JAMA最新文献

{"title":"Cardiovascular Care Should Incorporate Cognition and Frailty, Heart Group Says in New Statement","authors":"Jennifer Abbasi","doi":"10.1001/jama.2026.17524","DOIUrl":"https://doi.org/10.1001/jama.2026.17524","url":null,"abstract":"This Medical News article discusses a new scientific statement from the American College of Cardiology about caring for older adults with cardiovascular disease.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148836191","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":"ADVOCATing for Patients With Heart Failure","authors":"Roy Perlis","doi":"10.1001/jama.2026.12837","DOIUrl":"https://doi.org/10.1001/jama.2026.12837","url":null,"abstract":"The ADVOCATE initiative and how autonomous AI agents could help patients with heart failure are discussed by JAMA+ AI Editor in Chief Roy Perlis, MD, MSc, and Haider Warraich, MD, a cardiologist and the program manager at ARPA-H, for the <jats:italic toggle=\"yes\">JAMA+ AI Conversations</jats:italic> podcast.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148836187","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":"Nomenclature","authors":"Luke P. Burns","doi":"10.1001/jama.2026.14248","DOIUrl":"https://doi.org/10.1001/jama.2026.14248","url":null,"abstract":"In this narrative medicine essay, a maternal-fetal medicine physician trained to use clinical terms for developmental stages of pregnancy as an emotional stay against an uncertain outcome experiences tension between clinical and lived language during his wife’s miscarriage.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"381 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148836181","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":"Cannabinoid Hyperemesis Syndrome","authors":"Thangam Venkatesan, William L. Hasler, Michael Camilleri","doi":"10.1001/jama.2026.7873","DOIUrl":"https://doi.org/10.1001/jama.2026.7873","url":null,"abstract":"This JAMA Insights discusses cannabinoid hyperemesis syndrome, including pathophysiology, clinical presentation, and the epidemiology and risk factors.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815547","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":"Predictive Utility of Coronary Artery Calcium Score Added to the PREVENT Atherosclerotic Cardiovascular Disease Equations","authors":"Xiaoning Huang, Lucia C. Petito, Norrina B. Allen, Ron Blankstein, Roger S. Blumenthal, Josef Coresh, Philip Greenland, Jennifer E. Ho, Amit Khera, Donald M. Lloyd-Jones, Janani Rangaswami, James H. Stein, Chiadi E. Ndumele, Sadiya S. Khan, Nilay S. Shah","doi":"10.1001/jama.2026.13233","DOIUrl":"https://doi.org/10.1001/jama.2026.13233","url":null,"abstract":"Importance The 2026 American College of Cardiology/American Heart Association/Multisociety Dyslipidemia Guideline newly recommends selective use of coronary artery calcium (CAC) scoring based on a 10-year risk of 3% to less than 10% estimated with the Predicting Risk of Cardiovascular Disease EVENTS (PREVENT) atherosclerotic cardiovascular disease (ASCVD) equations. However, the utility of CAC scoring alongside the PREVENT equations for ASCVD risk estimation is not known. Objective To determine the change in predictive utility when adding CAC scores to the PREVENT-ASCVD equations. Design, Setting, and Participants Longitudinal observational cohort study conducted at 6 sites in the United States and enrolling adult participants aged 45 to 79 years without ASCVD at baseline in the Multi-Ethnic Study of Atherosclerosis. Exposures Ten-year ASCVD risk with the PREVENT-ASCVD equations before and after adding CAC scores. Main Outcomes Performance metrics for estimation of risk of fatal and nonfatal ASCVD, assessed using the Harrell C statistic, calibration, and net reclassification improvement (NRI) for newly defined ASCVD risk categories: low (&amp;amp;lt;3%); borderline (3% to &amp;amp;lt;5%); intermediate (5% to &amp;amp;lt;10%); and high (≥10%). Results A total of 6098 participants were included. At baseline, participant mean age was 61.4 (SD, 9.6) years, 52% were female, mean estimated 10-year ASCVD risk was 6.4% (SD, 4.8%) with the PREVENT-ASCVD base equations, and 49% had a CAC score greater than 0. During 10 years of follow-up, 366 (6%) experienced an ASCVD event. The Harrell C statistic for the PREVENT-ASCVD base equations was 0.73 (95% CI, 0.70-0.75). After adding CAC to the PREVENT-ASCVD base equations, the change in Harrell C statistic was 0.02 (95% CI, 0.01-0.03), and the categorical NRI was 0.095 (95% CI, 0.053-0.137). The calibration slope for the PREVENT-ASCVD base equations was 1.09 (95% CI, 0.93-1.25), and for the PREVENT-ASCVD base plus CAC equations was 0.92 (95% CI, 0.81-1.03). Among those at borderline risk, incident ASCVD occurred in 1.9% of those with CAC score of 0, 3.9% with CAC greater than 0 and less than 100, 7.4% with CAC 100 or greater and less than 300, and 14.3% with CAC 300 or greater. Conclusions and Relevance Among US adults aged 45 to 79 years, addition of CAC score to the PREVENT-ASCVD equations across all risk groups overall only modestly improved and, in some groups, did not change model discrimination and reclassification. Reclassification results support selective use of CAC in those with borderline to intermediate risk estimated by the PREVENT-ASCVD equations.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"159 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815548","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":"Health Care Ownership and Patient Care—A National Institute on Aging Workshop","authors":"Zirui Song, Mark A. Unruh, Jane M. Zhu","doi":"10.1001/jama.2026.15930","DOIUrl":"https://doi.org/10.1001/jama.2026.15930","url":null,"abstract":"This Viewpoint discusses how consolidation in frontline care delivery has shaped health care markets across the US and how changes in ownership of hospitals and practices affect clinicians and patient outcomes.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148806386","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":"Postural Orthostatic Tachycardia Syndrome (POTS)","authors":"Tae Hwan Chung, Satish R. Raj","doi":"10.1001/jama.2026.14809","DOIUrl":"https://doi.org/10.1001/jama.2026.14809","url":null,"abstract":"Importance Postural orthostatic tachycardia syndrome (POTS) is a chronic autonomic disorder characterized by excessive orthostatic tachycardia and multisystem symptoms that affects an estimated 0.1% to 1% of the US population. POTS can substantially impair daily functioning and quality of life. Observations Consensus criteria define POTS by chronic symptoms of orthostatic intolerance accompanied by a sustained heart rate increase of at least 30 beats/min (≥40 beats/min in adolescents aged 12-19 years) within 10 minutes of standing or head-up tilt, in the absence of orthostatic hypotension, defined as a decrease in either systolic blood pressure of at least 20 mm Hg or diastolic blood pressure of at least 10 mm Hg with positional change. POTS symptoms may include palpitations, lightheadedness, nausea, vomiting, gastroparesis, anorexia, generalized weakness, and muscle pain, despite absence of structural pathology within cardiovascular, gastrointestinal, and neurological organs. POTS predominantly affects females (approximately 90% of cases), with peak incidence from ages 13 to 29 years. However, the true prevalence remains uncertain partly due to underrecognition and lack of a specific diagnostic code for POTS until 2022. Common symptoms include lightheadedness, palpitations, fatigue, cognitive dysfunction (“brain fog”), exercise intolerance, nausea, bloating, constipation, diarrhea, and sleep disturbance. In a survey of 4835 patients, approximately 70% reported substantial functional impairment and loss of school or work participation, and median diagnostic delay was 24 months. In 30% to 40% of cases, symptoms began within 3 months after infections, such as SARS-CoV-2, Epstein-Barr virus, and influenza. Initial evaluation should exclude other conditions that cause sinus tachycardia, including thyroid disease, adrenal insufficiency, pheochromocytoma, cardiomyopathy, valvular heart disease, congenital heart disease, chronic lung disease, medication effects (eg, stimulants, norepinephrine reuptake inhibitors, and diuretics), anemia, and dehydration. First-line treatment includes nonpharmacological strategies to improve cardiac preload, including increased fluid and sodium intake, lower-body compression garments; avoidance of heat exposure, dehydration, and prolonged standing; and structured supervised aerobic training. Pharmacological therapies should be individualized and may include β-blockers, ivabradine, midodrine, fludrocortisone, and pyridostigmine, although evidence supporting many therapeutic interventions is limited by small studies and lack of large, randomized trials. Conclusions and Relevance POTS is a chronic autonomic disorder associated with functional impairment and reduced quality of life that is diagnosed based on characteristic orthostatic symptoms in the absence of orthostatic hypotension after excluding alternative causes of sinus tachycardia. Treatment involves nonpharmacological measures (such as increased fluid and sodium int","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148806382","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":"Rural-Urban Disparities in the Delivery and Intensity of the Medicare Hospice Benefit","authors":"Claire K. Ankuda, Ken Covinsky, Bocheng Jing, Helen P. Knight, Krista L. Harrison, Melissa D. Aldridge, Meredith A. MacMartin, Lauren J. Hunt","doi":"10.1001/jama.2026.16190","DOIUrl":"https://doi.org/10.1001/jama.2026.16190","url":null,"abstract":"This cross-sectional study examines how hospice care varies across the rural-urban continuum, including length of stay, care setting, visits by hospice staff, and rates of higher-level care.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148806379","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 Seismic Shift From Animal to “Human-Based” Research Is Underway—Here’s What to Know About Organoids","authors":"Jennifer Abbasi","doi":"10.1001/jama.2026.3047","DOIUrl":"https://doi.org/10.1001/jama.2026.3047","url":null,"abstract":"This Medical News article discusses a push for human-centric research models, such as mini-organs grown from human cells, to complement or replace animal studies.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148768083","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":"What the Cyclospora Outbreak Reveals About the State of US Foodborne Disease Surveillance","authors":"Kate Schweitzer","doi":"10.1001/jama.2026.16678","DOIUrl":"https://doi.org/10.1001/jama.2026.16678","url":null,"abstract":"This Medical News article discusses how the ongoing US cyclosporiasis outbreak, centered in Michigan, exposed weaknesses in the nation’s foodborne disease surveillance system and what needs to change to detect and contain future surges more quickly.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148768084","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}