The private hospital group Spire Healthcare has pleaded guilty to breaching the duty of candour in failing to give four patients prompt explanations about their inadequate treatment by a consultant…
Oncolytic HSV-1 G207 Immunovirotherapy for Pediatric High-Grade Gliomas
Malignant high-grade glioma accounts for 8 to 10% of pediatric brain tumors and is regularly fatal, with a rapid course. Survival rates have not improved in 30 years; the 3-year event-free survival among patients with newly diagnosed tumors who are
Effect of a Randomized, Controlled Trial on Surgery for Cervical Cancer
To the Editor: Minimally invasive (robotic or laparoscopic) surgery has been widely adopted for the treatment of cancer despite few randomized, controlled trials assessing outcomes. In the Laparoscopic Approach to Cervical Cancer (LACC) Trial, the results of which were reported
Transcription-dependent domain-scale three-dimensional genome organization in the dinoflagellate Breviolum minutum
Nature Genetics, Published online: 29 April 2021; doi:10.1038/s41588-021-00848-5 Analysis of the three-dimensional architecture of the dinoflagellate Breviolum minutum genome identifies large topological domains (dinoTADs) demarcated by convergent gene array boundaries. Transcriptional inhibition disrupts dinoTADs.
Case 13-2021: A Newborn Girl with a Neck Mass
Presentation of Case. Dr. Katherine A. Sparger: A newborn girl was admitted to the neonatal intensive care unit of this hospital after a planned delivery by cesarean section because of a neck mass. During pregnancy, the patient’s mother was 41
Case 13-2021: A Newborn Girl with a Neck Mass
Presentation of Case. Dr. Katherine A. Sparger: A newborn girl was admitted to the neonatal intensive care unit of this hospital after a planned delivery by cesarean section because of a neck mass. During pregnancy, the patient’s mother was 41
Choices in a Crisis — Individual Preferences among SARS-CoV-2 Vaccines
The extraordinarily swift development of effective vaccines against SARS-CoV-2 offers new optimism about combating the Covid-19 pandemic. So far, vaccine demand far exceeds supply, and people generally cannot choose which vaccine they receive. In the United States, this lack of
Australian Firearm Regulation at 25 — Successes, Ongoing Challenges, and Lessons for the World
Twenty-five years ago, on Sunday, April 28, 1996, a 28-year-old man used a Colt AR-15 semiautomatic rifle to kill 35 people in the quiet tourist town of Port Arthur, tucked away in the southeast corner of Tasmania, a small island
Nanima
“You are leaving?” she asked. “When will you come again?” “Soon,” I said. “I’ll be back soon, Nanima.” In my heart, I knew it wouldn’t be soon. In truth, I could only bear to visit her once every few months
Oncolytic HSV-1 G207 Immunovirotherapy for Pediatric High-Grade Gliomas
Malignant high-grade glioma accounts for 8 to 10% of pediatric brain tumors and is regularly fatal, with a rapid course. Survival rates have not improved in 30 years; the 3-year event-free survival among patients with newly diagnosed tumors who are
Zoom Family Meeting
As difficult as 2020 was, it also brought some exhilarating moments when care was redesigned on the fly and delivered in better ways. How can we preserve the benefits of these bursts of innovation once the Covid-19 pandemic eases? One
Oncolytic HSV-1 G207 Immunovirotherapy for Pediatric High-Grade Gliomas
Malignant high-grade glioma accounts for 8 to 10% of pediatric brain tumors and is regularly fatal, with a rapid course. Survival rates have not improved in 30 years; the 3-year event-free survival among patients with newly diagnosed tumors who are
Evidence that microbes identified as tick-borne pathogens are nutritional endosymbionts
Jia et al. (Jia et al., 2020) reported major discoveries on genetic basis of hematophagy and vector capacities in ticks. Our re-examination of the tick metagenomic datasets shows that nutritional endosymbionts required for hematophagy were also widely present. They were misidentified as
[Editorial] Miscarriage: worldwide reform of care is needed
Globally, an estimated 23 million miscarriages occur every year. Despite the personal toll involved, many miscarriages—defined as the loss of pregnancy before viability—are managed in relative isolation. Private grief and misconceptions—eg, the belief that miscarriage can be caused by lifting
Back to the Future — The Therapeutic Potential of Psychedelic Drugs
In The Doors of Perception, Aldous Huxley described his trial of mescaline as “the most extraordinary and significant experience available to human beings this side of the Beatific Vision.” His exegesis was preceded by the synthesis of the hallucinogen lysergic
Audio Interview: Advice for Clinicians on Covid-19 Vaccines and Social Restrictions
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
Sixty seconds on . . . concussion in football
What’s the score?A large study1 of US high school football (or, should we say, soccer) players has found that teenage girls face almost double the risk of concussion playing the game compared with…
Genetic and epigenetic mechanisms in the development of congenital heart diseases
Congenital heart disease (CHD) is the most common of congenital cardiovascular malformations associated with birth defects, and it results in significant morbidity and mortality worldwide. The classification of CHD is still elusive owing to the complex pathogenesis of CHD. Advances
Triage, consent and trusting black boxes
The coronavirus pandemic has brought to public attention a variety of questions long debated in medical ethics, but now given both added urgency and wider publicity. Among these is triage, with its origins in deciding which individual lives are to
HSV-1 G207 is active in paediatric glioma
Nature Reviews Clinical Oncology, Published online: 28 April 2021; doi:10.1038/s41571-021-00515-y HSV-1 G207 is active in paediatric glioma
[Editorial] Cervical cancer screening and New Zealand’s uncomfortable truths
On April 6, 2021, Kiritapu Allan, a Member of Parliament in New Zealand’s House of Representatives, announced that she had been diagnosed with stage III cervical cancer. Subsequently, Allan, of Māori descent, has been encouraging women to get tested, mentioning
Sacituzumab Govitecan in Metastatic Triple-Negative Breast Cancer
Patients with metastatic triple-negative breast cancer (defined by a lack of tumor-cell expression of the estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 [HER2]) have poor survival outcomes. Although immunotherapy has shown promising first-line clinical…
Third trimester repeat HIV testing: It’s time we make it universal
Since the 1990s, perinatal transmission of HIV has decreased substantially, largely as a result of improved detection secondary to routine HIV screening in pregnancy and the use of antiretroviral therapy. However, despite reductions, elimination of perinatal transmission, defined as an
Establishing Medical Civil Rights
If physicians were to amend the U.S. Constitution, the right to health care would almost certainly be guaranteed. Although the Constitution’s preamble offers the assurance of “general welfare,” the omission of an explicit right to health care from both the
Bimekizumab versus Adalimumab in Plaque Psoriasis
The proinflammatory cytokines interleukin-12 and tumor necrosis factor (TNF) play roles in the pathogenesis of psoriasis. Additional involvement of interleukin-17 and interleukin-23 in the pathogenesis of this condition has been identified; however, TNF inhibitors remain a mainstay treatment for…
Bone-free ancient DNA
Nature Reviews Genetics, Published online: 28 April 2021; doi:10.1038/s41576-021-00368-2 A new study in Science reports the extraction and analysis of ancient hominid nuclear DNA from Paleolithic sediments. This advance paves the way to a fuller picture of human evolution by
The Supreme Court’s Abortion Exceptionalism — Judicial Deference, Medical Science, and Mifepristone Access
On April 12, 2021, the Food and Drug Administration (FDA) temporarily lifted its decades-long restriction on access to medication abortion, which accounts for two in five abortions in the United States. The agency’s action nullifies a Supreme Court order, 3
The Supreme Court’s Abortion Exceptionalism — Judicial Deference, Medical Science, and Mifepristone Access
On April 12, 2021, the Food and Drug Administration (FDA) temporarily lifted its decades-long restriction on access to medication abortion, which accounts for two in five abortions in the United States. The agency’s action nullifies a Supreme Court order, 3
Case 12-2021: A 78-Year-Old Man with a Rash on the Scalp and Face
Presentation of Case. Dr. Carolina Chiou (Ophthalmology): A 78-year-old man was admitted to this hospital because of a rash on the forehead and frontal scalp and edema of the left eyelids. The patient had been well until 3 days before
Bimekizumab versus Adalimumab in Plaque Psoriasis
The proinflammatory cytokines interleukin-12 and tumor necrosis factor (TNF) play roles in the pathogenesis of psoriasis. Additional involvement of interleukin-17 and interleukin-23 in the pathogenesis of this condition has been identified; however, TNF inhibitors remain a mainstay treatment for…
Covid-19: One dose of vaccine cuts risk of passing on infection by as much as 50%, research shows
Adults infected with covid-19 three weeks after receiving one dose of the Pfizer-BioNTech or Oxford-AstraZeneca vaccine were 38-49% less likely to pass the virus on to their household contacts than…
Transcatheter mitral valve repair: an overview of current and future devices
The field of transcatheter mitral valve repair (TMVr) for mitral regurgitation (MR) is rapidly evolving. Besides the well-established transcatheter mitral edge-to-edge repair approach, there is also growing evidence for therapeutic strategies targeting the mitral annulus and mitral valve chordae. A
Striae and an Adrenal Mass
Figure 1.
Case 12-2021: A 78-Year-Old Man with a Rash on the Scalp and Face
Presentation of Case. Dr. Carolina Chiou (Ophthalmology): A 78-year-old man was admitted to this hospital because of a rash on the forehead and frontal scalp and edema of the left eyelids. The patient had been well until 3 days before
Nanima
“You are leaving?” she asked. “When will you come again?” “Soon,” I said. “I’ll be back soon, Nanima.” In my heart, I knew it wouldn’t be soon. In truth, I could only bear to visit her once every few months
Incorrect Values in Text and Table 4
In the Original Investigation entitled “Comparisons of Interventions for Preventing Falls in Older Adults: A Systematic Review and Meta-analysis,” published in the November 7, 2017, issue of JAMA, incorrect absolute risk differences (ARDs) were reported in several places. In the
Trial of Psilocybin versus Escitalopram for Depression
Major depressive disorder affects approximately 10% of the general population in the United Kingdom, impairs patients’ lives, and is costly to society. Selective serotonin-reuptake inhibitors are first-line treatments for major depressive disorder; however, these drugs take several weeks to work…
[Editorial] Pandemic fans the flames of smoking and health inequity
During the COVID-19 pandemic, evidence suggests that fewer people are stopping smoking and more ex-smokers are relapsing. This finding is especially concerning because smokers are at a higher risk of severe disease and death if they become infected with SARS-CoV-2.
Bimekizumab versus Secukinumab in Plaque Psoriasis
The interleukin-17 isoforms interleukin-17A and interleukin-17F are implicated in the pathophysiology of psoriasis and are overexpressed in psoriatic tissue. These cytokines form homodimers and heterodimers (interleukin-17A/A, 17A/F, and 17F/F) that signal through the interleukin-17RA/RC receptor…
Partha Kar: “Phir Bhi Dil Hai Hindustani”—the anguish of the Indian diaspora
I have a strong sense of déjà vu, witnessing the scenes of carnage in India as covid rips through the country. Perhaps I’m feeling the pain more intensely because, having seen the impact that covid…
COVID-19 vaccines, hesitancy and mental health
‘None of us will be safe until everyone is safe. Global access to coronavirus vaccines, tests and treatments for everyone who needs them, anywhere, is the only way out’. This statement by Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO
Emerging roles of rare and low-frequency genetic variants in type 1 diabetes mellitus
Type 1 diabetes mellitus (T1DM) is defined as an autoimmune disorder and has enormous complexity and heterogeneity. Although its precise pathogenic mechanisms are obscure, this disease is widely acknowledged to be precipitated by environmental factors in individuals with genetic susceptibility.
Origins of human disease: the chrono-epigenetic perspective
Nature Reviews Genetics, Published online: 26 April 2021; doi:10.1038/s41576-021-00348-6 In this Perspective article, Oh and Petronis discuss emerging evidence of time-dependent patterns of DNA modification and describe how incorporating this ‘chrono-epigenetic’ perspective could add value and interpretability in human disease
[Editorial] UNAIDS strategy aligns HIV priorities with development goals
The UNAIDS 90-90-90 targets have drawn attention to the remaining 10% in each—people without access to tests, those who do not have access to treatment, and those who do not achieve viral suppression. All too often, those left behind comprise
Case 12-2021: A 78-Year-Old Man with a Rash on the Scalp and Face
Presentation of Case. Dr. Carolina Chiou (Ophthalmology): A 78-year-old man was admitted to this hospital because of a rash on the forehead and frontal scalp and edema of the left eyelids. The patient had been well until 3 days before
Bimekizumab versus Adalimumab in Plaque Psoriasis
The proinflammatory cytokines interleukin-12 and tumor necrosis factor (TNF) play roles in the pathogenesis of psoriasis. Additional involvement of interleukin-17 and interleukin-23 in the pathogenesis of this condition has been identified; however, TNF inhibitors remain a mainstay treatment for…
Covid-19: Wider use of FFP3 masks may needed because of airborne transmission, say scientific advisors
Staff caring for patients with suspected or confirmed covid-19 may need higher grade protective masks—such as FFP3 masks—to protect them from contracting covid-19 through the air, according to the…
Sacituzumab Govitecan in Metastatic Triple-Negative Breast Cancer
Patients with metastatic triple-negative breast cancer (defined by a lack of tumor-cell expression of the estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 [HER2]) have poor survival outcomes. Although immunotherapy has shown promising first-line clinical…
The effect of maternal body mass index on fetal ultrasound image quality
Striae and an Adrenal Mass
Figure 1.
Striae and an Adrenal Mass
Figure 1.
Competing risks model for prediction of small for gestational age neonates from biophysical markers at 19-24 weeks’ gestation
Antenatal identification of women at high-risk to deliver small for gestational age (SGA) neonates, may improve the management of the condition. The traditional but ineffective methods for SGA screening are the use of risk scoring systems based on maternal demographic
From LD-based mapping to GWAS
Nature Reviews Genetics, Published online: 23 April 2021; doi:10.1038/s41576-021-00366-4 Cisca Wijmenga reflects on a seminal publication by Houwen et al. that set the stage for genome-wide association studies and inspired her to dedicate her lab to complex trait genetics.
Audio Interview: Covid-19 Vaccines and Pregnancy — A Conversation with CDC Director Rochelle Walensky
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
Bimekizumab versus Secukinumab in Plaque Psoriasis
The interleukin-17 isoforms interleukin-17A and interleukin-17F are implicated in the pathophysiology of psoriasis and are overexpressed in psoriatic tissue. These cytokines form homodimers and heterodimers (interleukin-17A/A, 17A/F, and 17F/F) that signal through the interleukin-17RA/RC receptor…
Adrenal Incidentaloma
Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author’s clinical recommendations. Stage.
Nanima
“You are leaving?” she asked. “When will you come again?” “Soon,” I said. “I’ll be back soon, Nanima.” In my heart, I knew it wouldn’t be soon. In truth, I could only bear to visit her once every few months
Case 12-2021: A 78-Year-Old Man with a Rash on the Scalp and Face
Presentation of Case. Dr. Carolina Chiou (Ophthalmology): A 78-year-old man was admitted to this hospital because of a rash on the forehead and frontal scalp and edema of the left eyelids. The patient had been well until 3 days before
A Microbiota-Directed Food Intervention for Undernourished Children
Childhood undernutrition is a global health challenge that produces impaired ponderal and linear growth (wasting and stunting), immune and metabolic dysfunction, altered development of the central nervous system (CNS), and other abnormalities. Acute malnutrition in children is classified by the…
Bimekizumab versus Secukinumab in Plaque Psoriasis
The interleukin-17 isoforms interleukin-17A and interleukin-17F are implicated in the pathophysiology of psoriasis and are overexpressed in psoriatic tissue. These cytokines form homodimers and heterodimers (interleukin-17A/A, 17A/F, and 17F/F) that signal through the interleukin-17RA/RC receptor…
Disposable E-Cigarette Use among U.S. Youth — An Emerging Public Health Challenge
To the Editor: Previous increases in the use of electronic cigarettes (e-cigarettes) by youth were driven by multiple factors, including advertising, the use of appealing flavors, and the introduction of new devices with prefilled pods or cartridges and high nicotine
Timing of pacemaker and ICD implantation in LMNA mutation carriers
Aims LMNA-cardiomyopathy is often associated with pathology in the cardiac conduction system necessitating device implantations. The aim was to study the timing and types of device implantations and need for re-implantations in LMNA mutation carriers. Methods We studied the hospital
John Knowles Stanley
bmj;373/apr23_10/n1027/FAF1faJohn Knowles Stanley was born in Cardiff on 3 March 1944 but grew up in Oswestry in north Wales. From the Boys’ High School, he moved in 1962 to Liverpool University,…
Correction: Animation-supported consent for urgent angiography and angioplasty: a service improvement initiative
Wald DS, Casey-Gillman O, Comer K, et al. Animation-supported consent for urgent angiography and angioplasty: a service improvement initiative. Heart 2020;106:1747–51. doi:10.1136/heartjnl-2019-316227. This article has been corrected since it was first published. Author name Howie Teo has been updated to
“Dangling” Accelerated Approvals in Oncology
In 1992, an accelerated approval pathway for pharmaceutical products was added to the Code of Federal Regulations in an attempt to address unmet medical needs of patients with serious or life-threatening diseases. The pathway allows the Food and Drug Administration
Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons
The first coronavirus disease 2019 (Covid-19) vaccines available in the United States were messenger RNA (mRNA) vaccines: BNT162b2 (Pfizer–BioNTech) and mRNA-1273 (Moderna). In December 2020, the vaccines were granted Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA)
In Vitro Fertilization and Placenta Accreta Spectrum in pregnancies with a history of previous cesarean delivery
Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination
Coronavirus disease 2019 (Covid-19) has been associated with considerable morbidity and mortality. From the onset of the Covid-19 pandemic to March 2021, more than 126.8 million cases and 2.7 million deaths were documented worldwide. With unprecedented speed, vaccines against severe
Author Correction: Distinct dynamics and functions of H2AK119ub1 and H3K27me3 in mouse preimplantation embryos
Nature Genetics, Published online: 22 April 2021; doi:10.1038/s41588-021-00871-6 Author Correction: Distinct dynamics and functions of H2AK119ub1 and H3K27me3 in mouse preimplantation embryos
Preparing for the Future — Nanobodies for Covid-19?
Many had hoped that monoclonal antibody drugs would provide an important stopgap to the coronavirus disease 2019 (Covid-19) pandemic by limiting severe disease and thus the number of hospitalizations until safe and effective vaccines could be approved. Despite the emergency
A Microbiota-Directed Food Intervention for Undernourished Children
Childhood undernutrition is a global health challenge that produces impaired ponderal and linear growth (wasting and stunting), immune and metabolic dysfunction, altered development of the central nervous system (CNS), and other abnormalities. Acute malnutrition in children is classified by the…
Advancing President Biden’s Equity Agenda — Lessons from Disparities Work
As of January 20, 2021, the United States has a national policy aimed at addressing systemic racism. On his first day in office, President Joe Biden signed an executive order on advancing racial equity and supporting underserved communities. Under the
[Editorial] “In an ocean of ashes, islands of order”: WHO’s SARS-CoV-2 origin report
The highly anticipated WHO report on the origin of SARS-CoV-2 was released on March 30. 34 international and Chinese multidisciplinary experts reviewed hundreds of thousands of items of epidemiological, clinical, and genomic data, some dating back to 2015, and the
Tocilizumab in Hospitalized Patients with Severe Covid-19 Pneumonia
Coronavirus disease 2019 (Covid-19) has rapidly developed into a global health threat since emerging in China in late 2019. Severe Covid-19 pneumonia, which occurs in approximately 15% of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated
Nanima
“You are leaving?” she asked. “When will you come again?” “Soon,” I said. “I’ll be back soon, Nanima.” In my heart, I knew it wouldn’t be soon. In truth, I could only bear to visit her once every few months
[Editorial] 2021: the beginning of a new era of immunisations?
While the world is firmly focused on the efficacy, adverse events, licensing, and roll-out of COVID-19 vaccines, the disruption of and barriers to routine immunisations during the pandemic have garnered much less attention. World Immunization Week (April 24–30) presents an
Antidepressants: Evidence on safe discontinuation is lacking, concludes Cochrane review
Good quality evidence is urgently needed to inform doctors on how to discontinue antidepressants safely and effectively, a Cochrane review has highlighted.1An international team of researchers…
Does postoperative cognitive decline after coronary bypass affect quality of life?
Objective This study aimed to explore the influence of coronary artery bypass grafting (CABG) on both postoperative cognitive dysfunction and quality of life (QoL) and the association between the two patient-related outcomes. Methods In a prospective, observational cohort study, patients
Highlights from this issue
Long-term follow-up of cystinosis patients treated with 0.55% cysteamine hydrochloride (see page 608) Results from the French ATU cohort to confirm the safety, efficacy and tolerability in real-world clinical practice of a 0.55% cysteamine hydrochloride ophthalmic solution for cystinosis are
Risk-based oral cancer screening — lessons to be learnt
Nature Reviews Clinical Oncology, Published online: 21 April 2021; doi:10.1038/s41571-021-00511-2 The Kerala Oral Cancer Screening Trial did not demonstrate an overall cancer-related mortality benefit. Herein, we discuss the important lessons learnt from a recent reanalysis of data from this trial
[Editorial] COVID-19 vaccines: building and maintaining confidence
As COVID-19 vaccines are rolled out globally, the AstraZeneca vaccine (Vaxzevria) continues to be marred in controversy, from its slow and still awaited approval by the US Food and Drug Administration amid concerns about paucity of large-scale trial data from
Effectiveness of Chlamydia Trachomatis expedited partner therapy in pregnancy
Expedited partner therapy for chlamydia trachomatis has had mixed efficacy in different populations, but data are lacking on the efficacy in a pregnant population.
Emerging causes and risk factors of heart failure: amyloidosis, myocarditis, immune checkpoint inhibitors, air pollution, and visceral adipose tissue
“Dangling” Accelerated Approvals in Oncology
In 1992, an accelerated approval pathway for pharmaceutical products was added to the Code of Federal Regulations in an attempt to address unmet medical needs of patients with serious or life-threatening diseases. The pathway allows the Food and Drug Administration
Vaccine Breakthrough Infections with SARS-CoV-2 Variants
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections caused more than 83 million known cases of coronavirus disease 2019 (Covid-19) by the end of 2020, but tremendous progress has been made with the authorization and deployment of vaccines and antibody
Loss of TREM2 facilitates tau accumulation, spreading, and brain atrophy, but only in the presence of amyloid pathology
TREM2 variants increase the risk for Alzheimer’s disease. In this issue of Neuron, Lee et al. demonstrate that TREM2-dependent microglial functions prevent accumulation and spreading of tau, but only in the presence of amyloid pathology. This provides additional fuel for the
[Editorial] Better care for people living with dementia in the USA
The care needs of people with dementia are complex and vary with type of dementia, personal circumstances and preferences, and disease stage. In general, care has improved over the past few decades, with better recognition of dementia as distinct from
Back to the Future — The Therapeutic Potential of Psychedelic Drugs
In The Doors of Perception, Aldous Huxley described his trial of mescaline as “the most extraordinary and significant experience available to human beings this side of the Beatific Vision.” His exegesis was preceded by the synthesis of the hallucinogen lysergic
SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia
The coronavirus disease 2019 (Covid-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulated the development of highly effective vaccines that were produced with unprecedented speed with the use of diverse technologies. No major safety warnings, other than
Back to the Future — The Therapeutic Potential of Psychedelic Drugs
In The Doors of Perception, Aldous Huxley described his trial of mescaline as “the most extraordinary and significant experience available to human beings this side of the Beatific Vision.” His exegesis was preceded by the synthesis of the hallucinogen lysergic
Covid-19: Is the UK heading towards mandatory vaccination of healthcare workers?
Why is mandatory vaccination in the news?Leaders at Chelsea and Westminster Hospital Foundation Trust have been discussing making covid-19 vaccination a contractual requirement for all staff, in a…
Risk stratification of adults with congenital heart disease during the COVID-19 pandemic: insights from a multinational survey among European experts
Objective Adults with congenital heart disease (ACHD) may be at a higher risk of a fatal outcome in case of COVID-19. Current risk stratification among these patients relies on personal experience and extrapolation from patients with acquired heart disease. We
Highlights from this issue
In deference to the equivocal A common (if not universal) human phenotype is the need for an answer—ideally a definitive, dichotomous one—a yes/no with no shades of grey. I don’t take sides on this nor am I being deliberately Machiavellian—conclusive
Highlight from this issue
This edition of the Emergency Medicine Journal has ‘something for everyone’ (as always), and at least one article that will be of interest to everyone (I think). The two main themes in this edition are ‘the difficult airway’ and Paediatric
Copanlisib safe and active in combination
Nature Reviews Clinical Oncology, Published online: 20 April 2021; doi:10.1038/s41571-021-00512-1 Copanlisib safe and active in combination
SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia
The coronavirus disease 2019 (Covid-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulated the development of highly effective vaccines that were produced with unprecedented speed with the use of diverse technologies. No major safety warnings, other than
SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia
The coronavirus disease 2019 (Covid-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulated the development of highly effective vaccines that were produced with unprecedented speed with the use of diverse technologies. No major safety warnings, other than
Omitted Decimal Point
In the Review titled “Diagnosis and Treatment of Irritable Bowel Syndrome: A Review,” published in the March 2, 2021, issue of JAMA, a decimal point was omitted in the description of the number of endoscopic procedures reported in a reference
All intensive care patients must have access to community rehabilitation, leaders urge
Rehabilitation leaders have called for the government to ensure that all intensive care patients are provided with “comprehensive multidisciplinary community rehabilitation” after they are discharged…
Cardiovascular risk factors and autonomic indices in relation to fatal and non-fatal coronary events
Objective Mortality caused by coronary artery disease has markedly decreased in recent years. However, a substantial proportion of patients suffering a coronary event (CE) die within the first day, most of them out of hospital. We aimed to investigate how
Exploring the relationship between gut microbiota and exercise: short-chain fatty acids and their role in metabolism
The human body is host to a multitude of bacteria, fungi, viruses and other species in the intestine, collectively known as the microbiota. Dietary carbohydrates which bypass digestion and absorption are broken down and fermented by the microbiota to produce
Ischaemic limb injury and autoamputation complicating peripheral cannula insertion
A preterm male infant was born at 26+0 weeks of gestation via caesarian section due to pre-eclampsia. Birth weight was 560 g (intrauterine growth restriction). He was vigorous at birth and was transferred to the neonatal intensive care unit with
Novel approaches to target the microenvironment of bone metastasis
Nature Reviews Clinical Oncology, Published online: 19 April 2021; doi:10.1038/s41571-021-00499-9 Various cancers can disseminate to the bone, including the most common malignancies in men and women, prostate and breast cancer, respectively. Herein, the authors review the roles of the bone
MeDiGes Study. Metformin versus insulin in gestational diabetes: Glycemic control, and obstetrical and perinatal outcomes. Randomized prospective trial.
Gestational diabetes not properly controlled with diet has been commonly treated with insulin. In recent years several studies have published that metformin can lead to, at least, similar obstetrical and perinatal outcomes as insulin. Nevertheless, not all clinical guidelines endorse
Large-scale sequencing of flatfish genomes provides insights into the polyphyletic origin of their specialized body plan
Nature Genetics, Published online: 19 April 2021; doi:10.1038/s41588-021-00836-9 Analysis of 11 flatfish genomes indicates that Pleuronectoidei and Psettodoidei are not a monophyletic group. Genomic and transcriptomic data suggest that the WNT and RA pathways played a role in the evolution
Statistical mechanics meets single-cell biology
Nature Reviews Genetics, Published online: 19 April 2021; doi:10.1038/s41576-021-00341-z In this Perspective, Teschendorff and Feinberg describe how single-cell analysis methods based on statistical mechanics can provide valuable insights into developmental phenomena, such as differentiation potency and lineage trajectories, as well
Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination
Coronavirus disease 2019 (Covid-19) has been associated with considerable morbidity and mortality. From the onset of the Covid-19 pandemic to March 2021, more than 126.8 million cases and 2.7 million deaths were documented worldwide. With unprecedented speed, vaccines against severe
Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination
Coronavirus disease 2019 (Covid-19) has been associated with considerable morbidity and mortality. From the onset of the Covid-19 pandemic to March 2021, more than 126.8 million cases and 2.7 million deaths were documented worldwide. With unprecedented speed, vaccines against severe
[Editorial] Trust and transparency
Medicine is a practice built on trust—from patients and from society in general—and this is especially true for psychiatry, in which trust has been forfeited in the past. Transparency is the foundation stone of trust. In research, this can be
Trial of Psilocybin versus Escitalopram for Depression
Major depressive disorder affects approximately 10% of the general population in the United Kingdom, impairs patients’ lives, and is costly to society. Selective serotonin-reuptake inhibitors are first-line treatments for major depressive disorder; however, these drugs take several weeks to work…
Birmingham council sets up task force to tackle high rate of infant mortality
A task force has been set up to tackle the high rate of neonatal mortality in Birmingham, which experts believe is linked to ethnicity and deprivation.The move by Birmingham City Council follows a…
Anti-inflammatory activity of ivermectin in late-stage COVID-19 may reflect activation of systemic glycine receptors
The effects of alcohol consumption and its associations with disease activity among 979 patients with inflammatory arthritis
Objective The role of alcohol in inflammatory disease remains debated. This study explores the relationship between alcohol and disease activity in patients with inflammatory arthritis. Methods Patients attending a rheumatology clinic between 2010 and 2020 were prospectively followed. Information on
Erratum to “Cancer statistics, 2021”
CA: A Cancer Journal for Clinicians, EarlyView.
It is Women & Sports at #sportfisio2021
The Swiss Sports Physiotherapy Association (SSPA) will hold—hopefully—its 19th annual conference on 19 November 2021 in Bern, capital of Switzerland and home of this event since 2005 (figure 1). The goal of SSPA has always been to organise a high-quality
Perils of hidden depths
Clinical question A man in his 60s presented with lower urinary tract symptoms. His serum prostate-specific antigen level was 6 ng/mL. A prostate biopsy was performed (figure 1). What is your diagnosis? Acinar adenocarcinoma. Benign. High-grade prostatic intraepithelial neoplasia. Intraductal
Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination
Coronavirus disease 2019 (Covid-19) has been associated with considerable morbidity and mortality. From the onset of the Covid-19 pandemic to March 2021, more than 126.8 million cases and 2.7 million deaths were documented worldwide. With unprecedented speed, vaccines against severe
Trial of Psilocybin versus Escitalopram for Depression
Major depressive disorder affects approximately 10% of the general population in the United Kingdom, impairs patients’ lives, and is costly to society. Selective serotonin-reuptake inhibitors are first-line treatments for major depressive disorder; however, these drugs take several weeks to work…
Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination
Coronavirus disease 2019 (Covid-19) has been associated with considerable morbidity and mortality. From the onset of the Covid-19 pandemic to March 2021, more than 126.8 million cases and 2.7 million deaths were documented worldwide. With unprecedented speed, vaccines against severe
January 2021 (vol. 224, no. 1, pages 62.e1 and 62.e13)
Vesco KK, Leo MC, Bulkley JE, et al. Improving management of the genitourinary syndrome of menopause: evaluation of a health system–based, cluster-randomized intervention. Am J Obstet Gynecol 2021;224:62.e1-13.
SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia
The coronavirus disease 2019 (Covid-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulated the development of highly effective vaccines that were produced with unprecedented speed with the use of diverse technologies. No major safety warnings, other than
Correction: Upper respiratory viral load in asymptomatic individuals and mildly symptomatic patients with SARS-CoV-2 infection
Ra SH, Lim JS, Kim G, et al. Upper respiratory viral load in asymptomatic individuals and mildly symptomatic patients with SARS-CoV-2 infection. Thorax 2021;76:61–63. The author affiliation of Sang Hyun Ra, Min Jae Kim, Jiwon Jung and Sung-Han Kim should
Precision oncology in metastatic colorectal cancer — from biology to medicine
Nature Reviews Clinical Oncology, Published online: 16 April 2021; doi:10.1038/s41571-021-00495-z Progress in precision medicine for colorectal cancer continues to lag behind the rapid improvements seen in patients with certain other solid tumour types. Nonetheless, owing largely to the availability of
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Figure 1.
Gestational Diabetes and Fetal Growth in Twin compared with Singleton Pregnancies
Gestational diabetes (GDM) is associated with accelerated fetal growth in singleton pregnancies, but may impact twin pregnancies differently due to the slower growth of twin fetuses during the third trimester and their greater predisposition to fetal growth restriction.
Disarming defences for pest control
Nature Reviews Genetics, Published online: 16 April 2021; doi:10.1038/s41576-021-00364-6 Xia et al. highlight an unexpected horizontal gene transfer event, whereby the sweet potato whitefly has harnessed a host plant detoxification mechanism to resist its defences.
SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia
The coronavirus disease 2019 (Covid-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulated the development of highly effective vaccines that were produced with unprecedented speed with the use of diverse technologies. No major safety warnings, other than
Back to the Future — The Therapeutic Potential of Psychedelic Drugs
In The Doors of Perception, Aldous Huxley described his trial of mescaline as “the most extraordinary and significant experience available to human beings this side of the Beatific Vision.” His exegesis was preceded by the synthesis of the hallucinogen lysergic
SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia
The coronavirus disease 2019 (Covid-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulated the development of highly effective vaccines that were produced with unprecedented speed with the use of diverse technologies. No major safety warnings, other than
Update in imaging of cancer therapy-related cardiac toxicity in adults
Over the past decades, prognosis of patients with cancer has strongly improved and the number of cancer survivors is rapidly growing. Despite this success, cancer treatment is associated with development of serious cardiovascular diseases including left ventricular (LV) systolic dysfunction,
Specific imaging features of intestinal perforation on supine abdominal X-ray evaluation in infants with necrotizing enterocolitis
Background Necrotizing enterocolitis (NEC) is associated with high mortality and morbidity in neonates. For infants with NEC, intestinal perforation is the most serious complication, and confirming perforation and performing radical surgical treatment as early as possible may reduce mortality and
Covid-19: US reports low rate of new infections in people already vaccinated
The US Centers for Disease Control and Prevention knows of about 5800 “breakthrough” infections of SARS-CoV-2 so far among the roughly 77 million people in the country who have been fully vaccinated,…
Putting the ‘Eye in Spirochaetes
In 2018, the Centers for Disease Control and Prevention reported an alarming increase in syphilis infection rates, and the numbers have continued to rise since, with rates highest in men who have sex with men (MSM). Ocular syphilis, often seen
Targeting ZNF410 as a potential β-hemoglobinopathy therapy
Nature Genetics, Published online: 15 April 2021; doi:10.1038/s41588-021-00817-y The nucleosome remodeling and deacetylase (NuRD) complex is a chromatin modifier with a key role in the switch from fetal to adult hemoglobin. In a new study, Vinjamur et al. identify a
Neutralizing Activity of BNT162b2-Elicited Serum
To the Editor: BNT162b2 is a nucleoside-modified RNA vaccine expressing the full-length prefusion spike glycoprotein (S) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In a randomized, placebo-controlled clinical trial involving approximately 44,000 participants, immunization…
Prediction of preeclampsia throughout gestation with maternal characteristics and biophysical and biochemical markers: a longitudinal study
The current approach to predict preeclampsia combines maternal risk factors and evidence from biophysical markers (mean arterial pressure, Doppler velocimetry of the uterine arteries) and maternal blood proteins (placental growth factor, soluble vascular endothelial growth factor receptor-1, pregnancy-associated plasma protein
Hypothermic Machine Perfusion in Liver Transplantation — A Randomized Trial
Nonanastomotic biliary strictures are a major complication after liver transplantation, resulting in cholestasis and cholangitis and, frequently, in the use of biliary interventions or even retransplantation (i.e. transplantation of a new liver graft and removal of the first graft). The
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Figure 1.
Hypothermic Machine Perfusion in Liver Transplantation — A Randomized Trial
Nonanastomotic biliary strictures are a major complication after liver transplantation, resulting in cholestasis and cholangitis and, frequently, in the use of biliary interventions or even retransplantation (i.e. transplantation of a new liver graft and removal of the first graft). The
BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting
Mass vaccination campaigns using newly approved vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are beginning in many parts of the world. Randomized clinical trials of mRNA-based vaccines reported efficacies for preventing coronavirus 2019 (Covid-19) in the range…
Insights into Glomerular Filtration and Albuminuria
Chronic kidney diseases affect more than 10% of the world’s population, and most cases arise from disorders of the kidney’s filtration barrier, which is located within a million microvascular units called glomeruli. Although it has been known for many decades
Lack of evidence for a role of PIWIL1 variants in human male infertility
Infertility affects one in six couples, half of which is explained by a male factor (Tüttelmann et al., 2018). While thousands of genes are involved in spermatogenesis, there is a lack of diagnostically relevant genes. Critical evaluation of newly reported candidate
[Editorial] The ACT Accelerator: heading in the right direction?
April 24, 2021, marks 1 year since the formation of the Access to COVID-19 Tools Accelerator (ACT-A) partnership. Its mission is to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines, which is central to ending
Back to the Future — The Therapeutic Potential of Psychedelic Drugs
In The Doors of Perception, Aldous Huxley described his trial of mescaline as “the most extraordinary and significant experience available to human beings this side of the Beatific Vision.” His exegesis was preceded by the synthesis of the hallucinogen lysergic
Unilateral nipple rash in a man
A man in his 50s was referred to the breast surgery clinic with a one month history of an exudating, oedematous, itchy right nipple-areolar complex. He had experienced hay fever in the past but…
COVID-19: are not all workers ‘essential?
During the current COVID-19 pandemic ‘essential’ workers have been praised daily by the mass media (and even applauded from balconies) as (involuntary) ‘heroes’ of our society. But who are they? The International Labour Organization has estimated that globally, there are
Correction: Brain iron deposition is linked with cognitive severity in Parkinsons disease
Thomas GEC, Leyland LA, Schrag A, et al. Brain iron deposition is linked with cognitive severity in Parkinson’s disease. J Neurol Neuro Psychiatry 2020;91:418-425. Instead of p maps as inputs to generate the FDR thresholds, raw T maps were erroneously
Detemir versus Neutral Protamine Hagedorn Insulin for Diabetes Mellitus in Pregnancy: A Comparative-Effectiveness, Randomized Controlled Trial
Insulin detemir, being used increasingly during pregnancy, may have pharmacological benefits compared to neutral protamine Hagedorn (NPH).
Old and new enemies: psychological stress, occupational stress, COVID-19, and a glimpse of the future
[Editorial] Addressing health disparities: no time like the present
Since its inception more than 70 years ago, World Health Day, on April 7, has aimed to raise awareness of a specific health theme of concern to WHO, and to launch an action policy plan. This year’s campaign focuses on
[Editorial] Endemic violence against women and girls
An outpouring of anger marked March, 2021, as thousands took to the streets to protest violence and discrimination against women. The contexts varied hugely across settings such as Turkey, Australia, Mexico, the UK, and the USA, but the frustration was
Covid-19: India authorises Sputnik V vaccine as cases soar to more than 180 000 a day
India has seen a sharp rise in new coronavirus infections with more than 180 000 a day recorded in mid-April, up from 10 000 cases a day in early February. To date there have been around 13.9 million…
Author Correction: Enhancer redundancy in development and disease
Nature Reviews Genetics, Published online: 13 April 2021; doi:10.1038/s41576-021-00361-9 Author Correction: Enhancer redundancy in development and disease
Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination
Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are the most important countermeasure to fight the coronavirus 2019 (Covid-19) pandemic. From December 2020 through March 2021, the European Medicines Agency approved four vaccines on the basis of randomized, blinded,…
Development of the Person-Centered Prenatal Care scale for People of Color
Given stark disparities in maternal mortality and adverse birth outcomes among Black, Indigenous, and other people of color, there is a need to better understand and measure how individuals from these communities experience their care during pregnancy.
A “KU” new sensor for cytosolic DNA in T cells
Adaptive immune cells are usually not equipped with pattern recognition receptors. In this issue of Immunity, Wang et al. revealed an “innate-like” cytosolic DNA-sensing mechanism by the KU complex in aged CD4+ T cells, which exacerbates aging-related autoimmunity.
Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination
Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are the most important countermeasure to fight the coronavirus 2019 (Covid-19) pandemic. From December 2020 through March 2021, the European Medicines Agency approved four vaccines on the basis of randomized, blinded,…
Teplizumab Improves Beta Cell Function, Delays Type 1 Diabetes
The investigational monoclonal antibody teplizumab improved beta cell function among high-risk relatives of individuals with type 1 diabetes in a phase 2 randomized clinical trial, according to extended follow-up data published in Science Translational Medicine. A previously reported delay in
The cause of obesity is multifactorial but GPs can do more
Though the causes and ways to treat obesity are many,1 the medical profession in general, and GPs in particular, can do more to tackle the problem. Adiposity now accounts for more deaths in England…
Air pollution and childrens health: where next?
New FSRH guideline on the progestogen-only implant
The UK Faculty of Sexual & Reproductive Healthcare (FSRH) has updated its 2014 guideline1 on the progestogen-only implant, reexamining old evidence, reflecting new evidence and highlighting changes in practice. While much remains unchanged, important new information and guidance is provided
Less nonsense upon stilts: the analysis of rights in medical ethics
Bentham’s famous remark was a response to the assertation of natural (or human) rights that did not depend on law or some other foundation for their normative force.1 Whatever we make of that claim, it flags a problem for making
Self-organization in cancer: Implications for histopathology, cancer cell biology, and metastasis
Pathologists use histological features to classify tumors and assign site of origin for metastasis. How and why tumors organize the way they do and recreate their histological organization during metastasis is unknown. Here, I discuss the concept of “histostasis” conferring
Lenvatinib plus Pembrolizumab or Everolimus for Advanced Renal Cell Carcinoma
First-line treatment with vascular endothelial growth factor receptor tyrosine kinase inhibitors has been shown to provide benefits for patients with advanced renal cell carcinoma, but most patients have disease relapse as resistance develops. Treatment with immune-checkpoint inhibitors, either as…
Minor intron retention drives clonal hematopoietic disorders and diverse cancer predisposition
Nature Genetics, Published online: 12 April 2021; doi:10.1038/s41588-021-00828-9 Loss of function of the minor spliceosome component ZRSR2 enhances hematopoietic stem cell self-renewal through minor intron retention of its target LZTR1, which is a regulator of RAS-related GTPases. Minor intron retention
[Editorial] Removing barriers to living organ donation
In 2020, almost 15% of organ donations in the USA came from living donors. Most of these were kidney or liver donations, which are the organs in highest demand: approximately 84% of patients on the US transplant waiting list are
Reporting of AstraZeneca studies may have caused vaccine reservations
Abbasi asks whether the negativity towards the AstraZeneca vaccine in the European Union is a political hangover from Brexit.1 I think the initial reservations were related to the way the results…
Severe liver trauma among pediatric patients in the Japan Trauma Registry
Background Limited information exists regarding the clinical characteristics, management practices, and outcomes of pediatric patients with liver injury in Japan. The aim of this study is to evaluate the characteristics, management, and outcome of pediatric patients with liver injury in
Surgical treatment for infective endocarditis in the ageing society: a nationwide retrospective study in Japan
Objective The current status of surgical treatment for infective endocarditis (IE) among very elderly people is unclear. Methods We extracted data on patients in Japan with community-acquired IE who were admitted and discharged between April 2010 and February 2018 using
Ethical dilemmas and validity issues related to the use of new cooling technologies and early recognition of exertional heat illness in sport
The Tokyo 2020 Olympic Games is expected to be among the hottest Games in modern history, increasing the chances for exertional heat stroke (EHS) incidence, especially in non-acclimatised athletes/workers/spectators. The urgent need to recognise EHS symptoms to protect all attendees’
COVID-19 in patients with rheumatological diseases treated with anti-TNF
We have read with great interest the recent article from Silva et al about the clinical course of COVID-19 in rheumatic disease.1 In this matched cohort study of patients with COVID-19 infection, although the authors found a similar proportion of
Heartbeat: racial and ethnic healthcare disparities in cardiovascular care
Racial and ethnic healthcare disparities in cardiovascular care have been magnified during the COVID-19 pandemic. In this issue of Heart, Rashid and colleagues1 compared admission rates, treatment and mortality of black, Asian and minority ethnic (BAME) patients with acute myocardial
Vestibular Schwannomas
Vestibular schwannomas account for 8% of all intracranial tumors and are the most common neoplasm of the cerebellopontine angle in adults. These tumors derive from myelinating Schwann cells of the vestibular division of the vestibulocochlear (eighth cranial) nerve. The term
Metabolic Syndrome in Obesity: Treatment Success and Adverse Pregnancy Outcomes with Ovulation Induction in Polycystic Ovary Syndrome
Obesity is common in women with polycystic ovary syndrome (PCOS). PCOS and obesity are associated with reduced fertility. Metabolic syndrome’s (MetS) effect on infertility treatment success and pregnancy outcomes in women with PCOS undergoing ovulation induction (OI) has not been
Remote Patient Monitoring — Overdue or Overused?
The Covid-19 pandemic has challenged clinicians to find innovative ways to provide essential services while minimizing risks for themselves and their patients. These approaches increasingly leverage remote patient monitoring (RPM), using technology to support treatment for chronic conditions. As…
Remote Patient Monitoring — Overdue or Overused?
The Covid-19 pandemic has challenged clinicians to find innovative ways to provide essential services while minimizing risks for themselves and their patients. These approaches increasingly leverage remote patient monitoring (RPM), using technology to support treatment for chronic conditions. As…
Oncolytic HSV-1 G207 Immunovirotherapy for Pediatric High-Grade Gliomas
Malignant high-grade glioma accounts for 8 to 10% of pediatric brain tumors and is regularly fatal, with a rapid course. Survival rates have not improved in 30 years; the 3-year event-free survival among patients with newly diagnosed tumors who are
Closed Gastroschisis
In a male neonate born at 37 weeks of gestation, a narrow stalk of small bowel and proximal colon protruded through a 1.5-cm defect in the abdominal wall. A diagnosis of gastroschisis had been made antenatally on the basis of
The risks of recurrent small for gestational age infants at term is dependent on the number of previous affected births
Small-for-gestational age (SGA) infants are at significantly increased risk of perinatal complications, but the risk of recurrent SGA is not well known, particularly as there are many demographic and obstetric factors that interact and modify this risk. We investigated the
Race, Policing, and History — Remembering the Freedom House Ambulance Service
Americans protesting violent policing of Black communities are calling for law-enforcement budgets to be reallocated to community health services. Although such proposals are sometimes dismissed as naive or unrealistic, history provides an example of a transfer of power and resources
Remote Patient Monitoring — Overdue or Overused?
The Covid-19 pandemic has challenged clinicians to find innovative ways to provide essential services while minimizing risks for themselves and their patients. These approaches increasingly leverage remote patient monitoring (RPM), using technology to support treatment for chronic conditions. As…
Closed Gastroschisis
In a male neonate born at 37 weeks of gestation, a narrow stalk of small bowel and proximal colon protruded through a 1.5-cm defect in the abdominal wall. A diagnosis of gastroschisis had been made antenatally on the basis of
Remote Patient Monitoring — Overdue or Overused?
The Covid-19 pandemic has challenged clinicians to find innovative ways to provide essential services while minimizing risks for themselves and their patients. These approaches increasingly leverage remote patient monitoring (RPM), using technology to support treatment for chronic conditions. As…
Society for Maternal-Fetal Medicine Special Statement: Maternal-fetal medicine subspecialist survey on abortion training and service provision
Following a collaborative workshop at the 39th Annual Pregnancy Meeting, the Society for Maternal-Fetal Medicine Reproductive Health Advisory Group identified a need to assess attitudes of maternal-fetal medicine subspecialists about abortion services and available resources at the local and regional
Linking human sympathoadrenal development and neuroblastoma
Nature Genetics, Published online: 08 April 2021; doi:10.1038/s41588-021-00845-8 Cells resembling human fetal adrenal neuroblasts have been identified as major neuroblastoma cancer cells through single-cell mRNA comparison. Tumor risk stratification correlates with the differentiation of neuroblast-like neuroblastoma cells.
Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality
Concern over the health effects of poor-quality carbohydrate foods and beverages has increased the popularity of so-called low-carbohydrate diets. Poor-quality carbohydrate foods include those that contain a low amount of fiber, a higher percentage of refined grains than whole grains,
Vancomycin Infusion Reaction — Moving beyond “Red Man Syndrome”
In 1959, an article entitled “An Anaphylactoid Reaction to Vancomycin” hypothesized that vancomycin-induced histamine release from mast cells had clinical manifestations similar to those of anaphylaxis but less severe. The author named this reaction “Red Man Syndrome,” reflecting the diffuse…
Vancomycin Infusion Reaction — Moving beyond “Red Man Syndrome”
In 1959, an article entitled “An Anaphylactoid Reaction to Vancomycin” hypothesized that vancomycin-induced histamine release from mast cells had clinical manifestations similar to those of anaphylaxis but less severe. The author named this reaction “Red Man Syndrome,” reflecting the diffuse…
Audio Interview: Antibody Responses to Natural Infection and Vaccination
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
Beyond the Rubble of Lake Street — Minds in Crisis in a City in Crisis
It is May 2020 in Minneapolis. Covid-19 reached us a few months ago, bringing daily routines to a halt. The few cars on the roads speed by, but the city is hushed. We are still wearing sweaters indoors, biding our
Covid-19 vaccines save lives
At the time of writing, over 500 million doses of vaccines to combat SARS-CoV-2 have been delivered worldwide. Not every country has received an equal share, however. The differences in rollout have…
Registration trials in countries without access to US standards of care — pitfalls of interpretation
Nature Reviews Clinical Oncology, Published online: 08 April 2021; doi:10.1038/s41571-021-00506-z Data from several trials support the efficacy of first-line tyrosine-kinase inhibitors combined with immune-checkpoint inhibitors (ICIs) in metastatic renal cell carcinoma. However, whether combining these drugs is preferable to using
Lenvatinib plus Pembrolizumab or Everolimus for Advanced Renal Cell Carcinoma
First-line treatment with vascular endothelial growth factor receptor tyrosine kinase inhibitors has been shown to provide benefits for patients with advanced renal cell carcinoma, but most patients have disease relapse as resistance develops. Treatment with immune-checkpoint inhibitors, either as…
Guiding authors to Open Access
Nature Genetics, Published online: 08 April 2021; doi:10.1038/s41588-021-00853-8 Guided Open Access is a new publishing option offered at Nature Genetics. Authors can submit once and be simultaneously considered by three journals. Editorial collaboration and a single submission system combine to
Base Editing in Progeria
“How much longer?” is a question all too familiar to parents. This is also a question that scientists ask themselves when trying to find a truly effective treatment for patients with the Hutchinson–Gilford progeria syndrome (HGPS) and other genetic diseases.
Purple Tomatoes, Black Rice and Food Security
Nature Reviews Genetics, Published online: 08 April 2021; doi:10.1038/s41576-021-00359-3 Qifa Zhang describes how a 2008 publication in Nature Biotechnology on transgenic purple tomatoes inspired him to tackle food security by improving the nutrient and culinary value of black rice.
A Pivotal Paradigm Shift: Group Care Challenges Racial Bias in Maternity Care
Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality
Concern over the health effects of poor-quality carbohydrate foods and beverages has increased the popularity of so-called low-carbohydrate diets. Poor-quality carbohydrate foods include those that contain a low amount of fiber, a higher percentage of refined grains than whole grains,
Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality
Concern over the health effects of poor-quality carbohydrate foods and beverages has increased the popularity of so-called low-carbohydrate diets. Poor-quality carbohydrate foods include those that contain a low amount of fiber, a higher percentage of refined grains than whole grains,
Case 10-2021: A 70-Year-Old Man with Depressed Mood, Unsteady Gait, and Urinary Incontinence
Presentation of Case. Dr. James W. Luccarelli (Psychiatry): A 70-year-old man with bipolar disorder was evaluated at this hospital because of depressed mood, suicidal ideation, and gait disturbance. The patient had a long history of depressive episodes, with two previous
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