Chest
-
Researchers have yet to obtain conclusive evidence differentiating among fixed-dose combinations (FDCs) of long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs) for COPD in terms of real-world clinical outcomes. ⋯ Our results revealed that the risk of severe AE was lower among patients with COPD receiving UMEC/VI or GLY/IND than among those receiving TIO/OLO, whereas the incidence of cardiovascular events was similar across groups but was slightly lower in GLY/IND users when compared with TIO/OLO users. Further research will be required to confirm these findings.
-
Deficiencies in risk assessment for patients with pulmonary nodules (PNs) contribute to unnecessary invasive testing and delays in diagnosis. ⋯ The RRM accurately reclassified some patients into low-risk and very high-risk categories, suggesting the potential to improve PN risk assessment.
-
Review Historical Article
The Science of Sleep in Medieval Arabic Medicine: Part 2: Sleep Theory and Practice After Ibn Sīnā.
In this second article on medieval Arabic medical discussions on sleep, I show that Ibn Sīnā's pneumatic paradigm of sleep opened up new research pathways for subsequent physicians in Islamic societies. Opposing those who posit a decline in scientific activity post-1200 in these societies, I show that Ibn al-Nafīs (d. 1288), Ibn al-Quff (d. 1286), and Quṭb al-Dīn al-Shīrāzī (d. 1311), among others, raised and answered new questions to highlight the (possible) active role played by the brain in sleep onset and the strengthening of certain brain activities during sleep. They also continued to investigate the (three) stages of sleep and paid attention to different breathing patterns, in addition to pulse, during each stage. Finally, they also applied the pneumatic paradigm in new ways to understand the broader impact of certain medical conditions on sleep.
-
Respiratory therapists (RTs) are credentialed health professionals who specialize in assessment of pulmonary conditions, performing assessment of pulmonary function and delivering pulmonary therapeutics including aerosol therapy, and noninvasive and invasive mechanical ventilation. Respiratory therapists work closely with various clinicians including physicians, nurses, and therapy staff in a number of different settings including outpatient clinics, long-term facilities, EDs, and ICUs. ⋯ In this review, we outline the importance, the elements of, and an approach to building a comprehensive RT program that allows delivery of high-quality care while ensuring RTs practice at the full scope of their licensure. Over the last two decades, we have implemented a suite of changes to the training, functioning, deployment, continuing education, and capacity building in our Lung Partners Program practice, under the supervision of a medical director, that have allowed us to create an effective inpatient and outpatient model of primary respiratory care.
-
The role of sex differences in clinical presentation, TB drug pharmacokinetic variables, and treatment outcomes is unclear. ⋯ Women present with lower mycobacterial burden, achieve higher TB drug exposure, and are less likely to have unfavorable treatment outcomes than men. Strategies to improve TB treatment success should take into account sex differences in risk factors for unfavorable outcomes.