Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations. Stage. A 72-year-old…
Thu Sep 05, 2019 03:00
Pulmonary alveolar proteinosis, an uncommon lung disease characterized by the accumulation of pulmonary surfactant within pulmonary alveoli, causes progressive respiratory insufficiency. Approximately 90% of cases of pulmonary alveolar proteinosis are autoimmune; autoimmune pulmonary alveolar…
Thu Sep 05, 2019 03:00
Michael Baden, an 85-year-old forensic pathologist, is best known for his role in investigations of such high-profile cases as the assassination of President John F. Kennedy and the murder of Nicole Brown Simpson. But for Baden, who worked in the New York City medical examiner’s office before the…
Thu Sep 05, 2019 03:00
Mobile health — the application of sensors, mobile apps, social media, and location-tracking technology to obtain data pertinent to wellness and disease diagnosis, prevention, and management — makes it theoretically possible to monitor and intervene whenever and wherever acute and chronic medical…
Thu Sep 05, 2019 03:00
Pyruvate kinase deficiency is an autosomal recessive enzymopathy in red cells that is caused by mutations in PKLR. These genetic alterations lead to a deficit of pyruvate kinase activity in red cells and to hemolytic anemia of variable severity. In addition to anemia, pyruvate kinase deficiency is…
Thu Sep 05, 2019 03:00
A key result of our cumulative efforts as U.S. health care providers over the past 46 years is that there are fewer abortions per 1000 reproductive-age women per year today than immediately after the Supreme Court’s decision in Roe v. Wade legalized abortion nationwide. Deaths due to unsafe…
Thu Sep 05, 2019 03:00
To the Editor: Improving support for patients with tuberculosis is a major priority for governments and development agencies. Digital health interventions have the potential to address shortfalls in the current standard of care. Although access to the Internet, smartphones, and other forms of…
Thu Sep 05, 2019 03:00
Nineteen years ago, I joined the New England Journal of Medicine as its editor-in-chief. This issue of the Journal is my last in that position. Over these years, substantial progress has been made in the art and science of medicine, and the Journal is proud to have been the voice for many of the…
Thu Sep 05, 2019 03:00
In the summer of 2011, I was diagnosed with stage IV gallbladder cancer that had metastasized to the liver. I’m still alive, against all the odds, because a surgeon took a long shot. As he was deciding whether to operate, we had a conversation whose full significance I did not appreciate until…
Thu Sep 05, 2019 03:00
Foreword. In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information by sharing relevant background and reasoning with the reader (regular type). The authors’ commentary follows. Stage. A 54-year-old man…
Thu Sep 05, 2019 03:00
Minimally invasive treatment options such as endovenous laser ablation therapy and ultrasound-guided foam sclerotherapy are now recommended alternatives to surgery for the treatment of varicose veins. Medium-term follow-up studies suggest that laser ablation, foam sclerotherapy, and surgery result…
Thu Sep 05, 2019 03:00
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