EDITORIAL A New Step in Postexposure Prophylaxis for Leprosy David M. Scollard N Engl J Med 2023; 388:1904-1905DOI: 10.1056/NEJMe2302667 Infection with Mycobacterium leprae is curable with a combination of dapsone, rifampin, and clofazimine (multidrug therapy), as recommended by the World Health Organization (WHO) in 1982. The use of this multidrug regimen led to an initial rapid decline in the global prevalence of M. leprae infection, a re...

Editorial  June 20, 2023 Revisiting the Analogy Between Clinical Trials and Diagnostic Tests by Interpreting a Negative Trial as a Negative Test for Efficacy Roger J. Lewis, Kert Viele JAMA. 2023;329(23):2023-2025. doi:10.1001/jama.2023.8972 As noted in JAMA more than 30 years ago,1 randomized clinical trials are like diagnostic tests in several ways. Clinical trials are designed to detect hypothesized treatment effects in the ...

Perspective Toward Comprehensive Care for Long Covid Janko Ž. Nikolich, Clifford J. Rosen N Engl J Med May 9, 2023DOI: 10.1056/NEJMp2304550 Three years into the Covid pandemic, SARS-CoV-2 is still with us. As the virus evolves, it continues to pose a health threat in terms of both acute infections (or reinfections) and postacute sequelae. In regard to the former, there is evidence that several pharmacologic interventions reduce the severity of infections, less...

Editorial  May 21, 2023 Conversations on Goals of Care With Hospitalized, Seriously Ill Patients Douglas B. White, Sarah K. Andersen JAMA. 2023;329(23):2021-2022. doi:10.1001/jama.2023.8970 Goals-of-care conversations between clinicians and patients with serious illness have been shown to improve measures of patient and family well-being, while also decreasing health care costs and high-intensity treatments at the end of life.1,2 Nonetheless, achi...

#ISICEM23: Low vs Standard Calorie and Protein Feeding Critical illness requiring organ support is associated with high mortality and prolonged recovery. The acute phase is characterised by anorexia, metabolic disorders, endocrine dysfunction, and hypercatabolism with muscle wasting. Nutritional support is essential during this phase. Calorie and protein deficits have been linked to higher risks of healthcare-associated infections, ICU-acquired weakness, prolonged inva...

EDITORIAL Transcatheter Therapy for Tricuspid Regurgitation — First Act Mathias Orban, Steffen Massberg N Engl J Med 2023; 388:1902-1903DOI: 10.1056/NEJMe2302457 Severe tricuspid regurgitation is associated with impaired quality of life and poor survival.1 The condition is managed medically with diuretic agents; surgery is of limited use, since many patients have a variety of coexisting conditions that increase surgical risk. Current U.S. and European soc...

ICU Management & Practice, Volume 23 - Issue 1, 2023 Biomarkers of Infection in the Intensive Care Unit Biomarkers are an area of rapid discovery in critical care medicine today. They have the potential to improve our ability to identify and manage patients at increased risk of organ failure and death. This article provides an overview of biomarkers of infection in the intensive care unit. The heterogeneity of sepsis makes its identification challenging ...

#ISICEM23: Effects of Therapeutic-Dose Heparin in Hospitalised Patients With COVID-19 At the #ISICEM23 this week in Brussels, the benefits and harms of therapeutic-dose heparin varied by hospitalised COVID-19 patient characteristics were discussed, and the importance of considering the heterogeneity of treatment effect (HTE) in the design and analysis of randomised clinical trials was highlighted. To date, RCTs that have tested therapeutic-dose heparin in COVID-...

ICU Management & Practice, Volume 23 - Issue 1, 2023 Biomarkers in Sepsis This article describes the application of existing and emerging biomarkers in the diagnosis and management of sepsis and pneumonia. Introduction: The Need for Biomarkers in Sepsis Sepsis is defined as a dysregulated host response to infection that results in life threatening organ dysfunction. It carries an estimated 30-day mortality rate of 24.4% and increases to ...

Editorial  May 9, 2023 The Future of Clinical Trials in Idiopathic Pulmonary Fibrosis Anna J. Podolanczuk, Luca Richeldi, Fernando J. Martinez JAMA. 2023;329(18):1554-1555. doi:10.1001/jama.2022.23955 Idiopathic pulmonary fibrosis (IPF) currently affects about 100 000 individuals in the US, and millions globally. Patients living with IPF experience disabling symptoms and progressive loss of lung function.1 The 2 treatments approved by th...