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  • Tuberculosis Elimination in the United States — The Need for Renewed Action
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-20
    Ronald Bayer, Kenneth G. Castro

    Tuberculosis has all but vanished from the U.S. public’s mind as a perceived threat, which jeopardizes the prospect of tuberculosis elimination in the United States. Critical ethical and policy questions must be addressed if elimination is to be pursued in earnest.

    更新日期:2017-09-20
  • A Nicotine-Focused Framework for Public Health
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-08-16
    Scott Gottlieb, Mitchell Zeller

    The FDA’s new tobacco strategy aims to reduce the addictiveness of combustible cigarettes while recognizing and clarifying the role that potentially less harmful tobacco products could play in improving public health.

    更新日期:2017-09-20
  • The Fate of FDA Postapproval Studies
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-20
    Steven Woloshin, Lisa M. Schwartz, Brian White, Thomas J. Moore
    更新日期:2017-09-20
  • Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-08-27
    Paul M Ridker, Brendan M. Everett, Tom Thuren, Jean G. MacFadyen, William H. Chang, Christie Ballantyne, Francisco Fonseca, Jose Nicolau, Wolfgang Koenig, Stefan D. Anker, John J.P. Kastelein, Jan H. Cornel, Prem Pais, Daniel Pella, Jacques Genest, Renata Cifkova, Alberto Lorenzatti, Tamas Forster, Zhanna Kobalava, Luminita Vida-Simiti, Marcus Flather, Hiroaki Shimokawa, Hisao Ogawa, Mikael Dellborg, Paulo R.F. Rossi, Roland P.T. Troquay, Peter Libby, Robert J. Glynn
    更新日期:2017-09-20
  • Bivalirudin versus Heparin Monotherapy in Myocardial Infarction
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-08-27
    David Erlinge, Elmir Omerovic, Ole Fröbert, Rikard Linder, Mikael Danielewicz, Mehmet Hamid, Eva Swahn, Loghman Henareh, Henrik Wagner, Peter Hårdhammar, Iwar Sjögren, Jason Stewart, Per Grimfjärd, Jens Jensen, Mikael Aasa, Lotta Robertsson, Pontus Lindroos, Jan Haupt, Helena Wikström, Anders Ulvenstam, Pallonji Bhiladvala, Bo Lindvall, Anders Lundin, Tim Tödt, Dan Ioanes, Truls Råmunddal, Thomas Kellerth, Leszek Zagozdzon, Matthias Götberg, Jonas Andersson, Oskar Angerås, Ollie Östlund, Bo Lagerqvist, Claes Held, Lars Wallentin, Fredrik Scherstén, Peter Eriksson, Sasha Koul, Stefan James
    更新日期:2017-09-20
  • Weight and Metabolic Outcomes 12 Years after Gastric Bypass
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-20
    Ted D. Adams, Lance E. Davidson, Sheldon E. Litwin, Jaewhan Kim, Ronette L. Kolotkin, M. Nazeem Nanjee, Jonathan M. Gutierrez, Sara J. Frogley, Anna R. Ibele, Eliot A. Brinton, Paul N. Hopkins, Rodrick McKinlay, Steven C. Simper, Steven C. Hunt
    更新日期:2017-09-20
  • Genetic Associations with Gestational Duration and Spontaneous Preterm Birth
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Ge Zhang, Bjarke Feenstra, Jonas Bacelis, Xueping Liu, Lisa M. Muglia, Julius Juodakis, Daniel E. Miller, Nadia Litterman, Pan-Pan Jiang, Laura Russell, David A. Hinds, Youna Hu, Matthew T. Weirauch, Xiaoting Chen, Arun R. Chavan, Günter P. Wagner, Mihaela Pavličev, Mauris C. Nnamani, Jamie Maziarz, Minna K. Karjalainen, Mika Rämet, Verena Sengpiel, Frank Geller, Heather A. Boyd, Aarno Palotie, Allison Momany, Bruce Bedell, Kelli K. Ryckman, Johanna M. Huusko, Carmy R. Forney, Leah C. Kottyan, Mikko Hallman, Kari Teramo, Ellen A. Nohr, George Davey Smith, Mads Melbye, Bo Jacobsson, Louis J. Muglia
    更新日期:2017-09-20
  • Food Allergy
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-20
    Caren G. Solomon
    更新日期:2017-09-20
  • Thrombophilia Testing and Venous Thrombosis
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-20
    Dan L. Longo
    更新日期:2017-09-20
  • Squamous-Cell Carcinoma of the Mouth
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-20
    Tanay V. Chaubal, Renjeet A. Bapat

    A 54-year-old woman who regularly chewed loose-leaf tobacco presented with swelling, soreness, and an indurated lesion in the floor of the mouth. A biopsy confirmed squamous-cell carcinoma.

    更新日期:2017-09-20
  • Intraocular Infection with a Trematode
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-20
    Pablo J. Guzman-Salas, Juan C. Serna-Ojeda
    更新日期:2017-09-20
  • The Road Less Traveled
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-20
    Caren G. Solomon, Amy Miller, Bruce D. Levy, Joseph Loscalzo

    This interactive feature presents the case of a 26-year-old woman with a 1-week history of worsening pleuritic chest pain. Test your diagnostic and therapeutic skills at NEJM.org.

    更新日期:2017-09-20
  • Case 29-2017 — A 59-Year-Old Woman with Pain and Swelling in the Right Hand and Ankles
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-20
    Richard C. Cabot, Eric S. Rosenberg, Virginia M. Pierce, David M. Dudzinski, Meridale V. Baggett, Dennis C. Sgroi, Jo-Anne O. Shepard, Allison R. Bond, Emily K. McDonald, Sally H. Ebeling
    更新日期:2017-09-20
  • Targeting Inflammation in Coronary Artery Disease
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-08-27
    Robert A. Harrington

    For more than 20 years, our understanding of the biology of atherosclerosis has incorporated the so-called inflammatory hypothesis.1,2 Inflammatory cells and signals drive the healing response to vascular injury, allowing the initiation and growth of atherosclerotic plaque. Inflammatory reactions probably increase plaque instability, possibly resulting in plaque rupture, fissuring, or erosion and setting up the substrate for the thrombotic response that causes myocardial damage or infarction. Yet, no strictly antiinflammatory drugs are used to treat patients with coronary artery disease. Effective cardiovascular drugs with antiinflammatory effects, such as aspirin and statins, predominantly exert therapeutic benefits by means of mechanisms other . . .

    更新日期:2017-09-20
  • Procedural Anticoagulation in Myocardial Infarction
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-08-27
    Gregg W. Stone

    The prognosis for patients with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) is improved with the use of percutaneous coronary intervention (PCI). Choosing the best procedural anticoagulation regimen to balance the risks of ischemia and bleeding during PCI is essential to optimize outcomes. Heparin, a nonspecific indirect thrombin inhibitor, was the only anticoagulant agent used during PCI for several decades, first with aspirin alone and then with aspirin plus a platelet P2Y12 receptor inhibitor (ticlopidine or clopidogrel). Adding a platelet glycoprotein IIb/IIIa receptor inhibitor to heparin therapy further reduced the risk of stent thrombosis, reinfarction, and death among patients . . .

    更新日期:2017-09-20
  • Health, Wealth, and the U.S. Senate
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-06-27
    Debra Malina, Stephen Morrissey, Mary Beth Hamel, Caren G. Solomon, Arnold M. Epstein, Edward W. Campion, Jeffrey M. Drazen

    The Better Care Reconciliation Act (BCRA), as the U.S. Senate calls the health care bill released by a small working group of Republican senators last week, is not designed to lead to better care for Americans. Like the House bill that was passed in early May, the American Health Care Act (AHCA), it would actually do the opposite: reduce the number of people with health insurance by about 22 million, raise insurance costs for millions more, and give states the option to allow insurers to omit coverage for many critical health care services so that patients with costly illnesses, preexisting . . .

    更新日期:2017-09-20
  • FDA Oversight of Postmarketing Studies
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-20
    Mwango Kashoki, Cathryn Lee, Peter Stein

    The FDA aims to ensure the timely dissemination of information from postmarketing studies of drugs. The authors argue that an analysis of the effect of the FDA Amendments Act would evaluate the timeliness of FDAAA postmarketing requirements separately from that of other types of requirements.

    更新日期:2017-09-20
  • Single-Nephron Glomerular Filtration Rate in Healthy Adults
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-20

    To the Editor: Denic et al. (June 15 issue)1 found a fairly constant single-nephron glomerular filtration rate (GFR) among kidney donors, even with declining numbers of nephrons in persons younger than 70 years of age. It is unclear whether there was a correlation between the number of nephrons and the single-nephron GFR in an analysis adjusted for demographic characteristics and other variables. It would be informative if the authors examined their data using such adjustments. Low birth weight has been associated with chronic kidney disease in adolescents2 and adults.3,4 Low birth weight has been shown to be associated with a . . .

    更新日期:2017-09-20
  • Glucocorticoid Sparing of Benralizumab in Asthma
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-20

    To the Editor: Nair et al. (June 22 issue)1 found in the ZONDA trial that the median blood eosinophil counts fell dramatically after treatment with benralizumab. In a previous trial, Bleecker et al.2 found that blood eosinophil counts were reduced by benralizumab treatment. To avoid bias, what was done to prevent unmasking of the trial-group assignment to the investigators by means of the patients’ eosinophil counts? To the Editor: Nair and colleagues found that benralizumab showed significant, clinically relevant benefits, as compared with placebo, on oral glucocorticoid use and exacerbation rates. However, certain proportions of patients who smoke were enrolled . . .

    更新日期:2017-09-20
  • Repeal, Replace, Repair, Retreat — Republicans’ Health Care Quagmire
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-08-09
    Jonathan Oberlander

    For 7 years, Republicans vowed to repeal and replace the Affordable Care Act. Less than 7 months into the Trump administration, that crusade has, at least for now, collapsed. Still, Obamacare’s fortunes remain uncertain.

    更新日期:2017-09-14
  • Small Change, Big Consequences — Partial Medicaid Expansions under the ACA
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-08-09
    Adrianna McIntyre, Allan M. Joseph, Nicholas Bagley

    The Trump administration may decide to permit states to partially expand their Medicaid programs to cover people with incomes up to 100% of the federal poverty level. Arkansas has requested a waiver to do so, and if it is granted, other states may follow suit.

    更新日期:2017-09-14
  • Patent Foramen Ovale after Cryptogenic Stroke — Assessing the Evidence for Closure
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Andrew Farb, Nicole G. Ibrahim, Bram D. Zuckerman
    更新日期:2017-09-14
  • Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Jean-Louis Mas, Geneviève Derumeaux, Benoît Guillon, Evelyne Massardier, Hassan Hosseini, Laura Mechtouff, Caroline Arquizan, Yannick Béjot, Fabrice Vuillier, Olivier Detante, Céline Guidoux, Sandrine Canaple, Claudia Vaduva, Nelly Dequatre-Ponchelle, Igor Sibon, Pierre Garnier, Anna Ferrier, Serge Timsit, Emmanuelle Robinet-Borgomano, Denis Sablot, Jean-Christophe Lacour, Mathieu Zuber, Pascal Favrole, Jean-François Pinel, Marion Apoil, Peggy Reiner, Catherine Lefebvre, Patrice Guérin, Christophe Piot, Roland Rossi, Jean-Luc Dubois-Randé, Jean-Christophe Eicher, Nicolas Meneveau, Jean-René Lusson, Bernard Bertrand, Jean-Marc Schleich, François Godart, Jean-Benoit Thambo, Laurent Leborgne, Patrik Michel, Luc Pierard, Guillaume Turc, Martine Barthelet, Anaïs Charles-Nelson, Christian Weimar, Thierry Moulin, Jean-Michel Juliard, Gilles Chatellier
    更新日期:2017-09-14
  • Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Stroke
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Jeffrey L. Saver, John D. Carroll, David E. Thaler, Richard W. Smalling, Lee A. MacDonald, David S. Marks, David L. Tirschwell
    更新日期:2017-09-14
  • Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Lars Søndergaard, Scott E. Kasner, John F. Rhodes, Grethe Andersen, Helle K. Iversen, Jens E. Nielsen-Kudsk, Magnus Settergren, Christina Sjöstrand, Risto O. Roine, David Hildick-Smith, J. David Spence, Lars Thomassen

    Among patients with a PFO who had had a cryptogenic stroke, the risk of subsequent ischemic stroke was lower among those assigned to PFO closure combined with antiplatelet therapy than among those assigned to antiplatelet therapy alone; however, PFO closure was associated with higher rates of device complications and atrial fibrillation. (Funded by W.L. Gore and Associates; Gore REDUCE ClinicalTrials.gov number, NCT00738894.)

    更新日期:2017-09-14
  • Evaluation of a Rapid Molecular Drug-Susceptibility Test for Tuberculosis
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Yingda L. Xie, Soumitesh Chakravorty, Derek T. Armstrong, Sandra L. Hall, Laura E. Via, Taeksun Song, Xing Yuan, Xiaoying Mo, Hong Zhu, Peng Xu, Qian Gao, Myungsun Lee, Jongseok Lee, Laura E. Smith, Ray Y. Chen, Joon Sung Joh, YoungSoo Cho, Xin Liu, Xianglin Ruan, Lili Liang, Nila Dharan, Sang-Nae Cho, Clifton E. III Barry, Jerrold J. Ellner, Susan E. Dorman, David Alland
    更新日期:2017-09-14
  • Hospital-Readmission Risk — Isolating Hospital Effects from Patient Effects
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Harlan M. Krumholz, Kun Wang, Zhenqiu Lin, Kumar Dharmarajan, Leora I. Horwitz, Joseph S. Ross, Elizabeth E. Drye, Susannah M. Bernheim, Sharon-Lise T. Normand
    更新日期:2017-09-14
  • Recent Developments in Radiotherapy
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Dan L. Longo

    Technological development has led to the more precise delivery of radiation to tumors. Advances in sensitizing tumors to and protecting normal tissues from the effects of radiation and in overcoming radiation resistance are improving the outcomes of radiotherapy.

    更新日期:2017-09-14
  • Marfan’s Syndrome with Ectopia Lentis
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Jayanth Sridhar, Jonathan S. Chang
    更新日期:2017-09-14
  • Iridodonesis
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Dhaval Desai, A. Jamil Tajik
    更新日期:2017-09-14
  • Case 28-2017 — A 13-Month-Old Girl with Pneumonia and a 33-Year-Old Woman with Hip Pain
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Richard C. Cabot, Eric S. Rosenberg, Virginia M. Pierce, David M. Dudzinski, Meridale V. Baggett, Dennis C. Sgroi, Jo-Anne O. Shepard, Allison R. Bond, Emily K. McDonald, Sally H. Ebeling
    更新日期:2017-09-14
  • Tipping Point for Patent Foramen Ovale Closure
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Allan H. Ropper
    更新日期:2017-09-14
  • Waving Hello to Noninvasive Deep-Brain Stimulation
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Elizabeth G. Phimister

    A recent study in mice provides proof of concept that deep-brain tissue can be specifically targeted by the exterior application of two electromagnetic fields of slightly different frequencies.

    更新日期:2017-09-14
  • Vaccination Rates among Younger Siblings of Children with Autism
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    Gena Glickman, Elizabeth Harrison, Karen Dobkins
    更新日期:2017-09-14
  • Head Positioning in Acute Stroke
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13

    To the Editor: Anderson et al. (June 22 issue)1 report that head positioning did not influence outcome in patients with acute stroke. The lying-flat position theoretically increases cerebral perfusion, which may alleviate acute ischemia through the recruitment of collaterals.2 However, in the Head Positioning in Acute Stroke Trial (HeadPoST), reported by Anderson et al., many patients had conditions that presumably were not the result of large perfusion defects: specifically, there were patients with stroke mimics (4.9%), lacunar stroke (30.2%), or intracerebral hemorrhage (8.4%). Moreover, the low median scores on the National Institutes . . .

    更新日期:2017-09-14
  • Transplanting HCV-Infected Kidneys into Uninfected Recipients
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-13
    更新日期:2017-09-14
  • From Last to First — Could the U.S. Health Care System Become the Best in the World?
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-07-14
    Eric C. Schneider, David Squires

    Commonwealth Fund reports have consistently rated the performance of the U.S. health care system last among high-income countries, though we spend far more on health care. An understanding of the reasons for that disparity may point the way to essential improvements.

    更新日期:2017-09-07
  • The HITECH Era and the Path Forward
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Vindell Washington, Karen DeSalvo, Farzad Mostashari, David Blumenthal
    更新日期:2017-09-07
  • The HITECH Era in Retrospect
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    John D. Halamka, Micky Tripathi

    The HITECH Act has played an invaluable role in accelerating the adoption of electronic health records throughout the United States. But along the way, the effort to computerize health care lost the hearts and minds of clinicians.

    更新日期:2017-09-07
  • Airway Mucin Concentration as a Marker of Chronic Bronchitis
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Mehmet Kesimer, Amina A. Ford, Agathe Ceppe, Giorgia Radicioni, Rui Cao, C. William Davis, Claire M. Doerschuk, Neil E. Alexis, Wayne H. Anderson, Ashley G. Henderson, R. Graham Barr, Eugene R. Bleecker, Stephanie A. Christenson, Christopher B. Cooper, MeiLan K. Han, Nadia N. Hansel, Annette T. Hastie, Eric A. Hoffman, Richard E. Kanner, Fernando Martinez, Robert III Paine, Prescott G. Woodruff, Wanda K. O’Neal, Richard C. Boucher
    更新日期:2017-09-07
  • Tiotropium in Early-Stage Chronic Obstructive Pulmonary Disease
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Yumin Zhou, Nan-shan Zhong, Xiaochen Li, Shuyun Chen, Jinping Zheng, Dongxing Zhao, Weimin Yao, Rongchang Zhi, Liping Wei, Bingwen He, Xiangyan Zhang, Changli Yang, Ying Li, Fenglei Li, Juan Du, Jianping Gui, Bin Hu, Chunxue Bai, Ping Huang, Gang Chen, Yongjian Xu, Changzheng Wang, Biao Liang, Yinhuan Li, Guoping Hu, Hui Tan, Xianwei Ye, Xitao Ma, Yan Chen, Xiwei Hu, Jia Tian, Xiaodan Zhu, Zhe Shi, Xiufang Du, Minjing Li, Shengming Liu, Ronghuan Yu, Jianping Zhao, Qianli Ma, Canmao Xie, Xiongbin Li, Tao Chen, Yingxiang Lin, Lizhen Zeng, Changxiu Ye, Weishu Ye, Xiangwen Luo, Lingshan Zeng, Shuqing Yu, Wei-jie Guan, Pixin Ran
    更新日期:2017-09-07
  • Tezepelumab in Adults with Uncontrolled Asthma
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Jonathan Corren, Jane R. Parnes, Liangwei Wang, May Mo, Stephanie L. Roseti, Janet M. Griffiths, René van der Merwe

    Among patients treated with long-acting beta-agonists and medium-to-high doses of inhaled glucocorticoids, those who received tezepelumab had lower rates of clinically significant asthma exacerbations than those who received placebo, independent of baseline blood eosinophil counts. (Funded by MedImmune [a member of the AstraZeneca Group] and Amgen; PATHWAY ClinicalTrials.gov number, NCT02054130.)

    更新日期:2017-09-07
  • Effectiveness of a Third Dose of MMR Vaccine for Mumps Outbreak Control
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Cristina V. Cardemil, Rebecca M. Dahl, Lisa James, Kathleen Wannemuehler, Howard E. Gary, Minesh Shah, Mona Marin, Jacob Riley, Daniel R. Feikin, Manisha Patel, Patricia Quinlisk
    更新日期:2017-09-07
  • Randomized, Controlled Trials in Health Insurance Systems
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Jeffrey M. Drazen, David P. Harrington, John J.V. McMurray, James H. Ware, Janet Woodcock
    更新日期:2017-09-07
  • Severe and Difficult-to-Treat Asthma in Adults
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Jeffrey M. Drazen
    更新日期:2017-09-07
  • Neobladder Stone
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Sabine Nguyen, Chester Choi
    更新日期:2017-09-07
  • Left Ventricular Free-Wall Rupture
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Enrico Cerrato, Ferdinando Varbella
    更新日期:2017-09-07
  • Connecting the Dots
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Caren G. Solomon
    更新日期:2017-09-07
  • Airway Mucins in Chronic Obstructive Pulmonary Disease
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Jadwiga A. Wedzicha

    Chronic bronchitis, also known as chronic mucus hypersecretion, is common in cigarette smokers and is a key component of chronic obstructive pulmonary disease (COPD). After the publication of the seminal study by Fletcher and Peto in the 1970s,1 chronic bronchitis was recognized as being associated with cigarette smoking and conferring a predisposition to lower respiratory infections, but was reported as not influencing the progressive airway obstruction that is characteristic of COPD.2 However, a number of later studies showed that chronic bronchitis was indeed not a benign feature of COPD and was clearly linked to disease progression, hospital admission, and mortality.3 . . .

    更新日期:2017-09-07
  • Drug Treatment for Early-Stage COPD
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Fanny W.S. Ko, Gary W.K. Wong

    Chronic obstructive pulmonary disease (COPD) is a common disease with an estimated global prevalence of 11.7%, affecting almost 400 million people around the world.1 In the United States, approximately 14% of adults 40 to 79 years of age have COPD.2 Although the prevalence of different stages of COPD as defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD)3 varies among different countries,4 early-stage COPD — stage 1 disease, a facet of which is a forced expiratory volume in 1 second (FEV1) of 80% or more of the predicted value, and stage 2 disease, which includes an FEV1 of . . .

    更新日期:2017-09-07
  • Moving Upstream — Anti-TSLP in Persistent Uncontrolled Asthma
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Elisabeth H. Bel

    At least 15% of patients with asthma have a poor response to standard therapy with inhaled glucocorticoids and long-acting bronchodilators.1 Even after nonadherence to treatment and inadequate inhalation technique are addressed, a substantial percentage of patients continue to have frequent exacerbations and hospitalizations.2 Over the past three decades, research has led to an improved understanding of the complex biologic mechanisms of airway inflammation. This, in turn, has led to the development of several monoclonal antibody–based, targeted add-on treatments for asthma that are approved by the Food and Drug Administration or are in phase 3 of development. These include monoclonal antibodies . . .

    更新日期:2017-09-07
  • Zoonotic Chlamydia caviae Presenting as Community-Acquired Pneumonia
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06
    Bart P. Ramakers, Marloes Heijne, Natascha Lie, Thuy-Nga Le, Monique van Vliet, Vivian P.J. Claessen, Paulien J.P. Tolsma, Mauro De Rosa, Hendrik I.J. Roest, Daisy Vanrompay, Edou R. Heddema, Peter Schneeberger, Mirjam H.A. Hermans
    更新日期:2017-09-07
  • Early, Goal-Directed Therapy for Septic Shock — A Patient-Level Meta-Analysis
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06

    To the Editor: In reporting the results of their meta-analysis of individual patient data from three trials, the Protocolized Resuscitation in Sepsis Meta-Analysis (PRISM) investigators (June 8 issue)1 conclude that early, goal-directed therapy (EGDT) did not result in better outcomes than usual care in the resuscitation of patients with septic shock. I was hoping that the meta-analysis would answer an important question — what is usual care? EGDT is a well-defined intervention to guide hemodynamic resuscitation according to targets for central venous pressure, mean arterial blood pressure, urinary output, and central venous oxygen saturation. Which monitoring tools and hemodynamic targets . . .

    更新日期:2017-09-07
  • Buprenorphine for the Neonatal Abstinence Syndrome
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-09-06

    To the Editor: Kraft et al. (June 15 issue)1 report that in the Blinded Buprenorphine or Neonatal Morphine Solution (BBORN) trial, the duration of treatment in infants with the neonatal abstinence syndrome was shorter with buprenorphine than with morphine. I am concerned that these findings do not account for the likely effects of 30% ethanol in their standard buprenorphine solution. Ethanol is a well-known facilitator of the γ-aminobutyric acid receptor, and its inclusion (one assumes to facilitate the stability of the solution) may have had an effect on the outcome of the trial. It seems to me that Kraft et . . .

    更新日期:2017-09-07
  • A Tale of Two Epidemics — HCV Treatment among Native Americans and Veterans
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-08-30
    Brigg Reilley, Jessica Leston

    In recent years, the Department of Veterans Affairs health care system has mounted a response to hepatitis C that should be the envy of any health system. On the other hand, the Indian Health Service is struggling to meet the needs of its patients with hepatitis C.

    更新日期:2017-08-31
  • Interprofessional Education — A Foundation for a New Approach to Health Care
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-08-30
    Alan Dow, George Thibault

    Training practitioners with better skills in teamwork and communication is thought to be essential for preventing medical errors, and it may help reduce health inequities and reverse rising costs by providing patients with the amount and type of expertise they need.

    更新日期:2017-08-31
  • Abandonment
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-08-30
    Ranjana Srivastava

    Having arranged for a patient to be transferred from another hospital to a hospice across town, the oncologist still feels sucked into a vortex of issues beyond her control. When, out of guilt, she visits, a nurse tells her, “Many patients just feel dumped at hospice.”

    更新日期:2017-08-31
  • Emicizumab Prophylaxis in Hemophilia A with Inhibitors
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-07-10
    Johannes Oldenburg, Johnny N. Mahlangu, Benjamin Kim, Christophe Schmitt, Michael U. Callaghan, Guy Young, Elena Santagostino, Rebecca Kruse-Jarres, Claude Negrier, Craig Kessler, Nancy Valente, Elina Asikanius, Gallia G. Levy, Jerzy Windyga, Midori Shima
    更新日期:2017-08-31
  • Targeting of Antithrombin in Hemophilia A or B with RNAi Therapy
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-07-10
    K. John Pasi, Savita Rangarajan, Pencho Georgiev, Tim Mant, Michael D. Creagh, Toshko Lissitchkov, David Bevan, Steve Austin, Charles R. Hay, Inga Hegemann, Rashid Kazmi, Pratima Chowdary, Liana Gercheva-Kyuchukova, Vasily Mamonov, Margarita Timofeeva, Chang-Heok Soh, Pushkal Garg, Akshay Vaishnaw, Akin Akinc, Benny Sørensen, Margaret V. Ragni
    更新日期:2017-08-31
  • Alectinib versus Crizotinib in Untreated ALK-Positive Non–Small-Cell Lung Cancer
    N. Engl. J. Med. (IF 72.406) Pub Date : 2017-06-06
    Solange Peters, D. Ross Camidge, Alice T. Shaw, Shirish Gadgeel, Jin S. Ahn, Dong-Wan Kim, Sai-Hong I. Ou, Maurice Pérol, Rafal Dziadziuszko, Rafael Rosell, Ali Zeaiter, Emmanuel Mitry, Sophie Golding, Bogdana Balas, Johannes Noe, Peter N. Morcos, Tony Mok
    更新日期:2017-08-31
Some contents have been Reproduced with permission of the American Chemical Society.
Some contents have been Reproduced by permission of The Royal Society of Chemistry.
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