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JAMA Diagnostic Test Interpretation September 14, 2018 Coagulation Test Interpretation in a Patient Taking Direct Oral Anticoagulant Therapy Michelle Sholzberg, Yan Xu JAMA. 2018;320(14):1485-1486. doi:10.1001/jama.2018.13998 Case 病例 A 74-year-old man presented with spontaneous, acute onset of confusion and headache. He had no preceding head trauma or falls. He had a history of atrial fibrillation with an annual stroke risk of 2.9% (based on points accrued for ...
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JAMA Diagnostic Test Interpretation September 14, 2018 Coagulation Test Interpretation in a Patient Taking Direct Oral Anticoagulant Therapy Michelle Sholzberg, Yan Xu JAMA. 2018;320(14):1485-1486. doi:10.1001/jama.2018.13998 Case 病例 A 74-year-old man presented with spontaneous, acute onset of confusion and headache. He had no preceding head trauma or falls. He had a history of atrial fibrillation with an annual stroke risk of 2.9% (based on points accrued for ...
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JAMA Guide to Statistics and Methods August 23, 2018 Case-Control Studies: Using “Real-world” Evidence to Assess Association Telba Z. Irony JAMA. Published online August 23, 2018. doi:10.1001/jama.2018.12115 Associations between patient characteristics or treatments received and clinical outcomes are often first described using observational data, such as data arising through usual clinical care without the experimental assignment of treatments that occurs in a randomi...
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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 Continue Current Treatment with Other Therapies Alan H. Morris, M.D. The decision to use ECMO for Mr. Jackson raises difficult issues that include both physician overconfidence in ECMO and the credibility of study results. Our first obligation is to ensure sa...
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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 Recommend Initiation of Venovenous ECMO Michael A. Matthay, M.D. This 36-year-old man has very severe ARDS caused by influenza pneumonia. His Pao2 is only 50 mm Hg, with an Fio2 of 1.0 and PEEP of 15 cm of water, and his arterial oxygen saturation is 80 to 82...
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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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