ORIGINAL ARTICLE Trial of Endovascular Therapy for Acute Ischemic Stroke with Large Infarct Xiaochuan Huo, Gaoting Ma, Xu Tong, et al N Engl J Med February 10, 2023DOI: 10.1056/NEJMoa2213379 Abstract BACKGROUND The role of endovascular therapy for acute stroke with a large infarction has not been extensively studied in differing populations. METHODS We conducted a multicenter, prospective, open-label, randomized trial in China involving patients wi...

ICU Management & Practice, Volume 22 - Issue 4, 2022 Diagnostic Stewardship in Five Common Infectious Syndromes This article defines diagnostic stewardship and discusses how it can be implemented in intensive care units and how it may improve patient outcomes. Introduction Antimicrobial resistance (AMR) is an imminent threat to global health and has been accelerated by the inappropriate use of antimicrobials (Llor and Bjerrum 2014). Antimicrobial stew...

ORIGINAL ARTICLE Evaluation of BNT162b2 Covid-19 Vaccine in Children Younger than 5 Years of Age Flor M. Muñoz, Lawrence D. Sher, Charu Sabharwal, et al N Engl J Med 2023; 388:621-634DOI: 10.1056/NEJMoa2211031 Abstract BACKGROUND Safe and effective vaccines against coronavirus disease 2019 (Covid-19) are urgently needed in young children. METHODS We conducted a phase 1 dose-finding study and are conducting an ongoing phase 2–3 safety, immunogen...

ORIGINAL ARTICLE Efficacy and Safety of an Ad26.RSV.preF–RSV preF Protein Vaccine in Older Adults Ann R. Falsey, Kristi Williams, Efi Gymnopoulou, et al N Engl J Med 2023; 388:609-620DOI: 10.1056/NEJMoa2207566 Abstract BACKGROUND Respiratory syncytial virus (RSV) can cause serious lower respiratory tract disease in older adults, but no licensed RSV vaccine currently exists. An adenovirus serotype 26 RSV vector encoding a prefusion F (preF) protein (Ad26....

ORIGINAL ARTICLE Respiratory Syncytial Virus Prefusion F Protein Vaccine in Older Adults Alberto Papi, Michael G. Ison, Joanne M. Langley, et al N Engl J Med 2023; 388:595-608DOI: 10.1056/NEJMoa2209604 Abstract BACKGROUND Respiratory syncytial virus (RSV) is an important cause of acute respiratory infection, lower respiratory tract disease, clinical complications, and death in older adults. There is currently no licensed vaccine against RSV infection. ...

ICU Management & Practice, Volume 22 - Issue 4, 2022 Rapid Diagnostics and Antimicrobial Resistance in the ICU The need to address the problem of antimicrobial resistance, the importance of faster diagnosis of bacterial infections and an overview of rapid diagnostic testing. Antimicrobial resistance (AMR) is rapidly increasing on a global scale. The discovery of penicillin revolutionised the field of medicine, providing safe harbour from the most pressin...

ORIGINAL ARTICLE Azithromycin to Prevent Sepsis or Death in Women Planning a Vaginal Birth Alan T.N. Tita, Waldemar A. Carlo, Elizabeth M. McClure, et al N Engl J Med February 9, 2023DOI: 10.1056/NEJMoa2212111 Abstract BACKGROUND The use of azithromycin reduces maternal infection in women during planned cesarean delivery, but its effect on those with planned vaginal delivery is unknown. Data are needed on whether an intrapartum oral dose of azithrom...

Original Investigation  February 9, 2023 Effect of Argatroban Plus Intravenous Alteplase vs Intravenous Alteplase Alone on Neurologic Function in Patients With Acute Ischemic Stroke: The ARAIS Randomized Clinical Trial Hui-Sheng Chen, Yu Cui, Zhong-He Zhou, et al JAMA. Published online February 9, 2023. doi:10.1001/jama.2023.0550 Key Points Question  Does argatroban improve neurologic function in patients with acute ischemic stro...

ARTICLES| VOLUME 401, ISSUE 10375, P447-457, FEBRUARY 11, 2023 Pregnancy outcomes and vaccine effectiveness during the period of omicron as the variant of concern, INTERCOVID-2022: a multinational, observational study Jose Villar, Constanza P Soto Conti, Robert B Gunier, et al. Lancet 2023; 401: 447-457 Published:January 17, 2023 DOI:https://doi.org/10.1016/S0140-6736(22)02467-9 Summary Background In 2021, we showed an increased risk as...

ICU Management & Practice, Volume 22 - Issue 4, 2022 Does Antimicrobial Resistance Affect Clinical Outcomes in the ICU? An overview of antimicrobial resistance and its impact on clinical outcomes in the ICU.  Antimicrobial resistance (AMR) has been defined as a major threat to healthcare and to humanity by the World Health Organization (WHO 2015). The level of evidence for the association between AMR and hospital deaths, hospital length of stay and ...