It’s all around you, especially if you venture into the world of social media: GPs against hospital specialists, hospital specialists against GPs, and specialists against one another. Everyone is…
Vaginal preparation with povidone iodine or chlorhexidine before hysterectomy: a propensity score matched analysis
To compare rates of postoperative infectious complications and hospital utilization with preoperative vaginal preparation using povidone iodine or chlorhexidine prior to hysterectomy.
The bowfin genome illuminates the developmental evolution of ray-finned fishes
Nature Genetics, Published online: 30 August 2021; doi:10.1038/s41588-021-00914-y Analysis of a chromosome-level bowfin genome assembly sheds light into neopterygian fish evolution. Chromatin accessibility and gene expression profiling provides insight into bowfin embryonic development.
Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation
The prognosis in patients who have out-of-hospital cardiac arrest is poor, with a mortality of up to 65% even among those who undergo successful resuscitation and admission to the hospital. Acute coronary syndrome accounts for up to 60% of out-of-hospital
Can Salt Substitution Save At-Risk Persons from Stroke?
For decades, opinions about the degree to which sodium intake affects the blood pressure level and the risk of adverse effects such as stroke have been varied, even partisan. Much relevant data have shown an association between high dietary sodium
Moving the Goalposts for Blood Pressure — Time to Act
We often lament the lack of confirmatory studies that can either reassure us all that the previous evidence for a trialed intervention is robust or indicate that the evidence is questionable. Zhang and colleagues have conducted such a study —
Can Salt Substitution Save At-Risk Persons from Stroke?
For decades, opinions about the degree to which sodium intake affects the blood pressure level and the risk of adverse effects such as stroke have been varied, even partisan. Much relevant data have shown an association between high dietary sodium
Change in cardiovascular risk assessment tool and updated Norwegian guidelines for cardiovascular disease in primary prevention increase the population proportion at risk: the Tromso Study 2015-2016
Aims To compare the population proportion at high risk of cardiovascular disease (CVD) using the Norwegian NORRISK 1 that predicts 10-year risk of CVD mortality and the Norwegian national guidelines from 2009, with the updated NORRISK 2 that predicts 10-year
Can Salt Substitution Save At-Risk Persons from Stroke?
For decades, opinions about the degree to which sodium intake affects the blood pressure level and the risk of adverse effects such as stroke have been varied, even partisan. Much relevant data have shown an association between high dietary sodium
Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes
Chronic kidney disease (CKD) exacerbates the cardiovascular risk associated with type 2 diabetes. The risks of cardiovascular events and new-onset heart failure increase as the urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) exceeds 10
The Fundamentals of Vaginal Surgery pilot study: developing, validating, and setting proficiency scores for a vaginal surgical skills simulation system
Surgical training in the simulation lab can develop basic skills that translate to the operating room. Standardized, basic skills programs that are supported by validated assessment measures exist for open, laparoscopic, and endoscopic surgery; however, there is yet to be
The Evolving Post-PCI Antithrombotic Therapies
Prolonged dual antiplatelet therapy is the treatment of choice for patients with an acute coronary syndrome who have undergone percutaneous coronary intervention (PCI) with a drug-eluting stent. The rationale is anchored in the understanding that drug-eluting stents impair the vascular
Edoxaban versus Vitamin K Antagonist for Atrial Fibrillation after TAVR
Atrial fibrillation occurs in approximately 33% of patients after transcatheter aortic-valve replacement (TAVR), and oral anticoagulation is generally recommended as treatment. Non–vitamin K oral anticoagulants are frequently used for this purpose instead of vitamin K antagonists. The effects of…
Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes
Chronic kidney disease (CKD) exacerbates the cardiovascular risk associated with type 2 diabetes. The risks of cardiovascular events and new-onset heart failure increase as the urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) exceeds 10
Adjuvant pembrolizumab shows promise
Nature Reviews Clinical Oncology, Published online: 27 August 2021; doi:10.1038/s41571-021-00554-5 Adjuvant pembrolizumab shows promise
Society for Maternal-Fetal Medicine (SMFM) Consult Series #59: The use of analgesia and anesthesia for maternal-fetal procedures
Pain is a complex phenomenon that involves more than a simple physical response to external stimuli. In maternal-fetal surgical procedures, fetal analgesia is used primarily to blunt fetal autonomic responses and minimize fetal movement. The purpose of this Consult is
Triple Therapy for Cystic Fibrosis Phe508del–Gating and –Residual Function Genotypes
Cystic fibrosis is a life-shortening autosomal recessive disease that affects more than 80,000 people worldwide. In cystic fibrosis, deficiencies in the cystic fibrosis transmembrane conductance regulator (CFTR) protein, an epithelial anion channel, manifest as a complex multiorgan disease,…
Controversy and Progress in Alzheimer’s Disease — FDA Approval of Aducanumab
On June 7, 2021, the Food and Drug Administration (FDA) granted accelerated approval to aducanumab (Aduhelm) for treatment of Alzheimer’s disease. In many respects, this move represents a landmark moment: not only is aducanumab the first drug approved for Alzheimer’s
Revisiting FDA Approval of Aducanumab
On June 7, 2021, the Food and Drug Administration (FDA) granted accelerated approval to aducanumab (Aduhelm) for treatment of Alzheimer’s disease. The approval marked the culmination of a highly unusual regulatory process that we observed as members of the FDA’s
An Appropriate Use of Accelerated Approval — Aducanumab for Alzheimer’s Disease
To the Editor: Although we agree with the Perspective article by Alexander et al. that the results of the clinical trials of aducanumab for Alzheimer’s disease were complicated — and leave some residual uncertainty regarding clinical benefit — we don’t
Controversy and Progress in Alzheimer’s Disease — FDA Approval of Aducanumab
On June 7, 2021, the Food and Drug Administration (FDA) granted accelerated approval to aducanumab (Aduhelm) for treatment of Alzheimer’s disease. In many respects, this move represents a landmark moment: not only is aducanumab the first drug approved for Alzheimer’s
Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19
In some patients, the clinical course of coronavirus disease 2019 (Covid-19) is characterized by an initial period of mild-to-moderate symptoms, followed by progressive respiratory failure leading to cardiovascular or respiratory organ support or death. However, the majority of patients who
Triple Therapy for Cystic Fibrosis Phe508del–Gating and –Residual Function Genotypes
Cystic fibrosis is a life-shortening autosomal recessive disease that affects more than 80,000 people worldwide. In cystic fibrosis, deficiencies in the cystic fibrosis transmembrane conductance regulator (CFTR) protein, an epithelial anion channel, manifest as a complex multiorgan disease,…
Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19
In some patients, the clinical course of coronavirus disease 2019 (Covid-19) is characterized by an initial period of mild-to-moderate symptoms, followed by progressive respiratory failure leading to cardiovascular or respiratory organ support or death. However, the majority of patients who
How the world is (not) handling surplus doses and expiring vaccines
In this feature article published on 25 August 2021 (doi:10.1136/bmj.n2062) the original version of the figure included summary EU data as well as individual countries. This has been removed.Also,…
Therapeutic Plasma Exchange in Vaccine-Induced Immune Thrombotic Thrombocytopenia
To the Editor: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is characterized by thrombosis and thrombocytopenia that occurs 5 to 30 days after ChAdOx1 nCoV-19 vaccination and is associated with heparin-independent platelet factor 4 (PF4) antibodies. Mortality from VITT is approximately…
Modeling Human Cardiac Chambers with Organoids
Congenital heart defects remain a leading cause of death in the first year of life and are the most common form of human malformation, affecting 1 to 2% of live births. Findings from large-scale sequencing efforts suggest that a distinct
Dissecting the genetics of ovarian ageing
Nature Reviews Genetics, Published online: 26 August 2021; doi:10.1038/s41576-021-00415-y A new study in Nature reports a large-scale genome-wide association study of menopause timing, revealing mechanistic details and potential therapeutic opportunities for preserving human fertility.
Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19
In some patients, the clinical course of coronavirus disease 2019 (Covid-19) is characterized by an initial period of mild-to-moderate symptoms, followed by progressive respiratory failure leading to cardiovascular or respiratory organ support or death. However, the majority of patients who
Circinate Syphilitic Lesions
Figure 1.
Controversy and Progress in Alzheimer’s Disease — FDA Approval of Aducanumab
On June 7, 2021, the Food and Drug Administration (FDA) granted accelerated approval to aducanumab (Aduhelm) for treatment of Alzheimer’s disease. In many respects, this move represents a landmark moment: not only is aducanumab the first drug approved for Alzheimer’s
[Editorial] Understanding long COVID: a modern medical challenge
As the COVID-19 pandemic continues, the need to understand and respond to long COVID is increasingly pressing. Symptoms such as persistent fatigue, breathlessness, brain fog, and depression could debilitate many millions of people globally. Yet very little is known about
Covid-19: UK cases continue to rise amid warnings of impact of schools reopening
The numbers of covid cases, hospitalisations, and deaths are continuing to rise across the UK, the latest figures have shown. In England, 200 705 people tested positive for covid-19 in the week to 18…
Brain and other central nervous system tumor statistics, 2021
Abstract Brain and other central nervous system (CNS) tumors are among the most fatal cancers and account for substantial morbidity and mortality in the United States. Population-based data from the Central Brain Tumor Registry of the United States (a combined
Monoclonal antibody treatment of symptomatic COVID-19 in pregnancy: Initial report
No Correlation between Anti-PF4 and Anti–SARS-CoV-2 Antibodies after ChAdOx1 nCoV-19 Vaccination
To the Editor: Vaccine-induced immune thrombotic thrombocytopenia (VITT), also known as thrombosis with thrombocytopenia syndrome, is a rare but potentially fatal complication of vector-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. The clinical picture and the…
No Correlation between Anti-PF4 and Anti–SARS-CoV-2 Antibodies after ChAdOx1 nCoV-19 Vaccination
To the Editor: Vaccine-induced immune thrombotic thrombocytopenia (VITT), also known as thrombosis with thrombocytopenia syndrome, is a rare but potentially fatal complication of vector-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. The clinical picture and the…
Revitalizing the U.S. Primary Care Infrastructure
The United States has learned from the Covid-19 pandemic what is required of the federal government’s executive branch to tackle a national health crisis. In addition to presidential leadership, there must be a team with a single purpose that reports
No Correlation between Anti-PF4 and Anti–SARS-CoV-2 Antibodies after ChAdOx1 nCoV-19 Vaccination
To the Editor: Vaccine-induced immune thrombotic thrombocytopenia (VITT), also known as thrombosis with thrombocytopenia syndrome, is a rare but potentially fatal complication of vector-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. The clinical picture and the…
Covid-19: Protection from two doses of vaccine wanes within six months, data suggest
Protection provided by two doses of the Pfizer and the AstraZeneca covid-19 vaccines wanes within six months, an analysis of UK data suggests.The latest analysis from the Zoe Covid Study, which…
Heartbeat: prevalence and treatment of severe aortic stenosis in older patients
Aortic stenosis (AS) is common in the elderly with an increasing number of patients as our population ages but precise estimates of prevalence have been limited by inadequate diagnostic data in most clinical databases. In this issue of Heart, Owens
[Editorial] Ensuring that accelerated approvals benefit patients
On Feb 26, 2021, through its accelerated approval programme, the US Food & Drug Administration (FDA) granted approval to melphalan flufenamide (melflufen) in combination with dexamethasone for adult patients with relapsed multiple myeloma refractory to at least one proteasome inhibitor,
Variant PNLDC1, Defective piRNA Processing, and Azoospermia
Worldwide, approximately one third of couples have fertility problems, with 50% arising from a male factor. Men with nonobstructive azoospermia have intact seminal ducts but impaired spermatogenesis, which results in no spermatozoa in the ejaculate. These men have very low
Administrative health datasets to study endometriosis: a population-based approach
[Editorial] COVID-19 vaccine equity and booster doses
The debate on COVID-19 vaccine equity has been long-running, and we have previously weighed in on the topic. However, the facts that (1) by Aug 9, only 12·6 million of the 4·46 billion doses administered globally were in low-income countries,
Incorrect Axis Labels in Figures
In the US Preventive Services Task Force Recommendation Statement titled “Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement,” published in the May 18, 2021, issue of JAMA, axes in 2 figures were incorrectly labeled. In Figure 2,
Covid-19: 40% of patients with weakened immune system mount lower response to vaccines
Four in 10 people who are clinically vulnerable generate lower levels of antibodies than healthy recipients after two shots of vaccine against SARS-CoV-2, a study has found.1The Octave (Observational…
Case 25-2021: A 48-Year-Old Man with Fatigue and Leg Swelling
Presentation of Case. Dr. Jonathan R. Wing: A 48-year-old man was admitted to this hospital because of fatigue and swelling in both legs. The patient had been well until 8 months before the current admission, when fatigue and lethargy developed.
Potential Role of the Corpus Luteum in Maternal Cardiovascular Adaptation to Pregnancy, and Preeclampsia Risk
Studies in the gravid rat model revealed a key role for the corpus luteal hormone, relaxin, in the maternal circulatory changes of early pregnancy epitomized by profound systemic vasodilation and increased arterial compliance. To determine whether the corpus luteum may
A Pink Salwar
I wake before the alarm goes off to a glorious dawn chorus in London. Usually drowned out by the cacophony of humans, cars, and sirens, now a symphony of birdsong bursts through the window. My morning coffee has no smell
Long-Term Survival after Kidney Transplantation
The survival advantages of transplantation over long-term dialysis are generally well described, provided a given patient with end-stage kidney disease is deemed a candidate for a transplant. As of December 2018, in the United States, 554,038 patients with end-stage kidney
Low myocardial energetic efficiency is associated with increased mortality in aortic stenosis
Objectives In hypertension, low myocardial energetic efficiency (MEEi) has been documented as an integrated marker of metabolic and left ventricular (LV) myocardial dysfunction. We tested the predictive performance of MEEi in initially asymptomatic aortic stenosis (AS) patients free from diabetes
Ear wax removal and core services in general practice
Minerva finds it inexplicable why many general practices no longer remove impacted ear wax.1Many people with problems caused by ear wax will not be aware of the distinction between core services and…
Words
When explaining the inadequacy of the words “Cheer him up” to describe the purpose of offering a drink to a murderer, TS Elliot’s Sweeney remarks, Well here again that don’t apply But I’ve gotta use words when I talk to
Holding Open the Door for Others Like Me
“We are sorry, you did not match to any position.” I groggily read the email message from the National Resident Matching Program (NRMP) the morning of March 16, 2020. At first, I didn’t believe it — surely this message was
Hypervirulent Klebsiella pneumoniae
A 45-year-old man with type 2 diabetes mellitus presented to the ophthalmology clinic with a 5-day history of pain and decreased vision in his left eye. His temperature was 39.2°C, and his pulse was 144 beats per minute. Examination of
Hypervirulent Klebsiella pneumoniae
A 45-year-old man with type 2 diabetes mellitus presented to the ophthalmology clinic with a 5-day history of pain and decreased vision in his left eye. His temperature was 39.2°C, and his pulse was 144 beats per minute. Examination of
Malignant Peripheral Nerve-Sheath Tumor
Figure 1.
Adjunct Immune Globulin for Vaccine-Induced Immune Thrombotic Thrombocytopenia
Recently, vaccination with adenoviral vector vaccines against coronavirus disease 2019 (Covid-19) has been implicated in a rare prothrombotic disorder that has been termed vaccine-induced immune thrombotic thrombocytopenia (VITT). Most patients in whom VITT has been diagnosed have been between the…
Variant PNLDC1, Defective piRNA Processing, and Azoospermia
Worldwide, approximately one third of couples have fertility problems, with 50% arising from a male factor. Men with nonobstructive azoospermia have intact seminal ducts but impaired spermatogenesis, which results in no spermatozoa in the ejaculate. These men have very low
Case 25-2021: A 48-Year-Old Man with Fatigue and Leg Swelling
Presentation of Case. Dr. Jonathan R. Wing: A 48-year-old man was admitted to this hospital because of fatigue and swelling in both legs. The patient had been well until 8 months before the current admission, when fatigue and lethargy developed.
Case 25-2021: A 48-Year-Old Man with Fatigue and Leg Swelling
Presentation of Case. Dr. Jonathan R. Wing: A 48-year-old man was admitted to this hospital because of fatigue and swelling in both legs. The patient had been well until 8 months before the current admission, when fatigue and lethargy developed.
Adjunct Immune Globulin for Vaccine-Induced Immune Thrombotic Thrombocytopenia
Recently, vaccination with adenoviral vector vaccines against coronavirus disease 2019 (Covid-19) has been implicated in a rare prothrombotic disorder that has been termed vaccine-induced immune thrombotic thrombocytopenia (VITT). Most patients in whom VITT has been diagnosed have been between the…
Constitutional de novo deletion CNV encompassing REST predisposes to diffuse hyperplastic perilobar nephroblastomatosis (HPLN)
Background Nephroblastomatosis is a recognised precursor for the development of Wilms tumour (WT), the most common childhood renal tumour. While the majority of WT is sporadic in origin, germline intragenic mutations of predisposition genes such as WT1, REST and TRIM28
Diagnostic value of 3D-FLAIR MRI in children with sudden deafness caused by inner ear hemorrhage
Objective To investigate the diagnostic value of three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) MRI in children with sudden deafness caused by inner ear hemorrhage. Methods The diagnostic efficacies of three different MRI sequences in the examination of the inner ear for
Julian Andre Bradley
bmj;374/aug20_10/n2051/FAF1faJulian André Bradley gave so much to the local medical community, and so many of us are deeply indebted to him for the support and guidance he gave to us throughout a 40…
Highlights from this issue
Prevalence, incidence and risk factors of strabismus in a Chinese population-based cohort of pre-school children: the Nanjing eye study (see page 1203) The prevalence of strabismus at baseline (3 years old) was 2.48% and the annual incidence of strabismus during
Variant PNLDC1, Defective piRNA Processing, and Azoospermia
Worldwide, approximately one third of couples have fertility problems, with 50% arising from a male factor. Men with nonobstructive azoospermia have intact seminal ducts but impaired spermatogenesis, which results in no spermatozoa in the ejaculate. These men have very low
Physiologic Subtypes of Gestational Glucose Intolerance and Risk of Adverse Pregnancy Outcomes
Women with gestational glucose intolerance, defined as an abnormal initial gestational diabetes screening test, are at risk for adverse pregnancy outcomes even if they do not have gestational diabetes. We previously defined gestational diabetes physiologic subtypes based on the primary
Adjunct Immune Globulin for Vaccine-Induced Immune Thrombotic Thrombocytopenia
Recently, vaccination with adenoviral vector vaccines against coronavirus disease 2019 (Covid-19) has been implicated in a rare prothrombotic disorder that has been termed vaccine-induced immune thrombotic thrombocytopenia (VITT). Most patients in whom VITT has been diagnosed have been between the…
Mobility Assessment in Older Adults
The Covid-19 Infodemic — Applying the Epidemiologic Model to Counter Misinformation
Throughout the world, including the United States, medical professionals and patients are facing both a pandemic and an infodemic — the first caused by SARS-CoV-2 and the second by misinformation and disinformation. The Annenberg Public Policy Center’s tracking of social
The Covid-19 Infodemic — Applying the Epidemiologic Model to Counter Misinformation
Throughout the world, including the United States, medical professionals and patients are facing both a pandemic and an infodemic — the first caused by SARS-CoV-2 and the second by misinformation and disinformation. The Annenberg Public Policy Center’s tracking of social
The Promise of Adjuvant Immunotherapy in Renal-Cell Carcinoma
Renal-cell carcinoma is a common cancer in both men and women around the world. Although nephrectomy remains the standard care for patients with locally advanced renal-cell carcinoma, recurrence occurs in up to 50 to 80% of patients, ultimately causing death
Lorlatinib in a Child with ALK-Fusion–Positive High-Grade Glioma
To the Editor: Advancements in molecular diagnostics have led to the identification of a new class of pediatric gliomas — infantile hemispheric gliomas — that arise in the cerebral hemispheres and often are histologically confirmed to be malignant (World Health
Adjunct Immune Globulin for Vaccine-Induced Immune Thrombotic Thrombocytopenia
Recently, vaccination with adenoviral vector vaccines against coronavirus disease 2019 (Covid-19) has been implicated in a rare prothrombotic disorder that has been termed vaccine-induced immune thrombotic thrombocytopenia (VITT). Most patients in whom VITT has been diagnosed have been between the…
The continuing search for the origins of SARS-CoV-2
Since the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019, there has been a global hunt for the origin of the ongoing pandemic. Zhou et al. provide further evidence of coronavirus diversity, including four novel SARS-CoV-2-related viruses, in
[Editorial] Health in a world of extreme heat
The heatwaves and wildfires that swept across southern Europe and the USA this summer have been traumatic and deadly. 600 excess deaths were reported in the Pacific Northwest in the USA alone. According to the Sixth Assessment Report of Working
[Editorial] Readiness is all
Emergency room psychiatry does not often make it into the pages of medical journals. Academic thought—and research money—is mostly directed towards longer-term issues in mental health. Epidemiological studies might track patients over decades. Trial endpoints are often set at weeks,
01 The effects of a leaflet-based intervention, ‘hypos can strike twice, on recurrent hypoglycaemic attendances by ambulance services: a non-randomised stepped wedge study
Background Hypoglycaemia is a common complication of diabetes therapy needing prompt recognition and treatment. It often results in ambulance attendance incurring health services costs and patient morbidity. Patient education is important for maintaining glycaemic control and preventing recurrent hypoglycaemia. We
Room for standardisation: the secondary prevention of coronary artery disease
Highlights from this issue
Therapeutic creep in provision of hypothermia for hypoxic ischaemic encephalopathy Three articles relate to the changing practices of UK clinicians in the provision of therapeutic hypothermia for hypoxic ischaemic encephalopathy (HIE). Lori Hage and colleagues report the clinical characteristics of
Aducanumab, amyloid, and culture wars
Those who thought that the US Food and Drug Administration (FDA) was a conservative regulator which maintained a high bar have been shocked by its approval of the anti-amyloid antibody…
Highlights from this issue
A vein of form In footballing vernacular (and I’m an ardent student) a ‘vein of form’ means a good run. For whatever reason ‘something’ gelled, continues to gel and there are no reasons to see an end to the gelling.
Intrapulmonary tumour showing recent growth
Clinical question A 68-year-old man presented with a well-delimited tumour measuring 31×28 mm in the right upper lobe of the lung (figure 1A) that had been detected by chest CT 5 years earlier. A recent CT scan showed that the
Who is providing contraception care in the United States? An Observational Study of the Contraception Workforce
Contraception care is essential to providing comprehensive healthcare, yet little is known nationally about the contraception workforce. Previous research has examined the supply, distribution, and adequacy of the health workforce providing contraception services, but this research has faced a series
Reframing Immune-Mediated Inflammatory Diseases through Signature Cytokine Hubs
Immune-mediated inflammatory diseases (IMIDs) are a heterogeneous group of diseases characterized by chronic inflammation and organ damage. IMIDs were traditionally classified on the basis of the predominant organ involvement. Improving the pathogenic characterization of IMIDs, however, should…
Opportunities and challenges of macrogenetic studies
Nature Reviews Genetics, Published online: 18 August 2021; doi:10.1038/s41576-021-00394-0 Leigh and colleagues describe the potential of the emerging field of macrogenetics to improve conservation and biodiversity management. Challenges preventing the field from reaching its full promise are highlighted and possible
The cranial windows of perception
Psilocybin has emerged as a potentially rapidly acting antidepressant with enduring actions. In this issue of Neuron, Shao et al. (2021) show that psilocybin quickly induces dendritic spine formation in cortical layer V pyramidal neurons. These results provide a potential cellular
[Editorial] Amid competing priorities, dementia must not be forgotten
Globally, more than 50 million people are estimated to have dementia, which could rise to around 80 million by 2030, yet governments are still not doing enough. According to a report published on May 26, 2021, by Alzheimer’s Disease International
[Editorial] Childhood vaccinations: playing catch-up
The COVID-19 pandemic has had huge indirect effects on health and health-care systems around the world, with one of the most severely affected being routine child immunisation services. A new report by WHO and UNICEF, published on July 15, outlines
Environmental Racism and Climate Change — Missed Diagnoses
The mother clutches her daughter as the nebulized albuterol permeates the young girl’s airways. My eyes dart between the monitor and the child’s small, dark-skinned chest as it heaves up and down at an alarming rate. I smile reassuringly, but
Covid-19: Australian outbreak surges as New Zealand sees first domestic cases in six months
New Zealand and much of eastern Australia are in lockdown this week, but these two countries that once shared a covid bubble are on divergent trajectories as New Zealand scrambles to maintain a “zero…
[Editorial] Gender disparities in publishing: from words to actions
“When everyone is included, everyone wins” were the words of US civil rights activist, Jesse Jackson. Gender disparities in research and publishing have been increasingly reported but remain largely unaddressed.
Racial and Ethnic Differences in Gestational Diabetes
During pregnancy, profound metabolic changes may reveal a predisposition toward glucose intolerance, manifesting as gestational diabetes. Gestational diabetes increases the risk of adverse pregnancy outcomes, including macrosomia, preeclampsia, birth trauma, and neonatal hypoglycemia. Notably, this diagnosis has implications that outlast
Lack of agreement forces NICE to pause publication of ME/CFS guideline
The National Institute for Health and Care Excellence (NICE) has paused the planned publication of its updated guideline on the diagnosis and management of myalgic encephalomyelitis/chronic fatigue…
Correction: Serum androgen levels and their relation to performance in track and field: mass spectrometry results from 2127 observations in male and female elite athletes
Bermon S, Garnier P-Y. Serum androgen levels and their relation to performance in track and field: mass spectrometry results from 2127 observations in male and female elite athletes. Br J Sports Med 2017;51:1309–14. doi: 10.1136/bjsports-2017-097792 In 2017 and 2018 the
Do pooled estimates from meta-analyses of observational epidemiology studies contribute to causal inference?
Introduction The purpose of meta-analyses that generate pooled risk estimates is generally to inform causal inference, compiling evidence to address an aetiological question. Logically, drawing on information from all relevant studies is likely to be superior to relying on any
Research news in clinical context
High efficacy of high dose intravenous ceftriaxone against extragenital gonorrhoea Ceftriaxone monotherapy is well established for treating Neisseria gonorrhoeae (NG) urethritis, but data are limited for pharyngeal and rectal infections. This prospective single-centre study was conducted in Japan in 2017–2020
Doctors call for ban on virginity testing and hymenoplasty
The Royal College of Obstetricians and Gynaecologists (RCOG) has urged the government to introduce a ban on virginity testing and hymenoplasty in the UK.In a policy statement published on 16 August,…
Exploring the macro-level, meso-level and micro-level barriers and facilitators to the provision of good quality early inflammatory arthritis (EIA) care in England and Wales
Background Evidence from a national clinical audit of early inflammatory arthritis (EIA) shows considerable variability between hospitals in performance, unexplained by controlling for case-mix. Objective To explore the macro-level, meso-level and micro-level barriers and facilitators to the provision of good
Reframing Immune-Mediated Inflammatory Diseases through Signature Cytokine Hubs
Immune-mediated inflammatory diseases (IMIDs) are a heterogeneous group of diseases characterized by chronic inflammation and organ damage. IMIDs were traditionally classified on the basis of the predominant organ involvement. Improving the pathogenic characterization of IMIDs, however, should…
Intermittent fasting in the prevention and treatment of cancer
Abstract Chronic caloric restriction (CR) has powerful anticarcinogenic actions in both preclinical and clinical studies but may be difficult to sustain. As an alternative to CR, there has been growing interest in intermittent fasting (IF) in both the scientific and
Longitudinal effects of adjuvant chemotherapy and lymph node staging on patient-reported outcomes in endometrial cancer survivors: a prospective cohort study
Most endometrial cancer patients with localized disease are effectively treated and survive for a long time. Primary treatment is hysterectomy, to which surgical staging procedures may be added to assess the need for adjuvant therapy. Longitudinal data on patient-reported outcomes
Genetic innovations in animal–microbe symbioses
Nature Reviews Genetics, Published online: 13 August 2021; doi:10.1038/s41576-021-00395-z The evolutionary persistence of animal symbioses depends on both host and symbiont innovations. Perreau and Moran review how genome sequencing and related experiments have clarified how these innovations arise under different
Abelacimab for Prevention of Venous Thromboembolism
Patients undergoing total knee arthroplasty are at high risk for postoperative venous thromboembolism. Enoxaparin, an inhibitor of factor Xa and thrombin, is often administered postoperatively to reduce this risk. Although reasonably effective, enoxaparin can be associated with bleeding. A search…
Reframing Immune-Mediated Inflammatory Diseases through Signature Cytokine Hubs
Immune-mediated inflammatory diseases (IMIDs) are a heterogeneous group of diseases characterized by chronic inflammation and organ damage. IMIDs were traditionally classified on the basis of the predominant organ involvement. Improving the pathogenic characterization of IMIDs, however, should…
Case 24-2021: A 63-Year-Old Woman with Fever, Sore Throat, and Confusion
Presentation of Case. Dr. Peiyun Ni (Medicine): A 63-year-old woman was admitted to this hospital because of fever, headache, sore throat, and confusion. The patient had been well until 2 weeks before this admission, when fever, chills, myalgias, and headache
Criminalization of Gender-Affirming Care — Interfering with Essential Treatment for Transgender Children and Adolescents
On April 6, 2021, the Arkansas state legislature overrode a veto by the governor to pass legislation making it illegal for medical professionals to provide gender-affirming treatment to patients with gender dysphoria who are younger than 18 or to refer
Implantable loop recorders in patients with heart disease: comparison between patients with and without syncope
Objective Patients with heart disease are at increased risk for sudden cardiac death. Guidelines recommend an implantable loop recorder (ILR) for symptomatic patients when symptoms are sporadic and possibly arrhythmia-related. In clinical practice, an ILR is mainly used in patients
Covid-19: China pressured WHO team to dismiss lab leak theory, claims chief investigator
A World Health Organisation mission to study the covid pandemic’s origins in China, which announced in February that the possibility that the virus had escaped from a laboratory needed no further…
Highlights from this issue
As we write this edition of Airwaves, the UK has abandoned lockdown and is relying on a high immunisation uptake and a world beating test and trace programme to keep COVID-19 at bay. The immediate effects have been a “pingdemic”
Sequencing of and escalation paradigms for MS therapies: time for a rethink?
The choice of MS DMTs in a treatment escalation paradigm may adversely effect long-term outcomes in those with active disease Pfeuffer et al1 report on a real-world experiment that assesses the role of prior multiple sclerosis (MS) disease-modifying therapy (DMT)
Practicing on the edge of oncology: when standard of care feels uncomfortable
Nature Reviews Clinical Oncology, Published online: 12 August 2021; doi:10.1038/s41571-021-00550-9 The treatments oncologists deliver are generally based on evidence from large randomized controlled trials, consistent with practice guidelines, and congruent with the treatments selected by our peers. In this Comment,
Abelacimab for Prevention of Venous Thromboembolism
Patients undergoing total knee arthroplasty are at high risk for postoperative venous thromboembolism. Enoxaparin, an inhibitor of factor Xa and thrombin, is often administered postoperatively to reduce this risk. Although reasonably effective, enoxaparin can be associated with bleeding. A search…
Holding Open the Door for Others Like Me
“We are sorry, you did not match to any position.” I groggily read the email message from the National Resident Matching Program (NRMP) the morning of March 16, 2020. At first, I didn’t believe it — surely this message was
Urologic morbidity associated with placenta accreta spectrum surgeries: single-center experience with a multidisciplinary team
Hysterectomy for placenta accreta spectrum (PAS) may be associated with urologic morbidity including intentional or unintentional cystostomy, ureteral injury and bladder fistula. Although previous retrospective studies have shown association between PAS and urologic morbidities, there is still paucity of literature
Somatic mutations of GNA11 and GNAQ in CTNNB1-mutant aldosterone-producing adenomas presenting in puberty, pregnancy or menopause
Nature Genetics, Published online: 12 August 2021; doi:10.1038/s41588-021-00906-y Sequence analysis identifies gain-of-function somatic mutations in GNA11 or GNAQ in CTNNB1-mutant aldosterone-producing adenomas. Most patients with these mutations presented during puberty, pregnancy or menopause, with elevated LHCGR expression.
New Vistas for Cell-Surface GlycoRNAs
RNAs are modified with diverse chemical groups, ranging from simple methyl groups to more complex moieties. These modifications are essential to their diverse roles as catalysts, structural scaffolds, and regulators of gene expression. However, apart from a few monosaccharide modifications
Delayed Large Local Reactions to mRNA Covid-19 Vaccines in Blacks, Indigenous Persons, and People of Color
To the Editor: Blumenthal et al. report delayed large local reactions in 12 patients who had received the mRNA-1273 vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19). Baeck et al. report
Myiasis from Larvae of Human Botfly
Figure 1.
[Editorial] The Lancet Gastroenterology & Hepatology: 5 years on
This issue of The Lancet Gastroenterology & Hepatology marks the journal’s fifth birthday. Much has happened in gastroenterology and hepatology in those 5 years, and this anniversary provides an opportunity to pause and reflect on progress.
Confronting Our Next National Health Disaster — Long-Haul Covid
Now that more than half of U.S. adults have been vaccinated against SARS-CoV-2, masking and distancing mandates have been relaxed, and Covid-19 cases and deaths are on the decline, there is a palpable sense that life can return to normal.
Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant
India has experienced a surge in cases of coronavirus disease 2019 (Covid-19) since late March 2021, reaching more than 400,000 cases and 4000 deaths reported each day in early May 2021. This increase has resulted in hospital services becoming overwhelmed
Three Doses of an mRNA Covid-19 Vaccine in Solid-Organ Transplant Recipients
To the Editor: A weak immune response to two doses of vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been observed in recipients of solid-organ transplants. Severe cases of coronavirus disease 2019 (Covid-19) have also been reported in
[Editorial] The NHS: the many challenges for leadership
Amanda Pritchard has her work cut out. The new Chief Executive of NHS England has taken charge of an organisation reeling from the pressures of the past 18 months, with huge backlogs in care, an exhausted workforce, and the COVID-19
Criminalization of Gender-Affirming Care — Interfering with Essential Treatment for Transgender Children and Adolescents
On April 6, 2021, the Arkansas state legislature overrode a veto by the governor to pass legislation making it illegal for medical professionals to provide gender-affirming treatment to patients with gender dysphoria who are younger than 18 or to refer
Abelacimab for Prevention of Venous Thromboembolism
Patients undergoing total knee arthroplasty are at high risk for postoperative venous thromboembolism. Enoxaparin, an inhibitor of factor Xa and thrombin, is often administered postoperatively to reduce this risk. Although reasonably effective, enoxaparin can be associated with bleeding. A search…
Reframing Immune-Mediated Inflammatory Diseases through Signature Cytokine Hubs
Immune-mediated inflammatory diseases (IMIDs) are a heterogeneous group of diseases characterized by chronic inflammation and organ damage. IMIDs were traditionally classified on the basis of the predominant organ involvement. Improving the pathogenic characterization of IMIDs, however, should…
Leaders call for NHS funding boost as data show 5.5 million patients are waiting for routine care
Healthcare leaders have called for more funding for the NHS as data show that 5.45 million patients in England are now waiting for routine care.Data published by NHS England and NHS Improvement on 12…
Periodontitis is associated to increased systemic inflammation in postmyocardial infarction patients
Objective Periodontitis has been independently associated to cardiovascular disease. However, the biological mechanisms underlying such association are still partially unknown. Thus, this study aimed to discover immunological clues accounting for the increased risk of myocardial infarction (MI) in patients having
Coronal sulcus-based ventral mucosal flap to help penile coverage in severe concealed penis
Introduction There are many techniques to treat congenital concealed penis (CP). Skin resurfacing is the most difficult step in severe cases. We aim to show medium-term results of coronal sulcus–based triangular ventral mucosal flap (CBVMF) as a treatment of prepubertal
Medications associated with fracture risk in patients with rheumatoid arthritis
Statins have been widely used to control dyslipidaemia, and there is strong evidence for beneficial effects for patients at risk for cardiovascular diseases.1 2 In particular, statins may influence bone metabolism by increasing bone formation.3 4 Recently, Ozen et al5
Heartbeat: Intervention for spontaneous coronary artery dissection?
Acute coronary syndrome due to spontaneous coronary artery dissection (SCAD) typically is managed conservatively because coronary anatomy returns to normal in most patients at follow-up and because there is a high rate of technical failure and complications with percutaneous coronary
Amivantamab is effective in NSCLC harbouring EGFR exon 20 insertions
Nature Reviews Clinical Oncology, Published online: 11 August 2021; doi:10.1038/s41571-021-00551-8 Amivantamab is effective in NSCLC harbouring EGFR exon 20 insertions
Turning Purple with Pain
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.
RE: In vitro fertilization as an independent risk factor for placenta accreta spectrum
Clinical Features of Vaccine-Induced Immune Thrombocytopenia and Thrombosis
As of June 6, 2021, approximately 175 million severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and 3.8 million deaths from coronavirus disease 2019 (Covid-19) have been reported worldwide. Programs providing unprecedented rapid clinical development of vaccines have been…
Third Time’s a Charm — Covid-19 Vaccine Hope for Solid-Organ Transplant Recipients
Solid-organ transplant recipients have an increased risk of contracting diseases that are preventable through vaccination. Much emphasis has been placed on ensuring completion of pretransplantation immunization, because the immunosuppressive therapy that prevents graft rejection may decrease the…
Placebo Benefits for Disruptive Aspects of Mood Dysregulation after Traumatic Brain Injury
Journal of Neurotrauma, Volume 38, Issue 16, Page 2193-2193, August 15, 2021.
“I feel like a spare part”
PreparationThe majority of work for the ward round occurs in the preparation.What to do before attending a ward roundAlways be 10 minutes early. There is nothing worse than trying to find a ward…
Smooth-talking T cells leave asthma breathless
The plasma membrane channel PANX1 mediates release of bio-active adenine nucleotides; however, its function in immune cells is unknown. In this issue of Immunity, Medina et al. show that PANX1 mediates adenosine-dependent communication between regulatory and effector CD4+ T cells during allergic
Author Correction: The origin of human mutation in light of genomic data
Nature Reviews Genetics, Published online: 10 August 2021; doi:10.1038/s41576-021-00410-3 Author Correction: The origin of human mutation in light of genomic data
Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock
Cardiogenic shock is defined as a state of low cardiac output resulting in clinical and biochemical manifestations of end-organ hypoperfusion. Although emergency revascularization has been shown to reduce the risk of death in patients with myocardial infarction complicated by cardiogenic
Ventromedial Prefrontal-Anterior Cingulate Hyperconnectivity and Resilience to Apathy in Traumatic Brain Injury
Journal of Neurotrauma, Volume 38, Issue 16, Page 2264-2274, August 15, 2021.
JAMA Arts and Medicine: The Doctors Blackwell
This Arts and Medicine essay describes the recent biography by Janice Nimura that profiles Elizabeth Blackwell, the first US woman to receive an MD, and her sister and fellow physician Emily, including their struggles, successes, and how they helped chart
Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock
Cardiogenic shock is defined as a state of low cardiac output resulting in clinical and biochemical manifestations of end-organ hypoperfusion. Although emergency revascularization has been shown to reduce the risk of death in patients with myocardial infarction complicated by cardiogenic
Echocardiography in suspected coronavirus infection: indications, limitations and impact on clinical management
Objectives To describe the use of echocardiography in patients hospitalised with suspected coronavirus infection and to assess its impact on clinical management. Methods We studied 79 adults from a prospective registry of inpatients with suspected coronavirus infection at a single
Covid-19: Charity offers scholarships to bereaved children of healthcare staff
A UK charity is offering education scholarships worth £5000 (€5600; $6900) a year to children of NHS health and care workers who died from covid and who are going on to higher education.Launched on…
Tumor heterogeneity
Tumor heterogeneity was traditionally considered in the genetic terms, but it has now been broadened into many more facets. These facets represent a challenge in our understanding of cancer etiology but also provide opportunity for us to understand prognosis and
Thromboembolic Events in the South African Ad26.COV2.S Vaccine Study
To the Editor: Rare thromboembolic events have been observed during the vaccination rollout, which have prompted cautionary pauses in vaccinations by some regulatory authorities, including the South Africa Health Products Regulatory Authority. Here, we report interim safety data from the
COVID-19 Vaccination During Pregnancy: Coverage and Safety
Concerns have been raised regarding a potential surge of COVID-19 in pregnancy, secondary to rising numbers of COVID-19 in the community, easing of societal restrictions, and vaccine hesitancy. Even though COVID-19 vaccination is now offered to all pregnant women in
High-quality genome assembly and resequencing of modern cotton cultivars provide resources for crop improvement
Nature Genetics, Published online: 09 August 2021; doi:10.1038/s41588-021-00910-2 High-quality genomes of two cultivated tetraploid cottons Gossypium hirsutum cv. NDM8 and Gossypium barbadense acc. Pima90 and resequencing of 1,081 G. hirsutum accessions provide insights into the role of structural variations.
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
A history of psychiatry in 1500 words
Psychiatry today, perhaps more than any other branch of medicine, has continuities with the past. King Lear said, “O let me not be mad, not mad, sweet heaven,”1 which chimes with today’s…
Turning Purple with Pain
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.
Turning Purple with Pain
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.
Further Implications from a Pragmatic Randomized Clinical Trial of Gestational Diabetes Screening: Per-Protocol and As-Treated Estimates
Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock
Cardiogenic shock is defined as a state of low cardiac output resulting in clinical and biochemical manifestations of end-organ hypoperfusion. Although emergency revascularization has been shown to reduce the risk of death in patients with myocardial infarction complicated by cardiogenic
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
Characterization of Cerebrospinal Fluid Ubiquitin C-Terminal Hydrolase L1 as a Biomarker of Human Acute Traumatic Spinal Cord Injury
Journal of Neurotrauma, Volume 38, Issue 15, Page 2055-2064, August 1, 2021.
Thromboembolic Events in the South African Ad26.COV2.S Vaccine Study
To the Editor: Rare thromboembolic events have been observed during the vaccination rollout, which have prompted cautionary pauses in vaccinations by some regulatory authorities, including the South Africa Health Products Regulatory Authority. Here, we report interim safety data from the
Sickle-cell anemia gene therapy
Nature Genetics, Published online: 06 August 2021; doi:10.1038/s41588-021-00918-8 Sickle-cell anemia gene therapy
Gene drives gaining speed
Nature Reviews Genetics, Published online: 06 August 2021; doi:10.1038/s41576-021-00386-0 In this Review, Ethan Bier discusses how several impactful technical advancements, particularly involving CRISPR-based methods, are providing a diverse toolkit of gene-drive systems for the control of populations such as insect
Neutrophilic Eccrine Hidradenitis
Figure 1.
Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes
Glucagon-like peptide-1 (GLP-1) receptor agonists are an effective treatment option for patients with type 2 diabetes. These agents act by stimulating insulin secretion in hyperglycemic states, suppressing glucagon secretion in hyperglycemic or euglycemic states, delaying gastric emptying,…
Contact Tracing for Covid-19 — A Digital Inoculation against Future Pandemics
Outbreaks of coronavirus disease 2019 (Covid-19) emerged in the United States and in European countries in February 2020. Urgent action was called for, since experts estimated that 30 to 70% of people in these Western countries could become infected —
Age-Related Macular Degeneration
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.
Pneumococcal Empyema
Figure 1.
Pneumococcal Empyema
Figure 1.
Presumed consent and sharing medical data: Scottish register allows researchers to approach patients
Salisbury wonders whether presumed consent is enough for sharing medical data and concludes that data sharing needs a clear plan.1In Scotland we have asked people to join SHARE, the Scottish Health…
Correction: Non-nucleatum Fusobacterium species are dominant in the Southern Chinese population with distinctive correlations to host diseases compared with F. nucleatum
He Y, Mujagond P, Tang W, et al. Non-nucleatum Fusobacterium species are dominant in the Southern Chinese population with distinctive correlations to host diseases compared with F. nucleatum. Gut 2021;70:810–12. The correct funding statement should read: This study was supported
Highlights from this issue
When burn-out reaches a pandemic level in gastroenterology: a call for a more sustainable work–life balance There is an increasing concern about ‘burnout’, exacerbated by the COVID-19 pandemic, across all sectors. In an excellent opinion piece in this edition Duong
Infection makes micro-CHIPs into macro-CHIPs
In this issue of Cell Stem Cell, Hormaechea-Agulla et al. (2021) demonstrate that IFNγ signaling following an infection in mice provides a selective pressure that drives growth of Dnmt3a−/− hematopoietic stem cells. This clonal expansion is mediated by global methylation changes
Are children born by cesarean section at higher risk for respiratory sequelae?
Globally, the number of children born by cesarean section (CS) is constantly increasing. However, hormonal and physiological changes associated with labor and vaginal delivery (VD) are considered necessary for lung maturation.
CRISPR-Cas9 In Vivo Gene Editing for Transthyretin Amyloidosis
Transthyretin amyloidosis, also called ATTR amyloidosis, is a progressive fatal disease characterized by accumulation in tissues of amyloid fibrils composed of misfolded transthyretin (TTR) protein. ATTR amyloidosis may be acquired; referred to as wild-type ATTR amyloidosis, this form of ATTR…
Transposable elements shape the evolution of mammalian development
Nature Reviews Genetics, Published online: 05 August 2021; doi:10.1038/s41576-021-00385-1 In this Review, Senft and Macfarlan discuss the diverse ways by which transposable elements (TEs) contribute to mammalian development and evolution, including direct contributions through TE-derived regulatory elements, RNAs and proteins,
CD19-Targeted CAR T Cells in Refractory Systemic Lupus Erythematosus
To the Editor: Systemic lupus erythematosus (SLE) is a severe autoimmune disease that predominantly affects young women. SLE is characterized by the formation of autoantibodies and immune complex–mediated inflammation and organ damage. Although autoreactive B cells play a key role
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
Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes
Glucagon-like peptide-1 (GLP-1) receptor agonists are an effective treatment option for patients with type 2 diabetes. These agents act by stimulating insulin secretion in hyperglycemic states, suppressing glucagon secretion in hyperglycemic or euglycemic states, delaying gastric emptying,…
Turning Purple with Pain
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.
Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes
Glucagon-like peptide-1 (GLP-1) receptor agonists are an effective treatment option for patients with type 2 diabetes. These agents act by stimulating insulin secretion in hyperglycemic states, suppressing glucagon secretion in hyperglycemic or euglycemic states, delaying gastric emptying,…
CRISPR-Cas9 In Vivo Gene Editing for Transthyretin Amyloidosis
Transthyretin amyloidosis, also called ATTR amyloidosis, is a progressive fatal disease characterized by accumulation in tissues of amyloid fibrils composed of misfolded transthyretin (TTR) protein. ATTR amyloidosis may be acquired; referred to as wild-type ATTR amyloidosis, this form of ATTR…
Fe, fi, fo, fum, I smell the diet of a healthy human
Diet-induced changes in the microbiome can alter immune function and promote inflammation. In a new paper in Cell, Wastyk et al. report that intervention with diets high in fermented foods or plant-based fiber have the potential to increase microbial diversity and
[Editorial] Attending to the threat of nuclear weapons
Aug 6 and Aug 9 mark the anniversaries of the atomic bombings of Hiroshima and Nagasaki, where roughly 140 000 and 74 000 people died, respectively. Last year saw the 75th anniversary, but it passed largely unnoticed by most of the world,
CD19-Targeted CAR T Cells in Refractory Systemic Lupus Erythematosus
To the Editor: Systemic lupus erythematosus (SLE) is a severe autoimmune disease that predominantly affects young women. SLE is characterized by the formation of autoantibodies and immune complex–mediated inflammation and organ damage. Although autoreactive B cells play a key role
Impact of COVID-19 on the imaging diagnosis of cardiac disease in Europe
Objectives We aimed to explore the impact of the COVID-19 pandemic on cardiac diagnostic testing and practice and to assess its impact in different regions in Europe. Methods The online survey organised by the International Atomic Energy Agency Division of
Trust boss gets GMC warning for failing to mention that doctor he referred had raised concerns
An NHS boss who wrongly assured the General Medical Council that a doctor he was reporting to the regulator was not a whistleblower has received a formal warning from the GMC for making a misleading…
International consensus recommendations on key outcome measures for organ preservation after (chemo)radiotherapy in patients with rectal cancer
Nature Reviews Clinical Oncology, Published online: 04 August 2021; doi:10.1038/s41571-021-00538-5 Patients with early-stage rectal cancer might potentially benefit from treatment with an organ-sparing approach, which preserves quality of life owing to avoidance of the need for permanent colostomy. Trials conducted
Variant PNLDC1, Defective piRNA Processing, and Azoospermia
Worldwide, approximately one third of couples have fertility problems, with 50% arising from a male factor. Men with nonobstructive azoospermia have intact seminal ducts but impaired spermatogenesis, which results in no spermatozoa in the ejaculate. These men have very low
Copper Intrauterine Device and, Incident Sexually Transmitted Infections
Variant PNLDC1, Defective piRNA Processing, and Azoospermia
Worldwide, approximately one third of couples have fertility problems, with 50% arising from a male factor. Men with nonobstructive azoospermia have intact seminal ducts but impaired spermatogenesis, which results in no spermatozoa in the ejaculate. These men have very low
Surviving Covid-19 with Heparin?
Patients who are admitted to the hospital with coronavirus disease 2019 (Covid-19) are at high risk for thrombosis, particularly venous thromboembolism (VTE). In a meta-analysis of 66 studies, the overall prevalence of VTE among patients with Covid-19 was 14.1%, with
Identifying and Tracking SARS-CoV-2 Variants — A Challenge and an Opportunity
The emergence of worrisome variants of the SARS-CoV-2 virus has exposed the limited scale of surveillance efforts in the United States. More than 30 other countries conduct more sequencing of viral isolates than the United States does, thereby permitting greater
Subcutaneous REGEN-COV Antibody Combination to Prevent Covid-19
Coronavirus disease 2019 (Covid-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first detected in December 2019 and was declared a global pandemic in March 2020. REGEN-COV (previously known as REGN-COV2), a combination of two neutralizing
ApoE and immunity in Alzheimer’s disease and related tauopathies: Low-density lipoprotein receptor to the rescue
In this issue of Neuron, Shi et al. (2021) show a protective role for the low-density lipoprotein receptor (LDLR) in tau pathology. Brain overexpression of LDLR lowers apolipoprotein E (apoE), suppresses microglial activation, preserves myelin, and ameliorates neurodegeneration, pointing the way
Surviving Covid-19 with Heparin?
Patients who are admitted to the hospital with coronavirus disease 2019 (Covid-19) are at high risk for thrombosis, particularly venous thromboembolism (VTE). In a meta-analysis of 66 studies, the overall prevalence of VTE among patients with Covid-19 was 14.1%, with
Skipping breakfast is a bad idea for patients with cancer
CA: A Cancer Journal for Clinicians, EarlyView.
United States trails other rich countries on almost every measure of health, report finds
The US is a distant outlier in delivering quality healthcare, a study has found, lagging far behind 10 other high income countries in a broad comparison that measured outcomes, access to care,…
Internationally validated score to predict the outcome of non-paroxysmal atrial fibrillation ablation: the ‘FLAME score
Background The clinical effectiveness of ablating non-paroxysmal atrial fibrillation (non-PAF) relies on proper patient selection. We developed and validated a scoring system to predict non-PAF ablation outcomes. Methods Data on 416 non-PAF ablations were analysed using binary logistic regression at
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