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JAMA
American Medical Association
JAMA

American Medical Association

0098-7484

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    The Dreaded "twindemic" of Influenza and COVID-19 Has Not Yet Materialized - Might This Be the Year?

    Rubin R
    2页
    查看更多>>摘要：Epidemiologist Michael Osterholm， PhD， MPH， likens predicting a flu season’s severity to forecasting a hurricane’s strength and its exact path 5 days before it makes landfall。With influenza， as with hurricanes， “[w]e have to expect the unexpected，” Osterholm， founder and director of the Center for Infectious Disease Research and Policy at the University of Minnesota， explained in an interview with JAMA。 “We have to plan as if this could be a severe flu season。”Some experts， including National Institute of Allergy and Infectious Diseases Director Anthony Fauci， MD， have pointed to Australia’s 2022 flu season—in the temperate regions of the Southern Hemisphere， flu season typically runs from April to September—as a warning about what could be in store for the US。 Influenza cases in 2022 peaked earlier and higher in Australia than in any of the previous 5 flu seasons， according to preliminary data in a government report， and children and teens were more likely to have been affected than adults。Despite the high number of cases， the impact of the 2022 flu season in Australia， as measured by the number of patients hospitalized or patients unable to go to work or school as usual， was low to moderate， the government report noted。 The number of patients hospitalized with influenza in Australia peaked early but not higher than in the previous 5 flu seasons。Forecasting the severity of the US flu season based on the Australian flu season preceding it “is a fair thing to say but is never a 1-to-1 comparison，” virologist Richard Webby， PhD， director of the World Health Organization Collaborating Centre for Studies on the Ecology of Influenza in Animals and Birds， cautioned in an interview with JAMA。 “I do think we’re likely going to have a big flu season，” Webby， a faculty member at St Jude Children’s Research Hospital in Memphis， added。
      原文链接:
    • NSTL
    • Amer Medical Assoc

    Estimate: 10.5 Million Children Lost a Parent, Caregiver to COVID-19

    Deanna Belli
    1页
    查看更多>>摘要：About 10。5 million children worldwide experienced COVID-19–associated loss of parents and caregivers through May 1， 2022， according to estimates based on World Health Organization (WHO) data。 COVID-19 orphaned an estimated 7。5 million of those children。Writing in JAMA Pediatrics， researchers cautioned that the consequences for bereaved children can be “devastating，” including traumatic grief， abuse， mental health problems， and poor educational and health outcomes。Using excess deaths data from WHO， The Economist， and the Institute for Health Metrics and Evaluation (IHME)， researchers estimated the number of bereft children in every country to measure COVID-19’s effect on orphanhood and caregiver loss。 WHO data are more conservative than findings from IHME and The Economist， the study authors explained。The WHO regions of Africa and Southeast Asia had more children affected by orphanhood and caregiver loss than had the Americas， Eastern Mediterranean， European， and Western Pacific regions through May 1， 2022。 Countries with the highest numbers of bereaved children in the Southeast Asia WHO region included Bangladesh， India， Indonesia， Myanmar， and Nepal。 In Africa， the Democratic Republic of Congo， Ethiopia， Kenya， Nigeria， and South Africa were among those with the most bereaved children， the study reported。“Effective， caring action to protect children from immediate and long-term harms of COVID-19 is an investment in the future and a public health imperative，” the researchers concluded。
      原文链接:
    • NSTL
    • Amer Medical Assoc

    Rotavirus Leads Global Diarrhea Hospitalizations Among Young Children

    Deanna Belli
    1页
    查看更多>>摘要：Rotavirus was the leading cause of diarrhea requiring hospitalization among young children in 28 low- and middle-income countries despite the introduction of rotavirus vaccine， according to a study published in BMJ Global Health。Stool specimens were randomly selected from children with diarrhea and tested for 16 causes。 The samples came from 5465 children younger than 5 years who were hospitalized with diarrhea in a surveillance network of 33 hospitals in 2017 and 2018。
      原文链接:
    • NSTL
    • Amer Medical Assoc

    An Association Between Heavy Rainfall and HIV in Sub-Saharan Africa

    Deanna Belli
    1页
    查看更多>>摘要：Underdeveloped regions such as sub-Saharan Africa are disproportionately affected by both climate change and HIV。 Now， researchers have used survey data collected over 12 years in 21 countries in sub-Saharan Africa to explore the associations between HIV infections and heavy rainfall。Experiencing heavy rainfall was associated with higher odds of having HIV， sexually transmitted infections， and more sexual partners in a study involving 288 333 survey respondents—about 60% of them women—published in JAMA Network Open。
      原文链接:
    • NSTL
    • Amer Medical Assoc

    Global Health Care Facilities Lack Basic Hygiene Services

    Deanna Belli
    2页
    查看更多>>摘要：Little more than half of health care facilities worldwide meet the criteria for basic hand hygiene services， according to a recent report。Basic service is defined as having functional hand hygiene facilities with water and soap， alcohol-based hand rub， or both available where patients receive care and are close to toilets at health care facilities， according to the August 2022 report from the World Health Organization (WHO)/United Nations Children’s Fund (UNICEF) Joint Monitoring Programme for Water Supply， Sanitation and Hygiene。
      原文链接:
    • NSTL
    • Amer Medical Assoc

    New Breast Implant Safety Concerns

    Rita Rubin
    1页
    查看更多>>摘要：Reports of squamous cell carcinomas and various lymphomas in scar tissue around breast implants spurred the FDA to issue a recent safety alert。The risks appear to be rare， the agency said after conducting an initial review， noting that as of September 1， 2022， it had received 10 medical device reports about squamous cell carcinoma and 12 about various lymphomas related to breast implants that don’t necessarily represent unique cases。 A preliminary review of the published literature revealed fewer than 20 cases of the former and fewer than 30 cases of the latter， the FDA said。
      原文链接:
    • NSTL
    • Amer Medical Assoc

    Another Recall Involving Philips Positive Airway Pressure Machines

    Rita Rubin
    1页
    查看更多>>摘要：Philips Respironics has recalled more than 17 million masks used with bilevel positive airway pressure and continuous positive airway pressure machines because they contain magnets that could affect a wide range of implanted metallic medical devices， resulting in injury or death， the FDA recently announced。The Philips positive airway devices are also known as bilevel PAP， BiPAP， BPAP， or CPAP machines and are used by people with obstructive sleep apnea， respiratory insufficiency， or respiratory failure。 The masks used with them feature magnetic headgear clips to keep them in place。 The recall involves 5 mask types: the DreamWisp， DreamWear， Amara View， Wisp， and Wisp Youth masks。
      原文链接:
    • NSTL
    • Amer Medical Assoc

    Partnership Focuses on Neurodegenerative Diseases

    Rita Rubin
    2页
    查看更多>>摘要：The FDA and the National Institutes of Health (NIH) have launched a public-private partnership to advance the understanding of and accelerate the development of treatments for rare neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS)。The 2 federal agencies are partnering with the Critical Path Institute (C-PATH)—an independent nonprofit， public-private partnership created in 2005 under the auspices of the FDA’s Critical Path Initiative program—on the Critical Path for Rare Neurodegenerative Diseases。
      原文链接:
    • NSTL
    • Amer Medical Assoc

    Moving to More Evidence-Based Primary Care Encounters: A Farewell to the Review of Systems

    Barry M.JTseng C.-W
    2页
    查看更多>>摘要：In the practice of medicine， what is documented in a patient’s medical record helps ensure continuity of care， facilitate coordination between clinicians， support quality improvement and research， can be useful in medical-legal disputes， and， increasingly， makes medical care more transparent to patients。 However， over the years， documentation has been increasingly driven by billing and coding requirements。 One example is the review of systems (ROS)。 For decades， clinicians were reimbursed at a higher level by the Centers for Medicare & Medicaid Services (CMS) if visits included an ROS。 For example， billing for a “comprehensive” visit was allowed if， among other required components， a “complete ROS” with inquiries about symptoms from at least 10 of 14 organ systems was documented。 These financial incentives linked tradition-based care with reimbursement-based care， which could be considered to be care documented largely for billing requirements。
      原文链接:
    • NSTL
    • Amer Medical Assoc

    Improving Prior Authorization in Medicare Advantage

    Anderson K.EDarden MJain A
    2页
    查看更多>>摘要：Prior authorization is a form of utilization managements whereby a clinician must receive insurer approval prior to rendering medical service。 Medicare Advantage (MA) insurers， which now cover more than 48% of Medicare beneficiaries， commonly use prior authorization to manage spending and use for their enrollees。 An estimated 99% of MA plans require prior authorization for at least some medical services。1 The use of prior authorization is also increasing in traditional Medicare。 Historically， traditional Medicare did not use prior authorization requirements， but with rising health care costs， the Centers for Medicare & Medicaid Services (CMS) is reevaluating this policy and has introduced prior authorization for a small number of services (eg， home health) and certain surgical procedures (eg， anterior cervical fusion surgery)。
      原文链接:
    • NSTL
    • Amer Medical Assoc