NEJM evidence最新文献

{"title":"Validation of a Salivary miRNA Signature of Endometriosis - Interim Data.","authors":"","doi":"10.1056/EVIDx2600264","DOIUrl":"https://doi.org/10.1056/EVIDx2600264","url":null,"abstract":"","PeriodicalId":74256,"journal":{"name":"NEJM evidence","volume":" ","pages":"EVIDx2600264"},"PeriodicalIF":11.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E-Cigarette and Nicotine Pouch Use Among Youth, United States, 2025.","authors":"Elizabeth L Seaman Jones, Jamie Cordova, Nina Hoffmeyer, Lauren R Pacek, Cristine D Delnevo, Michael A Tynan, Kristy Marynak","doi":"10.1056/EVIDpha2600171","DOIUrl":"https://doi.org/10.1056/EVIDpha2600171","url":null,"abstract":"<p><p>AbstractThe e-cigarette and nicotine pouch product landscape changes rapidly. Using publicly available data from the 2025 National Youth Tobacco Survey, we assessed prevalence, flavors, and brands of e-cigarettes and nicotine pouches used by U.S. middle and high school students. E-cigarettes were the most common tobacco product reportedly used, followed by nicotine pouches. Nearly all youth who used e-cigarettes or nicotine pouches used flavored products, especially fruit-flavored e-cigarettes and mint-flavored nicotine pouches. Geek Bar was the e-cigarette brand and ZYN the nicotine pouch brand most frequently used among youth in 2025. Multilevel youth tobacco prevention efforts, including consistent surveillance, remain critical.</p>","PeriodicalId":74256,"journal":{"name":"NEJM evidence","volume":" ","pages":"EVIDpha2600171"},"PeriodicalIF":11.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Hat Trick for RSV Vaccines - Prevention of Disease, Hospitalization, and Beyond.","authors":"Helen Y Chu, Kirby Erlandson","doi":"10.1056/EVIDe2600275","DOIUrl":"10.1056/EVIDe2600275","url":null,"abstract":"","PeriodicalId":74256,"journal":{"name":"NEJM evidence","volume":" ","pages":"EVIDe2600275"},"PeriodicalIF":11.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atenolol or Bisoprolol after Myocardial Infarction without Recorded Heart Failure.","authors":"Thomas Laurenceau, Ugo Meli, Louise Z Wang, Richard Chocron, Pierre Cezard, Emma Menant, Frankie Beganton, Jean-Philippe Empana, Emmanuel Bacry, Xavier Jouven","doi":"10.1056/EVIDoa2600138","DOIUrl":"10.1056/EVIDoa2600138","url":null,"abstract":"<p><strong>Background: </strong>Beta-blockers are a cornerstone of therapy following myocardial infarction. The effect of different β-blockers on the outcomes of patients without heart failure after myocardial infarction is not well-studied.</p><p><strong>Methods: </strong>This observational cohort study used administrative data from French National Health Data System. Eligible patients were 18 years of age or older, hospitalized in the Paris area between January 1, 2008, and December 31, 2018, with a new myocardial infarction, and were dispensed either atenolol or bisoprolol within 2 days of hospital discharge. Patients prescribed β-blockers or loop diuretics or with a recorded diagnosis of heart failure (based on International Classification of Diseases, 10th Revision codes) during the 2 years preceding hospital discharge were excluded. Outcomes were followed for up to 2 years following hospital discharge and included major adverse cardiovascular events (cardiac arrest, all-cause mortality, reinfarction, stroke, or hospitalization for heart failure) (primary outcome) and all-cause mortality (secondary outcome). Targeted maximum likelihood estimation was used to estimate the average treatment effects (ATEs) comparing patients initiated on atenolol versus bisoprolol.</p><p><strong>Results: </strong>Among 11,558 patients, 1523 (13.2%) initiated atenolol and 10,035 (86.8%) initiated bisoprolol within 2 days of discharge. Comparing the atenolol group to the bisoprolol group, the ATE was 2.9 percentage points (95% confidence interval [CI], 1.1-4.7) for major adverse cardiovascular events and 0.6 percentage points (95% CI, -0.2 to 1.3) for all-cause mortality. The weighted proportions of patients experiencing major adverse cardiovascular events were 10.8% and 14.1% in the atenolol and bisoprolol groups, respectively. The weighted proportions of patients experiencing all-cause mortality were 1.4% and 2.2% in the atenolol and bisoprolol groups, respectively.</p><p><strong>Conclusions: </strong>Among patients without recorded characteristics in an administrative database suggesting the presence of heart failure, initiation of atenolol after myocardial infarction was associated with a lower risk of major adverse cardiovascular events, but not all-cause mortality, at 2 years compared with bisoprolol. (Funded by PRAIRIE and others.).</p>","PeriodicalId":74256,"journal":{"name":"NEJM evidence","volume":"5 10","pages":"EVIDoa2600138"},"PeriodicalIF":11.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Class Effect - Does Beta-Blocker Choice Matter after Myocardial Infarction?","authors":"Jose-Angel Perez-Rivera, Fabian Blanco-Fernandez","doi":"10.1056/EVIDe2600289","DOIUrl":"https://doi.org/10.1056/EVIDe2600289","url":null,"abstract":"","PeriodicalId":74256,"journal":{"name":"NEJM evidence","volume":"5 10","pages":"EVIDe2600289"},"PeriodicalIF":11.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An 18-Year-Old Woman with Abdominal Pain.","authors":"Aleeya Shareef, Matthew Dawson, Jordan Wright, Michael Vish","doi":"10.1056/EVIDmr2500146","DOIUrl":"https://doi.org/10.1056/EVIDmr2500146","url":null,"abstract":"<p><p>AbstractMorning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the story of an 18-year-old woman who presented to the emergency department with acute abdominal pain. Using questions, physical examination, and testing, an illness script for the presentation emerges; as the clinical course evolves, the differential is refined until a final diagnosis is made.</p>","PeriodicalId":74256,"journal":{"name":"NEJM evidence","volume":"5 10","pages":"EVIDmr2500146"},"PeriodicalIF":11.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metoprolol in Chronic Obstructive Pulmonary Disease without Cardiovascular Disease.","authors":"Josefin Sundh, Anders Magnuson, Marika Kvarnström, Folke Sjöberg, Magnus Ekström, Johan SanMartin Berglund, David Ellingsen, Daniel Wilhelms, Mikael Hasselgren, Sara Fristorp Cesarini, Katarina Berndtsson Blom, Anders Blomberg, Lowie E G W Vanfleteren, Andreas Palm, Carolina Smith, Lina Renström, Jens Ellingsen, Christer Janson, Martin Lundvall, Florim Delijaj, Elsa Norberg, Beatrice Larsson, Taivo Kipper, Zaky Chowdhury, Emily Jensen, Henning Stenberg, Maria Hårdstedt, Zainab Ahmadi, Kaveh Azizi, Wolfgang Greger, Scott Montgomery, Ole Fröbert","doi":"10.1056/EVIDoa2600231","DOIUrl":"10.1056/EVIDoa2600231","url":null,"abstract":"<p><strong>Background: </strong>Beta-blockers may improve outcomes in patients with chronic obstructive pulmonary disease (COPD) without cardiovascular disease, but randomized trials have been inconclusive.</p><p><strong>Methods: </strong>This was a multicenter, open-label, pragmatic, phase 4 randomized trial. Patients 40 years of age or older with COPD, sinus rhythm, and no cardiovascular disease were randomly assigned in a 1:1 ratio to receive metoprolol, at a target dose of 100 mg daily, in addition to standard care or to receive standard care alone. The primary end point was the time to the first occurrence of a COPD exacerbation, cardiovascular event, or death during 1 year of follow-up.</p><p><strong>Results: </strong>A total of 1695 patients underwent random assignment; their mean age was 70 years, and 62% were female. The primary end point occurred in 27% of patients assigned to receive metoprolol and in 30% assigned to receive standard care (hazard ratio, 0.87; 95% confidence interval [CI], 0.73 to 1.05; P=0.14). The corresponding hazard ratios were 0.88 (95% CI, 0.72 to 1.06) for COPD exacerbations, 0.73 (95% CI, 0.48 to 1.11) for cardiovascular events, 0.92 (95% CI, 0.48 to 1.77) for death, and 0.87 (95% CI, 0.58 to 1.28) for exacerbations requiring hospitalization. Serious adverse events occurred in 80 (9.4%) of 848 participants in the metoprolol group and 66 (7.8%) of 847 participants in the standard care group. Nonserious adverse events occurred in 293 (34.6%) of 848 patients in the metoprolol group and 247 (29.2%) of 847 in the standard care group.</p><p><strong>Conclusions: </strong>Among patients with COPD and no cardiovascular disease, metoprolol did not significantly improve the time to a composite of exacerbations, cardiovascular events, or death. (Funded by research grants from the Swedish Research Council and others; ClinicalTrials.gov number, NCT03566667.).</p>","PeriodicalId":74256,"journal":{"name":"NEJM evidence","volume":" ","pages":"EVIDoa2600231"},"PeriodicalIF":11.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-Blockers in COPD - Getting to the Heart of the Issue.","authors":"R Chad Wade, Mark T Dransfield","doi":"10.1056/EVIDe2600306","DOIUrl":"10.1056/EVIDe2600306","url":null,"abstract":"","PeriodicalId":74256,"journal":{"name":"NEJM evidence","volume":" ","pages":"EVIDe2600306"},"PeriodicalIF":11.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyclosporiasis Outbreak in Michigan, May-July 2026 - An Interim Report.","authors":"Meena N Hasan, Heather L Leahy, Justin Henderson, Jeremy Kuo, Shannon Johnson, Tiffany Henderson, Danielle Donovan, Katherine Arends, Scott Schreiber, Lauren Edwards, James Barber, Meghan Weinberg, Joyce Lai, Joseph Coyle, Fatema Mamou, Seth Eckel, Jevon McFadden, Sarah Lyon-Callo, Natasha Bagdasarian","doi":"10.1056/EVIDpha2600277","DOIUrl":"10.1056/EVIDpha2600277","url":null,"abstract":"<p><p>AbstractIn June 2026, Michigan identified a cyclosporiasis outbreak; the number of reported cases substantially exceeded the usual number of seasonal reports. As of July 22, 2026, 6065 cases had been reported across 69 of Michigan's 83 counties, with dates of illness onset ranging from May 10 through July 18, 2026. Food history data, obtained from 51.3% of patients, indicated that iceberg lettuce and consumption at one restaurant chain were potential exposure sources. This report describes Michigan's ongoing outbreak investigation.</p>","PeriodicalId":74256,"journal":{"name":"NEJM evidence","volume":" ","pages":"EVIDpha2600277"},"PeriodicalIF":11.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Durability of RSV Prefusion F Vaccine Protection across Two RSV Seasons.","authors":"Mats C H Lassen, Niklas Dyrby Johansen, Sine H Christensen, Abby E Rudolph, Kristoffer G Skaarup, Daniel Modin, Brian L Claggett, Carsten S Larsen, Lykke Larsen, Lothar Wiese, Michael Dalager-Pedersen, Matias G Lindholm, Anne Marie R Jensen, Maria Dons, Katrine F Bernholm, Filip S Davidovski, Lisa S Duus, Camilla I Ottosen, Anne B Nielsen, Julie H Borchsenius, Caroline Espersen, Güldas Köse, Frederik H Fussing, Marat Yafasov, Manan Pareek, Lars Køber, Scott D Solomon, Jens Ulrik Stæhr Jensen, Cyril Jean-Marie Martel, Negar Aliabadi, Bradford D Gessner, Claudia Schwarz, Mette Skovdal, Pingping Zhang, Sabrina Welsh, Elizabeth Begier, Tor Biering-Sørensen","doi":"10.1056/EVIDoa2600242","DOIUrl":"10.1056/EVIDoa2600242","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is an important cause of hospitalization and death among older adults. Although first-season vaccine effectiveness against RSV-related hospitalization has been demonstrated for the bivalent RSV prefusion F protein-based vaccine (RSVpreF), data regarding the durability of protection beyond a single RSV season are lacking.</p><p><strong>Methods: </strong>In a pragmatic, open-label trial with individual randomization, participants 60 years of age or older were assigned in a 1:1 ratio to receive RSVpreF vaccine or no vaccine during the 2024-2025 winter season. Participants were followed through the 2025-2026 winter season to evaluate protection across two consecutive RSV seasons after a single vaccine dose. The primary endpoint was RSV-related respiratory tract disease (RTD) hospitalization. Secondary endpoints included RSV-related and all-cause lower respiratory tract disease hospitalization, all-cause respiratory hospitalization, all-cause cardiorespiratory hospitalization, and all-cause mortality.</p><p><strong>Results: </strong>Of 131,379 participants who underwent random assignment, 130,991 were included in the intention-to-treat population during the second season. During the second RSV season, the incidence rate of RSV-related RTD hospitalization was 0.11 events per 1000 person-years in the RSVpreF group and 0.25 events per 1000 person-years in the control group, corresponding to a vaccine effectiveness of 56.2% (95% confidence interval [CI], -12.4% to 84.8%), as compared with 83.3% (95% CI, 42.9%-96.9%) during the first season. Across both seasons, the corresponding incidence rates were 0.11 and 0.37 events per 1000 person-years in the RSVpreF and control groups, respectively, with a vaccine effectiveness of 70.6% (95% CI, 39.1%-87.0%). There was no apparent difference in all-cause respiratory and cardiorespiratory hospitalization outcomes in the second season among those randomly assigned to vaccine or no vaccine in the first season.</p><p><strong>Conclusions: </strong>Among adults 60 years of age or older, the RSVpreF vaccine was associated with a lower incidence of RSV-related respiratory tract disease during a second RSV season as compared to no vaccine. Vaccine effectiveness estimates appeared to be lower in the second season compared to the first. (Funded by Pfizer; ClinicalTrials.gov number, NCT06684743.).</p>","PeriodicalId":74256,"journal":{"name":"NEJM evidence","volume":" ","pages":"EVIDoa2600242"},"PeriodicalIF":11.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}