Humans

A 73-year-old woman presented to the dermatology clinic with an 11-month history of an evolving pruritic, erythematous rash on her thighs, buttocks, trunk, and axillae (Panel A). The rash initially consisted of pruritic annular lesions with central duskiness and was treated with prednisone and antihistamines without improvement. The rash evolved into polycyclic erythematous plaques during
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Presented at the 6th International Conference on Plasmodium vivax Research (ICPVR), Manaus, Brazil, June 11–14, 2017; and at the 66th Annual Meeting of the American Society of Tropical Medicine and Hygiene, Baltimore, November 5–9, 2017. Supported by GlaxoSmithKline (GSK) and Medicines for Malaria Venture. The meta-analysis was funded and conducted by GSK. Disclosure forms provided
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“Aspirin” as a trade-mark will no longer exist if the recommendation of the Examiner of Interferences of the United States Patent Office is upheld, as it probably would be, should the matter be taken to the courts. The opinion of the Patent Office was the result of a petition by the United Drug Company in
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In its recently finalized 2019 Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) introduced new billing codes for a range of services that enable clinicians to provide more coordinated care.1 Effective January 1, 2019, these codes will reimburse clinicians for asynchronous telehealth services, chronic care physiologic monitoring, e-consults between clinicians, and virtual
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During the recent IDWeek conference, physicians vied for research funding to support projects aimed at overcoming patient care challenges in resource-limited settings during the inaugural IDea Incubator competition. From 57 entries submitted by researchers from around the world, 3 finalists received awards ranging from $2500 to $10 000. First Place: Breath Printing Malaria Researchers developing a
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A recent data summary from the CDC shows that 2017 was a record-breaking year for tickborne diseases in the United States. Officials are also concerned about the arrival of a prolific species of disease-carrying tick. As new diseases emerge and some ticks expand their ranges, US public health authorities find themselves unprepared to deal with
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Preserving the viability of oxygen-sensitive bacteria may enhance the clinical effect of fecal microbiota transplantation (FMT) for patients with ulcerative colitis. Costello and colleagues randomized 73 adults with mild to moderately active ulcerative colitis and found that treatment with anaerobically prepared donor FMT compared with autologous FMT resulted in a higher likelihood of remission at
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Over the past 5 decades, the randomized clinical trial has become the gold standard for evaluation of the risks and benefits of new interventions, including drugs, medical devices, and surgical procedures.1 To justify the use of randomization, it is important to note that in a nonrandomized study comparing 2 interventions, a small P value (of
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Importance  β-Lactam antibiotics are among the safest and most effective antibiotics. Many patients report allergies to these drugs that limit their use, resulting in the use of broad-spectrum antibiotics that increase the risk for antimicrobial resistance and adverse events. Observations  Approximately 10% of the US population has reported allergies to the β-lactam agent penicillin, with
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We rarely portray Neanderthals, our close relatives, as telegenic. Museum exhibits give them wild tangles of hair, and Hollywood reduces them to grunting unsophisticates. Their skulls suggest broad faces, tiny chins and jutting brows. But to mock Neanderthals is to mock ourselves: Homo sapiens had lots of sex with Homo neanderthalensis. Neanderthal genes supply between
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To the Editor Paz-Bailey and colleagues (Sept. 27 issue)1 describe the dynamics of Zika virus (ZIKV) in body fluids in a cohort of participants who lived in an area where the virus was endemic and in whom ZIKV infection was detected on reverse-transcriptase–polymerase-chain-reaction assay. We are concerned about the external validity of these results. First,
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This article has no abstract; the first 100 words appear below. To the Editor: Colangeli et al. (Aug. 30 issue)1 report that higher minimum inhibitory concentration (MIC) values of rifampin and isoniazid were associated with a greater risk of treatment failure and relapse of tuberculosis than lower MIC values. We agree that critical concentrations may
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Toxic Alcohols (Review Article, N Engl J Med 2018;378:270-280). In the third paragraph of the Clinical Findings section (page 273), the second sentence should have read, “Serum isopropanol concentrations above 50 mg per deciliter (8.3 mmol per liter) are clinically significant, and those greater than 150 mg per deciliter (25 mmol per liter) produce deep
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This article has no abstract; the first 100 words appear below. To the Editor: Zaenglein (Oct. 4 issue)1 notes that “in the United States, minocycline is the most commonly used antibiotic for acne, followed closely by doxycycline.” However, there is no evidence that minocycline is superior to other antibiotics, including doxycycline, in the treatment of
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This article has no abstract; the first 100 words appear below. Coronary-artery bypass grafting (CABG) is the most common cardiac surgical procedure performed worldwide, with more than 200,000 of the procedures performed annually in the United States alone.1 Amidst several advances, the use of saphenous-vein grafts for bypass grafting remains common2,3: more than 90% of
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This article has no abstract; the first 100 words appear below. To the Editor: Geserick et al. (Oct. 4 issue)1 report tracking body-mass index (BMI) in individual children over time. However, they did not use longitudinal analytic strategies. Although Figures 1 and 2 (available with the full text of their article at NEJM.org) suggest longitudinal
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An archaeological dig in Suffolk, England has yielded up a Roman-era cemetery treasure: 52 beautifully preserved skeletons dating back to the 4th century. And of those skeletons, many had been decapitated, their disembodied heads placed neatly at their sides or feet for burial, or buried without bodies altogether. Only 17 skeletons had been buried normally.
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This article has no abstract; the first 100 words appear below. To the Editor: In the article by Kelkar et al.1 on bleeding associated with synthetic cannabinoids and in the accompanying editorial by Connors2 (Sept. 27 issue), the generous efforts of some of the agencies involved did not receive enough attention. This large outbreak was
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This article has no abstract; the first 100 words appear below. To the Editor: Muftuoglu et al. (Oct. 11 issue)1 describe the use of adoptive allogeneic BK virus–specific T cells for the treatment of progressive multifocal leukoencephalopathy (PML) and found that patients had alleviation of clinical symptoms and clearance of JC virus in the cerebrospinal
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A 29-year-old man presented to the dermatology clinic with a pruritic, erythematous, and scaly rash that had first appeared 2 years earlier. He had sought no medical treatment until this presentation. His medical history included eczema during childhood and seasonal allergies. He was taking no medications. A physical examination showed erythematous, violaceous plaques (Panel A)
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1. Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS), 2018 (www.cdc.gov/injury/wisqars/index.html). Google Scholar 2. Centers for Disease Control and Prevention. Wide-ranging Online Data for Epidemiologic Research (WONDER), 2018 (https://wonder.cdc.gov). Google Scholar 3. Department of Health and Human Services, Office of the Surgeon General, National Action Alliance for Suicide Prevention.
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Video A 76-year-old man with a history of congestive heart failure and an ejection fraction of 45% presented to the emergency department with worsening shortness of breath. He had undergone transcatheter aortic-valve replacement (TAVR) 9 months earlier. His temperature was 39.0°C, and a grade 5 systolic murmur (associated with a palpable thrill) was detected on
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The United States is in the midst of an opioid crisis. An estimated 2.1 million Americans had an opioid use disorder in 2016. The rate of opioid overdose deaths has increased by 500% since 1999, and each day an estimated 115 Americans die from opioid overdose.1 Despite the proven effectiveness of medication-assisted treatment (MAT) for
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This article has no abstract; the first 100 words appear below. To the Editor: The article by Bohula et al. (Sept. 20 issue)1 examined the use of lorcaserin, a selective agonist of the 5-hydroxytryptamine 2C serotonin receptor (5-HT2C), in overweight or obese patients. In this trial and previous trials,2 headache was one of the most
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Ken Gershman, M.D., M.P.H.Colorado Department of Public Health and Environment, Denver, CO Krista Timm, M.D.Meredith Frank, M.D.Denver Office of the Medical Examiner, Denver, CO Laurissa Lampi, M.D.Boulder County Coroner’s Office, Boulder, CO Jonathan Melamed, M.S.Roy Gerona, Ph.D.University of California, San Francisco, San Francisco, CA Andrew A. Monte, M.D., Ph.D.University of Colorado School of Medicine, Aurora,
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After Chinese scientist He Jiankui shocked the scientific community by announcing last month that he had edited the genes of human babies, he mysteriously vanished. And now he’s been found.  The New York Times reports that guards are holding He in a guesthouse at his university, the Southern University of Science and Technology. It’s unclear whether the guards work for the Chinese government, the university,
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Antibiotic resistance is currently one of the biggest public health challenges, with multidrug resistant (MDR) bacteria spreading at alarming rates. A recent World Health Organization report reveals widespread occurrence of antibiotic resistance among 500 000 people with suspected bacterial infections across 22 countries. Despite the seriousness of the problem, it has been more than 50 years
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The bell rang. I stared at the doorknob, wondering if I could put the moment off indefinitely if I simply stood still. But all along the hallway, medical students clad in white coats were stepping into their assigned rooms to meet their very first standardized patients. Greetings were muffled by doors clicking shut behind them.
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Key Points Question  In patients undergoing primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction (STEMI), does adjunctive fibrinolytic therapy with low-dose intracoronary alteplase given after reperfusion and before stent implant reduce microvascular obstruction? Findings  In this randomized clinical trial that included 440 participants randomized to receive alteplase 20 mg, alteplase 10 mg, or
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On a personal note, one of the joys of my position as Editor in Chief of JAMA and the JAMA Network is to meet and talk with individuals whom I have admired my entire academic career. Such was the case in meeting and discussing this article with Lisa and Steven. They clearly had boundless energy
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    Cassia grandis, Costa Rica Cassia fruit covers the forest floor, a blanket of black sausage stinking in the heat as it decomposes, a mote in the eye of permanence. Built for grinding by gigantic teeth, Cassia’s fibrous case condemns its seeds to suffering with neither mastodon nor megatherium alive to free them and distribute undigested
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