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Use of stepwise lactate kinetics-oriented hemodynamic therapy could improve the clinical outcomes of patients with sepsis-associated hyperlactatemia Xiang Zhou, Dawei Liu, Longxiang Su, et al Critical Care 2017; 21: 33 DOI: 10.1186/s13054-017-1617-1 Background 背景 Setting lactate kinetics at >30% might improve the clinical outcomes of patients with sepsis-associated hyperlactatemia. The aim of this study was to explore the outcome benefits of stepwise lactate ki...
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Safety and Efficacy of Antiviral Therapy for Prevention of Cytomegalovirus Reactivation in Immunocompetent Critically Ill Patients: A Randomized Clinical Trial. Cowley NJ, Owen A, Shiels SC, et al JAMA Intern Med. 2017;177(6):774-783 doi: 10.1001/jamainternmed.2017.0895. [Epub ahead of print] Abstract IMPORTANCE: 背景 Latent cytomegalovirus (CMV) infection is present in more than half the adult population, and a viral reactivation (ie, when the virus becomes measurable in...
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News & Perspective > Society for Healthcare Epidemiology of America (SHEA) > Expert Commentaries Treatment of Suspected VAP: When Shorter Is Better John A. Sellick, DO, MS May 31, 2017 Which VAP Patients Don't Need a Full Course of Antibiotics? 哪些VAP患者无需接受完整疗程抗生素治疗? Patients with suspected ventilator-associated pneumonia (VAP) are frequently started on empirical antibiotics, yet definitive diagnosis of VAP may not be made. Can antibiotics be...
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10 Common Wilderness and Environmental Medical Illnesses and Injuries William Selde, MD, FAWM; Will Smith, MD, FAWM, Paramedic | June 1, 2017 Outdoor recreational activities in wilderness environments or remote locations have become increasingly popular, with estimates of US consumer spending reaching $646 billion each year. [1] The growth of interest in these pastimes necessitates an understanding of the potential related illnesses and injuries, particularly in areas whe...
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Original Investigation May 23/30, 2017 Association Between Teaching Status and Mortality in US Hospitals Laura G. Burke, Austin B. Frakt, Dhruv Khullar, et al. JAMA. 2017; 317(20): 2105-2113. doi:10.1001/jama.2017.5702 Abstract Importance 背景 Few studies have analyzed contemporary data on outcomes at US teaching hospitals vs nonteaching hospitals. 仅有很少的研究分析了美国教学医院与非教学医院患者预后的差异。 Objective 目的 To examine risk-adjusted outcomes for patien...
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Intraoperative ketamine for prevention of postoperative delirium or pain after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial Michael S Avidan, Hannah R Maybrier, Arbi Ben Abdallah, et al. Lancet 2017 DOI: http://dx.doi.org/10.1016/S0140-6736(17)31467-8 Summary Background 背景 Delirium is a common and serious postoperative complication. Subanaesthetic ketamine is often administered intraoperatively for postoperati...
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News & Perspective CDC: Legionnaires' at Healthcare Sites Is 'Widespread, Deadly' Marcia Frellick June 06, 2017 People are getting Legionnaires' disease from healthcare facilities — primarily long-term care facilities — in most parts of the country, Anne Schuchat, MD (RADM, USPHS), acting director of the Centers for Disease Control and Prevention (CDC), told reporters on a conference call Tuesday. Reports from 2015 in 20 states and New York City were studied and t...
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News & Perspective C auris: CDC Warns of Institutional Spread, Updates Guidance Janis C. Kelly May 18, 2017 The emerging and often drug-resistant fungus Candida auris continues to spread in the United States, the Centers for Disease Control and Prevention (CDC) reported today. Less than a year after the first seven cases of C auris were reported in the United States, the agency now says there have been 77 patient cases, and another 45 cases have been identified v...
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News & Perspective Attack in Manchester: Emergency Services Response Isabelle Catala, MD May 26, 2017 MANCHESTER, UK — The suicide attack that took place as people were leaving the Ariana Grande concert at the Manchester Arena on May 22 injured more than 60 attendees and killed 22 people (12 of whom, between the ages of 8 and 50, have been identified as at May 24). Emergency services were quickly deployed in accordance with national recommendations put in place i...
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Original Investigation Caring for the Critically Ill Patient Discriminative Accuracy of Physician and Nurse Predictions for Survival and Functional Outcomes 6 Months After an ICU Admission Michael E. Detsky, Michael O. Harhay, Dominique F. Bayard, et al JAMA. Published online May 21, 2017. doi:10.1001/jama.2017.4078 Abstract Importance 背景 Predictions of long-term survival and functional outcomes influence decision making for critically ill patients, yet little is k...
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