Understanding “No Escalation of Treatment” Designations No Escalation of Treatment (NoET) designations are used in ICUs to limit treatment for critically ill patients. However, they are the subject of much debate and have not been qualitatively studied. In this study conducted at seven hospitals in the U.S., researchers evaluate how physicians understand and perceive NoET designations with regard to their utility and associated challenges. They also explore what...

Invited Commentary  September 18, 2022 Fluoroscopic Guidance for Femoral Artery Access—Pushing Patients Out of the Plane Without a Parachute? Alexander C. Fanaroff, Jay Giri JAMA Cardiol. 2022;7(11):1118-1120. doi:10.1001/jamacardio.2022.3413 Common femoral artery (CFA) access—for diagnostic angiography, percutaneous coronary intervention (PCI), or other endovascular or structural heart procedures—is among the most ubiquitous procedures performed in th...

ORIGINAL ARTICLE Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus Tim Hundscheid, Wes Onland, Elisabeth M.W. Kooi, et al N Engl J Med December 6, 2022DOI: 10.1056/NEJMoa2207418 Abstract BACKGROUND Cyclooxygenase inhibitors are commonly used in infants with patent ductus arteriosus (PDA), but the benefit of these drugs is uncertain. METHODS In this multicenter, noninferiority trial, we randomly assigned infants with echocardiogra...

Invasive Mechanical Ventilation and the Pulmonary Microbiota Healthy lungs are necessary to accomplish O2/CO2 exchange between blood and external air. The pulmonary microbiota is critical for maintaining the functional balance of the lungs and is associated with the development and progression of respiratory diseases, such as asthma, chronic obstructive pulmonary disease, cystic fibrosis (CF), non-CF bronchiectasis, tuberculosis, COVID-19, lung cancer and lung...

CORRESPONDENCE| VOLUME 23, ISSUE 1, P22-23, JANUARY 01, 2023 Omicron sublineage BQ.1.1 resistance to monoclonal antibodies Prerna Arora, Amy KempfInga, Nehlmeier Sebastian, et al. Lancet Infect Dis Published: November 18, 2022 DOI: https://doi.org/10.1016/S1473-3099(22)00733-2 Vaccination represents the key strategy to control the COVID-19 pandemic through induction of neutralising antibody responses and T cell-associated immunity that subst...

Viewpoint  August 22, 2022 The Current Status of Next-Generation Sequencing for Diagnosis of Central Nervous System Infections Michael R. Wilson, Kenneth L. Tyler JAMA Neurol. 2022;79(11):1-2. doi:10.1001/jamaneurol.2022.2287 The prime directive in diagnosing neuroinfectious disease is to answer 3 deceptively simple questions: (1) Is the patient infected? (2) If so, with what? (3) How do we treat the infection? Our ability to answer the first 2 questio...

Original Investigation  September 6, 2022 Association Between Traumatic Brain Injury and Subsequent Cardiovascular Disease Among Post-9/11–Era Veterans Ian J. Stewart, Megan E. Amuan, Chen-Pin Wang, et al JAMA Neurol. 2022;79(11):1122-1129. doi:10.1001/jamaneurol.2022.2682 Key Points Question  What is the association of a traumatic brain injury (TBI) with the subsequent risk of cardiovascular disease in veterans of the recent conflicts in ...

Original Research13 December 2022 Nirmatrelvir Plus Ritonavir for Early COVID-19 in a Large U.S. Health System: A Population-Based Cohort Study Scott Dryden-Peterson, Andy Kim, Arthur Y. Kim, et al Ann Intern Med https://doi.org/10.7326/M22-2141 Abstract Background: In the EPIC-HR (Evaluation of Protease Inhibition for Covid-19 in High-Risk Patients) trial, nirmatrelvir plus ritonavir led to an 89% reduction in hospitalization or death among unvaccinated...

Role of NO Pathway in Sepsis Sepsis and septic shock are accompanied by haemodynamic, microcirculatory and metabolic changes. These changes can lead to impaired tissue oxygenation, multiorgan damage and death. A common hallmark of sepsis is reduced blood pressure. An increase in nitric oxide (NO) because of inflammation can contribute to vasodilation. On the other hand, a decrease in NO can induce microvascular dysfunction.  There is a hypothesis that ...

Original Investigation  September 18, 2022 Routine Ultrasonography Guidance for Femoral Vascular Access for Cardiac ProceduresThe UNIVERSAL Randomized Clinical Trial Sanjit S. Jolly, Sulaiman AlRashidi, Marc-André d’Entremont, et al JAMA Cardiol. 2022;7(11):1110-1118. doi:10.1001/jamacardio.2022.3399 Key Points Question  Does routine ultrasonography guidance for femoral arterial access for cardiac procedures reduce bleeding or vascular com...