Chest
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ARDS is an inflammatory condition of the lungs and is a common condition in adult ICUs. The resources required and costs of care for patients with ARDS are significant because of the severity of the illness and extended ICU lengths of stay. ⋯ A wide range of costing data is available for ARDS. A comprehensive synthesis of this literature frames the reasons for this and allows estimates to reflect the context in which they were assessed. This information will be of value to researchers and administrators interested in the economics of caring for patients with ARDS.
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Prerecorded video content in medical education has become more common. Increasingly accessible technology coupled with the COVID-19 pandemic and subsequent need for distanced learning has greatly increased the interest in and need for high-quality video content. The use of short educational videos to augment other teaching methods has been shown to improve learners' experiences, knowledge retention, and understanding of content. ⋯ In addition, well-designed videos can be repurposed by educators, ultimately reducing time needed to create high-quality educational content. Currently available technology allows educators to create high-quality videos at minimal cost and with a modest investment of time. This article details practical tips for creating high-yield educational videos.
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Cystic fibrosis (CF) is caused by mutations in the cystic fibrosis transmembrane conductance regulator gene (CFTR). Novel, highly effective, modulator therapies correcting and potentiating CFTR function are changing the course of this disease. We present an ethical dilemma involving an 11-year-old child with CF and end-stage lung disease. ⋯ In summary, CFTR modulators affect the outcomes of CF disease and influence clinical decision-making. The current lack of data on long-term outcomes, in young patients with CF receiving effective modulator therapy, should not preclude CF team participation in decision-making. Shared decision-making, which is focused on respecting autonomy, is our preferred approach in these situations.
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Clinical Trial
Significant Spirometric Transitions and Preserved Ratio Impaired Spirometry Among Ever Smokers.
Emerging data from longitudinal studies suggest that preserved ratio impaired spirometry (PRISm), defined by proportionate reductions in FEV1 and FVC, is a heterogeneous population with frequent transitions to other lung function categories relative to individuals with normal and obstructive spirometry. Controversy regarding the clinical significance of these transitions exists (eg, whether transitions merely reflect measurement variability or noise). ⋯ gov.
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In December 2019, the command of a US Army Advanced Individual Training battalion on Fort Eustis, Virginia, was briefed on the results of tobacco and nicotine use surveys distributed to trainee soldiers and subsequently decided to ban tobacco and nicotine products in this population. The policy implementation process was thoroughly planned in a joint effort between battalion leadership and the installation military health facility. Data were collected throughout the process that evaluated nicotine product use among trainee soldiers, instructors, and leaders. ⋯ Comprehensive and multimodal resources and therapy to assist with treatment of dependence of tobacco and nicotine were offered. Although more data are needed on outcomes of this type of intervention, addressing tobacco and nicotine use in the military is long overdue, and our intervention offers a reproducible model to do so. It incorporates education, behavioral resources, and medication therapy with the aim to improve long-term quit rates and to improve the health of soldiers throughout and after their careers.