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Low dose hypomethylating agent therapy led to an overall response rate of 60% in pts with low- or intermediate-risk myelodysplastic syndromes or chronic myelomonocytic leukemia who had not received prior hypomethylating agents. #MDS #LeuSM #CMML
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The cause of recent pediatric acute #hepatitis cases remains elusive, though case series from the U.S. and U.K. suggest a possible link to human #adenovirus. @NEJM
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.@MichaelOkun sums up 2 @NEJM studies in which monoclonal antibodies fail to improve outcomes in #Parkinson disease. Prasinezumab for Parkinson Disease Fails in a Randomized Study: Can a Monoclonal Antibody Treat Parkinson Disease?
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“Statistical methods developed by climate scientists, termed detection and attribution, are quantifying the extent to which a single event or a longer-term trend could be attributed to climate change.” - @kristie_ebi | #ClimateChange #ClimateCrisis #MedEd
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New editorial by Alan Whone, F.R.C.P., Ph.D. : "Monoclonal Antibody Therapy in Parkinson’s – The End?"
This interactive feature describes the case of a 50-year-old woman who presents to the ED with a 4-month history of progressive neurologic symptoms and is admitted to the inpatient neurology service. Test your diagnostic & therapeutic skills at
12 innovative articles selected by NEJM Evidence editors. Download the PDF collection today: #MedTwitter #MedEd #ClinicalTrials
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In this report, investigators in China identified a new henipavirus associated with a febrile human illness. This virus was also found in shrews.
New editorial by Johanna P. Daily, M.D.: "Monoclonal Antibodies – A Different Approach to Combat Malaria"
A 68-year-old woman living in Japan presented with a 5-day history of rash and fevers. She had been bitten by a tick 1 week earlier. Examination revealed a petechial rash and eschar on the ankle.
A 71-year-old man presented with an 8-year history of enlarging nodules on his nose. What is the most likely diagnosis?
The malaria vaccine currently recommended for infants has limited efficacy, underscoring the need for new preventive strategies. Monoclonal antibodies may offer an alternative approach. New research findings are summarized in a short video.
A 61 y/o man has chest pain that started 2 days ago and is progressively worsening. What questions would you ask to develop a differential diagnosis? #MorningReport #CardioTwitter #MedEd @mkvidula @sheelakrishmd @PennCVFellows
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Lauren Thaxton, M.D., discusses the adverse effects on patients, physicians, and trainees of the new Texas abortion law.
New editorial by Timothy Wells, Sc.D., and Cristina Donini, Pharm.D., Ph.D.: "A New Approach to Preventing Malaria."
Spina bifida, a congenital disorder of the spinal cord, leads to medical and neurologic complications. Modern surgical techniques and comprehensive medical care have greatly improved outcomes.
After a child's death in the emergency department, a trainee ponders physicians' varied reactions and rituals as he carries on treating other patients amid the unease and sorrow.
A 63-year-old woman presented with dyspnea and cough. She had been in her usual state of health until 2 days earlier, when myalgias and dyspnea with ambulation developed, followed by a cough productive of green sputum.
A 47-year-old woman presented with shortness of breath. Chest CT showed a filling defect in the left atrium, and a mobile left atrial mass was seen on transthoracic echocardiography (shown in a video, follow link to view).
Evaluate the reasons, understand the results. Request institutional access to NEJM Evidence today: #MedEd #MedTwitter #ClinicalTrials
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Prasinezumab is a monoclonal antibody to α-synuclein, a protein involved in the pathogenesis of Parkinson's disease. In a placebo-controlled trial, prasinezumab did not slow the progression of disease over a period of 52 weeks.
The editors discuss soon-to-be-released Covid-19 vaccines against BA.4/BA.5 strains, as well as the current state of therapeutics for monkeypox.
In a phase 2 trial in early Parkinson's disease, treatment with cinpanemab, a monoclonal antibody to α-synuclein, did not affect clinical or imaging progression over a period of 72 weeks.
Tecovirimat might speed resolution of monkeypox illness and improve outcomes, but how can we manage compassionate access to a drug whose safety and efficacy in humans have not been established?
This phase 1 trial examined an engineered monoclonal antibody, L9LS, targeting the malaria sporozoite. L9LS protected against infection in a human challenge model.
“ is often clear when to start a treatment but not as obvious when to stop it. This uncertainty has particular relevance, for example, in the context of polypharmacy or management of a chronic disease.” Read the editorial by Dr. Teixeira-Pinto:
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Treatment options for cutaneous lupus erythematosus are limited. Litifilimab is a humanized monoclonal antibody that holds promise for patients with cutaneous lupus erythematosus. New research findings are summarized in a short video.
This RCT evaluated infliximab withdrawal in patients with Crohn’s disease in remission on infliximab maintenance therapy. Time to relapse was significantly shorter among patients who discontinued infliximab than those who continued therapy. #GITwitter
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New editorial by Steven R. Cummings, M.D., and Clifford Rosen, M.D.: "The VITAL Trial: A Decisive Verdict about Vitamin D Supplementation"
With policymakers targeting members of sexual and gender minority groups, the health care sector can mitigate resulting harm and advocate for evidence-based policies protecting health and well-being.
VIOLET trial in pts with recurrent vulvovaginal candidiasis: The primary objective was to evaluate oteseconazole efficacy through week 48; key secondary objectives evaluated time to first recurrence, safety, and patient-reported outcomes. #ObgynTwitter
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A 23-year-old man presented with double vision and eyelid drooping on the right side that worsened at the end of the day. The neurologic examination showed ptosis on the right side and "curtain sign."
Health law shapes the landscape of health care delivery in powerful ways. The history of health law can be broken into four eras, each with its own prevailing ethos.
In this editorial, @TimGreten and @CeciliaMonge4 evaluate the TOPAZ-1 trial by Oh et al. and the HIMALAYA trial by @GABOUALFA et al., trials describing novel immunotherapy options for patients with biliary tract cancer and hepatocellular carcinoma. #HCC
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A 68-year-old woman living in Japan presented with a 5 day history of fevers, myalgias, and petechial rash spreading on her arms, trunk, palms and soles. On exam, there was also an eschar on the right medial ankle. Which is the most appropriate treatment?
Sharpen your ability to evaluate medical evidence. Request institutional access to NEJM Evidence today: #MedEd #MedTwitter #ClinicalTrials
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A combination of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine has been shown to improve progression-free survival in Hodgkin's lymphoma. Data on overall survival are needed. New research findings are summarized in a short video.
Erin Fuse Brown, J.D., M.P.H., discusses the history of health law in the United States and potential future directions for the field.
In this editorial, Armando Teixeira-Pinto, PhD, discusses key points that should be considered when designing randomized discontinuation trials: noninferiority versus superiority design, cointervention bias, and follow-up time. #ClinicalTrials #MedTwitter
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Primary care practices are increasingly taking on accountability for total health care spending for a defined population. Such arrangements could have implications for clinicians and patients.
A 59-year-old woman with a history of smoking tobacco presented with a 5-month history of darkening of the skin on her palms. Velvety thickening on the palms and fingers was observed on physical examination.
A 61 y/o man presented with chest pain that had been progressively worsening for 2 days. In this #MorningReport, @PennCVFellows @mkvidula and @sheelakrishmd review their approach to evaluating this pt. #CardioTwitter #MedEd
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A 49-year-old man with a family history of diabetes was evaluated because of hypoglycemia. Two hours earlier, he had been found on the floor, obtunded and making nonpurposeful movements. A diagnostic test was performed.
Smoking addiction causes substantial illness and death; morbidity and mortality are markedly reduced with cessation. Effective treatments for smoking addiction include medications and counseling.
The editors are joined by ACTG Chair Judy Currier, M.D., to discuss the evolving role of research groups in combatting Covid-19 and future epidemics.
NEJM Evidence Special Collection: Original research and innovative articles that inform clinical decision making! Download the PDF Collection today: #MedTwitter #MedEd #ClinicalTrials
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Rare mutations in CIDEB protect against liver disease, making the gene a candidate target for treatment. Suppression of CIDEB interferes with the formation of fat droplets in cells.
Litifilimab, a blood dendritic cell antigen 2 antibody, was superior to placebo with regard to a measure of disease activity in cutaneous lupus erythematosus at 16 weeks.
A study ancillary to a large trial showed that supplemental vitamin D3 did not lower the risk of fractures among generally healthy midlife and older adults not selected for vitamin D deficiency, low bone mass, or osteoporosis.
Why are young internists flocking to the hospitalist practice style? Clinical Conversations hosts a roundtable to tackle this question. Listen in: #hospitalmedicine @HollandKaplan @SGBraunthal @TheFrancesUe
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