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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...
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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...