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A dying patient in a state psychiatric hospital has no access to a DNR order that would make the process as peaceful as possible — as the notorious Bedlam casts a shadow over mental health care to this day.
Author: Richard Elledge
Posted: September 10, 2026, 12:00 am
A 65-year-old man was admitted to this hospital because of fever, intermittent abdominal pain, and rash. The fever began 5 weeks earlier, and palpable purpura developed 1 week before admission. A diagnosis was made.
Author: Jacqueline T. Chu, Robert G. Rasmussen, Jacquelyn M. Nestor, Mack Y. Su
Posted: September 10, 2026, 12:00 am
In older adults without cardiovascular disease, treatment with atorvastatin led to a lower risk of major cardiovascular events than placebo at a median of 5.9 years but did not result in longer disability-free survival.
Author: Sophia Zoungas, Rory Wolfe, Chris Moran, Stephen J. Nicholls, Geoffrey C. Cloud, Christopher M. Reid, Andrew M. Τonkin, Lawrence Beilin, Anthony S. Wierzbicki, Trevor T.-J. Chong, Jonathan C. Broder, Andrea J. Curtis, Zachary Flanagan, Ingrid Hopper, Joanne Ryan, Simone Spark, John J. McNeil, Mark R. Nelson, the STAREE Investigators
Posted: August 29, 2026, 12:00 am
As the health of his brother and running buddy rapidly declines and he faces his own health scares, a physician feels compelled — and grateful — to keep moving forward.
Author: James T. Rosenbaum
Posted: August 13, 2026, 12:00 am
Since Dr. Phillip Hench reported on the efficacy of glucocorticoids for rheumatoid arthritis in 1949, glucocorticoids have saved many lives and have offered relief to countless patients. Glucocorticoids have been used as the mainstay of treatment for many immune-mediated inflammatory diseases, including polymyalgia rheumatica and giant-cell arteritis (GCA), owing to...
Author: Yoshiya Tanaka
Posted: August 13, 2026, 12:00 am
Among patients with relapsed polymyalgia rheumatica, treatment with secukinumab plus a 24-week glucocorticoid taper resulted in a higher percentage of patients with remission than a glucocorticoid taper alone.
Author: John H. Stone, Frank Buttgereit, Alain Saraux, Wolfgang A. Schmidt, Christian Dejaco, Robert Spiera, Bhaskar Dasgupta, Edit Drescher, Andrew Jordan, Libor Novosad, Daiki Nakagomi, Yoshinobu Koyama, Sergio Duran-Barragan, Gerald Tracey, Adeline Ruyssen-Witrand, Andrea Rubbert Roth, Juanzhi Fang, Jennifer Ng, Renuka Hiremath, Roselyne Raffner, Ruvie Martin, Silvia Napoletano, Songqiao Huang, Julian Storim, Manmath Patekar, the REPLENISH Investigators*
Posted: August 13, 2026, 12:00 am
This review summarizes the classification, evaluation, risk stratification, and management of syncope. History, examination, electrocardiography, and orthostatic blood-pressure measurement identify the cause in most patients.
Author: Rose Anne Kenny
Posted: August 6, 2026, 12:00 am
As legislative support for medical aid in dying grows, the paradox at the heart of this option, with its broader-than-expected benefits, becomes increasingly clear: its expansion hinges on its rarity.
Author: Mara Buchbinder
Posted: July 30, 2026, 12:00 am
As his physician-father’s neurologic health suddenly deteriorates, a physician-son takes notes. With his usual compartmentalization failing him, he knows he can at least bear witness to his father’s decline.
Author: Steven McGaughey
Posted: July 16, 2026, 12:00 am
The United States faces a projected shortage of millions of long-term–care workers by 2040. Yet in each area where progress could help address this gap, federal policy is moving in the wrong direction.
Author: Andrew R. Olenski, David C. Grabowski
Posted: July 9, 2026, 12:00 am
A rapid growth in the population of older Americans has long been anticipated. But projections didn’t anticipate that this transition would coincide with a sustained reduction in nursing-home services.
Author: Mark A. Unruh, Vincent Mor, Hye-Young Jung
Posted: July 9, 2026, 12:00 am
Growing acceptance of voluntary euthanasia, which opens the door to death by organ donation, warrants a recontextualization of the dead donor rule and assessment of the ethical principles involved.
Author: Carter Winberg, Ian Ball, Robert D. Truog
Posted: July 9, 2026, 12:00 am
An ICU physician believed letting her father die at home meant comfort, dignity, control, family close by, and the quiet reassurance of hospice. But she didn’t realize what it would require of her family.
Author: Danielle D. DeCourcey
Posted: July 9, 2026, 12:00 am
Patients with shrinking cognitive bandwidth may feel their disability keenly in daily life, even if they can pass a controlled test of cognitive capacity. How should clinicians approach and care for them?
Author: Jan Stubberud
Posted: July 2, 2026, 12:00 am
This review summarizes advances in the treatment of multiple sclerosis, with emphasis on effective disease-modifying therapies for relapsing disease and the need for better treatments to prevent progression and rebuild myelin.
Author: Stephen L. Hauser
Posted: July 2, 2026, 12:00 am
Observations in Down syndrome were critical to Alzheimer’s disease discoveries. But persons with Down syndrome have historically been excluded from trials relying on insights derived from their biology.
Author: Michael S. Rafii
Posted: June 18, 2026, 12:00 am
Post-thrombotic syndrome is the most common chronic complication of deep-vein thrombosis (DVT), affecting 20 to 50% of patients with DVT and causing debilitating symptoms involving the limbs — including pain, swelling, skin changes, and venous ulcers — that substantially reduce quality of life and impose considerable socioeconomic burden.1 ...
Author: Ronald Luiz Gomes Flumignan, Luís Carlos Uta Nakano
Posted: June 18, 2026, 12:00 am
Among patients with moderate or severe PTS, the addition of endovascular therapy to standard care resulted in less severe PTS and better quality of life at 6 months than standard care alone but with a higher risk of bleeding.
Author: Suresh Vedantham, Susan R. Kahn, William A. Marston, Ido Weinberg, Akhilesh K. Sista, Elizabeth A. Magnuson, David J. Cohen, Suman M. Wasan, Mahmood K. Razavi, Samuel Z. Goldhaber, Kristen M. Sanfilippo, Anthony J. Comerota, Ezana M. Azene, Cassius Iyad Ochoa Chaar, Daniel A. Leung, K. Pallav Kolli, Sanjeeva P. Kalva, Nassir Rostambeigi, Ajinkya Desai, Kush R. Desai, Alfonso J. Tafur, Bhavraj Khalsa, Elaine Majerus, Borong Wang, Yang Wang, Patricia Nieters, Mary Clare Derfler, Angela Oliver, Cassandra Hardy, Riyaz Bashir, Ronald Winokur, Natalie Weger, Minhaj S. Khaja, Aditya Sharma, Naganathan Mani, Pavan Kavali, Siddhant Thukral, Leslie L. Lake, Kathryn Mikkelsen, Sameer Parpia, the C-TRACT Trial Investigators*
Posted: June 18, 2026, 12:00 am
One way to classify acute ischemic stroke is by the anatomy of vessel occlusion. Initial randomized trials of endovascular thrombectomy focused on large-vessel occlusions.1-5 These proximal occlusions of the intracranial carotid artery or the stem of the middle cerebral artery (MCA) represent the most severe form of anterior...
Author: Johanna M. Ospel, Michael D. Hill
Posted: May 14, 2026, 12:00 am
Among patients with stroke due to medium-vessel occlusion, thrombectomy led to functional independence at 90 days (in 58.6% of patients, vs. 46.6% with medical management) but also to a higher risk of intracranial hemorrhage.
Author: Wei Hu, Xiaozhong Jing, Zhongjun Chen, Jin Zheng, Tingyu Yi, Tuanyuan Zheng, Zhide Li, Junzhong Liu, Tao Cui, Jianshang Wen, Ganghua Feng, Cunfeng Song, Lei Yang, Shunfu Jiang, Lin Tong, Changchun Jiang, Zhongfan Ruan, ˒Peiyang Zhou, Shouchun Wang, Tao Wang, Zhiming Zhou, Youquan Ren, Tao Qiu, Chong Zheng, Hao Wang, Yong Liu, Yun Luo, Jing Wang, Zhengfei Ma, Bin Mei, Yong Liang, Yuyou Zhu, Rui Li, Jun Sun, Li Wang, Chao Zhang, Tianlong Liu, Jianlong Song, Chunrong Tao, Anmo Wang, Jinjing Wang, Pengfei Xu, Xiaofan Guo, Liqi Shu, Adnan I. Qureshi, Thanh N. Nguyen, Mohamad AbdalKader, Jeffrey L. Saver, Wenhuo Chen, Raul G. Nogueira
Posted: May 14, 2026, 12:00 am