Sharvill raises valid concerns about women accessing early pregnancy care.12 The National Institute for Health and Care Excellence recommends that all women presenting with pain or bleeding in early…
Correction: Does transcatheter aortic valve alignment matter?
The rapidly changing landscape in mature T‐cell lymphoma (MTCL) biology and management
Abstract Historical advances in the care of patients with non‐Hodgkin lymphoma (NHL) have been restricted largely to patients with B‐cell lymphoma. The peripheral T‐cell lymphomas (PTCLs), which are rare and heterogeneous in nature, have yet to experience the same degree
Lipoprotein particles and coronary artery calcium in middle-aged US-White and Japanese men
Objective This cross-sectional study examined whether contrasting distributions of nuclear magnetic resonance (NMR)-measured lipoproteins contribute to differences in the prevalence of subclinical atherosclerosis measured using coronary artery calcium (CAC) between the two groups of middle-aged males: the US-residing Caucasian (US-White)
Early High-Dose Vitamin D3 for Critically Ill, Vitamin D–Deficient Patients
Vitamin D may improve outcomes in critically ill patients. Preclinical data suggest that vitamin D is a potent immunomodulatory agent that is essential for lung development and function. Observational data and initial clinical trial data indicate that vitamin D deficiency
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,
Defeating Schistosomiasis
Schistosomiasis is an ancient, neglected parasitic disease caused by blood flukes (trematode worms) of the genus schistosoma. Affecting an estimated 200 million persons in 78 countries, the disease is intimately associated with poverty and is grossly debilitating, leading to chronic
Which tasks could GPs drop to free up time for home visits?
I agree with Salisbury about visiting patients in their homes.1 As a GP in Kent, I don’t recall being asked my views on home visits, which our local medical committee has proposed are removed (unless…
The rapidly changing landscape in mature T‐cell lymphoma (MTCL) biology and management
Abstract Historical advances in the care of patients with non‐Hodgkin lymphoma (NHL) have been restricted largely to patients with B‐cell lymphoma. The peripheral T‐cell lymphomas (PTCLs), which are rare and heterogeneous in nature, have yet to experience the same degree
Case 40-2019: A 26-Year-Old Returning Traveler with Headache
Presentation of Case. Dr. Marcus T. Altman (Medicine): A 26-year-old woman with a history of migraines was evaluated in the emergency department of this hospital during the winter because of headache. Three weeks before this presentation, the patient had traveled
Effects of Intermittent Fasting on Health, Aging, and Disease
According to Weindruch and Sohal in a 1997 article in the Journal, reducing food availability over a lifetime (caloric restriction) has remarkable effects on aging and the life span in animals. The authors proposed that the health benefits of caloric
Editörden
Değerli Adli Bilimciler, Adli Tıp Bülteni’nin 2019 yılı son sayısıyla karşınızdayız. Her sayımızda 12 makale yayınlama geleneği bu sayıda da sürüyor. Medeni Kanun Kapsamında Çocuk Evlilikleri, Suça Sürüklenen Çocuklar, Mobbing, Postmortem Kalp Okulu, Amerikan Hekimler Birliği (AMA) Kalıcı Özürlülüğün Değerlendirmesi Kılavuzu,
Medeni Kanun Kapsamında Erken Evlilik Yapan Olguların Sosyodemografik Özellikleri: Tek Merkez Çalışması
Amaç: Türk Medeni Kanunu göre erkek ve kadın on yedi yaşını doldurmadıkça evlenemez. Ancak, hâkim olağanüstü durumlarda ve pek önemli sebeple on altı yaşını doldurmuş olan erkek veya kadının evlenmesine izin verebilir. Bu çalışmada Medeni Kanun’a göre erken evlilik için
Postmortem Kalp Okulu
Giriş: Ani kardiyak ölümlerde, otopsi kesin ölüm nedenini belirlemede ilk ve tek seçenektir. Avrupa Kardiyovasküler Patoloji Birliği tarafından, ani ölüm/ ani kardiyak ölüm tanımlamaları, otopsi prosedürü ve yapılması gereken laboratuvar tetkiklerinin açıklandığı, ani kardiyak ölümlerin otopsisi için güncellenmiş kılavuz yayınlanmıştır.
Sivas İlinde Suça Sürüklenen Çocuk Olguların Sosyodemografik ve Klinik Özellikleri
Amaç: Bu çalışmada suça sürüklenen çocukların sosyodemografik özelliklerinin, işledikleri suç tiplerinin ve zeka düzeylerinin belirlenmesi ve bu çocukları suça iten nedenlerin saptanması amaçlandı. Gereç ve Yöntem: Adli makamlarca 01.01.2017-01.06.2018 tarihleri arasında adli rapor düzenlenmesi için Cumhuriyet Üniversitesi çocuk ve ergen
Mobbing Mağdurlarının Sosyodemografik Özellikleri, İş Yaşamı ve Ruh Sağlıkları Açısından İncelenmesi: Olgu Serisi
Amaç: Çalışmanın amacı, mobbing yaşantısı ile İstanbul Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalı Polikliniği’ne başvuran ve buradaki muayeneleri sonrasında haklarında sosyal inceleme raporu hazırlanması istenen 34 hastanın verilerinin değerlendirilmesidir. Gereç ve Yöntem: Olgulara ait mobbing süreci, sosyodemografik özellikler ve
Effects of Intermittent Fasting on Health, Aging, and Disease
According to Weindruch and Sohal in a 1997 article in the Journal, reducing food availability over a lifetime (caloric restriction) has remarkable effects on aging and the life span in animals. The authors proposed that the health benefits of caloric
Case 40-2019: A 26-Year-Old Returning Traveler with Headache
Presentation of Case. Dr. Marcus T. Altman (Medicine): A 26-year-old woman with a history of migraines was evaluated in the emergency department of this hospital during the winter because of headache. Three weeks before this presentation, the patient had traveled
Schistosomiasis — Assessing Progress toward the 2020 and 2025 Global Goals
Schistosomiasis is a parasitic neglected tropical disease that is estimated to currently infect more than 140 million persons. Ninety percent of the disease burden is in sub-Saharan Africa, where the main species that cause schistosomiasis in humans are Schistosoma mansoni
Enhanced Recovery after Surgery (ERAS) at Cesarean to Reduce Postoperative Length of Stay:some details need to be improved
Early High-Dose Vitamin D3 for Critically Ill, Vitamin D–Deficient Patients
Vitamin D may improve outcomes in critically ill patients. Preclinical data suggest that vitamin D is a potent immunomodulatory agent that is essential for lung development and function. Observational data and initial clinical trial data indicate that vitamin D deficiency
Effects of Intermittent Fasting on Health, Aging, and Disease
According to Weindruch and Sohal in a 1997 article in the Journal, reducing food availability over a lifetime (caloric restriction) has remarkable effects on aging and the life span in animals. The authors proposed that the health benefits of caloric
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,
Cabazitaxel versus Abiraterone or Enzalutamide in Metastatic Prostate Cancer
Prostate cancer is the second leading cause of cancer-related death among men in the United States and the third leading cause of cancer-related death in Europe. Four different classes of medical treatments have prolonged survival among patients with metastatic castration-resistant
Bladder Endometriosis
Figure 1.
Hereditary Hemorrhagic Telangiectasia
Figure 1.
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)…
Early High-Dose Vitamin D3 for Critically Ill, Vitamin D–Deficient Patients
Vitamin D may improve outcomes in critically ill patients. Preclinical data suggest that vitamin D is a potent immunomodulatory agent that is essential for lung development and function. Observational data and initial clinical trial data indicate that vitamin D deficiency
Defeating Schistosomiasis
Schistosomiasis is an ancient, neglected parasitic disease caused by blood flukes (trematode worms) of the genus schistosoma. Affecting an estimated 200 million persons in 78 countries, the disease is intimately associated with poverty and is grossly debilitating, leading to chronic
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,
Case 40-2019: A 26-Year-Old Returning Traveler with Headache
Presentation of Case. Dr. Marcus T. Altman (Medicine): A 26-year-old woman with a history of migraines was evaluated in the emergency department of this hospital during the winter because of headache. Three weeks before this presentation, the patient had traveled
Defeating Schistosomiasis
Schistosomiasis is an ancient, neglected parasitic disease caused by blood flukes (trematode worms) of the genus schistosoma. Affecting an estimated 200 million persons in 78 countries, the disease is intimately associated with poverty and is grossly debilitating, leading to chronic
Early High-Dose Vitamin D3 for Critically Ill, Vitamin D–Deficient Patients
Vitamin D may improve outcomes in critically ill patients. Preclinical data suggest that vitamin D is a potent immunomodulatory agent that is essential for lung development and function. Observational data and initial clinical trial data indicate that vitamin D deficiency
The rapidly changing landscape in mature T‐cell lymphoma (MTCL) biology and management
Abstract Historical advances in the care of patients with non‐Hodgkin lymphoma (NHL) have been restricted largely to patients with B‐cell lymphoma. The peripheral T‐cell lymphomas (PTCLs), which are rare and heterogeneous in nature, have yet to experience the same degree
Niraparib in Patients with Newly Diagnosed Advanced Ovarian Cancer
Ovarian cancer is a leading cause of death from gynecologic cancers in women worldwide. The standard treatment for newly diagnosed advanced epithelial ovarian cancer is surgical cytoreduction and systemic platinum–taxane combination chemotherapy. Unfortunately, up to 85% of the patients with…
Trial of Anifrolumab in Active Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is associated with clinical burden for the patient and organ damage. One disease-specific therapy, belimumab, has been approved for SLE, but patients are typically treated with immunosuppressant agents and glucocorticoids. The development of therapies for SLE
Correction: 8 A prospective longitudinal follow up study using T1 and T2 mapping sequences and twelve-segment myocardial assessment to identify and monitor myocardial inflammation in myositis
Bromage D, Nabeebaccus A, O’gallagher K, et al. 8 A prospective longitudinal follow up study using T1 and T2 mapping sequences and twelve-segment myocardial assessment to identify and monitor myocardial inflammation in myositis. Heart 2019;105:A7–8. doi: 10.1136/heartjnl-2019-BSCMR.8. In this abstract, the
Too Young to Have a Stroke?–a Global Health Crisis
This editorial discusses the importance of improving awareness of stroke in young individuals. Stoke can occur in any age group and is not restricted to elderly populations. Today, the average age of the first-time stroke patient continues to decrease. However,
Rising above racism is for the individual, not the system
Mathew’s focus on patient centred, open access care is valid and important,1 but as BAME (black, Asian, or minority ethnic) medical students, we think that more consideration could be given to the…
[Editorial] Proliferation and differentiation
The Lancet Haematology launched as a new journal within The Lancet group in 2014. Since that time, we have published over 250 research articles across an array of topics in classical haematology and haematology-oncology. We have been delighted to see
The rapidly changing landscape in mature T‐cell lymphoma (MTCL) biology and management
Abstract Historical advances in the care of patients with non‐Hodgkin lymphoma (NHL) have been restricted largely to patients with B‐cell lymphoma. The peripheral T‐cell lymphomas (PTCLs), which are rare and heterogeneous in nature, have yet to experience the same degree
GeVIR is a continuous gene-level metric that uses variant distribution patterns to prioritize disease candidate genes
Nature Genetics, Published online: 23 December 2019; doi:10.1038/s41588-019-0560-2 GeVIR is a continuous gene-level metric that uses variant distribution patterns to prioritize both dominant and recessive Mendelian disease genes. GeVIR outperforms missense constraint metrics and complements loss-of-function constraint metrics.
[Editorial] Dare we dream of the end of malaria?
The 2019 edition of WHO’s World Malaria Report included a special focus on pregnant women and children, two groups on which malaria can have a profound impact beyond the immediate effects of the disease. In his foreword, Tedros Adhanom Ghebreyesus,
Education first, confrontation second?
Matthew’s comments on racism are welcome.1 Aggressive racism is always offensive, but perceiving racism is often easier than understanding the complex reasons behind it. These can change over…
Neonatal Hydrocolpos
Figure 1.
Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity
Although the growing obesity epidemic in the United States has been well documented, less is known about long-term trends and the future of obesity prevalence. Although national projections of obesity have been made previously, state-specific analyses are limited. State-specific projections
Case 38-2019: A 20-Year-Old Man with Dyspnea and Abnormalities on Chest Imaging
Presentation of Case. Dr. Michael B. Feldman: A 20-year-old man with a history of electronic-cigarette (e-cigarette) use, also known as vaping, was evaluated in the pulmonary clinic of this hospital because of progressive dyspnea and abnormal findings on chest imaging.
The rapidly changing landscape in mature T‐cell lymphoma (MTCL) biology and management
Abstract Historical advances in the care of patients with non‐Hodgkin lymphoma (NHL) have been restricted largely to patients with B‐cell lymphoma. The peripheral T‐cell lymphomas (PTCLs), which are rare and heterogeneous in nature, have yet to experience the same degree
From 2646 to 15: differentially regulated miRNAs between progenitors from normal myometrium and leiomyoma
Uterine leiomyomas (fibroids) are smooth muscle neoplasms of the myometrial layer of the uterus and the most common benign tumors in women. Although their etiology is still unclear, progenitor cells (PCs) seem to be implicated.
The Key Laboratory of Pulmonary Vascular Medicine, Chinese Academy of Medical Sciences (KLPVM-CAMS)A medical centre focusing on clinical, translational and basic research, whose mission is to improve the outcome of patients with pulmonary vascular disease: Over 1800 patient referrals during 2018
For over 20 years, the Key Laboratory of Pulmonary Vascular Medicine, under the leadership of Dr Zhi-Cheng Jing together with his multidisciplinary team have studied pulmonary vascular science in China. The major research performed, and internationally recognized findings are as follows.
Adjö — My Patient’s Prolonged Good-Bye
“Do you know how to say au revoir in Swedish?” His eyes light up like miniature moons, cataracts shimmering with childish joy. His lips pull back into a smile, revealing teeth browned and loosened from their foundation. His mind, having
Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity
Although the growing obesity epidemic in the United States has been well documented, less is known about long-term trends and the future of obesity prevalence. Although national projections of obesity have been made previously, state-specific analyses are limited. State-specific projections
Vitamin E Acetate in Bronchoalveolar-Lavage Fluid Associated with EVALI
As of December 12, 2019, the ongoing national outbreak of electronic-cigarette, or vaping, product use–associated lung injury (EVALI) has affected more than 2400 hospitalized patients across all 50 states, the District of Columbia, the U.S. Virgin Islands, and Puerto Rico.
The roles of patient groups in fostering cancer research
Nature Reviews Clinical Oncology, Published online: 20 December 2019; doi:10.1038/s41571-019-0314-1 As more patients with oncogene-driven non-small-cell lung cancer are treated with targeted therapies, they are joining forces online to form groups that provide support, education and advocacy focused on specific
Trial of Anifrolumab in Active Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is associated with clinical burden for the patient and organ damage. One disease-specific therapy, belimumab, has been approved for SLE, but patients are typically treated with immunosuppressant agents and glucocorticoids. The development of therapies for SLE
Early High-Dose Vitamin D3 for Critically Ill, Vitamin D–Deficient Patients
Vitamin D may improve outcomes in critically ill patients. Preclinical data suggest that vitamin D is a potent immunomodulatory agent that is essential for lung development and function. Observational data and initial clinical trial data indicate that vitamin D deficiency
Vitamin E Acetate in Bronchoalveolar-Lavage Fluid Associated with EVALI
As of December 12, 2019, the ongoing national outbreak of electronic-cigarette, or vaping, product use–associated lung injury (EVALI) has affected more than 2400 hospitalized patients across all 50 states, the District of Columbia, the U.S. Virgin Islands, and Puerto Rico.
Childhood Hardships Contribute to Poor Adult Health
About 60% of US adults have experienced at least 1 adverse childhood experience (ACE) and nearly 16% experienced 4 or more, substantially increasing their risk of poor health outcomes, according to the CDC’s first analysis of childhood ACEs.
Cognitive remediation for severe mental illness: state of the field and future directions
Trial of Anifrolumab in Active Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is associated with clinical burden for the patient and organ damage. One disease-specific therapy, belimumab, has been approved for SLE, but patients are typically treated with immunosuppressant agents and glucocorticoids. The development of therapies for SLE
Esketamine is approved in Europe for treating resistant major depressive disorder
Esketamine nasal spray—sold under the name Spravato—has been approved by the European Commission (EC) in combination with a selective serotonin reuptake inhibitor or serotonin and norepinephrine…
Reply to ‘Correcting the ASCO position on phase I clinical trials in cancer’
Nature Reviews Clinical Oncology, Published online: 19 December 2019; doi:10.1038/s41571-019-0312-3 Reply to ‘Correcting the ASCO position on phase I clinical trials in cancer’
Niraparib in Patients with Newly Diagnosed Advanced Ovarian Cancer
Ovarian cancer is a leading cause of death from gynecologic cancers in women worldwide. The standard treatment for newly diagnosed advanced epithelial ovarian cancer is surgical cytoreduction and systemic platinum–taxane combination chemotherapy. Unfortunately, up to 85% of the patients with…
Niraparib in Patients with Newly Diagnosed Advanced Ovarian Cancer
Ovarian cancer is a leading cause of death from gynecologic cancers in women worldwide. The standard treatment for newly diagnosed advanced epithelial ovarian cancer is surgical cytoreduction and systemic platinum–taxane combination chemotherapy. Unfortunately, up to 85% of the patients with…
Bleeding changes after levonorgestrel 52mg intrauterine system insertion for contraception in women with self-reported heavy menstrual bleeding
Condensation: Most women with self-reported heavy menstrual bleeding will have a rapid decrease in flow following levonorgestrel 52mg intrauterine system placement.
When the CAR Targets Scar
Deposition of extracellular matrix in disease-stressed tissue occurs in diverse organs and disease contexts. The resulting fibrosis may have short-term adaptive features, but it impairs tissue function over time. In the heart, fibrosis is commonly divided into two types: reactive
When the CAR Targets Scar
Deposition of extracellular matrix in disease-stressed tissue occurs in diverse organs and disease contexts. The resulting fibrosis may have short-term adaptive features, but it impairs tissue function over time. In the heart, fibrosis is commonly divided into two types: reactive
Trial of Anifrolumab in Active Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is associated with clinical burden for the patient and organ damage. One disease-specific therapy, belimumab, has been approved for SLE, but patients are typically treated with immunosuppressant agents and glucocorticoids. The development of therapies for SLE
Care of Transgender Persons
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 authors’ clinical recommendations. Stage.
Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity
Although the growing obesity epidemic in the United States has been well documented, less is known about long-term trends and the future of obesity prevalence. Although national projections of obesity have been made previously, state-specific analyses are limited. State-specific projections
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
Final Analysis of a Trial of M72/AS01E Vaccine to Prevent Tuberculosis
According to the World Health Organization (WHO), tuberculosis remains the leading cause of death from a single pathogen globally, and safe, effective tuberculosis vaccines will be key in ending the epidemic. According to the Preferred Product Characteristics published by the
Prognosis in Moderate and Severe Traumatic Brain Injury: A Systematic Review of Contemporary Models and Validation Studies
Journal of Neurotrauma, Volume 37, Issue 1, Page 1-13, January 1, 2020.
Care of Transgender Persons
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 authors’ clinical recommendations. Stage.
[Editorial] Health and medicine in 2019: what have we learned?
2019 has been a tumultuous year in health and medicine. This week’s World Report reviews some of the major global events. The world continued to grapple with infectious disease: Ebola in DR Congo, a widespread surge in measles, and a
[Editorial] Measuring success: the problem with primary outcomes
In clinical science, what we choose to measure says a lot about our priorities and the underlying power-structures that shape research. Nowhere is this better reflected than in the choice of primary outcomes for randomised controlled trials (RCTs), which are
[Editorial] Time to wake the giant of obstructive sleep apnoea
Earlier this year, The Lancet Respiratory Medicine reported staggering global estimates for the number of people aged 30–69 years who are affected by obstructive sleep apnoea (OSA). The figure of nearly a billion adults with mild to severe OSA suggests
Ranitidine: patients taking certain batches should “immediately discontinue use,” says FDA
Patients who have ranitidine tablets from certain batches, identified through the US’s National Drug Code, should “immediately discontinue use and consult with their physician or healthcare provider…
Influence of intranasal oxytocin on fear consolidation in healthy humans
Background Although recent data in healthy humans suggestthat treatment with intranasal oxytocin (OT) may facilitate extinction recall,to date, little is known about the effects of OT on memory consolidationprocesses. Aim To examine the effect of intranasal administration of OT compared
Glutamate Receptors: Not Just for Excitation
In this issue of Neuron, Fossati et al. (2019) report a new constellation of players regulating inhibitory synaptogenesis. They show that GluD1, through a non-canonical ionotropic-independent mechanism, controls GABAergic synapse formation via trans-synaptic interactions mediated by extracellular cerebellin-4. They identify ARHGEF12
Cognitive remediation for severe mental illness: state of the field and future directions
A Successful Trial for Lupus — How Good Is Good Enough?
Only one drug for patients with systemic lupus erythematosus (SLE), belimumab, has been approved on the basis of support from a randomized, placebo-controlled trial, and numerous development programs of immunomodulatory treatments have failed to show benefits with respect to primary
Marijuana use in e-cigarettes increases among US teens, studies find
Self-reported use of marijuana in electronic cigarettes has risen among US teenagers, two studies have found.The research letters, published in JAMA,12 looked at marijuana vaping rates from 2017 to…
Engineering strategies to overcome the current roadblocks in CAR T cell therapy
Nature Reviews Clinical Oncology, Published online: 17 December 2019; doi:10.1038/s41571-019-0297-y Chimeric antigen receptor (CAR) T cell therapy, the first approved therapeutic approach with a genetic engineering component, holds substantial promise in the treatment of a range of cancers but is
Evaluation of Genetic Variants in MIR3142HG in Susceptibility to and Prognosis of Glioma
Objectives: Studies have demonstrated that genetic variants in the miRNA-coding genes might be associated with cancer susceptibility and survival. Here, we aimed to investigate the influence of MIR3142HG single-nucleotide polymorphisms on the individual’s susceptibility to and patients’ prognosis of glioma.
Methods for mapping 3D chromosome architecture
Nature Reviews Genetics, Published online: 17 December 2019; doi:10.1038/s41576-019-0195-2 How chromosomes are positioned and folded within the nucleus has implications for gene regulation. In this Review, Kempfer and Pombo describe and evaluate methods for studying chromosome architecture and outline the
Ending Ebola
Promising vaccines and results from recent clinical trials of therapeutic antibodies against Ebola virus offer hope for an end to this devastating disease. We asked three investigators in the field to share their views on the remaining challenges and important
[Editorial] Action on improving access to insulin
As we start to approach the centenary of the discovery of insulin, the sad truth is that this essential medicine remains inaccessible or unaffordable for too many people with diabetes. The 1921 discovery by Banting, Best, Macleod, and Collip led
Widespread Blood Shortages Threaten Global Public Health
More than 100 countries worldwide lack adequate blood supplies to meet medical needs, according to a modeling study by scientists from the University of Washington.
Case 38-2019: A 20-Year-Old Man with Dyspnea and Abnormalities on Chest Imaging
Presentation of Case. Dr. Michael B. Feldman: A 20-year-old man with a history of electronic-cigarette (e-cigarette) use, also known as vaping, was evaluated in the pulmonary clinic of this hospital because of progressive dyspnea and abnormal findings on chest imaging.
E-cigarettes are independent risk factor for respiratory disease, study finds
Use of electronic cigarettes appears to be an independent risk factor for respiratory disease in addition to tobacco smoking, according to the first population based long term analysis to investigate…
Highlights from this issue
Welcome to the January edition of the EMJ. A new decade starts a time of heavy clinical activity here in the UK, but despite that workload there is still much to learn and love about emergency medicine. This month sees
Jewels in the crown: a century of achievement for the Journal of Neurology, Neurosurgery & Psychiatry
Centenary of key narratives in clinical neuroscience Welcome to 2020—a year in which the Journal of Neurology, Neurosurgery and Psychiatry reaches its century. It would be interesting to jump into the time machine, to turn back the clock to 1920
Reply to: Revisiting the origin of octoploid strawberry
Nature Genetics, Published online: 16 December 2019; doi:10.1038/s41588-019-0544-2 Reply to: Revisiting the origin of octoploid strawberry
Plenty of single cells in the sea
Nature Reviews Genetics, Published online: 16 December 2019; doi:10.1038/s41576-019-0208-1 A large-scale single-cell genomics study of planktonic bacteria and archaea that inhabit the surface ocean broadens insights into the heterogeneity and genomic composition of this marine microbiome.
NEJM Catalyst Innovations in Care Delivery — A New Journal Leading the Transformation of Health Care Delivery
Four years ago, the NEJM Group launched NEJM Catalyst as a forum for emerging ideas and practical innovations in health care delivery, creating robust dialogue among health care leaders, clinicians, researchers, and other experts. NEJM Catalyst is now entering a
Cataract operations should take no longer than 30 minutes to maximise capacity, says report
All NHS trusts should perform routine cataract surgery in 30 minutes or less to optimise capacity and treat more patients with deteriorating eyesight, a new report has advised.1Providing more…
Heartbeat: reducing inequities in cardiovascular disease mortality
Cardiovascular disease (CVD) remains a leading cause of death in Europe with persistent geographic and socioeconomic inequities even though overall CVD mortality has declined substantially over the past 30 years. In a prospective registry-based study of CVD mortality from the
Greetings from the editor 2020
A new decade of the 21st century is starting. We have experienced multiple shake-ups in the course of the last decade, the ‘teens-decade’—political ones and social ones, such as the climate crisis which affects us globally and might even influence
Highlights from this issue
It wasn’t until the early 1800s that children’s rights were societally acknowledged with the enactment of laws preventing child labour. The next milestone was the creation by the League of Nations of a committee for the protection of children. Soon
Highlights from this issue
Physiological studies of transition There are two thought provoking physiological studies from the group in Melbourne, Australia, led by Stuart Hooper. Both concern the physiology of transition in relation to whether or not the umbilical cord is clamped. In the
Asciminib in Chronic Myeloid Leukemia after ABL Kinase Inhibitor Failure
Failure of tyrosine kinase inhibitor (TKI) therapy in patients with Philadelphia chromosome (Ph)–positive chronic myeloid leukemia (CML) may result from resistance to or unacceptable side effects from the drug or both. Currently approved TKIs mainly target the ATP-binding site of
Neonatal Hydrocolpos
Figure 1.
Penicillin Allergy
In 1928, Sir Alexander Fleming discovered that the active component of a penicillium fungus had the capacity to kill bacteria in a petri dish, and he named it penicillin. In 1945, Fleming, Florey, and Chain were jointly awarded the Nobel
Changes in the Place of Death in the United States
To the Editor: Where people die is an important determinant of patient and caregiver experience. To assess changes in place of death, we analyzed data from the Centers for Disease Control and Prevention and the National Center for Health Statistics
Adjö — My Patient’s Prolonged Good-Bye
“Do you know how to say au revoir in Swedish?” His eyes light up like miniature moons, cataracts shimmering with childish joy. His lips pull back into a smile, revealing teeth browned and loosened from their foundation. His mind, having
Changes in the Place of Death in the United States
To the Editor: Where people die is an important determinant of patient and caregiver experience. To assess changes in place of death, we analyzed data from the Centers for Disease Control and Prevention and the National Center for Health Statistics
Penicillin Allergy
In 1928, Sir Alexander Fleming discovered that the active component of a penicillium fungus had the capacity to kill bacteria in a petri dish, and he named it penicillin. In 1945, Fleming, Florey, and Chain were jointly awarded the Nobel
Penicillin Allergy
In 1928, Sir Alexander Fleming discovered that the active component of a penicillium fungus had the capacity to kill bacteria in a petri dish, and he named it penicillin. In 1945, Fleming, Florey, and Chain were jointly awarded the Nobel
Coverage of immediate postpartum long acting reversible contraception has improved birth intervals for at risk populations
In 2012, South Carolina revised Medicaid policy to cover reimbursement for immediate postpartum long acting, reversible contraception. Immediate postpartum long acting. reversible contraception may improve health outcomes for populations at risk with a subsequent short interval pregnancy.
Cardiovascular issues in women: expanding diversity in medicine
Improved MHC II epitope prediction — a step towards personalized medicine
Nature Reviews Clinical Oncology, Published online: 13 December 2019; doi:10.1038/s41571-019-0315-0 Numerous neoepitope-based vaccination strategies are in testing for clinical use in the treatment of cancer. Rapid identification of immunostimulatory neoantigen targets hastens neoantigen vaccine development. Papers recently published in Nature
Post-traumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multi-center, prospective, cohort study
Early pregnancy losses are common, but their psychological sequalae are often overlooked. Previous studies have established links between miscarriage and early symptoms of anxiety and depression. However, the incidence of post-traumatic stress symptoms, and the psychological response specifically to ectopic
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
Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm
In accordance with the 2015 guidelines of the International Liaison Committee on Resuscitation (ILCOR), targeted temperature management with a target of 32°C to 36°C (moderate therapeutic hypothermia) is currently advocated for all patients with coma after successful resuscitation from cardiac…
Metoprolol for the Prevention of Acute Exacerbations of COPD
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Most of COPD-related morbidity, mortality, and health care costs are driven by exacerbations, particularly those leading to hospitalization. Since many patients have such exacerbations despite maintenance…
A Randomized, Controlled Trial of Ebola Virus Disease Therapeutics
In August 2018, an outbreak of Ebola virus disease (EVD) began in the provinces of North Kivu and Ituri in the Democratic Republic of Congo (DRC); it was the tenth known outbreak of EVD in that country. The outbreak became
NEJM Catalyst Innovations in Care Delivery — A New Journal Leading the Transformation of Health Care Delivery
Four years ago, the NEJM Group launched NEJM Catalyst as a forum for emerging ideas and practical innovations in health care delivery, creating robust dialogue among health care leaders, clinicians, researchers, and other experts. NEJM Catalyst is now entering a
[Editorial] The elusive end to HIV in the USA
Underscoring the tenacious HIV epidemic in the US, the Centers for Disease Control and Prevention (CDC) report on data from the National HIV Surveillance System, Vital signs: status of human immunodeficiency virus testing, viral suppression, and HIV preexposure prophylaxis—United States,
Metoprolol for the Prevention of Acute Exacerbations of COPD
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Most of COPD-related morbidity, mortality, and health care costs are driven by exacerbations, particularly those leading to hospitalization. Since many patients have such exacerbations despite maintenance…
Genetic T-type calcium channelopathies
T-type channels are low-voltage-activated calcium channels that contribute to a variety of cellular and physiological functions, including neuronal excitability, hormone and neurotransmitter release as well as developmental aspects. Several human conditions including epilepsy, autism spectrum disorders, schizophrenia, motor neuron disorders
Highlights from this issue
“I’ve got 20:20 vision and that’s all I need: enough to keep my baby for company.” The words of blues legend Rory Gallagher: “Ireland’s Jimi Hendrix”. At Thorax, we would like to keep you, our readership, for company in 2020.
Revalidation prevents consultants returning to clinical practice
Sinha says that calling on retired and retiring consultants could ease the shortage of doctors in the NHS.1 Unfortunately, these consultants are unlikely to want to return to clinical practice,…
MSI-H: a truly agnostic biomarker?
Nature Reviews Clinical Oncology, Published online: 12 December 2019; doi:10.1038/s41571-019-0310-5 MSI-H: a truly agnostic biomarker?
Motivational interviewing to promote long acting reversible contraception among Rwandan couples wishing to prevent or delay pregnancy
Few family planning programs in Africa base demand creation and service delivery on theoretical models. Motivational interviewing (MI) is a counseling modality that facilitates reflection on the benefits and disadvantages of a health outcome to encourage behavior change.
Sounding the Alarm on Climate Change, 1989 and 2019
“The subject of climatic and environmental changes that result from human activity has been much in the news recently,” Alexander Leaf wrote in the Journal 30 years ago. Threatened by acid rain, greenhouse gases, ozone depletion, and global warming, the
[Editorial] Youth without freedom
The 30th anniversary of the UN Convention on the Rights of the Child (UNCRC) on Nov 20, 2019, is a chance to reflect on the global status of children’s rights. A report by UNICEF addresses the progress made in the
Kiyoshi Nagai (1949–2019)
Kiyoshi Nagai has been discovering how proteins interact with RNA in ever-larger complexes for over three decades and, as some of his competitors have commented, he set the pace. His research culminated in visualization of the huge, dynamic spliceosome complex
Evaluating e-Cigarette Lung Disease
The CDC has issued an updated preliminary guidance for clinicians on how to evaluate cases of e-cigarette–linked lung disease as the investigation of its cause continues.
Early High-Dose Vitamin D3 for Critically Ill, Vitamin D–Deficient Patients
Vitamin D may improve outcomes in critically ill patients. Preclinical data suggest that vitamin D is a potent immunomodulatory agent that is essential for lung development and function. Observational data and initial clinical trial data indicate that vitamin D deficiency
Neovascularisation in tendinopathy: from eradication to stabilisation?
Tendinopathy is the most common disorder in sports medicine. Multiple hypotheses have been proposed for the aetiopathogenesis, but many aspects still remain elusive. Microdialysis studies have shown high levels of lactate within tendinosis, even at resting tendons,1 suggesting that hypoxia
Dengue control in Pakistan: prior planning is better than controlling too late
We are grateful to the World Health Organization for helping Pakistan to battle a severe dengue outbreak,1 but unfortunately it is too late. Over 44 000 confirmed dengue cases and at least 66 deaths…
Highlights from this issue
Outcome of peripheral iridotomy in subjects with uveitis (see page 8) The peripheral iridotomy (PI) survival time was 70 days for YAG PI and 11 years for surgical PI in uveitic patients. Younger age and iris bombe were associated with
Occupational radiation exposure and excess additive risk of cataract incidence in a cohort of US radiologic technologists
Objectives Previous analyses of cataract in radiation-exposed populations have assessed relative risk; radiogenic excess additive risk (EAR), arguably of more public health importance, has not been estimated. Previous analysis of a large prospective cohort of US radiologic technologists (USRT) quantified
Next-generation protein analysis in the pathology department
Traditionally, immunohistochemistry (IHC) is used by pathologists to localise specific proteins or peptides in tissue slides. In the era of personalised medicine, however, molecular tissue analysis becomes indispensable for correct diagnosis, prognosis and therapeutic decision, not only on the DNA
Pharmacotherapy of anxiety disorders in the 21st century: A call for novel approaches
While limited advances have occurred in the past 30 years in the pharmacological management of anxiety and stress-related disorders, novel molecular pathways both within and without the monoamine systems are currently under investigation and offer promising new avenues for more
Tucatinib, Trastuzumab, and Capecitabine for HER2-Positive Metastatic Breast Cancer
Approximately 15 to 20% of breast cancers overexpress human epidermal growth factor receptor 2 (HER2). Despite dramatic therapeutic advances over the past 20 years, most patients with HER2-positive metastatic breast cancer ultimately die from their disease. Moreover, as systemic therapies
Increasing long acting reversible contraceptives: The Australian Contraceptive ChOice pRoject (ACCORd) cluster randomized trial
Long-active reversible contraceptives (LARCs) reduce unintended pregnancy and abortions but uptake is low. Interventions to increase uptake in family medicine settings are untested.
Exons as enhancers
Nature Reviews Genetics, Published online: 11 December 2019; doi:10.1038/s41576-019-0207-2 A study in Cell identifies a mechanism by which exon splicing can increase gene expression through the activation of weak upstream promoters.
Early High-Dose Vitamin D3 for Critically Ill, Vitamin D–Deficient Patients
Vitamin D may improve outcomes in critically ill patients. Preclinical data suggest that vitamin D is a potent immunomodulatory agent that is essential for lung development and function. Observational data and initial clinical trial data indicate that vitamin D deficiency
Early High-Dose Vitamin D3 for Critically Ill, Vitamin D–Deficient Patients
Vitamin D may improve outcomes in critically ill patients. Preclinical data suggest that vitamin D is a potent immunomodulatory agent that is essential for lung development and function. Observational data and initial clinical trial data indicate that vitamin D deficiency
Parting the Clouds over Typhoid with a New Conjugate Vaccine
Typhoid fever is caused by fecal–oral transmission of Salmonella enterica serovar Typhi (S. Typhi). It has been a deadly companion to mankind for centuries, affecting 10.9 million persons and resulting in an estimated 116,800 deaths per year. Although vaccines against
[Editorial] A cornerstone initiative for progress in Parkinson’s disease
On Oct 15, 2019, the Aligning Science Across Parkinson’s (ASAP) initiative was launched, with Nobel Laureate Randy Schekman as scientific director. ASAP has the ambitious goal of using its generous philanthropic resources to fund basic research projects to uncover how
US researchers’ conflicts of interest are still widespread and under-reported, investigations find
Industry payments that could skew research results are still commonplace in the United States and frequently go unnoticed despite years of effort to police such practices better, two investigations…
Client-level predictors of treatment engagement, outcome and dropout: moving beyond demographics
Background Despite the availability of evidence-based treatments for posttraumatic stress disorder (PTSD), significant heterogeneity in the effectiveness of PTSD treatment persists, especially in community settings. Client demographics used to understand this variability in treatment outcome and dropout have yielded mixed
Contact maps and brain disease risk
Nature Reviews Genetics, Published online: 10 December 2019; doi:10.1038/s41576-019-0206-3 A new study in Science has mapped regulatory elements for major cell types of the human brain to help elucidate the transcriptional mechanisms underlying their developmental and functional properties in health
Early-onset preeclampsia, plasma microRNAs and endothelial cell function
Preeclampsia is a hypertensive pregnancy disorder, in which generalized systemic inflammation and maternal endothelial dysfunction are involved in the pathophysiology. MiRNAs are small non-coding RNAs responsible for post-transcriptional regulation of gene expression and involved in many physiological processes. They mainly
Bushfires: Australia issues health warnings as Sydney air quality plummets
bmj;367/dec10_10/l6914/FAF1faGetty ImagesLarge bushfires have shrouded Australia’s east coast in dense smoke, prompting health authorities to issue warnings as Sydney’s air quality index exceeded…
When Cold Is Hot: Immune Checkpoint Inhibition Therapy for Rhabdoid Tumors
Carcinogen-induced cancers typically have high mutation burdens and an inflamed microenvironment and thus are poised to respond to immune checkpoint inhibitors (ICIs). However, cancers with loss-of-function mutations in the SWI/SNF complex have few additional mutations yet also have an inflamed immunophenotype
NHS staff and patients urged to get vaccinated as flu season starts early
NHS services are braced for a tough winter after figures showed that hospitalisation rates from flu doubled last week.Figures1 from Public Health England (PHE) show that the hospitalisation rate from…
The rapidly changing landscape in mature T‐cell lymphoma (MTCL) biology and management
Abstract Historical advances in the care of patients with non‐Hodgkin lymphoma (NHL) have been restricted largely to patients with B‐cell lymphoma. The peripheral T‐cell lymphomas (PTCLs), which are rare and heterogeneous in nature, have yet to experience the same degree
Facing Uncertainty
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.
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…
Between Scylla and Charybdis: combining anticoagulants with platelet inhibitors and outcome
Ubrogepant for the Treatment of Migraine
Migraine is a chronic disease characterized by episodic attacks of headache, sensitivity to light and sound, and nausea. The major classes of medications for acute migraine treatment are analgesics, including nonsteroidal antiinflammatory drugs, ergots, and triptans. Triptans have been the
Phase 3 Efficacy Analysis of a Typhoid Conjugate Vaccine Trial in Nepal
Typhoid fever is a systemic illness caused by Salmonella enterica serovar Typhi. An estimated 11 million to 21 million cases of febrile illness and 117,000 to 161,000 deaths are attributed to the disease each year. Typhoid fever is a major
Reply to letter to the editor about The COSGROVE study
Taking a BAT to the Chains of Diabetes
Diabetes is widely understood to be a disease associated with sugars and fats. But extensive epidemiologic data going back 50 years have also shown that plasma levels of the branched-chain amino acids (BCAAs; leucine, valine, and isoleucine) are consistently elevated
Expanding applications for nanopore sequencing
Nature Reviews Genetics, Published online: 06 December 2019; doi:10.1038/s41576-019-0204-5 Two new studies report advances for nanopore-based long-read sequencing for characterizing complex human transcriptomes and for analysing human repetitive DNA regions.
Impact of social deprivation on outcome following transcatheter aortic valve implantation (TAVI)
Objectives We sought to evaluate whether socioeconomic status influences outcome after first-time transcatheter aortic valve implantation (TAVI). Method This is a single-centre study carried out in Swansea, South West Wales, UK between 5 November 2009 and 10 June 2018. Data
Phase 3 Efficacy Analysis of a Typhoid Conjugate Vaccine Trial in Nepal
Typhoid fever is a systemic illness caused by Salmonella enterica serovar Typhi. An estimated 11 million to 21 million cases of febrile illness and 117,000 to 161,000 deaths are attributed to the disease each year. Typhoid fever is a major
Ubrogepant for the Treatment of Migraine
Migraine is a chronic disease characterized by episodic attacks of headache, sensitivity to light and sound, and nausea. The major classes of medications for acute migraine treatment are analgesics, including nonsteroidal antiinflammatory drugs, ergots, and triptans. Triptans have been the
[Editorial] Time for honesty in the UK election
As the UK general election campaign reaches its climax, greater clarity on spending and ambitions for the next 5 years has suggested a thankfully renewed focus on aspects of UK society and politics beyond Brexit. The UK’s National Health Service
One size does not fit all: implementation of interventions for non-communicable diseases
Non-communicable diseases (NCDs) are recognised to be a major barrier to human health and development, and there have been global policy commitments to prevent and control them.1 Most notably, NCDs…
Highlights from this issue
Recognising eosinophilic oesophagitis as a cause of food bolus obstruction Eosinophilic oesophagitis is a chronic inflammatory disorder. Diagnosis is by strict histological criteria which include >15 eosinophils per high power field (upper and lower oesophagus). Eosinophilic oesophagitis is increasingly recognised
Targeting tumour microenvironment, a FAKtual challenge in pancreatic cancer
In the past two decades, investigators have turned their attention to the development of new approaches to inhibit the aggressive behaviour of the tumour microenvironment (TME) of pancreatic ductal adenocarcinoma (PDAC),1–7 a dismal disease predicted to be the second leading
Prospective evidence discourages secondary cytoreductive surgery
Nature Reviews Clinical Oncology, Published online: 05 December 2019; doi:10.1038/s41571-019-0309-y Prospective evidence discourages secondary cytoreductive surgery
Sensing the Environment: Extracellular Lactate Levels Control Adult Neurogenesis
Metabolism has emerged as a key player for stem cell behavior; however, the role of metabolism in the microenvironment remains poorly understood. In this issue of Cell Stem Cell, Wang et al. (2019) show that brain endothelial cells directly affect adult
Facing Uncertainty
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.
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
Investigation of early signs of systolic and diastolic dysfunction among persons with type 1 diabetes
Background Persons with type 1 diabetes have a higher risk to develop heart failure than the general population, and the mechanism behind the increased risk is unclear. In epidemiological studies with hospitalisation for heart failure as endpoint HbA1c, body mass
Lay Responder Care for an Adult with Out-of-Hospital Cardiac Arrest
Out-of-hospital cardiac arrest is a major public health issue. In the United States, an estimated 155,000 persons per year are treated by emergency medical services (EMS) for out-of-hospital cardiac arrest, and approximately 8% survive. In Europe, annual occurrence is estimated
Facing Uncertainty
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.
Retinal Hemorrhage from Blunt Ocular Trauma
Figure 1.
Taking a BAT to the Chains of Diabetes
Diabetes is widely understood to be a disease associated with sugars and fats. But extensive epidemiologic data going back 50 years have also shown that plasma levels of the branched-chain amino acids (BCAAs; leucine, valine, and isoleucine) are consistently elevated
[Editorial] Liver transplantation in the USA: ethical issues
Of all medical disciplines, organ transplantation is perhaps the most fraught with thorny ethical issues. This was apparent at The Liver Meeting 2019, held in Boston, MA, USA, when hepatologists from around the world gathered to present new science and
Endoscopic or Surgical Myotomy in Patients with Idiopathic Achalasia
Achalasia is an esophageal motor disorder consisting of defective relaxation of the lower esophageal sphincter and disturbed esophageal peristalsis. The clinical symptoms associated with the condition include dysphagia, regurgitation, chest pain, and weight loss. Current treatment options include…
Total Hip Arthroplasty or Hemiarthroplasty for Hip Fracture
Patients with a hip fracture are at substantial risk for death, health complications, and reduced quality of life. Despite the high frequency of the injury, the way in which displaced femoral neck fractures in elderly patients should be managed surgically
Should Total Hip Arthroplasty Be Used for Hip Fracture?
For an elderly and frail patient, a hip fracture is a severe injury associated with increased morbidity and mortality. Although the majority of femoral neck fractures have historically been treated with reduction and internal fixation, most current guidelines advocate arthroplasty
Preparing for the Next Pandemic — The WHO’s Global Influenza Strategy
Last year, the world marked 100 years since the beginning of the 1918 influenza pandemic. Over a little more than 2 years, the virus infected more than half a billion people, spreading to remote parts of the globe and causing
Parting the Clouds over Typhoid with a New Conjugate Vaccine
Typhoid fever is caused by fecal–oral transmission of Salmonella enterica serovar Typhi (S. Typhi). It has been a deadly companion to mankind for centuries, affecting 10.9 million persons and resulting in an estimated 116,800 deaths per year. Although vaccines against
Brain Changes in Response to Long Antarctic Expeditions
To the Editor: Studies in animals have shown that exposure to environmental monotony and social isolation have deleterious effects on the brain, particularly in reducing the generation of new neurons in the dentate gyrus of the hippocampus. Whether stressors associated
Parting the Clouds over Typhoid with a New Conjugate Vaccine
Typhoid fever is caused by fecal–oral transmission of Salmonella enterica serovar Typhi (S. Typhi). It has been a deadly companion to mankind for centuries, affecting 10.9 million persons and resulting in an estimated 116,800 deaths per year. Although vaccines against
Brain Changes in Response to Long Antarctic Expeditions
To the Editor: Studies in animals have shown that exposure to environmental monotony and social isolation have deleterious effects on the brain, particularly in reducing the generation of new neurons in the dentate gyrus of the hippocampus. Whether stressors associated
The False Promise of Natural Gas
Production of natural gas has grown by nearly 400% in the United States since 1950, and gas is now the country’s second-largest energy source. The main driver of this increase has been the wide-scale adoption of hydraulic fracturing (“fracking”). During
Total Hip Arthroplasty or Hemiarthroplasty for Hip Fracture
Patients with a hip fracture are at substantial risk for death, health complications, and reduced quality of life. Despite the high frequency of the injury, the way in which displaced femoral neck fractures in elderly patients should be managed surgically
Frank Dobson: Labour politician who became “best UK health secretary since Aneurin Bevan”
bmj;367/dec05_10/l6792/FAF1faPhoto credit: Glenn Corpus/ShutterstockFrank Dobson was the first Labour health secretary for nearly 20 years when Tony Blair appointed him after the landslide general…
Effects of oral sildenafil on exercise capacity in children with pulmonary arterial hypertension: a randomised trial
Objective The 16-week, randomised, double-blind Sildenafil in Treatment-Naïve Children, Aged1–17 years, with Pulmonary Arterial Hypertension (STARTS-1) study assessed the effect of sildenafil on cardiopulmonary exercise testing (CPET) in treatment-naïve paediatric patients with pulmonary arterial hypertension (PAH) and included a long-term
Elucidating the Role of Apolipoprotein E Isoforms in Spinal Cord Injury-Associated Neuropathology
Journal of Neurotrauma, Volume 36, Issue 24, Page 3317-3322, December 15, 2019.
Relax, Don’t RAN Translate It
The (GGGGCC)n repeat expansion in C9orf72, which is the most common cause of frontotemporal dementia and amyotrophic lateral sclerosis, is translated through repeat-associated non-AUG (RAN) translation. In this issue of Neuron, Cheng et al. (2019) report that the helicase DDX3X, which
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
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
Toward Healthy Drug Policy in the United States — The Case of Safehouse
In 2017, a committee convened by the mayor of Philadelphia as part of a task force on the opioid-overdose crisis recommended opening safe consumption sites in the city. The core function of the more than 165 such facilities operating globally
Gender dysphoria: puberty blockers and loss of bone mineral density
Cohen and Barnes clearly articulate the ongoing debate on the effects of puberty blockers (gonadotrophin releasing hormone (GnRH) agonists) on bone mineral density in trans and gender diverse young…
An Update to Changing Patterns of Anal Carcinoma in the United States
Objectives: Approximately 8,300 new cases of anal carcinoma will be diagnosed in the United States in 2019. Anal squamous cell carcinoma (SCC) accounts for about 70% of all anal cancers. As cancer prevention and treatments have evolved over time, medical
Unprotected intercourse in the 2 weeks prior to “quick start” initiation of an etonogestrel contraceptive implant with and without use of oral emergency contraception
Getting wise about lost Ys
Nature Reviews Genetics, Published online: 03 December 2019; doi:10.1038/s41576-019-0202-7 Getting wise about lost Ys
Facing Uncertainty
A 57-year-old woman presented to the dermatology clinic for evaluation of a facial rash that had been present for 1 year. She reported a 2-week history of productive cough and worsening shortness of breath despite completion of a course of
Adipose Tissue B Cells Come of Age: The AABs of Fat Inflammation
For nearly a decade, B cells residing locally within the adipose tissue have been linked to the control of metabolic homeostasis. In this issue, Camell et al. (2019) report an expansion of a unique age-associated B cell population in the visceral
Two thirds of GP trainees have no plan to work full time after qualifying, survey finds
Less than a third of GP trainees plan to work full time in general practice the year after they qualify, a survey carried out by the King’s Fund has found.The healthcare think tank surveyed 840 GP…
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