Systemic lupus erythematosus (SLE), a chronic autoimmune disease characterized by loss of immune tolerance, leads to multisystem inflammation and organ injury. Lupus nephritis, which occurs in 25 to 60% of patients with SLE, is the most common severe manifestation of SLE and a major cause of…
Thu Sep 17, 2020 03:00
Systemic lupus erythematosus is a chronic systemic autoimmune disease characterized by autoantibody production and immune-complex–mediated tissue damage. Autoantibody-secreting plasma cells are increasingly recognized as essential drivers of chronic inflammation in lupus, but targeting them…
Thu Sep 17, 2020 03:00
The induction and maintenance of robust immune tolerance has been the holy grail of immunology for decades. In the absence of robust unresponsiveness of the immune system to self antigens (immune tolerance), uncontrolled reactivity can lead to disorders like food allergies and autoimmune diseases.…
Thu Sep 17, 2020 03:00
Nephritis, the most common serious manifestation of systemic lupus erythematosus (SLE), affects up to 50% of patients with this condition. Proliferative lupus nephritis typically manifests with microscopic hematuria, nonnephrotic proteinuria, renal insufficiency, and hypertension, whereas…
Thu Sep 17, 2020 03:00
To the Editor: We report data from a large series of patients in whom the Guillain–Barré syndrome developed after they had been infected with Japanese encephalitis virus (JEV). JEV is a single-stranded RNA virus that is transmitted by mosquitoes. The first case of Japanese encephalitis was reported…
Thu Sep 17, 2020 03:00
Two landmark trials that were published in the early 1980s provided evidence that, under very specific circumstances, long-term oxygen therapy used for at least 15 to 18 hours per day improves survival in patients with chronic obstructive pulmonary disease (COPD). These two trials targeted patients…
Thu Sep 17, 2020 03:00
A 62-year-old man presented to the emergency department with a 1-day history of fever and a 3-day history of chest pain. His medical history was notable for coronary heart disease and for a splenectomy that he had undergone after a car accident. Four days before presentation, he had been bitten on…
Thu Sep 17, 2020 03:00
A 56-year-old man presented to the emergency department with a 2-month history of fatigue, weight loss of 10 kg, night sweats, and fever. He had a cough producing sputum that was occasionally blood-tinged. He had immigrated to the United States from Haiti 10 years earlier. On examination, his…
Thu Sep 17, 2020 03:00
In June Medical Services v. Russo, the U.S. Supreme Court considered two issues of substantial importance to people seeking abortions and the physicians who provide them: the constitutional validity of Act 620, Louisiana’s admitting-privileges requirement for abortion providers, and the legal…
Thu Sep 17, 2020 03:00
Political slogans paint stark choices for health care reform: "Medicare for All" or "Free-Market Competition." These slogans are designed to be simple and appealing — but vague enough to obscure the trade-offs involved, allowing listeners to fill in their own notions and masking varying beliefs.…
Wed Sep 16, 2020 03:00
Nine pharmaceutical company leaders took the unprecedented step on September 8, 2020, of stating that they would refuse to apply for approval of a Covid-19 vaccine until adequate trial data are available. This announcement reflected an unusual role reversal at a time of unexpected regulatory…
Tue Sep 15, 2020 03:00
Presentation of Case. Dr. Matthew B. Roberts: A 66-year-old man who had undergone orthotopic liver transplantation because of end-stage liver disease was admitted to this hospital because of fever and cough during the pandemic of coronavirus disease 2019 (Covid-19), the disease caused by severe…
Thu Sep 17, 2020 03:00
Responses to the Covid-19 pandemic by stakeholders throughout the health care ecosystem are contributing to rapid innovation. To support health care delivery today, capital equipment (such as ventilators) and personal protective equipment (such as masks and gowns) are being redesigned to permit…
Wed Sep 16, 2020 03:00
As Covid-19 cases surged in the United States in March 2020, stay-at-home orders were put in place. Schools closed, and many workers were furloughed, laid off, or told to work from home. With personal movement limited and people confined to their homes, advocates expressed concern about a potential…
Wed Sep 16, 2020 03:00
To the Editor: Every year, an estimated 350,000 persons in the United States have an out-of-hospital cardiac arrest; only approximately 10% survive. The probability of survival doubles when a bystander administers cardiopulmonary resuscitation (CPR) and uses an automated external defibrillator…
Thu Sep 17, 2020 03:00
New England Journal of Medicine, Ahead of Print.
Wed Sep 16, 2020 12:00
New England Journal of Medicine, Volume 383, Issue 12, September 2020.
Wed Sep 16, 2020 11:55
New England Journal of Medicine, Volume 383, Issue 12, Page 1099-1101, September 2020.
Wed Sep 16, 2020 11:55
New England Journal of Medicine, Volume 383, Issue 12, Page 1097-1099, September 2020.
Wed Sep 16, 2020 11:55
New England Journal of Medicine, Volume 383, Issue 12, Page 1192-1194, September 2020.
Wed Sep 16, 2020 11:55
Operation Warp Speed (OWS), an effort of the U.S. Department of Health and Human Services and the Department of Defense in partnership with the private sector, is providing financial investment, scientific support, regulatory expertise, and logistic assistance to deliver vaccines, therapeutics, and…
Tue Sep 15, 2020 03:00
As SARS-CoV-2 continues its global spread, it’s possible that one of the pillars of Covid-19 pandemic control — universal facial masking — might help reduce the severity of disease and ensure that a greater proportion of new infections are asymptomatic. If this hypothesis is borne out, universal…
Tue Sep 08, 2020 03:00
New England Journal of Medicine, Ahead of Print.
Thu Sep 10, 2020 13:05
On February 13, 2020, the Food and Drug Administration (FDA) announced that it had requested that the manufacturer of Belviq and Belviq XR (lorcaserin and extended-release lorcaserin) voluntarily withdraw the products from the U.S. market. The agency’s request was based on its assessment of…
Thu Sep 10, 2020 03:00
The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal. In this audio interview conducted…
Thu Sep 10, 2020 03:00
To the Editor: The incidence of prostate cancer and its associated mortality vary widely according to race or ethnic background. This association is probably due to the interplay of socioeconomic factors, environmental exposures, and biologic and epigenetic phenomena. Nevertheless, precision…
Thu Sep 10, 2020 03:00
Innate immunity is mediated by different cell types and cell-associated or fluid-phase pattern-recognition molecules and plays a key role in tissue repair and resistance against pathogens. Exposure to selected vaccines, such as bacille Calmette–Guérin (BCG) or microbial components, can increase the…
Thu Sep 10, 2020 03:00
Severe hemophilia A (defined as Prophylaxis with factor VIII products that have an extended half-life has advanced the treatment of severe hemophilia, in part by improving the control of bleeding, joint health, and quality of life, and by reducing treatment burden. However, residual burden still…
Thu Sep 10, 2020 03:00
Familial adenomatous polyposis is a rare, autosomal dominant, hereditary colorectal cancer syndrome that is most commonly caused by pathogenic germline variants in the adenomatous polyposis coli (APC) gene. In its classic presentation, familial adenomatous polyposis is characterized by progressive…
Thu Sep 10, 2020 03:00
Nonmetastatic, castration-resistant prostate cancer is defined by rising levels of serum prostate-specific antigen (PSA) and an absence of detectable metastases on conventional imaging in patients receiving androgen-deprivation therapy. Patients with nonmetastatic, castration-resistant prostate…
Thu Sep 10, 2020 03:00
Approximately 15% of patients undergoing mechanical ventilation receive a tracheostomy as part of their care, but experimental data regarding readiness for decannulation are limited. Evidence of decannulation readiness has been limited to expert opinion, survey studies, single-center experience,…
Thu Sep 10, 2020 03:00
Attention deficit–hyperactivity disorder (ADHD) is characterized by hyperactivity and impulsivity, by inattention, or by a combination of hyperactivity, impulsivity, and inattention that is inconsistent with developmental level and impairs daily function. The disorder is commonly diagnosed in…
Thu Sep 10, 2020 03:00
Health equity is a simple concept, but it is difficult to achieve. If health inequities are "inequalities that are deemed to be unfair, unjust, avoidable, or unnecessary, that can be reduced or remedied through policy action," the state of health equity can be defined — as it is by the U.S. Health…
Thu Sep 10, 2020 03:00
On February 4, 2020, the U.S. secretary of health and human services declared that emergency use of diagnostics for SARS-CoV-2 was justified, triggering emergency authority for the Food and Drug Administration (FDA) to grant an emergency use authorization (EUA) for a device if it reasonably…
Wed Sep 09, 2020 03:00
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