{"title":"CORE Principles in the Management of Severe Hypertriglyceridemia.","authors":"Pamela B Morris","doi":"10.1056/nejme2517580","DOIUrl":"https://doi.org/10.1056/nejme2517580","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"73 1","pages":"509-510"},"PeriodicalIF":158.5,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Seeing It Through - Lessons from a Retinal Stroke Trial.","authors":"Matthew Schrag,Brian Mac Grory","doi":"10.1056/nejme2514614","DOIUrl":"https://doi.org/10.1056/nejme2514614","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"217 1","pages":"511-512"},"PeriodicalIF":158.5,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peripheral artery disease affects approximately 236 million persons worldwide and is diagnosed with an ankle-brachial index of less than 0.90. Among older persons, 3.3% of those without peripheral artery disease, 18.1% with mild disease, and 52.0% with severe disease could not complete a 6-minute walk test without resting. To prevent cardiovascular events in persons with peripheral artery disease, intensive cholesterol-lowering medications (statins), antiplatelet medications or low-dose aspirin with rivaroxaban, blood-pressure lowering to less than 130/80 mm Hg, and semaglutide are recommended, along with sodium-glucose cotransporter 2 inhibitors in patients with diabetes. Supervised walking exercise and structured home-based walking exercise each improve walking ability in persons with peripheral artery disease. Revascularization in the legs should be reserved for those with persistent disease symptoms that do not respond to exercise.
外周动脉疾病影响全球约2.36亿人，诊断为踝肱指数小于0.90。在老年人中，3.3%没有外周动脉疾病的人、18.1%患有轻度疾病的人和52.0%患有严重疾病的人不能在不休息的情况下完成6分钟步行测试。为了预防外周动脉疾病患者的心血管事件，推荐使用强化降胆固醇药物（他汀类药物）、抗血小板药物或低剂量阿司匹林联合利伐沙班、血压降至低于130/80 mm Hg和西马鲁肽，以及糖尿病患者的钠-葡萄糖共转运蛋白2抑制剂。有监督的步行锻炼和有组织的家庭步行锻炼均可改善外周动脉疾病患者的步行能力。腿部血运重建术应该留给那些对运动没有反应的持续性疾病症状的患者。
{"title":"Peripheral Artery Disease in the Legs.","authors":"Mary M McDermott","doi":"10.1056/nejmcp2501200","DOIUrl":"https://doi.org/10.1056/nejmcp2501200","url":null,"abstract":"Peripheral artery disease affects approximately 236 million persons worldwide and is diagnosed with an ankle-brachial index of less than 0.90. Among older persons, 3.3% of those without peripheral artery disease, 18.1% with mild disease, and 52.0% with severe disease could not complete a 6-minute walk test without resting. To prevent cardiovascular events in persons with peripheral artery disease, intensive cholesterol-lowering medications (statins), antiplatelet medications or low-dose aspirin with rivaroxaban, blood-pressure lowering to less than 130/80 mm Hg, and semaglutide are recommended, along with sodium-glucose cotransporter 2 inhibitors in patients with diabetes. Supervised walking exercise and structured home-based walking exercise each improve walking ability in persons with peripheral artery disease. Revascularization in the legs should be reserved for those with persistent disease symptoms that do not respond to exercise.","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"38 1","pages":"486-496"},"PeriodicalIF":158.5,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shreya Shrestha,Tyler Brown,Jacqueline T Chu,M Lauren Donnelly-Morell
{"title":"Case 4-2026: An 80-Year-Old Woman with Cough and Hypoxemia.","authors":"Shreya Shrestha,Tyler Brown,Jacqueline T Chu,M Lauren Donnelly-Morell","doi":"10.1056/nejmcpc2513543","DOIUrl":"https://doi.org/10.1056/nejmcpc2513543","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"120 1 1","pages":"498-507"},"PeriodicalIF":158.5,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
George Karandinos,Mia Giuriato,José R Zubizarreta,Katherine A Koh,Peter T Masiakos,Zirui Song,Chana A Sacks
BACKGROUNDEvery year, approximately 20,000 youths lose a parent to firearm injury in the United States. Many more youths have parents who sustain nonfatal firearm injuries. The effect of parents' firearm injuries on their children's health and health care is poorly understood.METHODSUsing U.S. commercial health insurance claims data from the 2007-2022 period, we identified youths, 1 to 19 years of age, whose parents had received treatment for firearm injury (exposure). Each youth with exposure was matched with up to five control youths on the basis of year, month, youth sex, metropolitan statistical area, state, insurance plan type, and prescription drug coverage; mean values of age and a risk score predicting future health care use (to provide a proxy for health status) were balanced. The primary outcome was a diagnosis of psychiatric disorder among youths, assessed as a rate, which was defined as the number of youths with at least one related insurance claim in a given month, divided by the total number of youths. Secondary outcomes included substance use disorder diagnosis, health care use, and medical spending. After matching, we estimated the difference in differences in outcomes between the exposure group and the control group 12 months before the parental injury through 12 months after the injury, using a least-squares regression model with adjustment for age and risk score.RESULTSWe examined 3790 youths with exposure and 18,535 matched controls. The mean age of the youths was 10.7 years, and 51.5% were male. Parental firearm injury was associated with 8.4 additional psychiatric diagnoses (95% confidence interval [CI], 4.8 to 12.0) per 1000 youths and 23.1 additional mental health visits (95% CI, 8.2 to 38.1) per 1000 youths as compared with control, averaged over the year. This associated increase in the exposure group was largest for diagnoses of trauma-related disorders, including post-traumatic stress disorder, with an additional 8.5 diagnoses (95% CI, 6.0 to 10.9) per 1000 youths as compared with control, averaged over the year. No apparent changes relative to control were observed in rates of other diagnoses, medical encounters, procedures, and services or in medical spending.CONCLUSIONSParents' firearm injuries were associated with increases in rates of psychiatric disorders and mental health visits among their children. (Funded by the National Institute for Health Care Management and the National Institute of Mental Health.).
{"title":"Mental Health Outcomes in Children after Parental Firearm Injury.","authors":"George Karandinos,Mia Giuriato,José R Zubizarreta,Katherine A Koh,Peter T Masiakos,Zirui Song,Chana A Sacks","doi":"10.1056/nejmsa2502702","DOIUrl":"https://doi.org/10.1056/nejmsa2502702","url":null,"abstract":"BACKGROUNDEvery year, approximately 20,000 youths lose a parent to firearm injury in the United States. Many more youths have parents who sustain nonfatal firearm injuries. The effect of parents' firearm injuries on their children's health and health care is poorly understood.METHODSUsing U.S. commercial health insurance claims data from the 2007-2022 period, we identified youths, 1 to 19 years of age, whose parents had received treatment for firearm injury (exposure). Each youth with exposure was matched with up to five control youths on the basis of year, month, youth sex, metropolitan statistical area, state, insurance plan type, and prescription drug coverage; mean values of age and a risk score predicting future health care use (to provide a proxy for health status) were balanced. The primary outcome was a diagnosis of psychiatric disorder among youths, assessed as a rate, which was defined as the number of youths with at least one related insurance claim in a given month, divided by the total number of youths. Secondary outcomes included substance use disorder diagnosis, health care use, and medical spending. After matching, we estimated the difference in differences in outcomes between the exposure group and the control group 12 months before the parental injury through 12 months after the injury, using a least-squares regression model with adjustment for age and risk score.RESULTSWe examined 3790 youths with exposure and 18,535 matched controls. The mean age of the youths was 10.7 years, and 51.5% were male. Parental firearm injury was associated with 8.4 additional psychiatric diagnoses (95% confidence interval [CI], 4.8 to 12.0) per 1000 youths and 23.1 additional mental health visits (95% CI, 8.2 to 38.1) per 1000 youths as compared with control, averaged over the year. This associated increase in the exposure group was largest for diagnoses of trauma-related disorders, including post-traumatic stress disorder, with an additional 8.5 diagnoses (95% CI, 6.0 to 10.9) per 1000 youths as compared with control, averaged over the year. No apparent changes relative to control were observed in rates of other diagnoses, medical encounters, procedures, and services or in medical spending.CONCLUSIONSParents' firearm injuries were associated with increases in rates of psychiatric disorders and mental health visits among their children. (Funded by the National Institute for Health Care Management and the National Institute of Mental Health.).","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"3 1","pages":"475-485"},"PeriodicalIF":158.5,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel M Fernandes,Alejandro Llanos-Lizcano,Florian Brück,Victoria Oberreiter,Kadir T Özdoğan,Olivia Cheronet,Michaela Lucci,Albert Beckers,Patrick Pétrossians,Alfredo Coppa,Ron Pinhasi,Adrian F Daly
{"title":"A 12,000-Year-Old Case of NPR2-Related Acromesomelic Dysplasia.","authors":"Daniel M Fernandes,Alejandro Llanos-Lizcano,Florian Brück,Victoria Oberreiter,Kadir T Özdoğan,Olivia Cheronet,Michaela Lucci,Albert Beckers,Patrick Pétrossians,Alfredo Coppa,Ron Pinhasi,Adrian F Daly","doi":"10.1056/nejmc2513616","DOIUrl":"https://doi.org/10.1056/nejmc2513616","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"42 1","pages":"513-515"},"PeriodicalIF":158.5,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Blumenthal, Elizabeth Fowler, Gretchen Jacobson
{"title":"Medicare's Role in Fighting Chronic Disease.","authors":"David Blumenthal, Elizabeth Fowler, Gretchen Jacobson","doi":"10.1056/NEJMp2514040","DOIUrl":"https://doi.org/10.1056/NEJMp2514040","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":78.5,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inheritance.","authors":"Eve Rittenberg","doi":"10.1056/NEJMp2508330","DOIUrl":"https://doi.org/10.1056/NEJMp2508330","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":78.5,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Toxic Erythema of Chemotherapy.","authors":"Shihua Ling, Xia Dou","doi":"10.1056/NEJMicm2513411","DOIUrl":"https://doi.org/10.1056/NEJMicm2513411","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":78.5,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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