Viewpoint  May 5, 2025 Nitrites for Urinary Tract Infection—Time to Say Goodbye? Jackson J. Stewart, Joan L. Robinson, Justin Z. Chen JAMA Intern Med. Published online May 5, 2025. doi:10.1001/jamainternmed.2025.0973 The urinary nitrite test is a long-standing component of the dipstick portion of the urinalysis, but it is time to question its relevance in distinguishing urinary tract infection (UTI) from asymptomatic bacteriuria, and thus in ...

JAMA Insights  Communicating Medicine April 16, 2025 Communicating With Patients About Surgery Lauren J. Taylor, Emily B. Rivet, Muneera R. Kapadia JAMA. Published online April 16, 2025. doi:10.1001/jama.2025.2195 Surgeons face specific challenges when talking to patients and families about surgery. Surgical problems often involve rapid decision-making with limited time for deliberation and require proficiency...

Medical News  March 28, 2025 7 Takeaways for Primary Care Clinicians From the Updated Acute Coronary Syndromes Guideline Linda Rodgers JAMA. 2025;333(16):1375-1376. doi:10.1001/jama.2025.2931 The American College of Cardiology (ACC) and the American Heart Association (AHA) have published a new guideline for managing patients with acute coronary syndromes (ACS), the first update since 3 related guidelines were released from 2013 to 2015. That ...

Teachable Moment  Less Is More October 21, 2024 The Harm of Inappropriate Central Line Blood Cultures in Clinical Practice Alexandra N. Fuher, Heather Young, Mark E. Mikkelsen JAMA Intern Med. Published online October 21, 2024. doi:10.1001/jamainternmed.2024.5344 A57-year-old man with end-stage kidney disease who was receiving hemodialysis through a tunneled central venous catheter presented to the emergency department with severe hyperkal...

Basics of Volumetric Capnography ‑ Part 2: Single Beath CO2 Analysis Anatomical dead space, alveolar dead space, and CO2 elimination: Learn how they can give you an insight into the patient's lung condition. Single breath CO2 analysis: insight into the patient‘s lung condition The volumetric capnogram can also be divided into three areas: Area X ‑ CO2 elimination Area Y ‑ Alveolar dead space Area Z ‑ Anatomical dead space The size of the areas, ...

Guide to Statistics and Methods  Surgical Education Research January 3, 2024 Practical Guide to Common Flaws With Surgical Education Research Dimitrios Stefanidis, Laura Torbeck, Amy H. Kaji JAMA Surg. Published online January 3, 2024. doi:10.1001/jamasurg.2023.6675 Introduction Over the past 2 decades, surgical education literature has seen tremendous growth driven by changes in graduate medical education,...

Why Should We Be Measuring Ionized Magnesium? Magnesium in the Human Body Magnesium (Mg) is the 4th most abundant cation in the human body. The majority of it is found intracellularly, more than half in bone, about a third in muscle, and the remaining in soft tissue and extracellular fluid (Figure 1). Magnesium is found in the diet from a variety of sources: green leafy vegetables (Mg is found in chlorophyll), nuts and seeds, fruits, yogurt, and unrefined grains suc...

ORIGINAL ARTICLE Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19 Andre C. Kalil, Thomas F. Patterson, Aneesh K. Mehta, et al N Engl J Med December 11, 2020DOI: 10.1056/NEJMoa2031994 Abstract BACKGROUND Severe coronavirus disease 2019 (Covid-19) is associated with dysregulated inflammation. The effects of combination treatment with baricitinib, a Janus kinase inhibitor, plus remdesivir are not known. METHODS We conducted a dou...

Osmolar gap The osmolar gap is a diagnostic tool which can help identify the presence of some foreign solute in the body fluids. In the CICM fellowship SAQs, it mostly identifies young women who have ingested a toxic alcohol. Specific questions of this sort include the following examples: Question 7.2 from the first paper of 2014 - HAGMA, high osmolar gapQuestion 7.3 from the first paper of 2014 - HAGMA, normal osmolar gapQuestion 25.2 from the sec...

Urinary electrolytes and the urinary anion gap Urinary anion gap The urinary anion gap is extensively explored in the chapter on the diagnosis of renal tubular acidosis. Its role in the SAQs has been limited to the diagnosis of renal tubular acidosis (i.e where it is used to discriminate between renal and non-renal causes of a normal anion gap acidosis, such as in Question 3.4  from the second paperof 2013). In brief: Urinary anion gap...