Resp Care
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Seasonal variations in the incidence of pulmonary embolism (PE) have been reported. It has been suggested that changes in meteorological factors may explain this variation. Previous studies have provided inconsistent results, possibly as a result of a small number of observations, in some studies and confounding factors. ⋯ The results confirm the presence of seasonal variations in episodes of idiopathic PE and an association between decreased atmospheric pressure and increased temperature.
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The conflicts in Iraq and Afghanistan have seen the advancement of combat medicine. The nature of the conflicts, with troops located in remote areas and faced with explosive ordinance designed to focus massive injuries on dismounted personnel, have forced military medical personnel to adapt accordingly. There has been a rekindling of interest in the use of tourniquets to stop exsanguination from extremity wounds, as well as in the transfusion of fresh whole blood from walking blood banks. ⋯ The field of combat medicine has taken several concepts initially designed in civilian settings, such as temporary abdominal packing and vascular shunting, and adapted them to the military setting to provide state of the art trauma management to our troops in combat. In turn, developments in the resuscitation of the trauma patient, using increased blood and plasma products and less crystalloid, have been pioneered in conflict and transitioned to the civilian sector. Advancements made during the wars in Iraq and Afghanistan, as well as those still being developed, will shape the care of the injured patient, in both civilian and military settings, for the foreseeable future.
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Editorial Comment
Is it asthma, COPD, or something in between, and does it matter?