A slow summer: An opinionated take on NEJM highlights for August 2020

A cheap, low tech intervention for a common Achilles’ heel

When I am out and about, for instance at the grocery store, I am always surprised at the number of people I see with swollen legs. About half a million times a year in the US, these folks end-up in a hospital bed with cellulitis (a skin and subcutaneous infection) of the leg. In a single center randomized trial with 84 patients who had an episode of cellulitis, an Australian group tested whether compressive stockings would make a difference in preventing another episode. They found that the rate of recurrence was 3 times lower vs the control group.  No high science, no fancy devices, just the potential to avoid hundreds of thousands of admissions. I hope someone at CDC / NIH is paying attention and will be funding a trial at scale or, if that does not happen, payers should. Compression Therapy to Prevent Recurrent Cellulitis of the Leg


Saliva tests for SARS-CoV-2 are as good if not better than nasopharyngeal swabs

Not much to add except that saliva tests negate the need for the involvement of health care professionals in sample collection which is an important bottleneck in testing. Plus, it’s a lot less unpleasant. Saliva or Nasopharyngeal Swab Specimens for Detection of SARS-CoV-2 (free access)


The New England Journal of Medicine is a premier weekly medical journal covering many topics of interest to the health sector. In this monthly series we offer an opinionated perspective on selected highlights that might be of interest to our clients and others.

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