Abstract Onconephrology is a new subspecialty of nephrology that recognizes the important intersections of kidney disease with cancer. This intersection takes many forms and includes drug‐induced nephrotoxicity, electrolyte disorders, paraneoplastic glomerulonephritis, and the interactions of chronic kidney disease with cancer.
Onconephrology: The intersections between the kidney and cancer
Noninvasive inferring expressed genes and in vivo monitoring of the physiology and pathology of pregnancy using cell-free DNA
Noninvasive monitoring of fetal development and the early detection of pregnancy-associated complications is challenging, largely due to the lack of information about the molecular spectrum during pregnancy. Recently, cell-free DNA in plasma was found to reflect the global nucleosome footprint
A Randomized Trial of Closed-Loop Control in Children with Type 1 Diabetes
The glycemic target of a glycated hemoglobin level of less than 7% (as recommended by the American Diabetes Association) is attained by less than 20% of children with type 1 diabetes. The use of a closed-loop system that automates insulin
Case 27-2020: A 53-Year-Old Woman with Headache and Gait Imbalance
Presentation of Case. Dr. Jacob M. Rosenberg: A 53-year-old woman was transferred to this hospital because of progressive headache, gait instability, and weight loss. Approximately 2 months before the patient’s evaluation at this hospital, vertigo developed and resolved spontaneously. One
When are results of single-arm studies dramatic?
Nature Reviews Clinical Oncology, Published online: 28 August 2020; doi:10.1038/s41571-020-00429-1 Single-arm phase II trials can provide compelling results that facilitate the approval of a new therapy. Designing and interpreting single-arm studies based on four principles — instinct, comparative analysis, statistical
Efficacy of Selpercatinib in RET-Altered Thyroid Cancers
The RET proto-oncogene encodes a transmembrane receptor tyrosine kinase that is constitutively activated through two distinct mechanisms: mutations involving the cysteine-rich or kinase domains, and structural rearrangements leading to the fusion of RET to a 5′ upstream partner. Collectively, these…
Onconephrology: The intersections between the kidney and cancer
Abstract Onconephrology is a new subspecialty of nephrology that recognizes the important intersections of kidney disease with cancer. This intersection takes many forms and includes drug‐induced nephrotoxicity, electrolyte disorders, paraneoplastic glomerulonephritis, and the interactions of chronic kidney disease with cancer.
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
No evidence for a placental microbiome in human pregnancies at term
The placenta has an important role in the modulation of pregnancy immunity; however, there is no consensus regarding the existence of a placental microbiome in healthy full-term pregnancies.
Genetics meets proteomics: perspectives for large population-based studies
Nature Reviews Genetics, Published online: 28 August 2020; doi:10.1038/s41576-020-0268-2 In this Review, Suhre, McCarthy and Schwenk describe how combining genetics with plasma proteomics is providing notable insights into human disease. As changes in the circulating proteome are often an intermediate
Keeping it in the family
Atherosclerotic Plaque Healing
Atherosclerotic plaques typically develop over a period of years or decades. In contrast, the thrombotic complications of atherosclerotic disease occur suddenly, often without warning. The notion that acute coronary syndromes develop from the rupture or superficial erosion of an atherosclerotic…
Pemphigoid Gestationis
Figure 1.
Covid-19 and Immunity in Aging Populations — A New Research Agenda
The race is on throughout the world to develop Covid-19 vaccines and therapeutics and end a pandemic that threatens to infect a substantial portion of the planet’s population and perhaps kill millions of people, especially older adults. As billions of
Case 27-2020: A 53-Year-Old Woman with Headache and Gait Imbalance
Presentation of Case. Dr. Jacob M. Rosenberg: A 53-year-old woman was transferred to this hospital because of progressive headache, gait instability, and weight loss. Approximately 2 months before the patient’s evaluation at this hospital, vertigo developed and resolved spontaneously. One
Confirmatory evidence of visualization of SARS-CoV-2 virus invading the human placenta using electron microscopy
When E-Cadherin Becomes Unstuck in Cancer
E-cadherin behaves like a glue in healthy tissues, keeping epithelial cells connected and organized. Discovered 43 years ago, this transmembrane glycoprotein connects epithelial cells together at adherent junctions at their lateral surfaces, helping to maintain their polarized, differentiated…
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
Targeting autophagy in neuroblastoma
Background Neuroblastoma (NB) is the most common extracellular solid tumor among children accounting for serious mortality. Macroautophagy, a common housekeeping mechanism to maintain cellular homeostasis in eukaryotic cells, is involved in tumorigenesis and chemoresistance in a spectrum of cancers. Data
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
Gastrointestinal Myeloid Sarcoma
Figure 1.
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
Racial Disproportionality in Covid Clinical Trials
There are sufficient data demonstrating that coexisting conditions in patients with Covid-19 influence clinical outcomes and that older age and male sex are associated with a greater risk of death. But despite disproportionately higher rates of Covid-19 infection, hospitalization, and
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
A Randomized Trial of Closed-Loop Control in Children with Type 1 Diabetes
The glycemic target of a glycated hemoglobin level of less than 7% (as recommended by the American Diabetes Association) is attained by less than 20% of children with type 1 diabetes. The use of a closed-loop system that automates insulin
[Editorial] Research and higher education in the time of COVID-19
The COVID-19 pandemic has propelled the research and higher education sectors to the forefront of public attention. Laboratory capacity has been crucial for diagnostic testing; experts in infectious diseases, epidemiology, public health, mathematical modelling, and economics are central to national
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
Onconephrology: The intersections between the kidney and cancer
Abstract Onconephrology is a new subspecialty of nephrology that recognizes the important intersections of kidney disease with cancer. This intersection takes many forms and includes drug‐induced nephrotoxicity, electrolyte disorders, paraneoplastic glomerulonephritis, and the interactions of chronic kidney disease with cancer.
The impact of the COVID-19 pandemic on cardiology services
Objective The COVID-19 pandemic resulted in prioritisation of National Health Service (NHS) resources to cope with the surge in infected patients. However, there have been no studies in the UK looking at the effect of the COVID-19 work pattern on
An update on the immune landscape in lung and head and neck cancers
Abstract Immunotherapy has dramatically changed the treatment landscape for patients with cancer. Programmed death–ligand 1/programmed death‐1 checkpoint inhibitors have been in the forefront of this clinical revolution. Currently, there are 6 US Food and Drug Administration‐approved checkpoint inhibitors for approximately
A Specific Bacterial DNA Signature in the Vagina of Australian Women in Mid-Pregnancy Predicts High Risk of Spontaneous Preterm Birth (The Predict1000 Study)
Intrauterine infection accounts for about one quarter of cases of spontaneous preterm birth (sPTB); however, at present it is not possible to efficiently identify pregnant women at risk in order to deliver preventative treatments.
Atypical Femur Fracture Risk versus Fragility Fracture Prevention with Bisphosphonates
Osteoporosis, a bone disease characterized by bone loss and microarchitectural deterioration, is one of the most disabling consequences of aging. As the population ages, the incidence and associated costs of osteoporotic fractures will rise dramatically. These fractures lead to substantial…
Plans and Pandemics
“And Ms. M. — I’m so proud of her!” It was the first week of my oncology fellowship, and Dr. E. a senior fellow, was handing his patients over to me, as he was shifting from clinical work to research.
Worksite intervention study to prevent diabetes in Nepal: a randomised trial protocol
Introduction In Nepal, approximately 31% of adult industrial employees have diabetes. While the prevention of type 2 diabetes through behavioural intervention has been disseminated, worksite could be an effective platform for the translation of this knowledge into action as employed
[Editorial] Air travel in the time of COVID-19
The COVID-19 pandemic is changing the way we think about travelling. Most countries in the world have adopted some measure of lockdown or restriction to movement to reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and ease the
A man with a traumatic lower limb injury
A 59 year old man was driving a motorcycle and collided with a car at 30 miles per hour. He was thrown 30 feet from his bike. Traffic stopped and he was taken to hospital as a major trauma call.
Obstetrical outcome and treatments in seronegative primary APS: data from European retrospective study
Objective To compare characteristics, pregnancies and treatments during pregnancies of seronegative and seropositive antiphospholipid syndrome (APS), to analyse factors associated with obstetrical outcome. Patients and methods Inclusion criteria were: (1) thrombotic and/or obstetrical APS (Sydney criteria); (2) absence of conventional
Heartbeat: therapeutic targets for prevention of calcific aortic valve stenosis
Current management of calcific aortic valve stenosis (CAVS) is limited to palliation of end-stage disease with valve replacement to relieve left ventricular outflow obstruction. Rather than treating the mechanical consequences of severe CAVS, identification of causal disease pathways at the
Caster semenya and a level playing field
Sport is predicated on the idea of victors emerging from a level playing field. All ethically informed evaluate practices are like this; they require an equality of respect, consideration, and opportunity, while trying to achieve substantively unequal outcomes. For instance:
Artificial intelligence in radiation oncology
Nature Reviews Clinical Oncology, Published online: 25 August 2020; doi:10.1038/s41571-020-0417-8 The possible uses of artificial intelligence (AI) in radiation oncology are diverse and wide ranging. Herein, the authors discuss the potential applications of AI at each step of the radiation
Antenatal Corticosteroids and COVID-19: balancing benefits and harms
Bypassing the LDL Receptor in Familial Hypercholesterolemia
Several drug options are available for patients with an elevated plasma cholesterol level who are at increased risk for a cardiovascular event. These drugs, which include selective cholesterol-absorption inhibitors and PCSK9 inhibitors as well as statins, effectively lower plasma cholesterol
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
What Is Liberty? Addressing Undeserved Suffering in Health Care
“What brings your loved one here?” the hospice nurse asked. She was seeking an abbreviated history of my mémère’s terminal diagnosis, but I couldn’t muster the words without losing my composure. Somehow, the nurse understood. She said, “Tell me about
Plans and Pandemics
“And Ms. M. — I’m so proud of her!” It was the first week of my oncology fellowship, and Dr. E. a senior fellow, was handing his patients over to me, as he was shifting from clinical work to research.
Lung Diseases Affecting US Workers Cost Billions Annually
Annual expenditures for US workers totaled $7 billion for asthma care and $5 billion for chronic obstructive pulmonary disease (COPD) care between 2011 and 2015, according to CDC researchers.
Covid-19: MPs launch legal action against government over failure to disclose details of PPE contracts
Three MPs and the Good Law Project have launched legal action against the UK government over what they allege is a “persistent and unlawful” failure to disclose details of huge sums of money spent on…
Outdoor air pollution and cancer: An overview of the current evidence and public health recommendations
Abstract Outdoor air pollution is a major contributor to the burden of disease worldwide. Most of the global population resides in places where air pollution levels, because of emissions from industry, power generation, transportation, and domestic burning, considerably exceed the
Highlights from this issue
Core outcomes for geographic atrophy trials (see page 1196) Core outcomes for geographic atrophy trials were identified that are relevant to patients, clinicians and researchers: functional outcomes (reading speed, near, distance and low luminance visual acuity), a patient-reported outcome measure,
[Editorial] COVID-19 and haematology-oncology services
As the COVID-19 pandemic continues to develop, the situation for patients with haematological malignancies is also evolving. With the effects on health-care systems still being felt, and the enormous global research effort to uncover the biological mechanisms of COVID-19, an
Expression of SARS-CoV-2 cell entry genes, ACE2 and TMPRSS2, in the placenta across gestation and at the maternal-fetal interface in pregnancies complicated by preterm birth or preeclampsia
While there is some evidence that SARS-CoV-2 can invade the human placenta, limited data exist on the gestational-age dependent expression profile of the SARS-CoV-2 cell entry mediators, ACE2 and TMPRSS2 at the human maternal-fetal interface. There is also no information
Dynamic incorporation of multiple in silico functional annotations empowers rare variant association analysis of large whole-genome sequencing studies at scale
Nature Genetics, Published online: 24 August 2020; doi:10.1038/s41588-020-0676-4 STAAR is a powerful rare variant association test that incorporates variant functional categories and complementary functional annotations using a dynamic weighting scheme based on annotation principal components. STAAR accounts for population structure
The road ahead in genetics and genomics
Nature Reviews Genetics, Published online: 24 August 2020; doi:10.1038/s41576-020-0272-6 To celebrate the first 20 years of Nature Reviews Genetics, we asked 12 leading scientists to reflect on the key challenges and opportunities faced by the field of genetics and genomics.
Evinacumab for Homozygous Familial Hypercholesterolemia
Homozygous familial hypercholesterolemia is a rare genetic disorder of lipid metabolism affecting approximately 1 in 300,000 persons. The condition is most often caused by the presence of loss-of-function variants in the low-density lipoprotein (LDL) receptor, which leads to low or
Trigeminal Neuralgia
Trigeminal neuralgia, traditionally called tic douloureux, is a chronic neuropathic pain disorder characterized by spontaneous and elicited paroxysms of electric shock–like or stabbing pain in a region of the face. A poor quality of life and suicide in severe cases
Getting a second opinion: whose side are you on?
Helen Salisbury asks, “When the specialist’s view is that there is nothing more that can be done, how ready should I be to refer for a second opinion?”1 This question is packed with implied hints…
Under-reported aspects of diagnosis and treatment addressed in the Dutch-Flemish guideline for comprehensive diagnostics in disorders/differences of sex development
We present key points from the updated Dutch-Flemish guideline on comprehensive diagnostics in disorders/differences of sex development (DSD) that have not been widely addressed in the current (inter)national literature. These points are of interest to physicians working in DSD (expert)
Effects of Diet versus Gastric Bypass on Metabolic Function in Diabetes
Randomized clinical trials have shown that bariatric surgery is more effective than medical therapy for treatment of type 2 diabetes. Moreover, several studies suggest that surgical procedures that involve bypass of the upper gastrointestinal tract, such as Roux-en-Y gastric bypass,
Atypical Femur Fracture Risk versus Fragility Fracture Prevention with Bisphosphonates
Osteoporosis, a bone disease characterized by bone loss and microarchitectural deterioration, is one of the most disabling consequences of aging. As the population ages, the incidence and associated costs of osteoporotic fractures will rise dramatically. These fractures lead to substantial…
Plans and Pandemics
“And Ms. M. — I’m so proud of her!” It was the first week of my oncology fellowship, and Dr. E. a senior fellow, was handing his patients over to me, as he was shifting from clinical work to research.
Diagnostic accuracy of fetal choroid plexus length to head biometry ratio at 11-13 weeks for open spina bifida
Open spina bifida is a major congenital anomaly with an estimated incidence of less than 1 in 1000. The diagnosis of open spina bifida is usually made during the second trimester but first-trimester detection rate of spina bifida is increasingly
Comparison of estimated fetal weight percentiles near term for predicting extremes of birth weight percentile
The Intergrowth-21st (IG21) estimated fetal weight (EFW) percentiles are recommended for predicting extremes of birth weight percentile, although evidence for their superiority over the widely employed Hadlock method is lacking.
Serious Ivermectin Toxicity and Human ABCB1 Nonsense Mutations
To the Editor: The discoverers of ivermectin, a broad-spectrum parasiticide that is widely used in humans and animals, were awarded the Nobel Prize in Physiology or Medicine in 2015. This drug is reputed to be remarkably safe thanks to its
Traumatic Vascular Injury to the Hand
Figure 1.
What Is Liberty? Addressing Undeserved Suffering in Health Care
“What brings your loved one here?” the hospice nurse asked. She was seeking an abbreviated history of my mémère’s terminal diagnosis, but I couldn’t muster the words without losing my composure. Somehow, the nurse understood. She said, “Tell me about
Plans and Pandemics
“And Ms. M. — I’m so proud of her!” It was the first week of my oncology fellowship, and Dr. E. a senior fellow, was handing his patients over to me, as he was shifting from clinical work to research.
Atypical Femur Fracture Risk versus Fragility Fracture Prevention with Bisphosphonates
Osteoporosis, a bone disease characterized by bone loss and microarchitectural deterioration, is one of the most disabling consequences of aging. As the population ages, the incidence and associated costs of osteoporotic fractures will rise dramatically. These fractures lead to substantial…
Serious Ivermectin Toxicity and Human ABCB1 Nonsense Mutations
To the Editor: The discoverers of ivermectin, a broad-spectrum parasiticide that is widely used in humans and animals, were awarded the Nobel Prize in Physiology or Medicine in 2015. This drug is reputed to be remarkably safe thanks to its
Matteo Adinolfi: immunologist focusing on prenatal diagnosis of gene disorders
bmj;370/aug21_10/m3309/FAF1faMatteo Adinolfi was born in 1928 in Asmara, Eritrea, to Attilio, a bank manager, and his wife, Maria (née Sellitti), who had fled there from Italy to escape fascism. His…
Venetoclax in AML: efficacy confirmed
Nature Reviews Clinical Oncology, Published online: 20 August 2020; doi:10.1038/s41571-020-00430-8 Venetoclax in AML: efficacy confirmed
Plans and Pandemics
“And Ms. M. — I’m so proud of her!” It was the first week of my oncology fellowship, and Dr. E. a senior fellow, was handing his patients over to me, as he was shifting from clinical work to research.
Evolving standards of care and new challenges in the management of HER2‐positive breast cancer
Abstract The management of human epidermal growth factor receptor (HER2)–positive breast cancer (BC) has rapidly evolved over the last 20 years. Major advances have led to US Food and Drug Administration approval of 7 HER2‐targeted therapies for the treatment of
SMFM Fetal Anomalies Consult Series #3: Intracranial Anomalies
Testing the developing epigenome
Nature Reviews Genetics, Published online: 20 August 2020; doi:10.1038/s41576-020-00282-z A recent study combines CRISPR-based perturbation with single-cell RNA sequencing to characterize the roles of epigenome regulator proteins in controlling cell fate and identity during embryonic development.
Bypassing the LDL Receptor in Familial Hypercholesterolemia
Several drug options are available for patients with an elevated plasma cholesterol level who are at increased risk for a cardiovascular event. These drugs, which include selective cholesterol-absorption inhibitors and PCSK9 inhibitors as well as statins, effectively lower plasma cholesterol
Poststreptococcal Pustulosis
Figure 1.
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
Bariatric Surgery and Restoration of Insulin Sensitivity — It’s Weight Loss
Adiposity-based chronic disease is probably the greatest noninfectious epidemic of the 21st century. In the United States alone, more than 1 in 3 adults are obese. More than 40 chronic diseases, including type 2 diabetes mellitus, cancer, and atherosclerosis, are
Challenges of “Return to Work” in an Ongoing Pandemic
As economic and political pressure has built to relax “shelter in place” public health orders for control of coronavirus disease 2019 (Covid-19), industry, professional service firms, retail and service establishments, and educational institutions seek to establish norms that protect workers,…
Challenges of “Return to Work” in an Ongoing Pandemic
As economic and political pressure has built to relax “shelter in place” public health orders for control of coronavirus disease 2019 (Covid-19), industry, professional service firms, retail and service establishments, and educational institutions seek to establish norms that protect workers,…
Drug-Coated Balloons for Dysfunctional Dialysis Arteriovenous Fistulas
Approximately 850 million persons worldwide have chronic kidney disease, and almost 4 million receive renal replacement therapy. Among these 4 million, more than 520,000 Americans are undergoing dialysis, and fewer than 225,000 have a functioning kidney transplant. To improve treatment
Serious Ivermectin Toxicity and Human ABCB1 Nonsense Mutations
To the Editor: The discoverers of ivermectin, a broad-spectrum parasiticide that is widely used in humans and animals, were awarded the Nobel Prize in Physiology or Medicine in 2015. This drug is reputed to be remarkably safe thanks to its
High-dose versus low-dose angiotensin converting enzyme inhibitors in heart failure: systematic review and meta-analysis
Objective To systematically review evidence comparing the effect of low-dose versus high-dose ACE inhibitors (ACEIs) on all-cause and cardiovascular mortality and hospitalisation, functional capacity and side effects in patients with heart failure (HF). Methods We searched PubMed, Embase, Cochrane CENTRAL
Rosalind Franklin and the Advent of Molecular Biology
Rosalind Franklin provided the key data for deriving the double helix structure of DNA. The English chemist also pioneered structural studies of colloids, viruses, and RNA. To celebrate the 100th anniversary of Franklin’s birth, I summarize her work, which shaped
[Editorial] Trump versus Biden: a fight for the health of a nation
With only 73 days until Nov 3, the 2020 presidential election in the US has entered a decisive phase with Democratic candidate Joe Biden’s announcement of California Senator Kamala Harris as his running mate. It comes against the backdrop of
Study on the combination of brief psychodynamic psychotherapy with Viagra in the treatment of non-organic ED
Background Erectile dysfunction (ED) has gradually become an important issue that seriously affects the quality of life of Chinese men. In addition to classic oral medications, psychotherapeutic interventions are increasingly being used in the treatment of ED. Aim This study
[Editorial] The end, and the beginning, of global mental health
The Lancet Psychiatry’s recent Position Paper on how mental health care should change as a consequence of the COVID-19 pandemic was welcomed by many, but others expressed disquiet at its lack of authors from low-income and middle-income countries. “Far too
Case 26-2020: A 60-Year-Old Woman with Altered Mental Status and Weakness on the Left Side
Presentation of Case. Dr. Meridale V. Baggett (Medicine): A 60-year-old woman presented to this hospital with altered mental status during the pandemic of coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The patient
Trigeminal Neuralgia
Trigeminal neuralgia, traditionally called tic douloureux, is a chronic neuropathic pain disorder characterized by spontaneous and elicited paroxysms of electric shock–like or stabbing pain in a region of the face. A poor quality of life and suicide in severe cases
Covid-19 communication aids
This graphic, based on a guide by VitalTalk, explores conversations around serious illness.The full graphic can be seen at https://www.bmj.com/content/369/bmj.m2255The original text is at…
Telephone
As a child, you probably played the game “Telephone”: you whispered a message into the ear of the person next to you, who whispered it to the next person, and so forth down the line. When revealed at the end
Hydroxychloroquine use in COVID-19: is the risk of cardiovascular toxicity justified?
The outbreak of COVID-19 in Wuhan, China and its declaration as a global pandemic by WHO has left the medical community under significant pressure to rapidly identify effective therapeutic and preventative strategies. Chloroquine (CQ) and its analogue hydroxychloroquine (HCQ) were
Oxytocin Discrepancies in Social Dynamics
Social group dynamics are highly complex. In this issue of Neuron, Anpilov et al. use a novel wireless optogenetics device to demonstrate that the repeated stimulation of oxytocin neurons modulates pro-social and agonistic behaviors in a time- and context-dependent manner.
[Editorial] Our first footprints
Now we are three! Having launched The Lancet Child & Adolescent Health in September, 2017, this issue marks our third anniversary. In these crucial early years, we have grown in knowledge and reach, founded a trusted platform for the best
Telephone
As a child, you probably played the game “Telephone”: you whispered a message into the ear of the person next to you, who whispered it to the next person, and so forth down the line. When revealed at the end
Covid-19: Care homes in Belgium and Spain had “alarming living conditions,” says MSF report
A report into the global response to coronavirus outbreaks has heavily criticised the “alarming living conditions” in Belgian and Spanish care homes, the former being described as a “true…
Gene of the month: GLIS1-3
The GLIS 1–3 genes belong to a family of transcription factors, the Krüppel-like zinc finger proteins. The GLIS proteins function primarily as activators of transcription (GLIS 1 and 3), while GLIS 2 functions as a repressor. Collectively, the GLIS proteins
Highlights from this issue
Imaging the encephalopathy of prematurity Julia Kline and colleagues assessed MRI findings at term in 110 preterm infants born before 32 weeks’ gestation and cared for in four neonatal units in Columbus, Ohio. Using automated cortical and sub-cortical segmentation they
STI perspectives
High burden of antibiotic-resistant Mycoplasma genitalium in symptomatic urethritis Mycoplasma genitalium is an aetiological agent of sexually transmitted urethritis. A cohort study investigated M. genitalium prevalence, antibiotic resistance and association with previous macrolide exposure among 1816 Chinese men who presented
Correction: Match injury incidence during the Super Rugby tournament is high: a prospective cohort study over five seasons involving 93 641 player-hours
Schwellnus M, Jordaan E, Janse van Rensburg C, et al. Match injury incidence during the super rugby tournament is high: a prospective cohort study over five seasons involving 93 641 player-hours. Br J Sports Med 2019;55:620-7. An additional affiliation for
Highlights from this issue
Rheumatic fever Is there any disease group more ’deserving’ of a place at the neglected tropical disease table than the post streptococcal illnesses, glomerulonephritis and rheumatic fever? These dropped off the radar of most high income countries in the second
CD70 antibody-drug conjugate as a potential therapeutic agent for uterine leiomyosarcoma
Uterine leiomyosarcoma is a rare and aggressive gynecologic malignancy originating in the myometrium of the uterine corpus that tends to recur even after complete surgical excision. Current therapeutic agents have only modest effects on uterine leiomyosarcoma. Although antibodies and antibody-drug
Accessible disease insights
Nature Reviews Genetics, Published online: 18 August 2020; doi:10.1038/s41576-020-00281-0 A new study in Science uses chromatin accessibility profiles to reveal gene regulatory alterations associated with genetic variants in neuropsychiatric disease.
The More, the Merrier: DC3s Join the Human Dendritic Cell Family
Recent studies have reported additional subpopulations of human dendritic cells (DCs), but whether they are distinct subsets has been unclear. In this issue of Immunity, Cytlak et al. and Bourdely et al. show that DC3s possess a specific precursor and represent a
[Editorial] Indigenous peoples: resilience in the face of adversity
In commemoration of the first meeting of the United Nations Working Group on Indigenous Populations (Geneva; Aug 9, 1982), the anniversary is marked each year by International Day of the World’s Indigenous Peoples. The theme this year is “COVID-19 and
Characterisation of aortic stenosis severity: a retrospective analysis of echocardiography reports in a clinical laboratory
Objective To evaluate how common echocardiographic metrics of aortic stenosis (AS) influence the proportion of patients who may be categorised as having severe stenosis and therefore considered for valve replacement. Methods Retrospective analysis was performed of all echocardiograms with aortic
[Editorial] Eliminating viral hepatitis in the COVID-19 era: weighing challenge and opportunity
World Hepatitis Day—July 28—offers a timely opportunity to turn the spotlight towards global efforts to address viral hepatitis. Worldwide, the hepatitis viruses are responsible for an estimated 1·34 million deaths a year, with a disproportionate disease burden in low-income and
[Editorial] Latin America takes centre stage in dementia prevention
The study of Alzheimer’s disease has placed Latin America at the forefront of dementia research. In Colombia, researchers have focussed on autosomal dominant Alzheimer’s disease, while in Argentina and Brazil, their colleagues have been working hard to promote prevention of
Surge in Child Abuse, Harm During COVID-19 Pandemic Reported
A study documenting an alarming rise in abuse-related head injuries among children in the United Kingdom adds to increasing evidence that the novel coronavirus pandemic and efforts to contain it are taking a serious toll on children.
Basil Garo-Falides
bmj;370/aug18_22/m3195/FAF1faBasil Garo-Falides swept into Essex in 1961, having left Greece in 1948 to qualify in Dublin. For the next 60 years he dedicated his life to the NHS, as a surgeon at…
Azacitidine and Venetoclax in Previously Untreated Acute Myeloid Leukemia
Acute myeloid leukemia (AML) is primarily a disease of older adults, with a median age of 68 years at diagnosis. Standard curative treatment for AML consists of intensive induction chemotherapy followed by consolidation chemotherapy, allogeneic stem-cell transplantation, or both. However,
Cost of Care for the Initial Management of Cervical Cancer in Women with Commercial Insurance
Women with newly diagnosed cervical cancer are often treated with extensive, multimodal therapy that may include a combination of surgery, radiation, and chemotherapy. Little is known about the cost of treatment or how costs are passed on to patients.
Extrachromosomal DNA is associated with oncogene amplification and poor outcome across multiple cancers
Nature Genetics, Published online: 17 August 2020; doi:10.1038/s41588-020-0678-2 A pan-cancer analysis finds that extrachromosomal DNA is pervasive and associated with oncogene amplification and poor patient outcomes.
Integrating genetic and non-genetic determinants of cancer evolution by single-cell multi-omics
Nature Reviews Genetics, Published online: 17 August 2020; doi:10.1038/s41576-020-0265-5 Both genetic and non-genetic factors underlie the intratumoural heterogeneity that fuels cancer evolution. This Review discusses the application of single-cell multi-omics technologies to the study of cancer evolution, which capture and
Penetrating Injuries from “Less Lethal” Beanbag Munitions
To the Editor: In the spring of 2020, after the death of George Floyd in police custody, protests against racial injustice and police brutality broke out across the country. In Austin, Texas, tensions culminated in 2 days of vigorous protest,
Atrial fibrillation in patients with an atrial septal defect in a single centre cohort during a long clinical follow-up: its association with closure and outcome of therapy
Objective Currently, consensus is lacking on the relation between closure of atrial septal defect (ASD) and the incidence of atrial fibrillation (AF), which is a known complication in ASD patients. More importantly, studies reporting on the treatment applied for AF
Prevalence of cognitive dysfunction, psychological morbidity and abuse in the community-based elderly population in India
Background The elderly population in India is expected to grow enormously by 2050 owing to an increase in life expectancy. Community-based data on the prevalence of psychological morbidity, abuse and cognitive dysfunction are scarce. Aims To determine the prevalence of
Covid-19: Is local contact tracing the answer?
Last week, the government announced a major shift in its approach to covid-19 contact tracing in England, by giving local council public health teams more responsibility and shrinking the national…
Highlights from this issue
As we write this month’s Airwaves citizens, scientists and politicians around the world are preparing for a second wave of COVID-19 cases while hoping their fears are groundless. This month’s airwaves takes the “second wave” as its theme and we
The role of statins in the prevention of preeclampsia
Preeclampsia is a common hypertensive disorder of pregnancy associated with significant neonatal and maternal morbidity and mortality. Though the exact cause of preeclampsia remains unknown, it is generally accepted that abnormal placentation resulting in the release of soluble anti-angiogenic factors,
Compression Therapy to Prevent Recurrent Cellulitis of the Leg
Cellulitis is a common bacterial infection of the skin and subcutaneous tissue that occurs mostly in the legs and is associated with health care costs and adverse health outcomes. Recurrence of cellulitis is common: up to 47% of patients have
The Effect of Advances in Lung-Cancer Treatment on Population Mortality
Lung cancer is made up of a group of molecularly and histologically heterogeneous subtypes. Two major histologic subtypes are non–small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC), which account for 76% and 13%, respectively, of all cases of lung
A healthy diet and physical activity can help reduce your cancer risk
Prospective Phase II Trial of Levonorgestrel Intrauterine Device: Non-Surgical Approach for Complex Atypical Hyperplasia and Early Endometrial Cancer
The incidence of complex atypical hyperplasia and early stage endometrioid endometrial cancer is increasing, in part due to the epidemic of obesity, a risk factor tightly linked to development of endometrial hyperplasia and cancer. The standard upfront treatment for complex
Killer queens and supergenes
Nature Reviews Genetics, Published online: 14 August 2020; doi:10.1038/s41576-020-0279-z A study in PNAS describes a maternal-effect killer supergene that regulates social behaviour in Alpine silver ants. Queens carrying the ‘killer’ haplotype fail to produce live progeny homozygous for the alternative
Caught in a Flare
A 24-year-old woman presented to her primary care doctor with a 1-month history of worsening fatigue, diffuse arthralgias, a rash on her face and arms, and swelling in her legs. She also reported frequent urination. . . .
Compression Therapy to Prevent Recurrent Cellulitis of the Leg
Cellulitis is a common bacterial infection of the skin and subcutaneous tissue that occurs mostly in the legs and is associated with health care costs and adverse health outcomes. Recurrence of cellulitis is common: up to 47% of patients have
Caught in a Flare
A 24-year-old woman presented to her primary care doctor with a 1-month history of worsening fatigue, diffuse arthralgias, a rash on her face and arms, and swelling in her legs. She also reported frequent urination. . . .
Bilirubin, Intestinal Integrity, the Microbiome, and Inflammation
In a recent report, Lee et al. showed a new therapeutic approach: the use of hyaluronic acid–bilirubin nanoparticles to treat acute colitis in a mouse model of inflammatory bowel disease. They used hyaluronate, a potent activator of innate immunity and
Ofatumumab versus Teriflunomide in Multiple Sclerosis
The pathophysiology of multiple sclerosis involves B cells. Anti-CD20 monoclonal antibodies that induce B-cell depletion, such as rituximab and ocrelizumab, are effective disease-modifying therapies for multiple sclerosis. Ofatumumab, a fully human antibody that is used to treat chronic leukemia,…
Umbilical Cord Knot
Figure 1.
Case 25-2020: A 47-Year-Old Woman with a Lung Mass
Presentation of Case. Dr. Jonathan E. Eisen: A 47-year-old woman presented to this hospital early during the pandemic of coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), because of cough and shortness of
Sixty seconds on . . . quarantining
Quarantini, the cocktail of the pandemic?Sadly no, we’re talking about new rules which mean that travellers returning from countries including France, Malta, and the Netherlands will be required to…
Influence of changes in cholesterol levels and disease activity on the 10 years cardiovascular risk estimated with different algorithms in rheumatoid arthritis patients
European League Against Rheumatism (EULAR) recommendations for cardiovascular (CV) risk management in patients with Rheumatoid Arthritis (RA) suggest to ‘measure cholesterol and other lipid fractions when disease activity is stable or in remission’.1 This point ensues from the assumption that
Distribution of plaques in the cerebrum in multiple sclerosis
Distribution of plaques in the cerebrum in multiple sclerosis Authors: Brownell B, Hughes JTYear Published: 1962Number of times cited: 590 Published 58 years ago this seminal work from Oxford has been cited nearly 600 times. What did it describe and
A healthy diet and physical activity can help reduce your cancer risk
Umbilical Cord Knot
Figure 1.
EARLY POSTPARTUM PHYSICAL ACTIVITY AND PELVIC FLOOR SUPPORT AND SYMPTOMS ONE YEAR POSTPARTUM
Risks of pelvic organ prolapse and urinary incontinence rise after the first vaginal delivery. During the early postpartum period, a time of active regeneration and healing of the pelvic floor, women may be particularly vulnerable to greater pelvic floor loading.
Epigenetic Therapies for Cancer
Chromatin is one of the earliest identified targets for cancer therapeutics. Drug development aimed at altering chromatin can be traced to the differentiating agents of the 1970s and their link to DNA methylation. A more precise understanding of the complexity
Compression Therapy to Prevent Recurrent Cellulitis of the Leg
Cellulitis is a common bacterial infection of the skin and subcutaneous tissue that occurs mostly in the legs and is associated with health care costs and adverse health outcomes. Recurrence of cellulitis is common: up to 47% of patients have
The Covid-19 Pandemic and the Incidence of Acute Myocardial Infarction
To the Editor: During the Covid-19 pandemic, reports have suggested a decrease in the number of patients presenting to hospitals because of emergency conditions such as acute myocardial infarction. We examined this issue using data from Kaiser Permanente Northern California,
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
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
Compression Therapy to Prevent Recurrent Cellulitis of the Leg
Cellulitis is a common bacterial infection of the skin and subcutaneous tissue that occurs mostly in the legs and is associated with health care costs and adverse health outcomes. Recurrence of cellulitis is common: up to 47% of patients have
Case 25-2020: A 47-Year-Old Woman with a Lung Mass
Presentation of Case. Dr. Jonathan E. Eisen: A 47-year-old woman presented to this hospital early during the pandemic of coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), because of cough and shortness of
[Editorial] Humanitarian crises in a global pandemic
On Aug 19, the world will mark a UN World Humanitarian Day very different from any other. But while COVID-19 captures the world’s focus, other humanitarian crises also need attention, as evidenced most recently by the tragic aftermath of the
People with Hepatitis C Who Inject Drugs — Underserved, Not Undeserving
The development of highly curative direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection has transformed clinical management of HCV and provided the impetus for the World Health Organization’s ambitious HCV-related targets for 2030. These targets include marked improvements
Covid-19: England comes into line with rest of UK on recording deaths
A month after the “urgent” review promised by England’s health secretary, Public Health England (PHE) has announced new reporting definitions that bring England into line with Wales, Scotland, and…
Learning from a global pandemic
Taking on the job of Editor in Chief of Occupational and Environmental Medicine is a challenge, especially during a pandemic with enormous societal as well as environmental and occupational consequences. While we cannot fully anticipate the extent of these consequences,
Genomic Insights into Stillbirth
Stillbirth, or fetal loss after 20 weeks of gestation, remains a major public health challenge that occurs in approximately 6 per 1000 pregnancies in the United States. Unfortunately, many of these losses remain unexplained, even after standard postmortem evaluation. The
Benefit and burden in the Dutch cytology-based versus high-risk human papillomavirus-based cervical cancer screening program
In 2017, the Dutch cervical cancer screening program has replaced primary cytology-based screening by primary high-risk human papillomavirus based screening, including the opportunity to participate through self-sampling. Evaluation and balancing benefit (detection of high-grade cervical intraepithelial neoplasia) and burden (unnecessary
Purifying Selection against Pathogenic Mitochondrial DNA in Human T Cells
Some of the most challenging mitochondrial disorders arise from mutations in mitochondrial DNA (mtDNA), a high-copy-number genome that is maternally inherited. These disorders manifest with marked clinical heterogeneity, in part because tissues generally contain a mixture of both nonmutant and…
Dr Hein Wellens MD PhD
On 9 June 2020, Dr Hein Wellens passed away, at the age of 84
Evaluation of an Unsanctioned Safe Consumption Site in the United States
To the Editor: Nearly 70,000 people in the United States die each year from a drug overdose. Opioid-involved overdose deaths may be preventable by the timely administration of naloxone. Eleven countries have responded to health concerns regarding people who use
Covid-19 and the Mandate to Redefine Preventive Care
As the U.S. health care system defines the new normal for ambulatory care in the Covid-19 era, it needs a new approach to providing routine preventive care for adults. Concerns about contagion, competing demands, and shortages of personal protective equipment
The Goals of Care — Is There a (Black) Doctor in the House?
One Saturday morning, an ICU physician called and asked me to talk to a family with whom the team was having difficulty establishing care goals for the family’s loved one. The team knew I’d recently seen the patient for a
Purifying Selection against Pathogenic Mitochondrial DNA in Human T Cells
Some of the most challenging mitochondrial disorders arise from mutations in mitochondrial DNA (mtDNA), a high-copy-number genome that is maternally inherited. These disorders manifest with marked clinical heterogeneity, in part because tissues generally contain a mixture of both nonmutant and…
Covid-19: Healthcare professional is referred to regulator for delaying seeing a patient because of lack of PPE
A healthcare professional is facing a fitness to practise investigation for delaying attending to a covid-19 positive patient because of inadequate personal protective equipment (PPE), in what may be…
Heartbeat: taking care of patients with cardiovascular disease during a pandemic
Cardiovascular disease (CVD) specialists have faced many challenges during the COVID-19 pandemic starting with a critical role in caring for severely ill patients with COVID-19, recognising the cardiovascular complications of COVID-19, performing and publishing clinical studies on cardiac involvement, and
Reply to Dr. Ayoob, and “Consumption of Non-nutritive Sweeteners (NNS) During Pregnancy”
Presentation and outcomes of mitral valve surgery in France in the recent era: a nationwide perspective
Objectives Unbiased information regarding the surgical management of patients with mitral regurgitation (MR) at the nationwide level are scarce and mainly US-based. The Programme de Médicalisation des Systèmes d’Information, a mandatory national database, offers the unique opportunity to assess the
Emerging Drug-Resistant Meningitis Detected in the US
Although rare in the US, antibiotic-resistant strains of Neisseria meningitidis have been detected in a dozen states, according to a CDC report.
Mental Health and the Covid-19 Pandemic
Uncertain prognoses, looming severe shortages of resources for testing and treatment and for protecting responders and health care providers from infection, imposition of unfamiliar public health measures that infringe on personal freedoms, large and growing financial losses, and conflicting…
Mortality rates are lower with higher continuity of care, review finds
Higher continuity of care is associated with lower mortality rates, while discontinuity can cause patients to feel as though they are not being taken seriously, two studies have found in the British…
Models for Immuno-oncology Research
The interactions between cancer cells and immune cells are complex and context dependent. Choosing the right model to study these interactions is a crucial step in the development of immunotherapies. From cell co-cultures to organoids, organs-on-chip, and a variety of
Trends in Operative Time and Outcomes in Minimally Invasive Hysterectomy from 2008 to 2018
There is a national shift toward laparoscopic hysterectomy as the predominant form of minimally invasive hysterectomy. Prior research suggests that vaginal hysterectomy is associated with lower operative time and improved outcomes; however, this has not been validated in a modern
N6-Methyladenosine co-transcriptionally directs the demethylation of histone H3K9me2
Nature Genetics, Published online: 10 August 2020; doi:10.1038/s41588-020-0677-3 METTL3-induced deposition of N6-methyladenosine (m6A) in RNA correlates with removal of H3K9me2 genome wide. The m6A reader YTHDC1 recruits the H3K9me2 demethylase KDM3B to chromatin.
Emerging mechanisms of cell competition
Nature Reviews Genetics, Published online: 10 August 2020; doi:10.1038/s41576-020-0262-8 The growth and survival of cells within tissues can be influenced by competition between different cell clones. Genetic and cell biological studies suggest that cell competition may occur through the molecular
Zonulin in serum as a biomarker fails to identify the IBS, functional dyspepsia and non-coeliac wheat sensitivity
We read with interest the recent work by Stevens et al1 showing the association between zonulin, fatty acid binding protein 2 (FABP2) and lipopolysaccharide (LPS) plasma levels and increased gut permeability in asymptomatic gastroenterology patients with depression and anxiety disorders,
Treatment of muscle‐invasive and advanced bladder cancer in 2020
Abstract Bladder cancer accounts for nearly 170,000 deaths worldwide annually. For over 4 decades, the systemic management of muscle‐invasive and advanced bladder cancer has primarily consisted of platinum‐based chemotherapy. Over the past 10 years, innovations in sequencing technologies have led
Prospective Randomized Double-Blind, Placebo Controlled Evaluation of the Pharmacokinetics, Safety and Efficacy of Recombinant Antithrombin Versus Placebo in Preterm Preeclampsia (PRESERVE-1)
Despite expectant management, preeclampsia remote from term usually results in preterm delivery. Antithrombin displays anti-inflammatory and anticoagulant properties and thus may have a therapeutic role treating preterm preeclampsia, a disorder characterized by endothelial dysfunction, inflammation and activation of the coagulation
Led Astray
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.
What Is Liberty? Addressing Undeserved Suffering in Health Care
“What brings your loved one here?” the hospice nurse asked. She was seeking an abbreviated history of my mémère’s terminal diagnosis, but I couldn’t muster the words without losing my composure. Somehow, the nurse understood. She said, “Tell me about
Magnetic Resonance Imaging Biomarkers of Brain Connectivity in Predicting Outcome after Mild Traumatic Brain Injury: A Systematic Review
Journal of Neurotrauma, Volume 37, Issue 16, Page 1761-1776, August 15, 2020.
Ofatumumab versus Teriflunomide in Multiple Sclerosis
The pathophysiology of multiple sclerosis involves B cells. Anti-CD20 monoclonal antibodies that induce B-cell depletion, such as rituximab and ocrelizumab, are effective disease-modifying therapies for multiple sclerosis. Ofatumumab, a fully human antibody that is used to treat chronic leukemia,…
Led Astray
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.
Pregnancy outcomes in nulliparous women with positive first-trimester preterm preeclampsia screening test: The Great Obstetrical Syndromes (GOS) cohort study
The Fetal Medicine Foundation (FMF) proposed a competing risks model for early identification of women at high risk of preterm preeclampsia, typically associated with deep placentation disorders. The Great Obstetrical Syndromes include a spectrum of pregnancy complications (preeclampsia, intrauterine growth
The Human Genome Project changed everything
Nature Reviews Genetics, Published online: 07 August 2020; doi:10.1038/s41576-020-0275-3 Thirty years on from the launch of the Human Genome Project, Richard Gibbs reflects on the promisesthat this voyage of discovery bore. Its success should be measured by how this project
Necrolytic Migratory Erythema Associated with a Glucagonoma
Figure 1.
What Is Liberty? Addressing Undeserved Suffering in Health Care
“What brings your loved one here?” the hospice nurse asked. She was seeking an abbreviated history of my mémère’s terminal diagnosis, but I couldn’t muster the words without losing my composure. Somehow, the nurse understood. She said, “Tell me about
The Goals of Care — Is There a (Black) Doctor in the House?
One Saturday morning, an ICU physician called and asked me to talk to a family with whom the team was having difficulty establishing care goals for the family’s loved one. The team knew I’d recently seen the patient for a
Zika Virus Disease and Pregnancy Outcomes in Colombia
Zika virus is a flavivirus that is transmitted to humans primarily by the bite of an infected mosquito of the aedes genus. Sexual transmission and transmission of Zika virus from mother to fetus have also been reported. Congenital Zika virus
Charles Jonathan Mortiboy Poole
bmj;370/aug07_10/m3161/FAF1faMy friend and colleague, Charles Jonathan Mortiboy Poole (“Jon”), was the only son of Leslie Poole, a noted ceramicist and inventor, and of Gwyndolene Mortiboy Poole (née…
Highlights from this issue
Jejunal feeding: when is it the right thing to do? This is a complex topic – straightforward if there is a structural problem which precludes oral or intra gastric feeding, but more complicated in patients with no clear structural abnormality.
Unleashing Immunotherapy by Targeting Cancer Stem Cells
In this issue of Cell Stem Cell, Jia et al. (2020) identify residual cancer stem cells (CSCs) as a mechanism of immunotherapy resistance in head and neck squamous cell carcinoma (HNSCC). Remarkably, targeting this population of CSCs can be exploited to
Uvula Amyloidosis
Figure 1.
Zika Virus Disease in Colombia — Preliminary Report
Zika virus is a flavivirus transmitted primarily by the bite of an infected aedes mosquito. In Colombia, a country with a population of 48 million, Aedes aegypti and Aedes albopictus mosquitoes are the species that are most commonly found at
Unintended Consequences of the Transition to Telehealth for Pregnancies Complicated by Opioid Use Disorder During COVID-19 Pandemic
RNA: a double-edged sword in genome maintenance
Nature Reviews Genetics, Published online: 06 August 2020; doi:10.1038/s41576-020-0263-7 Genome instability can lead to a number of human diseases, including neurodegeneration and cancer. In this Review, Zong et al. discuss the various ways in which RNA can both promote genome
Native-Valve Infective Endocarditis
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.
The Expert When the Only
On hospital rounds as a first-year medical student — by far the least clinically experienced team member — I tried my best to fit in. I marveled at the confidence of clerks, who introduced themselves to families and updated management
Evaluation of an Unsanctioned Safe Consumption Site in the United States
To the Editor: Nearly 70,000 people in the United States die each year from a drug overdose. Opioid-involved overdose deaths may be preventable by the timely administration of naloxone. Eleven countries have responded to health concerns regarding people who use
The Goals of Care — Is There a (Black) Doctor in the House?
One Saturday morning, an ICU physician called and asked me to talk to a family with whom the team was having difficulty establishing care goals for the family’s loved one. The team knew I’d recently seen the patient for a
Led Astray
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.
False Negative Tests for SARS-CoV-2 Infection — Challenges and Implications
There is broad consensus that widespread SARS-CoV-2 testing is essential to safely reopening the United States. A big concern has been test availability, but test accuracy may prove a larger long-term problem. While debate has focused on the accuracy of
A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the global, rapidly emerging virus causing coronavirus disease 2019 (Covid-19). The current public health strategies to mitigate transmission are rapid identification of cases, isolation, contact tracing, and self-quarantine of those…
Echocardiographic diagnosis of right-to-left shunt using transoesophageal and transthoracic echocardiography
Background The diagnosis and quantification of right-to-left shunt (RLS) using transthoracic echocardiography (TTE) as well as transoesophageal echocardiography (TOE) have not been well established. We aimed to diagnose RLS by TOE using direct visualisation of the shunt and to compare
Multiorgan and Renal Tropism of SARS-CoV-2
To the Editor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preferentially infects cells in the respiratory tract, but its direct affinity for organs other than the lungs remains poorly defined. Here, we present data from an autopsy series of 27
Mental Health and the Covid-19 Pandemic
Uncertain prognoses, looming severe shortages of resources for testing and treatment and for protecting responders and health care providers from infection, imposition of unfamiliar public health measures that infringe on personal freedoms, large and growing financial losses, and conflicting…
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