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Original Investigation December 12, 2017 Development and Validation of a Deep Learning System for Diabetic Retinopathy and Related Eye Diseases Using Retinal Images From Multiethnic Populations With Diabetes Daniel Shu Wei Ting, Carol Yim-Lui Cheung, Gilbert Lim, et al. JAMA. 2017;318(22):2211-2223. doi:10.1001/jama.2017.18152 Abstract Importance 背景 A deep learning system (DLS) is a machine learning technology with potential for screening diabetic retinopathy and r...
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Idiopathic Pulmonary Fibrosis: Killer Without a Cause Mehran Farid-Moayer, MD; Mark P Brady, PA-C | December 5, 2017 Image courtesy of author's practice database. A 71-year-old man comes to the office with complaints of shortness of breath and a dry cough for the last 8 months. His cough has not improved with antibiotics or albuterol inhalers. His other main symptom is fatigue. He reports no significant past medical history, takes no medications, and has no known allergie...
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ORIGINAL ARTICLE Pharmacomechanical Catheter-Directed Thrombolysis for Deep-Vein Thrombosis Suresh Vedantham, Samuel Z. Goldhaber, Jim A. Julian, et al. N Engl J Med 2017; 377:2240-2252 DOI: 10.1056/NEJMoa1615066 BACKGROUND 背景 The post-thrombotic syndrome frequently develops in patients with proximal deep-vein thrombosis despite treatment with anticoagulant therapy. Pharmacomechanical catheter-directed thrombolysis (hereafter “pharmacomechanical thrombolysis”) rapidly re...
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Medical News & Perspectives December 5, 2017 JAMA Network Articles of the Year Jennifer Abbasi JAMA. 2017;318(21):2065-2068. doi:10.1001/jama.2017.17346 Which articles published in the JAMA Network of journals resonated with readers the most this year—and why? Those are the questions we set out to answer in our first-ever end-of-year roundup. We did an accounting of all Original Investigations and Special Communications published in our journals between September 1...
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Drugs & Diseases > Clinical Trends Clinical Trends for November 2017 Ryan Syrek December 01, 2017 Each week, we identify one top search term, speculate as to what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what's trending and why, feel free to share them with us on Twitter or Facebook! Clinical Trend of the Week (November 25 – December 1): Legionnaires Disease News from both coasts of America resulted in t...
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[Lancet Infect Dis在线发表]:对于全身性感染患者在救护车上开始使用抗生素不降低病死率已关闭评论
Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial Nadia Alam, Erick Oskam, Patricia M Stassen, et al. Lancet Respir Med 2017 Published: 28 November 2017 DOI: http://dx.doi.org/10.1016/S2213-2600(17)30469-1 Summary Background 背景 Emergency medical services (EMS) personnel have already made substantial contributions to improving care for patients with time-dependent illnesses, such as trauma and myocardial infarction. Patien...
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Perspective > Critical Issues COMMENTARY Protocolized APRV Versus Assist Control for ARDS Aaron B. Holley, MD November 27, 2017 Settling the APRV in ARDS Debate The 2017 American Thoracic Society/European Respiratory Society guidelines on mechanical ventilation for acute respiratory distress syndrome (ARDS)[1]failed to address airway-pressure release ventilation (APRV). Although many consider APRV to be a "rescue mode" for refractory hypoxemia,[2] others argue that...
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Intensive Monitoring of Urine Output Is Associated With Increased Detection of Acute Kidney Injury and Improved Outcomes Kui Jin, Raghavan Murugan, Florentina E. Sileanu, et al. Chest 2017; 152: 972-979 Background 背景 Urine output (UO) is a vital sign for critically ill patients, but standards for monitoring and reporting vary widely between ICUs. Careful monitoring of UO could lead to earlier recognition of acute kidney injury (AKI) and better fluid management. We sou...
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ORIGINAL ARTICLE Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine Steven D. Weisbord, Martin Gallagher, Hani Jneid, et al. N Engl J Med 2017; November 12, 2017DOI: 10.1056/NEJMoa1710933 BACKGROUND 背景 Intravenous sodium bicarbonate and oral acetylcysteine are widely used to prevent acute kidney injury and associated adverse outcomes after angiography without definitive evidence of their efficacy. 静脉碳酸氢钠和口服乙酰半胱氨酸广泛用于预防血管造影后的...
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Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40 138 bleeding patients Angèle Gayet-Ageron, David Prieto-Merino, Katharine Ker, et al Lancet Published Online November 7, 2017 http://dx.doi.org/10.1016/S0140-6736(17)32455-8 Summary Background 背景 Antifibrinolytics reduce death from bleeding in trauma and post-partum haemorrhage. We examined the effect of trea...
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