Widespread efforts by Republican leaning US states to limit abortion by requiring providers to meet unusually onerous standards seemed to run out of road this week, as the Supreme Court struck down a…
Research priorities in advanced heart failure: James Lind alliance priority setting partnership
Objective To determine research priorities in advanced heart failure (HF) for patients, carers and healthcare professionals. Methods Priority setting partnership using the systematic James Lind Alliance method for ranking and setting research priorities. An initial open survey of patients, carers
Approaches to global stroke care during the COVID-19 pandemic
Publisher Correction: Personalized early detection and prevention of breast cancer: ENVISION consensus statement
Nature Reviews Clinical Oncology, Published online: 29 June 2020; doi:10.1038/s41571-020-0412-0 Publisher Correction: Personalized early detection and prevention of breast cancer: ENVISION consensus statement
[Editorial] Racism, discrimination, and the practice of oncology
The appalling death of George Floyd on May 25, 2020, at the hands of the Minneapolis police in the USA has sparked large rallies and protests on a global scale. This lawless act of overt brutality is symbolic of structural
Genomic analyses implicate noncoding de novo variants in congenital heart disease
Nature Genetics, Published online: 29 June 2020; doi:10.1038/s41588-020-0652-z Computational analyses integrating whole-genome sequencing, cardiac epigenomic data and RNA-binding-protein data identify a role for noncoding de novo mutations in congenital heart disease.
Polygenic adaptation: a unifying framework to understand positive selection
Nature Reviews Genetics, Published online: 29 June 2020; doi:10.1038/s41576-020-0250-z Increased capacities for sequencing and genotyping are enabling a more comprehensive understanding of the genetics of adaptation for diverse species. In this Perspective, Barghi, Hermisson and Schlötterer describe how polygenic adaptation
Multisystem Inflammatory Syndrome in U.S. Children and Adolescents
The coronavirus disease 2019 (Covid-19) pandemic has caused catastrophic disease worldwide, although children have been relatively spared. Severe lung involvement with acute respiratory failure is the most common complication of Covid-19 in adults, but many have complications in multiple organs,…
Multisystem Inflammatory Syndrome in U.S. Children and Adolescents
The coronavirus disease 2019 (Covid-19) pandemic has caused catastrophic disease worldwide, although children have been relatively spared. Severe lung involvement with acute respiratory failure is the most common complication of Covid-19 in adults, but many have complications in multiple organs,…
Multisystem Inflammatory Syndrome in U.S. Children and Adolescents
The coronavirus disease 2019 (Covid-19) pandemic has caused catastrophic disease worldwide, although children have been relatively spared. Severe lung involvement with acute respiratory failure is the most common complication of Covid-19 in adults, but many have complications in multiple organs,…
The role of countertransference in contemporary psychiatric treatment
Multisystem Inflammatory Syndrome in U.S. Children and Adolescents
The coronavirus disease 2019 (Covid-19) pandemic has caused catastrophic disease worldwide, although children have been relatively spared. Severe lung involvement with acute respiratory failure is the most common complication of Covid-19 in adults, but many have complications in multiple organs,…
Covid-19: healthcare students face unique mental health challenges
Investigating the exacerbating and mitigating factors that affect healthcare professionals’ mental health in pandemics is important, but Gold’s editorial overlooks a distinct subgroup in the clinical…
COVID-19 current controversies
This July 2020 issue of JME introduces a new section, “COVID-19 Current Controversies,” which will be a recurring section in each issue for the foreseeable future. This issue reflects on some of the most pressing ethical issues that have arisen
Catheter strategy to ease the procedure and reduce radiation exposure when requiring neck access
Objectives To assess the potential occupational radiation reduction and technical feasibility in patients rotated 180° (upside-down) when requiring neck access for transcervical or trans-subclavian catheterisation. Methods Upside-down positioning is defined as rotating patients in supine position by 180°, so that
Salicylate Toxicity
On presentation to the emergency department, patients with fever, tachypnea, rales on lung examination, and acid–base disturbances are often given a suspected diagnosis of viral infection, yet persons with salicylate toxicity may present with similar symptoms. This article highlights the
Hydroxyurea Dose Escalation for Sickle Cell Anemia in Sub-Saharan Africa
Sickle cell anemia is characterized by the polymerization of sickle hemoglobin to form abnormally shaped erythrocytes, which leads to severe hemolytic anemia, acute vaso-occlusive complications, chronic organ damage, and early death. Sickle cell anemia is increasingly recognized as having a
Salicylate Toxicity
On presentation to the emergency department, patients with fever, tachypnea, rales on lung examination, and acid–base disturbances are often given a suspected diagnosis of viral infection, yet persons with salicylate toxicity may present with similar symptoms. This article highlights the
Serum Urate Lowering with Allopurinol and Kidney Function in Type 1 Diabetes
The estimated lifetime risk of diabetic kidney disease among patients with type 1 diabetes is as high as 60%. Intensive glucose control was widely implemented to reduce the incidence of microalbuminuria after the Diabetes Control and Complications Trial, but longer
Salicylate Toxicity
On presentation to the emergency department, patients with fever, tachypnea, rales on lung examination, and acid–base disturbances are often given a suspected diagnosis of viral infection, yet persons with salicylate toxicity may present with similar symptoms. This article highlights the
Community Health Centers and Covid-19 — Time for Congress to Act
“So, when can I actually see you again, doc?” Silence fills the space of our televisit, save for the occasional crackle of static. Do we tell our patients the truth — that we don’t know whether we’ll ever see them
Community Health Centers and Covid-19 — Time for Congress to Act
“So, when can I actually see you again, doc?” Silence fills the space of our televisit, save for the occasional crackle of static. Do we tell our patients the truth — that we don’t know whether we’ll ever see them
Salicylate Toxicity
On presentation to the emergency department, patients with fever, tachypnea, rales on lung examination, and acid–base disturbances are often given a suspected diagnosis of viral infection, yet persons with salicylate toxicity may present with similar symptoms. This article highlights the
Salicylate Toxicity
On presentation to the emergency department, patients with fever, tachypnea, rales on lung examination, and acid–base disturbances are often given a suspected diagnosis of viral infection, yet persons with salicylate toxicity may present with similar symptoms. This article highlights the
Cannabis and public health: a global experiment without control
Sequencing Treatments for Cancer During the COVID-19 Pandemic
No abstract available
Mailed fecal immunochemical test outreach for colorectal cancer screening: Summary of a Centers for Disease Control and Prevention–sponsored summit
Abstract Uptake of colorectal cancer screening remains suboptimal. Mailed fecal immunochemical testing (FIT) offers promise for increasing screening rates, but optimal strategies for implementation have not been well synthesized. In June 2019, the Centers for Disease Control and Prevention convened
Early vaginal progesterone versus Placebo in Twin Pregnancies for prevention of spontaneous preterm birth (EVENTS): A randomised double-blind trial
In women with a singleton pregnancy and sonographic short cervix in mid-gestation, vaginal administration of progesterone reduces the risk of early preterm birth and improves neonatal outcomes, without any demonstrable deleterious effects on childhood neurodevelopment. In women with twin pregnancies
Renal kinetics in acute heart failure
Aims Worsening renal function (WRF) in acute heart failure (AHF) has multifactorial pathophysiological mechanisms and heterogeneous prognostic impacts. The aim of this study was to determine the characteristics and renal kinetics of this phenomenon. Methods and results We prospectively enrolled
Case 20-2020: A 7-Year-Old Girl with Severe Psychological Distress after Family Separation
Presentation of Case. Dr. Rachel M. Erdil (Medicine and Pediatrics): A 7-year-old girl who had immigrated to the United States from Central America was evaluated in the asylum clinic of this hospital — where forensic medical evaluations of asylum seekers
[Editorial] Generation coronavirus?
The catastrophic elements that have perpetuated the COVID-19 pandemic—global interconnectedness, climate change due to human activity, vast economic inequality, and deep veins of antiscience—have resulted in more than 9 million infections and almost 500 000 deaths worldwide. Although children might be
Community Health Centers and Covid-19 — Time for Congress to Act
“So, when can I actually see you again, doc?” Silence fills the space of our televisit, save for the occasional crackle of static. Do we tell our patients the truth — that we don’t know whether we’ll ever see them
Correction: Percent low attenuation volume and fractal dimension of low attenuation clusters on computed tomography predict different long-term outcomes in COPD
Shimizu K, Tanabe N, Tho NV, et al. Percent low attenuation volume and fractal dimension of low attenuation clusters on computed tomography predict different long-term outcomes in COPD. Thorax 2020;75(2):116–122. doi: 10.1136/thoraxjnl-2019-213525. Since the publication of this article, the authors
Dianne Mary Burton
bmj;369/jun26_9/m2568/FAF1faAfter house jobs in Bristol, Suffolk, and Leeds, Dianne Mary Burton was a consultant in child and adolescent psychiatry in York in 1975-76. Subsequently she worked as a…
Early prediction of acute kidney injury in neonates with cardiac surgery
Background Acute kidney injury (AKI) occurs in 42%–64% of the neonatal patients experiencing cardiac surgery, contributing to postoperative morbidity and mortality. Current diagnostic criteria, which are mainly based on serum creatinine and hourly urine output, are not sufficiently sensitive and
Vasoactive Intestinal Peptide in Checkpoint Inhibitor–Induced Pneumonitis
To the Editor: Therapy with immune checkpoint inhibitors has become a new therapeutic option for several types of cancer, but immune-related adverse events can limit their use. Outside of clinical studies, pneumonitis develops in as many as 10 to 20%
Does umbilical cord milking increase the risk of severe intraventricular hemorrhage in extreme preterm neonates? a multi treatment comparison
Author Correction: Cas9 activates the p53 pathway and selects for p53-inactivating mutations
Nature Genetics, Published online: 25 June 2020; doi:10.1038/s41588-020-0663-9 Author Correction: Cas9 activates the p53 pathway and selects for p53-inactivating mutations
Hydroxyurea Dose Escalation for Sickle Cell Anemia in Sub-Saharan Africa
Sickle cell anemia is characterized by the polymerization of sickle hemoglobin to form abnormally shaped erythrocytes, which leads to severe hemolytic anemia, acute vaso-occlusive complications, chronic organ damage, and early death. Sickle cell anemia is increasingly recognized as having a
Vasoactive Intestinal Peptide in Checkpoint Inhibitor–Induced Pneumonitis
To the Editor: Therapy with immune checkpoint inhibitors has become a new therapeutic option for several types of cancer, but immune-related adverse events can limit their use. Outside of clinical studies, pneumonitis develops in as many as 10 to 20%
Guillain–Barré Syndrome Associated with SARS-CoV-2
To the Editor: From February 28 through March 21, 2020, in three hospitals in northern Italy, we examined five patients who had Guillain–Barré syndrome after the onset of coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome
Urate-Lowering Therapy and Chronic Kidney Disease Progression
The prevalence and severity of chronic kidney disease (CKD) has been increasing for decades. Because of its tremendous financial and health burden, both to persons and to health systems, mitigation of the progression of CKD is of critical importance. Two
Mesenteric Volvulus from Jejunal Diverticulosis
Figure 1.
Kinder, Gentler Dementia-Friendly Alzheimer’s Care
Many of us navigate the issues surrounding dementia (most often Alzheimer’s disease) without enough advance planning, forethought, or help. My family’s story is not unusual: as my mother entered her late 90s, her long-sharp intellect lost its edge. She no
Salicylate Toxicity
On presentation to the emergency department, patients with fever, tachypnea, rales on lung examination, and acid–base disturbances are often given a suspected diagnosis of viral infection, yet persons with salicylate toxicity may present with similar symptoms. This article highlights the
Hospitalization and Mortality among Black Patients and White Patients with Covid-19
Surveillance of the clinical characteristics and outcomes of hospitalized patients with coronavirus disease 2019 (Covid-19) is imperative for elucidating the epidemiology of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the United States. As of May 13, 2020, the
Hospitalization and Mortality among Black Patients and White Patients with Covid-19
Surveillance of the clinical characteristics and outcomes of hospitalized patients with coronavirus disease 2019 (Covid-19) is imperative for elucidating the epidemiology of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the United States. As of May 13, 2020, the
Urate-Lowering Therapy and Chronic Kidney Disease Progression
The prevalence and severity of chronic kidney disease (CKD) has been increasing for decades. Because of its tremendous financial and health burden, both to persons and to health systems, mitigation of the progression of CKD is of critical importance. Two
Guillain–Barré Syndrome Associated with SARS-CoV-2
To the Editor: From February 28 through March 21, 2020, in three hospitals in northern Italy, we examined five patients who had Guillain–Barré syndrome after the onset of coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome
Science Has a Racism Problem
We are the editors of a science journal, committed to publishing and disseminating exciting work across the biological sciences. We are 13 scientists. Not one of us is Black. Underrepresentation of Black scientists goes beyond our team—to our authors, reviewers,
Case 20-2020: A 7-Year-Old Girl with Severe Psychological Distress after Family Separation
Presentation of Case. Dr. Rachel M. Erdil (Medicine and Pediatrics): A 7-year-old girl who had immigrated to the United States from Central America was evaluated in the asylum clinic of this hospital — where forensic medical evaluations of asylum seekers
Reach agreement on GP safeguarding fees or risk legal action, judge tells local agencies
Local authorities, the police, and clinical commissioning groups (CCGs) could face a mass of civil claims by GPs if they fail to reach agreement locally on whether fees are to be paid for doctors’…
Heartbeat: Early cardiomyopathy or physiological left ventricular dilation in athletes?
Athletic physical conditioning results in changes in cardiac anatomy and function that make it challenging to distinguish normal physiological changes from a pathological process in athletes with left ventricular (LV) dilation or a reduced ejection fraction. Millar and colleagues1 propose
Susceptibility and prognosis of COVID-19 patients with cardiovascular disease
Delivery of monochorionic twins – lessons learned from the Twin Birth Study
The current literature regarding the recommended mode of delivery in monochorionic-diamniotic (MCDA) twins is limited by small numbers, retrospective studies, and comparisons of outcomes of MCDA gestations to those of dichorionic-diamniotic (DCDA) gestations, instead of outcomes of trial of labor
[Editorial] Political casualties of the COVID-19 pandemic
After implementing to varying degrees of success non-pharmaceutical interventions to control the COVID-19 outbreak, countries around the world are now lifting restrictions, many seemingly without heed of epidemic curves, reproductive number estimates, or regional differences in these. Economic pressures are
Case 21-2020: A 66-Year-Old Homeless Man with Covid-19
Presentation of Case. Dr. Denise De Las Nueces: A 66-year-old homeless man who had sought refuge at a local men’s congregate shelter for the past several years was evaluated for cough and rhinorrhea during the pandemic of coronavirus disease 2019
Triple Inhaled Therapy at Two Glucocorticoid Doses in Moderate-to-Very-Severe COPD
Treatment recommendations for chronic obstructive pulmonary disease (COPD) involve a stepwise approach, in which treatments are added as necessary to control symptoms and reduce or eliminate exacerbations, with an additional goal of reducing mortality from the disease. Triple therapy with
Covid-19: Doctors feel shut out of plans for dealing with backlog of missed care
A quarter of doctors have not been involved in planning to deal with the increased demand for non-covid-19 care despite many already seeing a significant rise, a survey by the BMA has found.A…
[Editorial] Black lives matter in haematology
The death of George Floyd at the hands of police in Minneapolis on May 25, 2020 has rightly sparked an outpouring of rage which is reverberating around the world. Racism costs lives, from disproportionate danger for Black people in the
Multitasking for base editors
Nature Reviews Genetics, Published online: 23 June 2020; doi:10.1038/s41576-020-0261-9 Three new studies in Nature Biotechnology combine the adenine and cytosine deaminase activities of single base editors to generate dual base editor systems for combinatorial editing in human cells.
Extending the age limit of commercial pilots?
A cardiovascular risk assessment concept is presented by a physician consultant for aerospace medicine and a former cardiology expert of the Federal Office of Civil Aviation, Switzerland
Postpartum Depression Screening Needs More Consistency
About 13% of US women report depressive symptoms after giving birth, according to a CDC survey. Yet 1 in 8 women said they weren’t asked about feeling depressed during their postpartum care.
Enhancing postnatal care of women with gestational diabetes
Vounzoulaki and colleagues’ finding that women with a history of gestational diabetes are almost 10 times more likely to develop type 2 diabetes starkly underscores the importance of providing…
Gene editing prospects for treating inherited retinal diseases
Retinal diseases (RD) include inherited retinal dystrophy (IRD), for example, retinitis pigmentosa and Leber’s congenital amaurosis, or multifactorial forms, for example, age-related macular degeneration (AMD). IRDs are clinically and genetically heterogeneous in nature. To date, more than 200 genes are
Highlights from this issue
Smoking and treatment outcomes of neovascular age-related macular degeneration over 12 months (see page 893) In this cohort of neovascular age-related macular degeneration (AMD) patients, current smoking was associated with a younger age of AMD onset and key treatment outcomes
Towards new horizons: characterization, classification and implications of the tumour antigenic repertoire
Nature Reviews Clinical Oncology, Published online: 22 June 2020; doi:10.1038/s41571-020-0387-x Immune-checkpoint inhibition has transformed the treatment of patients with advanced-stage cancers. Nonetheless, the specific antigens targeted by T cells that are activated or reactivated by these agents remain largely unknown.
Fetal molding examined with transperineal ultrasound and associations with position and delivery mode
To accommodate passage through the birth canal, the fetal skull is compressed and reshaped, a phenomenon known as molding. The fetal skull bones are separated by membranous sutures which facilitate compression and overlap, resulting in a reduced diameter. This increases
Cohesin promotes stochastic domain intermingling to ensure proper regulation of boundary-proximal genes
Nature Genetics, Published online: 22 June 2020; doi:10.1038/s41588-020-0647-9 A combination of super-resolution microscopy and Oligopaint technology shows that TAD boundaries are variable at the single-cell level. Loss of cohesin, in contrast to WAPL or CTCF depletion, reduces interactions across boundaries
Medical cannabis: campaigner calls on home secretary to deliver on access promises
The mother of Alfie Dingley has called on the home secretary to finally deliver appropriate access to medical cannabis on the NHS, saying that the covid-19 pandemic has exacerbated the situation for…
Role for machine learning in sex-specific prediction of successful electrical cardioversion in atrial fibrillation?
Objective Electrical cardioversion is frequently performed to restore sinus rhythm in patients with persistent atrial fibrillation (AF). However, AF recurs in many patients and identifying the patients who benefit from electrical cardioversion is difficult. The objective was to develop sex-specific
Angioedema after t-PA Infusion
Figure 1.
Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19
As the coronavirus disease 2019 (Covid-19) pandemic has spread around the globe, there has been growing recognition that persons with underlying increased cardiovascular risk may be disproportionately affected. Several studies of case series have noted cardiac arrhythmias, cardiomyopathy, and…
Renin–Angiotensin–Aldosterone System Inhibitors and Risk of Covid-19
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19), can infect host cells by means of interaction with membrane-bound angiotensin-converting enzyme 2 (ACE2) on respiratory epithelium. ACE2 is part of the…
Trastuzumab Deruxtecan in Previously Treated HER2-Positive Gastric Cancer
An estimated 15 to 20% of advanced gastric and gastroesophageal junction cancers, which are especially prevalent in East Asia, have overexpression or amplification of human epidermal growth factor receptor 2 (HER2). Chemotherapy plus the anti-HER2 antibody trastuzumab is the recommended
Unrepaired Tetralogy of Fallot in Adulthood
Figure 1.
Handgun Ownership and Suicide in California
Suicide attempts are often impulsive acts, driven by transient life crises. Most attempts are not fatal, and most people who attempt suicide do not go on to die in a future suicide. Whether a suicide attempt is fatal depends heavily
ICI rechallenge in mRCC
Nature Reviews Clinical Oncology, Published online: 19 June 2020; doi:10.1038/s41571-020-0407-x ICI rechallenge in mRCC
Trastuzumab Deruxtecan in Previously Treated HER2-Positive Gastric Cancer
An estimated 15 to 20% of advanced gastric and gastroesophageal junction cancers, which are especially prevalent in East Asia, have overexpression or amplification of human epidermal growth factor receptor 2 (HER2). Chemotherapy plus the anti-HER2 antibody trastuzumab is the recommended
Clinical Characteristics of Pregnant Women with Covid-19 in Wuhan, China
To the Editor: Despite the large and rapidly rising number of cases of coronavirus disease 2019 (Covid-19) and resulting deaths, there are limited data about the clinical characteristics of pregnant women with the disease. We extracted information regarding epidemiologic, clinical,
Detection of Structural Rearrangements in Embryos
To the Editor: Carriers of balanced chromosomal rearrangements (BCRs) are at risk for infertility, recurrent miscarriages, and abnormal offspring because of unbalanced rearrangements. A small subgroup of carriers is at risk for neurodevelopmental or neuropsychiatric conditions. Preimplantation…
Sequencing sperm to untangle meiotic variation
Nature Reviews Genetics, Published online: 19 June 2020; doi:10.1038/s41576-020-0259-3 A study in Nature describes a new method for studying variation in meiosis. Sperm-seq is a single-cell sequencing approach that enables genome-wide analysis of multiple meiotic phenotypes in thousands of sperm
Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms
Physicians still lack consensus on the meaning of race. When the Journal took up the topic in 2003 with a debate about the role of race in medicine, one side argued that racial and ethnic categories reflected underlying population genetics
Case 19-2020: A 74-Year-Old Man with Acute Respiratory Failure and Unclear Goals of Care
Presentation of Case. Dr. Kathy M. Tran: A 74-year-old man with mantle-cell lymphoma was admitted to this hospital during the coronavirus disease 2019 (Covid-19) pandemic because of acute respiratory failure. One day before this admission, productive cough and dyspnea developed.
“We Signed Up for This!” — Student and Trainee Responses to the Covid-19 Pandemic
On January 20, 2020, the first U.S. case of Covid-19 was reported in Washington State. Substantial challenges lay ahead. Covid-19 is highly contagious, it can cause severe illness, and no proven, effective treatments or vaccines are available. As leaders at
Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19
The aminoquinolines chloroquine and hydroxychloroquine are widely used in the treatment of malaria and rheumatic diseases, and they have been suggested as effective treatments for coronavirus disease 2019 (Covid-19) on the grounds of both antiinflammatory and antiviral effects. In the
Renin–Angiotensin–Aldosterone System Inhibitors and Risk of Covid-19
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19), can infect host cells by means of interaction with membrane-bound angiotensin-converting enzyme 2 (ACE2) on respiratory epithelium. ACE2 is part of the…
Angioedema after t-PA Infusion
Figure 1.
[Editorial] Home of the brave?
In early April, 2008, as the USA was in the midst of its worst economic crisis since the great depression, then presidential candidate Barack Obama described people in rural, small US towns as responding to tough economic times by “clinging
Case 19-2020: A 74-Year-Old Man with Acute Respiratory Failure and Unclear Goals of Care
Presentation of Case. Dr. Kathy M. Tran: A 74-year-old man with mantle-cell lymphoma was admitted to this hospital during the coronavirus disease 2019 (Covid-19) pandemic because of acute respiratory failure. One day before this admission, productive cough and dyspnea developed.
Highlights from this issue
Coronavirus So many more questions, but at the same time so much knowledge gleaned in such a short time. COVID-19 continues appropriately to dominate the headlines but, while only weeks ago, most literature was in the realm of speculative, we
Covid-19: Health and care workers will be “highest priority” for vaccination, says JCVI
“Frontline” health and social care workers will be the “highest priority for vaccination” once a vaccine against covid-19 becomes available, the UK Joint Committee on Vaccination and Immunisation has…
Highlights from this issue
Embracing moral distress Trisha Prentice and colleagues’ leading article on moral distress is the Editor’s choice. It continues the theme from the May issue and is a worthwhile read for all involved in neonatal care. With improving outcomes in the
Personalized early detection and prevention of breast cancer: ENVISION consensus statement
Nature Reviews Clinical Oncology, Published online: 18 June 2020; doi:10.1038/s41571-020-0388-9 Risk-adapted approaches to breast cancer prevention and screening could potentially be more effective than universal approaches, which have important limitations. In this Consensus Statement, representatives of the European Collaborative on
Persistent Breech Presentation In A Bicornuate Uterus
[Editorial] Global governance for COVID-19 vaccines
The COVID-19 pandemic has uncovered serious gaps in the health-care systems of many nations. In particular, it exposes a fragmented global governance system that does not have the structures to coordinate the pooling and sharing of resources needed to combat
Reconsidering Risks of Gun Ownership and Suicide in Unprecedented Times
In March 2020, as the coronavirus pandemic spread throughout the United States, Americans bought nearly 2 million guns — the second highest monthly total in the decades since such records have been kept. Previous spikes in U.S. firearm sales have
The Journal of Neurology, Neurosurgery and Psychiatry centenary milestone award 2020
JNNP 2020—a centenary of publishing neuroscience achievement Late last year, the Journal of Neurology, Neurosurgery and Psychiatry (JNNP) polled readers, asking them to nominate the single most important or transformative development in neurology, neurosurgery or psychiatry in the past 100
UK launches subscription style model for antibiotics to encourage new development
The UK has launched its subscription style payment model for antibiotics, with the first two drugs to be selected and evaluated next year.The scheme hopes to incentivise companies to invest in…
The role of the Clinical Chemistry laboratory in facilitating earlier diagnosis of dyslipidaemia-associated inherited metabolic disease
Sulaiman presents a best practice review for primary/monogenic dyslipidaemia, their clinical presentation and best use of molecular genetics for earlier diagnosis.1 This review is important in the context of such patients, with multisystem issues, presenting to non-lipidology specialties to enable
Pattern, clinical and demographic profile of inpatient psychiatry referrals in a tertiary care teaching hospital: a descriptive study
Background Consultation liaison psychiatry (CLP) as a subspecialty is defined as the area of clinical psychiatry that encompasses clinical understanding, teaching and research activities of psychiatrists and allied health professionals in the non-psychiatric divisions of a general hospital. Psychiatric comorbidity
Towards multi-cancer screening using liquid biopsies
Nature Reviews Clinical Oncology, Published online: 17 June 2020; doi:10.1038/s41571-020-0404-0 Cell-free DNA and proteins are secreted into the bloodstream by multiple types of cancer. In a recently published prospective study involving 10,006 women, such markers were used in a cancer
Placenta accreta spectrum grading: The devil is in the histopathology details
Tofacitinib for Refractory Immune-Related Colitis from PD-1 Therapy
To the Editor: In the OCTAVE trials, the Janus kinase (JAK) inhibitor tofacitinib was established as a new therapeutic strategy for patients with ulcerative colitis refractory to biologic agents. A similar clinical need exists in patients affected by immune-related colitis,
Making the Call
“Yes, hello?” Her voice was breathy and anxious — that of someone who’d been waiting all day for this call. It was 10:30 p.m. “Hi, Ms. A. it’s Dr. Stuart. I’m sorry to be calling so late. I wanted to
Sex Differences in Susceptibility to Depression: A Role for LncRNAs
In this issue of Neuron, Issler et al. (2020) have identified the neuronal, long intergenic noncoding RNA LINC00473 as a potential molecular risk factor for the increased susceptibility for depression in females.
[Editorial] COVID-19: a catalyst for flexibility and creativity in neurology
The European Academy of Neurology (EAN) Congress took place virtually this year, on May 23–26. The event attracted more than 42 000 participants, compared with around 6000 participants in previous years. Somewhat surprisingly, the Congress has reached a very different audience—only
Regulating drugs, medical devices, and diagnostic tests in the European Union: early lessons from the COVID-19 pandemic?
Recently, in the European Heart Journal, we described how the European Union (EU) Regulation on Medical Devices (MDR)1 will affect our daily clinical practice.2 That law—which increases the requirements for clinical evidence before new high-risk medical devices are approved—was due
[Editorial] Prioritising children’s rights in the COVID-19 response
Although substantial progress has been made in many aspects of child health in the past two decades, the COVID-19 pandemic and its wide-ranging effects are threatening some of these hard-won gains. Public health measures such as lockdown, school closures, and
Making the Call
“Yes, hello?” Her voice was breathy and anxious — that of someone who’d been waiting all day for this call. It was 10:30 p.m. “Hi, Ms. A. it’s Dr. Stuart. I’m sorry to be calling so late. I wanted to
Opportunities to improve global health: using the strengths of the BJSM community to change lives for the better
One of the founding principles of the British Association of Sport Rehabilitators and Trainers—BASRaT—was to improve the health of patients and the public with a clear focus on exercise for health and exercise rehabilitation. That goal has never been more
Covid-19: Deaths in the community approach 20 000 in the UK
The number of deaths involving covid-19 that have occurred in the community has passed 20 000 in the UK, according to new figures.Office for National Statistics (ONS) data from the start of the…
Personalized treatment of immune-related adverse events — balance is required
Nature Reviews Clinical Oncology, Published online: 16 June 2020; doi:10.1038/s41571-020-0400-4 Personalized treatment of immune-related adverse events — balance is required
A call for precision in COVID-linked case reporting- a crucial step more important now than ever
The Promise and Peril of Natural Killer Cell Therapies in Pulmonary Infection
The emergence of novel respiratory viruses such as SARS-CoV-2 results in rapid dissemination through virus-naive populations and an accumulation of critically ill patients in hospitals across the globe. In the absence of an effective vaccine or proven treatment, this accelerating
[Editorial] Technology in the COVID-19 era: pushing the boundaries
In the continued absence of a vaccine or cure, efforts to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have focused mainly on establishing public health and social measures, such as frequent hand hygiene, physical distancing, and
Facing the Monster in Haiti
To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. Covid-19 has arrived at
Facing the Monster in Haiti
To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. Covid-19 has arrived at
Genetic Analysis Tracks SARS-CoV-2 Mutations in Human Hosts
An analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes collected from more than 7500 patients worldwide has identified mutations in the virus that could aid in drug and vaccine development.
Let all international health and social care workers who worked in the pandemic stay in the UK, says college
The NHS must secure a new deal for international health and social care workers now that the covid-19 pandemic is subsiding, says the Royal College of Physicians (RCP).As the initial peak of the…
Diagnosis of COVID-19 pneumonia in pregnant women: can we rely on lung ultrasound?
Recurrent inversion toggling and great ape genome evolution
Nature Genetics, Published online: 15 June 2020; doi:10.1038/s41588-020-0646-x Genome-wide detection of inversions in great ape genomes by using long-read sequencing and single-cell DNA template strand sequencing (Strand-seq) expands the number of known ape inversions and identifies several regions that have
[Editorial] Drinking alone: COVID-19, lockdown, and alcohol-related harm
Coronavirus disease 2019 (COVID-19) has, it is frequently said, changed everything. But to appreciate its effects fully, one must not only look at the ways in which clinical services have been reorganised to cope with the flood of patients with
Autoantigen TRIM21/Ro52 is expressed on the surface of antigen-presenting cells and its enhanced expression in Sjögrens syndrome is associated with B cell hyperactivity and type I interferon activity
John Nicolas Rea: GP and reluctant peer
bmj;369/jun15_13/m2385/FAF1faPhoto credit: Judith ReaThe north London GP Nicolas “Nic” Rea spent a year agonising over whether to take up his hereditary seat in the House of Lords. He feared that it…
Maternal Mortality Among Women with COVID-19 Admitted to the Intensive Care Unit
TARA study: a new perspective on tapering drugs in RA
We read with great interest the article on ‘Gradual tapering TNF inhibitors vs conventional synthetic DMARDs after achieving controlled disease in patients with rheumatoid arthritis: first-year results of the randomised controlled TARA study’1by van Mulligen et al. This was the
Intravenous labetalol versus oral nifedipine for acute hypertension in pregnancy: effects on cerebral perfusion pressure
Pregnant women with preeclampsia have been shown to have elevated cerebral perfusion pressure and impaired cerebral autoregulation compared to normal pregnant women. Transcranial Doppler is a non-invasive technique used to estimate cerebral perfusion pressure. The effects of different antihypertensives on
Lung cancer at ASCO20 Virtual
Nature Reviews Clinical Oncology, Published online: 12 June 2020; doi:10.1038/s41571-020-0405-z Lung cancer at ASCO20 Virtual
Between Scylla and Charybdis — Oncologic Decision Making in the Time of Covid-19
“Doctor, should we activate the sepsis protocol?” my medical assistant asked with obvious concern. I triaged the patient in question. The metrics that had caused alarm at intake were tachycardia and tachypnea, but there was no fever or hypotension in
A healthy diet and physical activity can help reduce your cancer risk
Spread of SARS-CoV-2 in the Icelandic Population
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused clusters of severe respiratory illness in Wuhan, China, in late 2019. By January 2020, the virus had been isolated and sequenced, which revealed close relationships to coronaviruses such as SARS-CoV-1 and MERS-CoV.
A decade of advances in transposon-insertion sequencing
Nature Reviews Genetics, Published online: 12 June 2020; doi:10.1038/s41576-020-0244-x In this Review, several experts discuss progress in the decade since the development of transposon-based approaches for bacterial genetic screens. They describe how advances in both experimental technologies and analytical strategies
Tofacitinib for Refractory Immune-Related Colitis from PD-1 Therapy
To the Editor: In the OCTAVE trials, the Janus kinase (JAK) inhibitor tofacitinib was established as a new therapeutic strategy for patients with ulcerative colitis refractory to biologic agents. A similar clinical need exists in patients affected by immune-related colitis,
COVID-19 and relative angiotensin-converting enzyme 2 deficiency: role in disease severity and therapeutic response
New-Onset Diabetes in Covid-19
To the Editor: There is a bidirectional relationship between Covid-19 and diabetes. On the one hand, diabetes is associated with an increased risk of severe Covid-19. On the other hand, new-onset diabetes and severe metabolic complications of preexisting diabetes, including
Givosiran — Running RNA Interference to Fight Porphyria Attacks
The porphyrias are a group of rare and ultra-rare devastating disorders of heme biosynthesis. The majority of these disorders are inherited, and patients present with disabling symptoms that have a profound effect on their quality of life. The subtypes of
Natural History of Asymptomatic SARS-CoV-2 Infection
To the Editor: Information on the natural history of asymptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains scarce. The outbreak of coronavirus disease 2019 (Covid-19) on the cruise ship Diamond Princess led to 712 persons being infected
New-Onset Diabetes in Covid-19
To the Editor: There is a bidirectional relationship between Covid-19 and diabetes. On the one hand, diabetes is associated with an increased risk of severe Covid-19. On the other hand, new-onset diabetes and severe metabolic complications of preexisting diabetes, including
Neuropathological Features of Covid-19
To the Editor: Neurologic symptoms, including headache, altered mental status, and anosmia, occur in many patients with Covid-19. We report the neuropathological findings from autopsies of 18 consecutive patients with SARS-CoV-2 infection who died in a single teaching hospital between
Waiting for Something Positive
In early March, I was paged to evaluate a 13-month-old with a retropharyngeal neck abscess. She was a delightful child who had the misfortune of presenting to the hospital at the beginning of the Covid-19 crisis with fevers, upper respiratory
Sixty seconds on . . . bubbles
Is this a football reference?No, it’s got nothing to do with West Ham United or their favourite song.1 The term actually refers to the latest step in the government’s relaxation of the lockdown rules…
Another changing of the guard at OEM, this time during the COVID-19 pandemic
After seven busy and very enjoyable, although sometimes challenging, years as editor-in-chief (EIC) of Occupational and Environmental Medicine (OEM), it is time for me to move on and allow someone new to take over the leadership of the journal. The
Atezolizumab improves outcomes in mUC
Nature Reviews Clinical Oncology, Published online: 11 June 2020; doi:10.1038/s41571-020-0398-7 Atezolizumab improves outcomes in mUC
Gabapentin as an Adjunct to Paracervical Block for Perioperative Pain Management for First Trimester Uterine Aspiration: A Randomized Controlled Trial
Pain management approaches during uterine aspiration vary, with methods including local anesthetic, oral analgesics, moderate sedation, deep sedation, or a combination of approaches. For local anesthetic approaches specifically, we continue to have suboptimal pain control [1]. Gabapentin as an adjunct
The Untold Toll — The Pandemic’s Effects on Patients without Covid-19
In late March, Zoran Lasic, an interventional cardiologist at Jamaica Hospital Medical Center and Lenox Hill Hospital in New York, was finishing afternoon clinic when he was approached by a nurse colleague seeking his advice. Her husband — a 56-year-old
Audio Interview: The Impact of Covid-19 on Minority Communities
The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal. In this
Cutaneous Colon Cancer Metastases in a Surgical Scar
Figure 1.
Down Syndrome
Down syndrome, also called Down’s syndrome (DS), is the most common chromosomal condition associated with intellectual disability and is characterized by a variety of additional clinical findings. It occurs in approximately 1 of 800 births worldwide. In the United States,
Drug Evaluation during the Covid-19 Pandemic
The search for a treatment for Covid-19 is testing our country’s ability to quickly develop, test, and deploy medications, presenting both opportunities and challenges to our drug-assessment apparatus. Several aspects of the U.S. response raise serious concerns, highlighting how the
Compassionate Use of Remdesivir for Patients with Severe Covid-19
Since the first cases were reported in December 2019, infection with the severe acute respiratory coronavirus 2 (SARS-CoV-2) has become a worldwide pandemic. Covid-19 — the illness caused by SARS-CoV-2 — is overwhelming health care systems globally. The symptoms of
Biomedical Research Goes Viral: Dangers and Opportunities
Researchers around the globe have been mounting, accelerating, and redeploying efforts across disciplines and organizations to tackle the SARS-CoV-2 outbreak. However, humankind continues to be afflicted by numerous other devastating diseases in increasing numbers. Here, we outline considerations and opportunities
[Editorial] Medicine and medical science: Black lives must matter more
Emblematic of the profound sense of outrage at the killing of George Floyd, Breonna Taylor, and countless other Black men and women at the hands of law enforcement, hundreds of thousands of protestors took to the streets in the USA
Compassionate Use of Remdesivir for Patients with Severe Covid-19
Since the first cases were reported in December 2019, infection with the severe acute respiratory coronavirus 2 (SARS-CoV-2) has become a worldwide pandemic. Covid-19 — the illness caused by SARS-CoV-2 — is overwhelming health care systems globally. The symptoms of
Heartbeat: Rapid rule-out pathways for acute myocardial infarction
Clinical decision making in patients presenting to the Emergency Department with chest pain remains a challenge; while only 10% to 20% are ultimately diagnosed with acute myocardial infarction (AMI), it is important to not miss any patient with an AMI.
Too slow and fundamentally flawed: why test and trace is a weak and inequitable defence against covid-19
“I don’t believe the virus is under control, and I don’t believe that the system of surveillance we have at the present time is sufficient,” says Gabriel Scally, former regional public health…
A healthy diet and physical activity can help reduce your cancer risk
Diagnosing and Treating Systemic Racism
For physicians, the words “I can’t breathe” are a primal cry for help. As many physicians have left their comfort zones to care for patients with Covid-19–associated respiratory failure, the role of the medical profession in addressing this life-defining need
The Need for a Tighter Particulate-Matter Air-Quality Standard
The Environmental Protection Agency (EPA) proposes to retain the current National Ambient Air Quality Standards (NAAQS) for fine particulate matter (particles with a diameter of ≤2.5 μm [PM2.5]) — that is, levels not exceeding an annual average of 12 μg
Covid-19: Clinicians must be able to access all test results, pathologists say
Future testing programmes for covid-19 or other diseases must be designed so that all results can be swiftly accessed by clinicians in primary and secondary care, the Royal College of Pathologists…
From the ASCO20 Virtual meeting
Nature Reviews Clinical Oncology, Published online: 09 June 2020; doi:10.1038/s41571-020-0402-2 From the ASCO20 Virtual meeting
Reply to the letter to the editor
Homeless Shelters Face High COVID-19 Risks
The CDC has recommended steps that homeless shelters should take to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission after studying outbreaks at several facilities across the United States.
Covid-19: Test and trace system is not fit for purpose, says Independent SAGE
The government’s test, track, and trace system needs a radical overhaul because it is “not fit for purpose,” an independent group of experts has said.A draft report from the Independent Scientific…
A healthy diet and physical activity can help reduce your cancer risk
MET-dependent solid tumours — molecular diagnosis and targeted therapy
Nature Reviews Clinical Oncology, Published online: 08 June 2020; doi:10.1038/s41571-020-0377-z Therapies targeting MET-overexpressing cancers have limited efficacy. However, owing to advances in detection methods, therapies targeting MET-dependent tumours harbouring MET amplifications, activating mutations or fusions are emerging. In this review,
Translating Basic Cancer Discoveries to the Clinic
Targeted therapies and immunotherapies have impacted the care and outcomes of adults with cancer. By contrast, pediatric and adolescent/young adult (AYA) cancer patients have not similarly benefitted. As a result, early-age cancer survivors experience significantly elevated risk of secondary cancer
Management of glioblastoma: State of the art and future directions
Abstract Glioblastoma is the most common malignant primary brain tumor. Overall, the prognosis for patients with this disease is poor, with a median survival of
CTCF is dispensable for immune cell transdifferentiation but facilitates an acute inflammatory response
Nature Genetics, Published online: 08 June 2020; doi:10.1038/s41588-020-0643-0 CTCF is dispensable for transdifferentiation of B cells into induced macrophages despite widespread loss of topologically associating domains. CTCF depletion impairs upregulation of inflammatory genes after endotoxin exposure by destabilizing promoter–enhancer interactions.
Maternal H3K27me3-dependent autosomal and X chromosome imprinting
Nature Reviews Genetics, Published online: 08 June 2020; doi:10.1038/s41576-020-0245-9 The role of DNA methylation in genomic imprinting and X-chromosome inactivation (XCI) is well documented, but other imprinting mechanisms exist. Here, the authors review the role of oocyte-derived histone H3 lysine
The saga continues: is COVID-19 a cardiopulmonary disease?
[Editorial] The future of critical care: lessons from the COVID-19 crisis
The COVID-19 pandemic has put a huge strain on critical care resources worldwide, as systems have struggled to provide high-quality care for a surge of critically ill patients. The response of clinicians and researchers—in providing care in extraordinary circumstances and
Covid-19: Drug firms warn stockpiles have been eroded amid fears of no deal Brexit
Drug industry leaders have warned the UK government that stockpiles of some drugs have been eroded by covid-19, leaving supplies even more vulnerable if a no deal Brexit occurs.In a briefing paper…
Real-world insight into public access defibrillator use over five years
Background Public access defibrillators (PADs) represent unique life-saving medical devices as they may be used by untrained lay rescuers. Collecting representative clinical data on these devices can be challenging. Here, we present results from a retrospective observational cohort study, describing
Management of glioblastoma: State of the art and future directions
Abstract Glioblastoma is the most common malignant primary brain tumor. Overall, the prognosis for patients with this disease is poor, with a median survival of
The role of countertransference in contemporary psychiatric treatment
Special Ambulatory Gynecologic Considerations in the Era of COVID-19 and Implications for Future Practice
The COVID-19 pandemic has altered medical practice in unprecedented ways. While much of the emphasis in obstetrics and gynecology to date has been on the as yet uncertain impacts of COVID-19 in pregnancy and on changes to surgical management, the
Cannabis and public health: a global experiment without control
Putting the Public Back in Public Health — Surveying Symptoms of Covid-19
To address the unprecedented challenge posed by the Covid-19 pandemic, much of the world — including an estimated 90% of Americans — was locked down and socially distanced. Large gatherings were prohibited, most schools and nonessential businesses were closed, and
Seasonal and residential clustering at disease onset of anti-MDA5-associated interstitial lung disease
Objectives To investigate whether the onset of polymyositis (PM)/dermatomyositis (DM)-associated interstitial lung disease (ILD) is influenced by season and residence in the context of myositis-specific autoantibodies. Methods For patients with PM/DM-associated ILD enrolled in a multicentre cohort, 365 and 481
Challenges and opportunities for IBD drug development: from early stage to regulatory approval
Introduction Increased understanding of the immunopathology of inflammatory bowel disease (IBD) has resulted in the development of novel therapies such as vedolizumab or ustekinumab, and the investigation of new agents including Janus kinase inhibitors, anti-mucosal vascular addressin cell adhesion molecule-1
Highlights from this issue
Gastrointestinal endoscopy during COVID 19 when less is more The last few months have been challenging. The country has been locked down as a consequence of COVD-19 with a significant impact on the delivery of services for non COVID disease
Exploring and visualizing large-scale genetic associations by using PheWeb
Nature Genetics, Published online: 05 June 2020; doi:10.1038/s41588-020-0622-5 Exploring and visualizing large-scale genetic associations by using PheWeb
How to Discover Antiviral Drugs Quickly
We urgently need effective drugs for coronavirus disease 2019 (Covid-19), but what is the quickest way to find them? One approach that sometimes seems akin to a “Hail Mary” pass in American football is to hope that drugs that have
Long-read human genome sequencing and its applications
Nature Reviews Genetics, Published online: 05 June 2020; doi:10.1038/s41576-020-0236-x Long-read sequencing is becoming more accessible and more accurate. In this Review, Logsdon et al. discuss the currently available platforms, how the technologies are being applied to assemble and phase human
Atrioventricular Dissociation during Ventricular Fibrillation
Figure 1.
The Game Is Afoot
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.
Putting the Public Back in Public Health — Surveying Symptoms of Covid-19
To address the unprecedented challenge posed by the Covid-19 pandemic, much of the world — including an estimated 90% of Americans — was locked down and socially distanced. Large gatherings were prohibited, most schools and nonessential businesses were closed, and
Putting the Public Back in Public Health — Surveying Symptoms of Covid-19
To address the unprecedented challenge posed by the Covid-19 pandemic, much of the world — including an estimated 90% of Americans — was locked down and socially distanced. Large gatherings were prohibited, most schools and nonessential businesses were closed, and
The role of countertransference in contemporary psychiatric treatment
Covid-19: transforming healthcare will require collaboration and innovative policies
Recovering from the covid-19 pandemic will be a long and difficult journey.1 The medical consequences will lead to an increasing number of patients with chronic multimorbidities—some of them far…
What Is Cell Stem Cell Doing to Support the Global Stem Cell Community during the COVID-19 Pandemic?
We live in paradoxical times. The COVID-19 pandemic is physically isolating us, but it is increasingly clear that collaboration and collective action are the most powerful tools to combat this crisis.
Correction: Role of dietary histidine in the prevention of obesity and metabolic syndrome
Bedbugs
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.
Neurologic Features in Severe SARS-CoV-2 Infection
To the Editor: We report the neurologic features in an observational series of 58 of 64 consecutive patients admitted to the hospital because of acute respiratory distress syndrome (ARDS) due to Covid-19. The patients received similar evaluations by intensivists in
Surgery Scheduling in a Crisis
To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. On March 15, 2020,
Using GIS Mapping to Track Hot Spots of Kidney Disease in California
To the Editor: Chronic kidney disease of unknown origin is a leading cause of death in adults living in dry, lowland farming regions of Sri Lanka, Nicaragua, El Salvador, and India. The Central Valley of California has a high annual
Neurologic Features in Severe SARS-CoV-2 Infection
To the Editor: We report the neurologic features in an observational series of 58 of 64 consecutive patients admitted to the hospital because of acute respiratory distress syndrome (ARDS) due to Covid-19. The patients received similar evaluations by intensivists in
Neurologic Features in Severe SARS-CoV-2 Infection
To the Editor: We report the neurologic features in an observational series of 58 of 64 consecutive patients admitted to the hospital because of acute respiratory distress syndrome (ARDS) due to Covid-19. The patients received similar evaluations by intensivists in
Bedbugs
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.
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