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Viewpoint August 28, 2018 Gaps in the Clinical Management of Influenza: A Century Since the 1918 Pandemic Timothy M. Uyeki, Robert A. Fowler, William A. Fischer II JAMA. 2018;320(8):755-756. doi:10.1001/jama.2018.8113 This year marks the centennial of the devastating 1918 influenza A(H1N1) pandemic, which killed an estimated 50 million people worldwide. Prevention and control activities were limited in 1918 because global surveillance did not exist, influenza viruses w...
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Perspective > Medscape General Surgery > Viewpoints COMMENTARY Not Too Low, Not Too High: Optimal Fluid Volume During Surgery Albert B. Lowenfels, MD August 08, 2018 What is the optimum amount of intravenous fluid that should be administered during surgery to obtain the best outcome? The authors of a study, published in Annals of Surgery,[1] investigated this topic in 92,094 patients undergoing noncardiac surgery with endotracheal intubation between 2007 and 2014...
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The 10 false beliefs in adult critical care nephrology Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco Intensive Care Med 2018; 44: 1302-1305 1. Acute tubular necrosis is the main histopathologic finding in AKI 急性肾小管坏死是AKI的主要组织病理学表现 Acute tubular necrosis (ATN), a histological pattern observed after ischemic insult, is considered the most frequent cause of any form of acute kidney injury (AKI) despite the absence of extensive histological data. This bel...
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Perspective > Society for Healthcare Epidemiology of America (SHEA) > Expert Commentaries COMMENTARY Multidrug-Resistant Infections: What's on the Horizon? Jasmine R. Marcelin, MD July 18, 2018 Ceftazidime-Avibactam Resistance 头孢他啶-阿维巴坦耐药 Ceftazidime-avibactam is approved by the US Food and Drug Administration (FDA) for the treatment of complicated intra-abdominal and urinary tract infections, and has activity against carbapenem-resistant Enterobacteri...
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Antibiotic decisions in the ICU: a dragon’s tale Pieter Depuydt, MD, PhD Head of Clinic - Department of Intensive Care Ghent University Hospital Ghent, Belgium Associate Professor - Department of Internal Medicine Faculty of Medicine Ghent University consider the clinical problem of suspected infection in your ICU patient as a ‘monster’ … with a ‘head’, a ‘body’ and a ‘tail’ Medical decision-making about antibiotic use in critically ill patients is challenging and comple...
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Algorithm for early diagnosis and treatment of thrombocytopaenia in ICU Patients in the intensive care unit (ICU) have a range of clinical problems, including multi-organ failure, sepsis, and shock, and early diagnosis and management are crucial to optimise outcomes. A report in the journal Critical Care proposes a new algorithm to help intensivists make a rapid diagnosis so that they can initiate early appropriate management for ICU patients with thrombocytopaenia. The...
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Perspective > Medscape Critical Care > Critical Issues COMMENTARY A Negative APRV Trial in ARDS Aaron B. Holley, MD June 29, 2018 Recently, I reviewed a randomized, controlled trial (RCT)[1] comparing acute respiratory distress syndrome (ARDS) management with protocolized airway pressure release ventilation (APRV) with low-tidal-volume (LTV) ventilation. APRV showed superiority for the primary outcome, ventilator-free days, and a number of secondary outcomes. Mo...
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News > Medscape Medical News > Conference News > ESOC 2018 TICH-2: Tranexamic Acid for ICH Yields Mixed Results Damian McNamara June 19, 2018 GOTHENBURG, Sweden — Tranexamic acid for intracranial hemorrhage failed to significantly improve functional status compared with placebo at 90 days in a randomized controlled study. However, the antifibrinolytic agent was associated with a decrease in deaths in the first week and attenuation of hematoma expansion. The pri...
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News > Medscape Medical News Oxytocin Not Best for Postpartum Hemorrhage Prevention, Study Finds Norra MacReady May 29, 2018 Postpartum hemorrhage (PPH), defined as maternal blood loss of 500 mL or more within 24 hours after delivery, is the leading cause of maternal mortality worldwide. The World Health Organization (WHO) currently recommends treatment with oxytocin to reduce the risk for excessive postpartum bleeding, but a new meta-analysis suggests that other dru...
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Perspective SHATTUCK LECTURE Innovation for Pandemics Bill Gates N Engl J Med 2018; 378:2057-2060 DOI: 10.1056/NEJMp1806283 Over recent decades, the world has seen incredible progress in reducing child mortality and tackling infectious diseases. Thanks to better vaccines and other interventions, child mortality has decreased by more than 50% since 1990. We are on the verge of eradicating polio. HIV is no longer a certain death sentence. And half the world is now malaria-fr...
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