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NEJM Quick Takes

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New research findings summarized in a short video

The unmet need for donor hearts and advances in machine-perfusion technology have led to consideration of transplanting hearts from donors after circulatory death. New research findings are summarized in a short video.

Outcomes with Donor Hearts after Circulatory Death

Long-term outcomes are poor with standard first-line chemotherapy for primary advanced or recurrent endometrial cancer. Whether adding immunotherapy could improve outcomes is uncertain. New research findings are summarized in a short video.

Dostarlimab for Endometrial Cancer

Women at risk for diabetes are often tested early in pregnancy to exclude undiagnosed diabetes, but it is unknown whether treating gestational diabetes early could improve clinical outcomes. New research findings are summarized in a short video.

Treating Gestational Diabetes Early in Pregnancy

Whether the addition of pembrolizumab to standard first-line chemotherapy improves outcomes in patients with advanced endometrial cancer is unclear. New research findings are summarized in a short video.

Pembrolizumab in Advanced Endometrial Cancer

Appropriate endocrine therapy is unclear for hormone receptor–positive, HER2- negative advanced breast cancer that progresses despite treatment with an aromatase inhibitor with or without a CDK4/6 inhibitor. New research findings are summarized in a short video.

Capivasertib in Advanced Breast Cancer

Many patients with acute ischemic stroke have stenosis without occlusion of large or medium-sized vessels. Whether intravenous tirofiban can improve outcomes in these patients is unknown. New research findings are summarized in a short video.

Tirofiban for Recent-Onset Stroke

Initial diagnostic ultrasonography for suspected pediatric distal forearm fractures is accurate and timely. Whether this approach is noninferior to radiography for later physical function is unclear. New research findings are summarized in a short video.

Ultrasonography for Suspected Pediatric Distal Forearm Fractures

In patients with heart failure and secondary mitral regurgitation, transcatheter edge-to-edge repair of the mitral valve was safe and effective at 2 years, but longer-term outcomes are unknown. New research findings are summarized in a short video.

Transcatheter Repair of Secondary Mitral Regurgitation

Glucocorticoids can help mitigate the adverse consequences of pneumonia, but whether they can reduce mortality in severe community-acquired pneumonia is unknown. New research findings are summarized in a short video.

Hydrocortisone in Severe Pneumonia

In patients with severe thrombocytopenia, whether prophylactic transfusion is needed to prevent bleeding complications related to central venous catheter placement is unclear. New research findings are summarized in a short video.

Platelet Transfusion for CVC Placement in Thrombocytopenia

Because of vaccination, meningitis caused by serogroup A has been nearly eliminated in the African meningitis belt. However, countries continue to have high rates of disease from other serogroups. New research findings are summarized in a short video. ...

Meningococcal ACWYX Conjugate Vaccine in Africa

The JAK inhibitor upadacitinib previously showed promise for Crohn’s disease in a phase 2b trial. New research findings from phase 3 trials of upadacitinib induction and maintenance therapy for Crohn’s disease are summarized in a short video.

Upadacitinib for Crohn’s Disease

Emodepside, an antiparasitic drug registered for veterinary use, is being studied for human Trichuris trichiura and hookworm infections. New research findings are summarized in a short video.

Emodepside for T. trichiura and Hookworm Infection

To prevent new cases of leprosy, single-dose rifampin can be given to close contacts of infected persons. Rifapentine, which has a longer half-life than rifampin, might be an effective alternative. New research findings are summarized in a short video. ...

Rifapentine for Leprosy Prophylaxis

Peresolimab is a monoclonal antibody that activates the PD-1 inhibitory pathway. Activation of this pathway would be a novel therapeutic approach in rheumatoid arthritis. New research findings are summarized in a short video.

Peresolimab for Rheumatoid Arthritis

Transcatheter edge-to-edge repair, or TEER, has emerged as a potentially effective treatment option for tricuspid regurgitation. How TEER compares with medical therapy alone has been unknown. New research findings are summarized in a short video. ...

Transcatheter Repair for Tricuspid Regurgitation

No treatment for peanut allergy has been approved for children younger than 4 years of age, but immunotherapy with a peanut-protein skin patch has shown promise in older children. New research findings are summarized in a short video. ...

Epicutaneous Immunotherapy with Peanut Patch in Toddlers with Peanut Allergy

Cabozantinib, used alone or with nivolumab, can benefit patients with advanced renal-cell carcinoma. The efficacy and safety of cabozantinib combined with nivolumab and ipilimumab are unknown. New research findings are summarized in a short video. ...

Cabozantinib in Advanced Renal-Cell Carcinoma

The efficacy and safety of venetoclax plus rituximab or obinutuzumab in patients with previously untreated, advanced chronic lymphocytic leukemia and few coexisting conditions have been unknown. New research findings are summarized in a short video. ...

Venetoclax Combinations in CLL

Intravascular imaging during percutaneous coronary intervention for complex coronary lesions may optimize stent placement. Whether this approach improves clinical outcomes has been unclear. New research findings are summarized in a short video.

Imaging- or Angiography-Guided PCI

Curbside Consults Podcast

A deep dive with clinician experts and educators

In this episode of Curbside Consults, we examine the 2022 scientific statement from the American Heart Association on the management of acute coronary syndrome in the older adult population. We are joined by Dr. Abdulla Damluji, the lead author on the...

Management of Acute Coronary Syndrome in Older Adults with Dr. Abdulla Damluji

In this episode of Curbside Consults, Jaclyn Albin, MD and Milette Siler, RD share their passion for food as medicine and talk about their experiences at The Culinary Medicine Program at UT Southwestern Medical Center. Jaclyn believes food as medicine delivers...

Culinary Medicine with Dr. Jaclyn Albin and Milette Siler, RD

In this episode of Curbside Consults, we examine the Endocrine Society’s 2022 Clinical Practice Guideline on management of hyperglycemia in hospitalized adults in non-critical care settings. We are joined by Dr. Mary Korytkowski, Emeritus Professor of Medicine at the University of...

Management of Hyperglycemia in Hospitalized Adults with Dr. Mary Korytkowski

In this episode of Curbside Consults, we examine the American College of Chest Physicians recent clinical practice guideline on Perioperative Management of Antithrombotic Therapy. We are joined by Dr. James Douketis, Chair in Thromboembolic Disease at McMaster University and the first...

American College of Chest Physicians Clinical Practice Guideline on Perioperative Management of Antithrombotic Therapy with Dr. James Douketis

In this episode of Curbside Consults, we examine the 2022 revision of the clinical practice guideline on the management of hyperbilirubinemia in the newborn infant by the American Academy of Pediatrics (AAP). We are joined by two authors of the revised...

Management of Hyperbilirubinemia in the Newborn Infant with Drs. Alex Kemper and Tom Newman

In this episode of Curbside Consults, we discuss aerospace medicine with two physicians who are double boarded in internal and aerospace medicine and are also NASA astronauts. Dr. Auñón-Chancellor recently served as Flight Engineer on the International Space Station for Expeditions...

Space Medicine with Drs. Serena Auñón-Chancellor and Michael Barratt

In this episode of Curbside Consults, we examine an update on management of opiate use disorder in hospitalized adults by the SHM (Society of Hospital Medicine). We are joined by Dr. Susan Calcaterra, Associate Professor of Medicine, Director of the Addiction...

Management of Opiate Use Disorder in Hospitalized Adults with Dr. Susan Calcaterra

In this episode of Curbside Consults, we examine the American Thoracic Society Clinical Practice Guideline (CPG) on Sarcoidosis. We are joined by one of its co-authors, Dr. Kevin Wilson, Chief of Guidelines and Documents at the American Thoracic Society and Professor...

American Thoracic Society Clinical Practice Guideline on Sarcoidosis with Dr. Kevin Wilson

In this episode of Curbside Consults, we examine an update on sleep-related infant deaths by the American Academy of Pediatrics (AAP). We are joined by Rachel Moon, Harrison Distinguished Teaching Professor of Pediatrics of at the University of Virginia and Chair...

Sleep-Related Infant Deaths with Dr. Rachel Moon

In this episode of Curbside Consults, we are joined by Dr. Cheri Blauwet, Chief Medical Officer at Spaulding Rehabilitation Hospital, Associate Professor of Physical Medicine and Rehabilitation at Harvard Medical School, and retired Paralympian in the sport of competitive wheelchair...

Understanding Disability with Dr. Cheri Blauwet

In this episode of Curbside Consults, we examine the latest guidelines on the diagnosis and management of idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) by the American Thoracic Society (ATS). We are joined by Mary Strek, Professor of Medicine...

Update on Idiopathic and Progressive Pulmonary Fibrosis with Dr. Mary Strek

In this episode of Curbside Consults, we examine the latest standards of medical care published by the American Diabetes Association (ADA). We are joined by Dr. Bob Gabbay, who is Chief Science and Medical Officer at the American Diabetes Association, an...

ADA Standards of Medical Care in Diabetes with Dr. Bob Gabbay

In this episode of Curbside Consults, we examine the latest recommendation statement on the use of aspirin to prevent cardiovascular disease from the United States Preventive Services Task Force (USPSTF). We are joined by Michael Barry, who is Director of the Informed Medical Decisions Program in the Health Decision Sciences...

USPSTF Recommendation Statement on Aspirin Use with Dr. Michael Barry

In this episode of Curbside Consults, we are joined by Dr. Clyde Yancy, Chief of Cardiology at the Feinberg School of Medicine, past chair of the American College of Cardiology/American Heart Association Heart Failure Guidelines Committee, and a senior member of the committee that authored the new 2022 Guideline for...

Guideline for the Management of Heart Failure with Dr. Clyde Yancy

In this episode of Curbside Consults, we examine the latest guidelines from the Centers for Disease Control (CDC) on the treatment of sexually transmitted infections (STIs). We are joined by Dr. Kimberly Workowski, a Professor of Medicine in the Division of Infectious Diseases at Emory, and one of the guideline...

CDC Sexually Transmitted Infections Treatment Guidelines with Dr. Kimberly Workowski

As Editor-In-Chief of the New England Journal of Medicine , Dr. Eric Rubin is an authority on medical publishing, but he didn’t always know this was the job he wanted. In this special episode of Curbside Consults, we explore the highlights and challenges of being a physician editor at a...

Pursuing a Career in Medical Publishing: A Conversation with Dr. Eric Rubin

In this episode of Curbside Consults, we examine the latest guidelines on the diagnosis and management of Barrett’s esophagus by the American College of Gastroenterology (ACG). We are joined by Dr. Nick Shaheen, a Professor of Medicine and Chief of Gastroenterology and Hepatology at UNC Chapel Hill, and one of...

Diagnosis and Management of Barrett’s Esophagus with Dr. Nicholas Shaheen

In this episode of Curbside Consults, we examine the latest guidelines on the diagnosis and management of pediatric osteomyelitis by the Infectious Diseases Society of America (IDSA) and Pediatric Infectious Diseases Society (PIDS). We are joined by Dr. Samir Shah, a Professor of Pediatrics at Cincinnati Children’s Hospital, Editor-in-Chief of...

Diagnosis and Management of Pediatric Osteomyelitis with Dr. Samir Shah

In this episode of Curbside Consults, we examine the latest guidelines on the management of Clostridiodes difficile (C. difficile ) infection. This year, updated guidelines were developed by the Infectious Diseases Society of America and Society for Healthcare Epidemiology of America, as well as the American College...

Diagnosis and Treatment of C. difficile Infection with Dr. Jessica Allegretti

In this episode of Curbside Consults, we examine the latest guidelines on the evaluation and management of well-appearing febrile infants 8-60 days old by the American Academy of Pediatrics (AAP). We are joined by Dr. Benard Dreyer, a Professor of Pediatrics at NYU, the past president of the AAP, who...

Evaluation and Management of Febrile Neonates with Dr. Benard Dreyer

From Pages To Practice

Pulmonary arterial hypertension (PAH) involves the obliteration of the small arterioles of the pulmonary vasculature. PAH is categorized as World Health Organization (WHO) group 1 pulmonary hypertension, based on the presence of elevated pulmonary arterial pressures, normal pulmonary capillary wedge/left heart...

Lung Story Short: A New Therapy for Pulmonary Arterial Hypertension

The perennial question of whether to use glucocorticoids to treat patients with community acquired pneumonia (CAP) continues to consume hours of discussion in intensive care units (ICUs). Pneumonia elicits an inflammatory response in the lung, which left unchecked, can lead to a deleterious decline in pulmonary function and oxygenation. Glucocorticoids...

Should Glucocorticoids Be All the Rage in the Treatment of CAP?

Some anticoagulation decisions in patients with thrombosis are straightforward, thanks to a preponderance of data. First provoked deep-vein thrombosis (DVT)? There’s a guideline for that (no less than 3 months of anticoagulation). Recurrent DVT, pulmonary embolism, or decisions between a direct...

Hydrochlorothiazide or Chlorthalidone for Hypertension?

Venous thromboembolism (VTE) is the most common cause of preventable death in hospitalized medical patients, yet pharmacologic prophylaxis remains underutilized. The Virchow’s triad of venous stasis, vascular injury, and hypercoagulability is key in the assessment of VTE risk. Based on the Padua Score — a validated risk assessment model that...

Broken Bones and Thromboprophylaxis: Is Aspirin Enough?

Opioid use disorder (OUD) continues to be a national crisis in the United States. President Biden has identified battling the opioid crisis as a top priority and the U.S. Department of Health and Human Services (HHS) has awarded $1.6 billion to...

Methadone or Buprenorphine in Mothers and Neonates: A Tale of Two Drugs for OUD

Going with the Flow — Rivaroxaban Prophylaxis in Noncirrhotic Portal Venous Thrombosis

Tuberculosis (TB) is the leading cause of death worldwide from a single infectious agent. TB is caused by the bacillus Mycobacterium tuberculosis , infecting about a quarter of the world’s population. Drug-resistant TB continues to be a threat to public health; in 2019, approximately 465,000 patients worldwide had rifampicin-resistant disease,...

Assessing What’s PRACTECAL in Rifampicin-Resistant Tuberculosis

Eosinophils are granulocytes theorized to have developed in humans to guard against parasitic infections, including nematodes that reside in human intestines. As a result, eosinophils appear to be normal constituents of gastrointestinal tissue, with an increasing gradient... ...

Dupilumab for Eosinophilic Esophagitis: Therapy for a Tough Diagnosis to Swallow?

Mr. Pool is a 64-year-old man with high blood pressure while taking lisinopril, diabetes (HbA1c level, 7.3), obesity (BMI, 32 kg/m2 ), and dysplipidemia while taking statin therapy (elevated triglyceride of 270 mg/dL and low HDL of 33 mg/dL...

Fibrate Therapy Does Not Reduce Cardiovascular Events in Patients with Mild-to-Moderate Hypertriglyceridemia

The pancreas is a notoriously complex endocrine organ and when inflamed can cause a wide range of clinical symptoms, ranging from simple epigastric pain, nausea, and vomiting, all the way to circulatory collapse and acute respiratory distress syndrome (ARDS). As...

Fluid Resuscitation in Pancreatitis

Cigarette smoking is the leading cause of chronic obstructive pulmonary disease (COPD). More than 3 million people worldwide die of COPD each year, accounting for approximately 6% of all deaths. COPD is a heterogenous condition with various phenotypes including emphysema...

Inhalers for Smokers' Cough? Time for a RETHINC

When an area of the myocardium is not moving normally, it is important to realize that all may not be lost. Although ischemia can lead to infarction —or death of the cardiomyocytes— the cells may survive by “hibernating” or suspending the...

To PCI or Not to PCI — a Revascularization Question

The idiopathic inflammatory myopathies (IIM) are a group of diseases characterized by muscle inflammation with resultant weakness, the potential presence of other autoimmune signs (e.g., rash and calcinosis), specific autoantibodies that correspond to unique syndromes, and a variable clinical course ranging...

The ProDERM Trial: Muscling Ahead for Dermatomyositis

Lung cancers tend to be more highly mutated than other solid organ malignancies. Over the past decade, an increasing number of targeted therapies have been developed against specific mutations that drive tumor growth. Their use is largely responsible for the recent...

The KRYSTAL-1 Study: Expanding Options in KRAS-Mutated Lung Cancer

Esophageal cancer is the eighth most common cancer worldwide, with squamous cell carcinoma being the most common subtype. During the last 60 years, the 5-year survival rate for esophageal cancer has increased from 5% to 20% with the implementation of platinum-based therapy and radiotherapy; yet both esophageal adenocarcinoma...

Nivolumab Combination Therapy in Advanced Esophageal Squamous Cell Carcinoma

The ubiquitous respiratory syncytial virus (RSV) has historically affected millions of children worldwide. The viral infection is associated with the clinical syndrome of bronchiolitis, consisting of rhinorrhea, a fluctuating physical examination, and varying levels of respiratory distress. The rhinorrhea (also known as coryza) is such a prominent...

The MELODY Trial: A New Tune in the Song and Dance of Bronchiolitis

Bronchopulmonary dysplasia (BPD) is a common morbidity in preterm infants. At the core of the disease, an insult leads to disruption of normal lung development and ultimately presents as respiratory insufficiency. In the past few decades, the epidemiology of BPD has shifted as our understanding of the disease has evolved,...

Hydrocortisone to Prevent Bronchopulmonary Dysplasia: A Coup de Grâce for Corticosteroids?

Mrs. Smith is a 61-year-old woman with a history of recurrent urinary tract infections (UTIs). She reported the onset of dysuria and hematuria a few days ago and thought the symptoms felt similar to prior UTI episodes. She promptly made an appointment to see her primary care doctor the next...

Oral Tebipenem for Complicated Urinary Tract Infection

Ms. Cooper is a 32-year-old primigravida at 19 weeks and 2 days’ gestation, based on last menstrual period (LMP) and confirmed on 8-week ultrasound. She presented to the resident continuity clinic for routine prenatal care. You discuss how she is feeling and her upcoming anatomy sonogram and glucose tolerance test....

Treatment for Pregnant Women with Mild Chronic Hypertension

Mr. Strickland is a 77-year-old man who presents to the emergency department with fever and dysuria. He is febrile to 38.5°C, has a heart rate of 130 beats per minute and blood pressure of 80/50 mmHg. His white blood cell count is elevated at 16,000/mm3 and urinalysis demonstrates >50...

Fluids in the ICU: Are Balanced Electrolyte Solutions Better than Normal Saline?

Research Summaries

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Research summaries with expert commentaries

LAMA-LABA was associated with fewer chronic obstructive pulmonary disease exacerbations and pneumonia hospitalizations than was corticosteroid plus LABA.

Which Combination Inhaler Is Most Effective for Patients with COPD?


Using computed tomography for suspected pulmonary embolism is increasing, despite clinical decision rules designed to limit use.

Chest CT for Suspected Pulmonary Embolism in Emergency Departments


Daytime or clinic BP readings were not as good, and white-coat hypertension did not confer excess risk.

Nighttime Blood Pressure Predicts 10-Year Mortality


In a large retrospective study, ultrasound's sensitivity was 89% and specificity was 81%.

Ultrasound for Detecting Hepatic Steatosis

Emergency department and rheumatology visits increased.

Changes in Prescription Drug and Healthcare Use After a Large Price Increase for Colchicine


A few sessions with a physical therapist provided substantial relief for at least 1 year.

Cognitive Functional Therapy Shows Large and Durable Benefits for Chronic Low Back Pain

A randomized trial has addressed holding versus continuing ACE inhibitors and ARBs perioperatively.

Perioperative Blood Pressure Management


Sulfonylureas, compared with DPP-4 inhibitors and thiazolidinediones, were not associated with excess risk for adverse CV events.

Sulfonylureas and Cardiovascular Outcomes — A Real-World Study


For answering online medical questions, AI outperformed humans in both facts and empathy.

Can Doctors Learn Something from Chatbots?

Routine vitamin D supplementation didn't lower fracture rates in community-dwelling older adults.

Vitamin D and Fractures: Another Negative Trial

Patients with dyspnea despite normal pulmonary and cardiac function had evidence of diaphragmatic weakness.

Diaphragmatic Weakness Might Explain Persistent Dyspnea After COVID-19

They compared favorably for typical mild-to-moderate hearing loss in a small randomized trial.

How Do Over-the-Counter Hearing Aids Compare with Those Fitted by Audiologists?

An observational study suggests the answer is “no” in people older than 60.

In Patients with Primary Hyperparathyroidism, Does Surgery Prevent Decline in Renal Function?

Extensive or obstructive subclinical atherosclerosis conveys substantial excess risk for myocardial infarction.

Natural History of Asymptomatic Coronary Disease

COVID-19 vaccination and receiving nirmatrelvir within 5 days of a positive SARS-CoV-2 test lowered risk for long COVID.

Preventing “Long COVID”

But this apparent benefit plateaued at 3 to 4 days weekly.

Lower Mortality Was Associated with Walking Even 2 Days Weekly

Many screening colonoscopies are done in patients with limited life expectancy.

Use and Outcomes of Screening Colonoscopy in People Older Than 75

In a real-world study, metabolic outcomes were more favorable with GLP-1 agonists than with SGLT-2 inhibitors.

Off-Label Use of GLP-1 Agonists and SGLT-2 Inhibitors in Type 1 Diabetes


Meta-analysis shows that cellulitis is misdiagnosed in more than one third of patients hospitalized for the condition.

Cellulitis Misdiagnosis Is Common


A prospective study using scribes not physically present, but rather connected by audio-only cell lines, showed improved job satisfaction.

Remote Scribes in Primary Care?


Stats, Stat!

Stats

This Stats, STAT! animated video explores two possible approaches to analyzing data in a randomized controlled trial: “Frequentist” versus “Bayesian.”

Bayesian Way

This Stats, STAT! animated video explores common approaches to analyzing data from randomized controlled trials, including intention-to-treat, per-protocol, and as-treated analyses.

Good Intentions to Treat


This Stats, STAT! animated video explores the concept of competing risks — and discusses why it is so important for investigators to consider whether the occurrence of one event can prevent or change the likelihood of the occurrence of another. ...

Of Climate Change and Competing Risks


Blinding is a critical strategy used to limit certain types of bias in randomized controlled trials. This animated video explores the rationale and examines potential threats to keeping group allocation concealed — from study participants and investigators. ...

Threats to Blinding

This animated video explores some of the potential pitfalls of performing subgroup analyses in randomized controlled trials and explains how to approach potential findings with caution.

Subgroup Analyses: Subpar or Sublime?

Clinical Spotlight

Exploring controversies in clinical research

According to a new study, we still have a long way to go.

Has Inpatient Care Become Safer?

Protection against mild COVID-19 wanes within a few months, but prevention of severe outcomes lasts longer (except in immunocompromised persons).

Vaccine Effectiveness Against SARS-CoV-2 Variants, Revisited

New research suggests patients often call female physicians by their first names. Is that really news?

Call Me Doctor

Their in vitro performance is excellent; their real-world efficacy awaits more data.

Two New COVID-19 Boosters Come to Market in Time for a Winter Surge

Cases have been mostly benign, although all patients should be presumed to be contagious.

COVID-19 Rebound After Oral Treatment

Clinical Pearls & Morning Reports

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NEJM articles presented as teaching topics

A randomized trial compared standard chemotherapy plus dostarlimab or placebo. Patients with mismatch repair–deficient tumors had 2-year progressionfree survival of 61.4% with dostarlimab and 15.7% with placebo.

Anti-PD1 Therapy plus Chemotherapy in Endometrial Cancer

A 58-year-old woman presented with fatigue, abdominal bloating, and eosinophilia. Eight months earlier, she had fractured her tibia while traveling in the Democratic Republic of Congo. A diagnostic test was performed. ...