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Decline in US Overdose Deaths May Be Tied to Fentanyl Disruption. 美国过量死亡人数下降可能与芬太尼中断有关。
Pub Date : 2026-01-23 DOI: 10.1001/jama.2025.23028
Samantha Anderer
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引用次数: 0
Alcohol-Related Hospitalizations Stabilize, but Deaths and Costs Rise. 与酒精相关的住院治疗稳定,但死亡人数和费用上升。
Pub Date : 2026-01-23 DOI: 10.1001/jama.2025.23030
Samantha Anderer
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引用次数: 0
Higher Food Preservative Intake Linked With Type 2 Diabetes. 高食物防腐剂摄入量与2型糖尿病有关
Pub Date : 2026-01-23 DOI: 10.1001/jama.2025.23033
Samantha Anderer
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引用次数: 0
Limited Evidence Supporting Melatonin Use in Most Children. 支持大多数儿童使用褪黑激素的证据有限。
Pub Date : 2026-01-23 DOI: 10.1001/jama.2025.23029
Samantha Anderer
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引用次数: 0
Oral Nalbuphine in Idiopathic Pulmonary Fibrosis-Associated Cough: Research Summary. 口服纳布啡治疗特发性肺纤维化相关性咳嗽:研究综述。
Pub Date : 2026-01-22 DOI: 10.1001/jama.2025.26285
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引用次数: 0
Prevention of Pregnancy Complications in Polycystic Ovary Syndrome With Myo-inositol Supplementation. 补充肌醇预防多囊卵巢综合征妊娠并发症。
Pub Date : 2026-01-22 DOI: 10.1001/jama.2025.22968
Po-Yu Huang,Tieh-Cheng Fu,Ching-Mao Chang
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引用次数: 0
Prevention of Pregnancy Complications in Polycystic Ovary Syndrome With Myo-inositol Supplementation-Reply. 补充肌醇预防多囊卵巢综合征妊娠并发症的研究
Pub Date : 2026-01-22 DOI: 10.1001/jama.2025.22971
Anne W T van der Wel,Joop S E Laven,Bas B van Rijn
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引用次数: 0
Blood-Based Biomarkers for Alzheimer Disease: Preventing Unintended Consequences. 阿尔茨海默病的血液生物标志物:预防意外后果。
Pub Date : 2026-01-22 DOI: 10.1001/jama.2025.26049
Heather E Whitson,Nicole R Fowler,Michelle M Mielke
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引用次数: 0
Oral Nalbuphine in Idiopathic Pulmonary Fibrosis-Associated Cough: The CORAL Randomized Clinical Trial. 口服纳布啡治疗特发性肺纤维化相关性咳嗽:CORAL随机临床试验
Pub Date : 2026-01-22 DOI: 10.1001/jama.2025.26179
Philip L Molyneaux,Nesrin Mogulkoc,Hakan Gunen,Anna Doboszynska,Michael Kreuter,Blue Neustifter,Vandana Mathur,James Cassella,
ImportanceFor patients with idiopathic pulmonary fibrosis (IPF), cough impairs quality of life; effective treatments for IPF-associated cough are needed.ObjectiveTo determine if nalbuphine extended release (ER), a κ opioid receptor agonist and μ-opioid receptor antagonist, decreases cough compared with placebo in patients with IPF-associated cough.Design, Setting, and ParticipantsIn this randomized, double-blind, placebo-controlled phase 2b trial conducted at 52 sites in 10 countries, patients with IPF, chronic cough for at least 8 weeks, and a Cough Severity Numerical Rating Scale (0, no cough; 10, worst possible cough) score of 4 or higher were enrolled from February 2024 to February 2025, with last follow-up in April 2025. Statistical analyses were conducted from May to August 2025.InterventionPatients were randomized 1:1:1:1 to receive nalbuphine ER at doses of 27 mg, 54 mg, or 108 mg or placebo twice daily for 6 weeks.Main Outcomes and MeasuresThe primary outcome was the relative change from baseline in 24-hour cough frequency (coughs/h), measured with a digital cough monitor, for nalbuphine ER compared with placebo at week 6. The key secondary outcome was the relative change from baseline in the patient-reported cough frequency (Evaluating Respiratory Symptoms in IPF cough subscale; scores range from 0-4, lower scores indicate lesser cough frequency) at week 6.ResultsOf the 223 patients screened, 165 were randomized (42, 43, 40, and 40 to receive nalbuphine ER 27 mg, 54 mg, and 108 mg, and placebo, respectively) and 160 were included in the primary analysis (median age, 71 [range, 51-85] years; 28.5% female). The baseline mean (SD) cough count was 28.3 (27.4) coughs/h. In the nalbuphine ER 27 mg, 54 mg, and 108 mg twice-daily groups, the mean relative decrease in the cough count and the absolute decrease in coughs/h were 47.9% (from 24.6 to 11.9; P = .008), 53.4% (from 28.0 to 14.9; P < .001), and 60.2% (from 31.5 to 11.9; P < .001), respectively, compared with placebo (16.9%; from 29.4 to 28.1 coughs/h). For the key secondary outcome of patient-reported cough frequency at week 6, the relative and absolute changes were -31.4% (from 2.3 to 1.5; P = .14), -40.6% (from 2.6 to 1.4; P = .004), and -40.2% (from 2.4 to 1.4; P < .005) in the 27-mg, 54-mg, and 108-mg groups, respectively, compared with -21.9% (from 2.6 to 1.9) with placebo.Conclusions and RelevanceFor patients with IPF-associated chronic cough, all 3 doses of nalbuphine ER reduced objective cough frequency and the 2 higher doses improved patient-reported cough frequency at 6 weeks.Trial RegistrationClinicalTrials.gov Identifier: NCT05964335.
对于特发性肺纤维化(IPF)患者,咳嗽会损害生活质量;需要对ipf相关咳嗽进行有效治疗。目的观察κ阿片受体激动剂和μ阿片受体拮抗剂纳布啡缓释剂(ER)与安慰剂相比是否能减轻ipf相关性咳嗽患者的咳嗽。设计、环境和参与者:在这项随机、双盲、安慰剂对照的2b期试验中,在10个国家的52个地点进行,在2024年2月至2025年2月期间招募了IPF、慢性咳嗽至少8周、咳嗽严重程度数值评定量表(0分,无咳嗽;10分,可能最严重的咳嗽)评分为4分或更高的患者,最后一次随访时间为2025年4月。统计分析时间为2025年5月至8月。干预:患者以1:1:1∶1的比例随机接受纳布啡ER,剂量分别为27mg、54mg、108mg或安慰剂,每天两次,持续6周。主要结果和测量主要结果是在第6周时,用数字咳嗽监测仪测量的纳布啡ER与安慰剂相比,24小时咳嗽频率(咳嗽次数/小时)与基线的相对变化。关键的次要结局是患者报告的咳嗽频率与基线的相对变化(在IPF咳嗽亚量表中评估呼吸道症状;得分范围从0-4分,得分越低表明咳嗽频率越低)。结果在223例筛选的患者中,165例被随机分配(分别为42、43、40和40例接受纳布啡ER 27 mg、54 mg和108 mg以及安慰剂),160例被纳入初步分析(中位年龄71岁[范围,51-85]岁;28.5%为女性)。基线平均(SD)咳嗽次数为28.3(27.4)次/h。纳布啡er27 mg、54 mg和108 mg每日2次组咳嗽次数和绝对次数平均相对减少47.9% (24.6 ~ 11.9);008), 53.4%(从28.0到14.9;P <。P < 0.001), 60.2%(从31.5到11.9;0.001),与安慰剂相比(16.9%;从29.4到28.1咳嗽/h)。对于患者报告的第6周咳嗽频率这一关键次要指标,相对和绝对变化为-31.4%(从2.3到1.5;14), -40.6%(从2.6到1.4;P =。004), -40.2%(从2.4到1.4;P <。在27毫克、54毫克和108毫克组中,分别为-21.9%(从2.6到1.9),而安慰剂组为-21.9%。结论和相关性对于ipf相关的慢性咳嗽患者,所有3个剂量的纳布啡ER在6周时都降低了客观咳嗽频率,2个较高剂量的纳布啡ER改善了患者报告的咳嗽频率。临床试验注册号:NCT05964335。
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引用次数: 0
Leading Cancer Deaths in People Younger Than 50 Years. 50岁以下人群癌症死亡率最高
Pub Date : 2026-01-22 DOI: 10.1001/jama.2025.25467
Rebecca L Siegel,Nikita Sandeep Wagle,Ahmedin Jemal
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引用次数: 0
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