Posts Tagged ‘NEJM’

Antimicrobial Therapy for Intraabdominal Infection

Posted by Chana Sacks • May 20th, 2015

When the paramedics wheeled Mr. L into the Emergency Department, you knew exactly what to do.  Low blood pressure: establish good IV access and start fluids. Fever of 102 and left lower quadrant abdominal pain: obtain blood cultures, order antibiotics, and get him to the CT scanner once his vitals stabilize. In medical school, you… Read More…

Refractory Metastatic Colon Cancer

Posted by Carla Rothaus • May 15th, 2015

TAS-102, a combination of trifluridine and tipiracil in which tipiracil interferes with the deactivation of trifluridine, improved overall and progression-free survival in patients whose disease had progressed after treatment with fluorouracil-containing drug combinations. A new Original Article assesses the efficacy and safety of TAS-102 in a global population of such patients. Early clinical trials conducted… Read More…

Appendectomy or “Antibiotics First”

Posted by Carla Rothaus • May 15th, 2015

Prompt appendectomy is generally recommended for uncomplicated appendicitis. Randomized trials comparing appendectomy with an antibiotics-first strategy have shown similar complication rates but substantial crossover to or later need for appendectomy with the latter strategy.  A new Clinical Practice review article covers this topic. A major uncertainty in the management of appendicitis is whether an appendectomy… Read More…

Incentive Programs to Urge Smokers to Quit: Lessons from Behavioral Science

Posted by Rachel Wolfson • May 13th, 2015

Many of the major public health issues currently threatening our population, including smoking and obesity, require lifestyle and behavioral changes. Effecting these changes in patients has been challenging, but a deeper understanding of the forces that drive human behavior could inspire the design of better programs leading to behavioral change. For example, behavioral scientists have… Read More…

Iron-Deficiency Anemia

Posted by Carla Rothaus • May 8th, 2015

Iron-deficiency anemia is the most common form of anemia in the world. A new review article covers the global nature of the disease, iron homeostasis in normal and iron-deficient states, clinical findings, treatment, and causes of iron-resistant iron deficiency. Iron is crucial to biologic functions, including respiration, energy production, DNA synthesis, and cell proliferation. Although… Read More…

Sick as a Dog

Posted by Carla Rothaus • May 8th, 2015

In the latest Clinical Problem-Solving article, a 42-year-old man presented to an emergency department in rural Colorado with a 2-day history of fever, cough with scant hemoptysis, chest pain, and myalgias. He reported no sick contacts and no oropharyngeal or gastrointestinal symptoms, rashes, or lymphadenopathy. Yersinia pestis is a gram-negative, facultatively anaerobic bacillus or coccobacillus… Read More…

Inflammatory Muscle Diseases

Posted by Carla Rothaus • May 1st, 2015

The four main types of inflammatory muscle disease — dermatomyositis, polymyositis, necrotizing autoimmune myositis, and inclusion-body myositis — are summarized in a new review article. Pathogenesis, differential diagnosis, and treatment approaches are discussed. The inflammatory myopathies constitute a heterogeneous group of disorders that are best classified, on the basis of distinct clinicopathologic features, as four… Read More…

A Woman with Shortness of Breath

Posted by Carla Rothaus • May 1st, 2015

In the latest Case Record of the Massachusetts General Hospital, a 58-year-old woman presented with an 8-month history of shortness of breath on exertion. Previous chest imaging had shown pleural thickening and peripheral nodules in the upper lung zones, without lymphadenopathy. A diagnostic procedure was performed. When a pulmonologist is presented with a case of… Read More…

A Woman with Arthralgias

Posted by Carla Rothaus • April 24th, 2015

In the latest Case Record of the Massachusetts General Hospital, a 27-year-old woman was seen in the emergency department of this hospital during the summer because of fever, arthralgias, and a rash. Three days before the onset of illness, she had returned from a vacation in the Caribbean. A diagnostic test was performed. When considering… Read More…

Uterine Fibroids

Posted by Carla Rothaus • April 24th, 2015

Fibroids, which are common in women of reproductive age, may cause heavy menstrual bleeding and symptoms related to leiomyoma bulk. Hysterectomy is an effective treatment, but many uterus-sparing options are available and should be discussed with patients. The latest Clinical Practice review is on this topic, and comes from Elizabeth A. Stewart, M.D., at the… Read More…