Medical News & Perspectives  April 5, 2023 It Takes an Average of 17 Years for Evidence to Change Practice—the Burgeoning Field of Implementation Science Seeks to Speed Things Up Rita Rubin JAMA. Published online April 5, 2023. doi:10.1001/jama.2023.4387 Colorectal cancer screening with an at-home stool test is more convenient than with a colonoscopy, but an abnormal result on the former still requires a follow-up with the latter. ...

Research Letter  April 6, 2023 Risk of Death in Patients Hospitalized for COVID-19 vs Seasonal Influenza in Fall-Winter 2022-2023 Yan Xie, Taeyoung Choi, Ziyad Al-Aly JAMA. Published online April 6, 2023. doi:10.1001/jama.2023.5348 In the first year of the COVID-19 pandemic, 2 US studies suggested that people hospitalized for COVID-19 had nearly 5 times the risk of 30-day mortality compared with those hospitalized for seasonal influenza.1,2&n...

Remote Ischaemic Conditioning in Septic Shock Septic shock is one of the most severe complications of any infection. It affects millions of people each year. Studies show that in the U.S. and Europe, nearly 10% of patients admitted to the ICU have septic shock. Significant efforts have been made to recognise and treat septic shock early. Still, over 50% of patients die of septic shock within days or weeks after diagnosis. Thus, there is a need for new therapeutic a...

Research Letter  April 3, 2023 Sharing of Individual Patient-Level Data by Trialists of Randomized Clinical Trials of Pharmacological Treatments for COVID-19 Laura C. Esmail, Philipp Kapp, Rouba Assi, et al JAMA. Published online April 3, 2023. doi:10.1001/jama.2023.4590 Access to individual patient-level data (IPD) of randomized clinical trials (RCTs) increases the reproducibility of research, facilitates exploration of effect modifiers, and leve...

Editorial  April 11, 2023 Lack of Benefit of Renin-Angiotensin System Inhibitors in COVID-19 Matthew M. Y. Lee, John J. V. McMurray JAMA. 2023;329(14):1155-1156. doi:10.1001/jama.2023.4405 There has been considerable interest in the potential role of renin-angiotensin system (RAS) inhibitors in patients with COVID-19 given that angiotensin-converting enzyme 2 (ACE2) is the functional receptor for SARS-CoV-2.1 Because ACE inhibitors and angiot...

Original Investigation  Caring for the Critically Ill Patient April 11, 2023 Effect of Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Initiation on Organ Support–Free Days in Patients Hospitalized With COVID-19: A Randomized Clinical Trial Writing Committee for the REMAP-CAP Investigators JAMA. 2023;329(14):1183-1196. doi:10.1001/jama.2023.4480 Key Points Question  Does initiating an angiotensin-conve...

Original Investigation  April 11, 2023 Renin-Angiotensin System Modulation With Synthetic Angiotensin (1-7) and Angiotensin II Type 1 Receptor–Biased Ligand in Adults With COVID-19: Two Randomized Clinical Trials Wesley H. Self, Matthew S. Shotwell, Kevin W. Gibbs, et al JAMA. 2023;329(14):1170-1182. doi:10.1001/jama.2023.3546 Key Points Question  Among adults hospitalized with severe COVID-19, does treatment with synthetic angio...

ECMO for COVID-19 ARDS There is increasing evidence supporting the use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) in patients that do not respond to maximal medical therapy. ARDS can occur in some COVID-19 patients who are hospitalised, and ECMO can be utilised as a treatment option in some cases. Using ECMO can help avoid ventilator-induced lung injury and give the lungs time to rest while waiting for recove...

Original Investigation  April 11, 2023 Heterogeneity in Blood Pressure Response to 4 Antihypertensive Drugs: A Randomized Clinical Trial Johan Sundström, Lars Lind, Shamim Nowrouzi, et al JAMA. 2023;329(14):1160-1169. doi:10.1001/jama.2023.3322 Key Points Question  Is there a potential for personalized drug therapy in hypertension, and, if so, what is the magnitude of the benefit of personalization? Findings  In this...

ORIGINAL ARTICLE Tranexamic Acid to Prevent Obstetrical Hemorrhage after Cesarean Delivery Luis D. Pacheco, Rebecca G. Clifton, George R. Saade, et al N Engl J Med 2023; 388:1365-1375DOI: 10.1056/NEJMoa2207419 Abstract BACKGROUND Prophylactic use of tranexamic acid at the time of cesarean delivery has been shown to decrease the calculated blood loss, but the effect on the need for blood transfusions is unclear. METHODS We randomly assigned patients...