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Comment & Response | July 19, 2016 Statins to Reduce Acute Kidney Injury After Cardiac Surgery Pingping Yang, Gaosi Xu, MD. JAMA. 2016;316(3):349. doi:10.1001/jama.2016.6134. To the Editor 致编辑 Dr Billings and colleagues1 tested the hypothesis that statins (short-term use of high-dose atorvastatin) would reduce the incidence of acute kidney injury (AKI) following cardiac surgery. The results did not support the initiation of atorvastatin therapy to prevent AKI fol...
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Comment & Response | July 19, 2016 Incidence of Acute Respiratory Distress Syndrome—Reply Giacomo Bellani, Tai Pham, John Laffey. JAMA. 2016;316(3):347. doi:10.1001/jama.2016.6471. In Reply Drs Siempos and Berlin are concerned that the computer algorithm may have overestimated the incidence of ARDS reported in our study. We used objective data (eg, arterial partial pressure of oxygen to fraction of inspired oxygen ratio, presence of an ARDS risk factor, presence of ...
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Comment & Response | July 12, 2016 Management of Community-Acquired Pneumonia—Reply Jonathan S. Lee, Daniel L. Giesler, Michael J. Fine JAMA. 2016;316(2):222-223. doi:10.1001/jama.2016.5028. In Reply Dr Paul and colleagues question our decision to exclude observational studies that did not perform statistical adjustment for illness severity or comorbidity when assessing the association between time to initiate antibiotic therapy and mortality. All studies meeting el...
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Comment & Response | July 19, 2016 Incidence of Acute Respiratory Distress Syndrome Ilias I. Siempos, David A. Berlin JAMA. 2016;316(3):346. doi:10.1001/jama.2016.6465. To the Editor 致编辑 In a large observational study of the incidence of acute respiratory distress syndrome (ARDS),1 the diagnosis was made in the analysis phase by a computer algorithm using raw data collected for each component of the Berlin Definition2 for all study patients with hypoxemia who were...
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Comment & Response | July 12, 2016 Management of Community-Acquired Pneumonia Mical Paul; Dafna Yahav; Leonard Leibovici JAMA. 2016;316(2):220-221. doi:10.1001/jama.2016.5013. To the Editor Dr Lee and colleagues1 addressed several important questions in their review of the management of community-acquired pneumonia. We have concerns about the analysis of time to first antibiotic dose and the conclusions inferred from the use of observational studies. Lee医生及其同事...
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Medscape Critical Care > Viewpoints  COMMENTARY The CLEAN Trial Clears Up Questions About Preventing Catheter-Related Infections Greg Martin, MD July 01, 2016 Skin Antisepsis With Chlorhexidine-Alcohol Versus Povidone Iodine-Alcohol, With and Without Skin Scrubbing, for Prevention of Intravascular-Catheter-Related Infection (CLEAN): An Open-Label, Multicentre, Randomised, Controlled, Two-by-Two Factorial Trial Mimoz O, Lucet JC, Kerforne T, et al; CLEAN trial investigat...
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Editorials Caring with evidence based medicine Ian Hargraves, Marleen Kunneman, Juan P Brito, et al. BMJ 2016;353:i3530 doi: http://dx.doi.org/10.1136/bmj.i3530 (Published 28 June 2016) Using evidence for kind and careful care The task of evidence based medicine is to care for each patient. The “evidence based” adjective draws attention to the need to explicitly consider clinical research findings in caring for patients.1 In the 25 years since Guyatt first used the term...
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Medscape Critical Care > Viewpoints  COMMENTARY Choosing Fluids Wisely for Septic Shock Greg Martin, MD June 24, 2016 Association Between Initial Fluid Choice and Subsequent In-hospital Mortality During the Resuscitation of Adults With Septic Shock Raghunathan K, Bonavia A, Nathanson BH, et al Anesthesiology. 2015;123:1385-1393 Summary 总结 Sepsis is a common condition in the intensive care unit (ICU), and the Surviving Sepsis Campaign (SSC) recommends specific doses o...
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Medscape Medical News Diagnosis Problems Blamed for 30-fold Overuse of MRSA Drugs Janis C. Kelly June 16, 2016 Current clinical guidelines for identifying methicillin-resistant Staphylococcus aureus (MRSA) at hospital admission are resulting in 30 times more patients with pneumonia being treated with anti-MRSA drugs than theoretically necessary because clinicians have no better options than empiric anti-MRSA therapy for many patients with community-acquired pneumonia (CAP...
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Effect of dexmedetomidine added to standard care on ventilator-free time in patients with agitated delirium: A randomized clinical trial. ICM Index Number: 23/036 Authors: Reade MC, Eastwood GM, Bellomo R et al. Reference: JAMA 2016; 315:1460-1468. Trial registration number: NCT01151865. © American Medical Association. ICM ABSTRACT Objective To determine whether dexmedetomidine could result in a shorter duration of delirium and earlier extubation when added to standard...
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