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.

Long-Term Oxygen for COPD

Posted by • October 27th, 2016

Two trials that were conducted in the 1970s showed that long-term treatment with supplemental oxygen reduced mortality among patients with chronic obstructive pulmonary disease (COPD) and severe resting hypoxemia. In the 1990s, two trials evaluated long-term treatment with supplemental oxygen in patients with COPD who had mild-to-moderate daytime hypoxemia; neither trial showed a mortality benefit,… Read More…

A Woman with Lower Abdominal Pain

Posted by • October 27th, 2016

Most ovarian abscesses that occur in patients in the Western world are associated with pelvic inflammatory disease and are preceded by involvement of the fallopian tube as part of an ascending bacterial infection. Direct extension from nongynecologic infections or hematogenous or lymphatic spread may occur less commonly. The absence of marked tubal involvement is uncommon…. Read More…

Chronic Cough

Posted by • October 20th, 2016

Cough is the most common symptom for which patients seek medical attention. Chronic cough is more common among women than among men, most commonly occurs in the fifth and sixth decades of life, and can persist for years, with substantial physical, social, and psychological effects. Professional guidelines describe systematic approaches to the evaluation and management… Read More…

Graves’ Disease

Posted by • October 20th, 2016

Graves’ disease is an autoimmune disorder in which the thyroid is activated by antibodies to the thyrotropin receptor. The hyperthyroidism that develops is one of many somatic and psychiatric manifestations of the disease that can affect the quality and length of life. The disease is the most common cause of hyperthyroidism, with an annual incidence… Read More…

A Man with Diplopia and Polyuria

Posted by • October 13th, 2016

The histologic diagnosis of IgG4-related disease is predicated on the presence of characteristic histologic features, which include the presence of a dense lymphoplasmacytic infiltrate accompanied by storiform fibrosis (fibrosis with a whorled or starlike pattern that resembles a woven mat), obliterative phlebitis, or both. Another essential component of the diagnostic algorithm is the presence of… Read More…

Ten-Year Follow-up in the ProtecT Trial

Posted by • October 13th, 2016

The management of clinically localized prostate cancer that is detected on the basis of prostate-specific antigen (PSA) levels remains controversial. The National Institute for Health Research–supported Prostate Testing for Cancer and Treatment (ProtecT) trial was designed to evaluate the effectiveness of the three major contemporary treatment approaches to reducing prostate-cancer mortality and improving clinical outcomes… Read More…

Daratumumab for Myeloma

Posted by • October 6th, 2016

The incorporation of proteasome inhibitors and immunomodulatory drugs into the standard of care has improved outcomes in patients with multiple myeloma over the past 10 years, but most patients still eventually have a relapse. In the October 6, 2016, issue of the New England Journal of Medicine, Dimopoulos et al. report the results of a… Read More…

The Health Effects of Electronic Cigarettes

Posted by • October 6th, 2016

Although the sale of e-cigarettes is prohibited in some countries, it is legal in most, including the United States, where the FDA recently finalized rules for the regulation of e-cigarettes as a tobacco product. The U.S. market for e-cigarettes is now estimated to be worth $1.5 billion, a number that is projected to grow by… Read More…

Influenza Vaccination

Posted by • September 29th, 2016

The effects of influenza traditionally have been assessed by comparing hospitalizations and deaths during an influenza season with a baseline model. These calculations suggest that seasonal influenza epidemics in the United States are responsible for between 55,000 and 431,000 hospitalizations due to pneumonia and influenza each year and as many as 49,000 deaths. The highest… Read More…

Azithromycin Prophylaxis for Cesarean Delivery

Posted by • September 29th, 2016

Cesarean delivery is the most common major surgical procedure and is associated with a rate of surgical-site infection (including endometritis and wound infection) that is 5 to 10 times the rate for vaginal delivery. Tita et al. assessed whether the addition of azithromycin to standard antibiotic prophylaxis before skin incision would reduce the incidence of… Read More…