Original Article: Transdermal Estradiol Patches in Locally Advanced Prostate Cancer (STAMPEDE-1 and PATCH trials) https://www.nejm.org/doi/full/10.1056/NEJMoa2511781
#Oncology
The number of referrals to ID doctors for latent tuberculosis has exploded. What happened? Read the latest from @PaulSaxMD: https://voices.nejm.org/doi/full/10.1056/VOICESpost2600005
Perspective by A.W. Gaffney et al.: The Dismantling of Environmental Protections — A Grave Threat to America’s Health https://www.nejm.org/doi/full/10.1056/NEJMp2514370
#GlobalHealth #HealthPolicy
Patients with stage III mismatch repair–deficient colon cancer remain at risk for recurrence despite adjuvant chemotherapy. Research findings from the phase 3 ATOMIC trial are summarized in a short video. https://www.nejm.org/doi/full/10.1056/NEJMdo008412
Primary Prevention with Statins: How Much Risk Reduction Do People Expect?
@NEJMClinician Editor-in-Chief Raja-Elie Abdulnour, MD (@BageLeMage), describes a recent survey of ≈500 people who had no prior statin use to determine their willingness to take statins based on their hypothetical levels of 10-year risk. Read the context and comment by Christopher W. Goodman, MD: https://jwat.ch/4bsoPOU
Visit http://clinician.nejm.org to see What Matters Most This Week, including:
🫁 New AHA/ACC Guideline on Pulmonary Embolism
💉 Shingles Vaccine Safety in Autoimmune Diseases
🧘 Can Qigong Lower Blood Pressure?
🫀 Controversy about the New Guideline on Community-Acquired Pneumonia
The authors of a new Perspective argue that recent changes in U.S. vaccine policy are sowing confusion and threatening the health of children and the wider population. How should pediatric clinicians communicate with parents to stem the damage? Read the Perspective by Douglas J. Opel, MD, MPH, and Sean T. O’Leary, MD, MPH: https://www.nejm.org/doi/full/10.1056/NEJMp2600539
Original Article: Setidegrasib in Advanced Non–Small-Cell Lung Cancer and Pancreatic Cancer https://www.nejm.org/doi/full/10.1056/NEJMoa2600752
@myESMO | #ELCC26
Case Record of the Massachusetts General Hospital (@MassGeneralNews): A 12-year-old girl was admitted to the pediatric service of this hospital because of altered mental status, abdominal distention, and persistent hypoglycemia.
On the morning of the hospital admission, the patient’s mother had difficulty rousing the patient. On awakening, the patient could not maintain her gaze and was speaking nonsensically. Her grandmother reported that she had been well the night before, when she was noted to have eaten a full meal and was behaving normally. The patient was transported by emergency medical services to the emergency department of this hospital.
On presentation to the emergency department, the patient had a temporal temperature of 35.4°C; the vital signs were otherwise normal. She appeared ill and was intermittently responsive, at times answering questions with one-word responses. There were intermittent periods of stupor. Spontaneous movement of the arms and legs was noted. The blood glucose level was 30 mg per deciliter (1.7 mmol per liter; reference range, 70 to 110 mg per deciliter [3.9 to 6.1 mmol per liter]). Treatment with an ampule of intravenous glucose in water was administered, with subsequent improvement in mental status, and a continuous intravenous infusion of dextrose in water was started.
Read the full case details in “A 12-Year-Old Girl with Altered Mental Status and Hypoglycemia,” a Case Record of the Massachusetts General Hospital, by K. Lord et al., from Children’s Hospital of Philadelphia (@ChildrensPhila), the Perelman School of Medicine at the University of Pennsylvania, Massachusetts General Hospital (@MassGeneralNews), and @harvardmed: https://www.nejm.org/doi/full/10.1056/NEJMcpc2517859
A 33-year-old pregnant woman with previously controlled atopic dermatitis presented with 3 days of fever and an itchy, painful rash. Erythematous vesiculopapular lesions were noted on the face, neck, chest, and arms.
Read the full case details in the Images in Clinical Medicine article “Eczema Herpeticum” from McMaster University (@mcmasteru): https://www.nejm.org/doi/full/10.1056/NEJMicm2516038
New in the March 26, 2026, issue of NEJM:
Atezolizumab plus FOLFOX for Stage III Colon Cancer (phase 3 ATOMIC trial) https://www.nejm.org/doi/full/10.1056/NEJMoa2507874
Early Surgery for Asymptomatic Aortic Stenosis (RECOVERY trial) https://www.nejm.org/doi/full/10.1056/NEJMoa2511920
Dengue Suppression by Wolbachia-Infected Mosquitoes https://www.nejm.org/doi/full/10.1056/NEJMoa2503304
AAV9 Gene Therapy in Type II GM1 Gangliosidosis https://www.nejm.org/doi/full/10.1056/NEJMoa2510935
Brief Report: Prime Editing to Treat Genetic Disease https://www.nejm.org/doi/full/10.1056/NEJMoa2509807
Subscribe to NEJM for the latest medical research: https://nej.md/subscribe
A new review discusses minipuberty, a transient phase in infancy during which levels of gonadal hormones are similar to those in adults, after which they become undetectable until the onset of puberty.
Read “Clinical Implications of Minipuberty” by Anders Juul, MD, DMSc, PhD, from Copenhagen University Hospital–Rigshospitalet and the University of Copenhagen: https://www.nejm.org/doi/full/10.1056/NEJMra2305989
Early surgery in asymptomatic patients with very severe aortic stenosis led to a lower risk of a composite of operative mortality or death from cardiovascular causes at 10 years than conservative care. Full RECOVERY trial results: https://www.nejm.org/doi/full/10.1056/NEJMoa2511920
The authors of a new Perspective write that as part of a restructuring of federal loan limits, loans for graduate nursing programs may be capped below amounts for medical and law programs. This proposal isn’t supported by publicly available data. Read the full Perspective: https://www.nejm.org/doi/full/10.1056/NEJMp2600236
In the phase 3 ATOMIC trial in resected stage III mismatch repair–deficient colon cancer, adding atezolizumab to modified FOLFOX6 improved 3-year disease-free survival, with a higher incidence of grade 3 or 4 toxic effects, mainly fatigue. Full trial results: https://www.nejm.org/doi/full/10.1056/NEJMoa2507874
Editorial: ATOMIC Energy — Biomarker-Bespoke Adjuvant Therapy for Colon Cancer https://www.nejm.org/doi/full/10.1056/NEJMe2517910
Among men with locally advanced prostate cancer, transdermal estradiol was noninferior to LHRH agonists for 3-year metastasis-free survival and led to a lower incidence of hot flashes but a higher incidence of gynecomastia. Full results of the STAMPEDE-1 and PATCH trials: https://www.nejm.org/doi/full/10.1056/NEJMoa2511781
The authors of a new Perspective argue that the Trump administration’s wide-ranging actions to dismantle U.S. environmental regulations will cause long-lasting health harms, disproportionately affecting low-income and other vulnerable groups. Learn more: https://www.nejm.org/doi/full/10.1056/NEJMp2514370
Perspective essay by Lena Becker, BS, BA: Good Compressions https://www.nejm.org/doi/full/10.1056/NEJMp2510698
#MedEd #MedicalEthics
In untreated chronic lymphocytic leukemia, fixed-duration venetoclax-based regimens were noninferior to continuous ibrutinib with regard to 3-year progression-free survival and were associated with higher MRD-negative rates. Full phase 3 CLL17 trial results and Research Summary: https://www.nejm.org/doi/full/10.1056/NEJMoa2515458
Presented at #ELCC26:
In a phase 1 trial of setidegrasib, a KRAS G12D degrader, 42% of patients had adverse events of grade 3 or higher; 36% of patients with NSCLC and 24% of those with pancreatic cancer had a response. Full trial results: https://www.nejm.org/doi/full/10.1056/NEJMoa2600752
@myESMO
Correspondence: Tuberculosis Cases and Deaths Averted by PEPFAR https://www.nejm.org/doi/full/10.1056/NEJMc2506284
@CDCgov | #WorldTBDay
Polymyalgia rheumatica is an inflammatory condition that affects persons >50 years of age and is characterized by pain in both shoulders with or without hip or neck pain (or both) and with pronounced morning stiffness. Learn more about the diagnosis and management: https://www.nejm.org/doi/full/10.1056/NEJMcp2506817
Case Record of the Massachusetts General Hospital (@MassGeneralNews): A 57-Year-Old Woman with Chest Pain, Dyspnea, and Syncope https://www.nejm.org/doi/full/10.1056/NEJMcpc2517857
#Cardiology #IDTwitter
Strengthen your ability to deliver effective, evidence-based obesity care in everyday practice with a free, on-demand webinar, Advancing Obesity Care: Leveraging Evidence-Based Medicine and Shared Decision-Making for Effective Weight Management from NEJM Group.
Enroll now: https://nej.md/3PqXhCg
Obesity affects more than 40% of U.S. adults and contributes to over 200 disease states, including Type 2 diabetes, cardiovascular disease, metabolic disorders, and cancer. Its management should therefore fall within the scope of every clinician’s practice.
Perspective by A. Sutton (@AbeSutton) et al.: The Cell and Gene Therapy Access Model — A Vision for Future Development https://www.nejm.org/doi/full/10.1056/NEJMp2513320
#HealthPolicy
Sounding Board: 𝘏𝘦𝘭𝘪𝘤𝘰𝘣𝘢𝘤𝘵𝘦𝘳 𝘱𝘺𝘭𝘰𝘳𝘪 Screen-and-Treat Programs for Gastric Cancer Prevention — IARC Working Group Report https://www.nejm.org/doi/full/10.1056/NEJMsb2515372
@IARCWHO | #Oncology #Gastroenterology
Tuberculosis remains a leading cause of death worldwide among persons with HIV. In this report, the effect of the PEPFAR program on incident cases of tuberculosis and related deaths is presented. Read the full report: https://www.nejm.org/doi/full/10.1056/NEJMc2506284
@CDCgov | #WorldTBDay
Volume 5 Issue 4 of 𝘕𝘌𝘑𝘔 𝘌𝘷𝘪𝘥𝘦𝘯𝘤𝘦 is now available! Here is a preview of the latest content:
𝗣𝘂𝗯𝗹𝗶𝗰 𝗛𝗲𝗮𝗹𝘁𝗵 𝗔𝗹𝗲𝗿𝘁𝘀
Multistate Infant Botulism Outbreak Associated with Powdered Infant Formula https://eviden.cc/4qXflB5
Images in Clinical Medicine: Massive Intravascular Hemolysis from 𝘊𝘭𝘰𝘴𝘵𝘳𝘪𝘥𝘪𝘶𝘮 𝘱𝘦𝘳𝘧𝘳𝘪𝘯𝘨𝘦𝘯𝘴 Bacteremia https://www.nejm.org/doi/full/10.1056/NEJMicm2514135
#EmergencyMedicine #IDTwitter
A new Clinical Practice article summarizes the diagnosis and management of polymyalgia rheumatica in adults older than 50 years of age, emphasizing clinical diagnosis, glucocorticoids as first-line therapy, relapses, and glucocorticoid-sparing options. Read the full article: https://www.nejm.org/doi/full/10.1056/NEJMcp2506817
A 65-year-old woman with a recent history of acute necrotizing pancreatitis presented with a 5-day history of abdominal pain and fevers. Physical examination was notable for tenderness in the upper abdomen. Computed tomography of the abdomen is shown. Submit your answer or see how others responded: https://www.nejm.org/image-challenge?ci=20260319
🧵 In the United States, Black adults experience disproportionately high rates of hypertension and are nearly twice as likely to die due to a cardiovascular disease–related complication as white adults.
RECITE: In a phase 3 trial in patients with persistent chemotherapy-induced thrombocytopenia, 84% of those receiving romiplostim had no chemotherapy dose modifications, as compared with 36% of those receiving placebo (odds ratio, 10.16). Full trial results and Research Summary: https://www.nejm.org/doi/full/10.1056/NEJMoa2511882
From an Original Article published March 29, 1951:
A 34-year-old blind basket maker was admitted on August 15, 1950, to the Second Medical Service of the Wilhelmina-Gasthuis. For about a year he had noticed increasing fatigue and nausea with occasional vomiting after meals. Since June these complaints had increased so that he had stopped working. At about the same time he had feelings of faintness, "as if the blood ran out of his body and into the legs." He had also noticed an increasing appetite for salty dishes. He could no longer tolerate alcoholic beverages and his taste for cigarettes had gone. He was, however, remarkably free from migraine, from which he had suffered for most of his life.
In 1938 the patient had a glandular suppuration of the left side of the neck, which had healed after a course of x-ray irradiations. In February, 1949, a calcified tuberculous lesion had been detected in the upper part of the right lung in the course of a mass screening examination. Since then he had been under regular supervision, but the lesion was considered inactive. Several sputum examinations were negative for tubercle bacilli.
In 1942 the patient lost one eye as a result of a war wound; two months later the other eye was enucleated for sympathetic ophthalmia. Since then he has worn ocular prostheses and has had to change his profession to his present work of basket making.
Read “Extract of Licorice for the Treatment of Addison's Disease,” an article from 1951, published in the NEJM Archive: https://www.nejm.org/doi/full/10.1056/NEJM195103292441303
Images in Clinical Medicine: Soft Tick Relapsing Fever https://www.nejm.org/doi/full/10.1056/NEJMicm2514982
#EmergencyMedicine #IDTwitter
A video shows improvements in hearing in a child who received gene therapy for 𝘖𝘛𝘖𝘍-related deafness. Full video and accompanying article: https://www.nejm.org/doi/full/10.1056/NEJMoa2400521
The IARC Working Group summarizes guidance on 𝘏. 𝘱𝘺𝘭𝘰𝘳𝘪 screen-and-treat programs for gastric cancer prevention and concludes that prevention is the most effective strategy amid a rising global burden. Learn more: https://www.nejm.org/doi/full/10.1056/NEJMsb2515372
Faced with a young woman whose seizures, of untraceable cause, can’t be stopped by the medical team, a medical student viscerally learns the limits to what can be accomplished by pushing harder. Read the Perspective essay by Lena Becker, BS, BA: https://www.nejm.org/doi/full/10.1056/NEJMp2510698
Are we measuring team quality the right way in health care?
Hannah Neprash, PhD, a health economist at the University of Minnesota (@UMNews) who has done some work studying teams, explains why it’s challenging to describe an ideal primary care team.
How do you measure team quality in your practice? Reply with your tips.
Learn more about primary care teams in the latest episode of the Not Otherwise Specified podcast hosted by NEJM National Correspondent Lisa Rosenbaum, MD: 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/
A 66-year-old woman with a remote kidney transplant is found unresponsive with intermittent myoclonic jerks. How would you build the differential diagnosis & prioritize initial tests? 🩺️ Read the full case details in the Morning Report: https://eviden.cc/3MJOaLJ
@hopkinsneurons
A 73-year-old woman presented in shock with a 1-day history of malaise, dyspnea, and confusion. Serum samples could not be processed owing to gross hemolysis. Dehemoglobinized red cells and bacilli were seen on a peripheral-blood smear.
Read the full case details in the Images in Clinical Medicine article “Massive Intravascular Hemolysis from 𝘊𝘭𝘰𝘴𝘵𝘳𝘪𝘥𝘪𝘶𝘮 𝘱𝘦𝘳𝘧𝘳𝘪𝘯𝘨𝘦𝘯𝘴 Bacteremia,” from the Faculty of Medicine at the University of British Columbia and Royal Columbian Hospital (@fraserhealth): https://www.nejm.org/doi/full/10.1056/NEJMicm2514135