NEJM This Week

We discuss the latest in medical research and ideas.

A 50-year-old, previously healthy man presents to the ED with 2 days of worsening dyspnea. He had fever, cough, and fatigue during the week before presentation. He appears acutely ill. The body temperature is 39.5°C, heart rate 110 beats per minute, respiratory rate 24 breaths per minute, and blood pressure 130/60 mm Hg. The oxygen saturation is 87% while the patient is breathing ambient air. The white-cell count is 7300 per microliter with lymphopenia. Chest X-ray shows patchy bilateral opacities in the lung parenchyma. An RT–PCR assay detects the presence of SARS-CoV-2 RNA in a nasopharyngeal swab. How would you evaluate and manage this case? Full-text recordings of Clinical Practice articles can be found at NEJM.org.

We discuss the latest in medical research and ideas.

We discuss the latest in medical research and ideas.

A 73-year-old man with hypertension and chronic obstructive pulmonary disease calls to report that he has had a fever and a dry cough for the past 2 days. He notes that his shortness of breath has worsened. His medications include losartan and inhaled glucocorticoids. He lives alone. How should he be evaluated? If he has Covid-19, the disease caused by SARS-CoV-2, then how should he be treated? Full-text recordings of Clinical Practice articles can be found at NEJM.org.

We discuss the latest in medical research and ideas.

We discuss the latest in medical research and ideas.

Featuring articles on deaths due to e-cigarette– or vaping-associated lung injury, apixaban for venous thromboembolism in cancer, the management of coronary disease in patients with advanced kidney disease, health-status outcomes in the ISCHEMIA-CKD trial, ten weeks to crush the curve, renin–angiotensin–aldosterone system inhibitors in patients with Covid-19, and teasing the immune system to repair the heart; a review article on the care of patients with diabetic retinopathy; a case report of a man with high blood pressure, renal insufficiency, and hematuria; and Perspective articles on clinical and social risk adjustment, on prediction models, and on medical care during the pandemic.

Featuring articles on a non–D2-receptor-binding drug for schizophrenia, inclisiran in patients with elevated LDL cholesterol, inclisiran for heterozygous familial hypercholesterolemia, and reconsidering prostate cancer mortality; a review article on cochlear implantation in adults; a case report of a man with fever, cough, and dyspnea; and Perspective articles on a strategy for improving U.S. health care delivery, on evidence from pragmatic trials during routine care, on the importance of comprehensive fertility benefits for the medical workforce, and on Covid-19 and the importance of language.

Featuring articles on an invasive or conservative strategy for stable coronary disease, health-status outcomes in the ISCHEMIA trial, physical therapy vs. glucocorticoids for osteoarthritis of the knee, selumetinib for plexiform neurofibromas, and resolving inflammation in asthma and beyond; a review article on alpha1–antitrypsin deficiency; a case report of a man with facial droop, dysarthria, and kidney failure; and Perspective articles on standing up against gender bias and harassment, on hospital mergers and conscience-based objections, on a new era for mind–body medicine, and on chart warfare.

We discuss the latest in medical research and ideas.

We discuss the latest in medical research and ideas.

We discuss the latest in medical research and ideas.

We discuss the latest in medical research and ideas.

We discuss the latest in medical research and ideas.