New England Journal of Medicine (NEJM) - Latest Issue

New England Journal of Medicine

The New England Journal of Medicine (NEJM) RSS feed -- current issue. NEJM (http://www.nejm.org) is a weekly general medical journal that publishes new medical research findings, review articles, and editorial opinion on a wide variety of topics of importance to biomedical science and clinical practice

URL: http://content.nejm.org

Updated: 23 hours 19 min ago

PERSPECTIVE: Communicating Medical News -- Pitfalls of Health Care Journalism

Wed, 31/12/2008 - 22:55

Whether they realize it or not, journalists reporting on health care developments deliver public health messages that can influence the behavior of clinicians and patients. Often these messages are delivered ...

Categories: Medical - Médical

PERSPECTIVE: Focus on Research: The Many Causes of Severe Congenital Neutropenia

Wed, 31/12/2008 - 22:55

In 1956, Rolf Kostmann, a Swedish pediatrician, described an autosomal recessive disorder that he called infantile genetic agranulocytosis -- which is now called severe congenital neutropenia. The Kostmann form of ...

Categories: Medical - Médical

ORIGINAL ARTICLE: Machine Perfusion or Cold Storage in Deceased-Donor Kidney Transplantation

Wed, 31/12/2008 - 22:55

In this international randomized, controlled trial, one kidney from each pair from 336 consecutive deceased donors was randomly assigned to machine perfusion and the other to cold storage. All recipients were followed for 1 year. Hypothermic machine perfusion was associated with a reduced risk of the primary end point -- delayed graft function -- and improved graft survival in the first year after transplantation.

Categories: Medical - Médical

ORIGINAL ARTICLE: Decontamination of the Digestive Tract and Oropharynx in ICU Patients

Wed, 31/12/2008 - 22:55

Infection is a major cause of death in the intensive care unit (ICU). Strategies to reduce rates of infection in ICUs include selective digestive tract decontamination (SDD), in which cefotaxime and topical antimicrobial agents are administered for 4 days, and selective oropharyngeal decontamination (SOD), in which only topical antimicrobial agents are administered. In this cluster-randomization study involving 13 ICUs in the Netherlands, SOD and SDD did not affect crude mortality but did appear to reduce mortality slightly at day 28, with adjustment for covariates.

Categories: Medical - Médical

ORIGINAL ARTICLE: A Syndrome with Congenital Neutropenia and Mutations in G6PC3

Wed, 31/12/2008 - 22:55

Five children from two consanguineous families were born with severe congenital neutropenia, prominent venous angiectasia, and congenital heart defects, urogenital abnormalities, or both. All five children had the same mutation in the gene for glucose-6-phosphatase, catalytic subunit 3 (G6PC3). Their neutrophils had increased susceptibility to apoptosis, and the mutation abolished the enzymatic activity of glucose-6-phosphatase.

Categories: Medical - Médical

ORIGINAL ARTICLE: Modulation of Blood Pressure by Central Melanocortinergic Pathways

Wed, 31/12/2008 - 22:55

This study shows that the prevalence of hypertension in subjects carrying a loss-of-function mutation in MC4R is less than that in overweight or obese control subjects. Metabolic measurements and results of a clinical trial testing an MC4R agonist suggest that melanocortinergic signaling influences blood pressure through an insulin-independent mechanism.

Categories: Medical - Médical

ORIGINAL ARTICLE: Giant Osteoclast Formation and Long-Term Oral Bisphosphonate Therapy

Wed, 31/12/2008 - 22:55

This study examined bone-biopsy specimens obtained after a 3-year, double-blind, randomized, placebo-controlled, dose-ranging trial of oral alendronate to prevent bone resorption in healthy postmenopausal women. Long-term alendronate treatment was associated with an increase in the number of osteoclasts, which include distinctive giant, hypernucleated, detached osteoclasts that undergo protracted apoptosis. The finding of such cells, despite decreased resorption after long-term therapy with oral nitrogen-containing bisphosphonate, may have clinical implications.

Categories: Medical - Médical

CLINICAL THERAPEUTICS: Radiation Therapy for Early-Stage Breast Cancer after Breast-Conserving Surgery

Wed, 31/12/2008 - 22:55

A 45-year-old woman is found to have invasive breast cancer and undergoes lumpectomy with dissection of the sentinel lymph nodes. After 6 months of adjuvant chemotherapy, radiation therapy is recommended. Radiation therapy has been shown to reduce the risk of local recurrence after breast-conserving surgery. The most serious complications include lung and heart injury and secondary cancers.

Categories: Medical - Médical

IMAGES IN CLINICAL MEDICINE: Chondrocalcinosis and Hypomagnesemia

Wed, 31/12/2008 - 22:55

A 50-year-old woman presented with a several-year history of acute and chronic joint pain. Her serum magnesium level was 0.9 mg per deciliter (0.4 mmol per liter) (normal range, 1.6 ...

Categories: Medical - Médical

IMAGES IN CLINICAL MEDICINE: Monocular Paralysis of Vertical Ductions after Facial Trauma

Wed, 31/12/2008 - 22:55

A 44-year-old woman presented with painful diplopia while looking up or down after being struck in the left eye with a bare fist. She had no proptosis or ptosis, and ...

Categories: Medical - Médical

CLINICAL PROBLEM-SOLVING: Keeping an Open Mind

Wed, 31/12/2008 - 22:55

A 67-year-old man presented with a 3-month history of fatigue and fever. He had undergone heart transplantation 6 years earlier for idiopathic cardiomyopathy. He reported no weight loss, night sweats, or chills. He also reported no headache, rash, joint swelling, dysuria, or abdominal or respiratory problems.

Categories: Medical - Médical

EDITORIAL: Organ Procurement and Perfusion before Transplantation

Wed, 31/12/2008 - 22:55

Organ transplantation is one of the great success stories of modern medicine. Living-donor kidney transplantations between identical twins during the early 1950s first demonstrated the overall feasibility of this procedure ...

Categories: Medical - Médical

EDITORIAL: The Deceiving Appearances of Osteoclasts

Wed, 31/12/2008 - 22:55

Osteoclasts are multinucleated cells responsible for the resorption of bone matrix. During the development and growth of a human, they ensure proper contouring of the bones and extension of the ...

Categories: Medical - Médical

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Does the Trojan Horse Have an Achilles' Heel?

Wed, 31/12/2008 - 22:55

Blocking a bacterial sensor that is activated in vivo suppresses the bacterial virulence of Salmonella typhimurium and Francisella tularensis in mice.

Categories: Medical - Médical

CORRESPONDENCE: Calcific Aortic Stenosis

Wed, 31/12/2008 - 22:55

To the Editor: In their article on intensive lipid lowering, Rossebø et al. (Sept. 25 issue)1 report that therapy with ...

Categories: Medical - Médical

CORRESPONDENCE: Analyses of Cancer Data from Three Ezetimibe Trials

Wed, 31/12/2008 - 22:55

To the Editor: The article by Peto et al. (Sept. 25 issue),1 which reports cancer incidence and mortality in three ...

Categories: Medical - Médical

CORRESPONDENCE: Lung Cancer

Wed, 31/12/2008 - 22:55

To the Editor: In the introductory remarks of their article, Herbst et al. (Sept. 25 issue)1 note, "Smoking causes all ...

Categories: Medical - Médical

CORRESPONDENCE: Persistent Fainting after Implantation of a "Curative" Pacemaker

Wed, 31/12/2008 - 22:55

To the Editor: Syncope is a common and disabling problem, and its cause may be difficult to elucidate. A 64-year-old ...

Categories: Medical - Médical

CORRESPONDENCE: Reports of Esophageal Cancer with Oral Bisphosphonate Use

Wed, 31/12/2008 - 22:55

To the Editor: Between the time of the initial marketing of alendronate in October 1995 through mid-May 2008, the Food ...

Categories: Medical - Médical

BOOK REVIEW: Hope and Suffering: Children, Cancer, and the Paradox of Experimental Medicine

Wed, 31/12/2008 - 22:55

Hope and Suffering is an apt title for this dense, encyclopedic, and riveting book. It includes narratives from patients and their family members that detail the hope, suffering, and despair ...

Categories: Medical - Médical