Professor
Brian Andrews NEJM Recommendations for Medical Students and Tutors
Week
of 19th January 2017 (#78)
University
of Notre Dame Australia (Fremantle Campus)
Occasional Editorial Comment
None
Must Read Articles
Perspective
Psychocatalytic
Benefits of the Unexpected
Few
doctors would say they deliberately try to catch their patients off guard, but
doing so under the right circumstances can have what might be called
“psychocatalytic” effects, triggering or crystallizing a change in perspective.
REVIEW ARTICLE
Mechanisms,
Pathophysiology, and Management of Obesity
Obesity
is prevalent in the U.S. population and contributes significantly to morbidity
and mortality. Treatments include behavioral therapy, pharmacotherapy, and
bariatric surgery. Some sequelae of obesity are reversed with weight loss.
Maintaining weight loss is a challenge.
EDITORIAL
B-Cell
Depletion — A Frontier in Monoclonal Antibodies for Multiple Sclerosis
Articles Recommended for Medical Students
CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL
Case
2-2017 — An 18-Year-Old Woman with Acute Liver Failure
An
18-year-old woman presented with acute liver failure. The total bilirubin was
19.7 mg per deciliter. Three days earlier, she had received a diagnosis of
bronchitis and was treated with azithromycin. A diagnosis was made.
Perspective
Transparency
and Trust — Online Patient Reviews of Physicians
With
Yelp forcing the issue of publicly available patient ratings of doctors, health
care organizations need to consider the goals of transparency efforts, how they
can best be achieved, whose responsibility it is, and the best venues for such
data sharing.
IMAGES IN CLINICAL MEDICINE
Serrated
Marine Nose
A
37-year-old woman taking adalimumab for ankylosing spondylitis presented with
ulcerations with a hemorrhagic crust over her nose. Two waterborne organisms
grew in biopsy samples obtained from the ulcers.
IMAGES IN CLINICAL MEDICINE
Swirl
Sign — Intestinal Volvulus after Roux-en-Y Gastric Bypass
A 56-year-old
man who had undergone gastric bypass 7 years earlier presented with
midabdominal pain, nausea, and bilious emesis. Swirling of the bowel and
mesenteric vessels, shown in a video, was noted on CT.
ORIGINAL ARTICLE
Transmission
of Extensively Drug-Resistant Tuberculosis in South Africa
This
study from South Africa showed that extensively drug-resistant tuberculosis, an
emerging global public health threat, is largely associated with transmission
of drug-resistant strains rather than new emergence of drug resistance.
Important Articles Related to Mechanisms of Disease and
Translational Research
CLINICAL IMPLICATIONS OF BASIC RESEARCH
Antibodies
to Mycobacterium tuberculosis
Two
studies shed light on and underscore the functional importance of the humoral
immune response to infection by M. tuberculosis.
Other Articles which should interest medical students
None
New and Novel Therapies
ORIGINAL ARTICLE
Ocrelizumab
versus Placebo in Primary Progressive Multiple Sclerosis
Patients
with primary progressive MS who received the anti-CD20+ humanized antibody
ocrelizumab were less likely to have clinical deterioration that was sustained
for 12 weeks than those who received placebo. The drug was associated with
decreased lesion activity on MRI.
ORIGINAL ARTICLE
Ocrelizumab
versus Interferon Beta-1a in Relapsing Multiple Sclerosis
In
two trials involving patients with relapsing multiple sclerosis, the anti-CD20+
monoclonal antibody ocrelizumab was associated with lower annualized relapse
rates, lower risk of disability progression, and better MRI features than
interferon beta-1a.
