The Rational Clinical Examination  Does This Patient Have Volume Overload? The Rational Clinical Examination Benjamin Drum, Bryce La Course, Mark Kelly, et al JAMA Published Online: February 23, 2026 doi: 10.1001/jama.2026.0446 Key Points Question  Which physical examination, ultrasonographic techniques, and laboratory studies have the best evidence for determining volume overload in spontaneous...

When the heart goes to the wrong side Mabuchi, S., Minami, K. & Takeuchi, M When the heart goes to the wrong side. Intensive Care Med (2026). https://doi.org/10.1007/s00134-026-08321-9 Cardiac herniation is a rare but potentially serious complication that can occur when the pericardium is left unclosed after cardiac surgery, particularly following minimally invasive thoracotomy approaches (Fig. 1). Diagnosis is primarily based on postoperative imaging fin...

JOURNAL ARTICLE A 46-Year-Old With Persistent Altered Mental Status and Respiratory Failure Ann F Yang, Aesha Jobanputra, Thomas J Kirn, et al  Clinical Infectious Diseases, Volume 82, Issue 1, 15 January 2026, Pages 159–161, https://doi.org/10.1093/cid/ciaf439 Question: A 46-year-old undomiciled man with a past medical history of alcohol use disorder was found unresponsive and admitted for evaluation of altered mental status. He immigra...

JOURNAL ARTICLE A 46-Year-Old With Persistent Altered Mental Status and Respiratory Failure Ann F Yang, Aesha Jobanputra, Thomas J Kirn, et al  Clinical Infectious Diseases, Volume 82, Issue 1, 15 January 2026, Pages 159–161, https://doi.org/10.1093/cid/ciaf439 Question: A 46-year-old undomiciled man with a past medical history of alcohol use disorder was found unresponsive and admitted for evaluation of altered mental status. He immigrated from Mexico in 1...

IMAGES IN CLINICAL MEDICINE Pulmonary Mucormycosis Jonas Lötscher, Justus Baarts N Engl J Med 2026;394:699 A 49-year-old man with acute myeloid leukemia who had been admitted to the hospital for induction chemotherapy was evaluated for prolonged neutropenic fever. On physical examination, crackles were heard at the lung bases. Computed tomography (CT) of the chest revealed rounded opacities with central ground-glass attenuation and ring...

#LIVES2025: Getting Your Research Published In ICU Wed, 29 Oct 2025 n an interesting and useful workshop at @ESICM LIVES 2025, Darren Taichman, Deputy Editor and Online Editor of New England Journal of Medicine and Executive Strategy Editor for the NEJM Group, shared insight on submitting a meaningful manuscript for publication that makes an impact. Writing a scientific paper is about more than just documenting your research; it's about making your ...

Imaging in Intensive Care Medicine Published: 19 January 2026 Portal venous gas on point-of-care ultrasound van Gastel, L., de Kok, L. Intensive Care Med(2026). https://doi.org/10.1007/s00134-025-08232-1 Abdominal computed tomography (CT) confirmed the presence of portal venous gas and pneumatosis intestinalis in the ileum and ascending colon, with patent mesenteric arteries (Fig. 1, panel A, B and C respectively). Non-occlusive mesenteric ischem...

Imaging in Intensive Care Medicine Ghost cells in Clostridium perfringens liver abscess with massive hemolysis Yoshihiro Nagai, Seiya Nishiyama, Tadashi Kamio, et al Intensive Care Med 2025 https://doi.org/10.1007/s00134-025-08227-y Clostridium perfringens produces phospholipase C, the systemic dissemination of which can lead to severe intravascular hemolysis. Erythrocytes whose cell membranes are lysed lose hemoglobin, and the resulting small, me...

Acute respiratory failure unmasking an unexpected disease Loïc Velten, Anaïs Curtiaud, Antoine Studer, et al Intensive Care Med (2025). https://doi.org/10.1007/s00134-025-08093-8 Relapsing polychondritis (RP) is a rare, immune-mediated disease characterized by recurrent inflammation of cartilaginous structures, including the auricles, nasal cartilage, peripheral joints, and respiratory tract (Fig. 1). It affects both men and women, typically presenting around...

CLINICAL DECISIONS Simplify or Stratify? The Debate over Medical School Grading Systems Harleen Marwah, Abhinav Suri, Clarence H. Braddock III, et al N Engl J Med 2025;393:2268-2270 CASE VIGNETTE A Medical School Evaluating the Grading System Harleen Marwah, M.D. You have recently been named the dean in charge of preclinical curriculum for your medical school. There is debate among the faculty and students in your school regarding the approach to grad...