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.

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A study of national data shows the devastating impact the pandemic has had on those with intellectual disabilities and their caregivers.

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Peter Chen, MD, remembers those early days of March 2020 as one of swirling hyperactivity in the intensive care unit he leads at Cedars-Sinai. Chen and his team were struggling to respond to an emerging health crisis that was quickly growing into a global pandemic.

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A repurposed drug used to treat arthritis did not significantly improve the outcomes of patients with severe COVID-19 pneumonia. Tocilizumab did not significantly improve clinical status or mortality rate at 28 days for participants who received it compared to a placebo.

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In a major advance in the treatment of multiple myeloma, a CAR T-cell therapy has generated deep, sustained remissions in patients who had relapsed from several previous therapies, an international clinical trial has found.

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A total of 137,851 people aged 35 to 70 years old were followed for a median of 9.5 years through the Population Urban and Rural Epidemiology (PURE) study run by the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences.

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A significant number of non-Hodgkin lymphoma (NHL) patients in a Penn Medicine-initiated clinical trial continue to be in remission five years after receiving the chimeric antigen receptor (CAR) T cell therapy Kymriah™, researchers in Penn’s Abramson Cancer Center reported today in the New England Journal of Medicine.

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A University of Chicago Medicine researcher working with an international team of scientists has developed a daily oral combination therapy that is reliable, safe and effective for long-term treatment of uterine fibroids.

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Avacopan, which targets a receptor that attracts the cells that cause inflammation, was shown to be more effective at keeping patients in remission for a year than prednisone

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Among the orthopaedic surgery patients in a study using text messaging to monitor opioid use, 61 percent of their tablets were found to be left over

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Um novo estudo multi-institucional liderado pelo Fergus Couch, Ph.D, um patologista da Mayo Clinic, fornece estimativas mais precisas do risco de câncer de mama para mulheres dos EUA que têm mutações herdadas nos genes de predisposição do câncer de mama.

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Patients with advanced kidney cancer, who received a targeted drug combined with a checkpoint-blocker immunotherapy agent had longer survival than patients treated with the standard targeted drug, said an investigator from Dana-Farber Cancer Institute, reporting results from a phase 3 clinical trial.

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In a new study led by researchers at Yale Cancer Center, the drug enfortumab vedotin significantly prolonged survival as compared with standard chemotherapy in patients with locally advanced or metastatic urothelial carcinoma or bladder cancer, who had previously received platinum-based treatment and a PD-1–PD-L1 inhibitor.

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Getting around without the need to concentrate on every step is something most of us can take for granted because our inner ears drive reflexes that make maintaining balance automatic. However, for about 1.8 million adults worldwide with bilateral vestibular hypofunction (BVH) — loss of the inner ears’ sense of balance — walking requires constant attention to avoid a fall. Now, Johns Hopkins Medicine researchers have shown that they can facilitate walking, relieve dizziness and improve quality of life in patients with BVH by surgically implanting a stimulator that electrically bypasses malfunctioning areas of the inner ear and partially restores the sensation of balance.

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妙佑医疗国际(Mayo Clinic) 病理学家Fergus Couch博士主持的一项新的多机构研究为携带乳腺癌易感基因遗传突变的美国女性提供了更准确的乳腺癌风险评估。于1月20日星期三发表在《New England Journal of Medicine》（新英格兰医学杂志）上的CARRIERS Consortium研究结果让医疗服务提供者能够更好地评估女性患乳腺癌的风险（其中许多女性都没有乳腺癌家族史），并提供更合适的风险管理策略。

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A study published today in the New England Journal of Medicine provides the most definitive evidence to date that, of the two drugs recommended for light sedation of patients receiving mechanical ventilation in the ICU, one is as effective and safe as the other.

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Un nuevo estudio llevado a cabo en varias instituciones y dirigido por el Dr. Fergus Couch, patólogo en Mayo Clinic, aporta un cálculo más exacto sobre el riesgo de cáncer de mama en las mujeres estadounidenses con mutaciones heredadas en los genes de predisposición a ese tipo de cáncer.

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in a first-of-its-kind study, University of Utah Health scientists found that hormonal IUDs were comparable to copper IUDs for use as emergency contraceptives. The researchers say the finding supports adding hormonal IUDs to current emergency contraception options.

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妙佑医疗国际(Mayo Clinic) 的研究人员和合作者发现，在未使用呼吸机的COVID-19住院患者中，输注含高水平抗体的恢复期血浆与COVID-19死亡率下降有关。研究结果“恢复期血浆抗体水平与COVID-19致死风险”于2021年1月13日发表在《New England Journal of Medicine》（新英格兰医学杂志）上。

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Investigadores y colaboradores de Mayo Clinic descubrieron una asociación entre la administración de plasma convaleciente con alta carga de anticuerpos y menores tasas de mortalidad en pacientes internados con COVID-19 sin respirador.

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Several genetic mutations previously linked to breast cancer and included on commercial genetic tests, including direct-to-consumer tests, were found not to increase a woman’s risk of disease, according to a population study of more than 64,000 women published online today in the New England Journal of Medicine from several institutions, including Penn Medicine.

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A new multi-institution study led by Fergus Couch, Ph.D., a Mayo Clinic pathologist, provides more accurate estimates of breast cancer risk for U.S. women who harbor inherited mutations in breast cancer predisposition genes.

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University of Illinois Chicago is one of the U.S. sites participating in clinical trials to cure severe red blood congenital diseases such as sickle cell anemia or Thalassemia by safely modifying the DNA of patients’ blood cells.

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A clinical trial involving COVID-19 patients hospitalized at UT Health San Antonio and University Health, among roughly 100 sites globally, found that a combination of the drugs baricitinib and remdesivir reduced time to recovery, according to results published Dec. 11 in the New England Journal of Medicine.

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DALLAS – Jan. 13, 2021 – A new treatment that combines two existing medications may provide long-sought relief for many battling debilitating methamphetamine use disorder, according to a study to be published tomorrow in The New England Journal of Medicine.

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Researchers at the Indiana University Melvin and Bren Simon Comprehensive Cancer Center published promising findings today in the New England Journal of Medicine on preventing a common complication to lifesaving blood stem cell transplantation in leukemia.

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Many individuals with COVID-19 say they experience headaches, along with a “fuzziness” or brain fog that can persist for weeks or months following recovery from the acute respiratory symptoms. This is sometimes referred to as “COVID brain.” The long-term clinical implications of infection by the virus continue to baffle scientists and, until now, the neurological manifestations have been believed to be a result of direct damage to nerve cells. However, a new study in the New England Journal of Medicine suggests the virus might actually damage the brain’s small blood vessels rather than nerve cells, themselves.

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As the first doses of COVID-19 vaccines are being rolled out, it is still unclear whether enough Americans are willing to be vaccinated to allow the nation to return to normalcy.

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Very low birthweight infants are at a high risk for anemia and often need blood transfusions to survive.

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New research BIDMC-led sheds light on the genetic risk factors that make individuals more or less susceptible to severe COVID-19.