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.

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…

Atrial Fibrillation in Cryptogenic Stroke

Posted by Carla Rothaus • June 25th, 2014

Your 69-year-old patient has just had an ischemic stroke. Fortunately, he should make a good recovery. And yet, you feel unsettled. A standard post-stroke work up – 12-lead ECG, ambulatory 24-hour Holter ECG monitoring, brain and neurovascular imaging, and echocardiography – failed to reveal a cause for his stroke, putting it in the “cryptogenic” stroke… Read More…

Naloxegol for Opioid-Induced Constipation

Posted by John Staples • June 18th, 2014

Did opioid-induced constipation contribute to Elvis Presley’s death? Would he still be making music today if he’d won the battle with his bowels? Though many disagree, Elvis’ former personal physician thinks that a cure for the King’s constipation might have spared his life. If this kind of conjecture from suspicious minds leaves you all shook… Read More…

Pharmacology and the Treatment of Complicated Skin and Skin-Structure Infections

Posted by Daniela Lamas • June 11th, 2014

Treating skin and soft tissue infections isn’t the most glamorous job in medicine. But as these infections – ranging from cellulitis to abscess and often accompanied by fever and other signs of systemic illness – lead to nearly 900,000 hospital admissions annually, it’s an essential one. And with the emergence of strains of methicillin-resistant Staphylococcus… Read More…