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Effects of Variable Pressure Support Ventilation on Regional Homogeneity and Aeration Tommaso Mauri, Marta Lazzeri, Alfio Bronco, et al. Am J Respir Crit Care Med 2017; 195: e27-e28 Figure 1.Physiologic effects of variable pressure support assessed by electrical impedance tomography. After application of variable pressure support, distribution of tidal ventilation within the patient’s chest became more homogeneous (A and B) and was associated with improved lung aerati...
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Lobar Necrosis from Pulmonary Embolism Ramiro Fernandez ,  Jonathan M. Tomasko ,  Daphne Edgren, et al Am J Respir Crit Care Med 2017; 195: 685-686 A 63-year-old male heart transplant recipient with recurrent lower extremity deep vein thrombosis, receiving warfarin, with chronically reduced glomerular filtration rate (30 ml/min), presented with worsening cough and dyspnea. Laboratory testing revealed normal blood cell counts, mildly elevated C-reactive protein, and in...
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[编者按]:以下病例来自即将发表的麻省总医院病例。诊断是什么?哪种诊断检查最可能有帮助?请就诊断发表你的意见,并对应当进行何种诊断检查发表评论。正确的诊断以及病例完整介绍及诊疗过程将于2017年3月23日的新英格兰医学杂志发表。 A 27-Year-Old Woman with Nausea, Vomiting, Confusion, and Hyponatremia Presentation of Case 病例报告 Dr. Meaghan E. Colling (Medicine): A 27-year-old woman was admitted to this hospital because of nausea, vomiting, confusion, and hyponatremia. Meaghan E. Co...
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Images in Clinical Medicine Empyema Necessitatis Ronaldo A. Gismondi, M.D., Ph.D. Luiz F.F. de Souza, M.D. N Engl J Med 2017; 376: e13 DOI: 10.1056/NEJMicm1608914 A 40-year-old man presented with a 3-month history of fever, weight loss, dyspnea, and cough. Physical examination revealed a tender, bulging anterior thoracic mass and a small ulcerative lesion that was inferomedial to the right nipple (Panel A). Computed tomographic scans showed a pleural effusion (Pa...
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16 Anatomic Mnemonics Editor: Christine Wiebe  |  March 14, 2017 How do you remember the anatomical structures housed by the retroperitoneum? Nick Love, PhD, a second-year medical student at Stanford University, created these whimsical images to help remember parts of the human anatomy. All images courtesy of Nick Love, PhD The heart's left ventricle pumps blood throughout the entire body. After leaving the left ventricle, blood enters the aorta, brachiocephalic trunk, t...
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Images in Clinical Medicine Gas in the Left Atrium and Ventricle Mary Thomson, Fredy El Sakr. N Engl J Med 2017; 376: 683 A 60-year-old man with coronary artery disease, ischemic cardiomyopathy with biventricular implantable cardioverter–defibrillator placement, and atrial fibrillation presented with chest pain and numbness in both arms. During his initial presentation, he suddenly collapsed and became unresponsive. Computed tomographic (CT) angiography of his chest...
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[编者按]:以下病例来自即将发表的麻省总医院病例。诊断是什么?哪种诊断检查最可能有帮助?请就诊断发表你的意见,并对应当进行何种诊断检查发表评论。正确的诊断以及病例完整介绍及诊疗过程将于2017年3月23日的新英格兰医学杂志发表。 A 27-Year-Old Woman with Nausea, Vomiting, Confusion, and Hyponatremia Presentation of Case 病例报告 Dr. Meaghan E. Colling (Medicine): A 27-year-old woman was admitted to this hospital because of nausea, vomiting, confusion, and hyponatremia. Meaghan E. Co...
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Images in Clinical Medicine Disseminated Cysticercosis Qiang Meng, M.D., Ph.D. Lingchun Liu, M.D. N Engl J Med 2016; 375: e52 A 23-year-old woman presented with a 1-month history of headache, vomiting, recurrent episodes of syncope, weight gain, and leg pain. A physical examination revealed several subcutaneous nodules on the patient's face and trunk. Exophthalmos, fundal hemorrhage, neck rigidity, and a hypertrophic appearance of the thigh and calf muscles were ...
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Images in Clinical Medicine Swirl Sign — Intestinal Volvulus after Roux-en-Y Gastric Bypass N Engl J Med 2017; 376: e3 DOI: 10.1056/NEJMicm1601775 A 56-year-old man presented after a day and a half of midabdominal pain, nausea, and bilious emesis. The patient had undergone Roux-en-Y gastric bypass 7 years earlier. During the physical examination, tachycardia and tachypnea were noted. The abdominal examination showed a distended, tympanic abdomen with severe...
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Takotsubo cardiomyopathy (TCM), first described in 1990 by Sato et al,[1,2] is a transient cardiac syndrome that involves left ventricular (LV) apical akinesis and basal hypercontraction that may symptomatically mimic acute coronary syndrome (ACS).[1,3] A significant emotional (eg, an unexpected death of a loved one, a divorce, bad financial news) or physical stressor (eg, motor vehicle collision, significant surgery, a stay in the intensive care unit [ICU]) typically...
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