ORIGINAL ARTICLE Association of 2024–2025 Covid-19 Vaccine with Covid-19 Outcomes in U.S. Veterans Miao Cai, Yan Xie, Ziyad Al-Aly N Engl J Med Published October 8, 2025 DOI: 10.1056/NEJMoa2510226 Abstract BACKGROUND Amid the declining clinical severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and diminishing public uptake of annual coronavirus disease 2019 (Covid-19) vaccines, contemporary evidence on vaccine effecti...

Research Letter  Revisiting Minimum Case Volume Recommendations for Complex Surgery in Contemporary Practice Akash Kartik, Zhi Ven Fong, Chee-Chee Stucky, et al JAMA Published Online: October 8, 2025 doi: 10.1001/jama.2025.17274 The volume-outcome relationship informs policies guiding complex cancer surgery—historically, higher case volumes were associated with better postoperative mortality.1 Consequen...

Ventilator-Associated Pneumonia: Bridging Global Disparities In ICU Wed, 9 Jul 2025 Ventilator-associated pneumonia (VAP) is the most frequent hospital-acquired infection in patients receiving invasive mechanical ventilation (IMV) globally. It affects up to 40% of ventilated patients, with mortality rates up to 50% for all-cause mortality and 13% for direct VAP-related mortality. VAP significantly increases hospital length of stay, diagnostic testing, ...

Invited Commentary  Antibiotic Prophylaxis in Variceal Hemorrhage—Time to Stop? Catherine Mezzacappa, Guadalupe Garcia-Tsao JAMA Intern Med 2025;185;(10):1204-1205. doi:10.1001/jamainternmed.2025.3841 In their systematic review and bayesian meta-analysis published in this issue of JAMA Internal Medicine, Prosty et al1 assess the evidence supporting the universally recommended practice of administering prophylactic broad-spectrum antibiotics to patients wi...

ORIGINAL ARTICLE Hypertonic Saline or Carbocisteine in Bronchiectasis Judy M. Bradley, Brenda O’Neill, Daniel F. McAuley, et al N Engl J Med Published September 28, 2025 DOI: 10.1056/NEJMoa2510095 Abstract BACKGROUND Bronchiectasis guidelines are inconsistent with regard to the effectiveness of mucoactive agents, and their use varies geographically. Large trials are needed to assess safety and effectiveness. METHODS For this open-label, randomiz...

Original Investigation  Prophylactic Antibiotics for Upper Gastrointestinal Bleeding in Patients With Cirrhosis: A Systematic Review and Bayesian Meta-Analysis Connor Prosty, Dean Noutsios, Laurie-Rose Dubé, et al JAMA Intern Med 2025;185;(10):1194-1203. doi:10.1001/jamainternmed.2025.3832 Key Points Question  Are shorter durations (including 0 days) noninferior to longer durations of antibiotic prophylaxis ...

Using Nonpatient Features in Machine Learning for Hospital-Onset Bacteraemia  In ICU Wed, 9 Jul 2025 Hospital-onset bacteraemia and fungaemia (HOB) are frequent, often preventable hospital complications linked to high mortality, morbidity, and costs. While many studies have focused on patient-related, non-modifiable factors (e.g., demographics, comorbidities), these offer limited prevention opportunities.  Since up to two-thirds of HOB cas...

Prolonged Mechanical Ventilation in ICU Patients In ICU Tue, 15 Jul 2025 About 25% of ICU patients require mechanical ventilation, with most discontinuing it after 3–4 days. However, around 5% need prolonged mechanical ventilation (PMV), typically defined as ventilation for 21 or more days or 4+ days with tracheostomy.  The number of PMV patients has been rising. PMV is associated with high in-hospital mortality (~29%), a 50% weaning ...

Original Investigation  Nephrology AI-Based System for Analysis of Electron Microscope Images in Glomerular Disease Pengcheng Ma, Jinbang Li, Zhengyu Zhang, et al JAMA Netw Open 2025;8;(10):e2534985. doi:10.1001/jamanetworkopen.2025.34985 Key Points Question  What is the performance of an artificial intelligence (AI) system for the analysis of kidney transmission electron microscopy (TEM) images for diagn...

Imaging and Pulmonary Function Techniques in ARDS In ICU Wed, 9 Jul 2025 Acute Respiratory Distress Syndrome (ARDS) is a complex and heterogeneous condition requiring precise diagnosis and personalised treatment based on a thorough assessment of lung structure and function. Traditional physiological measures, such as respiratory compliance, driving pressure, transpulmonary pressure, and mechanical power, offer valuable insights for guiding therapy. How...