Two decades ago, unable to swim, a palliative care physician was saved from a muscular riptide by a lifeguard. The sensation of drowning comes back to haunt her during the catastrophic time of the pandemic.

The 2023 Lasker Award for Basic Medical Research underscores the value of an AI system that predicts the three-dimensional structure of proteins from the one-dimensional sequence of their amino acids.

The 2023 Lasker–DeBakey Clinical Medical Research Award recognizes the effect of optical coherence tomography, invented by Drs. Fujimoto, Huang, and Swanson.

Historical oppression fueled both the Lāhainā fires and the health inequities faced by Native Hawaiian communities. Healing and rebuilding should be shaped by community voices and perspectives.

To the Editor: Lee and colleagues (July 13 issue)1 describe two patients with chronic graft-versus-host-disease (GVHD) in whom aggressive cutaneous squamous-cell carcinoma developed while they received treatment that included ruxolitinib or belumosudil, recently approved drugs for the management of chronic GVHD. These two patients had multiple risk factors for cutaneous squamous-cell carcinoma, including

To the Editor: Although the Perspective article by Miotto and Cogan (July 6 issue)1 calls attention to an important issue, it contains some factually incorrect statements. Existing research refutes claims that there are no data to inform us about how often drills should be conducted or their effects on actual school shootings.2 The authors reported that we performed unscheduled surprise active-shooter

To the Editor: The ZUMA-7 trial showed breakthrough progress in the treatment of early relapsed or refractory large B-cell lymphoma. However, Westin et al. (July 13 issue)1 listed limitations such as the low proportion of non-Hispanic patients, restricted eligibility as compared with the real-world distribution of the disease, and the absence of patients who were ineligible for autologous stem-cell

To the Editor: We describe the case of a 21-year-old man who died from an intractable disabling pansclerotic morphea (DPM). The disease began when he was 12 years of age and manifested as localized morphea with multiple oval, shiny, and thickened lesions. At 16 years of age, severe erosive ulcers developed on his hands, feet, and legs, resulting in a highly disabling form of DPM (

To the Editor: Lincoff et al. (July 13 issue)1 report the results of the Testosterone Replacement Therapy for Assessment of Long-term Vascular Events and Efficacy Response in Hypogonadal Men (TRAVERSE) trial, a noninferiority trial comparing the effect of testosterone-replacement therapy with that of placebo on major adverse cardiac events in men with hypogonadism and preexisting or high cardiovascular

A 34-year-old woman was admitted to the hospital because of abdominal distention, fatigue, and acute kidney injury that occurred 10 months after orthotopic liver transplantation. A diagnosis was made.

Background Detection of the BRAF V600E mutation in pediatric low-grade glioma has been associated with a lower response to standard chemotherapy. In previous trials, dabrafenib (both as monotherapy and in combination with trametinib) has shown efficacy in recurrent pediatric low-grade glioma with BRAF V600 mutations, findings that warrant further evaluation of this combination as first-line therapy

In this second episode of “Type 2 Diabetes — Controlling the Epidemic,” a four-part Double Take video miniseries from the New England Journal of Medicine, Drs. Jane E.B. Reusch (University of Colorado), E. Dale Abel (UCLA), and Monica Peek (University of Chicago) describe the process of tailoring type 2 diabetes interventions and education to the individual patient. The video also highlights the impact

In January 2023, the Science and Security Board of the Bulletin of the Atomic Scientists moved the hands of the Doomsday Clock forward to 90 seconds before midnight, reflecting the growing risk of nuclear war.1 In August 2022, United Nations Secretary-General António Guterres warned that the world is now in “a time of nuclear danger not seen since the height of the Cold War.”2 The danger has been underlined

The evidence for breast cancer screening of women in their 40s is insufficient to support a new public health imperative, given the uncertain benefits and common harms for healthy women.

Requests to help mold abortion legislation that runs counter to evidence-based medicine create substantial moral distress for clinicians and raise important ethical questions about how to respond.

To the Editor: In his Perspective article, Woodcock (June 29 issue)1 appropriately praises the effectiveness of the Montreal Protocol and argues for increased phasedown of hydrofluorocarbons (HFCs). However, there are three points that we think require some corrective clarification. First, the Antarctic ozone hole was not the proof of Rowland and Molina’s laboratory results. Computer models in the

To the Editor: As shown in the Videos in Clinical Medicine by Singh et al.,1 visual-field testing by confrontation is an important bedside examination technique in screening for defects in the anterior (retina and optic nerve) and posterior (optic chiasm to occipital lobe) visual pathways. Although confrontation testing has high specificity as compared with automated perimetry, its sensitivity is low

To the Editor: Kampmann et al. (Apr. 20 issue)1 report the results of the Maternal Immunization Study for Safety and Efficacy (MATISSE). Breast-feeding is an important potential modifying factor for respiratory syncytial virus (RSV) infection,2 and indeed the trial protocol says that these data will be collected. Can the authors provide outcomes stratified according to some, all, or no breast-feeding

Pharmacotherapy in patients with nonalcoholic steatohepatitis (NASH) has been a frustrating endeavor, with failures outnumbering successes by some margin, even in late-phase clinical trials. The complex pathobiologic features of NASH, the slow and variable natural history of the disease, and the nefarious nature of assessing histologic end points have contributed to the difficulty of attaining efficacy

A 37-year-old man was admitted because of difficulty with swallowing and a diffuse maculopapular rash. Laboratory evaluation revealed lymphopenia and an elevated globulin gap. A diagnosis was made.

Background The efficacy of continuous antibiotic prophylaxis in preventing urinary tract infection (UTI) in infants with grade III, IV, or V vesicoureteral reflux is controversial. Methods Download a PDF of the Research Summary. In this investigator-initiated, randomized, open-label trial performed in 39 European centers, we randomly assigned infants 1 to 5 months of age with grade III, IV, or V vesicoureteral

The use of continuous antibiotic prophylaxis in the prevention of urinary tract infection (UTI), particularly in children with vesicoureteral reflux, has been studied extensively during the past 15 years. Double-blind, placebo-controlled trials such as the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial and the Prevention of Recurrent Urinary Tract Infection in Children

Some members of the U.S. Congress want to apply the “global gag rule” regarding abortion to the President’s Emergency Plan for AIDS Relief, jeopardizing this essential global AIDS control program.

Rapid corporatization of health care raises questions about the corporate-practice-of-medicine doctrine and whether state laws could be strengthened to protect the profession and the public interest.

Recently, the FDA proposed guidance that would update the accelerated approval pathway for cancer drugs. Although the guidance includes important provisions, it could be strengthened.

Though health care consolidation was supposed to improve care coordination, a primary care physician in private practice finds specialists increasingly unlikely to keep him informed about patients.

Policy discussions related to affirmative action have typically focused on its effects on education, employment, and earnings. But affirmative action may also play a role in shaping population health.

To the Editor: In a recent letter to the editor, Belzer et al. (June 29 issue)1 note that armadillos as a maintenance host cannot account for all current cases of autochthonous leprosy in the United States. Armadillos also die from the disease, and whether the pathogen is maintained permanently in wild populations of armadillos is undetermined. In addition to armadillos, other animal hosts have been

To the Editor: Uda and Yashiro (June 8 issue)1 report a case that they described as idiopathic pulmonary hemosiderosis. Although the imaging provides an illustrative example for which alveolar hemorrhage is an important etiologic consideration, we wish to highlight additional critical steps in the evaluation of children with these imaging findings — namely, lung biopsy and genetic testing. Idiopathic

In this small case series, semaglutide after the diagnosis of type 1 diabetes led to elimination of prandial insulin in all patients and basal insulin in most, along with improved glycemic control.

This editorial describes the science behind a study that used base-edited CAR T cells to treat patients with T-cell lymphoblastic leukemia.

Obesity is a major risk factor for many health conditions, including cardiovascular disease, type 2 diabetes, sleep apnea, and cancer. The therapeutic armamentarium for long-term weight management is limited by side effects and contraindications.1 Two injectable incretin-based glucagon-like peptide-1 (GLP-1) receptor agonists — liraglutide (3.0 mg daily) and semaglutide (2.4 mg weekly) — have been

A 55-year-old man with acute myeloid leukemia began to have shortness of breath, cough with blood-tinged sputum, and hypoxemia 17 days after receiving a myeloablative allogeneic stem-cell transplant from a haploidentical donor.

Wilson’s disease, which may lead to severe copper overload and multiorgan dysfunction, is best managed collaboratively by specialists in hepatology, neurology, psychiatry, and clinical genetics.

In this first episode of “Type 2 Diabetes — Controlling the Epidemic,” a four-part Double Take video miniseries from the New England Journal of Medicine, Drs. Jane E.B. Reusch (University of Colorado), E. Dale Abel (UCLA), and Monica Peek (University of Chicago) discuss the pathophysiology of the disease and its common complications. The experts also review prediabetes and the importance of engaging

A new policy for foreign subrecipients of NIH funding departs sharply from decades of efforts to promote research integrity and build research capacity globally — and may have wide-ranging negative consequences.

In 20th-century China, gender norms were often a factor in the decision to wear a mask during an epidemic, and public health authorities and businesses took advantage of this.

Efforts to implement heat-safety protections for workers are falling short. Given these gaps, clinicians can help support their patients who may be at risk for heat-related illness.

Background Despite recent progress, multiple myeloma remains incurable. Mezigdomide is a novel cereblon E3 ubiquitin ligase modulator with potent antiproliferative and tumoricidal activity in preclinical models of multiple myeloma, including those resistant to lenalidomide and pomalidomide. Methods In this phase 1–2 study, we administered oral mezigdomide in combination with dexamethasone to patients

This editorial describes the science behind a study of mezigdomide, which augments the degradation of the proteins Ikaros and Aiolos, to treat multiple myeloma.

To the Editor: The trials by Mirza et al. and Eskander et al. (June 8 issue)1,2 showed that the addition of immune checkpoint inhibitor therapies to standard chemotherapy significantly improved progression-free survival among women who received a diagnosis of advanced mismatch repair–deficient (dMMR) endometrial cancer. The response rate among patients with advanced mismatch repair–proficient (pMMR)

To the Editor: An accurate examination of the baseline characteristics of the patients in the Trial to Evaluate Cardiovascular Outcomes in Patients Treated with the Tricuspid Valve Repair System Pivotal (TRILUMINATE Pivotal) by Sorajja et al. (May 18 issue)1 suggests a considerable overlap with heart failure with preserved ejection fraction, an extremely heterogeneous syndrome. The majority of patients

To the Editor: Hutchinson and colleagues (June 15 issue)1 report that in patients with traumatic acute subdural hematoma, surgical evacuation by means of routine depressive craniectomy (in which the bone flap is not replaced) provides no outcome benefit over craniotomy (in which the bone flap is replaced). We are interested in clarification of some issues to assist in understanding the implications

A provisional recommendation from the WHO against the use of artificial sweeteners to control body weight is supported by preclinical studies showing effects on immunity and cardiovascular health.

Orofacial clefts are the most common congenital facial anomaly. Fusion of the primary palate at 4 to 6 weeks of gestation facilitates the formation of the lip, nose, alveolus, and anterior hard palate. Fusion of the secondary palate at 6 to 12 weeks of gestation facilitates the formation of the posterior hard palate and the soft palate. The failure of fusion results in a gap that we call a “cleft.”

This editorial describes the science behind a clinical trial of concizumab, an inhibitor of a naturally occurring anticoagulant, to treat hemophilia A and B.

A 53-year-old woman with celiac disease was admitted with diarrhea and hemorrhagic shock. Imaging was notable for a retroperitoneal mass and horseshoe kidney. A diagnosis was made.

Medical AI tools that are trained on skewed data may exhibit bias. The authors discuss how thinking of clinical data as artifacts can identify values, practices, and patterns of inequity in health care.

Background Sickle cell disease is caused by a defect in the β-globin subunit of adult hemoglobin. Sickle hemoglobin polymerizes under hypoxic conditions, producing deformed red cells that hemolyze and cause vaso-occlusion that results in progressive organ damage and early death. Elevated fetal hemoglobin levels in red cells protect against complications of sickle cell disease. OTQ923, a clustered regularly

Background Population screening of asymptomatic persons with Epstein–Barr virus (EBV) DNA or antibodies has improved the diagnosis of nasopharyngeal carcinoma and survival among affected persons. However, the positive predictive value of current screening strategies is unsatisfactory even in areas where EBV is endemic. Methods We designed a peptide library representing highly ranked B-cell epitopes

Background Among infants with isolated cleft palate, whether primary surgery at 6 months of age is more beneficial than surgery at 12 months of age with respect to speech outcomes, hearing outcomes, dentofacial development, and safety is unknown. Methods Download a PDF of the Research Summary. We randomly assigned infants with nonsyndromic isolated cleft palate, in a 1:1 ratio, to undergo standardized

Background Concizumab is an anti–tissue factor pathway inhibitor monoclonal antibody designed to achieve hemostasis in all hemophilia types, with subcutaneous administration. A previous trial of concizumab (explorer4) established proof of concept in patients with hemophilia A or B with inhibitors. Methods Download a PDF of the Research Summary. We conducted the explorer7 trial to assess the safety

Background In patients with ST-segment elevation myocardial infarction (STEMI) with multivessel coronary artery disease, the time at which complete revascularization of nonculprit lesions should be performed remains unknown. Methods We performed an international, open-label, randomized, noninferiority trial at 37 sites in Europe. Patients in a hemodynamically stable condition who had STEMI and multivessel

Background Catheter-based pulmonary vein isolation is an effective treatment for paroxysmal atrial fibrillation. Pulsed field ablation, which delivers microsecond high-voltage electrical fields, may limit damage to tissues outside the myocardium. The efficacy and safety of pulsed field ablation as compared with conventional thermal ablation is not known. Methods In this randomized, single-blind, noninferiority

Background The role of catheter ablation in patients with symptomatic atrial fibrillation and end-stage heart failure is unknown. Methods We conducted a single-center, open-label trial in Germany that involved patients with symptomatic atrial fibrillation and end-stage heart failure who were referred for heart transplantation evaluation. Patients were assigned to receive catheter ablation and guideline-directed