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New England Journal of Medicine

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https://www.readbyqxmd.com/read/28530840/oral-glucocorticoid-sparing-effect-of-benralizumab-in-severe-asthma
#1
Parameswaran Nair, Sally Wenzel, Klaus F Rabe, Arnaud Bourdin, Njira L Lugogo, Piotr Kuna, Peter Barker, Stephanie Sproule, Sandhia Ponnarambil, Mitchell Goldman
Background Many patients with severe asthma rely on oral glucocorticoids to manage their disease. We investigated whether benralizumab, a monoclonal antibody directed against the alpha subunit of the interleukin-5 receptor that significantly reduces the incidence of asthma exacerbations, was also effective as an oral glucocorticoid-sparing therapy in patients relying on oral glucocorticoids to manage severe asthma associated with eosinophilia. Methods In a 28-week randomized, controlled trial, we assessed the effects of benralizumab (at a dose of 30 mg administered subcutaneously either every 4 weeks or every 8 weeks [with the first three doses administered every 4 weeks]) versus placebo on the reduction in the oral glucocorticoid dose while asthma control was maintained in adult patients with severe asthma...
May 22, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28528569/time-to-treatment-and-mortality-during-mandated-emergency-care-for-sepsis
#2
Christopher W Seymour, Foster Gesten, Hallie C Prescott, Marcus E Friedrich, Theodore J Iwashyna, Gary S Phillips, Stanley Lemeshow, Tiffany Osborn, Kathleen M Terry, Mitchell M Levy
Background In 2013, New York began requiring hospitals to follow protocols for the early identification and treatment of sepsis. However, there is controversy about whether more rapid treatment of sepsis improves outcomes in patients. Methods We studied data from patients with sepsis and septic shock that were reported to the New York State Department of Health from April 1, 2014, to June 30, 2016. Patients had a sepsis protocol initiated within 6 hours after arrival in the emergency department and had all items in a 3-hour bundle of care for patients with sepsis (i...
May 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28528561/angiotensin-ii-for-the-treatment-of-vasodilatory-shock
#3
Ashish Khanna, Shane W English, Xueyuan S Wang, Kealy Ham, James Tumlin, Harold Szerlip, Laurence W Busse, Laith Altaweel, Timothy E Albertson, Caleb Mackey, Michael T McCurdy, David W Boldt, Stefan Chock, Paul J Young, Kenneth Krell, Richard G Wunderink, Marlies Ostermann, Raghavan Murugan, Michelle N Gong, Rakshit Panwar, Johanna Hästbacka, Raphael Favory, Balasubramanian Venkatesh, B Taylor Thompson, Rinaldo Bellomo, Jeffrey Jensen, Stew Kroll, Lakhmir S Chawla, George F Tidmarsh, Adam M Deane
Background Vasodilatory shock that does not respond to high-dose vasopressors is associated with high mortality. We investigated the effectiveness of angiotensin II for the treatment of patients with this condition. Methods We randomly assigned patients with vasodilatory shock who were receiving more than 0.2 μg of norepinephrine per kilogram of body weight per minute or the equivalent dose of another vasopressor to receive infusions of either angiotensin II or placebo. The primary end point was a response with respect to mean arterial pressure at hour 3 after the start of infusion, with response defined as an increase from baseline of at least 10 mm Hg or an increase to at least 75 mm Hg, without an increase in the dose of background vasopressors...
May 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28528558/state-sepsis-mandates-a-new-era-for-regulation-of-hospital-quality
#4
Tina B Hershey, Jeremy M Kahn
Sepsis is a major cause of illness and death in the United States, affecting more than 1.5 million Americans each year at an annual cost of over $20 billion. To improve outcomes of sepsis, policymakers are increasingly using regulatory mechanisms intended to provide incentives to clinicians and..
May 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28525302/treatment-of-endometriosis-associated-pain-with-elagolix-an-oral-gnrh-antagonist
#5
Hugh S Taylor, Linda C Giudice, Bruce A Lessey, Mauricio S Abrao, Jan Kotarski, David F Archer, Michael P Diamond, Eric Surrey, Neil P Johnson, Nelson B Watts, J Chris Gallagher, James A Simon, Bruce Carr, W Paul Dmowski, Nicholas Leyland, Jean P Rowan, W Rachel Duan, Juki Ng, Brittany Schwefel, James W Thomas, Rita I Jain, Kristof Chwalisz
Background Endometriosis is a chronic, estrogen-dependent condition that causes dysmenorrhea and pelvic pain. Elagolix, an oral, nonpeptide, gonadotropin-releasing hormone (GnRH) antagonist, produced partial to nearly full estrogen suppression in previous studies. Methods We performed two similar, double-blind, randomized, 6-month phase 3 trials (Elaris Endometriosis I and II [EM-I and EM-II]) to evaluate the effects of two doses of elagolix - 150 mg once daily (lower-dose group) and 200 mg twice daily (higher-dose group) - as compared with placebo in women with surgically diagnosed endometriosis and moderate or severe endometriosis-associated pain...
May 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28520519/oil-based-or-water-based-contrast-for-hysterosalpingography-in-infertile-women
#6
Kim Dreyer, Joukje van Rijswijk, Velja Mijatovic, Mariëtte Goddijn, Harold R Verhoeve, Ilse A J van Rooij, Annemieke Hoek, Petra Bourdrez, Annemiek W Nap, Henrike G M Rijnsaardt-Lukassen, Catharina C M Timmerman, Mesrure Kaplan, Angelo B Hooker, Anna P Gijsen, Ron van Golde, Cathelijne F van Heteren, Alexander V Sluijmer, Jan-Peter de Bruin, Jesper M J Smeenk, Jacoba A M de Boer, Eduard Scheenjes, Annette E J Duijn, Alexander Mozes, Marie J Pelinck, Maaike A F Traas, Machiel H A van Hooff, Gijsbertus A van Unnik, Cornelia H de Koning, Nan van Geloven, Jos W R Twisk, Peter G A Hompes, Ben W J Mol
Background Pregnancy rates among infertile women have been reported to increase after hysterosalpingography, but it is unclear whether the type of contrast medium used (oil-based or water-soluble contrast) influences this potential therapeutic effect. Methods We performed a multicenter, randomized trial in 27 hospitals in the Netherlands in which infertile women who were undergoing hysterosalpingography were randomly assigned to undergo this procedure with the use of oil-based or water-based contrast. Subsequently, couples received expectant management or the women underwent intrauterine insemination...
May 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28514226/the-march-of-science-the-true-story
#7
Lisa Rosenbaum
"The human understanding when it has once adopted an opinion...draws all things else to support and agree with it." Francis Bacon, the "Father of Empiricism," came to this conclusion in the 17th century, and some 350 years later, three Stanford psychologists confirmed its validity. They recruited..
May 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28489481/efficient-trial-design-fda-approval-of-valbenazine-for-tardive-dyskinesia
#8
Michael C Davis, Brian J Miller, Jasmeet K Kalsi, Thomas Birkner, Mitchell V Mathis
A well-executed development program that addresses both regulatory and clinical requirements is critical for making novel therapeutics available as quickly as possible to patients with unmet medical needs. In the case of valbenazine, which was recently approved by the U.S. Food and Drug..
May 10, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28471717/randomized-trial-of-thymectomy-in-myasthenia-gravis
#9
(no author information available yet)
No abstract text is available yet for this article.
May 4, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28468518/buprenorphine-for-the-treatment-of-the-neonatal-abstinence-syndrome
#10
Walter K Kraft, Susan C Adeniyi-Jones, Inna Chervoneva, Jay S Greenspan, Diane Abatemarco, Karol Kaltenbach, Michelle E Ehrlich
Background Current pharmacologic treatment of the neonatal abstinence syndrome with morphine is associated with a lengthy duration of therapy and hospitalization. Buprenorphine may be more effective than morphine for this indication. Methods In this single-site, double-blind, double-dummy clinical trial, we randomly assigned 63 term infants (≥37 weeks of gestation) who had been exposed to opioids in utero and who had signs of the neonatal abstinence syndrome to receive either sublingual buprenorphine or oral morphine...
May 4, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28467732/separating-families-at-the-border-consequences-for-children-s-health-and-well-being
#11
Michael J MacKenzie, Emily Bosk, Charles H Zeanah
Decades of research on child development confirms that children develop best in the context of safe, supportive, nurturing relationships. Positive relationships with primary caregivers are essential for children’s healthy physical and emotional development. For children who experience serious..
May 3, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28459186/trial-of-transplantation-of-hcv-infected-kidneys-into-uninfected-recipients
#12
David S Goldberg, Peter L Abt, Emily A Blumberg, Vivianna M Van Deerlin, Matthew Levine, K Rajender Reddy, Roy D Bloom, Susanna M Nazarian, Deirdre Sawinski, Paige Porrett, Ali Naji, Richard Hasz, Lawrence Suplee, Jennifer Trofe-Clark, Anna Sicilia, Maureen McCauley, Midhat Farooqi, Caren Gentile, Jennifer Smith, Peter P Reese
No abstract text is available yet for this article.
April 30, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28445656/learning-what-we-didn-t-know-the-sprint-data-analysis-challenge
#13
Nancy S Burns, Pamela W Miller
No abstract text is available yet for this article.
April 26, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28445112/tracking-the-evolution-of-non-small-cell-lung-cancer
#14
Mariam Jamal-Hanjani, Gareth A Wilson, Nicholas McGranahan, Nicolai J Birkbak, Thomas B K Watkins, Selvaraju Veeriah, Seema Shafi, Diana H Johnson, Richard Mitter, Rachel Rosenthal, Max Salm, Stuart Horswell, Mickael Escudero, Nik Matthews, Andrew Rowan, Tim Chambers, David A Moore, Samra Turajlic, Hang Xu, Siow-Ming Lee, Martin D Forster, Tanya Ahmad, Crispin T Hiley, Christopher Abbosh, Mary Falzon, Elaine Borg, Teresa Marafioti, David Lawrence, Martin Hayward, Shyam Kolvekar, Nikolaos Panagiotopoulos, Sam M Janes, Ricky Thakrar, Asia Ahmed, Fiona Blackhall, Yvonne Summers, Rajesh Shah, Leena Joseph, Anne M Quinn, Phil A Crosbie, Babu Naidu, Gary Middleton, Gerald Langman, Simon Trotter, Marianne Nicolson, Hardy Remmen, Keith Kerr, Mahendran Chetty, Lesley Gomersall, Dean A Fennell, Apostolos Nakas, Sridhar Rathinam, Girija Anand, Sajid Khan, Peter Russell, Veni Ezhil, Babikir Ismail, Melanie Irvin-Sellers, Vineet Prakash, Jason F Lester, Malgorzata Kornaszewska, Richard Attanoos, Haydn Adams, Helen Davies, Stefan Dentro, Philippe Taniere, Brendan O'Sullivan, Helen L Lowe, John A Hartley, Natasha Iles, Harriet Bell, Yenting Ngai, Jacqui A Shaw, Javier Herrero, Zoltan Szallasi, Roland F Schwarz, Aengus Stewart, Sergio A Quezada, John Le Quesne, Peter Van Loo, Caroline Dive, Allan Hackshaw, Charles Swanton
Background Among patients with non-small-cell lung cancer (NSCLC), data on intratumor heterogeneity and cancer genome evolution have been limited to small retrospective cohorts. We wanted to prospectively investigate intratumor heterogeneity in relation to clinical outcome and to determine the clonal nature of driver events and evolutionary processes in early-stage NSCLC. Methods In this prospective cohort study, we performed multiregion whole-exome sequencing on 100 early-stage NSCLC tumors that had been resected before systemic therapy...
April 26, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28445103/whose-data-are-they-anyway-can-a-patient-perspective-advance-the-data-sharing-debate
#15
Charlotte J Haug
No abstract text is available yet for this article.
April 26, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28445080/bridging-the-data-sharing-divide-seeing-the-devil-in-the-details-not-the-other-camp
#16
Lisa Rosenbaum
No abstract text is available yet for this article.
April 26, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28402245/thyroid-hormone-therapy-for-older-adults-with-subclinical-hypothyroidism
#17
David J Stott, Nicolas Rodondi, Patricia M Kearney, Ian Ford, Rudi G J Westendorp, Simon P Mooijaart, Naveed Sattar, Carole E Aubert, Drahomir Aujesky, Douglas C Bauer, Christine Baumgartner, Manuel R Blum, John P Browne, Stephen Byrne, Tinh-Hai Collet, Olaf M Dekkers, Wendy P J den Elzen, Robert S Du Puy, Graham Ellis, Martin Feller, Carmen Floriani, Kirsty Hendry, Caroline Hurley, J Wouter Jukema, Sharon Kean, Maria Kelly, Danielle Krebs, Peter Langhorne, Gemma McCarthy, Vera McCarthy, Alex McConnachie, Mairi McDade, Martina Messow, Annemarie O'Flynn, David O'Riordan, Rosalinde K E Poortvliet, Terence J Quinn, Audrey Russell, Carol Sinnott, Jan W A Smit, H Anette Van Dorland, Kieran A Walsh, Elaine K Walsh, Torquil Watt, Robbie Wilson, Jacobijn Gussekloo
Background The use of levothyroxine to treat subclinical hypothyroidism is controversial. We aimed to determine whether levothyroxine provided clinical benefits in older persons with this condition. Methods We conducted a double-blind, randomized, placebo-controlled, parallel-group trial involving 737 adults who were at least 65 years of age and who had persisting subclinical hypothyroidism (thyrotropin level, 4.60 to 19.99 mIU per liter; free thyroxine level within the reference range). A total of 368 patients were assigned to receive levothyroxine (at a starting dose of 50 μg daily, or 25 μg if the body weight was <50 kg or the patient had coronary heart disease), with dose adjustment according to the thyrotropin level; 369 patients were assigned to receive placebo with mock dose adjustment...
April 3, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28402239/device-thrombosis-with-bioresorbable-scaffolds
#18
Debabrata Mukherjee
No abstract text is available yet for this article.
March 29, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28402237/bioresorbable-scaffolds-versus-metallic-stents-in-routine-pci
#19
Joanna J Wykrzykowska, Robin P Kraak, Sjoerd H Hofma, Rene J van der Schaaf, E Karin Arkenbout, Alexander J IJsselmuiden, Joëlle Elias, Ivo M van Dongen, Ruben Y G Tijssen, Karel T Koch, Jan Baan, M Marije Vis, Robbert J de Winter, Jan J Piek, Jan G P Tijssen, Jose P S Henriques
Background Bioresorbable vascular scaffolds were developed to overcome the shortcomings of drug-eluting stents in percutaneous coronary intervention (PCI). We performed an investigator-initiated, randomized trial to compare an everolimus-eluting bioresorbable scaffold with an everolimus-eluting metallic stent in the context of routine clinical practice. Methods We randomly assigned 1845 patients undergoing PCI to receive either a bioresorbable vascular scaffold (924 patients) or a metallic stent (921 patients)...
March 29, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28320259/levosimendan-for-hemodynamic-support-after-cardiac-surgery
#20
Giovanni Landoni, Vladimir V Lomivorotov, Gabriele Alvaro, Rosetta Lobreglio, Antonio Pisano, Fabio Guarracino, Maria G Calabrò, Evgeny V Grigoryev, Valery V Likhvantsev, Marcello F Salgado-Filho, Alessandro Bianchi, Vadim V Pasyuga, Massimo Baiocchi, Federico Pappalardo, Fabrizio Monaco, Vladimir A Boboshko, Marat N Abubakirov, Bruno Amantea, Rosalba Lembo, Luca Brazzi, Luigi Verniero, Pietro Bertini, Anna M Scandroglio, Tiziana Bove, Alessandro Belletti, Maria G Michienzi, Dmitriy L Shukevich, Tatiana S Zabelina, Rinaldo Bellomo, Alberto Zangrillo
Background Acute left ventricular dysfunction is a major complication of cardiac surgery and is associated with increased mortality. Meta-analyses of small trials suggest that levosimendan may result in a higher rate of survival among patients undergoing cardiac surgery. Methods We conducted a multicenter, randomized, double-blind, placebo-controlled trial involving patients in whom perioperative hemodynamic support was indicated after cardiac surgery, according to prespecified criteria. Patients were randomly assigned to receive levosimendan (in a continuous infusion at a dose of 0...
March 21, 2017: New England Journal of Medicine
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