 |
 |
|
|
|
|
|
|
Redesigning Primary Care
In a discussion moderated by Dr. Thomas Lee, four experts in primary care and related policy — Drs. Thomas Bodenheimer, Allan Goroll, Barbara Starfield, and Katharine Treadway — explore the current crisis in U.S. primary care and possible solutions for training, practice, compensation, and systemic change.
THE FUTURE OF PRIMARY CARE
The editors asked several experts to share their perspectives on the crisis in U.S. primary care. Their articles address the issue from six different angles.
|
Anterior Cruciate Ligament Tear
A soccer player reacts to a defender, plants her leg, cuts to the left without contact, feels her leg give out, hears a pop, and has acute pain. The next day she presents for evaluation. How should her case be managed?
CME Exam
 Listen to the full text of this article.
|
Inherited Susceptibility to Common Cancers
This review deals with germ-line genes that increase susceptibility to five major types of cancer — breast, lung, pancreatic, prostate, and colorectal cancer — and includes a discussion of clinical implications, especially for genetic counseling.
|
A Man with Confusion and Memory Loss
A 65-year-old man was transferred to the hospital because of the recent onset of confusion and memory loss. MRI scans of the brain showed symmetric abnormalities. A CT scan of the chest disclosed an anterior mediastinal mass.
CME Exam
|
Mechanical Ventilation in Acute Lung Injury
Patients with acute lung injury or ARDS were randomly assigned to mechanical ventilation directed either by esophageal-pressure measurements or according to standard-of-care recommendations. The use of esophageal pressures to estimate the transpulmonary pressure significantly improved oxygenation and respiratory-system compliance.
Published Online November 11, 2008 (DOI: 10.1056/NEJMoa0708638)
|
General and Abdominal Adiposity and Risk of Death
This study suggests that both general and abdominal adiposity are associated with the risk of death and supports the use of waist circumference or waist-to-hip ratio for assessment of the risk of death.
Free Full Text
CME Exam
|
Subthalamic Nucleus Stimulation in Severe Obsessive–Compulsive Disorder
Stimulation of the subthalamic nucleus reduced the symptoms of OCD in 16 patients; however, 11 patients had serious adverse events.
|
Irbesartan in Patients with Heart Failure and Preserved Ejection Fraction
Patients with heart failure and a preserved ejection fraction were randomly assigned to treatment with irbesartan or placebo and followed for a mean of 49.5 months. There were no significant differences between the two study arms in the rate of the primary end point (death or hospitalization for heart failure).
 November 11, 2008 (DOI: 10.1056/NEJMoa0805450), in Print December 4, 2008
|
|
PEEP Guided by Esophageal Pressure — Any Added Value?
Published Online November 11, 2008 (DOI: 10.1056/NEJMe0806637)
Weight Loss with a Low-Carbohydrate, Mediterranean,
or Low-Fat Diet Free Full Text
Tibolone in Older Postmenopausal Women
Rivaroxaban for Thromboprophylaxis
Pay-for-Performance System for English Physicians
MRSA USA300 Clone and VREF —
A U.S.–Colombian Connection? Free Full Text
|
|
|
|
|
|
|
|
|
Will You Change Your Practice?
The JUPITER trial studied the use of a statin to prevent cardiovascular events in asymptomatic subjects with elevated C-reactive protein.
Take a poll about this trial and contribute your comments.
Open for comments until November 26
Ocular Myiasis
This 49-year-old man presented to the emergency room with a 2-day history of decreased vision in his left eye. His visual acuity in that eye was 20/200.
 More Featured Images
|
|
The New England Journal of Medicine is owned, published, and copyrighted © 2008 Massachusetts Medical Society.
All rights reserved. Electronic ISSN 1533-4406 Print ISSN 0028-4793.
The content of this site is intended for health care professionals.
| |
|
| |
|
The New England Journal of Medicine (NEJM) is a weekly general medical journal that publishes new medical research findings, review articles, and editorial opinion on a wide variety of topics of importance to biomedical science and clinical practice. Material is published with an emphasis on internal medicine and specialty areas including allergy/immunology, cardiology, endocrinology, gastroenterology, hematology, kidney disease, oncology, pulmonary disease, rheumatology, HIV, and infectious diseases.
NEJM Online contains both the current issue and an online archive that can be accessed through browsing, advanced searching, or collections by disease or topic.
Subscriber services include PDA content access, PowerPoint downloads, and continuing medical education (CME).
| |
|
|
|
NEJM Tools
