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Original Article
Randomized, Controlled Trial of Ebola Treatments
S. Mulangu and Others
Ebola transmission has been ongoing in the Democratic Republic of Congo since August 2018. In this trial of MAb114, REGN-EB3, remdesivir, and ZMapp (as the control), mortality from Ebola virus disease was lower in the MAb114 and REGN-EB3 groups than in the other groups.
Dec 12Editorial Monoclonal Antibody Therapy for Ebola Virus Disease
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Original Article
Ribociclib and Fulvestrant in Metastatic Breast Cancer
D.J. Slamon and Others
An earlier report documented significant improvement in progression-free survival among patients with metastatic breast cancer treated with fulvestrant and a cyclin-dependent kinase inhibitor, ribociclib. With longer follow-up, it is clear that fulvestrant and ribociclib also prolong overall survival.
Dec 11 -
Case Challenge
A 26-Year-Old Returning Traveler with Headache
A 26-year-old woman presented with severe headache that developed during a winter vacation in Europe. What is the most likely diagnosis? Vote and comment. On twitter, use #NEJMCases.
Dec 11
Find the answers in the full text of the case, to be published on December 26.
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Original Article
Ribociclib and Fulvestrant in Metastatic Breast Cancer
D.J. Slamon and Others
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Original Article
San Antonio Breast Cancer Symposium
Tucatinib for HER2-Positive Metastatic Breast Cancer
R.K. Murthy and Others
In women with HER2-positive metastatic breast cancer who had previously received HER2-targeted therapy, tucatinib, a new selective inhibitor of the HER2 tyrosine kinase, was added to trastuzumab and capecitabine and compared with trastuzumab and capecitabine plus placebo. Progression-free survival at 1 year was 33% with tucatinib and 12% with placebo.
Dec 11 -
Perspective
Double Environmental Injustice
J.M. Shultz and Others
The escalating effects of hurricanes on population health represent a double environmental injustice: disadvantaged populations sustain disproportionate harm, and those most vulnerable to hurricanes contribute little to the climate change that is exacerbating them.
Dec 11
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Original Article
San Antonio Breast Cancer Symposium
Tucatinib for HER2-Positive Metastatic Breast Cancer
R.K. Murthy and Others
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Original Article
San Antonio Breast Cancer Symposium
Trastuzumab Deruxtecan in HER2-Positive Breast Cancer
S. Modi and Others
In this single-group, phase 2 study, the use of trastuzumab deruxtecan resulted in a response in 60% of women with HER2-positive advanced breast cancer who had received a median of six previous lines of therapy. The drug was associated with myelosuppression and gastrointestinal toxicity; interstitial lung disease was reported in 13.6% of the patients.
Dec 11 -
Perspective
History of Medicine
Sounding the Alarm on Climate Change, 1989 and 2019
J.H. Dunk and D.S. Jones
As the climate crisis continues to unfold, the story of physician Alexander Leaf, who devoted his attention first to the nuclear threat and then to planetary health, offers much-needed inspiration for physician-activists.
Dec 11
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Original Article
San Antonio Breast Cancer Symposium
Trastuzumab Deruxtecan in HER2-Positive Breast Cancer
S. Modi and Others
Original Research
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Original Article
Asciminib in Chronic Myeloid Leukemia
T.P. Hughes and Others
Asciminib, a novel ABL tyrosine kinase inhibitor that targets the myristoyl site of the molecule rather than the ATP-binding domain, showed mainly low-grade toxic effects in a minority of patients and considerable antileukemic activity in the majority of those who had resistance to or unacceptable side effects from standard TKIs.
Dec 12
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Original Article
Therapeutic Hypothermia for Cardiac Arrest with Nonshockable Rhythm
J.-B. Lascarrou and Others
Patients who were comatose after resuscitation from cardiac arrest with a nonshockable rhythm were randomly assigned to moderate therapeutic hypothermia (33°C) or targeted normothermia (37°C). Therapeutic hypothermia improved survival with a favorable neurologic outcome at 90 days.
Dec 12 -
Original Article
Metoprolol in COPD
M.T. Dransfield and Others
In this randomized trial involving patients with moderate or severe COPD, treatment with the beta-blocker metoprolol did not result in a shorter time until the first COPD exacerbation than placebo.
Dec 12Editorial Beta-Blockers in COPD — A Controversy Resolved?
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Original Article
Therapeutic Hypothermia for Cardiac Arrest with Nonshockable Rhythm
J.-B. Lascarrou and Others
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Original Article
High-Dose Vitamin D3 in Critically Ill, Vitamin D–Deficient Patients
The National Heart, Lung, and Blood Institute PETAL Clinical Trials Network
This randomized, placebo-controlled trial examined the potential benefits of vitamin D3 supplementation in acute critical illness. Among patients with proven vitamin D deficiency, early administration of high-dose enteral vitamin D3 did not improve 90-day mortality or other, nonfatal outcomes.
Dec 11
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Original Article
High-Dose Vitamin D3 in Critically Ill, Vitamin D–Deficient Patients
The National Heart, Lung, and Blood Institute PETAL Clinical Trials Network
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Original Article
Phase 3 Trial of a Typhoid Vaccine
M. Shakya and Others
Typhoid remains a major cause of illness and death globally. In this trial, the efficacy of a typhoid conjugate vaccine was assessed in children in Nepal. A total of 20,019 children were randomly assigned to receive either a TCV or a meningococcal A vaccine. The TCV was associated with a decrease of 81.6% in Salmonella Typhi bacteremia.
Dec 05Editorial Parting the Clouds over Typhoid with a New Conjugate Vaccine
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Original Article
Phase 3 Trial of a Typhoid Vaccine
M. Shakya and Others
Clinical Practice and Review
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Clinical Problem-Solving
Facing Uncertainty
C. Thomas and Others
A 57-year-old woman presented with a 1-year history of an itchy facial rash, which was unresponsive to a 3-month course of prednisone and hydroxychloroquine. Redness had spread from her face to her scalp and neck. She reported a productive cough and progressive dyspnea for the preceding 2 weeks.
Dec 05 -
Clinical Practice
Essential Thrombocythemia
A. Tefferi and A. Pardanani
Essential thrombocythemia is associated with increased risks of bleeding and thrombosis. Estimation of the risk of thrombosis is based on history of thrombosis, presence of the JAK2 V617F mutation, age, and cardiovascular risk. Treatment commonly involves low-dose aspirin; therapy is used in patients with high thrombotic risk.
Nov 28
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Clinical Problem-Solving
Facing Uncertainty
C. Thomas and Others
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Review Article
Penicillin Allergy
M. Castells, D.A. Khan, and E.J. Phillips
Many more patients are labeled as penicillin-allergic than actually are allergic. The label should be analyzed with skin testing and test exposure. Patients with true penicillin allergy can be desensitized with a slow-escalation protocol under physician observation.
Dec 12
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Perspective
Machine Learning and the Cancer-Diagnosis Problem
A.S. Adamson and H.G. Welch
Machine learning has the potential to be extremely useful in medicine, particularly in the interpretation of medical images. But it also has inherent limitations, especially when it comes to diagnosing early-stage cancer.
Dec 12
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Perspective
Machine Learning and the Cancer-Diagnosis Problem
A.S. Adamson and H.G. Welch
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Perspective
Adjö
U. Ikediobi
“Do you know how to say au revoir in Swedish?” the patient asks. Smiling, the physician pretends she’s answering for the first time. She can’t help but compare the life of this lonely 95-year-old to those of the respected Igbo elders she knew growing up in Nigeria.
Dec 12
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Perspective
Adjö
U. Ikediobi
Commentary
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Machine Learning and the Cancer-Diagnosis Problem
A.S. Adamson and H.G. Welch
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Monoclonal Antibody Therapy for Ebola Virus Disease
M.M. Levine -
Beta-Blockers in COPD — A Controversy Resolved?
W. MacNee -
Kicking the Can Down the Road
S.A. Santen and Others -
Adjö
U. Ikediobi -
Double Environmental Injustice
J.M. Shultz and Others
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Sounding the Alarm on Climate Change, 1989 and 2019
J.H. Dunk and D.S. Jones
How much of a contributor are drug prices to the overall cost of health care?
- Major contributor
- Moderate contributor
- Minor contributor
- Not a contributor