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Correspondence The Magic Bullet in Sepsis or the Inflation of Chance Findings? Morten H. Møller, Jon H. Laake, John A. Myburgh, et al. Chest 2017; 152: 222-223 To the Editor: In the June 2017 issue of CHEST, Marik et al1 presented a single-center retrospective before and after study assessing the effects of treating patients with severe sepsis/septic shock with IV vitamin C, hydrocortisone, and thiamine. Forty-seven patients were treated with IV vitamin C, hydroc...
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EDITORIAL Finding the Right Balance Birgitte Brandstrup N Engl J Med 2018; 378:2335-2336 DOI: 10.1056/NEJMe1805615 When I was a young resident in the 1990s, surgical patients received so much intravenous saline on the day of surgery that they often gained 4 to 6 kg, and by postoperative day 2 or 3, pulmonary congestion and cardiac arrhythmias were commonplace. That was the basis for a 2003 trial of restrictive versus standard fluid therapy,1 which aimed to answer a simple ...
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News > WebMD Health News Vitamin Cocktail for Sepsis Getting Wider Test Matt Smith May 29, 2018 A simple vitamin cocktail to treat sepsis has shaken up the medical world, raising hopes of a more effective treatment for one of history's great killers. But will it stand up to tougher tests? 一种简单的维生素鸡尾酒疗法治疗全身性感染对医学界产生了震动,为治疗这种一个世纪以来危及生命的临床疾病带来了有效治疗的曙光。但是,这种疗法能否经受更加严苛的验证呢? Researchers at sev...
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Editorial May 20, 2018 qSOFA Score for Patients With Sepsis in Low- and Middle-Income Countries Neill K. J. Adhikari, Gordon D. Rubenfeld JAMA. Published online May 20, 2018. doi:10.1001/jama.2018.6413 In the past 2 years, sepsis has received considerable attention from the global community. In 2017, the World Health Assembly passed a resolution urging all 194 UN Member States to implement actions to reduce the burden of sepsis, and for the World Health Organization to...
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News > Medscape Medical News Add-on Vasopressin May Lower AF Risk in Distributive Shock Patrice Wendling May 14, 2018 Patients in distributive shock appear to have a lower risk for atrial fibrillation when vasopressin is added to catecholamine vasopressors, but its effect on other outcomes are mixed, according to a new systematic review and meta-analysis. Based on pooled data from 13 studies at low risk of bias, the addition of vasopressin was associated with a 33% r...
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Perspective > Medscape Neurology > Viewpoints COMMENTARY Additions to Glasgow Coma Scale Aid Prognosis in TBI Laurie Barclay, MD May 15, 2018 Simplifying the Use of Prognostic Information in Traumatic Brain Injury. Part 1: The GCS-Pupils Score: An Extended Index of Clinical Severity. Murray GD, Brennan PM, Teasdale GM J Neurosurg. 2018 April 10. [Epub ahead of print] Simplifying the Use of Prognostic Information in Traumatic Brain Injury. Part 2: Graphical Presen...
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News > Reuters Health Information Restricting Fluids During Abdominal Surgery Shows No Benefit, Possible Renal Risk By Gene Emery May 11, 2018 (Reuters Health) - In a discovery that goes against emerging surgical wisdom, a new study suggests that restricting intravenous fluids before major abdominal surgery not only fails to make the operation safer for higher-risk patients, it may cause short-term kidney injury. 一项新的研究结果提示,腹部大手术前限制静脉液体不仅无法...
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SeptiCyte LAB: new test aims to make sepsis molecular Sepsis is a life-threatening condition and early detection is critical to ensure that the patient receives timely and appropriate treatment. For almost 25 years, clinicians have used the systemic inflammatory response syndrome (SIRS) criteria, a measure of the clinical expression of the host response to inflammation, as a marker of sepsis. A new approach to the diagnosis of sepsis has been proposed by Miller et al., ba...
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News > Medscape Medical News > Neurology News Glasgow Coma Scale Gets an Eye-Opening Update Damian McNamara April 19, 2018 Working with a developer of the original Glasgow Coma Scale (GCS), researchers have found that adding pupil response to the GCS more accurately predicts prognosis after traumatic brain injury, including the likelihood of death, than either measure alone. Because previous research suggested that the GCS score and pupil reaction independently ...
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Hyperchloraemia in sepsis: saline vs. balanced crystalloids Chloride, as the major anion of the extracellular fluid, constitutes an important element in the homeostasis of the human organism. Hyperchloraemia, whether a result of the sepsis process or a consequence of its treatment with supraphysiologic chloride fluids, appears to have a negative impact on the clinical outcome of septic patients, according to an article published in Annals of Intensive Care. Acidosis is a f...
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