NEJM This Week

This week, we discuss left atrial appendage closure for atrial fibrillation, oxygen strategies in respiratory failure, an all-oral treatment for acute myeloid leukemia, CAR T-cell therapy enabling kidney transplantation, and a case of a neuroepithelial tumor that developed after gene therapy. We review childhood vaccine hesitancy, follow a complex diagnostic case, and examine Perspectives on corporatization in medicine, famine and war, and the future of health care systems.

This week, we present new research guiding treatment of pulmonary embolism, early progress in cardiac regeneration with engineered heart tissue, and treatments for gastroesophageal cancer and Chiari malformation. We review leishmaniasis and follow a revealing neurologic case. Perspectives discuss nutrition policy, tickborne illness, structural competence in medicine, and the arrival of closure.

This week, we present a promising new therapy for dermatomyositis, evolving approaches to stroke care, the prevention of Covid-19 after household exposure, and new treatments for kidney disease. We review inflammatory myopathies and follow a complex case of multisystem illness. Perspectives discuss AI and uncertainty in clinical care, health equity, the forces shaping affordability in health care, and on unpacking the ordinary.

This week, we present research on high-risk coronary intervention strategies, targeted therapy for pancreatic cancer, an mRNA influenza vaccine, and treatments for severe scabies and sickle cell disease. We review cerebral amyloid angiopathy and follow a complex case of a disseminated infection. Perspectives address the impact of corporate medicine on medical training and drug pricing policy.

This week, we feature advances in targeted therapy for HER2-mutant lung cancer, interventions to reduce maternal infection, an emerging treatment for hemophilia A, and a new diagnostic test for tuberculosis. We review Barrett’s esophagus and follow a case of systemic illness with kidney failure. Perspectives address GLP-1 drugs and eating disorders, directed blood donation, generic drug safety, and an in-flight medical emergency.

What happens when medicine gets race wrong? In a new 8-week series, The Race Equation confronts harmful assumptions about race in clinical medicine, why they endure, and what it will take to change.

This week, we explore new strategies for blood-pressure control after intracerebral hemorrhage, Covid-19 treatment in higher-risk patients, hormonal therapy for prostate cancer, and anesthesia for tracheal intubation. We review spinal epidural abscess and follow a case of progressive weakness and liver lesions. We examine advances in tRNA research, and Perspectives discuss the use AI in prescribing, pediatric drug research, the impact of pharmaceutical mergers, and the goals of care.

This week, we present new research on stroke prevention, Kawasaki disease, ICU infection strategies, and immune thrombocytopenia. We review hormone therapy and thrombotic risk. A case highlights an evolving diagnosis of severe fatigue and sleep disturbance. Perspectives explore nursing workforce policy, the role of nurse scientists in rebuilding trust, and the health consequences of environmental rollbacks.

This week, we present new research on intensive LDL cholesterol targets, team-based strategies to improve blood pressure control, emerging therapies for immune and oncologic diseases, and a next-generation yellow fever vaccine. We review celiac disease and follow a compelling case of post-procedural complications. Perspectives explore health disparities and efforts to strengthen care in vulnerable communities.

This week, we present new research on treatment for muscle-invasive bladder cancer, left atrial appendage closure versus medical therapy for atrial fibrillation, gene-editing approaches for sickle cell disease and β-thalassemia, and the safety of discontinuing beta-blockers after myocardial infarction. We also review GLP-1 receptor agonists and discuss a Clinical Problem-Solving case of a man with progressive confusion. Perspectives explore corporatization; biologic, as opposed to chronologic, aging; and a legal case that could affect mental-health policy.

This week, we present new clinical trials on immunotherapy for stage III mismatch repair–deficient colon cancer, early surgery for asymptomatic aortic stenosis, an approach to dengue virus suppression, and advances in gene and prime-editing therapies for rare disorders. We also review minipuberty. We follow the case of a 12-year-old girl with altered mental status and persistent hypoglycemia, and we explore Perspectives on corporate influences on health, vaccine communication, antitrust policy, conflicts of interest, and the meaning of the number needed to treat.

This week, we explore new evidence comparing oral anticoagulants for acute venous thromboembolism, treatment for chemotherapy-induced thrombocytopenia, and early results of gene therapy for inherited deafness. We also examine evolving strategies for chronic lymphocytic leukemia, review the management of polymyalgia rheumatica, and present a case discussion of a woman with chest pain, dyspnea, and syncope. We explore gastric cancer prevention, competency-based billing, the health consequences of immigration enforcement, access to high-cost gene therapies, and we present a Perspective on good compressions.

This week, we explore a phase 3 trial of finerenone in type 1 diabetes and chronic kidney disease and guidance on timing of nonculprit-lesion PCI after STEMI. We cover an investigational therapy for Dravet syndrome and neoadjuvant treatment for high-risk intrahepatic cholangiocarcinoma. We review the effects of radiotherapy on normal tissue, a puzzling case of progressive neurologic decline after suspected foodborne illness, and Perspectives on private equity, the AHEAD model, and medical credit cards.

This week, we explore a new standard of care for high-risk HER2-positive early breast cancer, long-acting therapy for people with HIV facing adherence challenges, a first-in-class trial of a p53 reactivator, and tecovirimat for mpox. We review group B streptococcal disease and a revealing case of prosthetic joint infection. Perspectives examine the role of folate therapy, Medicare drug-price negotiation, AI in medical education, and incidental findings.

This week, we highlight major advances in multiple myeloma, gene therapy for cystinosis, and experimental treatments for myotonic dystrophy. We review long-term outcomes of aortic-valve replacement, strategies for secondary stroke prevention, and a revealing diagnostic case of eosinophilic disease in an older adult. A Sounding Board explores FDA approval standards. Perspectives delve into tobacco cessation, influenza evolution, and the uncertainty patients and clinicians share when facing life-altering diagnoses.

This week includes studies on promising new therapies for IgA nephropathy, evolving antithrombotic strategies after coronary stenting, and the inciting antigen in rare vaccine-related clotting syndromes. We review the urgent challenge of mucormycosis and follow the case of a young woman with headaches and hypertension. We discuss human-subjects research. Perspectives examine rural health, data interoperability, drug labels in the courts, and a pediatrician’s dilemma.

This week, we look at new evidence on oral cholesterol-lowering therapy, the evolving role of beta-blockers after myocardial infarction, and advances in breast and prostate cancer treatment. We review the inherited risk of coronary disease. We also work through a revealing diagnostic case in a young woman and reflect on science under pressure, corporatized insurance, the reach of FDA law, and what it means to live with life-sustaining technology.

This week, we explore new therapies to reduce pancreatitis risk in severe hypertriglyceridemia, advances in breast cancer treatment, and long-term results of gene therapy for hemophilia B. We discuss vision-threatening vascular emergencies, the mental health effects of firearm injury on families, and care for peripheral artery disease. We also follow a revealing diagnostic case in an older woman with respiratory failure. Perspectives reflect on hypertension control, immunization access, chronic disease policy, and on the inherited risk of disease.

In this episode, we explore evolving evidence on anticoagulation after atrial fibrillation ablation, long-term outcomes with immunotherapy for melanoma, and promising new treatments for hepatitis D and triple-negative breast cancer. We review advances in physiologic pacing for heart failure and work through a challenging case involving fever, rash, and neurologic symptoms. An article considers fairness for late-career physicians, and Perspectives discuss misconceptions about autism, access to contraception, and the financial pressures shaping health care.

This week, we explore new evidence on managing asymptomatic carotid stenosis, restoring vision in advanced macular degeneration, and preventing migraine in children. We discuss innovative cellular therapy for autoimmune disease, review sudden cardiac arrest in athletes, and describe a case of severe systemic infection with vision loss. Perspectives examine global tobacco risks, the future of telehealth payment, Medicare coverage of new technologies, and the things physicians carry.

This week, we explore new options in cardiovascular prevention, fish-oil supplementation in dialysis patients, RSV vaccination, and cutting-edge cellular therapy for leukemia. We discuss advances in lung cancer treatment, approaches to functional dyspepsia, and a complex case of severe infection after travel. Perspectives examine access to and cost of weight-loss drugs, the promise and risks of AI in clinical care, and what it means to care for others while carrying personal loss.

This week, we share advances in treatment for EGFR-mutated lung cancer, a brain-penetrant enzyme therapy for a rare pediatric disorder, and dual targeting of extramedullary myeloma. We review cardiogenic shock, work through a challenging diagnostic puzzle in a young woman with recurrent illness, and explore Perspectives on corporatized care, vaccine policy, AI in medicine, and where clinicians carry grief.

This week, we look at ctDNA-guided immunotherapy for bladder cancer, cardiovascular outcomes with tirzepatide, and evidence that one HPV vaccine dose may be enough. We explore high-dose rifampin for tuberculous meningitis, review measles amid rising outbreaks, and follow a challenging case of gastrointestinal bleeding. Essays examine how clinicians navigate post-Dobbs care, tobacco harm among people with mental illness, congenital syphilis, and sustaining medical research.