An 𝐚𝐫𝐚𝐜𝐡𝐢𝐝𝐨𝐧𝐢𝐜 𝐚𝐜𝐢𝐝 𝐩𝐚𝐭𝐡𝐰𝐚𝐲 is a pathway that involves the metabolism of arachidonic acid, a polyunsaturated fatty acid released from cell membranes by phospholipases on cellular activation. Full definition of this NEJM Illustrated Glossary term: nej.md/4jfUhna #MedSky

A 43-year-old woman who had a cervical ectopic pregnancy diagnosed at a Florida clinic at 10 weeks’ gestation was denied care at two hospitals owing to the presence of a detectable fetal heart rate. Full case details: nej.md/3KWXjQm

In patients with type 2 diabetes and atherosclerotic cardiovascular disease, tirzepatide was noninferior to dulaglutide with respect to major cardiovascular events. Full SURPASS-CVOT trial results and Research Summary: nej.md/4qd5rLx  #MedSky #EndoSky #CardioSky

Tuberculous meningitis is associated with high mortality despite standard therapy that includes daily rifampin at 10 mg per kilogram. Whether a higher dose would improve outcomes is unclear. Research findings from the HARVEST phase 3 trial are summarized in a short video. nej.md/4j2Qidb

A 50-year-old woman was admitted to the hospital because of fever and abdominal pain after visiting rural Brazil. Shock and disseminated intravascular coagulation developed. What is the most likely diagnosis in this case?  🗳️ Cast your vote before January 8: nej.md/3Yfizns

In muscle-invasive bladder cancer, ctDNA-guided atezolizumab led to longer disease-free survival (9.9 vs. 4.8 months), as well as to longer overall survival (32.8 vs. 21.1 months), than placebo among ctDNA-positive patients. Full IMvigor011 phase 3 trial results and Research Summary: nej.md/3WIRtEg

A new interactive feature describes a 34yo man who presented to the hospital w/ exercise intolerance, night sweats & bradycardia. 2 wks before the current presentation, he had seen his physician after a vacation along the Massachusetts coast. Test your diagnostic & therapeutic skills: nej.md/4qkJFWl

An 80-year-old man presented with a 4-day history of a rash on his abdomen. What is the most likely diagnosis? Submit your answer: nej.md/4jmqkBS #MedSky

A 38-year-old woman presented with a 12-month history of annular plaques on the forehead, cheeks, and neck. Skin biopsy revealed noncaseating epithelioid granulomas with sparse lymphocytic infiltration in the superficial dermis. Read the full case details: nej.md/3L26Llk #MedSky #DermSky #PulmSky

Case Record of the Massachusetts General Hospital: A 55-year-old woman with myasthenia gravis was admitted to the hospital with recurrent gastrointestinal bleeding. Upper and lower endoscopy did not reveal a source of bleeding. A diagnosis was made. Read the full case details: nej.md/48Jytwv

SURPASS-CVOT trial: For patients with high-risk type 2 diabetes, the effect of tirzepatide, a dual agonist of the GLP-1 and glucose-dependent insulinotropic polypeptide receptors, on cardiovascular outcomes is uncertain. Research is summarized in a new Quick Take video. nej.md/4s7lv3m

Visit NEJM.org Wednesday at 5 PM ET for a brand-new Case Challenge and test your diagnostic skills.  #MedSky

A 75-year-old man with hypertension was brought to the emergency department after a motor vehicle collision. A video recording from the dashboard camera in his car showed a loss of ability to react to events on his left side. Read the full case details: nej.md/48GkW8U   #MedSky #NeuroSky

NEJM Clinician Editor-in-Chief Raja-Elie Abdulnour, MD, discusses a recent study that examined a less-intensive, conservative approach to dialysis in patients with severe acute kidney injury. Read the full summary and see what else is in this week's edition at clinician.nejm.org.

A new Double Take video reviews evidence-based recommendations on measles prevention and management and explores commonly asked questions about the measles virus and infection. Watch on YouTube: youtu.be/PI6M680p9i0

HPV vaccination could prevent most cervical cancers, but only 27% of eligible adolescent girls worldwide have received the vaccine. Data suggest that a single dose may be protective. Research findings from the ESCUDDO trial are summarized in a new Quick Take video. nej.md/3MFcHBr #MedSky #IDSky

A 6-month-old baby boy was referred to a pediatric neurology clinic in Brazil for evaluation of developmental delay. At the beginning of the second trimester, the baby’s mother had had a rash. At birth, the baby had microcephaly. 1/2 #MedSky #PedSky #NeuroSky

A 72-year-old woman presented with a 3.5-month history of an enlarging, painless lump on her cheek. Examination showed a dome-shaped, reddish nodule on the left cheek, with a shiny surface and central hemorrhagic crust. Read the full case details: nej.md/3MDwXU5 #MedSky #DermSky #Oncology

Take a look back at the numbers that went into a year of publishing at the world’s leading medical journal. To discover the 15 articles NEJM editors selected as among the most impactful in advancing clinical practice and patient care this year, download the Notable Articles of 2025: nej.md/3YD0EXU

Inspired by a @nejm.org piece by Drs Brian Garibaldi and Steven Russell, I add my two cents on the physical examination. Because limitations notwithstanding, it still matters. blogs.nejm.org/hiv-id-obser...

In a Review Article on measles, Lien Anh Ha Do, MD, PhD, and Kim Mulholland, MB, BS, MD, review the epidemiology, clinical presentation, and associated illnesses as well as treatment and prevention strategies. Read the full review: nej.md/4lmC1Ir #MedSky #PedSky #IDSky

After cystectomy for muscle-invasive bladder cancer, many patients are at risk for recurrence. Research findings from the IMvigor011 phase 3 trial are summarized in a new Quick Take video. nej.md/4p0xrB4 #MedSky #Oncology

New in the December 18/25, issue of NEJM: ctDNA-Guided Atezolizumab in Bladder Cancer (IMvigor011 phase 3 trial) nej.md/3WIRtEg Cardiovascular Outcomes with Tirzepatide (SURPASS-CVOT trial) nej.md/4qd5rLx #MedSky

Tuberculous meningitis is often fatal, and current therapies need to be improved. In the HARVEST phase 3 trial, high-dose rifampin plus standard treatment was assessed. Full trial results: nej.md/49iiDsQ #MedSky #NeuroSky #IDSky

In patients with type 2 diabetes and atherosclerotic cardiovascular disease, tirzepatide was noninferior to dulaglutide with respect to major cardiovascular events. Full SURPASS-CVOT trial results: nej.md/4qd5rLx #MedSky #EndoSky #CardioSky

A 26-year-old woman presented with left elbow pain after falling on an outstretched hand while ice-skating. Radiographs showed a fracture of the proximal third of the ulnar shaft and a posterior dislocation of the radial head. Full case details: nej.md/3KJKs3K #MedSky #Orthopedics #Radiology

NEJM Evidence, in partnership with CIDRAP, announces the launch of Public Health Alerts, a new section featuring descriptive reports on topics of #PublicHealth importance. Learn more: eviden.cc/3KWhu0P #MedSky

In the latest episode of the AI Grand Rounds podcast, Dr. Zak Kohane, editor-in-chief of NEJM AI, explains why this year’s advances in #AI were personal, why it’s spreading fast, and why its most profound theme is values. Full episode: nejm.ai/ep37 #MedSky #MLSky

In HER2-expressing urothelial cancer, disitamab vedotin plus toripalimab doubled the median progression-free survival, increased the median overall survival, and reduced adverse events as compared with chemotherapy. Full RC48-C016 phase 3 trial results and Research Summary: nej.md/3W76VtS

Complex regional pain syndrome (CRPS) is characterized by substantial pain in a distal limb. Approximately 90% of cases are triggered by physical limb trauma; the condition typically commences immediately to less than 1 month after the inciting event. Learn more: nej.md/3MSMW0n #MedSky

Our latest video in our partnership with @glaucomflecken.bsky.social summarizes the final analysis of 23 years of follow-up to evaluate the long-term effects of PSA screening. Read the full analysis for free: nej.md/DrG32 #MedSky #ProstateCancer #MedEd

After coronary bypass for acute coronary syndrome, adding ticagrelor to aspirin did not reduce cardiovascular events but increased major bleeding at 1 year, as compared with aspirin alone. Full TACSI trial results and Research Summary: nej.md/45OjEWN #MedSky #Surgery #Cardiology

RC48-C016 phase 3 trial: For patients with HER2-expressing, locally advanced, or metastatic urothelial cancer, standard chemotherapy has limited benefit. Research findings on disitamab vedotin plus toripalimab are summarized in a Quick Take video. nej.md/48NBaMi #MedSky #Oncology

NEJM wants your lens on climate & health. Whether it’s Lyme in new zones, wildfire lung injury, or heat-related renal failure — submit high-quality clinical images for the April 2026 Climate Change and Health–themed Images in Clinical Medicine section. Learn more: nej.md/event-info

In adults 65 to 79 years of age, there appeared to be fewer hospitalizations for influenza or pneumonia with high-dose influenza vaccine than with the standard dose, with a similar incidence of serious adverse events. Full GALFLU trial results and Research Summary: nej.md/46712T2  #MedSky

NEJM Clinician Editor-in-Chief Raja-Elie Abdulnour, MD, talks about a new study on using cap-refill time to manage resuscitation in septic shock. Read the full summary and see what else is new in this week's edition: nej.md/4s9tDQS #CriticalCare

Guidelines recommend dual antiplatelet therapy after CABG for acute coronary syndrome, but whether it reduces adverse events as compared with aspirin alone is unclear. Research findings from the TACSI trial are summarized in a new Quick Take video. nej.md/499wznZ #MedSky #CardioSky

A new study shows that aspirin enhances antimetastatic immunity by decreasing platelet activation, thereby releasing T cells from suppression by thromboxane A2. Learn more: nej.md/4pTzyaw #MedSky @ucl.ac.uk

Among adults 65 years of age or older, a high-dose influenza vaccine did not result in a significantly lower incidence of hospitalization for influenza or pneumonia than a standard-dose vaccine. Full DANFLU-2 trial results and Research Summary: nej.md/4lPGMtT #MedSky #IDSky

The effectiveness of high-dose inactivated influenza vaccine at preventing hospitalization for influenza in adults 65 years of age and older is unclear. Research findings from the GALFLU trial are summarized in a new Quick Take video. nej.md/4535tgK #MedSky #IDSky

Antibiotic duration for bacteremia is something most of us learned by habit, not by trial data. In the latest episode of Beyond Journal Club from @coreimpodcast.bsky.social and NEJM Group, we walk through the BALANCE trial and use it as a lens for treatment guidance. nej.md/3XNgajK

An 80-year-old man presented to the emergency department with a 12-hour history of pleuritic chest pain and an elevated D-dimer level. A CT scan showed an ulcerlike projection in the ascending thoracic aorta. Read the full case details: nej.md/4pU0I1c #MedSky

A 72-year-old woman presented to the dermatology clinic with a 3.5-month history of an enlarging, painless lump on her left cheek. 1/2 #MedSky #DermSky

In a new Perspective, Ziad Obermeyer, MD, writes that today, medical research builds up an understanding of the whole from molecular parts, but #ArtificialIntelligence can revive an approach building down from patient-level data to theory and understanding. Learn more: nej.md/4rWYakP

Whether the high-dose influenza vaccine is more effective than the standard-dose vaccine in preventing severe outcomes of influenza in older adults is unclear. Research findings from the DANFLU-2 trial are summarized in a new Quick Take video. nej.md/3KVyVOZ #MedSky #IDSky

In the latest episode of the Not Otherwise Specified podcast, host Lisa Rosenbaum, MD, and her guests dissect the common notion that the key to improving the primary care system is simply increasing reimbursement. 🎧 Full episode: nej.md/4oPVwKW 📄 Full episode transcript: nej.md/3KJLnBp

Case Record of the MGH: A 5-year-old boy was admitted to the hospital because of fever and rash. Nonblanching papules spread from the feet to the legs, buttocks, lower back, arms, and ears. A diagnostic test was performed. Read the full case details: nej.md/4rV135I #MedSky #DermSky

New in the December 11, 2025, issue of NEJM: High-Dose Influenza Vaccine in Older Adults (DANFLU-2 trial) nej.md/4lPGMtT High-Dose Influenza Vaccine and Hospitalizations (GALFLU trial) nej.md/46712T2

The authors of a new Perspective write that the market entry of generic liraglutide could meaningfully reduce the fiscal burden of GLP-1 drug coverage, but only if patients, clinicians, and insurers choose to leverage this opportunity. Read the full Perspective: nej.md/4oQyxPV #MedSky

A new review summarizes the diagnosis and treatment of complex regional pain syndrome, a rare limb-pain disorder. Early rehabilitation and multidisciplinary care are key; most patients improve within 18 months. Read the Clinical Practice article: nej.md/3MSMW0n @liverpooluni.bsky.social #MedSky