Posts Tagged ‘NEJM’

Heparin-Induced Thrombocytopenia

Posted by Carla Rothaus • July 17th, 2015

A new Clinical Practice article provides an overview of heparin induced thrombocytopenia. HIT is characterized by a platelet count fall of more than 50% at 5 to 10 days after the start of heparin and hypercoagulability. Platelet factor 4–heparin antibody testing has a high negative, but low positive, predictive value. Treatment involves therapeutic-dose anticoagulation. In contrast… Read More…

A Man with Sore Throat and Myalgias

Posted by Carla Rothaus • July 17th, 2015

In the latest Case Record of the Massachusetts General Hospital, a 20-year-old man presented with fever and a pericardial effusion. Five weeks earlier, sore throat, fever, malaise, and myalgias had developed. Broad-spectrum antibiotic therapy was administered, without improvement. A diagnosis was made. A number of case reports indicate an association between tamponade and adult-onset Still’s disease…. Read More…

Take the New Case Challenge!

Posted by Karen Buckley • July 16th, 2015

A 28-year-old pregnant woman was admitted in the summer with fever, headache, and fatigue. She reported neck stiffness, earache, intermittent contractions, and a possible erythematous rash on her shin. What is the most likely diagnosis? Vote and comment now on NEJM.org. The answer will appear within the full text of the Case Record of the Massachusetts… Read More…

Mastocytosis and Related Disorders

Posted by Carla Rothaus • July 10th, 2015

A new review article provides an overview of recent developments concerning the physiology and pathobiology of mast cells and discusses current diagnostic and therapeutic approaches to mast-cell disorders, with an emphasis on mastocytosis. Pathologic conditions involving mast cells appear to be more common than once thought. The diagnosis and treatment of such disorders are challenging, given… Read More…

Loss of FEV1 and the pathogenesis of COPD

Posted by Rachel Wolfson • July 8th, 2015

For years, the dominant model for the pathogenesis of chronic obstructive pulmonary disease (COPD) has been that exposure to particulate matter (usually tobacco smoke) leads to a rapid decline in lung function, i.e., more than 40ml of FEV1 per year. This paradigm has recently come into question, but a careful study to test this model… Read More…

Apply to Be an NEJM Editorial Fellow

Posted by Karen Buckley • July 6th, 2015

The NEJM invites applications for two one-year, full-time, paid editorial fellowships beginning in July 2016 from medical professionals at any career stage. Applications are due by September 1, 2015. The editorial fellows review and edit Images in Clinical Medicine submissions, organize the Clinical Decisions series and write the Quick Takes under the supervision of senior editors…. Read More…

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 think… 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 primarily… 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 is… 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…