JAMA最新文献

{"title":"Beyond Genes: Human Exposome Project to Tackle External Drivers of Disease","authors":"Samantha Anderer","doi":"10.1001/jama.2025.8666","DOIUrl":"https://doi.org/10.1001/jama.2025.8666","url":null,"abstract":"This Medical News article discusses the recent Exposome Moonshot Forum, a global meeting to accelerate research in exposomics—the study of the full range of environmental exposures that shape health and disease.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Woman With Headache, Fatigue, and Aphasia","authors":"Natalie S. Rosen, Michael Hughes, Andrew Eisenberger","doi":"10.1001/jama.2025.6076","DOIUrl":"https://doi.org/10.1001/jama.2025.6076","url":null,"abstract":"A woman with no significant medical history had 3 days of headache, fatigue, and expressive aphasia; laboratory testing showed microangiopathic hemolytic anemia, increasing schistocytes on serial blood smears, diminished ADAMTS13 activity, and a high inhibitor titer. What is the diagnosis and what would you do next?","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144165673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"’Til Death Do Our Smartphones Part","authors":"Grace Jenq","doi":"10.1001/jama.2025.7333","DOIUrl":"https://doi.org/10.1001/jama.2025.7333","url":null,"abstract":"In this narrative medicine essay, a geriatrician and palliative care physician finds comfort after her husband’s death by reading notes and viewing video messages he left on his phone.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144165675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet Transfusion","authors":"Ryan A. Metcalf, Susan Nahirniak, Gordon Guyatt, Aarti Bathla, Sandra K. White, Arwa Z. Al-Riyami, Rachel C. Jug, Ursula La Rocca, Jeannie L. Callum, Claudia S. Cohn, Abe DeAnda, Robert A. DeSimone, Allan Dubon, Lise J. Estcourt, Daniela C. Filipescu, Mark K. Fung, Ruchika Goel, Aaron S. Hess, Heather A. Hume, Richard M. Kaufman, Peter Kranke, Vernon J. Louw, Morten H. Møller, Michael F. Murphy, Jennifer A. Muszynski, Cian J. O’Kelly, Monica B. Pagano, Gopal K. Patidar, Katerina Pavenski, Jacqueline N. Poston, Nabiha H. Saifee, Moritz Stolla, Zbigniew M. Szczepiorkowski, Aaron A.R. Tobian, Raman Uberoi, Jonathan Waters, Brittney Williams, Erica M. Wood, Nicole D. Zantek, Michelle P. Zeller, Brenda J. Grossman, Simon J. Stanworth","doi":"10.1001/jama.2025.7529","DOIUrl":"https://doi.org/10.1001/jama.2025.7529","url":null,"abstract":"ImportancePlatelet transfusion is a frequent procedure with benefits and risks.ObjectiveTo provide recommendations in adult and pediatric populations in whom platelet transfusions are commonly performed.Evidence ReviewGrading of Recommendations Assessment Development and Evaluation (GRADE) methodology was applied to findings from 21 randomized trials and 13 observational studies in contexts of limited randomized clinical trial data. Transfusion strategies using fewer (restrictive) vs greater (liberal) amounts of platelets were compared.FindingsEvidence demonstrated that restrictive transfusion strategies probably did not cause increases in mortality or bleeding relative to liberal strategies across predefined clinical populations. Exceedingly low incidence of spinal hematoma was identified in patients with thrombocytopenia undergoing lumbar puncture. Because definitions of restrictive strategies varied across trials, recommendations reflect practical guidance. The following recommendations are strong recommendations with high/moderate–certainty evidence. For hypoproliferative thrombocytopenia in nonbleeding patients receiving chemotherapy or undergoing allogeneic stem cell transplant, platelet transfusion is recommended when platelet count is less than 10 × 10<jats:sup>3</jats:sup>/μL. For consumptive thrombocytopenia in neonates without major bleeding, platelet transfusion is recommended when platelet count is less than 25 × 10<jats:sup>3</jats:sup>/μL. In patients undergoing lumbar puncture, platelet transfusion is recommended when platelet count is less than 20 × 10<jats:sup>3</jats:sup>/μL. In patients with consumptive thrombocytopenia due to Dengue without major bleeding, platelet transfusion is not recommended. The following recommendations are conditional recommendations with low/very low–certainty evidence. For hypoproliferative thrombocytopenia in nonbleeding adults undergoing autologous stem cell transplant or with aplastic anemia, prophylactic platelet transfusion is not recommended. In adults with consumptive thrombocytopenia without major bleeding, platelet transfusion is recommended when platelet count is less than 10 × 10<jats:sup>3</jats:sup>/μL. In adults undergoing central venous catheter placement in compressible anatomic sites, platelet transfusion is recommended when platelet count is less than 10 × 10<jats:sup>3</jats:sup>/μL. In adults undergoing interventional radiology, platelet transfusion is recommended when platelet count is less than 20 × 10<jats:sup>3</jats:sup>/μL for low-risk procedures and less than 50 × 10<jats:sup>3</jats:sup>/μL for high-risk procedures. For adults undergoing major nonneuraxial surgery, platelet transfusion is recommended when platelet count is less than 50 × 10<jats:sup>3</jats:sup>/μL. For patients without thrombocytopenia undergoing cardiovascular surgery in the absence of major hemorrhage, including those receiving cardiopulmonary bypass, platelet transfusion is not recommended. For nonoper","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Call for Improved Strategies to Support Aging in Place","authors":"Kahli Zietlow, Lona Mody, Caroline A. Vitale","doi":"10.1001/jama.2025.7404","DOIUrl":"https://doi.org/10.1001/jama.2025.7404","url":null,"abstract":"This Viewpoint explores the various challenges of aging in place and how long-term care planning and essential community resources can benefit older adults.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144165674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The WHO Pandemic Agreement","authors":"Lawrence O. Gostin, Sam Halabi, Alexandra Finch","doi":"10.1001/jama.2025.9198","DOIUrl":"https://doi.org/10.1001/jama.2025.9198","url":null,"abstract":"This Viewpoint describes the World Health Assembly’s newly adopted Pandemic Agreement, which lays a framework for action including preventing zoonotic spillovers, health system preparedness, and equitable response, and discusses the ramifications of the absence of US participation in the agreement.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid Disease May Be Overdiagnosed, Study Finds.","authors":"Samantha Anderer","doi":"10.1001/jama.2025.6466","DOIUrl":"https://doi.org/10.1001/jama.2025.6466","url":null,"abstract":"","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"137 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer Deaths Decline, Driven by Drop in Smoking-Related Cancers.","authors":"Samantha Anderer","doi":"10.1001/jama.2025.6461","DOIUrl":"https://doi.org/10.1001/jama.2025.6461","url":null,"abstract":"","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"498 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WHO Warns of Preventable Disease Outbreaks Amid Immunization Disruptions.","authors":"Samantha Anderer","doi":"10.1001/jama.2025.6464","DOIUrl":"https://doi.org/10.1001/jama.2025.6464","url":null,"abstract":"","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IV Fluid Shortages Persist Months After Hurricane Helene Hit a Supplier-Hospitals Have Had to Adapt.","authors":"Eli Cahan","doi":"10.1001/jama.2025.0075","DOIUrl":"https://doi.org/10.1001/jama.2025.0075","url":null,"abstract":"","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}