.webp&w=384&q=75){kind=logo}
Loading, please wait...
Loading, please wait...
The ProCESS, ARISE and ProMISe randomized trials collectively challenged the idea that protocolized early goal-directed therapy with mandatory central venous oxygen saturation targets is necessary for all patients with septic shock. Across contemporary trial settings, EGDT did not improve mortality compared with usual contemporary resuscitation, which already included rapid antibiotics, fluid therapy, vasopressors and close monitoring. The practical consequence is important: sepsis care should focus on timely recognition and physiologically appropriate resuscitation rather than rigid adherence to a single bundle of invasive targets. For internists, repeated clinical reassessment remains central. Fluid responsiveness, perfusion, lactate trends, urine output, capillary refill and bedside ultrasound can all contribute to a more individualized strategy. The trials do not justify therapeutic delay or undertreatment; they support flexible protocols that adapt to the patient rather than forcing every patient into the same algorithm.
Read summarized clinical updates, watch expert medical content, and earn CME certifications right from your smartphone.
Open your smartphone camera to scan and install.
The ProCESS, ARISE and ProMISe randomized trials collectively challenged the idea that protocolized early goal-directed therapy with mandatory central venous oxygen saturation targets is necessary for all patients with septic shock. Across contemporary trial settings, EGDT did not improve mortality compared with usual contemporary resuscitation, which already included rapid antibiotics, fluid therapy, vasopressors and close monitoring. The practical consequence is important: sepsis care should focus on timely recognition and physiologically appropriate resuscitation rather than rigid adherence to a single bundle of invasive targets. For internists, repeated clinical reassessment remains central. Fluid responsiveness, perfusion, lactate trends, urine output, capillary refill and bedside ultrasound can all contribute to a more individualized strategy. The trials do not justify therapeutic delay or undertreatment; they support flexible protocols that adapt to the patient rather than forcing every patient into the same algorithm.
Today
The phase 3 ACACIA-HCM trial reveals that aficamten improves cardiac structure, diastolic relaxation, functional capacity, and symptom burden in symptomatic nonobstructive hypertrophic cardiomyopathy, marking a major milestone in targeted myosin inhibition.
6 days back
A clinical study shows that automated breast ultrasound paired with artificial intelligence accurately classifies BIRADS 3-4 lesions, reaching 95% sensitivity and 79% specificity. This diagnostic advance promises to reduce unnecessary core needle biopsies and refine clinical workflows in breast imaging.
3 weeks back
Researchers have engineered freestanding hierarchical-porous BCZT thin films that resist cracking and enhance ultrasonic energy harvesting in soft tissue. Achieving high piezoelectric output and acoustic matching, this lead-free material offers transformative potential for implantable bioelectronics.
6 days back
A novel pathology-adaptive surface engineering strategy uses functionalized plasma polymer coatings to selectively modulate AGE adsorption, reducing oxidative stress and restoring bone formation in diabetic and aging microenvironments.
3 weeks back
A breakthrough study identifies the Klotho/PKCα/CUX1/SPARC/TGFβ-RII axis as a critical driver of podocyte mitochondrial injury and ferroptosis in diabetic kidney disease, unveiling promising molecular targets to halt renal disease progression.
6 days back
