-
-
Editorial
A New mRNA Vaccine
E.J. Rubin, L.R. Baden, and S. Morrissey
In this audio interview conducted on June 22, the editors discuss preliminary results from a study of CVnCoV, a new mRNA vaccine, as well as new data on Covid-19 transmission and the effectiveness of vaccination in immunosuppressed patients.
Jun 24 -
Original Article
Meeting of the Peripheral Nerve Society
CRISPR-Cas9 Disruption of TTR in Transthyretin Amyloidosis
J.D. Gillmore and Others
A lipid nanoparticle containing mRNA for Cas9 protein and a single guide RNA targeting TTR was infused with the goal of insertion into hepatocytes and blocking of transthyretin production in patients with transthyretin amyloidosis. At a dose of 0.3 mg per kilogram, a single intravenous injection resulted in an 87% reduction in transthyretin levels, with only mild adverse events.
Jun 26
-
Editorial
A New mRNA Vaccine
E.J. Rubin, L.R. Baden, and S. Morrissey
-
-
Original Article
Meeting of the American Diabetes Association
Cardiovascular and Renal Outcomes with Efpeglenatide
H.C. Gerstein and Others
This trial compared weekly injections of efpeglenatide, an exendin-based glucagon-like peptide-1 receptor agonist, at a dose of 4 or 6 mg with placebo in participants with known type 2 diabetes and either a history of cardiovascular disease or current kidney disease plus at least one other cardiovascular risk factor. The risk of cardiovascular events was lower with efpeglenatide.
Jun 28
-
-
-
Perspective
Pregnant Women with Substance Use Disorders
R.L. Haffajee, L.J. Faherty, and K. Zivin
Behavioral health conditions in pregnant women are often associated with negative health outcomes. But there has been an alarming trend among states to punish pregnant women with substance use disorders, rather than ensure that they receive appropriate care.
Jun 24 -
Correspondence
Vaccination and Household Transmission of SARS-CoV-2
R.J. Harris and Others
In this study involving household contacts of persons with laboratory-confirmed Covid-19, the risk of household transmission was 40 to 50% lower among household contacts of index patients who had received one dose of vaccine 21 days or more before testing positive than among contacts of unvaccinated index patients.
Jun 23
-
Perspective
Pregnant Women with Substance Use Disorders
R.L. Haffajee, L.J. Faherty, and K. Zivin
-
-
Perspective
Health Equity and Medicaid Transformation
S. Rosenbaum
President Biden has made reforms intended to “protect and strengthen Medicaid” a centerpiece of his health policy agenda. Given Medicaid’s size and complexity, the administration faces myriad policy and operational challenges.
Jun 24 -
Correspondence
Three Covid-19 Vaccine Doses in Transplant Recipients
N. Kamar and Others
Solid-organ transplant recipients receiving immunosuppressive therapy appear to have a poor response to Covid-19 vaccination. A group of 101 consecutive transplant recipients received two doses of the BNT162b2 vaccine 1 month apart and a third dose 2 months after the second dose; 40% had antibodies after the second dose and 68% had antibodies after the third dose.
Jun 23
-
Perspective
Health Equity and Medicaid Transformation
S. Rosenbaum
-
COVID-19 in 2021:
Lessons Learned and Remaining Challenges131st Annual Shattuck Lecture
Anthony S. Fauci, M.D., and Eric J. Rubin, M.D., Ph.D.

Massachusetts Medical Society and New England Journal of Medicine
Original Research
-
-
Original Article
Genetic Deficit in the Cellular Sanitation System
J.J. Collier and Others
Autophagy is a cellular process through which toxic aggregates, pathogens, and damaged organelles are disposed of and essential metabolites recycled. This study challenges the belief that a core autophagy protein is indispensable.
Jun 24Editorial The Importance of Being Autophagic
-
-
-
Original Article
Meeting of the American Diabetes Association
Tirzepatide versus Semaglutide for Type 2 Diabetes
J.P. Frías and Others
This open-label, 40-week, phase 3 trial assessed the efficacy and safety of tirzepatide, a weekly dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist under development for type 2 diabetes. Tirzepatide was noninferior and superior to semaglutide with respect to the mean change in the glycated hemoglobin level from baseline to 40 weeks.
Jun 25Editorial Breaking New Ground with Incretin Therapy in Diabetes
-
Original Article
Treatment of Rectal Chlamydia
A. Lau and Others
In this randomized, controlled trial involving men who have sex with men being treated in five Australian sexual health clinics, 7-day doxycycline therapy was found to be superior to single-dose azithromycin for the treatment of rectal chlamydia infection.
Jun 24
-
Original Article
Meeting of the American Diabetes Association
Tirzepatide versus Semaglutide for Type 2 Diabetes
J.P. Frías and Others
-
-
Original Article
Resistance to KRAS Inhibition
M.M. Awad and Others
A study involving 38 patients who initially had a response to adagrasib or who had a long period of stable disease in response to the drug but then had progression yielded diverse mechanisms of acquired resistance in 45% of them. Unlike resistance to the tyrosine kinase inhibitors, the cancer cell uses many mechanisms to overcome the inhibition of KRAS.
Jun 24Original Article Sotorasib for Lung Cancers with KRAS p.G12C Mutation
Editorial Finally, Effective Inhibitors of Mutant KRAS -
Correspondence
Vaccination after SARS-CoV-2 Infection
Y. Lustig and Others
Six patients previously infected with the original SARS-CoV-2 virus received the BNT162b2 vaccine. Before vaccination, they had neutralizing activity against the B.1.1.7 and P.1 variants but not the B.1.351 variant. After one dose, neutralizing activity against all variants increased substantially.
Jun 24
-
Original Article
Resistance to KRAS Inhibition
M.M. Awad and Others
-
-
Original Article
Lutetium-177–PSMA-617 in Prostate Cancer
O. Sartor and Others
Guiding the beta-emitting isotope lutetium-177 to prostate cancer lesions with the prostate-specific membrane antigen–targeted radioligand 177Lu-PSMA-617 plus using standard care was compared with standard care in patients with metastatic castration-resistant prostate cancer. The radioligand therapy prolonged progression-free and overall survival. Adverse effects were more common, but quality of life was maintained.
Jun 23 -
Correspondence
Reducing the Need for HLA-Matched Platelet Transfusion
A. Cardillo and Others
Some patients with acute leukemia or myelodysplastic syndromes with thrombocytopenia may become resistant to random donor transfusions of platelets and require HLA-matched platelets to have an adequate response. In one large center, the use of leukoreduction and universal ABO matching reduced the requirement for HLA-matched platelets from 12.5% to 0.4% of all platelet transfusions.
Jun 24
-
Original Article
Lutetium-177–PSMA-617 in Prostate Cancer
O. Sartor and Others
-
Learn More
Covid-19 Vaccine Resource Center
Practical guidance for your practice and patients
Clinical Practice and Review
-
-
Case Records of the Massachusetts General Hospital
A Man with Irritability, Confusion, and Odd Behaviors
N. Kontos and Others
A 54-year-old man was evaluated in the neuropsychology clinic because of irritability, confusion, and odd behaviors. Nine months earlier, he had been treated for cancer, after which chronic pain had developed. Six weeks before the current evaluation, he had been found unresponsive with medication bottles nearby. What is the diagnosis?
Jun 24 -
Review Article
Infections in Patients with Cirrhosis
J.S. Bajaj, P.S. Kamath, and K.R. Reddy
Patients with cirrhosis are at increased risk for serious infections, including spontaneous bacterial peritonitis, multidrug-resistant infection, and infection with gut microorganisms. In-hospital mortality exceeds 50%. Empirical antibiotic coverage is used until a precise diagnosis can be made.
Jun 17
-
-
-
Clinical Practice
Stress Incontinence in Women
J.M. Wu
Stress incontinence is common among women but underdiagnosed. Effective initial interventions include weight loss in overweight or obese women and pelvic-floor muscle exercises. Other options include pessaries or surgery (most commonly midurethral mesh sling surgery) for women with bothersome symptoms not responsive to other interventions.
Jun 24 -
Videos in Clinical Medicine
Nasal Cauterization with Silver Nitrate for Recurrent Epistaxis
D.A. Gudis and Z.M. Soler
Most epistaxis is isolated or self-limited, but it is recurrent in approximately 16% of the general population, many of whom seek medical advice. This video demonstrates the evaluation of a patient with recurrent epistaxis and the technique used to perform nasal cauterization with silver nitrate in the office.
Jun 24 -
Perspective
Missing the Point
S. Ratzan and Others
To date, relatively few Americans have received Covid vaccinations where they usually receive care: their regular doctor’s office. Going forward, the sidelining of primary care clinicians and health systems that people trust could hinder progress and undermine equity.
Jun 24
-
Clinical Practice
Stress Incontinence in Women
J.M. Wu
Commentary
-
Advancing the Learning Health System
J.M. McGinnis, H.V. Fineberg, and V.J. Dzau -
Is Learning Worth the Trouble?
R.Platt, G.E. Simon, and A.F. Hernandez -
Finally, Effective Inhibitors of Mutant KRAS
N. Rosen -
The Importance of Being Autophagic
I. Ganley -
Combating Anti-Asian Sentiment
J.H. Lee -
Repairing Harms Inflicted on Immigrant Children
N.E. Wang, R. Matlow, and A. Shapiro -
Missing the Point
S. Ratzan and Others -
Polling Results: Doctor, How Long Should I Isolate?
S.R. Kadire, V. Fabre, and R.P. WenzelRead the polling results analysis, located in the Comments.



