NEJM Group

Free Live Webinar: Recent Advancements in the Management of Obesity with a Focus on Pharmacotherapies    📅 May 23, 2024, 12:00–1:30 PM ET  🎓 Earn CME Credit  🔗 Register: https://nej.md/3UIjhbS    Through this free webinar, you will gain a comprehensive understanding of recent advancements in the management of #obesity with a focus on pharmacotherapies. Join national obesity experts for an interactive, case-based discussion on medications that are approved for chronic weight management. You will understand the mechanism of the new medications that act on gut hormone receptors such as the GLP-1 and GIP receptors, with practical tips on using these in clinical practice. You can also expect a preview of new agents in the pipeline.    𝗠𝗼𝗱𝗲𝗿𝗮𝘁𝗼𝗿  Adam Gilden, M.D., M.S.C.E.    𝗦𝗽𝗲𝗮𝗸𝗲𝗿𝘀  Jaime Almandoz, MD, MBA, FTOS Rebecca Andrick, D.O.    View the full agenda and register: https://nej.md/3UIjhbS 

In the LASTE trial, investigators compared outcomes of thrombectomy plus medical care with outcomes of medical care alone in patients with stroke and a large infarct of unrestricted size.    In the initial trials of thrombectomy for stroke with large-artery occlusion in the anterior circulation, patients with the largest infarcts (ASPECTS value, ≤1) were excluded. But because the benefit of thrombectomy did not diminish with larger infarcts in these trials, even patients with the largest infarcts at baseline might benefit.    333 patients with proximal cerebral vessel occlusion in the anterior circulation and a large infarct (ASPECTS value, ≤5) were assigned to receive either thrombectomy plus medical care or medical care alone. The primary outcome was the score on the modified Rankin scale at 90 days, with higher scores indicating greater disability or death.    Read the full LASTE trial results and Plain Language Summary: https://nej.md/4dwLPfW    #ClinicalTrials #MedicalResearch 

The June 2024 issue of NEJM Catalyst Innovations in Care Delivery includes an in-depth look at the innovative approach of the HealthPartners Institute, which created an environment conducive to accelerated system performance.    Read the article: https://nej.md/3WujBw0    Here are more highlights from the June issue:     𝗖𝗔𝗦𝗘 𝗦𝗧𝗨𝗗𝗜𝗘𝗦  A Novel Value-Based Procurement Agreement to Improve Outcomes for Patients Undergoing Knee Replacement https://nej.md/3WFP9iz    Enhancing Community-Based Specialty Access Through Virtual Care https://nej.md/4bE5qc6    Targeting Racial Inequities in Inpatient Pulmonary Specialty Care Access https://nej.md/4bDU480    Developing and Scaling Remote Patient Monitoring Capacity in Ambulatory Practice https://nej.md/4anh4av    𝗜𝗡𝗦𝗜𝗚𝗛𝗧𝗦 𝗥𝗘𝗣𝗢𝗥𝗧   Unequal Treatment: Disparities in Care Continue https://nej.md/4bFskjB    𝗜𝗡𝗦𝗜𝗚𝗛𝗧𝗦 𝗜𝗡𝗧𝗘𝗥𝗩𝗜𝗘𝗪   How Health Care Leaders View Disparities in Care https://nej.md/44L91TM    𝗙𝗥𝗢𝗠 𝗧𝗛𝗘 𝗘𝗗𝗜𝗧𝗢𝗥𝗦   Assessments and Action on Disparities in Care Delivery https://nej.md/3wokkoc    Explore the current issue: https://nej.md/4dEmMYa    #CareDelivery 

Adenomatous colon polyp: An abnormal growth of colonic mucosal cells (polyp) that is benign but that may, with time, develop into a malignant neoplasm.     To learn more about this NEJM Illustrated Glossary term, read “Cell-free DNA for Colorectal Cancer Screening” by Y.M. Dennis Lo, BM, BCh, DPhil, DM: https://nej.md/43noybx       Explore more terms: https://nej.md/glossary  

Among patients with moderate-to-severe asthma who were receiving a range of inhaled glucocorticoid maintenance therapies, the risk of severe asthma exacerbation was significantly lower with as-needed use of a fixed-dose combination of 180 μg of albuterol and 160 μg of budesonide than with albuterol alone. Learn more about the results of the MANDALA trial, published in NEJM: https://nej.md/3Me7344    Then listen to the latest episode of Beyond Journal Club, a podcast by Core IM in collaboration with NEJM Group, where pulmonologist and NEJM Group Editor Dr. Jeff Drazen and Dr. Shreya P. Trivedi explain why those trial results should be used as a call to action for changing asthma management. Listen to the full episode, which also includes insights from Drs. Julie Barzilay and Gregory Katz: https://nej.md/3UdZf8P    #ClinicalTrials #MedicalResearch 

Excerpt from “All’s Fair in Love and Work,” a new Perspective by Tessa Adžemović, M.D.:    It wasn’t unusual for me to be asked at work about my relationship status. When I introduced myself as Dr. Adžemović, a common response to my Bosnian last name was, “Did you take your husband’s last name?” When I performed procedures in the neonatal intensive care unit, I was told to make sure to remove my engagement ring (I didn’t wear an engagement ring). When I conducted well-child exams in my clinic, parents often asked me, “Did you vaccinate your kids?” Without children at home, I felt like a fraud. “How many little ones do you have at home?” I’d be asked. I was acutely aware of my rapidly diminishing fertility and the difficulties that young female physicians face trying to have children, a process that they usually start later than women in the general U.S. population.    Hounded by questions about her love life, a young physician finds relief in the isolation imposed by the Covid pandemic, while she gains an education in the meaning of love from patients’ stories.    Read the Perspective “All’s Fair in Love and Work” by Tessa Adžemović, M.D., from Fogarty International Center at NIH, Brigham and Women's Hospital, and Boston Children's Hospital: https://nej.md/3xUn4K7 

In the latest Case Record of the Massachusetts General Hospital, a 30-year-old woman was evaluated in the neurology clinic of this hospital because of back pain and leg stiffness.    The patient had been in her usual state of health until 3 years before the current presentation, when stiffness in the back and upper legs developed abruptly while she attempted to rise from a seated position. She also began to have associated low back pain that worsened with bending the knees or climbing stairs. During the next several months, back and leg stiffness waxed and waned; at times, the patient could walk normally and engage in running or exercise, and at other times, she was unable to walk because her knees felt as though they had “locked up.” Two months after the onset of symptoms, the patient fell and broke her right arm. She perceived the fall as being unusual in that after she tripped, she was unable to prevent herself from falling because of tension in her legs. After the fall, the patient underwent physical therapy for several months, but she did not resume running for exercise because of a fear of falling.    Read more about the case in “A 30-Year-Old Woman with Back Pain, Leg Stiffness, and Falls,” which includes differential and final diagnoses from guest physicians based on evidence from the test results, by Christopher T. Doughty, M.D., Pamela W. Schaefer, M.D., Kate Brizzi, M.D., and Jenny Linnoila, M.D., Ph.D., from Brigham and Women's Hospital, Massachusetts General Hospital, and Harvard Medical School: https://nej.md/4bkxuS0 

NEJM CareerCenter resource highlight: Preparing for the Virtual Physician-Job Interview The shift to virtual interviews in health care is reshaping the hiring landscape. Physicians and employers are adjusting to this novel experience, emphasizing the need for preparation on both ends. While the virtual setting might pose challenges, it's essential to approach it with professionalism, mirroring the formality of an in-person interview. Dressing professionally, understanding the participants' roles, and inquiring about the interview structure are crucial steps. For physicians, this means treating virtual interviews as seriously as traditional site visits, ensuring a polished appearance, and a distraction-free environment. As the virtual interview becomes the norm, both parties are encouraged to navigate this evolving process with adaptability and readiness. Here are some of the most important considerations in preparing for a video interview: ✨ Prepare and “professionalize” the immediate environment. For starters, the room should be well and brightly lit and the background clean and free of clutter. 🗣️ Do a trial run and then take the time to record a hypothetical session with a friend or family member. 🔇 Get rid of noise and potential distractions. 👩💼 Ensure optimal body and face positioning. 🖥️ Test that your computer, web cam, microphone, and other technology are in order. The interview has become a new world and both prospective employers and physician candidates are adjusting. For more tips on maximizing virtual physician interviews, read "Preparing for the Virtual Physician-Job Interview," by Bonnie Darves, a Seattle-based freelance health care writer: https://lnkd.in/gFdmvhmT #VirtualInterviews #PhysicianRecruitment

In the first episode of a four-part Double Take video miniseries on #depression from the New England Journal of Medicine, Shannon Scott-Vernaglia, M.D., recounts her personal experiences with depression. She and Gerard Sanacora, Ph.D., M.D., Christine M. Crawford, M.D., M.P.H., Joseph Teel, M.D., and Eleanor Anderson, M.D., discuss the prevalence of depression and the need to empower the primary care physician to screen for, diagnose, and address suicidality. Available therapies for treatment-resistant depression are briefly introduced and will be explored in greater depth in episode 2 of the miniseries.     📺 Watch the full video: https://nej.md/4aVmYka    📚 For further reading:  Treatment-Resistant Depression in Older Adults https://nej.md/3OEePHS  Ketamine versus ECT for Nonpsychotic Treatment-Resistant Major Depression https://nej.md/3ODZMPc    #DepressionTreatment 

DNA methylation: The process by which a methyl group, consisting of one carbon and three hydrogen atoms, is added to DNA. Methylation of a gene’s promotor (a regulatory region upstream of the coding sequence) can suppress the expression of that gene.    To learn more about this NEJM Illustrated Glossary term, read “Cell-free DNA for Colorectal Cancer Screening” by Y.M. Dennis Lo, BM, BCh, DPhil, DM: https://nej.md/43noybx     Explore more terms: https://nej.md/glossary