doi: 10.1056/NEJMicm2304237pmid: 38146747
Clonorchis sinensis Liver FlukesA 70-year-old man undergoing cholangioscopy to evaluate dilatation of the common bile duct was found to have flatworms in his biliary tract (shown in a video).
Calderon Vargas, Psyche; Cuneo, C. Nicholas; Janeway, Hannah; Kubica, Marcelina; Malina, Debra; Rojas García, Ximena
doi: 10.1056/NEJMp2310170pmid: 38157498
Health Care on the Edge — Refugee MedicineThis Double Take video discusses the health care challenges and complex trauma that refugees experience and highlights the importance of taking a holistic approach toward their care.
doi: 10.1056/NEJMc2312559pmid: 38157512
To the Editor: In their article describing the development of partial resistance of Plasmodium falciparum to artemisinin therapy in Eritrea, Mihreteab and colleagues (Sept. 28 issue)1 conclude that both Pf kelch13-mediated resistance to artemisinin and deletions in hrp2 and hrp3 threaten to compromise regional malaria control and elimination campaigns. In this regard, in 2014, our group described an analysis of Pfkelch13 R622I in northwest Ethiopia in an in vivo efficacy study involving patients who had been treated with a combination of artemether and lumefantrine.2 Subsequently, in 2017, we documented the expansion of R622I (from 2.4 to 9.5%), although all the . . .
doi: 10.1056/NEJMpv2311908pmid: 38157508
The Black Youth Hospital CrisisSubjecting young Black people in crisis to the N-word harms them twice: first they’re hit by hate speech and then, often, by clinicians who stand by and allow racist behavior to occur — or even defend it.
doi: 10.1056/NEJMc2312844pmid: 38157516
To the Editor: In their review, Freedman et al. (Oct. 12 issue)1 dedicate only a few lines to complement activation. However, several studies have shown that complement plays an important role in the pathophysiology of Shiga toxin–producing Escherichia coli (STEC)–associated hemolytic–uremic syndrome (HUS).2 Shiga toxins have been shown to induce C3b deposition on human cultured endothelial cells. In human whole blood, Shiga toxin 2 promoted the formation of C3- and C5b-9–coated red cell–derived microvesicles.2 Glomerular C3 and C5b-9 deposits have been found in mice and children with STEC-associated HUS.2 Deficiency of the key component of the complement alternative pathway factor . . .
Ross, Joseph S.; Waldstreicher, Joanne; Krumholz, Harlan M.
doi: 10.1056/NEJMp2308792pmid: 37966303
A New Era for Research Funded by the U.S. GovernmentIn January 2023, the NIH implemented its new Data Management and Sharing Policy. The potential effects of this shift in the clinical research enterprise toward data sharing are profound.
doi: 10.1056/NEJMp2312301pmid: 38146707
Poet as PatientA hospitalized poet writes a series of poems that seem possible only when one is near death. Grasping his condition through metaphor, he shares with his doctors an evolving understanding of life’s mysteries.
Pressley Byrd, Dolly; Buys, Elizabeth; Brickhouse Murphy, Amanda; Cené, Crystal
doi: 10.1056/NEJMp2308601pmid: 38146710
Community-Based DoulasPartnerships between perinatal care providers and community-based doulas are one way to improve health outcomes. Unfortunately, U.S. clinicians are often hesitant or unwilling to share power.
Drysdale, Simon B.; Cathie, Katrina; Flamein, Florence; Knuf, Markus; Collins, Andrea M.; Hill, Helen C.; Kaiser, Friedrich; Cohen, Robert; Pinquier, Didier; Felter, Christian T.; Vassilouthis, Natalya C.; Jin, Jing; Bangert, Mathieu; Mari, Karine; Nteene, Rapi;
Showing 1 to 10 of 23 Articles
doi: 10.1056/NEJMoa2309189pmid: 38157500
AbstractBackgroundThe safety of the monoclonal antibody nirsevimab and the effect of nirsevimab on hospitalizations for respiratory syncytial virus (RSV)–associated lower respiratory tract infection when administered in healthy infants are unclear.MethodsIn a pragmatic trial, we randomly assigned, in a 1:1 ratio, infants who were 12 months of age or younger, had been born at a gestational age of at least 29 weeks, and were entering their first RSV season in France, Germany, or the United Kingdom to receive either a single intramuscular injection of nirsevimab or standard care (no intervention) before or during the RSV season. The primary end point was hospitalization for RSV-associated lower respiratory tract infection, defined as hospital admission and an RSV-positive test result. A key secondary end point was very severe RSV-associated lower respiratory tract infection, defined as hospitalization for RSV-associated lower respiratory tract infection with an oxygen saturation of less than 90% and the need for supplemental oxygen.ResultsA total of 8058 infants were randomly assigned to receive nirsevimab (4037 infants) or standard care (4021 infants). Eleven infants (0.3%) in the nirsevimab group and 60 (1.5%) in the standard-care group were hospitalized for RSV-associated lower respiratory tract infection, which corresponded to a nirsevimab efficacy of 83.2% (95% confidence interval [CI], 67.8 to 92.0; P<0.001). Very severe RSV-associated lower respiratory tract infection occurred in 5 infants (0.1%) in the nirsevimab group and in 19 (0.5%) in the standard-care group, which represented a nirsevimab efficacy of 75.7% (95% CI, 32.8 to 92.9; P=0.004). The efficacy of nirsevimab against hospitalization for RSV-associated lower respiratory tract infection was 89.6% (adjusted 95% CI, 58.8 to 98.7; multiplicity-adjusted P<0.001) in France, 74.2% (adjusted 95% CI, 27.9 to 92.5; multiplicity-adjusted P=0.006) in Germany, and 83.4% (adjusted 95% CI, 34.3 to 97.6; multiplicity-adjusted P=0.003) in the United Kingdom. Treatment-related adverse events occurred in 86 infants (2.1%) in the nirsevimab group.ConclusionsNirsevimab protected infants against hospitalization for RSV-associated lower respiratory tract infection and against very severe RSV-associated lower respiratory tract infection in conditions that approximated real-world settings. (Funded by Sanofi and AstraZeneca; HARMONIE ClinicalTrials.gov number, NCT05437510).