Essential Landmark Journals in Medicine

Critical Care Emergency Medicine Landmark Pediatric Emergency

PRoMPT RCT—Balanced Fluid vs. Saline in Pediatric Septic Shock
May 11, 2026May 16, 2026

Spoon Feed —
In children with suspected septic shock, balanced crystalloids did not reduce the incidence of death, new renal-replacement therapy, or persistent kidney dysfunction compared with 0.9% saline, suggesting either fluid is reasonable for initial ED resuscitation.

Source
Balanced Fluid or 0.9% Saline in Children Treated for Septic Shock. N Engl J Med. 2026 Apr 24:10.1056/NEJMoa2601969. doi: 10.1056/NEJMoa2601969. Epub ahead of print. PMID: 42028918; PMCID: PMC13134814.

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Endocrine Internal Medicine Landmark Neurology

Do Glucose-Lowering Drugs Impact Cognitive Outcomes?
June 13, 2025June 7, 2025

Spoon Feed —
In the GRADE RCT, poor glycemic control was associated with worse cognitive scores in patients with type 2 diabetes. However, none of the investigated treatments showed a superior effect on cognitive scores, despite insulin glargine and liraglutide offering better glycemic control.

Source
Glucose-Lowering Medications, Glycemia, and Cognitive Outcomes: The GRADE Randomized Clinical Trial. JAMA Intern Med. 2025 May 19:e251189. doi: 10.1001/jamainternmed.2025.1189. Epub ahead of print. PMID: 40388190

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Cardiology Family Medicine Internal Medicine Landmark Pharmacy/Pharmacology Surgery

Landmark Corner – Extended-Release Metoprolol Before Surgery?
June 11, 2025June 7, 2025

Spoon Feed —
The POISE trial showed that initiating metoprolol therapy shortly before noncardiac surgery results in increased mortality, stroke, bradycardia, and hypotension.

Source
Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet. 2008 May 31;371(9627):1839-47. doi: 10.1016/S0140-6736(08)60601-7. Epub 2008 May 12. PMID: 18479744

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Hematology/Oncology Internal Medicine Landmark

Landmark Corner – Platelet-Transfusion for Hematologic Cancers
June 10, 2025June 7, 2025

Spoon Feed —
The TOPPS trial showed that patients undergoing treatment for hematologic malignancy who develop thrombocytopenia <10 x10⁹/L should receive prophylactic platelet transfusion to prevent bleeding.

Source
A no-prophylaxis platelet-transfusion strategy for hematologic cancers. N Engl J Med. 2013 May 9;368(19):1771-80. doi: 10.1056/NEJMoa1212772. PMID: 23656642

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Critical Care Internal Medicine Landmark Renal

Landmark Corner – Early vs. Late Renal-Replacement in the ICU?
June 9, 2025June 7, 2025

Spoon Feed —
Early vs. delayed renal replacement therapy (RRT) showed no mortality difference in ICU patients with KDIGO stage 3 acute kidney injury.

Source
Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit. N Engl J Med. 2016 Jul 14;375(2):122-33. doi: 10.1056/NEJMoa1603017. Epub 2016 May 15. PMID: 27181456

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Family Medicine Internal Medicine Landmark Pharmacy/Pharmacology Pulmonary/Allergy

Landmark Corner – Omalizumab in Severe Asthma
June 6, 2025June 5, 2025

Spoon Feed —
In patients with asthma inadequately controlled on high-dose inhaled corticosteroids (ICS) and long acting beta agonists (LABAs), omalizumab significantly reduces symptom burden.

Source
Omalizumab in severe allergic asthma inadequately controlled with standard therapy: a randomized trial. Ann Intern Med. 2011 May 3;154(9):573-82. doi: 10.7326/0003-4819-154-9-201105030-00002. Erratum in: Ann Intern Med. 2019 Oct 1;171(7):528. doi: 10.7326/L19-0549. PMID: 21536936

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Family Medicine Internal Medicine Landmark Orthopedics

Landmark Corner – Surgery vs. PT for Meniscal Tear and OA
May 12, 2025May 10, 2025

Spoon Feed —
Though confounded by high crossover, there were no outcome differences in patients with meniscal tears and knee osteoarthritis treated with arthroscopic surgery with post-operative physical therapy (PT) versus PT alone.

Source
Surgery versus physical therapy for a meniscal tear and osteoarthritis. N Engl J Med. 2013 May 2;368(18):1675-84. doi: 10.1056/NEJMoa1301408. Epub 2013 Mar 18. Erratum in: N Engl J Med. 2013 Aug 15;369(7):683. PMID: 23506518

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Critical Care Internal Medicine Landmark

Landmark Corner – Acetaminophen for Fever in Critically Ill Patients
April 25, 2025April 25, 2025

Spoon Feed —
Antipyretic therapy in febrile patients has not been shown to improve death or serious adverse events.

Source
Acetaminophen for Fever in Critically Ill Patients with Suspected Infection. N Engl J Med. 2015 Dec 3;373(23):2215-24. doi: 10.1056/NEJMoa1508375. Epub 2015 Oct 5. PMID: 26436473

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Family Medicine Internal Medicine Landmark Neurology Stroke

Landmark Corner – Warfarin vs Aspirin to Prevent Stroke
April 24, 2025May 6, 2025

Spoon Feed —
The WARSS trial found aspirin (325 mg daily) as effective as warfarin (INR 1.4-2.8) for the secondary prevention of noncardioembolic stroke, with fewer bleeding events, establishing aspirin as first-line therapy.

Source
Warfarin-Aspirin Recurrent Stroke Study Group. A comparison of warfarin and aspirin for the prevention of recurrent ischemic stroke. N Engl J Med. 2001 Nov 15;345(20):1444-51. doi: 10.1056/NEJMoa011258. PMID: 11794192

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Family Medicine Infectious Disease Internal Medicine Landmark

Antibiotics for 1 or 2 Weeks for Bacteremia?
April 15, 2025May 17, 2025

Spoon Feed —
For a patient with bacteremia, with notable exclusions below, a 7-day course of antibiotics is noninferior to the traditional 14-day course.

Source
Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections. N Engl J Med. 2025 Mar 13;392(11):1065-1078. doi: 10.1056/NEJMoa2404991. Epub 2024 Nov 20. PMID: 39565030.

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