Curated News: NEJM

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Thomas Jefferson University Hotspotting Program Addresses Hospital “Super Utilizers” Using Team-Based Model

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A new clinical trial in the emergency department finds no difference in efficacy or adverse effects of three commonly used treatments for patients with refractory status epilepticus.

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A study led by Hamilton researchers has found a new way to interpret blood test results in patients who are investigated for blood clots in their lungs, a condition known as pulmonary embolism. This new approach applies to D-dimer blood tests, which are used by physicians to rule out the presence of a blood clot.

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Researchers from The University of Texas MD Anderson Cancer Center reported that secondary tumor-reduction, or cytoreduction, surgery followed by chemotherapy did not result in longer survival than chemotherapy alone in patients with platinum-sensitive recurrent ovarian cancer.

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A phase three clinical trial that UT Southwestern participated in determined that a three-drug combination improved lung function and reduced symptoms in cystic fibrosis (CF) patients who have a single copy of the most common genetic mutation for the disease.

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Though identifying data typically are removed from medical image files before they are shared for research, a Mayo Clinic study finds that this may not be enough to protect patient privacy.

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Dransfield said their findings showed no evidence that beta-blockers were helpful in reducing the risk of exacerbations.

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A study published today in The New England Journal of Medicine found that in patients seen for heartburn unresponsive to treatment with Proton Pump Inhibitors (PPIs), an extensive, systematic workup revealed truly PPI-refractory and reflux-related heartburn in only a minority of cases. In other words, most patients with heartburn unrelieved by PPIs did not have gastroesophageal reflux disease (GERD) causing the symptom. Furthermore, for the selected subgroup identified as having reflux-related, PPI-refractory heartburn, surgery that corrects reflux was significantly superior (67% success rate) to continued medical therapy (28% success rate).

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A multi-center randomized clinical trial evaluating a new artificial pancreas system — which automatically monitors and regulates blood glucose levels — has found that the new system was more effective than existing treatments at controlling blood glucose levels in people with type 1 diabetes.The study showed that the system improved participants’ blood glucose control throughout the day and overnight.

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Study based at the Icahn School of Medicine at Mount Sinai and other centers finds new system has safety, efficacy benefits for people with type 1 diabetes

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La investigación sobre la anatomía patológica de la lesión pulmonar asociada al uso del cigarrillo electrónico está en etapas iniciales, pero, de acuerdo con un estudio llevado adelante por Mayo Clinic que se publicó en el The New England Journal of Medicine, las lesiones pulmonares por uso del cigarrillo electrónico posiblemente son producto de la intoxicación directa o del daño en los tejidos provocado por los vapores químicos nocivos.

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Um estudo liderado pela Mayo Clinic publicado no The New England Journal of Medicine descobriu que as lesões pulmonares causadas pelo uso de cigarros eletrônicos provavelmente são causadas por toxicidade direta ou dano tecidual causado por vapores químicos nocivos.

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Eine von der Mayo Clinic geleitete Studie, die in The New England Journal of Medicine veröffentlicht wurde, hat ergeben, dass Lungenverletzungen durch Vaping höchstwahrscheinlich von der direkten Toxizität oder Gewebeverletzungen durch giftige chemische Dämpfe verursacht.

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Une étude menée par la Mayo Clinic et publiée dans The New England Journal of Medicine révèle que les lésions pulmonaires dues au vapotage sont très probablement causées par une toxicité directe ou des lésions tissulaires dues à des vapeurs chimiques nocives.

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Research into the pathology of vaping-associated lung injury is in its early stages, but a Mayo Clinic study published in The New England Journal of Medicine finds that lung injuries from vaping most likely are caused by direct toxicity or tissue damage from noxious chemical fumes.

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A new study of African Americans with poorly controlled asthma, found differences in patients’ responses to commonly used treatments. Contrary to what researchers had expected, almost half of young children in the study responded differently than older children and adults, and than white children in prior studies.

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The three-year results from the COAPT trial demonstrated that reducing severe secondary mitral regurgitation (SMR) with the MitraClip device safely improves prognosis in selected heart failure (HF) patients. In addition, those patients that crossed over and received the MitraClip after 24 months showed the same benefits as those who received the device at the beginning of the study. Two-year data were presented at TCT 2018 and published in the New England Journal of Medicine.

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Patients with left main coronary artery disease (LMCAD) typically have a poor prognosis due to the large amount of myocardium at risk. Revascularization with either percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG) has been shown to prolong survival in patients with left main disease compared with medical therapy alone. Three-year data from the large-scale randomized ECXEL trial found no significant difference in the composite rate of death, stroke or myocardial infarction (MI) between the two treatments, with a reduction in 30-day major adverse events with PCI. These results were first reported at TCT 2016 and published in NEJM.

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The three-drug combination of encorafenib, binimetinib and cetuximab significantly improved overall survival (OS) in patients with BRAF-mutated metastatic colorectal cancer (mCRC), according to results of the BEACON CRC Phase III clinical trial led by researchers at The University of Texas MD Anderson Cancer Center.