About Graham McMahon

Graham McMahon

Graham is NEJM’s Editor for Medical Education, an Associate Professor of Medicine at Harvard Medical School, and an endocrinologist at the Brigham & Women’s Hospital in Boston where he completed his postgraduate training. He received his medical education at the Royal College of Surgeons in Ireland, a master’s degree in clinical research from Harvard Medical School, and his doctorate in education from the National University of Ireland.

All posts by Graham McMahon

Rivaroxaban in ACS

• January 6th, 2012

In a study of patients with acute coronary syndromes, low doses of rivaroxaban were effective in reducing the primary end point of death from cardiovascular causes, myocardial infarction, or stroke. Rivaroxaban also reduced overall mortality, although there was more bleeding.         After an acute coronary syndrome, patients remain at risk for recurrent cardiovascular events despite optimal medical therapy,… Read More…


Pulmonary Thrombotic Microangiopathy

• January 6th, 2012

In our latest Clinical Problem-Solving article, a 50-year-old woman presented with fatigue and shortness of breath. Dyspnea after moderate exertion had developed gradually, along with profound malaise and a nonproductive cough. In the 48 hours before admission, her shortness of breath had worsened.     The clinicopathological syndrome of subacute cor pulmonale caused by tumor microemboli to the… Read More…


Statins and Atherosclerosis

• December 2nd, 2011

In the SATURN trial, intravascular ultrasonography was used to compare the effects of atorvastatin versus rosuvastatin on regression of coronary atherosclerosis. Both statins led to regression in two thirds of patients, with no significant difference between their effects. Statins reduce adverse cardiovascular outcomes and slow the progression of coronary atherosclerosis in proportion to their ability to… Read More…


Iodine-Induced Hyperthyroidism

• December 2nd, 2011

In the latest article in our Clinical Problem-Solving series, a 51-year-old woman presented to the ER with a 6-month history of intermittent palpitations, which had worsened that day. She described her pulse as fast but regular. She also reported worsening fatigue, heat intolerance, and an 18-kg (40-lb) weight loss. Excess iodine results in hyperthyroidism among persons… Read More…


Screening for Prostate Cancer

• November 25th, 2011

In the latest article in our Clinical Practice review series, “Screening for Prostate Cancer,” current recommendations for prostate-specific antigen testing are reviewed, as well as the initial results of two randomized trials. The potential risks of screening, including morbidity from overdiagnosis and overtreatment, are described. In the United States, approximately 90% of prostate cancers are detected… Read More…


Adjunctive Antithrombotic Therapy During PCI

• November 23rd, 2011

The ISAR-REACT 4 trial compared the combination of abciximab and unfractionated heparin with bivalirudin in patients with non–STsegment elevation MI who were undergoing coronary stenting. The two regimens had similar efficacy, but there was more bleeding with abciximab and heparin. Identifying the most appropriate adjunctive antithrombotic therapy before, during, and after percutaneous coronary intervention (PCI) has… Read More…


Endometritis

• November 18th, 2011

In the latest Case Record of the Massachusetts General Hospital, a 33-year-old woman was admitted to the ICU 16.5 hours post partum because of leukocytosis and gram-positive rods in the blood. Diagnostic test results were received, and management decisions were made. Clostridium species are obligate anaerobic bacteria that have a long history of causing serious infection… Read More…


ECMO for Adult ARDS

• November 18th, 2011

In the latest article in our Clinical Therapeutics review series, a 41-year-old woman presents with severe pneumonia, and the acute respiratory distress syndrome (ARDS) develops. Despite mechanical ventilation, her oxygenation deteriorates. The use of extracorporeal membrane oxygenation (ECMO) is recommended. ARDS is characterized by the acute onset of hypoxemia and bilateral pulmonary infiltrates consistent with pulmonary… Read More…


Limbic Encephalitis

• November 11th, 2011

In the latest Case Record of the Massachusetts General Hospital, a 75-year-old man was seen because of memory loss and episodes of near-syncope, with word-finding difficulty and unilateral twitching. MRI with contrast material revealed hyperintensity and mild expansion of the left hippocampus, without enhancement. Limbic encephalitis is an inflammatory process centered in the limbic system. Clinical Pearls… Read More…


Alcoholic Hepatitis

• November 11th, 2011

In a trial involving patients with severe alcoholic hepatitis, treatment with acetylcysteine reduced 1-month mortality (8% vs. 24%, P=0.006), but differences in mortality at 6 months, the primary outcome, were not significant (27% vs. 38%, P=0.07). Severe acute alcoholic hepatitis is a life-threatening liver disease. Although glucocorticoid treatment is recommended and improves survival, the mortality remains… Read More…