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.

Amoxicillin for Severe Acute Malnutrition

Posted by Carla Rothaus • February 5th, 2016

Severe acute malnutrition affects approximately 19 million children under 5 years of age worldwide and contributes substantially to mortality and the disease burden among children. Only one previous randomized trial has examined the routine use of antibiotics in the community-based treatment of severe acute malnutrition. Isanaka et al. conducted a randomized, double-blind, placebo-controlled trial in… Read More…

Hereditary Breast and Ovarian Cancer

Posted by Carla Rothaus • February 5th, 2016

Hereditary breast and ovarian cancer is a syndrome that involves an increased predisposition to breast cancer, ovarian cancer, or both and an autosomal dominant pattern of transmission. Risk-reducing mastectomy and risk-reducing salpingo-oophorectomy are options for the primary prevention of breast and ovarian cancers, and they have been shown in multiple studies to have efficacy. The risk… Read More…

A Girl with Abdominal Pain

Posted by Carla Rothaus • January 29th, 2016

A Case Records of the Massachusetts General Hospital summarizes torsion of an accessory spleen is most commonly reported in children but can also occur in adults. Patients with torsion may present with acute abdominal pain, but intermittent or chronic pain has also been described, and infarction or rupture leading to acute abdominal hemorrhage can occur. A 9-year-old girl… Read More…

Brain Disease Model of Addiction

Posted by Carla Rothaus • January 29th, 2016

Advances in neurobiology have begun to clarify the mechanisms underlying the profound disruptions in decision-making ability and emotional balance displayed by persons with drug addiction. The neurobiology of addiction is pointing the way to potential methods of disrupting the neurocircuitry with both pharmaceutical and behavioral tools. Altering the reward and emotional circuits may prevent and treat the… Read More…

Postmenopausal Osteoporosis

Posted by Carla Rothaus • January 22nd, 2016

Osteoporosis results in 1.5 million fractures per year in the United States, with the vast majority occurring in postmenopausal women. Treatment is generally recommended in postmenopausal women who have a bone mineral density T score of −2.5 or less, a history of spine or hip fracture, or a Fracture Risk Assessment Tool (FRAX) score indicating… Read More…

Eluxadoline for Irritable Bowel Syndrome

Posted by Carla Rothaus • January 22nd, 2016

The irritable bowel syndrome (IBS) with diarrhea is a common functional gastrointestinal disorder that is characterized by recurring abdominal pain, bloating, and loose, frequent stools in the absence of structural, inflammatory, or biochemical abnormalities. Lembo et al. conducted two phase 3 trials to evaluate the clinical response of patients with IBS with diarrhea to eluxadoline,… Read More…

Prescription-Opioid Abuse and Heroin Abuse

Posted by Carla Rothaus • January 15th, 2016

The nonmedical use of prescription opioids is a major public health issue in the United States, both because of the overall high prevalence and because of marked increases in associated morbidity and mortality.  A key underlying characteristic of the epidemic is the association between the increasing rate of opioid prescribing and increasing opioid-related morbidity and… Read More…

A Man with Thrombocytopenia

Posted by Carla Rothaus • January 15th, 2016

In the latest Case Record of the Massachusetts General Hospital, an 18-year-old man presented with fever, abdominal pain, and thrombocytopenia. Abdominal imaging studies showed nonspecific fluid collection and necrotic lymph nodes, and there were elevated levels of C-reactive protein and ferritin. A diagnostic procedure was performed. A ferritin level as high as 7000 ng/ml is a… Read More…

Viral Bronchiolitis

Posted by Carla Rothaus • January 8th, 2016

Few diseases have a greater effect on the health of young children than viral lower respiratory tract illness. Approximately 800,000 children in the United States, or approximately 20% of the annual birth cohort, require outpatient medical attention during the first year of life because of illness caused by respiratory syncytial virus (RSV). This review article… Read More…

A Complementary Affair

Posted by Carla Rothaus • January 8th, 2016

What is the most common type of cryoglobulinemia associated with Sjögren’s syndrome? Sjögren’s syndrome, a systemic autoimmune disease that is characterized by diminished lacrimal-gland and salivary-gland function, is one of the most common connective-tissue diseases. Decreased glandular function leads to typical manifestations of dry eyes and dry mouth, or sicca complex. Although the disease typically follows… Read More…