- Medicine and SocietyVOL. 387 No. 9, Sep 01, 2022
Building Black Wealth — The Role of Health Systems in Closing the GapN Engl J Med 2022; 387:844-849
Since wealth is a fundamental driver of health, health equity strategies that fail to close the racial wealth gap may be ineffective. What can health systems do to help address this major social determinant of health?
Linezolid for Drug-Resistant TuberculosisN Engl J Med 2022; 387:842-843
The development of a highly effective, oral, 6-month regimen for the treatment of multidrug-resistant tuberculosis, which previously took 18 to 24 months to cure, is one of the defining achievements of the tuberculosis research community in this century. The results of the Nix-TB study, which were published in the
Audio Interview: Covid-19 and the WHON Engl J Med 2022; 387:e24
In this audio interview conducted on August 30, 2022, the editors are joined by Soumya Swaminathan, Chief Scientist of the World Health Organization, to discuss the work of the WHO in fighting SARS-CoV-2.
Choosing a Method for Guiding PCIN Engl J Med 2022; 387:840-841
In contemporary clinical practice, interventional cardiologists use both fractional flow reserve (FFR) and intravascular ultrasonography (IVUS) to guide percutaneous coronary intervention (PCI) for intermediate coronary stenosis (i.e., a narrowing of the coronary-artery lumen by 40 to 70%). FFR, a physiological test, is used to evaluate the ischemic potential of a...
- EditorialAug 28, 2022
Anticoagulation in Atrial Fibrillation and Rheumatic Heart Disease10.1056/NEJMe2210187
The landscape for stroke prevention in atrial fibrillation has been changed by the availability of the direct oral anticoagulants (DOACs) that have been tested in large, prospective, randomized trials for stroke prevention in patients with so-called nonvalvular atrial fibrillation. However, the definition of what is valvular or nonvalvular atrial fibrillation...
- EditorialAug 28, 2022
Surveillance Stress Testing “POST-PCI” — A Future Class III Recommendation?10.1056/NEJMe2210021
More than 100 years ago, Einthoven reported the presence of ST-segment changes on electrocardiography in a patient during exercise.1 His discovery led to the development of the modern-day stress test. In patients with known coronary artery disease, the stress test is useful in assessing residual ischemia after an...
New Decongestion Strategies in an Evolving Heart Failure Landscape10.1056/NEJMe2209997
Hospitalization for heart failure, usually due to volume overload, is among the most common reasons for hospitalization worldwide, and decongestion with loop diuretics is the primary focus of treatment in most patients.1 Despite the ubiquity of this clinical scenario in daily practice, high-quality data from randomized trials evaluating...
DELIVERing Progress in Heart Failure with Preserved Ejection Fraction10.1056/NEJMe2210177
More than 6 million adults in the United States have heart failure, accounting for at least 800,000 hospitalizations annually.1 More than half of these persons have heart failure with a preserved left ventricular ejection fraction.1 As the population ages, the overall prevalence of patients with heart...
REVIVE-ing a Weak Heart — Details Matter10.1056/NEJMe2210183
Ischemic cardiomyopathy represents the pathophysiological convergence of two growing clinical problems: atherosclerotic coronary artery disease and congestive heart failure. When a patient presents with congestive heart failure, it is incumbent on clinicians to undertake an etiologic workup that includes evaluation for a diagnosis of coronary artery disease1 ; simply...
- EditorialAug 26, 2022
The Polypill at 20 — What Have We Learned?10.1056/NEJMe2210020
Next year marks the 20th anniversary of the first appearance of the polypill in the medical literature. Wald and Law coined the term to denote a fixed-dose combination of medications for preventing cardiovascular disease.1 They suggested that administering a polypill to all adults 55 years of age or...
- Clinical Implications of Basic ResearchVOL. 387 No. 8, Aug 25, 2022
When Silence DisruptsN Engl J Med 2022; 387:753-756
Genomes have different types of genetic variation, and many changes are assumed to be “silent” — that is, they have no effect on biology, health, or fitness. A recent study shows that it is not that simple.
Evidence for Step Therapy in Diabetic Macular EdemaN Engl J Med 2022; 387:751-752
Step therapy is a treatment approach often required by health insurers to control costs. It involves treating first with a lower-cost medication and, only if that proves ineffective, switching to another, more costly medication. Although step therapy is commonly applied in treating hypertension, diabetes, cancer, and other conditions, concerns regarding...
Monkeypox — Past as PrologueN Engl J Med 2022; 387:749-750
In this issue of the Journal, Thornhill et al. report on 528 persons with monkeypox in a cohort spanning 16 countries on five continents.1 The authors provide important demographic, epidemiologic, and clinical details on the largest reported cohort of patients in the latest emerging infectious disease...
Audio Interview: Choosing an Antiviral to Treat Covid-19N Engl J Med 2022; 387:e22
In this audio interview conducted on August 23, 2022, the editors discuss the use of antivirals to treat Covid-19 and a new study of the real-world effectiveness of nirmatrelvir.
Acute Hepatitis in Children in 2022 — Human Adenovirus 41?N Engl J Med 2022; 387:656-657
Acute hepatitis in children is certainly not new, and it can be worrisome. Successful worldwide vaccination campaigns over the past few decades have led to demonstrable improvements in public health and well-being by reducing the incidence and consequences of two viral causes — hepatitis A and B viruses. Many other...
Audio Interview: Responding to MonkeypoxN Engl J Med 2022; 387:e21
In this audio interview conducted on August 16, 2022, the editors are joined by White House National Monkeypox Response Deputy Coordinator Demetre Daskalakis to discuss the new public health emergency and what HIV and Covid-19 have taught us.
Drawing the Line on Glycemia in PregnancyN Engl J Med 2022; 387:652-654
In the first decade of this millennium, convincing data showing that screening for and treatment of gestational diabetes mellitus improve both maternal and fetal outcomes1,2 ended debates within the obstetrical community about the usefulness of screening for gestational diabetes. Essentially all U.S. professional societies now recommend universal biochemical...
Time to Stop Using Ineffective Covid-19 DrugsN Engl J Med 2022; 387:654-655
In practicing evidence-based medicine, physicians use the best evidence currently available on safety and efficacy in making decisions on treatment choices for their patients. During the Covid-19 pandemic, some of the early treatment trials were rushed, leading to studies that were badly conducted1 or had too few patients.
- EditorialVOL. 387 No. 6, Aug 11, 2022
Reviewers for the Journal, January–June 2022N Engl J Med 2022; 387:564-564
Each year thousands of reviewers contribute their expertise to peer review, a process that contributes critically to the quality of the Journal. The editors and the authors of the papers submitted to the Journal are grateful for the help of all our reviewers. Here we acknowledge,...
- Clinical DecisionsVOL. 387 No. 6, Aug 11, 2022
Screening for Atrial Fibrillation in Asymptomatic Older AdultsN Engl J Med 2022; 387:565-567
This interactive feature about screening for atrial fibrillation in asymptomatic older adults offers a case vignette accompanied by two essays, one supporting screening and the other supporting deferral of screening.