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Management of Skin and Soft-Tissue Infection
This interactive feature presents the case of a 20-year-old basketball player with acute onset of a red, painful area on his right buttock over the previous 2 days. Three possible treatment options are presented. Vote and submit a comment about your clinical decision.
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| Read the Case Vignette, consider Treatment Options, then cast your Vote. |
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Quality of Life with Defibrillator Therapy or Amiodarone in Heart Failure
It has been suggested that ICD implantation may adversely affect the quality of life. In this trial, the evaluation of several quality-of-life measures disclosed no long-term effect, although a temporary adverse effect was evident within 1 month after an ICD shock.
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Prognostic Importance of Defibrillator Shocks in Patients with Heart Failure
The occurrence of ICD shocks, whether appropriate or inappropriate, was associated with a significant increase in the subsequent risk of death from all causes.
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Hyponatremia and Mortality among Patients on the Liver-Transplant Waiting List
This analysis of registrants on the waiting list for liver transplantation showed that the addition of the serum sodium concentration to the Model for End-Stage Liver Disease (MELD) score improves prognostic accuracy and may reduce mortality among patients on the waiting list who have low MELD scores and serum sodium levels.
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Hereditary Angioedema
A 19-year-old woman presents to the emergency department with light-headedness, severe abdominal pain, and intractable nausea and vomiting that began 12 hours earlier. How should her case be evaluated and treated?
CME Exam
 Listen to the full text of this article.
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Management of Acute Cutaneous Wounds
The primary goal in the management of wounds is to achieve rapid healing with optimal functional and cosmetic results. The authors summarize the current treatments for lacerations, including abrasions, skin tears, puncture wounds, and bite wounds, and for burns. CME Exam
VIDEO: MANAGEMENT OF ACUTE CUTANEOUS WOUNDS
This video demonstrates techniques for the irrigation of wounds, application of topical skin adhesives and surgical tapes, and treatment of subungual hematomas.
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Collateral Damage
A 50-year-old man presented to the emergency room with severe right-sided abdominal and flank pain for the previous 18 hours.
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Guns and Suicide in the United States
In 2005, an average of 46 Americans per day committed suicide with a firearm, accounting for 53% of all completed suicides. Dr. Matthew Miller and David Hemenway write that the empirical evidence linking suicide risk in the United States to the presence of firearms in the home is compelling.
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Drug Warnings That Can Cause Fits
In January, the FDA announced that it had found a near-doubling of suicidal ideation and behavior among trial subjects randomly assigned to receive anticonvulsant medications rather than placebo. Dr. Jerry Avorn writes that the anticonvulsant–suicidality controversy reveals the limits of our capacity to ascertain adverse events and the challenges inherent in risk communication.
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Close Calls
Dr. Perri Klass writes that she didn’t realize she was on call one night until she was at Fenway Park and a ball game was well under way. Then she got the kind of page that you don’t want as an on-call pediatrician — let alone from a parent who doesn’t speak English very clearly, let alone when you’re stuck in a noisy public place.
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The FDA and Tobacco Regulation
Soon the U.S. Senate will vote on a bill that would grant authority to the FDA to regulate tobacco products. Journal editors Gregory Curfman, Stephen Morrissey, and Jeffrey Drazen urge the Senate to pass it and to do so with a veto-proof margin.
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Fatal Oseltamivir-Resistant Influenza Virus Infection
The incidence of influenza A (H1N1) viruses that carry the neuraminidase H274Y mutation has increased by 30% this year in the Netherlands. This case suggests that this oseltamivir-resistant virus can be pathogenic, at least in an immunocompromised patient.
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Identifying and Addressing Safety Signals in Clinical Trials
 September 3, 2008 (DOI: 10.1056/NEJMe0807372), in Print September 25, 2008
Life and Death after ICD Implantation
Predicting Mortality in Cirrhosis — Serum Sodium Helps
Aliskiren Combined with Losartan in Diabetes and Nephropathy
Methylnaltrexone for Opioid-Induced Constipation in Advanced Illness
Cancer Immunotherapy
Cricothyroidotomy
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