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JAMA Diagnostic Test Interpretation November 16, 2018 Serum Creatinine in the Critically Ill Patient With Sepsis Matthieu Legrand, John A. Kellum JAMA. Published online November 16, 2018. doi:10.1001/jama.2018.16627 Case 病例 A 73-year-old man underwent esophageal resection for cancer. He had a history of hypertension that was treated with an angiotensin receptor blocker. Preoperative estimated glomerular filtration rate (GFR) was 98 mL/min/1.73 m2. On the second post...
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JAMA Diagnostic Test Interpretation November 16, 2018 Serum Creatinine in the Critically Ill Patient With Sepsis Matthieu Legrand, John A. Kellum JAMA. Published online November 16, 2018. doi:10.1001/jama.2018.16627 Case 病例 A 73-year-old man underwent esophageal resection for cancer. He had a history of hypertension that was treated with an angiotensin receptor blocker. Preoperative estimated glomerular filtration rate (GFR) was 98 mL/min/1.73 m2. On the second post...
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IMAGES IN CLINICAL MEDICINE Portal Venous Gas Ming Cui, and Xin Lu N Engl J Med 2018; 379:e37 DOI: 10.1056/NEJMicm1806082 A 72-year-old man presented to the emergency department with an 11-hour history of periumbilical abdominal pain and inability to pass flatus. His medical history included chronic lymphocytic leukemia (for which he had been taking ibrutinib), type 2 diabetes, and chronic hepatitis B virus infection. The pulse was 155 beats per minute, and the blood press...
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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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