NEJM Group

NEJM Editorial Fellow Abigail Schubach, M.D., shares why she decided to apply for an NEJM editorial fellowship, what NEJM fellows typically work on during their one-year term, what she's learned during her time, and how this fellowship will help further her career.    Applications for the 2025–26 NEJM editorial fellowship are now open. NEJM will accept applications for several one-year, full-time, paid editorial fellowships that begin July 2025. Applications are due Thursday, August 1, 2024.    For more reflections from prior NEJM fellows and for more information, visit https://nej.md/421foPx 

The human monoclonal antibody dupilumab is approved to treat eosinophilic esophagitis in adults and adolescents. Data on the efficacy and safety of dupilumab in children younger than 12 years of age are needed.    In a new trial, researchers evaluated whether dupilumab would improve histologic outcomes in children 1 to 11 years of age with eosinophilic esophagitis.    In Part A of the trial, 102 children 1 to 11 years of age with eosinophilic esophagitis that was unresponsive to proton-pump inhibitors were randomly assigned to higher-exposure (HE) or lower-exposure (LE) subcutaneous dupilumab regimens (tiered according to body weight) or to placebo for 16 weeks.     In Part B, eligible patients who completed Part A continued the same dupilumab regimen or switched from placebo to HE or LE dupilumab for an additional 36 weeks. The primary end point was histologic remission (≤6 eosinophils per high-power field) at week 16.    In children 1 to 11 years of age with eosinophilic esophagitis, weight-tiered dupilumab treatment regimens led to histologic remission in a significantly higher percentage of children than placebo.    Read the full trial results and Plain Language Summary: https://nej.md/3VVnWYE 

Climate change is causing a global increase in average temperatures and increasing the frequency, duration, and intensity of extreme heat events, resulting in unprecedented levels of heat exposure.     In the latest Double Take video, NEJM Editorial Fellow Julie Barzilay, M.D., reviews the range of acute heat-related illnesses, including their symptoms, complications, and management. Risk factors associated with increased morbidity and mortality from heat-related illnesses and strategies for primary care clinicians to reduce risk are also examined. Watch the video: https://nej.md/3zjVyq9    Further reading: Treatment and Prevention of Heat-Related Illness (Sorensen and Hess, September 28, 2022, NEJM) https://nej.md/3xV787u 

𝗫𝗲𝗻𝗼𝘁𝗿𝗮𝗻𝘀𝗽𝗹𝗮𝗻𝘁𝗮𝘁𝗶𝗼𝗻 is the transplantation of cells, tissue, or organs to a recipient organism of a different species. The example illustrates a partially humanized pig organ (purple dots) transplanted into a human patient.     To learn more about this NEJM Illustrated Glossary term, read the Review Article “Risks of Infectious Disease in Xenotransplantation” by Jay Fishman, M.D.: https://nej.md/3W9bH7S     Explore more terms: https://nej.md/glossary   

Care of patients with systemic immunoglobulin light chain (AL) amyloidosis has undergone transformative changes, leading to marked, steady progress in outcomes for patients over the past four decades. Substantial progress has been made through the implementation of treatments targeting the underlying plasma cell dyscrasia, mostly adapted from the treatment of myeloma. The past decade has seen remarkable advancements that have instilled hope among patients with AL amyloidosis. This review focuses on recent advances in our understanding of the pathogenesis and clinical features of amyloid fibrillogenesis, as well as risk stratification and therapeutic advances, and describes unmet needs in AL amyloidosis.    Continue reading the Review Article “Systemic Light Chain Amyloidosis” by Vaishali Sanchorawala, M.D.: https://nej.md/4eHjGU3 

Among critically ill adults undergoing tracheal intubation, hypoxemia increases the risk of cardiac arrest and death.     The effect of preoxygenation with noninvasive ventilation, as compared with preoxygenation with an oxygen mask, on the incidence of hypoxemia during tracheal intubation is uncertain.    In the PREOXI trial, researchers evaluated whether preoxygenation with noninvasive ventilation would be more effective in decreasing the risk of hypoxemia than preoxygenation with an oxygen mask among critically ill adults undergoing endotracheal intubation.     1301 critically ill adults undergoing tracheal intubation in the ICU or ED were randomly assigned to receive preoxygenation with either noninvasive ventilation or an oxygen mask.     The primary outcome was hypoxemia during intubation (defined by an oxygen saturation lower than 85% during the interval between induction of anesthesia and 2 minutes after tracheal intubation).    Among critically ill adults undergoing tracheal intubation in an ED or ICU, the incidence of hypoxemia was lower when preoxygenation was performed with noninvasive ventilation than when it was performed with an oxygen mask.    Read the full PREOXI trial results and Plain Language Summary: https://nej.md/45lC0xt    #ClinicalTrials #MedicalResearch 

Drs. Gregory Katz, Shreya P. Trivedi, and Abby Schubach discuss the NordICC trial's impact on colonoscopy screening. Both the news media and medical community share varied views on its efficacy in preventing colorectal cancer deaths.    Hear more in the latest episode of Beyond Journal Club, a Core IM in collaboration with NEJM Group: https://nej.md/3KZ0js0 

In the latest Case Record of the Massachusetts General Hospital, a 73-year-old man was admitted to this hospital because of recurrent fever.    The patient had been in his usual state of health until 22 months before the current presentation, when 2 days of fever, cough, and fatigue developed. The patient sought evaluation at a primary care clinic affiliated with another hospital. Empirical oral antibiotic agents were administered to treat pneumonia. During the subsequent month, the cough resolved but fever recurred intermittently. The patient returned to the primary care clinic.   Read more about this real-life case in “A 73-Year-Old Man with Recurrent Fever and Liver Lesions,” which includes differential and final diagnoses from guest physicians based on evidence from the test results, by Lakshmi Ganapathi, M.B., B.S., Rory L. Cochran, M.D., Ph.D., Gregory K. Robbins, M.D., Sara Barmettler, M.D., Steven M. Holland, M.D., and Emad Ababneh, M.D.: https://nej.md/4cmGuqE    

Neural crest: A group of ectodermal cells that are pinched off during neural tube closure. The neural crest migrates to various locations to contribute to diverse tissues, including melanocytes, craniofacial bones, and peripheral-nerve ganglia.     To learn more about this NEJM Illustrated Glossary term, read “The Developmental Origin of Calcific Aortic Stenosis” by Elena Aikawa, M.D., Ph.D., and Josh Hutcheson, Ph.D.: https://nej.md/3u6ziek    Explore more terms: https://nej.md/glossary 

The July 2024 issue of NEJM Catalyst Innovations in Care Delivery includes an in-depth look at strategies that leaders at the Mass General Brigham health system have used in launching a standardized patient-reported outcome measure (PROM) collection program in 2012, a major step in the value-based transformation of health care.    Read the article: https://nej.md/3RgoNQH    Here are more highlights from the July issue:     𝗖𝗔𝗦𝗘 𝗦𝗧𝗨𝗗𝗜𝗘𝗦  🚑 Emergency Department in Home (EDiH): A Novel Approach to Delivering Acute Care https://nej.md/3x8kC2T    📋 The Amsterdam PROM Implementation Strategy: Policy and Pathway https://nej.md/4c02rvd    𝗔𝗥𝗧𝗜𝗖𝗟𝗘   🏥 How Payers Can Help Hospitals Become Safer Through Value-Based Programs https://nej.md/3VrQkQy    𝗖𝗢𝗠𝗠𝗘𝗡𝗧𝗔𝗥𝗬  🩺 Outcomes or Experiences — What Do Patients Value More When Evaluating Medical Teams? https://nej.md/45rE07m    𝗜𝗡𝗦𝗜𝗚𝗛𝗧𝗦 𝗥𝗘𝗣𝗢𝗥𝗧   🔑 Keys to Measuring Patient-Centered Care https://nej.md/3VJvzQL    𝗜𝗡𝗦𝗜𝗚𝗛𝗧𝗦 𝗜𝗡𝗧𝗘𝗥𝗩𝗜𝗘𝗪   🔍 Understanding What Matters to Patients https://nej.md/4clFi66    𝗙𝗥𝗢𝗠 𝗧𝗛𝗘 𝗘𝗗𝗜𝗧𝗢𝗥𝗦   💡 Innovation in Pursuit of Patient-Centered Care https://nej.md/45rDTbW    Explore the current issue: https://nej.md/3RtKX22     #CareDelivery