Curated News: NEJM

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UCLA researchers have found a better way to treat many skin abscesses in the emergency department. The findings are important due to the emergence of community-acquired methicillin-resistant Staphylococcus aureus, or MRSA, which since 2000 has become the most common cause of skin infections in the U.S. The findings could improve recovery from infection while limiting its spread.

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Sophisticated prenatal techniques, not yet in clinical practice, offer the potential to prevent a cruel multi-system genetic disease passing from mother to child long before birth. However, these emerging tools raise ethical and social questions.

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There is a unique role for the United States medical community to play in determining the future application of, and ethically acceptable approach to, mitochondrial replacement techniques (MRTs), according to a commentary published online by the New England Journal of Medicine.

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Stenting and surgery are equally effective at lowering the long-term risk of stroke from a narrowed carotid artery, according to results of CREST – a 10-year, federally funded clinical trial led by researchers at Mayo Clinic’s campus in Florida. The results are being published today online in the New England Journal of Medicine and presented at the American Heart Association’s International Stroke Conference in Los Angeles.

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As men age, their testosterone levels decrease, but prior studies of the effects of administering testosterone to older men have been inconclusive. Now, research shows that testosterone treatment for men over 65 improves sexual function, walking ability and mood, according to a study published in the New England Journal of Medicine by team researchers from the Perelman School of Medicine at the University of Pennsylvania, and twelve other medical centers in the United States, in partnership with the National Institute on Aging.

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Yale Cancer Center researchers have identified what causes a third of all myelomas, a type of cancer affecting plasma cells. The findings, published in the Feb. 11 issue of the New England Journal of Medicine, could fundamentally change the way this cancer and others are treated.

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The public defunding of Planned Parenthood in Texas may have led to a decrease in highly effective forms of contraceptive services and an increase in Medicaid-paid childbirths among women who previously used injectable contraception, according to a peer-reviewed study by University of Texas at Austin researchers.

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Chlorhexidine-alcohol skin prep is superior to iodine-alcohol for preventing infection after C-section, according to a new study from Washington University School of Medicine in St. Louis.

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Researchers from Columbia University Medical Center and NewYork-Presbyterian have found that using corticosteroids in mothers at risk for late preterm delivery reduced the incidence of severe respiratory complications in their babies.

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For the first time, an immunosuppressive agent has shown better organ survival in kidney transplant recipients than a calcineurin inhibitor, the current standard of care, according to a worldwide study led by UC San Francisco and Emory University investigators.

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Using a new computer science approach, researchers at University of California, San Diego School of Medicine, Columbia University and Stanford University discovered a distinctive molecular feature — a biomarker — that identified colon cancer patients who were most likely to remain disease-free up to five years after surgery. The biomarker, a protein called CDX2, also helped the researchers identify Stage II colon cancer patients who are most likely to benefit from chemotherapy after surgery.

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Each year approximately 1 in 1,000 pregnant women will experience peripartum cardiomyopathy, an uncommon form of often severe heart failure that occurs in the final month of pregnancy or up to five months following delivery. But the cause of peripartum cardiomyopathy has been largely unknown – until now. Researchers from the Perelman School of Medicine at the University of Pennsylvania analyzed the genetic variants that have been associated with another form of inherited cardiomyopathy, and determined that peripartum cardiomyopathy is often the result of a genetic mutation. The findings of this study are detailed in this week’s New England Journal of Medicine.

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Scientists have found that women who suffer unexplained heart failure towards the end of pregnancy or shortly after giving birth share certain genetic changes.

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Scientists have found that women who suffer unexplained heart failure towards the end of pregnancy or shortly after giving birth share certain genetic changes.

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In one of the most tightly controlled trials ever conducted of drugs used to treat sexually transmitted infections, researchers at UAB have confirmed that azithromycin remains effective in the treatment of urogenital chlamydia.

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Largest study ever of pulmonary hypertension could lead to easier treatment of the heart disease that most often affects young women. The oral medication Selexipag significantly reduced hospitalizations and worsening symptoms.

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Researchers found that very low water pressure was an acceptable, low-cost alternative for washing out open fractures, and that the reoperation rate was higher in the group that used soap.

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Experts can speak on the factors contributing to the rise in popularity of walk-in urgent care and primary care centers across the U.S., as well as the future growth of this sector and the business potential associated with consolidation among urgent care networks.

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In a study into the prevention of HIV transmission, people who took the antiretroviral drug Truvada were 86% less likely to contract the disease than those who took a placebo, report the researchers who led the study.

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New research from the University of Birmingham, UK, has shown that progesterone supplements in the first trimester of pregnancy do not improve outcomes in women with a history of unexplained recurrent miscarriages.

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As new scientific discoveries deepen our understanding of how cancer develops in children, doctors and other healthcare providers face challenges in better using that knowledge to guide treatment and counsel families and patients. A CHOP oncologist offers expert commentary on a major study of cancer predisposition genes.

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Even in war, hospitals have a kind of invisible bubble around them. But in Syria, that bubble has burst dozens of times, says a new report. And that may put medical facilities and workers in other conflict zones in danger too, according to a new opinion piece in the New England Journal of Medicine.

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St. Jude Children’s Research Hospital-Washington University Pediatric Cancer Genome Project completes the most comprehensive analysis yet of the role genes associated with cancer predisposition play in childhood cancer

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Researchers at the Toronto Western Hospital (TWH) Liver Clinic have found that a simple drug regimen delivered over 1​2 weeks achieved sustained eradication of several genotypes of the hepatitis C virus (HCV) in 99 per cent of the trial's patients.

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Approximately 12 million people in the United States experience diagnostic errors annually, but it is time for a change, according to researchers at RTI International, the Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center.

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TAMPA, Fla. – New research from Moffitt Cancer Center and its collaborators find that the drug combination rituximab plus lenalidomide was effective and produced long-term responses in patients with mantle cell lymphoma. The results from the multicenter phase 2 study were published in the Nov. 5 issue of The New England Journal of Medicine.

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Bleeding complications present the most common risk for patients taking blood thinners. Without an antidote, there is no way to quickly reverse the effects of a blood thinner in emergency situations.

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Treating patients 50 and older with high blood pressure to a systolic blood pressure of less than 120 mm Hg reduced rates of cardiovascular events, including heart attack, heart failure and stroke, by 25 percent.

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Treating patients 50 and older with high blood pressure to a systolic blood pressure of less than 120 mm Hg reduced rates of cardiovascular events, including heart attack, heart failure and stroke, by 25 percent.

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Continuous chest compression, touted as the new way to perform cardiopulmonary resuscitation, was not an improvement over standard CPR, according to findings published in NEJM by eight US and Canadian universities in the ROC consortium.

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Continuous chest compression, touted as the new way to perform cardiopulmonary resuscitation, was not an improvement over standard CPR, according to findings published in NEJM by eight US and Canadian universities in the ROC consortium.

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Jackson T. Wright Jr., MD, PhD, and researchers from University Hospitals Case Medical Center presented new results from the Systolic Blood Pressure Intervention Trial (SPRINT) showing that in patients at high risk for cardiovascular events, targeting a systolic blood pressure of less than 120 mm Hg resulted in lower rates of fatal and non-fatal major events or death compared to targeting systolic blood pressure to the usually recommended target of less than 140 mm Hg.

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Researchers have identified a protein measured by an inexpensive blood test can predict a person’s chances of developing chronic kidney disease up to five years before kidney damage begins. In findings published online today in the New England Journal of Medicine (NEJM), researchers led by Rush University Medical Center Chairman of Medicine Jochen Reiser, MD, PhD, showed that High levels of the suPAR protein indicate future kidney disease much like cholesterol and blood pressure levels help predict heart disease. “SuPAR promises to do for kidney disease what cholesterol has done for cardiovascular disease,” predicts Reiser.

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Drug abusers are not completely abandoning prescription opioids for heroin, according to researchers at Washington University School of Medicine in St. Louis. Instead, many use the two concurrently based on their availability. The findings also reveal regional variations in the use of heroin and prescription painkillers.

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Identifying a patient’s genetic mutation led University of Arkansas for Medical Sciences (UAMS) physician-researcher Ling Gao, M.D., Ph.D., to an existing drug that eliminated the patient’s stage IV Merkel-cell carcinoma. Gao’s findings, made in collaboration with two other UAMS researchers, were published today in The New England Journal of Medicine. Metastatic Merkel-cell carcinoma is often fatal and there is no effective treatment. Gao’s 86-year-old female patient was diagnosed in 2013 with stage IIIB Merkel-cell carcinoma of the right temple. She had surgery and received radiation therapy in May 2013 and additional surgery in July 2014. In November 2014, doctors confirmed that the cancer had metastasized.

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A large, randomized study at 11 U.S. hospitals including Dartmouth-Hitchcock Medical Center found that vitamin D and calcium supplements fail to protect against developing colorectal cancer.

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A study published in the New England Journal of Medicine found that vitamin D and calcium supplements do not reduce the risk of colorectal adenomas, which are benign tumors that can evolve into colorectal cancer.

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The New England Journal of Medicine reports the results of a 2,259-person study conducted at 11 academic medical centers, including University of Colorado Cancer Center, showing that taking vitamin D and/or calcium supplements after the removal of pre-cancerous colorectal polyps does not reduce risk of developing polyps in the future.

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Although the public and private sectors are currently engaged in an unprecedented array of efforts to improve end-of-life care, too many of these programs are not evidence-based, according to a scholar from the Perelman School of Medicine at the University of Pennsylvania. Writing in the New England Journal of Medicine, Scott Halpern, MD, PhD, associate professor of Medicine, Epidemiology, and Medical Ethics and Health Policy, says that despite recent federal decisions that signal a renewed interest in improving end-of-life care, investigators and research sponsors must be more involved to “identify, develop and rigorously test interventions so they can offer guidance” on implementing programs that work among the terminally ill.

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Heart valve replacements made from tissue (bioprosthetic valves) have long been thought to be spared the complication of blood clot formation. Researchers have now found that about 15 percent of all bioprosthetic aortic heart valve patients develop blood clots on the leaflets affecting valve opening, regardless of whether the patient received the new valve via open-heart surgery or a minimally-invasive catheter procedure, a new study from the Cedars-Sinai Heart Institute shows.

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An experimental, biologic treatment, brodalumab, achieved 100 percent reduction in psoriasis symptoms in twice as many patients as a second, commonly used treatment, according to the results of a multicenter clinical trial led by Mount Sinai researchers and published online today in the New England Journal of Medicine.

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A new study led by researchers in the UNC Department of Pediatrics finds a direct correlation between more severe forms of obesity in children and related risk factors for developing heart disease and diabetes—particularly in boys.

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Two decades after a UCSF researcher proposed that reducing nicotine in cigarettes as a national regulatory policy might facilitate quitting, a new study he co-authored has added to a body of evidence that indicates that doing just that may accomplish this goal.

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It is the first large-scale clinical trial to examine the effects of reduced-nicotine cigarettes on smoking behavior and exposure to products contained within cigarette smoke, according to study co-investigator Hilary Tindle, M.D., MPH, associate professor of Medicine and founding director of the Vanderbilt Center for Tobacco, Addiction and Lifestyle (ViTAL).

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It is the first large-scale clinical trial to examine the effects of reduced-nicotine cigarettes on smoking behavior and exposure to products contained within cigarette smoke, according to study co-investigator Hilary Tindle, M.D., MPH, associate professor of Medicine and founding director of the Vanderbilt Center for Tobacco, Addiction and Lifestyle (ViTAL).

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More than 3 million children in the United States who are severely obese may be at a higher risk of developing heart disease and diabetes than overweight children, according to a new study by researchers at Wake Forest Baptist Medical Center and the University of North Carolina at Chapel Hill.

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A new drug for renal cell carcinoma slowed the growth of advanced kidney cancer in patients who became resistant to the first-line therapies that had previously kept it in check, according to results from a clinical trial led by Dana-Farber Cancer Institute.

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For the first time, an immune checkpoint inhibitor has been proven to increase survival among patients with advanced renal cell carcinoma (RCC), a patient population for whom treatment options are currently limited.

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In this week's New England Journal of Medicine, researchers report results of a trial showing the efficacy of a new enzyme-replacement therapy for lysosomal acid lipase deficiency. In an accompanying editorial, Daniel J. Rader, MD, chair of the department of Genetics in the Perelman School of Medicine at the University of Pennsylvania, notes that this first-ever hepatocyte-targeting therapy will be pivotal in treating this disease.

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Imetelstat, a novel drug that targets telomerase, has demonstrated potential value in treating patients with myelofibrosis, according to the results of a study published today in the New England Journal of Medicine.