Posts in the ‘Insights’ Category

Insights are brief stories about NEJM content, written by contributors appointed by NEJM editorial staff. While the posts often include quotes from editors, and are approved by editors, these blog posts about NEJM content are not published in NEJM, and should not be considered NEJM editorials or commentary. They are intended to provide insight into the clinical significance of interesting content found on NEJM.org, and where it may lead us in practice and research. Questions are included at the end to stimulate thinking and discussion.

The Final Nail in Early Goal Directed Therapy’s Coffin?

Posted by Joshua Allen-Dicker • March 24th, 2015

You are called to evaluate Ms. Smith urgently.  She reports several days of progressive malaise, weakness and a new cough. On your exam she is tachycardic, tachypneic and febrile.  You diagnose Ms. Smith with sepsis and explain the importance of quickly treating this life-threatening condition. In the United States, situations like this—presentations leading to the… Read More…

CABG or PCI in Patients with Coronary Disease?

Posted by Chana Sacks • March 16th, 2015

The great singer Whitney Houston posed a question over 25 years ago that many still ponder today.  “Where,” she asked, “do broken hearts go?” Of course, her classic song asks us to imagine a destination for the pain wrought by the dissolution of love.  Physicians, however, have more concrete possibilities in mind when asking where… Read More…

Improved Air Quality and Lung Development in Children

Posted by Chana Sacks • March 4th, 2015

In 1905, the Public Health Congress convened in London, where Dr. Henry Antoine des Voeux presented a paper entitled “Fog and Smoke.”  In it, he described the characteristic black smoky fog – or “smog” – that enveloped London and many of the world’s other urban centers.  Credited with coining this new term, Dr. des Voeux… Read More…

Outcomes of Pregnancy After Bariatric Surgery

Posted by Daniela Lamas • February 25th, 2015

Your patient has been trying to lose weight for years. But no matter how many grapefruits she eats, whether she goes ‘gluten free’ or replaces her snacks with lean meats and long walks on the treadmill, the 35-year old’s weight has hit a plateau. And with the weight have come a series of troubling health… Read More…

Peanut Consumption in Infants at Risk for Peanut Allergy

Posted by Chana Sacks • February 23rd, 2015

In a famous “Peanuts” cartoon, a glum Charlie Brown sits alone on a bench, eating a sandwich; his thought bubble reads, “Nothing takes the taste out of peanut butter quite like unrequited love.”  Charles Schulz was perhaps better than any other at simply and brilliantly capturing the timeless angst that defines the human condition. And… Read More…

Preexposure Prophylaxis for HIV-1 Infection

Posted by Chana Sacks • February 4th, 2015

In December 2007, Elizabeth Mataka, the United Nations Special Envoy for HIV/AIDS in Africa, highlighted one of many stark realities of the HIV epidemic: “61% of all those living with HIV in Africa are women,” she wrote. “And 26 years into the epidemic, we know that underpinning this terrible statistic is gender inequality.” Condoms work…. Read More…

Infant Mortality through the Years

Posted by Rena Xu • January 21st, 2015

Prematurity has long been recognized as a major contributor to infant mortality. One in every four infants born extremely prematurely (between 22 and 29 weeks’ gestation) does not survive. A large number die within the first 12 hours after birth, and many more never make it out of the hospital, most commonly dying from a… Read More…

Intraarterial Treatment for Acute Ischemic Stroke

Posted by Chana Sacks • December 31st, 2014

She knew the signs. When Mary suddenly dropped her coffee cup because all of the strength in her right arm disappeared and her speech became garbled, she knew that she was having a stroke.  A wise 78-year-old, Mary couldn’t remember where she had learned these warning signs – was it from from her doctor? A… Read More…

Where There’s Smoke: Cytisine versus Nicotine Replacement Therapy

Posted by Rena Xu • December 17th, 2014

Motivation, it’s often said, is half the battle of behavior change.  In the battle against nicotine addiction, however, motivation alone may not be enough.  Mass media campaigns have helped to raise awareness about the dangers of smoking.  But for the majority of smokers who already want to quit, the question remains: how? In 2006, a… Read More…

Polycystic Kidney Disease

Posted by Carla Rothaus • December 11th, 2014

In patients with autosomal dominant polycystic kidney disease, the rate of increase in total kidney volume was not slowed by lisinopril and telmisartan, as compared with lisinopril and placebo, but was slowed with rigorous blood-pressure control. Autosomal dominant polycystic kidney disease (ADPKD) is characterized by gradual cyst enlargement over a period of decades before the… Read More…