New England Journal of Medicine最新文献

{"title":"Acrometastases.","authors":"Harriet O'Rourke, Mahesh Iddawela","doi":"10.1056/NEJMicm2501158","DOIUrl":"https://doi.org/10.1056/NEJMicm2501158","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"393 3","pages":"289"},"PeriodicalIF":96.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651224","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":"New Perioperative Strategy in Gastric Cancer.","authors":"Kohei Shitara","doi":"10.1056/nejme2507207","DOIUrl":"https://doi.org/10.1056/nejme2507207","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"13 1","pages":"302-303"},"PeriodicalIF":158.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645956","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":"Microcysts in Lithium-Induced Nephropathy.","authors":"Cheng-Hung Liao, Kao-Lang Liu","doi":"10.1056/NEJMicm2500259","DOIUrl":"10.1056/NEJMicm2500259","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":"e3"},"PeriodicalIF":96.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638733","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":"Apixaban for Cancer-Associated Venous Thromboembolism. Reply.","authors":"Isabelle Mahé, Marc Carrier, Silvy Laporte","doi":"10.1056/NEJMc2506526","DOIUrl":"https://doi.org/10.1056/NEJMc2506526","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"393 3","pages":"311-312"},"PeriodicalIF":96.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651264","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":"Apixaban for Cancer-Associated Venous Thromboembolism.","authors":"Yong Jie Ding, Ke Huang, Qing Yun Li","doi":"10.1056/NEJMc2506526","DOIUrl":"10.1056/NEJMc2506526","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"393 3","pages":"310"},"PeriodicalIF":96.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651263","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":"Rapid Recovery of Donor Hearts for Transplantation after Circulatory Death.","authors":"Aaron M Williams,John M Trahanas,Swaroop Bommareddi,Brian Lima,Stephen A DeVries,Joshua Lowman,Awab Ahmad,Eric Quintana,Shelley R Scholl,Stacy Tsai,Dawn Pedrotty,Matthew Warhoover,Harry Moneypenny,Stephen Tapia-Ruano,Matthew Bacchetta,Kelly Schlendorf,Ashish S Shah","doi":"10.1056/nejmoa2500456","DOIUrl":"https://doi.org/10.1056/nejmoa2500456","url":null,"abstract":"We report a method for the recovery of hearts for transplantation from deceased donors after circulatory death that obviates the need for thoracoabdominal normothermic regional perfusion or ex situ perfusion systems. After death, the aorta is clamped and a flush circuit is established to perform a controlled, extended, ultraoxygenated flush of the donor heart at a mean aortic-root pressure of 80 mm Hg. In the first three reported cases in which this method was used, the hearts were transplanted successfully with normal biventricular function, no evidence of acute cellular or antibody-mediated rejection, and excellent early postoperative outcomes. No adverse events were reported during the perioperative period. By avoiding the limitations of ex situ perfusion platforms as well as the controversial aspects of thoracoabdominal normothermic regional perfusion, this method of heart recovery offers the possibility of broad application.","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"17 1","pages":"267-274"},"PeriodicalIF":158.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645757","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":"Case 20-2025: An 86-Year-Old Woman with Neck Swelling and Dysphagia.","authors":"Matthew L Russell,Javier M Romero,Christopher J Kwolek,Kevin A Raskin,Yin P Hung","doi":"10.1056/nejmcpc2412527","DOIUrl":"https://doi.org/10.1056/nejmcpc2412527","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"13 1","pages":"290-300"},"PeriodicalIF":158.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645959","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":"Apixaban for Cancer-Associated Venous Thromboembolism.","authors":"Vincenza Conteduca, Guido Giordano, Matteo Landriscina","doi":"10.1056/NEJMc2506526","DOIUrl":"10.1056/NEJMc2506526","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"393 3","pages":"310-311"},"PeriodicalIF":96.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651262","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":"Graft-versus-Host Disease Prophylaxis with Cyclophosphamide and Cyclosporin.","authors":"David J Curtis, Sushrut S Patil, John Reynolds, Duncan Purtill, Clinton Lewis, David S Ritchie, David J Gottlieb, David T Yeung, Eric Wong, Siok-Keen Tey, Travis Perera, John Moore, Rachel M Koldej, Richard De Abreu Lourenco, John Stubbs, C Orla Morrissey, Nadia Munsef, Andrea Arenas, Geoffrey R Hill","doi":"10.1056/NEJMoa2503189","DOIUrl":"10.1056/NEJMoa2503189","url":null,"abstract":"<p><strong>Background: </strong>Allogeneic peripheral-blood stem-cell transplantation (SCT) from a matched related donor after myeloablative conditioning is the preferred curative treatment for patients with high-risk blood cancers. The combination of a calcineurin inhibitor and an antimetabolite remains standard care for graft-versus-host disease (GVHD) prophylaxis in these patients. Data from two randomized trials have suggested that post-transplantation cyclophosphamide can reduce the risk of GVHD after SCT from a matched donor when it is added to or replaces the antimetabolite. However, the effects of post-transplantation cyclophosphamide specifically after SCT from a matched related donor remain uncertain, and effects in the context of myeloablative conditioning are unclear.</p><p><strong>Methods: </strong>We randomly assigned adults who were undergoing SCT from a matched related donor after myeloablative or reduced-intensity conditioning to receive either post-transplantation cyclophosphamide-cyclosporin (experimental prophylaxis) or cyclosporin-methotrexate (standard prophylaxis). The primary end point was GVHD-free, relapse-free survival.</p><p><strong>Results: </strong>Among 134 patients who underwent randomization, 66 were assigned to receive experimental prophylaxis and 68 to receive standard prophylaxis. GVHD-free, relapse-free survival was significantly longer with experimental prophylaxis (median, 26.2 months; 95% confidence interval [CI], 9.1 to not reached) than with standard prophylaxis (median, 6.4 months; 95% CI, 5.6 to 8.3; P<0.001 by a log-rank test). GVHD-free, relapse-free survival at 3 years was 49% (95% CI, 36 to 61) with experimental prophylaxis and 14% (95% CI, 6 to 25) with standard prophylaxis (hazard ratio for GVHD, relapse, or death, 0.42; 95% CI, 0.27 to 0.66). The cumulative incidence of grade III to IV acute GVHD at 3 months was 3% (95% CI, 1 to 10) in the experimental-prophylaxis group and 10% (95% CI, 4 to 19) in the standard-prophylaxis group. At 2 years, overall survival was 83% and 71%, respectively (hazard ratio for death, 0.59; 95% CI, 0.29 to 1.19). The incidence of serious adverse events was similar in the two groups in the first 100 days after SCT.</p><p><strong>Conclusions: </strong>The combination of post-transplantation cyclophosphamide and a calcineurin inhibitor led to longer GVHD-free, relapse-free survival than standard prophylaxis after transplantation from a matched related donor with either reduced-intensity or myeloablative conditioning in patients with blood cancers. (Funded by the Australian Government Medical Research Future Fund and others; ALLG BM12 CAST Australian-New Zealand Clinical Trials Registry number, ACTRN12618000505202.).</p>","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":"243-254"},"PeriodicalIF":96.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289760","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":"The Spectrum of Fragile X Disorders.","authors":"Randi Jenssen Hagerman,Paul J Hagerman","doi":"10.1056/nejmra2300487","DOIUrl":"https://doi.org/10.1056/nejmra2300487","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"15 1","pages":"281-288"},"PeriodicalIF":158.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645958","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}