- Review ArticleAug 31, 202210.1056/NEJMra2206573
The protective effects of vaccination and prior infection on severe Covid-19 are reviewed, with proposed directions for future research, including mucosal immunity and intermittent vaccine boost strategies.
- N Engl J Med 2022; 387:727-736
Lesions of the ovary and fallopian tube are common and may be acute or chronic. Diagnostic assessment is designed to distinguish benign from malignant causes. Referral to a gynecologic oncologist is often necessary.
- N Engl J Med 2022; 387:631-639
Formerly known as Devic’s disease, this relapsing, demyelinating disorder of the central nervous system encompasses six syndromes and is associated with aquaporin-4 autoantibodies. Effective treatment prevents relapses.
- N Engl J Med 2022; 387:160-166
Inhibitors of proximal and terminal complement cascades can often control red-cell hemolysis associated with paroxysmal nocturnal hemoglobinuria, but some patients have breakthrough hemolysis.
- N Engl J Med 2022; 386:2495-2506
Accounting for 5 to 7% of all lymphomas, mantle-cell lymphoma has historically been associated with a poor outcome, but survival is improving. The epidemiology, pathology, pathophysiology, diagnosis, and treatment of mantle-cell lymphoma are described.
- N Engl J Med 2022; 386:2399-2411
Until recently, Ph-positive ALL was very aggressive and difficult to treat. Current frontline therapy, based on tyrosine kinase inhibitors, glucocorticoids, and blinatumomab, has increased survival, with high-level clearance of measurable tumor cells.
- N Engl J Med 2022; 386:2303-2314
Climate change and air pollution, largely caused by the burning of fossil fuels, pose serious harms to children’s health. Children from communities of color and low-income communities are disproportionately harmed.
- N Engl J Med 2022; 386:2213-2220
Cold injury is a combination of direct cellular damage from freezing and cellular ischemia from vasospasm and small-vessel thrombosis. The severity is related to the degree to which frozen tissues are reperfused on thawing.
- N Engl J Med 2022; 386:2120-2128
Testing for kidney disease is routine in clinical practice. This review focuses on advances in clinical evaluation of the glomerular filtration rate and albuminuria and their use in detecting acute and chronic kidney disease, designing trials of disease progression, and predicting risk in clinical practice.
- N Engl J Med 2022; 386:2024-2034
Gliflozins — sodium–glucose cotransporter 2 inhibitors — lower blood glucose and glycated hemoglobin in patients with type 2 diabetes without causing hypoglycemia. The agents also improve cardiac function in patients who have heart failure with or without type 2 diabetes and improve renal function, with few adverse effects.
- N Engl J Med 2022; 386:1922-1931
Childhood brain tumors were previously classified by histologic appearance and location. A new classification includes genetic changes, which have prognostic significance and may lead to therapeutic targets. This review focuses on pediatric gliomas, ependymomas, and medulloblastomas.
- N Engl J Med 2022; 386:1817-1832
Preeclampsia complicates 2 to 4% of all pregnancies and accounts for about 46,000 maternal deaths and 500,000 fetal or newborn deaths each year. Antihypertensive agents and magnesium sulfate can help control the systemic manifestations of preeclampsia, which is usually resolved by delivery of the placenta.
- N Engl J Med 2022; 386:1638-1645
Development and public acceptance of vaccines are crucial for disease control. This review covers the process of evaluating vaccines for safety and efficacy, authorization pathways, and factors that advisory bodies consider when establishing vaccine recommendations.
- N Engl J Med 2022; 386:1547-1558
Early-onset disease (at <50 years of age) accounts for 10% of colorectal cancer cases, and the incidence is increasing, particularly in high-income countries. Patients often present with advanced disease in the left colon. One in six patients has deficient DNA mismatch repair. Screening is now recommended to begin at 45...
- N Engl J Med 2022; 386:1345-1350
The diagnosis of Creutzfeldt–Jakob disease has advanced from detection of characteristic EEG and MRI features to include the detection in CSF of 14-3-3 protein and, with the use of RT-QuIC assays, of abnormally folded prion protein, with close to 100% sensitivity and specificity.