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Keep Your Eyes on the Prize — Focusing on Health Care Equity N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-11 Alicia Fernandez, and Marshall H. Chin From the Department of Medicine, University of California, San Francisco (A.F.), and the Department of Medicine, University of Chicago, Chicago (M.H.C.).
Prioritization of individual social-needs screening in health care may strip energy, attention, and resources from the goal of advancing equity in patient experience and clinical outcomes.
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Chronic Silicosis N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-11 Shan Kai Ing Sibu General Hospital, Sibu, Malaysia, Sze Shyang Kho Sarawak General Hospital, Kuching, Malaysia
A 47-year-old man was incidentally found to have diffuse nodular opacities on chest radiography. He had worked in a quarry for more than 30 years.
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Global Health Law for a Safer and Fairer World N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-08 Debra Malina, Sam Halabi, Lawrence O. Gostin, Olohikhuae Egbokhare, and Matthew M. Kavanagh From the O’Neill Institute for National and Global Health Law, Georgetown University Law Center and Georgetown University School of Health, Washington, DC.
After Covid-19, the global health community must address major gaps in global preparedness, critical capacities needed for a safer and fairer world, and international instruments required for reali...
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Case 14-2024: A 30-Year-Old Woman with Back Pain, Leg Stiffness, and Falls N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-09 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, Christopher T. Doughty, Pamela W. Schaefer, Kate Brizzi, and Jenny J. Linnoila From the Department of Neurology, Brigham and Women’s Hospital (C.T.D.), the Departments of Radiology (P.W.S.), Medicine (K.B.), and Neurology (K.B., J.J.L
A 30-year-old woman was evaluated because of back pain, leg stiffness, and falling. Tone was increased in the legs. Exaggeration of the normal lumbar lordosis was seen on MRI. A diagnosis was made.
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Microplastics and Nanoplastics in Atheromas N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-09
To the Editor: Marfella et al. (March 7 issue)1 found the presence of microplastics and nanoplastics (MNPs) in carotid artery plaque and linked it with a higher risk of cardiovascular events. Howev...
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Physiological Integration of Taste and Metabolism N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-09 Dan L. Longo, Josephine M. Egan From the Diabetes Section, Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore.
Much of what we learned in school about how we taste is wrong. Progress in understanding how taste works is providing insights that may help in the management of obesity, diabetes, and other illnesses.
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Recombinant ADAMTS13 for Immune Thrombotic Thrombocytopenic Purpura N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-09 Pavan K. Bendapudi, Brody H. Foy, Sarah B. Mueller, Jun Liu, Louis M. Feingold, Kristen E. Burke, Wendy Cruz, Maria Y. Chen, Emily S. Lau, Rachel L. Goldberg, Ishan Tatake, Shelby C. Wilkinson, Brian J. Carney, James R. Stone, Doyun Park, Alzira R. Avelino, Sajjad Hassan, Chester Andrzejewski, Kristen N. Ruby, Kenneth D. Friedman, Patricia A.R. Brunker, Rebecca K. Leaf, John Higgins, Walter H. Dzik
In patients with immune thrombotic thrombocytopenic purpura (iTTP), autoantibodies against the metalloprotease ADAMTS13 lead to catastrophic microvascular thrombosis. However, the potential benefit...
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Trial of Thrombectomy for Stroke with a Large Infarct of Unrestricted Size N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-09 Vincent Costalat, Tudor G. Jovin, J.F. Albucher, Christophe Cognard, Hilde Henon, Nasreddine Nouri, Benjamin Gory, Sebastien Richard, Gaultier Marnat, Igor Sibon, Federico Di Maria, Mariam Annan, Grégoire Boulouis, Pere Cardona, Michael Obadia, Michel Piotin, Romain Bourcier, Benoit Guillon, Sophie Godard, Anne Pasco-Papon, Omer F. Eker, Tae-Hee Cho, Guillaume Turc, Olivier Naggara, Stéphane Velasco
The use of thrombectomy in patients with acute stroke and a large infarct of unrestricted size has not been well studied.We assigned, in a 1:1 ratio, patients with proximal cerebral vessel occlusio...
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Gene Editing for CEP290-Associated Retinal Degeneration N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-06 Eric A. Pierce, Tomas S. Aleman, Kanishka T. Jayasundera, Bright S. Ashimatey, Keunpyo Kim, Alia Rashid, Michael C. Jaskolka, Rene L. Myers, Byron L. Lam, Steven T. Bailey, Jason I. Comander, Andreas K. Lauer, Albert M. Maguire, and Mark E. Pennesi From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine
CEP290-associated inherited retinal degeneration causes severe early-onset vision loss due to pathogenic variants in CEP290. EDIT-101 is a clustered regularly interspaced short palindromic repeats ...
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Video versus Direct Laryngoscopy for Urgent Intubation of Newborn Infants N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-05 Lucy E. Geraghty, Emma A. Dunne, Caitríona M. Ní Chathasaigh, Akke Vellinga, Niamh C. Adams, Eoin M. O’Currain, Lisa K. McCarthy, and Colm P.F. O’Donnell From the Departments of Neonatology (L.E.G., E.A.D., C.M.N.C., E.M.O., L.K.M., C.P.F.O.) and Radiology (N.C.A.), National Maternity Hospital, and the School of Medicine (L.E.G., C.M.N.C., E.M.O., L.K.M., C.P.F.O.) and the Centre for Support and Training
Repeated attempts at endotracheal intubation are associated with increased adverse events in neonates. When clinicians view the airway directly with a laryngoscope, fewer than half of first attempt...
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All’s Fair in Love and Work N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-04 Tessa Adžemović From the Fogarty International Center, U.S. National Institutes of Health, Kampala, Uganda, and Brigham and Women’s Hospital and Boston Children’s Hospital — both in Boston.
Hounded by questions about her love life, a young physician finds relief in the isolation imposed by the Covid pandemic, while she gains an education in the meaning of love from patients’ stories.
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Reengineering Addiction — The Tobacco Industry’s Potential Response to a Nicotine Standard for Cigarettes N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-04 Ahmad El-Hellani, Theodore L. Wagener, and Marielle C. Brinkman From the Divisions of Environmental Health Sciences (A.E.-H.) and Epidemiology (M.C.B.), College of Public Health, the Center for Tobacco Research, Comprehensive Cancer Center (A.E.-H., T.L.W., M.C.B.), and the Division of Medical Oncology, Department of Internal Medicine (T.L.W.), Ohio State University, Columbus.
The FDA is considering implementing a nicotine product standard, under which cigarettes could contain only very low levels of nicotine. Preparing for the tobacco industry’s potential response is im...
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Lymphatic Filariasis N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-04 Matiar Madanchi University Hospital Basel, Basel, Switzerland, Peter Itin Basel, Switzerland
A 72-year-old man who had emigrated from Zimbabwe 20 years previously presented with a 17-year history of swelling of the penis, scrotum, and left leg.
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Highly Pathogenic Avian Influenza A(H5N1) Virus Infection in a Dairy Farm Worker N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-03 Timothy M. Uyeki Centers for Disease Control and Prevention, Atlanta, GA, Scott Milton, and Cherissa Abdul Hamid Texas Department of State Health Services, Lubbock, TX, Cynthia Reinoso Webb, and Steven M. Presley Texas Tech University Bioterrorism Response Laboratory, Lubbock, TX, Varun Shetty, Susan N. Rollo, Diana L. Martinez, Saroj Rai, and Emilio R. Gonzales Texas Department of State Health Services
A highly pathogenic avian influenza A(H5N1) virus infection was identified in a dairy farm worker in Texas. This pathogen has been reported in multiple dairy herds in several states.
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Depression — Understanding, Identifying, and Diagnosing N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-02 Eleanor Anderson, Christine M. Crawford, Maurizio Fava, Julie Ingelfinger, Sina Nikayin, Gerard Sanacora, Shannon Scott-Vernaglia, and Joseph Teel From the Perelman School of Medicine at the University of Pennsylvania, Philadelphia (E.A., J.T.), Boston Medical Center (C.M.C.) and Massachusetts General Hospital (M.F., S.S.-V.) — both in Boston, and Yale School of Medicine, New Haven, CT (S.N., G.S.)
This first episode of the four-part Double Take video miniseries on depression empowers the primary care physician to screen for, diagnose, and address suicidality.
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Double Corneal Arcus N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-02 Ziyuan Liu, and Wei Wang Peking University Third Hospital, Beijing, China
A 63-year-old woman was noted to have white-yellow rings in both eyes. On slit-lamp examination, two concentric rings were seen in each cornea.
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The Meat of the Matter N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-02 Caren G. Solomon, David Rutenberg, Yumeng Zhang, Jose G. Montoya, John Sinnott, and Despina G. Contopoulos-Ioannidis From the Department of Medicine, Division of Infectious Disease and International Medicine, Morsani College of Medicine, University of South Florida (D.R., Y.Z., J.S.), and the Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute (Y.Z.) — both in Tampa
A 32-year-old woman with no notable medical history presented to the ED with a 10-day history of shortness of breath, fevers, and cough. She also reported sore throat and myalgias but no chest pain.
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Trial Update of Pitavastatin to Prevent Cardiovascular Events in HIV Infection N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-02 Steven K. Grinspoon Massachusetts General Hospital, Boston, MA, Heather J. Ribaudo Harvard T.H. Chan School of Public Health, Boston, MA, Pamela S. Douglas Duke Clinical Research Institute, Durham, NC
In the final results of a randomized trial involving patients with HIV infection, pitavastatin reduced the incidence of adverse cardiovascular events at 5.6 years of follow-up as compared with placebo.
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CAR T-Cell Therapy in Autoimmune Disease N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-02
To the Editor: In the case series presented by Müller et al. (Feb. 22 issue),1 CD19-targeting chimeric antigen receptor (CAR) T-cell therapy in patients with systemic lupus erythematosus (SLE) resu...
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Being Well while Doing Well N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-02
To the Editor: We welcome Rosenbaum’s commentary on contemporary medical training in her Medicine and Society article (Feb. 8 issue)1 and do not dispute the veracity of the anecdotal situations pre...
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A Phase 3 Trial of Resmetirom in NASH with Liver Fibrosis N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-02
To the Editor: Harrison et al. (Feb. 8 issue)1 found that resmetirom treatment reduced levels of free thyroxine (FT4) by approximately 16 to 19% in patients with nonalcoholic steatohepatitis (NASH)...
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Chronic Lymphocytic Leukemia Therapy Guided by Measurable Residual Disease N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-02
To the Editor: In their article on the latest FLAIR platform trial involving patients with chronic lymphocytic leukemia (CLL), Munir and colleagues (Jan. 25 issue)1 found that the percentage of pat...
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Cryptococcal Disease in Diverse Hosts N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-02 C. Corey Hardin, David B. Meya, and Peter R. Williamson From the Infectious Diseases Institute and the Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda (D.B.M.), the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.B.M.), and the Laboratory of Clinical Immunology and Microbiology, National
Cryptococcus accounts for up to 180,000 deaths annually and 68% of HIV-related meningitis cases. The authors discuss diagnostic, preventive, and therapeutic strategies and the pathophysiological ro...
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Recombinant ADAMTS13 in Congenital Thrombotic Thrombocytopenic Purpura N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-02 Marie Scully, Ana Antun, Spero R. Cataland, Paul Coppo, Claire Dossier, Nathalie Biebuyck, Wolf-Achim Hassenpflug, Karim Kentouche, Paul Knöbl, Johanna A. Kremer Hovinga, M. Fernanda López-Fernández, Masanori Matsumoto, Thomas L. Ortel, Jerzy Windyga, Indranil Bhattacharya, Michael Cronin, Hong Li, Björn Mellgård, Munjal Patel, Parth Patwari, Shan Xiao, Pinghai Zhang, and Linda T. Wang the cTTP Phase
Congenital thrombotic thrombocytopenic purpura (TTP) results from severe hereditary deficiency of ADAMTS13. The efficacy and safety of recombinant ADAMTS13 and standard therapy (plasma-derived prod...
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Journal Voices in the Civil Rights Era — New Horizons and Limits in Medical Publishing N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-27 Merlin Chowkwanyun From the Mailman School of Public Health, Columbia University, New York.
During the social tumult of the 1960s and 1970s, the Journal opened its pages to advocates of reform in the profession and society at large, but it did not completely break with its troubled racial...
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Acute Promyelocytic Leukemia N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-27 Christoph Winkler Tirol Kliniken, Innsbruck, Austria
A 47-year-old man presented with 2-day history of weakness and fever. Laboratory studies showed pancytopenia. A bone marrow biopsy showed promyelocytes with abundant intracellular rods.
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The Quest for Transformative Tools to Eradicate Malaria N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-02 Trevor Mundel From the Bill and Melinda Gates Foundation, Seattle.
We in the global malaria community are at a critical juncture in our journey toward malaria eradication. Decades of experience in deploying our existing interventions have made it clear that there ...
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Subcutaneous Administration of a Monoclonal Antibody to Prevent Malaria N. Engl. J. Med. (IF 158.5) Pub Date : 2024-05-02 Kassoum Kayentao, Aissata Ongoiba, Anne C. Preston, Sara A. Healy, Zonghui Hu, Jeff Skinner, Safiatou Doumbo, Jing Wang, Hamidou Cisse, Didier Doumtabe, Abdrahamane Traore, Hamadi Traore, Adama Djiguiba, Shanping Li, Mary E. Peterson, Shinyi Telscher, Azza H. Idris, William C. Adams, Adrian B. McDermott, Sandeep Narpala, Bob C. Lin, Leonid Serebryannyy, Somia P. Hickman, Andrew J. McDougal, Sandra
Subcutaneous administration of the monoclonal antibody L9LS protected adults against controlled Plasmodium falciparum infection in a phase 1 trial. Whether a monoclonal antibody administered subcut...
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The Public Good on the Docket — The Supreme Court’s Evolving Approach to Public Health N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-24 Joshua M. Sharfstein, and Lawrence O. Gostin From the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore (J.M.S.), and the O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC (L.O.G.).
The Supreme Court has imposed new legal principles that impede the ability of states, Congress, and agencies to use evidence to protect the public. It now has the opportunity to reconsider this app...
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Welcoming the Era of Gene Editing in Medicine N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-24 George Q. Daley From Boston Children’s Hospital and Harvard Medical School — both in Boston.
Recent approvals of exa-cel for treatment of sickle cell disease and transfusion-dependent β-thalassemia mark the dawn of the era of gene editing in medicine. But ensuring access will be challenging.
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Extending Gene Medicines to All in Need N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-24 Joseph M. McCune, and Hans-Peter Kiem From the Global Health Division, Bill and Melinda Gates Foundation (J.M.M.), and the Fred Hutchinson Cancer Center and University of Washington School of Medicine (H.-P.K.) — all in Seattle.
Sixty years ago, Fessas and Stamatoyannopoulos noticed that patients with hereditary persistence of fetal hemoglobin have a milder course of β-thalassemia than other patients with the condition.1 L...
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Specificity of CRISPR-Cas9 Editing in Exagamglogene Autotemcel N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-24 Angela Yen, Zachary Zappala, Rebecca S. Fine, and Timothy D. Majarian Vertex Pharmaceuticals, Boston, MA, Parin Sripakdeevong CRISPR Therapeutics, Boston, MA, David Altshuler Vertex Pharmaceuticals, Boston, MA
The autologous cellular therapy exagamglogene autotemcel is generated by editing an erythroid-specific enhancer of BCL11A. Could another site be edited unintentionally? This study gauged the likeli...
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Exagamglogene Autotemcel for Severe Sickle Cell Disease N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-24 Haydar Frangoul, Franco Locatelli, Akshay Sharma, Monica Bhatia, Markus Mapara, Lyndsay Molinari, Donna Wall, Robert I. Liem, Paul Telfer, Ami J. Shah, Marina Cavazzana, Selim Corbacioglu, Damiano Rondelli, Roland Meisel, Laurence Dedeken, Stephan Lobitz, Mariane de Montalembert, Martin H. Steinberg, Mark C. Walters, Michael J. Eckrich, Suzan Imren, Laura Bower, Christopher Simard, Weiyu Zhou, Fengjuan
Exagamglogene autotemcel (exa-cel) is a nonviral cell therapy designed to reactivate fetal hemoglobin synthesis by means of ex vivo clustered regularly interspaced short palindromic repeats (CRISPR...
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Exagamglogene Autotemcel for Transfusion-Dependent β-Thalassemia N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-24 Franco Locatelli, Peter Lang, Donna Wall, Roland Meisel, Selim Corbacioglu, Amanda M. Li, Josu de la Fuente, Ami J. Shah, Ben Carpenter, Janet L. Kwiatkowski, Markus Mapara, Robert I. Liem, Maria Domenica Cappellini, Mattia Algeri, Antonis Kattamis, Sujit Sheth, Stephan Grupp, Rupert Handgretinger, Puja Kohli, Daoyuan Shi, Leorah Ross, Yael Bobruff, Christopher Simard, Lanju Zhang, Phuong Khanh Morrow
Exagamglogene autotemcel (exa-cel) is a nonviral cell therapy designed to reactivate fetal hemoglobin synthesis through ex vivo clustered regularly interspaced short palindromic repeats (CRISPR)–Ca...
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Age-Related Hearing Loss N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-25 Patrick G. O’Malley, Frank R. Lin From the Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore.
Hearing progressively declines with age, manifesting initially as difficulty understanding speech in background noise and detrimentally affecting social functioning. Strategies and technologies can...
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CAR T-Cells and Safety Signals N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-25
This podcast episode examines CAR T-cell therapy’s early successes, broader promise, and emerging risks, as the FDA considers reports of occasional secondary cancers.
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Case 13-2024: A 27-Year-Old Man with Leg Weakness N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-25 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, Andrew S. Allegretti, Cynthia L. Czawlytko, Nikolaos Stathatos, and Peter M. Sadow From the Departments of Medicine (A.S.A., N.S.), Radiology (C.L.C.), and Pathology (P.M.S.), Massachusetts General Hospital, and the Departments of Medicine
A 27-year-old man presented with weight loss, diarrhea, tremor, and proximal muscle weakness. The blood level of potassium was 1.8 mmol per liter. A diagnosis was made.
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Drug-Induced Oxidative Hemolysis N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-25 Wing Kit Lam, and Sze Fai Yip Tuen Mun Hospital, Hong Kong, China
A 57-year-old woman presented with a 3-day history of shortness of breath and dizziness. Laboratory studies showed severe anemia with hemolysis, along with cellular abnormalities in peripheral blood.
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CAR as Booster to Launch Allogeneic Transplantation in Refractory Leukemia N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-25 Didier Blaise From the Department of Hematology, Transplant and Cellular Immunotherapy Program, Institut Paoli Calmettes, Management Sport Cancer laboratory, Aix-Marseille University, Marseille, France.
Chimeric antigen receptor (CAR) T-cell therapies have revolutionized the treatment landscape for patients with relapsed or refractory B-cell lymphoid cancers.1 With studies showing that more than 5...
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Oral Simnotrelvir for Adult Patients with Mild-to-Moderate Covid-19 N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-25
To the Editor: Cao et al. (Jan. 18 issue)1 evaluated changes in log10 copies of SARS-CoV-2 RNA per milliliter in adults with mild-to-moderate Covid-19 receiving simnotrelvir or placebo. However, on...
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Corin and Left Atrial Cardiomyopathy, Hypertension, Arrhythmia, and Fibrosis N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-25
To the Editor: Baris Feldman et al. (Nov. 2 issue)1 describe two siblings with biallelic loss-of-function (Met229Aspfs*16) variants in CORIN and hypertension, atrial fibrillation, atrial fibrosis, ...
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Buprenorphine Dispensing after Elimination of the Waiver Requirement N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-25 Kao-Ping Chua, Mark C. Bicket, and Amy S.B. Bohnert University of Michigan Medical School, Ann Arbor, MI, Rena M. Conti Boston University Questrom School of Business, Boston, MA, Pooja Lagisetty University of Michigan Medical School, Ann Arbor, MI, Thuy D. Nguyen University of Michigan School of Public Health, Ann Arbor, MI
In the year after the elimination of a waiver requirement to prescribe buprenorphine, the number of prescribers increased above the anticipated value, but the number of persons who received the dru...
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Skin Antisepsis before Surgical Fracture Fixation N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-25
To the Editor: In the PREPARE trial conducted by the PREP-IT investigators, Sprague and colleagues (Feb. 1 issue)1 found a protective effect of skin antisepsis with iodine povacrylex as compared wi...
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Two Randomized Trials of Low-Dose Calcium Supplementation in Pregnancy N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-25
To the Editor: The noninferiority trials of high-dose and low-dose calcium supplementation that were reported by Dwarkanath et al. (Jan. 11 issue)1 were premised on the assumption that high-dose ca...
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Nutritional Support for Moderate-to-Late–Preterm Infants — A Randomized Trial N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-25 Tanith Alexander, Sharin Asadi, Michael Meyer, Jane E. Harding, Yannan Jiang, Jane M. Alsweiler, Mariana Muelbert, and Frank H. Bloomfield the DIAMOND Trial Group* From Liggins Institute (T.A., S.A., J.E.H., M. Muelbert, F.H.B.), the Department of Statistics, Faculty of Science (Y.J.), and the Department of Paediatrics, Child and Youth Health (J.M.A.), University of Auckland, and the Neonatal Unit
Most moderate-to-late–preterm infants need nutritional support until they are feeding exclusively on their mother’s breast milk. Evidence to guide nutrition strategies for these infants is lacking....
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Sequential CD7 CAR T-Cell Therapy and Allogeneic HSCT without GVHD Prophylaxis N. Engl. J. Med. (IF 158.5) Pub Date : 2024-04-25 Yongxian Hu, Mingming Zhang, Tingting Yang, Zhuomao Mo, Guoqing Wei, Ruirui Jing, Houli Zhao, Rongrong Chen, Cheng Zu, Tianning Gu, Pingnan Xiao, Ruimin Hong, Jingjing Feng, Shan Fu, Delin Kong, Huijun Xu, Jiazhen Cui, Simao Huang, Bin Liang, Xiaolin Yuan, Qu Cui, Hongshan Guo, Yunxian Yu, Youqin Feng, Chunxiang Jin, Jiangtao Ren, Alex H. Chang, Dongrui Wang, and He Huang From the Bone Marrow Transplantation
Patients with relapsed or refractory hematologic cancers have a poor prognosis. Chimeric antigen receptor (CAR) T-cell therapy as a bridge to allogeneic hematopoietic stem-cell transplantation (HSC...
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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...