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.

The Child or Adolescent with Elevated Blood Pressure

Posted by Sara Fazio • June 13th, 2014

Evaluation of children and adolescents with hypertension can detect evidence of the secondary systemic effects of hypertension (in particular, renal disease). Initial therapy is usually nonpharmacologic, but pharmacotherapy is used if other methods fail, hypertension is severe, or there are coexisting conditions such as diabetes mellitus.  NEJM Deputy Editor and Massachusetts General Hospital pediatrician Dr…. Read More…

Rash, Myalgia, and Weakness

Posted by Sara Fazio • June 13th, 2014

In the latest Case Record of the Massachusetts General Hospital, a 32-year-old man was admitted to this hospital because of a violaceous eruption that was followed by muscle pain and weakness, leading to respiratory failure. New papules with white centers developed. A diagnostic procedure was performed. Malignant atrophic papulosis can occur in association with autoimmune… Read More…

Adverse Health Effects of Marijuana Use

Posted by Sara Fazio • June 5th, 2014

As marijuana use becomes legal in some states, the dominant public opinion is that marijuana is a harmless source of mood alteration. Although the harms associated with marijuana use have not been well studied, enough information is available to cause concern.  A new review on this topic comes from Drs. Nora Volkow, Ruben Baler, Wilson… Read More…

Pregnancy and Infection

Posted by Sara Fazio • June 5th, 2014

Pregnant women have an increased severity of infections with some organisms, including influenza virus, hepatitis E virus, herpes simplex virus, and malaria parasites. A new review on this topic includes an update on immunologic alterations during pregnancy. Pregnant women are more severely affected by infections with some organisms, including influenza virus, hepatitis E virus, and… Read More…

Traumatic Intracranial Hypertension

Posted by Sara Fazio • May 30th, 2014

The latest article in the Critical Care series reviews the methods of monitoring and treating traumatic intracranial hypertension in intensive care settings. An elevation in intracranial pressure can be a medical or surgical emergency. There are many possible conditions that can lead to elevated intracranial pressure on either an acute or a chronic basis. Clinical Pearls… Read More…

Chest Pain and a Pleural Effusion

Posted by Sara Fazio • May 30th, 2014

In the latest Case Record of the Massachusetts General Hospital, a 64-year-old man was admitted to the hospital with recurrent pleuritic chest pain. Imaging showed a loculated left pleural effusion and underlying consolidation in the left lower lobe. Treatment with antibiotics brought some improvement, but pain recurred and worsened. The differential diagnosis of a persistent… Read More…

46-Year-Old Woman in Botswana with Postcoital Bleeding

Posted by Sara Fazio • May 23rd, 2014

In the latest Case Record of the Massachusetts General Hospital, a 46-year-old woman with HIV and a high-grade squamous intraepithelial lesion was evaluated in Botswana because of postcoital bleeding. During examination of the cervix and vagina, a large fungating lesion was seen. Diagnostic procedures were performed. Postcoital bleeding is defined as bleeding that occurs during… Read More…

Hoarding Disorder

Posted by Sara Fazio • May 23rd, 2014

The latest Clinical Practice article is on hoarding disorder, which is characterized by persistent difficulty in parting with possessions, resulting in severely cluttered living spaces, distress, and impairment. First-line treatment involves behavioral therapy specifically tailored to hoarding difficulties. Hoarding disorder is a mental disorder that has been newly included in the Diagnostic and Statistical Manual… Read More…

Ledipasvir and Sofosbuvir for 8 or 12 Weeks for Chronic HCV

Posted by Sara Fazio • May 16th, 2014

In previously untreated patients with HCV genotype 1 infection without cirrhosis, the rate of sustained virologic response was 94% with 8 weeks of ledipasvir–sofosbuvir, 93% with 8 weeks of ledipasvir–sofosbuvir plus ribavirin, and 95% with 12 weeks of ledipasvir–sofosbuvir. More than 3 million people in the United States are chronically infected with the hepatitis C… Read More…

Aortic Dilatation in Patients with Bicuspid Aortic Valve

Posted by Sara Fazio • May 16th, 2014

This new Review Article comes from University of Toronto’s Subodh Verma, M.D., Ph.D., and Western University’s Samuel C. Siu, M.D. Bicuspid aortic valve is the most common congenital heart defect in adults, affecting 1.3% of the population worldwide, and is responsible for more deaths and morbidity than the combined effects of all the other congenital… Read More…