ARTICLES|ONLINE FIRST Algorithm-based care versus usual care for the early recognition and management of complications after pancreatic resection in the Netherlands: an open-label, nationwide, stepped-wedge cluster-randomised trial F Jasmijn Smits, Anne Claire Henry, Marc G Besselink, et al Lancet Published:April 28, 2022 DOI:https://doi.org/10.1016/S0140-6736(22)00182-9 Summary Background Early recognition and management of postoperative complication...

CORRESPONDENCE| VOLUME 22, ISSUE 5, P588-589, MAY 01, 2022 Dynamics of humoral and T-cell immunity after three BNT162b2 vaccinations in adults older than 80 years Addi J Romero-Olmedo, Axel Ronald Schulz, Svenja Hochstätter, et al Lancet Infect Dis 2022; 22: 588-589 A third mRNA-based booster vaccination is the currently favoured strategy to maintain protection against SARS-CoV-2 infection. Yet, significant waning of specific immunity within 6 m...

ICU Management & Practice, Volume 22 - Issue 2, 2022 Septic Shock and Vasopressor Initiation: Why Earlier is Better An overview of vasopressor management, current evidence and when to initiate vasopressor therapy for best possible patient outcome. Vasopressor management is a cornerstone in the haemodynamic management of septic shock for reversing hypotension by increasing systemic vascular resistance and improving organ perfusion. The Surviving Sepsis Ca...

ORIGINAL ARTICLE Homologous and Heterologous Covid-19 Booster Vaccinations Robert L. Atmar, Kirsten E. Lyke, Meagan E. Deming, et al N Engl J Med 2022; 386:1046-1057DOI: 10.1056/NEJMoa2116414 Abstract BACKGROUND Although the three vaccines against coronavirus disease 2019 (Covid-19) that have received emergency use authorization in the United States are highly effective, breakthrough infections are occurring. Data are needed on the serial use of homologo...

ARTICLES|ONLINE FIRST A village doctor-led multifaceted intervention for blood pressure control in rural China: an open, cluster randomised trial Yingxian Sun, Jianjun Mu, Dao Wen Wang, et al. Lancet Published:April 29, 2022 DOI:https://doi.org/10.1016/S0140-6736(22)00325-7 Summary Background The prevalence of uncontrolled hypertension is high and increasing in low-income and middle-income countries. We tested the effectiveness of a multifaceted inte...

ARTICLES|ONLINE FIRST Vaccine effectiveness against SARS-CoV-2 infection and severe outcomes among individuals with immune-mediated inflammatory diseases tested between March 1 and Nov 22, 2021, in Ontario, Canada: a population-based analysis Jessica Widdifield, Jeffrey C Kwong, Simon Chen, et al Lancet Rheumatol Published:April 14, 2022 DOI:https://doi.org/10.1016/S2665-9913(22)00096-0 Summary Background We estimated COVID-19 vaccine effectiveness ag...

electronic Poor Outcome Screening (ePOS) Score The number of elderly and multimorbid patients admitted to the ICU continues to increase. These patients are at a high risk of dying and are likely to suffer from poor long-term outcomes such as functional and cognitive impairment, psychological distress and 6-month mortality. In addition, these patients have complex palliative care needs and could benefit from specialised palliative care consultation, which could redu...

CORRESPONDENCE Efficacy of a Fourth Dose of Covid-19 mRNA Vaccine against Omicron Gili Regev-Yochay, Tal Gonen, Mayan Gilboa, et al N Engl J Med March 16, 2022DOI: 10.1056/NEJMc2202542 TO THE EDITOR: In this open-label, nonrandomized clinical study, we assessed the immunogenicity and safety of a fourth dose of either BNT162b2 (Pfizer–BioNTech) or mRNA-1273 (Moderna) administered 4 months after the third dose in a series of three BNT162b2 doses (ClinicalTria...

ARTICLES|ONLINE FIRST Clinical features and management of human monkeypox: a retrospective observational study in the UK Hugh Adler, Susan Gould, Paul Hine, et al Lancet Infect Dis Published: May 24, 2022 DOI:https://doi.org/10.1016/S1473-3099(22)00228-6 Summary Background Cases of human monkeypox are rarely seen outside of west and central Africa. There are few data regarding viral kinetics or the duration of viral shedding and no licensed treatments...

ARTICLES| VOLUME 4, ISSUE 5, E351-E361, MAY 01, 2022 Ruxolitinib in addition to standard of care for the treatment of patients admitted to hospital with COVID-19 (RUXCOVID): a randomised, double-blind, placebo-controlled, phase 3 trial MeiLan K Han, Martti Antila, Joachim H Ficker, et al Lancet Rheumatol 2022; 4: e351-e361 Summary Background COVID-19 is associated with acute respiratory distress and cytokine release syndrome. The Janus kin...