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81. Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction.
作者: Udo Bavendiek.;Anika Großhennig.;Johannes Schwab.;Dominik Berliner.;Andreas Rieth.;Lars S Maier.;Thomas Gaspar.;Nele Henrike Thomas.;Xiaofei Liu.;Sven Schallhorn.;Eleonora Angelini.;Samira Soltani.;Fabian Rathje.;Mircea-Andrei Sandu.;Welf Geller.;Rainer Hambrecht.;Marija Zdravkovic.;Sebastian Philipp.;Dragana Kosevic.;Georg Nickenig.;Daniel Scheiber.;Sebastian Winkler.;Peter Moritz Becher.;Philipp Lurz.;Martin Hülsmann.;Sören Wiesner.;Christoph Schröder.;Barbara Neuhaus.;Anika Seltmann.;Heiko von der Leyen.;Christian Veltmann.;Stefan Störk.;Michael Böhm.;Armin Koch.;Johann Bauersachs.; .
来源: N Engl J Med. 2025年393卷12期1155-1165页
The therapeutic efficacy of the cardiac glycoside digitoxin in patients with heart failure and reduced ejection fraction is not established.
82. Multidomain Rehabilitation for Older Patients with Myocardial Infarction.
作者: Elisabetta Tonet.;Andrea Raisi.;Silvia Zagnoni.;Giorgio Chiaranda.;Giovanni Pasanisi.;Daniela Aschieri.;Paola Emanuela D'Intino.;Rita Pavasini.;Paolo Cimaglia.;Roberta Campana.;Francesco Vitali.;Tommaso Piva.;Gianni Casella.;Serena Caglioni.;Valentina Zerbini.;Giulia Bugani.;Marta Cocco.;Erica Menegatti.;Martina De Raffele.;Simona Mandini.;Donato Martella.;Nicola Pesenti.;Gianni Mazzoni.;Simone Biscaglia.;Stefano Volpato.;Giovanni Grazzi.;Gianluca Campo.; .
来源: N Engl J Med. 2025年393卷10期973-982页
The benefit of rehabilitation interventions in patients who are 65 years of age or older with myocardial infarction and impaired physical performance remains unclear.
83. Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias.
作者: Christian Jøns.;Chaoqun Zheng.;Ulrik C G Winsløw.;Elisabeth M Danielsen.;Tharsika Sakthivel.;Emil A Frandsen.;Hillah Saffi.;Sadjedeh S Vakilzadeh-Hashemi.;Ketil J Haugan.;Niels E Bruun.;Kasper K Iversen.;Helle S Bosselmann.;Niels Risum.;Henning Bundgaard.; .
来源: N Engl J Med. 2025年393卷20期1979-1989页
Hypokalemia and even low-normal plasma potassium levels increase the risk of ventricular arrhythmias among patients with cardiovascular disease. An assessment of a strategy of actively increasing plasma potassium levels to the high-normal range is needed.
84. Reduction of Antihypertensive Treatment in Nursing Home Residents.
作者: Athanase Benetos.;Sylvie Gautier.;Anne Freminet.;Alice Metz.;Carlos Labat.;Ioannis Georgiopoulos.;François Bertin-Hugault.;Jean-Baptiste Beuscart.;Olivier Hanon.;Patrick Karcher.;Patrick Manckoundia.;Jean-Luc Novella.;Abdourahmane Diallo.;Eric Vicaut.;Patrick Rossignol.; .
来源: N Engl J Med. 2025年393卷20期1990-2000页
Among older adults with frailty, evidence on the benefits and risks of discontinuing antihypertensive drugs is limited.
85. Phase 3 Trial of Inhaled Molgramostim in Autoimmune Pulmonary Alveolar Proteinosis.
作者: Bruce C Trapnell.;Yoshikazu Inoue.;Francesco Bonella.;Tisha Wang.;Cormac McCarthy.;Toru Arai.;Keiichi Akasaka.;Francesca Mariani.;Nesrin Mogulkoc.;Jin Woo Song.;Tomohisa Baba.;Stephane Jouneau.;Tadahisa Numakura.;Nesrin Öcal.;Florin Mihaltan.;Ali Ataya.;Elisabeth Bendstrup.;Ilaria Campo.;Brenna Carey.;Ross Arena.;Brian Robinson.;Rosanna Fleming.;Yasmine Wasfi.;Raymond Pratt.; .
来源: N Engl J Med. 2025年393卷8期764-773页
Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare disease characterized by progressive surfactant accumulation and hypoxemia caused by autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF), which alveolar macrophages require to clear surfactant. Molgramostim is a formulation of inhaled recombinant human GM-CSF, but its efficacy and safety in patients with aPAP have not been studied sufficiently.
86. Ciprofloxacin versus Aminoglycoside-Ciprofloxacin for Bubonic Plague.
作者: Rindra Vatosoa Randremanana.;Mihaja Raberahona.;Josephine Bourner.;Minoarisoa Rajerison.;Tansy Edwards.;Ravaka Randriamparany.;Tsinjo Fehizoro Razafindratsinana.;Lisy Hanitra Razananaivo.;Gabriella Zadonirina.;Théodora Mayouya-Gamana.;Alex Paddy Abdel Salam.;Reziky Tiandraza Mangahasimbola.;Voahangy Andrianaivoarimanana.;Elise Pesonel.;Rivonirina Andry Rakotoarivelo.;Mamy Jean de Dieu Randria.;Peter Horby.;Piero Olliaro.; .
来源: N Engl J Med. 2025年393卷6期544-555页
Plague is a high-consequence infectious disease with epidemic potential. Current treatment guidelines are based on weak evidence.
87. Ivermectin to Control Malaria - A Cluster-Randomized Trial.
作者: Carlos Chaccour.;Marta Maia.;Mercy Kariuki.;Paula Ruiz-Castillo.;Caroline Wanjiku.;Lydia Kasiwa.;Aurelia Brazeal.;Aina Casellas.;Mwanajuma Ngama.;Truphena Onyango.;Eldo Elobolobo.;Karisa Kazungu.;Mary Mael.;Winnie Wangari.;Khadija Nuru.;Rachel Otuko.;Almudena Sanz.;Isaac Ringera.;Allan Matano.;Starford Mitora.;Marta Ribes.;Joe Brew.;Nika Gorski.;Patricia Nicolas.;Sara Stanulovic.;Isaiah Omondi.;Joanna Furnival-Adams.;Laura Túnez.;Jamal Mbarak.;Vegovito Vegove.;Esther Yaa.;Shadrack Mramba.;Yegon Kibet.;Naomi Nyambura.;Charles Rotich.;Scholastica Wanjiru.;Musa Vura.;Faith Wanjiku.;Leslie Sam.;Lisa Collins.;Kang Xia.;Felix Hammann.;Francisco Saúte.;Matthew Rudd.;Cassidy Rist.;Caroline Jones.;Joseph Mwangangi.;N Regina Rabinovich.
来源: N Engl J Med. 2025年393卷4期362-375页
Malaria control and elimination is threatened by the spread of insecticide resistance and behavioral adaptation of vectors. Whether mass administration of ivermectin, a broad-spectrum antiparasitic drug that also kills mosquitoes feeding on treated persons, can reduce malaria transmission is unclear.
88. Multidose Ondansetron after Emergency Visits in Children with Gastroenteritis.
作者: Stephen B Freedman.;Sarah Williamson-Urquhart.;Amy C Plint.;Andrew Dixon.;Darcy Beer.;Gary Joubert.;Petros Pechlivanoglou.;Yaron Finkelstein.;Anna Heath.;Jasper Zhongyuan Zhang.;Angela Wallace.;Martin Offringa.;Terry P Klassen.; .
来源: N Engl J Med. 2025年393卷3期255-266页
Ondansetron improves outcomes when administered in emergency departments to children with acute gastroenteritis-associated vomiting. It is commonly prescribed at discharge to reduce symptoms, but evidence to support this practice is limited.
89. Early Tirofiban Infusion after Intravenous Thrombolysis for Stroke.
作者: Chunrong Tao.;Tianlong Liu.;Tao Cui.;Jie Liu.;Zongliang Li.;Youquan Ren.;Xingli Zhao.;Fuyou Xie.;Jianqiao Li.;Hao Wang.;Ling Huang.;Jianjun Li.;Jianshang Wen.;Jianzhong Zeng.;Junyong Zhu.;Zhide Li.;Dajun Li.;Xuefeng Hu.;Biao Huang.;Jing Wang.;Chi Zhang.;Bin Ye.;Yubao Hou.;Yanlin Gan.;Hong Sun.;Fei Guan.;Ya Shao.;Zongtao Liu.;Zehu Ou.;Shikai Fan.;Yao Wang.;Hongjiang Zhai.;Chunhua Ni.;Hao Wang.;Chenggang Zhang.;Yan Zhao.;Guoping Wang.;Yuyou Zhu.;Rui Li.;Jun Sun.;Haiying Hu.;Jiangping Cui.;Li Wang.;Chao Zhang.;Jianlong Song.;Xiaozhong Jing.;Anmo Wang.;Jinjing Wang.;Pengfei Xu.;Adnan I Qureshi.;Thanh N Nguyen.;Raul G Nogueira.;Jeffrey L Saver.;Wei Hu.; .
来源: N Engl J Med. 2025年393卷12期1191-1201页
Intravenous thrombolysis remains a standard treatment for acute ischemic stroke within 4.5 hours after onset. Vascular reocclusion may occur after intravenous thrombolysis and may be preventable with an antiplatelet agent within the first 24 hours after thrombolysis. Tirofiban, a platelet glycoprotein IIb-IIIa receptor antagonist, has reduced macrovascular reocclusion in experimental models.
90. Once-Monthly Maridebart Cafraglutide for the Treatment of Obesity - A Phase 2 Trial.
作者: Ania M Jastreboff.;Donna H Ryan.;Harold E Bays.;Peter R Ebeling.;Mia G Mackowski.;Nisha Philipose.;Leorah Ross.;Yimeng Liu.;Cassandra E Burns.;Siddique A Abbasi.;Nicola Pannacciulli.; .
来源: N Engl J Med. 2025年393卷9期843-857页
Maridebart cafraglutide (known as MariTide) is a long-acting peptide-antibody conjugate that combines glucagon-like peptide-1 receptor agonism and glucose-dependent insulinotropic polypeptide receptor antagonism and that is intended for the treatment of obesity.
91. Weekly Fixed-Dose Insulin Efsitora in Type 2 Diabetes without Previous Insulin Therapy.
作者: Julio Rosenstock.;Timothy Bailey.;Lisa Connery.;Eden Miller.;Cyrus Desouza.;Qianqian Wang.;Jennifer Leohr.;Alastair Knights.;Molly C Carr.;Christopher J Child.; .
来源: N Engl J Med. 2025年393卷4期325-335页
In previous treat-to-target trials, adjustments to the dose of basal insulin have been made at least weekly, according to fasting blood glucose levels. A fixed-dose regimen of insulin efsitora alfa (efsitora), a once-weekly basal insulin, may provide a benefit in adults with type 2 diabetes who have not received previous insulin therapy.
92. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist, in Early Type 2 Diabetes.
作者: Julio Rosenstock.;Stanley Hsia.;Luis Nevarez Ruiz.;Sarah Eyde.;David Cox.;Wen-Shuo Wu.;Rong Liu.;Jianghao Li.;Laura Fernández Landó.;Max Denning.;Lisa Ludwig.;Yanyun Chen.; .
来源: N Engl J Med. 2025年393卷11期1065-1076页
Orforglipron is a small-molecule, nonpeptide glucagon-like peptide-1 (GLP-1) receptor agonist in clinical development for type 2 diabetes and weight management. Additional data on the efficacy and safety of orforglipron are needed.
93. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity.
作者: W Timothy Garvey.;Matthias Blüher.;Cynthia Karenina Osorto Contreras.;Melanie J Davies.;Eva Winning Lehmann.;Kirsi H Pietiläinen.;Domenica Rubino.;Paolo Sbraccia.;Thomas Wadden.;Niels Zeuthen.;John P H Wilding.; .
来源: N Engl J Med. 2025年393卷7期635-647页
Semaglutide at a dose of 2.4 mg has established weight-loss and cardiovascular benefits, and cagrilintide at a dose of 2.4 mg has shown promising results in early-phase trials; the efficacy of the combination (known as CagriSema) on weight loss in persons with either overweight and coexisting conditions or obesity is unknown.
94. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes.
作者: Melanie J Davies.;Harpreet S Bajaj.;Christa Broholm.;Astrid Eliasen.;W Timothy Garvey.;Carel W le Roux.;Ildiko Lingvay.;Christian Bøge Lyndgaard.;Julio Rosenstock.;Sue D Pedersen.; .
来源: N Engl J Med. 2025年393卷7期648-659页
Cagrilintide and semaglutide have each been shown to induce weight loss as monotherapies. Data are needed on the coadministration of cagrilintide and semaglutide (called CagriSema) for weight management in adults with type 2 diabetes, including those in a subgroup who are undergoing continuous glucose monitoring.
95. Neoadjuvant and Adjuvant Pembrolizumab in Locally Advanced Head and Neck Cancer.
作者: Ravindra Uppaluri.;Robert I Haddad.;Yungan Tao.;Christophe Le Tourneau.;Nancy Y Lee.;William Westra.;Rebecca Chernock.;Makoto Tahara.;Kevin J Harrington.;Arkadiy L Klochikhin.;Irene Braña.;Gustavo Vasconcelos Alves.;Brett G M Hughes.;Marc Oliva.;Iane Pinto Figueiredo Lima.;Tsutomu Ueda.;Tomasz Rutkowski.;Ursula Schroeder.;Paul-Stefan Mauz.;Thorsten Fuereder.;Simon Laban.;Nobuhiko Oridate.;Aron Popovtzer.;Nicolas Mach.;Yevhen Korobko.;Diogo Alpuim Costa.;Anupama Hooda-Nehra.;Cristina P Rodriguez.;R Bryan Bell.;Cole Manschot.;Kimberly Benjamin.;Burak Gumuscu.;Douglas Adkins.; .
来源: N Engl J Med. 2025年393卷1期37-50页
The benefit of the addition of perioperative pembrolizumab to standard care with surgery and adjuvant therapy for patients with locally advanced head and neck squamous-cell carcinoma (HNSCC) is unclear.
96. Measurable Residual Disease-Guided Therapy for Chronic Lymphocytic Leukemia.
作者: Talha Munir.;Sean Girvan.;David A Cairns.;Adrian Bloor.;David Allsup.;Abraham M Varghese.;Satyen Gohil.;Shankara Paneesha.;Andrew Pettitt.;Toby Eyre.;Christopher P Fox.;Francesco Forconi.;Ben Kennedy.;Constantine Balotis.;Nicholas Pemberton.;Oonagh Sheehy.;John Gribben.;Nagah Elmusharaf.;Simona Gatto.;Gavin Preston.;Anna Schuh.;Renata Walewska.;Lelia Duley.;Nichola Webster.;Surita Dalal.;Andrew Rawstron.;Dena Howard.;Anna Hockaday.;Sharon Jackson.;Natasha Greatorex.;Sue Bell.;David Stones.;Julia M Brown.;Piers E M Patten.;Peter Hillmen.; .
来源: N Engl J Med. 2025年393卷12期1177-1190页
An interim analysis of progression-free survival in this trial showed that ibrutinib-venetoclax was superior to fludarabine-cyclophosphamide-rituximab (FCR) among patients with chronic lymphocytic leukemia (CLL). Whether ibrutinib-venetoclax is more effective than ibrutinib alone is unclear.
97. Graft-versus-Host Disease Prophylaxis with Cyclophosphamide and Cyclosporin.
作者: David J Curtis.;Sushrut S Patil.;John Reynolds.;Duncan Purtill.;Clinton Lewis.;David S Ritchie.;David J Gottlieb.;David T Yeung.;Eric Wong.;Siok-Keen Tey.;Travis Perera.;John Moore.;Rachel M Koldej.;Richard De Abreu Lourenco.;John Stubbs.;C Orla Morrissey.;Nadia Munsef.;Andrea Arenas.;Geoffrey R Hill.; .
来源: N Engl J Med. 2025年393卷3期243-254页
Allogeneic peripheral-blood stem-cell transplantation (SCT) from a matched related donor after myeloablative conditioning is the preferred curative treatment for patients with high-risk blood cancers. The combination of a calcineurin inhibitor and an antimetabolite remains standard care for graft-versus-host disease (GVHD) prophylaxis in these patients. Data from two randomized trials have suggested that post-transplantation cyclophosphamide can reduce the risk of GVHD after SCT from a matched donor when it is added to or replaces the antimetabolite. However, the effects of post-transplantation cyclophosphamide specifically after SCT from a matched related donor remain uncertain, and effects in the context of myeloablative conditioning are unclear.
98. Intravenous Rehydration for Severe Acute Malnutrition with Gastroenteritis.
作者: Kathryn Maitland.;San Maurice Ouattara.;Hadiza Sainna.;Abdullahi Chara.;Oluwakemi F Ogundipe.;Temmy Sunyoto.;M Hamaluba.;Peter Olupot-Olupot.;Florence Alaroker.;Roisin Connon.;Amadou Saidou Maguina.;William Okiror.;Denis Amorut.;Eric Mwajombo.;Emmanuel Oguda.;Christabel Mogaka.;Céline Langendorf.;Juan Emmanuel Dewez.;Iza Ciglenecki.;Diana M Gibb.;Matthew E Coldiron.;Roberta Petrucci.;Elizabeth C George.; .
来源: N Engl J Med. 2025年393卷13期1257-1268页
International recommendations advise against the use of intravenous rehydration therapy in children with severe acute malnutrition because of the concern about fluid overload, but evidence to support this concern is lacking. Given the high mortality associated with the current recommendations, the adoption of intravenous rehydration strategies might improve outcomes.
99. Proportional-Assist Ventilation for Minimizing the Duration of Mechanical Ventilation.
作者: Karen J Bosma.;Karen E A Burns.;Claudio M Martin.;Yoanna Skrobik.;Jordi Mancebo Cortés.;Sorcha Mulligan.;Myriam Lafreniere-Roula.;Kevin E Thorpe.;Juan Carlos Suárez Montero.;Indalecio Morán Chorro.;Núria Rodríguez-Farré.;Ron Butler.;Tracey Bentall.;Gaëtan Beduneau.;Pauline Enguerrand.;Marlene Santos.;Thomas Piraino.;Savino Spadaro.;Federica Montanaro.;John Basmaji.;Eileen Campbell.;Alain Mercat.;François M Beloncle.;Guillaume Carteaux.;Tommaso Maraffi.;Emmanuel Charbonney.;Marie Lecronier.;Martin Dres.;Yaseen M Arabi.;Andre Carlos Kb Amaral.;Nicole Marinoff.;Neill K J Adhikari.;Anna Geagea.;Phil Shin.;Katerina Vaporidi.;Eumorfia Kondili.;Jason Shahin.;Josie Campisi.;Pablo O Rodriguez.;Mariano Setten.;Ewan C Goligher.;Niall D Ferguson.;Vito Fanelli.;Gabriela Ferreyra.;Francois Lellouche.;Stephanie Sibley.;Laurent Brochard.; .
来源: N Engl J Med. 2025年393卷11期1088-1103页
In critically ill patients, acceleration of liberation from mechanical ventilation is important in order to reduce the risk of complications and to improve long-term outcomes. Whether the use of proportional-assist ventilation with load-adjustable gain factors (PAV+) results in a shorter time to successful liberation from mechanical ventilation than pressure-support ventilation (PSV) is unclear.
100. A Crossover Trial of Hospital-Wide Lactated Ringer's Solution versus Normal Saline.
作者: Lauralyn McIntyre.;Dean Fergusson.;Tracy McArdle.;Shane English.;Deborah J Cook.;Alison E Fox-Robichaud.;Claudio Martin.;John Marshall.;Michael Pugliese.;Kusum Menon.;Kednapa Thavorn.;Ian D Graham.;Steven Hawken.;Akshai Iyengar.;Kwadwo Kyeremanteng.;Raphael Saginur.;Andrew J E Seely.;Ian G Stiell.;Daniel Bainbridge.;Charles Weijer.;Monica Taljaard.; .
来源: N Engl J Med. 2025年393卷7期660-670页
Whether lactated Ringer's solution is clinically superior to normal saline for routine intravenous administration of fluids is uncertain.
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