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<論文紹介:NEJM 2019;380:2157-2167.他>

NEJMがとても役立ちますよ、ということを以前お話ししましたが、
最新号の“Case Records of the MGH”を紹介します。

Case 17-2019: A 44-Year-Old Man with Joint Pain, Weight Loss, and Chest Pain.(NEJM 2019;380:2157-2167.)

心嚢水貯留をきたす疾患の鑑別を学ぶことが出来ます。
病理所見も興味深いですよ。

ついでに、最近のNEJM論文も紹介します。

REVIEW ARTICLE: Contrast-Associated Acute Kidney Injury.(NEJM 2019;380:2146-2155.)
造影剤による急性腎障害の総説ですが、あんまりすっきりしませんね。

More recent studies have suggested that the risk of acute kidney injury due to contrast material is overestimated.
However, reliance on a definition based on small increments in the plasma creatinine level, which are frequently transient and nonspecific for contrast-induced damage, coupled with observational studies showing an association with serious, adverse outcomes without known cause, has limited meaningful progress in determining the clinical importance of this condition.

BRIEF REPORT: Mesenchymal Hamartoma of the Liver and DICER1 Syndrome.(NEJM 2019;380:1834-1842.)
DICER1症候群は、成人と小児に影響を及ぼす良性腫瘍と悪性腫瘍を含む多面的腫瘍素因症候群です。
本症候群には、胸膜肺芽腫、嚢胞性腎腫、卵巣の性索間質性腫瘍、多結節性甲状腺腫および甲状腺がんならびに松果体芽腫および下垂体芽腫を含む脳腫瘍といったリスクが含まれますが、こんなのもあるんですね。

Case 14-2019: A 44-Year-Old Man with Neck Pain and Swelling.(NEJM 2019;380:1854-1863.)
Historyが大切!
REVIEW ARTICLE FRONTIERS IN MEDICINE: Machine Learning in Medicine.(NEJM 2019;380:1347-1358.)
誰もが関心のある、医学における機械学習の総説です。
ただ、Google社員も共著者に入っていますので、信用すべきか宣伝目的なのか、注意深く読むべきと思います。

他のNEJM関連は、こちら。
(かなり数がたまったので今後はリンクははりません。ご了承ください。
内容を記載しますので、ご関心があればリンク先アドレスをコピペしてご参照ください。)

(http://ocu-radiology.jp/news/news-2148/):
Idiopathic pulmonary fibrosis.
Pulmonary alveolar proteinosis.
Mucinous Ovarian Carcinoma.
Ocular syphilis.

(http://ocu-radiology.jp/news/news-2115/):
Herpes simplex virus lymphadenitis, Chronic lymphocytic leukemia.
Perforation of the sigmoid colon by a foreign body (toothpick) that caused a fistula to the right common iliac artery.
Powassan virus encephalitis.

(http://ocu-radiology.jp/news/news-2037/):
Papulonecrotic tuberculid (cutaneous tuberculosis).
Hepatobiliary Tuberculosis.
Sudden death caused by pulmonary fat embolism in a patient with miliary tuberculosis.

(http://ocu-radiology.jp/news/news-1974/):
眼窩領域Granulomatosis with polyangiitis, Susac’s syndrome.
Clostridium perfringens bacteremia with a hepatic abscess.
Osteoblastic and Osteolytic Spine Metastases by Using SWI.

(http://ocu-radiology.jp/news/news-1921/):
The t(6;11) TFEB translocation variant of renal-cell carcinoma.
比較的新しい病理組織概念でUncommonな腎腫瘤の復習.

(http://ocu-radiology.jp/news/news-1901/):
Pulmonary adenocarcinoma, hypercoagulable state with nonbacterial thrombotic endocarditis.
BK Virus–Progressive Multifocal Leukoencephalopathy.

(http://ocu-radiology.jp/news/news-1843/):
Anti–N-methyl-d-aspartate (NMDA) receptor encephalitis.
The drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, associated with human herpesvirus 6.
Acute Viral Encephalitis. 特にarbovirus encephalitisについて.

(http://ocu-radiology.jp/news/news-1793/):
Vitamin C deficiency (scurvy).“bachelor scurvy”
Vitamin B6, folate, zinc, and selenium deficiencies.
Alcohol-use disorder.
Multiple vitamin deficiencies.

(http://ocu-radiology.jp/news/news-1681/):
Polyarteritis nodosa. HBVとの関連.

(http://ocu-radiology.jp/news/news-1605/):
Membranous nephropathy, PLA2R type. IgG4との関連性など.
Idiopathic Pulmonary Fibrosis.

(http://ocu-radiology.jp/news/news-1588/):
Giant-cell myocarditis.
Takotsubo cardiomyopathy and catecholamine-induced crisis due to pheochromocytoma.
Fulminant Myocarditis with Combination Immune Checkpoint Blockade.

(http://ocu-radiology.jp/news/news-1462/):
Homocystinuriaの様々な表現型:Cystathionine β-synthase deficiency, Methylenetetrahydrofolate reductase deficiency.
Primary Sjögren’s Syndrome.
Antibody-Mediated Encephalitis.

(http://ocu-radiology.jp/news/news-1374/):
Immune-Related Adverse Events Associated with Immune Checkpoint Blockade.
Multiple Sclerosis. Neuromyelitis Optica Spectrum Disorders.
Adenovirus infection, disseminated.

(http://ocu-radiology.jp/news/news-1253/):
Biotin–thiamine–responsive basal ganglia disease.

(http://ocu-radiology.jp/news/news-1109/):
好酸球増多症(Eosinophilia)について.

(http://ocu-radiology.jp/news/news-897/):
Copper deficiency. Zincとの関連.

(http://ocu-radiology.jp/news/news-891/):
Takayasu’s arteritis.
Atypical immunoblastic reaction that was consistent with primary Epstein–Barr virus infection.

(http://ocu-radiology.jp/news/news-783/):
NEJMの紹介、Case Recordsの変遷についての私見.