JAMA Internal Medicine最新文献

{"title":"Access to Dialysis Facilities in Socioeconomically Advantaged and Disadvantaged Communities.","authors":"Yu-Chu Shen, Renee Y Hsia","doi":"10.1001/jamainternmed.2025.8031","DOIUrl":"10.1001/jamainternmed.2025.8031","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"481-482"},"PeriodicalIF":23.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270869","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":"Hypertensive Disorders of Pregnancy Subtypes and Long-Term Cardiovascular Risk.","authors":"Soongu Kwak, Chan Soon Park, Yebin Park, Tae-Min Rhee, Heesun Lee, Hyung-Kwan Kim, Yong-Jin Kim, Kyungdo Han, Jun-Bean Park","doi":"10.1001/jamainternmed.2025.7802","DOIUrl":"10.1001/jamainternmed.2025.7802","url":null,"abstract":"<p><strong>Importance: </strong>Hypertensive disorders of pregnancy (HDPs) are associated with an increased long-term risk of cardiovascular disease, but the risks across different HDP subtypes, particularly those other than preeclampsia, remain unclear.</p><p><strong>Objective: </strong>To examine whether the risk and distribution of specific cardiovascular outcomes differ across HDP subtypes.</p><p><strong>Design, setting, and participants: </strong>This nationwide cohort study retrospectively analyzed women with deliveries in South Korea from 2010 to 2018 using the National Health Insurance Service database. HDPs were classified into 5 subtypes: chronic hypertension, gestational hypertension, superimposed preeclampsia, preeclampsia/eclampsia, and unspecified hypertension. Events were verified through December 2022. Data were analyzed from June 1 to October 31, 2025.</p><p><strong>Exposures: </strong>HDPs and their subtypes.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was a composite of cardiovascular events, including cardiovascular death, heart failure, myocardial infarction, stroke, and atrial fibrillation. Adjusted hazard ratios (AHRs) were estimated using Cox models accounting for age, cardiovascular comorbidities, demographic, lifestyle, and pregnancy-related factors.</p><p><strong>Results: </strong>Among 570 843 women (mean [SD] age, 32.7 [4.0] years), 22 876 (4.0%) had HDPs. HDPs were associated with a higher incidence of cardiovascular events compared with women without HDPs (AHR, 1.62; 95% CI, 1.49-1.76; P < .001). The absolute risk increase was approximately 2.10 additional cardiovascular events per 1000 person-years over a median follow-up of 6.5 years (IQR, 4.7-8.7 years; incidence rate, 4.39 vs 2.29 per 1000 person-years). Among those with HDPs, 34.8% had gestational hypertension, 32.4% had preeclampsia or eclampsia, 17.7% had unspecified hypertension, 12.3% had chronic hypertension, and 2.8% had superimposed preeclampsia. All subtypes were independently associated with higher cardiovascular risk, with the highest risk observed in superimposed preeclampsia compared with women without HDPs (AHR, 2.93; 95% CI, 2.15-3.99; P < .001). All subtypes were associated with increased risks of heart failure and stroke, and most subtypes were associated with higher cardiovascular mortality. Unspecified hypertension was associated with myocardial infarction, and chronic hypertension and unspecified hypertension were associated with atrial fibrillation.</p><p><strong>Conclusions and relevance: </strong>In this cohort study, all HDP subtypes were associated with modest increases in long-term cardiovascular risk, except superimposed preeclampsia, which was associated with a markedly higher risk. These findings suggest that women with superimposed preeclampsia may benefit from closer postpartum cardiovascular surveillance.</p>","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"469-478"},"PeriodicalIF":23.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105443","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":"Promoting Health Equity for People With Intellectual and Developmental Disabilities Through Research.","authors":"Dimitri A Christakis, Douglas S Diekema","doi":"10.1001/jamainternmed.2025.7419","DOIUrl":"10.1001/jamainternmed.2025.7419","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"395-396"},"PeriodicalIF":23.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105489","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":"Importance of Function for Alzheimer Diagnosis and Management-More Than Memory.","authors":"Nathaniel A Chin, Claire M Erickson, Eric Widera","doi":"10.1001/jamainternmed.2025.7621","DOIUrl":"10.1001/jamainternmed.2025.7621","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"397-398"},"PeriodicalIF":23.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142351","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":"Transcatheter Aortic Valve Replacement for Patients at Low Risk and Younger Patients-A Contemporary View.","authors":"Jeffrey Shuhaiber","doi":"10.1001/jamainternmed.2025.7624","DOIUrl":"10.1001/jamainternmed.2025.7624","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"400-401"},"PeriodicalIF":23.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201788","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":"Voices of Resilience-Empowering Lifetime Survivors of HIV.","authors":"Derinthia Williams, Allison Agwu","doi":"10.1001/jamainternmed.2025.8098","DOIUrl":"10.1001/jamainternmed.2025.8098","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"393-394"},"PeriodicalIF":23.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270872","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":"Unproven Rules and the Need for Rigorous Policy Evaluation.","authors":"Justin J Choi, Cary P Gross, Ishani Ganguli","doi":"10.1001/jamainternmed.2025.7835","DOIUrl":"10.1001/jamainternmed.2025.7835","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"454-455"},"PeriodicalIF":23.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142382","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":"Reducing Potentially Inappropriate Medication Use for Older Adults in the Emergency Department-A Safer Script.","authors":"Alexander T Pham, Timothy S Anderson, Lona Mody, Jerard Z Kneifati-Hayek","doi":"10.1001/jamainternmed.2025.7888","DOIUrl":"10.1001/jamainternmed.2025.7888","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"402-403"},"PeriodicalIF":23.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142418","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":"Addressing Food Insecurity Is Complicated but Needed.","authors":"Anna Hung, Raegan W Durant, Giselle Corbie","doi":"10.1001/jamainternmed.2025.7846","DOIUrl":"10.1001/jamainternmed.2025.7846","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"425"},"PeriodicalIF":23.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201775","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":"Comparative Effectiveness and Safety of LAMA-LABA Inhalers in Chronic Obstructive Pulmonary Disease.","authors":"Gerard T Portela, Shirley V Wang, Samy Suissa, William B Feldman","doi":"10.1001/jamainternmed.2025.8087","DOIUrl":"10.1001/jamainternmed.2025.8087","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Dual bronchodilator therapy with a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist (LABA) is recommended for most patients with symptomatic chronic obstructive pulmonary disease (COPD). Fixed-dose LAMA-LABA therapies are available in metered-dose, dry powder, and soft mist inhalers. However, metered-dosed inhalers are associated with greater greenhouse gas emissions than either dry powder or soft mist inhalers, and questions persist about potential intraclass differences among LAMA-LABAs given variability in their active ingredients, dosing schedules, and delivery devices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the comparative effectiveness and safety of once-daily umeclidinium-vilanterol dry powder inhalers, twice-daily glycopyrrolate-formoterol metered-dosed inhalers, and once-daily tiotropium-olodaterol soft mist inhalers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This observational active-comparator study analyzed claims of patients (≥40 years) newly treated with LAMA-LABA inhalers and continuously enrolled in a large commercial health insurance or Medicare Advantage plan during the 183-day baseline period. Patients were propensity score matched 1:1 into 3 cohorts with index dates ranging from May 1, 2016, to February 28, 2025. Data were analyzed from July to August 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;Patients treated with umeclidinium-vilanterol, glycopyrrolate-formoterol, or tiotropium-olodaterol fixed-dose inhalers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Time to the first moderate or severe COPD exacerbation, major adverse cardiovascular event, urinary tract infection, and pneumonia hospitalization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cohorts included 9479 matched pairs of patients receiving umeclidinium-vilanterol vs glycopyrrolate-formoterol (mean age, 68.9 [SD, 9.0] years; 10 319 women [54.4%]; 8636 men [45.6%]), 9598 receiving tiotropium-olodaterol vs glycopyrrolate-formoterol (mean age, 69.2 [SD, 8.7] years; 10 513 women [54.8%]; 8680 men [45.2%]), and 36 740 receiving umeclidinium-vilanterol vs tiotropium-olodaterol (mean age, 71.5 [SD, 8.4] years; 39 429 women [53.7%]; 34 044 men [46.3%]). Umeclidinium-vilanterol was associated with a 14% lower hazard of a first moderate or severe COPD exacerbation than glycopyrrolate-formoterol (hazard ratio [HR], 0.86; 95% CI, 0.81-0.91; number needed to treat [NNT], 17) and was associated with a 3% lower hazard than tiotropium-olodaterol (HR, 0.97; 95% CI, 0.94-0.99; NNT, 100). Tiotropium-olodaterol was associated with a 6% lower hazard of a first moderate or severe COPD exacerbation than glycopyrrolate-formoterol (HR, 0.94; 95% CI, 0.89-1.00). Similar risks of first major adverse cardiovascular event, urinary tract infection, and pneumonia hospitalization were observed among patients in all 3 cohorts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;This cohort study found that umeclidinium-vilanterol w","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"456-468"},"PeriodicalIF":23.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270889","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}