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In This Issue of JAMA
July 16, 2019

Highlights

JAMA. 2019;322(3):183-185. doi:10.1001/jama.2018.15421
Research

Flexible visitation policies in intensive care units may increase family satisfaction and reduce patient stress. For the ICU Visits Study Group Investigators and the Brazilian Research in Intensive Care Network, Rosa and colleagues randomized 36 intensive care units caring for 1685 patients and 1295 family members and found that a flexible family visitation policy, compared with standard restrictive visiting hours, did not reduce the incidence of delirium. In an Editorial, Rose and colleagues suggest that improving mental status and psychological outcomes of critically ill patients and their families is likely to be as challenging as improving patient survival.

Editorial and Related Article

Visual Abstract and CME

Reviewing a daily record of a patient’s experiences in intensive care may help the patient gain a sense of reality by addressing traumatic memories and gaps in recall. In a randomized clinical trial that enrolled 657 patients from 35 intensive care units, Garrouste-Orgeas and colleagues found that the use of an intensive care unit diary did not reduce the proportion of patients who exceeded a predetermined threshold of posttraumatic stress disorder symptoms.

Editorial and Related Article

Visual Abstract

Timely sepsis treatment improves health outcomes, but the role of government mandates to enforce the use of sepsis protocols is controversial. Kahn and colleagues conducted an interrupted time series analysis of 1 012 410 sepsis admissions in 509 hospitals and found that mandated protocolized sepsis care was associated with a greater decrease in mortality for patients who were hospitalized with sepsis.

Editor’s Note

Evidence from randomized trials suggests that the benefit of endovascular reperfusion therapy may be time dependent. Jahan and colleagues conducted a retrospective cohort study of 6756 patients with large vessel occlusion acute ischemic stroke treated in routine clinical practice and found that shorter time to endovascular reperfusion therapy was associated with better vascular and functional outcomes.

Editor’s Note

Summary Video and CME

Clinical Review & Education

This JAMA Clinical Challenge by R. Micieli and J. A. Micieli presents a 39-year-old woman with palmar and axillary hyperhidrosis who noticed that her left pupil was dilated when she looked in a mirror. What would you do next?

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