More rapid completion of a 3-hour #sepsis bundle and administration of antibiotics, but not completion of an initial IV fluid bolus, were associated with lower risk- adjusted in-hospital mortality. Join this discussion to pose questions to the authors and leading experts to learn more!
More rapid completion of a 3hour sepsis bundle and administration of antibiotics

@NEJM Ask the Authors & Experts: Time to Treatment and Mortality during Mandated Emergency Care for Sepsis

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Bao Luu
Answer to yesterday’s #MedEd Quiz:

Which one of the following statements about brucella species or brucellosis is true?
A. Brucella species grow rapidly in culture.
B. Brucellosis is caused by a gram-positive bacillus.
C. Consumption of unpasteurized goat milk is an uncommon mode of transmission.
D. Joint pain is common in brucellosis.

The correct answer is D. Joint pain is common in...
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Answer to yesterdays MedEd Quiz Which one of the following statements about

A Woman with Skin Lesions | NEJM Resident 360

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Monica Soto
An IDH2 mutation that was not present in a patient’s tumor was detected in circulating DNA. However, the patient had clonal hematopoiesis with an IDH2 mutation that was responsible for the false positive result. [ Nej.md Link ]
An IDH2 mutation that was not present in a patients tumor was

IDH2 Mutation in a Patient with Metastatic Colon Cancer — NEJM

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The use of benralizumab, a monoclonal antibody directed against the alpha subunit of the interleukin-5 receptor, allowed patients with asthma who were dependent on oral glucocorticoids to reduce the glucocorticoid dose to a greater extent than those who received placebo. [ Nej.md Link ]

This article was presented today at the American Thoracic Society (ATS) 2017 Conference in Washington, D.C....
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The use of benralizumab a monoclonal antibody directed against the alpha subunit
Benjamin Ng
Umberto de Marca
Eugenia Rdgz.
Patients with vasodilatory shock were randomly assigned to angiotensin II or placebo. At 3 hours, more patients in the angiotensin II group than in the placebo group had an increase in mean arterial pressure of at least 10 mm Hg or to at least 75 mm Hg. [ Nej.md Link ]

This article was published today to coincide with the American Thoracic Society (ATS) 2017 Conference in Washington, D.C....
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Patients with vasodilatory shock were randomly assigned to angiotensin II or placebo

Time to Treatment and Mortality during Mandated Emergency Care for Sepsis | NEJM

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Miguel A. Martínez Romo
#MedEd Quiz:

Which one of the following statements about brucella species or brucellosis is true?
A. Brucella species grow rapidly in culture.
B. Brucellosis is caused by a gram-positive bacillus.
C. Consumption of unpasteurized goat milk is an uncommon mode of transmission.
D. Joint pain is common in brucellosis.

Learn more about the case associated with this question on NEJM Resident 360:
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MedEd Quiz Which one of the following statements about brucella species or

A Woman with Skin Lesions | NEJM Resident 360

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Susan Jones
Susan Stark
Pitágoras Alves de Oliveira
A 27-year-old woman presented with skin lesions that had developed after international travel. Biopsy of a skin lesion revealed granulomatous dermatitis. Fatigue, weakness, and pulselessness developed in the left arm. A diagnosis was made. NEJM Resident 360 has Clinical Pearls, Morning Report Questions, and free access to the article. [ Nej.md Link ]
A 27yearold woman presented with skin lesions that had developed after international

A Woman with Skin Lesions | NEJM Resident 360

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Marcela Rocha
Belka Cem
Estephania Pignaton Naseri
In an analysis including nearly 50,000 patients with sepsis treated at 149 New York hospitals, more rapid delivery of a 3-hour sepsis-care bundle (a protocol recommending blood cultures, broad spectrum antibiotics, and lactate measurement within 3 hours) was associated with lower mortality. [ Nej.md Link ]

Read the related Perspective article by Tina B. Hershey, J.D., M.P.H., and Jeremy M....
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In an analysis including nearly 50000 patients with sepsis treated at 149
Troy Siron
Kimberly Brock Wright
Jon Daniels
Answer to yesterday’s #MedEd Quiz:

Mepolizumab is a monoclonal antibody that binds to which one of the following choices?
A. CD-34 receptor.
B. Formyl peptide receptor 1.
C. Interleukin-5.
D. Leukotriene B4.

The correct answer is C. Mepolizumab is an anti–interleukin-5 monoclonal antibody that binds to interleukin-5 and prevents its interaction with its receptor on the eosinophil surface....
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Answer to yesterdays MedEd Quiz Mepolizumab is a monoclonal antibody that binds

Mepolizumab for Eosinophilic Granulomatosis with Polyangiitis | NEJM Resident 360

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Is a #Zika vaccine imminent? Should we focus on prevention or treatment? Discuss recent Zika research findings with your peers in this new NEJM Group Open Forum: [ Nej.md Link ]
Is a Zika vaccine imminent Should we focus on prevention or treatment

Zika Virus: What Do We Know and What Do We Need to Know? • NEJM Group Open Forum • Medstro

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Stephen D. Fix
Myriam Juarez
Barb Lathrop
#MedEd Quiz:

Mepolizumab is a monoclonal antibody that binds to which one of the following choices?
A. CD-34 receptor.
B. Formyl peptide receptor 1.
C. Interleukin-5.
D. Leukotriene B4.

Learn more about the study associated with this question on NEJM Resident 360: [ Nej.md Link ]
MedEd Quiz Mepolizumab is a monoclonal antibody that binds to which one

Mepolizumab for Eosinophilic Granulomatosis with Polyangiitis | NEJM Resident 360

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Muhammad Al-Jobouri
Saied Sabagh
Pitágoras Alves de Oliveira
Among participants with eosinophilic granulomatosis with polyangiitis, 32% had remission at weeks 36 and 48 when treated with mepolizumab, an anti–interleukin-5 monoclonal antibody, as compared with 3% of the participants in the placebo group. NEJM Resident 360 has Clinical Pearls, Morning Report Questions, and access to the full article. [ Nej.md Link ]

Mepolizumab for Eosinophilic Granulomatosis with Polyangiitis | NEJM Resident 360

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James Bergfield
Andy Khan
Claudio Rogerio Werka Junior
In two randomized trials of women with endometriosis and moderate/severe endometriosis-associated pain, the oral gonadotropin-releasing hormone antagonist elagolix (at 2 doses) significantly improved dysmenorrhea and non-menstrual pelvic pain, but had hypoestrogenic adverse effects. [ Nej.md Link ]

This article was presented today at the 13th World Congress Endometriosis in Vancouver. #WCE2017
In two randomized trials of women with endometriosis and moderatesevere endometr

Treatment of Endometriosis-Associated Pain with Elagolix, an Oral GnRH Antagonist | NEJM

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Rusiru Thathsara Ekanayaka
Bram Hengeveld
There is sexism in medicine, but there may also be a more insidious obstacle, writes Dr. Suzanne Koven. “I’ve been haunted at every step of my career by the fear that I am a fraud…And not only do we women tend to perseverate over our inadequacies, we also often denigrate our strengths.” Read Dr. Koven’s “Letter to a Young Female Physician.” [ Nej.md Link ]
There is sexism in medicine but there may also be a more

Letter to a Young Female Physician — NEJM

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זַכִּיָּה שָׂרָה
Rob Elliott
Serenella Fasulo
A 71-year-old man presented for the evaluation of chronic kidney disease and was noted to have erythematous papules on his face and lesions over his toenails suggestive of tuberous sclerosis. [ Nej.md Link ]
A 71yearold man presented for the evaluation of chronic kidney disease and

Tuberous Sclerosis Complex — NEJM

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Abdisalam Hajji Yusuf Moalim
Monica LaPointe
Cortney Booth
This week’s From Pages to Practice post on NEJM Resident 360 looks at KIT inhibition by imatinib in severe asthma. This proof-of-principle trial showed that imatinib treatment reduced mast-cell activation and improved airway responsiveness in patients with severe refractory asthma. [ Nej.md Link ]
This weeks From Pages to Practice post on NEJM Resident 360 looks

Imatinib for Severe Refractory Asthma? Thinking About KIT Inhibition Beyond Cancer | NEJM Resident 360

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In a patient with colon cancer and a history of autoimmunity, skin and gastrointestinal toxicity developed after the receipt of pembrolizumab. Interleukin-17 blockade reversed the autoimmunity but led to tumor progression. [ Nej.md Link ]
In a patient with colon cancer and a history of autoimmunity skin

Reversal of Autoimmune Toxicity and Loss of Tumor Response by Interleukin-17 Blockade — NEJM

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Pitágoras Alves de Oliveira
Saied Sabagh
Renzo Di Natale
A 20-year-old man presented with a sore throat and a rash. A rapid test for streptococcal pharyngitis was positive, confirming a diagnosis of scarlet fever. [ Nej.md Link ]
A 20yearold man presented with a sore throat and a rash A

Scarlet Fever — NEJM

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Michelle Nuñez França
Saied Sabagh
Renato Vabo
Does exercise improve physical function in obese older adults? New research findings are summarized in this short video. Full study: [ Nej.md Link ]

Watch more Quick Take videos: [ Nej.md Link ]
Daniel Aronov
João Flávio Baêta
Pablo Serrano
A 69-year-old man presented with progressive neutropenia and anemia and this result of his bone marrow aspiration. What’s the diagnosis? Take the new Image Challenge now! [ Nej.md Link ]
A 69yearold man presented with progressive neutropenia and anemia and this result

NEJM - Image Challenge

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Tom Wahswarc
ลีลาวันต์ วิบูลมงคล
Gerardo Rincon Castill