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Original Article
Albumin Infusions in Patients with Cirrhosis
L. China and Others
Patients hospitalized with decompensated cirrhosis and a serum albumin level of less than 30 g per liter were randomly assigned to daily albumin infusions to raise the albumin level to 30 g per liter or higher or to standard care. Albumin infusions did not reduce the incidences of infection, kidney dysfunction, and death. More serious adverse events occurred in the albumin group.
Mar 04Original Article Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome
Editorial Terlipressin and Intravenous Albumin in Advanced Cirrhosis — Friend and Foe
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Editorial
A New SARS-CoV-2 Vaccine and a New Look at Treatment
E.J. Rubin, L.R. Baden, and S. Morrissey
In this audio interview conducted on March 2, the editors discuss the recently approved Ad26.Cov2.S vaccine, as well as two new studies of IL-6 inhibitors for the treatment of Covid-19.
Mar 04 -
Correspondence
Delayed Local Reactions to mRNA-1273 Vaccine
K.G. Blumenthal and Others
Delayed cutaneous reactions developed in 12 patients days after initial injection-related symptoms resolved. The reactions, some as severe as grade 3, resolved in a few days with local therapy, and all 12 patients received the second vaccination; 6 had no recurrence of the local reaction, 3 had similar reactions to the initial injection reaction, and 3 had milder reactions.
Mar 03
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Editorial
A New SARS-CoV-2 Vaccine and a New Look at Treatment
E.J. Rubin, L.R. Baden, and S. Morrissey
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Perspective
Vaccination plus Decarceration
B.A. Barsky and Others
With the rollout of Covid vaccines, public debate regarding health in jails and prisons has increasingly shifted from decarceration toward vaccination of incarcerated people. But several factors suggest that vaccination alone won’t be enough to stop carceral outbreaks.
Mar 03 -
Perspective
An Uncertain Public
G.K. SteelFisher, R.J. Blendon, and H. Caporello
An analysis of multiple polls suggests that much of the U.S. public is currently undecided about whether to take a Covid-19 vaccine. These findings can inform outreach efforts to encourage vaccine uptake — efforts in which physicians can play an important role.
Mar 03
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Perspective
Vaccination plus Decarceration
B.A. Barsky and Others
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Case Challenge
A Man with Shock, Multiple Organ Failure, and Rash
A 19-year-old man was admitted because of shock, multiple organ failure, skin mottling, and a rapidly progressive reticular rash. What is the diagnosis? Vote and comment. Find the answers in the full text of the case, to be published on March 10.
Feb 24 -
Perspective
Choices in a Crisis
D.B. Kramer and Others
As experience with SARS-CoV-2 vaccination accumulates, meaningful differences among vaccines may emerge, making the question of whether individual vaccinees should be able to choose which vaccine they receive increasingly salient.
Mar 03
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Case Challenge
A Man with Shock, Multiple Organ Failure, and Rash
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Learn More
Covid-19 Vaccine Resource Center
Practical guidance for your practice and patients
Original Research
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Original Article
Nivolumab plus Cabozantinib in Renal-Cell Carcinoma
T.K. Choueiri and Others
In a randomized trial involving patients with previously untreated advanced renal-cell carcinoma, nivolumab plus cabozantinib had significant benefits over sunitinib with respect to progression-free and overall survival and the likelihood of response. A total of 19.7% of the patients in the combination group discontinued one or both of the trial drugs prematurely.
Mar 04
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Original Article
Trial of Terlipressin for Hepatorenal Syndrome
F. Wong and Others
In a phase 3 randomized trial, 199 patients with type 1 hepatorenal syndrome were assigned to receive the vasoconstrictor terlipressin plus albumin and 101 to receive placebo plus albumin. Renal function was better with terlipressin than with placebo; however, mortality was not lower, and terlipressin was associated with adverse events, including respiratory failure.
Mar 04Original Article A Randomized Trial of Albumin Infusions in Hospitalized Patients with Cirrhosis
Editorial Terlipressin and Intravenous Albumin in Advanced Cirrhosis — Friend and Foe -
Original Article
Baricitinib plus Remdesivir for Adults with Covid-19
A.C. Kalil and Others
In a trial involving 1033 patients hospitalized with Covid-19, the addition of baricitinib to remdesivir was associated with shorter recovery time, particularly among patients receiving high-flow oxygen, and with a 30% higher odds of improvement at day 15 than remdesivir alone. Adverse events were less frequent with the combination therapy.
Mar 04Editorial Baricitinib Therapy in COVID-19 Pneumonia — An Unmet Need Fulfilled
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Original Article
Trial of Terlipressin for Hepatorenal Syndrome
F. Wong and Others
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Original Article
BCMA-Specific CAR T Cells in Refractory Myeloma
N.C. Munshi and Others
Autologous T cells engineered to express a chimeric antigen receptor specific for the B-cell maturation antigen produced responses in the majority of patients with refractory and resistant myeloma, including deep molecular responses in 26% of treated patients. High-grade hematologic toxic effects and cytokine release syndrome were common.
Feb 25
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Original Article
BCMA-Specific CAR T Cells in Refractory Myeloma
N.C. Munshi and Others
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Original Article
SMN2 Pre-mRNA Splicing Modification in SMA
G. Baranello and Others
The small molecule risdiplam increased the expression of SMN protein in blood in 21 infants with type 1 spinal muscular atrophy. Post hoc clinical features of sitting ability and respiratory status were reported.
Feb 24
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Original Article
SMN2 Pre-mRNA Splicing Modification in SMA
G. Baranello and Others
Clinical Practice and Review
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Clinical Problem-Solving
A Treacherous Course
N. Jilg and Others
A 33-year-old man with a history of smoking and heavy alcohol use presented to the emergency department in September 2019 with fever, vomiting, abdominal pain, and hemoptysis. Two days before admission, malaise, fevers, and chills had developed, followed by diffuse abdominal pain, nausea, and bilious vomiting. What is the diagnosis?
Mar 04Interactive Medical Case A Treacherous Course
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Clinical Decisions
Delayed Second Dose vs. Standard Regimen for Covid-19 Vaccine
S.R. Kadire, R.M. Wachter, and N. Lurie
This interactive feature about administration of the second dose of Covid-19 vaccine either according to the standard schedule or delayed offers a case vignette accompanied by two essays, each of which recommends a different approach. Vote and comment.
Mar 04 -
Perspective
Reform of Payment for Primary Care
A.H. Goroll, A.C. Greiner, and S.C. Schoenbaum
Primary care plays a foundational role in a high-value health system, but the United States has seen troubling declines in practices’ financial viability. How best to pay for primary care, how much to pay, and how rapidly change needs to occur are urgent questions.
Mar 04
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Clinical Problem-Solving
A Treacherous Course
N. Jilg and Others
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Review Article
Diffuse Large B-Cell Lymphoma
L.H. Sehn and G. Salles
DLBCL, an aggressive cancer, accounts for about 30% of all lymphomas. Empirical combination chemotherapy cures about 65% of patients initially, with another 20 to 25% cured with salvage therapy. Efforts are ongoing to tailor therapy to particular genetic lesions.
Mar 04 -
Perspective
Without Sanctuary
S.M. Ogunwole
I often reflect on how our society decides who deserves punishment and who deserves redemption. I think about grace, and how Black people get so little. And I think about the varied manifestations of Ms. A.’s pain — how no one, me included, offered her a sanctuary.
Mar 04
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Commentary
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Conquering Atherosclerotic Cardiovascular Disease
G.H. Gibbons, C.E. Seidman, and E.J. Topol
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Baricitinib Therapy in COVID-19 Pneumonia — An Unmet Need Fulfilled
D. Goletti and F. Cantini -
Terlipressin and Intravenous Albumin in Advanced Cirrhosis — Friend and Foe
G. Garcia-Tsao -
Vaccination plus Decarceration
B.A. Barsky and Others -
An Uncertain Public
G.K. SteelFisher, R.J. Blendon, and H. Caporello -
Reform of Payment for Primary Care
A.H. Goroll, A.C. Greiner, and S.C. Schoenbaum -
Without Sanctuary
S.M. Ogunwole
How has Covid-19 affected your organization’s ability to provide equitable access to care?
- Improved
- Worsened
- No change