JAMA Network Open最新文献

{"title":"Intimate Partner Violence Against Women and Mortality Among Children Younger Than 5 Years: A Systematic Review and Meta-Analysis.","authors":"Bereket Kefale, Aditi Roy, Daniel Gashaneh Belay, Tesfaye Setegn Mengistu, Jennifer Dunne, Sylvester Dodzi Nyadanu, Amanuel T Gebremedhin, Marshall Makate, Jacqueline Hendriks, Gavin Pereira, Gizachew A Tessema","doi":"10.1001/jamanetworkopen.2026.31794","DOIUrl":"10.1001/jamanetworkopen.2026.31794","url":null,"abstract":"<p><strong>Importance: </strong>Intimate partner violence (IPV) against women is a persistent global public health concern with lasting impacts on the health of affected women and their children. Although previous studies suggest a potential link between IPV and mortality among children younger than 5 years (under-5 mortality [U5M]), the evidence remains inconclusive.</p><p><strong>Objective: </strong>To examine whether different forms of IPV are associated with under-5, infant, and neonatal mortality.</p><p><strong>Data sources: </strong>Seven databases (MEDLINE, EMBASE, Global Health, PsycINFO, Scopus, Web of Science, and CINAHL) were searched from database inception to April 22, 2026.</p><p><strong>Study selection: </strong>Studies were included if they examined the association between forms of IPV (any IPV or subtypes such as physical, sexual, emotional violence, or partner control behavior) and under-5, infant, and neonatal mortality. Two reviewers independently conducted study selection.</p><p><strong>Data extraction and synthesis: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline was followed. Risk of bias was assessed using the Risk of Bias in Non-randomized Studies of Exposures tool. Random-effects meta-analyses were conducted to estimate pooled odds ratios (ORs) and 95% CIs.</p><p><strong>Results: </strong>Twenty-eight studies comprising 684 065 participants were included in the systematic review, of which 25 were included in the meta-analyses. IPV was associated with higher odds of U5M (OR, 1.10; 95% CI, 1.05-1.16), infant mortality (OR, 1.32; 95% CI, 1.11-1.57), and neonatal mortality (OR, 1.36; 95% CI, 1.19-1.55). Physical IPV (OR, 1.37; 95% CI, 1.17-1.61), sexual IPV (OR, 1.70; 95% CI, 1.33-2.17), and emotional IPV (OR, 1.29; 95% CI, 1.07-1.56) were associated with higher odds of neonatal mortality. Physical IPV was also associated with higher odds of infant mortality (OR, 1.20; 95% CI, 1.01-1.44). No statistically significant associations were observed between IPV subtypes and U5M.</p><p><strong>Conclusions and relevance: </strong>In this systematic review and meta-analysis, IPV against women was associated with higher odds of under-5, infant, and neonatal mortality. These findings suggest the importance of addressing IPV within child health strategies.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"9 9","pages":"e2631794"},"PeriodicalIF":11.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Management of Anticoagulation in Patients With Mechanical Heart Valves.","authors":"Gabriella Hrubesz, Vincent Chan, Yan Xu, Nicola Potere, Marcel Miron-Celis, Jean Connors, Jerrold H Levy, Deborah M Siegal, James Douketis, Grégoire Le Gal, Marc Carrier, Joseph R Shaw","doi":"10.1001/jamanetworkopen.2026.32282","DOIUrl":"10.1001/jamanetworkopen.2026.32282","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Perioperative interruption of vitamin K antagonist (VKA) therapy in patients with mechanical heart valves (MHVs) is complex, and contemporary data to inform management are limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To describe perioperative anticoagulation management and to estimate 30-day risks of arterial thromboembolism (ATE) and bleeding after VKA interruption in adults with left-sided MHVs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This retrospective cohort study included consecutive adult patients (aged ≥18 years) with left-sided aortic, mitral, or dual MHVs undergoing planned invasive procedures requiring VKA interruption from January 1, 2016, to December 31, 2023, with 30-day follow-up. The study was conducted at the thrombosis clinic at The Ottawa Hospital in Ontario, Canada.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Planned invasive procedure requiring temporary interruption of VKA therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Primary outcomes were 30-day postoperative ATE and major bleeding. Secondary outcomes included clinically relevant nonmajor bleeding (CRNMB) and all-cause mortality. Major bleeding and CRNMB were defined according to the International Society on Thrombosis and Hemostasis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cohort included 373 patients (median [IQR] age, 67 [60-73] years; 217 [58.2%] male) contributing 613 interruptions. Therapeutic-dose bridging was used preoperatively in 516 interruptions (84.2%) and postoperatively in 193 (31.5%) (99 of 215 [46.0%] in mitral or dual MHV vs 94 of 398 [23.6%] in aortic MHV interruptions). Patients with mitral or dual (vs aortic) valve position and prior thromboembolism had higher estimated odds of receiving postoperative therapeutic-dose bridging (mitral or dual vs aortic: adjusted odds ratio [aOR], 2.90; 95% CI, 1.91-4.41; prior thromboembolism: aOR, 1.91; 95% CI, 1.05-3.46). Estimated 30-day risks of ATE and major bleeding were 1.5% (95% CI, 0.8%-2.8%) and 2.1% (95% CI, 1.2%-3.6%), respectively. Clinically relevant bleeding (composite of major bleeding and CRNMB) occurred in 3.9% (95% CI, 2.6%-5.8%) of interruptions. Three deaths occurred (0.5%; 95% CI, 0.2%-1.5%), 1 attributed to fatal ischemic stroke. Omission of postoperative bridging was associated with higher estimated ATE risk (4.9% vs 0.9%; subdistribution hazard ratio [sHR], 5.30; 95% CI, 1.45-19.40; P = .01); this finding was no longer statistically significant in landmark analysis (sHR, 3.26; 95% CI, 0.62-17.21).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this retrospective cohort study, patients with MHVs experienced clinically meaningful risks of perioperative ATE and bleeding. These data do not establish a causal protective effect of postoperative bridging. However, omitting bridging in patients with MHVs was associated with a higher estimated risk of ATE in exploratory analyses and should be approached cautiously, pending stronger evidence from repres","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"9 9","pages":"e2632282"},"PeriodicalIF":11.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Z-Drug Prescription Duration and Long-Term Use.","authors":"Jonathan N Cloughesy, Johanna Thunell, Xiaofan Liu, Stephen D Persell, Jeffrey A Linder, Mark D Sullivan, Jason N Doctor","doi":"10.1001/jamanetworkopen.2026.32006","DOIUrl":"10.1001/jamanetworkopen.2026.32006","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"9 9","pages":"e2632006"},"PeriodicalIF":11.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Anticoagulants in Patients With Atrial Fibrillation and Advanced CKD Not Requiring Dialysis.","authors":"Qiaoxi Chen, Daniel E Singer, Edouard L Fu, Chun-Ting Yang, Kevin Pritchard, Rishi J Desai, Kueiyu Joshua Lin","doi":"10.1001/jamanetworkopen.2026.32225","DOIUrl":"10.1001/jamanetworkopen.2026.32225","url":null,"abstract":"<p><strong>Importance: </strong>The net benefit of oral anticoagulants (OACs) in patients with atrial fibrillation (AF) and advanced chronic kidney disease (CKD) not receiving dialysis remains uncertain.</p><p><strong>Objective: </strong>To compare the estimated effectiveness and safety of apixaban compared with warfarin and no OAC use among patients with AF and advanced CKD not receiving dialysis.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study used a 3-group target trial emulation framework and included patients from Medicare fee-for-service claims (January 1, 2013, to December 31, 2022) and the Optum deidentified Clinformatics Data Mart database (January 1, 2013, to February 28, 2025). Eligible participants had AF, CKD stage 4 or 5, no prior dialysis, and continuous medical and pharmacy coverage. Data analysis was conducted from February 2025 to June 2026.</p><p><strong>Exposures: </strong>Initiation of apixaban or warfarin vs no oral anticoagulation.</p><p><strong>Main outcomes and measures: </strong>Primary outcomes were hospitalization for major bleeding, ischemic stroke, and their composite. Propensity score matching weights were used to balance baseline characteristics, and weighted hazard ratios (HRs) and rate differences (RDs) per 1000 person-years (PYs) were estimated.</p><p><strong>Results: </strong>The study included 14 712 apixaban users (7954 female [54.1%]; mean [SD] age, 78.93 [7.35] years), 6335 warfarin users (3148 female [49.7%]; mean [SD] age, 77.47 [7.03] years), and 21 005 nonusers of OACs (10 797 female [51.4%]; mean [SD] age, 79.59 [7.49] years). Compared with nonusers, apixaban was associated with an increased rate of major bleeding (HR, 1.32 [95% CI, 1.11 to 1.58]; RD, 17.16 [95% CI, 2.45 to 31.87] per 1000 PYs) and a lower rate of ischemic stroke (HR, 0.46 [95% CI, 0.32 to 0.66]; RD, -12.67 [95% CI, -20.65 to -4.69] per 1000 PYs), but there was no association with the composite outcome (HR, 1.05 [95% CI, 0.89 to 1.22]; RD, 6.13 [95% CI, -10.61 to 22.87] per 1000 PYs). Warfarin users had a higher rate of major bleeding (HR, 2.44 [95% CI, 2.06 to 2.88]) and no significant diffrence in the rate of ischemic stroke (HR, 0.87 [95% CI, 0.61 to 1.22]), resulting in a higher rate of the composite outcome compared with nonuse (HR, 1.95 [95% CI, 1.69 to 2.26]). Compared with warfarin, apixaban was associated with lower risk of major bleeding (HR, 0.55 [95% CI, 0.46 to 0.65]) and ischemic stroke (HR, 0.50 [95% CI, 0.33 to 0.78]).</p><p><strong>Conclusions and relevance: </strong>This study found that among patients with AF and advanced CKD not receiving dialysis, anticoagulation was associated with reduced risk of ischemic stroke, but increased risk of bleeding compared with nonuse, suggesting that the trade-off between ischemic stroke reduction and bleeding risk was more favorable for apixaban than for warfarin.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"9 9","pages":"e2632225"},"PeriodicalIF":11.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet and Life After Prostate Cancer-the Journey From Evidence to Guidance Continues.","authors":"David-Dan Nguyen, Hari S Iyer, Christopher J D Wallis","doi":"10.1001/jamanetworkopen.2026.30595","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2026.30595","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"9 9","pages":"e2630595"},"PeriodicalIF":11.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestational Age and Childhood Educational Outcomes in Primary and High School Years.","authors":"Francisco J Schneuer, Anthea Lindquist, Anna Forsythe, Parinaz Mehdipour, Jessica A Atkinson, Antonia W Shand, Adrienne Gordon, Andrew J Martin, Raghu Lingam, Stephen Tong, Roxanne Hastie, Natasha Nassar","doi":"10.1001/jamanetworkopen.2026.31747","DOIUrl":"10.1001/jamanetworkopen.2026.31747","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Gestational age at birth plays a critical part in childhood neurodevelopment, especially for individuals born preterm (&lt;37 weeks' gestation).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the association between gestational age and educational outcomes at primary and high school age, controlling for unmeasured confounding by family-level factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This population-based cohort study conducted in Australia included all individuals born at 23 to 42 weeks' gestation in New South Wales (NSW) between 2001 and 2011 and in Victoria between 2005 and 2012 who had school outcomes assessed by standardized assessments in grade 3 (age 8-9 years) and/or grade 9 (age 14-15 years). Analyses were conducted between June 2024 and February 2026.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Gestational age at birth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Standardized numeracy and reading assessment z-scores were calculated in grade 3 and grade 9 and compared across gestational age groups using multivariable general linear mixed models. A clinically meaningful difference was considered an adjusted mean difference (AMD) in z-score of 0.2 or greater.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included 1 095 816 children in grade 3 (772 589 NSW-born [50.7% male] and 323 227 Victoria-born [50.5% male]) and 292 027 NSW-born adolescents in grade 9 (50.7% male). Among children assessed at grade 3, 6.4% in NSW and 7.0% in Victoria were born before 37 weeks' gestation and 54.1% in NSW and 41.1% in Victoria were born at 39 to 40 weeks' gestation; 6.3% of NSW adolescents assessed at grade 9 were born before 37 weeks' gestation and 53.8% at 39 to 40 weeks' gestation. Compared with children born at 39 to 40 weeks, children born at 38 weeks had lower numeracy (AMD, -0.02; 95% CI, -0.03 to -0.02) and reading (AMD, -0.02; 95% CI, -0.02 to -0.01) z-scores in grade 3. z-Scores decreased in a stepwise manner for each gestational age group, with the greatest difference for those born at 23 to 27 weeks vs 39 to 40 weeks (numeracy: AMD, -0.54 [95% CI, -0.58 to -0.49]; reading: AMD, -0.29 [95% CI, -0.34 to -0.25]). However, among siblings at grade 3, these differences were attenuated, and clinically meaningful differences compared with birth at 39 to 40 weeks were only seen for numeracy in children born at 28 to 31 weeks (AMD, -0.23; 95% CI, -0.27 to -0.19) and 23 to 27 weeks (AMD, -0.45; 95% CI, -0.53 to -0.38) and for reading, only for children born at 23 to 27 weeks (AMD, -0.28; 95% CI, -0.36 to -0.21). Results were similar in grade 9, with clinically meaningful differences for numeracy (AMD, -0.53; 95% CI, -0.62 to -0.45) and reading (AMD, -0.39; 95% CI, -0.48 to -0.30) only seen for adolescents born at 23 to 27 vs 39 to 40 weeks' gestation in the full-cohort analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this cohort study of over 1 million Australian children, the independent assoc","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"9 9","pages":"e2631747"},"PeriodicalIF":11.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No-Flow Duration and Outcomes After Cardiogenic Out-of-Hospital Cardiac Arrest in Older Adults.","authors":"Yuki Kishihara, Masahiro Kashiura, Hideto Yasuda, Shunsuke Amagasa, Hiroyuki Tamura, Chisato Nakajima, Yuki Shiraoka, Masashi Okubo, Takashi Moriya","doi":"10.1001/jamanetworkopen.2026.31343","DOIUrl":"10.1001/jamanetworkopen.2026.31343","url":null,"abstract":"<p><strong>Importance: </strong>The burden of cardiogenic out-of-hospital cardiac arrest (OHCA) among older adults is increasing. No-flow time is a key determinant of prognosis, and the aging brain may be increasingly vulnerable to ischemic injury during this interval.</p><p><strong>Objective: </strong>To delineate the association between no-flow duration and outcomes in older adults with cardiogenic OHCA using dynamic probability curves.</p><p><strong>Design, setting, and participants: </strong>This nationwide, population-based, multicenter retrospective observational cohort study used data from the All-Japan Utstein Registry from January 1, 2010, through December 31, 2023. Participants included adults 65 years or older with witnessed cardiogenic OHCAs treated within Japan's nationwide emergency medical service (EMS) system. Data were analyzed from December 1, 2025, to July 7, 2026.</p><p><strong>Exposure: </strong>No-flow time, defined as the interval from witnessed arrest to initiation of cardiopulmonary resuscitation by EMS clinicians.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was 30-day favorable neurologic outcome, defined as cerebral performance category of 1 or 2. Age-stratified dynamic probability curves were constructed for patients aged 65 to 74 years, 75 to 84 years, 85 to 94 years, and 95 years or older to describe the time-dependent likelihood of outcome according to no-flow duration. For each age group, the no-flow time at which the estimated probability fell below 1% with 95% CIs was identified.</p><p><strong>Results: </strong>Among 1 795 502 registry cases, 259 851 patients met the inclusion criteria. The median patient age was 82 (IQR, 75-88) years, 148 018 (57.0%) were male, and the median no-flow time was 11 (IQR, 8-15) minutes. Overall, 8711 patients (3.4%) achieved a 30-day favorable neurologic outcome. In all patients 65 years or older, the no-flow times at which the estimated probability of favorable neurologic outcome fell below 1% was 11 (95% CI, 11-11) minutes. Corresponding thresholds for favorable neurologic outcome was 14 (95% CI, 14-14) minutes for those aged 65 to 74 years, 11 (95% CI, 10-11) minutes for those aged 75 to 84 years, 2 (IQR, 0-4) minutes for those aged 85 to 94 years, and 0 (95% CI, 0-0) minutes for those 95 years or older.</p><p><strong>Conclusions and relevance: </strong>In this cohort study of older adults with cardiogenic OHCA, the no-flow time window compatible with an estimated probability of at least 1% for favorable neurologic outcome became progressively shorter with advancing age. These findings may inform resuscitation decision-making in aging populations.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"9 9","pages":"e2631343"},"PeriodicalIF":11.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HLA-A*32:01 and Lamotrigine-Induced Drug Reaction With Eosinophilia and Systemic Symptoms.","authors":"Matthew S Krantz, Li Zhou, Liqin Wang, Alexis Yu, Rama Gangula, Edric A Ramirez-Valdez, Suzanne Blackley, David A Ostrov, Danmeng Li, Abha Chopra, Simon Mallal, Kimberly Blumenthal, Elizabeth J Phillips","doi":"10.1001/jamanetworkopen.2026.31291","DOIUrl":"10.1001/jamanetworkopen.2026.31291","url":null,"abstract":"<p><strong>Importance: </strong>Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe, potentially fatal hypersensitivity syndrome with 3% to 10% mortality, and lamotrigine, a first-line treatment for bipolar and seizure disorders, is among the top 5 causative agents of DRESS in the United States and globally. Commercial panels test HLA-B*15:02 and HLA-A*31:01 for risk of carbamazepine-associated severe cutaneous adverse reactions; however, these are not validated for lamotrigine-induced DRESS, and current reports from these commercial assays could therefore provide false reassurance. No HLA associations with lamotrigine-induced DRESS have been established in US populations.</p><p><strong>Objective: </strong>To identify HLA genetic variants associated with lamotrigine-induced DRESS in a US population.</p><p><strong>Design, setting, and participants: </strong>This matched case-control study was conducted at 2 US academic medical centers (Vanderbilt University Medical Center and Mass General Brigham). Patients with lamotrigine-induced DRESS confirmed by Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) criteria (score ≥4) were prospectively enrolled between April 2016 and June 2025. Lamotrigine-tolerant controls were matched 10:1 from the Vanderbilt BioVU biobank on sex, self-reported race, and age. HLA typing included class I (HLA-A, HLA-B, and HLA-C) and class II (HLA-DPB1, HLA-DQA1, HLA-DQB1, and HLA-DRB1) loci for case (high-resolution typing) and control (imputed from genotyping array data) participants.</p><p><strong>Main outcomes and measures: </strong>HLA class I and II alleles and haplotypes were tested using logistic regression with Bonferroni correction for their association with lamotrigine-induced DRESS.</p><p><strong>Results: </strong>This study included 29 patients with lamotrigine-induced DRESS (case participants; median [IQR] age, 33 [24-56] years; 25 female [86.2%]; 2 Asian [6.9%], 2 Black [6.9%], 23 White [79.3%], and 2 unknown race [6.9%]) and 290 matched control participants. HLA-A*32:01 was associated with lamotrigine-induced DRESS (41.4% [12 case participants] vs 4.1% [12 control participants]; odds ratio [OR], 16.4; 95% CI, 6.4-42.5; Bonferroni-corrected P < .001). No other alleles or class II loci showed significant associations after correction. The A*32:01 ~ B*44:02 haplotype was enriched (OR, 18.4; 95% CI, 4.6-83.8; Bonferroni-corrected P = .001) in lamotrigine-induced DRESS.</p><p><strong>Conclusions and relevance: </strong>In this case-control study, HLA-A*32:01 was associated with lamotrigine-induced DRESS in a US population. Given that HLA-A*32:01 is not included in existing commercial pharmacogenomic panels, adding this marker could improve preprescription DRESS risk identification for lamotrigine.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"9 9","pages":"e2631291"},"PeriodicalIF":11.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Table 2 Footnote.","authors":"","doi":"10.1001/jamanetworkopen.2026.36401","DOIUrl":"10.1001/jamanetworkopen.2026.36401","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"9 9","pages":"e2636401"},"PeriodicalIF":11.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Projected Aging Among People With HIV in the US.","authors":"Andrew Zalesak, Parastu Kasaie, Zoe Dansky, Keri N Althoff, David W Dowdy, Maunank Shah, Anthony T Fojo, Melissa Schnure","doi":"10.1001/jamanetworkopen.2026.32299","DOIUrl":"10.1001/jamanetworkopen.2026.32299","url":null,"abstract":"<p><strong>Importance: </strong>As the population living with HIV in the US ages, state-level projections of the aging dynamics among people with diagnosed HIV (PWDH) will be needed to inform local planning and intervention efforts.</p><p><strong>Objective: </strong>To explore how aging dynamics of PWDH in the US are expected to differ at the state level between 2025 and 2040.</p><p><strong>Design, setting, and participants: </strong>This decision analytic model used a calibrated model of HIV transmission to project epidemic trajectories from 2025 to 2040 in 24 US states representing 86% of PWDH in the US.</p><p><strong>Main outcomes and measures: </strong>Change in median age of PWDH, among those older than 13 years, was estimated from 2025 to 2040 for each state.</p><p><strong>Results: </strong>Among the 24 states analyzed, projections showed that by 2040, the median age of adult PWDH will increase from a mean of 51 (95% credible interval [CrI], 51-52) years to 61 (95% CrI, 59-63) years, and 46% (95% CrI, 43%-48%) of adult PWDH will be older than 65 years. Substantial heterogeneities were found in age distributions by state. More populous and urban states with higher median ages of PWDH in 2025 were projected to experience even further aging of the population with diagnosed HIV in the coming 15 years. By contrast, more rural and less populous states had younger populations of PWDH that were not projected to age substantially over time.</p><p><strong>Conclusions and relevance: </strong>This decision analytic model found that although the overall population of PWDH in the US is projected to age substantially, these effects will unfold differently across states. In the coming years, health care systems will need to plan to adapt to changing state-level demographic patterns among PWDH.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"9 9","pages":"e2632299"},"PeriodicalIF":11.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}