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Hospital Consolidation and Physician Unionization N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-20 Kevin Schulman, and Barak Richman From the Clinical Excellence Research Center, School of Medicine (K.S., B.R.), and the Graduate School of Business (K.S.), Stanford University, Stanford, CA, and the George Washington University School of Law, Washington, DC (B.R.).
Most physicians now face the experience of being employees of hospitals or other large organizations. Unionization is a natural consequence of consolidation and the corporatization of health care d...
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Beyond Code Status N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-20 Louise Aronson From the Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco.
Despite being absolutely clear that she wanted a quick, painless end of life, a geriatrician’s elderly mother receives aggressive care. How can we ensure that such patient preferences are honored?
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The Myth of the Free Market for Pharmaceuticals N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-20 Rena M. Conti, Richard G. Frank, and David M. Cutler From the Questrom School of Business, Boston University, Boston (R.M.C.), and the Conference on Research in Income and Wealth (R.M.C.), the National Bureau of Economic Research (R.G.F., D.M.C.), and the Department of Economics, Harvard University (D.M.C.), Cambridge — all in Massachusetts, and the Brookings Institution, Washington, DC (R.G.F.).
The U.S. pharmaceutical market has always been influenced by government. The 2022 Inflation Reduction Act is the latest policy aiming to improve access and affordability while supporting innovation.
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Small-Bowel Bleeding N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-20 Zongli Han Peking University Shenzhen Hospital, Shenzhen, China, Yanli Du Shenzhen Polytechnic University, Shenzhen, China
Abdominal pain and large-volume hematochezia developed in a man who was in the hospital for a ruptured cerebral aneurysm. Findings on endoscopy and colonoscopy were unremarkable, so CT angiography ...
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Increasing Firearm-Related Deaths among U.S. Black Rural Youths N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-19 Allison Lind, Susan M. Mason, and Elizabeth Wrigley-Field University of Minnesota, Minneapolis, MN
Mortality among young persons has risen, with firearm-related deaths disproportionately affecting Black youths. Firearm-related deaths now affect Black youths across both rural and urban settings.
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Fair Allocation of GLP-1 and Dual GLP-1–GIP Receptor Agonists N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-17 Ezekiel J. Emanuel, Johan L. Dellgren, Matthew S. McCoy, and Govind Persad From the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia (E.J.E., J.L.D., M.S.M.), the Bergen Center for Ethics and Priority Setting, University of Bergen, Bergen, Norway (E.J.E., J.L.D., M.S.M., G.P.), and the Sturm College of Law, University of Denver, Denver
A shortage of GLP-1 receptor agonists and other drugs raises questions about how limited supplies should be allocated. A proposed framework could guide governments, professional societies, and phys...
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Injured, Not Sidelined N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-18
This season finale examines the moral injury that the current U.S. health care system inflicts on physicians and trainees — and how they may be able to offer care that aligns with their values.
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Case 12-2024: A 58-Year-Old Woman with Confusion, Aphasia, and Abnormal Head Imaging N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-18 Richard C. Cabot, Eric S. Rosenberg, David M. Dudzinski, Meridale V. Baggett, Kathy M. Tran, Dennis C. Sgroi, Jo-Anne O. Shepard, Emily K. McDonald, and Tara Corpuz, Jenny J. Linnoila, Otto Rapalino, Melissa A. Walker, and Maria Martinez-Lage From the Department of Neurology, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh (J.J.L.), and the Departments
A 58-year-old woman was transferred to the hospital after 16 months of waxing and waning confusion and aphasia and evolving changes on MRI of the head. A diagnosis was made.
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Aortic Coarctation N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-18 Bailang Chen, and Minxin Wei The University of Hong Kong–Shenzhen Hospital, Shenzhen, China
A 35-year-old man received an incidental diagnosis of hypertension during a routine medical assessment. Computed tomographic angiography revealed aortic coarctation.
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Adjuvant Immunotherapy for Kidney Cancer — A New Strategy with New Challenges N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-18 Martin H. Voss, and Robert J. Motzer From Memorial Sloan Kettering Cancer Center, New York.
Surgery with curative intent constitutes the standard of care for patients with advanced renal-cell carcinoma, yet more than 50% of patients with high-risk features will have disease recurrence. Tw...
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Outbreak of Listeriosis Associated with Consumption of Vegan Cheese N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-18 Alexandre Leclercq Institut Pasteur, Paris, France, Mathieu Tourdjman Santé Publique France, Saint-Maurice, France, Wesley Mattheus Sciensano, Brussels, Belgium, Ingrid Friesema Rijksinstituut voor Volksgezondheid en Milieu, Utrecht, the Netherlands, Nina M. van Sorge Amsterdam UMC, Amsterdam, the Netherlands, Sven Halbedel, and Hendrik Wilking Robert Koch Institute, Berlin, Germany, Marc Lecuit Institut
Plant-based cheeses are marketed as safe alternatives to raw-milk cheese for populations at high risk for foodborne infection. Listeriosis cases in Europe, including in pregnancy, were linked to co...
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On Calling N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-18
To the Editor: Rosenbaum’s cri de coeur in her Medicine and Society article (Feb. 1 issue)1 omits the role of physicians in the genesis of our present system. Before the post–World War II era, Amer...
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Four-Drug Therapy for Multiple Myeloma N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-18
To the Editor: In the PERSEUS trial reported by Sonneveld et al. (Jan. 25 issue),1 transplantation-eligible patients with newly diagnosed multiple myeloma were assigned to receive either subcutaneo...
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Stroke Prevention in Subclinical Atrial Fibrillation N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-18
To the Editor: In the ARTESIA trial involving patients with subclinical atrial fibrillation, Healey and colleagues (Jan. 11 issue)1 compared apixaban with aspirin with respect to stroke or systemic...
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Peripartum Cardiomyopathy N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-18
To the Editor: The review of peripartum cardiomyopathy by Arany (Jan. 11 issue)1 suggests that hormonal changes are the main culprit underlying the condition. In light of the widely held opinion th...
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Retinoblastoma Origins and Destinations N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-18 Dan L. Longo, David Cobrinik From the Vision Center, Department of Surgery, and Saban Research Institute, Children’s Hospital Los Angeles, and the Departments of Ophthalmology and Biochemistry and Molecular Medicine, Roski Eye Institute, and Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California — both in Los Angeles.
The study of retinoblastoma has led to fundamental insights into carcinogenesis, cell-cycle regulation, the genetic basis of cancer, and tumor-suppressor genes, as well as to advances in therapy.
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Overall Survival with Adjuvant Pembrolizumab in Renal-Cell Carcinoma N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-18 Toni K. Choueiri, Piotr Tomczak, Se Hoon Park, Balaji Venugopal, Tom Ferguson, Stefan N. Symeonides, Jaroslav Hajek, Yen-Hwa Chang, Jae-Lyun Lee, Naveed Sarwar, Naomi B. Haas, Howard Gurney, Piotr Sawrycki, Mauricio Mahave, Marine Gross-Goupil, Tian Zhang, John M. Burke, Gurjyot Doshi, Bohuslav Melichar, Evgeniy Kopyltsov, Ajjai Alva, Stephane Oudard, Delphine Topart, Hans Hammers, Hiroshi Kitamura
Adjuvant pembrolizumab therapy after surgery for renal-cell carcinoma was approved on the basis of a significant improvement in disease-free survival in the KEYNOTE-564 trial. Whether the results r...
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Twenty-Five Years after Columbine — Firearms and Public Health in the United States N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-13 David Hemenway From the Harvard T.H. Chan School of Public Health, Boston.
Since the Columbine shooting, the gun problem in the United States has worsened, and the Supreme Court’s new interpretations of the Second Amendment don’t help. But there are some reasons for hope.
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Advocating for a Healthy Response to Climate Change — COP28 and the Health Community N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-13 Jeni Miller, Courtney Howard, and Lujain Alqodmani From the Global Climate and Health Alliance, Berkeley, CA (J.M., C.H.), the Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, and Stanton Territorial Hospital, Yellowknife, NT — both in Canada (C.H.), the World Medical Association, Ferney-Voltaire, France, and EAT, Vienna (L.A.).
At the recent COP28 climate negotiations in Dubai, participants from the health care and public health communities advocated for a focus on both health and phasing out of fossil fuels.
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Silver Resident N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-13 Farrin A. Manian From the Department of Medicine, Mercy Hospital, St. Louis.
Increasingly, lifelong learning is not an option but a necessity, even for senior clinician educators. What should the roles — and goals — of such “silver residents” be?
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Expanding Applications of Clinical Genetic Testing — Ethical Challenges N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-13 Stephanie M. Fullerton, and Kyle B. Brothers From the Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle (S.M.F.), and the Norton Children’s Research Institute, University of Louisville School of Medicine, Louisville, KY (K.B.B.).
The widening scope and scale of genetic tests are posing new challenges, and the need to address these challenges is becoming immediately relevant for all clinicians, not just genetics experts.
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Hemotympanum with a Basilar Skull Fracture N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-13 Carlos Carazo Casas, and Marimar Medina Gonzalez Hospital Universitario Ramón y Cajal, Madrid, Spain
A 15-year-old boy presented with a 1-hour history of hearing loss and pain in the left ear after he had tripped and fallen on the street. An otoscopic examination of the left ear showed blood behin...
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Integrating Public Health and Health Care — Protecting Health as a Team Sport N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-10 Charlene A. Wong, Debra Houry, and Mandy K. Cohen From the Centers for Disease Control and Prevention, Atlanta.
Protecting health is a team sport — yet the public health and clinical care systems meant to advance this goal have been siloed for too long.
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Corporate Medicine 2.0 — Special Purpose Acquisition Companies in the United States N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-10 Nishant Uppal, and Zirui Song From the Department of Medicine, Brigham and Women’s Hospital (N.U.), the Department of Health Care Policy and the Center for Primary Care, Harvard Medical School (Z.S.), and the Department of Medicine, Massachusetts General Hospital (Z.S.) — all in Boston.
So-called special purpose acquisition companies represent a new phase in the corporatization of medicine, and their activities could have implications for providers, patients, and policymakers.
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Walking the Dog N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11
This podcast episode considers what happens when the rigors of training and the pursuit of excellence in medicine collide with the mental health needs of trainees.
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Case 11-2024: An 82-Year-Old Woman with Falls and Cognitive Decline N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11 Richard C. Cabot, Eric S. Rosenberg, David M. Dudzinski, Meridale V. Baggett, Kathy M. Tran, Dennis C. Sgroi, Jo-Anne O. Shepard, Emily K. McDonald, and Tara Corpuz, Sharon A. Chung, Ambrose J. Huang, Mandakolathur R. Murali, Bart K. Chwalisz, Zachary S. Wallace, and Liana N. Kozanno From the Department of Medicine, University of California, San Francisco, San Francisco (S.A.C.), and the Departments
An 82-year-old woman was admitted because of difficulty walking, falls, and cognitive decline. Light touch of the right hand, right knee, and both feet caused pain. A diagnosis was made.
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Central Cyanosis in Acquired Methemoglobinemia N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11 Pankaj Das, and Gautam Singh Base Hospital Delhi Cantt, Delhi, India
A 35-year-old man being treated for leprosy presented with a 4-day history of anxiety, insomnia, and resting tremor of the hands and feet. Bluish discoloration of the lips and tongue was seen on ex...
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Money as Medicine — Clinicism, Cash Transfers, and the Political–Economic Determinants of Health N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11 Debra Malina, Eric Reinhart From the Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago.
Cash transfers to individuals that the U.S. government made during the Covid pandemic demonstrated how such a policy tool could help address the political–economic determinants of health.
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Adjuvant Alectinib in ALK-Rearranged NSCLC — Here and Now N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11 Antonio Passaro, and Solange Peters From the Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan (A.P.), and Lausanne University Hospital, Lausanne, Switzerland (S.P.).
In 2009, the groundbreaking Iressa Pan-Asia Study (IPASS)1 showed the activity of gefitinib, a first-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), and marked a...
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CAR T-Cell Therapy for Glioblastoma N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11 Elizabeth G. Phimister, Misty R. Jenkins, and Katharine J. Drummond From the Immunology Division, Walter and Eliza Hall Institute, and the Department of Medical Biology, University of Melbourne, Parkville, VIC (M.R.J.), and the Department of Surgery, University of Melbourne, Melbourne, VIC (K.J.D.) — all in Australia.
Glioblastoma is the most formidable of primary brain tumors, owing to its aggressive nature and the limited efficacy of the best available treatment, which comprises maximal safe surgical resection...
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Nutrition in Medicine — A New Review Article Series N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11 C. Corey Hardin, Clement D. Lee, C. Corey Hardin, Dan L. Longo, and Julie R. Ingelfinger From Tufts University School of Medicine, Boston, and the Department of Hospital and Pediatrics, Newton–Wellesley Hospital, Newton, MA (C.D.L.).
The editors announce a new series focusing on fundamental and emerging concepts in nutrition, from the “pharmacodynamics” of food to the gut and immunity and the role of the gut microbiome in healt...
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CXCR4 Antagonist in HPV5-Associated Perianal Squamous-Cell Carcinoma N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11 Viviana Marin-Esteban, Lucie Molet, and Marta Laganà Université Paris-Saclay, INSERM, Orsay, France, Dragos Ciocan Assistance Publique–Hôpitaux de Paris, Clamart, France, Clément Dominguez-Lafage, Nagham Alouche, Julie Nguyen, Carmen Gallego, Françoise Mercier-Nomé, and Agnieszka Jaracz-Ros Université Paris-Saclay, INSERM, Orsay, France, Blandine Beaupain Centre de Référence des Neutropénies Chroniques
WHIM-like syndrome (warts, hypogammaglobulinemia, infections, and myelokathexis) developed in a patient with gain of CXCR4 function. Plerixafor, a CXCR4 antagonist, led to symptom reduction.
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Hospital Prices for Physician-Administered Drugs N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11
To the Editor: As a past physician owner of an oncology practice for 25 years and as a current employee of a hospital oncology program that is eligible for the federal 340B Drug Pricing Program, I ...
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Long-Term Outcomes of Resynchronization–Defibrillation for Heart Failure N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11
To the Editor: In the Resynchronization–Defibrillation for Ambulatory Heart Failure Trial (RAFT) by Sapp et al. (Jan. 18 issue),1 the authors found that the addition of cardiac-resynchronization th...
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Testosterone Treatment and Fractures in Men with Hypogonadism N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11
To the Editor: One in five men older than 50 years of age will have an osteoporosis-related fracture, which is often associated with high risks of complications and death and high costs.1 Guideline...
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Acoramidis in Transthyretin Amyloid Cardiomyopathy N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11
To the Editor: In a phase 3 trial of acoramidis for transthyretin amyloid cardiomyopathy, Gillmore et al. (Jan. 11 issue)1 used the Finkelstein–Schoenfeld test to assess the hierarchical composite ...
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Guidance on Energy and Macronutrients across the Life Span N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11 C. Corey Hardin, Steven B. Heymsfield, and Sue A. Shapses From the Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge (S.B.H.), and the Department of Nutritional Sciences and the New Jersey Institute for Food, Nutrition, and Health, Rutgers University, and the Department of Medicine, Rutgers–Robert Wood Johnson School of Medicine — both in New Brunswick (S.A.S.).
Poor nutrition is a major risk factor for disease. In this first review in a new series on nutrition, the authors provide an overview of nutritional guidance, with a focus on energy and macronutrients.
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Alectinib in Resected ALK-Positive Non–Small-Cell Lung Cancer N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11 Yi-Long Wu, Rafal Dziadziuszko, Jin Seok Ahn, Fabrice Barlesi, Makoto Nishio, Dae Ho Lee, Jong-Seok Lee, Wenzhao Zhong, Hidehito Horinouchi, Weimin Mao, Maximilian Hochmair, Filippo de Marinis, M. Rita Migliorino, Igor Bondarenko, Shun Lu, Qun Wang, Tania Ochi Lohmann, Tingting Xu, Andres Cardona, Thorsten Ruf, Johannes Noe, and Benjamin J. Solomon the ALINA Investigators* From the Guangdong Lung Cancer
Platinum-based chemotherapy is the recommended adjuvant treatment for patients with resectable, ALK-positive non–small-cell lung cancer (NSCLC). Data on the efficacy and safety of adjuvant alectini...
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Trial of Early Minimally Invasive Removal of Intracerebral Hemorrhage N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-11 Gustavo Pradilla, Jonathan J. Ratcliff, Alex J. Hall, Benjamin R. Saville, Jason W. Allen, Giorgio Paulon, Anna McGlothlin, Roger J. Lewis, Mark Fitzgerald, Angela F. Caveney, Xiao T. Li, Mark Bain, Joao Gomes, Brain Jankowitz, Georgios Zenonos, Bradley J. Molyneaux, Jason Davies, Adnan Siddiqui, Michael R. Chicoine, Salah G. Keyrouz, Jonathan A. Grossberg, Mitesh V. Shah, Ranjeet Singh, Bradley N
Trials of surgical evacuation of supratentorial intracerebral hemorrhages have generally shown no functional benefit. Whether early minimally invasive surgical removal would result in better outcom...
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Role of Physiology in the Management of Nonculprit Lesions in Acute Coronary Syndrome N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-08 Vijay Kunadian From the Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University and Cardiothoracic Centre, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom.
Current international clinical practice guidelines recommend complete revascularization for patients with ST-segment elevation myocardial infarction (STEMI) with multivessel coronary artery disease...
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FFR-Guided Complete or Culprit-Only PCI in Patients with Myocardial Infarction N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-08 Felix Böhm, Brynjölfur Mogensen, Thomas Engstrøm, Goran Stankovic, Ilija Srdanovic, Jacob Lønborg, Sammy Zwackman, Mehmet Hamid, Thomas Kellerth, Jörg Lauermann, Olli A. Kajander, Jonas Andersson, Rikard Linder, Oskar Angerås, Henrik Renlund, Andrejs Ērglis, Madhav Menon, Carl Schultz, Mika Laine, Claes Held, Andreas Rück, Ollie Östlund, and Stefan James the FULL REVASC Trial Investigators.* From the
The benefit of fractional flow reserve (FFR)–guided complete revascularization in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease remains un...
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Transcatheter or Surgical Treatment of Aortic-Valve Stenosis N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-08 Stefan Blankenberg, Moritz Seiffert, Reinhard Vonthein, Helmut Baumgartner, Sabine Bleiziffer, Michael A. Borger, Yeong-Hoon Choi, Peter Clemmensen, Jochen Cremer, Martin Czerny, Nina Diercks, Ingo Eitel, Stephan Ensminger, Derk Frank, Norbert Frey, Andreas Hagendorff, Christian Hagl, Christian Hamm, Utz Kappert, Matthias Karck, Won-Keun Kim, Inke R. König, Markus Krane, Ulf Landmesser, Axel Linke
Among low-risk patients with severe, symptomatic aortic stenosis who are eligible for both transcatheter aortic-valve implantation (TAVI) and surgical aortic-valve replacement (SAVR), data are lack...
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Routine Beta-Blockers in Secondary Prevention — On Injured Reserve N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-07 P. Gabriel Steg From Université Paris-Cité, Assistance Publique–Hôpitaux de Paris, INSERM Unité 1148, Laboratory for Vascular Translational Science, French Alliance for Cardiovascular Trials, Paris.
The benefit of beta-blockers after myocardial infarction was established before the advent of reperfusion and percutaneous coronary intervention and the availability of effective secondary preventi...
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Shooting the Messenger to Treat Hypertriglyceridemia N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-07 Elizabeth G. Phimister, Gerald F. Watts From the Cardiometabolic Service, Department of Cardiology, Royal Perth Hospital, and the Medical School of the University of Western Australia — both in Perth, Australia.
This editorial describes the science behind an antisense drug targeting APOC3 mRNA to treat hypertriglyceridemia.
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Olezarsen for Hypertriglyceridemia in Patients at High Cardiovascular Risk N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-07 Brian A. Bergmark, Nicholas A. Marston, Thomas A. Prohaska, Veronica J. Alexander, André Zimerman, Filipe A. Moura, Sabina A. Murphy, Erica L. Goodrich, Shuanglu Zhang, Daniel Gaudet, Ewa Karwatowska-Prokopczuk, Sotirios Tsimikas, Robert P. Giugliano, and Marc S. Sabatine the Bridge–TIMI 73a Investigators* From the TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women’s Hospital
Reducing the levels of triglycerides and triglyceride-rich lipoproteins remains an unmet clinical need. Olezarsen is an antisense oligonucleotide targeting messenger RNA for apolipoprotein C-III (A...
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Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-07 Troels Yndigegn, Bertil Lindahl, Katarina Mars, Joakim Alfredsson, Jocelyne Benatar, Lisa Brandin, David Erlinge, Ola Hallen, Claes Held, Patrik Hjalmarsson, Pelle Johansson, Patric Karlström, Thomas Kellerth, Toomas Marandi, Annica Ravn-Fischer, Johan Sundström, Ollie Östlund, Robin Hofmann, and Tomas Jernberg the REDUCE-AMI Investigators* From the Department of Cardiology, Clinical Sciences, Lund
Most trials that have shown a benefit of beta-blocker treatment after myocardial infarction included patients with large myocardial infarctions and were conducted in an era before modern biomarker-...
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Olezarsen, Acute Pancreatitis, and Familial Chylomicronemia Syndrome N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-07 Erik S.G. Stroes, Veronica J. Alexander, Ewa Karwatowska-Prokopczuk, Robert A. Hegele, Marcello Arca, Christie M. Ballantyne, Handrean Soran, Thomas A. Prohaska, Shuting Xia, Henry N. Ginsberg, Joseph L. Witztum, and Sotirios Tsimikas the Balance Investigators* From the Department of Vascular Medicine, Amsterdam University Medical Center, Amsterdam, (E.S.G.S.), Ionis Pharmaceuticals, Carlsbad (V.J
Familial chylomicronemia syndrome is a genetic disorder associated with severe hypertriglyceridemia and severe acute pancreatitis. Olezarsen reduces the plasma triglyceride level by reducing hepati...
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Self-Expanding or Balloon-Expandable TAVR in Patients with a Small Aortic Annulus N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-07 Howard C. Herrmann, Roxana Mehran, Daniel J. Blackman, Stephen Bailey, Helge Möllmann, Mohamed Abdel-Wahab, Walid Ben Ali, Paul D. Mahoney, Hendrik Ruge, David A. Wood, Sabine Bleiziffer, Basel Ramlawi, Hemal Gada, Anna Sonia Petronio, Charles D. Resor, William Merhi, Bruno Garcia del Blanco, Guilherme F. Attizzani, Wayne B. Batchelor, Linda D. Gillam, Mayra Guerrero, Toby Rogers, Joshua D. Rovin,
Patients with severe aortic stenosis and a small aortic annulus are at risk for impaired valvular hemodynamic performance and associated adverse cardiovascular clinical outcomes after transcatheter...
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Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-07 Jacob E. Møller, Thomas Engstrøm, Lisette O. Jensen, Hans Eiskjær, Norman Mangner, Amin Polzin, P. Christian Schulze, Carsten Skurk, Peter Nordbeck, Peter Clemmensen, Vasileios Panoulas, Sebastian Zimmer, Andreas Schäfer, Nikos Werner, Martin Frydland, Lene Holmvang, Jesper Kjærgaard, Rikke Sørensen, Jacob Lønborg, Matias G. Lindholm, Nanna L.J. Udesen, Anders Junker, Henrik Schmidt, Christian J. Terkelsen
The effects of temporary mechanical circulatory support with a microaxial flow pump on mortality among patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic sh...
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What Is Rheumatoid Arthritis? N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-04 Gary S. Firestein, Ellen M. Gravallese, Natalie Koscal, Emily Ling, Dan L. Longo, Lori A. Messenger, and Abigail Schubach From the University of California San Diego School of Medicine, La Jolla (G.S.F.), and Brigham and Women’s Hospital, Boston (E.G.).
This Double Take video provides a review of the pathogenesis, clinical features, and diagnostic evaluation of rheumatoid arthritis as well as therapeutic approaches to the disease.
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Building Up without Breaking Down N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-04
This podcast episode asks how medical educators should navigate between demanding intense commitment and hard-won excellence from trainees and seriously threatening their well-being.
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Anticoagulation for Secondary Atrial Fibrillation N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-04 Suellen Li, Gregory Y.H. Lip, Darae Ko, and Allan Walkey
This feature about a women with AF triggered by sepsis offers a case vignette accompanied by two essays, one supporting oral anticoagulant therapy after discharge and the other recommending no anti...
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Case 10-2024: A 46-Year-Old Woman with Hyperglycemia Refractory to Insulin Therapy N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-04 Richard C. Cabot, Eric S. Rosenberg, David M. Dudzinski, Meridale V. Baggett, Kathy M. Tran, Dennis C. Sgroi, Jo-Anne O. Shepard, Emily K. McDonald, and Tara Corpuz, Lindsay T. Fourman, Leo L. Tsai, Rebecca J. Brown, and Stephen O’Rahilly From the Departments of Medicine (L.T.F.) and Radiology (L.L.T.), Massachusetts General Hospital, and the Departments of Medicine (L.T.F.) and Radiology (L.L.T.)
A 46-year-old woman with type 2 diabetes was admitted to this hospital because of hyperglycemia for which she was receiving over 2000 units of insulin per day. A diagnosis was made.
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A Coin in the Airway N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-04 Victor Bor-Chang Hsue Cedars–Sinai Medical Center, Los Angeles, CA, Vijay Patel Rady Children’s Hospital–San Diego, San Diego, CA
A healthy 14-year-old boy presented with a 6-hour history of hoarseness and difficulty swallowing after having accidentally swallowed a coin. Bronchoscopy showed a coin situated vertically within t...
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Secondary Hypertrophic Osteoarthropathy N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-04 Margarida Lucas Rocha, and Vitor Silvestre-Teixeira Hospital de Faro, Faro, Portugal
A 55-year-old woman with a 29-pack-year smoking history presented with a 1.5-year history of pain in her fingers, wrists, hips, knees, and ankles. Clubbing of the fingers and toes was seen on exami...
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GLP-1, Parkinson’s Disease, and Neuroprotection N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-04 David G. Standaert From the Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham.
Parkinson’s disease is a common and debilitating disorder. The best-known features are resting tremor, rigidity, and slowness, but recently a fuller picture of the associated complications has emer...
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Early Treatment of Patent Ductus Arteriosus with Ibuprofen N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-04
To the Editor: In their randomized, placebo-controlled trial, Gupta and colleagues (Jan. 25 issue)1 found that among extremely preterm neonates (born between 23 weeks’ and 28 weeks’ gestation) with...
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Syphilis Complicating Pregnancy and Congenital Syphilis N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-04
To the Editor: In the review article by Stafford et al. (Jan. 18 issue),1 the description of therapy for congenital syphilis omitted a discussion of the Jarisch–Herxheimer reaction, which was descr...
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Drug-Eluting Resorbable Scaffold for Infrapopliteal Artery Disease N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-04
To the Editor: In their article on the LIFE-BTK trial, Varcoe et al. (Jan. 4 issue)1 compare treatment with a drug-eluting scaffold with angioplasty in patients with infrapopliteal artery disease a...
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Phase 2 Trial of Sibeprenlimab in Patients with IgA Nephropathy N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-04
To the Editor: In the ENVISION trial by Mathur et al. (Jan. 4 issue),1 the investigators found that in patients with IgA nephropathy, sibeprenlimab, a monoclonal antibody that binds APRIL (a prolif...