Posts in the ‘Physicians-In-Training’ Category

The posts below are excerpted from the NEJM Resident e-Bulletin, a free weekly email of teaching topics. Including the content here in Now@NEJM enables you to have a conversation or ask questions about clinical points that interest you. To receive the email version, register as a student or resident on NEJM.org.

Postpartum Depression

Posted by • December 1st, 2016

Untreated postpartum depression is common affects the health of the woman, infant, and family. Pregnant women should receive information about the signs and symptoms of postpartum depression and its effects. Treatment depends on the severity of symptoms and the level of functional impairment and can include social support, psychological therapy, and pharmacotherapy (generally an SSRI… Read More…

Niraparib Maintenance Therapy in Ovarian Cancer

Posted by • December 1st, 2016

Ovarian cancer is a leading cause of death from gynecologic cancers worldwide. A randomized, placebo-controlled, phase 3 trial conducted by Mirza et al. evaluated the efficacy and safety of niraparib versus placebo as maintenance treatment in a broad population of patients with platinum-sensitive, recurrent ovarian cancer. Among these patients, the use of niraparib, a PARP… Read More…

Von Willebrand’s Disease

Posted by • November 24th, 2016

Von Willebrand’s disease is an inherited bleeding disorder characterized by defective platelet adhesion and aggregation. It is the most common inherited bleeding disorder and is generally transmitted as an autosomal dominant trait. It is mainly associated with mucosal bleeding and excessive bleeding after trauma or surgery. A variety of effective treatments are available and research… Read More…

A Man with Acute Liver Injury

Posted by • November 24th, 2016

HEV infection is uncommon in the United States, although 20% of the population has antibodies to HEV. The diagnosis should be considered in patients who present with acute hepatitis after returning from a trip to an area in which HEV is endemic. In a new Case Record article, a 50-year-old man from India with a… Read More…

Acute Pancreatitis

Posted by • November 17th, 2016

Approximately 80% of patients admitted with acute pancreatitis have mild, self-limited disease and are discharged within several days. Mortality associated with acute pancreatitis has decreased over time, and the overall mortality is now approximately 2%. A new Review Article summarizes recent changes in the management of acute pancreatitis, encompassing fluid resuscitation, antibiotic use, nutritional support,… Read More…

Ustekinumab for Crohn’s Disease

Posted by • November 17th, 2016

In a previous phase 2b trial, intravenous ustekinumab induction therapy in patients with Crohn’s disease that was refractory to treatment with tumor necrosis factor (TNF) antagonists showed a significant benefit in terms of clinical response but not remission, and subcutaneously administered maintenance doses of ustekinumab were efficacious during a period of 22 weeks. Feagan et… Read More…

Heart Failure with Preserved Ejection Fraction

Posted by • November 10th, 2016

Epidemiologic studies indicate that up to 50% of patients with heart failure have a preserved ejection fraction, and this proportion has increased over time. In observational studies, rates of hospitalization and death among patients who have heart failure with a preserved ejection fraction approach those among patients who have heart failure with a reduced ejection… Read More…

Semaglutide in Patients with Type 2 Diabetes

Posted by • November 10th, 2016

Regulatory guidance specifies the need to establish cardiovascular safety of new diabetes therapies in patients with type 2 diabetes in order to rule out excess cardiovascular risk. The preapproval Trial to Evaluate Cardiovascular and Other Long-term Outcomes with Semaglutide in Subjects with Type 2 Diabetes (SUSTAIN-6) conducted by Marso et al. was designed to assess… Read More…

Ribociclib for HR-Positive Breast Cancer

Posted by • November 3rd, 2016

Hortobagyi et al. conducted the Mammary Oncology Assessment of LEE011’s (Ribociclib’s) Efficacy and Safety (MONALEESA-2) trial, which evaluated the efficacy and safety of the combination of ribociclib and letrozole as initial therapy in postmenopausal women with hormone-receptor (HR)–positive, human epidermal growth factor 2 (HER2)–negative advanced breast cancer. In patients with advanced HR-positive, HER2-negative breast cancer,… Read More…

Just a Cut

Posted by • November 3rd, 2016

Vibrio is a gram-negative rod that is typically found in warm saltwater, although it has been isolated in waters as cold as 17°C. Vibrio infections can rapidly progress to septicemia and death and often require major amputation in patients who survive. A 51-year-old surgeon lacerated his left ring finger near the volar distal interphalangeal joint… Read More…