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2218 Articles
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What Is the Relative Value of a Baby?
Rachel Fleishman, M.D.
perinatal care, neonatal respiratory distress, U.S. healthcare inequities, relative value units (RVUs), Medicaid reimbursement, hospital closures, maternal mortality

This article, written from the perspective of a neonatologist, reflects on a newborn’s struggle to breathe in the first moments of life and the systemic challenges in U.S. perinatal care. The physic... 4 weeks ago

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Way Stations in Progress — Burgeoning Treatment Options for IgA Nephropathy
Julie R. Ingelfinger, M.D
IgA nephropathy, glomerulopathy, sodium-glucose cotransporter 2 inhibitors, targeted budesonide, sibeprenlimab, iptacopan, atrasentan, kidney function, proteinuria reduction, eGFR, clinical trials

IgA nephropathy, once considered a benign condition, is now recognized as the most common glomerulopathy worldwide, often progressing to end-stage kidney disease. Despite decades of symptomatic care, ... 4 weeks ago

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Tumoral Melanosis
Deshan F. Sebaratnam, F.A.C.D.; James P. Pham, M.D.
tumoral melanosis, melanoma regression, immunotherapy response, dermoscopy-guided biopsy, melanin-laden macrophages, dermatologic surveillance

An 84-year-old man with a history of melanoma on the right forehead, complicated by in-transit metastases to the scalp, developed blue-gray macules after receiving immunotherapy.Seven months after sta... 4 weeks ago

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Tubal Ectopic Pregnancy
Courtney A. Schreiber, M.D., M.P.H.; Sarita Sonalkar, M.D., M.P.H. Journal: The ...
tubal ectopic pregnancy, pelvic inflammatory disease, maternal mortality, transvaginal ultrasound, methotrexate therapy, salpingectomy, reproductive health disparities

Tubal ectopic pregnancy occurs when a fertilized egg implants in the fallopian tube, posing a serious risk of rupture and hemorrhage. This condition accounts for approximately 2% of pregnancies in Nor... 4 weeks ago

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Traveling Companions
Rachel K. Gardner, M.D.; Daniel A. Solomon, M.D.; Allison S. Bloom, M.D.; Yee-P...
secondary syphilis, septic arthritis, injection-drug use, MRSA, sexually transmitted infections, migratory polyarthritis, vancomycin, dalbavancin

This clinical problem-solving case discusses a 29-year-old man who presented with fever, chills, and joint pain, revealing an unusual dual diagnosis of secondary syphilis and methicillin-resistant Sta... 4 weeks ago

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Timing the Taming of Vascular Inflammation
Joseph Loscalzo, M.D., Ph.D.
vascular inflammation, acute myocardial infarction, colchicine therapy, spironolactone, endothelial dysfunction, fibrinolysis

This editorial examines vascular inflammation in atherothrombosis and assesses whether early anti-inflammatory intervention can improve outcomes in patients with acute myocardial infarction.The articl... 4 weeks ago

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Tirzepatide for Congenital Generalized Lipodystrophy
Svetlana Ten, M.D.; Amrit Bhangoo, M.D.; Christoph Buettner, M.D., Ph.D.
congenital generalized lipodystrophy, AGPAT2 variant, severe insulin resistance, leptin deficiency, tirzepatide monotherapy, glucose

This correspondence details the use of tirzepatide, a once-weekly dual GLP-1/GIP agonist, in two patients with congenital generalized lipodystrophy type 1 (AGPAT2 variant). Congenital generalized lipo... 4 weeks ago

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The Rise of Private Equity in Health Care — Not a Uniquely American Phenomenon
Yashaswini Singh, Ph.D.; Erin Fuse Brown, J.D., M.P.H.; Irene Papanicolas, Ph.D.
private equity in health care, financialization, global investments, hospital closures, medical regulations, market consolidation, health care transparency, policy interventions

Private equity investments in global health care have surged, reaching $446 billion between 2018 and 2022. Historically associated with U.S. health care financialization, private equity has expanded i... 4 weeks ago

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The Man Who Lives in the Cardboard Box
Teva D. Brender, M.D.
medical ethics, compassion, homelessness, institutional responsibility, physician self-awareness, societal inequalities, human dignity

This reflective essay explores the complexities of compassion, moral responsibility, and self-awareness in medical practice. The author, a physician, recounts an early morning scene in which a naked w... 4 weeks ago

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The Future of Gender-Affirming Care — A Law and Policy Perspective on the Cass Review
Daniel G. Aaron, M.D., J.D.; Craig Konnoth, J.D.
gender-affirming care, Cass Review, NHS policies, transgender healthcare, randomized controlled trials, informed consent, medical ethics

This article critiques the Cass Review, a report commissioned by England’s National Health Service (NHS) in 2024, which argues that there is insufficient evidence to support gender-affirming care (G... 4 weeks ago

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The Death of an Unlikable Man
Mark Earnest, M.D., Ph.D.
medical ethics, patient care, difficult patients, physician bias, empathy, prejudice in healthcare, palliative reflection, hospital mortality, caregiver burden

This deeply reflective piece explores the ethical and emotional challenges faced by healthcare providers when caring for difficult patients. The author recounts multiple hospital admissions of Mr. M.,... 4 weeks ago

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The Consequences of Silencing the "Voice of CDC"
Sonja A. Rasmussen, M.D.; Mary Lou Lindegren, M.D., M.P.H.; Lawrence K. Altman, ...
CDC, MMWR, public health communication, scientific integrity, H5N1 influenza, health advisories, political interference, Trump administration, NIH, FDA

This article examines the implications of a temporary halt on public communications from the Centers for Disease Control and Prevention (CDC) under the Trump administration in early 2025. The directiv... 4 weeks ago

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Routine Spironolactone in Acute Myocardial Infarction
anjit S. Jolly, M.D.; Marc-André d'Entremont, M.D., M.P.H.; Bertram Pitt, M...
myocardial infarction, spironolactone, mineralocorticoid receptor antagonist, heart failure, CLEAR trial, cardiovascular mortality,

Spironolactone, a mineralocorticoid receptor antagonist, is established in the treatment of heart failure following myocardial infarction (MI). However, its routine use post-MI remains uncertain.This ... 4 weeks ago

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Pleural Paragonimiasis
Lin Wang, M.D.; Niaz Banaei, M.D.
pleural paragonimiasis, lung fluke infection, Paragonimus mexicanus, eosinophilia, pleural effusion, parasitic lung disease

A 17-year-old boy from El Salvador was diagnosed with pleural paragonimiasis after a routine chest radiograph at an immigration clinic revealed a pleural effusion. Despite being asymptomatic, further ... 4 weeks ago

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Pulling Out the Rug on Informed Consent — New Legal Threats to Clinicians and Patients
Kristen Underhill, D.Phil., J.D.; Kimberly M. Nelson, Ph.D., M.P.H.
informed consent, medical litigation, gender-affirming care, healthcare restrictions, malpractice risks, legislative impact, medical ethics, patient autonomy

Recent legislative efforts in multiple U.S. states have sought to limit access to gender-affirming care, introducing novel legal tactics that may impact informed consent across other medical areas. Wh... 4 weeks ago

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Plaques en Prairie Fauchée Tongue Lesions in Secondary Syphilis
Jonathan P. Angel, M.D
secondary syphilis, plaques en prairie fauchée, HIV infection, oral lesions, treponemal testing, rapid plasma reagin, penicillin therapy, infectious diseases

A 29-year-old man with well-controlled HIV infection presented with a painful, whitish discoloration on his tongue for one week. He also reported scrotal ulcers that had resolved over the previous fou... 4 weeks ago

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Oral Manifestations of Pemphigus Vulgaris
Joseph Katz, D.M.D.; Indraneel Bhattacharyya, D.D.S.
pemphigus vulgaris, oral lesions, autoimmune blistering disorder, IgG deposition, gingival biopsy, mucocutaneous disease, steroid therapy, rituximab, immunosuppressant

A previously healthy 44-year-old woman presented with mouth ulcers and blistered lips persisting for 11 months, causing pain while eating and unintentional weight loss. She also reported skin blisters... 4 weeks ago

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One Size Fits … Some
Danielle Chammas, M.D.
medical education, patient communication, palliative care, emotional intelligence, psychotherapy techniques, cultural sensitivity, doctor-patient interaction

This article examines the challenges of applying standardized communication techniques in medical education and palliative care. The author reflects on a family meeting where a trainee struggled to co... 4 weeks ago

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My Mother’s Choices
Hannah Kirsch, M.D
Medical aid in dying (MAID), palliative care, caregiver burden, patient autonomy, end-of-life decisions, physician ethics, metastatic cancer

In this deeply personal narrative, Dr. Hannah Kirsch, a neurointensivist and palliative care researcher, recounts her experience as both a physician and daughter during her mother’s terminal illness... 4 weeks ago

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Middle Meningeal Artery Embolization and Nonacute Subdural Hematoma
Peter Kan
Middle meningeal artery embolization, nonacute subdural hematoma, chronic subdural hematoma, recurrence, surgical adjunct, liquid embolic agent, anticoagulation

Nonacute subdural hematoma (SDH) is a growing concern among aging populations, particularly with increased use of antiplatelet and anticoagulant therapies. Traditional treatments, including glucocorti... 4 weeks ago

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Microvascular Inflammation of Kidney Allografts and Clinical Outcomes
M. Sablik, A. Sannier, M. Raynaud, V. Goutaudier, G. Divard, et al., for the Par...
kidney transplantation, microvascular inflammation, Banff Classification, antibody-mediated rejection, donor-specific antibodies, renal pathology, transplant glomerulopathy, graft survival, precision diagnostics

The clinical relevance of microvascular inflammation in kidney transplants remains unclear, posing diagnostic and therapeutic challenges. This multicenter cohort study assessed biopsy specimens from 6... 4 weeks ago

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Lymphoid Interstitial Pneumonia
Furkan Ufuk, M.D.
lymphoid interstitial pneumonia, Sjögren’s syndrome, autoimmune lung disease, pulmonary cysts

Rwanda’s rapid containment of the 2024 Marburg virus disease (MVD) outbreak demonstrated a transformative model for epidemic response, contrasting historical trends. The outbreak began in September ... 4 weeks ago

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Marburg Virus Disease in Rwanda — Centering Both Evidence and Equity
Cameron T. Nutt, M.D
Marburg virus disease, Rwanda outbreak, epidemic response, health equity, filovirus infections, supportive care

Rwanda’s rapid containment of the 2024 Marburg virus disease (MVD) outbreak demonstrated a transformative model for epidemic response, contrasting historical trends. The outbreak began in September ... 4 weeks ago

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Long-Term Effects of Empagliflozin in Patients with Chronic Kidney Disease
William G. Herrington, F.R.C.P.; Natalie Staplin, Ph.D.; et al., for the EMPA-K...
chronic kidney disease, empagliflozin, SGLT2 inhibitors, kidney disease progression, cardiovascular risk

The EMPA-KIDNEY trial previously demonstrated positive cardiorenal effects of empagliflozin, an SGLT2 inhibitor, in patients with chronic kidney disease (CKD). This study assessed whether these benefi... 4 weeks ago

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Laryngeal Involvement in Disseminated Cryptococcosis
Christopher C. Marino, M.D.; Nanki Hura, M.D.
disseminated cryptococcosis, multiple myeloma, laryngeal involvement, fungal infections, Cryptococcus neoformans, hematogenous spread, immunosuppression, antifungal therapy

A 46-year-old woman with multiple myeloma presented with hoarseness and a painful sensation while swallowing. She had undergone autologous stem-cell transplantation five years earlier and was receivin... 4 weeks ago

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Hypothyroid Myopathy with Muscle Pseudohypertrophy
Kajananan Sivagurunathan, M.D.; Nalayini Jegathesan, M.D.
hypothyroid myopathy, muscle pseudohypertrophy, Hashimoto's thyroiditis, Hoffman’s syndrome, macroglossia, muscle hypertrophy, levothyroxine therapy, creatine kinase elevation, endocrinology, neuromuscular disorders

A 35-year-old man with progressive limb weakness, intermittent muscle cramping, fatigue, weight gain, and constipation was diagnosed with hypothyroid myopathy with muscle pseudohypertrophy (Hoffman’... 4 weeks ago

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Endobronchial Kaposi’s Sarcoma
Fredrik Eika, M.D.; Samer Al-Saad, M.D., Ph.D.
Kaposi’s sarcoma, orthotopic liver transplantation, human herpesvirus 8, immunosuppression, endobronchial lesions, CT imaging, everolimus toxicity, pulmonary opacities, histopathology

A 55-year-old man with a history of orthotopic liver transplantation developed post-transplantation Kaposi’s sarcoma, which was previously diagnosed in his liver, ventricle, and lymph nodes. A routi... 4 weeks ago

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Embolization of the Middle Meningeal Artery for Chronic Subdural Hematoma
David Fiorella, M.D., Ph.D.; Stephen J. Monteith, M.D.; Ricardo Hanel, M.D., Ph...
chronic subdural hematoma, middle meningeal artery embolization, neurosurgery, embolic therapy, stroke risk, treatment failure, STEM trial, endovascular procedures

Patients undergoing standard treatment for chronic subdural hematoma have a high risk of treatment failure, with recurrence rates ranging from 5% to 50%. This randomized controlled trial (STEM) examin... 4 weeks ago

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Effects of Food and Nutrition Insecurity on Global Health
Danielle Gallegos, Ph.D.
food insecurity, nutrition security, malnutrition, public health, global food systems, climate change, poverty, health disparities, sustainable food solutions, policy interventions

Food and nutrition insecurity affects populations globally, with disproportionate harm to those with limited resources. The review highlights its role in malnutrition, communicable and noncommunicable... 4 weeks ago

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Cutaneous Larva Migrans
Amanda Truong, M.D., Ph.D.; Stephanie Martin, M.D.
cutaneous larva migrans, hookworm larvae, parasitic skin infection, serpiginous rash, beach exposure, ivermectin therapy, dermatology, zoonotic infections

A 19-year-old man presented with a three-week history of asymptomatic serpiginous eruptions on his neck. As a beach lifeguard in Southern California, he had no history of international travel. Physica... 4 weeks ago

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Colchicine in Acute Myocardial Infarction
Sanjit S. Jolly, M.D.; Marc-André d'Entremont, M.D., M.P.H.; Shun Fu Lee, P...
colchicine, myocardial infarction, inflammation, cardiovascular disease, CLEAR trial, C-reactive protein, coronary revascularization, adverse effects, clinical tria

Inflammation plays a key role in adverse cardiovascular events, leading researchers to investigate colchicine as a potential treatment for myocardial infarction. This multicenter, randomized controlle... 4 weeks ago

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Atrasentan in Patients with IgA Nephropathy
Hiddo J.L. Heerspink, Ph.D.; Meg Jardine, M.B., B.S., Ph.D.; Donald E. Kohan, M....
IgA nephropathy, atrasentan, endothelin receptor antagonist, proteinuria reduction, kidney failure, renin-angiotensin system inhibitors, SGLT2 inhibitors, ALIGN trial, nephrology, long-term renal outcomes

Patients with IgA nephropathy and severe proteinuria face a high lifetime risk of kidney failure. This phase 3 randomized controlled trial evaluated the efficacy of atrasentan, a selective endothelin ... 4 weeks ago

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Another Win for SGLT2 Inhibitors in Chronic Kidney Disease
David E. Leaf, M.D.; Nisha Bansal, M.D.
chronic kidney disease, EMPA-KIDNEY trial, empagliflozin, SGLT2 inhibitors, cardiorenal therapy, kidney disease progression, cardiovascular risk reduction, proteinuria, eGFR, long-term follow-u

Chronic kidney disease (CKD) affects 14% of the U.S. population and poses substantial risks for end-stage kidney disease, cardiovascular events, and mortality. Despite therapeutic stagnation, sodium-g... 4 weeks ago

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Alternative Complement Pathway Inhibition with Iptacopan in IgA Nephropathy
Vlado Perkovic, M.B., B.S., Ph.D.; Jonathan Barratt, Ph.D.; Brad Rovin, M.D.; Na...
IgA nephropathy, iptacopan, alternative complement pathway, factor B inhibition, glomerulonephritis, proteinuria reduction, renal pathology, clinical trial, complement inhibitors, kidney disease therapy

IgA nephropathy is the most prevalent type of glomerulonephritis, leading to progressive kidney damage due to immune complex deposition. The alternative complement pathway plays a central role in dise... 4 weeks ago

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Acquired Osteomalacia Associated with Autoantibodies against PHEX
Yoshitomo Hoshino, M.D.; Kazuo Okamoto, Ph.D.; Tomohiro Ogawa; Hajime Kato, M.D....
acquired osteomalacia, tumor-induced osteomalacia, FGF23rHR, phosphate metabolism, PHEX autoantibodies, immunoassays, autoimmune bone disease, burosumab therapy, phosphaturic disorders, flow cytometry

Tumor-induced osteomalacia is the most common acquired form of fibroblast growth factor 23-related hypophosphatemic rickets-osteomalacia (FGF23rHR). However, in 27% to 45% of cases, causative tumors r... 4 weeks ago

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A Hitchhiker’s Guide to Antibody-Mediated Rejection
Parmjeet Randhawa, M.D.
antibody-mediated rejection, allograft survival, Banff Classification, microvascular inflammation, C4d deposition, donor-specific antibodies, non-HLA antibodies, AT1R, MICA, renal transplant pathology, immunosuppressive therapy

Antibody-mediated rejection is a major determinant of allograft survival and has evolved significantly since the era of hyperacute rejection. The Banff Classification of Allograft Pathology, first int... 4 weeks ago

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A 62-Year-Old Man with Abdominal Pain
Gabrielle K. Bromberg, M.D.; Robert G. Rasmussen, M.D., Ph.D.; Kenneth E. Sherma...
portal vein thrombosis, hepatic atrophy, cavernous transformation, cirrhosis misdiagnosis, transjugular intrahepatic portosystemic shunt, anticoagulation, mesenteric congestion, splenomegaly, portal hypertension, interventional radiology

A 62-year-old man presented with postprandial abdominal pain worsening over two years, alongside weight loss, nausea, and an irreducible umbilical hernia. While living in Costa Rica, he was diagnosed ... 4 weeks ago

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A 30-Year-Old Woman with Headache and Dysesthesia
Joseph Zunt, M.D., M.P.H.; Amy K. Barczak, M.D.; Daniel Y. Chang, M.D., Ph.D.
eosinophilic meningitis, Angiostrongylus cantonensis, rat lungworm, dysesthesia, headache, lumbar puncture, CSF eosinophilia, travel-related infections, nucleic acid amplification testing, parasitic meningitis, Hawaii

A 30-year-old woman presented with progressive dysesthesia, worsening headache, and confusion following recent travel to Thailand, Japan, and Hawaii. Initially experiencing burning sensations in her f... 4 weeks ago

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When Blurry Vision Clouds the Bigger Picture
Rohan Khazanchi, M.D., M.P.H.; Patricia A. Stoeck, M.D.; Ryan Gise, M.D.; Kather...
systemic lupus erythematosus, childhood-onset SLE, papilledema, intracranial hypertension, lupus nephritis, immunosuppressive therapy, autoantibodies, neuropsychiatric lupus, pediatric rheumatology, corticosteroids

A 14-year-old adolescent presented with a 12-month history of joint pain, intermittent blurry vision, and severe bifrontal headaches. Symptoms worsened over three weeks despite ibuprofen use, leading ... 4 weeks ago

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Westermark’s Sign and Palla’s Sign in Pulmonary Embolism
Yuichiro Shimoyama, M.D.; Yoshitaka Tomoda, M.D., Ph.D.
: pulmonary embolism, Westermark’s sign, Palla’s sign, oligemia, atrial fibrillation, computed tomography pulmonary angiography, anticoagulation therapy, apixaban treatment, emergency medicine

A 90-year-old man with atrial fibrillation and dementia presented with sudden-onset dyspnea, which began one hour before admission. The patient had not been receiving anticoagulation therapy due to pr... 4 weeks ago

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