Nature Reviews Clinical Oncology, Published online: 29 November 2019; doi:10.1038/s41571-019-0306-1 The identification of biomarkers and the development of genomics-based assays predictive of outcomes following radiotherapy, in an effort to help guide the treatment of patients with cancer, is an area
Diagnosis of Pulmonary Embolism with d-Dimer Adjusted to Clinical Probability
The primary goal of diagnostic testing for pulmonary embolism is to identify which patients should be treated with anticoagulant agents and which should not. The patients who should be treated are those who have pulmonary embolism that has a substantial
WNT signaling and AHCTF1 promote oncogenic MYC expression through super-enhancer-mediated gene gating
Nature Genetics, Published online: 29 November 2019; doi:10.1038/s41588-019-0535-3 Oncogenic MYC expression involves super-enhancer-mediated tethering of MYC alleles to nuclear pores, thus increasing messenger RNA export. This is regulated by AHCTF1 and β-catenin.
From a distance — gene regulation in plants
Nature Reviews Genetics, Published online: 29 November 2019; doi:10.1038/s41576-019-0201-8 Two papers in Nature Plants provide evidence that plants, like mammals, regulate gene expression from long-range cis-regulatory elements (CREs). Plant CREs are widespread and have distinct evolutionarily conserved chromatin characteristics that
Trial of Satralizumab in Neuromyelitis Optica Spectrum Disorder
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease that is characterized by inflammatory lesions mainly affecting the optic nerve and spinal cord and possibly affecting the brain stem and cerebrum. Symptoms include visual impairment, paralysis, sensory loss, and bladder…
Imbalance in T-Helper 17 Cells and Targeted Therapy in an Infant with SAM-like Syndrome
To the Editor: The SAM syndrome, which is characterized by severe dermatitis, multiple allergies, and metabolic wasting (Online Mendelian Inheritance in Man number, 615508), is a congenital skin disease caused by mutations in the genes encoding either desmoglein-1 (DSG1) or
Diagnosis of Pulmonary Embolism with d-Dimer Adjusted to Clinical Probability
The primary goal of diagnostic testing for pulmonary embolism is to identify which patients should be treated with anticoagulant agents and which should not. The patients who should be treated are those who have pulmonary embolism that has a substantial
Case 36-2019: A 34-Year-Old Man with Dyspnea, Odynophagia, and Abdominal Pain
Presentation of Case. Dr. Pierre O. Ankomah (Medicine): A 34-year-old man with asthma was admitted to this hospital during the winter because of dyspnea. Three months before admission, odynophagia developed, and the patient noted white plaques in his mouth. He
Transforming Culture in Health Care
Health care organizations that are struggling to reorient themselves toward delivery of higher-value care often identify culture as their greatest barrier. As with any diagnostic process, accuracy and precision are essential. Despite health care’s widespread embrace and frequent use of
Congenital Syphilis
Figure 1.
Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus
Evidence supports the use of benzodiazepines as the initial treatment for status epilepticus; however, seizures do not respond to benzodiazepines in up to a third of patients. The treatment for this type of benzodiazepine-refractory status epilepticus has not been well
Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus
Evidence supports the use of benzodiazepines as the initial treatment for status epilepticus; however, seizures do not respond to benzodiazepines in up to a third of patients. The treatment for this type of benzodiazepine-refractory status epilepticus has not been well
Diagnosis of Pulmonary Embolism with d-Dimer Adjusted to Clinical Probability
The primary goal of diagnostic testing for pulmonary embolism is to identify which patients should be treated with anticoagulant agents and which should not. The patients who should be treated are those who have pulmonary embolism that has a substantial
Trial of Apremilast for Oral Ulcers in Behçet’s Syndrome
Behçet’s syndrome is a multisystem vasculitis that causes oral and genital ulcers, papulopustular and nodular lesions, arthritis, uveitis, arterial aneurysms, and arterial and venous thrombosis and may involve the central nervous system and gastrointestinal tract. Recurrent relapsing and remitting…
Heartbeat: is the keyword ‘atrial or ‘fibrillation?
The association of left atrial (LA) enlargement, atrial fibrillation (AF) and adverse cardiovascular outcomes is well known. However, it remains unclear whether this association is simply related to AF or whether LA size also is an important prognostic variable. In
Doctors call for action on poverty to reverse stalled life expectancy in Scotland
Public health doctors have called for urgent action from government to tackle stalled life expectancy in Scotland.Experts have identified low incomes faced by many people in Scotland as the leading…
Fitz-Hugh–Curtis Syndrome
Figure 1.
Case 37-2019: A 20-Month-Old Boy with Severe Anemia
Presentation of Case. Dr. Nicole de Paz (Pediatrics): A 20-month-old boy was admitted to the pediatric intensive care unit of this hospital because of severe anemia. The patient was well until 5 days before admission, when his aunt noted that
Cell-free gene expression: an expanded repertoire of applications
Nature Reviews Genetics, Published online: 28 November 2019; doi:10.1038/s41576-019-0186-3 Cell-free gene expression systems have long been used to address fundamental research questions. Now, owing to technological advances, these systems are finding wider applications in the field of synthetic biology, including
Diagnosis of Pulmonary Embolism with d-Dimer Adjusted to Clinical Probability
The primary goal of diagnostic testing for pulmonary embolism is to identify which patients should be treated with anticoagulant agents and which should not. The patients who should be treated are those who have pulmonary embolism that has a substantial
Management of Established Status Epilepticus
Status epilepticus is a medical emergency characterized either by continued seizures or by a lack of full recovery between seizures. It is relatively common, with a reported annual incidence of between 10 and 41 cases per 100,000 population (the variation
[Editorial] Research integrity: time for global action
China has become a formidable global leader in scientific—including medical—research, with the world’s largest publication output, a rapid surge in the number of highly cited researchers, and an increasingly unparalleled quality of scientific publications. However, there is often a shadow
Attacks on Ebola sites in DRC leave four workers dead
Four Ebola workers have been killed and five others injured during two attacks in eastern Democratic Republic of the Congo (DRC), the World Health Organization has reported.The dead include a…
Sports and exercise medicine coming together
The European College of Sports and Exercise Physicians (ECOSEP) has contributed to this issue of the BJSM, and brings together the Sports and Exercise Medicine community at the sixth ECOSEP–INSEP Congress in Paris 2019. It is really important to develop
Drug-Resistant E. coli Bacteremia Transmitted by Fecal Microbiota Transplant
An altered intestinal microbiome has been implicated in the pathogenesis of many disorders. Fecal microbiota transplantation (FMT) refers to the administration of intestinal microbes from a healthy donor into a recipient with the intent of modifying the recipient’s intestinal microbiome.
PrEParing to End the HIV Epidemic — California’s Route as a Road Map for the United States
More than 1.1 million U.S. adults are currently living with HIV, and 38,739 Americans were newly infected with the virus in 2017. Yet ending the U.S. epidemic — once unimaginable — has become a realistic endeavor. On February 5, 2019,
[Editorial] Infectious disease crisis in the Philippines
The Philippines was among the first countries in the world to introduce the Haemophilus influenzae type b vaccine, and one of the earliest countries in the Western Pacific region to introduce the rotavirus vaccine and the pneumococcal conjugate vaccine. The
Monoclonal Antibody Therapy for Ebola Virus Disease
Early reports in 1976 and 1995 documented cases in the Democratic Republic of Congo (DRC) of what we now know to be Ebola virus disease (EVD) caused by Zaire ebolavirus. The reports showed high case fatality rates and a propensity
An Anti-Opioid System, Courtesy of a Worm Model
The worm Caenorhabditis elegans is a simple yet powerful model organism that is useful in carrying out rapid genomewide genetic screens. There, high-throughput functional tests are designed to detect specific phenotypic (e.g. behavioral) deficits after the knockout of thousands of
Walter Fiers (1931–2019)
Walter Fiers, professor in Molecular Biology, passed away on July 28, 2019. From the very beginning of his scientific career, Walter Fiers has made groundbreaking contributions in a vast number of domains ranging from pure molecular biology to molecular virology
US Narrowly Preserves Measles Elimination Status
The official end of New York State’s measles outbreak allowed the United States to narrowly retain its measles elimination status, according to the US Department of Health and Human Services (HHS). Four other countries have already lost their measles elimination
Apremilast in Treatment-Refractory Recurrent Aphthous Stomatitis
To the Editor: Recurrent aphthous stomatitis is a chronic, painful ulcerative disease of the oral mucosa that may be resistant to treatment. Its clinical heterogeneity has complicated classification of the disorder, but variants in cytokine genes, including tumor necrosis factor
Sexual violence against women: a multidisciplinary integrated care model
Ades and colleagues say that women who have experienced sexual violence require multidisciplinary, trauma informed care tackling their medical and psychological needs, either short or long term.1 Our…
Case for genome sequencing in infants and children with rare, undiagnosed or genetic diseases
Up to 350 million people worldwide suffer from a rare disease, and while the individual diseases are rare, in aggregate they represent a substantial challenge to global health systems. The majority of rare disorders are genetic in origin, with children
Two new agents target KRAS G12C
Nature Reviews Clinical Oncology, Published online: 26 November 2019; doi:10.1038/s41571-019-0304-3 Two new agents target KRAS G12C
[Editorial] Essential medicines: a balancing act
On Oct 14, The New York Times reported on vincristine shortages in the USA, an essential chemotherapy drug with no appropriate substitute used as a backbone for many childhood cancers. Four days later, Teva, one of the two US manufacturers
June 2019 (vol. 220, no. 6, pages 590.e1-10)
Hersh AR, Skeith AE, Sargent JA, Caughey AB. Induction of labor at 39 weeks of gestation versus expectant management for low-risk nulliparous women: a cost-effectiveness analysis. Am J Obstet Gynecol 2019;220:590.e1-10.
Case 36-2019: A 34-Year-Old Man with Dyspnea, Odynophagia, and Abdominal Pain
Presentation of Case. Dr. Pierre O. Ankomah (Medicine): A 34-year-old man with asthma was admitted to this hospital during the winter because of dyspnea. Three months before admission, odynophagia developed, and the patient noted white plaques in his mouth. He
[Editorial] Pneumonia research: time to fill in the gaps
Pneumonia remains a leading cause of death worldwide without substantial improvements in mortality since the introduction of antibiotics over 50 years ago. Approximately 1 million adults in the USA attend hospital for the treatment of pneumonia each year, and 50 000
Pension reprieve: will the new scheme work for you?
Earlier this month NHS England announced a temporary scheme to allow doctors to work extra hours over winter, with the promise that the NHS would reimburse them for any additional tax they accrued on…
Lack of detectable neoantigen depletion signals in the untreated cancer genome
Nature Genetics, Published online: 25 November 2019; doi:10.1038/s41588-019-0532-6 Pan-cancer genomic analyses based on HLA affinity predictions show that apparent neoantigen depletion signals in untreated tumors become negligible after correction for trinucleotide-based mutational signatures.
Chromosome organization in bacteria: mechanistic insights into genome structure and function
Nature Reviews Genetics, Published online: 25 November 2019; doi:10.1038/s41576-019-0185-4 Advances in sequencing- and imaging-based techniques for chromosome structure analysis have led to a mature understanding of bacterial chromosome structure and dynamics. In this Review, Dame, Rashid and Grainger discuss the
Case 36-2019: A 34-Year-Old Man with Dyspnea, Odynophagia, and Abdominal Pain
Presentation of Case. Dr. Pierre O. Ankomah (Medicine): A 34-year-old man with asthma was admitted to this hospital during the winter because of dyspnea. Three months before admission, odynophagia developed, and the patient noted white plaques in his mouth. He
Sexism at the BMA: grassroots GPs call for “action not words” by next May
Local GP leaders have demanded that the BMA’s General Practitioners Committee publish a formal action plan for tackling sexism and harassment in the organisation by May next year in response to the…
Withdrawn: Thank you to our reviewers 2018
Eastern Equine Encephalitis Virus — Another Emergent Arbovirus in the United States
Humans have always lived in intimate association with arthropods that transmit pathogens between humans or from animals to humans. About 700,000 deaths due to vectorborne diseases occur globally each year, according to World Health Organization estimates. In the summer and
Traumatic Brain Injury as a Risk Factor for Dementia and Alzheimer Disease: Critical Review of Study Methodologies
Journal of Neurotrauma, Volume 36, Issue 23, Page 3191-3219, December 1, 2019.
Eastern Equine Encephalitis Virus — Another Emergent Arbovirus in the United States
Humans have always lived in intimate association with arthropods that transmit pathogens between humans or from animals to humans. About 700,000 deaths due to vectorborne diseases occur globally each year, according to World Health Organization estimates. In the summer and
Intra and extra abdominal course of umbilical veins in a four vessel umbilical cord of a fetus with dextro – transposition of great vessels.
Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction
Large clinical trials involving patients with type 2 diabetes have shown that inhibitors of sodium–glucose cotransporter 2 (SGLT2) reduce the risk of hospitalization for heart failure. Most patients in these trials did not have heart failure at baseline, so the
Biological Citizenship — A 53-Year-Old Man with Schizoaffective Disorder and PTSD Applying for Supplemental Security Income
Mr. P. a 53-year-old black man with schizoaffective disorder, post-traumatic stress disorder, and substance use disorder, had been a patient at a community mental health clinic in Los Angeles County for 3 years. At first, he had trouble being around
Efficacy of a Tetravalent Dengue Vaccine in Healthy Children and Adolescents
Dengue is a pandemic-prone viral disease, the incidence of which has increased by a factor of 30 over the past 50 years. Nearly half of the world’s population lives in dengue-endemic areas in more than 100 countries worldwide, where approximately
[Editorial] 2020: unleashing the full potential of nursing
In December, the UK’s nursing profession will celebrate the centenary of the Nurses Registration Act 1919, which set training and education standards for nursing and introduced regulation of the profession. This milestone nicely segues into 2020, designated by WHO as
[Editorial] In with the new?
The turn of the year is a point of endings and beginnings, a concept that the ancient Romans embodied as the god Janus. Janus had two faces, and hence the enviable ability to see into both the past and the
Biological Citizenship — A 53-Year-Old Man with Schizoaffective Disorder and PTSD Applying for Supplemental Security Income
Mr. P. a 53-year-old black man with schizoaffective disorder, post-traumatic stress disorder, and substance use disorder, had been a patient at a community mental health clinic in Los Angeles County for 3 years. At first, he had trouble being around
Trial of Apremilast for Oral Ulcers in Behçet’s Syndrome
Behçet’s syndrome is a multisystem vasculitis that causes oral and genital ulcers, papulopustular and nodular lesions, arthritis, uveitis, arterial aneurysms, and arterial and venous thrombosis and may involve the central nervous system and gastrointestinal tract. Recurrent relapsing and remitting…
Helen Salisbury: Why I resist giving up home visits
GPs no longer have time to visit patients in their own homes, so the requirement to do so should be removed from their contract. This was the outcome of a motion debated on 22 November by the Local…
Nivolumab plus Ipilimumab in Advanced Non–Small-Cell Lung Cancer
Substantial progress has been made in the first-line treatment of patients with advanced non–small-cell lung cancer (NSCLC) without driver alterations that can be targeted. These treatments include monotherapy blockade of programmed death 1 (PD-1) in patients with tumors that express
Achieving clinically meaningful response in endometriosis pain symptoms is associated with improvements in health-related quality of life and work productivity: Analysis of 2 phase III clinical trials
Endometriosis-related pain symptoms negatively impact health-related quality of life (HRQoL) and productivity. In fact, as endometriosis-related symptom severity and the number of symptoms experienced increases, HRQoL decreases. Dysmenorrhea and non-menstrual pelvic pain are prominent symptoms experienced by women with endometriosis
An Anti-Opioid System, Courtesy of a Worm Model
The worm Caenorhabditis elegans is a simple yet powerful model organism that is useful in carrying out rapid genomewide genetic screens. There, high-throughput functional tests are designed to detect specific phenotypic (e.g. behavioral) deficits after the knockout of thousands of
Young Investigators Awards
Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction
Large clinical trials involving patients with type 2 diabetes have shown that inhibitors of sodium–glucose cotransporter 2 (SGLT2) reduce the risk of hospitalization for heart failure. Most patients in these trials did not have heart failure at baseline, so the
Case 36-2019: A 34-Year-Old Man with Dyspnea, Odynophagia, and Abdominal Pain
Presentation of Case. Dr. Pierre O. Ankomah (Medicine): A 34-year-old man with asthma was admitted to this hospital during the winter because of dyspnea. Three months before admission, odynophagia developed, and the patient noted white plaques in his mouth. He
Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction
Large clinical trials involving patients with type 2 diabetes have shown that inhibitors of sodium–glucose cotransporter 2 (SGLT2) reduce the risk of hospitalization for heart failure. Most patients in these trials did not have heart failure at baseline, so the
Drug-Resistant E. coli Bacteremia Transmitted by Fecal Microbiota Transplant
An altered intestinal microbiome has been implicated in the pathogenesis of many disorders. Fecal microbiota transplantation (FMT) refers to the administration of intestinal microbes from a healthy donor into a recipient with the intent of modifying the recipient’s intestinal microbiome.
Efficacy of a Tetravalent Dengue Vaccine in Healthy Children and Adolescents
Dengue is a pandemic-prone viral disease, the incidence of which has increased by a factor of 30 over the past 50 years. Nearly half of the world’s population lives in dengue-endemic areas in more than 100 countries worldwide, where approximately
An Anti-Opioid System, Courtesy of a Worm Model
The worm Caenorhabditis elegans is a simple yet powerful model organism that is useful in carrying out rapid genomewide genetic screens. There, high-throughput functional tests are designed to detect specific phenotypic (e.g. behavioral) deficits after the knockout of thousands of
Does transcatheter aortic valve alignment matter?
Objective This study investigates the effect of transcatheter aortic valve (TAV) angular alignment on the postprocedure haemodynamics. TAV implantation has emerged as an effective alternative to surgery when treating valve dysfunction. However, the benefit of avoiding surgery is paid back
Very early family-based intervention for anxiety: two case studies with toddlers
Anxiety disorders represent the most common category of psychiatric disorder in children and adolescents and contribute to distress, impairment and dysfunction. Anxiety disorders or their temperamental precursors are often evident in early childhood, and anxiety can impair functioning, even during
Highlights from this issue
Do we know what older patients want from emergency care? We are increasingly aware of the preponderance of older patients attending our emergency departments as well as the fact that they are often acutely unwell. It is heartening then to
Seven days in medicine: 13-19 Nov 2019
AlcoholNew laws limit advertising in IrelandLegislation to reduce children’s exposure to advertisements featuring alcohol products came into force in the Republic of Ireland. The Public Health…
Highlights from this issue
BTNL2 gene polymorphism and sarcoid uveitis (see page 1690) The butyrophilin-like 2 G16071A gene polymorphism seems to predispose for sarcoidosis; however, it does not seem to predispose for all subtypes of sarcoid uveitis. Retinal vessel oxygen saturation is affected in
Professional education in the field of injury prevention
One of the defining characteristics of a profession is that its members take responsibility for enabling, educating and training emerging professionals in their field. This education role goes hand-in-hand with a profession’s responsibility to monitor members’ adherence to ethical, technical
Cervicovaginal fluid proteomic analysis to identify potential biomarkers for preterm birth
Proteomic analyses using cervicovaginal fluid samples identified biologically relevant proteins that could not be validated by ELISA as useful biomarkers for predicting spontaneous preterm birth.
Who Pays in Medicare Part D? Giving Plans More Skin in the Game
Americans have ranked “taking action to lower prescription drug prices” as their top priority for Congress this year. Policymakers seem to be listening. Proposals have emanated from Senate and House committees, the Trump administration, and several Democratic presidential candidates. Though
The Critically Tuned Cortex
The criticality hypothesis predicts that cortex operates near a critical point for optimum information processing. In this issue of Neuron, Ma et al. (2019) find evidence consistent with a mechanism that tunes cortex to criticality, even in the face of a
Shared decision making in cancer care requires better communication and understanding of pathology reports
Venhuizen emphasises the importance of patients being involved in management decisions.1 But this requires the patient to be guided by a well informed clinician.Precision medicine seeks to accurately…
Highlights from this issue
Real life: just fantasy? Lest anyone risks seducing themselves to the contrary, we should remind ourselves constantly how little (if anything) we genuinely know. Time gives us more familiarity with exposure outcome phenotype pattern recognition but do we get closer
Fluid-based assays and precision medicine of cardiovascular diseases: the ‘hope for Pandoras box?
Progresses in liquid-based assays may provide novel useful non-invasive indicators of cardiovascular (CV) diseases. By analysing circulating cells or their products in blood, saliva and urine samples, we can investigate molecular changes present at specific time points in each patient
Teens, sexual assault and ethical research: how do we include their voice?
Young people aged 16–19 years are the group reporting the highest prevalence in the last year of sexual assault in the England and Wales survey, with 1 in 10 reporting experience of sexual assault.1 Of note, younger teens were not
Gilteritinib improves outcomes in AML
Nature Reviews Clinical Oncology, Published online: 19 November 2019; doi:10.1038/s41571-019-0305-2 Gilteritinib improves outcomes in AML
Is Povidone-iodine 1% the most effective vaginal antiseptic?
A different perspective on alternative cleavage and polyadenylation
Nature Reviews Genetics, Published online: 19 November 2019; doi:10.1038/s41576-019-0198-z A different perspective on alternative cleavage and polyadenylation
Docking Complete: A Step Further toward the Holy Grail of γδ T Cell Biology
The direct ligands recognized by γδ T cell receptors (γδ TCRs) remain uncertain and controversial. In a study appearing in this issue, Willcox et al. use surface plasmon resonance and isothermal titration calorimetry to demonstrate that B7-like molecule BTNL3 makes physical contact
Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction
Inflammation appears to play an important role in atherosclerosis. Inhibition of interleukin-1β by the injectable monoclonal antibody canakinumab led to a 15% lower risk of cardiovascular events than was observed with placebo in the Canakinumab Antiinflammatory Thrombosis Outcomes Study (CANTOS)…
[Editorial] Equitable diabetes care: still a long way off
Nov 14, World Diabetes Day, is a day to focus our thoughts on the global diabetes epidemic, which in 2017, affected 425 million people worldwide and claimed the lives of 4 million people. With those figures projected to rise substantially
A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke
Intensive therapy to lower serum lipid levels with the use of statins is recommended after transient ischemic attack (TIA) or ischemic stroke of atherosclerotic origin. These recommendations are based on the results of the Stroke Prevention by Aggressive Reduction in
Concerns raised with speak-up guardians are steadily rising
The number of concerns reported to the NHS’s “freedom to speak up guardians” has been steadily increasing since the guardians were introduced in England in 2017. Since April that year thousands of…
The mutational footprints of cancer therapies
Nature Genetics, Published online: 18 November 2019; doi:10.1038/s41588-019-0525-5 Analysis of whole-genome sequences from more than 3,500 metastatic tumors identifies mutational signatures associated with different chemotherapies and provides estimates of the relative contribution of different treatments to tumor mutational burden.
Total Penis, Scrotum, and Lower Abdominal Wall Transplantation
To the Editor: Male genital tissue loss can have devastating effects on sexual and reproductive function as well as on the psychosocial well-being of the injured patient. Conventional reconstructive efforts are often insufficient to restore full function of the phallus.
On the “Take” as a Biomarker
Arguably the best biomarker in the world for vaccine efficacy is the “take.” The take, the reaction observed after an inoculation of smallpox vaccine, is typically a small pustular lesion that occurs approximately 1 week after inoculation and often leaves
Cost of drugs prescribed in primary care continues to fall
The cost of drugs prescribed in primary care fell by 2.8% in 2018-19, data from NHS Digital show.1 Over the same period the cost of drugs prescribed in hospitals rose by 11.1%.Hospitals accounted for…
Acute Upper Airway Obstruction
Acute upper airway obstruction is a life-threatening emergency and requires immediate assessment and intervention with little margin for error, making it a constant challenge for clinicians. Substantial advances have been made in preventive medicine, our understanding of the pathophysiology of…
Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest
Despite improved management, overall survival rates at hospital discharge among patients with out-of-hospital cardiac arrests do not exceed 20%, and neurologic outcomes remain poor. Even though controversies persist, targeted temperature management at 32 to 36°C remains recommended in patients with…
Timing of Intervention in Aortic Stenosis
Current guidelines require that in patients with severe aortic stenosis, symptoms related to the valvular disease be present for consideration of transcatheter aortic-valve replacement (TAVR) or surgical aortic-valve replacement. In the absence of symptoms, only very severe aortic stenosis is
Apremilast in Treatment-Refractory Recurrent Aphthous Stomatitis
To the Editor: Recurrent aphthous stomatitis is a chronic, painful ulcerative disease of the oral mucosa that may be resistant to treatment. Its clinical heterogeneity has complicated classification of the disorder, but variants in cytokine genes, including tumor necrosis factor
On the “Take” as a Biomarker
Arguably the best biomarker in the world for vaccine efficacy is the “take.” The take, the reaction observed after an inoculation of smallpox vaccine, is typically a small pustular lesion that occurs approximately 1 week after inoculation and often leaves
PD-1 inhibition enters the frontline
Nature Reviews Clinical Oncology, Published online: 15 November 2019; doi:10.1038/s41571-019-0303-4 PD-1 inhibition enters the frontline
Structural variation in the sequencing era
Nature Reviews Genetics, Published online: 15 November 2019; doi:10.1038/s41576-019-0180-9 To map the full extent of structural variation in the human genome, detection methods are needed that improve on short-read approaches. This Review discusses how ensemble algorithms and emerging sequencing technologies
Analgesic use at ovulation and implantation and human fertility
Studies investigating the effects of pain-relieving medication use on conceiving a pregnancy have shown conflicting results. Furthermore, no previous study has examined medication use around ovulation or implantation, and the associations with the probability of conception, fecundability.
Large-Scale Assessment of a Smartwatch to Identify Atrial Fibrillation
Wearable devices with optical sensors, such as smartwatches, are commonly used to measure wearers’ pulse rates. Algorithms that use pulse wave data to detect atrial fibrillation and atrial flutter have been developed. An Apple Watch application (app) can use intermittent,
Case 35-2019: A 66-Year-Old Man with Pancytopenia and Rash
Presentation of Case. Dr. Joshua Salvi (Medicine): A 66-year-old man with a history of pancytopenia was transferred to this hospital in the winter for evaluation of pancytopenia and rash. The patient had been well until 1 year before admission, when
Acute Upper Airway Obstruction
Acute upper airway obstruction is a life-threatening emergency and requires immediate assessment and intervention with little margin for error, making it a constant challenge for clinicians. Substantial advances have been made in preventive medicine, our understanding of the pathophysiology of…
Last Song — Sharing Humanity while Maintaining Boundaries
“You must sing for me,” she said. “I’m dying, after all.” Ms. N. was sitting on her vast white sofa, frail among the cushions, enveloped in a pink dressing gown that paled next to the fuchsia of her lipstick. She
Learning from the Dead
A striking trend in medical education and practice over the past half century has been the decline in the rate of autopsies conducted throughout much of the world. Older physicians recall regular visits to the autopsy room to have a
Acute Upper Airway Obstruction
Acute upper airway obstruction is a life-threatening emergency and requires immediate assessment and intervention with little margin for error, making it a constant challenge for clinicians. Substantial advances have been made in preventive medicine, our understanding of the pathophysiology of…
Acute Upper Airway Obstruction
Acute upper airway obstruction is a life-threatening emergency and requires immediate assessment and intervention with little margin for error, making it a constant challenge for clinicians. Substantial advances have been made in preventive medicine, our understanding of the pathophysiology of…
[Editorial] Raising the profile of men’s health
In September, at the first UN General Assembly focused on universal health coverage (UHC), member states were urged to progress faster on health-related Sustainable Development Goals (SDGs) to achieve UHC by 2030—“leaving no one behind”. Despite major health gains over
Cognitive remediation for severe mental illness: state of the field and future directions
Highlights from this issue
Traditions are an important part of Christmas (and this is your Christmas edition). There is a tradition (of which we at Practical Neurology thoroughly approve) that all talks, and most articles, on dizziness and vertigo should start with a quotation
China’s organ donation figures appear to be falsified, study claims
China’s organ donation numbers appear to have been systematically manipulated and falsified, according to new research which casts doubt on the credibility of the country’s transplantation…
Experiences and challenges of adults living with type 2 diabetes mellitus presenting at the University Teaching Hospital in Lusaka, Zambia
Objective The study explored the experiences and challenges of adults living with type 2 diabetes mellitus (T2DM) presenting at the University Teaching Hospital (UTH) in Lusaka. Research design A qualitative descriptive study was conducted. The research relied on purposive sampling
Achieving equal and timely access to innovative anticancer drugs in the European Union (EU): summary of a multidisciplinary CECOG-driven roundtable discussion with a focus on Eastern and South-Eastern EU countries
The Central European Cooperative Oncology Group (CECOG) and ‘ESMO Open—Cancer Horizons’ roundtable discussion brought together stakeholders from several European Union (EU) countries involved in drug development, drug authorisation and reimbursement or otherwise affected by delayed and unequal access to innovative
Case 35-2019: A 66-Year-Old Man with Pancytopenia and Rash
Presentation of Case. Dr. Joshua Salvi (Medicine): A 66-year-old man with a history of pancytopenia was transferred to this hospital in the winter for evaluation of pancytopenia and rash. The patient had been well until 1 year before admission, when
Secondary Surgical Cytoreduction for Recurrent Ovarian Cancer
The American Cancer Society has estimated that in 2019 approximately 22,500 women would be diagnosed with epithelial ovarian, primary peritoneal, or fallopian-tube (“ovarian”) cancer, and 14,000 would die. Despite the absence of randomized data showing a survival benefit conferred by
Acute Upper Airway Obstruction
Acute upper airway obstruction is a life-threatening emergency and requires immediate assessment and intervention with little margin for error, making it a constant challenge for clinicians. Substantial advances have been made in preventive medicine, our understanding of the pathophysiology of…
The William Harvey Lecture on Basic ScienceProfessor Connie Bezzina delivered the William Harvey Lecture entitled ‘When Genetic Burden Reaches Threshold’ to a full audience at ESC Congress 2019 in Paris
Apremilast in Treatment-Refractory Recurrent Aphthous Stomatitis
To the Editor: Recurrent aphthous stomatitis is a chronic, painful ulcerative disease of the oral mucosa that may be resistant to treatment. Its clinical heterogeneity has complicated classification of the disorder, but variants in cytokine genes, including tumor necrosis factor
On the “Take” as a Biomarker
Arguably the best biomarker in the world for vaccine efficacy is the “take.” The take, the reaction observed after an inoculation of smallpox vaccine, is typically a small pustular lesion that occurs approximately 1 week after inoculation and often leaves
Multisystem Toxicity in Cancer: Lessons from NASA’s Countermeasures Program
Astronauts and cancer patients are subject to similar multisystem physiological toxicities. Over the past sixty years, NASA developed a state-of-the-art countermeasures program (CMP) to characterize and mitigate the physiological consequences of spaceflight. Here, we propose a NASA-modeled CMP to elucidate
Cognitive remediation for severe mental illness: state of the field and future directions
Acute Upper Airway Obstruction
Acute upper airway obstruction is a life-threatening emergency and requires immediate assessment and intervention with little margin for error, making it a constant challenge for clinicians. Substantial advances have been made in preventive medicine, our understanding of the pathophysiology of…
Apremilast in Treatment-Refractory Recurrent Aphthous Stomatitis
To the Editor: Recurrent aphthous stomatitis is a chronic, painful ulcerative disease of the oral mucosa that may be resistant to treatment. Its clinical heterogeneity has complicated classification of the disorder, but variants in cytokine genes, including tumor necrosis factor
12.15 Distinguishing neurosarcoidosis from multiple sclerosis based on cerebrospinal fluid analysis: a retrospective cohort study
Introduction Neurosarcoidosis is a great mimicker and distinction from multiple sclerosis can be troublesome. This study characterises a cohort of neurosarcoidosis patients with focus on CSF analysis and whether this could help distinguish these two conditions. Methods We enrolled 80
Highlights from this issue
This month’s airwaves has a festive flavour… Incremental costs and Ebenezer Scrooge “If they would rather die, they had better do it, and decrease the surplus population.” So said Ebenezer Scrooge in Charles Dickens’ “A Christmas Carol”. His views may
Correction: Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions
Sonnery-Cottet B, Saithna A, Quelard B, et al. Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions. Br J Sports Med 2019;53:289–98. doi: 10.1136/bjsports-2017-098401 The study protocol (trial registration number: CRD42017067499) was prospectively registered with
Blood markers to diagnose Parkinson’s . . . and other stories
Biomarkers for Parkinson’s diseaseScreening 1000 different proteins in blood samples from people with Parkinson’s disease and controls identified 10 candidate biomarkers for the disease. Four of…
Value of occupational health research
Most readers of this journal would recognise that occupational health (OH) research is valuable. The Society of Occupational Medicine (SOM), a UK-based organisation for healthcare professionals working in or with an interest in OH, recently released a report where the
Massachusetts General Hospital and the Shanghai Mental Health Center: the past, present and future of a psychiatric research partnership
From Molecular Targets and Cancer Therapeutics
Nature Reviews Clinical Oncology, Published online: 13 November 2019; doi:10.1038/s41571-019-0302-5 From Molecular Targets and Cancer Therapeutics
Scientific pathophysiology of intrapartum fetal hypoxemia and cardiotocography pattern-recognition.
New Zealand will hold referendum on assisted dying in 2020
The New Zealand government has announced a public referendum on euthanasia which, if passed, will allow assisted dying for terminally ill patients with two doctors’ approval.1This is the first time a…
Heartbeat: the potential power of naps for cardiovascular health
The significance of napping for cardiovascular disease (CVD) has been a matter of controversy, with studies showing discordant results depending on the methods of evaluation, nap duration, age range of the population and outcomes measured (total vs cardiovascular mortality or
A new methodologic approach for clinico-pathologic correlations in invasive placenta previa accreta
The development of new management strategies for women presenting with placenta accreta spectrum requires quality epidemiology data which have so far been limited by the high variability in clinical and histopathologic data confirming the diagnosis at birth.
MRI-guided pulmonary vein isolation for atrial fibrillation: what is good enough? An early health technology assessment
Next to anticoagulation, pulmonary vein isolation (PVI) is the most important interventional procedure in the treatment of atrial fibrillation (AF). Despite widespread clinical application of this therapy, patients often require multiple procedures to reach clinical success. In contrast to conventional
Tuberculosis in Deer Hunters
Three human cases of tuberculosis have been confirmed in Michigan deer hunters exposed to Mycobacterium bovis–infected deer, according a CDC investigation.
Acute Severe Hypertension
Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author’s clinical recommendations. Stage.
Tories promise 6000 extra GPs by 2024
General practice hit the headlines this week when the Conservatives promised to deliver 6000 more GPs by 2024-25 as part of a pledge to provide 50 million more appointments in GP surgeries every…
Metering the METEOR in methotrexate failure: is propensity score a falling star?
The debate on the preferred treatment of rheumatoid arthritis (RA) after methotrexate (MTX) failure has always been fascinating. Sytske Anne Bergstra and associates have analysed data from patients in the METEOR cohort who had failed MTX monotherapy.1 It was absorbing
Cytoreductive treatment strategies for de novo metastatic prostate cancer
Nature Reviews Clinical Oncology, Published online: 11 November 2019; doi:10.1038/s41571-019-0284-3 Systemic hormone therapies and chemotherapy are the cornerstones of treatment for patients with de novo metastatic prostate cancer, with a currently limited role for local treatments. Herein, the authors outline
Inhibit versus Destroy: Are PROTAC Degraders the Solution to Targeting STAT3?
Despite the role of STAT3 as a known driver of oncogenesis, efforts to develop therapeutic STAT3 inhibitors have thus far been unsuccessful. In this issue of Cancer Cell, Bai et al. report a potent and selective STAT3 degrader capable of producing
NICE recommends cannabis based drugs for epilepsy and multiple sclerosis
In final appraisal documents the UK National Institute for Health and Care Excellence has recommended the use of cannabidiol with clobazam for treating seizures associated with two rare and severe…
Selective and marked decrease of complement receptor C5aR2 in human thoracic aortic aneurysms: a dysregulation with potential inflammatory effects
Objective The aetiology of thoracic aortic aneurysm (TAA) is largely unknown, but inflammation is likely to play a central role in the pathogenesis. In this present study, we aim to investigate the complement receptors in TAA. Methods Aortic tissue and
Most Intended Home Births in the US Are Not Low Risk: 2016-2018
Pregnant patients with high risk factors are at increased risk for morbidity and mortality.1,2 It has been claimed that intended home births in the US are largely restricted to low risk patients.3 The objective of this study was to assess
Acute Severe Hypertension
Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author’s clinical recommendations. Stage.
A Phase 3 Trial of Difelikefalin in Hemodialysis Patients with Pruritus
Chronic kidney disease–associated pruritus, also known as uremic pruritus, is a common, distressing, and underrecognized condition that affects more than 60% of patients undergoing hemodialysis, with 20 to 40% of patients reporting moderate-to-severe pruritus. Intense and generalized systemic…
Acute Severe Hypertension
Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author’s clinical recommendations. Stage.
Nonalcoholic Fatty Liver Disease, Insulin Resistance, and Ceramides
Insulin resistance is present in most, but not all, obese and elderly patients and even in some young and lean persons. It is a precursor to and accelerant of coexisting conditions such as type 2 diabetes, atherosclerosis, nonalcoholic fatty liver
Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest
Despite improved management, overall survival rates at hospital discharge among patients with out-of-hospital cardiac arrests do not exceed 20%, and neurologic outcomes remain poor. Even though controversies persist, targeted temperature management at 32 to 36°C remains recommended in patients with…
A Phase 3 Trial of Difelikefalin in Hemodialysis Patients with Pruritus
Chronic kidney disease–associated pruritus, also known as uremic pruritus, is a common, distressing, and underrecognized condition that affects more than 60% of patients undergoing hemodialysis, with 20 to 40% of patients reporting moderate-to-severe pruritus. Intense and generalized systemic…
From state-of-the-art treatments to novel therapies for advanced-stage pancreatic cancer
Nature Reviews Clinical Oncology, Published online: 08 November 2019; doi:10.1038/s41571-019-0281-6 Virtually all patients with resectable pancreatic ductal adenocarcinoma (PDAC) will have disease progression, which is generally associated with dismal outcomes. However, novel targeted therapies and immunotherapies, selected based on the
Deaths Associated with Emicizumab in Patients with Hemophilia A
To the Editor: Emicizumab was recently licensed for the prophylactic treatment of hemophilia A in patients in whom antibodies (inhibitors) have not developed against the product they were using to treat or prevent bleeding episodes. Since the licensing of emicizumab
Five-Year Outcomes after PCI or CABG for Left Main Coronary Disease
Percutaneous coronary intervention (PCI) with drug-eluting stents has emerged as an acceptable treatment for selected patients with left main coronary artery disease. However, long-term data from randomized trials comparing PCI involving contemporary drug-eluting stents with coronary-artery bypass…
Nonalcoholic Fatty Liver Disease, Insulin Resistance, and Ceramides
Insulin resistance is present in most, but not all, obese and elderly patients and even in some young and lean persons. It is a precursor to and accelerant of coexisting conditions such as type 2 diabetes, atherosclerosis, nonalcoholic fatty liver
Will Emergency Holds Reduce Opioid Overdose Deaths?
The opioid overdose crisis has claimed more than 400,000 lives in the United States since 1999. As part of efforts to reduce overdose deaths and increase enrollment in treatment, lawmakers in some states are contemplating enacting or expanding emergency hold
Liver Fluke
Figure 1.
Neurodegenerative Disease Mortality among Former Professional Soccer Players
Concerns have been raised about the risk of several neurodegenerative diseases, such as Alzheimer’s disease, amyotrophic lateral sclerosis, and chronic traumatic encephalopathy (CTE), associated with participation in contact sports. Recognition of the pathologic changes of CTE in former players who…
[Editorial] ICPD at 25 years: time to expand the agenda
In September, 1994, 11 000 delegates from governments, the UN, non-governmental organisations, and media gathered in Cairo, Egypt, for the International Conference on Population and Development (ICPD). This event was transformative for the reproductive health and rights community. The global consensus
Double Trouble
Foreword. In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information by sharing relevant background and reasoning with the reader (regular type). The authors’ commentary follows.
Sixty seconds on . . . sickies
I don’t feel too goodThat may be so, but new figures from the Office for National Statistics1 (ONS) show that in the UK, sickness absence among normally healthy employees fell to 1.1% last year, the…
Immune checkpoint inhibitors may be safe for patients with preexisting autoimmune disease
Evaluation of Xie et al.: Sphingolipid Modulation Activates Proteostasis Programs to Govern Human Hematopoietic Stem Cell Self-Renewal
This article shows an example of the peer review process for “Sphingolipid Modulation Activates Proteostasis Programs to Govern Human Hematopoietic Stem Cell Self-Renewal” (Xie et al., 2019).
Tuberculosis in term pregnancy
Elexacaftor–Tezacaftor–Ivacaftor for Cystic Fibrosis with a Single Phe508del Allele
Cystic fibrosis is a lethal, inherited, autosomal recessive disorder that affects approximately 80,000 people worldwide and is caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein that lead to reduced CFTR function. CFTR codes
A Bleeding Toe
Figure 1.
Neurodegenerative Disease Mortality among Former Professional Soccer Players
Concerns have been raised about the risk of several neurodegenerative diseases, such as Alzheimer’s disease, amyotrophic lateral sclerosis, and chronic traumatic encephalopathy (CTE), associated with participation in contact sports. Recognition of the pathologic changes of CTE in former players who…
Total Penis, Scrotum, and Lower Abdominal Wall Transplantation
To the Editor: Male genital tissue loss can have devastating effects on sexual and reproductive function as well as on the psychosocial well-being of the injured patient. Conventional reconstructive efforts are often insufficient to restore full function of the phallus.
Nonalcoholic Fatty Liver Disease, Insulin Resistance, and Ceramides
Insulin resistance is present in most, but not all, obese and elderly patients and even in some young and lean persons. It is a precursor to and accelerant of coexisting conditions such as type 2 diabetes, atherosclerosis, nonalcoholic fatty liver
Acute Severe Hypertension
Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author’s clinical recommendations. Stage.
Elexacaftor–Tezacaftor–Ivacaftor for Cystic Fibrosis with a Single Phe508del Allele
Cystic fibrosis is a lethal, inherited, autosomal recessive disorder that affects approximately 80,000 people worldwide and is caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein that lead to reduced CFTR function. CFTR codes
Will Emergency Holds Reduce Opioid Overdose Deaths?
The opioid overdose crisis has claimed more than 400,000 lives in the United States since 1999. As part of efforts to reduce overdose deaths and increase enrollment in treatment, lawmakers in some states are contemplating enacting or expanding emergency hold
Elexacaftor–Tezacaftor–Ivacaftor for Cystic Fibrosis with a Single Phe508del Allele
Cystic fibrosis is a lethal, inherited, autosomal recessive disorder that affects approximately 80,000 people worldwide and is caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein that lead to reduced CFTR function. CFTR codes
Wellbeing, not more beings, to tackle lack of consultant physicians
The lack of consultancy posts being filled is concerning.1 I fear the consequences for training, staff morale, and patient safety.As a medical student graduating soon, I struggle to see how effective…
Issue Information
New warning signs on the road: 5-hydroxymethylcytosine-based liquid biopsy for the early detection of hepatocellular carcinoma
Hepatocellular carcinoma (HCC) ranks as the sixth most common neoplasm and the third leading cause of cancer-related death.1 As with many other cancers, HCC detected at an early stage has a better prognosis than the advanced-stage disease, in part due
Obesity, smoking, and risk of vasomotor menopausal symptoms: a pooled analysis of eight cohort studies
Frequent and severe vasomotor symptoms during menopause are linked with adverse health outcomes. Understanding modifiable lifestyle factors for the risk of vasomotor menopausal symptoms is important to guide preventive strategies.
Decoding cancer immunology: Hunting hidden tumours
Nature Reviews Genetics, Published online: 06 November 2019; doi:10.1038/s41576-019-0190-7 Decoding cancer immunology: Hunting hidden tumours
Tennessee’s Opening Bid for a Medicaid Block Grant
In the spring of 2019, the Tennessee General Assembly passed legislation requiring the governor to ask the federal government for a block grant for its Medicaid program within 180 days. Although this move was seen as precedent-setting, Tennessee’s history of
Solving the Mysteries of Dementia: FTD Mutant Tau Impairs Structural Axon Initial Segment Plasticity
Accumulation of abnormal Tau is a characteristic feature of a number of neurodegenerative disorders, called tauopathies. What is the reason for Tau toxicity in neuronal cells? In this issue of Neuron, Sohn et al. (2019) found that FTD mutant Tau-V337M blocks
[Editorial] Essential medicines for patients with multiple sclerosis
Although neurological disorders are the leading cause of disability and the second cause of deaths worldwide, access to affordable drugs to treat neurological patients is appallingly low in most countries. To guide countries in their national drug policies, WHO has
[Editorial] A balanced online life
Advancing technology has changed the way we communicate and interact with the world around us. For the majority of modern adolescents, social media and online messaging is a core aspect of forming and maintaining friendships. Yet there is concern from
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training
Burnout, a syndrome of emotional exhaustion, cynicism, and reduced effectiveness at work, has been linked to poor health, alcoholism, depression, and suicide in physicians. Burnout has adverse effects on patient care and the physician workforce, since burned-out physicians are more
Environmental impact of bottles, teats, and packaging in maternity units
Joffe and colleagues point out some of the environmental effects of infant feeding.1 Another aspect is the thousands of ready-to-use bottles, associated teats and packaging, and the volume of…
September 2019 (vol. 221, no. 3, page 175)
Romero R. AJOG opens editorial office in China: Professor Huixia Yang appointed editor. Am J Obstet Gynecol 2019;221:175-6.
The genetics of human ageing
Nature Reviews Genetics, Published online: 05 November 2019; doi:10.1038/s41576-019-0183-6 Bringing together different strands of genetic research, including results from recent large-scale genome-wide association studies relevant to human ageing, the authors highlight how genetics can further our understanding of the underlying
The Transsulfuration Pathway Makes, the Tumor Takes
Cells can take up cysteine or synthesize it de novo from methionine, but synthesis alone does not meet the high demands of cancer cells to proliferate. In this issue, Zhu et al. (2019) identify the SAH:SAM ratio, indicative of the cellular
Schizophrenia
Schizophrenia is a psychiatric syndrome characterized by psychotic symptoms of hallucinations, delusions, and disorganized speech, by negative symptoms such as decreased motivation and diminished expressiveness, and by cognitive deficits involving impaired executive functions, memory, and speed of…
JAMA
Is the NHS being privatised?
What is the latest claim?On 3 November the Labour Party released figures showing that 78 981 NHS operations were cancelled at the last minute last year because of staffing and capacity pressures.12…
Realizing the Dream of Molecularly Targeted Therapies for Cystic Fibrosis
The diary entry of an 8-year-old girl with cystic fibrosis indicates that Aug. 25, 1989, was an important day for her (Figure 1). That was the day the research teams at the University of Michigan and the Hospital for Sick
[Editorial] Gender equality in medicine: change is coming
2019 saw a welcome—and overdue—flurry of activity around gender equality in medicine. Notable advances included the publication of The Lancet’s themed issue on advancing women in science, medicine, and global health and the launch of Time’s Up Healthcare, the aims
Association of Pediatric Obesity Treatment, Including a Dietary Component, With Change in Depression and Anxiety
This systematic review and meta-analysis investigates the association between obesity treatment interventions, with a dietary component, and symptoms of depression and anxiety in children and adolescents with overweight/obesity.
Case 34-2019: A 16-Year-Old Boy with Jaundice
Presentation of Case. Dr. Akash Gupta (Pediatrics): A 16-year-old boy was admitted to this hospital in autumn because of jaundice and abnormal results on liver-function tests. The patient had been well until 4 days before admission, when he noted pruritus
Doctor who worked as private GP is suspended for 12 months for excessive prescribing
A doctor who trained in cardiology but worked for many years as a private practice GP has been suspended from the UK medical register for 12 months for exceeding his competence in prescribing risky…
Preeclampsia resolution after fetal death in multifetal gestation: A systematic literature review
Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know
Journal of Neurotrauma, Volume 36, Issue 22, Page 3063-3091, November 15, 2019.
Schizophrenia
Schizophrenia is a psychiatric syndrome characterized by psychotic symptoms of hallucinations, delusions, and disorganized speech, by negative symptoms such as decreased motivation and diminished expressiveness, and by cognitive deficits involving impaired executive functions, memory, and speed of…
Schizophrenia
Schizophrenia is a psychiatric syndrome characterized by psychotic symptoms of hallucinations, delusions, and disorganized speech, by negative symptoms such as decreased motivation and diminished expressiveness, and by cognitive deficits involving impaired executive functions, memory, and speed of…
Determinants of aortic growth rate in patients with bicuspid aortic valve by cardiovascular magnetic resonance
Objectives This study aimed to identify determinants of aortic growth rate in bicuspid aortic valve (BAV) patients. We hypothesised that (1) BAV patients with repaired coarctation (CoA) exhibit decreased aortic growth rate, (2) moderate/severe re-coarctation (reCoA) results in increased growth
cfDNA monitoring is feasible in SCLC
Nature Reviews Clinical Oncology, Published online: 01 November 2019; doi:10.1038/s41571-019-0300-7 cfDNA monitoring is feasible in SCLC
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