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. These posts can now be found on NEJM Resident 360.

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…

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…