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New England Journal of Medicine
The New England Journal of Medicine (NEJM) RSS feed -- current issue. NEJM (http://www.nejm.org) is a weekly general medical journal that publishes new medical research findings, review articles, and editorial opinion on a wide variety of topics of importance to biomedical science and clinical practice

EARLY RELEASE: Stroke Prevention -- Insights from Incoherence (No abstract is available for this citation) EARLY RELEASE: Toll-like Receptor 3 and Geographic Atrophy in Age-Related Macular Degeneration Background Age-related macular degeneration is the most common cause of irreversible visual impairment in the developed world. Advanced age-related macular degeneration consists of geographic atrophy and choroidal neovascularization. The specific ... EARLY RELEASE: Telmisartan to Prevent Recurrent Stroke and Cardiovascular Events Background Prolonged lowering of blood pressure after a stroke reduces the risk of recurrent stroke. In addition, inhibition of the renin-angiotensin system in high-risk patients reduces the rate of subsequent ... EARLY RELEASE: Aspirin and Extended-Release Dipyridamole versus Clopidogrel for Recurrent Stroke Background Recurrent stroke is a frequent, disabling event after ischemic stroke. This study compared the efficacy and safety of two antiplatelet regimens -- aspirin plus extended-release dipyridamole (ASA-ERDP) versus clopidogrel. ... EARLY RELEASE: Ezetimibe and Cancer -- An Uncertain Association (No abstract is available for this citation) EARLY RELEASE: Intensive Lipid Lowering with Simvastatin and Ezetimibe in Aortic Stenosis Background Hyperlipidemia has been suggested as a risk factor for stenosis of the aortic valve, but lipid-lowering studies have had conflicting results. Methods We conducted a randomized, double-blind trial involving ... EARLY RELEASE: Analyses of Cancer Data from Three Ezetimibe Trials Background Five years of statin therapy lowers low-density lipoprotein (LDL) cholesterol substantially and, over a 5-year period, results in reductions in the incidence of cardiovascular events. The Simvastatin and Ezetimibe ... EARLY RELEASE: Identifying and Addressing Safety Signals in Clinical Trials (No abstract is available for this citation) PERSPECTIVE: Guns and Suicide in the United States This past June, in a 5-to-4 decision in District of Columbia v. Heller, the Supreme Court struck down a ban on handgun ownership in the nation's capital and ruled that ... PERSPECTIVE: Drug Warnings That Can Cause Fits -- Communicating Risks in a Data-Poor Environment In 2005, after receiving case reports of suicides by patients taking anticonvulsant medications, the Food and Drug Administration (FDA) asked the manufacturers of 11 drugs in this class to report ... PERSPECTIVE: Close Calls I didn't realize I was on call that night until we were at Fenway Park and the ball game was well under way. Call started at 9 p.m., and frankly, ... ORIGINAL ARTICLE: Quality of Life with Defibrillator Therapy or Amiodarone in Heart Failure The use of implantable cardioverter-defibrillators (ICDs) prolongs survival for some patients with heart failure. However, it has been suggested that ICD implantation may adversely affect the quality of life. In this trial, the evaluation of several quality-of-life measures disclosed no long-term effect, although a temporary adverse effect was evident within 1 month after an ICD shock. ORIGINAL ARTICLE: Prognostic Importance of Defibrillator Shocks in Patients with Heart Failure In the Sudden Cardiac Death in Heart Failure Trial, 811 patients were randomly assigned to receive implantable cardioverter-defibrillators (ICDs). Of these patients, 269 (33.2%) received at least one ICD shock over a median follow-up period of 45.5 months. The occurrence of ICD shocks, whether appropriate or inappropriate, was associated with a significant increase in the subsequent risk of death from all causes. ORIGINAL ARTICLE: Hyponatremia and Mortality among Patients on the Liver-Transplant Waiting List The Model for End-Stage Liver Disease (MELD) uses bilirubin, the international normalized ratio for prothrombin time, and creatinine to estimate the risk of death in patients waiting for liver transplantation. This analysis of about 14,000 registrants on the waiting list showed that the addition of the serum sodium concentration to the MELD score improves prognostic accuracy and may reduce mortality among patients on the waiting list who have low MELD scores and serum sodium levels. CLINICAL PRACTICE: Hereditary Angioedema A 19-year-old woman presents to the emergency department with light-headedness, severe abdominal pain, and intractable nausea and vomiting that began 12 hours earlier. The patient reports previous episodes of abdominal pain and swelling of her hands and feet that have been attributed possibly to food allergies, which have recently become more frequent. How should her case be evaluated and treated? REVIEW ARTICLE: Current Concepts: Current Management of Acute Cutaneous Wounds The primary goal in the management of wounds is to achieve rapid healing with optimal functional and cosmetic results. In this review, the authors summarize the current treatments for lacerations, including abrasions, skin tears, puncture wounds, and bite wounds, and for burns. A video demonstrates techniques for the application of topical skin adhesives and surgical tapes, as well as for the irrigation of wounds and the treatment of subungual hematomas. IMAGES IN CLINICAL MEDICINE: Bedbug Bites A 30-year-old healthy woman presented with pruritic papules on both arms and breasts. Physical examination revealed multiple erythematous papules in a partially linear pattern. The patient had stayed in a ... IMAGES IN CLINICAL MEDICINE: Austin Flint Murmur A 67-year-old woman presented with a 3-month history of progressive exertional dyspnea. Her blood pressure was 132/50, and her pulse was 74 beats per minute. Examination revealed a large-volume collapsing ... CLINICAL PROBLEM-SOLVING: Collateral Damage A 50-year-old man presented to the emergency room with severe right-sided abdominal and flank pain for the previous 18 hours. EDITORIAL: The FDA and Tobacco Regulation Soon the U.S. Senate will vote on a bill1 with unprecedented implications for the health of the American people. The bill would, for the first time, grant authority to the ... EDITORIAL: Life and Death after ICD Implantation Randomized trials have established that the prophylactic use of implantable cardioverter-defibrillators (ICDs) prolongs survival in patients with left ventricular dysfunction that is due to myocardial infarction1 or associated with heart ... EDITORIAL: Predicting Mortality in Cirrhosis -- Serum Sodium Helps Liver transplantation is widely accepted as a standard method of treatment for many patients with advanced cirrhosis, and survival rates among patients who have undergone liver transplantation approach 80% at ... CLINICAL DECISIONS: Management of Skin and Soft-Tissue Infection This interactive Journal feature presents the case of an otherwise healthy 20-year-old basketball player with acute onset of a red, painful area on his right buttock over the previous 2 days. Three possible treatment options, any of which could be considered correct, are presented. Which option do you recommend? At www.nejm.org you can vote for one and then, if you wish, submit a comment about your clinical decision. Voting results and a broad selection of comments will be posted on the Web site. CORRESPONDENCE: Aliskiren Combined with Losartan in Diabetes and Nephropathy To the Editor: In the report on the Aliskiren in the Evaluation of Proteinuria in Diabetes (AVOID) study by Parving ... CORRESPONDENCE: Methylnaltrexone for Opioid-Induced Constipation in Advanced Illness To the Editor: In their article on methylnaltrexone for opioid-induced constipation in patients with advanced illness, Thomas et al. (May ... CORRESPONDENCE: Cancer Immunotherapy To the Editor: In his review of cancer immunology, Finn (June 19 issue)1 states that the results of immunotherapy involving ... CORRESPONDENCE: Cricothyroidotomy To the Editor: In the Video in Clinical Medicine on cricothyroidotomy, Hsiao and Pacheco-Fowler (May 29 issue)1 focus on the ... CORRESPONDENCE: Fatal Oseltamivir-Resistant Influenza Virus Infection To the Editor: The incidence of influenza A (H1N1) viruses that carry the neuraminidase H274Y mutation has increased by 30% ... BOOK REVIEW: Complications in Anesthesiology Contemporary anesthesia is an important "safety paradox" of excellent outcome despite routine risk. Although it carries perhaps the greatest potential for hazard for millions of patients annually, anesthesia also has ... BOOK REVIEW: Current Therapy of Trauma and Surgical Critical Care; Trauma: Contemporary Principles and Therapy The statistics alone are daunting. In the United States, traumatic injury is the leading cause of death in the first four decades of life. On average, approximately 2 people are ...