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In This Issue of JAMA
December 17, 2019


JAMA. 2019;322(23):2261-2263. doi:10.1001/jama.2018.15641


It is unclear whether early, aggressive vasodilation is beneficial for most patients with acute heart failure (AHF). Kozhuharov and colleagues for the GALACTIC Investigators randomized 788 patients with AHF and found that a strategy of early intensive and sustained vasodilation, compared with usual care, did not significantly improve a composite outcome of all-cause mortality and AHF rehospitalization at 180 days. In an Editorial, Curfman discusses the clinical management of acute decompensated heart failure with and without systemic hypertension.


Visual Abstract and CME

Neuromuscular blocking agents improve overall intubating conditions and first-attempt success rates in patients requiring emergency endotracheal intubation. A trial by Guihard and colleagues randomized 1248 patients undergoing endotracheal intubation and failed to demonstrate noninferiority for the success rate of rocuronium, compared with succinylcholine, for first intubation in patients receiving emergency intubation.

Visual Abstract

The technique of transcarotid artery revascularization with flow reversal was developed to decrease the risk of stroke associated with transfemoral carotid artery stenting. Schermerhorn and colleagues analyzed data for 11 891 patients undergoing treatment for carotid stenosis and found that transcarotid artery revascularization, compared with transfemoral carotid artery stenting, was significantly associated with a lower risk of in-hospital stroke or death.


Clinical Review & Education

Patients with osteoarthritis of the hip may benefit from weight loss, physiotherapy, intra-articular injections, or total hip replacement. This article in the JAMA Rational Clinical Examination series by Metcalfe and colleagues reviews the clinical diagnosis of hip osteoarthritis.

Many women with persistent symptoms and signs of ischemia have no evidence of obstructive coronary artery disease on angiography. This JAMA Insights article by Wei and colleagues discusses the diagnosis and treatment of coronary microvascular dysfunction.

JAMA Patient Page

Audio Interview

This JAMA Diagnostic Test Interpretation article by Latifi and colleagues presents a 40-year-old woman with abdominal pain, constipation, and amenorrhea whose point-of-care urine human chorionic gonadotropin test result was negative for pregnancy. What would you do next?