The 50 most-cited articles in Journal watch, 2017

Sponsoring Organization: CDCTarget Audience: Healthcare epidemiologists, surgeons, acute care hospitals, and ambulatory surgical centers Background

The Global Burden of Disease project researchers estimated diarrhea-related mortality as of 2015 by age and geography. They then modeled morbidity and

This study was done to evaluate the reliability and validity of the Narcolepsy Severity Scale (NSS), a novel scale of severity, frequency, and outcomes

Although many afflictions have been attributed to vitamin D deficiency, bone disease (i.e., osteomalacia) is the clinical entity with the strongest

Educational attainment is associated with risk for cardiovascular disease (CVD), presumably as a marker or mediator of other traditional risk factors.

Patients are increasingly requesting commercially available genetic testing. What is the level of evidence supporting such requests?Genetic Testing

Thrombogenic von Willebrand factor released from stimulated endothelial cells is cleaved and inactivated by ADAMTS13, a plasma protease. Patients with

The prevalence of Helicobacter pylori infection varies globally according to socioeconomic factors and levels of hygiene. Investigators performed a

In October 2016, the U.S. FDA approved bezlotoxumab (Zinplava), a human monoclonal antibody directed against C. difficile toxin B, for use in the

Water immersion (WI), or infusion of water during colonoscope insertion, is well known to reduce pain and to facilitate cecal intubation in patients

Appropriate care of women with pelvic floor disorders (PFDs; primarily urinary incontinence and pelvic organ prolapse), involves assessing how

Intracranial atherosclerotic disease (ICAD) is one of the leading causes of stroke worldwide. Traditional risk factors such as hypertension, diabetes,

This year was another active one for research and clinical advances.Heading our Top 10 Stories in 2017 is a study reflecting the integration of

Achieving near-universal antiretroviral therapy (ART) coverage has been proposed to reduce HIV transmission and is the basis of the UNAIDS 90-90-90

On November 9, 2017, the FDA approved letermovir for prevention of cytomegalovirus (CMV) infection and disease in adult allogeneic hematopoietic stem

Sorafenib, the only approved first-line therapy for hepatocellular cancer (HCC), has limited activity (mainly disease stabilization) and a modest

We have previously expressed some hesitance about use of ketamine as a first-line choice for sedation in agitated patients (NEJM JW Emerg Med Apr 2017

The emergence in many tertiary hospitals of multidrug-resistant gram-negative bacteria, particularly carbapenemase-producing Enterobacteriaciae, has

Recent studies of claims data suggest that the incidence of sepsis in hospitals is increasing and sepsis-related mortality is declining. However, such

Chimeric antigen receptor-modified T (CAR-T) cells directed against the B-cell surface antigen CD19 have shown impressive activity in relapsed and

Rates of opioid use disorder (OUD) and deaths from overdose have been rising in the last 10 years, driven largely by opioid prescribing. Identifying

To define the difference in rural versus urban emergency medical services (EMS) response times, investigators reviewed records from 485 EMS agencies in

Cognitive-behavioral therapy (CBT) has been efficacious in treating hypochondriasis, with small-to-large effect sizes, and selective serotonin reuptake inhibitors have been beneficial. Now, researchers have compared these approaches head to head and tested their combination in a first-ever study. In the two-site, 24-week trial, 195 patients with moderate-to-severe, DSM-IV–diagnosed hypochondriasis were randomized to four treatments:

QRISK, a calculator for estimating 10-year risk for myocardial infarction and stroke, is used across the British National Health Service (BMJ 2007;

When prescribing a direct-acting oral anticoagulant (DOAC) for patients with atrial fibrillation (AF) and poor renal function, physicians need to make

Accurate estimation of age-specific risk for breast and ovarian cancer can facilitate counseling of BRCA mutation carriers. Investigators followed

Inflammation probably plays a role in osteoarthritis (OA), and some evidence suggests that this inflammation can lead to progressive cartilage loss.

Investigators in the U.K. and the Czech Republic analyzed factors related to nonadherence to antihypertensive treatment, as nonadherence is an

There are many known mechanisms leading to hypertriglyceridemia. Now, researchers have described a novel one — GPIHBP1 autoantibodies that cause severe

Hospitalized adults, including as many as 90% of intensive care unit patients, often cannot make their own medical decisions. However, many lack

Powassan virus (POWV), a flavivirus carried by several tick species including the common Ixodes scapularis, can be transmitted to a human host in as

Malpractice risk often colors U.S. physicians' decision making, even though studies have shown that a small percentage of physicians account for a

Acute fatty liver disease of pregnancy (AFLP) is an uncommon but serious obstetrical emergency, usually occurring during the third trimester. The

Hypertension remains a dominant risk factor for cardiovascular diseases, and others, around the world. To provide further insight to the global nature

Meta-analyses have concluded that speech and language therapy is effective for treating aphasia in chronic stroke, if administered with sufficient

Despite positive results of prior systematic reviews for the efficacy of probiotics in preventing Clostridium difficile infection in hospitalized patients, current guidelines do not recommend their use in this setting. In a systematic review of probiotic use in hospitalized patients to prevent C. difficile infection in patients started on antibiotics, 19 randomized trials were identified, including 3277 patients randomized to probiotic intervention and 2984 to placebo. Results of a meta-analysis of these data were …

Hypokalemia and other electrolyte disturbances can result from any of the commercially available or homemade bowel preparations for colonoscopy. In the

Lung-protective ventilation has been shown to improve outcomes for patients with acute respiratory distress syndrome (ARDS) but compliance is poor in

It is an article of faith in emergency medicine and radiology that the intravenous contrast used for computed tomography (CT) may cause kidney injury.

Sponsoring Organization: The Endocrine SocietyTarget Audience: Pediatricians and other clinicians who treat childrenBackground and ObjectiveBased on

Many studies have shown that people who are more socially active have better health outcomes, including longer lifespans. Is the same true of people

Anecdotal experience and small single-center studies suggest that physician trainees at teaching hospitals order more laboratory tests than do more

Severe alcoholic hepatitis (Maddrey's Discriminant Function [MDF] score, >32) can carry risk for 1-month mortality of greater than 50%. Current

Dear Readers,We are pleased to present our top 10 stories for 2017. These not only represent the most important articles from the past year but also

It has been an interesting year of publication findings in gastroenterology. Now that we have incredibly effective therapies for hepatitis C virus

Each year, the editors of NEJM Journal Watch General Medicine choose the year's most important thematic areas in clinical research. We try to strike a

Dear Readers,I'm pleased to highlight the NEJM Journal Watch Women's Health Top Stories of 2017. Timely topics include prevention of postcesarean

Dear Readers,The NEJM Journal Watch Infectious Diseases editorial board has revisited the articles that we covered during the past year to select the

During the past year or two, probably the most common concern that patients expressed to me about a potential medication-related risk was this one: “Do

The conventional wisdom is that the incidence of psychotic disorders, such as schizophrenia and psychotic affective disorders, is the same in different