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CLINICAL DECISIONS Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome Michael Y. Mi, Michael A. Matthay, and Alan H. Morris N Engl J Med 2018; 379:884-887 DOI: 10.1056/NEJMclde1804601 Case Vignette: A Man With Severe ARDS Mr. Jackson is a 36-year-old man whom you are caring for in the intensive care unit (ICU). Before this hospitalization, he was healthy and took no medications. He has never smoked, and he drinks three or four beers every ...
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Re-expansion pulmonary oedema Alice Petiot, Sammy Tawk, Benoît Ghaye Lancet 2018; 392: 507 A 46-year-old man presented to the emergency department with moderate dyspnoea and a 4-day history of cough. His medical history also included alcoholic cirrhosis with portal hypertension and ascites. On admission, a chest x-ray showed complete white-out of the right hemithorax with contralateral mediastinal deviation compatible with a large pleural effusion—presumed to be hepatic hy...
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Perspective > Medscape > Fast Five Quizzes Fast Five Quiz: Refresh Your Knowledge on Key Aspects of Sepsis Richard H. Sinert, DO June 07, 2018 Sepsis is defined as life-threatening organ dysfunction due to dysregulated host response to infection. Organ dysfunction is defined as an acute change in total Sequential Organ Failure Assessment (SOFA) score greater than 2 points secondary to the infection cause. Septic shock occurs in a subset of patients with sepsis and...
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IMAGES IN CLINICAL MEDICINE Corrigan’s Pulse and Quincke’s Pulse Hector I. Michelena, and Maurice Enriquez-Sarano N Engl J Med 2018; 379:e9 DOI: 10.1056/NEJMicm1715353 A 58-year-old man was referred to the cardiology clinic for evaluation of exertional dyspnea. Twelve years before presentation, he had undergone a bioprosthetic aortic-valve replacement for treatment of severe bicuspid aortic stenosis and for repair of an ascending aortic aneurysm. On physical examination, h...
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Perspective > Medscape > Fast Five Quizzes Fast Five Quiz: Refresh Your Knowledge on Key Aspects of Sepsis Richard H. Sinert, DO June 07, 2018 Sepsis is defined as life-threatening organ dysfunction due to dysregulated host response to infection. Organ dysfunction is defined as an acute change in total Sequential Organ Failure Assessment (SOFA) score greater than 2 points secondary to the infection cause. Septic shock occurs in a subset of patients with sepsis and...
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IMAGES IN CLINICAL MEDICINE Vibrio vulnificus Infection Jin Park, and Chang-Seop Lee N Engl J Med 2018; 379:375 DOI: 10.1056/NEJMicm1716464 A 71-year-old man presented to the emergency department with a 2-day history of fever and excruciating pain in his left hand that had developed 12 hours after eating raw seafood. He had a history of type 2 diabetes mellitus and hypertension and was undergoing hemodialysis for end-stage renal disease. At the time of presentation, hemor...
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Perspective > Medscape > Fast Five Quizzes Fast Five Quiz: Refresh Your Knowledge on Key Aspects of Sepsis Richard H. Sinert, DO June 07, 2018 Sepsis is defined as life-threatening organ dysfunction due to dysregulated host response to infection. Organ dysfunction is defined as an acute change in total Sequential Organ Failure Assessment (SOFA) score greater than 2 points secondary to the infection cause. Septic shock occurs in a subset of patients with sepsis and...
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IMAGES IN CLINICAL MEDICINE Cryptococcus neoformans Meningoencephalitis Raul Recio, and Ana Perez-Ayala N Engl J Med 2018; 379:281 DOI: 10.1056/NEJMicm1801051 A 36-year-old man presented to the emergency department with a 2-week history of fever, headache, drowsiness, and photophobia. He was previously healthy and was sexually active with men. The physical examination was notable for a temperature of 38.3°C and neck stiffness. Computed tomography of the head was normal. T...
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Perspective > Medscape > Fast Five Quizzes Fast Five Quiz: Refresh Your Knowledge on Key Aspects of Sepsis Richard H. Sinert, DO June 07, 2018 Sepsis is defined as life-threatening organ dysfunction due to dysregulated host response to infection. Organ dysfunction is defined as an acute change in total Sequential Organ Failure Assessment (SOFA) score greater than 2 points secondary to the infection cause. Septic shock occurs in a subset of patients with sepsis and...
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Perspective > Medscape > Fast Five Quizzes Fast Five Quiz: Refresh Your Knowledge on Key Aspects of Sepsis Richard H. Sinert, DO June 07, 2018 Sepsis is defined as life-threatening organ dysfunction due to dysregulated host response to infection. Organ dysfunction is defined as an acute change in total Sequential Organ Failure Assessment (SOFA) score greater than 2 points secondary to the infection cause. Septic shock occurs in a subset of patients with sepsis and...
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