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This Viewpoint discusses enrollment in Medicare Advantage vs traditional Medicare among older adults and common reasons for plan disenrollment, including the lack of in-network physicians and hospitals.

ImportanceCalcific aortic stenosis (AS) restricts the aortic valve opening during systole due to calcification and fibrosis of either a congenital bicuspid or a normal trileaflet aortic valve. In the US, AS affects 1% to 2% of adults older than 65 years and approximately 12% of adults older than 75 years. Worldwide, AS leads to more than 100 000 deaths annually.ObservationsCalcific AS is characterized

Two studies reveal high transmissibility and lethality of the viral isolate in animal models, and hint at potential drug susceptibility — but further analysis and ongoing surveillance of infections will be critical for public health.

### What you need to know James is a 16 year old boy who lives in a residential (children’s) home. Over the past two months, he has regularly gone missing, returning with new clothes and a new smartphone and laptop. He has been dropped off by different cars late at night. His reluctance to offer explanations for his absences and new possessions raised concerns among care workers. He presents to the

### What you need to know Child abuse and neglect, collectively known as maltreatment, is common, and most healthcare providers who care for children will encounter some form of maltreatment in their practice.1 Common presentations include physical abuse, sexual abuse and commercial sexual exploitation of children, and neglect. In this article, we make recommendations for frontline healthcare providers

Helen Jackson gently asked patients who arrived at the clinic where she practised in Malé, the capital of the Maldives, “Haalu kihineh? Rangalhu tha?”—“How are you? Are you okay?” Primary care is held in low esteem in this South Asian island state, and patients often arrived at the capital’s dedicated pain clinic hoping to be seen by a specialist, rather than by Jackson, a British GP. They also arrived

Donald Trump is the new US president after an ill tempered campaign that saw abortion dominate on the Democratic side but healthcare a minor part of the overall election discourse. Joanne Silberner reports on the medical issues that were debated—and what this may bode for the new president’s agenda The route to the US presidency this election season was a wild ride, marked by a relatively last minute

Standardising practice can improve identification and reduce bias Even for the most experienced healthcare providers, recognising and evaluating suspected child maltreatment or exploitation is challenging. The pressure to make the correct diagnosis is extremely high. Failing to recognise maltreatment can result in the child experiencing severe harm or even death. Conversely, incorrect diagnoses of

Ike Anya talks to Kathy Oxtoby about how he realised his dream of having a published memoir When Ike Anya was working his way through medical training in Nigeria his grandmother reassured him, “Everything worthwhile is achieved small by small.” Some 30 years later, Anya chose that saying as the title of his memoir. “You become a doctor ‘small by small.’ This Nigerian expression is also a lovely way

Tolu Oni and colleagues argue that building healthy low carbon transport infrastructure in Africa’s rapidly growing cities requires addressing historical contexts, confronting power imbalances, and claiming transport as a social good Africa is undergoing rapid urbanisation while facing growing climate vulnerabilities and a rising burden of non-communicable diseases. With global urban growth expected

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A gallery of portraits of prominent alumnae of color at Harvard Medical School provides inspiration for diverse current students and makes past sexist practices visible to all.

In this episode of Sharp Scratch, the panel got together to discuss the many reasons why someone might take time out of medical school. They reflected on how decisions to take time out are often viewed negatively by others, and why taking time out can be beneficial, regardless of the reason behind it. In this episode, the panel, Éabha and Nat, were joined by Kate Owen, who is director of medical studies

Academic norms include: preservation of academic autonomy; integrity in academic practices; a priori formulation of hypotheses and publication of protocols; the use of appropriate methods by which evidence is obtained; the use of appropriate methods for interpreting the accumulated knowledge so obtained; the need to take heed of the possible consequences, both intended and unintended, of research;

BackgroundTransfusion-dependent β-thalassaemia (TDT) is a severe disease, resulting in lifelong blood transfusions, iron overload, and associated complications. Betibeglogene autotemcel (beti-cel) gene therapy uses autologous haematopoietic stem and progenitor cells (HSPCs) transduced with BB305 lentiviral vector to enable transfusion independence. MethodsHGB-212 was a non-randomised, multicentre,

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A study based in the United Kingdom reports that, in general, most women between the ages of 15 and 39 years who have survived a cancer diagnosis are at low risk for pregnancy complications later in their lives. The study appears in The Lancet Oncology (doi:10.1016/S1470-2045(24)00269-9). According to the study authors, limited data are available on the risks of obstetric complications among survivors

“While it’s been known for some time in the surgical literature that bilateral mastectomy does not impact mortality, this study more clearly confirms that through large sample sizes, length of prospective follow-up, and thoughtful subgroup analysis.” —Monique Gary, DO Although rates of contralateral prophylactic mastectomy and bilateral mastectomy are increasing among women with unilateral sporadic

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BackgroundThe Human Development Index (HDI)—a composite metric encompassing a population's life expectancy, education, and income—is used widely for assessing and comparing human development and wellbeing at the country level, but does not account for within-country inequality. In this study of the USA, we aimed to adapt the HDI framework to measure the HDI at an individual level to examine disparities

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BackgroundThe loss of corneal epithelial stem cells from the limbus at the edge of the cornea has severe consequences for vision, with the pathological manifestations of a limbal stem-cell deficiency (LSCD) difficult to treat. Here, to the best of our knowledge, we report the world's first use of corneal epithelial cell sheets derived from human induced pluripotent stem cells (iPSCs) to treat LSCD

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Experiential evidence must be open to scrutiny and criticism The literature on development of clinical guidelines generally accepts that patients and carers should be involved in the process.123 Patients contribute subjective and practical knowledge of a condition, including what it feels like, what challenges it poses to living a productive and fulfilling life, and how to manage symptoms and flare-ups

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Hickey M, Hunter MS, Crandall CJ, et al. Reflections on The Lancet menopause Series. Lancet 2024; 404: 1307–08—In this Correspondence, the order of the author list and Hadine Joffe's name were incorrect. These corrections have been made to the online version as of Nov 7, 2024.

Section snippets ContributorsWe were all involved in the patient's care. KN conceived the paper and drafted the manuscript. All the authors reviewed, edited, and approved the final manuscript. Written consent for publication was obtained from the patient. Declaration of interestsWe declare no competing interests.

This Medical News article discusses the first high-level meeting on antimicrobial resistance at the United Nations since 2016 and a new report on the global burden of bacterial antimicrobial resistance.

This Medical News article is an interview with National Academy of Sciences President Marcia McNutt, PhD, and JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, about responsible use of generative AI for scientific research.

Objective To investigate the association between sodium-glucose cotransporter-2 (SGLT-2) inhibitor use and risk of all cause mortality among patients with heart failure with reduced ejection fraction. Design Linked database study. Setting National registers in Denmark, July 2020 to June 2023. Participants Patients with heart failure, aged ≥45 years, with left ventricular ejection fraction ≤40%. Main

Witnessing a postmortem examination can be markedly different from undertaking a dissection, and may be more distressing. Medical students should receive a detailed brief about the technical practice of a postmortem examination before viewing one, writes Annie Graham “Have you ever seen a dead body?” This was the only question I was asked by the autopsy technician before witnessing my first postmortem

Abortion bans or restrictions in US states are endangering all women, including those with pregnancies that are not viable or are actively harming their health, writes Maryl Sackeim On 24 June 2022, the Supreme Court of the United States overturned Roe v Wade and revoked the constitutional right to abortion. Following the Dobbs decision, control of abortion policies was returned to individual states

The UK is making progress in developing cancer vaccines, but there are still challenges ahead, Chris Baraniuk reports The UK is on its way to becoming a hotbed of cancer vaccine trials. In May this year,1 it emerged that 30 British hospitals had signed up to be part of the Cancer Vaccine Launch Pad,2 a scheme to enrol NHS patients in messenger RNA (mRNA) cancer vaccine trials. Just three months later

Drawing inferences from observational data with possible confounding Heart failure is increasing in prevalence and is a major cause of morbidity and mortality worldwide,1 with prevalence ranging from 1% to 3% of the general adult population in high income countries.1 Limited data from low and middle income countries suggest high heart failure disease burden.23 Heart failure with reduced ejection fraction

New study reports protective effect among people with type 2 diabetes Kidney stones and the systemic conditions associated with them have a major impact on health and the economy in the US and worldwide.12 In recent years, the prevalence of kidney stones has increased in parallel with the epidemics of obesity and metabolic syndrome, as well as cardiorenal disease. Since 1988, when the US Food and Drug