- N 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.
- N Engl J Med 2022; 387:421-432
Prasinezumab is a monoclonal antibody to α-synuclein, a protein involved in the pathogenesis of Parkinson’s disease. In a placebo-controlled trial, prasinezumab did not slow the progression of disease over a period of 52 weeks.
- N Engl J Med 2022; 387:408-420
In a phase 2 trial in early Parkinson’s disease, treatment with cinpanemab, a monoclonal antibody to α-synuclein, did not affect clinical or imaging progression over a period of 72 weeks.
- N Engl J Med 2022; 387:466-467
Parkinson’s disease is increasing in incidence at a faster rate than any other serious neurologic condition.1 Despite multiple agents putatively showing preclinical promise, there is no disease-modifying therapy available for clinical use in this disorder. Indeed, no potential treatment has survived scrutiny in a clinical trial to reach...
- N Engl J Med 2022; 387:368-370
An estimated one third or more of U.S. adults 60 years of age or older take vitamin D supplements, not including those who take multivitamins or other compounds containing vitamin D.1 Yet controversy continues about its overall benefits. In this issue of the Journal, LeBoff and...
- N Engl J Med 2022; 387:299-309
A study ancillary to a large trial showed that supplemental vitamin D3 did not lower the risk of fractures among generally healthy midlife and older adults not selected for vitamin D deficiency, low bone mass, or osteoporosis.
- N Engl J Med 2022; 386:e54
Although the Covid pandemic drew renewed attention to problems in U.S. nursing homes, the underlying issues with long-term care are long-standing. Susan Mitchell moderates a Perspective Roundtable about shortcomings and possible solutions.
- N Engl J Med 2022; 386:1869-1871
More than 30 years after the Nursing Home Reform Act, the United States still fails to protect nursing home residents and provide them with high-quality care. The Covid-19 pandemic’s devastating effect on nursing homes reminds us that further reforms are sorely needed.
- N Engl J Med 2022; 386:1467-1469
This interactive feature about the use of bisphosphonates to treat osteoporosis offers a case vignette accompanied by two essays, one supporting continuation of bisphosphonate therapy beyond 5 years and the other supporting a “drug holiday.”
- N Engl J Med 2022; 386:1453-1461
An 80-year-old woman was admitted with pancytopenia. Five weeks earlier, nausea, vomiting, diarrhea, chills, and fever had developed. CT revealed bilateral pelvic masses; examination of a peripheral-blood smear revealed schistocytes, anisocytosis, and a low platelet count. A diagnostic test was performed, and management decisions were made.
- N Engl J Med 2022; 386:1010-1011
The patient’s eyes close as his diagnosis sinks in. The resident sits with him in a silence filled with racing fears of the unknown. It’s that moment when everything has changed for this man: he’s gone from before to after. The resident knows this moment all too well.
- N Engl J Med 2022; 386:1008-1010
The perception that a good death is one that occurs at home is ingrained in our cultural and social history. But palliative care clinicians have begun to question this idea. What is needed is high-quality end-of-life care that aligns with individual goals and needs.
- N Engl J Med 2022; 386:667-672
ECT is effective for several disorders, particularly severe or treatment-resistant depression, with a rapid response, but stigma has impeded its use. The mechanism is not known, but a seizure is required for efficacy. Effects on memory are prominent though usually transient.
- N Engl J Med 2022; 386:614-615
When her mother is discharged from rehab after a fall that caused multiple pelvic fractures, a doctor experiences first-hand the frustrations of getting the requisite home help up and running. Even in a generous health system, time, advocacy, and resources are required.
- N Engl J Med 2022; 386:503-505
Hispanic Americans’ health profile doesn’t adhere to the paradigm in which minority ethnic or poverty status determines poor health outcomes. But the U.S. health enterprise has not used this information to recalibrate or rethink our models of health and risk factors.
- N Engl J Med 2022; 386:594-595
A majority of persons in whom a femoral neck fracture occurs have physical impairment, cognitive impairment, or both. For these patients, a hemiarthroplasty is considered to be the most suitable treatment; bone cement may or may not be used for fixation of the prosthesis. Using an uncemented stem reduces both...
- N Engl J Med 2022; 386:521-530
In this multicenter, randomized trial comparing cemented with modern uncemented hemiarthroplasty in persons 60 years of age or older with an intracapsular hip fracture, cemented hemiarthroplasty resulted in a modestly but significantly better quality of life and a lower risk of periprosthetic fracture than uncemented hemiarthroplasty.
- N Engl J Med 2022; 386:399-401
During a surge in cases of Covid-19 in Israel, a rapid deployment of BNT162b2 booster injections was initiated in long-term care facilities over a 3-week period in July. When infection rates were increasing in the general population, rates in long-term care facilities decreased by 71%, and hospitalization rates fell by...
- N Engl J Med 2022; 386:397-398
In nursing homes, the lowest quartile of staff vaccination rates in counties in the highest quartile of prevalence of Covid-19 was associated with 1.56 additional cases per 100 beds among residents, 1.50 additional cases per 100 beds among staff, and 0.19 additional Covid-19–related deaths of residents per 100 beds relative...
- N Engl J Med 2022; 386:302-303
After her grandmother attempts suicide, a physician finds that the medical team’s avoidance of honest conversation about her grandmother’s reality and desires creates a chasm between the clinicians and the family that is counterproductive and painful.