Clinics in chest medicine
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Clinics in chest medicine · Dec 2006
ReviewNew modalities of mechanical ventilation: high-frequency oscillatory ventilation and airway pressure release ventilation.
Management of acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) is largely supportive, with the use of mechanical ventilation being a central feature. Recent advances in the understanding of ALI/ARDS and mechanical ventilation have revealed that lung-protective ventilation strategies may attenuate ventilator-associated lung injury and improve patient morbidity/mortality. High-frequency oscillatory ventilation and airway pressure release ventilation are two novel alternative modes of ventilation that theoretically fulfill the principles of lung protection and may offer an advantage over conventional ventilation for ALI/ARDS.
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Disparities in critical illness are evident in a variety of racial and ethnic groups. Most data available in the literature reflect variations in the incidence, presentation, diagnosis,treatment, and outcomes between African Americans and whites. ⋯ Data are significantly lacking delineating the reasons for disparities in the critically ill. Further re-search is required to elucidate the root causes for racial or ethnic differences, provide adequate education for health care providers, and develop and implement evidence-based interventions targeted for specific patient groups.
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Clinics in chest medicine · Sep 2006
ReviewLung cancer disparities in African Americans: health versus health care.
African Americans with lung cancer have disproportionately worse outcomes than other ethnic groups. The incidence of lung cancer in blacks has remained well above the rates seen for the general population and the 5-year and overall survival rates for blacks with lung cancer are among the lowest of all racial groups. ⋯ Other stu-dies, however, have identified additional factors related to risks for poor outcomes in blacks with lung cancer. This article reviews data on these risks and their relationships to the health and health care of African Americans with lung cancer.
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Clinics in chest medicine · Sep 2006
ReviewCOPD: racial disparities in susceptibility, treatment, and outcomes.
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States and mortality continues to increase particularly among African Americans. Although this increase may be caused by changing smoking habits, some studies suggest that African Americans may be more susceptible to tobacco smoke than whites. Unlike other respiratory diseases for which there are significant published data on racial and ethnic disparities in disease outcomes, such information is notably lacking in the COPD literature. This article examines the available data concerning racial disparities in COPD susceptibility and care.
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Ultrasonography has achieved acceptance as a routine clinical tool for clinicians managing pleural disease. This article provides an overview of the field of pleural ultrasonography with an emphasis on clinical applicability and procedure guidance.