Induction medication for emergency intubation — does the choice matter? NEJM Editorial Fellow Katerina Lin, MD, explains a randomized trial to determine the effects of ketamine vs. etomidate for induction of anesthesia during emergency tracheal intubation. Full RSI trial results: https://nej.md/44EOlxB
Case Record of the Massachusetts General Hospital (@MassGeneralNews): A 24-year-old man was evaluated in the outpatient psychiatry clinic of this hospital because of depression, anhedonia, and severe fatigue.
Eighteen months before the current presentation, the patient had been admitted to another hospital for depression, suicidality, and management of opioid withdrawal. He was then transferred to a residential facility for further care, where he received induction treatment with buprenorphine. Treatment with venlafaxine and prazosin was started in the outpatient setting after discharge from the facility.
Four months before the current presentation, the patient presented to the psychiatry clinic of this hospital for treatment of coexisting substance use disorder and mood disorder. He reported long-standing anhedonia, feelings of hopelessness, and depressed mood, which had begun 5 years earlier, when he was a student in high school. The patient also noted severe anxiety with perseveration, especially in social contexts related to how others perceived him, and intrusive thoughts that kept him from falling asleep. Two years before the current presentation, these symptoms had led him to begin using recreational fentanyl intranasally, orally, and occasionally by intravenous injection. In addition, he reported intermittent recreational nonprescribed benzodiazepine use. During this time period, the patient had two unintentional opioid overdoses.
Read the full case details “A 24-Year-Old Man with Depression, Anhedonia, and Fatigue,” a Case Record of the Massachusetts General Hospital, by Masoud P. Kamali, MD, Aaron R. Quiggle, MD, and Amit Chopra, MB, BS, from Massachusetts General Hospital (@MassGeneralNews) and @harvardmed: https://www.nejm.org/doi/full/10.1056/NEJMcpc2517861
A 27-year-old woman presented with a 2-week history of joint pain, fever, sore throat, and a nonpruritic rash that worsened during fever. Laboratory tests showed an elevated ESR and elevated C-reactive protein and ferritin levels.
Read the full case details in the Images in Clinical Medicine article “Adult-Onset Still’s Disease,” from @RoyalFreeNHS: https://www.nejm.org/doi/full/10.1056/NEJMicm2514594
Is coffee helping or harming our patients’ hearts? In the latest episode of the Beyond Journal Club podcast from @COREIMpodcast and NEJM Group, the hosts unpack the CRAVE trial and use it as a lens to answer a bigger question: How should clinicians interpret nutrition research, especially when it feels inconsistent or hard to trust?
Listen to the full episode for a concise, practical framework you can use the next time a patient asks about coffee, diet, or lifestyle: https://www.coreimpodcast.com/2026/04/15/nutrition-coffee-bjc-nejm/
📖 Further reading
Original Article by G.M. Marcus et al.: Acute Effects of Coffee Consumption on Health among Ambulatory Adults (CRAVE trial) https://www.nejm.org/doi/full/10.1056/NEJMoa2204737
New in the April 16, 2026, issue of NEJM:
Asundexian for Secondary Stroke Prevention (phase 3 OCEANIC-STROKE trial) https://www.nejm.org/doi/full/10.1056/NEJMoa2513880
Adjunctive Prednisolone for Kawasaki Disease (phase 3 trial) https://www.nejm.org/doi/full/10.1056/NEJMoa2511478
Selective Decontamination of the Digestive Tract (SuDDICU trial) https://www.nejm.org/doi/full/10.1056/NEJMoa2506398
Ianalumab plus Eltrombopag in Immune Thrombocytopenia (phase 3 VAYHIT2 trial) https://www.nejm.org/doi/full/10.1056/NEJMoa2515168
Subscribe to NEJM for the latest medical research: https://store.nejm.org/nejm/subscribe/choice
A 16-year-old girl presented with 1 month of ankle pain and 11 days of fever. Radiographs showed an ill-defined, radiolucent distal tibial lesion; on MRI, the lesion was hypointense and surrounded by a hyperintense sclerotic rim.
Read the full case details in the Images in Clinical Medicine article “Intraosseous Abscess from Subacute Osteomyelitis”: https://www.nejm.org/doi/full/10.1056/NEJMicm2514540
In a new Perspective, Joseph and colleagues argue that despite the erosion of public confidence in science and medicine, nurses remain highly trusted professionals. Integrating nurse scientists into health communication strategies would benefit public health. Read the full Perspective: https://www.nejm.org/doi/full/10.1056/NEJMp2518286
Combined oral contraceptives and hormone-replacement therapy increase the risk of venous thromboembolism, although the absolute risk is low. Transdermal estradiol and micronized progesterone carry lower risk.
Learn more in the Review Article “Sex Hormone Influences on Venous Thrombotic and Cardiovascular Risk” by Leslie Skeith, MD, MHPE, and Shannon M. Bates, MDCM, from @ucalgary and @mcmasteru: https://www.nejm.org/doi/full/10.1056/NEJMra2202438
In a phase 3, randomized trial involving 3208 children with Kawasaki disease, adding prednisolone to standard primary therapy did not reduce the incidence of coronary-artery lesions at 1 month. Full trial results: https://www.nejm.org/doi/full/10.1056/NEJMoa2511478
Editorial: Glucocorticoids in Kawasaki Disease — Refining Indications and the Science https://www.nejm.org/doi/full/10.1056/NEJMe2518759
In the phase 3 OCEANIC-STROKE trial involving patients with noncardioembolic ischemic stroke or high-risk TIA, asundexian added to antiplatelet therapy led to a lower risk of ischemic stroke without increasing major bleeding. Full trial results: https://www.nejm.org/doi/full/10.1056/NEJMoa2513880
Editorial: Asundexian for Noncardioembolic Ischemic Stroke https://www.nejm.org/doi/full/10.1056/NEJMe2601859
In a phase 1 trial of first-line zongertinib for HER2-mutated non–small-cell lung cancer, an objective response occurred in 76% of patients, with a median progression-free survival of 14.4 months. Full Beamion LUNG-1 trial results: https://www.nejm.org/doi/full/10.1056/NEJMoa2516969
Editorial: EGFR’s Poor Sibling https://www.nejm.org/doi/full/10.1056/NEJMe2603357
𝐉𝐮𝐬𝐭 𝐩𝐮𝐛𝐥𝐢𝐬𝐡𝐞𝐝!
Original Article by N.E. Hammond et al.: Selective Decontamination of the Digestive Tract in Adult Mechanically Ventilated Patients — An Updated Systematic Review with Bayesian Meta-Analysis https://eviden.cc/48nwn4G
#CriticalCare
Clinical Implications of Basic Research: Altering the Diet to Rewire Cancer https://www.nejm.org/doi/full/10.1056/NEJMcibr2516825
#Oncology #Pediatrics
The authors of a Perspective argue that the types of immigration-enforcement actions being taken in the United States can activate children’s stress-response systems, disrupting neurodevelopment, immune function, and emotional regulation. Read the Perspective by Nikhil A. Patel, MD, MPH, Amy Hunter, MSW, and Royce B. Murray, JD: https://www.nejm.org/doi/full/10.1056/NEJMp2601176
Catheter-Directed PE Treatment: Does it Deliver?
@NEJMClinician Editor-in-Chief Raja-Elie Abdulnour, MD (@BageLeMage), explains a trial recently published in NEJM that compared catheter-directed thrombolysis to anticoagulation alone for acute, intermediate-risk pulmonary embolism. Read the key results and comment from Michael E. Billington, MD: https://jwat.ch/4ciQuSK
Visit http://clinician.nejm.org to see What Matters Most This Week, including:
🫀 New ACC/AHA Guideline on Lipid Management and ASCVD Prevention
💊 Chronic Beta-Blocker Use in Low-Risk Patients after MI: Time to Re-Evaluate
🧠 Reducing the Risk of Recurrent Stroke in Patients with Left Ventricular Dysfunction
🎯 What's the Ideal LDL Target for Patients with Cardiovascular Disease?
In a phase 2 trial, a new yellow fever vaccine grown in Vero cells was shown to elicit immunogenicity similar to that of the standard yellow fever vaccine. Full trial results and Research Summary: https://www.nejm.org/doi/full/10.1056/NEJMoa2505665
Case Record of the Massachusetts General Hospital (@MassGeneralNews): A 70-Year-Old Woman with a Racing Heart, Fatigue, and Dyspnea https://www.nejm.org/doi/full/10.1056/NEJMcpc2513542
#AFib #Cardiology
Images in Clinical Medicine: Silent Aspiration https://www.nejm.org/doi/full/10.1056/NEJMicm2516115
#Pulmonology #CriticalCare
In the latest episode of AI Grand Rounds, Dr. @byrondcrowe, chief medical officer of @doctronic, describes how administrative complexity can interfere with timely, effective treatment, and how AI may help address those challenges. Full episode: https://nejm.ai/ep41
Celiac disease is a chronic, small-intestinal, immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed persons. It is increasingly common, affecting persons of all ages, and has a wide geographic distribution. Learn more: https://www.nejm.org/doi/full/10.1056/NEJMcp2415548
Efforts toward Equity by H. Abbasi et al.: Antiracism Pedagogy in Medical Education https://www.nejm.org/doi/full/10.1056/NEJMp2602091
#MedEd #PublicHealth
Correspondence: Trends in Youth-Onset Type 2 Diabetes, 2013–2024 https://www.nejm.org/doi/full/10.1056/NEJMc2507615
#Pediatrics #Endocrinology
Our latest video in our partnership with @DGlaucomflecken summarizes a trial evaluating the clinical efficacy of tecovirimat against human clade II mpox. Read the full study for free: https://nej.md/DrG38
Among adults with persistent or chronic ITP, the incidence of adverse events with mezagitamab appeared to be similar to that with placebo. Mezagitamab treatment appeared to result in increased platelet counts at all three doses tested. Full trial results and Research Summary: https://www.nejm.org/doi/full/10.1056/NEJMoa2513120
In a new blog post, Michelle Kittleson, MD, PhD, explains how a patient’s reference to a late-70s country hit inspires a framework for shared decision-making. Read “Kenny Rogers and the Art of Shared Decision-Making”: https://voices.nejm.org/doi/full/10.1056/VOICESpost2600003
Original Article: Endovascular Therapy for Post-Thrombotic Syndrome — A Randomized Trial (phase 3 C-TRACT trial) https://www.nejm.org/doi/full/10.1056/NEJMoa2519001
Editorial: Stenting for Post-Thrombotic Syndrome — A Step Forward https://www.nejm.org/doi/full/10.1056/NEJMe2603048
#SIR26TOR | @SIRspecialists
Why is advanced training important for advanced practice providers, even though it’s not required?
Antonio Sanchez Gonzalez, a nurse practitioner and a primary care clinician at Oak Street in Providence, Rhode Island, explains in the latest episode of the Not Otherwise Specified podcast hosted by NEJM National Correspondent Lisa Rosenbaum, MD.
How do you see training impacting advanced practice providers in your organization? Let us know in the comments.
Learn more in the full episode: https://not-otherwise-specified-podcast.nejm.org/e/dream-team/
Listen to past episodes and subscribe to the podcast: https://not-otherwise-specified-podcast.nejm.org/
Images in Clinical Medicine: Necrolytic Migratory Erythema https://www.nejm.org/doi/full/10.1056/NEJMicm2516331
#Dermatology #Endocrinology
Efforts toward Equity by E. Chan et al.: Tailoring Digital Diabetes Care for Culture and Language https://www.nejm.org/doi/full/10.1056/NEJMp2516041
#MedicalPractice #PublicHealth
A new Clinical Practice article summarizes the epidemiology, diagnosis, and management of celiac disease and highlights serologic testing, biopsy confirmation, associated autoimmune conditions, and a gluten-free diet as treatment. Read the full article: https://www.nejm.org/doi/full/10.1056/NEJMcp2415548
Original Article: Immunogenicity and Safety of vYF, a Yellow Fever Vaccine — A Phase 2 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2505665
#InfectiousDisease #GlobalHealth
An innovative care delivery model at @mayoclinic integrates virtual oversight, remote patient monitoring, mobile health services, and a unified software platform connected to the electronic medical record that could serve as a scalable blueprint for expanding access to cancer treatment across diverse populations and geographies.
Read the In Depth article “Cancer CARE (Connected Access and Remote Expertise) Beyond Walls — Safety, Feasibility, and Patient Experience of Home-Based Chemotherapy” by R.S. Dronca et al. in the April issue of @nejmcatalyst Innovations in Care Delivery: https://catalyst.nejm.org/doi/full/10.1056/CAT.25.0168
Explore the full issue: https://catalyst.nejm.org/toc/catalyst/7/4
A clinical examination of the lumbar spine should be performed while the patient is standing. Perform palpation systematically, starting with an assessment of the bony landmarks and then the soft tissue. Learn more in the full video and summary: https://www.nejm.org/doi/full/10.1056/NEJMvcm2402306
#MedEd #Orthopedics
A new Double Take video discusses the importance and benefits of a comprehensive patient-centered approach to treating older patients, and how such efforts can provide high-value care and improve the quality of life for this patient population. 📺 https://youtu.be/GXUr5NtzanU
Presented at #SIR26TOR:
Among patients with moderate or severe PTS, the addition of endovascular therapy to standard care resulted in less severe PTS and better quality of life at 6 months than standard care alone but with a higher risk of bleeding. Full phase 3 C-TRACT trial results: https://www.nejm.org/doi/full/10.1056/NEJMoa2519001
Editorial: Stenting for Post-Thrombotic Syndrome — A Step Forward https://www.nejm.org/doi/full/10.1056/NEJMe2603048
@SIRspecialists
Among low-income patients with hypertension, a multifaceted, team-based strategy resulted in a greater reduction in systolic blood pressure than enhanced usual care. Full IMPACTS-BP trial results and Research Summary: https://www.nejm.org/doi/full/10.1056/NEJMoa2504068
In a new blog post, @PaulSaxMD writes about at-home microbiome tests and how the same sample can have strikingly different results, depending on the companies doing the testing. Learn more: https://voices.nejm.org/doi/full/10.1056/VOICESpost2600008
Efforts toward Equity by W.T. Moore et al.: From Clinic to Community — The EveryONE Project in Family Medicine https://www.nejm.org/doi/full/10.1056/NEJMp2509686
#HealthPolicy #MedicalEthics
Original Article: A Phase 2 Randomized Trial of Mezagitamab in Primary Immune Thrombocytopenia https://www.nejm.org/doi/full/10.1056/NEJMoa2513120
#Hematology #Immunology
To help ensure a sufficient supply of yellow fever vaccine, a next-generation, live-attenuated vaccine — vYF — has been developed. Research findings on its safety and immunogenicity are summarized in a new Quick Take video. https://www.nejm.org/do/10.1056/NEJMdo008441/full/