NEJM Journal Watch - General Medicine

The Spectrum of Prodromal Symptoms Before Migraine Attacks

Common prodromal symptoms include light or sound sensitivity, fatigue, neck pain, and difficulty thinking or concentrating.

Intranasal Epinephrine Is Approved for Younger Children

1-mg “neffy” is now approved for children who weigh 15 to 30 kg.

Interventions for Intermediate-Risk Pulmonary Embolism

Large-bore mechanical thrombectomy was superior to catheter-directed thrombolysis in a randomized trial.

Is Vaping Associated with Less Nicotine Exposure Than Smoking in Adolescents?

Not in this study, and salt-based nicotine liquids are associated with higher exposure than freebase nicotine.

New Guidelines Recommend a Restrictive Red Blood Cell Transfusion Strategy for Most Critically Ill Patients

The CHEST guidelines support restrictive practices for patients with isolated elevated troponin and discourage permissive strategies for those with septic shock.

Treatment of Acute Episodic Migraine

A guideline from the American College of Physicians makes only two formal recommendations.

Gepotidacin Approved for Uncomplicated UTI

With its novel mechanism of action, gepotidacin is the first oral antibiotic approved for UTI in over 20 years.

Cannabis and Cannabinoids for Chronic Noncancer Pain: Guidance from the ACP

The authors found limited benefits and substantial risks.

Risk for Venous Thromboembolism Recurrence After Pregnancy-Associated VTE

Nearly one third of patients had a second episode during 30 years.

A Behavioral Activation App for Primary Care Patients with Depression

In a randomized trial, a commercially available app reduced depressive symptoms.