doi: 10.1056/NEJMicm2400802pmid: 39167810
Diabetes-Associated ScleredemaA 68-year-old man with type 2 diabetes presented with a 3-year history of hardening of the skin on his neck and upper back.
Masiakos, Peter T.; Chéry, Clementina M.; Gardner, Rachele; Gordon, Eric
doi: 10.1056/NEJMp2408294pmid: 39158139
Transforming Narratives of Gun ViolenceA storytelling initiative launched by health care, academic, and community organizations produces narrative interventions to help heal and empower the people most deeply affected by gun violence in Boston.
doi: 10.1056/NEJMicm2403183pmid: 39158145
Alpha1-Antitrypsin DeficiencyA 60-year-old woman with a 15-pack-year smoking history was referred with a several-year history of dyspnea on exertion. A chest radiograph showed hyperlucency of the lung bases.
Caro, José A.; Genné-Bacon, Elizabeth; Jacque, Berri; Masilamani, Revati F.
doi: 10.1056/NEJMp2405205pmid: 39158147
A Multitiered Mentorship ModelTufts’ STEM+M Connect program uses multitiered near-peer mentoring to help students navigate key academic transition points by building career awareness, a sense of belonging, and social networks.
Soni, S. Monica; Altman, Jessica
doi: 10.1056/NEJMp2405798pmid: 39158135
Table Stakes for EquityCovered California, the state’s health insurance marketplace, collects demographic data from applicants to inform its efforts to equitably increase health care coverage and reduce health disparities.
Fruin, Kaitlyn M.; Tung, Elizabeth L.; Franczyk, Jean M.; Detmer, Wayne M.
doi: 10.1056/NEJMp2407166pmid: 39158146
An Urban Farm–Anchored Produce Prescription ProgramTo reduce high levels of food insecurity among Black and Latinx residents of Chicago, three institutions partnered to create VeggieRx, a produce prescription program anchored by an urban agriculture facility.
Davis, Elizabeth; Mayer, Stockton; Pacilli, Massimo
doi: 10.1056/NEJMp2407283pmid: 39158143
Partnerships for Outbreak ResponseRecognizing that public health crises often hit hardest in underresourced communities, two academic medical centers have partnered with the Chicago Department of Public Health to provide rapid responses to outbreaks.
Goldmann, Don; Rajan, Sowmya; Udayakumar, Krishna
doi: 10.1056/NEJMp2401360pmid: 39158136
Controlling Global Antimicrobial ResistanceDespite efforts to address antimicrobial resistance, many challenges remain, particularly in low- and middle-income countries. Several steps could be taken to accelerate progress.
Landoni, Giovanni; Monaco, Fabrizio; Ti, Lian Kah; Baiardo Redaelli, Martina; Bradic, Nikola; Comis, Marco; Kotani, Yuki; Brambillasca, Claudio; Garofalo, Eugenio; Scandroglio, Anna Mara; Viscido, Cristina; Paternoster, Gianluca; Franco, Annalisa; Porta, Sabrina; Ferrod, Federica;
Showing 1 to 10 of 22 Articles
doi: 10.1056/NEJMoa2403769pmid: 38865168
AbstractBackgroundAcute kidney injury (AKI) is a serious and common complication of cardiac surgery, for which reduced kidney perfusion is a key contributing factor. Intravenous amino acids increase kidney perfusion and recruit renal functional reserve. However, the efficacy of amino acids in reducing the occurrence of AKI after cardiac surgery is uncertain.MethodsIn a multinational, double-blind trial, we randomly assigned adult patients who were scheduled to undergo cardiac surgery with cardiopulmonary bypass to receive an intravenous infusion of either a balanced mixture of amino acids, at a dose of 2 g per kilogram of ideal body weight per day, or placebo (Ringer’s solution) for up to 3 days. The primary outcome was the occurrence of AKI, defined according to the Kidney Disease: Improving Global Outcomes creatinine criteria. Secondary outcomes included the severity of AKI, the use and duration of kidney-replacement therapy, and all-cause 30-day mortality.ResultsWe recruited 3511 patients at 22 centers in three countries and assigned 1759 patients to the amino acid group and 1752 to the placebo group. AKI occurred in 474 patients (26.9%) in the amino acid group and in 555 (31.7%) in the placebo group (relative risk, 0.85; 95% confidence interval [CI], 0.77 to 0.94; P=0.002). Stage 3 AKI occurred in 29 patients (1.6%) and 52 patients (3.0%), respectively (relative risk, 0.56; 95% CI, 0.35 to 0.87). Kidney-replacement therapy was used in 24 patients (1.4%) in the amino acid group and in 33 patients (1.9%) in the placebo group. There were no substantial differences between the two groups in other secondary outcomes or in adverse events.ConclusionsAmong adult patients undergoing cardiac surgery, infusion of amino acids reduced the occurrence of AKI. (Funded by the Italian Ministry of Health; PROTECTION ClinicalTrials.gov number, NCT03709264.)