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...

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...

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 ...

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...

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...

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...

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...

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...

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...

Osmolar gap The osmolar gap is a diagnostic tool which can help identify the presence of some foreign solute in the body fluids. In the CICM fellowship SAQs, it mostly identifies young women who have ingested a toxic alcohol. Specific questions of this sort include the following examples: Question 7.2 from the first paper of 2014 - HAGMA, high osmolar gapQuestion 7.3 from the first paper of 2014 - HAGMA, normal osmolar gapQuestion 25.2 from the sec...