Jama-Journal of the American Medical Association最新文献

{"title":"Preventive Health Care Use Among Adults Eligible for Lung Cancer Screening in the US.","authors":"Alexandra L Potter, Soneesh Kothagundla, Chinmay Haridas, Allison E B Chang, Lecia V Sequist, Chi-Fu Jeffrey Yang","doi":"10.1001/jama.2025.2157","DOIUrl":"10.1001/jama.2025.2157","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1635-1638"},"PeriodicalIF":63.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765954","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":"Personalized Patient Data and Behavioral Nudges for Medication Adherence-Reply.","authors":"P Michael Ho, Thomas J Glorioso, Sheana Bull","doi":"10.1001/jama.2025.0694","DOIUrl":"10.1001/jama.2025.0694","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1639-1640"},"PeriodicalIF":63.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812544","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":"Personalized Patient Data and Behavioral Nudges for Medication Adherence.","authors":"Yuan-Yuan Pei","doi":"10.1001/jama.2025.0688","DOIUrl":"10.1001/jama.2025.0688","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1638"},"PeriodicalIF":63.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812974","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":"Inhaled Sedation in Acute Respiratory Distress Syndrome: The SESAR Randomized Clinical Trial.","authors":"Matthieu Jabaudon, Jean-Pierre Quenot, Julio Badie, Jules Audard, Samir Jaber, Benjamin Rieu, Caroline Varillon, Antoine Monsel, François Thouy, Julien Lorber, Joël Cousson, Stéphanie Bulyez, Jérémy Bourenne, Ghada Sboui, Claire Lhommet, Virginie Lemiale, Belaïd Bouhemad, Clément Brault, Sigismond Lasocki, François Legay, Thomas Lebouvier, Arthur Durand, Julien Pottecher, Alexandre Conia, Delphine Brégeaud, Lionel Velly, Arnaud W Thille, Fabien Lambiotte, Erwan L'Her, Mehran Monchi, Antoine Roquilly, Aziz Berrouba, Franck Verdonk, Russell Chabanne, Thomas Godet, Marc Garnier, Raiko Blondonnet, Jérémy Vernhes, Vincent Sapin, Lucile Borao, Emmanuel Futier, Bruno Pereira, Jean-Michel Constantin","doi":"10.1001/jama.2025.3169","DOIUrl":"10.1001/jama.2025.3169","url":null,"abstract":"<p><strong>Importance: </strong>Whether the use of inhaled or intravenous sedation affects outcomes differentially in mechanically ventilated adults with acute respiratory distress syndrome (ARDS) is unknown.</p><p><strong>Objective: </strong>To determine the efficacy and safety of inhaled sevoflurane compared with intravenous propofol for sedation in patients with ARDS.</p><p><strong>Design, setting, and participants: </strong>Phase 3 randomized, open-label, assessor-blinded clinical trial conducted from May 2020 to October 2023 with 90-day follow-up. Adults with early moderate to severe ARDS (defined by a ratio of Pao2 to the fraction of inspired oxygen of <150 mm Hg with a positive end-expiratory pressure of ≥8 cm H2O) were enrolled in 37 French intensive care units.</p><p><strong>Interventions: </strong>Patients were randomized to a strategy of inhaled sedation with sevoflurane (intervention group) or to a strategy of intravenous sedation with propofol (control group) for up to 7 days.</p><p><strong>Main outcomes and measures: </strong>The primary end point was the number of ventilator-free days at 28 days; the key secondary end point was 90-day survival.</p><p><strong>Results: </strong>Of 687 patients enrolled (mean [SD] age, 65 [12] years; 30% female), 346 were randomized to sevoflurane and 341 to propofol. The median total duration of sedation was 7 days (IQR, 4 to 7) in both groups. The number of ventilator-free days through day 28 was 0.0 days (IQR, 0.0 to 11.9) in the sevoflurane group and 0.0 days (IQR, 0.0 to 18.7) in the propofol group (median difference, -2.1 [95% CI, -3.6 to -0.7]; standardized hazard ratio, 0.76 [95% CI, 0.50 to 0.97]). The 90-day survival rates were 47.1% and 55.7% in the sevoflurane and propofol groups, respectively (hazard ratio, 1.31 [95% CI, 1.05 to 1.62]). Among 4 secondary outcomes, sevoflurane was associated with higher 7-day mortality (19.4% vs 13.5%, respectively; relative risk, 1.44 [95% CI, 1.02 to 2.03]) and fewer intensive care unit-free days through day 28 (median, 0.0 [IQR, 0.0 to 6.0] vs 0.0 [IQR, 0.0 to 15.0]; median difference, -2.5 [95% CI, -3.7 to -1.4]) compared with propofol.</p><p><strong>Conclusions and relevance: </strong>Among patients with moderate to severe ARDS, inhaled sedation with sevoflurane resulted in fewer ventilator-free days at day 28 and lower 90-day survival than sedation with propofol.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04235608.</p>","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1608-1617"},"PeriodicalIF":63.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652057","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":"Sevoflurane Sedation in Acute Respiratory Distress Syndrome: Time to Put It to Sleep.","authors":"Balasubramanian Venkatesh, Naomi Hammond, Anthony Delaney","doi":"10.1001/jama.2025.3023","DOIUrl":"10.1001/jama.2025.3023","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1586-1588"},"PeriodicalIF":63.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652060","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":"JAMA.","authors":"","doi":"10.1001/jama.2024.18814","DOIUrl":"https://doi.org/10.1001/jama.2024.18814","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":"333 18","pages":"1561-1562"},"PeriodicalIF":63.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200885","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":"Interventions to Support Breastfeeding: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.","authors":"Carrie D Patnode, Caitlyn A Senger, Erin L Coppola, Megan O Iacocca","doi":"10.1001/jama.2024.27267","DOIUrl":"10.1001/jama.2024.27267","url":null,"abstract":"<p><strong>Importance: </strong>Interventions to support breastfeeding may help individuals and families initiate breastfeeding or breastfeed exclusively or for a prolonged period of time.</p><p><strong>Objective: </strong>To systematically review the evidence on the benefits and harms of breastfeeding interventions to support the US Preventive Services Task Force in updating its 2016 recommendation.</p><p><strong>Data sources: </strong>Studies included in the previous review were reevaluated for inclusion and updated searches in MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, and PsycINFO through June 3, 2024. Surveillance for new evidence in targeted publications through January 24, 2025.</p><p><strong>Study selection: </strong>Randomized clinical trials that evaluated a primary care-relevant intervention designed to support breastfeeding. Of 290 full-text articles reviewed, 90 met inclusion criteria.</p><p><strong>Data extraction and synthesis: </strong>Independent critical appraisal of all provisionally included studies. Data were independently abstracted by one reviewer and confirmed by another.</p><p><strong>Main outcomes and measures: </strong>Child and maternal health outcomes, prevalence, and duration of any and exclusive breastfeeding, and harms related to interventions.</p><p><strong>Results: </strong>Ninety trials (N = 49 597) reported in 125 publications were included. The evidence represented individuals from diverse backgrounds and interventions that varied in timing, delivery, and duration. There was limited and mixed evidence on the effectiveness of breastfeeding support interventions on infant health outcomes (10 trials [n = 6592]) and maternal symptoms of anxiety, depression, and well-being (9 trials [n = 2334]). Pooled analyses indicated beneficial associations between breastfeeding support interventions and any or exclusive breastfeeding for up to and at 6 months (any breastfeeding: risk ratio, 1.13 [95% CI, 1.05-1.22]; 37 trials [n = 13 579] and exclusive breastfeeding: risk ratio, 1.46 [95% CI, 1.20-1.78]; 37 trials [n = 14 398]). There was no relationship between interventions and breastfeeding initiation or breastfeeding at 12 months.</p><p><strong>Conclusions and relevance: </strong>The updated evidence confirms that breastfeeding support interventions can increase the prevalence of any or exclusive breastfeeding up to and at 6 months. Future efforts should focus on how to best provide this support consistently for all individuals making feeding decisions for their infants.</p>","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1527-1537"},"PeriodicalIF":63.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804896","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":"Medical School.","authors":"Amit Majmudar","doi":"10.1001/jama.2024.27704","DOIUrl":"10.1001/jama.2024.27704","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1551"},"PeriodicalIF":63.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813031","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":"Primary Care Behavioral Counseling Interventions to Support Breastfeeding: US Preventive Services Task Force Recommendation Statement.","authors":"Wanda K Nicholson, Michael Silverstein, John B Wong, David Chelmow, Tumaini Rucker Coker, Esa M Davis, Alicia Fernandez, Ericka Gibson, Carlos Roberto Jaén, Marie Krousel-Wood, Sei Lee, Goutham Rao, John M Ruiz, James Stevermer, Joel Tsevat, Sandra Millon Underwood, Sarah Wiehe","doi":"10.1001/jama.2025.3650","DOIUrl":"10.1001/jama.2025.3650","url":null,"abstract":"<p><strong>Importance: </strong>The association between breastfeeding and health benefits in children has been previously well established; health benefits have also been found for women who breastfeed. However, breastfeeding rates in the US are relatively modest; as of 2021, 59.8% of infants at age 6 months are breastfed and 27.2% of infants at that age are exclusively breastfed.</p><p><strong>Objective: </strong>The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the evidence on the benefits and harms of primary care behavioral counseling interventions to support breastfeeding.</p><p><strong>Population: </strong>Adolescents and adults who are pregnant or postpartum, and their infants and children.</p><p><strong>Evidence assessment: </strong>The USPSTF concludes with moderate certainty that primary care behavioral counseling interventions to support breastfeeding have a moderate net benefit.</p><p><strong>Recommendation: </strong>The USPSTF recommends providing interventions or referrals, during pregnancy and after birth, to support breastfeeding. (B recommendation).</p>","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1520-1526"},"PeriodicalIF":63.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804897","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":"Behavioral Counseling Interventions to Support Breastfeeding.","authors":"Rebecca Voelker","doi":"10.1001/jama.2025.4144","DOIUrl":"10.1001/jama.2025.4144","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1556"},"PeriodicalIF":63.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804894","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}