The New England Journal of Medicine

09/06/2025

A 75-year-old man presented with a 3-week history of fatigue and palpitations. Bulging of the biceps during elbow flexion was noted. ECG showed low-voltage QRS complexes, and echocardiography showed left ventricular hypertrophy.

09/05/2025

A 37-year-old woman presented with a 4-day history of pain, swelling, and bruising on the upper portion of her left knee after using a massage gun. She reported no other bruising or bleeding apart from chronic menorrhagia.

09/05/2025

A previously healthy 42-year-old man presented with a 20-day history of an expanding, asymptomatic rash on his trunk. The initial lesion had been a red spot on the patient’s left side. Ten days after that spot had first appeared, smaller lesions had developed elsewhere. The patient reported no viral prodrome. The skin examination — including the initial lesion that had appeared — is shown. What is the diagnosis? https://nej.md/IC09042025

09/04/2025

Kevan C. Herold, MD, and Jordan S. Pober, MD, PhD, describe the science behind two studies that examined different cellular strategies to treat type 1 diabetes.

09/04/2025

A new article in NEJM Catalyst Innovations in Care Delivery explores whether an AI-enabled bundled system of sensors and coaching could help patients with type 2 diabetes achieve glycemic targets while concurrently de-escalating glucose-lowering medications. Read the results: https://nej.md/41aafHw

Explore the September 2025 issue of NEJM Catalyst Innovations in Care Delivery: https://nej.md/3HztCDc

09/03/2025

In NEJM Journal Watch, Dr. Molly Brett comments on a study that compared slower, individualized dose escalation of a GLP-1 agonist with label-recommended titration.

Does gradual titration of semaglutide improve tolerability? https://jwat.ch/3JwBqpX

09/03/2025

The abdominojugular reflux test was performed by applying firm, sustained pressure to the center of the abdomen. A sustained increase in jugular venous pressure (JVP) of more than 3 cm of water for more than 10 seconds, as occurred in this patient, indicates a positive test. (A transient increase in JVP that returns to baseline in 10 seconds or less while abdominal pressure is applied would indicate a negative test.)

09/02/2025

Case Record of the Massachusetts General Hospital: A 32-year-old woman was evaluated at MGH because of fatigue and myalgias.

Two and a half years before the current presentation, the patient had fatigue, headache, myalgias, and “brain fog” after infection with SARS-CoV-2. Evaluation of these symptoms included consultations with neurology, immunology, and rheumatology specialists at another hospital. The blood levels of electrolytes, thyrotropin, alanine aminotransferase, aspartate aminotransferase, bilirubin, alkaline phosphatase, C-reactive protein, and ferritin were normal, as were the complete blood count and differential count and the results of tests of kidney function. Serologic tests for cytomegalovirus, Epstein–Barr virus, ehrlichia species, anaplasma species, and Borrelia burgdorferi were reportedly negative. The results of magnetic resonance imaging of the head were reportedly normal.

09/01/2025

A 𝐧𝐞𝐮𝐫𝐨𝐟𝐢𝐥𝐚𝐦𝐞𝐧𝐭 is an intermediate filament with three isoforms (light, medium, and heavy) that is expressed specifically in neurons. Neurofilaments form heteropolymers and are crucial constituents of the cytoskeleton, particularly in axons. During neuronal or axonal breakdown, neurofilaments are released extracellularly and can be measured in blood or cerebrospinal fluid as a biomarker of neurodegeneration.

08/31/2025

In hypertrophic cardiomyopathy, thickened heart muscle often obstructs blood flow. Imaging aids in diagnosis, and treatments such as myosin inhibitors and defibrillators have improved the prognosis.

08/30/2025

A man with heart failure presented with 2 weeks of shortness of breath. The jugular venous pressure was seen at the angle of the jaw and increased for more than 10 seconds when pressure was applied to the abdomen (shown in a video).

08/29/2025

A 71-year-old man presented with a 2-year history of a gradually darkening line on his left thumbnail. What is the most likely diagnosis? https://nej.md/IC08282025