[编者按]: 纵观国际医学领域，近年来也不乏各种运动造势，推出各种理念，最终只是空欢喜一场。相应的例证如他汀类药物的神奇疗效。肠道菌丛的无限应用范围以及与各种急性慢性疾病的普遍相关性，未来很有可能成为又一经典范例。精准医学也是近年的宠儿。事实上，在精准医学盛行其道的今天，仍然有部分专家保持了清醒的头脑（学会网址既往也转载JAMA述评介绍相应观点）。本文虽然并不直接与重症医学领域相关，但文中观点对我们可能仍有帮助。 From The JAMA Network August 1, 2017 Viral Testing for Pediatric ...

Clinical trial research in focus: rethinking trials in sepsis David Grimaldi, Jean-Louis Vincent Lancet Respir Med 2017; 8: 610-611 Published: August 2017 DOI: http://dx.doi.org/10.1016/S2213-2600(17)30268-0 Sepsis is a frequent condition, defined as life-threatening organ dysfunction associated with a severe infection.1 Over the past three decades, progress in understanding of the pathophysiology of sepsis has led to the development of a large number of potential new the...

【编者按】：JAMA杂志近期发表的文章显示，2011年全国去甲肾上腺素供应短缺与感染性休克患者病死率升高具有显著相关性。网站曾于4月6日介绍了该文摘要及主要结果。近日，MEDSCAPE刊登了Greg Martin的简短评论。我们在此刊出，以飨读者。 News & Perspective > Viewpoints COMMENTARY Drug Shortages and Septic Shock: Not a Good Mix Greg Martin, MD June 28, 2017 Association Between US Norepinephrine Shortage and Mortality Among Patients With Septic Shock Vail E, Gershengorn HB, Hua M, ...

Medical News & Perspectives July 19, 2017 In Treating Sepsis, Questions About Timing and Mandates Jennifer Abbasi JAMA. Published online July 19, 2017. doi:10.1001/jama.2017.7997 In 2012, Rory Staunton, a 12-year-old boy from Queens, New York, died from sepsis after his pediatrician and an emergency department (ED) physician reportedly misinterpreted warning signs—a high fever and vomiting, but also a cut on his arm, and severe leg pain—as an intestinal illness and...

[编者按]：自从各大医院的比拼指标从床位数及总收入转变为发表论文数后，在高影响因子杂志发表论文的现金奖励已经成为业内共识。这种政策的出台的确鼓励临床医生投入更多精力从事科研，但是，现金奖励政策真的能够催生好的科研吗？这一政策对科研工作有何潜在影响？ Business Impact The Truth about China’s Cash-for-Publication Policy The first study of payments to Chinese scientists for publishing in high-impact journals has serious implications for the future of research by Emerging Technolog...

[编者按]：文章是ICU Management & Practice对匹兹堡大学Jemery M. Kahn教授的采访记录。他对于重症医学未来发展的观点与众不同，或许对读者有另一方面的提示意义。 What’s the future of intensive care medicine? Jemery M. Kahn, MD, MS Professor of Critical Care Medicine and Health Policy & Management University of Pittsburgh School of Medicine and Graduate School of Public Health Pittsburgh, USA Over time, I think we are going to recognise that we can’t continue to develop...

Observations The Art of Risk Communication Can search engine data predict pancreatic cancer? Gerd Gigerenzer BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3159 (Published 03 July 2017) Cite this as: BMJ 2017;358:j3159   Imagine this warning popping up on your search engine page: “Attention! There are signs that you might have pancreatic cancer. Please visit your doctor immediately.” Just as search engines use big data analytics to detect your book and music ...

News & Perspective > Critical Issues COMMENTARY What Happens to Patients After They Leave the ICU Aaron B. Holley, MD June 08, 2017 Joblessness and Lost Earnings After ARDS in a 1-Year National Multicenter Study Kamdar BB, Huang M, Dinglas VD, et al; National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network Am J Respir Crit Care Med. 2017 Apr 27. [Epub ahead of print] Background 背景 When designing a study in the intensive care unit...

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...

Recommended Reading from the University of Ottawa Nephrology Fellows David Massicotte-Azarniouch, Syed Obaid Amin, Caitlin Hesketh and Edward G. Clark AJRCCM Articles in Press. Published on 02-May-2017 as 10.1164/rccm.201611-2375RR Bitker L, et al.; Prevalence and risk factors of hypotension associated with preload-dependence during intermittent hemodialysis in critically ill patients. Crit Care (10) Reviewed by Caitlin Hesketh Intradialytic hypotension (IDH) is a common ...