Original Investigation Caring for the Critically Ill Patient July 25, 2017 Targeted Temperature Management for 48 vs 24 Hours and Neurologic Outcome After Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial Hans Kirkegaard, Eldar Søreide, Inge de Haas, et al. JAMA. 2017;318(4):341-350. doi:10.1001/jama.2017.8978 Abstract Importance 背景 International resuscitation guidelines recommend targeted temperature management (TTM) at 33°C to 36°C in unconscious patients...

Drugs of Abuse: What Clinicians Need to Know Larissa Mooney, MD | June 28, 2017 New Drugs of Abuse According to the United Nations Office on Drugs and Crime (UNODC), drug use is shifting to new markets, and the number of new psychoactive substances is on the rise. These newer drugs of abuse include bath salts, synthetic marijuana (e.g. K2, Spice), salvia, methoxetamine, fentanyl, carfentanil, synthetic piperazines, dextromethorphan (DXM), ecstasy (Molly), kratom, anabolic...

Screening for Pancreatic Adenocarcinoma Using Signals From Web Search Logs: Feasibility Study and Results John Paparrizos, MSc, Ryen W. White, PhD, and Eric Horvitz, MD, PhD J Oncol Pract 2016; 358: 737-44 Abstract Introduction People’s online activities can yield clues about their emerging health conditions. We performed an intensive study to explore the feasibility of using anonymized Web query logs to screen for the emergence of pancreatic adenocarcinoma. The methods us...

Clinical Review State of the Art Review Advances in the causes and management of community acquired pneumonia in adults Richard G Wunderink, professor of medicine, Grant Waterer, professor of medicine BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j2471 (Published 10 July 2017) Cite this as: BMJ 2017;358:j2471 Fig 1 Temporal trends in US mortality from pneumonia and influenza compared with other important infections since 1900 (source: Centers for Disease Control and Prev...

News & Perspective Crimean-Congo Fever Reemerging, Cases Suggest Veronica Hackethal, MD July 12, 2017 Two cases of Crimean Congo Hemorrhagic Fever (CCHF) have been reported in Spain. Both infections were acquired within the country — the index case from a tick bite, the other while caring for the index patient — suggesting CCHF may be spreading geographically. 西班牙报告了两例克里米亚刚果热(CCHF)患者。两例患者均在西班牙国内感染—指示病例源于蜱虫叮咬后感染，另一例是在...

Original Investigation July 4, 2017 Effect of Depth and Duration of Cooling on Death or Disability at Age 18 Months Among Neonates With Hypoxic-Ischemic Encephalopathy: A Randomized Clinical Trial Seetha Shankaran, Abbot R. Laptook, Athina Pappas, et al JAMA. 2017;318(1):57-67. doi:10.1001/jama.2017.7218 Abstract Importance 背景 Hypothermia for 72 hours at 33.5°C for neonatal hypoxic-ischemic encephalopathy reduces death or disability, but rates continue to be high. ...

Improving comfort around dying in elderly people: a cluster randomised controlled trial Kim Beernaert, Tinne Smets, Joachim Cohen, et al. Lancet 2017; 390: 125-134 Summary Background 背景 Over 50% of elderly people die in acute hospital settings, where the quality of end-of-life care is often suboptimum. We aimed to assess the effectiveness of the Care Programme for the Last Days of Life (CAREFuL) at improving comfort and quality of care in the dying phase in elderly p...

Perspective Recognizing Sepsis as a Global Health Priority — A WHO Resolution Konrad Reinhart, M.D., Ron Daniels, M.D., Niranjan Kissoon, M.D., Flavia R. Machado, M.D., Ph.D., Raymond D. Schachter, L.L.B., and Simon Finfer, M.D. N Engl J Med June 28, 2017 DOI: 10.1056/NEJMp1707170 “Some very important clinical issues, some of them affecting life and death, stay largely in a backwater which is inhabited by academics and professionals and enthusiasts, dealt with very well a...

Drugs & Diseases > Clinical Trends Clinical Trends for June 2017 Ryan Syrek June 30, 2017 Each week, we identify one top search term, speculate as to what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what's trending and why, feel free to share them with us on Twitter or Facebook! Clinical Trend of the Week (June 24-30): Sleep Apnea Two new studies and revelations about a high-profile celebrity's death result...

JAMA Insights July 4, 2017 Penicillin Allergy Is Not Necessarily Forever Jason A. Trubiano, N. Franklin Adkinson, Elizabeth Jane Phillips JAMA. 2017;318(1):82-83. doi:10.1001/jama.2017.6510 Penicillin allergy is often diagnosed early in life, and the history of penicillin allergy persists in a patient’s medical record for many years without verification. Some physicians’ consideration of a patient having penicillin allergy is based on patient experience that may have ...