NEJM Journal Watch - General Medicine

Does Hormonal Contraception Influence Breast Cancer Risk?

Excess risk is small but varies by hormone type and delivery route.

Acute Conversion of Atrial Fibrillation in the Emergency Department

Vernakalant beats procainamide for rapid conversion of patients with atrial fibrillation.

Post-Hospitalization Outcomes of Antipsychotics for Critically Ill Patients with Delirium

Neither haloperidol nor ziprasidone had significant effects on cognitive, functional, quality-of-life, or psychological outcomes.

Is Empirical Initiation of Dexamethasone Harmful in Patients with Viral Meningitis?

Dexamethasone begun empirically for suspected bacterial meningitis was not associated with worse outcomes when the infection was ultimately confirmed to be viral.

High-Dose or Standard-Dose Influenza Vaccine: Which Is Better for Older Adults?

In a retrospective cohort study in France, high-dose influenza vaccine was associated with 23% lower hospitalization rates among those aged ≥65.

Quantitative Proteinuria Analysis Following Abnormal Result on a Urine Protein Dipstick

Low follow-up rates suggest missed opportunities to identify patients with clinically important proteinuria.

Does Food Insecurity Affect Glycemic Control?

Food insecurity was associated with severe hypoglycemia among older patients with type 2 diabetes who used insulin or sulfonylureas.

Another Look at Whether Paternal Metformin Is Associated with Congenital Malformations

In a new cohort study, the association disappeared after careful adjustment for possible confounders.

Initial Physical Therapy vs. Surgery in Patients with Severe Hip Osteoarthritis

Total hip arthroplasty was superior to resistance training, with some caveats.

How Common Are Hospitalizations Involving Alcohol Withdrawal?

In a large cohort of adult primary care patients, 1 in 43 hospitalizations involved alcohol withdrawal.