A physician offers to help in a medical emergency on a transatlantic flight. Though she faces limits of bureaucracy, equipment, and ultimately biology, she discovers her physicianhood is inescapable.
Author: Elizabeth Rourke
Posted: April 25, 2026, 12:00 am
In children with septic shock, no significant difference was seen in the incidence of death, new renal-replacement therapy, or persistent kidney dysfunction with balanced fluid as compared with 0.9% saline for fluid resuscitation.
Author: Fran Balamuth, Scott L. Weiss, Elliot Long, Graham C. Thompson, Amanda S. Artis, Atzael B. Campos, Meredith L. Borland, Stuart R. Dalziel, Adriana Yock-Corrales, Ruchi Singh, Amanda Williams, Beata Mickiewicz, Christopher P. Hickey, Julie C. Fitzgerald, Benjamin L. Laskin, Robert W. Hickey, Michelle Eckerle, Waleed Alqurashi, Elizabeth Alpern, Lilliam Ambroggio, Mohamed Badawy, Shannon Baumer-Mouradian, Simon Berthelot, Lindsay D. Clukies, Simon Craig, Sarah J. Curtis, Adrienne L. Davis, Susan Duffy, Matthew A. Eisenberg, Jason G. Emsley, Ara Festekjian, Shane George, Rebecca Green, Karen E. Gripp, Priya G. Jain, Shefali Jani, Gary I. Joubert, Pavan Judge, April Kam, Amit Kochar, Ioannis Koutroulis, Maria Y. Kwok, Roni D. Lane, Anna Lithgow, Julia Lloyd, Karim Mansour, Julie K. McManemy, Claudia Morris, Natalie Phillips, Arjun Rao, Alexander Rogers, Anupam Sehgal, Yasaman Shayan, Jonathan Silverman, Eunicia Tan, Neil G. Uspal, Cheryl Vance, Emma Whyte, Jing Huang, Stephen B. Freedman, Franz E. Babl, Nathan Kuppermann, the PRoMPT BOLUS Investigators of the PECARN, PERC, and PREDICT Networks*
Posted: April 24, 2026, 12:00 am
An 87-year-old man presented with difficulty breathing after having inhaled thick smoke from a forest fire for several hours. Respiratory failure developed. On flexible bronchoscopy, black casts were seen in the airway.
Author: Yuling Wang, Xiangdong Mu
Posted: April 23, 2026, 12:00 am
Effective blood-pressure control is the cornerstone of management after intracerebral hemorrhage; it is both the primary determinant of risk and the most vital intervention for reducing the threat of a second vascular event.1 Yet, despite the availability of effective treatments, blood pressure remains poorly controlled in survivors of...
Author: Ayush Batra, Farzaneh Sorond
Posted: April 23, 2026, 12:00 am
A 74-year-old man presented with a painful laceration on his leg that he had sustained 3 days earlier in waters off the Gulf Coast of Florida. Ecchymosis, swelling, and crepitus were observed in the lower leg.
Author: Natalie Rosseau, Norman L. Beatty
Posted: April 23, 2026, 12:00 am
Spinal epidural abscess is an infection in the epidural space commonly caused by Staphylococcus aureus. Symptoms include back pain, neck pain, fever, and neurologic symptoms. Prompt evaluation is important.
Author: Aaron J. Tande, Bradford L. Currier, Douglas R. Osmon
Posted: April 23, 2026, 12:00 am
In this randomized trial involving critically ill patients undergoing intubation in EDs or ICUs, the use of ketamine for the induction of anesthesia did not lead to significantly lower in-hospital mortality than etomidate.
Author: Jonathan D. Casey, Kevin P. Seitz, Brian E. Driver, Kevin W. Gibbs, Adit A. Ginde, Stacy A. Trent, Derek W. Russell, Amelia L. Muhs, Matthew E. Prekker, John P. Gaillard, Daniel Resnick-Ault, L. Jane Stewart, Micah R. Whitson, Stephanie C. DeMasi, Aaron E. Robinson, Jessica A. Palakshappa, Neil R. Aggarwal, Jason C. Brainard, David J. Douin, Tanya K. Marvi, Benjamin K. Scott, Sarah M. Alber, Carolynn Lyle, Sheetal Gandotra, Graham W. Van Schaik, Aaron J. Lacy, Kristen C. Sherlin, Heidi L. Erickson, J. Maycee Cain, Brianne Redman, Logan L. Beach, Barbara Gould, Jasmine McIntosh, Ariel A. Lewis, Bradley D. Lloyd, Tiffany L. Israel, Brant Imhoff, Li Wang, Alexandra B. Spicer, Matthew M. Churpek, Todd W. Rice, Wesley H. Self, Jin H. Han, Matthew W. Semler, the RSI Investigators and the Pragmatic Critical Care Research Group*
Posted: April 23, 2026, 12:00 am
Among survivors of intracerebral hemorrhage, a single pill with three low-dose antihypertensive agents added to standard care was associated with a lower incidence of stroke and major cardiovascular events than placebo.
Author: The Trident Research Group, Craig S. Anderson, Clara K. Chow, H. Asita de Silva, Bimsara Senanayake, Kolawole Wahab, Rustam Al-Shahi Salman, Catharina J.M. Klijn, Sheila Ouriques Martins, Natalie Espinosa, Lauren Kuhles, Laurent Billot, Hisatomi Arima, Cheryl Carcel, Xia Wang, Qiang Li, Sana Shan, Mathangi Shanthakumar, Huy Thang Nguyen, Dilum Palliyaguruge, Janaka Peiris, Udaya K. Ranawaka, Senaka Bandusena, Thambipillai Rajendiran, Darshana Wijegunasinghe, Harsha Gunasekera, Indunil Wijeweera, Athula Dissanayake, Ajantha Keshavaraj, Reginald O. Obiako, Rufus Akinyemi, Luiz Nasi, Rodrigo Bazan, Carla Heloisa Cabral Moro, Mariana Battaglini, Viviane Zétola, Wan Chung Law, Yuen Kang Chia, Dennis Cordato, Rohan Grimley, Anuradha Dahanayaka, Sonali Liyanagamage, Nilukshi Fernando, Nihara Abdul Rasheed, Nodar Kakabadze, Maia Beridze, Mythily Aravinthan, Vithoosan Sahathevan, Devasmitha Wijesundara, Pramith Ruwanpathirana, Wan Asyraf Wan Zaidi, Tinatin Kherkheulidze, Urs Fischer, Ana Cláudia de Souza, Tsong-Hai Lee, Christopher Chen, Octavio Pontes-Neto, Thompson Robinson, Jiguang Wang, Sharon L. Naismith, Michael Barnett, Carlos Delfino, Shoujiang You, Feifeng Liu, Candice Delcourt, Tom J. Moullaali, Tim Wilkinson, Neil Watson, Karla Santo, Qiao Han, Mariana Almudi Souza, Wilmar M.T. Jolink, Anderson Berni Cristofari, Zien Zhou, Floris H. Schreuder, Richard I. Lindley, Manuela Armenis, Mark Woodward, Ruth Freed, Lili Song, John Chalmers, Anthony Rodgers
Posted: April 23, 2026, 12:00 am
Despite the implementation of efficacious interventions for secondary prevention, patients with ischemic stroke or transient ischemic attack (TIA) remain at substantial residual risk for short- and long-term recurrent ischemic stroke and coronary events.1,2 Approximately three quarters of ischemic strokes or TIAs are noncardioembolic and may be attributable to...
Author: Marion Boulanger
Posted: April 16, 2026, 12:00 am
A 27-year-old woman presented with a 2-week history of joint pain, fever, sore throat, and a nonpruritic rash that worsened during fever. Laboratory tests showed an elevated ESR and elevated C-reactive protein and ferritin levels.
Author: Gabrielle Cognacq, Richard Stratton
Posted: April 16, 2026, 12:00 am
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