Posts Tagged ‘NEJM Group’

Vasopressin Antagonists

Posted by • June 5th, 2015

A new review in the Disorders of Fluids and Electrolytes series summarizes the salient discoveries that culminated in the development of vasopressin antagonists, focusing on their actions, side effects, emerging safety concerns, and important gaps in data. The review also considers how and when to use these agents. Ample evidence is available to implicate vasopressin, a… Read More…

In Sight and Out of Mind

Posted by • June 5th, 2015

In the latest Clinical Problem-Solving article, a 21-year-old man presented to the emergency department with fever and rash. His fever had started about 1 week before presentation and was associated with chills, myalgia, nausea, and vomiting. He also had a headache without photophobia. In the United States, recent declines in the rate of vaccination against measles… Read More…

Ezetimibe and Cardiovascular Outcomes

Posted by • June 3rd, 2015

As you walk into Mr. R’s room to see if he has last-minute questions about his discharge medications, you can’t believe how different – how much better – he looks dressed in his usual clothes, instead of an errantly-snapped hospital gown.   You met him 4 days ago, when he was wheeled, pale and groggy, onto… Read More…

High-Flow Oxygen Therapy: a Lifesaver for Patients with Acute Hypoxemic Respiratory Failure

Posted by • June 2nd, 2015

For hospitalists and residents across the country, this is an all too familiar scenario: a 60-year-old man is admitted to the hospital with pneumonia. Unfortunately, his course is complicated by acute hypoxemic respiratory failure secondary to the pneumonia, and he is transferred to the ICU. Physicians would like to avoid intubation if possible due to… Read More…

Latent Tuberculosis Infection

Posted by • May 29th, 2015

About one third of the world population has latent M. tuberculosis infection. A new review explains the approach to patients with latent infection, including an update on the risks and benefits of treatment and assessment of the likelihood of progression to active disease. Studies suggest that active tuberculosis will develop in 5 to 15% of persons… Read More…

Intractable Pain Due to Cancer

Posted by • May 29th, 2015

In the latest Case Record of the Massachusetts General Hospital, a 44-year-old woman with metastatic non–small-cell lung carcinoma with an EGFR mutation presented with severe pain, which was worsened by opioids other than hydrocodone and was unresponsive to most other analgesics. Management decisions were made. The discomfort of most dying patients can be controlled with state-of-the-art… Read More…

The Increasing Rate of Neonatal Withdrawal

Posted by • May 27th, 2015

When expecting mothers use opioids, their babies are exposed to the drugs in utero and, after birth, are at risk of withdrawal. The neonatal abstinence syndrome frequently necessitates admission to a Neonatal Intensive Care Unit (NICU) for treatment and monitoring. As the rate of opioid use among pregnant women has risen, the incidence of neonatal… Read More…

Pelvic Inflammatory Disease

Posted by • May 22nd, 2015

Pelvic inflammatory disease can produce acute symptoms and result in infertility, ectopic pregnancy, and chronic pelvic pain. A new review summarizes current approaches to diagnosis and treatment and the future prospects for better prevention strategies. Pelvic inflammatory disease is an infection-induced inflammation of the female upper reproductive tract (the endometrium, fallopian tubes, ovaries, or pelvic peritoneum)…. Read More…

A Girl with Seizures

Posted by • May 22nd, 2015

In the latest Case Record of the Massachusetts General Hospital, a 9-year-old girl presented to the emergency department with loss of consciousness and a seizure. She had returned from a trip to Puerto Rico 3 weeks earlier. Unilateral inguinal lymphadenopathy was present, and rapidly progressive encephalopathy developed. The diagnosis of cat scratch disease is based primarily… Read More…

Refractory Metastatic Colon Cancer

Posted by • 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…