In June 1948, Sidney Farber reported promising results in treatment of early childhood leukemia. Based on anecdotal evidence that children with acute leukemia worsened if they were given folic acid, he worked on blocking folic acid metabolism. His team gave 16 infants and children with acute lymphoblastic leukemia a folic acid inhibitor, aminopterin—10 showed improvement by clinical and hematologic parameters after three months.[11] In his article, Farber advised receiving the results cautiously: "It is again emphasized that these remissions are temporary in character and that the substance is toxic and may be productive of even greater disturbances than have been encountered so far in our studies," he wrote. "No evidence has been mentioned in this report that would justify the suggestion of the term 'cure' of acute leukemia in children."
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.

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]
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]

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.
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.
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.
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.
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.

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]
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.
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]
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