NEJM This Week — December 18, 2025

This week, we look at ctDNA-guided immunotherapy for bladder cancer, cardiovascular outcomes with tirzepatide, and evidence that one HPV vaccine dose may be enough. We explore high-dose rifampin for tuberculous meningitis, review measles amid rising outbreaks, and follow a challenging case of gastrointestinal bleeding. Essays examine how clinicians navigate post-Dobbs care, tobacco harm among people with mental illness, congenital syphilis, and sustaining medical research.

This week, we look at new studies on high-dose influenza vaccines for older adults, antiplatelet therapy after coronary surgery, and HER2-targeted immunotherapy for advanced bladder cancer. We review complex regional pain syndrome and a pediatric case of fever and rash. We also explore FDA innovation and safety, aspirin’s role in metastasis prevention, the meaning of “the good doctor,” smallpox in the Revolution, and how AI may reshape medical science.

This week, we look at new trials on glucocorticoids for pneumonia in Africa, shunting for normal-pressure hydrocephalus, and pegcetacoplan for two rare kidney diseases. We review updated vaccine evidence for Covid-19, RSV, and influenza, and present a case of respiratory decline and muscle weakness. Perspectives explore health care incentives, U.S. global health strategy, and bringing AI-enabled care to rural America.

This week, we look at new studies on early aspirin discontinuation after myocardial infarction, an antiviral pill for dengue prevention, and CRISPR-based gene editing for lipid disorders. We review bedside clinical teaching and present a complex case of seizures and visual disturbances. Perspectives explore antidepressant safety in pregnancy, restoring trust in public health, academic medical centers’ venture investments, and a young physician’s wrinkled white coat.

This week, we look at new research on potassium optimization in patients with defibrillators, reducing antihypertensive therapy in nursing homes, an mRNA influenza vaccine, and belzutifan for rare neuroendocrine tumors. We review long QT syndrome and present a case of abnormal behavior and seizures in a young man. We also explore perspectives on primary care reform, tobacco cessation in HIV and tuberculosis care, corporate control in health care, and the simple power of compassion with ice cream.

In this episode, we look at new trials on deferring arterial catheterization in shock, beta-blocker use after myocardial infarction, and a treatment for triple-negative breast cancer. We review acromegaly. A case describes a man with dyspnea, edema, and pacemaker lead displacement. We explore perspectives on the burdens of primary care, the erosion of harm reduction, child health policy, and the meaning of hospice.

In this episode, we discuss long-term outcomes after chest-wall irradiation for breast cancer, new treatments for psoriasis and obesity, and early results on a vaccine for Lassa fever. We review opioid deprescribing and a clinical case describes spiraling into a distant past. Perspectives examine the corporatization of health care, the health effects of new energy legislation, and Medicaid cuts affecting U.S. children.

This week, we look at new findings from the European prostate cancer screening study, advances in lung cancer therapy, physical therapy for meniscal tear, and a promising vaccine for Salmonella Paratyphi A. We review noninvasive liver fibrosis assessment and a complex clinical case, and explore perspectives on concierge care, kidney disease equity, WIC enrollment, community health, FDA regulation, and standing with colleagues in Gaza.

In this episode, we look at new research on mucoactive therapy for bronchiectasis, aspirin use in anticoagulated patients with coronary disease, and sotatercept for early pulmonary arterial hypertension. We explore the genetics behind misdiagnosed common diseases and review uncertainty in medical training. We also share a case of woman with abdominal distention, edema, and pleural effusions and Perspectives on sickle cell disease, fetal personhood, and living with a genetic diagnosis.

In this episode, we look at new research in cervical cancer, lupus, gene therapy for immune deficiency, and malaria prevention in infants. We review hair loss in women, follow a case of tuberculosis in advanced HIV, and hear perspectives on vaccines, primary care, digital health, infection surveillance, AI in disaster response, Medicare policy, and bearing witness in conflict zones.