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 ...

JAMA Diagnostic Test Interpretation February 6, 2018 Evaluating Thrombocytopenia During Heparin Therapy Yu-Min Shen, Heather Wolfe, Stephen Barman JAMA. 2018;319(5):497-498. doi:10.1001/jama.2017.21898 Case A 45-year-old man was hospitalized with abdominal pain. He was diagnosed with superior mesenteric vein thrombosis with mesenteric ischemia and treated with partial small bowel resection and 2 weeks of enoxaparin while hospitalized. Three weeks later, he presented ...

JAMA Diagnostic Test Interpretation February 6, 2018 Evaluating Thrombocytopenia During Heparin Therapy Yu-Min Shen, Heather Wolfe, Stephen Barman JAMA. 2018;319(5):497-498. doi:10.1001/jama.2017.21898 Case A 45-year-old man was hospitalized with abdominal pain. He was diagnosed with superior mesenteric vein thrombosis with mesenteric ischemia and treated with partial small bowel resection and 2 weeks of enoxaparin while hospitalized. Three weeks later, he presented ...

Methemoglobinemia Due to Antifreeze Ingestion Andrew N. Farkas, Anthony Scoccimarro, Anthony F. Pizon N Engl J Med 2017; 377: 1993-1994 To the Editor: Ingestion of antifreeze that contains ethylene glycol produces acidosis, nephropathy, coma, and cardiovascular collapse.1 Previously, minimal increases in methemoglobin levels (to as high as 6%; normal value, < 1.0% or < 1.5%, depending on the assay) after ingestion of antifreeze have been reported,2 with no known caus...

Drugs & Diseases > Fast Five Quizzes Fast Five Quiz: Are You Familiar With Key Elements Regarding Heat Stroke? Richard H. Sinert, DO August 02, 2017 问题5. Which of the following is accurate about the treatment of heat stroke?有关热射病的治疗，以下说法哪个是准确的？ A. Patients with EHS should be admitted to the hospital for 24 hours, but patients with NEHS typically do not require hospitalization EHS患者应住院24小时，但NEHS患者通常无需住院治疗 B. Cooling of athle...

Drugs & Diseases > Fast Five Quizzes Fast Five Quiz: Are You Familiar With Key Elements Regarding Heat Stroke? Richard H. Sinert, DO August 02, 2017 问题4. Which of the following is accurate regarding the workup of heat stroke? 有关热射病实验室检查的以下说法哪个是准确的？ A. Hypoglycemia is more common in patients with NEHS than in patients with EHS NEHS患者低血糖较EHS患者更常见 B. Aminotransferase levels typically peak at 48 hours, but may take as long as 2 weeks...

Drugs & Diseases > Fast Five Quizzes Fast Five Quiz: Are You Familiar With Key Elements Regarding Heat Stroke? Richard H. Sinert, DO August 02, 2017 问题3. Which of the following is accurate about the physical examination of patients with heat stroke? 有关热射病患者体格检查的以下说法哪个是准确的？ A. Bradycardia is a common finding in patients with NEHS 心动过缓是NEHS患者的常见表现 B. Central nervous system (CNS) findings may not indicate dysfunction in persons w...

Drugs & Diseases > Fast Five Quizzes Fast Five Quiz: Are You Familiar With Key Elements Regarding Heat Stroke? Richard H. Sinert, DO August 02, 2017 问题2. Which of the following is accurate about the presentation of heat stroke? 以下哪种说法准确描述了热射病的临床表现？ A. Anhidrosis is required for diagnosis of heat stroke 无汗是诊断热射病的必要条件 B. EHS is extremely rare in acclimatized individuals 在已经适应环境的人中EHS极为罕见 C. A hypodynamic state rules o...

Drugs & Diseases > Fast Five Quizzes Fast Five Quiz: Are You Familiar With Key Elements Regarding Heat Stroke? Richard H. Sinert, DO August 02, 2017 问题1. Which of the following is an indicator of poor prognosis during acute episodes of heat stroke?热射病急性期的以下哪种表现提示预后不良？ A. Lactic acidosis in patients with classic heat stroke 经典热射病患者出现乳酸酸中毒 B. Aminotransferase levels > 800 IU/L during the first 12 hours 最初12小时转氨酶> 800 ...

Drugs & Diseases > Fast Five Quizzes Fast Five Quiz: Are You Familiar With Key Elements Regarding Heat Stroke? Richard H. Sinert, DO August 02, 2017 Heat illness may be viewed as a continuum of illnesses relating to the body's inability to cope with heat. It includes minor illnesses, such as heat edema, heat rash (ie, prickly heat), heat cramps, and heat tetany, as well as heat syncope and heat exhaustion. Heat stroke is the most severe heat-related illness and is...