Randomized, placebo-controlled trials are widely accepted as the scientific reference standard to determine a causal association between an intervention and an outcome. They are pivotal for product licensure. Although such trials establish safety and efficacy with the assumption that bias has been eliminated, limitations remain. For vaccines, establishing the duration...
Author: Kathleen M. Neuzil
Posted: December 11, 2025, 12:00 am
Among adults 65 years of age or older, a high-dose influenza vaccine did not result in a significantly lower incidence of hospitalization for influenza or pneumonia than a standard-dose vaccine.
Author: Niklas Dyrby Johansen, Daniel Modin, Matthew M. Loiacono, Rebecca C. Harris, Marine Dufournet, Carsten Schade Larsen, Lykke Larsen, Lothar Wiese, Michael Dalager-Pedersen, Brian L. Claggett, Kira Hyldekær Janstrup, Katja Vu Bartholdy, Katrine Feldballe Bernholm, Julie Inge-Marie Helene Borchsenius, Filip Soeskov Davidovski, Lise Witten Davodian, Maria Dons, Lisa Steen Duus, Caroline Espersen, Frederik Holme Fussing, Anne Marie Reimer Jensen, Nino Emanuel Landler, Adam Cadovius Femerling Langhoff, Mats Christian Højbjerg Lassen, Anne Bjerg Nielsen, Camilla Ikast Ottosen, Morten Sengeløv, Kristoffer Grundtvig Skaarup, Scott D. Solomon, Martin J. Landray, Gunnar H. Gislason, Lars Køber, Line Ralfkiaer, Joshua Nealon, Pradeesh Sivapalan, Cyril Jean-Marie Martel, Jens Ulrik Stæhr Jensen, Tor Biering-Sørensen
Posted: December 11, 2025, 12:00 am
In adults 65 to 79 years of age, there appeared to be fewer hospitalizations for influenza or pneumonia with high-dose influenza vaccine than with the standard dose, with a similar incidence of serious adverse events.
Author: Jacobo Pardo-Seco, Carmen Rodríguez-Tenreiro-Sánchez, Iago Giné-Vázquez, Narmeen Mallah, Susana Mirás-Carballal, Marta Piñeiro-Sotelo, Martín Cribeiro-González, Mónica Conde-Pájaro, Juan-Manuel González-Pérez, Irene Rivero-Calle, Xabier Bello, Josefina Lorena Razzini, Ana Dacosta-Urbieta, Antonio Salas, Rebecca C. Harris, Matthew M. Loiacono, Robertus van Aalst, Joan Manel Farre, Marine Dufournet, Niklas Dyrby Johansen, Daniel Modin, Tor Biering-Sørensen, Carmen Durán-Parrondo, Federico Martinón-Torres, the GALFLU Trial Team*
Posted: December 11, 2025, 12:00 am
Artificial intelligence is increasingly being positioned as a tool for transforming rural care delivery, but it must be integrated into the social support network that sustains patients in their homes and communities.
Author: Angelo E. Volandes, Aretha D. Davis, Nathan E. Goldstein
Posted: December 4, 2025, 12:00 am
After 60 years of cogitation about normal-pressure hydrocephalus, the results of a worthy randomized trial that assessed the effects of cerebrospinal fluid (CSF) shunting are now published in the Journal.1 No one seems to want to own idiopathic normal-pressure hydrocephalus. The symptoms are neurologic, the treatment...
Author: Allan H. Ropper
Posted: December 4, 2025, 12:00 am
Idiopathic normal-pressure hydrocephalus typically causes gait, cognitive, and urinary impairment. The diagnosis is aided by a medical evaluation, imaging findings, and tests that predict improvement with CSF shunting.
Author: Mark D. Johnson, Michael A. Williams
Posted: December 4, 2025, 12:00 am
Results from recently published, peer-reviewed studies support the safety and effectiveness of immunizations against Covid-19, RSV, and influenza.
Author: Jake Scott, Michael S. Abers, Harleen K. Marwah, Nicole C. McCann, Eric A. Meyerowitz, Aaron Richterman, Derek F. Fleming, Elise J. Holmes, Leah E. Moat, Sydney G. Redepenning, Emily A. Smith, Clare J. Stoddart, Maria E. Sundaram, Angela K. Ulrich, Christopher Alba, Cory J. Anderson, Meredith K. Arpey, Ethan Borre, Joseph Ladines-Lim, Angela J. Mehr, Katherine Rich, Corey Watts, Nicole E. Basta, Jana Jarolimova, Rochelle P. Walensky, Caitlin M. Dugdale
Posted: December 4, 2025, 12:00 am
In patients with idiopathic normal-pressure hydrocephalus responsive to CSF drainage, shunting improved gait and balance at 3 months, but not cognition or incontinence, and was associated with some procedure-related risks.
Author: Mark G. Luciano, Michael A. Williams, Mark G. Hamilton, Heather L. Katzen, Nickolas A. Dasher, Abhay Moghekar, Jun Hua, Jan Malm, Anders Eklund, Naomi Alpert Abel, Ahmed M. Raslan, Benjamin D. Elder, Jesse J. Savage, Daniel L. Barrow, Kiarash Shahlaie, Hailey Jensen, Thomas J. Zwimpfer, Jessica Wollett, Daniel F. Hanley, Richard Holubkov, the PENS Trial Investigators and the Adult Hydrocephalus Clinical Research Network*
Posted: December 4, 2025, 12:00 am
Twelve former commissioners of the FDA express concern that the agency’s recent moves will undermine a regulatory model designed to ensure vaccine safety, effectiveness, and availability.
Author: Robert M. Califf, Andrew C. von Eschenbach, Michael A. Friedman, Brett P. Giroir, Scott Gottlieb, Margaret A. Hamburg, Jane E. Henney, David A. Kessler, Mark B. McClellan, Stephen M. Ostroff, Norman E. Sharpless, Janet Woodcock
Posted: December 3, 2025, 12:00 am
In high-grade asymptomatic carotid stenosis, addition of stenting to medical therapy led to a lower risk of stroke over a 4-year period. Endarterectomy did not lead to a significant benefit.
Author: Thomas G. Brott, George Howard, Brajesh K. Lal, Jenifer H. Voeks, Tanya N. Turan, Gary S. Roubin, Ronald M. Lazar, Robert D. Brown Jr., John Huston III, Lloyd J. Edwards, Michael Jones, Wayne M. Clark, Ángel Chamorro, Laura Llull, Carlos Mena-Hurtado, Donald Heck, Randolph S. Marshall, Virginia J. Howard, Wesley S. Moore, Kevin M. Barrett, Bart M. Demaerschalk, Navdeep Sangha, Herbert Aronow, Malcolm Foster, W. Charles Sternbergh III, Fayaz Shawl, Giuseppe Lanzino, Joseph Rapp, Hoang S. Tran, Robert Ecker, Ariane Mackey, Vaqar Ali, Curtis Given II, Philip Teal, Vikram S. Kashyap, Dipankar Mukherjee, Mark Harrigan, Scott Silverman, Matthew Koopmann, Virginia G. Wadley, Yu Zhang, J. David Rhodes, Seemant Chaturvedi, James F. Meschia, the CREST-2 Investigators*
Posted: November 21, 2025, 12:00 am
The management of carotid-artery stenosis that has not caused recent symptoms — asymptomatic carotid stenosis — has been controversial. Clinical trials that began more than 30 years ago showed a small benefit of carotid endarterectomy as compared with medical treatment, but improvements in medical prevention of stroke call into question...
Author: Martin M. Brown, Leo H. Bonati
Posted: November 21, 2025, 12:00 am
Sometimes, as patients near the end of life, eliciting and fulfilling a simple wish can lead to acceptance and a peaceful death — a lesson absorbed by a physician during a week of ice cream.
Author: Biren B. Kamdar
Posted: November 20, 2025, 12:00 am
In older patients with frailty who were receiving antihypertensive drugs and had a systolic blood pressure below 130 mm Hg, reducing antihypertensive drugs did not lead to lower all-cause mortality over 4 years than usual care.
Author: Athanase Benetos, Sylvie Gautier, Anne Freminet, Alice Metz, Carlos Labat, Ioannis Georgiopoulos, François Bertin-Hugault, Jean-Baptiste Beuscart, Olivier Hanon, Patrick Karcher, Patrick Manckoundia, Jean-Luc Novella, Abdourahmane Diallo, Eric Vicaut, Patrick Rossignol, the RETREAT-FRAIL Study Group*
Posted: November 20, 2025, 12:00 am
When a patient’s family struggles to grasp what enrolling him in hospice will mean, a physician recognizes the limits of the standard script about hospice care.
Author: Teva D. Brender
Posted: November 13, 2025, 12:00 am
Opioid deprescribing is advised when risks of opioid use outweigh benefits. A tailored, patient-centered plan with gradual dose reduction, monitoring, and support can improve outcomes and reduce harm.
Author: Chung-Wei Christine Lin, Aili V. Langford
Posted: November 6, 2025, 12:00 am
In this episode of NOS, Lisa Rosenbaum and her guests consider the ideals and realities of primary care — and the expectations and misunderstandings that are contributing to its current crisis.
Posted: October 30, 2025, 12:00 am
In this randomized trial, reduction in knee pain at 3 months was similar in participants assigned to home exercise alone and those assigned to home exercise, motivational text messages, and standard physical therapy.
Author: Jeffrey N. Katz, Jamie E. Collins, Leslie Bisson, Morgan H. Jones, James J. Irrgang, Faith Selzer, Clare E. Safran-Norton, Kurt P. Spindler, Heidi Y. Yang, Swastina Shrestha, Kim L. Bennell, James K. Sullivan, Melissa A. Kluczynski, Kaetlyn Arant, Maame Opare-Addo, Jamie L. Huizinga, Zoe Zimmerman, Derek Sople, Peter Tonsoline, Madhuri Kale, William M. Wind Jr., Antonia F. Chen, Michael Freitas, Bryson Lesniak, Kelly Jordan, Elizabeth G. Matzkin, Courtney Dawson, Lutul Farrow, Volker Musahl, John J. Leddy, Scott D. Martin, Elena Losina
Posted: October 30, 2025, 12:00 am
Use of prior authorization in traditional Medicare has historically been limited. But in June 2025, CMS announced the WISeR model, which will expand technology-enabled prior authorization.
Author: Michael Liu, Kushal T. Kadakia, Rishi K. Wadhera
Posted: October 16, 2025, 12:00 am
Female-pattern hair loss increases with age and varies according to age at onset and hormone status. Treatments include minoxidil, antiandrogens, and nondrug options such as platelet-rich plasma or light or laser therapy.
Author: Elise A. Olsen
Posted: October 16, 2025, 12:00 am
In rural South Africa, home-based hypertension care — delivered by community health workers and supported by remote nurses — led to a lower mean systolic blood pressure than clinic-based care.
Author: Mark J. Siedner, Nombulelo Magula, Lusanda Mazibuko, Nsika Sithole, Alison Castle, Siyabonga Nxumalo, Thabang Manyaapelo, Shafika Abrahams-Gessel, Dickman Gareta, Joanna Orne-Gliemann, Kathy Baisley, Max Bachmann, Thomas A. Gaziano
Posted: October 2, 2025, 12:00 am