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In a multicenter study, critically ill patients with initial hyperlactatemia had improved outcomes (including shorter ICU stays and lower adjusted mortality) compared to control patients when they were managed for the first 8 hours with a resuscitation protocol targeted at reducing the lactate level by at least 20% every 2 hours.
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A 74-year retired veterinarian presents to the emergency department (ED) with shortness of breath. He was recently diagnosed with diffuse large-cell lymphoma with prominent abdominal lymphadenopathy and positive bone marrow and has been treated with two cycles of R-CHOP.
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Episodes of severe sepsis in older adults is associated with worsening cognition and functional status.Source: Iwashyna TJ, et al. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA 2010;304:1787-94.
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Acetaminophen (known as paracetamol outside the United States) is the most commonly used analgesic in the world, usually considered to be safe and benign.
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Clinicians who send samples to the 95% of U.S. laboratories that test for Clostridium difficile infection using an enzyme-immunoassay (EIA) for toxins A and B are often frustrated by a negative laboratory result that doesn't fit their clinical impression or their olfactory suspicions.
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Central line-associated infections, particularly bloodstream infections (BSI), remain a huge issue in our technological age.
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Outpatients with uncomplicated seasonal influenza were treated with single doses of IV peramivir 300 mg/kg, 600 mg/kg, or placebo. Peramivir significantly reduced the time to alleviation of symptoms at both doses compared with placebo. Peramivir was well-tolerated, and side effects were comparable to placebo.
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Using a quality improvement (QI) process, ICU delirium, physical rehabilitation, and functional mobility were significantly improved and associated with a decreased length of stay.
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A multicenter, observational study retrospectively compared 59 individuals with acute or early HIV infection who elected to receive antiretroviral (ARV) therapy for 12 weeks to 337 patients who declined treatment.
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When ICU clinicians estimated rather than calculated ideal body weight in mechanically ventilated patients in order to set tidal volume, the majority of such estimations were sufficiently inaccurate that the resulting tidal volume was outside the unit's target range.
