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1.
JAMA ; 2024 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-38833246

RESUMEN

Importance: Falls are the leading cause of injury-related morbidity and mortality among older adults in the US. In 2018, 27.5% of community-dwelling adults 65 years or older reported at least 1 fall in the past year and 10.2% reported a fall-related injury. In 2021, an estimated 38 742 deaths resulted from fall-related injuries. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the effectiveness and harms of primary care-relevant interventions to prevent falls and fall-related morbidity and mortality in community-dwelling adults 65 years or older. Population: Community-dwelling adults 65 years or older at increased risk of falls. Evidence Assessment: The USPSTF concludes with moderate certainty that exercise interventions provide a moderate net benefit in preventing falls and fall-related morbidity in older adults at increased risk for falls. The USPSTF concludes with moderate certainty that multifactorial interventions provide a small net benefit in preventing falls and fall-related morbidity in older adults at increased risk for falls. Recommendation: The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. (B recommendation) The USPSTF recommends that clinicians individualize the decision to offer multifactorial interventions to prevent falls to community-dwelling adults 65 years or older who are at increased risk for falls. Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small. When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior falls, presence of comorbid medical conditions, and the patient's values and preferences. (C recommendation).

2.
JAMA ; 2024 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-38888912

RESUMEN

Importance: Approximately 19.7% of children and adolescents aged 2 to 19 years in the US have a body mass index (BMI) at or above the 95th percentile for age and sex, based on Centers for Disease Control and Prevention growth charts from 2000. The prevalence of high BMI increases with age and is higher among Hispanic/Latino, Native American/Alaska Native, and non-Hispanic Black children and adolescents and children from lower-income families. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the evidence on interventions (behavioral counseling and pharmacotherapy) for weight loss or weight management in children and adolescents that can be provided in or referred from a primary care setting. Population: Children and adolescents 6 years or older. Evidence Assessment: The USPSTF concludes with moderate certainty that providing or referring children and adolescents 6 years or older with a high BMI to comprehensive, intensive behavioral interventions has a moderate net benefit. Recommendation: The USPSTF recommends that clinicians provide or refer children and adolescents 6 years or older with a high BMI (≥95th percentile for age and sex) to comprehensive, intensive behavioral interventions. (B recommendation).

3.
JAMA ; 331(22): 1918-1930, 2024 06 11.
Artículo en Inglés | MEDLINE | ID: mdl-38687503

RESUMEN

Importance: Among all US women, breast cancer is the second most common cancer and the second most common cause of cancer death. In 2023, an estimated 43 170 women died of breast cancer. Non-Hispanic White women have the highest incidence of breast cancer and non-Hispanic Black women have the highest mortality rate. Objective: The USPSTF commissioned a systematic review to evaluate the comparative effectiveness of different mammography-based breast cancer screening strategies by age to start and stop screening, screening interval, modality, use of supplemental imaging, or personalization of screening for breast cancer on the incidence of and progression to advanced breast cancer, breast cancer morbidity, and breast cancer-specific or all-cause mortality, and collaborative modeling studies to complement the evidence from the review. Population: Cisgender women and all other persons assigned female at birth aged 40 years or older at average risk of breast cancer. Evidence Assessment: The USPSTF concludes with moderate certainty that biennial screening mammography in women aged 40 to 74 years has a moderate net benefit. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of screening mammography in women 75 years or older and the balance of benefits and harms of supplemental screening for breast cancer with breast ultrasound or magnetic resonance imaging (MRI), regardless of breast density. Recommendation: The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of supplemental screening for breast cancer using breast ultrasonography or MRI in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement).


Asunto(s)
Neoplasias de la Mama , Detección Precoz del Cáncer , Mamografía , Humanos , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/prevención & control , Neoplasias de la Mama/diagnóstico por imagen , Femenino , Persona de Mediana Edad , Anciano , Adulto , Imagen por Resonancia Magnética , Factores de Edad , Ultrasonografía Mamaria , Estados Unidos , Tamizaje Masivo
4.
JAMA ; 331(11): 951-958, 2024 03 19.
Artículo en Inglés | MEDLINE | ID: mdl-38502069

RESUMEN

Importance: Child maltreatment, which includes child abuse and neglect, can have profound effects on health, development, survival, and well-being throughout childhood and adulthood. The prevalence of child maltreatment in the US is uncertain and likely underestimated. In 2021, an estimated 600 000 children were identified by Child Protective Services as experiencing abuse or neglect and an estimated 1820 children died of abuse and neglect. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate benefits and harms of primary care-feasible or referable behavioral counseling interventions to prevent child maltreatment in children and adolescents younger than 18 years without signs or symptoms of maltreatment. Population: Children and adolescents younger than 18 years who do not have signs or symptoms of or known exposure to maltreatment. Evidence Assessment: The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of primary care interventions to prevent child maltreatment in children and adolescents younger than 18 years without signs or symptoms of or known exposure to maltreatment. Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of primary care interventions to prevent child maltreatment. (I statement).


Asunto(s)
Maltrato a los Niños , Atención Primaria de Salud , Adolescente , Niño , Humanos , Comités Consultivos , Terapia Conductista , Maltrato a los Niños/mortalidad , Maltrato a los Niños/prevención & control , Servicios de Protección Infantil/estadística & datos numéricos , Atención Primaria de Salud/métodos , Derivación y Consulta , Medición de Riesgo , Estados Unidos/epidemiología
5.
JAMA ; 331(4): 329-334, 2024 01 23.
Artículo en Inglés | MEDLINE | ID: mdl-38261037

RESUMEN

Importance: Speech and language delays and disorders can pose significant problems for children and their families. Evidence suggests that school-aged children with speech or language delays may be at increased risk of learning and literacy disabilities, including difficulties with reading and writing. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate benefits and harms of screening for speech and language delay and disorders in children 5 years or younger. Population: Asymptomatic children 5 years or younger whose parents or clinicians do not have specific concerns about their speech, language, hearing, or development. Evidence Assessment: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for speech and language delay and disorders in children who do not present with signs or symptoms or parent/caregiver concerns. Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for speech and language delay and disorders in children 5 years or younger without signs or symptoms. (I statement).


Asunto(s)
Trastornos del Desarrollo del Lenguaje , Tamizaje Masivo , Niño , Humanos , Comités Consultivos , Trastornos del Desarrollo del Lenguaje/diagnóstico , Preescolar , Enfermedades Asintomáticas
6.
JAMA ; 330(17): 1666-1673, 2023 11 07.
Artículo en Inglés | MEDLINE | ID: mdl-37934215

RESUMEN

Importance: Oral health is fundamental to health and well-being across the lifespan. Oral health conditions affect the daily lives of school-age children and adolescents, leading to loss of more than 51 million school hours every year. Untreated oral health conditions in children can lead to serious infections and affect growth, development, and quality of life. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate screening and preventive interventions for oral health conditions in children and adolescents aged 5 to 17 years. Population: Asymptomatic children and adolescents aged 5 to 17 years. Evidence Assessment: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for oral health conditions (eg, dental caries) performed by primary care clinicians in asymptomatic children and adolescents aged 5 to 17 years. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions for oral health conditions (eg, dental caries) performed by primary care clinicians in asymptomatic children and adolescents aged 5 to 17 years. Recommendations: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening performed by primary care clinicians for oral health conditions, including dental caries, in children and adolescents aged 5 to 17 years. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions performed by primary care clinicians for oral health conditions, including dental caries, in children and adolescents aged 5 to 17 years. (I statement).


Asunto(s)
Caries Dental , Salud Bucal , Adolescente , Niño , Humanos , Comités Consultivos , Caries Dental/diagnóstico , Caries Dental/prevención & control , Calidad de Vida , Tamizaje Masivo , Preescolar , Enfermedades Asintomáticas , Atención Primaria de Salud , Enfermedades Estomatognáticas/diagnóstico , Enfermedades Estomatognáticas/prevención & control , Medición de Riesgo , Estados Unidos/epidemiología
7.
JAMA ; 330(18): 1773-1779, 2023 11 14.
Artículo en Inglés | MEDLINE | ID: mdl-37934473

RESUMEN

Importance: Oral health is fundamental to health and well-being across the life span. Dental caries (cavities) and periodontal disease (gum disease) are common and often untreated oral health conditions that affect eating, speaking, learning, smiling, and employment potential. Untreated oral health conditions can lead to tooth loss, irreversible tooth damage, and other serious adverse health outcomes. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate screening and preventive interventions for oral health conditions in adults. Population: Asymptomatic adults 18 years or older. Evidence Assessment: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for oral health conditions (eg, dental caries or periodontal disease) performed by primary care clinicians in asymptomatic adults. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions for oral health conditions (eg, dental caries or periodontal disease) performed by primary care clinicians in asymptomatic adults. Recommendations: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening performed by primary care clinicians for oral health conditions, including dental caries or periodontal-related disease, in adults. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions performed by primary care clinicians for oral health conditions, including dental caries or periodontal-related disease, in adults. (I statement).


Asunto(s)
Caries Dental , Enfermedades Periodontales , Adulto , Humanos , Tamizaje Masivo/efectos adversos , Salud Bucal , Caries Dental/diagnóstico , Caries Dental/prevención & control , Caries Dental/etiología , Servicios Preventivos de Salud , Enfermedades Periodontales/diagnóstico , Enfermedades Periodontales/prevención & control , Atención Primaria de Salud
8.
JAMA ; 330(11): 1074-1082, 2023 09 19.
Artículo en Inglés | MEDLINE | ID: mdl-37721605

RESUMEN

Importance: Hypertensive disorders of pregnancy are among the leading causes of maternal morbidity and mortality in the US. The rate of hypertensive disorders of pregnancy has been increasing from approximately 500 cases per 10 000 deliveries in 1993 to 1021 cases per 10 000 deliveries in 2016 to 2017. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for hypertensive disorders of pregnancy. Population: Pregnant persons without a known diagnosis of a hypertensive disorder of pregnancy or chronic hypertension. Evidence Assessment: The USPSTF concludes with moderate certainty that screening for hypertensive disorders in pregnancy with blood pressure measurements has substantial net benefit. Recommendation: The USPSTF recommends screening for hypertensive disorders in pregnant persons with blood pressure measurements throughout pregnancy. (B recommendation).


Asunto(s)
Hipertensión Inducida en el Embarazo , Femenino , Humanos , Embarazo , Comités Consultivos , Hipertensión Inducida en el Embarazo/diagnóstico , Servicios Preventivos de Salud , Tamizaje Masivo , Determinación de la Presión Sanguínea
9.
JAMA ; 330(8): 736-745, 2023 08 22.
Artículo en Inglés | MEDLINE | ID: mdl-37606666

RESUMEN

Importance: An estimated 1.2 million persons in the US currently have HIV, and more than 760 000 persons have died of complications related to HIV since the first cases were reported in 1981. Although treatable, HIV is not curable and has significant health consequences. Therefore, effective strategies to prevent HIV are an important public health and clinical priority. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of preexposure prophylaxis with antiretroviral therapy for the prevention of HIV acquisition, and the diagnostic accuracy of risk assessment tools to identify persons at increased risk of HIV acquisition. Population: Adolescents and adults who do not have HIV and are at increased risk of HIV. Evidence Assessment: The USPSTF concludes with high certainty that there is a substantial net benefit from the use of effective antiretroviral therapy to reduce the risk of acquisition of HIV in persons at increased risk of acquiring HIV. Recommendation: The USPSTF recommends that clinicians prescribe preexposure prophylaxis using effective antiretroviral therapy to persons at increased risk of HIV acquisition to decrease the risk of acquiring HIV. (A recommendation).


Asunto(s)
Antirretrovirales , Infecciones por VIH , Profilaxis Pre-Exposición , Adolescente , Adulto , Humanos , Comités Consultivos , Antirretrovirales/administración & dosificación , Antirretrovirales/efectos adversos , Antirretrovirales/uso terapéutico , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Infecciones por VIH/etiología , Infecciones por VIH/prevención & control , Profilaxis Pre-Exposición/métodos , Profilaxis Pre-Exposición/normas , Servicios Preventivos de Salud , Salud Pública , Medición de Riesgo/métodos , Medición de Riesgo/normas , Estados Unidos/epidemiología
10.
JAMA ; 330(5): 454-459, 2023 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-37526713

RESUMEN

Importance: Neural tube defects are among the most common congenital malformations in the US, with an estimated 3000 pregnancies affected each year. Many of these neural tube defects are caused by low folate levels in the body. Objective: The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update on the benefits and harms of folic acid supplementation. Population: Persons who are planning to or could become pregnant. Evidence Assessment: The USPSTF concludes that, for persons who are planning to or could become pregnant, there is high certainty that folic acid supplementation has a substantial net benefit to prevent neural tube defects in their offspring. Recommendation: The USPSTF recommends that all persons planning to or who could become pregnant take a daily supplement containing 0.4 to 0.8 mg (400 to 800 µg) of folic acid. (A recommendation).


Asunto(s)
Suplementos Dietéticos , Deficiencia de Ácido Fólico , Ácido Fólico , Defectos del Tubo Neural , Complicaciones del Embarazo , Femenino , Humanos , Embarazo , Comités Consultivos , Ácido Fólico/administración & dosificación , Ácido Fólico/uso terapéutico , Tamizaje Masivo , Defectos del Tubo Neural/etiología , Defectos del Tubo Neural/prevención & control , Servicios Preventivos de Salud , Deficiencia de Ácido Fólico/complicaciones , Deficiencia de Ácido Fólico/diagnóstico , Deficiencia de Ácido Fólico/tratamiento farmacológico , Complicaciones del Embarazo/etiología , Complicaciones del Embarazo/prevención & control , Atención Preconceptiva/normas
11.
JAMA ; 330(3): 253-260, 2023 07 18.
Artículo en Inglés | MEDLINE | ID: mdl-37462699

RESUMEN

Importance: Familial hypercholesterolemia and multifactorial dyslipidemia are 2 conditions that cause abnormally high lipid levels in children, which can lead to premature cardiovascular events (eg, myocardial infarction and stroke) and death in adulthood. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for lipid disorders in asymptomatic children and adolescents. Population: Asymptomatic children and adolescents 20 years or younger without a known diagnosis of a lipid disorder. Evidence Assessment: The USPSTF concludes that the current evidence is insufficient and the balance of benefits and harms for screening for lipid disorders in asymptomatic children and adolescents 20 years or younger cannot be determined. Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for lipid disorders in children and adolescents 20 years or younger. (I statement).


Asunto(s)
Dislipidemias , Tamizaje Masivo , Adolescente , Niño , Humanos , Comités Consultivos , Dislipidemias/complicaciones , Dislipidemias/diagnóstico , Dislipidemias/terapia , Lípidos , Tamizaje Masivo/efectos adversos , Tamizaje Masivo/métodos , Servicios Preventivos de Salud , Medición de Riesgo , Adulto Joven , Enfermedades Asintomáticas , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control
12.
JAMA ; 329(24): 2163-2170, 2023 06 27.
Artículo en Inglés | MEDLINE | ID: mdl-37338866

RESUMEN

Importance: Anxiety disorders are commonly occurring mental health conditions. They are often unrecognized in primary care settings and substantial delays in treatment initiation occur. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for anxiety disorders in asymptomatic adults. Population: Asymptomatic adults 19 years or older, including pregnant and postpartum persons. Older adults are defined as those 65 years or older. Evidence Assessment: The USPSTF concludes with moderate certainty that screening for anxiety disorders in adults, including pregnant and postpartum persons, has a moderate net benefit. The USPSTF concludes that the evidence is insufficient on screening for anxiety disorders in older adults. Recommendation: The USPSTF recommends screening for anxiety disorders in adults, including pregnant and postpartum persons. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for anxiety disorders in older adults. (I statement).


Asunto(s)
Ansiedad , Tamizaje Masivo , Femenino , Embarazo , Humanos , Anciano , Tamizaje Masivo/efectos adversos , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/terapia , Servicios Preventivos de Salud , Miedo
13.
JAMA ; 329(23): 2057-2067, 2023 06 20.
Artículo en Inglés | MEDLINE | ID: mdl-37338872

RESUMEN

Importance: Major depressive disorder (MDD), a common mental disorder in the US, may have substantial impact on the lives of affected individuals. If left untreated, MDD can interfere with daily functioning and can also be associated with an increased risk of cardiovascular events, exacerbation of comorbid conditions, or increased mortality. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate benefits and harms of screening, accuracy of screening, and benefits and harms of treatment of MDD and suicide risk in asymptomatic adults that would be applicable to primary care settings. Population: Asymptomatic adults 19 years or older, including pregnant and postpartum persons. Older adults are defined as those 65 years or older. Evidence Assessment: The USPSTF concludes with moderate certainty that screening for MDD in adults, including pregnant and postpartum persons and older adults, has a moderate net benefit. The USPSTF concludes that the evidence is insufficient on the benefit and harms of screening for suicide risk in adults, including pregnant and postpartum persons and older adults. Recommendation: The USPSTF recommends screening for depression in the adult population, including pregnant and postpartum persons and older adults. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for suicide risk in the adult population, including pregnant and postpartum persons and older adults. (I statement).


Asunto(s)
Trastorno Depresivo Mayor , Tamizaje Masivo , Suicidio , Adulto , Anciano , Femenino , Humanos , Masculino , Embarazo , Depresión/diagnóstico , Trastorno Depresivo Mayor/complicaciones , Trastorno Depresivo Mayor/diagnóstico , Tamizaje Masivo/efectos adversos , Tamizaje Masivo/métodos , Medición de Riesgo , Estados Unidos
14.
JAMA ; 329(17): 1487-1494, 2023 05 02.
Artículo en Inglés | MEDLINE | ID: mdl-37129649

RESUMEN

Importance: In the US, tuberculosis remains an important preventable disease, including active tuberculosis, which may be infectious, and latent tuberculosis infection (LTBI), which is asymptomatic and not infectious but can later progress to active disease. The precise prevalence rate of LTBI in the US is difficult to determine; however, estimated prevalence is about 5.0%, or up to 13 million persons. Incidence of tuberculosis varies by geography and living accommodations, suggesting an association with social determinants of health. Objective: To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on LTBI screening and treatment in asymptomatic adults seen in primary care, as well as the accuracy of LTBI screening tests. Population: Asymptomatic adults 18 years or older at increased risk for tuberculosis. Evidence Assessment: The USPSTF concludes with moderate certainty that there is a moderate net benefit in preventing active tuberculosis disease by screening for LTBI in persons at increased risk for tuberculosis infection. Recommendation: The USPSTF recommends screening for LTBI in populations at increased risk. (B recommendation).


Asunto(s)
Tuberculosis Latente , Adulto , Humanos , Tuberculosis Latente/complicaciones , Tuberculosis Latente/diagnóstico , Tuberculosis Latente/epidemiología , Tuberculosis Latente/etiología , Tamizaje Masivo/efectos adversos , Tamizaje Masivo/métodos , Medición de Riesgo , Tuberculosis/epidemiología , Tuberculosis/etiología , Tuberculosis/prevención & control , Estados Unidos/epidemiología , Determinantes Sociales de la Salud/estadística & datos numéricos
15.
JAMA ; 329(15): 1290-1295, 2023 04 18.
Artículo en Inglés | MEDLINE | ID: mdl-37071089

RESUMEN

Importance: Skin cancer is the most commonly diagnosed cancer in the US. There are different types of skin cancer varying in disease incidence and severity. Basal and squamous cell carcinomas are the most common types of skin cancer but infrequently lead to death or substantial morbidity. Melanomas represent about 1% of skin cancer and cause the most skin cancer deaths. Melanoma is about 30 times more common in White persons than in Black persons. However, persons with darker skin color are often diagnosed at later stages, when skin cancer is more difficult to treat. Objective: To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on the benefits and harms of screening for skin cancer in asymptomatic adolescents and adults. Population: Asymptomatic adolescents and adults who do not have a history of premalignant or malignant skin lesions. Evidence Assessment: The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in asymptomatic adolescents and adults. Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adolescents and adults. (I statement).


Asunto(s)
Carcinoma Basocelular , Carcinoma de Células Escamosas , Detección Precoz del Cáncer , Tamizaje Masivo , Melanoma , Neoplasias Cutáneas , Adolescente , Adulto , Humanos , Detección Precoz del Cáncer/efectos adversos , Detección Precoz del Cáncer/métodos , Tamizaje Masivo/efectos adversos , Tamizaje Masivo/métodos , Melanoma/diagnóstico , Examen Físico/efectos adversos , Examen Físico/métodos , Medición de Riesgo , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/prevención & control , Carcinoma Basocelular/diagnóstico , Carcinoma de Células Escamosas/diagnóstico
16.
JAMA ; 329(6): 502-507, 2023 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-36786784

RESUMEN

Importance: Genital herpes is a common sexually transmitted infection caused by 2 related viruses, herpes simplex type 1 (HSV-1) and herpes simplex type 2 (HSV-2). Infection is lifelong; currently, there is no cure for HSV infection. Antiviral medications may provide clinical benefits to symptomatic persons. Transmission of HSV from a pregnant person to their infant can occur, most commonly during delivery; when genital lesions or prodromal symptoms are present, cesarean delivery can reduce the risk of transmission. Neonatal herpes infection is uncommon yet can result in substantial morbidity and mortality. Objective: To reaffirm its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update on targeted key questions to systematically evaluate the evidence on accuracy, benefits, and harms of routine serologic screening for HSV-2 infection in asymptomatic adolescents, adults, and pregnant persons. Population: Adolescents and adults, including pregnant persons, without known history, signs, or symptoms of genital HSV infection. Evidence Assessment: The USPSTF concludes with moderate certainty that the harms outweigh the benefits for population-based screening for genital HSV infection in asymptomatic adolescents and adults, including pregnant persons. Recommendation: The USPSTF recommends against routine serologic screening for genital HSV infection in asymptomatic adolescents and adults, including pregnant persons. (D recommendation).


Asunto(s)
Herpes Genital , Herpesvirus Humano 1 , Herpesvirus Humano 2 , Tamizaje Masivo , Complicaciones Infecciosas del Embarazo , Pruebas Serológicas , Adolescente , Adulto , Femenino , Humanos , Recién Nacido , Embarazo , Herpes Genital/diagnóstico , Herpes Genital/tratamiento farmacológico , Tamizaje Masivo/efectos adversos , Tamizaje Masivo/psicología , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/prevención & control , Pruebas Serológicas/efectos adversos , Pruebas Serológicas/métodos , Pruebas Serológicas/psicología , Herpes Simple/diagnóstico
17.
JAMA ; 328(17): 1740-1746, 2022 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-36318127

RESUMEN

Importance: Menopause is defined as the cessation of a person's menstrual cycle. It is defined retrospectively, 12 months after the final menstrual period. Perimenopause, or the menopausal transition, is the few-year time period preceding a person's final menstrual period and is characterized by increasing menstrual cycle length variability and periods of amenorrhea, and often symptoms such as vasomotor dysfunction. The prevalence and incidence of most chronic diseases (eg, cardiovascular disease, cancer, osteoporosis, and fracture) increase with age, and US persons who reach menopause are expected on average to live more than another 30 years. Objective: To update its 2017 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of systemic (ie, oral or transdermal) hormone therapy for the prevention of chronic conditions in postmenopausal persons and whether outcomes vary by age or by timing of intervention after menopause. Population: Asymptomatic postmenopausal persons who are considering hormone therapy for the primary prevention of chronic medical conditions. Evidence Assessment: The USPSTF concludes with moderate certainty that the use of combined estrogen and progestin for the primary prevention of chronic conditions in postmenopausal persons with an intact uterus has no net benefit. The USPSTF concludes with moderate certainty that the use of estrogen alone for the primary prevention of chronic conditions in postmenopausal persons who have had a hysterectomy has no net benefit. Recommendation: The USPSTF recommends against the use of combined estrogen and progestin for the primary prevention of chronic conditions in postmenopausal persons. (D recommendation) The USPSTF recommends against the use of estrogen alone for the primary prevention of chronic conditions in postmenopausal persons who have had a hysterectomy. (D recommendation).


Asunto(s)
Enfermedad Crónica , Estrógenos , Terapia de Reemplazo de Hormonas , Hormonas , Posmenopausia , Progestinas , Femenino , Humanos , Enfermedad Crónica/prevención & control , Estrógenos/efectos adversos , Estrógenos/uso terapéutico , Prevención Primaria , Progestinas/efectos adversos , Progestinas/uso terapéutico , Terapia de Reemplazo de Hormonas/efectos adversos , Terapia de Reemplazo de Hormonas/métodos , Hormonas/efectos adversos , Hormonas/uso terapéutico
18.
JAMA ; 328(14): 1438-1444, 2022 10 11.
Artículo en Inglés | MEDLINE | ID: mdl-36219403

RESUMEN

Importance: Anxiety disorder, a common mental health condition in the US, comprises a group of related conditions characterized by excessive fear or worry that present as emotional and physical symptoms. The 2018-2019 National Survey of Children's Health found that 7.8% of children and adolescents aged 3 to 17 years had a current anxiety disorder. Anxiety disorders in childhood and adolescence are associated with an increased likelihood of a future anxiety disorder or depression. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for anxiety disorders in children and adolescents. This is a new recommendation. Population: Children and adolescents 18 years or younger who do not have a diagnosed anxiety disorder or are not showing recognized signs or symptoms of anxiety. Evidence Assessment: The USPSTF concludes with moderate certainty that screening for anxiety in children and adolescents aged 8 to 18 years has a moderate net benefit. The USPSTF concludes that the evidence is insufficient on screening for anxiety in children 7 years or younger. Recommendation: The USPSTF recommends screening for anxiety in children and adolescents aged 8 to 18 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for anxiety in children 7 years or younger. (I statement).


Asunto(s)
Trastornos de Ansiedad , Tamizaje Masivo , Adolescente , Comités Consultivos , Trastornos de Ansiedad/diagnóstico , Niño , Humanos , Tamizaje Masivo/métodos , Servicios Preventivos de Salud , Medición de Riesgo , Estados Unidos
19.
JAMA ; 328(15): 1534-1542, 2022 10 18.
Artículo en Inglés | MEDLINE | ID: mdl-36219440

RESUMEN

Importance: Depression is a leading cause of disability in the US. Children and adolescents with depression typically have functional impairments in their performance at school or work as well as in their interactions with their families and peers. Depression can also negatively affect the developmental trajectories of affected youth. Major depressive disorder (MDD) in children and adolescents is strongly associated with recurrent depression in adulthood; other mental disorders; and increased risk for suicidal ideation, suicide attempts, and suicide completion. Suicide is the second-leading cause of death among youth aged 10 to 19 years. Psychiatric disorders and previous suicide attempts increase suicide risk. Objective: To update its 2014 and 2016 recommendations, the US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening, accuracy of screening, and benefits and harms of treatment of MDD and suicide risk in children and adolescents that would be applicable to primary care settings. Population: Children and adolescents who do not have a diagnosed mental health condition or are not showing recognized signs or symptoms of depression or suicide risk. Evidence Assessment: The USPSTF concludes with moderate certainty that screening for MDD in adolescents aged 12 to 18 years has a moderate net benefit. The USPSTF concludes that the evidence is insufficient on screening for MDD in children 11 years or younger. The USPSTF concludes that the evidence is insufficient on the benefit and harms of screening for suicide risk in children and adolescents owing to a lack of evidence. Recommendation: The USPSTF recommends screening for MDD in adolescents aged 12 to 18 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for MDD in children 11 years or younger. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for suicide risk in children and adolescents. (I statement).


Asunto(s)
Trastorno Depresivo Mayor , Prevención del Suicidio , Adolescente , Niño , Humanos , Comités Consultivos , Depresión/diagnóstico , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/etiología , Susceptibilidad a Enfermedades , Tamizaje Masivo/efectos adversos , Tamizaje Masivo/normas
20.
JAMA ; 328(10): 963-967, 2022 09 13.
Artículo en Inglés | MEDLINE | ID: mdl-36098719

RESUMEN

Importance: The Centers for Disease Control and Prevention estimates that 210 000 children and adolescents younger than 20 years had diabetes as of 2018; of these, approximately 23 000 had type 2 diabetes. Youth with type 2 diabetes have an increased prevalence of associated chronic comorbid conditions, including hypertension, dyslipidemia, and nonalcoholic fatty liver disease. Data indicate that the incidence of type 2 diabetes is rising; from 2002-2003 to 2014-2015, incidence increased from 9.0 cases per 100 000 children and adolescents to 13.8 cases per 100 000 children and adolescents. Objective: The US Preventive Services Task Force (USPSTF) commissioned a review of the evidence on screening for prediabetes and type 2 diabetes in asymptomatic, nonpregnant persons younger than 18 years. This is a new recommendation. Population: Children and adolescents younger than 18 years without known diabetes or prediabetes or symptoms of diabetes or prediabetes. Evidence Assessment: The USPSTF concludes that the evidence is insufficient to assess the balance of benefits and harms of screening for type 2 diabetes in children and adolescents. There is a lack of evidence on the effect of screening for, and early detection and treatment of, type 2 diabetes on health outcomes in youth, and the balance of benefits and harms cannot be determined. Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for type 2 diabetes in children and adolescents. (I statement).


Asunto(s)
Diabetes Mellitus Tipo 2 , Tamizaje Masivo , Estado Prediabético , Adolescente , Comités Consultivos , Niño , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiología , Humanos , Tamizaje Masivo/efectos adversos , Tamizaje Masivo/métodos , Estado Prediabético/diagnóstico , Estado Prediabético/epidemiología , Servicios Preventivos de Salud , Medición de Riesgo
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