Curated News: NEJM

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A phase 3 clinical trial co-led by Mount Sinai researchers is the first to show that immunotherapy after surgery to remove bladder cancer can reduce the risk of relapse for patients who are at high risk of their cancer returning in a deadly metastatic form, according to results published in The New England Journal of Medicine. The immunotherapy nivolumab was used as an adjuvant therapy, which is given after surgery in the hopes of maximizing its effectiveness.

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A new paper describes how a framework called "designing for value" was used to re-imagine the referral system of patients from primary care doctors to psychiatrists. The results seems to be an improved experience for patients, primary care doctors, and psychiatrists who participated in the model.

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News release about the follow-up data from the landmark SPRINT study of the effect of high blood pressure on cardiovascular disease have confirmed that aggressive blood pressure management — lowering systolic blood pressure to less than 120 mm Hg -- dramatically reduces the risk of heart disease, stroke, and death from these diseases, as well as death from all causes, compared to lowering systolic blood pressure to less than 140 mm Hg.

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Heart failure (HF) – when the heart can’t pump enough blood and oxygen through the body – affects approximately 6.2 million adults in the United States and is the primary cause of hospitalization in the elderly. Unfortunately, older adults with heart failure often have poor outcomes resulting in reduced quality of life, high mortality and frequent rehospitalizations.

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People with cardiovascular disease (CVD) taking aspirin to lower their chances of suffering a heart attack or stroke experienced similar health benefits, including reduced death and hospitalization for heart attack and stroke, whether they took a high or low dose of aspirin, according to a study presented today at ACC.21, the American College of Cardiology’s 70th Annual Scientific Session and published in the New England Journal of Medicine.

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The study tracked 4,811 people in 27 countries who are living with atrial fibrillation and taking blood thinners. Consenting patients undertaking cardiopulmonary bypass surgery were randomly selected for the additional left atrial appendage occlusion surgery; their outcomes compared with those who only took medicine. They were all followed for a median of four years.

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There is no long-term benefit to surgically placing tubes in a young child’s ears to reduce recurrent ear infections, compared with giving oral antibiotics, a randomized trial determined.

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In a Correspondence to the New England Journal of Medicine, researchers found that many medical centers changed surgical practices for early cervical cancer based on findings from the LACC study in 2018, but non-academic medical centers could improve in making the change compared with academic centers.

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A letter published today by Huntsman Cancer Institute (HCI) at the University of Utah (U of U) in the New England Journal of Medicine reports that melanoma mortality among Utahns outpaced that of the rest of the United States during the period from 1975 to 2013. Melanoma death rates have been decreasing in recent years both in Utah and the United States, a trend likely attributable to new, more effective treatments, like immunotherapy. However, melanoma remains the deadliest type of skin cancer, and the incidence of melanoma diagnoses in Utahns is higher than in any other state.

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Nationwide, the rollout for the COVID-19 vaccine has been inequitable, with white individuals being vaccinated at higher rates compared to Black individuals.

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New medicines for people who have diabetes seem to pop up all the time. Drugs that help the body break down carbohydrates, drugs that increase excretion of glucose in the urine, drugs that help muscles respond to insulin and drugs that stimulate the pancreas to produce it — the list of pharmaceutical options to treat diabetes gets longer and longer.

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Among the nation’s largest providers of monoclonal antibodies for Covid-19, Houston Methodist has infused nearly 4,000 patients. The hospital system was able to quickly ramp up its program by leveraging numerous resources through interdisciplinary collaboration. A commentary outlining challenges, resources and benchmarks published online March 29 in the New England Journal of Medicine and serves as a valuable model as more hospitals begin to treat Covid-19 with mAB therapy.

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Dr. James Lee is a Korean-American resident in psychiatry at the University of Washington School of Medicine. His perspective, “Combating anti-Asian sentiment — a practical guide for clinicians,” was published March 24 in The New England Journal of Medicine.

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DALLAS – March 23, 2021 – Vaccinating health care workers resulted in an immediate and notable reduction of positive COVID-19 cases among employees, reducing the number of required isolations and quarantines by more than 90 percent, according to data at UT Southwestern Medical Center published in the New England Journal of Medicine.

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Investigators from UC San Diego and UCLA report COVID-19 infection rates for a cohort of health care workers previously vaccinated for the novel coronavirus. Risk of infection is minuscule, but exists.

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The proof-of-concept AMP studies demonstrated that a broadly neutralizing antibody (bnAb) called VRC01 was effective at preventing the acquisition of HIV strains to the 30% of strains that were sensitive to the bnAb. This finding was seen both in Sub-Saharan Africa and the U.S. and South America. VRCO1 did not prevent the acquisition of HIV to strains that were resistant to the bNAb.

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This is a landmark study in so far as being the first to raise the alarm that, despite early successes with Covid-19 vaccines, further research is warranted on a next generation of Covid-19 vaccines.

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A single shot of one of the currently authorized COVID-19 vaccines may be sufficient to provide immunity to individuals who have previously been infected by the virus, thus eliminating the need for a second dose and helping to stretch severely limited vaccine supplies, a study from Mount Sinai has found

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A new study from Washington University School of Medicine in St. Louis shows that whole genome sequencing is at least as accurate and often better than conventional genetic tests that help determine the treatment for a patient’s blood cancer. Genome sequencing technology continuously is decreasing in cost and recently reached a level similar to that of conventional testing.

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DALLAS – March 8, 2021 – A new type of CAR T-cell therapy more than triples the expected length of remission for multiple myeloma patients who have relapsed several times, according to an international clinical trial with UT Southwestern as the lead enrolling site.