xColorectal cancer is common with a lifetime risk of 5% and remains the second most common cause of cancer death, with low 5-year survival (55%). Early detection through bowel screening and surveillance of high-risk groups aims to identify early disease. Specialist surgery, despite the associated morbidity and mortality, offers the best chance of cure. Isolated multiorgan metastatic disease is increasingly resected, with good results. This article summarizes management of colorectal cancer, with a focus on early rectal and polyp cancers, which can pose management dilemmas.
Patients with interstitial lung disease associated with systemic sclerosis were treated with usual care plus placebo or nintedanib. The annual rate of change in forced vital capacity assessed over a 52-week period was −52.4 ml per year with nintedanib and −93.3 ml per year with placebo. There were no differences in other measures of systemic sclerosis.

In November 1846, Henry Jacob Bigelow, a Boston surgeon, reported a breakthrough in the search for surgical anesthetics with the first uses of inhaled ether in 1846. This allowed patients to remain sedated during operations ranging from dental extraction to amputation.[8] "A patient has been rendered completely insensible during an amputation of the thigh, regain consciousness after a short interval," Bigelow wrote. "Other severe operations have been performed without the knowledge of the patients."
The journal’s logo depicts the Rod of Asclepius crossed over a quill pen. The dates on the logo represent the founding of the components of the New England Journal of Medicine: 1812 for the New England Journal of Medicine and Surgery and Collateral Branches of Medical Science, 1823 for the Boston Medical Intelligencer, 1828 for the Boston Medical and Surgical Journal, and 1928 for the New England Journal of Medicine. 

The journal’s logo depicts the Rod of Asclepius crossed over a quill pen. The dates on the logo represent the founding of the components of the New England Journal of Medicine: 1812 for the New England Journal of Medicine and Surgery and Collateral Branches of Medical Science, 1823 for the Boston Medical Intelligencer, 1828 for the Boston Medical and Surgical Journal, and 1928 for the New England Journal of Medicine.
xColorectal cancer (CRC) is common, affecting >40,000 people a year in the UK. Most cancers are sporadic but a few, such as those occurring at a younger age, have a clear genetic basis. Most are situated in the rectum or rectosigmoid and cause rectal bleeding, often with a looser or more frequent stool. Right-sided cancers typically result in anaemia, because the blood in the stool is occult and unnoticed by the patient. Almost all symptoms of malignancy can also be caused by benign disease. Diagnosis relies on luminal imaging, with colonoscopy being the gold standard.

xColorectal cancer (CRC) is common, affecting >40,000 people a year in the UK. Most cancers are sporadic but a few, such as those occurring at a younger age, have a clear genetic basis. Most are situated in the rectum or rectosigmoid and cause rectal bleeding, often with a looser or more frequent stool. Right-sided cancers typically result in anaemia, because the blood in the stool is occult and unnoticed by the patient. Almost all symptoms of malignancy can also be caused by benign disease. Diagnosis relies on luminal imaging, with colonoscopy being the gold standard.


In November 1952, cardiologist Paul Zoll published an early report on resuscitation of the heart. "The purpose of this report is to describe the successful use in 2 patients of a quick, simple, effective and safe method of arousing the heart from ventricular standstill by an artificial, external, electric pacemaker," he wrote. "For the first time it was possible to keep a patient alive during ventricular asystole lasting for hours to days. This procedure may prove valuable in many clinical situations."[12]
In April 2001, Druker et al. reported a targeted therapy for chronic myelogenous leukemia. Based on the knowledge that BCR-ABL, a constitutively activated tyrosine kinase, causes CML, the authors tested with success an inhibitor of this tyrosine kinase in patients who had failed first-line therapy. The finding helped begin the era of designing cancer drugs to target specific molecular abnormalities.[18]

The journal usually has the highest impact factor of the journals of internal medicine. According to the Journal Citation Reports, NEJM had a 2017 impact factor of 79.258,[24] ranking it first of 153 journals in the category "General & Internal Medicine".[25] It was the only journal in the category with an impact factor of more than 70. By comparison, the second and third ranked journals in the category (The Lancet and JAMA) had impact factors of 53.254 and 47.661 respectively.[26]
Patients with interstitial lung disease associated with systemic sclerosis were treated with usual care plus placebo or nintedanib. The annual rate of change in forced vital capacity assessed over a 52-week period was −52.4 ml per year with nintedanib and −93.3 ml per year with placebo. There were no differences in other measures of systemic sclerosis.
xColorectal cancer (CRC) is one of the leading causes of cancer deaths worldwide. This article reviews the aetiology and risk factors for CRC and focuses on strategies for prevention and early diagnosis. Prevention involves identifying and optimizing modifiable risk factors through public health awareness as well as population screening, for example using detection of occult blood in stool. Endoscopic surveillance in the UK is currently performed on a population basis with the bowel scope programme and faecal immunochemical testing, with colonoscopy reserved for patients known to be at higher risk of developing CRC.
xColorectal cancer (CRC) is one of the leading causes of cancer deaths worldwide. This article reviews the aetiology and risk factors for CRC and focuses on strategies for prevention and early diagnosis. Prevention involves identifying and optimizing modifiable risk factors through public health awareness as well as population screening, for example using detection of occult blood in stool. Endoscopic surveillance in the UK is currently performed on a population basis with the bowel scope programme and faecal immunochemical testing, with colonoscopy reserved for patients known to be at higher risk of developing CRC.
In September 1811, John Collins Warren, a Boston physician,[2] along with James Jackson, submitted a formal prospectus to establish the New England Journal of Medicine and Surgery and Collateral Branches of Science as a medical and philosophical journal.[3] Subsequently, the first issue of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science was published in January 1812.[4] The journal was published quarterly.

xColorectal cancer is common with a lifetime risk of 5% and remains the second most common cause of cancer death, with low 5-year survival (55%). Early detection through bowel screening and surveillance of high-risk groups aims to identify early disease. Specialist surgery, despite the associated morbidity and mortality, offers the best chance of cure. Isolated multiorgan metastatic disease is increasingly resected, with good results. This article summarizes management of colorectal cancer, with a focus on early rectal and polyp cancers, which can pose management dilemmas.
Elsevier’s Medicine is a continually updated, evidence-based learning resource for trainees. It is an essential tool to help trainees achieve their postgraduate medical qualification, wherever you are in the world. It provides a concise overview of the latest medical knowledge and practice based upon the UK Core Medical Training curriculum, with each article written by invited qualified experts. Given its comprehensive coverage of internal medicine, this resource is also an ideal companion for GPs and consultants in the acute medicine setting.
Patients with interstitial lung disease associated with systemic sclerosis were treated with usual care plus placebo or nintedanib. The annual rate of change in forced vital capacity assessed over a 52-week period was −52.4 ml per year with nintedanib and −93.3 ml per year with placebo. There were no differences in other measures of systemic sclerosis.
In November 1952, cardiologist Paul Zoll published an early report on resuscitation of the heart. "The purpose of this report is to describe the successful use in 2 patients of a quick, simple, effective and safe method of arousing the heart from ventricular standstill by an artificial, external, electric pacemaker," he wrote. "For the first time it was possible to keep a patient alive during ventricular asystole lasting for hours to days. This procedure may prove valuable in many clinical situations."[12]
The journal’s logo depicts the Rod of Asclepius crossed over a quill pen. The dates on the logo represent the founding of the components of the New England Journal of Medicine: 1812 for the New England Journal of Medicine and Surgery and Collateral Branches of Medical Science, 1823 for the Boston Medical Intelligencer, 1828 for the Boston Medical and Surgical Journal, and 1928 for the New England Journal of Medicine.
xColorectal cancer is common with a lifetime risk of 5% and remains the second most common cause of cancer death, with low 5-year survival (55%). Early detection through bowel screening and surveillance of high-risk groups aims to identify early disease. Specialist surgery, despite the associated morbidity and mortality, offers the best chance of cure. Isolated multiorgan metastatic disease is increasingly resected, with good results. This article summarizes management of colorectal cancer, with a focus on early rectal and polyp cancers, which can pose management dilemmas.

A letter published in the NEJM in 1980 was later described by the journal as having been "heavily and uncritically cited"[14] to claim that addiction due to use of opioids was rare, and its publication in such an authoritative journal was used by pharmaceutical companies to push widespread use of opioid drugs, leading to an addiction crisis in the U.S. and other countries.[15]


In April 2001, Druker et al. reported a targeted therapy for chronic myelogenous leukemia. Based on the knowledge that BCR-ABL, a constitutively activated tyrosine kinase, causes CML, the authors tested with success an inhibitor of this tyrosine kinase in patients who had failed first-line therapy. The finding helped begin the era of designing cancer drugs to target specific molecular abnormalities.[18]
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