Новости за 09.12.2025

This review discusses superficial vein thrombosis, including pathophysiology, risk factors, epidemiology, and diagnostic testing.

This JAMA Patient Page describes lower urinary tract symptoms in men and their associated diagnoses and treatments.

This JAMA Insights discusses risk factors for, assessment, and management of postpartum hemorrhage.

This Viewpoint describes the substance use reduction app marketplace, highlights concerns related to integration of generative artificial intelligence into such apps, and suggests how oversight can be strengthened to protect public health.

This study characterizes stillbirth rates in 2016-2022 across clinical risk factors and geographic-based measures of access, income, and race in a large US commercially insured population.

This Viewpoint discusses a recent presidential proclamation restricting the entry of workers under the H-1B visa program unless their employers pay $100 000 and how this change might affect US health care, particularly in rural areas where many international medical graduates tend to practice.

In this narrative medicine essay, a pediatric palliative care physician reflects on the end of her mother’s life and offers clinicians advice on guiding patients and their families in the last months and days of a patient’s life.

In Reply We thank Drs Fleurence and Collins, Dr Baird and colleagues, and Dr Gallo and colleagues for their interest in the DETECT Hep C randomized clinical trial. We echo the concern about the relatively low rate of linkage to care and cure among those included in this trial. This lack of linkage to care highlights a clear limitation of simple clinician referral from EDs for HCV—the current standard of care for most EDs—and emphasizes the critical importance of developing novel strategies to improve HCV care continuum outcomes. Читать дальше...

To the Editor The DETECT Hep C randomized clinical trial of emergency department (ED)–based testing reported that nontargeted testing in the ED successfully identified many individuals with hepatitis C virus (HCV) infection. However, we share the authors’ concern about the ultimate outcome—treatment initiation and completion rates were distressingly low. These findings underscore the need for a comprehensive strategy to achieve HCV elimination in the US.

This national study evaluates the percentage of US health care professionals sponsored for H-1B visas in fiscal year 2024 across occupation groups and county characteristics.

This study evaluated whether a personalized hemodynamic resuscitation protocol targeting capillary refill time normalization improves outcomes in adults with early septic shock compared with usual care.

This randomized clinical trial examines whether a personalized hemodynamic resuscitation protocol targeting capillary refill time was more effective than usual care in patients with early septic shock.

This randomized clinical trial examines whether sodium bicarbonate infusion decreases day 90 all-cause mortality for patients with severe metabolic acidosis and moderate to severe acute kidney injury.

Almost 25 years ago, a landmark trial of early goal-directed therapy (EGDT) by Rivers and colleagues reshaped the care of septic shock by introducing the concept that “early” management was crucial. Although implementation has varied across high- and low-resource settings, the importance of early sepsis recognition and treatment is now nearly universally accepted. In contrast, the specific manner by which goal-directed therapy for septic shock should be provided remains highly controversial. Conceptually... Читать дальше...

Severe acidemia commonly complicates critical illness. If unresolved or untreated, acidemia may exacerbate multiorgan dysfunction, prompt escalation in life support, and portend greater risk of adverse outcomes. Intravenous (IV) sodium bicarbonate is often used in clinical practice to buffer severe acidemia; however, existing evidence on its effectiveness remains inconclusive. The most recent iteration of the Surviving Sepsis Guidelines offers only a weak recommendation (low quality of evidence)... Читать дальше...

In Reply We appreciate the Letter from Dr Krommes about our Viewpoint. However, she and Doctors for America are misinformed. No scientific reviewers were let go as part of the reduction in force at the FDA, and our ability to provide timely, accurate reviews is uncompromised. Doctors for America is not an independent organization as it claims. It was founded to support a presidential campaign, and the Letter reveals its partisan bias.

To the Editor As the chair of the Doctors for America Food and Drug Administration (FDA) Task Force, I am responding to the recent Viewpoint “Priorities for a New FDA” by FDA Commissioner Martin A. Makary and Center for Biologics Evaluation and Research Director Vinay Prasad. The Doctors for America FDA Task Force is the only independent physician organization advocating for patient safety, transparency, and accountability at the FDA, and we welcome new solutions to long-standing agency challenges... Читать дальше...

This Viewpoint discusses patient participation in kidney transplant candidacy decisions.

This randomized clinical trial assesses the effect of rituximab on disease relapse in adults with frequently relapsing nephrotic syndrome or steroid-dependent nephrotic syndrome.

In Reply We thank Dr Ceelen for his Letter in response to our Review of diverticulitis. As clearly stated in our Review, the pathophysiology of diverticular disease is incompletely understood and indeed multifactorial. The principles of the law of Laplace (P = T/R) for a cylindrical structure provide a rational mathematical explanation for the increased incidence of diverticular disease in the sigmoid colon. Yet it does not necessarily account for the etiology and pathogenesis of diverticular disease.

To the Editor In the recent Review on colonic diverticulitis by Dr Brown and colleagues, the description of the mechanical pathophysiology of sigmoid diverticula, and specifically the supposed role of the Laplace law, deserves a comment. The law attributed to Pierre-Simon de Laplace (1749-1827) describes the relationship among pressure, surface tension, and curvature in fluid-filled, curved surfaces. In its application to colonic physiology, the Laplace law is commonly expressed as surface tension (T) = pressure (P) × radius (R)... Читать дальше...

This Viewpoint discusses federal student loan cap changes, their implications regarding demographics of medical students and the US physician workforce, and consequences on the US health care system.

This Medical News article discusses changes in peanut allergy incidence after health organizations released guidance for early introduction in infancy.

An unsupervised virtual intervention of tai chi—a gentle movement practice that integrates meditation and controlled breathing—led to improved pain and physical function in people with knee osteoarthritis in a new trial.

Greater nighttime light exposure may increase the risk of cardiovascular disease, according to a recent large study published in JAMA Network Open.