis of preoperative tumor rupture, and immediate surgery or delayed surgery are available therapeutic methods. The treatment plan was based on patients' general conditions, tumor size, position and impairment degree of tumor rupture, extent of invasion and experience of a multidisciplinary team (including surgeon and anesthesiologists). In our experience, for ruptured preoperative...

Chronic obstructive pulmonary disease (COPD) has a profound impact on people living with the disease and has a high global economic and social burden. Often, people with COPD are undiagnosed, while those diagnosed are undertreated and undereducated on different aspects of COPD care. Although there are many published evidence-based treatment guidelines from different expert groups and societies, they are frequently not adhered to, which results in significant gaps in care. In particular,...

Hand washing or using an alcohol-based hand sanitizer after touching shopping carts, gas pumps, automated teller machines, and other frequently touched surfaces is a key strategy the CDC recommends to curb the spread of coronavirus disease 2019 (COVID-19). Yet a pair of surveys in the CDC’s Morbidity and Mortality Weekly Report found serious gaps in hand hygiene practices by race, age, and sex.

Personnel in neonatal intensive care units (NICUs) should conduct active surveillance testing for Staphylococcus aureus colonization of neonates to prevent the spread of infection during outbreaks or when incidence increases, according to a new CDC guideline.

This 2020 US Preventive Services Task Force Recommendation Statement recommends offering or referring adults with CVD risk factors to behavioral counseling interventions to promote a healthy diet and physical activity (B recommendation).

This systematic review to support the 2020 US Preventive Services Task Force Recommendation Statement on behavioral counseling to promote healthy diet and physical activity for cardiovascular disease (CVD) prevention summarizes published evidence on the benefits and harms of behavioral counseling to promote healthy diet and physical activity for CVD prevention in adults with cardiovascular risk factors.

Could Frequent Testing Help Squelch COVID-19?; Nursing Homes’ Next Test—Vaccinating Workers Against COVID-19; SARS-CoV-2 Testing Hesitancy Could Hamper Mitigation Efforts

Related Articles:

The Challenges of Expanding Rapid Tests to Curb COVID-19

Nursing Homes’ Next Test—Vaccinating Workers Against COVID-19

First It Was Masks; Now Some Refuse Testing for SARS-CoV-2

JAMA Medical News comes to you live from the American Heart Association’s first-ever virtual Scientific Sessions conference. Host Jennifer Abbasi chats with conference chair and AHA president-elect Donald Lloyd-Jones, MD, ScM, about this year’s hottest clinical trials and themes: fish oil vs corn oil placebo for primary or secondary prevention; Polycap polypill with or without aspirin for primary prevention; statins, side effects, and the nocebo effect; ferric carboxymaltose iron infusion in acute heart failure; omecamtiv mecarbil, a novel cardiac myosin activator, in HFrEF; sotagliflozin, an SGLT2/1 inhibitor, in diabetes with recent worsening heart failure or in diabetes and chronic kidney disease; MINOCA’s underlying cause in women; rilonacept, an IL-1α and IL-1β Trap, in recurrent pericarditis; COVID-19’s cardiovascular effects, risk factors, and racial/ethnic disparities.

Related article:

Omega-3 Fatty Acids vs Corn Oil and Major Adverse Cardiovascular Events in Patients at High Risk

Large Meta-analysis Digs Into Obesity’s COVID-19 Risks; As Their Numbers Grow, COVID-19 “Long Haulers” Stump Experts; Telephone Visits Surge During the Pandemic, but Will They Last?

Related articles:

Large Meta-analysis Digs Into Obesity’s COVID-19 Risks

As Their Numbers Grow, COVID-19 “Long Haulers” Stump Experts

Telephone Visits Surge During the Pandemic, but Will They Last?

University of North Carolina (UNC) at Chapel Hill nutrition scholar Barry Popkin, PhD, and JAMA Medical News Associate Managing Editor Jennifer Abbasi discuss new findings on obesity and COVID-19. Popkin is the lead author of a systematic review and meta-analysis on the topic that was published recently in Obesity Reviews. He is a distinguished professor in the department of nutrition at the UNC Gillings School of Global Public Health.

Related Article(s):

Large Meta-analysis Digs Into Obesity’s COVID-19 Risks

What Happens When COVID-19 Collides With Flu Season?; Flu Vaccination Urged During COVID-19 Pandemic; COVID-19 and mRNA Vaccines—First Large Test for a New Approach

Related Article(s):

What Happens When COVID-19 Collides With Flu Season?

Flu Vaccination Urged During COVID-19 Pandemic

COVID-19 and mRNA Vaccines—First Large Test for a New Approach

Certificates of Need are regulations required by some states before any construction or expansion of services at medical facilities are undertaken. Originally developed to prevent excessive construction of expensive health care facilities, these rules have distorted health care markets and probably should be repealed. Karl Bilimoria, MD, from Northwestern University, Tarik K Yuce, MD, and JAMA Associate Editor Karen Joynt Maddox, MD, from Washington University, discuss the current status of these regulations and their effect on health care markets.

Related Article(s):

Association of State Certificate of Need Regulation With Procedural Volume, Market Share, and Outcomes Among Medicare Beneficiaries

Mark Litwin, MD, chair of Urology at the UCLA School of Medicine, discusses the evaluation of hematuria and also the presentation, diagnosis, and treatment of bladder cancer.

Related Article(s):

Bladder Cancer

There are hundreds of thousands of liver transplant patients, all of whom will be seen in general clinical practices. It is common for them to develop elevated liver enzymes--a potentially serious problem that may be a sign that the transplanted liver is failing. Traditionally, patients with these findings are sent to a liver transplant center for an inpatient workup. A new protocol facilitating management of most of these patients in routine outpatient clinics has been developed, greatly improving the efficiency of managing patients with this clinical problem. Fady Kaldas, MD, director of the Dumont-UCLA transplant center, discusses how to manage elevated liver function results in liver transplant patients on an outpatient basis.

Related Article(s):

Outpatient Management of Liver Function Test Abnormalities in Patients With a Liver Transplant

Are e-cigarettes helpful or harmful as a tool to help people stop smoking? Mark J. Eisenberg, MD, MPH, from the Jewish General Hospital and McGill University in Montreal, Canada, discuss a recent clinical trial he reported in the November 10, 2020, issue of JAMA examining the efficacy of e-cigarettes as a smoking cessation aid.

Related Article:

Effect of e-Cigarettes Plus Counseling vs Counseling Alone on Smoking Cessation

A new multisociety guideline was recently released suggesting that for many patients, the interval between colonoscopies following polyp resection is less than previously recommended. Cecelia Zhang, MD, Duke University, and Maylyn Martinez, MD, University of Chicago, discuss the new guideline.

Related Article:

Recommendations for Follow-up Colonoscopy After Polypectomy

This Viewpoint from CDC officials discusses late summer and early fall increases in COVID-19 cases among college-age students when they were returning to campus, and reiterates public health measures that could reduce outbreaks and the need for university-community partnership to reduce SARS-CoV-2 transmission.

This JAMA Guide to Statistics and Methods explains worst-rank score methods, a nonparametric statistical technique that assigns worst-case outcomes for patients with missing data to account for missingness that may reflect an adverse change in patient status (informative rather than random missingness).

In 2019 and early 2020, drug pricing in the United States was a top concern of the public and therefore of politicians. President Trump, the moderate Democrats, the progressive Democrats, and some Republicans competed to denounce louder and regulate more substantially the manner by which pharmaceutical firms set their prices.

In most regions of the U.S., less than 10% of the population had evidence of previous SARS-CoV-2 infection as of late September, according...

See what's happening around NEJM Group: NEJM Group: COVID-19 Comorbidities and Cutaneous Manifestations of Systemic Diseases in Adults and Children: Join the final session...

Today's training model for new physicians is kinder, writes Dr. Vivek Sant. Not surprisingly then, older generations seem to think subsequent generations have lost a...

Infectious disease specialist Dr. Paul Sax writes, "Even in the cursed year that began shortly after the first report of the disease now known as...

This week, a third vaccine showed high efficacy against SARS-CoV-2, reaching 90% with one particular dosing strategy. Elsewhere, the FDA issued emergency use...

We present the week's summaries, commentary, and news on the pandemic.

A new U.S. Preventive Services guideline focuses on patients with hypertension, elevated blood pressure, and dyslipidemia.

Adults older than 80 experienced fewer adverse CV events when LDL cholesterol levels were lower.

In mice with TBI, neurodegeneration was arrested and cognition improved.

A multisession intervention that promoted weight loss and exercise was not enhanced by lay volunteers' support.

Noninjection drug use, sex between males, and homelessness were significantly associated with hospitalization.

The Society for Healthcare Epidemiology of America provides updated guidelines for management of healthcare workers with chronic hepatitis B virus, hepatitis C virus, and HIV infection.

Early administration of antivirals prior to transplantation may allow for a shorter treatment course.

Time trend analyses support the hypothesis that HCV eradication reduces the incidence of hepatocellular carcinoma.

Risk for VZV reactivation was not greater with DAAs than with placebo.

A multidisciplinary panel addresses the use of IVC filters in a variety of clinical scenarios.

We present the week's summaries, commentary, and news on the pandemic.

These scores need to be validated in the populations in which they will be used.

Adults older than 80 experienced fewer adverse CV events when LDL cholesterol levels were lower.

A multisession intervention that promoted weight loss and exercise was not enhanced by lay volunteers' support.

A farewell from the Editor-in-Chief

Boluses of hypertonic saline to correct moderate-to-severe hyponatremia were easier to administer and did not lead to more overcorrection of hyponatremia in this small trial.

In this multicenter study, these organisms were identified in 17% of patients, and administration of an in vitro active antibiotic was often delayed.

This randomized trial found tetracaine reduces the pain of corneal abrasions, but the trial was too small to assess safety.

But for most patients, there are better first-line options.

Eric Rubin is editor-in-chief of the New England Journal of Medicine. I asked him how COVID-19 has affected that journal, which has been around since the War of 1812 and seen its share of pandemics. Listen in — it’s the first in a planned series of interviews with the editors of the principal clinical journals. Running time: 19 minutes […]

The post Podcast 273: The journals and the pandemic -- NEJM first appeared on Clinical Conversations.

Dr. Paul Sax writes the closest thing that the NEJM Group has to humor. He’s serious, of course, since his blog “HIV and ID Observations” concerns all things infectious . But he sprinkles in the odd cartoon or links to … dog videos, fer cryin’ out loud. He scours the ID literature (and we must include […]

The post Podcast 272: And now for something completely different... almost first appeared on Clinical Conversations.

Back in late March (people often tell me that, these days, 4 months ago might as well be 4 years ago) we talked with emergency physician Julian Flores, who was working out of Broward County. Covid-19 cases were modest in number but threatening to get worse, and indeed they did. The county’s cases jumped 100-fold, from […]

The post Podcast 271: Checking back in with Florida -- 4 months later first appeared on Clinical Conversations.

Don’t expect HIPAA regulations to protect your “digital health footprint” from prying eyes. Every time you swipe your card to buy goodies at the supermarket (are you risking diabetes with all that ice cream?), or binge-watch that kinky series (how’s your mental health these days, really?), or let your step-tracker show you’ve fallen off the pace […]

The post Podcast 270: Is healthcare privacy possible if "all data are health data"? first appeared on Clinical Conversations.

We interview Dr. Michael Gonzalez, a Houston-based emergency physician, who describes the situation there as “an ongoing, slow-rolling, level 6 hurricane that just isn’t gonna go away and, more importantly, isn’t gonna tell us when landfall is coming and when it’s gonna be over.” How are his patients reacting to this surge? What does he do […]

The post Podcast 269: The pandemic in Texas is like a "slow-rolling level 6 hurricane" first appeared on Clinical Conversations.

A Mendelian randomization study demonstrates a causal effect of prescription opioid use on the risks for anxiety and depression, independent of the presence of chronic pain.

Although the mental health benefits outweigh the harms, combined hormonal contraceptives might risk dysphoric mood and could interact with psychiatric medications.

U.S. data again raise concerns over potential teratogenic effects.

A very small preliminary trial suggests possible benefit, although a concomitant psychotherapeutic intervention may have been more important.

Veterans with service dogs trained to interrupt post-traumatic stress disorder symptoms show improvement overall and in the four PTSD symptom clusters.

A multisession intervention that promoted weight loss and exercise was not enhanced by lay volunteers' support.

The SGLT-2 inhibitor sotagliflozin reduced deaths from cardiovascular causes, hospitalizations, and urgent care visits, compared with placebo, without major safety issues.

Reduction in glycosylated hemoglobin was greater with a GLP-1 agonist.

Preeclampsia consistently carries heightened risks, oral contraceptives carry risks for some outcomes, and longer breast-feeding is associated with lower risk for some outcomes.

Compared with placebo, metformin resulted in better maternal metabolic outcomes but lower neonatal birth weight.

A Mendelian randomization study demonstrates a causal effect of prescription opioid use on the risks for anxiety and depression, independent of the presence of chronic pain.

Although the mental health benefits outweigh the harms, combined hormonal contraceptives might risk dysphoric mood and could interact with psychiatric medications.

A very small preliminary trial suggests possible benefit, although a concomitant psychotherapeutic intervention may have been more important.

Veterans with service dogs trained to interrupt post-traumatic stress disorder symptoms show improvement overall and in the four PTSD symptom clusters.

In a pooled analysis, response or remission was more than twice as likely in patients receiving adjunctive minocycline.