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NEJM Quick Takes

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New research findings summarized in a short video

Oral anticoagulation reduces stroke risk in patients with atrial fibrillation. Whether such treatment would be beneficial in patients with AHREs is unknown. New research findings are summarized in a short video.

Edoxaban for Atrial High-Rate Episodes

Hyperglycemia is common and associated with poor outcomes in critically ill patients in the intensive care unit. Randomized trials of tight glucose control have shown variable results. New research findings are summarized in a short video.

Tight Blood-Glucose Control in the ICU

Many patients with heart failure with preserved ejection fraction have obesity. Whether treatments that target obesity can reduce heart failure symptoms and physical limitations is unknown. New research findings are summarized in a short video. ...

Semaglutide in Heart Failure with Obesity

The pathologic processes of Alzheimer’s disease begin more than a decade before clinically evident cognitive impairment. Therapies that slow cognitive decline at the preclinical stage are needed. New research findings are summarized in a short video. ...

Solanezumab in Preclinical Alzheimer’s Disease

Inhaled fluticasone furoate used early in mild-to-moderate Covid-19 did not prevent progression. New research findings are summarized in a short video.

Inhaled Fluticasone Furoate for Covid-19 Outpatients

Pediatric low-grade gliomas often harbor the BRAF V600E mutation. Dabrafenib is a BRAF inhibitor that targets BRAF V600 mutations. New research findings on dabrafenib plus trametinib for pediatric low-grade glioma with BRAF V600 mutations are...

Dabrafenib plus Trametinib in Pediatric Low-Grade Glioma

In patients with heart failure, a reduced ejection fraction, and iron deficiency, intravenous ferric carboxymaltose improves quality of life and functional capacity; clinical outcomes are unclear. New research findings are summarized in a short video.

Ferric Carboxymaltose in HF with Iron Deficiency

Pegozafermin is under development for the treatment of nonalcoholic steatohepatitis, for which there are no currently approved pharmacologic treatments. New research findings are summarized in a short video.

FGF21 Analogue Pegozafermin for NASH

Infants with grade III, IV, or V vesicoureteral reflux often receive continuous antibiotic prophylaxis to limit UTI and kidney scarring, but this strategy is controversial. New research findings are summarized in a short video.

Antibiotic Prophylaxis in Infants with Vesicoureteral Reflux

The benefits of complete revascularization in older patients with myocardial infarction and multivessel coronary artery disease are unclear. New research findings are summarized in a short video.

Complete PCI in Older Patients with Myocardial Infarction

Easy-to-use, oral GLP-1 receptor agonists are of interest as alternatives to injectable formulations approved for weight reduction. An oral nonpeptide GLP1 receptor agonist shows promise. New research findings are summarized in a short video.

An Oral GLP-1 Receptor Agonist for Adults with Obesity

For patients with hemophilia with inhibitors, intravenous bypassing agents carry a substantial treatment burden. Subcutaneous prophylaxis with concizumab might offer another treatment option. New research findings are summarized in a short video.

Concizumab for Hemophilia with Inhibitors

For infants with an isolated cleft palate, the age for surgical repair of the cleft palate that leads to better speech and hearing outcomes is unclear. New research findings are summarized in a short video.

Timing of Cleft Palate Surgery

Persons with HIV infection have up to twice the risk of atherosclerotic cardiovascular disease as the general population. Data on primary prevention strategies in this population are needed. New research findings are summarized in a short video.

Pitavastatin to Prevent CV Disease in HIV Infection

Whether mortality outcomes in patients with kidney failure are improved with high-dose hemodiafiltration as compared with conventional hemodialysis is unclear. New research findings are summarized in a short video.

Hemodiafiltration vs. Hemodialysis in Kidney Failure

Gliomas are the most common malignant primary brain tumor in adults, and most grade 2 gliomas have mutations in isocitrate dehydrogenase 1 and 2, the inhibitory targets of the drug vorasidenib. New research findings are summarized in a short video. ...

Vorasidenib in IDH-Mutant Glioma

Dietary patterns might affect cognitive decline, but clinical findings are limited. A new trial assessed the effect of the MIND diet on cognitive function. New research findings are summarized in a short video.

MIND Diet for Cognitive Decline

The most appropriate treatment for patients with resectable, stage III, non– small-cell lung cancer is unclear. New research findings comparing neoadjuvant nivolumab plus chemotherapy with chemotherapy alone are summarized in a short video.

Neoadjuvant Nivolumab in Stage III Lung Cancer

Adjuvant pembrolizumab can improve disease-free survival among patients with early-stage non–small-cell lung cancer. The effects of neoadjuvant pembrolizumab in these patients are unclear. New research findings are summarized in a short video.

Neoadjuvant Pembrolizumab for Lung Cancer

Obesity is expected to affect nearly a quarter of the world population by 2035. Retatrutide, an investigational GIP, GLP-1, and GCG receptor agonist, holds promise for weight reduction in adults. New research findings are summarized in a short video. ...

Phase 2 Trial of Retatrutide for Obesity

Curbside Consults Podcast

A deep dive with clinician experts and educators

On this episode of Curbside Consults, we discuss current approaches, adverse effects, and management of complications associated with immune checkpoint inhibitors (ICIs). We are joined by Dr. Kerry Reynolds, Clinical Director of Inpatient Oncology at Massachusetts General Hospital and Director of...

Immune Checkpoint Inhibitors with Dr. Kerry Reynolds

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...

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

From Pages To Practice

From Pages to Practice

Glucagon-like peptide 1 (GLP-1) receptor agonists are gaining attention for the management of type 2 diabetes and obesity. These drugs have multifactorial effects that include stimulating glucose-dependent insulin secretion, delaying gastric emptying, and inhibiting postprandial glucagon secretion. Consequently, GLP-1 receptor agonists...

Promising Results for GLP-1 Receptor Agonists in Obesity-Related HFpEF

A 40-year-old man with bipolar I disorder who is currently on a mood stabilizer is feeling better after a recent depressive episode. During the episode, he was treated with an adjunctive antidepressant. Now that his depression is in remission, you are...

Duration of Adjunctive Antidepressants After Remission of Depression in Bipolar I Disorder

Ms. Apple is a 74-year-old woman with a history of overweight but otherwise very active and still working as a part-time schoolteacher. At a primary care visit, she explains that she is concerned about memory loss because her mother developed dementia...

Diet for Prevention of Cognitive Decline in Older Adults

Mr. Wang is a 73-year-old male with a history of atrial fibrillation (AF) and diabetes who presented with left-sided weakness. Head imaging showed an ischemic stroke affecting the superficial cortical branch of the right middle cerebral artery. When should he restart...

Early Anticoagulation After Stroke Due to Atrial Fibrillation Prevents Recurrent Ischemic Events

Men who receive a diagnosis of low- or intermediate-risk clinically localized prostate cancer can live for decades. Each treatment option is associated with different effects on quality of life and sexual, urinary, and bowel function. To compare the effectiveness of these...

Similarly Low 15-Year Mortality After Monitoring, Surgery, or Radiotherapy for Prostate Cancer

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

Research Summaries

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Research summaries with expert commentaries

A 2-day regimen of low-dose colchicine or prednisone had similar short-term efficacy.

Colchicine vs. Prednisone for Acute Pseudogout

Patients with gastroesophageal reflux disease and normal mucosa on initial endoscopy might not require repeat examinations.

Nonerosive GERD Might Not Be a Precursor of Esophageal Cancer

Intensive blood glucose control might not be necessary in patients with diabetes who are undergoing major surgery.

Perioperative Glycemic Control in Patients with Diabetes

An observational study suggests this possibility.

Can a Gout Flare Provoke Venous Thrombosis?

Lactated Ringer's within the first 24 hours lowered the odds of moderate-to-severe pancreatitis.

Is Lactated Ringer's Superior to Normal Saline in Acute Pancreatitis?

A focus on mindful ordering showed sustained success.

Reducing Resident Ordering of Daily Labs in Hospitalized Patients

The FDA recently approved zuranolone, a mechanistically novel antidepressant that works faster than standard antidepressants.

A New, Rapidly Acting Antidepressant for Patients with Postpartum Depression

A meta-analysis confirms that revascularization leads to an excess of repeat procedures, without conferring long-term benefit.

Exercise Therapy vs. Revascularization for Intermittent Claudication


In an observational study, social determinants of health accounted for disparities almost completely.

Racial Disparities in Cardiovascular Disease–Related Mortality


Older adults who received low- and moderate-intensity statins had slightly greater LDL-cholesterol reduction than did younger adults.

How Does Age Affect LDL-Cholesterol Response to Statin Therapy?


Incidence of alpha-gal syndrome is increasing but is not widely recognized by clinicians.

Did You Know That Tick Bites Can Cause Meat Allergy?


The ACP's recommendations differ somewhat from other influential guidelines.

The American College of Physicians Weighs In on Colorectal Cancer Screening


But hearing aids imparted no cognitive benefit after 3 years in lower-risk patients.

Hearing Aids Might Slow Cognitive Decline in High-Risk, Hearing-Impaired Older Adults


All women and nonwhite men were less likely to receive appropriate statin therapy than were non-Hispanic white men.

Disparities in Statin Use for Preventing and Treating Heart Disease


In an observational study, a modestly higher risk for dementia was noted among menopausal hormone users.

Does Menopausal Hormone Therapy Raise Dementia Risk?


Moderate-to-vigorous exercise of ≥150 minutes weekly, regardless of how it was distributed, prevented some incident cardiovascular disease.

Are “Weekend Warriors” Protected from Heart Disease?


During 3-year randomized trials, older people who took multivitamins scored better on some cognition tests, but the clinical importance of the findings remains unclear.

Do Daily Multivitamins Protect Against Cognitive Decline?


Two newly approved vaccines for adults 60 or older should be available in autumn 2023.

RSV Vaccines for Older Adults


Compared with patients who received opioids, patients who received placebo had less pain after 6 to 12 weeks.

Risks Associated with Short-Term Opioids for Recent-Onset Low Back and Neck Pain Might Exceed Benefits


Weight reductions with higher doses approach those seen with bariatric surgery.

Tirzepatide Yields Substantial Weight Loss in Patients with or Without Diabetes


Stats, Stat!

Stats

In the latest edition of Stats, STAT!, Fralick and colleagues explain the statistics behind large language models — used in chat bots like ChatGPT and Bard. While these new tools may seem remarkably intelligent, at their core they just assemble sentences...

Large Language Models

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

Clinical Spotlight

Exploring controversies in clinical research

Similar neurological, immunological, metabolic, and cardiopulmonary abnormalities are present.

Long COVID and Chronic Fatigue Syndrome Share Pathophysiology


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

Beyond Journal Club Podcast from Core IM

Evaluating new trials and their place in the literature

Does adding revascularization by percutaneous coronary intervention (PCI) to optimal medical therapy improve survival and heart failure hospitalizations in patients with severe ischemic left ventricular systolic dysfunction? Some evidence suggests that patients with low ejection fraction benefit from revascularization by PCI....

The REVIVED Trial: Does PCI save lives in Heart Failure and CAD?

Clinical Pearls & Morning Reports

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NEJM articles presented as teaching topics

In patients with atrial high-rate episodes, edoxaban did not significantly reduce the incidence of stroke and cardiovascular outcomes as compared with placebo, but it led to a higher incidence of bleeding. ...