EDITORIAL Reinforcing the Checkpoint in Rheumatoid Arthritis Ellen M. Gravallese, Ranjeny Thomas N Engl J Med 2023; 388:1905-1907DOI: 10.1056/NEJMe2300734 Programmed cell death protein 1 (PD-1) is a critical inhibitory receptor in lymphocyte activation, acting as an immune checkpoint to prevent the continued activation of T cells after an immune response and to maintain peripheral immune tolerance. PD-1 is a marker of antigen-experienced T cells. With sustaine...

Research Analysis of peer reviewers’ response to invitations by gender and geographical region: cohort study of manuscripts reviewed at 21 biomedical journals before and during covid-19 pandemic Khaoula Ben Messaoud, Sara Schroter, Mark Richards, et al BMJ 2023; 381 doi: https://doi.org/10.1136/bmj-2023-075719 (Published 13 June 2023)Cite this as: BMJ 2023;381:e075719 Abstract Objectives To describe gender and geographical inequalities in invitations t...

Two Shocks Better Than One? In a recent investigation, the researchers aimed to answer whether alternative defibrillation strategies, including vector-change (VC) defibrillation and double sequential external defibrillation (DSED), improve survival to hospital discharge in patients experiencing out-of-hospital cardiac arrest with refractory ventricular fibrillation. The authors chose a cluster randomised controlled trial as the study design to investigate the ef...

JAMA Clinical Guidelines Synopsis  June 17, 2023 Caring for Patients With Acute Respiratory Distress Syndrome: Summary of the 2023 ESICM Practice Guidelines Derek C. Angus, Christopher W. Seymour, Kirsten Bibbins-Domingo JAMA. Published online June 17, 2023. doi:10.1001/jama.2023.6812 Guideline title ESICM Guidelines on Acute Respiratory Distress Syndrome: Definition, Phenotyping and Respiratory Support Strategies Release date Ju...

Original Investigation  May 9, 2023 Ziritaxestat, a Novel Autotaxin Inhibitor, and Lung Function in Idiopathic Pulmonary Fibrosis: The ISABELA 1 and 2 Randomized Clinical Trials Toby M. Maher, Paul Ford, Kevin K. Brown, et al JAMA. 2023;329(18):1567-1578. doi:10.1001/jama.2023.5355 Key Points Question  Does the autotaxin inhibitor ziritaxestat improve outcomes, compared with placebo, in patients with idiopathic pulmonary fibrosis...

ORIGINAL ARTICLE Patient-Level Meta-Analysis of Low-Dose Hydrocortisone in Adults with Septic Shock Romain Pirracchio, Djillali Annane, Andre K. Waschka, et al NEJM Evid 2023;2(6) DOI: 10.1056/EVIDoa2300034 Abstract BACKGROUND Trials and study-level meta-analyses have failed to resolve the role of corticosteroids in the management of patients with septic shock. Patient-level meta-analyses may provide more precise estimates of treatment effects, partic...

ICU Management & Practice, Volume 23 - Issue 1, 2023 Biomarkers for ARDS. What is New? Despite several biomarkers having been studied for diagnosis and/or prognosis of acute respiratory distress syndrome (ARDS), their extensive use has not been established. Better knowledge of the pathophysiology of ARDS and acute lung injury (ALI) may help develop new biomarkers. Acute respiratory distress syndrome (ARDS) is characterised by non-cardiogenic pulmonary oe...

ARTICLES|ONLINE FIRST Effectiveness of nirmatrelvir–ritonavir in preventing hospital admissions and deaths in people with COVID-19: a cohort study in a large US health-care system Joseph A Lewnard, John M McLaughlin, Debbie Malden, et al Lancet Infect Dis Open Access Published:March 15, 2023 DOI:https://doi.org/10.1016/S1473-3099(23)00118-4 Summary Background In the USA, oral nirmatrelvir–ritonavir is authorised for use in patients aged 12 years or ol...

COMMENT 20 March 2019 Scientists rise up against statistical significance Valentin Amrhein, Sander Greenland, Blake McShane and more than 800 signatories call for an end to hyped claims and the dismissal of possibly crucial effects. Valentin Amrhein, Sander Greenland & Blake McShane Nature 567, 305-307 (2019) When was the last time you heard a seminar speaker claim there was ‘no difference’ between two groups because the difference was ‘statistica...

EDITORIAL Tranexamic Acid for Trauma Patients — More Lives to Save and Outcomes to Consider Haleema Shakur-Still, Ian Roberts N Engl J Med June 14, 2023DOI: 10.1056/NEJMe2305075 Traumatic hemorrhage accounts for approximately 2 million deaths each year worldwide.1 In 2010, the results of the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage (CRASH)–2 trial showed that tranexamic acid reduces mortality among patients with bleeding tr...