Novedades Bibliográficas

SARS-CoV-2 Vaccines and the Growing Threat of Viral Variants

JAMA - Mar, 02/03/2021 - 02:00
This Viewpoint reviews circulating SARS-CoV-2 genetic variants and mechanisms of immunity by which they might escape coronavirus vaccine-induced protection and proposes 6 measures to address them, including enhanced variant isolation and testing procedures and continued adherence to mask-wearing and other established public health measures.

In-Person Education and the Spread of SARS-CoV-2 Infection

JAMA - Mar, 02/03/2021 - 02:00
This Viewpoint from the CDC summarizes global data about SARS-CoV-2 outbreaks at K-12 schools and emphasizes implementation of community- and school-based policies shown to diminish spread of infection that would allow safer resumption of in-person education in the 2021/22 school year.

Change in Self-Reported Adherence to Nonpharmaceutical Interventions During the COVID-19 Pandemic

JAMA - Mar, 02/03/2021 - 02:00
This study uses national survey data to describe overall and regional trends in adherence to protective behaviors (mask wearing, physical distancing, staying at home, others) among US adults during the COVID-19 pandemic from April to November 2020.

Funding of Pharmaceutical Innovation During and After the COVID-19 Pandemic

JAMA - Mar, 02/03/2021 - 02:00
This Viewpoint considers whether the shift away from private investment toward government funding of drug and vaccine development and commercialization during the coronavirus disease 2019 (COVID-19) pandemic is sustainable, arguing that the same or greater level of public investment will be necessary if drug prices are to remain affordable and if the US wants to maintain its global leadership position.

An EUA for Bamlanivimab—A Monoclonal Antibody for COVID-19

JAMA - Mar, 02/03/2021 - 02:00
This Medical Letter review summarizes the evidence underlying the US Food and Drug Administration’s emergency use authorization of bamlanivimab, an investigational neutralizing IgG1 monoclonal antibody for treatment of COVID-19, including specification of high-risk patient groups eligible for the drug and its dosage and administration.

Global Partnership Aims to Improve Infant HIV Care

JAMA - Mar, 16/02/2021 - 02:00
After stakeholders secured lower prices for a recently approved pediatric HIV medication, an international partnership has urged low- and middle-income countries to procure the drug and make it widely available.

Clinical Trials Overlook Diseases of Low-Income Countries

JAMA - Mar, 16/02/2021 - 02:00
Conditions like respiratory infections, tuberculosis, and enteric infections that disproportionately affect low-income countries are consistently understudied in clinical trials, according to a recent study.

High-Income Countries Have Secured the Bulk of COVID-19 Vaccines

JAMA - Mar, 16/02/2021 - 02:00
High-income countries have reserved more than half of the world’s coronavirus disease 2019 (COVID-19) vaccine doses despite representing just 14% of the world’s population, according to an analysis of publicly available data on premarket purchase agreements.

A Blueprint for Comprehensive Medicaid Reform

JAMA - Mar, 16/02/2021 - 02:00
This Viewpoint proposes broad principles to guide Medicaid reform as a means to advance health equity, including stabilization of its funding and coverage; coordination of its infrastructure; alignment of health care and social spending at the point of care; and a value-based approach to benefits.

Declining Life Expectancy in the United States—The Need for Social Policy as Health Policy

JAMA - Mar, 16/02/2021 - 02:00
This Viewpoint reviews the social and economic drivers of declines in longevity in the US, especially among lower socioeconomic status groups, and proposes policy options for the Biden-Harris administration to mitigate the trend, including an increase in the federally mandated minimum wage.

JAMA

JAMA - Mar, 16/02/2021 - 02:00

Diagnosis and Treatment of Metastatic Colorectal Cancer

JAMA - Mar, 16/02/2021 - 02:00
This narrative review summarizes treatment options for patients with unresectable metastatic colorectal cancer, focusing on the importance of genomic profiling to identify KRAS/NRAS/BRAF variants to guide immunotherapy.

Enjoy the Vase—Everything Changes

JAMA - Mar, 16/02/2021 - 02:00
In this narrative medicine essay, a psychiatrist finally at peace after his wife's death to cancer learns that his prostate-specific antigen levels have begun to rise, reminding him to embrace uncertainty, a loss of control, and change.

Hospital Vigil

JAMA - Mar, 16/02/2021 - 02:00
While doctors operate, striving to save your life, I walk a windowless corridor—no clocks, surely past midnight—find the neurosurgery waiting room, open the door and stop, ambushed by aromas of Sunday dinner. A family eats, rosary beads slid wordlessly, chairs and loveseats pulled around a table spread with fried chicken in a bucket, quarts of slaw, baked beans, mashed potatoes. Plastic cutlery and napkins sealed in packets like surgical instruments. A stranger offers me a paper plate, blank as a communion wafer, inviting me to sit down with them, break bread, pray this picnic won’t become a wake.

Patient Information: Lateral Internal Sphincterotomy

JAMA - Mar, 16/02/2021 - 02:00
This JAMA Patient Page explains lateral internal sphincterotomy, a surgical procedure used for treatment of anal fissures unresponsive to supportive or medical therapy.

Effect of High-Intensity Strength Training on Pain From Knee Osteoarthritis

JAMA - Mar, 16/02/2021 - 02:00
This randomized trial compares the effects of high- vs low-intensity strength training vs control on 18-mo knee pain and knee joint compressive force among adults with knee pain and radiographic evidence of osteoarthritis.

Associations of Maternal Cardiovascular Health in Pregnancy With Offspring Cardiovascular Health in Early Adolescence

JAMA - Mar, 16/02/2021 - 02:00
This international cohort study examines associations between the cardiovascular (CV) health of pregnant women (defined by 5 CV risk factors) and CV health of their offspring at ages 10 to 14 years.

Geographic Differences in Uncontrolled Chronic Medical Conditions—Reply

JAMA - Mar, 16/02/2021 - 02:00
In Reply Dr Tompkins and colleagues suggest additional analyses to clarify the relationship between moving and chronic medical conditions in reference to our recent publication. We would first emphasize that our study does not argue that there is a relationship between moving itself and the prevalence of uncontrolled chronic conditions. Rather, our study sought to estimate the association between changes in individuals’ likelihood of an uncontrolled chronic condition after moving and the difference in the prevalence of the uncontrolled chronic condition between movers’ destination vs origin zip code. Conceptually, we compared changes in chronic condition control among people from the same zip code who subsequently moved to separate zip codes with different rates of chronic condition control, after adjusting for secular trends in outcomes among nonmovers from their zip code (eFigure 2 in the Supplement). The primary analysis accounted for baseline differences in chronic condition control associated with moving itself by including patient-specific fixed effects. The primary analysis also accounted for changes in chronic condition control over time associated with the time since each person moved by including quarter-years since moving as fixed effects.

The Advantages of Medicare Advantage—Reply

JAMA - Mar, 16/02/2021 - 02:00
In Reply Even though I agree with Dr Metz that a key criterion of health care reform is to provide “better care to more people for less money,” this should not be the only factor considered when choosing a reform strategy. In the US, many people value choice and the avoidance of disruption of familiar forms of health care coverage.

Wound Dressings for Obese Women After Cesarean Delivery—Reply

JAMA - Mar, 16/02/2021 - 02:00
In Reply Drs Vo and Richards express concerns about the difference in duration of the prophylactic negative pressure wound therapy device vs standard wound dressing in our recent study involving obese women after cesarean delivery. As a pragmatic trial, our study compared effects of typical use of prophylactic negative pressure wound therapy and standard wound dressing. The average duration of use of prophylactic negative pressure wound therapy was 4 days, which is within the 2 to 7 days recommended by the manufacturer. Similarly, consistent with practice in most clinical settings in the US, the duration of standard wound dressing was 24 to 48 hours, and new dressings were not placed after the initial dressing was removed, unless there was a complication such as wound dehiscence. Therefore, the differences in duration of prophylactic negative pressure wound therapy and standard wound dressing in the trial were by design and do not represent confounding.
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