To the Editor: In a randomized trial involving 42 patients, we assessed deep brain stimulation targeting the fornix to improve cognition in patients with Alzheimer’s disease (ClinicalTrials.gov number, NCT01608061; the protocol for the trial is available with the published article). Although the…
8h
Virtually every U.S. state has implemented a prescription drug monitoring program (PDMP) to address high-risk opioid-prescribing and opioid-seeking behaviors that have contributed to the opioid-overdose crisis. PDMPs — electronic databases that track dispensing of controlled substances — are…
16h
Presentation of Case. Dr. Andrew Cruz (Psychiatry): A 27-year-old woman was evaluated at this hospital because of a suicide attempt. Approximately 3 months before admission, the patient became homeless and was staying intermittently with friends. Two months before admission, she began to ingest…
16h
There is a growing list of medications known to adversely affect thyroid function or interpretation of the results of standard thyroid laboratory testing. Many of these drugs are commonly used preparations, ranging from over-the-counter supplements to advanced medical therapy, and include…
11h
What can we do when the patient needing emergency care is the earth? What life support can physicians offer our ailing planet? History can help us understand and answer these pressing questions. A deluge of recent reports document the degradation of Earth’s ecosystems. Local and national…
3h
The link between particulate pollution and mortality was originally recognized in the context of severe episodes of poor air quality in the 20th century, such as the London Fog of 1952. These episodes showed clear evidence that the number of deaths increased in association with high levels of…
3h
As medical professionals navigate busy days in temperature-controlled hospitals and seemingly indestructible health care systems, it can be easy to lose sight of the environmental chaos unfolding outside. The stark reality is that high levels of greenhouse gases caused by the combustion of fossil…
3h
The adverse health effects of short-term exposure to ambient air pollution are well documented. Particulate matter (PM), especially, arouses public health concerns because of its toxicity and the widespread human exposure to this pollutant. PM, which includes inhalable particles with an aerodynamic…
3h
With a rising death toll from chronic kidney disease of unknown origin (CKDu) — also known in Central America as Mesoamerican nephropathy — and with greenhouse gas emissions driving global temperature increases, we are woefully short of early screening tools and treatment options for tens of…
3h
Despite the availability of proteasome inhibitors, immunomodulatory agents, and monoclonal antibodies for multiple myeloma, most patients will have a relapse and refractory disease will develop. An increasing number of patients have triple-class refractory myeloma, defined as disease refractory to…
21h
Years ago, I heard about the death of an old family friend whom I’d loved as a child for her eccentric cooking habits, feeding her parakeets saliva-soaked crumbs from her lips, and letting me rap my knuckles on her wooden leg. Although I wasn’t with her at the end of her colorful life, I can almost…
21h
Ischemic heart disease is the most common and most lethal cause of heart failure. It is also the only cause of left ventricular dysfunction that is amenable to the benefit of surgical revascularization. The Surgical Treatment for Ischemic Heart Failure (STICH) trial and its extension study…
21h
Acute heart failure remains a leading cause of hospitalization. Among hospitalized patients with acute heart failure, 10 to 15% have worsening heart failure during the hospitalization, and 10 to 15% die within 60 to 90 days after discharge; these numbers are dramatically higher than those among…
21h
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