NEJM 18 December 2014 Vol 371 2353 Try to make winter bearable by thinking of the joys of late spring, such as seeing laburnum trees in full blossom. But you need to have plenty of garden space for the brief show they provide, and you also need to warn children against their poisonous seeds. This […]
NEJM 11 December 2014 Vol 371 OL The clones! The clones! There is something of Edgar Allen Poe about this study, which describes how “clonal hematopoiesis with somatic mutations is readily detected by means of DNA sequencing, is increasingly common as people age, and is associated with increased risks of hematologic cancer and death.” “Heh, […]
NEJM 4 December 2014 Vol 371 2227 “We need to remember that these drugs also have toxic effects, they are enormously and inappropriately expensive, and they haven’t cured anyone yet. It is premature to be opening the victory champagne bottles.” Yes, this editorial refers to a new drug class for cancers—the ALK inhibitors. But it […]
NEJM 27 November 2014 Vol 371 2061 Antoine Bernard-Jean Marfan (1858-1942) was a French paediatrician who lived in the happy era of medicine when you could affix your name to new signs, symptoms, laws, and syndromes, and Marfan bagged at least one of each for himself. But, ironically, his name is immortalised by a syndrome […]
NEJM 20 November 2014 Vol 371 1963 The melanoma trials last week got me thinking about how the current model of cancer drug research lets down trial participants and dying patients. Between 2002 and 2014, there have been 71 drug approvals by the Food and Drug Administration (FDA) for the treatment of metastatic and/or advanced and/or […]
NEJM 13 November 2014 Vol 371 1867 “Metastatic melanoma remains just over the border of curability. As we wait and hope for some breakthrough in an agonizingly incremental process, there will be more trials like this one,” I wrote last week about a paper in JAMA. They haven’t been long coming. The two in this […]
NEJM 6 November 2014 Vol 371 1771 The first paper in the New England Journal this week describes a French trial of rituximab versus azathioprine for maintenance in ANCA associated vasculitis. “At month 28, major relapse had occurred in 17 patients in the azathioprine group (29%) and in 3 patients in the rituximab group (5%) […]
NEJM 30 October 2014 Vol 371 1685 The treatment of childhood and adolescent cancer is territory that most of us don’t trespass on, but we’ll need to go there this week just to have something to read about. JAMA is taking a Halloween break and the others seem to be going into an end of year […]
NEJM 22 October 2014 Vol 371 1577 The whole point about tuberculosis is that it is slow. The discoverer of its causative organism, Robert Koch, called it the fungus-germ, or Mycobacterium. It takes 20 times longer to divide than most other bacteria. It is only after years of division that it can do terrible things. […]
NEJM 16 October 2014 Vol 371 1507 I hate military metaphors for cancer as much as anybody, but here is a study which describes hell in the leukaemia trenches. The 30 patients in the trial had acute lymphoblastic leukaemia. The youngest was 5 years old; most were under 20. All of them had relapsed after […]