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IMAGES IN CLINICAL MEDICINE Bronchoesophageal Fistula Pierluigi di Mauro and Vittorio Ferrari N Engl J Med 2020; 383:e137DOI: 10.1056/NEJMicm2018535 A 50-year-old man presented to the emergency department with a 5-day history of shortness of breath, chest pain, and a cough. Fifteen days before presentation, he had received a diagnosis of large-cell neuroendocrine carcinoma of the lung with brain metastases. The oxygen saturation was 93% while the patient w...
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CLINICAL DECISIONS Doctor, How Long Should I Isolate? Siri R. Kadire, Valeria Fabre, and Richard P. Wenzel N Engl J Med March 10, 2021DOI: 10.1056/NEJMclde2100910 Case Vignette 病例介绍 A Woman with Covid-19 一名女性新冠肺炎患者 Siri R. Kadire, M.D. A 24-year-old woman with no relevant medical history presented to the emergency department with a 1-week history of cough and shortness of breath. She stated that she had not had any contact with people...
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ORIGINAL ARTICLE Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19 Andre C. Kalil, Thomas F. Patterson, Aneesh K. Mehta, et al N Engl J Med December 11, 2020DOI: 10.1056/NEJMoa2031994 Abstract BACKGROUND Severe coronavirus disease 2019 (Covid-19) is associated with dysregulated inflammation. The effects of combination treatment with baricitinib, a Janus kinase inhibitor, plus remdesivir are not known. METHODS We conducted a dou...
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IMAGES IN CLINICAL MEDICINE Green UrineVCAD510 JN0-643 Maja Boshkovska Spaseski, and Dejan Spaseski N Engl J Med 2020; 383:e128DOI: 10.1056/NEJMicm2017137 A 62-year-old man with chronic obstructive pulmonary disease presented to the emergency department with a 2-day history of dyspnea and was found to have hypercapnic respiratory failure. Intubation was performed, mechanical ventilation and a continuous infusion of propofol were initiated, and the patient ...
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Capnocytophaga canimorsus Infection Robert D.H. Markewitz and Tobias Graf N Engl J Med 2020; 383:1167DOI: 10.1056/NEJMicm1916407 A 62-year-old man presented to the emergency department with a 1-day history of fever and a 3-day history of chest pain. His medical history was notable for coronary heart disease and for a splenectomy that he had undergone after a car accident. Four days before presentation, he had been bitten on the left hand by his dog and h...
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Miliary Tuberculosis Jerald Pelayo and Kathleen Ruddiman N Engl J Med 2020; 383:e78DOI: 10.1056/NEJMicm2001934 A 56-year-old man presented to the emergency department with a 2-month history of fatigue, weight loss of 10 kg, night sweats, and fever. He had a cough producing sputum that was occasionally bloodtinged. He had immigrated to the United States from Haiti 10 years earlier. On examination, his temperature was 36.2°C. He was breathing comfortably but ap...
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Dissociated Oxygen Saturations by Dr Paul Young, last update March 16, 2019 aka Hematology Hoodwinker 004 One of the emergency residents has just taken an ABG on the 44 year-old woman in cubicle 3. Prior to her current presentation she had no known medical problems. The patient’s pulse oximetry reading is SpO2 98% on air. 急诊科的一名住院医师刚刚为一名44岁的女性患者做了动脉血气检查。此次发病前,患者没有既往病史。患者吸空气时脉搏氧饱和度(SpO...
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Dissociated Oxygen Saturations by Dr Paul Young, last update March 16, 2019 aka Hematology Hoodwinker 004 One of the emergency residents has just taken an ABG on the 44 year-old woman in cubicle 3. Prior to her current presentation she had no known medical problems. The patient’s pulse oximetry reading is SpO2 98% on air. 急诊科的一名住院医师刚刚为一名44岁的女性患者做了动脉血气检查。此次发病前,患者没有既往病史。患者吸空气时脉搏氧饱和度(SpO...
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Dissociated Oxygen Saturations by Dr Paul Young, last update March 16, 2019 aka Hematology Hoodwinker 004 One of the emergency residents has just taken an ABG on the 44 year-old woman in cubicle 3. Prior to her current presentation she had no known medical problems. The patient’s pulse oximetry reading is SpO2 98% on air. 急诊科的一名住院医师刚刚为一名44岁的女性患者做了动脉血气检查。此次发病前,患者没有既往病史。患者吸空气时脉搏氧饱和度(SpO...
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Dissociated Oxygen Saturations by Dr Paul Young, last update March 16, 2019 aka Hematology Hoodwinker 004 One of the emergency residents has just taken an ABG on the 44 year-old woman in cubicle 3. Prior to her current presentation she had no known medical problems. The patient’s pulse oximetry reading is SpO2 98% on air. 急诊科的一名住院医师刚刚为一名44岁的女性患者做了动脉血气检查。此次发病前,患者没有既往病史。患者吸空气时脉搏氧饱和度(SpO...
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