Chest
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Spinal muscular atrophy (SMA) causes respiratory compromise that is difficult to assess in young children. The forced oscillation technique (FOT) is commercially available for children as young as 2 years of age and is nonvolitional. The aim of this study was to assess the usefulness of FOT in young children with SMA. ⋯ FOT is feasible in young children with SMA, with abnormal values of reactance and resistance on grouped data, worsening over 12 months. Xrs8 is related to respiratory tests used to monitor progress in SMA (FVC, PCF, AHI). Further research on the value of FOT in managing individuals is warranted.
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In the 13 years since their promulgation, the Health Insurance Portability and Accountability Act (HIPAA) rules and their enforcement have shown considerable evolution, as has the context within which they operate. Increasingly, it is the health information circulating outside the HIPAA-protected zone that is concerning: big data based on HIPAA data that have been acquired by public health agencies and then sold; medically inflected data collected from transactions or social media interactions; and the health data curated by patients, such as personal health records or data stored on smartphones. HIPAA does little here, suggesting that the future of health privacy may well be at the state level unless technology or federal legislation can catch up with state-of-the-art privacy regimes, such as the latest proposals from the European Commission.
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This article describes the curricular milestones and entrustable professional activities for trainees in pulmonary, critical care, or combined fellowship programs. Under the Next Accreditation System of the Accreditation Council for Graduate Medical Education (ACGME), curricular milestones compose the curriculum or learning objectives for training in these fields. Entrustable professional activities represent the outcomes of training, the activities that society and professional peers can expect fellowship graduates to be able to perform unsupervised. ⋯ After consensus was achieved using the Delphi process, the document was revised with input from the sponsoring societies and program directors. The resulting lists can serve as a roadmap and destination for trainees, program directors, and educators. Together with the reporting milestones, they will help mark trainees' progress in the mastery of the six ACGME core competencies of graduate medical education.
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Randomized Controlled Trial
Benefits of high dose N-acetylcysteine to exacerbation-prone COPD patients.
Although high-dose N-acetylcysteine (NAC) has been suggested to reduce COPD exacerbations, it is unclear which category of patients with COPD would benefit most from NAC treatment. The objective of this study was to compare the effect of high-dose NAC (600 mg bid) between high-risk and low-risk Chinese patients with COPD. ⋯ High-dose NAC (600 mg bid) for 1 year reduces exacerbations and prolongs time to first exacerbation in high-risk but not in low-risk Chinese patients with COPD.