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Screening for colorectal neoplasia should be initiated at 50 years of age, with tailored screening between 76 and 85 years of age. Most guidelines do not specifically recommend one screening strategy over others; this article reviews current screening strategies. NEJM Resident 360 has Clinical Pearls, Morning Report Questions, and free access to the article. [ Nej.md Link ]

Screening for Colorectal Neoplasia | NEJM Resident 360

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Screening for trisomies by sequencing cell-free DNA obtained from pregnant women has become routine in many countries. In this study involving 31,278 women, adjusting for copy-number variation improved the positive predictive value of screening. [ Nej.md Link ]

Improving the Accuracy of Prenatal Screening with DNA Copy-Number Analysis - NEJM

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Join in on the latest NEJM Resident 360 discussion “Apple for the Teacher: Careers in Medical Education.” Do you love to teach medical students and residents and want to be more involved with developing medical education programs and curricula? If so, do you wonder what additional resources you need to develop a career in medical education? Get advice from experts in the field by joining this...
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Res360 Discussion - Apple for the Teacher: Careers in Medical Education

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Images in Clinical Medicine: Fibromuscular Dysplasia of the Brachial Artery

A 68-year-old woman presented with exertional dyspnea and chest pain. She had undergone CABG 5 years earlier. Vascular examination revealed palpable radial pulses on both sides of the body; right brachial angiography revealed a “string of beads” pattern. [ Nej.md Link ]

Fibromuscular Dysplasia of the Brachial Artery - NEJM

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This week’s From Pages to Practice post on NEJM Resident 360 looks at amitriptyline and topiramate for childhood migraine. In childhood and adolescent migraine, amitriptyline and topiramate were no better than placebo and not significantly different from each other in achieving a 50% or greater reduction in days with headache. The trial was stopped early for futility. Click through for free...
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Trial of Amitriptyline, Topiramate, and Placebo for Pediatric Migraine | NEJM Resident 360

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New guidelines for diagnosing tuberculosis have been issued by the American Thoracic Society, Infectious Diseases Society of America, and Centers for Disease Control and Prevention. Dr. Thomas Gluck of NEJM Journal Watch reviews the key points.

Diagnosis of Tuberculosis in Adults and Children

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A new protein-delivery platform can provide sustained secretion of recombinant human erythropoietin with the use of small, transduced autologous dermal implants. Study patients with end-stage renal disease were found to have maintenance of stable hemoglobin levels.
Local, autochthonous transmission of #Zika virus was identified in a 23-week pregnant woman in July 2016 in southern Florida. [ Nej.md Link ]

NEJM - Cutaneous Eruption in a U.S. Woman with Locally Acquired Zika Virus Infection

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A 37-year-old man presented with genital lesions, weight loss, and back pain, preceded 2 months earlier by dysuria and urethral discharge that had resolved. Examination revealed erythematous, annular plaques on the glans penis, and meatal inflammation. [ Nej.md Link ]

NEJM - Circinate Balanitis

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More than 6 million U.S. children and adolescents have migraine headaches, but there is little evidence to support any specific therapy for prevention. Are the most commonly used medications beneficial or harmful? New research findings are summarized in this short video. Full study: [ Nejm.org Link ]

Watch more Quick Take videos: [ Nej.md Link ]
A 56-year-old man with a history of roux-en-y gastric bypass presented with abdominal pain, nausea, -and bilious emesis. What’s the diagnosis? Take the new Image Challenge now! [ Nej.md Link ]

NEJM - Image Challenge

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Each year, the editors of NEJM Journal Watch General Medicine choose the most important thematic areas in clinical research for the year. In 2016, three of the ten topics involved cardiovascular outcomes. The first discussion in this series covers these three areas:

1. Cardiovascular Outcomes with Newer Antidiabetes Drugs
2. Does CPAP Prevent Adverse CV Events in Patients with Obstructive...
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NEJM Group Open Forum: NEJM Journal Watch 2016 Year in Review – Cardiovascular Outcomes Studies

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When a pregnant physician winds up in her own hospital with a ruptured occult adenoma of the liver and barely survives, she learns that though medical professionals do so many difficult, technical things so perfectly right, they fail their patients in many ways.

In this trending article, Rana L.A. Awdish, M.D., points to personal experience in her Perspective "A View from the Edge — Creating...
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#SPRINTChallenge Update: Due to high levels of interest, the deadline for submitting a Qualifying Round entry in the SPRINT Data Analysis Challenge has been extended to February 8, 2017 at midnight EST.

If you were thinking about participating, there is still time to request the data and submit a Qualifying Round entry. Learn more and enter the Challenge: [ Challenge.nejm.org Link ]

The SPRINT Data Analysis Challenge | How To Enter

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A few medicine and family practice residency programs around the country have a dedicated track that focuses on HIV care. Though the programs naturally differ somewhat in structure — here are two examples from University of Washington and Yale — they generally involve placing the resident into an HI...

Poll: Should Medicine and Family Practice Residency Programs Have a Dedicated HIV Track? - HIV and ID Observations

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Your new diet plan might fail. That daily planner might collect dust on the corner of your desk. The gym membership gifted by a well-intentioned (but not-so-subtle) cousin might go unused. But fear not. You can still resolve to make 2017 just a little bit better than last year. And it starts by clea...

7 Medical Terms to Ditch in 2017 - In Practice

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Answer to yesterday’s quiz:

Which one of the following statements about inclisiran is true?
A. It binds to extracellular proprotein convertase subtilisin–kexin type 9 (PCSK9) and prevents its interaction with the low-density lipoprotein (LDL) receptor.
B. It inhibits the synthesis of PCSK9 protein in the liver.
C. It is a short-acting RNA interference therapeutic agent.
D. It promotes the...
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A Highly Durable Inhibitor of PCSK9 | NEJM Resident 360

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Organ loss due to late-stage cancer is a heavy burden on both the patient and the health care system. This letter describes a patient who received an artificial larynx to replace lost laryngeal functions and who underwent 16 months of follow-up. This video shows the patient with an artificial larynx swallowing. View additional videos: [ Nej.md Link ]
In a phase 1 trial, healthy volunteers were assigned to an RNAi therapeutic inhibitor of PCSK9 or placebo. Single doses of 300 mg or more reduced LDL cholesterol by up to 50%; multiple-dose regimens reduced LDL cholesterol by up to 59%. No serious adverse events were reported. NEJM Resident 360 has Clinical Pearls, Morning Report Questions, and free access to the article. [ Nej.md Link ]

A Highly Durable Inhibitor of PCSK9 | NEJM Resident 360

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“What the past 8 years have taught us, writes President Barack Obama in NEJM, “is that health care reform requires an evidence-based, careful approach, driven by what is best for the American people. That is why Republicans’ plan to repeal the ACA with no plan to replace and improve it is so reckless.” Read the article: [ Nej.md Link ]