[JAMA Intern Med发表论文]:血必净注射液治疗脓毒症:FDA审批路径将是怎样的?已关闭评论
Invited Commentary
May 1, 2023
Xuebijing Injection for the Treatment of Sepsis: What Would a Path to FDA Approval Look Like?
Ellis F. Unger, David B. Clissold
JAMA Intern Med. Published online May 1, 2023. doi:10.1001/jamainternmed.2023.0788
Sepsis is a serious condition with high morbidity and mortality for which treatment advancements are desperately needed. In this issue of JAMA Internal Medicine, Liu et al1 describe the results...
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[ICU Management & Practice]: 脓毒症的序贯体外治疗已关闭评论
Sequential Extracorporeal Therapy in Sepsis
Sepsis and septic shock are significant causes of morbidity and mortality in critical care, with a complex and rapidly evolving clinical presentation. This involves microbial invasion, infection focus, immune response, circulating pathogen and pathogen products, immunodysregulation, organ damage, and multiple organ dysfunction. Extracorporeal therapies may be used to target specific molecules at different stages, includin...
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[JAMA Intern Med发表述评]:是否应当联合氟氢可的松和氢化可的松治疗感染性休克?已关闭评论
Invited Commentary
March 27, 2023
Should We Add Fludrocortisone to Hydrocortisone for Treatment of Septic Shock?
Michael A. Matthay, Issa J. Dahabreh, B. Taylor Thompson
JAMA Intern Med. 2023;183(5):460-461. doi:10.1001/jamainternmed.2023.0257
Mortality for patients with septic shock is greater than 30% in most studies. The mechanisms that contribute to poor survival are primarily explained by the development of multiorgan failure from activ...
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[ICU Management & Practice]: 采用颈部血管超声快速评估液体反应性和耐受性已关闭评论
ICU Management & Practice, Volume 22 - Issue 5, 2022
Rapid Assessment of Fluid Responsiveness and Tolerance With Ultrasound of the Neck Vessels
Ultrasonographic assessment of the neck vessels in critically ill patients contributes to rapid and non-invasive management of fluids to evaluate responsiveness and tolerance and blood volume status.
Introduction
There are multiple ways to evaluate the responsiveness and tolerance to IV fluids, as well as veno...
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[JAMA发表述评]:迈向个体化治疗:评估随机临床试验中疗效的异质性已关闭评论
Editorial
March 21, 2023
Toward Personalizing Care: Assessing Heterogeneity of Treatment Effects in Randomized Trials
Issa J. Dahabreh, Dhruv S. Kazi
JAMA. 2023;329(13):1063-1065. doi:10.1001/jama.2023.3576
Clinicians know that individual patients may respond differently to a given treatment and that the overall treatment effect reported in a randomized trial of the treatment may not be directly applicable to all patients in clinical practice.1 D...
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[ICU Management & Practice]: 优化气管插管拔管策略已关闭评论
Strategies to Optimise Extubation
Extubation failure refers to the inability to sustain spontaneous breathing after the removal of an artificial airway. The need for reintubation with 24 to 72 hours or up to seven days can lead to high morbidity, mortality and disability. The incidence of extubation failure in ICUs remains high (10-15%) and has two main causes: weaning failure and airway failure.
In this paper, the authors aim to update strategies for opti...
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[JAMA发表观点]:医学院校排名—对职业和公众健康有害已关闭评论
Viewpoint
March 23, 2023
Medical School Rankings—Bad for the Health of the Profession and the Public
Holly J. Humphrey, Dana Levinson, Keme Carter
JAMA. Published online March 23, 2023. doi:10.1001/jama.2023.2815
All of higher education sat up and took notice when Heather Gerken, dean of Yale Law School, announced in November 2022 that Yale would no longer contribute data to US News & World Report (USNWR) for the ranking of law...
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[ICU Management & Practice]: 预测从ICU出院后再次住院或死亡已关闭评论
Predicting Readmission, Death After Discharge From ICU
Many machine learning (ML) models have been developed for use in the ICU, but their effectiveness in new settings is uncertain due to a lack of external validation. A study showed that less than one-third of Food and Drug Administration (FDA) approved ML models have undergone multisite assessment. In addition, only 11% of ICU prediction models have been externally validated.
The ICU is a popular ...
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[JAMA发表观点]:人工智能生成的医学建议——GPT及其他已关闭评论
Viewpoint
March 27, 2023
AI-Generated Medical Advice—GPT and Beyond
Claudia E. Haupt, Mason Marks
JAMA. Published online March 27, 2023. doi:10.1001/jama.2023.5321
For years, experts have speculated about the future role of artificial intelligence (AI) in health care. Some AI tools can outperform physicians on specific tasks in radiology, dermatology, and other fields, which raised concerns that AI might render certain specialists obsolete. ...
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[ICU Management & Practice]: 危重病患者较高蛋白摄入量的影响已关闭评论
Effect of Higher Protein Dosing in Critically Ill Patients
The international critical care nutrition guidelines recommend a wide range of protein doses that are based on low-quality evidence. The impact of high-dose protein in critically ill patients is unknown.
A study was conducted to test the hypothesis that a higher dose of protein improves clinical outcomes in critically ill patients. This was an international, registry-based, single-blinded, randomis...
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