JAMA Internal Medicine最新文献

{"title":"Errors in the Visual Abstract.","authors":"","doi":"10.1001/jamainternmed.2026.4852","DOIUrl":"10.1001/jamainternmed.2026.4852","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":"186 10","pages":"1284"},"PeriodicalIF":26.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109784","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":"Intensification and Deintensification of Diabetes Medications Among Older Adults With Type 2 Diabetes.","authors":"Phuc Le, Ning Guo, Anita D Misra-Hebert, Nicholas J Casacchia, Yihua Yue, Hamlet Gasoyan, Glen B Taksler, Michael B Rothberg","doi":"10.1001/jamainternmed.2026.3483","DOIUrl":"10.1001/jamainternmed.2026.3483","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"1278-1282"},"PeriodicalIF":26.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701415","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":"Artificial Intelligence and the Financialization of Medical Knowledge.","authors":"Teva D Brender, Allan S Detsky, Lindsey Yourman","doi":"10.1001/jamainternmed.2026.2961","DOIUrl":"10.1001/jamainternmed.2026.2961","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"1189-1190"},"PeriodicalIF":26.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591630","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":"Automation Is Not Always the Answer.","authors":"Raegan W Durant, Cary P Gross, Ilana Richman","doi":"10.1001/jamainternmed.2026.3664","DOIUrl":"10.1001/jamainternmed.2026.3664","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"1245"},"PeriodicalIF":26.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701463","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":"Serologic Immunity to Hepatitis A and B in US Adults and High-Risk Populations.","authors":"Giovanni A Roldan, Jesse Fletcher, Timothy Davie, Thomas M Leventhal, John R Lake, Prowpanga Udompap","doi":"10.1001/jamainternmed.2026.3831","DOIUrl":"10.1001/jamainternmed.2026.3831","url":null,"abstract":"<p><strong>Importance: </strong>Serologic immunity to hepatitis A virus (HAV) and hepatitis B virus (HBV) protects against acute infection and severe outcomes among high-risk groups; however, contemporary data on population-level immunity remain limited, especially in high-risk populations.</p><p><strong>Objective: </strong>To estimate the prevalence and factors associated with serologic immunity in the overall population and across high-risk subgroups, including those with chronic liver disease (CLD), chronic kidney disease, diabetes, and immunosuppression and pregnant people.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study used data from the National Health and Nutrition Examination Survey from January 2017 to August 2023 and included adults aged 20 years or older with available HAV and HBV serologic test results. Data were analyzed from January 3 to May 10, 2026.</p><p><strong>Main outcomes and measures: </strong>The primary outcomes were the prevalence of serologic immunity to HAV, defined by hepatitis A antibody positivity, and HBV, defined by hepatitis B surface antibody positivity, with vaccine-derived immunity specifically identified by surface antibody positivity in the absence of hepatitis B core antibodies. Data were weighted to generate nationally representative estimates of the US adult population. Multivariable survey-weighted logistic regression models were used to identify independent factors associated with viral hepatitis immunity.</p><p><strong>Results: </strong>Among 13 514 individuals, representing an estimated 226.1 million US adults (mean [SE] age, 48.65 [0.40] years; 51.76% female), 39.5% (95% CI, 37.7%-41.3%) demonstrated serologic immunity to hepatitis A, corresponding to approximately 89.4 million individuals. For HBV, 27.1% (95% CI, 25.8%-28.4%) demonstrated serologic immunity, corresponding to approximately 61.3 million individuals, while vaccine-derived immunity was present in 25.2% (95% CI, 23.9%-26.5%). In adjusted models, HAV immunity was associated with younger age (eg, 20-29 vs ≥65 years: adjusted odds ratio [AOR], 0.51; 95% CI, 0.44-0.60); lower educational attainment (eg, <grade 9 vs college graduate or above: AOR, 0.32; 95% CI, 0.24-0.42); non-Hispanic Black (AOR, 1.67; 95% CI, 1.34-2.09), Mexican American (AOR, 4.22; 95% CI, 3.42-5.21), other Hispanic (AOR, 2.01; 95% CI, 1.60-2.54), non-Hispanic Asian (AOR, 3.03; 95% CI, 2.45-3.76), and multiracial or other (AOR, 1.36; 95% CI, 1.04-1.79) race and ethnicity; being born outside the US (AOR, 4.54; 95% CI, 3.74-5.52); and liver disease awareness (OR, 1.65; 95% CI, 1.29-2.09). Obesity was associated with lower odds of HAV immunity (AOR, 0.83; 95% CI, 0.72-0.96). Vaccine-derived HBV immunity was associated with younger age (eg, 20-29 vs ≥65 years: AOR, 0.18; 95% CI, 0.15-0.23), female sex (AOR, 1.36; 95% CI, 1.18-1.56), non-Hispanic Asian (AOR, 1.47; 95% CI, 1.17-1.86) and non-Hispanic Black (AOR, 1.15; 95% CI, 1.00-1.32) race ","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"1213-1223"},"PeriodicalIF":26.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793326","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 References.","authors":"","doi":"10.1001/jamainternmed.2026.4429","DOIUrl":"10.1001/jamainternmed.2026.4429","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"1284"},"PeriodicalIF":26.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813019","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":"Reframing the Approach to High-Risk Electrocardiography Patterns.","authors":"Arihant Jain, Nayer Jamshed","doi":"10.1001/jamainternmed.2026.3721","DOIUrl":"10.1001/jamainternmed.2026.3721","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"1269-1270"},"PeriodicalIF":26.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793333","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":"Cost of Article Processing Charges to Adhere to National Institutes of Health Public Access Policy.","authors":"Ryan Huebinger, Marla Hertz, Ryan A Coute","doi":"10.1001/jamainternmed.2026.3463","DOIUrl":"10.1001/jamainternmed.2026.3463","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"1273-1275"},"PeriodicalIF":26.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813046","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":"Public Access to NIH-Funded Research Manuscripts-Ensuring Dissemination Without Shifting Costs to Scientists.","authors":"Cary P Gross, Deborah Grady, Sharon K Inouye","doi":"10.1001/jamainternmed.2026.3718","DOIUrl":"10.1001/jamainternmed.2026.3718","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"1197-1199"},"PeriodicalIF":26.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812999","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":"Management of Shoulder Pain in Primary Care: A Review.","authors":"Romi Haas, Thomas Ibounig, Rachelle Buchbinder","doi":"10.1001/jamainternmed.2026.3135","DOIUrl":"10.1001/jamainternmed.2026.3135","url":null,"abstract":"<p><strong>Importance: </strong>Shoulder pain is a common and disabling condition most often managed in primary care. This review provides an evidence-based update on the diagnosis and management of shoulder pain to support clinical decision-making and improve patient outcomes.</p><p><strong>Observations: </strong>Shoulder pain arises from benign, self-limiting soft-tissue disorders or rare but serious causes. In primary care, most cases are nontraumatic and involve periarticular soft tissues. The subacromial region is the most frequent source of pain, and the term subacromial pain is preferred over overlapping and inconsistently defined labels such as rotator cuff tendinopathy or tear, impingement syndrome, or subacromial bursitis. Less commonly, pain originates from the glenohumeral joint, as in glenohumeral osteoarthritis or adhesive capsulitis. Assessment should focus on a detailed history and physical examination to assess pain patterns and movement limitation and to exclude serious causes, such as infection, malignant neoplasm, or nonshoulder referred pain. Once these are excluded, first-line treatment is similar for most patients and aligns with recommended care for other regional musculoskeletal concerns: education about the favorable natural history, symptom relief and activity modification if needed, and watchful waiting. Early imaging is not indicated in the absence of significant trauma or suspicious features, such as fever, unexplained weight loss, or history of malignant neoplasm, as structural abnormalities often do not correlate with symptoms, rarely alter management, and may lead to overdiagnosis and overtreatment. Specialist referral should be reserved for suspected serious pathology, such as infection, malignant neoplasm, fracture, or dislocation; significant functional or neurologic deficit; features suggestive of systemic inflammatory disease; or persistent or worsening pain and debility. High-certainty evidence indicates that subacromial pain does not benefit from surgical intervention.</p><p><strong>Conclusions and relevance: </strong>Shoulder pain is the third most common musculoskeletal presentation in primary care. Although causes vary, the initial management is largely the same once serious conditions have been excluded. Most patients with subacromial pain will fully recover with minimal intervention and can be safely treated with supportive care. Imaging and referral to surgical subspecialists should be reserved for rare and carefully selected cases to avoid unnecessary intervention.</p>","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":"1256-1268"},"PeriodicalIF":26.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793249","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}