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.

PARADIGM-HF Prompts a New Line of Thinking about Heart Failure

Posted by Chana Sacks • August 30th, 2014

Your patient – a 65-year-old man with an ischemic cardiomyopathy – presents to clinic one week after discharge from another hospitalization for a heart-failure exacerbation. He is doing much better. He remains at his discharge weight and reports good adherence to a low-salt diet and to the extensive medication regimen that you have prescribed: he… Read More…

Long-Term Colorectal Cancer Mortality after Adenoma Removal

Posted by Daniela Lamas • August 27th, 2014

Your patient had thought it would be a relief to get the colonoscopy over with. “Not for another ten years,” she had vowed as she chugged that dreaded colonoscopy prep. But then there was a polyp – low-risk, she was told – but with it, recommendations to return for another colonoscopy in as few as… Read More…

Learning to Modify the Chronic Neurologic Burden of Sickle Cell Anemia

Posted by Joshua Allen-Dicker • August 20th, 2014

The patient sitting in front of you is a smiling, well-adjusted 6-year old boy.  He has a supportive family, eats a healthy diet, and is physically active.  What if, despite all of this, you knew that he had more than a 30 percent chance of developing a condition that would hamper his educational attainment?  Every… Read More…

A Salty Subject: Sodium Consumption and Cardiovascular Health

Posted by Rena Xu • August 13th, 2014

Salt has long been a staple of life.  Once upon a time, it was a form of currency; roads were built to transport it; cities arose to produce and trade it.  And, of course, people ate it.  Today, we continue to consume it the whole world over. It’s hard to believe something so integral to… Read More…

Novel Ways to Detect Creutzfeld-Jacob Disease?

Posted by Daniela Lamas • August 6th, 2014

Anyone who has eaten a burger has had a sneaking fear, however irrational: Could I have been exposed to mad cow? And how could I possibly find out before symptoms of the disease take hold? As it is, the way to confirm the diagnosis of the fatal disease is by direct examination of brain tissue,… Read More…

The Future of Malaria: Rising Rates of Resistance and a Potential New Hope

Posted by Joshua Allen-Dicker • July 30th, 2014

What do Emperor Charles V, Thomas Jefferson, and King Tut all have in common?  Each historical figure is thought to have suffered from malaria at some point during his life. Plasmodium, malaria’s causative organism, is known as much for its effects on great civilizations and their leaders as for its present world-wide disease burden.  Yearly,… Read More…

Niacin with Laropiprant in High-Risk Patients

Posted by Daniela Lamas • July 16th, 2014

Your patient, a 70-year-old man with a history of a heart attack three years ago, sits across from you at his regular outpatient follow-up appointment. He’s doing well. He’s exercising and taking the medications you prescribed, including his statin, but he’s wondering if there’s anything more he should be doing to lower his “bad,” or… Read More…

Dupilumab as a Treatment for Atopic Dermatitis

Posted by Rachel Wolfson • July 9th, 2014

For thousands of years, our knowledge of medications has largely been based on trial and error: we haphazardly used substances and learned from the effects. Within the last half a century, however, rational drug design slowly took to the forefront as scientific discoveries improved our understanding of the underlying pathogenesis of diseases. While there have… Read More…

Glucocorticoid Injections for Spinal Stenosis

Posted by Daniela Lamas • July 2nd, 2014

Spinal stenosis is a pain – both for those who suffer it, and the doctors who treat it. As surgery is a potentially risky option with uncertain benefit, many doctors turn to glucocorticoid injections for their patients, to decrease pain and increase mobility.  An estimated ten to eleven million such injections are performed in the… Read More…

Dying with Dignity in the Intensive Care Unit

Posted by Sara Fazio • June 27th, 2014

It is common for patients to have an expected death in an ICU. The final review in the Critical Care series covers issues related to the end of life in the absence of discordance between the patient’s family and caregivers. The traditional goals of intensive care are to reduce the morbidity and mortality associated with… Read More…