item: #1 of 658 id: pulmonarychronicles-10 author: None title: Demographics, Microbiology and Outcome in Necrotizing Soft Tissue Infections date: None words: 2217 flesch: 49 summary: Discussion This study found that an elevated respiratory rate on admission is an independent predictor of death in NSTI patients. SWRCCC 2013;1(1)4-10 doi: 10.12746/swrccc2013.0101.003 ................................................................................................................................................................................................................................................................................................................................... Abstract Background: Necrotizing soft tissue infections (NSTI) are potentially severe infections that have a high morbidity and mortality even with modern medical care. keywords: diagnosis; infections; mortality; nsti; patients; surgery; tissue cache: pulmonarychronicles-10.htm plain text: pulmonarychronicles-10.txt item: #2 of 658 id: pulmonarychronicles-100 author: None title: BOARD REVIEW QUESTION Issue4 date: None words: 497 flesch: 63 summary: Discussion:Occupational lung diseases are caused by exposure of the lungs to irritating or toxic substances, like silica dust in the case of silicosis. Chronic silicosis on the other hand develops after long term exposure (multiple years) and may be asymptomatic or involve cough and dyspnea without crackles on exam. keywords: risk; silicosis cache: pulmonarychronicles-100.htm plain text: pulmonarychronicles-100.txt item: #3 of 658 id: pulmonarychronicles-1001 author: None title: Focused review date: None words: 304 flesch: 21 summary: The Southwest Respiratory and Critical Care Chronicles 2022;10(42):12–15 From: Department of Internal Medicine (MA, JB), Texas Tech University Health Sciences Center, Lubbock, Texas; Cardiology and Angiology Unit (MA), Clinical and Experimental Internal Medicine Department, Medical Research Institute, Alexandria University, Alexandria, Egypt; Cardiology Department (AA), Faculty of Medicine, Alexandria University, Alexandria, Egypt; Critical Care Department (MA), Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK Submitted: 1/10/2022 Accepted: 1/14/2022 Conflicts of interest: none This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Focused review Midkine as a novel biomarker for contrast-induced acute kidney injury Mahmoud Abdelnabi MD, Abdallah Almaghraby MD, Juthipong Benjanuwattra MD, Mohamed Ahmed MD ABSTRACT Contrast-induced acute kidney injury (CI-AKI) is an intrinsic kidney injury caused by contrast injection in susceptible individuals. keywords: contrast; injury cache: pulmonarychronicles-1001.htm plain text: pulmonarychronicles-1001.txt item: #4 of 658 id: pulmonarychronicles-1007 author: None title: Original article date: None words: 314 flesch: 30 summary: No-show rates were significantly associated with time period (p < 0.01). Original article Viability of telepsychiatry–results from an ambulatory academic tertiary care clinic Chuck Giles PhD, Wail Amor MD, Ashish Sarangi MD, Regina Baronia MD, Dalynn Kim BS, Jayasudha Gude MD ABSTRACT During the 2020 COVID-19 pandemic, telemedicine became an important method of providing patient care and minimizing person-to-person contact. keywords: telepsychiatry cache: pulmonarychronicles-1007.htm plain text: pulmonarychronicles-1007.txt item: #5 of 658 id: pulmonarychronicles-1009 author: None title: Focused review date: None words: 352 flesch: 22 summary: Keywords: Catatonia, COVID-19, neuropsychiatric syndrome, pandemic, electroconvulsive therapy Article citation: Sharma S, Sarangi A, Sachdeva V, Rangineni S. The association of COVID-19 and catatonia in the ICU-recognition, management, and the role of electroconvulsive therapy. Methods: A thorough literature review was conducted focusing on studies which reported any association or non-association between COVID-19 and catatonia. keywords: catatonia cache: pulmonarychronicles-1009.htm plain text: pulmonarychronicles-1009.txt item: #6 of 658 id: pulmonarychronicles-101 author: None title: Pulmonary Sequestration date: None words: 494 flesch: 47 summary: Pulmonary sequestrations are fragments of normal lung tissue that lack continuity with the tracheo-bronchial tree and receive their blood supply from the systemic circulation.1 Seventy-five percent of sequestrations are in a lower lobe (left> right) and are intralobar.1 Twenty-five percent of sequestrations are extralobar and consist of accessory lobes with their own pleural lining. These are commonly found between the diaphragm and the lower lobe of the lung.2 The blood vessels to extralobar sequestrations are often from the thoracic or abdominal aorta.3 Sequestrations usually present before the age of 20. keywords: extralobar; pulmonary; sequestration cache: pulmonarychronicles-101.htm plain text: pulmonarychronicles-101.txt item: #7 of 658 id: pulmonarychronicles-1011 author: None title: Case report date: None words: 254 flesch: 30 summary: Case report An unusual infective endocarditis case presenting as meningitis in a young man with recent dental work Michelle Zur DO, MS, Anil Magge MD, Srinivas Nadadur MD, Ameer Rasheed MD ABSTRACT Introduction: Infective endocarditis (IE) has several clinical presentations. Here, we report a case of infective endocarditis with uncommon presentation, unusual risk factors, and a rapidly progressing course to alert clinicians to this scenario. keywords: endocarditis cache: pulmonarychronicles-1011.htm plain text: pulmonarychronicles-1011.txt item: #8 of 658 id: pulmonarychronicles-1013 author: None title: Case report date: None words: 203 flesch: 25 summary: Keywords: ostium secundum atrial septal defect, pulmonary valve stenosis, Amplatzer septal occluder, adult Article citation: Temple H, Cevik, C. Atrial septal defect and concomitant significant pulmonic stenosis in an adult patient. This sequence of events warrants review of his workup at his initial visit and follow-up visit and of the diagnosis and treatment of his pulmonic stenosis and atrial septal defect. keywords: septal cache: pulmonarychronicles-1013.htm plain text: pulmonarychronicles-1013.txt item: #9 of 658 id: pulmonarychronicles-1015 author: None title: Case report date: None words: 270 flesch: 33 summary: The Southwest Respiratory and Critical Care Chronicles 2022;10(43):33–36 From: School of Medicine (NM, JG); Department of Internal Medicine (ZS, AL, MMA), Texas Tech University Health Sciences Center, Lubbock, Texas; Texas Tech University (RM), Lubbock, Texas Submitted: 1/22/2022 Accepted: 1/26/2022 Conflicts of interest: none This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Keywords: AngioVac, tricuspid endocarditis, vegetations, trans-esophageal echocardiography Article citation: Mittal N, Mittal R, Greene J, Sly Z, Lahoti A, Ansari MM. keywords: tricuspid cache: pulmonarychronicles-1015.htm plain text: pulmonarychronicles-1015.txt item: #10 of 658 id: pulmonarychronicles-102 author: None title: Acute respiratory distress syndrome, metabolic acidosis, and respiratory acidosis associated with citalopram overdose date: None words: 2511 flesch: 50 summary: We are reporting the second case of ARDS and the fifth case of metabolic acidosis due to citalopram overdose and suggest that the metabolic acidemia is explained by propionic acid. syndrome.2 There are limited data on respiratory complications from citalopram overdoses. keywords: acidosis; acute; citalopram; metabolic; overdose; patient; propionic; serotonin; syndrome cache: pulmonarychronicles-102.htm plain text: pulmonarychronicles-102.txt item: #11 of 658 id: pulmonarychronicles-1021 author: None title: Case report date: None words: 230 flesch: 39 summary: Case report Addison’s disease presenting as shortness of breath and hypotension in early pregnancy Avery Williams MD, Blair Buschmann MD, Afrina Rimu MD, Jennifer Phy DO ABSTRACT Background: Addison’s disease is an adrenal cortex disorder that is considered rare, and the pathophysiology is not well understood. After further evaluation, she was noted to have symptoms that led to the differential diagnosis of Addison’s disease. keywords: disease cache: pulmonarychronicles-1021.htm plain text: pulmonarychronicles-1021.txt item: #12 of 658 id: pulmonarychronicles-1023 author: None title: Case series date: None words: 324 flesch: 51 summary: Case series Stevens-Johnson syndrome/toxic epidermal necrolysis management in the burn intensive care unit: A case series Jasmin Rahesh MS, MBA, Layan Al-Sukhni, John A. Griswold MD ABSTRACT Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) comprise a spectrum of severe hypersensitivity skin reactions. Keywords: Stevens-Johnson syndrome, toxic epidermal necrolysis, burn unit ICU Article citation: Rahesh J, Al-Sukhni L, Griswold JA. keywords: johnson; stevens cache: pulmonarychronicles-1023.htm plain text: pulmonarychronicles-1023.txt item: #13 of 658 id: pulmonarychronicles-1027 author: None title: Commentary date: None words: 2497 flesch: 55 summary: Larger studies have greater statistical power compared to smaller studies. Controlled studies avoid biases due to effects of extraneous variables. keywords: conclusion; covid-19; elephant; ivermectin; men cache: pulmonarychronicles-1027.htm plain text: pulmonarychronicles-1027.txt item: #14 of 658 id: pulmonarychronicles-1029 author: None title: Medical image date: None words: 681 flesch: 32 summary: Computed tomography of the left lower extremity showing honeycomb pattern of subcutaneous edema and skin thickening extending from foot to upper thigh. Ultrasound elastography use in lower extremity lymphedema: a systematic review of the literature. keywords: figure; lymphedema; skin cache: pulmonarychronicles-1029.htm plain text: pulmonarychronicles-1029.txt item: #15 of 658 id: pulmonarychronicles-103 author: None title: Fat Embolism Syndrome date: None words: 468 flesch: 44 summary: Fat embolism occurs in nearly all patients (> 90%) with bone fractures during orthopedic prosthesis procedures and rarely occurs in other pathologic conditions.1 Approximately 3 to 4% of these patients develop the classical triad of the fat embolus syndrome (FES), which consists of petechial hemorrhages (Figure 1), respiratory distress (Figure 2), and cerebral abnormalities (Figure 3); most patients remain asymptomatic.1 Fat embolism syndrome, a 10-year review.  keywords: fat; patients; syndrome cache: pulmonarychronicles-103.htm plain text: pulmonarychronicles-103.txt item: #16 of 658 id: pulmonarychronicles-1031 author: None title: Medical image date: None words: 336 flesch: 54 summary: L. Glenn and his wife, Roxie, termed the symbol “guns up”, and it is now used to convey Texas Tech pride and values at athletic events and social gatherings. Medical image Guns up, baby Bernardo Galvan BS, Katherine G. Holder BBA Corresponding author: Bernardo Galvan Contact Information: Bernardo.Galvan@ttuhsc.edu DOI: 10.12746/swrccc.v10i43.1031 College hand signals, typically used to convey university pride at collegiate sporting events, have been used for almost a century.1 The first college hand signals were thought to have originated with Pinky Downs at Texas A&M University in the 1930s, and the practice quickly spread to other universities in the Southwest Conference.1 In 1961, L. Glenn Dippel, a proud alumnus of Texas Tech University (TTU), began promoting a hand sign for the fans of his alma mater.2 The sign was produced by extending a hand’s index finger and thumb while carefully flexing the medial three digits into a fist, as seen in the ultrasound image. keywords: texas; university cache: pulmonarychronicles-1031.htm plain text: pulmonarychronicles-1031.txt item: #17 of 658 id: pulmonarychronicles-1033 author: None title: Case report date: None words: 169 flesch: 43 summary: Keywords: AML, pleural effusion, blast cell, leukemic pleural infiltrate Article citation: Songtanin B, Evans A, Warraich I. Blasts in pleural fluid: Leukemic pleural infiltration has been reported previously but is very rare. keywords: acute cache: pulmonarychronicles-1033.htm plain text: pulmonarychronicles-1033.txt item: #18 of 658 id: pulmonarychronicles-1035 author: None title: Original article date: None words: 477 flesch: 23 summary: Original article Predictive characteristics of prolonged symptoms and seroconversion in ambulatory patients recovering from SARS-CoV-2 infection Vamsi P. Guntur MD, MSc, Brian Modena MD, MSc, Claudia Onofrei MD, MSc, Shu-Yi Liao MD, MPH, ScD, Pearlanne Zelarney MS, Jared J. Eddy MD, MPhil, MSc, Rebecca Keith MD, Rachel DeCosta NP, Irina Petrache, MD**, Nir Goldstein, MD** ABSTRACT Introduction: With an increasing number of ambulatory visits for acute COVID-19 follow-up, we set out to characterize and identify clinical predictors of prolonged symptoms and antibody seroconversion. Methods: All adults with confirmed SARS-CoV-2 infection evaluated at a single ambulatory center between April–September 2020 were studied retrospectively using a logit model and ANOVA, and the importance of variables associated with prolonged symptoms and seroconversion was determined by machine learning methodology. keywords: symptoms cache: pulmonarychronicles-1035.htm plain text: pulmonarychronicles-1035.txt item: #19 of 658 id: pulmonarychronicles-1037 author: None title: Focused review date: None words: 383 flesch: 36 summary: Focused review Ventilator management using esophageal balloon pressure measurements Cristina Morataya MD, MPH, Sabiha Armin BS, Kenneth Nugent MD ABSTRACT Mechanical ventilation provides essential support for patients with acute respiratory failure and provides time for these patients to recover from the primary disorder. Beitler et al. randomized 200 patients with moderate to severe ARDS into one group in which PEEP titration was based on esophageal balloon pressure measurements, and a second group in which PEEP titration was based on a high FiO2/PEEP table studied in earlier trials. keywords: peep; pressure cache: pulmonarychronicles-1037.htm plain text: pulmonarychronicles-1037.txt item: #20 of 658 id: pulmonarychronicles-1039 author: None title: Statistics column date: None words: 2070 flesch: 49 summary: While block randomization works well for ensuring a desirable treatment allocation ratio, it has no control over whether the risk factors are balanced among the arms, especially in small studies. DETERMINISTIC For smaller studies, methods such as block randomization, stratified and adaptive randomization are preferable, because they often achieve better balance compared to simple randomization. keywords: block; factors; randomization; study; treatment cache: pulmonarychronicles-1039.htm plain text: pulmonarychronicles-1039.txt item: #21 of 658 id: pulmonarychronicles-104 author: None title: Metastatic Pulmonary Calcification An Uncommon Clinical Condition in End-Stage Renal Disease date: None words: 1887 flesch: 38 summary: This patient had metastatic pulmonary calcification and possibly dystrophic calcification due to renal failure which probably contributed to his pulmonary symptoms. Atypical radiological manifestation of pulmonary metastatic calcification. keywords: calcification; calcium; chest; end; lung; mpc; patients; stage cache: pulmonarychronicles-104.htm plain text: pulmonarychronicles-104.txt item: #22 of 658 id: pulmonarychronicles-1041 author: None title: Focused review date: None words: 205 flesch: 30 summary: The Southwest Respiratory and Critical Care Chronicles 2022;10(43):6–10 From: Department of Internal Medicine (NG), St. Barnabas Hospital Health System, The Bronx, NY; Pulmonology and Critical Care (DS), CoxHealth, Branson, Missouri2 Submitted: 3/9/2022 Accepted: Keywords: Surfactant, COVID 19, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), pathogenesis, treatment Article citation: Guevara N, Sotello D. Role of the surfactant in Severe Acute Respiratory Syndrome Coronavirus 2 Infections. keywords: surfactant cache: pulmonarychronicles-1041.htm plain text: pulmonarychronicles-1041.txt item: #23 of 658 id: pulmonarychronicles-1043 author: None title: Review date: None words: 248 flesch: 37 summary: The Southwest Respiratory and Critical Care Chronicles 2022;10(45):28–36 From: School of Medicine (BL, CJP), Texas Tech University Health Sciences Center, Lubbock, Texas; College of Engineering (BL), Texas Tech University, Lubbock Texas Submitted: 4/11/2022 Accepted: 10/5/2022 Conflicts of interest: none This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. This review provides an introduction to AI and the potential it has to affect medical practice. keywords: medicine cache: pulmonarychronicles-1043.htm plain text: pulmonarychronicles-1043.txt item: #24 of 658 id: pulmonarychronicles-1045 author: None title: Medicine in art date: None words: 1963 flesch: 74 summary: While hubris boasts with excessive pride, humility goes about its way quietly, free from pride or arrogance. Although the base of this chalice is more ornate than the one Indiana Jones chose, the cup itself is plain, reflecting the message of the movie: humility triumphs over hubris. keywords: arrogance; hubris; humility; jones; lucifer; new; oxford cache: pulmonarychronicles-1045.htm plain text: pulmonarychronicles-1045.txt item: #25 of 658 id: pulmonarychronicles-105 author: None title: Medicare and the U.S. Unfunded Liability date: None words: 1338 flesch: 41 summary: For the most recently concluded fiscal year (2013), the official estimate of total U.S. government revenue was $2.9 trillion, the official estimate of total U.S. government expenditure was $3.8 trillion, and the official U.S. budget deficit was $0.9 trillion.1 Of the $3.8 trillion in expenditures, $2.563 trillion (67.4%) was for Human Resources. Given that retirement programs, such as Social Security and Medicare, are becoming larger determinants of both the short term and long term imbalances, increasing attention is being drawn to the actuarial concepts of unfunded liabilities. keywords: medicare; term; u.s; unfunded cache: pulmonarychronicles-105.htm plain text: pulmonarychronicles-105.txt item: #26 of 658 id: pulmonarychronicles-1053 author: None title: Case report date: None words: 240 flesch: 32 summary: In conclusion, hydroxychloroquine overdose can result in life-threatening rapid decompensation requiring gastric decontamination, alkalization, high dose diazepam, hemodynamic support, and frequent electrolyte replacement. The management of severe hydroxychloroquine overdose does not have any well-established protocols. keywords: hydroxychloroquine cache: pulmonarychronicles-1053.htm plain text: pulmonarychronicles-1053.txt item: #27 of 658 id: pulmonarychronicles-1055 author: None title: Case report date: None words: 311 flesch: 36 summary: Persistent left superior vena cava, if known or suspected, requires additional caution in central venous line placement to avoid potentially fatal complications, such as arrhythmias. Keywords: Persistent left superior vena cava, vascular malformations, catheterization, central venous catheter Article citation: keywords: cava; vena cache: pulmonarychronicles-1055.htm plain text: pulmonarychronicles-1055.txt item: #28 of 658 id: pulmonarychronicles-1057 author: None title: Regional medicine date: None words: 322 flesch: 27 summary: Each center recruited three panels consisting of hospital administrators, practicing healthcare providers, and healthcare provider students, including medical, nurse practitioner, and physician assistant students. Results: The themes that emerged revolve around advantages, disadvantages, suggestions and requests, and overall strategies regarding recruitment and retention of rural providers. keywords: healthcare; rural cache: pulmonarychronicles-1057.htm plain text: pulmonarychronicles-1057.txt item: #29 of 658 id: pulmonarychronicles-1059 author: None title: Case report date: None words: 206 flesch: 32 summary: There have been very few reported cases of Rhodococcus osteomyelitis. Our patient is a 27-year-old man with human immunodeficiency virus infection who was diagnosed with Rhodococcus osteomyelitis and bacteremia. keywords: rhodococcus cache: pulmonarychronicles-1059.htm plain text: pulmonarychronicles-1059.txt item: #30 of 658 id: pulmonarychronicles-106 author: None title: Contamination of Unused, Nonsterile Gloves in the Critical Care Setting date: None words: 3172 flesch: 41 summary: Data analysis Contamination rate analysis was conducted using a Chi-square test for proportions to measure the significance of the differences in glove pair contamination rates between specialty ICUs and between samples grouped based on the isolation status of the room from which they were obtained. Correlation between the composition of glove contamination and organisms found to cause nosocomial infections in the same environment could suggest that contamination of gloves and other areas of the environment have a significant role in the spread of nosocomial infections, independent of hand hygiene practices by healthcare workers.  keywords: burden; care; contamination; differences; glove; icu; room; samples; study cache: pulmonarychronicles-106.htm plain text: pulmonarychronicles-106.txt item: #31 of 658 id: pulmonarychronicles-1061 author: None title: Original article date: None words: 397 flesch: 40 summary: Negative pressure wound therapy was compared to standard post-operative surgical wound dressing. Original article Effect of negative pressure wound therapy in exploratory laparotomies with coexisting ostomy Avery C. Williams MD, Kripa Shrestha MBBS, MPH, MS, Alexis Cruz MD, Anastazia H. Gilman MD, MBA, Jonathan Huynh MD, Justin Vaughan MD, MS, Ariel P. Santos MD, MPH, FRCSC, FACS, FCCM ABSTRACT Background: Surgical site infection (SSI) is one of the most common healthcare-associated infections. keywords: patients; wound cache: pulmonarychronicles-1061.htm plain text: pulmonarychronicles-1061.txt item: #32 of 658 id: pulmonarychronicles-1063 author: None title: Original article date: None words: 361 flesch: 38 summary: Results: Patients with higher pre-operative mFI (≥2) were more likely to be older in age (P = 0.047), have worse ECOG performance status (P = 0.019), and worse ASA scores (P < 0.01). The Modified Frailty Index should be assessed pre-operatively in prostate cancer patients to determine the risk of post-operative morbidity and the best treatment plan. keywords: day cache: pulmonarychronicles-1063.htm plain text: pulmonarychronicles-1063.txt item: #33 of 658 id: pulmonarychronicles-1065 author: None title: Case report date: None words: 228 flesch: 38 summary: Keywords: Second cancer, childhood cancers, brain cancers, neurosurgery, pediatric cancers Article citation: Rahesh J, Khan S, Siddiqui A, Jacob R. Second primary cancer in the brain: A longitudinal case study from childhood into adulthood. The most likely reason second cancers occur is multifactorial and involves an interaction between environmental and genetic factors. keywords: cancers cache: pulmonarychronicles-1065.htm plain text: pulmonarychronicles-1065.txt item: #34 of 658 id: pulmonarychronicles-1067 author: None title: Image report date: None words: 504 flesch: 41 summary: He then underwent additional evaluation for gastrointestinal bleeding by video capsule endoscopy (VCE) with the PillCam (Medtronic; Minneapolis, MN; dimensions: length 26.2 mm, diameter 11.4 mm, weight 3.0 g). Keywords: PillCam, Video capsule aspiration, endoscopy Article citation: Songtanin B, Iwuji K, Shakespeare A, Sanchez S, Islam E, Islam S. Video capsule endoscopy aspiration. keywords: capsule cache: pulmonarychronicles-1067.htm plain text: pulmonarychronicles-1067.txt item: #35 of 658 id: pulmonarychronicles-1069 author: None title: Medical image date: None words: 636 flesch: 51 summary: This type of hand lesion is uncommon, and recognition is important. Tuberculous tenosynovitis of the flexor tendons of the wrist and hand. keywords: finger; hand; tuberculosis cache: pulmonarychronicles-1069.htm plain text: pulmonarychronicles-1069.txt item: #36 of 658 id: pulmonarychronicles-107 author: None title: Update on azithromycin and cardiac side effectsMetastatic Pulmonary Calcification date: None words: 1536 flesch: 27 summary: However, azithromycin may have greater activity against Gram-negative organisms, especially Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, Neisseria gonorrhea, Ureaplasma urealyticum, and Borrelia burgdorferi.4 Like other macrolides azithromycin is also highly effective against atypical intracellularorganisms, such as Legionella pneumophila, Chlamydia spp, and Mycoplasma spp.5 2. Strle F, Maraspin V. Is azithromycin treatment associated with prolongation of the Q-Tc interval? keywords: azithromycin; cardiac; cardiovascular; effects; patients; risk cache: pulmonarychronicles-107.htm plain text: pulmonarychronicles-107.txt item: #37 of 658 id: pulmonarychronicles-1071 author: None title: Regional medicine date: None words: 385 flesch: 23 summary: Keywords: Uninsured, Underserved, minorities, vaccine, vaccine hesitancy, COVID-19, pandemic, free healthcare, rural health, public health Article citation: Nesiama E, Vopni R, Fuentes N, Prabhu F, Bennett K. Assessing and addressing COVID-19 vaccine hesitancy in a West Texas Free Clinic through motivational interview-guided intervention. Regional medicine Assessing and addressing COVID-19 vaccine hesitancy in a West Texas Free Clinic through motivational interview-guided intervention Esere Nesiama MBA, Rachel Vopni BA, Nayeli Fuentes BS, Fiona Prabhu MD, FAAFP, Kelly Bennett MD, FAAFP ABSTRACT Background: Vaccine hesitancy is a public health issue that threatens the successful prevention of vaccine-preventable diseases. keywords: hesitancy; vaccine cache: pulmonarychronicles-1071.htm plain text: pulmonarychronicles-1071.txt item: #38 of 658 id: pulmonarychronicles-1073 author: None title: Medical image date: None words: 354 flesch: 36 summary: doi:10.1111/1754-9485.54_12784 Diri A, Diri B. Management of staghorn renal stones. Noncontrast CT displaying left renal staghorn calculus. keywords: calculus; staghorn cache: pulmonarychronicles-1073.htm plain text: pulmonarychronicles-1073.txt item: #39 of 658 id: pulmonarychronicles-1075 author: None title: Statistics column date: None words: 2226 flesch: 53 summary: While we all understand that avoiding this situation is preferable, and that it is important to design studies and develop trial protocols to limit the amount of missing data, sometimes, missing values are unavoidable. However, although it is possible to demonstrate that missing data are not MCAR,3 the MAR and MNAR mechanisms cannot be distinguished because the missing data are unknown, and it therefore cannot be verified whether the observed data can predict the unknown data. keywords: analysis; data; imputation; missing; values cache: pulmonarychronicles-1075.htm plain text: pulmonarychronicles-1075.txt item: #40 of 658 id: pulmonarychronicles-1077 author: None title: Case report date: None words: 212 flesch: 33 summary: Bilateral infraclavicular brachial plexus nerve blocks in an ambulatory surgery center. Our aim was to explore the safety of bilateral parasagittal infraclavicular brachial plexus blocks (BPBBs) in an outpatient surgery center. keywords: plexus cache: pulmonarychronicles-1077.htm plain text: pulmonarychronicles-1077.txt item: #41 of 658 id: pulmonarychronicles-108 author: None title: Nosocomial Infections: Environmental Sources date: None words: 773 flesch: 47 summary: In addition, the rate of glove contamination was lower when samples were obtained from rooms with isolation precautions (71.1% vs 88.5%, p=0.037). This study was conducted in an attempt to determine whether glove contamination could have a role in the spread of nosocomial infections in the ICUs. keywords: contamination; gloves; infections cache: pulmonarychronicles-108.htm plain text: pulmonarychronicles-108.txt item: #42 of 658 id: pulmonarychronicles-1081 author: None title: Case report date: None words: 211 flesch: 18 summary: Case report Left ventricular outflow tract pseudoaneurysms and severe paravalvular aortic regurgitation treated by percutaneous approach in a Marfan syndrome patient Dean C. Paz BS, Timothy Hegeman DO, Onur Nadi Varli, Cihan Cevik MD ABSTRACT A 66-year-old man with a history of Marfan syndrome and resolved infective endocarditis was found to have shortness of breath after a previous aortic valve replacement in 2010. Keywords: Marfan syndrome, infective endocarditis, paravalvular leaks, left ventricular outflow tract pseudoaneurysm, Amplatzer vascular plug Article citation: Paz DC, Hegeman T, Varli ON, Cevik C. Left ventricular outflow tract pseudoaneurysms and severe paravalvular aortic regurgitation treated by percutaneous approach in a Marfan syndrome patient. keywords: outflow cache: pulmonarychronicles-1081.htm plain text: pulmonarychronicles-1081.txt item: #43 of 658 id: pulmonarychronicles-1083 author: None title: Case report date: None words: 197 flesch: 21 summary: These sharp metal objects are commonly removed using rigid bronchoscopy, but removal by flexible bronchoscopy, although challenging, is still possible. Case report Tic-“tack”-toe, out I go: A strategic implementation of flexible bronchoscopy in the removal of an aspirated thumbtack Saria Tasnim MD, Balaji Mohanakrishnan MD, Nandini Ray MD, Manish Patel MD ABSTRACT Thumbtack aspiration is a medical emergency as the sharp end poses a risk of injuring the respiratory tract and potentially causing fatal complications. keywords: bronchoscopy cache: pulmonarychronicles-1083.htm plain text: pulmonarychronicles-1083.txt item: #44 of 658 id: pulmonarychronicles-1085 author: None title: Review date: None words: 241 flesch: 29 summary: In this review paper, we discuss the possible benefits and consequences of remote work on various measures of mental health and discuss the implications of future WFH models which may provide workers with greater autonomy and flexibility. Keywords: work from home, mental health, job satisfaction, depression Article citation: Sarangi A, Kim D, Rafael J. The mental health impact of work from home: A literature review. keywords: health cache: pulmonarychronicles-1085.htm plain text: pulmonarychronicles-1085.txt item: #45 of 658 id: pulmonarychronicles-1087 author: None title: Case report with focused review date: None words: 212 flesch: 31 summary: Case report with focused review Relapsing polychondritis presenting as otitis externa Benjamin Lee BS, Christopher J Peterson MD, MS, Joshua Peterson MD, Mark D. Lacy MD ABSTRACT Relapsing polychondritis remains a challenging diagnosis with cartilage inflammation being the hallmark of this disease. Keywords: Relapsing polychondritis; neurologic; central nervous system Article citation: Lee B, Peterson CJ, Peterson J, Lacy MD. keywords: polychondritis cache: pulmonarychronicles-1087.htm plain text: pulmonarychronicles-1087.txt item: #46 of 658 id: pulmonarychronicles-109 author: None title: Drug-Induced Methemoglobinemia: a Case Report and Review of Literature date: None words: 2275 flesch: 49 summary: With methemoglobin levels above 20% to 30% neurological (dizziness, headache, anxiety, somnolence, and seizures) and cardiovascular symptoms (dyspnea, low cardiac output symptoms) start to appear. Clinical presentation of methemoglobinemia based on methemoglobin level in blood.6 Methemoglobinemia should be suspected in patients with central cyanosis, tachypnea, and low O2 saturations on pulse oximetry, especially if not responding to 100% oxygen. keywords: benzocaine; blue; levels; methemoglobinemia; methylene; oxygen; patients; treatment cache: pulmonarychronicles-109.htm plain text: pulmonarychronicles-109.txt item: #47 of 658 id: pulmonarychronicles-1091 author: None title: Case report date: None words: 176 flesch: 22 summary: Keywords: carotid cavernous fistula, cellulitis, embolization Article citation: Peterson CJ, Lee B. Lacy MD. Here we present a case of carotid cavernous fistula mimicking orbital cellulitis, ultimately diagnosed with magnetic resonance venography. keywords: fistula cache: pulmonarychronicles-1091.htm plain text: pulmonarychronicles-1091.txt item: #48 of 658 id: pulmonarychronicles-1093 author: None title: MICU rounds date: None words: 175 flesch: 27 summary: MICU rounds Iatrogenic opioid withdrawal syndrome presentation and considerations Abbie Evans MD, Kenneth Nugent MD ABSTRACT The 2018 Critical Care Medicine Guidelines for Analgesia and Sedation in the ICU Good Practice Statement emphasized the importance in the treatment of pain taking precedence over sedation. Keywords: opioids, withdrawal, ICU, mechanical ventilation Article citation: Evans A, Nugent K. Iatrogenic opioid withdrawal syndrome presentation and considerations. keywords: withdrawal cache: pulmonarychronicles-1093.htm plain text: pulmonarychronicles-1093.txt item: #49 of 658 id: pulmonarychronicles-1095 author: None title: Medical image date: None words: 408 flesch: 41 summary: In a phase IV clinical trial analyzing cephalexin side effects, 12,600 patients reported having side effects; 102 patients (0.81%) had bradycardia. Keywords: Bradycardia, side effects, cephalexin REFERENCES Lu ZK, Yuan J, Li M, Sutton SS, et al. keywords: bradycardia; cephalexin cache: pulmonarychronicles-1095.htm plain text: pulmonarychronicles-1095.txt item: #50 of 658 id: pulmonarychronicles-1097 author: None title: Medical image date: None words: 544 flesch: 49 summary: Medical image COVID-19 induced pulmonary artery aneurysm Tushi Singh MD, Ricardo Franco MD, Bharat Kakarala MD, Andres Yepes Hurtado MD Corresponding author: Tushi Singh Contact Information: Tushi.singh@ttuhsc.edu DOI: 10.12746/swrccc.v10i45.1097 CASE A 56-year-old man with a recent COVID 19 pneumonia presented to the emergency center with cough, hemoptysis, and increasing dyspnea. Infections are the leading cause of acquired pulmonary artery pseudoaneurysm (PAP). keywords: artery; pseudoaneurysm cache: pulmonarychronicles-1097.htm plain text: pulmonarychronicles-1097.txt item: #51 of 658 id: pulmonarychronicles-1099 author: None title: Medical image date: None words: 530 flesch: 56 summary: Foreign body aspiration of large objects is rare in adults but the presence of a permanent tracheal stoma in a laryngectomized patient is an important predisposing factor. An unusual way of tracheal stoma cleaning could end up with foreign body aspiration in a laryngectomized patient. keywords: aspiration; body; tracheal cache: pulmonarychronicles-1099.htm plain text: pulmonarychronicles-1099.txt item: #52 of 658 id: pulmonarychronicles-11 author: None title: Necrotizing Soft Tissue Infections date: None words: 173 flesch: 37 summary: Necrotizing Soft Tissue Infections PDF Necrotizing Soft Tissue Infections Chance Witt MDa, Sharmila Dissanaike MDb Correspondence to Sharmila Dissanaike MD Email: sharmila.dissanaike@ttuhsc.edu + Author Affiliation - Author Affiliation a a resident in General Surgery at the Mayo School of Graduate Medical Education in Rochester, MN b a trauma and burn surgeon in the Department of Surgery at TTUHSC in Lubbock, TX SWRCCC 2013;1.(1):30 doi: 10.12746/swrccc2013.0101.009 ................................................................................................................................................................................................................................................................................................................................... Figure 1 Left leg with necrotizing soft tissue infections.  Figure 2 Debridement of the left leg: showing purulence This is a very heavy woman who initially had an Necrotizing Soft Tissue Infection (NSTI) of the right leg which was extensively debrided and skin grafted and healed well, then presented 2 months later with a new NSTI of the left leg. keywords: tissue cache: pulmonarychronicles-11.htm plain text: pulmonarychronicles-11.txt item: #53 of 658 id: pulmonarychronicles-110 author: None title: Miliary Tuberculosis in a Healthy Adult date: None words: 2847 flesch: 42 summary: She was diagnosed with miliary TB at the late stage of infection which presented with a fulminant clinical course, including DIC and multi-organ failure. The diagnosis of miliary TB was established by the clinical findings and imaging abnormalities despite the absence of microbiologic confirmation. keywords: diagnosis; dic; dissemination; infection; lung; miliary; patient; symptoms; tuberculosis cache: pulmonarychronicles-110.htm plain text: pulmonarychronicles-110.txt item: #54 of 658 id: pulmonarychronicles-1101 author: None title: Review date: None words: 163 flesch: 12 summary: Keywords: sedations, mechanical ventilation, intensive care unit, sedation assessment tools Article citation: Motes A. Monitoring sedation during mechanical ventilation. Review Monitoring sedation during mechanical ventilation Arunee Motes MD ABSTRACT Sedative medications have been used in intensive care units (ICU) to minimize discomfort, prevent pain/anxiety, allow invasive procedures, reduce stress, and improve synchrony in mechanically ventilated (MV) patients. keywords: sedation cache: pulmonarychronicles-1101.htm plain text: pulmonarychronicles-1101.txt item: #55 of 658 id: pulmonarychronicles-1103 author: None title: Original article date: None words: 435 flesch: 28 summary: Original article Clinical effectiveness of generic vancomycin products compared to Vancocin CP® in patients with methicillin-resistant Staphylococcus aureus infections: A retrospective cohort Juliana Castaño-Rendón MD, Sebastián Sánchez López MD, Andrés Felipe Barbosa Padierna MD, María Paulina Cortés Palacio MD, Laura María Mesa Tobon MD, María Sady Bustamante De La Ossa MD, Carolina Zapata Muriel MD, Johana Ascuntar Tello MD, Fabián Jaimes MD ABSTRACT Introduction: Approval of generic drugs requires only bioequivalence studies. Some research suggests that generic vancomycin is not clinically equivalent to the branded drug, and this exposes patients to therapeutic failure and the development of microbial resistance. keywords: generic; vancomycin cache: pulmonarychronicles-1103.htm plain text: pulmonarychronicles-1103.txt item: #56 of 658 id: pulmonarychronicles-1105 author: None title: Case report date: None words: 188 flesch: 21 summary: Case report Collagenous gastritis presenting as chronic heartburn in a patient with psoriatic arthritis Anasua Deb MD, Busara Songtanin MD, Thanita Thongtan MD, Sameer Islam MD ABSTRACT Collagenous gastritis is a rare cause of heartburn in adults. Here we report a case of collagenous gastritis in a 29-year-old woman with psoriatic arthropathy who presented with persistent heartburn. keywords: gastritis cache: pulmonarychronicles-1105.htm plain text: pulmonarychronicles-1105.txt item: #57 of 658 id: pulmonarychronicles-1107 author: None title: Statistics column date: None words: 1752 flesch: 43 summary: Network meta-analysis, which is also called mixed treatment comparison or multiple treatment comparison meta-analysis, is an analysis method for comparing multiple treatments simultaneously within a network of randomized controlled trials.1,2 While a network meta-analysis and a traditional meta-analysis (pair-wise comparison) share many commonalities, including literature searches, study selection, quality evaluation, bias assessment, and sensitivity analysis, etc.,3 a network meta-analysis is a powerful extension of a traditional meta-analysis that can estimate the relative effect between any pair of treatments in the network, and usually has more precise estimates. In addition, with more data contributing to the estimates, the results of treatment comparisons are often more precise. keywords: analysis; comparisons; meta; network; treatments cache: pulmonarychronicles-1107.htm plain text: pulmonarychronicles-1107.txt item: #58 of 658 id: pulmonarychronicles-1109 author: None title: Case report date: None words: 326 flesch: 38 summary: Worsening back pain and lower extremity weakness in elderly patients should raise concerns for acute cord compression. We report a case of progressive lower extremity weakness as the initial presentation of a thoracic plasmacytoma. keywords: compression; plasmacytoma cache: pulmonarychronicles-1109.htm plain text: pulmonarychronicles-1109.txt item: #59 of 658 id: pulmonarychronicles-111 author: None title: Escherichia coli Pyomyositis Presenting as Right Hip Pain - a Case Report and Review of Literature date: None words: 1233 flesch: 45 summary: Since the first reported case of pyomyositis in 1971, there have been over 300 reported cases of pyomyositis in the United States.6 There were 246 cases reported between 1981 and 1994 in HIV-negative patients; these included 24 cases with Gram-negative bacteria.4 Twenty cases of Escherichia coli pyomyositis have been reported, with nearly all of them occurring in immunocompromised patients.7 In 2010, Clinical Infectious Diseases published an article by Vigil et al. that reported an emerging trend of Escherichia coli pyomyositis in patients with hematologic malignancies. We report a patient with Escherichia coli pyomyositis who presented in the third phase (sepsis); this patient responded well to the recommended treatment of drainage of the abscess with appropriate antibiotic therapy. keywords: coli; escherichia; hip; pain; pyomyositis cache: pulmonarychronicles-111.htm plain text: pulmonarychronicles-111.txt item: #60 of 658 id: pulmonarychronicles-1111 author: None title: Review date: None words: 3440 flesch: 40 summary: How ethics failed— The role of psychiatrists and physicians in Nazi programs from exclusion to extermination, 1933–1945. Taken together, such factors further emphasize the importance of incorporation into the training of medical and healthcare professionals information about relevant historical events and conflicts of interest that can influence the ethical care of patients.32 CONCLUSION Educating physicians today about the distortions of scientific theory and ideology, the inhumane use of technology, the ethical failures in Nazi era medicine, and how similar sentiments may continue to linger in current society is an essential undertaking. keywords: care; euthanasia; health; individual; medical; medicine; nazi; physicians; psychiatry; racial; social; sterilization cache: pulmonarychronicles-1111.htm plain text: pulmonarychronicles-1111.txt item: #61 of 658 id: pulmonarychronicles-1113 author: None title: Case series date: None words: 239 flesch: 23 summary: These cases highlight the importance of recognizing the possible involvement of uncharacteristic bacteria for the proper management of canaliculitis and using appropriate lacrimal procedures when empiric therapy is ineffective. Case series Cases with uncharacteristic bacteria in canaliculitis Harrison D. Marsh BS, MBA, Addie Pederson BA, Coby N. Ray MD, MBA, Kenn A. Freedman, MD, PhD ABSTRACT Canaliculitis is not considered to be a common condition and can be frequently misdiagnosed. keywords: canaliculitis cache: pulmonarychronicles-1113.htm plain text: pulmonarychronicles-1113.txt item: #62 of 658 id: pulmonarychronicles-1115 author: None title: Case report date: None words: 236 flesch: 42 summary: Keywords: Granulomatosis with polyangiitis, renal failure, treatment failure Article citation: Rahesh J, Mapp T, Gonugunta A, Kazi I, Day S, Diab M, Ratheesh R, Naguib T. Treatment-resistant granulomatosis with polyangiitis: An unusual presentation. The Southwest Respiratory and Critical Care Chronicles 2023;11(47):47–51 From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo, Texas Submitted: 11/26/2022 Accepted: 3/29/2023 Conflicts of interest: none This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. keywords: treatment cache: pulmonarychronicles-1115.htm plain text: pulmonarychronicles-1115.txt item: #63 of 658 id: pulmonarychronicles-1119 author: None title: Review date: None words: 232 flesch: 28 summary: Review The effects of body habitus, age, and sex on adequate propofol dosing and infusion for general anesthesia Cole Pollina BS, Luis Fernandez-Nava MS, and Cooper W. Phillips MD, FCCM ABSTRACT Propofol (Diprivan) is the most widely used intravenous (IV) anesthetic for the induction and maintenance of general anesthesia. The effects of body habitus, age, and sex on adequate propofol dosing and infusion for general anesthesia keywords: propofol cache: pulmonarychronicles-1119.htm plain text: pulmonarychronicles-1119.txt item: #64 of 658 id: pulmonarychronicles-112 author: None title: BOARD REVIEW QUESTION Issue5 date: None words: 470 flesch: 39 summary: Her WBC count is 11.3k/mcL and creatinine is 1.6 mg/dl. Which of the following is the best choice of therapy for this patient?   A.Daptomycin B.Ampicillin with or without sulbactam C.Linezolid D.Tigecycline E.Gentamicin   + Answer and Discussion - Answer and Discussion Answer: B – Ampicillin with or without sulbactam Key point: If the organism is sensitive, using the simplest drug for therapy can help reduce resistance to other broad spectrum antimicrobials and/or maintain effectiveness in those antimicrobials usually reserved for critically ill patients with resistant organisms. The choice of whether or not to use combination therapy is not clear in this situation, but most experts recommend it in the settings of prosthetic valves and/or very prolonged infections or critical illness. keywords: therapy; vancomycin cache: pulmonarychronicles-112.htm plain text: pulmonarychronicles-112.txt item: #65 of 658 id: pulmonarychronicles-1121 author: None title: Review date: None words: 267 flesch: 26 summary: Keywords: Trapped lung, fibrous visceral pleural peel, malignant pleural effusion, pleurodesis, decortication Article citation: Divya Vangipuram Wyatt D. Trapped lung: A review of literature and recent cases. The majority of these patients presented with trapped lung due to malignancy, infection, or autoimmune disorders. keywords: lung cache: pulmonarychronicles-1121.htm plain text: pulmonarychronicles-1121.txt item: #66 of 658 id: pulmonarychronicles-1123 author: None title: Medical image date: None words: 556 flesch: 37 summary: A rare case report of acute upper gastrointestinal hemorrhage due to splenic artery pseudoaneurysm. Clinical features and management of splenic artery pseudoaneurysm: case series and cumulative review of literature. keywords: aneurysm; artery; pancreatitis cache: pulmonarychronicles-1123.htm plain text: pulmonarychronicles-1123.txt item: #67 of 658 id: pulmonarychronicles-1125 author: None title: Commentary date: None words: 1597 flesch: 64 summary: The government has repeatedly declared COVID vaccines to be safe and effective. Others have reached the same conclusion of net harm by COVID vaccines in university students.8 Figure 1. keywords: apprentice; data; deaths; dissent; sorcerer cache: pulmonarychronicles-1125.htm plain text: pulmonarychronicles-1125.txt item: #68 of 658 id: pulmonarychronicles-113 author: None title: Critical Updates date: None words: 261 flesch: 47 summary: Also a surprising finding from the same meeting in abstract form…at one 240-bed hospital in only 15% of patients treated with vancomycin or TMP/SMX for C. diff infection actually had lab confirmed disease. Critical Updates PDF Selected news items and updates for the practicing clinician Zachary Mulkeya Correspondence to Zachary Mulkey MD Email: zachary.mulkey @ttuhsc.edu + Author Affiliation - Author Affiliation a Department of Internal Medicine at Texas Tech University Health Science Center in Lubbock, TX SWRCCC : 2014;2.(5):55 ................................................................................................................................................................................................................................................................................................................................... keywords: patients cache: pulmonarychronicles-113.htm plain text: pulmonarychronicles-113.txt item: #69 of 658 id: pulmonarychronicles-1131 author: None title: Medical image date: None words: 776 flesch: 31 summary: Pulmonary involvement can include aspergilloma, Aspergillus nodule, chronic cavitary pulmonary aspergillosis, chronic fibrosing pulmonary aspergillosis, and subacute invasive pulmonary aspergillosis.1 Chronic cavitary pulmonary aspergillosis (CCPA) describes a disease pattern in immunocompetent patients in which one or more cavitary lesions are formed over months. Keywords: Aspergillosis, cavitary pulmonary aspergillosis, immunocompetent patient REFERENCES Denning DW, Cadranel J, Beigelman-Aubry C, et al. Chronic pulmonary aspergillosis: Rationale and clinical guidelines for diagnosis and management. keywords: aspergillosis; aspergillus; chest cache: pulmonarychronicles-1131.htm plain text: pulmonarychronicles-1131.txt item: #70 of 658 id: pulmonarychronicles-1133 author: None title: Review date: None words: 200 flesch: 14 summary: Keywords: analgesia, opioids, intensive care unit, pain assessment tools Article citation: Motes A. Pain management in the intensive care unit. Review Pain management in the intensive care unit Arunee Motes MD ABSTRACT Critically ill patients often experience pain from an underlying illness or injury, a recent surgical or other invasive procedure, or various interventions in the intensive care unit (ICU), e.g., endotracheal intubation, vascular access devices, nasogastric tubes, urinary catheters, mechanical ventilation, and routine nursing care, such as repositioning. keywords: care cache: pulmonarychronicles-1133.htm plain text: pulmonarychronicles-1133.txt item: #71 of 658 id: pulmonarychronicles-1135 author: Berdine, Gilbert title: Comparisons between health care practices in Nazi Germany and the current United States date: 2023-01-24 words: 1755 flesch: 64 summary: 72 The Southwest Respiratory and Critical Care Chronicles 2023;11(46):72–74 Letter Comparisons between health care practices in Nazi Germany and the current United States Gilbert Berdine MD Corresponding author: Gilbert Berdine Contact Information: Gilbert.Berdine@ttuhsc.edu DOI: 10.12746/swrccc.v11i46.1135 In the commentary Revisiting Psychiatric Support for the National Socialist Agenda in Germany: Impli­ cations for medical and residency training,1 the authors note similarities between horrible practices in Nazi Germany and what seems to be creeping up on us in the United States. Health care costs in the US are about 1/6 of the Gross National Product. keywords: authors; care; health; people; point cache: pulmonarychronicles-1135.pdf plain text: pulmonarychronicles-1135.txt item: #72 of 658 id: pulmonarychronicles-1137 author: None title: Medical image date: None words: 533 flesch: 39 summary: Her vital signs included a blood pressure of 87/59 mmHg, a heart rate of 64/ minute, an oxygen saturation of 95% on room air, and a temperature of 98 °F. Computed tomography (CT) of the abdomen showed the aortomesenteric angle of 25 degree suggestive of superior mesenteric artery syndrome (Figure 1). Superior mesenteric artery syndrome. keywords: artery; superior cache: pulmonarychronicles-1137.htm plain text: pulmonarychronicles-1137.txt item: #73 of 658 id: pulmonarychronicles-1139 author: None title: Statistics column date: None words: 2220 flesch: 44 summary: However, it is worth noting, sensitivity analysis has its limitations and might not capture all the interactions among input and output of a network.15 Traditional analysis tools have also been used to improve AI transparency, including validating the results of AI models to ensure that they are accurate and consistent, supplementing the results of AI to provide additional context and details, and identifying the factors that are most important in the AI system. CT volumes to predict the risk of lung cancer was able to achieve a 94.4% area under the curve among 6,716 national lung cancer screening trial cases.12 Compared with traditional statistical modelling, AI algorithms can often be easily scaled and automated to perform tasks without human intervention, and many are designed to continually learn and improve over time, and thus have better adaptivity to changing circumstances. keywords: artificial; data; intelligence; learning; methods cache: pulmonarychronicles-1139.htm plain text: pulmonarychronicles-1139.txt item: #74 of 658 id: pulmonarychronicles-1141 author: None title: Review date: None words: 267 flesch: 37 summary: A smaller number of more robust studies did not support ivermectin use for COVID-19 treatment. The drug has a history of off-label use for a variety of clinical disorders and has shown some potential as an antiviral drug in in vitro studies and animal studies, and it has a relatively favorable safety profile. keywords: covid-19 cache: pulmonarychronicles-1141.htm plain text: pulmonarychronicles-1141.txt item: #75 of 658 id: pulmonarychronicles-1143 author: None title: Case report date: None words: 242 flesch: 37 summary: Prescribing systemic steroids has many potential risks. This case is a grim example of the dangers that can occur with systemic steroid use. keywords: case cache: pulmonarychronicles-1143.htm plain text: pulmonarychronicles-1143.txt item: #76 of 658 id: pulmonarychronicles-1147 author: None title: Case report date: None words: 163 flesch: 8 summary: Keywords: Uremic hemopericardium, uremic pericarditis, pericardiocentesis Article citation: Martin J, Williams B, Otahbachi M. Hemopericardium in chronic kidney disease: An uncommon manifestation of pericarditis with bloody pericardial effusion. Case report Hemopericardium in chronic kidney disease: An uncommon manifestation of pericarditis with a bloody pericardial effusion Jackson Martin BS, Brian Williams MD, Mohammed Otahbachi MD ABSTRACT Patients with end-stage renal disease are at increased risk for the development of uremic pericarditis or dialysis-associated pericarditis, and either comorbidity can be complicated by pericardial effusion. keywords: pericarditis cache: pulmonarychronicles-1147.htm plain text: pulmonarychronicles-1147.txt item: #77 of 658 id: pulmonarychronicles-115 author: None title: Treatment of chest burn contracture causing respiratory compromise with island release and grafting using cross-link collagen and Integra™ bilayer dressing date: None words: 2322 flesch: 54 summary: Contractures can lead to multiple problems, including decreased range of motion of joints, increased difficulty breathing, and further complications of wound care and treatment.7 Studies have shown severe functional limitations and disfigurement from scars and have demonstrated the need to promptly and adequately treat burn wounds to prevent contractures from forming.8-9 Chest contractures have also arisen iatrogenically from breast augmentation and reconstruction.10-11 Regardless of the etiology, chest contractures (and contractures in general) cause multiple complications, and their treatment and prevention is important. Treatment of chest burn contracture causing respiratory compromise with island release and grafting using cross-link collagen and Integra™ bilayer dressing Abstract/ PDF Treatment of chest burn contracture causing respiratory compromise with island release and grafting using cross-link collagen and Integra™ bilayer dressing Neil Doctor BSa, Erin Woller MDb, Sharmila Dissanaike MDc Correspondence to Sharmila Dissanaike MD. keywords: burn; chest; contractures; integra; release; scar; surg; wound cache: pulmonarychronicles-115.htm plain text: pulmonarychronicles-115.txt item: #78 of 658 id: pulmonarychronicles-1153 author: None title: Medical image date: None words: 639 flesch: 53 summary: It should be distinguished from sub pleural lung masses, like lung carcinoma or lung metastasis.1 Computed tomography is the ideal tool for making the correct diagnosis for rounded atelectasis. Computed tomography (CT) of his chest (Figure 2A) showed bibasilar pleural thickening with small right sided pleural effusion with an area of soft tissue thickening in the right lower lobe resembling rounded atelectasis. keywords: atelectasis; lung; right cache: pulmonarychronicles-1153.htm plain text: pulmonarychronicles-1153.txt item: #79 of 658 id: pulmonarychronicles-1155 author: None title: Case report date: None words: 240 flesch: 32 summary: you are about to find out… Cesar Peralta MD, Jose Ramos MD ABSTRACT Traumatic chylothorax most commonly occurs after thoracic surgeries with a few cases reported in patients after abdominal surgery. Having a medical history preceding abdominal surgery is always important to consider the possibility of a pancreatic pleural fistula, which can be excluded by an abdominal computed tomography. keywords: surgery cache: pulmonarychronicles-1155.htm plain text: pulmonarychronicles-1155.txt item: #80 of 658 id: pulmonarychronicles-1157 author: None title: Case report date: None words: 217 flesch: 26 summary: Even though it is expected that the trans-ulnar approach has a similar risk of developing compartment syndrome like trans-radial approach, the literature does not have many case reports describing this complication. Here we report a case of a woman who developed forearm compartment syndrome after trans-ulnar coronary intervention in the setting of ST-segment elevation myocardial infarction. keywords: compartment cache: pulmonarychronicles-1157.htm plain text: pulmonarychronicles-1157.txt item: #81 of 658 id: pulmonarychronicles-1159 author: None title: Letter date: None words: 1003 flesch: 61 summary: Extending the analogy to health care, if one can get public insurance for free that is just as good as private insurance, then why would anyone buy private insurance? The authors use “health insurance” as an example of equity vs. equality. keywords: equity; game; health cache: pulmonarychronicles-1159.htm plain text: pulmonarychronicles-1159.txt item: #82 of 658 id: pulmonarychronicles-116 author: None title: When should care be withdrawn? date: None words: 2670 flesch: 56 summary: Family members may regard expensive health care measures as needless dissipation of the estate. Although the socialization of health care costs eliminates the financial burden of a long treatment, emotional and opportunity costs remain a burden on the family. keywords: care; case; family; health; patient cache: pulmonarychronicles-116.htm plain text: pulmonarychronicles-116.txt item: #83 of 658 id: pulmonarychronicles-1161 author: None title: Medicine and public policy date: None words: 987 flesch: 46 summary: For 2021, General Revenue contributed $318.6 billion to Medicare Part B and $85.3 billion to Medicare Part D.1 In addition, Medicare beneficiaries whose deaths were identified as related to COVID had costs that were much higher than the average Medicare beneficiary prior to the onset of the pandemic. keywords: covid; medicare; revenue cache: pulmonarychronicles-1161.htm plain text: pulmonarychronicles-1161.txt item: #84 of 658 id: pulmonarychronicles-1163 author: None title: Medical image date: None words: 919 flesch: 53 summary: The patient had a left knee hematoma following a fall 3 weeks ago and had left knee hemarthrosis at an outside facility. Keywords: Morel-Lavallée lesion, knee swelling, trauma, hemarthrosis, hematoma, injury REFERENCES Nair AV, Nazar P, Sekhar R, et al. keywords: knee; lavallée; lesion cache: pulmonarychronicles-1163.htm plain text: pulmonarychronicles-1163.txt item: #85 of 658 id: pulmonarychronicles-1165 author: None title: Review date: None words: 203 flesch: 20 summary: Review Neuromuscular blocker agents in mechanically ventilated patients with ARDS Jose H. Ramos MD ABSTRACT The clinical use of neuromuscular blocker agents (NMBAs) in patients with moderate-to-severe acute respiratory distress syndrome (ARDS) is a controversial topic in critical care medicine. Neuromuscular blocker agents in mechanically ventilated patients with ARDS: The Southwest Respiratory and Critical Care Chronicles 2023;11(47):5–9 From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas Submitted: 2/13/2023 Accepted: 4/3/2023 Conflicts of interest: none This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. keywords: agents cache: pulmonarychronicles-1165.htm plain text: pulmonarychronicles-1165.txt item: #86 of 658 id: pulmonarychronicles-1167 author: None title: Review date: None words: 219 flesch: 13 summary: Keywords: Acute respiratory distress syndrome, lung ultrasound, PEEP Article citation: York J, Nugent K. Using lung ultrasound to guide PEEP determination in mechanically ventilated patients with acute respiratory distress syndrome. Review Using lung ultrasound to guide PEEP determination in mechanically ventilated patients with acute respiratory distress syndrome Jesse York MS, Kenneth Nugent, MD ABSTRACT Supportive care with mechanical ventilation is the cornerstone of management for acute respiratory distress syndrome (ARDS). keywords: peep cache: pulmonarychronicles-1167.htm plain text: pulmonarychronicles-1167.txt item: #87 of 658 id: pulmonarychronicles-1169 author: None title: Review date: None words: 298 flesch: 31 summary: Keywords: health literacy, health outcomes, rural health, rural population, patient education Article citation: Flores D, House M, Pearson J, Stuart D. Health literacy and social determinants of health. This review seeks to identify correlations between health literacy and social determinants of health. keywords: health; literacy cache: pulmonarychronicles-1169.htm plain text: pulmonarychronicles-1169.txt item: #88 of 658 id: pulmonarychronicles-117 author: None title: Hypothesis Tests for a Population Mean date: None words: 1292 flesch: 52 summary: Normal distributions are very important in making statistical inferences because they provide a reasonable approximation to the distribution of many different variables. There are many different normal distributions that are distinguished by their mean and standard deviation. keywords: distribution; hypothesis; population cache: pulmonarychronicles-117.htm plain text: pulmonarychronicles-117.txt item: #89 of 658 id: pulmonarychronicles-1173 author: None title: Case report date: None words: 299 flesch: 38 summary: Keywords: adenoid cystic carcinoma, liver metastasis, nasopharyngeal salivary glands, head and neck cancer Article citation: Jang W, Raghuram A, Arif D. Nasopharyngeal adenoid cystic carcinoma metastasis to the liver. Our patient initially presented to the hospital with dental and sinus pain with initial imaging suggesting nasopharyngeal carcinoma invading the temporal lobe laterally and the cavernous sinus and clivus medially. keywords: metastasis cache: pulmonarychronicles-1173.htm plain text: pulmonarychronicles-1173.txt item: #90 of 658 id: pulmonarychronicles-1175 author: None title: Statistics column date: None words: 2410 flesch: 43 summary: There are many considerations in sequential analysis; this review will focus on the aspects that are more relevant to trial sequential analysis: 1.1 STOPPING RULE Sequential analysis requires prespecified stopping rules, which define if the study will be terminated at an interim analysis, based on the accumulating data. However, in order to enhance the reliability of their findings, and to avoid the potential for errors and false-positive results, researchers are increasingly turning to trial sequential analysis (TSA). keywords: analysis; meta; sequential; trial; tsa; type cache: pulmonarychronicles-1175.htm plain text: pulmonarychronicles-1175.txt item: #91 of 658 id: pulmonarychronicles-1177 author: None title: Case series date: None words: 476 flesch: 37 summary: Patient demographics, allergies, comorbidities, medications used (including sedation), adverse reactions, and type of contrast formulation were recorded and analyzed. Once the supply of the original Iodine 270 mg/mL Iodixanol Injection was restored, adverse reactions ceased, and none occurred in the following months. keywords: covid-19 cache: pulmonarychronicles-1177.htm plain text: pulmonarychronicles-1177.txt item: #92 of 658 id: pulmonarychronicles-1183 author: None title: Medical education date: None words: 281 flesch: 33 summary: Keywords: Communication, medical education, medical curriculum Article citation: Seth N, Riaz M, Sikka A, Martinez G. As effective communication is key to patient safety, this study proves that communication curricula can improve physician-patient interactions. keywords: education cache: pulmonarychronicles-1183.htm plain text: pulmonarychronicles-1183.txt item: #93 of 658 id: pulmonarychronicles-1187 author: None title: Case report date: None words: 169 flesch: 41 summary: Keywords: Micrococcus luteus, bacteremia Article citation: Pederson A, Coleman B, Irving M. An unknown source of Micrococcus luteus bacteremia. We report the clinical course of an 82-year-old man who underwent complex management of multiple diverticular abscesses and had three serial positive blood cultures for M. luteus. keywords: luteus cache: pulmonarychronicles-1187.htm plain text: pulmonarychronicles-1187.txt item: #94 of 658 id: pulmonarychronicles-119 author: None title: Mediastinal mass: an unusual presentation of coccidioidomycosis date: None words: 1603 flesch: 34 summary: Here we report a rare case of coccidioidomycosis infection in an immunocompromised host who presented with a mediastinal mass. ................................................................................................................................................................................................................................................................................................................................... Introduction Coccidioidomycosis, the oldest of the major mycoses, was first recognized as a human disease in Argentina in 1892.[1] We are reporting a rare case of coccidioidomycosis infection presenting with a mediastinal mass. keywords: coccidioidomycosis; disease; infection; mass; patient; pneumonia; pulmonary cache: pulmonarychronicles-119.htm plain text: pulmonarychronicles-119.txt item: #95 of 658 id: pulmonarychronicles-1193 author: None title: Commentary date: None words: 180 flesch: 27 summary: The Southwest Respiratory and Critical Care Chronicles 2023;11(48):18–30 From: Department of Internal Medicine, Virginia Tech School of Medicine, Roanoke, VA Submitted: 6/18/2023 Accepted: 6/28/2023 Conflicts of interest: none This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Furthermore, the challenges from and worries over new technology are nothing new, with professionals and industries historically adapting to these changes. keywords: chatgpt cache: pulmonarychronicles-1193.htm plain text: pulmonarychronicles-1193.txt item: #96 of 658 id: pulmonarychronicles-1195 author: None title: Brief report date: None words: 1081 flesch: 61 summary: There was a very noticeable decline year over year in Lubbock births in December 2020 and February 2021 with a smaller decline in January 2021. The most notable increases year over year in Lubbock births included the rebounds following the largest declines (Dec 2020–Feb 2021), but there was another sizeable increase year over year in November 2022. keywords: births; figure; year cache: pulmonarychronicles-1195.htm plain text: pulmonarychronicles-1195.txt item: #97 of 658 id: pulmonarychronicles-1197 author: None title: Medical image date: None words: 782 flesch: 39 summary: Keywords: pulmonary emboli, endobronchial ultrasound REFERENCES Bertini P, Ribechini A, Guarracino F. Improved diagnosis of pulmonary embolism causing cardiac arrest by combined endobronchial ultrasound and echocardiography. DISCUSSION Pulmonary emboli (PE) are life-threatening, difficult to diagnose, and sometimes fatal.1 Its prevalence in hospitalized patients is about 1%, with some diagnosed post-mortem at autopsy.2 The Centers for Disease Control and Prevention estimates that 900,000 people are affected by venous thromboembolisms each year, with a quarter of patients presenting with sudden death as their first symptom of PE.3 The best imaging modality to identify pulmonary emboli is computed tomography pulmonary angiography, which remains the gold standard. keywords: patients; thrombus; ultrasound cache: pulmonarychronicles-1197.htm plain text: pulmonarychronicles-1197.txt item: #98 of 658 id: pulmonarychronicles-1199 author: None title: Medical image date: None words: 764 flesch: 42 summary: Anterior cervical osteophytes causing dysphagia and paradoxical vocal cord motion leading to dyspnea and dysphonia. Chen Y.-R., Sung K, Tharin S, Symptomatic anterior cervical osteophyte causing dysphagia: case report, imaging, and review of the literature. keywords: dysphagia; figure; osteophyte cache: pulmonarychronicles-1199.htm plain text: pulmonarychronicles-1199.txt item: #99 of 658 id: pulmonarychronicles-120 author: None title: Cavitary Tuberculosis date: None words: 877 flesch: 43 summary: In November, 2008, a 58-year-old man was admitted to the Phthisiopulmonology clinic in Moscow, Russia, for the treatment of pulmonary tuberculosis (TB). At age 17, pulmonary tuberculosis was diagnosed and successfully treated with the standard course of anti-tuberculous medication. keywords: infection; lung; pulmonary; tuberculosis cache: pulmonarychronicles-120.htm plain text: pulmonarychronicles-120.txt item: #100 of 658 id: pulmonarychronicles-1201 author: None title: Medicine in art date: None words: 556 flesch: 53 summary: Dr. Peterson includes this iconic painting in his article as an example of “the humanity and empathy that are associated with the practice of medicine … Patients want human doctors, both literally and morally.”1 Certainly, the AI program can analyze medical data and organize it into reasonable answers to complex questions, but as Dr. Peterson cites, one patient remarked, “We can’t be reduced to data.”1 keywords: doctor; medicine cache: pulmonarychronicles-1201.htm plain text: pulmonarychronicles-1201.txt item: #101 of 658 id: pulmonarychronicles-1203 author: None title: Original article date: None words: 457 flesch: 41 summary: Methods: This retrospective study reviewed a cohort of pregnant patients with confirmed COVID-19 admitted to Texas Tech University Health Sciences Center and its affiliated University Medical Center between April 12, 2020, and January 25, 2021. A retrospective chart review and literature review Christopher J Peterson MD, MS, Mostafa Abohelwa MD, Sima Shahbandar MD, Dylan Landis BS, Nandini Ray BS, Nabeela Manal BS, Patrice Lamey BS, Akhila Reddy BS, Mariam Rizi BS, Drew Payne DO ABSTRACT Objective: Pregnant women are at a higher risk for severe 2019 novel coronavirus (COVID-19) infection compared to non-pregnant women. keywords: covid-19 cache: pulmonarychronicles-1203.htm plain text: pulmonarychronicles-1203.txt item: #102 of 658 id: pulmonarychronicles-1205 author: None title: Original article date: None words: 475 flesch: 38 summary: Methods: This is a single center retrospective observational cohort study of patients who underwent percutaneous tracheostomies between March 1, 2020, and September 30, 2021, due to respiratory failure secondary to COVID-19. Inclusion criteria included performance of percutaneous tracheostomies on patients with confirmed diagnosis of COVID-19. keywords: covid-19; patients cache: pulmonarychronicles-1205.htm plain text: pulmonarychronicles-1205.txt item: #103 of 658 id: pulmonarychronicles-1209 author: None title: Statistics column date: None words: 3375 flesch: 43 summary: In summary, saliency mapping is a tool for improving the interpretability of AI model predictions, for improving explainability of AI models to consumers of the predictions, and to possibly improve how experts interpret the difficult examples. Moreover, AI models scale effectively with increasing data size and complexity. keywords: image; maps; model; predictions; saliency; saliency maps cache: pulmonarychronicles-1209.htm plain text: pulmonarychronicles-1209.txt item: #104 of 658 id: pulmonarychronicles-121 author: None title: Mitral annular calcification date: None words: 547 flesch: 43 summary: This study showed mitral annular calcification, calcification of the aortic knob, pleural calcification, and a fibrotic band on the right side. Progressive deposition of calcium beneath and along the mitral annulus leads to mitral annular calcification. keywords: calcification; mitral cache: pulmonarychronicles-121.htm plain text: pulmonarychronicles-121.txt item: #105 of 658 id: pulmonarychronicles-122 author: None title: An arterial pressure waveform that told a story beyond the blood pressure date: None words: 603 flesch: 52 summary: However, in patients with hypertrophic cardiomyopathy, vigorous contraction increases  the  systolic obstruction and lowers systolic pressure and pulse pressure in the post ectopic beat.   The recording also shows that the systolic pressure and pulse pressures are lower than the baseline in the post ectopic beat. keywords: beat; pressure cache: pulmonarychronicles-122.htm plain text: pulmonarychronicles-122.txt item: #106 of 658 id: pulmonarychronicles-123 author: None title: The Case for a Market for Transplantable Organs date: None words: 1261 flesch: 58 summary: We each only have one heart and one liver and cannot survive without them; these organs are not well suited for market exchange. 3 Without presenting any evidence for coercion, Dr. Delmonico insists on proof that market based exchanges -- which are by definition voluntary -- are voluntary. keywords: kidney; market; organs cache: pulmonarychronicles-123.htm plain text: pulmonarychronicles-123.txt item: #107 of 658 id: pulmonarychronicles-124 author: None title: Fever of the South date: None words: 737 flesch: 42 summary: Approximately one hundred years later, William Osler was the first to describe infective endocarditis by reviewing the records of 200 patients with socalled ulcerative, malignant endocarditis in London.1 He included patients with fever and new murmurs, and he described his experience with a woman who developed erythematous, painful, swollen small spots occurring on the fingertips and feet resembling “beehives”that became known as Osler’s nodes. In the 21st century, the risk of infective endocarditis remains a major concern, especially in patients with device implants, indwelling catheters, and IV drug abuse. keywords: endocarditis; fever; patients cache: pulmonarychronicles-124.htm plain text: pulmonarychronicles-124.txt item: #108 of 658 id: pulmonarychronicles-126 author: None title: Biofilms in the ICU date: None words: 1507 flesch: 44 summary: The classic clinical hallmarks of biofilm infection include the 3Rs- resolution, relapse, and recalcitrance. Cycle of biofilm infection. keywords: biofilm; cells; icu; infections; planktonic; surfaces cache: pulmonarychronicles-126.htm plain text: pulmonarychronicles-126.txt item: #109 of 658 id: pulmonarychronicles-127 author: None title: Chest radiographs as predictors of length of stay in right-sided infective endocarditis date: None words: 1873 flesch: 43 summary: The role of septic pulmonary embolism in pulmonary hypertension is uncertain. Septic pulmonary embolism can cause an abnormal chest radiograph (CXR), possibly raise pulmonary artery pressures, and may influence clinical and hospital outcomes. keywords: cxr; drug; endocarditis; length; patients; pulmonary; stay cache: pulmonarychronicles-127.htm plain text: pulmonarychronicles-127.txt item: #110 of 658 id: pulmonarychronicles-128 author: None title: Pott’s Disease date: None words: 873 flesch: 49 summary: Neurologic deficits develop in some cases.3,4 Our patient presented with abdominal pain which is atypical for spinal tuberculosis.  It has a sensitivity of 84% and the specificity of 95% in patients with spinal TB.6  Approximately 70% of patients with spinal tuberculosis have a history of pulmonary tuberculosis or radiographic findings consistent with pulmonary tuberculosis. keywords: pain; spinal; spine; tuberculosis cache: pulmonarychronicles-128.htm plain text: pulmonarychronicles-128.txt item: #111 of 658 id: pulmonarychronicles-129 author: None title: A complex acid-base disorder in an alcoholic date: None words: 1456 flesch: 42 summary: This presentation is consistent with alcoholic ketoacidosis, and this disorder represents a primary emphasis in our discussion.   Ketoacidosis due to diabetes mellitus, alcohol ingestion, or starvation 2) Lactic acidosis (type A, type B, and D lactic acidosis) 3) HAGMA due to ingestion of methanol, ethylene glycol, propylene glycol, salicylates 4) HAGMA due to renal failure Alcoholic ketoacidosis should be strongly suspected in patients with a history of alcohol abuse and rapid cessation of binge drinking who present with unexplained HAGMA and superimposed metabolic and respiratory alkalosis. keywords: alcoholic; gap; hagma; ketoacidosis; ref cache: pulmonarychronicles-129.htm plain text: pulmonarychronicles-129.txt item: #112 of 658 id: pulmonarychronicles-130 author: None title: Post-anoxic myoclonus date: None words: 3336 flesch: 52 summary: The clinical features and prognosis of chronic posthypoxic myoclonus. Cortical myoclonus is highly action-induced and stimulus sensitive. keywords: acute; arrest; chronic; chronic pam; mse; myoclonus; neurol; pam; patients; post; prognosis cache: pulmonarychronicles-130.htm plain text: pulmonarychronicles-130.txt item: #113 of 658 id: pulmonarychronicles-131 author: None title: Jump-Start Smoking Cessation date: None words: 1339 flesch: 65 summary: And even very brief intervention by a physician to target a patient’s need for smoking cessation can increase quit rates. For example, smoking cessation is useful for virtually any patient with any type of cancer undergoing any treatment. keywords: cessation; physician; quit; smoking cache: pulmonarychronicles-131.htm plain text: pulmonarychronicles-131.txt item: #114 of 658 id: pulmonarychronicles-132 author: None title: Atrial Fibrillation: Risk Assessment date: None words: 1480 flesch: 47 summary: The CHA2DS2-VASc can evaluate stroke risk, and the HAS-BLED calculator can evaluate the risk of major bleeding (Table 4). An estimated 2.2 million people in the US have this arrhythmia, and the incidence increases annually by 1.3% to 18%.1 One important consideration for patients with atrial fibrillation is the risk of thromboembolic events. keywords: bleeding; fibrillation; patients; risk; stroke cache: pulmonarychronicles-132.htm plain text: pulmonarychronicles-132.txt item: #115 of 658 id: pulmonarychronicles-133 author: None title: Critical Updates date: None words: 178 flesch: 53 summary: Unsurprisingly, a report has linked secondhand smoke exposure to higher risks of spontaneous abortions, stillbirths and ectopic pregnancy. Surprisingly, some of the odds ratios seem to indicate that secondhand smoke exposure is associated with a higher risk of these adverse outcomes than primary cigarette use. keywords: medicine cache: pulmonarychronicles-133.htm plain text: pulmonarychronicles-133.txt item: #116 of 658 id: pulmonarychronicles-134 author: None title: BOARD REVIEW QUESTION Issue6 date: None words: 408 flesch: 27 summary: Key Point: Only patients at the highest risk undergoing high risk procedures need prophylaxis for infection endocarditis (IE). This includes: Those with prosthetic heart valves or other prosthetic material Prior IE Unrepaired cyanotic congenital heart disease Repaired congenital heart disease with residual defects Any repaired congenital heart disease within the first 6 months Cardiac transplant with valve dysfunction Compared to the previous recommendations patients no longer requiring prophylaxis include native valve aortic or mitral stenosis/regurgitation, including bicuspid valves. keywords: heart; prophylaxis cache: pulmonarychronicles-134.htm plain text: pulmonarychronicles-134.txt item: #117 of 658 id: pulmonarychronicles-135 author: None title: Ischemic Brain Injury Secondary to Severe Systemic Loxoscelism date: None words: 1602 flesch: 53 summary: Keywords: spider bite, Loxosceles reclusa, systemic loxoscelism ................................................................................................................................................................................................................................................................................................................................... Introduction Rhabdomyolysis, acute renal failure, and disseminated intravascular coagulation (DIC) frequently occurs in patients with severe systemic loxoscelism.1 A literature search failed to recover any cases that reported central nervous system (CNS) lesions associated with systemic loxoscelism. keywords: bite; day; injury; loxoscelism; recluse; spider cache: pulmonarychronicles-135.htm plain text: pulmonarychronicles-135.txt item: #118 of 658 id: pulmonarychronicles-136 author: None title: Pulmonary Function Testing date: None words: 2339 flesch: 57 summary: African-Americans have FEV1 values lower than both Caucasians and Mexican-Americans even though they have similar heights for age. The general form of the reference equation is: Lung function parameter = b0 + b1 * age + b2 * age2 + b3 * height2 They concluded that both male and female Mexican-Americans and African-Americans have lower FEV1 values than do Caucasians for all age groups. keywords: fev1; flow; fvc; lung; obstruction; values; volume cache: pulmonarychronicles-136.htm plain text: pulmonarychronicles-136.txt item: #119 of 658 id: pulmonarychronicles-137 author: None title: Linear Regression date: None words: 1280 flesch: 66 summary: Other best-fit models may work better for data sets where most points are good fits and a few points are outliers. Note that  where n is the number of data points. keywords: data cache: pulmonarychronicles-137.htm plain text: pulmonarychronicles-137.txt item: #120 of 658 id: pulmonarychronicles-138 author: None title: Familial Thoracic Aortic Aneurysm and Dissection date: None words: 527 flesch: 50 summary: TAAD occurs at rate of 3 cases per 100,000 individuals per year and is a major cause of death in these patients.1 These conditions are autosomal dominant and display variable penetrance and severity.2 Albornoz studied 520 patients with thoracic aortic aneurysm and their families and found an inherited pattern for thoracic aortic aneurysm was present in 21.5% of the non Marfan’s syndrome patients. The genetic studies for thoracic aortic aneurysm and dissection (TAAD) revealed no mutations. keywords: aneurysm; aortic; thoracic cache: pulmonarychronicles-138.htm plain text: pulmonarychronicles-138.txt item: #121 of 658 id: pulmonarychronicles-139 author: None title: A shadow of air within the heart date: None words: 474 flesch: 50 summary: For patients with severe symptoms due to hiatal hernias, surgery, including Nissen’s fundoplication, should be considered.1,2 References Garcia-Rinaldi R, Lanza F. Hiatal hernia with severe reflux esophagitis: treatment by superselective vagotomy and Nissen fundoplication. Figure1: PA chest x-ray shows a radiolucent hourglass shaped shadow due to hiatal hernia within the cardiac border. keywords: hernia; hiatal cache: pulmonarychronicles-139.htm plain text: pulmonarychronicles-139.txt item: #122 of 658 id: pulmonarychronicles-140 author: None title: An unusual mycobacterial infection date: None words: 2099 flesch: 39 summary: Due to clinical similarities, patients with M. kansasii infection are frequently started on treatment for M. tuberculosis which overlaps with the current recommendations for treatment of M. kansasii lung disease, which include isoniazid (300 mg/day), rifampin (600 mg/day), and ethambutol (15 mg/kg/day) given daily for 18 months with at least 12 months of negative sputum cultures. Specific risk factors for M. kansasii infection include pneumoconiosis, COPD, previous mycobacterial disease, malignancy, and alcoholism. keywords: disease; infection; kansasii; ntm; patients; pulmonary; treatment cache: pulmonarychronicles-140.htm plain text: pulmonarychronicles-140.txt item: #123 of 658 id: pulmonarychronicles-141 author: None title: Painless skin erythema in a patient with a chemoport: Anthracycline therapy extravasation presenting with skin necrosis date: None words: 1076 flesch: 41 summary: In 2012 the European Society for Medical Oncology released clinical guidelines for management of chemotherapy extravasation using a simplified scheme for management, prevention, and classification. Monoclonal antibodies Taxanes   Cyclophosphamide The risks for chemotherapy extravasation can be either patient or infusion related.1,2,5,6 keywords: chemotherapy; extravasation; management; patient; skin cache: pulmonarychronicles-141.htm plain text: pulmonarychronicles-141.txt item: #124 of 658 id: pulmonarychronicles-142 author: None title: Chilaiditi sign date: None words: 595 flesch: 40 summary: It is important to distinguish gas-containing bowel loops between the liver and right hemidiaphragm from other significant pathological conditions, such as perforated viscous, subdiaphragmatic abscess, and pneumoperitoneum, which require surgical operations.4 In most cases of Chilaiditi syndrome, management is conservative and consists of bowel decompression, bowel rest, and aggressive fluid rehydration. Patients who fail conservative therapy should undergo an exploratory laparotomy.5 Failure of nonsurgical treatment for Chilaiditi syndrome has been associated with colonic volvulus and obstruction.6 References Murphy JM, Maıbaum A, Alexander G, Dıxon AK. keywords: chilaiditi; sign; syndrome cache: pulmonarychronicles-142.htm plain text: pulmonarychronicles-142.txt item: #125 of 658 id: pulmonarychronicles-143 author: None title: Supply and Demand: Government Interference with the Unhampered Market in U.S. Health Care date: None words: 1521 flesch: 67 summary: Unfortunately, the unintended sided effect is an increase in market clearing price from P* to the higher value P’. T h e effects of price controls are more complicated as they do not shift the supply or demand curves. keywords: health; market; price cache: pulmonarychronicles-143.htm plain text: pulmonarychronicles-143.txt item: #126 of 658 id: pulmonarychronicles-144 author: None title: The association between blood glucose levels and hospital outcomes in patients admitted with acute exacerbations of chronic obstructive pulmonary disease date: None words: 5511 flesch: 40 summary: The association between blood glucose levels and hospital outcomes in patients admitted with acute exacerbations of chronic obstructive pulmonary disease Abstract/ PDF The association between blood glucose levels and hospital outcomes in patients admitted with acute exacerbations of chronic obstructive pulmonary disease Nagham Jafar MDa, Hawa Edriss MDb, Ebtesam Islam MD PhDc, Kenneth Nugent MDd Correspondence to Nagham Jafar MD.  Email: drnaghamsaeed@yahoo.com + Blood glucose levels were higher in patients with NIV failure (162.7 ±58 mg/dl vs. 127±39.2 mg/dl; p=0.003). keywords: acute; aecopd; blood; care; chronic; diabetes; disease; glucose; hospital; hyperglycemia; insulin; levels; outcomes; patients; risk; studies; study cache: pulmonarychronicles-144.htm plain text: pulmonarychronicles-144.txt item: #127 of 658 id: pulmonarychronicles-145 author: None title: Clinical decision making: what is the next step? date: None words: 372 flesch: 54 summary: Lateral chest X-ray for physicians. Portable AP chest radiographs, although easy to obtain, may not disclose infiltrates in the retro-cardiac region, and, as seen in this case, PA films must also be scrutinized carefully in the setting of a significantly abnormal physical examination. keywords: chest cache: pulmonarychronicles-145.htm plain text: pulmonarychronicles-145.txt item: #128 of 658 id: pulmonarychronicles-146 author: None title: Obstructive Sleep Apnea in Patients with Chronic Obstructive Pulmonary Disease date: None words: 2488 flesch: 49 summary: Systemic inflammation: a key factor in the pathogenesis of cardiovascular complications in obstructive sleep apnoea syndrome? Chaouat A, Weitzenblum E, Krieger J, Ifoundza T, Oswald M, Kessler R. Association of chronic obstructive pulmonary disease and sleep apnea syndrome. keywords: copd; disease; osa; overlap; oxygen; patients; sleep; syndrome; treatment cache: pulmonarychronicles-146.htm plain text: pulmonarychronicles-146.txt item: #129 of 658 id: pulmonarychronicles-147 author: None title: Early Mobilization in the ICU: An Update date: None words: 1667 flesch: 38 summary: Rather than the usual care of deep sedation in mechanically ventilated patients that resulted in a clinical benefit from daily sedation interruption, the more current model of global sedation minimization now negated the previous beneficial effects of daily sedation interruption.3 In addition to minimizing sedation, a strategy of analgesia only versus analgesia plus sedation in mechanically ventilated patients has also been examined. In a follow-up study published in JAMA in 2012, daily sedation holidays were re-examined by comparing daily sedation interruption combined with a protocol based sedation strategy (designed to reduce overall sedation) to a protocol based sedation strategy alone. keywords: mobilization; patients; protocol; sedation; therapy cache: pulmonarychronicles-147.htm plain text: pulmonarychronicles-147.txt item: #130 of 658 id: pulmonarychronicles-150 author: None title: Extra Corporeal Membrane Oxygenation (ECMO) date: None words: 2624 flesch: 45 summary: One meta-analysis review article14 of ECMO use in the last decade cited 10 observational studies and only one randomized controlled study (CESAR). ELSO guidelines 200911 PaO2/FiO2 ratio<80 with FiO2 ≥0.9 and Murray score 3–4, or CO2 retention with PaCO2>80 mmHg or inability to achieve adequate ventilation with Pplat ≤30 cmH2O, or severe air leak syndromes ANZ ECMO 20094 68 patients placed on ECMO; they all failed advanced mechanical ventilation support and 80% failed other rescue measures, like prone positioning, inhaled nitric oxide, prostacyclin and HFOV (median pO2/FiO2 ratio 56, median PEEP 18, and median acute lung injury score 3.8) 2. keywords: ecmo; extracorporeal; failure; fio2; membrane; oxygenation; patients; pressure; respiratory; support; ventilation cache: pulmonarychronicles-150.htm plain text: pulmonarychronicles-150.txt item: #131 of 658 id: pulmonarychronicles-151 author: None title: Rifapentine date: None words: 1437 flesch: 38 summary: US national guidelines do not recommend RPT use in the intensive phase. Although the relapse rate was slightly higher in the RPT arm, the development of resistance was lower.2 RPT is given with INH during the continuation phase for treatment of drug susceptible pulmonary tuberculosis after being treated with rifampin (or rifabutin), INH, pyrazinamide and ethambutol for two months. keywords: inh; rifapentine; rpt; tuberculosis cache: pulmonarychronicles-151.htm plain text: pulmonarychronicles-151.txt item: #132 of 658 id: pulmonarychronicles-152 author: None title: Critical Updates date: None words: 174 flesch: 54 summary: An updated systematic review is reporting that weaning via non-invasive ventilation continues to offer benefits over continued invasive ventilation, including mortality. According to the WHO, Middle East coronavirus is a serious concern (50% of patients have died) but not a global health emergency (only 50 cases identified since late 2012). keywords: care cache: pulmonarychronicles-152.htm plain text: pulmonarychronicles-152.txt item: #133 of 658 id: pulmonarychronicles-153 author: None title: BOARD REVIEW QUESTION Issue7 date: None words: 606 flesch: 56 summary: Discussion: Shift work sleep disorder and jet lag are the most common types of circadian rhythm sleep disorders and can appear similar to each other during patient assessment. Shift work sleep disorder may be treated with bright light treatment, caffeine or other stimulants and planned napping during work hours if allowed.   keywords: sleep; work cache: pulmonarychronicles-153.htm plain text: pulmonarychronicles-153.txt item: #134 of 658 id: pulmonarychronicles-154 author: None title: Spinal Block date: None words: 503 flesch: 51 summary: Cervicomedullary compression secondary to proliferation of transverse atlantal ligament. The patient was treated for meningitis without the lumbar puncture due to complete spinal block. keywords: ligament; spinal cache: pulmonarychronicles-154.htm plain text: pulmonarychronicles-154.txt item: #135 of 658 id: pulmonarychronicles-155 author: None title: Tree-in-buds date: None words: 523 flesch: 47 summary: Tree-in-buds PDF Tree-in-bud Mohamed Attaya MDa, Eman Attaya MDb,Ebtesam Islam MD PhDc Correspondence to Ebtesam Islam MD PhD Email: ebtesam.islam@ttuhsc.edu + Author Affiliation - Author Affiliation a a resident in radiology at Oklahoma University Health Science Center, Oklahoma City, OK. Figure 2 is a drawing rendition of tree-in-bud. keywords: bud; pattern; tree cache: pulmonarychronicles-155.htm plain text: pulmonarychronicles-155.txt item: #136 of 658 id: pulmonarychronicles-156 author: None title: Pericardial_Effussion date: None words: 543 flesch: 44 summary: Pericardial effusion is uncommonly diagnosed with an NMPI, but in this particular patient it can be clearly seen due to the presence of increased lung uptake of the radiotracer. Clin Nucl Med 2001 Feb; 26(2):171-2. Herzog E, Rasnow N, DePuey G. Diagnosis of pericardial effusion and its effects on ventricular function using gated Tc-99m sestamibi perfusion SPECT. keywords: effusion; nucl; pericardial cache: pulmonarychronicles-156.htm plain text: pulmonarychronicles-156.txt item: #137 of 658 id: pulmonarychronicles-157 author: None title: Peritoneal dialysis associated peritonitis secondary to Mycobacterium fortuitum date: None words: 1618 flesch: 29 summary: Peritoneal dialysis associated with M. fortuitum infection occurs very rarely; no guidelines exist for treatment recommendations. M. fortuitum is a rapidly growing mycobacterial species (RGM) widely distributed in nature; tap water is the major reservoir. keywords: dialysis; fortuitum; mycobacterium; peritoneal; peritonitis; table cache: pulmonarychronicles-157.htm plain text: pulmonarychronicles-157.txt item: #138 of 658 id: pulmonarychronicles-158 author: None title: A young man with oligoarthritis preceded by urethritis and diarrhea date: None words: 1697 flesch: 47 summary: Keywords: Reactive arthritis, oligoarthritis, chlamydial urinary tract infection, HLA-B27 positive arthritis ................................................................................................................................................................................................................................................................................................................................... Introduction Reactive arthritis is an autoimmune disease which usually develops soon after or during a presumptive gastrointestinal or urogenital infection.1 Typically reactive arthritis presents with asymmetric oligoarthritis that mainly involves lower limbs.2 Here we present an interesting case of young man who presented with reactive arthritis after gastro-urogenital symptoms. Nevertheless certain microorganisms, most commonly Chlamydia trachomatis, Yersinia spp, Salmonella spp, Shigella spp, Campylobacter spp, and Escherichia coli, have been strongly associated with reactive arthritis.2 Reactive arthritis commonly affects persons between 15 to 35 years of age.3 The clinical presentation of reactive arthritis typically occurs one to four weeks after an inciting infection.4 keywords: arthritis; b27; hla; infection; oligoarthritis; patients; reactive; spp cache: pulmonarychronicles-158.htm plain text: pulmonarychronicles-158.txt item: #139 of 658 id: pulmonarychronicles-159 author: None title: Vancomycin-induced severe asymptomatic immune thrombocytopenia: a rare cause date: None words: 1754 flesch: 37 summary: The role of IV immunoglobulin (IgG) is unclear but can be used in patients with severe bleeding.10 Our patient had asymptomatic vancomycininduced severe immune thrombocytopenia; his platelet count dropped to 2,000/mm3 from his baseline 204,000/ mm3 on the 15th day of vancomycin administration. The presence of vancomycininduced immune platelet antibody and resolution of thrombocytopenia after discontinuing the vancomycin confirms the diagnosis in most cases.9 keywords: antibodies; drug; immune; mm3; platelet; thrombocytopenia; vancomycin cache: pulmonarychronicles-159.htm plain text: pulmonarychronicles-159.txt item: #140 of 658 id: pulmonarychronicles-160 author: None title: Review of the Joint National Committee 8 Guideline for Hypertension date: None words: 1264 flesch: 43 summary: However, the new guidelines focus on establishing new thresholds for initiating pharmacologic treatment and new blood pressure goals for certain subpopulations. Within the general population, the JNC 8 distinguishes between different blood pressure goals for those 60 years or older and those under 60 years. keywords: jnc; treatment cache: pulmonarychronicles-160.htm plain text: pulmonarychronicles-160.txt item: #141 of 658 id: pulmonarychronicles-161 author: None title: Physical impairment after acute lung injury date: None words: 900 flesch: 46 summary: This study suggests that medical management in the ICU influences physical impairment in patients with acute lung injury. This was a prospective longitudinal study of 203 patients who had acute lung injury and were evaluated at 6 and 12 months for physical impairment. keywords: acute; outcomes; patients; score cache: pulmonarychronicles-161.htm plain text: pulmonarychronicles-161.txt item: #142 of 658 id: pulmonarychronicles-162 author: None title: Multiple pulmonary contusions in a collegiate football player date: None words: 2089 flesch: 53 summary: Early imaging with computed tomography (CT) is preferred due to its superior sensitivity and specificity (compared to chest radiography) in detecting pulmonary contusions. Keywords: Pulmonary contusion, football, hemoptysis ................................................................................................................................................................................................................................................................................................................................... keywords: chest; contusion; football; hemoptysis; injury; lung; wall cache: pulmonarychronicles-162.htm plain text: pulmonarychronicles-162.txt item: #143 of 658 id: pulmonarychronicles-163 author: None title: Non-parametric Tests date: None words: 2158 flesch: 60 summary: Non-parametric tests are also called distribution free statistics because they do not require that the data fit a known parameterized distribution such as normal. In fact, assigning any value less than 0.01 would be acceptable since non-parametric test uses the rank of the data to make inferences, thus as long as the assigned value is less than the threshold, the result will be the same. keywords: capsule; data; test; values cache: pulmonarychronicles-163.htm plain text: pulmonarychronicles-163.txt item: #144 of 658 id: pulmonarychronicles-164 author: None title: So-Called Market Failure in Health Caree date: None words: 1530 flesch: 61 summary: Health insurance companies, back when health insurance was still insurance, stratified customers on the basis of actuarial risk. Invariably the presenters assert that markets fail for health care. keywords: care; health; insurance; krugman cache: pulmonarychronicles-164.htm plain text: pulmonarychronicles-164.txt item: #145 of 658 id: pulmonarychronicles-165 author: None title: BOARD REVIEW QUESTION Issue8 date: None words: 576 flesch: 54 summary: Patients exhibiting signs and symptoms who have high risk exposure to Ebola virus need to be immediately isolated and admitted to an intensive care unit. The most immediate action that should be taken for patients suspected of having Ebola infection is isolation of the patient. keywords: ebola; patient cache: pulmonarychronicles-165.htm plain text: pulmonarychronicles-165.txt item: #146 of 658 id: pulmonarychronicles-166 author: None title: Critical Updates date: None words: 133 flesch: 53 summary: • There may be a seasonal variation to Clostridium difficile infections. • Whether or not influenza vaccination helps pregnant women and their infants has been an ongoing question. keywords: updates cache: pulmonarychronicles-166.htm plain text: pulmonarychronicles-166.txt item: #147 of 658 id: pulmonarychronicles-167 author: None title: The Diagnosis of Acute Pulmonary Embolism date: None words: 5502 flesch: 50 summary: In a multicenter, prospective trial, Nazerian, et al. showed that lung, heart, and leg ultrasound along with D-dimer assays improved the accuracy of diagnosing PE. Carson JL, Kelly MA, Duff A, Weg JG, et al. keywords: acute; chest; clinical; diagnosis; dimer; embolism; et al; med; patients; probability; pulmonary; study; wells cache: pulmonarychronicles-167.htm plain text: pulmonarychronicles-167.txt item: #148 of 658 id: pulmonarychronicles-168 author: None title: Pulmonary Embolism in Patients with Chronic Lung Disease date: None words: 996 flesch: 54 summary: The ambulation (or lack thereof) criteria will be met for all ICU patients, patients who require non-invasive ventilator support, and many patients with hypoventilation syndromes. It would be an interesting study to see if OSA patients, properly controlled for ambulation, exhibit a risk for DVT. keywords: embolism; patients; pulmonary cache: pulmonarychronicles-168.htm plain text: pulmonarychronicles-168.txt item: #149 of 658 id: pulmonarychronicles-169 author: None title: Self-extubation in ICU patients date: None words: 2130 flesch: 48 summary: Frequency The incidence of unplanned extubations per 100 intubated patients, which includes both self-extubation and accidental extubation, ranges from 0.5-14.2 patients. In a retrospective study of 273 patients admitted to the ICU and requiring intubation, Singh reported a 12.4% incidence of self-extubation.1 When calculated per 100 intubation days, the incidence of unplanned extubation is 0.3-4.0 per 100 days. keywords: care; extubation; icu; patients; risk; sedation; self cache: pulmonarychronicles-169.htm plain text: pulmonarychronicles-169.txt item: #150 of 658 id: pulmonarychronicles-170 author: None title: A self-extubation case series in an ICU after the introduction of an early mobilization project date: None words: 2320 flesch: 52 summary: Tung, et al. found that patients with self-extubation had received benzodiazepines and considered the possibility that paradoxic reactions to these drugs led to these outcomes.7 Moons developed a risk assessment tool based on the Bloomsbury sedation score in the Glasgow Coma Scale.8 Patients at increased risk for self-extubation had low sedation levels and higher levels of consciousness. A pulmonary physician in the Department of Internal Medicine at TTUHSC in Lubbock, TX SWRCCC 2014;2(8):17-20  doi:: 10.12746/swrccc2014.0208.098 ................................................................................................................................................................................................................................................................................................................................... Abstract Background: Recent studies demonstrate that early mobilization of patients with acute respiratory failure reduces ICU and hospital length of stay.  keywords: care; extubation; icu; patients; project; sedation; self cache: pulmonarychronicles-170.htm plain text: pulmonarychronicles-170.txt item: #151 of 658 id: pulmonarychronicles-172 author: None title: Diagnosing Pulmonary Embolism in Patients with Suspected or Established Chronic Lung Disease date: None words: 5032 flesch: 45 summary: 8-9 The diagnosis of an acute pulmonary embolism is a clinical challenge in the setting of underlying lung disease because many of the symptoms are vague and non-specific, physical findings can be lacking, and diagnostic tests have limited sensitivity and specificity.1-3 It cannot be overstated that the most important aspect of PE diagnosis in the setting of established or even presumed underlying lung disease is suspicion of the diagnosis. D-dimer determination is a reasonable first diagnostic step with subsequent testing directed by the D-dimer result in the context of an individualized assessment of PE risk.  keywords: acute; airflow; chronic; copd; diagnosis; disease; embolism; exacerbation; med; obstruction; patients; pulmonary; risk cache: pulmonarychronicles-172.htm plain text: pulmonarychronicles-172.txt item: #152 of 658 id: pulmonarychronicles-173 author: None title: Pulmonary embolus and acute exacerbations of chronic obstructive pulmonary disease date: None words: 1185 flesch: 49 summary: Bertoletti and his colleagues prospectively evaluated COPD patients who had venous thromboembolic disease (VTE, i.e., DVT and/or PE) and found that COPD patients presented more frequently with PE (59%) than with DVT (41%).3 Compared to non-COPD patients the three month prognosis in patients with COPD and PE was worse, and they had higher mortality rates and more VTE recurrences.3 COPD patients with PE had a higher cumulative incidence of recurrent VTE as PE, all-cause mortality, and fatal PE than COPD patients presenting with DVT. keywords: copd; patients; pulmonary cache: pulmonarychronicles-173.htm plain text: pulmonarychronicles-173.txt item: #153 of 658 id: pulmonarychronicles-177 author: None title: Wellen's sign date: None words: 731 flesch: 52 summary: This sign indicates a pre-infarction state of coronary artery disease and progression to anterior wall myocardial infarction occurs within a mean duration of 8.5 days after the onset of this sign. Seventy-five percent of patients who did not undergo revascularization developed anterior wall myocardial infarction within a few weeks. keywords: patients; sign; wellens cache: pulmonarychronicles-177.htm plain text: pulmonarychronicles-177.txt item: #154 of 658 id: pulmonarychronicles-178 author: None title: Digital Clubbing date: None words: 854 flesch: 53 summary: The absence of digital clubbing does not rule out malignancy, but its presence increases the probability of lung malignancy (likelihood ratio:  3.9; 95% CI: 1.6-9.4).7 . Its presentation usually involves digital clubbing, also referred to as “drumstick fingers”, painful swollen joints, and periosteal new bone keywords: clubbing; digital; lung; patient cache: pulmonarychronicles-178.htm plain text: pulmonarychronicles-178.txt item: #155 of 658 id: pulmonarychronicles-179 author: None title: An adult male with abdominal pain and skin rash date: None words: 1536 flesch: 47 summary: Response of crescentic Henoch- Schönlein purpura nephritis to corticosteroid and azathioprine therapy. Semin Resp Crit Care 2004; 25: 455-464. Borrás-Blasco J, Enriquez R, Amoros F, Cabezuelo JB, Navarro-Ruiz A, Pérez M, Fernández J. Henoch- Schönlein purpura associated with clarithromycin. keywords: henoch; hsp; iga; purpura; schönlein; skin cache: pulmonarychronicles-179.htm plain text: pulmonarychronicles-179.txt item: #156 of 658 id: pulmonarychronicles-180 author: None title: ACE- inhibitor induced angioedema requiring an emergency surgical airway date: None words: 1112 flesch: 41 summary: We report two patients who required emergency surgical airways secondary to angioedema related to ACE-inhibitors. An increased need for intubation/tracheostomy has been reported in hospitalized patients with angioedema due to hypertension drugs.8 Occasionally, the usual preference for endotracheal intubation is replaced with tracheostomy for better control of the airway.9 While Mallampati tests have limited accuracy for predicting difficult intubation,10 some retrospective studies have reported the value of fiberoptic laryngoscopy to predict early airway intervention based on the patient’s age and various sites involved in upper respiratory tract and oropharynx.11,12 Patients with difficult airways may be good candidates for more invasive airway management instead of attempting intubation. keywords: ace; airway; angioedema cache: pulmonarychronicles-180.htm plain text: pulmonarychronicles-180.txt item: #157 of 658 id: pulmonarychronicles-181 author: None title: Ebola and the Kidney date: None words: 975 flesch: 41 summary: Limiting laboratory or radiological studies may be useful to minimize the transmission risk to health care professionals.2 The CDC recommends the use of Personal Protective Equipment, and all health care workers including dialysis providers must adhere to these guidelines.6 Dialysis providers should carefully consider center-specific expertise when modes of therapy and equipment are chosen, since employing new procedures or methods of dialysis can increase errors.3 As in other AKI patients, continuous renal replacement therapy (CRRT) generally offers advantages over intermittent hemodialysis (IHD) in hemodynamically unstable patients. The Ebola virus disease (EVD) re-emergence in March 2014 has caused global alarm among the public as well as with health care providers. keywords: care; dialysis; evd; patients cache: pulmonarychronicles-181.htm plain text: pulmonarychronicles-181.txt item: #158 of 658 id: pulmonarychronicles-182 author: None title: Symptomatic paroxysmal atrial fibrillation in a patient with unilateral pulmonary vein atresia date: None words: 826 flesch: 29 summary: Unilateral pulmonary vein atresia is a rare condition in adults which results from failure of incorporation of the common pulmonary vein into the left atrium. Symptomatic paroxysmal atrial fibrillation in a patient with unilateral pulmonary vein atresia Abstract / PDF Symptomatic paroxysmal atrial fibrillation in a patient with unilateral pulmonary vein atresia Sharmila Sehli MDa, David M Donaldson MD, FACCb Correspondence to Sharmila Sehli MD. keywords: ablation; atresia; vein cache: pulmonarychronicles-182.htm plain text: pulmonarychronicles-182.txt item: #159 of 658 id: pulmonarychronicles-183 author: None title: Shortness of breath caused by a tracheal web date: None words: 1269 flesch: 53 summary: Arrows indicate the attachment of the tracheal web to the tracheal wall. Figure 2 Tracheal web Figure 3 Removal of tracheal web using cautery, balloon dilatation, and cryotherapy   Discussion Congenital tracheal malformations can be either an intrinsic disorder in the trachea or an extrinsic disorder compressing the airway. A three dimensional CT scan was also used for diagnosis in a case of tracheal web reported by Yang.9 Thus CT scans should be employed as a screening tool in case of tracheal deformities and stenosis. keywords: symptoms; tracheal; web; webs cache: pulmonarychronicles-183.htm plain text: pulmonarychronicles-183.txt item: #160 of 658 id: pulmonarychronicles-184 author: None title: Drug-induced leukocytoclastic vasculitis: tigecycline a rare cause date: None words: 1621 flesch: 40 summary: Sibutramine induced cutaneous leukocytoclastic vasculitis: Ann Dermatol 2011; 23:544-7. Lasić D, Ivanišević R, Uglešić B, Cvitanović MZ, Glučina D, Hlevnjak I. Valproate-acid induced cutaneous leukocytoclastic vasculitis. keywords: drug; lcv; patient; skin; tigecycline; vasculitis; vessel cache: pulmonarychronicles-184.htm plain text: pulmonarychronicles-184.txt item: #161 of 658 id: pulmonarychronicles-185 author: None title: The Hippocratic Oath date: None words: 2964 flesch: 58 summary: Modern physicians wish to retain their cartel privileges. The Hippocratic Oath is associated with the practice of medicine, but over time fewer medical graduates have taken any form of the Hippocratic Oath. keywords: medical; oath; obligation; patient; physicians; pledge cache: pulmonarychronicles-185.htm plain text: pulmonarychronicles-185.txt item: #162 of 658 id: pulmonarychronicles-186 author: None title: Diffuse alveolar hemorrhage date: None words: 3451 flesch: 34 summary: 12 Bronchoscopy Bronchoscopy is the key investigation needed to diagnose alveolar hemorrhage by lavage and to exclude other associated infections.14 Bronchoscopy has higher yield if performed within the first 48 hours. Persistent or increasing blood on three sequential lavage aliquots from one affected area of lung supports the diagnosis of alveolar hemorrhage, but DAH must be suspected before this procedure is considered. keywords: alveolar; dah; diagnosis; diffuse; disease; hemorrhage; immune; patients; pulmonary; syndrome; vasculitis cache: pulmonarychronicles-186.htm plain text: pulmonarychronicles-186.txt item: #163 of 658 id: pulmonarychronicles-187 author: None title: Lung abscess post bronchoscopy date: None words: 966 flesch: 49 summary: Lung abscesses can be classified as primary or secondary based upon the presence or absence of common associated conditions. Symptoms of lung abscess may include fever, malaise, cough with foul smelling sputum, hemoptysis, shortness of breath, and weight loss. keywords: abscess; bronchoscopy; chest; lung cache: pulmonarychronicles-187.htm plain text: pulmonarychronicles-187.txt item: #164 of 658 id: pulmonarychronicles-188 author: None title: Prognostic factors for mortality with febrile neutropenia in hospitalized patients date: None words: 3788 flesch: 57 summary: TABLE 2 Characteristics of patients in study (total N=127)   TABLE 2 Characteristics of patients in study (total N=127) (continued)   TABLE 3 Prognostic factors associated with in-hospital mortality in febrile neutropenia patients Variable In hospital Expired (n=22) Crude OR (CI) P-Value Adjusted OR (CI) P-Value Age (years)   6(12%)   3.41 (1.25-9.31)   0.017   3.32 (0.48-23.11)   0.23   TABLE 5 Prognostic factor associated with more than 8 days length of stay (LOS) in febrile neutropenia patients Variable LOS Crude OR (CI) P-Value Adjusted OR (CI) P-Value Age (years)   ≤60   >60   34(50%) 22(37.3%)   1.68 (0.83-3.42)   0.50   2.84 (0.90-8.93)   0.07 Gender   Male   Female   35(43.8%) 21(44.7%)   1.04 (0.50-2.14)   0.92   1.20 (0.41-3.53)   0.74 Race   White   Hispanic   African-American   38(46.9%) 16(37.2%)   2(66.7%)   0.83 (0.43-1.62)   0.59   0.87 (0.36-2.14)   0.76 Type   Hematologic Malignancy   Solid tumor   48(57.1%) keywords: cancer; days; factors; mortality; neutropenia; patients; risk; study cache: pulmonarychronicles-188.htm plain text: pulmonarychronicles-188.txt item: #165 of 658 id: pulmonarychronicles-189 author: None title: BOARD REVIEW QUESTION Issue8 date: None words: 411 flesch: 50 summary: Convert the pretest probability to pretest odds by the following formula, Pretest odds = pretest probability/(1 – pretest probability) Calculate the pretest odds to posttest odds by multiplying by the +LR,                                                       Pretest odds  x  +LR  = Posttest odds Convert the posttest odds to posttest probability which we said earlier is the same as the PPV using the following formula,                                                       PPV = Posttest odds/(1+posttest odds) Using the numbers provided by the question stem for prevalence, sensitivity and specificity this series of calculations gives the value for PPV as 91%. Given this information, if one of your patients has a positive test which of the following represents the probability of a true diagnosis of asthma?   A. 9% B. 99% C. 10% D. 91% E. 90%   + Answer and Discussion - Answer and Discussion Correct answer:D – 91% Key Point: Positive predictive value (PPV) depends on the prevalence of disease and can be calculated with the sensitivity and specificity of a given test. keywords: odds cache: pulmonarychronicles-189.htm plain text: pulmonarychronicles-189.txt item: #166 of 658 id: pulmonarychronicles-190 author: None title: Critical Updates date: None words: 170 flesch: 58 summary: • Asthma may be a risk factor for incident obstructive sleep apnea according to a prospective cohort study published in JAMA.                                                                                           Email: zachary.mulkey @ttuhsc.edu + Author Affiliation - Author Affiliation aDepartment of Internal Medicine, TTUHSC, Lubbock, TX. SWRCCC 2015;3(9):65. ................................................................................................................................................................................................................................................................................................................................... keywords: mulkey cache: pulmonarychronicles-190.htm plain text: pulmonarychronicles-190.txt item: #167 of 658 id: pulmonarychronicles-191 author: None title: Poisson Regression date: None words: 1685 flesch: 52 summary: Since the focus of this article is to demonstrate the application of Poisson regression model in count data analysis, we will not discuss the details of the computational issues here.   For count data, Poisson regression is commonly used.   keywords: data; distribution; poisson; regression cache: pulmonarychronicles-191.htm plain text: pulmonarychronicles-191.txt item: #168 of 658 id: pulmonarychronicles-192 author: None title: Successful treatment of post-intubation tracheal stenosis with balloon dilation, argon plasma coagulation, electrocautery and application of mitomycin C date: None words: 1751 flesch: 39 summary: Our results suggest that success with topical mitomycin C is more likely in post-intubation rather than post-tracheostomy tracheal stenosis. Topical mitomycin C was then applied at the site of granulation tissue. keywords: mitomycin; patient; stenosis; topical cache: pulmonarychronicles-192.htm plain text: pulmonarychronicles-192.txt item: #169 of 658 id: pulmonarychronicles-193 author: None title: FB Granuloma date: None words: 620 flesch: 28 summary: These agents may induce an excessive inflammatory reaction in the vicinity of the surgical site, which potentially produces a clinically symptomatic and radiographically apparent lesion that could mimic recurrent tumor.1 Intracranial FB granulomas can present at any time from the intermediate postoperative period to several decades after initial surgery.1 The signal intensities of FB granulomas are variable on T1- and T2-weighted images reflecting a complex pathology, including acute or chronic inflammation, granuloma formation, fibrosis, collagen deposition, and degeneration of foreign materials. Foreign bodies previously reported as causes of intracranial granulomas include hemostatic agents, dura mater substitutes, chemotherapy wafers, and agents employed for embolization of highly vascular tumors or arteriovenous malformations, such as polyvinyl alcohol, or sutures, or N-butyl-2-cyanoacrylate (N-BCA Histoacryl, B. Braun, Melsungen, Germany).1,2 Hemostatic agents are the most common causes of intracranial FB granulomas. keywords: figure; granulomas; intracranial cache: pulmonarychronicles-193.htm plain text: pulmonarychronicles-193.txt item: #170 of 658 id: pulmonarychronicles-194 author: None title: Amiodarone pulmonary toxicity:a report on two cases date: None words: 2709 flesch: 46 summary: It is metabolized in the liver by cytochrome P-450 enzyme with subsequent excretion via the biliary system ; it is not dialyzable in overdose intoxication.7,8 Amiodarone pulmonary toxicity is a common and serious side effect of amiodarone, but the exact mechanism for this toxicity is unclear.9 Some authors have postulated that direct cytotoxic lung injury or an indirect hypersensitivity reaction are the main mechanisms.10 The risk for amiodarone pulmonary toxicity is associated with a high cumulative dose of amiodarone rather than plasma concentration or daily dose.4 Patients taking 400 mg daily for two months or 200 mg for two years are at high risk of amiodarone pulmonary toxicity with reported incidence of 5-15%.11 Other risk factors for amiodarone pulmonary toxicity include male gender, advanced age, preexisting lung disease and high oxygen requirements, thoracic surgery, and pulmonary angiography.4,12,13 The differential diagnosis of amiodarone pulmonary toxicity includes bronchiolitis obliterans, chronic eosinophilic pneumonia, bronchiolitis obliterans organizing pneumonia, and interstitial pneumonitis.11 Amiodarone tends to accumulate in certain organs, like skin, thyroid, eye, peripheral nerves, and lungs, and can cause bluish skin discoloration, photosensitivity, thyroid dysfunction, corneal deposits, peripheral neuropathy, bone marrow suppression, hepatitis, heart blocks, and pneumonitis.3 One well known serious side effect of amiodarone is pulmonary toxicity which can be acute, sub-acute, or chronic and can be irreversible and fatal.4,5 The diagnosis of amiodarone pulmonary toxicity is challenging and requires a high level of suspicion due to the nonspecific symptoms and image findings. keywords: amiodarone; blood; chest; infiltrates; interstitial; lung; minute; patients; pulmonary; toxicity cache: pulmonarychronicles-194.htm plain text: pulmonarychronicles-194.txt item: #171 of 658 id: pulmonarychronicles-195 author: None title: Nutrition in ICU date: None words: 3826 flesch: 44 summary: Raguso CA, Dupertuis YM, Pichard C. The role of visceral proteins in the nutritional assessment of intensive care unit patients. A recent retrospective observational study reported that trauma ICU patients, whose average ICU LOS was about 19 days, had EN stopped for planned procedures for a mean duration of 30 hours per patient.15 This is a significant amount of time to be without nutrients for these critically ill patients whose metabolic demands are already increased. keywords: care; education; enteral; feeding; grade; guidelines; icu; management; medical; nutrition; patients cache: pulmonarychronicles-195.htm plain text: pulmonarychronicles-195.txt item: #172 of 658 id: pulmonarychronicles-196 author: None title: Spirometry, the St. George’s Respiratory Questionnaire, and other clinical measures as predictors of medical costs and COPD exacerbation events in a prospective cohort date: None words: 4078 flesch: 49 summary: Many factors correlated with increased total costs, but in linear regression models the parameters most predictive were age, Charlson comorbidity score, spirometry measures (%pFEV1or other measures, depending on the model), and the SGRQ Activity score. However, physicians who treat COPD patients regularly note that %pFEV1does not reliably correlate with an individual patient’s clinical status. keywords: age; copd; costs; exacerbations; index; mean; measures; patients; respiratory; spirometry cache: pulmonarychronicles-196.htm plain text: pulmonarychronicles-196.txt item: #173 of 658 id: pulmonarychronicles-197 author: None title: Pulmonary leukostasis as a complication of leukemia date: None words: 2810 flesch: 32 summary: Diffuse ground glass opacities and/or consolidation Effects of tyrosine kinase inhibitor therapy History of imatinib therapy with a median duration of 49 days (range, 10–282 days), interstitial pneumonia Varying degree of interstitial pneumonia, ground glass opacities, nodular, or reticular infiltration AML-acute myeloid leukemia, ALL-acute lymphocytic leukemia, ATRA- all-trans–retinoic acid, PJP- Pneumocystis jiroveci pneumonia Pulmonary complications, including leukostasis, occur in up to 80% of all leukemia patients and are a major cause of death in these patients.16  Pulmonary leukostasis has been identified as the single worst prognostic factor in patients presenting with hyperleukocytosis with either AML or CML in myeloid blast crisis.13 Patients with pulmonary leukostasis present with fever, dyspnea, tachypnea, and hypoxia; symptoms range from mild shortness of breath to acute respiratory failure and death. Pulmonary leukostasis is one of the most common life-threatening complications in patients with hyperleukocytosis. keywords: acute; aml; blood; chemotherapy; hyperleukocytosis; leukapheresis; leukemia; leukostasis; patients; pulmonary cache: pulmonarychronicles-197.htm plain text: pulmonarychronicles-197.txt item: #174 of 658 id: pulmonarychronicles-198 author: None title: Pressure Ulcer Classification date: None words: 1194 flesch: 55 summary: Although pressure ulcer prevention focuses on reduction of pressure on body sites of at risk patients, pressure ulcer management is based on three principles: removing the offending agent (pressure), protecting the wound from contamination, and promoting healing through nutrition and supplementation by the adding of nutrients, such as protein, vitamins, and/or minerals to improve wound healing. This update provides a description of pressure ulcer stages and a brief summary of treatment.   keywords: pressure; stage; treatment; ulcer cache: pulmonarychronicles-198.htm plain text: pulmonarychronicles-198.txt item: #175 of 658 id: pulmonarychronicles-199 author: None title: Pulmonary leukostasis as a complication of leukemia date: None words: 3277 flesch: 43 summary: 2013;28(1):59-70. Kaneko M, Tanigawa T, Hashizume K, Kajikawa M, Tajiri M, Mueck W. Confirmation of model-based dose selection for a Japanese phase III study of rivaroxaban in non-valvular atrial fibrillation patients. Oral rivaroxaban for symptomatic venous thromboembolism. keywords: bleeding; daily; factor; hours; journal; patients; risk; rivaroxaban; study; warfarin cache: pulmonarychronicles-199.htm plain text: pulmonarychronicles-199.txt item: #176 of 658 id: pulmonarychronicles-200 author: None title: Negative Binomial Regression date: None words: 1330 flesch: 43 summary: To handle such a situation, negative binomial regression is commonly recommended. 2. Application of negative binomial regression in count data analysis. keywords: binomial; distribution; regression cache: pulmonarychronicles-200.htm plain text: pulmonarychronicles-200.txt item: #177 of 658 id: pulmonarychronicles-201 author: None title: Acute mesenteric ischemia date: None words: 1210 flesch: 50 summary: Portal venous gas in the pediatric age group. Markelov A. A case of hepatic portal venous gas due to viral gastroenteritis. keywords: acute; gas; hepatic; hpvg; ischemia; portal cache: pulmonarychronicles-201.htm plain text: pulmonarychronicles-201.txt item: #178 of 658 id: pulmonarychronicles-202 author: None title: Critical Updates date: None words: 188 flesch: 49 summary: A reduction in the cutoff size for lung nodules found on low dose CT scan screening tests resulted in a large reduction in the false positive rate. • CMS has further refined the criteria for approval of annual low dose CT scans for lung cancer screening. keywords: reduction cache: pulmonarychronicles-202.htm plain text: pulmonarychronicles-202.txt item: #179 of 658 id: pulmonarychronicles-203 author: None title: Hydralazine prn, should we really use it? date: None words: 531 flesch: 39 summary: Campbell, et al. performed an observational study describing the appropriateness, efficacy, and side effects of intravenous hydralazine doses given in hospitalized patients. As an assessment of routine practices in the in-patient management of BP elevations, Weder, et al. performed a retrospective review of patients receiving prn doses of hydralazine and/or labetalol who were not admitted specifically for management of hypertension. keywords: hydralazine; patients; use cache: pulmonarychronicles-203.htm plain text: pulmonarychronicles-203.txt item: #180 of 658 id: pulmonarychronicles-204 author: None title: BOARD REVIEW QUESTION Issue10 date: None words: 741 flesch: 52 summary: This question involves the concept of decision making capacity which frequently comes up in the ICU setting, usually involving patient decisions that make physicians uncomfortable. + Answer and Discussion - Answer and Discussion Correct answer:D – Evaluate the patient’s decision making capacity Key Point: Decision making capacity can be determined by any physician after a brief evaluation of the patient. keywords: capacity; patient cache: pulmonarychronicles-204.htm plain text: pulmonarychronicles-204.txt item: #181 of 658 id: pulmonarychronicles-205 author: None title: ACA date: None words: 1172 flesch: 56 summary: Twenty four million are expected to purchase insurance through the ACA exchanges and 16 million are expected to receive ACA benefits through expansion of Medicaid. ACA PDF  ACA and the Direction of U.S. Healthcare Gilbert Berdine MDa Correspondence to Gilbert Berdine MD Email: Gilbert.Berdine@ttuhsc.edu + Author Affiliation - Author Affiliation aDepartment of Internal Medicine at Texas Tech University Health Sciences Center in Lubbock, TX. keywords: aca; health; u.s cache: pulmonarychronicles-205.htm plain text: pulmonarychronicles-205.txt item: #182 of 658 id: pulmonarychronicles-206 author: None title: pan-resistant Pseudomonas aeruginosa ventilator-associated pneumonia date: None words: 1875 flesch: 36 summary: SWRCCC 2015;3(11):35-39 doi: 10.12746/swrccc2015.0311.144 ................................................................................................................................................................................................................................................................................................................................... Abstract Emergence of multi-drug resistant microorganisms, such as pan-resistant Pseudomonas aeruginosa, has recently created a therapeutic challenge in ICU patients worldwide. We present a case of VAP due to pan-resistant Pseudomonas aeruginosa in a patient with advanced multiple sclerosis. keywords: aeruginosa; ceftolozane; colistin; pseudomonas; rifampin; tazobactam; therapy cache: pulmonarychronicles-206.htm plain text: pulmonarychronicles-206.txt item: #183 of 658 id: pulmonarychronicles-207 author: None title: Post Flu Shot Confusion – think ADEM! date: None words: 1642 flesch: 52 summary: A repeat MRI of the head demonstrated extensive bilateral, poorly marginated white matter, and some grey matter involvement characteristic of acute disseminated encephalomyelitis (ADEM). Acute disseminated encephalomyelitis (ADEM), a demyelinating disease of the nervous system, is one such complication. keywords: acute; adem; days; encephalomyelitis; influenza; matter cache: pulmonarychronicles-207.htm plain text: pulmonarychronicles-207.txt item: #184 of 658 id: pulmonarychronicles-208 author: None title: Obscure gastrointestinal bleeding secondary to gastroduodenal pseudoaneurysm date: None words: 1796 flesch: 42 summary: Discussion Upper gastrointestinal bleeding is a leading cause of admission to the emergency department.1 Hemorrhage from the papilla of Vater via the pancreatic duct, known as hemosuccus pancreaticus, is a rare cause of intermittent upper gastrointestinal bleeding that usually develops from complications of pancreatitis.2,7 Visceral artery pseudoaneurysms are responsible for 20% of hemosuccus pancreaticus cases, and gastroduodenal artery pseudoaneurysms are among the rarest forms of visceral artery pseudoaneurysm (9 Pseudoaneurysms are primarily a condition of middle age and most commonly found between 50 and 58 years of age. Keywords: pseudoaneurysm, gastroduodenal artery pseudoaneurysm, gastrointestinal bleeding, visceral angiography ................................................................................................................................................................................................................................................................................................................................... Introduction Upper gastrointestinal bleeding is one of the leading causes of admission to the emergency department.1 Hemorrhage from the ampulla of Vater via the pancreatic duct, known as hemosuccus pancreaticus (HP), is a rare cause of intermittent upper gastrointestinal bleeding.2 Hemosuccus pancreaticus usually occurs as a complication of acute or chronic pancreatitis. keywords: artery; bleeding; embolization; gastrointestinal; pancreatitis; pseudoaneurysm cache: pulmonarychronicles-208.htm plain text: pulmonarychronicles-208.txt item: #185 of 658 id: pulmonarychronicles-209 author: None title: osocomial Fever of Unknown Origin date: None words: 1384 flesch: 37 summary: In some cases nosocomial fever occurs in postoperative patients after the release of cytokines and interleukins from tissue injury and not infection.6 In a prospective cross sectional study conducted in pediatric and adult ICUs (n=63), 82% of patients with nosocomial FUO were found to have acute bacterial nosocomial sinusitis diagnosed by microbiological analysis of sinus fluid aspirates.7 Other common causes of nosocomial FUO include drug fever, health care associated infections, thrombosis, pulmonary embolism, and neoplasm.2 Evaluation of FUO FUO is a diagnosis made after thorough history taking, physical examination, and obligatory investigations as listed in Table 2. She is diagnosed with nosocomial fever of unknown origin. keywords: fever; fuo; history; nosocomial; origin; patients; work cache: pulmonarychronicles-209.htm plain text: pulmonarychronicles-209.txt item: #186 of 658 id: pulmonarychronicles-210 author: None title: Febrile Neutropenia in Intensive Care Unit date: None words: 2371 flesch: 40 summary: Since most patients will not have localizing signs and symptoms, broad-spectrum antipseudomonal monotherapy agents are class IA recommendation in febrile neutropenia patients, including cephalosporins (cefepime), carbapenems (meropenem or imipenem-cilastatin) or beta-lactamase inhibitors (piperacillin-tazobactam).3 The choice among these varies depending on institutional antibiograms and the patients’ allergy profile.   Noninfectious condition, such as cardiovascular events, neurologic complications, tumor lysis syndrome, venous thromboembolism, bleeding complications from thrombocytopenia, and life-threatening side effects of chemotherapeutic agents, were associated with increased mortality in neutropenic cancer patients in critical care units. keywords: antibiotics; cancer; care; febrile; infection; mortality; neutropenia; patients; risk; therapy cache: pulmonarychronicles-210.htm plain text: pulmonarychronicles-210.txt item: #187 of 658 id: pulmonarychronicles-211 author: None title: Prophylaxis and treatment of antibiotic-associated diarrhea: is there evidence for using probiotics? date: None words: 1670 flesch: 38 summary: Prophylaxis and treatment of antibiotic-associated diarrhea: is there evidence for using probiotics? PDF Prophylaxis and treatment of antibiotic-associated diarrhea: is there evidence for using probiotics? Natalie Kashefi MDa, Kokila Kakarala MDa Correspondence to Natalie Kashefi , MD. Are probiotics an appropriate adjunct to therapeutic regimens for AAD and could prophylactic use of probiotics have prevented this complication? keywords: aad; antibiotic; diarrhea; lactobacillus; patients; probiotics; treatment; use cache: pulmonarychronicles-211.htm plain text: pulmonarychronicles-211.txt item: #188 of 658 id: pulmonarychronicles-213 author: None title: Is acute severe asthma a risk factor for the propofol infusion syndrome? date: None words: 1549 flesch: 51 summary: The diagnosis of propofol infusion syndrome (PRIS) was entertained, and propofol (total 2.937gm of propofol infused over 11hrs) was stopped. Propofol infusion syndrome in children. keywords: acute; asthma; infusion; pris; propofol; syndrome cache: pulmonarychronicles-213.htm plain text: pulmonarychronicles-213.txt item: #189 of 658 id: pulmonarychronicles-214 author: None title: Cryobiopsy date: None words: 3470 flesch: 41 summary: However, the specimens obtained by transbronchial forceps biopsies are often nondiagnostic due to the small size of specimens and crush artifacts.7 The diagnostic yield of transbronchial lung biopsies varies significantly according to the radiographic pattern,8 but can be as high as 60-90% in selected disorders, such as sarcoidosis and lymphangitic carcinomatosis.8-10 Transbronchial lung biopsy: the pathologist's point of view. keywords: cryobiopsy; diffuse; disease; forceps; lung; parenchymal; patients; study; transbronchial; yield cache: pulmonarychronicles-214.htm plain text: pulmonarychronicles-214.txt item: #190 of 658 id: pulmonarychronicles-215 author: None title: FB Granuloma date: None words: 682 flesch: 35 summary: Persistent left superior vena cava: a case report and review of literature. doi:10.1186/1476-7120-6-50. Irwin RB, Greaves M, Schmitt M. Left superior vena cava: revisited. keywords: cava; persistent; vena cache: pulmonarychronicles-215.htm plain text: pulmonarychronicles-215.txt item: #191 of 658 id: pulmonarychronicles-216 author: None title: IP date: None words: 2129 flesch: 61 summary: New Hampshire prices were used as a proxy for U.S. prices since New Hampshire had online listing of pharmaceutical prices available in that state that were sortable by drug and price. For all the drugs available outside of the United States as a generic equivalent, U.S. prices were higher than prices outside the U.S. The largest disparity was for Abilify with the U.S. form costing over 29 times the world price. keywords: drugs; price; property; u.s cache: pulmonarychronicles-216.htm plain text: pulmonarychronicles-216.txt item: #192 of 658 id: pulmonarychronicles-217 author: None title: Interprofessional nursing education: a pilot study in the medical intensive care unit and internal medicine outpatient clinics date: None words: 2327 flesch: 35 summary: These educational efforts included medical students, nursing students, pharmacy students, allied health students, physician assistants, and social workers.  Nursing students thought that physicians had more need for collaboration with other healthcare workers following their observations but also thought that physicians spent less time with patients and family than expected.  keywords: care; education; experience; nursing; physicians; students cache: pulmonarychronicles-217.htm plain text: pulmonarychronicles-217.txt item: #193 of 658 id: pulmonarychronicles-218 author: None title: Count data analysis date: None words: 1812 flesch: 53 summary: As we can see from Figure 1, there does not seem to have a strong relationship between side effect rate and age group. In addition, the diff option provides all pairwise comparisons of side effect rates among age groups. keywords: .0001; age; country; data cache: pulmonarychronicles-218.htm plain text: pulmonarychronicles-218.txt item: #194 of 658 id: pulmonarychronicles-219 author: None title: Recurrent hemoptysis - a complication associated with an azygos lobe date: None words: 1775 flesch: 52 summary: Keywords: azygos lobe, hemoptysis, chest radiograph ................................................................................................................................................................................................................................................................................................................................... It originates at the area of right brachiocephalic vein and SVC and ends at the lateral side of the vertebral bodies and the azygos lobe (B). keywords: azygos; azygos lobe; fissure; lobe; lung; vein cache: pulmonarychronicles-219.htm plain text: pulmonarychronicles-219.txt item: #195 of 658 id: pulmonarychronicles-221 author: None title: Cardiac toxicity with monoclonal antibodies therapy date: None words: 973 flesch: 36 summary: This requires monitoring of LVEF during treatment, but the best schedule for LVEF monitoring in asymptomatic patients during trastuzumab treatment is uncertain. Based on these criteria, it was recommended to monitor cardiac function at three month intervals during trastuzumab treatment and every six months for at least two years after completion of treatment. keywords: effusion; therapy; trastuzumab; treatment cache: pulmonarychronicles-221.htm plain text: pulmonarychronicles-221.txt item: #196 of 658 id: pulmonarychronicles-222 author: None title: Critical Updates date: None words: 202 flesch: 65 summary: The FDA is seeking feedback from the public on proposed rulemaking related to requiring nicotine exposure warnings and child-resistant packaging for e-cigarrete related products. • West Nile infection season is underway. keywords: years cache: pulmonarychronicles-222.htm plain text: pulmonarychronicles-222.txt item: #197 of 658 id: pulmonarychronicles-223 author: None title: BOARD REVIEW QUESTION Issue10 date: None words: 471 flesch: 61 summary: Pneumococcal vaccine-naïve persons: Adults aged ≥65 years who have not previously received pneumococcal vaccine or whose previous vaccination history is unknown should receive a dose of PCV13 first, followed by a dose of PPSV23. The dose of PPSV23 should be given 6–12 months after a dose of PCV13. keywords: ppsv23 cache: pulmonarychronicles-223.htm plain text: pulmonarychronicles-223.txt item: #198 of 658 id: pulmonarychronicles-225 author: None title: Ciprofloxacin-Induced Renal Failure date: None words: 2598 flesch: 35 summary: Here we report the development of acute renal failure within a few days of initiating oral ciprofloxacin therapy and briefly describe the different types of renal failure secondary to fluoroquinolone administration. It was previously reported that fluoroquinolones could cause acute renal failure after ingestion of large quantities, but it is now recognized that therapeutic doses of fluoroquinolones can also cause renal injury. keywords: acute; ciprofloxacin; failure; oral; renal; tab cache: pulmonarychronicles-225.htm plain text: pulmonarychronicles-225.txt item: #199 of 658 id: pulmonarychronicles-226 author: None title: Acute motor and sensory axonal neuropathy-associated syndrome of inappropriate antidiuretic hormone secretion date: None words: 1247 flesch: 38 summary: Decaux G, Musch W. Clinical laboratory evaluation of the syndrome of inappropriate secretion of antidiuretic hormone. Acute motor and sensory axonal neuropathy-associated syndrome of inappropriate antidiuretic hormone secretion Abstract / PDF Acute motor and sensory axonal neuropathy-associated syndrome of inappropriate antidiuretic hormone secretion Weeraporn Srisung MDa, Aumyot Prongdong MDb Pavis Laengvejkal MDc, Sorot Phisitkul MDd Correspondence to Weeraporn Srisung MD. keywords: amsan; barre; hormone; motor; siadh; syndrome cache: pulmonarychronicles-226.htm plain text: pulmonarychronicles-226.txt item: #200 of 658 id: pulmonarychronicles-227 author: None title: Scientific writing date: None words: 1508 flesch: 57 summary: Have you chosen precise words that convey your meaning clearly? Specifically, writers are advised to employ precise language, avoid unnecessary jargon, eliminate unnecessary repetition, and revise verbose phrases. keywords: clarity; language; term; writing cache: pulmonarychronicles-227.htm plain text: pulmonarychronicles-227.txt item: #201 of 658 id: pulmonarychronicles-228 author: None title: Cryobiopsy date: None words: 1294 flesch: 46 summary: Blood culture speciation revealed Pseudomonas luteola in two bottles and Escherichia vulneris in one bottle. The second pathogen, Escherichia vulneris, is a Gram negative, oxidase negative, indole negative, fermentative motile rod of the family Enterobacteriaceae that has been isolated from animals, drinking water, and humans.9 keywords: dis; escherichia; luteola; patient; pneumonia; vulneris cache: pulmonarychronicles-228.htm plain text: pulmonarychronicles-228.txt item: #202 of 658 id: pulmonarychronicles-229 author: None title: Letter to the editor date: None words: 1223 flesch: 61 summary: If we can predict quantum events with certainty, and nerve impulses originate from quantum event changes in membrane molecules, then predicting what people do will become like predicting the weather: we understand how it works but the number of variables is so large and small deviations from given inputs lead to very large deviations from future results due to butterfly effects and chaos theory. Random quantum events are candidates for the mechanism of free will by virtue of having no deterministic explanation, but that is not enough. keywords: events; quantum cache: pulmonarychronicles-229.htm plain text: pulmonarychronicles-229.txt item: #203 of 658 id: pulmonarychronicles-230 author: None title: osocomial Fever of Unknown Origin date: None words: 1649 flesch: 60 summary: Standardized tools for the assessment of nicotine dependence are imperative for clinical research and subsequent use with patients. Background of the Fagerstrom measures For decades, it has been known that nicotine dependence is a major reason that many smokers are unable to quit smoking. keywords: dependence; fagerstrom; ftnd; nicotine; smoking cache: pulmonarychronicles-230.htm plain text: pulmonarychronicles-230.txt item: #204 of 658 id: pulmonarychronicles-231 author: None title: Pulmonary rehabilitation improves frailty and gait speed in some ambulatory patients with chronic lung diseases date: None words: 3771 flesch: 50 summary: Methods: Forty-one patients started pulmonary rehabilitation, and 30 patients completed at least 6 weeks of rehabilitation. Conclusions: Gait speed increased in patients with chronic lung diseases with pulmonary rehabilitation. keywords: chronic; disease; frailty; gait; health; patients; pre; pulmonary; rehabilitation; speed; study; week cache: pulmonarychronicles-231.htm plain text: pulmonarychronicles-231.txt item: #205 of 658 id: pulmonarychronicles-232 author: None title: A unique case presentation of recurrent self-inflicted chemical burns date: None words: 2388 flesch: 41 summary: The total costs for malingering patients requiring burn care has not been established since only a few case reports comment on the overall healthcare costs with these patients (Table 1).3,4,5 Table 1   Factitious hand disorders Study Patient population and injury type Time of injury to referral Average direct cost of care  Grunert 3 29 patients with factitious hand disorders  3 to 62 months  (average delay in referral of 18 months) $52,240 (range 10,200-103,600) Connor4 174 workers' compensation patients with factitious hand disorders  3 to 34 months $39,130 (range of 21,000-87,000) Kasdan and Stutts5 1 case report with a factitious hand disorder 132 months $117,660 Our case examines a 52-year-old man who presented with new chemical burns to his hand after sustaining a work related chemical burn injury five years prior. Factitious hand disorders: Review of 29 years of multidisciplinary care. keywords: burn; care; case; hand; injury; patient; self; wound cache: pulmonarychronicles-232.htm plain text: pulmonarychronicles-232.txt item: #206 of 658 id: pulmonarychronicles-233 author: None title: Editorial Commentary date: None words: 493 flesch: 44 summary: Dr. Cashmore is correct that there cannot be a scientific explanation for Free Will since Free Will would become Deterministic rather than Free. Dr. Cashmore emphasized the implications of Determinism for the criminal justice system. keywords: cashmore cache: pulmonarychronicles-233.htm plain text: pulmonarychronicles-233.txt item: #207 of 658 id: pulmonarychronicles-234 author: None title: Suicide risk among general hospital inpatients date: None words: 2157 flesch: 44 summary: While this mnemonic provides a very brief way to screen for suicide risk, it lacks specificity in predicting suicidal behaviors due to its reliance on broad risk factors.11 An alternative screening instrument is the IS PATH WARM mnemonic, which focuses on the presence of suicide Ideation, Substance abuse, feelings of Purposelessness, feelings of Anger, feeling Trapped, feelings of Hopelessness, Withdrawing from social circles, Anxiety, Recklessness, and Mood changes.11 A more thorough evidenced-based suicide risk assessment is the Suicide Status Form, a clinical assessment and treatment-planning tool that examines quantitative and qualitative aspects of psychological pain, stress, agitation, hopelessness, and self-hate using a 5-point ordinal response scale.12 Other important factors to consider when determining risk include a history of suicide attempts or non-suicidal self-injurious behaviors and access to firearms, as these risk factors are highly correlated with lethal or near-lethal suicide attempts and are consistent with theoretical models of suicidal behaviors.13,14 When formulating a plan for the safety of a patient reporting suicide ideation, it is important to understand that no-suicide contracts are not effective at helping patients cope or at reducing the risk for suicidal behaviors.15 On the other hand, crisis response plans have been repeatedly found to be more effective at reducing suicide risk.16-18 A crisis response plan is a document created collaboratively between the patient and healthcare provider that is most often comprised of the following domains: identifying warning signs and triggers for suicidal thoughts (e.g., people, places, objects, songs, times of the year), identifying coping strategies the patient can rely on in times of crisis (e.g., distraction techniques, relaxation techniques), friends and family members the patient can reach out to in a time of crisis, and professional agencies that can be contacted if the preceding steps do not reduce the patient’s desire for suicide.18 Several options should be listed for each domain, with ideas primarily generated by the patient.16 Among inpatients who die by suicide, those in general medical hospitals are more likely to be older, married, and employed compared to those in psychiatric units.8 General medical inpatients who die by suicide are less likely to communicate suicide-related thoughts, but more are likely to engage in suicide attempts shortly after admission, to use violent methods for suicide, to die by suicide at night, and to have physical diagnoses, compared to psychiatric inpatients.5 keywords: crisis; discharge; hospital; patient; risk; suicidal; suicide cache: pulmonarychronicles-234.htm plain text: pulmonarychronicles-234.txt item: #208 of 658 id: pulmonarychronicles-235 author: None title: stat date: None words: 1946 flesch: 49 summary: As a alternative to the above traditional model selection methods, penalized regressions achieve coefficient estimation and model selection simultaneously.          (B) Penalized regressions (LASSO regression and Elastic Net)         The LASSO (Least Absolute Shrinkage and Selection Operator) achieves model selection by penalizing the absolute size of the regression coefficients. keywords: data; model; sample; selection cache: pulmonarychronicles-235.htm plain text: pulmonarychronicles-235.txt item: #209 of 658 id: pulmonarychronicles-236 author: None title: Letter to the editor date: None words: 993 flesch: 44 summary: An implication of this would be that economic forecasting and central planning of the economy are only limited by unattained information regarding objective exchange values from the inability to solve an enormous system of complex simultaneous equations. Much of economic science is performed under the assumption that individuals consciously make choices according to subjective valuation of desired outcomes. keywords: berdine; economic; free cache: pulmonarychronicles-236.htm plain text: pulmonarychronicles-236.txt item: #210 of 658 id: pulmonarychronicles-237 author: None title: Letter to the editor date: None words: 2792 flesch: 66 summary: The axiom can be called free will. So, I think it is impossible to prove free will, but the question is not moot at all as long as someone is suggesting that Determinism demands that I surrender my autonomy. keywords: cashmore; choices; determinism; rules cache: pulmonarychronicles-237.htm plain text: pulmonarychronicles-237.txt item: #211 of 658 id: pulmonarychronicles-239 author: None title: Daptomycin-induced acute eosinophilic pneumonia date: None words: 2353 flesch: 28 summary: Miller BA, et al. Acute eosinophilic pneumonia secondary to daptomycin: a report of three cases. If this presentation occurs for a maximum of 5 days, it is characterized as acute eosinophilic pneumonia. keywords: aep; daptomycin; drug; eosinophilic; pneumonia; weeks; withdrawal cache: pulmonarychronicles-239.htm plain text: pulmonarychronicles-239.txt item: #212 of 658 id: pulmonarychronicles-24 author: None title: Cadiorenal syndrome date: None words: 4538 flesch: 40 summary: Weight loss at 96 hours was similar with the two approaches, but ultrafiltration was associated with higher rates of adverse events.38 An earlier ultrafiltration vs. intravenous diuretics trial for patients hospitalized for acute decompensated heart failure with two or more signs of hypervolemia compared the safety and efficacy of veno-venous ultrafiltration and standard intravenous  diuretic therapy for acute decompensated heart failure patients; this study had a different outcome.39 Two hundred patients were randomized to ultrafiltration or intravenous  diuretics. Digoxin and diuretics improve symptoms in congestive heart failure but have no effect on mortality.43 However, vasodilators (e.g., nesiritide) can affect renal function and in some cases exacerbate renal injury.44 Vasopressin receptor 2 antagonists can improve hyponatremia in heart failure patients but have no clear survival benefit.45 Intra-aortic balloon pumps can be used for persistent hypotension in patients with acute decompensation. keywords: acute; cardiac; chronic; crs; disease; failure; function; heart; heart failure; kidney; patients; type cache: pulmonarychronicles-24.htm plain text: pulmonarychronicles-24.txt item: #213 of 658 id: pulmonarychronicles-241 author: None title: E-cigarettes and smoking cessation date: None words: 983 flesch: 50 summary: The results of the third RCT are difficult to compare since there was no control group without e-cigarette use and it had a smaller sample size (N=48). For example, the battery potency of each individual model affects the aerosol (colloquially termed “vapor”, hence the term “vaping”) produced and the types of e-cigarettes solutions are numerous. keywords: cessation; cigarettes; nicotine; smoking cache: pulmonarychronicles-241.htm plain text: pulmonarychronicles-241.txt item: #214 of 658 id: pulmonarychronicles-242 author: None title: pleural plaque date: None words: 831 flesch: 39 summary: In one cohort study, approximately 38.2% of the asbestos workers had parietal pleural plaques, and most were incidental findings.12 Robinson et al followed 22 patients with benign asbestos pleural effusion for 17 years and no mesothelioma developed.8 Management of patients with asbestos effusion is observation as in the case of our patient, and drainage if symptomatic. DISCUSSION           Despite increasing awareness and campaigns for the reduction or elimination of occupational asbestos exposure, asbestosis still remains a significant clinical problem.1 Asbestos exposure from direct occupational exposure or para-occupational exposure can lead to the following pulmonary problems: asbestosis, pleural plaques, diffuse pleural thickening, benign asbestos pleural effusion, lung cancer, and mesothelioma.2             Benign asbestos pleural effusion was first described by Eisenstadt in 1964.3 Pleural effusion is a common manifestation and can be the earliest abnormality seen within 10 years of exposure to asbestos.4 keywords: asbestos; effusion; exposure; plaques cache: pulmonarychronicles-242.htm plain text: pulmonarychronicles-242.txt item: #215 of 658 id: pulmonarychronicles-243 author: None title: pleural fluid date: None words: 610 flesch: 55 summary: The color and clarity of pleural fluid can suggest what caused the pleural effusion, but there seem to be few terms to describe the appearance of pleural fluid color. An observant practitioner of thoracentesis cannot help but appreciate the similarity between pleural fluid and another of nature’s fluids: beer.           keywords: beer; fluid cache: pulmonarychronicles-243.htm plain text: pulmonarychronicles-243.txt item: #216 of 658 id: pulmonarychronicles-244 author: None title: Scientific writing date: None words: 1421 flesch: 59 summary: Editing techniques such as analyzing the use of the verb “to be,” phrasal verbs, and passive voice and learning field-specific vocabulary help medical writers to use verbs effectively in their writing. Selecting precise verbs and using them effectively enhances clarity and affects style. keywords: verb; voice; writing cache: pulmonarychronicles-244.htm plain text: pulmonarychronicles-244.txt item: #217 of 658 id: pulmonarychronicles-245 author: None title: statistics date: None words: 1688 flesch: 39 summary: In conclusion, health data are being collected, aggregated, and stored at unprecedented rates, and the future holds many possibilities for how this data may be used to improve health care systems and population health, respectively. Potential applications of big data in health care administration, practice, and research are widespread. keywords: big; care; data; databases; health; research cache: pulmonarychronicles-245.htm plain text: pulmonarychronicles-245.txt item: #218 of 658 id: pulmonarychronicles-246 author: None title: Cardiac ablation date: None words: 2520 flesch: 34 summary: Keywords: catheter ablation, atrial fibrillation, arrhythmia, mapping, radiofrequency ................................................................................................................................................................................................................................................................................................................................... Introduction Cardiac ablation is a procedure used to destroy cells in the heart to terminate and/or prevent arrhythmias. Ablation is less likely to work the longer a patient has persistent atrial fibrillation and in patients with structural heart disease.27 After catheter ablation, medications and follow-up are essential components of management. keywords: ablation; cardiac; catheter; fibrillation; heart; patients; tachycardia cache: pulmonarychronicles-246.htm plain text: pulmonarychronicles-246.txt item: #219 of 658 id: pulmonarychronicles-247 author: None title: Pulmonary vein stenosis date: None words: 2128 flesch: 39 summary: Initially ablation was performed inside the pulmonary veins (PV), but this caused pulmonary vein stenosis (PVS) in some patients. Baranowski B, Saliba W. Our approach to management of patients with pulmonary vein stenosis following AF ablation. keywords: ablation; catheter; fibrillation; patients; pulmonary; pvs; stenosis; vein cache: pulmonarychronicles-247.htm plain text: pulmonarychronicles-247.txt item: #220 of 658 id: pulmonarychronicles-248 author: None title: review date: None words: 5099 flesch: 40 summary: Raised pulmonary artery pressures measured with Doppler echocardiography in rheumatoid arthritis patients. Risk of serious bacterial infections among rheumatoid arthritis patients exposed to tumor necrosis factor alpha antagonists. keywords: arthritis; case; disease; drug; ild; interstitial; leflunomide; lung; lung disease; methotrexate; patients; pneumonitis; pulmonary; rheumatoid; rheumatoid arthritis; therapy; toxicity; treatment cache: pulmonarychronicles-248.htm plain text: pulmonarychronicles-248.txt item: #221 of 658 id: pulmonarychronicles-249 author: None title: Colovesical Fistula date: None words: 882 flesch: 46 summary: The most common etiology of these fistulae is inflammatory bowel disease, specifically diverticulitis, in which a fistula is formed by direct extension of a ruptured diverticulum or erosion of a peridiverticular abscess into the bladder.1 The relative risk for developing enterovesical fistula in the presence of diverticular disease is 1 to 4 percent.1 Cancer, particularly of the bowel, is the second most common cause (10–20% of cases) of an enterovesical fistula.1 Additionally, reports have been made of patients having air in the bladder as an incidental finding upon imaging for other various reasons prior to the diagnosis of enterovesical fistula.4 Diagnosis of enterovesical fistula can be made several ways. keywords: bladder; enterovesical; fistula cache: pulmonarychronicles-249.htm plain text: pulmonarychronicles-249.txt item: #222 of 658 id: pulmonarychronicles-250 author: None title: Behavioral medicine treatment for patients with chronic obstructive pulmonary disease date: None words: 2427 flesch: 40 summary: Physical activity is essential for COPD patients; walking or cycling 2 hours/week is associated with a 30–40% reduction in respiratory mortality.25 Endurance and strength training can also improve skeletal muscle function and mitigate chronic pain, which improves treatment outcomes for COPD patients.26 Helping patients find motivation and determining specific exercise regimens are imperative, as lethargy is a strong predictor of mortality in COPD patients.27 Nutrition Counseling. The accuracy of the anxiety inventory respiratory disease scale for patients with chronic obstructive pulmonary disease. keywords: behavioral; biofeedback; chronic; copd; disease; health; pain; patients; symptoms cache: pulmonarychronicles-250.htm plain text: pulmonarychronicles-250.txt item: #223 of 658 id: pulmonarychronicles-251 author: None title: health policy date: None words: 1395 flesch: 53 summary: Under this homogenized risk scheme, the expected “premium” for “health insurance” becomes the cost of health care divided by the number of people. Two changes in policy are necessary to reduce health care costs. keywords: care; health; insurance cache: pulmonarychronicles-251.htm plain text: pulmonarychronicles-251.txt item: #224 of 658 id: pulmonarychronicles-252 author: None title: stat date: None words: 2231 flesch: 52 summary: For example, due to masking (when a group of true outliers exist, they can pull the mean estimate toward them, thus, few or none of the true outliers appear to be extreme values, i.e., some of the true outliers were masked by other outliers) and swamping (a group of true outliers make one or more observations appear to be outliers) effects, some true outliers do not appear to be outliers, and thus removing one outlier introduces another one. However, mean and variance themselves are sensitive to outliers, and one “bad” observation might completely skew the mean and substantially inflate the variance, thus using robust estimates of the distribution parameters can improve the performance of outlier detection. keywords: analysis; data; methods; observations; outliers cache: pulmonarychronicles-252.htm plain text: pulmonarychronicles-252.txt item: #225 of 658 id: pulmonarychronicles-253 author: None title: Malignant hyperthermia date: None words: 2526 flesch: 47 summary: Malignant hyperthermia was associated with a high mortality rate, but this has decreased with the use of dantrolene. Keywords: malignant hyperthermia, succinylcholine, muscle injury, rigidity ................................................................................................................................................................................................................................................................................................................................... Introduction Malignant hyperthermia is a rare metabolic crisis triggered by volatile anesthetics and/or succinylcholine. keywords: calcium; dantrolene; hyperthermia; malignant; muscle; patient; signs; temperature cache: pulmonarychronicles-253.htm plain text: pulmonarychronicles-253.txt item: #226 of 658 id: pulmonarychronicles-255 author: None title: Suicide risk among general hospital inpatients date: None words: 1612 flesch: 36 summary: Diaphragmatic weakness in the ICU patients could be secondary to neuropathy or myopathy induced by hyperglycemic states.12,13 Most of the complications related to hyperglycemia are secondary to both microvascular and macrovascular complications induced by increased production of superoxide in endothelial cells of vessels and the myocardium resulting in decreased tissue perfusion.13 Major pathways involved in pathogenesis of complications secondary to hyperglycemia induced superoxide overproduction include increased reactive oxygen species production from mitochondrial electron transport chain, polyol pathway flux, increased formation of advanced glycation end products, increased expression of receptors for these end products and its activating ligands, increased activity of hexosamine pathway, and activation of protein kinase C isoforms.13-15 Increased reactive oxygen species (ROS) generated from hyperglycemia alter single fiber contractile protein function evidenced by loss of diaphragm troponin T. In skeletal muscles, ROS activate signaling kinases, like JNK, PKR, and p38, which trigger downstream pathways, most importantly the caspase pathway, the proteasomal degradation pathway, and factors regulating protein translation.16,17  Du and Russel reported that hyperglycemia activates skeletal muscle caspase-3 degrading myofibrillar proteins, specifically actin which leads to subsequent activation of the ubiquitin-proteasomal degradation pathway causing muscle atrophy and a decrease in protein synthesis.18 Vincent, et al. also noted that two hours of high glucose exposure (20 mM added glucose) resulted in severe oxidative stress, mitochondrial disruption, activation of caspase 3, and apoptosis in cultured neurons, leading to neuronal and tissue damage.19 Animal studies on hyperglycemia and diaphragm dysfunction report that N-acetylcysteine and other thiol containing compounds can reverse hyperglycemia induced diaphragm weakness by detoxifying a variety of reactive electrophiles and by inhibiting the cytotoxic effects of tumor necrosis factor alpha (TNFα) on the diaphragm.20These results suggest that diaphragmatic weakness in hyperglycemia is mediated by TNFα or oxidative stress. Suicide risk among general hospital inpatients PDF Hyperglycemia and diaphragmatic weakness in ICU patients Maria Gabriela Suarez a, Avinash Adiga MDa Correspondence to Maria Gabriela Suarez MD Email: gabriela.suarez@ttuhsc.edu + Author Affiliation - Author Affiliation a Residents in the Department of Internal Medicine at Texas Tech University Health Sciences Center in Lubbock, TX. keywords: care; diaphragm; hyperglycemia; icu; patients; weakness cache: pulmonarychronicles-255.htm plain text: pulmonarychronicles-255.txt item: #227 of 658 id: pulmonarychronicles-256 author: None title: BOARD REVIEW QUESTION Issue13 date: None words: 464 flesch: 40 summary: Which of the following is the most likely diagnosis?   A. Granulomatosis with polyangiitis B. Microscopic polyangiitis C. Rheumatoid arthritis D. Eosinophilic granulomatosis with polyangiitis E. Eosinophilic pneumonia   + Answer and Discussion - Answer and Discussion Correct answer:D – Eosinophilic granulomatosis with polyangiitis Key Point: Eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss disease) is characterized by eosinophilia, migratory pulmonary infiltrates, skin findings such as nodules or purpuric rash, and peripheral neuropathy (usually mononeuritis multiplex) in a patient with a history of atopy (allergic rhinitis, dermatitis, asthma). Other ANCA-associated vasculitides to consider in this scenario are granulomatosis with polyangiitis (GPA) and microscopic polyangiitis. keywords: eosinophilic; polyangiitis cache: pulmonarychronicles-256.htm plain text: pulmonarychronicles-256.txt item: #228 of 658 id: pulmonarychronicles-257 author: None title: Critical Updates date: None words: 179 flesch: 63 summary: Critical Updates PDF Selected News Items and Updates for the Practicing Clinician Zachary Mulkey MDa Correspondence to Zachary Mulkey MD. Email: zachary.mulkey @ttuhsc.edu + Author Affiliation - Author Affiliation aDepartment of Internal Medicine, TTUHSC, Lubbock, TX. SWRCCC 2016;4(13):60. keywords: mulkey cache: pulmonarychronicles-257.htm plain text: pulmonarychronicles-257.txt item: #229 of 658 id: pulmonarychronicles-260 author: None title: Your first foray into clinical research date: None words: 888 flesch: 44 summary: Apart from improving job prospects and election to medical honor societies, doing clinical research enables the development of critical thinking skills that may prove lifesaving for your patients and provide a higher level of job satisfaction as a physician.1 While the choice of clinical versus basic research is a personal one, clinical research has the added benefit of direct interaction with patients and arguably relates better with ongoing clinical training. At Texas Tech University Health Sciences Center we are fortunate in having a Clinical Research Institute dedicated to helping faculty and trainees do clinical research. keywords: health; project; research cache: pulmonarychronicles-260.htm plain text: pulmonarychronicles-260.txt item: #230 of 658 id: pulmonarychronicles-261 author: None title: Jehovah’s Witnesses as Patients date: None words: 1350 flesch: 61 summary: The importance of Jehovah’s Witnesses to the health care profession is that Jehovah’s Witnesses believe that blood transfusions are prohibited. Jehovah’s Witnesses, through the voice of The Watchtower, officially banned blood transfusions for the first time in 1945. keywords: blood; jehovah; witnesses cache: pulmonarychronicles-261.htm plain text: pulmonarychronicles-261.txt item: #231 of 658 id: pulmonarychronicles-262 author: None title: Crisis averted: a patient in cardiopulmonary arrest date: None words: 1208 flesch: 38 summary: Keywords: myasthenia gravis, respiratory failure, thymoma ................................................................................................................................................................................................................................................................................................................................... Introduction Myasthenia gravis is an autoimmune neuromuscular disease causing muscle weakness, characteristically worse at the end of the day and with repetitive muscle use. Respiratory failure is a potentially fatal complication of myasthenia gravis called myasthenic crisis.1 This complication occurs in 15-20% of all cases and requires intubation in 66 to 90% of patients.1 Myasthenic crisis is the initial pre-sentation in 20% of patients with myasthenia gravis.1 Case A 35-year-old Hispanic man with no significant medical history presented with worsening dyspnea, fever, and a non-productive cough for three weeks. keywords: crisis; failure; gravis; myasthenia; patients cache: pulmonarychronicles-262.htm plain text: pulmonarychronicles-262.txt item: #232 of 658 id: pulmonarychronicles-263 author: None title: Scientific writing date: None words: 1287 flesch: 52 summary: Revision Strategies             Bearing in mind the general system of revising from HOCs to LOCs, you can employ several revision strategies. Key words: writing, medical writing, medical manuscript, periodicals as topic ................................................................................................................................................................................................................................................................................................................................... Introduction           Regardless of writers’ levels of experience or areas of expertise, many struggle with revision, a component of the writing process that encompasses everything from transformative changes in content and argumentation to minor corrections in grammar and punctuation. keywords: paragraph; revision; text; writing cache: pulmonarychronicles-263.htm plain text: pulmonarychronicles-263.txt item: #233 of 658 id: pulmonarychronicles-264 author: None title: review date: None words: 4671 flesch: 39 summary: In a double-blind, randomized controlled trial, oral glycerol therapy used to decrease intracranial pressure increased mortality and neurological disability in adult patients with bacterial meningitis (83%).36 A retrospective study suggested that lumbar drainage of CSF targeting ICP of < 10 mmHg in severe bacterial meningitis was safe and contributed to lower mortality and morbidity.37 At this point, these various measures to decrease ICP are best used based on clinical indication rather than as a routine treatment. review PDF Bacterial meningitis and neurological complications in adults Parunyou Julayanont MDa, Doungporn Ruthirago MDb, John C. DeToledo MDb Correspondence to - Parunyou Julayanont MD Email: p.Julayanont.edu + Author Affiliation - Author Affiliation a a medical student at Texas Tech University Health Sciences Center, Lubbock, TX a a faculty member in the Department of Internal Medicine at TTUHSC, Lubbock, TX. keywords: adults; bacterial; beek; cerebral; complications; empyema; figure; hydrocephalus; infarction; infect; meningitis; patients; pneumococcal; spinal; treatment; van cache: pulmonarychronicles-264.htm plain text: pulmonarychronicles-264.txt item: #234 of 658 id: pulmonarychronicles-266 author: None title: stat date: None words: 1560 flesch: 40 summary: The effect of interaction ( ) can be tested by using a likelihood ratio test (LRT),3 which asymptotically follows a chi-squared distribution with degrees of freedom equal to the difference between the number of parameters of the full and the reduced models.4 (D) Interpreting interactions           In general, models with interaction effect should include the main effects of the variables used to compute the interaction term even if the main effects are not significant. ii. Continuous dependent variable         If the dependent variable has a normal distribution, then the SAS proc reg, proc glm, proc mixed procedures can be used. keywords: aspirin; interaction; variable cache: pulmonarychronicles-266.htm plain text: pulmonarychronicles-266.txt item: #235 of 658 id: pulmonarychronicles-267 author: None title: Reexamination of reflexive arterial catheter placement in ICU patients date: None words: 826 flesch: 36 summary: Reexamination of reflexive arterial catheter placement in ICU patients PDF Reexamination of reflexive arterial catheter placement in ICU patients David Sheely MSCSa, Hawa Edriss MDb Correspondence to David Sheely MSCS Email: David.sheely@ttuhsc.edu + Author Affiliation - Author Affiliation a A medical student at Texas Tech University Health Sciences Center in Lubbock, TX. Recent studies by Gershengorn and Garland suggest that approximately one-third of ICU patients (～2,000,000) in the United States, perhaps more in Canada, have an arterial catheter (AC) during their ICU stay, with replacements and reinsertions increasing the total number.1,2 keywords: arterial; blood cache: pulmonarychronicles-267.htm plain text: pulmonarychronicles-267.txt item: #236 of 658 id: pulmonarychronicles-268 author: None title: review date: None words: 3017 flesch: 50 summary: In a previous study, the lack of initial response to HFNC, more severe disease, and additional organ dysfunction are associated with increased risk of HFNC failure.11 Lee reported that patients with hematologic malignancies and acute respiratory failure would more likely require intubation if they had bacterial pneumonia.20 Kang reported that intubation more than 48 hours after HFNC use and failure was associated with increased mortality.21 Roca et al concluded that ARDS, renal failure, and addition of vasopressors are predictors of HFNC failure and associated with an increased risk of intubation and mortality. This model demonstrated that larger pleural effusions and higher SOFA scores were associated with HFNC failure. keywords: acute; cannula; failure; flow; hfnc; nasal; oxygen; patients cache: pulmonarychronicles-268.htm plain text: pulmonarychronicles-268.txt item: #237 of 658 id: pulmonarychronicles-269 author: None title: health policy date: None words: 1324 flesch: 57 summary: Figure 2            Figure 2 illustrates the past, present and future of Medicare expenses and income as a percent of Gross Domestic Product (GDP). Note that the portion of Medicare expenses funded by General Revenue is also increasing over time. keywords: figure; income; medicare cache: pulmonarychronicles-269.htm plain text: pulmonarychronicles-269.txt item: #238 of 658 id: pulmonarychronicles-270 author: None title: Malignant mesothelioma date: None words: 2096 flesch: 42 summary: Patients with malignant pleural mesothelioma have higher levels of circulating VEGF than patients with nonmalignant diseases of the pleura. A double-blind, placebo-controlled trial will be conducted by the manufacturer in patients with malignant pleural mesothelioma and is expected to enroll about 400 patients in 11 countries.19 Triple modality therapy involves all 3 standard strategies, namely surgery, chemotherapy, and radiotherapy, and has a two year survival rate of 36% and a five year survival rate of 14%. keywords: asbestos; chest; diagnosis; exposure; lung; malignant; mesothelioma; patients; right cache: pulmonarychronicles-270.htm plain text: pulmonarychronicles-270.txt item: #239 of 658 id: pulmonarychronicles-271 author: None title: BOARD REVIEW QUESTION Issue14 date: None words: 444 flesch: 55 summary: The cough generally appears 1-2 hours into her exertional activities, but it has occasionally occurred suddenly after she has been at rest after exertional activities. The short acting beta agonist should be used 5-20 minutes prior to activity and provides symptom relief for up to 4 hours. keywords: cough; test cache: pulmonarychronicles-271.htm plain text: pulmonarychronicles-271.txt item: #240 of 658 id: pulmonarychronicles-272 author: None title: images date: None words: 373 flesch: 26 summary: References Hye RJ, Mackey A, Hill MD, Voeks JH, Cohen DJ, Wang K, et al. Incidence, outcomes, and effect on quality of life of cranial nerve injury in the Carotid Revascularization Endarterectomy versus Stenting Trial. The incidence of cranial injury following CEA reportedly ranges from 3% to 30%.1 The Carotid Revascularization Endarterectomy vs Stenting Trial (CREST) trial reported relative frequencies of nerve injuries as hypoglossal nerve in 13%, facial nerve in 16%, glossopharyngeal and vagus nerves in 22%, and sympathetic nerves in 2%.1 Myocardial infarction and postoperative neck hematoma are non-neurological immediate post-operative complications of CEA. keywords: carotid; nerve cache: pulmonarychronicles-272.htm plain text: pulmonarychronicles-272.txt item: #241 of 658 id: pulmonarychronicles-274 author: None title: review date: None words: 2157 flesch: 43 summary: review PDF CD-4/CD-8 lymphocytopenia in HIV negative patients with severe, chronic granulomatous infections RC Kimbrough MDa,RE Winn MDa, S Issarachai MDbS Suwanvecho MDb Correspondence to - RE Winn MD Email: Richard.winn@ttuhsc.edu + Author Affiliation - Author Affiliation a RC Kimbrough (deceased) and RE Winn : faculty members in Infectious Disease in the Department of Internal Medicine. We defined an abnormal CD-4/CD-8 ratio as less than 1.2, the same definition as in HIV patients. keywords: cd-4; cd-8; hiv; infection; lymphocytopenia; patients; tuberculosis cache: pulmonarychronicles-274.htm plain text: pulmonarychronicles-274.txt item: #242 of 658 id: pulmonarychronicles-275 author: None title: stat date: None words: 2130 flesch: 46 summary: If there are 87 Treatment C patients and 82 Treatment E patients with significant differences between groups, one cannot just “do propensity score matching” and expect to get 82 Treatment C patients perfectly matched to the 82 Treatment E patients. Definitions of propensity score and matching The definition of a propensity score is “the conditional probability of assignment to a particular treatment given a vector of observed covariates.” keywords: covariates; groups; matching; patients; propensity; score; treatment cache: pulmonarychronicles-275.htm plain text: pulmonarychronicles-275.txt item: #243 of 658 id: pulmonarychronicles-276 author: None title: review date: None words: 2743 flesch: 29 summary: (73) Vancomycin/piperacillin-tazobactam(16 out of 49, %32) vs   vancomycin /cefepime (21 out of 73, %28) 1.20 (0.55-2.63) NA Peyko17 85 Prospective, one center vancomycin/piperacillin-tazobactam(59 vs vancomycin/ cefepime or meropenem (26) Vancomycin/piperacillin-tazobactam (22 out of 59, %37) s vancomycin/ cefepime or meropenem (2 out of 26, 7.7%) 7.14 (1.54-33.15) NA   AKI- acute kidney injury, vanco- vancomycin, OR- odds ratio, Cl- confidence interval, NA- not available   Among the seven studies, five were retrospective, single-center cohort studies investigating the possible association mostly in non-critically ill hospitalized patients.11-15 In four of these studies, a higher proportion of patients who received concomitant vancomycin and piperacillin-tazobactam developed AKI than those who received vancomycin alone or in combination with cefepime.11-14 In the other study, 139 diabetic patients with osteomyelitis were included; the rate of nephrotoxicity was not significantly higher in patients receiving vancomycin-piperacillin/tazobactam than in those receiving vancomycin-cefepime.15 In a recent meta-analysis of the fifteen studies evaluating vancomycin nephrotoxicity, higher troughs (>15 mg/liter) compared with lower trough levels (< 15 mg/liter) were associated with an increased odds of nephrotoxicity (odds ratio [OR], 2.67; 95% confidence interval keywords: aki; combination; nephrotoxicity; patients; piperacillin; studies; tazobactam; vancomycin cache: pulmonarychronicles-276.htm plain text: pulmonarychronicles-276.txt item: #244 of 658 id: pulmonarychronicles-277 author: None title: An unusual cause of acute pulmonary embolism: giant hepatic hemangioma date: None words: 1576 flesch: 36 summary: Pulmonary embolism is a very rare complication of giant hepatic hemangiomas. In this case report, we describe a patient with acute pulmonary emboli, which presumably originated from laminar thrombi in the inferior vena cava caused by compression by giant hepatic hemangiomas. keywords: hemangiomas; hepatic; ivc; pulmonary; thrombosis cache: pulmonarychronicles-277.htm plain text: pulmonarychronicles-277.txt item: #245 of 658 id: pulmonarychronicles-278 author: None title: New definitions for sepsis and septic shock date: None words: 1142 flesch: 47 summary: In addition, use of the SOFA score assumes that patients have a baseline SOFA score of zero when, in fact, many patients have SOFA scores ≥2 at baseline. Electronic medical record systems need to develop automatic alerts based on SIRS criteria, the qSOFA score, the SOFA score, and the septic shock definition. keywords: criteria; patients; score; sepsis cache: pulmonarychronicles-278.htm plain text: pulmonarychronicles-278.txt item: #246 of 658 id: pulmonarychronicles-279 author: None title: TAVR-right for everyone? date: None words: 716 flesch: 52 summary: Transcatheter aortic valve replacement versus surgical replacement in intermediate risk patients: a propensity score analysis. Initially approved only for patients with severe calcific aortic stenosis at high risk for surgical aortic valve replacement (defined as predicted mortality of greater than 8% in the 30-day perioperative period), the recently reported Partner 2A Trial cohort results suggest an expanding of the indication for TAVR. keywords: aortic; tavr; valve cache: pulmonarychronicles-279.htm plain text: pulmonarychronicles-279.txt item: #247 of 658 id: pulmonarychronicles-280 author: None title: Zika Infection: Rubella Re-visited? date: None words: 1541 flesch: 57 summary: The Americas never had documentation of Zika virus infection until febrile exanthems were observed at the end of 2014; the first confirmed case of Zika virus was reported in Brazil in March 2015. Zika virus infection among U.S. pregnant travelers - August 2015-February 2016. keywords: brazil; dengue; infection; outbreak; transmission; virus; zika cache: pulmonarychronicles-280.htm plain text: pulmonarychronicles-280.txt item: #248 of 658 id: pulmonarychronicles-281 author: None title: Acute porphyrias and porphyric neuropathy date: None words: 4657 flesch: 42 summary: Infection and inflammation induce the expression of hepatic acute phase protein that catabolizes heme.3 Transcription of ALAS is stimulated by peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), which involves energy metabolism and explains why acute porphyria is precipitated by starvation.9 Pathophysiology of porphyric neuropathy Every symptom of acute porphyrias can be explained by dysfunction of the nervous system.3 Abdominal pain during acute attacks reflects autonomic neuropathy that causes ileus, abdominal distension, followed by pain, constipation, nausea, and vomiting. Treatment of acute porphyria and avoidance of precipitating factors should be initiated early to prevent potentially severe long-term sequelae from nerve damage.  keywords: acute; attacks; diagnosis; heme; nerve; neuropathy; pain; patients; porphyrias; precursors; symptoms; tests; treatment; urine cache: pulmonarychronicles-281.htm plain text: pulmonarychronicles-281.txt item: #249 of 658 id: pulmonarychronicles-282 author: None title: D-dimer measurements in acute aortic dissection date: None words: 4021 flesch: 57 summary: Evaluation of D-dimer in the diagnosis of suspected aortic dissection. This review article evaluates the evidence for the use of D-dimer assays in the diagnosis of AAD, in differentiation of AAD from acute coronary syndromes, and in risk stratification of AAD patients. keywords: aad; acute; aortic; diagnosis; dimer; dissection; levels; patients; risk; studies cache: pulmonarychronicles-282.htm plain text: pulmonarychronicles-282.txt item: #250 of 658 id: pulmonarychronicles-284 author: None title: research date: None words: 2905 flesch: 46 summary: These statements of ethical principles led to the adoption of formal regulations in the US related to the protection of human subjects in research, including the requirement for IRB review and approval of research involving human participants that receives federal funding: Code of Federal Regulations, Title 45, Part 466. The federal regulations requiring IRB review applies only to research that receives federal funding, but nearly every academic institution in the United States which conducts research with human subjects has indicated in their internal policies that IRB review and approval is required prior to the initiation of ALL research with human subjects, regardless of the funding source for the project. keywords: human; irb; project; research; review; subjects cache: pulmonarychronicles-284.htm plain text: pulmonarychronicles-284.txt item: #251 of 658 id: pulmonarychronicles-285 author: None title: Untreated latent tuberculosis leads to CNS lesions date: None words: 564 flesch: 51 summary: Physicians need to consider tuberculomas in the differential diagnosis of mass lesions in the elderly, since early diagnosis and treatment can reduce the morbidity and mortality in these cases.   Central nervous system tuberculosis: pathogenesis and clinical aspects. keywords: figure; lesions; tuberculosis cache: pulmonarychronicles-285.htm plain text: pulmonarychronicles-285.txt item: #252 of 658 id: pulmonarychronicles-286 author: None title: Inferior vena cava dimensions in patients with acute kidney injury date: None words: 3335 flesch: 43 summary: Patients were screened at 8 AM each day to identify patients with clinical presentations and abnormal laboratory tests consistent with acute kidney injury.  Inferior vena cava dimensions in patients with acute kidney injury Abstract / PDF Inferior vena cava dimensions in patients with acute kidney injury Andres Yepes-Hurtadol MDa, Khalid Monzer MDa, Sabry Omar MDb, Raed Alalawi MDc, Kenneth Nugent MDc Correspondence to Kenneth Nugent, MD. keywords: cava; dimensions; fluid; inferior; ivc; measurements; patients; vena cache: pulmonarychronicles-286.htm plain text: pulmonarychronicles-286.txt item: #253 of 658 id: pulmonarychronicles-287 author: None title: Amniotic fluid emboli update date: None words: 2066 flesch: 40 summary: Abenhaim HA, Azoulay L, Kramer MS, et al. Incidence and risk factors of amniotic fluid embolisms: a population-based study on 3 million births in the United States. Amniotic fluid embolism: incidence, risk factors, and impact on perinatal outcome. keywords: afe; amniotic; embolism; factors; fluid; maternal; patients; risk cache: pulmonarychronicles-287.htm plain text: pulmonarychronicles-287.txt item: #254 of 658 id: pulmonarychronicles-288 author: None title: BOARD REVIEW QUESTION Issue15 date: None words: 471 flesch: 52 summary: What is the next best step in management?   A. High-resolution chest CT B. Methacholine challenge test C. Recommend changing to a different job D. Repeat spirometry after workplace exposure E. Inhaled glucocorticoid daily   + Answer and Discussion - Answer and Discussion Correct answer:D – Repeat spirometry after workplace exposure Key Point: Occupational asthma is symptomatic mainly during exposure to the workplace specific allergen and will improve after avoidance of this trigger. Discussion: Occupational asthma is due to exposure to specific environmental triggers that occur in the workplace and may occur in up to 15% of patients with asthma. keywords: asthma; workplace cache: pulmonarychronicles-288.htm plain text: pulmonarychronicles-288.txt item: #255 of 658 id: pulmonarychronicles-289 author: None title: New definitions for sepsis and septic shock date: None words: 1745 flesch: 38 summary: Their meta-analysis showed that vancomycin continuous infusions were associated with a lower risk of nephrotoxicity when compared with intermittent infusions. Most patients (91.8%) received intermittent vancomycin infusions for a mean treatment duration of 158 hours. keywords: aki; infusions; intermittent; nephrotoxicity; patients; society; vancomycin cache: pulmonarychronicles-289.htm plain text: pulmonarychronicles-289.txt item: #256 of 658 id: pulmonarychronicles-29 author: None title: Haboob Lung Syndrome date: None words: 479 flesch: 50 summary: There is no medical literature regarding development of acute lung infiltrates/disease after exposure to dust storms except our recent case series.1 However, pneumonia precipitated by dust exposure occurred in the dust bowl era (1930s) in the U.S. A video of the actual storm that the patient was exposed to can be seen using this link - http://youtu.be/wfuDFEZYHTE We named this presentation Haboob (Arabic for blasting/drafting) Lung Syndrome earlier,1 the components being hypoxemia and multilobar infiltrates after exposure to dust storm. keywords: dust; exposure; storm cache: pulmonarychronicles-29.htm plain text: pulmonarychronicles-29.txt item: #257 of 658 id: pulmonarychronicles-290 author: None title: New definitions for sepsis and septic shock date: None words: 1217 flesch: 51 summary: Writing paragraphs of an effective length is, then, a matter of being considerate to the audience.2 Paragraph Coherence and Cohesion Both coherence and cohesion are important qualities of effective paragraphs and texts. This article describes a typical model for paragraph structure, explains the significance of coherence and cohesion, and recommends revision strategies. keywords: paragraph; sentence; writing cache: pulmonarychronicles-290.htm plain text: pulmonarychronicles-290.txt item: #258 of 658 id: pulmonarychronicles-291 author: None title: Supraventricular tachycardia associated with phentermine use date: None words: 1736 flesch: 47 summary: Tachycardia occurred in only 0.4% of the participants in this study, and no SVT or ventricular arrhythmias have been reported.6 Although monotherapy with phentermine has been approved by the FDA for only three months, longer use of the medication is not uncommon in clinical practice to achieve and maintain weight reduction.7 There are case reports of ischemic stroke, myocardial infarction, ventricular arrhythmia, and cardiac arrest associated with phentermine use.9,10 Three cases of ventricular arrhythmia associated with phentermine use have been reported in the literature. We report a 36-year-old woman with no significant past medical history who developed supraventricular tachycardia after taking phentermine for four months. keywords: cardiac; obesity; patient; phentermine; tachycardia; use; weight cache: pulmonarychronicles-291.htm plain text: pulmonarychronicles-291.txt item: #259 of 658 id: pulmonarychronicles-292 author: None title: Role of cardiopulmonary stress testing in heart failure management date: None words: 3455 flesch: 47 summary: Guazzi M, Labate V, Cahalin LP, Arena R. Cardiopulmonary exercise testing reflects similar pathophysiology and disease severity in heart failure patients with reduced and preserved ejection fraction. Exercise ventilatory power in heart failure patients: Functional phenotypes definition by combining cardiopulmonary exercise testing with stress echocardiography. keywords: cardiac; cardiopulmonary; cpx; exercise; failure; heart; heart failure; patients; risk; testing cache: pulmonarychronicles-292.htm plain text: pulmonarychronicles-292.txt item: #260 of 658 id: pulmonarychronicles-293 author: None title: OSA date: None words: 2129 flesch: 53 summary: United Healthcare will no longer approve laboratory sleep tests for the diagnosis of sleep apnea unless the patient has certain co-morbid conditions.9 This patient’s problem would go unrecognized in a world where laboratory sleep tests are denied. keywords: cpap; curve; patient; price; sleep; subsidy cache: pulmonarychronicles-293.htm plain text: pulmonarychronicles-293.txt item: #261 of 658 id: pulmonarychronicles-294 author: None title: A personal note date: None words: 582 flesch: 75 summary: I want to thank all the other residents, fellows and attending physicians for your support through all those intense nights, for your positive energy, team work and amazing friendship. He, just as Mike, had no past medical history, in other words, he was not supposed to die. keywords: patients cache: pulmonarychronicles-294.htm plain text: pulmonarychronicles-294.txt item: #262 of 658 id: pulmonarychronicles-312 author: None title: A physiology-based perspective on high-flow nasal cannula oxygen delivery in the critically ill patient date: None words: 1280 flesch: 38 summary: For instance Parke et al. found a positive correlation (~10L/min = ~1.2 cmH2O) between HFNC flow rate and nasopharyngeal PEEP10, but patients receiving enough flow (60L/min) to generate the equivalent of 5cm H2O or more by NIV under this hypothesis in reality had significantly lower PaO2 than the NIV group for a given FiO2.11 It is also rare, at least at our institution, to see chin straps to prevent flow (and pressure loss) through the oropharynx employed on a regular basis. VT).4 Yet with HFNC clinicians lose the opportunity to estimate or control tidal volume, thus surrendering a key parameter for targeting lung strain and stress, minimizing cycling frequency of shear forces, and preventing VILI.   keywords: care; hfnc; lung; pressure cache: pulmonarychronicles-312.htm plain text: pulmonarychronicles-312.txt item: #263 of 658 id: pulmonarychronicles-314 author: None title: pulmonarychronicles-314 date: None words: 1692 flesch: 37 summary: However, porphyria patients often have extensive investigations and unnecessary surgeries for the abdominal pain. Currently, there is inadequate information about the safety of levetiracetam in porphyria patients. keywords: acute; pain; patients; porphyrias; symptoms; treatment cache: pulmonarychronicles-314.htm plain text: pulmonarychronicles-314.txt item: #264 of 658 id: pulmonarychronicles-316 author: None title: Review date: None words: 3249 flesch: 45 summary: N= 90 86% vs 60% OR 4·22, (12); p<0·0001 Abbreviations: NIHSS- National institute of health stroke scale; LVO- large vessel occlusion; TIMI- thrombolysis in myocardial infarction; TICI- thrombolysis in cerebral infarction Guidelines, data synthesis and meta-analyses Having learned the limitations in the initial studies and with cautious enthusiasm from the device vs. device trials, new endovascular stroke trials were designed and conducted. The four RCTs (ESCAPE, REVASCAT, EXTEND IA, and SWIFT PRIME) showed benefit of endovascular stroke therapy and were presented and published in 2015 (Table 4).8-11 keywords: acute; endovascular; generation; lvo; mrs; patients; stent; stroke; therapy; tpa; trials; van cache: pulmonarychronicles-316.htm plain text: pulmonarychronicles-316.txt item: #265 of 658 id: pulmonarychronicles-317 author: None title: Hepatic Abscess date: None words: 892 flesch: 45 summary: Ultrasound can help to distinguish biliary disease from hepatic disease; it identifies pathology >1cm in diameter.1 It is particularly useful in identifying amebic abscesses which typically appear as oval or round masses near the liver capsule, are hypoechoic with low-level internal echoes, and do not have significant wall echoes compared to pyogenic abscesses, which can appear as either discrete hypoechoic nodules or as ill-defined areas of distortion. The three most common etiological causes of liver abscess are polymicrobial (pyogenic) infection which accounts for 80% of cases, amebic infection (10%), and fungal infection (<10%), most frequently due to Candida species. keywords: abscess; drainage; hepatic; liver cache: pulmonarychronicles-317.htm plain text: pulmonarychronicles-317.txt item: #266 of 658 id: pulmonarychronicles-318 author: None title: Uncertainty and the welfare economics of medical care date: None words: 3078 flesch: 62 summary: While this definition may be violated by existing health care in the United States, such as the mandatory provisions of the Affordable Care Act (ACA), there is no intrinsic feature of health care that make Austrian free markets impossible in the United States. 10.12746/swrccc2016.0416.221 ................................................................................................................................................................................................................................................................................................................................... Opponents of free market solutions to the scarcity of health care claim that health care is special and cannot be treated like a commodity. keywords: arrow; care; health; kenneth; market; price cache: pulmonarychronicles-318.htm plain text: pulmonarychronicles-318.txt item: #267 of 658 id: pulmonarychronicles-319 author: None title: Potential pitfalls in observational study designs date: None words: 1497 flesch: 50 summary: Just as case-control studies are inefficient for tracking rare exposures, cohort studies do a poor job evaluating rare outcomes.  Note that cohort studies also allow us to compute the incidence (new cases/study-years), relative risk, and various other useful comparative measures (risk difference, attributable risk %, etc.).  keywords: design; disease; risk; study cache: pulmonarychronicles-319.htm plain text: pulmonarychronicles-319.txt item: #268 of 658 id: pulmonarychronicles-320 author: None title: ACE-inhibitor induced angioedema masked by nephrotic syndrome date: None words: 1598 flesch: 40 summary: C1 esterase inhibitors, ecallantide (a kallikrein inhibitor), and fresh frozen plasma have also been used effectively in the treatment of ACE-inhibitor induced angioedema.12 Conclusion Angiotensin converting enzyme inhibitor induced angioedema can occur anytime during the course of treatment with ACE-inhibitors. Hoover T, Lippmann M, Grouzmann E, Marceau F, Herscu P. Angiotensin converting enzyme inhibitor induced angio-oedema: A review of the pathophysiology and risk factors. keywords: ace; angioedema; angiotensin; converting; enzyme; inhibitor; swelling cache: pulmonarychronicles-320.htm plain text: pulmonarychronicles-320.txt item: #269 of 658 id: pulmonarychronicles-321 author: None title: Idiopathic nodular glomerulosclerosis- a rare case date: None words: 1455 flesch: 45 summary: Idiopathic nodular glomerulosclerosis is a very rare disease and has been associated with obesity, hypertension, and smoking. Given the lack of history of diabetes, the morphologic features were consistent with idiopathic nodular glomerulosclerosis (Figure 1A, 1B and 1C). keywords: case; diabetes; diabetic; glomerulosclerosis; ing; patients cache: pulmonarychronicles-321.htm plain text: pulmonarychronicles-321.txt item: #270 of 658 id: pulmonarychronicles-322 author: None title: Literacy and health literacy - why they matter to health professionals date: None words: 2179 flesch: 43 summary: Keywords: Literacy, health literacy, patient education ................................................................................................................................................................................................................................................................................................................................... Introduction The purpose of this article is to provide an overview to literacy, factors that impact literacy, literacy’s relationship to health, and resources to help improve health literacy. keywords: adults; education; health; literacy; materials; medicine; national; patients cache: pulmonarychronicles-322.htm plain text: pulmonarychronicles-322.txt item: #271 of 658 id: pulmonarychronicles-323 author: None title: Aeromonas infection from river and playa-lake waters in West Texas and southeastern New Mexico date: None words: 3870 flesch: 44 summary: Of the 52 patients who received benzodiazepines, only 15 received increases in ethanol infusion rates indicating appropriate protocol use. Charts were reviewed for documentation of AWS and for increased ethanol infusion rates or use of anti-emetics and benzodiazepines. keywords: alcohol; aws; ethanol; infusion; patients; prophylaxis; protocol; rate; study; withdrawal cache: pulmonarychronicles-323.htm plain text: pulmonarychronicles-323.txt item: #272 of 658 id: pulmonarychronicles-324 author: None title: Intrathoracic Manifestations of IgG4-Related Disease date: None words: 3223 flesch: 38 summary: The frequency of interstitial lung disease is less common.7-10   Besides these four main patterns affecting the lungs, airspace disease and central airway involvement have been reported. Four main patterns of pulmonary disease have been described, including the solid nodular type, the bronchovascular type, the alveolar interstitial type, and the round shaped ground glass type. keywords: disease; findings; igg4; intrathoracic; lung; patients; pulmonary cache: pulmonarychronicles-324.htm plain text: pulmonarychronicles-324.txt item: #273 of 658 id: pulmonarychronicles-325 author: None title: Aeromonas infection from river and playa-lake waters in West Texas and southeastern New Mexico date: None words: 3770 flesch: 51 summary: Aeromonas infection in the former patient led to a year-long study of the seasonal occurrence and incidence of resistance to antimicrobial agents among Aeromonas isolates from two urban playa lakes within the city limits of Lubbock, TX.4 In addition, we surveyed the recent (1998–2011) scientific and medical literature for reports of Aeromonas infections and summarize pertinent information. keywords: aeromonas; aeromonas hydrophila; case; clinical; dis; freshwater; hydrophila; infections; isolates; lake; microbiol; playa; resistance; river; species; spp; water; wound cache: pulmonarychronicles-325.htm plain text: pulmonarychronicles-325.txt item: #274 of 658 id: pulmonarychronicles-326 author: None title: Aeromonas infection from river and playa-lake waters in West Texas and southeastern New Mexico date: None words: 2328 flesch: 48 summary: These patients are susceptible to multiple stressful factors which can cause anxiety and in turn increase oxygen consumption.5             The first question was whether music therapy improves a patient's sleep quality in the ICU over standard care without the addition of music. However, there were no significant changes in these four biomarkers in patients who listened to music and in patients who rested quietly.15 Chlan also measured 24 hour urinary free cortisol levels as a stress biomarker in 70 patients; music intervention did not significantly reduce urinary free cortisol levels.16               keywords: anxiety; care; group; music; patients; study; therapy cache: pulmonarychronicles-326.htm plain text: pulmonarychronicles-326.txt item: #275 of 658 id: pulmonarychronicles-327 author: None title: The frequency, implications, and strategies for the reduction of COPD readmissions date: None words: 1528 flesch: 46 summary: Health insurance organizations, including the Centers for Medicare & Medicaid Services, have directed hospitals to reduce AECOPD readmissions by reducing reimbursement and applying penalties to hospitals with increased AECOPD readmission rates.  Guerrero M, Crisafulli E, Liapikou A, et al. Readmission for Acute Exacerbation within 30 Days of Discharge Is Associated with a Subsequent Progressive Increase in Mortality Risk in COPD Patients: A Long-Term Observational Study. keywords: aecopd; copd; discharge; hospital; patients; readmission; risk cache: pulmonarychronicles-327.htm plain text: pulmonarychronicles-327.txt item: #276 of 658 id: pulmonarychronicles-328 author: None title: Left ventricular assist devices in end-stage heart failure with "fixed" pulmonary hypertension-a test of reversibility? date: None words: 1442 flesch: 40 summary: Key words -editorial, pulmonary hypertension, heart assist devices, cardiac transplantation Figure 1: LVADS in the management of fixed PH in end-stage heaert failure References Fang JC, DeMArco T, Givertz MM et al World HealthOrganization Pulmonary Hypertension Group 2: Pulmonary hypertension due to left heart disease in the adult- a summary statement from the Pulmonary Hypertension Council of the International Society for Heart and Lung Transplantation J Heart Lung Transplant 2012; 31:913-33 Costard-Jäckle A, Fowler MB. Comparison ofcontinuous-flow and pulsatile-flow blood pumps on reducing pulmonary artery pressure in patients with fixed pulmonary hypertension. keywords: assist; heart; hypertension; patients; pulmonary cache: pulmonarychronicles-328.htm plain text: pulmonarychronicles-328.txt item: #277 of 658 id: pulmonarychronicles-329 author: None title: Aeromonas infection from river and playa-lake waters in West Texas and southeastern New Mexico date: None words: 3237 flesch: 53 summary: Many studies have compared MELD scores with ICU-specific prognosis scores in predicting in-ICU mortality and in-hospital mortality for cirrhotic patients after ICU admission.  Moreover, the accuracy of SOFA scores was improved when reassessed at 48 to 72 hours after the admission to the ICU.18, 38 However, Boone et al reported that both SOFA scores and MELD scores did not perform well in predicting 28-day mortality in the surgical ICU patients.42             Each of the six different organ failures in the SOFA score has a different weight in cirrhotic patients.43 Hematologic failure in SOFA score defined by platelet count < 50 k/μL has no impact on the prognosis in cirrhotic patients33 New cut-off values for SOFA scores dedicated to cirrhotic patients were proposed resulting in a development of new scoring systems: the Chronic Liver Failure-SOFA (CLIF-SOFA) score and the Chronic Liver Failure Consortium Acute-on-Chronic Liver Failure (CLIF-C ACLF) score.             keywords: care; cirrhosis; failure; icu; liver; meld; meld score; mortality; organ; patients; score; sofa cache: pulmonarychronicles-329.htm plain text: pulmonarychronicles-329.txt item: #278 of 658 id: pulmonarychronicles-36 author: None title: News Updates issue1 date: None words: 160 flesch: 39 summary: News Updates issue1 PDF Selected news items and updates for the practicing clinician Zachary Mulkey Correspondence to Zachary Mulkey MD, Department of Internal Medicine, TTUHSC, Lubbock, TX. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6203a4.htm From the same study come two new thoughts: lowering BP during ICH doesn’t reduce the size of the bleed, but it didn’t cause harm either, even with rapid lowering. http://www.medpagetoday.com/MeetingCoverage/ISC/37271 http://www.medpagetoday.com/Cardiology/Strokes/37287 PMID: 23391776 The FDA is requiring the dose of zolpidem be lowered in women and that clinicians should consider a lower dose for men. keywords: news cache: pulmonarychronicles-36.htm plain text: pulmonarychronicles-36.txt item: #279 of 658 id: pulmonarychronicles-361 author: None title: In the Clinic date: None words: 208 flesch: 36 summary: Article citation: Arvandi A. Left atrial function. Key words: Left atrium, left atrial function, left atrial size, left atrial strain, speckle tracking, atrial fibrillation, pulmonary veins. keywords: function cache: pulmonarychronicles-361.htm plain text: pulmonarychronicles-361.txt item: #280 of 658 id: pulmonarychronicles-362 author: None title: Original Article date: None words: 394 flesch: 49 summary: Keywords: Acute kidney injury, intensive care unit, critically ill patients, mortality, length of stay Article citation: Anaele CU, Suarez G, Kennedy-Prieto S, Bashir M, Laski M, Yang S. Acute kidney injury patterns and outcomes in low-risk versus high-risk critically ill patients admitted to the medical intensive care unit. Original Article Acute kidney injury patterns and outcomes in low-risk versus high-risk critically ill patients admitted to the medical intensive care unit Cyriacus U Anaele MD, Gabriela Suarez MD, Sofia Kennedy-Prieto MD, Mamoun Bashir MD, Melvin Laski MD, Shengping Yang PhD ABSTRACT Background: Acute kidney injury (AKI) is often one component of multiple organ failure (MOF) in the intensive care unit (ICU). keywords: aki; patients cache: pulmonarychronicles-362.htm plain text: pulmonarychronicles-362.txt item: #281 of 658 id: pulmonarychronicles-363 author: None title: Case Report date: None words: 171 flesch: 35 summary: Cannabis potentially reduces recurrent episodes of hereditary angioedema. Recent studies indicate that cannabis has an important role in regulating innate immunity and inflammatory responses through the inhibition of pro-inflammatory cytokines and upregulation of anti-inflammatory cytokines. keywords: angioedema cache: pulmonarychronicles-363.htm plain text: pulmonarychronicles-363.txt item: #282 of 658 id: pulmonarychronicles-364 author: None title: Editorial date: None words: 1224 flesch: 41 summary: Faculty members at medical schools had to work like regular doctors—seeing patients, documenting care provided, and actually submitting bills for service. The new model, though, brought new challenges for the T&P committee: how to assess faculty members’ accomplishments in this world of changing faculty expectations? One approach to revamping the assessment of medical school faculty members was published by Ernest Boyer in his monograph Scholarship Reconsidered: Priorities for the Professoriate (1990).1 Although this approach has its detractors (see the experience at the University of Louisville published in 2000)2, many T&P committee members consider it a useful paradigm for assessing non-traditional kinds of scholarship. keywords: boyer; scholarship; school; teaching cache: pulmonarychronicles-364.htm plain text: pulmonarychronicles-364.txt item: #283 of 658 id: pulmonarychronicles-365 author: None title: Editorial date: None words: 1097 flesch: 39 summary: Heffner did a similar study and also reported that post-intubation hypotension was associated with increased mortality and length of stay.9 These studies suggest the pre-intubation shock index is an easy and simple tool to help clinicians predict post-intubation cardiovascular instability and to take action to minimize this outcome in emergent situations. However, there was no association between pre-intubation shock index and ICU length of stay or 30 day mortality. keywords: index; intubation; patients; shock cache: pulmonarychronicles-365.htm plain text: pulmonarychronicles-365.txt item: #284 of 658 id: pulmonarychronicles-366 author: None title: Original Article date: None words: 289 flesch: 37 summary: Keywords: electromagnetic navigational bronchoscopy, transbronchial biopsy, transbronchial needle aspiration, lung cancer, solitary pulmonary nodule Article citation: Copeland S, Kambali S, Berdine G, Alalawi R. Electromagnetic navigational bronchoscopy in patients with solitary pulmonary nodules. Original Article Electromagnetic navigational bronchoscopy in patients with solitary pulmonary nodules Samuel Copeland MD, Shrinivas Kambali MD, Gilbert Berdine MD, Raed Alalawi MD ABSTRACT Background: Electromagnetic navigational bronchoscopy (ENB) is a tool used to help the bronchoscopist reach target lesions in the lung which would otherwise be very difficult or impossible to reach. keywords: patients cache: pulmonarychronicles-366.htm plain text: pulmonarychronicles-366.txt item: #285 of 658 id: pulmonarychronicles-367 author: None title: Case Report date: None words: 197 flesch: 37 summary: To our knowledge, no case of HAVS syndrome of similar severity has been previously described. Hand-arm vibration syndrome with distal brachial artery occlusion. keywords: hand cache: pulmonarychronicles-367.htm plain text: pulmonarychronicles-367.txt item: #286 of 658 id: pulmonarychronicles-368 author: None title: Case Report date: None words: 247 flesch: 37 summary: Keywords: Septic arthritis, prosthetic joint, Pasteurella multocida Article citation: Suvorava N, Dobronski L, Nichols J, Winn R. Pasteurella multocida cellulitis and possible septic arthritis of the knee after a recent total knee arthroplasty due to a dog lick. Case Report Pasteurella multocida cellulitis and possible septic arthritis of the knee after exposure to dog saliva after a recent total knee arthroplasty Natallia Suvorava MD, Leopoldo Dobronski MD, Jacob Nichols MD, Richard Winn MD ABSTRACT Prosthetic joint replacement occurs frequently. keywords: infection cache: pulmonarychronicles-368.htm plain text: pulmonarychronicles-368.txt item: #287 of 658 id: pulmonarychronicles-369 author: None title: Statistics Column date: None words: 221 flesch: 31 summary: Keywords: Experimental design, hypothesis formulation, sample size, randomization Article citation: Watkins P. Potential Pitfalls of Experimental Design. Southwest Respiratory and Critical Care Chronicles 2017;5(17):68-70. DOI: 10.12746/swrccc2017.0517.226 Author Affiliation: Phillip Watkins is a statistician who works in the Clinical Research Institute at Texas Tech University Health Sciences Center in Lubbock, TX. keywords: statistician cache: pulmonarychronicles-369.htm plain text: pulmonarychronicles-369.txt item: #288 of 658 id: pulmonarychronicles-37 author: None title: Palliative Care and COPD date: None words: 972 flesch: 57 summary: Studies show that patients who have consulted palliative care services have a greater satisfaction with their hospital care, lowered rates of admission to the ICU, and decreased health care costs after discharge from the hospital.5,6 Of note, patients with palliative care consultation had a reduction of costs with those discharged alive having an adjusted net saving of $1696 in direct costs per admission ($279 in direct cost / day) and Among other services, palliative care can accommodate conversations about Goals of Care.  keywords: care; palliative; team cache: pulmonarychronicles-37.htm plain text: pulmonarychronicles-37.txt item: #289 of 658 id: pulmonarychronicles-370 author: None title: Regional Medicine News date: None words: 323 flesch: 45 summary: Regional Medicine News Regional Medicine News DOI: 10.12746/swrccc2017.0517.230 ZIKA VIRUS The Texas Department of State Health Services has identified 283 cases of Zika virus infection through December 16, 2016. Most Zika virus infections are asymptomatic or cause only mild infections. keywords: virus cache: pulmonarychronicles-370.htm plain text: pulmonarychronicles-370.txt item: #290 of 658 id: pulmonarychronicles-371 author: None title: Medicine and Public Policy date: None words: 219 flesch: 41 summary: Keywords: health care economics, free market, information asymmetry Article citation: Berdine G. Uncertainty and the welfare economics of medical care: an Austrian rebuttal: Part 2. The conclusions are that free market insurance (as opposed to subsidy) handles uncertainty of demand, branding handles uncertainty of outcome, and the free market for specialized information handles information asymmetry. keywords: care cache: pulmonarychronicles-371.htm plain text: pulmonarychronicles-371.txt item: #291 of 658 id: pulmonarychronicles-372 author: None title: ICU rounds date: None words: 105 flesch: 25 summary: Keywords: ventricular tachycardia, ventricular fibrillation, treatment Article citation: Singh A. Ventricular tachycardia. There are several ways to classify ventricular tachycardia, and it is important that physicians working in critical care units identify the cause and start appropriate treatment for effective care of these critically ill patients. keywords: ventricular cache: pulmonarychronicles-372.htm plain text: pulmonarychronicles-372.txt item: #292 of 658 id: pulmonarychronicles-373 author: None title: ICU rounds date: None words: 241 flesch: 40 summary: ICU rounds Acetaminophen, the missing anion gap in the patient with metabolic acidosis Camilo Pena MD, Kenedy Brandon ABSTRACT Acetaminophen intake is well-known but an often missed cause of high anion gap (AG) metabolic acidosis, and physicians must understand the metabolic pathway which increases the AG. More recently developed memory tools, such as GOLDMARK, provide a complete differential diagnosis for high AG metabolic acidosis. keywords: acidosis cache: pulmonarychronicles-373.htm plain text: pulmonarychronicles-373.txt item: #293 of 658 id: pulmonarychronicles-374 author: None title: Images in Medicine date: None words: 764 flesch: 45 summary: Surgical resection of mediastinal mass was performed, and pathology reported a pleomorphic rhabdomyosarcoma. The most common agents used are vincristine, actinomycin, cyclophosphamide, doxorubicin, ifosfamide, and etoposide.5 Most patients received a multidrug regimen that includes cyclophosphamide or ifosfamide, in addition to doxorubicin, epirubicin or dactinomycin, and vincristine.6 Keywords: mediastinal mass, rhabdomyosarcoma, adult REFERENCES Yu L, keywords: mass; resection; rhabdomyosarcoma; tumors cache: pulmonarychronicles-374.htm plain text: pulmonarychronicles-374.txt item: #294 of 658 id: pulmonarychronicles-375 author: None title: Original Article date: None words: 393 flesch: 13 summary: Keywords: Staphylococcus aureus, methicillin resistance, septic arthritis, community–acquired, hospital-acquired Article citation: Lim SY, Panikkath D, Ratra A, Panikkath R, Nugent K. Clinical characteristics and outcomes of community-acquired methicillin resistant Staphylococcus aureus septic arthritis. Original Article Clinical characteristics and outcomes of community-acquired methicillin-resistant Staphylococcus aureus septic arthritis Sian Yik Lim MD, Deepa Panikkath MD, Atul Ratra MD, Ragesh Panikkath MD, Kenneth Nugent MD ABSTRACT Objective: We investigated the clinical characteristics, treatment patterns and outcomes of community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) septic arthritis. keywords: arthritis; septic cache: pulmonarychronicles-375.htm plain text: pulmonarychronicles-375.txt item: #295 of 658 id: pulmonarychronicles-376 author: None title: Images in Medicine date: None words: 831 flesch: 54 summary: Chest radiograph showed branching radiopaque opacities in both upper lobes, right greater then left, and a clinical diagnosis of pulmonary cement embolism was made. Pulmonary cement embolism. keywords: cement; chest; pulmonary cache: pulmonarychronicles-376.htm plain text: pulmonarychronicles-376.txt item: #296 of 658 id: pulmonarychronicles-381 author: None title: Editorial date: None words: 886 flesch: 43 summary: Impact of medical student research in the development of physician scientists. Medical student research at Texas Tech University Health Sciences Center: increasing research participation with a summer research program. keywords: health; medical; research; students cache: pulmonarychronicles-381.htm plain text: pulmonarychronicles-381.txt item: #297 of 658 id: pulmonarychronicles-382 author: None title: Medical Education date: None words: 2687 flesch: 47 summary: Keywords: Medical student research, summer research program, medical school, research INTRODUCTION Medical knowledge is one of the core competencies endorsed by the Accreditation Council for Graduate Medical Education (ACGME). Moreover, a 2006 study of the selection criteria for residency programs found that research experience increases the chances for acceptance into the most competitive specialties.3 In 2016, 42,370 applicants applied for 30,594 filled positions, and U.S. allopathic seniors who matched had more research experiences on average than those who did not match for all specialties except Diagnostic Radiology, Internal Medicine, and Internal Medicine/Pediatrics.4,5 Given these important concerns, we sought to use the School of Medicine (SOM) Student Summer Research Program (SSRP) to increase medical student research participation in the SOM at Texas Tech University Health Sciences Center (TTUHSC). keywords: medical; participation; program; research; students cache: pulmonarychronicles-382.htm plain text: pulmonarychronicles-382.txt item: #298 of 658 id: pulmonarychronicles-383 author: None title: Abstracts date: None words: 15190 flesch: 43 summary: The study sample is restricted to pediatric patients, with the aim of reducing potential bias or stigma relating to perceived criminality or medication seeking behaviors. Among pediatric patients presenting with a fever greater than or equal to 101, Hispanic and African American patients were about 35-45% less likely to receive a triage score of 1-3 verses 4 or 5 compared to white patients. keywords: aging; american; analysis; birth; cancer; care; cells; data; diagnosis; disease; exposure; expression; group; health; levels; medical; mice; model; month; pain; patients; pediatric; population; post; research; results; students; studies; study; texas; time; trauma; treatment; visits; vitamin; wound; years cache: pulmonarychronicles-383.htm plain text: pulmonarychronicles-383.txt item: #299 of 658 id: pulmonarychronicles-384 author: None title: Special Issue date: None words: 837 flesch: 55 summary: Everything we do in medicine to treat our patients is based on scientifically proven evidence, so it is important to not only appreciate the value of research in my future practice but also make a conscious effort to keep up with all of the novel research that is constantly improving medicine and the quality of care we provide to our patients. What I learned: Because I chose to do an original research project, I learned everything from submitting an IRB to presenting results at a conference to writing up and submitting research for a journal publication. keywords: program; research cache: pulmonarychronicles-384.htm plain text: pulmonarychronicles-384.txt item: #300 of 658 id: pulmonarychronicles-387 author: None title: Editorial date: None words: 1097 flesch: 52 summary: The observations and hypotheses brought forth in case reports and case series supply many of the questions that randomized trials seek to answer. Case reports are fresh, speculative, hypothetical, and innately creative because they must try to explain the unexpected. keywords: case; medicine; reports; trials cache: pulmonarychronicles-387.htm plain text: pulmonarychronicles-387.txt item: #301 of 658 id: pulmonarychronicles-388 author: None title: Health care and public policy date: None words: 269 flesch: 54 summary: Keywords: health care economics, health care uncertainty, health care right, health care costs, health care market failure Article citation: Berdine G. Uncertainty and the welfare economics of medical care: an Austrian rebuttal-part 3. An Austrian Rebuttal-Part 3 Gilbert Berdine MD ABSTRACT Part 3 concludes the rebuttal to the argument that health care is special and that markets cannot properly distribute health care. keywords: care cache: pulmonarychronicles-388.htm plain text: pulmonarychronicles-388.txt item: #302 of 658 id: pulmonarychronicles-389 author: None title: ICU rounds date: None words: 239 flesch: 24 summary: Usually patients with diabetic ketoacidosis are admitted to the intensive care unit for continuous infusion of insulin; however, the development of rapid acting insulin analogues has made it possible to treat mild to moderate diabetic ketoacidosis with subcutaneous insulin. Keywords: Diabetic ketoacidosis, acute complication in diabetes, rapid acting insulin analogues, subcutaneous insulin in diabetic ketoacidosis Article citation: Gavidia Quezada R, Edriss H. Diabetic ketoacidosis: should current management include subcutaneous insulin injection? keywords: insulin cache: pulmonarychronicles-389.htm plain text: pulmonarychronicles-389.txt item: #303 of 658 id: pulmonarychronicles-390 author: None title: Editorial date: None words: 1560 flesch: 39 summary: It may not be feasible to initiate these protocols early in a high percentage of ICU patients due to the severity of their underlying illnesses. 3. Does extubation to noninvasive ventilation in high risk patients have a favorable effect on extubation success? keywords: extubation; leak; patients; ventilation cache: pulmonarychronicles-390.htm plain text: pulmonarychronicles-390.txt item: #304 of 658 id: pulmonarychronicles-391 author: None title: Statistics column date: None words: 1560 flesch: 51 summary: Many statistical software packages can be used for generating ROC curves. ROC curves are most useful when the predictors are continuous. keywords: roc; sensitivity; test; value cache: pulmonarychronicles-391.htm plain text: pulmonarychronicles-391.txt item: #305 of 658 id: pulmonarychronicles-392 author: None title: Medical image date: None words: 845 flesch: 40 summary: Computed tomography of the head revealed new bilateral symmetrical low density changes in both occipital lobes (Figure 1) suggestive of posterior reversible encephalopathy syndrome (PRES). Keywords: posterior reversible encephalopathy syndrome, vasogenic edema, seizures REFERENCES Fugate JE, Rabinstein AA. keywords: edema; posterior; pres cache: pulmonarychronicles-392.htm plain text: pulmonarychronicles-392.txt item: #306 of 658 id: pulmonarychronicles-393 author: None title: Medical image date: None words: 654 flesch: 44 summary: Representative CT images in both mediastinal and lung windows show flattening, thinning, and inward bending of right ribs from prior thoracoplasty resulting in deformity of the right rib cage. Insertion of various materials between the ribs and collapsed chest wall to act as a plombe has been abandoned as it resulted in a high rate of complications.3 Thoracoplasty was commonly performed before the advent of medical chemotherapy in the treatment of pulmonary tuberculosis. keywords: chest; surgery; tuberculosis cache: pulmonarychronicles-393.htm plain text: pulmonarychronicles-393.txt item: #307 of 658 id: pulmonarychronicles-394 author: None title: Focused review date: None words: 334 flesch: 37 summary: The exposure of cell cultures to e-cigarette liquid or aerosols has been shown to reduce cell viability, induce cytokine production, and cause oxidative stress. Studies in healthy, non-smoking volunteers and smokers with no clinical pulmonary disease have demonstrated that the inhalation of e-cigarette vapor has minimal short-term effects on pulmonary function. keywords: cigarettes; use cache: pulmonarychronicles-394.htm plain text: pulmonarychronicles-394.txt item: #308 of 658 id: pulmonarychronicles-395 author: None title: Scientific writing date: None words: 2048 flesch: 70 summary: One strategy for finding sentence fragments in a draft is to read the paper aloud sentence by sentence. One area that many writers find difficult is correct grammar and usage. keywords: errors; information; sentence; writers; writing cache: pulmonarychronicles-395.htm plain text: pulmonarychronicles-395.txt item: #309 of 658 id: pulmonarychronicles-396 author: None title: Medicine in paintings date: None words: 495 flesch: 64 summary: Medicine in paintings Hieronymus Bosch, Extracting the Stone of Madness, 1501–1505, Oil on oak panel, 48.5 × 34.5 cm, Museo Del Prado. Dutch painter Hieronymus Bosch was born in S’Hertogenbosch, Netherlands (present day) around 1450, and he lived until around 1516. keywords: bosch; painting cache: pulmonarychronicles-396.htm plain text: pulmonarychronicles-396.txt item: #310 of 658 id: pulmonarychronicles-397 author: None title: Regional medicine case report date: None words: 261 flesch: 38 summary: Keywords: ammonia, toxic inhalation, acute respiratory failure, agriculture Article citation: Waheed I, Fuller A. Anhydrous ammonia pulmonary toxicity: a significant farming hazard. An 80-year-old male farmer was accidentally exposed to anhydrous ammonia released from a pressurized fertilizer tank. keywords: ammonia cache: pulmonarychronicles-397.htm plain text: pulmonarychronicles-397.txt item: #311 of 658 id: pulmonarychronicles-398 author: None title: ICU rounds date: None words: 206 flesch: 31 summary: Recently, several researchers have studied the role of thiamine deficiency in critically ill patients and the link between thiamine supplementation and changes in lactate levels in septic shock patients. In this review, we discuss the most common conditions associated with thiamine deficiency and the limited literature available on thiamine supplementation in critically ill patients. keywords: thiamine cache: pulmonarychronicles-398.htm plain text: pulmonarychronicles-398.txt item: #312 of 658 id: pulmonarychronicles-399 author: None title: Case report date: None words: 238 flesch: 33 summary: Keywords: meningitis, Pasteurella multocida, multi-organ failure, disseminated intravascular coagulation Article citation: Juarez E, Avinash Adiga A. Pasteurella multocida meningitis with disseminated intravascular coagulation and multi-organ failure in an adult with no bite history. Case report Pasteurella multocida meningitis with disseminated intravascular coagulation and multi-organ failure in an adult with no bite history Edna Juarez MD, Avinash Adiga MD ABSTRACT A 70-year-old woman with an extensive past medical history presented to the emergency center with two weeks of generalized weakness, fatigue, resting shortness of breath, and abdominal pain. keywords: coagulation cache: pulmonarychronicles-399.htm plain text: pulmonarychronicles-399.txt item: #313 of 658 id: pulmonarychronicles-4 author: None title: Mild Traumatic Brain Injury date: None words: 1258 flesch: 47 summary: Indications for Inpatient Admission Because they are at risk for immediate complications from head injury, hospital admission is recommended for patients with concussion if the patient has: GCS <15 Abnormal CT scan: intracranial bleeding, cerebral edema Seizures Abnormal bleeding parameters from underlying bleeding diathesis or oral anticoagulation Admission should also be considered if no responsible person is available at home to monitor the patient for progression of symptoms. Diagnosis Concussion/Mild Traumatic Brain Injury (TBI) Discussion Mild traumatic brain injury (TBI) occurs with head injury due to contact and/or acceleration/deceleration forces. keywords: brain; concussion; head; injury; patients cache: pulmonarychronicles-4.htm plain text: pulmonarychronicles-4.txt item: #314 of 658 id: pulmonarychronicles-400 author: None title: Regional medicine news date: None words: 610 flesch: 51 summary: Dadpour reported an epidemic of aluminum phosphide poisoning in 36 tourists staying in a hotel in Iran.3 These guests inhaled phosphine gas released from an aluminum phosphide powder placed in the hotel room for pest control. Product dealers and pest removal personnel need to be licensed to use aluminum phosphide; investigators are currently tracing the source of the man’s illegal possession of this hazardous material.1 Aluminum phosphide is used as a pesticide and rodenticide. keywords: aluminum; gas; phosphide cache: pulmonarychronicles-400.htm plain text: pulmonarychronicles-400.txt item: #315 of 658 id: pulmonarychronicles-401 author: None title: Medicine and public policy date: None words: 183 flesch: 44 summary: Keywords: Price Controls, Cost Containment, Health Care Costs, Thoracentesis Costs, Austrian Analysis of Health Care Article citation: Berdine G. Thoracentesis: a case study in the failure of cost containment. Austrian economic theory explains why price controls fail to contain costs, and an Austrian analysis of price controls is presented in this review. keywords: thoracentesis cache: pulmonarychronicles-401.htm plain text: pulmonarychronicles-401.txt item: #316 of 658 id: pulmonarychronicles-402 author: None title: Review date: None words: 280 flesch: 42 summary: In 1992, Reich and Johnson presented a case series of six women describing a predilection of Mycobacterium spp pulmonary disease for the middle lobe, and its homolog, the lingula, in elderly women without preexisting pulmonary disease. NTM pulmonary disease occurring in patients without preexisting lung disease was only recently described by Prince in 1988. keywords: disease cache: pulmonarychronicles-402.htm plain text: pulmonarychronicles-402.txt item: #317 of 658 id: pulmonarychronicles-403 author: None title: Review date: None words: 159 flesch: 27 summary: Keywords: Advanced heart failure, left ventricular assist devices Article citation: Bas HD, Baser K, Nair N. Updates on management of advanced heart failure. This review summarizes the management of advanced heart failure with updates in medical therapy and recent advances in surgical therapy, particularly left ventricular assist device therapy. keywords: heart cache: pulmonarychronicles-403.htm plain text: pulmonarychronicles-403.txt item: #318 of 658 id: pulmonarychronicles-404 author: None title: Case report date: None words: 174 flesch: 42 summary: Case report A case of an 81-year-old woman with ‘broken-heart syndrome’ after a house fire Teryn Perkins BS, Kenneth Iwuji MD, Phumpattra Chariyawong MD, Leigh Ann Jenkins MD ABSTRACT Takotsubo cardiomyopathy is a transient cardiomyopathy predominantly characterized by left ventricular hypokinesis and wall motion abnormalities, usually apical ballooning during the systolic phase of heart contraction. Keywords: Takotsubo cardiomyopathy, broken heart syndrome, ventriculogram, acute coronary syndrome, myocardial infarction Article citation: Perkins T, Iwuji K, Chariyawong P, Jenkins LA. keywords: syndrome cache: pulmonarychronicles-404.htm plain text: pulmonarychronicles-404.txt item: #319 of 658 id: pulmonarychronicles-405 author: None title: Medicine in art date: None words: 337 flesch: 57 summary: Medicine in art Science and Charity, Picasso’s Realistic Masterpiece DOI: 10.12746/swrccc.v5i20.405 When most individuals think of Pablo Picasso, they think of Cubism, an art movement he helped create with artist Georges Braque. One of Picasso’s first major works was Science and Charity (1897), a very large canvas at 197 × 249.5 cm (6.5 × 8 feet). keywords: picasso cache: pulmonarychronicles-405.htm plain text: pulmonarychronicles-405.txt item: #320 of 658 id: pulmonarychronicles-406 author: None title: Regional medicine review date: None words: 248 flesch: 24 summary: Current evidence suggests that pesticide exposure is one of the risk factors of PD. In addition, exposure to different pesticides affecting different mechanisms may have synergistic effects in increasing risk of PD. keywords: parkinson cache: pulmonarychronicles-406.htm plain text: pulmonarychronicles-406.txt item: #321 of 658 id: pulmonarychronicles-407 author: None title: ICU Rounds date: None words: 117 flesch: 15 summary: Keywords: cyclodextrin, encapsulation, selective relaxant binding agent, sugammadex, supramolecular Article citation: Yepes Hurtado V. Sugammadex: a neuromuscular blockade agent encapsulator. The cylindrical, basket-like structure encapsulates neuromuscular blocking agents which results in rapid reversal of paralysis within three minutes. keywords: sugammadex cache: pulmonarychronicles-407.htm plain text: pulmonarychronicles-407.txt item: #322 of 658 id: pulmonarychronicles-408 author: None title: Original article date: None words: 381 flesch: 42 summary: Non-morning chronotype interns appeared to have more daytime sleepiness and poorer sleep quality. Original article Sleep quality, sleep habits, and chronotypes of medical interns at the beginning of their training Chok Limsuwat MD, Pantaree Aswanetmanee MD, Mustafa Awili MD, Ahmed Raziuddin MD, Supat Thammasitboon MD ABSTRACT Introduction: Despite the implementation of resident work hour regulations, studies have not consistently shown beneficial changes in residents’ sleep quality or duration. keywords: quality; sleep cache: pulmonarychronicles-408.htm plain text: pulmonarychronicles-408.txt item: #323 of 658 id: pulmonarychronicles-409 author: None title: Statistics column date: None words: 264 flesch: 69 summary: Breast cancer patients Normal individuals 2.34 1.72 2.98 1.70 2.04 2.57 1.90 1.07 2.89 3.35 1.60 4.26 1.99 1.78 2.56 4.57 0.57 1.66 2.00 4.89 4.61 1.31 0.99 1.30 1.48 1.35 1.22 1.14 1.23 1.31 1.08 2.00 0.50 1.51 1.17 1.43 1.15 1.53 0.80 1.85 1.03 1.40 Each test has a normal range representing the 95% confidence limits of normal values. keywords: test cache: pulmonarychronicles-409.htm plain text: pulmonarychronicles-409.txt item: #324 of 658 id: pulmonarychronicles-41 author: None title: BOARD REVIEW QUESTION issue1 date: None words: 487 flesch: 56 summary: What is the next best step in the management of this patient asthma? A. Add ipratropium by nebulizer B. Change from inhaled budesonide to inhaled fluticasone C. Start oral prednisone and taper D. Add inhaled salmeterol E. Add theophylline   + Answer and Discussion - Answer and Discussion Answer: D – Add a long acting beta agonist such as salmeterol Key point: It is safer for pregnant women with asthma to be treated with asthma medications than it is for them to have asthma symptoms and exacerbations. BOARD REVIEW QUESTION issue1   Board Review Question A 29-year-old woman in her first trimester of pregnancy presents to your clinic and complains of worsening asthma symptoms. keywords: asthma; symptoms cache: pulmonarychronicles-41.htm plain text: pulmonarychronicles-41.txt item: #325 of 658 id: pulmonarychronicles-410 author: None title: Review date: None words: 219 flesch: 32 summary: Review Management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage Mohamed Shehabeldin MD, Yazan J Alderazi MD ABSTRACT Cerebral vasospasm is a serious complication following aneurysmal subarachnoid hemorrhage (SAH); it causes delayed cerebral ischemia (DCI) or infarction. Keywords: cerebral vasospasm, aneurysmal subarachnoid hemorrhage, delayed cerebral ischemia, transcranial Doppler, nimodipine Article citation: Shehabeldin M, Alderazi YJ. keywords: vasospasm cache: pulmonarychronicles-410.htm plain text: pulmonarychronicles-410.txt item: #326 of 658 id: pulmonarychronicles-411 author: None title: Editorial date: None words: 1524 flesch: 43 summary: However, meta-regression analysis showed that there was an inverse relationship between larger tidal volume gradients (i.e., the differences between the higher tidal volume in control patients and the low tidal volume in experimental patients) and the relative risk for mortality associated with low tidal volume ventilation; trials with larger gradients showed a lower mortality risk with low tidal volumes. This editorial will review these questions and recommendations. Question 1: Should patients with ARDS receive mechanical ventilation using low tidal volumes and inspiratory pressures? keywords: ards; patients; peep; trials cache: pulmonarychronicles-411.htm plain text: pulmonarychronicles-411.txt item: #327 of 658 id: pulmonarychronicles-412 author: None title: Images in medicine date: None words: 631 flesch: 50 summary: The actual prevalence of right heart thrombi in patients with PE remains an open question. Keywords: cardiac thrombus, echocardiogram REFERENCES Kronik G. The European Cooperative Study on the clinical significance of right heart thrombi. keywords: heart; right; thrombi cache: pulmonarychronicles-412.htm plain text: pulmonarychronicles-412.txt item: #328 of 658 id: pulmonarychronicles-413 author: None title: Medical image date: None words: 1019 flesch: 50 summary: On the following day, he started having left shoulder, left chest wall, and left leg pain. Pulmonary actinomycosis with chest wall fistula formation. keywords: abscess; chest; empyema; patient; wall cache: pulmonarychronicles-413.htm plain text: pulmonarychronicles-413.txt item: #329 of 658 id: pulmonarychronicles-414 author: None title: Letter to the editor date: None words: 570 flesch: 40 summary: Letter to the editor Regression of basal cell carcinomas in multiple sclerosis patient on Aubagio treatment Judy Park DeWitt, BS1; Kleesy L. Thomas, MD2; Ashley Sturgeon, MD2 Corresponding author: Kleesy L. Thomas, MD Contact Information: Kleesy.Thomas@ttuhsc.edu DOI: 10.12746/swrccc.v5i21.414 October 5, 2017 Basal cell carcinoma (BCC) is the most common type of skin cancer.1 BCCs can develop on any part of the body. During preclinical research stage, teriflunomide showed CNS lymphocyte infiltration reduction and axonal loss reduction without neurological damage in animals.3 In clinical trials, patients taking teriflunomide experienced significantly fewer relapses than the patients taking the placebo.3 Teriflunomide is not only used for treatment of MS, but have also been implicated in treatment for melanomas.3 Although the use of Aubagio is not a standard treatment of care for BCCs, we report a case of cancer regression after onset of Aubagio treatment in our MS patient. keywords: cell; teriflunomide; treatment cache: pulmonarychronicles-414.htm plain text: pulmonarychronicles-414.txt item: #330 of 658 id: pulmonarychronicles-415 author: None title: Medicine and public policy date: None words: 2673 flesch: 64 summary: I propose the following definition of affordable health care: Affordable health care is something that an average head of household with an average household and an average job paying an average wage can fit into his average budget yet continue to save for future dreams such as retirement. Available at: http://www.pulmonarychronicles.com/index.php/pulmonarychronicles/article/view/403/887 Keywords: Health care, costs, affordable health care From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX Submitted: 8/24/17 Accepted: 10/2/2017 Reviewer: keywords: affordable; care; health; insurance; life; system cache: pulmonarychronicles-415.htm plain text: pulmonarychronicles-415.txt item: #331 of 658 id: pulmonarychronicles-416 author: None title: Case report date: None words: 300 flesch: 42 summary: Keywords: carcinoid heart disease, carcinoid tumor, carcinoid syndrome Article citation: Juarez E, Adiga A, Sanchez P, Fanasch H. Metastatic carcinoid tumor with severe double valve disease at diagnosis: case report and review of literature. Case report Metastatic carcinoid tumor with severe double valve disease at diagnosis: Case report and review of literature Edna Juarez MD, Avinash Adiga MD, Paloma Sanchez MD, Hilal Fanasch MD ABSTRACT A 27-year-old woman with a history of anxiety presented with three months of diarrhea. keywords: carcinoid; disease cache: pulmonarychronicles-416.htm plain text: pulmonarychronicles-416.txt item: #332 of 658 id: pulmonarychronicles-417 author: None title: Editorial date: None words: 1657 flesch: 47 summary: The trial was appropriately powered to assess clinical cardiovascular events, with over 13,000 patients enrolled in each group. Evidence of the lipid-lowering efficacy of these agents has been robust,2 and evidence of clinical cardiovascular event reduction has begun to arrive. keywords: cholesterol; coronary; events; evolocumab; ldl; pcsk9; trial cache: pulmonarychronicles-417.htm plain text: pulmonarychronicles-417.txt item: #333 of 658 id: pulmonarychronicles-418 author: None title: Medicine in art date: None words: 444 flesch: 55 summary: The copy was paid for by money obtained in a jewel heist, and with many other copies and original paintings in the possession of Valguarnera, the second version might have had a nefarious intent. Medicine in art The Plague at Ashdod Christian Conrad PhD, Connie Nugent MLS Corresponding author: Christian Conrad PhD Contact Information: Conradmerz@yahoo.com DOI: 10.12746/swrccc.v5i21.418 The word “plague” appears in Exodus 11, when the Lord said to Moses, “I will bring one more plague upon Pharaoh and upon Egypt…. keywords: christian; plague cache: pulmonarychronicles-418.htm plain text: pulmonarychronicles-418.txt item: #334 of 658 id: pulmonarychronicles-420 author: None title: Student research report date: None words: 329 flesch: 42 summary: Keywords: Depression, cognitive decline, cognitive functioning, rural health, American National Adult Reading Test, Project FRONTIER Article citation: Miller B, Hudson C, Gordon Gong G. Depression is associated with lower American National Adult Reading Test scores among rural dwellers aged between 50 and 64 years in Texas: A Project FRONTIER Study. Student research report Depression is associated with lower American National Adult Reading Test scores among rural dwellers aged between 50 and 64 years in Texas: A Project FRONTIER Study Brady Miller BS, Catherine Hudson MPH, Gordon Gong MD ABSTRACT Background: Previous studies have shown that depression is associated with cognitive impairment. keywords: depression; scores cache: pulmonarychronicles-420.htm plain text: pulmonarychronicles-420.txt item: #335 of 658 id: pulmonarychronicles-421 author: None title: Case report date: None words: 408 flesch: 45 summary: Case report Coal worker’s pneumoconiosis and sarcoid-like reaction mimicking lymph node metastases in a patient with lung cancer: Keywords: lung neoplasms, anthracosis, sarcoid-like reaction, fludeoxyglucose-positron emission tomography Article citation: Duncan C, Tijani L, Graham S, Tran R, Jumper C. Coal worker’s pneumoconiosis and sarcoid-like reaction mimicking lymph node metastases in a patient with lung cancer: a case report. keywords: lymph; nodes cache: pulmonarychronicles-421.htm plain text: pulmonarychronicles-421.txt item: #336 of 658 id: pulmonarychronicles-422 author: None title: Regional medicine review date: None words: 228 flesch: 42 summary: Mold, especially Alternaria and Aspergillus species, are occasionally found in cotton crops and can be a source of allergens and mycotoxins. A multitude of allergens, microbes, irritants, and chemical agents that co-exist or are a byproduct of cotton harvesting and ginning are potential contributors to respiratory disease. keywords: cotton cache: pulmonarychronicles-422.htm plain text: pulmonarychronicles-422.txt item: #337 of 658 id: pulmonarychronicles-423 author: None title: ICU rounds date: None words: 150 flesch: 43 summary: Keywords: Kcentra, four factor prothrombin complex concentrate, acute major bleeding, urgent hemostasis, INR reversal, warfarin Article citation: Ismail A. Kcentra® (Prothrombin Complex Concentrate Southwest Respiratory and Critical Care Chronicles 2017;5(21):11–15 From: Department of Internal Medicine at Texas Tech University Health Sciences Center, Lubbock, Texas Submitted: 4/6/2017 Accepted: 10/4/2017 Reviewer: keywords: kcentra cache: pulmonarychronicles-423.htm plain text: pulmonarychronicles-423.txt item: #338 of 658 id: pulmonarychronicles-424 author: None title: Statistics column date: None words: 1454 flesch: 41 summary: On the other hand, although non-inferiority trials are becoming increasingly popular, they have serious issues, mostly weaknesses compared with superiority trials that need to be addressed. On other occasions, non-inferiority trials can be used to show efficacy of an experimental treatment when it is unethical to include a placebo control in the trial. keywords: inferiority; treatment; trial cache: pulmonarychronicles-424.htm plain text: pulmonarychronicles-424.txt item: #339 of 658 id: pulmonarychronicles-425 author: None title: Case report date: None words: 206 flesch: 25 summary: Keywords: Pulmonic valve stenosis, pulmonary artery aneurysm, hilar mass Article citation: Schwalk A, Berdine G. Pulmonary artery aneurysm secondary to congenital pulmonic valve stenosis. The most common conditions associated with pulmonary artery aneurysm are congenital heart defects with left-to-right shunts and pulmonic valve abnormalities. keywords: artery cache: pulmonarychronicles-425.htm plain text: pulmonarychronicles-425.txt item: #340 of 658 id: pulmonarychronicles-426 author: None title: Regional medicine news date: None words: 499 flesch: 51 summary: Physicians need to consider non-toxigenic V. cholerae infections in patients with significant exposure to water in ponds and lakes. In the United States, V. cholerae infections are uncommon. keywords: cholerae cache: pulmonarychronicles-426.htm plain text: pulmonarychronicles-426.txt item: #341 of 658 id: pulmonarychronicles-427 author: None title: Statistics column date: None words: 460 flesch: 66 summary: A Bartlett’s test shows that there is a significant difference in data variation between the two groups (p<0.001), and a two sample t test shows that cancer patients have significant higher expression of this gene than the normal individuals (p<0.001). The BRAC1 gene expression values (normalized read count) for a group of breast cancer patients and a group of independent normal individuals are presented in the following table. keywords: test cache: pulmonarychronicles-427.htm plain text: pulmonarychronicles-427.txt item: #342 of 658 id: pulmonarychronicles-429 author: None title: Regional medicine report date: None words: 728 flesch: 35 summary: Our data also appear consistent with the traditional understanding of RSV A and RSV B infections.3 We had more patients with RSV B, yet a higher percentage of patients with RSV A bronchiolitis were treated as inpatients versus as outpatients (56% RSV A vs. 33% RSV B). Regional medicine report A regional report: Respiratory Syncytial Virus infection in the 2016-17 season Erin Baroni MD,1 Kenzie Daniels MD,2 Shawn Reeves RN, MSN, ACPNP,3 Mary Frances Flores MLT(ASCP),4 Kerrie Pinkney MD, MPH,3 Fatma Levent MD3 Corresponding author: Fatma Levent Contact Information: Fatma.levent@ttuhsc.edu DOI: 10.12746/swrccc.v6i22.429 Respiratory syncytial virus (RSV) is the most frequent cause of bronchiolitis in children and responsible for more than 125,000 hospitalizations and 250 infant deaths every year.1 In this report, an anecdotal increase in RSV bronchiolitis infections in Lubbock, Texas, is discussed. keywords: bronchiolitis; pediatrics; rsv; virus cache: pulmonarychronicles-429.htm plain text: pulmonarychronicles-429.txt item: #343 of 658 id: pulmonarychronicles-431 author: None title: Regional medicine review date: None words: 349 flesch: 48 summary: Regional medicine review The health effects of dust storms in the Southwest United States Larrité Reed BS, Kenneth Nugent MD ABSTRACT Blowing dust events are a common feature of life in West Texas and the Southwestern United States and are increasing in frequency. Haboob (Arabic for strong wind) dust storms stir up large amounts of dust from the environment and can blow it into densely populated areas. keywords: dust; storms cache: pulmonarychronicles-431.htm plain text: pulmonarychronicles-431.txt item: #344 of 658 id: pulmonarychronicles-432 author: None title: Medicine in art date: None words: 496 flesch: 65 summary: Texas painter Alexandre Hogue deplored this disaster, holding mankind responsible for the effects of the Dust Bowl depicted in his Erosion Series of paintings (1933-36). Keywords: Dust Bowl, 1930s, Central Plains states, economic depression REFERENCES Hesse K. Out of the Dust. keywords: dust; hogue cache: pulmonarychronicles-432.htm plain text: pulmonarychronicles-432.txt item: #345 of 658 id: pulmonarychronicles-433 author: None title: Crossroads-culture and medicine date: None words: 1982 flesch: 64 summary: Dust Bowl experience: https://www.youtube.com/watch?v=jQYKJaWuj0Y. http://woodyguthrie.org/biography/biography2.htm Accessed 12/29/2017. Keywords: Dust Bowl; dust pneumonia; Dust Bowl migrants; John Steinbeck; Grapes of Wrath; Sanora Babb; Whose Names are Unknown; Woody Guthrie; Dorothea Lange REFERENCES McLeman RA, Dupre J, Ford LB, Ford J, Gajewski K, Marchildon G. What we learned from the dust bowl: lessons in science, policy, and adaptation. keywords: bowl; dust; dust bowl; health; land; wind cache: pulmonarychronicles-433.htm plain text: pulmonarychronicles-433.txt item: #346 of 658 id: pulmonarychronicles-434 author: None title: Medicine and public policy date: None words: 2570 flesch: 52 summary: Everyone would prefer to have health care vs. not having health care. Advocates of government subsidized health care either do not realize or do not mention, however, that nobody would prefer having health care vs. having all other possible things. keywords: aca; care; conditions; health; insurance; medicare cache: pulmonarychronicles-434.htm plain text: pulmonarychronicles-434.txt item: #347 of 658 id: pulmonarychronicles-435 author: None title: Regional medicine case report date: None words: 201 flesch: 21 summary: Keywords: scorpion, envenomation, acute respiratory failure, anaphylaxis Article citation: Castillo A, Attaluri P. Acute respiratory failure following scorpion stings: Anaphylaxis or severe systemic envenomation? Regional medicine case report Acute respiratory failure following scorpion stings: Anaphylaxis or severe systemic envenomation? keywords: scorpion cache: pulmonarychronicles-435.htm plain text: pulmonarychronicles-435.txt item: #348 of 658 id: pulmonarychronicles-436 author: None title: Original article date: None words: 311 flesch: 42 summary: Keywords: Hantavirus pulmonary syndrome, Texas, laboratory tests, outcomes Article citation: Alexander JL, Nugent K. Hantavirus pulmonary syndrome in Texas: an update covering years 1993 through 2016. This report updates the information on Hantavirus pulmonary syndrome cases identified between 2007 and 2016 to determine whether or not there are differences in clinical presentation or outcomes. keywords: hantavirus; texas cache: pulmonarychronicles-436.htm plain text: pulmonarychronicles-436.txt item: #349 of 658 id: pulmonarychronicles-437 author: None title: Editorial date: None words: 1954 flesch: 51 summary: compounds”;8 this clearly holds for dust aerosols, and must be kept in mind for its medical implications. Illustration of the dust emission process, showing how saltation and creep of large grains release dust aerosols transported downwind. keywords: aerosol; air; dust; journal; plains; wind cache: pulmonarychronicles-437.htm plain text: pulmonarychronicles-437.txt item: #350 of 658 id: pulmonarychronicles-438 author: None title: Focused review date: None words: 160 flesch: 32 summary: Focused review Average volume-assured pressure support Abdurahim Aloud MD ABSTRACT Average volume-assured pressure support (AVAPS) is a relatively new mode of non-invasive positive pressure ventilation (NiPPV); only a few studies have been done to compare its effectiveness and safety to bilevel positive airway pressure (BiPAP) in chronic respiratory failure secondary to obesity hypoventilation syndrome, obstructive sleep apnea, chronic obstructive pulmonary disease, and neuromuscular disorders with respiratory muscle weakness. Keywords: non-invasive ventilation, pressure support, average volume-assured pressure support, obesity-hypoventilation syndrome, COPD, hypercapnia Article citation: keywords: pressure cache: pulmonarychronicles-438.htm plain text: pulmonarychronicles-438.txt item: #351 of 658 id: pulmonarychronicles-439 author: None title: Review date: None words: 224 flesch: 32 summary: The characteristic feature of hepatorenal syndrome is intense renal vasoconstriction. Hepatorenal syndrome is a diagnosis of exclusion and is considered a challenging medical condition in both diagnosis and treatment as it is associated with a poor prognosis. keywords: syndrome cache: pulmonarychronicles-439.htm plain text: pulmonarychronicles-439.txt item: #352 of 658 id: pulmonarychronicles-440 author: None title: Statistics column date: None words: 1335 flesch: 50 summary: Keywords: non-inferiority trial, non-inferiority margin, statistical power, outcome REFERENCES Landow L. Current issues in clinical trial design: superiority versus equivalency studies. This is, however, not the case for non-inferiority trials, although non-inferiority trials are becoming increasingly popular recently. keywords: inferiority; non; trial cache: pulmonarychronicles-440.htm plain text: pulmonarychronicles-440.txt item: #353 of 658 id: pulmonarychronicles-441 author: None title: Editorial commentary date: None words: 684 flesch: 58 summary: Keywords: Dust Bowl, art, literature, economics, health effects REFERENCES Gill TE. This primer is essential to understanding dust storms, but numbers cannot convey the enormity of this human tragedy. keywords: art; bowl; dust cache: pulmonarychronicles-441.htm plain text: pulmonarychronicles-441.txt item: #354 of 658 id: pulmonarychronicles-442 author: None title: Editorial date: None words: 1721 flesch: 48 summary: The following clinical conditions have been suggested for PFO closure devices: cryptogenic stroke, migraine, decompression sickness, hypoxia, platypnea-orthodeoxia syndrome, and obstructive sleep apnea.5 Many observational studies were initially performed to assess the relationship between PFO and cryptogenic stroke, and there are now four multicenter, randomized control trials that have been published evaluating PFO closure for secondary prevention of stroke: Closure or Medical Therapy for Cryptogenic Stroke with Patent Foramen Ovale (CLOSURE), Percutaneous Closure of Patent Foramen Ovale in Cryptogenic Embolism (PC trial), Closure of Patent Foramen Ovale vs. Medical Therapy after Cryptogenic Stroke (RESPECT), and Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke (REDUCE). keywords: closure; ovale; patients; pfo; stroke cache: pulmonarychronicles-442.htm plain text: pulmonarychronicles-442.txt item: #355 of 658 id: pulmonarychronicles-443 author: None title: Medical image date: None words: 785 flesch: 47 summary: This patient was treated for persistent asthma for several years before she was diagnosed with recurrent respiratory papillomatosis. Risk factors for dysplasia in recurrent respiratory papillomatosis in an adult and pediatric population. keywords: lesions; papillomatosis; recurrent cache: pulmonarychronicles-443.htm plain text: pulmonarychronicles-443.txt item: #356 of 658 id: pulmonarychronicles-444 author: None title: Original article date: None words: 319 flesch: 30 summary: There was a non-statistically significant trend toward decreased duration of mechanical ventilation in the dexmedetomidine group (p = 0.107), and multivariable analysis demonstrated a small to moderate effect size in the sample. Conclusions: Although underpowered for statistical significance, there was a trend toward decreased duration of mechanical ventilation with dexmedetomidine. keywords: dexmedetomidine; duration cache: pulmonarychronicles-444.htm plain text: pulmonarychronicles-444.txt item: #357 of 658 id: pulmonarychronicles-452 author: None title: Medical image date: None words: 962 flesch: 49 summary: Predicting the evolution of Kaposi sarcoma, in the highly active antiretroviral therapy era. Patient’s right eye with Kaposi lesion appearing as a “black eye”. keywords: figure; kaposi; patient; sarcoma cache: pulmonarychronicles-452.htm plain text: pulmonarychronicles-452.txt item: #358 of 658 id: pulmonarychronicles-459 author: None title: Statistics column date: None words: 266 flesch: 31 summary: Statistics column Research methods: Clinical studies based on routine laboratory tests Shengping Yang PhD, Menfil Orellana-Barrios MD, Kenneth Nugent MD ABSTRACT Clinical research using routine laboratory tests can provide important opportunities to investigators, especially those with limited resources, and can improve patient care, especially if the result improves clinical decision making without the use of more sophisticated or expensive tests. Keywords: laboratory data, mean platelet volume, study design, literature searches, data management Article citation: Yang S, Orellana-Barrios M, Nugent K. Research methods: clinical studies based on routine laboratory tests. keywords: laboratory; tests cache: pulmonarychronicles-459.htm plain text: pulmonarychronicles-459.txt item: #359 of 658 id: pulmonarychronicles-46 author: None title: Double Jeopardy - Acute Myocardial Infarction Complicated by Cardiogenic Shock and Contrast Mediated Anaphylactoid Reaction date: None words: 2098 flesch: 35 summary: Although there have been reports on anaphylactoid contrast reactions in the catheterization lab or cardiogenic shock following an acute myocardial infarction, we believe that ours is the first reported case of cardiogenic shock following an anaphylactoid iodinated contrast mediated reaction in the setting of a STEMI. In conclusion, although anaphylactoid contrast reactions leading to cardiogenic shock are rare, prompt recognition and treatment is essential to prevent death. keywords: anaphylactoid; anaphylaxis; contrast; infarction; media; reactions; shock cache: pulmonarychronicles-46.htm plain text: pulmonarychronicles-46.txt item: #360 of 658 id: pulmonarychronicles-460 author: None title: Medicine and Public Policy date: None words: 234 flesch: 52 summary: Keywords: opioid crisis, black market, free market, Medicaid subsidy Article citation: Berdine G. Opioids: government intervention and black markets. In this article, the formation of black markets in response to government regulation will be examined. keywords: opioids cache: pulmonarychronicles-460.htm plain text: pulmonarychronicles-460.txt item: #361 of 658 id: pulmonarychronicles-461 author: None title: Editorial date: None words: 1700 flesch: 50 summary: The mistakes made in the Gelsinger case fundamentally changed how universities conduct clinical trials that involve gene therapy and how they admit human patients into future clinical studies.4,5 Indeed, gene therapy research was set back by a decade as a result of the Gelsinger case. For almost 40 years, gene therapy has been hailed as a cure for all of man’s ailments. keywords: aav; adeno; cftr; fibrosis; gene; therapy; virus cache: pulmonarychronicles-461.htm plain text: pulmonarychronicles-461.txt item: #362 of 658 id: pulmonarychronicles-462 author: None title: Case report date: None words: 216 flesch: 6 summary: Case report Post-infectious encephalomyelitis in an orthopedic surgeon with motor and cognitive impairment following Campylobacter gastroenteritis with complete recovery Christopher J Crist MD, Nattamol Hosiriluck MD, Richard E Winn MD ABSTRACT Acute disseminated encephalomyelitis, also known as post-infectious encephalomyelitis, is an acute central nervous system demyelinating disorder which typically follows an autoimmune response secondary to a post-viral infection/syndrome. Keywords: Acute disseminated encephalomyelitis, post-infectious encephalomyelitis, Campylobacter Article citation: Crist CJ, Hosiriluck N, Winn RE. keywords: encephalomyelitis cache: pulmonarychronicles-462.htm plain text: pulmonarychronicles-462.txt item: #363 of 658 id: pulmonarychronicles-463 author: None title: Case report date: None words: 266 flesch: 37 summary: Keywords: exertional rhabdomyolysis, spinning, acute kidney injury Article citation: Rao A. Exercise-induced exertional rhabdomyolysis. A full work-up showed his serum creatine kinase was significantly elevated to 178,786 U/L and he had acute kidney injury. keywords: exercise; rhabdomyolysis cache: pulmonarychronicles-463.htm plain text: pulmonarychronicles-463.txt item: #364 of 658 id: pulmonarychronicles-464 author: None title: Medicine in Art date: None words: 833 flesch: 63 summary: Currently, millions of people around the world are victims of opioid addiction, with devastating effects. Opioid addiction has plagued mankind for centuries. keywords: addiction; opium; vereshchagin cache: pulmonarychronicles-464.htm plain text: pulmonarychronicles-464.txt item: #365 of 658 id: pulmonarychronicles-465 author: None title: Case report date: None words: 292 flesch: 21 summary: Keywords: Factor VIII inhibitor, hepatitis C, hematoma, acquired hemophilia A, autoimmune hemophilia Article citation: Shredi A, Elberson BW, El Nawaa S, Ismail A. Acquired factor VIII inhibitor associated with chronic untreated hepatitis C. The Southwest Respiratory and Critical Care Chronicles 2018;6(23):17–21 From: The Department of Internal Medicine at Texas Tech University Health Sciences Center in Lubbock, TX Submitted: 1/22/2018 Accepted: 3/28/2018 Reviewers: Catherine Jones MD, Kenneth Nugent MD Conflicts of interest: None This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Acquired factor VIII inhibitor – or acquired hemophilia A – is a rare disorder and presents similarly to hemophilia A, though patients are less likely to develop hemarthroses. keywords: factor; viii cache: pulmonarychronicles-465.htm plain text: pulmonarychronicles-465.txt item: #366 of 658 id: pulmonarychronicles-466 author: None title: Focused Review date: None words: 247 flesch: 35 summary: Keywords: Refeeding syndrome, hypomagnesemia, hypokalemia, hypophosphatemia, malnourished patients, critically ill, nutrition Article citation: Vorakunthada Y, Laoveeravat P, Vutthikraivit W, Lilitwat W, Rakvit A. Refeeding syndrome: an overlooked condition? The Southwest Respiratory and Critical Care Chronicles 2018;6(23):4–9 From: The Department of Internal Medicine at Texas Tech University Health Sciences Center in Lubbock, TX (YV, PL, WV, AR) and the Department of Pediatric Critical Care Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA (WL). keywords: rfs cache: pulmonarychronicles-466.htm plain text: pulmonarychronicles-466.txt item: #367 of 658 id: pulmonarychronicles-467 author: None title: Original article date: None words: 939 flesch: 43 summary: The differential diagnosis includes lymphangioleiomyomatosis (LAM), pulmonary Langerhans cell histiocytosis (PLCH), lymphocytic interstitial pneumonia (LIP), pulmonary amyloidosis, infections, including Pneumocystis jiroveci pneumonia, aspergilosis, septic emboli, Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, miliary tuberculosis, nontuberculous mycobacteria, and metastatic malignancy, including colorectal adenocarcinoma, lung adenocarcinoma, metastatic leiomyoma, and endometrial stromal sarcoma. Napsin A is a cytoplasmic marker identified in type II pneumocytes and alveolar macrophages and is positive in 83% of lung adenocarcinomas (ADC). keywords: adenocarcinoma; lung; napsin; pulmonary cache: pulmonarychronicles-467.htm plain text: pulmonarychronicles-467.txt item: #368 of 658 id: pulmonarychronicles-468 author: None title: Regional medicine news date: None words: 488 flesch: 50 summary: The effectiveness was 25% against influenza A (H3N2) virus infection, 67% against influenza A (H1N1) virus infection, and 42% against influenza B virus infection. There was a definite increase in the number of positive influenza tests (antigen, culture, PCR) reported by Texas Hospital laboratories starting in November 2017. keywords: influenza; tests cache: pulmonarychronicles-468.htm plain text: pulmonarychronicles-468.txt item: #369 of 658 id: pulmonarychronicles-469 author: None title: Regional Medicine Report date: None words: 264 flesch: 64 summary: In 2016 Poison Control Centers received 1,234 calls regarding opioid abuse and misuse. Regional Medicine Report Opioid use in Texas in 2016 Jane Carlisle Maxwell, PhD, in the Addiction Research Institute in the School of Social Work at the University of Texas issued a report on substance abuse trends in Texas in 2016 on November 6, 2017. keywords: heroin cache: pulmonarychronicles-469.htm plain text: pulmonarychronicles-469.txt item: #370 of 658 id: pulmonarychronicles-470 author: None title: In the clinic date: None words: 164 flesch: 19 summary: In the clinic Autoimmunity in cystic fibrosis: significance and clinical implications Kenneth Iwuji MD, Sharan Bijlani BA, Rose Izuchi MD, David Sotello MD ABSTRACT Anti-neutrophil cytoplasmic antibodies specific for bactericidal/permeability-increasing protein (BPI-ANCA) are frequently present in cystic fibrosis patients. Keywords: Anti-neutrophil cytoplasmic antibodies, autoimmune disease, inflammation, bactericidal/permeability-increasing protein, cystic fibrosis, Pseudomonas aeruginosa Article citation: Iwuji K, Bijlani S, Izuchi R, Sotello D. Autoimmunity in cystic fibrosis: significance and clinical implications. keywords: fibrosis cache: pulmonarychronicles-470.htm plain text: pulmonarychronicles-470.txt item: #371 of 658 id: pulmonarychronicles-471 author: None title: Journal supplement date: None words: 8103 flesch: 45 summary: The association between body mass index and airway pressures in patients with sepsis and acute respiratory failure Michelle Lear, Hawa Edriss, Asley Sanchez, Edna Juarez, Shengping Yang, Kenneth Nugent Purpose: Patients with increased BMI have excessive adipose tissue in the thoracic wall and abdomen. Student knowledge integration of life lessons in spirituality Cheryl Erwin, Adam Judd Background: Religion and spirituality are important to many patients; and connecting with patients on a spiritual level can benefit patient care. keywords: age; care; cell; health; mortality; outcomes; patients; pct; placement; rate; results; study; time; tissue; treatment; vaccine; weeks cache: pulmonarychronicles-471.htm plain text: pulmonarychronicles-471.txt item: #372 of 658 id: pulmonarychronicles-473 author: None title: Journal supplement date: None words: 8103 flesch: 45 summary: The association between body mass index and airway pressures in patients with sepsis and acute respiratory failure Michelle Lear, Hawa Edriss, Asley Sanchez, Edna Juarez, Shengping Yang, Kenneth Nugent Purpose: Patients with increased BMI have excessive adipose tissue in the thoracic wall and abdomen. Student knowledge integration of life lessons in spirituality Cheryl Erwin, Adam Judd Background: Religion and spirituality are important to many patients; and connecting with patients on a spiritual level can benefit patient care. keywords: age; care; cell; health; mortality; outcomes; patients; pct; placement; rate; results; study; time; tissue; treatment; vaccine; weeks cache: pulmonarychronicles-473.htm plain text: pulmonarychronicles-473.txt item: #373 of 658 id: pulmonarychronicles-474 author: None title: Editorial date: None words: 659 flesch: 49 summary: For instance, a previous Troponin T value of 0.019 ng/ml would be reported at 19 ng/l. The new assay has a very low “limit of blank” – the level at which Troponin T can reliably be detected – and the limit of quantification is 6 ng/l. New protocols for “rule out” of chest pain patients presenting to emergency departments (ED) have been developed. The positive predictive value and specificity of hs-cTnT for MI diagnosis were not as high, however, generally ranging from 50% to 75%.1 Interestingly, in the sites participating in the APACE study, switching to the use of hs-cTnT increased the frequency of MI diagnosis (10% vs 14%), reduced the use of stress testing in ED chest patients (29% to 19%), and reduced the median time to discharge from the ED (by > 9 minutes). keywords: troponin cache: pulmonarychronicles-474.htm plain text: pulmonarychronicles-474.txt item: #374 of 658 id: pulmonarychronicles-475 author: None title: Editorial date: None words: 1039 flesch: 41 summary: Publishers have also launched a particular new type of OA journal, that peer reviews only for scientific soundness, not anticipated novelty or impact, and has a very broad scope. The OA movement was actually started during the 1990s by individual academics or academic institutions who founded OA journals often by converting existing ones. keywords: access; journals; publishing cache: pulmonarychronicles-475.htm plain text: pulmonarychronicles-475.txt item: #375 of 658 id: pulmonarychronicles-476 author: None title: ICU rounds date: None words: 256 flesch: 29 summary: Unfortunately, the widespread use of antimicrobials has led to the development of antimicrobial resistance. The rational use of antibiotics is required to prevent the spread of antimicrobial resistance; this requires multidisciplinary efforts among clinicians, Infection Control departments, and Antimicrobial Stewardship programs. keywords: resistance cache: pulmonarychronicles-476.htm plain text: pulmonarychronicles-476.txt item: #376 of 658 id: pulmonarychronicles-477 author: None title: Original article date: None words: 400 flesch: 43 summary: Keywords: Recurrent pleural effusion, indwelling pleural catheter, mortality, survival, pleurodesis Article citation: Copeland S, Schwalk A, Suchartlikitwong S, Yang S, Berdine G. Indwelling pleural catheters for recurrent pleural effusions: a useful clinical tool with serious implications. There were 33 patients with malignant pleural effusion and 12 patients with benign pleural effusion. keywords: effusion; patients cache: pulmonarychronicles-477.htm plain text: pulmonarychronicles-477.txt item: #377 of 658 id: pulmonarychronicles-478 author: None title: Original article date: None words: 271 flesch: 43 summary: We estimate based on our results that future studies would need at least 800 children to achieve adequate statistical power. Excess weight is thought to contribute adversely to this disease and has been associated with both an increased incidence and severity of asthma in multiple studies. keywords: asthma cache: pulmonarychronicles-478.htm plain text: pulmonarychronicles-478.txt item: #378 of 658 id: pulmonarychronicles-479 author: None title: Review date: None words: 195 flesch: 30 summary: Liver cirrhosis with portal hypertension is considered one of the most common causes of gastrointestinal bleeding in general and comes after peptic ulcer disease. Gastrointestinal bleeding in the setting of portal hypertension occurs secondary to either esophageal varices or portal hypertensive gastropathy. keywords: gastrointestinal cache: pulmonarychronicles-479.htm plain text: pulmonarychronicles-479.txt item: #379 of 658 id: pulmonarychronicles-48 author: None title: Why this new journal? date: None words: 409 flesch: 43 summary: Medical journals in United States attract an international audience of readers and authors. New journals may try different formats which potentially expand the scope of academic activity. keywords: journal; medicine cache: pulmonarychronicles-48.htm plain text: pulmonarychronicles-48.txt item: #380 of 658 id: pulmonarychronicles-481 author: None title: Focused review date: None words: 299 flesch: 37 summary: The RFR is also important in patients who develop acute kidney injury and chronic kidney disease. Physicians should focus on clinical history and physical examination in patients with a history of prior episodes of acute kidney injury, monitor renal function, and avoid nephrotoxic insults. keywords: kidney cache: pulmonarychronicles-481.htm plain text: pulmonarychronicles-481.txt item: #381 of 658 id: pulmonarychronicles-482 author: None title: Focused review date: None words: 299 flesch: 37 summary: The RFR is also important in patients who develop acute kidney injury and chronic kidney disease. Physicians should focus on clinical history and physical examination in patients with a history of prior episodes of acute kidney injury, monitor renal function, and avoid nephrotoxic insults. keywords: kidney cache: pulmonarychronicles-482.htm plain text: pulmonarychronicles-482.txt item: #382 of 658 id: pulmonarychronicles-483 author: None title: Case report date: None words: 221 flesch: 21 summary: Keywords: tPA/DNAse, loculated pleural effusion, empyema Article citation: Medrano R, Schwalk A, Islam E. Intra-pleural tissue plasminogen activator and deoxyribonuclease: An alternative treatment option for pleural infections in specific populations. Case report Intra-pleural tissue plasminogen activator and deoxyribonuclease: An alternative treatment option for pleural infections in specific populations Rita Medrano MD, Audra Schwalk MD, Ebtesam Islam MD, PhD ABSTRACT Pleural infections can be associated with significant morbidity and mortality. keywords: dnase cache: pulmonarychronicles-483.htm plain text: pulmonarychronicles-483.txt item: #383 of 658 id: pulmonarychronicles-485 author: None title: Medical image date: None words: 641 flesch: 38 summary: Medical image Atrial conduction pathways Anurag Singh MD, Kenneth Nugent MD Corresponding author: Anurag Singh Contact Information: Anurag.singh@ttuhsc.edu DOI: 10.12746/swrccc.v6i25.485 In this issue of the Southwest Respiratory and Critical Care Chronicles, Argueta and coworkers report a patient who underwent two surgical procedures to resect a recurrent left atrial myxoma. In particular, surgical resection of left atrial myxomas in an atypical location, such as near the sinus node, can injure the sinus node and the Bachmann’s bundle.3 keywords: atrium; right cache: pulmonarychronicles-485.htm plain text: pulmonarychronicles-485.txt item: #384 of 658 id: pulmonarychronicles-486 author: None title: Regional medicine report date: None words: 263 flesch: 19 summary: Regional medicine report Abstract Improving health self-efficacy at a community health fair in Lubbock, Texas Taylor H. Lindgren MBA, Chelsea Burroughs, Mark Burroughs, George Parker MBA, Fatma Levent MD ABSTRACT To improve the health self-efficacy of the Lubbock, Texas community, Texas Tech University Health Sciences Center School of Medicine students organized a health fair to promote patient education and improve awareness of health issues, such as diabetes, heart health, hypertension, skin care, hypercholesterolemia, nutrition, stress management, cancer screening and recommendations, physical fitness, and mental health. Although the health fair was successful in marginally improving patient self-efficacy, patient education and overall community health can continue to be improved by expanding educational opportunities for health promotion and illness prevention, furthering overall access to care, and broadening the health fair’s target population. keywords: health; self cache: pulmonarychronicles-486.htm plain text: pulmonarychronicles-486.txt item: #385 of 658 id: pulmonarychronicles-487 author: None title: Statistics column date: None words: 1508 flesch: 52 summary: In this article, we will discuss some issues associated with sample size calculation. Formulas and considerations for sample size calculation differ for different outcome variable types. keywords: calculation; sample; size cache: pulmonarychronicles-487.htm plain text: pulmonarychronicles-487.txt item: #386 of 658 id: pulmonarychronicles-488 author: None title: Medicine and public policy date: None words: 4110 flesch: 60 summary: A layoff for health insurance cost reasons compounds the loss of health insurance with the loss of income from employment. There is no compelling reason for employers to provide health insurance for employees other than for specific risks related to employment. keywords: care; cargo; cost; health; health insurance; insurance; people cache: pulmonarychronicles-488.htm plain text: pulmonarychronicles-488.txt item: #387 of 658 id: pulmonarychronicles-489 author: None title: Medicine in the media date: None words: 2180 flesch: 58 summary: You’ve got your own cigarette now, baby You’ve come a long, long way”6 Emotional imagery depicting “cool” characters was also important in cigarette advertising that specifically targeted children and teenagers. In the United States, early cigarette advertising contained inches of text explaining the benefits of tobacco or providing testimonials from famous people. keywords: advertising; camel; cigarettes; man; marlboro; smoking; tobacco cache: pulmonarychronicles-489.htm plain text: pulmonarychronicles-489.txt item: #388 of 658 id: pulmonarychronicles-49 author: None title: Treatment Of Cardiorenal Syndrome Type 1: Ultrafiltration vs. Boluresis date: None words: 817 flesch: 42 summary: I am anticipating that the next heart failure guidelines will consider the results of this study and downgrade the recommendations for ultrafiltration in acute decompensated heart failure patients.   One third of patients with acute decompensated heart failure also develop worsening kidney function, and the management of these patients is very challenging. keywords: heart; patients; syndrome; ultrafiltration cache: pulmonarychronicles-49.htm plain text: pulmonarychronicles-49.txt item: #389 of 658 id: pulmonarychronicles-490 author: None title: Regional health news date: None words: 768 flesch: 44 summary: This report suggested reductions in tobacco use will depend on population based interventions, including increased tobacco prices, enforcing comprehensive smoke-free laws, public education through the mass media, and increasing access to clinical interventions with counseling and FDA approved medications. The Morbidity and Mortality Weekly Report for October 7, 2016, provided state specific prevalence rates for current cigarette smoking and smokeless tobacco use in adults for the year 2014.1 keywords: texas; tobacco; use cache: pulmonarychronicles-490.htm plain text: pulmonarychronicles-490.txt item: #390 of 658 id: pulmonarychronicles-491 author: None title: Medical image date: None words: 1077 flesch: 45 summary: Sonographic signs of free peritoneal air include gas above the liver, which results in a brighter liver capsule and an obscured liver parenchyma due to free gas, the movable gas sign, which refers to repositioning of the gas with patient motion or while applying pressure with the transducer, and, finally, peritoneal line enhancement, another sign that refers to a continuous or adjacent brightness of the peritoneal line due to the reflecting quality of the air in the sonogram.5 Keywords: pneumoperitoneum, peptic ulcer, esophagogastroduodenoscopy Figures-Figures 2,3 and 4 were obtained from OPENi (beta), an open source for medical images, at the Texas Tech University Health Sciences Center Library in Lubbock, Texas. Other less sensitive signs include Rigler’s sign (Figure 4) which is described as a bowel wall enhancement by intraluminal and extraluminal air, the falciform ligament sign in which the falciform ligament becomes visible due to the free air, and the inverted V sign which refers to enhancement of the lateral umbilical ligaments due to free air. keywords: air; figure; pneumoperitoneum; sign cache: pulmonarychronicles-491.htm plain text: pulmonarychronicles-491.txt item: #391 of 658 id: pulmonarychronicles-492 author: None title: Case report date: None words: 199 flesch: 41 summary: Keywords: HSV-1, HSV-2, buttock, recurrent infection Article citation: Sakya SM, DeWitt JP, Sturgeon A. Multiple recurrences of HSV-1 on right lower buttock. Case report Multiple recurrences of HSV-1 on right lower buttock Surav Man Sakya BS, Judy Park DeWitt BS, Ashley Sturgeon MD ABSTRACT Herpes simplex virus type 1 (HSV-1) is a common localized viral infection that affects many individuals in the general population. keywords: buttock cache: pulmonarychronicles-492.htm plain text: pulmonarychronicles-492.txt item: #392 of 658 id: pulmonarychronicles-494 author: None title: Case report date: None words: 323 flesch: 19 summary: Keywords: Catamenial pneumothorax, endometriosis/therapy, thoracic diseases, menstrual cycle Article citation: Iyer SK, Jessica Clay Ehrig JC, Marcos Sosa M, Phy J. Operative and hormonal management of recurrent catamenial pneumothorax: a case report. Case report Operative and hormonal management of recurrent catamenial pneumothorax: A case report Sivaraman K Iyer BS, Jessica Clay Ehrig MD, Marcos Sosa MD, Jennifer Phy DO ABSTRACT Catamenial pneumothorax refers to the recurrent collapse of a lung in conjunction with the menstrual cycle. keywords: pneumothorax; treatment cache: pulmonarychronicles-494.htm plain text: pulmonarychronicles-494.txt item: #393 of 658 id: pulmonarychronicles-495 author: None title: Case report date: None words: 143 flesch: 27 summary: Keywords: Mycobacterium tuberculosis, panuveitis, uveitis, ocular tuberculosis, Ozurdex, Quantiferon Gold Article citation: Burkes W, Freedman K, Dominguez L. Panuveitis: a case of suspected ocular tuberculosis. Case report Panuveitis: A case of suspected ocular tuberculosis William Burkes MD, Kenn Freedman MD, Leo Dominguez MD ABSTRACT A 32-year-old incarcerated man was evaluated for decreased vision in both eyes at a tertiary care facility. keywords: tuberculosis cache: pulmonarychronicles-495.htm plain text: pulmonarychronicles-495.txt item: #394 of 658 id: pulmonarychronicles-496 author: None title: Focused review date: None words: 210 flesch: 37 summary: Focused review Diagnosis and management of portal vein thrombosis in patients with cirrhosis of the liver Logan Adams BS, Somedeb Ball MD ABSTRACT Portal vein thrombosis (PVT) is an occlusion of the portal venous system and is a common complication of liver cirrhosis. Portal vein thrombosis is diagnosed by imaging modalities, such as ultrasound and computed tomography. keywords: vein cache: pulmonarychronicles-496.htm plain text: pulmonarychronicles-496.txt item: #395 of 658 id: pulmonarychronicles-497 author: None title: Medical image date: None words: 743 flesch: 43 summary: Medical image Loculated pneumothorax with a deep sulcus sign Daniel Hernandez MD, Rita Medrano MD, David Sotello MD, Andres Yepes MD, Ebtesam Islam MD, PhD Corresponding author: David Sotello Contact Information: David.sotello@ttuhsc.edu DOI: 10.12746/swrccc.v6i26.497 A 61-year-old man with amyotrophic lateral sclerosis, s/p tracheostomy, and ventilator dependence was admitted for evaluation of respiratory distress, fever, and increased secretions. AP chest x-ray showing interval resolution of loculated pneumothorax after a 16 French thoracostomy tube placement (arrow). keywords: air; chest; figure; pneumothorax cache: pulmonarychronicles-497.htm plain text: pulmonarychronicles-497.txt item: #396 of 658 id: pulmonarychronicles-498 author: None title: Medical news date: None words: 562 flesch: 59 summary: In an interview with Bloomberg, FDA Commissioner Scott Gottlieb characterized teenage vaping as an epidemic.1 Previous data from the CDC showed that teenage vaping substantially increased from 2013 to 2014, peaked in 2015, and had decreased in 2016 and 2017. Medical news FDA cracks down on teenage vaping Gilbert Berdine MD On September 12, 2018 the Food and Drug Administration (FDA) announced a series of actions concerning the use of electronic cigarettes or ecigs by teenagers. keywords: fda; vaping cache: pulmonarychronicles-498.htm plain text: pulmonarychronicles-498.txt item: #397 of 658 id: pulmonarychronicles-499 author: None title: Medical image date: None words: 296 flesch: 34 summary: Figure 1A. Posteroanterior view showing complete occlusion of the proximal segment of left MC. Posteroanterior view showing complete occlusion of the proximal segment of the left MCA. keywords: occlusion cache: pulmonarychronicles-499.htm plain text: pulmonarychronicles-499.txt item: #398 of 658 id: pulmonarychronicles-5 author: None title: The Supreme Court Decision on Obama Care Part I date: None words: 1318 flesch: 54 summary: This was a technical decision that has little impact on policy, law, or future Court decisions. Part 2 will examine the effects of the Supreme Court decision on health care from the perspective of Austrian economics. keywords: court; health; medicaid cache: pulmonarychronicles-5.htm plain text: pulmonarychronicles-5.txt item: #399 of 658 id: pulmonarychronicles-50 author: None title: Acrometastasis as the initial presentation of bronchogenic carcinoma date: None words: 1660 flesch: 48 summary: The patient was subsequently diagnosed with non-small cell lung cancer with right thumb metastasis. Rare site of metastasis of non small cell lung cancer. keywords: acrometastasis; cancer; lung; patient; right; thumb cache: pulmonarychronicles-50.htm plain text: pulmonarychronicles-50.txt item: #400 of 658 id: pulmonarychronicles-500 author: None title: Medicine in the arts date: None words: 1570 flesch: 66 summary: In moderate doses, alcohol consumption can produce feelings of well-being, but in larger doses can result in serious health problems, “Alcohol intoxication can be harmful for a variety of reasons, including impaired brain function . . . The earliest mention of alcohol consumption in the Bible occurs in Genesis 9:20-27; after the flood, Noah becomes drunk with wine and falls into a stupor, lying “uncovered.” . . . keywords: alcohol; consumption; father; new; york cache: pulmonarychronicles-500.htm plain text: pulmonarychronicles-500.txt item: #401 of 658 id: pulmonarychronicles-501 author: None title: Focused review date: None words: 178 flesch: 21 summary: Focused review Review of inflammatory biomarkers in hospitalized adults with suspected infection Mark D Lacy MD, FIDSA ABSTRACT Quantitative measurement of inflammatory biomarkers is frequently obtained in evaluating hospitalized patients with suspected or confirmed infections and other inflammatory disorders. Inflammatory biomarkers in hospitalized adults with suspected infection. keywords: biomarkers cache: pulmonarychronicles-501.htm plain text: pulmonarychronicles-501.txt item: #402 of 658 id: pulmonarychronicles-502 author: None title: Medical education date: None words: 214 flesch: 20 summary: Keywords: Myers-Briggs type indicator, physician personality, thinking, feeling, patient confidence Article citation: Kopel J. Physician personality and patient confidence. The alignment of physician-patient personalities and its effect on patient confidence and compliance have potential importance in the management of some disorders, such as, for example, substance abuse. keywords: patient cache: pulmonarychronicles-502.htm plain text: pulmonarychronicles-502.txt item: #403 of 658 id: pulmonarychronicles-504 author: None title: Statistics column date: None words: 1639 flesch: 45 summary: For example, we might define outcome clusters of “positive myocardial infarction with death”, “positive myocardial infarction who survive”, “negative myocardial infarction with death”, and “negative myocardial infarction who survive.” Often, a training data set is used to train the classification model, to determine the best parameters for mapping input variables onto outcome clusters. keywords: clustering; clusters; outcome; subjects cache: pulmonarychronicles-504.htm plain text: pulmonarychronicles-504.txt item: #404 of 658 id: pulmonarychronicles-505 author: None title: Medical news date: None words: 1037 flesch: 50 summary: The harmful components of tobacco cigarette smoke are products of incomplete combustion (pyrolysis) and the thermogenic degradation of tobacco cigarettes through heat (thermogenic degradation). Typical markers of pyrolysis and thermogenic degradation of tobacco cigarettes are acetaldehyde, an irritant carcinogenic volatile organic compound, benzo[a]pyrene, a carcinogenic polycyclic aromatic hydrocarbon, and carbon monoxide.2 Heat-Not-Burn products first came to market in 1988 but were not commercially successful.5 In November 2014, Japan was the focal market for the newly introduced Philip Morris International’s IQOS brand, Heat-Not-Burn tobacco products. keywords: iqos; morris; products; tobacco cache: pulmonarychronicles-505.htm plain text: pulmonarychronicles-505.txt item: #405 of 658 id: pulmonarychronicles-506 author: None title: Medicine and public policy date: None words: 168 flesch: 46 summary: Medicine and public policy Charity vs. government health care Gilbert Berdine MD ABSTRACT Part 3 of this series on sustainable health care discusses charity as a market phenomenon. Charity is contrasted with government health care or public health care. keywords: health cache: pulmonarychronicles-506.htm plain text: pulmonarychronicles-506.txt item: #406 of 658 id: pulmonarychronicles-507 author: None title: Medical student research report date: None words: 293 flesch: 45 summary: This proposed plan is based on four fundamental principles: staff hierarchy, universal patient triaging, patient movement procedure, and end point locations. Evacuation plans are necessary for any emergency when mass coordinated patient and staff movement to safety is required. keywords: evacuation cache: pulmonarychronicles-507.htm plain text: pulmonarychronicles-507.txt item: #407 of 658 id: pulmonarychronicles-508 author: None title: Editorial date: None words: 1422 flesch: 46 summary: CD64 of neutrophils is a strong marker for sepsis diagnosis; CD25 and CD69 are upregulated in lymphocytes during infection and sepsis. Assessment of clinical criteria for sepsis for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). keywords: blood; chip; diagnosis; patient; sepsis cache: pulmonarychronicles-508.htm plain text: pulmonarychronicles-508.txt item: #408 of 658 id: pulmonarychronicles-509 author: None title: ICU rounds date: None words: 258 flesch: 46 summary: Keywords: midodrine, vasopressor, septic shock, alpha (1)-agonist, refractory hypotension, intensive care unit Article citation: Dziuk BD, Iwuji K. Midodrine use in intensive care unit patients recovering from septic shock. ICU rounds Midodrine use in intensive care unit patients recovering from septic shock Bethannie D Dziuk PharmD, Kenneth Iwuji MD ABSTRACT Background: With the rising cost of ICU care and concerns about vasopressor associated complications, clinicians need oral medications that can hasten recovery from septic shock in patients requiring low dose IV vasopressors. keywords: midodrine cache: pulmonarychronicles-509.htm plain text: pulmonarychronicles-509.txt item: #409 of 658 id: pulmonarychronicles-51 author: None title: Skin Metastasis in a patient with Small-Cell Lung Cancer date: None words: 1823 flesch: 53 summary: The percentage of patients with lung cancer who develop skin metastasis ranges from 1-12%.9 Between 7-24% of these patients have cutaneous lesions as an initial sign of malignancy.10 Patients often present with nodules which can be single or multiple and varied in size; less common lesions include papules, plaques, ulcerations, and sclerodermoid lesions.9,11 Lung cancer with cutaneous metastasis usually involves the anterior chest, abdomen, head, neck, and back.11 Adenocarcinoma and large cell carcinoma have a higher incidence of cutaneous metastasis than squamous cell and small cell carcinoma.11 Reported mean survival after skin metastasis is approximately five months.13 Patients who present with skin lesions earlier have a lower survival rate than patients who develop skin metastasis later in the disease course.14 Various diagnostic and treatment modalities are involved in the next steps of patient management.  keywords: cancer; cell; chest; lung; metastasis; patients; skin cache: pulmonarychronicles-51.htm plain text: pulmonarychronicles-51.txt item: #410 of 658 id: pulmonarychronicles-510 author: None title: Editorial date: None words: 1218 flesch: 50 summary: Editorial Transforming pollen grains from an allergy causing material into a biomaterial for oral vaccination Harvinder Singh Gill, PhD Corresponding author: Harvinder Gill Contact Information: Harvinder.gill@ttu.edu DOI: 10.12746/swrccc.v7i27.510 For many people, the words ‘pollen grains’ are likely to conjure an image of a runny nose and itchy eyes. My group has been studying the potential of pollen grains for oral vaccination for many years. keywords: cells; pollen; ragweed; vaccination cache: pulmonarychronicles-510.htm plain text: pulmonarychronicles-510.txt item: #411 of 658 id: pulmonarychronicles-511 author: None title: Review date: None words: 367 flesch: 9 summary: Review Oxidative stress in intensive care unit patients: A review of glutathione linked metabolism and lipid peroxidation Srikala Meda MD, Sharda P. Singh PhD, Philip T. Palade PhD, Sahil Tonk, Sanjay Awasthi MD ABSTRACT Despite clear evidence of increased oxidative stress in the blood and tissues of critically ill intensive care unit patients, consistent beneficial effects of many different antioxidants have not been observed, and antioxidant therapy has not yet translated into widely accepted clinical practice. Control of lipid peroxidation is a crucial requirement for the beneficial effects of antioxidants, but the interactions of biological antioxidant defenses with the potentially harmful free radical behavior of pharmacological antioxidants complicates the dose and selection of the optimal antioxidants. keywords: lipid; peroxidation cache: pulmonarychronicles-511.htm plain text: pulmonarychronicles-511.txt item: #412 of 658 id: pulmonarychronicles-512 author: None title: ICU rounds date: None words: 221 flesch: 40 summary: During the mid-20th century, two physicians, Horace W. Davenport and Robert W. Winters, revealed the physiological mechanisms and provided a mathematical description of acid-base physiology. In this paper, we discuss the history of acid-base physiology and revisit Winters’s formula with respect to extreme disturbances in pH. Keywords: Lawrence Henderson, Horace Davenport, Robert Winters, Henderson-Hasselbalch equation, acid-base physiology, Winters’s formula, and Davenport diagrams Article citation: Kopel J, keywords: base cache: pulmonarychronicles-512.htm plain text: pulmonarychronicles-512.txt item: #413 of 658 id: pulmonarychronicles-513 author: None title: Regional medicine original article date: None words: 332 flesch: 59 summary: Regional medicine original article Trends in emergency department visits in Lubbock from 2011–2017 Sarah Jaroudi BS, Shengping Yang PhD, Gilbert Berdine MD ABSTRACT To determine trends in daily emergency department (ED) visits, a preliminary retrospective study was done to analyze the relationship of long-term trends, day of week, and month of year to ED volume at University Medical Center in Lubbock, TX. An increase in ED visits from 2011 to 2014 was followed by a decrease in ED visits from 2014 to 2017. keywords: day; visits cache: pulmonarychronicles-513.htm plain text: pulmonarychronicles-513.txt item: #414 of 658 id: pulmonarychronicles-518 author: None title: Editorial date: None words: 1214 flesch: 26 summary: Editorial Oxidative stress Kenneth Nugent MD Corresponding author: Kenneth Nugent Contact Information: Kenneth.nugent@ttuhsc.edu DOI: 10.12746/swrccc.v7i27.518 In this issue of the Southwest Respiratory and Critical Care Chronicles, Meda and coauthors review oxidative stress in critically ill patients.1 They provide a detailed summary of oxidation reactions and the cellular damage associated with oxidative stress, discuss the importance of balance between endogenous and exogenous oxidants and antioxidants to maintain physiological processes and to prevent injury, review glutathione metabolism, and summarize recent studies on the enzyme RalA Binding Protein 1 (RALBP1, also called Rlip) involved in the transport of glutathione adducts out cells for metabolism and excretion. keywords: neutrophils; oxidative; oxygen; sepsis; stress cache: pulmonarychronicles-518.htm plain text: pulmonarychronicles-518.txt item: #415 of 658 id: pulmonarychronicles-519 author: None title: Case report date: None words: 282 flesch: 26 summary: Keywords: Vascular endothelial growth factor, sunitinib, anti-VEGF nephropathy, renal cell carcinoma, podocytes, thrombotic microangiopathy, hypertension, acute renal injury Article citation: Pena-Hernandez C, Rahman RM, Thavaraputta S, Garg N. VEGF modulation and renal effects: case report and review of the literature. With the disruption of nutritional processes in the kidney, there can be renal injury starting at the cellular level and referred to by some experts as anti-VEGF nephropathy (hypertension, thrombotic microangiopathy, proteinuria, renal failure). keywords: vegf cache: pulmonarychronicles-519.htm plain text: pulmonarychronicles-519.txt item: #416 of 658 id: pulmonarychronicles-52 author: None title: Molecular Tools for S. aureus Typing date: None words: 404 flesch: 55 summary: The best treatment for adult tracheal stenosis is endobronchial laser resection, but complex lesions may require surgical resection and/or stents.    The current state of congenital tracheal stenosis. keywords: stenosis; tracheal cache: pulmonarychronicles-52.htm plain text: pulmonarychronicles-52.txt item: #417 of 658 id: pulmonarychronicles-521 author: None title: Medical image date: None words: 716 flesch: 48 summary: This report of such clear eggshell calcifications could be due to exposure to Agent Orange/dioxin coupled with years of exposure to silica. Due to his history of dyspnea on exertion and his occupation, an x-ray was obtained which showed bilateral hilar and mediastinal adenopathy with eggshell calcifications (Figure). keywords: agent; calcification; eggshell cache: pulmonarychronicles-521.htm plain text: pulmonarychronicles-521.txt item: #418 of 658 id: pulmonarychronicles-522 author: None title: Commentary date: None words: 1914 flesch: 51 summary: In agreement with the above concepts, Murphy and Hart suggested that disease severity and the degree to which respiratory failure was successfully treated by NIV were both important determinants to the long term success of home NIV in patients with COPD.5 If favorable results are achieved, the patient must be motivated to continue the hours of use forever. Failure due to inadequate time of NIV use may not be apparent if monitoring is by arterial blood gas taken shortly before NIV is discontinued in the morning. keywords: co2; failure; niv; patient cache: pulmonarychronicles-522.htm plain text: pulmonarychronicles-522.txt item: #419 of 658 id: pulmonarychronicles-523 author: None title: Medicine in art date: None words: 749 flesch: 60 summary: Medicine in art The Art of Surgery Anuj Shah MD, Anne Nugent MPH Corresponding author: Anuj Shah Contact Information: Artanuj@gmail.com DOI: 10.12746/swrccc.v7i27.523 The processes of performing an operation and of creating woodcut prints are surprisingly similar. “The Art of Surgery” is a series of woodcut prints that depicts the surgical procedure from start to finish. keywords: artist; prints cache: pulmonarychronicles-523.htm plain text: pulmonarychronicles-523.txt item: #420 of 658 id: pulmonarychronicles-524 author: None title: Focused review date: None words: 223 flesch: 25 summary: It is a known complication of invasive mechanical ventilation and has been reported with non-invasive ventilation. Keywords: Pneumomediastinum, barotrauma, mechanical ventilation, air leak, ventilator induced lung injury Article citation: Mousa S, Edriss H. Pneumomediastinum secondary to invasive and non-invasive mechanical ventilation. keywords: ventilation cache: pulmonarychronicles-524.htm plain text: pulmonarychronicles-524.txt item: #421 of 658 id: pulmonarychronicles-525 author: None title: Case report date: None words: 180 flesch: 40 summary: Case report A case of acute onset headache and visual loss Deepa Ragesh Panikkath MD ABSTRACT Granulomatosis with polyangiitis (GPA) is a multisystem autoimmune disorder. The Southwest Respiratory and Critical Care Chronicles 2019;7(27):55–57 From: The Department of Internal Medicine at Texas Tech University Health Sciences Center in Lubbock, Texas Submitted: 9/28/2018 Accepted: 12/10/2018 Reviewers: James Tarbox MD, John Pixley MD Conflicts of interest: none This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. keywords: case cache: pulmonarychronicles-525.htm plain text: pulmonarychronicles-525.txt item: #422 of 658 id: pulmonarychronicles-526 author: None title: Case report date: None words: 236 flesch: 26 summary: Keywords: hyperthyroidism, dilated cardiomyopathy, impaired ventricular systolic function Article citation: Chariyawong P, Rao A, Panikkath D, Panikkath R. Hyperthyroidism-induced dilated cardiomyopathy. Case report Hyperthyroidism-induced dilated cardiomyopathy Phumpattra Chariyawong MD, Angela Rao BA, Deepa Panikkath MD, Ragesh Panikkath MD ABSTRACT Hyperthyroidism is a common endocrine disorder with a prevalence of 1.3% in the general population, affecting more women than men. keywords: hyperthyroidism cache: pulmonarychronicles-526.htm plain text: pulmonarychronicles-526.txt item: #423 of 658 id: pulmonarychronicles-527 author: None title: Statistics column date: None words: 1502 flesch: 62 summary: P value is also associated with sample size. However, a few other factors also affect the FI, such as the proportion of events and the true result absolute p value. keywords: treatment; value cache: pulmonarychronicles-527.htm plain text: pulmonarychronicles-527.txt item: #424 of 658 id: pulmonarychronicles-528 author: None title: Medical news date: None words: 416 flesch: 43 summary: The viral causality in confirmed cases has been heterogeneous; some authorities propose that the etiology must be multifactorial and that environmental factors need to be considered. There are no specific vaccines recommended to prevent all cases of AFM, and the CDC recommends standard hygiene measures, such as hand washing, the administration of poliovirus vaccine, and seasonal mosquito control to prevent West Nile virus cases. keywords: afm; cases cache: pulmonarychronicles-528.htm plain text: pulmonarychronicles-528.txt item: #425 of 658 id: pulmonarychronicles-529 author: None title: Medical news date: None words: 787 flesch: 64 summary: The last year that U.S. life expectancy was less than the 2017 value of 78.6 years was in 2009 when life expectancy was 78.5 years. Society needs to consider that policies which decrease labor force participation may be partially responsible for the increase in suicides that are causing life expectancy in the U.S. to decline. keywords: life; years cache: pulmonarychronicles-529.htm plain text: pulmonarychronicles-529.txt item: #426 of 658 id: pulmonarychronicles-53 author: None title: Acute Kidney Injury and Rhabdomyolysis as an Initial Presentation of Hashimoto’s Thyroiditis date: None words: 1423 flesch: 48 summary: Table 1 Laboratory values   Admission Day 2 Follow up 2 months Follow up 3 months Follow up 6 months Free T4 (0.93-1.70) ng/dL 0.42 − 0.57 1.18 1.44 TSH (0.27-4.20) μIU /ml 69.2 − 52.1 34.0 4.7 CK (26-308) IU/ml 5,369 2,866 216 − − LDH (135-225) U/L 511 400 − − − AST (5-37) U/L 60 64 − − − ALT (5-41) U/L 90 79 − − − Creatinine (0.5-1.2) mg/dL 1.9 1.5 − − − Discussion Nearly 40% of patients with hypothyroidism have mild forms of myopathy.1 However, hypothyroidism presenting with rhabdomyolysis and AKI has rarely been reported.2-8 Our literature review using the PubMed database identified seven adults and two children with hypothyroidism and rhabdomyolysis.2-8 Most of the patients presented with acute renal failure secondary to rhabdomyolysis. Sekine N, Yamamoto M, Michikawa M, Enomoto T, Hayashi M, Ozawa E, Kobayashi Y. Rhabdomyolysis and acute renal failure in a patient with hypothyroidism. keywords: acute; hypothyroidism; patient; renal; rhabdomyolysis cache: pulmonarychronicles-53.htm plain text: pulmonarychronicles-53.txt item: #427 of 658 id: pulmonarychronicles-530 author: None title: Medical news date: None words: 768 flesch: 52 summary: Keywords: Affordable Care Act, Individual Mandate, Court ruling REFERENCES Texas Judge Rules Affordable Care Act Unconstitutional, But Supporters Vow To Appeal. Judge O’Connor’s ruling was based on the text of the ACA, a previous Supreme Court challenge to ACA: National Federation of Independent Businesses vs. Sebelius (NFIB), and the Tax Cuts and Jobs Act of 2017 (TCJA). keywords: aca; court cache: pulmonarychronicles-530.htm plain text: pulmonarychronicles-530.txt item: #428 of 658 id: pulmonarychronicles-531 author: None title: Case report date: None words: 213 flesch: 25 summary: Keywords: Pheochromocytoma, magnesium sulfate, hypertension, hemodynamics, adrenal gland neoplasm Article citation: Krueger CK, Turner KA, Moreno RA, Jones BB, Idowu O. The Southwest Respiratory and Critical Care Chronicles 2019; 7(30):47–50 From: University of Texas MD Anderson Cancer Center Division of Pharmacy (CKK); Texas Tech University Health Sciences Center School of Pharmacy (CKK); University of Texas MD Anderson Cancer Center Department of Critical Care (KAT, RAM, BBJ, OI). This case highlights the role and dosing of magnesium sulfate in the management of pheochromocytoma crisis. keywords: magnesium; pheochromocytoma cache: pulmonarychronicles-531.htm plain text: pulmonarychronicles-531.txt item: #429 of 658 id: pulmonarychronicles-536 author: None title: Editorial date: None words: 1554 flesch: 39 summary: Sepsis alters RBC morphology, deformability, aggregation, metabolism and function. The evolving erythrocyte: red blood cells as modulators of innate immunity. keywords: erythrocyte; oxygen; rbc; rbcs; sepsis cache: pulmonarychronicles-536.htm plain text: pulmonarychronicles-536.txt item: #430 of 658 id: pulmonarychronicles-537 author: None title: Editorial date: None words: 1230 flesch: 30 summary: Peripheral symmetrical gangrene. Management of symmetrical peripheral gangrene. keywords: gangrene; patients; spg; symmetrical; treatment cache: pulmonarychronicles-537.htm plain text: pulmonarychronicles-537.txt item: #431 of 658 id: pulmonarychronicles-538 author: None title: Original article date: None words: 401 flesch: 20 summary: Keywords: Thrombolytic therapy, cardiac arrest, advanced cardiac life support, cardiopulmonary resuscitation, tissue plasminogen activator Article citation: Cordoba D, Eneko Larumbe E, Rosales BN, Nugent K. Use of systemic thrombolytic therapy in patients with non-traumatic cardiac arrest: a systematic review and meta-analysis. Original article Use of systemic thrombolytic therapy in patients with non-traumatic cardiac arrest: A systematic review and meta-analysis Daniel Cordoba MD, Eneko Larumbe PhD, Brittany N. Rosales MD, Kenneth Nugent MD ABSTRACT Objective: To better delineate the benefits and risks of systemic thrombolytic therapy in patients with cardiac arrest from non-traumatic etiologies. keywords: analysis; therapy cache: pulmonarychronicles-538.htm plain text: pulmonarychronicles-538.txt item: #432 of 658 id: pulmonarychronicles-539 author: None title: Original article date: None words: 535 flesch: 48 summary: Since the SI with a cut-off of 1.0 identified patients with higher mortality risk, we would recommend using this cut-off instead of 0.7. Keywords: shock index, age shock index, modified shock index, outcomes Article citation: Comparison of the shock index, modified shock index, and age shock index in adult admissions to a tertiary hospital. Original article Comparison of the shock index, modified shock index, and age shock index in adult admissions to a tertiary hospital David Sotello MD, Shengping Yang PhD, Kenneth Nugent MD ABSTRACT Background: Multiple variables interact constantly to maintain the hemodynamic status of patients. keywords: index; shock cache: pulmonarychronicles-539.htm plain text: pulmonarychronicles-539.txt item: #433 of 658 id: pulmonarychronicles-54 author: None title: A Rare Case of Posterior Mediastinal Seminoma Mimicking Primary Lung Neoplasm date: None words: 1654 flesch: 40 summary: The diagnosis of mediastinal germ cell tumors can be established with a high degree of accuracy through fine needle aspiration biopsy with immunohistochemical analysis.9 After the diagnosis of a germ cell tumor is made, a primary testicular tumor must be excluded, and ultrasonography should be performed in all patients since  testicular palpation is insufficient to exclude a primary testicular tumor.10 Patients with extragonadal seminomas may have small increases in beta-HCG levels. He was diagnosed with primary mediastinal seminoma and was started on bleomycin, etoposide, and cisplatin. keywords: cell; germ; mediastinum; primary; seminoma; tumors cache: pulmonarychronicles-54.htm plain text: pulmonarychronicles-54.txt item: #434 of 658 id: pulmonarychronicles-540 author: None title: Case report date: None words: 181 flesch: 33 summary: Keywords: Takayasu arteritis, vasculitis, heart failure Article citation: Panikkath DR, Panikkath R. An unusual case of acute heart failure. This case report describes an atypical presentation of this disease in a 49-year-old Caucasian woman who presented in acute congestive heart failure. keywords: case cache: pulmonarychronicles-540.htm plain text: pulmonarychronicles-540.txt item: #435 of 658 id: pulmonarychronicles-541 author: None title: Case report date: None words: 316 flesch: 29 summary: The patient presented with pericardial effusion without other common clinical manifestations of lymphoma, such as fever, night sweats, and weight loss. Cardiac involvement in non-Hodgkin’s lymphoma is usually a late manifestation, and pericardial effusion as an initial presentation is rare. keywords: lymphoma cache: pulmonarychronicles-541.htm plain text: pulmonarychronicles-541.txt item: #436 of 658 id: pulmonarychronicles-542 author: None title: Case report date: None words: 208 flesch: 4 summary: Case report A case report of an immunocompetent patient with Coccidioides meningoencephalitis with atypical brain magnetic resonance imaging findings during a 1 year follow-up Dongkwan Jin MD, Juliana Gomez MD ABSTRACT Coccidioides meningoencephalitis is a central nervous system (CNS) fungal infection with Coccidioides species which can lead to various CNS complications, such as hydrocephalus, vasculitis, and stroke. Gomez J. A case report of an immunocompetent patient with Coccidioides meningoencephalitis with atypical brain magnetic resonance imaging findings during a 1 year follow-up. keywords: coccidioides cache: pulmonarychronicles-542.htm plain text: pulmonarychronicles-542.txt item: #437 of 658 id: pulmonarychronicles-543 author: None title: Medical education date: None words: 348 flesch: 37 summary: Keywords: Trauma, teamwork, team leader, medical eduation, assessment methods Article citation: Tuma F, Nassar A, Elder T, Reid S. Establishing an evaluation tool for trauma team leader performance during trauma resuscitation. The purpose of this study is to establish a formal and scientifically-based Trauma Team Leader Evaluation Tool. Methods and Results: A literature review was conducted on the assessment of trauma team leaders. keywords: team; trauma cache: pulmonarychronicles-543.htm plain text: pulmonarychronicles-543.txt item: #438 of 658 id: pulmonarychronicles-544 author: None title: Regional medicine case report date: None words: 326 flesch: 52 summary: Keywords: fracking, work site trauma, abscess, Aeromonas species Article citation: Reed L, Umelo J, Cotty S. Fracking, worksite injuries, and Aeromonas infection. Cultures from the thigh were positive for Aeromonas species. keywords: aeromonas; fracking cache: pulmonarychronicles-544.htm plain text: pulmonarychronicles-544.txt item: #439 of 658 id: pulmonarychronicles-545 author: None title: Regional medicine case report date: None words: 249 flesch: 39 summary: Regional medicine case report The management of a pregnant patient with malaria in West Texas Hanna Kodeih DO, James Maher MD, David Moore MD, Natalia Schlabritz-Lutsevich MD ABSTRACT Travel associated infectious disease, such as malaria, should be considered in returning travelers from an endemic area presenting with fever. She became acutely symptomatic including high grade fever while visiting West Texas from Nigeria. keywords: malaria cache: pulmonarychronicles-545.htm plain text: pulmonarychronicles-545.txt item: #440 of 658 id: pulmonarychronicles-546 author: None title: Medicine and public policy date: None words: 719 flesch: 43 summary: The Centers for Disease Control (CDC) has a simpler definition: “Medical tourism refers to traveling to another country for medical care. The very first piece of information offered by the CDC, even prior to the definition of medical tourism, is this warning in bold text: “Receiving medical care abroad can be risky. keywords: care; medical; tourism cache: pulmonarychronicles-546.htm plain text: pulmonarychronicles-546.txt item: #441 of 658 id: pulmonarychronicles-547 author: None title: Medicine in art date: None words: 1094 flesch: 67 summary: Professor Randy Pausch and writer Christopher Hitchens each published reflections on their mortality after being struck with terminal illnesses. In his book Mortality, Christopher Hitchens is not as sanguine about the chance to inspire others. keywords: hitchens; mortality; new; pausch cache: pulmonarychronicles-547.htm plain text: pulmonarychronicles-547.txt item: #442 of 658 id: pulmonarychronicles-548 author: None title: Medical image date: None words: 820 flesch: 38 summary: Tracheal stenosis is classified morphologically into: 1) Circumferential or concentric stenosis, which is usually caused by cuff related injury from endotracheal or tracheostomy tubes, or autoimmune disorders; 2) Triangular stenosis, which is usually caused by tracheal injury after tracheostomy, or chondritis; 3) Eccentric stenosis, which often occurs after intubation or thermal injury (inappropriate use of laser or electrocautery); 4) Complex stenosis, which happens most commonly after intubation or tracheostomy with cartilaginous injury; and 5) Simple stenosis, which is mucosal ischemia following endotracheal intubation with no associated chondritis. DISCUSSION Acquired tracheal stenosis often results from trauma (mostly iatrogenic from endotracheal intubation), neoplasm, infection, vasculitis, or an inflammatory, infiltrative process. keywords: narrowing; stenosis; tracheal cache: pulmonarychronicles-548.htm plain text: pulmonarychronicles-548.txt item: #443 of 658 id: pulmonarychronicles-549 author: None title: Case report date: None words: 155 flesch: 14 summary: Keywords: atrial septal defect, arrhythmogenic right ventricular cardiomyopathy, arrhythmogenic right ventricular dysplasia, congenital heart disease, left to right shunt Article citation: The Southwest Respiratory and Critical Care Chronicles 2019;7(30):58–62 From: Rocky Vista University College of Osteopathic Medicine, UC Health Heart Center Memorial Hospital Central, Colorado Springs, CO. Submitted: 5/9/2019 Accepted: 7/1/2019 Reviewers: Scott Shurmur MD; Aliakbar Arvandi MD Conflicts of interest: none This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. keywords: right cache: pulmonarychronicles-549.htm plain text: pulmonarychronicles-549.txt item: #444 of 658 id: pulmonarychronicles-55 author: None title: Clinical Staging of COPD date: None words: 811 flesch: 68 summary: In my own practice, I stage patients with COPD based on their response to steroids when treated for exacerbations. The following staging strategy is based on 20 years of following patients with COPD longitudinally within a private practice based in both clinic and hospital settings. keywords: patients; stage cache: pulmonarychronicles-55.htm plain text: pulmonarychronicles-55.txt item: #445 of 658 id: pulmonarychronicles-551 author: Nugent, Kenneth title: Abstracts from The Texas Tech University Health Sciences Center School of Medicine Summer Research Program from the Lubbock Campus presented at the Student Research Week in March 2019. The names in bold are the medical students who participated in this program in 2018. The author index starts after the last abstract (#32). date: 2019-06-20 words: 6976 flesch: 46 summary: This registry will contribute to fur- ther research, quality improvement, and better met- rics and guidelines when addressing PAD patients in West Texas. 10 Abstracts from The Texas Tech University Health Sciences Center School of Medicine Summer Research Program The Southwest Respiratory and Critical Care Chronicles 2019;7(29):3–13 Conclusion: This registry will contribute to fur- ther research, quality improvement, and better met- rics and guidelines when addressing PAD patients in West Texas. keywords: cancer; care; cells; center; control; disease; expression; health; medicine; patients; research; school; students; study; tech; texas; vaccine cache: pulmonarychronicles-551.pdf plain text: pulmonarychronicles-551.txt item: #446 of 658 id: pulmonarychronicles-553 author: Kaur, Gurvinder; Dufour, Jannette title: Highlighting the importance of medical research: School of Medicine medical student research program date: 2019-06-20 words: 1052 flesch: 49 summary: This is an eight-week program dur- ing the summer between years 1 and 2 of medical school that provides an opportunity for medical students to gain research experience. The Southwest Respiratory and Critical Care Chronicles 2019;7(29):1–2 1 Commentary Highlighting the importance of medical research: School of Medicine medical student research program Gurvinder Kaur PhD, Jannette M. Dufour PhD Corresponding author: Jannette Dufour Contact Information: Jannette.dufour@ttuhsc.edu DOI: 10.12746/swrccc.v7i29.550 Research into human physiology and causes of disease is necessary to provide cutting edge medical treatment. keywords: medical; research; students cache: pulmonarychronicles-553.pdf plain text: pulmonarychronicles-553.txt item: #447 of 658 id: pulmonarychronicles-556 author: None title: Editorial date: None words: 1880 flesch: 41 summary: They noted that microvessel density increased with fluid administration in both cardiac surgery patients and patients with sepsis but that there was a poor correlation between the fluid volume administered and the change in total vessel density in sepsis patients. Severe abnormalities in microvascular perfused vessel density are associated to organ dysfunctions and mortality and can be predicted by hyperlactatemia and norepinephrine requirements in septic shock patients. keywords: blood; flow; norepinephrine; patients; sepsis; shock cache: pulmonarychronicles-556.htm plain text: pulmonarychronicles-556.txt item: #448 of 658 id: pulmonarychronicles-558 author: None title: Original article date: None words: 511 flesch: 43 summary: Individuals with a congestive heart failure (CHF) or coronary heart disease (CHD) diagnosis had over twice the odds (OR 2.06, 95% CI: 1.50-2.82, p =< 0.001, and 2.11, 95% CI: 1.48-3.01, p =< 0.001, respectively) of having TPC <10th percentile. Weighted 10th and 90th percentiles were calculated, and logistic regression was used to predict likelihood (Odds ratio [OR]) of being in categories with TPC < 10th percentile or > 90th percentile. keywords: percentile; tpc cache: pulmonarychronicles-558.htm plain text: pulmonarychronicles-558.txt item: #449 of 658 id: pulmonarychronicles-559 author: None title: Review date: None words: 242 flesch: 23 summary: Keywords: unfractionated heparin, heparin, aPTT, anti-factor Xa, discordance, clotting Article citation: Opoku A, Iwuji K, Clough B, Le J, Moore M, Simmons C, Hyde B. Discordance between aPTT and anti-factor Xa levels and implications in patients receiving intravenous unfractionated heparin therapy. This article assesses the performance of aPTT and anti-Xa monitoring protocols and analyzes the discordance between aPTT and anti-Xa levels and its clinical implications in patients receiving intravenous heparin therapy. keywords: heparin cache: pulmonarychronicles-559.htm plain text: pulmonarychronicles-559.txt item: #450 of 658 id: pulmonarychronicles-560 author: None title: Pilot study date: None words: 397 flesch: 29 summary: Southwest Respiratory and Critical Care Chronicles 2019;7(30):19–28 From: Faculty of Medicine Siriraj Hospital (CL, WR, OR, NP), Mahidol University, Bangkok, Thailand; Pulmonary Division, Siriraj Piyamaharajkarun Hospital (CL), Thailand; Internal Medicine, Bumrungrad International Hospital (CL), Thailand Submitted: 5/20/2019 Accepted: 7/2/2019 Reviewer: The primary goal of this study was to compare patient satisfaction between bi-level positive airway pressure-spontaneous/timed with average volume assured pressure support (BiPAP S/T with AVAPS) and BiPAP S/T alone in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) using self-reported intensity of dyspnea measured with the modified Borg scale (MBS) and a numeric rating scale (NRS) and comfort level measured with a dyspnea and comfort scale. keywords: avaps cache: pulmonarychronicles-560.htm plain text: pulmonarychronicles-560.txt item: #451 of 658 id: pulmonarychronicles-561 author: None title: Medical ethics date: None words: 202 flesch: 24 summary: A majority of the general population and physicians support physician-assisted dying, but there is a need for medical societies to develop training, support, and implementation standards to aid physicians in this process. The Southwest Respiratory and Critical Care Chronicles 2019;7(30):36–42 From: The Department of Internal Medicine at Texas Tech University Health Sciences Center in Lubbock, Texas Submitted: 1/24/2019 Accepted: 6/7/2019 Reviewers: Gilbert Berdine MD, Chery Erwin JD, PhD Conflicts of interest: none This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. keywords: physician cache: pulmonarychronicles-561.htm plain text: pulmonarychronicles-561.txt item: #452 of 658 id: pulmonarychronicles-562 author: None title: In the clinic date: None words: 243 flesch: 25 summary: Keywords: Cystic fibrosis, acquired cystic fibrosis, smoking, mucociliary clearance Article citation: Kopel J. Acquired cystic fibrosis transmembrane conductance regulator protein (CFTR) dysfunction and cigarette smoking. More studies are needed to investigate the prevalence of acquired CFTR dysfunction and the differences between acquired and genetically-inherited CFTR dysfunction. keywords: cftr cache: pulmonarychronicles-562.htm plain text: pulmonarychronicles-562.txt item: #453 of 658 id: pulmonarychronicles-563 author: None title: Case report date: None words: 207 flesch: 30 summary: Keywords: Cystic lung disease, Birt–Hogg–Dubé, spontaneous pneumothorax Article citation: Ram J, Zaidan M, Duarte A. Birt–Hogg–Dubé – a rare case of cystic lung disease. Case report Birt–Hogg–Dubé – a rare case of cystic lung disease Jonathan Ram MD, Mohammed Zaidan MD, Alexander Duarte, MD ABSTRACT The differential diagnosis of cystic lung disease in adults includes inherited genetic syndromes and several acquired conditions. keywords: disease cache: pulmonarychronicles-563.htm plain text: pulmonarychronicles-563.txt item: #454 of 658 id: pulmonarychronicles-564 author: None title: Statistics column date: None words: 140 flesch: 35 summary: Is there any study design that can be utilized? Keywords: crossover design, carryover effect, sample size Article citation: Yang S, Berdine G. Crossover design. The Southwest Respiratory and Critical Care Chronicles 2019;7(30):63–66 From: Department of Biostatistics (SY), Pennington Biomedical Research Center, Baton Rouge, LA; Department of Internal Medicine (GB), Texas Tech University Health Sciences Center, Lubbock, Texas Submitted: 7/2/2019 Conflicts of interest: none This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. keywords: design cache: pulmonarychronicles-564.htm plain text: pulmonarychronicles-564.txt item: #455 of 658 id: pulmonarychronicles-565 author: None title: Medicine in art date: None words: 925 flesch: 69 summary: The Death of Socrates, by French painter Jacques Louis David in 1787, portrays the ancient philosopher Socrates immediately before his suicide.2 He has been on trial for “impiety” against the Athenian pantheon of gods and for corrupting the city’s youth by presenting them with “new” ideas. Socrates sits upright on his bed surrounded by distraught supporters, including an elderly Plato, who slumps with his back turned in a chair at the end of the bed. keywords: decision; making; socrates cache: pulmonarychronicles-565.htm plain text: pulmonarychronicles-565.txt item: #456 of 658 id: pulmonarychronicles-566 author: None title: Medicine and public policy date: None words: 1156 flesch: 57 summary: The New England Journal of Medicine recently featured a commentary about popular demand for government solutions to health care problems.1 The commentary discussed polls that demonstrate that the public is concerned about the high cost of health care. keywords: care; government; people cache: pulmonarychronicles-566.htm plain text: pulmonarychronicles-566.txt item: #457 of 658 id: pulmonarychronicles-567 author: None title: Medical image date: None words: 765 flesch: 37 summary: The history of surgery for pulmonary tuberculosis. Alexander J. The surgery of pulmonary tuberculosis. keywords: lung; thoracoplasty; tuberculosis cache: pulmonarychronicles-567.htm plain text: pulmonarychronicles-567.txt item: #458 of 658 id: pulmonarychronicles-568 author: None title: Medical image date: None words: 1061 flesch: 49 summary: Our case with an excellent outcome supports the current literature that sternal plate fixation is an effective approach for secondary closure. Titanium plate fixation versus wire sternal closure in coronary artery bypass graft patients: Need for rigid sternal fixation. keywords: closure; dehiscence; fixation; plate; titanium cache: pulmonarychronicles-568.htm plain text: pulmonarychronicles-568.txt item: #459 of 658 id: pulmonarychronicles-569 author: None title: Abstract supplement date: None words: 2088 flesch: 41 summary: The Southwest Respiratory and Critical Care Chronicles 2019; v.7 (27):36–42. Impact of Preoperative Atrial Fibrillation in Patients with Left Ventricular Assist Device: A Systematic Review and Meta-Analysis Pakpoom Tantrachoti, Saranapoom Klomjit, Wasawat Vutthikraivit, Sofia Prieto, Nandini Nair Background: Atrial fibrillation (AF) is commonly found in patients being evaluated for left ventricular assist devices (LVAD). The pooled analysis revealed a significantly increased risk of mortality in pre-operative AF patients who underwent LVAD operation compared to those with NAF (Risk Ratio [RR] 1.19, 95% CI 1.07-1.33, I2 = 0%). keywords: cdi; patients; residents; risk; studies; study cache: pulmonarychronicles-569.htm plain text: pulmonarychronicles-569.txt item: #460 of 658 id: pulmonarychronicles-57 author: None title: Molecular Tools for S. aureus Typing date: None words: 1535 flesch: 45 summary: Here, we summarize some of the key tools for S. aureus typing, and their applications for healthcare providers. Koreen, L., et al., spa typing method for discriminating among Staphylococcus aureus isolates: implications for use of a single marker to detect genetic micro- and macrovariation. keywords: aureus; isolates; mrsa; spa; typing cache: pulmonarychronicles-57.htm plain text: pulmonarychronicles-57.txt item: #461 of 658 id: pulmonarychronicles-570 author: None title: Regional medical news date: None words: 374 flesch: 39 summary: Regional medical news National shortage of tuberculin skin test antigens David Sotello MD Corresponding author: David Sotello Contact Information: David.sotello@ttuhsc.edu DOI: 10.12746/swrccc.v7i30.570 Adequate identification and treatment of patients with latent tuberculous infection (LTI) is a matter of high importance in public health. Keywords: tuberculosis, skin tests, interferon gamma release assays REFERENCE Nationwide shortage of tuberculin skin test antigens: CDC recommendations for patient care and public health practice. keywords: skin; tst cache: pulmonarychronicles-570.htm plain text: pulmonarychronicles-570.txt item: #462 of 658 id: pulmonarychronicles-571 author: None title: Letter to the editor date: None words: 640 flesch: 55 summary: Physicians are also part of a community of physicians. If a helper—physician or otherwise—assists an individual in ending that individual’s life, it depends on how the assistance is given. keywords: end cache: pulmonarychronicles-571.htm plain text: pulmonarychronicles-571.txt item: #463 of 658 id: pulmonarychronicles-572 author: None title: Letter to the editor date: None words: 486 flesch: 43 summary: First, the ethical issues involved in the possibility for disabled individuals to be disproportionately affected by physician assisted dying has concerned the bioethics community for many years. There are a full range of issues that physicians, ethicists, and patients need to explore together, but two points in particular have received robust discussion. keywords: dying; physician cache: pulmonarychronicles-572.htm plain text: pulmonarychronicles-572.txt item: #464 of 658 id: pulmonarychronicles-573 author: None title: Focused review date: None words: 193 flesch: 33 summary: Immunoglobulin E associated systemic conditions. Keywords: Immunoglobulin E, Eosinophilic granulomatosis with polyangiitis, Churg Strauss syndrome, drug hypersensitivity, anaphylaxis, hyper IgE syndrome Article citation: Ismail A, Iwuji KC, Tarbox JA. keywords: immunoglobulin cache: pulmonarychronicles-573.htm plain text: pulmonarychronicles-573.txt item: #465 of 658 id: pulmonarychronicles-579 author: None title: Case report date: None words: 243 flesch: 21 summary: Article citation: Maksimovich D, Merrick CM, Cevik C. PFO closure consideration for refractory hypoxia and secondary prevention of recurrent arterial thromboembolism. This case demonstrates the potential beneficial role of PFO closure in a hypoxic patient with a right to left intracardiac shunt. keywords: pfo cache: pulmonarychronicles-579.htm plain text: pulmonarychronicles-579.txt item: #466 of 658 id: pulmonarychronicles-581 author: None title: Case report date: None words: 354 flesch: 38 summary: Case report Rare case of upside-down stomach in advanced hiatal hernia Nooraldin Merza MD, John Lung BS, Omar Bazzaz MD, Farah Aljuboory MD, Mazin Saadaldin MD, FRCS ABSTRACT Upside-down stomach (UDS) is the rarest type of hiatal hernia; it involves migration of the entire stomach into the posterior mediastinum with volvulus. We report a patient with chronic gastroesophageal reflux disease (GERD) and myelodysplastic syndrome who was admitted for syncope and signs of aspiration pneumonia with an incidental findings of hiatal hernia type IV with UDS. keywords: hernia; hiatal cache: pulmonarychronicles-581.htm plain text: pulmonarychronicles-581.txt item: #467 of 658 id: pulmonarychronicles-583 author: None title: Systematic review date: None words: 388 flesch: 39 summary: Systematic review Clinical value of pulmonary metastasectomy for thyroid malignancies: a systematic review and meta-analysis Yusuf Dundar MD, Quinton Mandle, Julie Samantray MD, Jeffrey Hotaling MD, Syed M Rizi, John Cramer MD, Ho-Sheng Lin MD, Syed N Raza MD ABSTRACT Background: There is currently no consensus on the role of pulmonary metastasectomy (PM) for thyroid malignancies. Clinical value of pulmonary metastasectomy for thyroid malignancies: a systematic review and meta-analysis. keywords: review cache: pulmonarychronicles-583.htm plain text: pulmonarychronicles-583.txt item: #468 of 658 id: pulmonarychronicles-587 author: None title: Editorial date: None words: 1117 flesch: 45 summary: Structural causal models have been used and applied in various epidemiological research projects and are becoming widely known to help answer clinical questions using observational data.3 A systematic approach is needed to create a structural causal model to understand a causal relationship between a variable and outcome of interest.4 The first step is to create a causal model based on prior knowledge about the question, as, for example, how low tidal volume ventilation decreases mortality. However, the most remarkable feature about using structural causal models in such clinical scenarios is how quickly results become available as opposed to trials that take years to complete. keywords: causal; distress; models; syndrome cache: pulmonarychronicles-587.htm plain text: pulmonarychronicles-587.txt item: #469 of 658 id: pulmonarychronicles-589 author: None title: Commentary date: None words: 1319 flesch: 55 summary: Some people use electronic cigarettes to help quit cigarette smoking. According to the CDC cigarette smoking was responsible for more than 480,000 deaths per year in the United States.5 Electronic cigarettes have been tolerated by the Food and Drug Administration (FDA) due to the possible reductions in cigarette smoking by the availability of electronic cigarettes. keywords: cigarettes; motor; vaping; vehicles cache: pulmonarychronicles-589.htm plain text: pulmonarychronicles-589.txt item: #470 of 658 id: pulmonarychronicles-591 author: None title: Original article date: None words: 2202 flesch: 42 summary: Rapid response teams have been in place in many hospital systems for more than 15 years with the primary objective of reducing avoidable adverse patient events. Looking forward to the future of rapid response teams, an accurate predictive model to determine the patients requiring close RRT follow-up to improve mortality is important future research. keywords: care; nurse; patient; response; rrt; team cache: pulmonarychronicles-591.htm plain text: pulmonarychronicles-591.txt item: #471 of 658 id: pulmonarychronicles-595 author: None title: Micu rounds date: None words: 2778 flesch: 50 summary: When available, cutoff levels of 2.0 μg/dL have been recommended to identify patients who would benefit from steroid use.17 Formulas have been established to calculate free cortisol levels based on total cortisol levels, CBG and protein levels, but studies of the use of these formulas have shown that they are not precise and result in up to 66 percent error when compared to actual measured free cortisol.18 THERAPEUTIC APPROACH OF CIRCI After the study mentioned above by Annane et al,13 several subsequent studies have examined the benefits of steroids in sepsis and septic shock patients without finding reduced mortality with the use of steroids.19,20,21 In 2008 the “Corticosteroid Therapy of Septic Shock Study” (CORTICUS) group found no survival benefits in patients with septic shock treated with hydrocortisone 50 mg every 6 hours, regardless of their responses to cosyntropin stimulation.19 Similarly, the “Hydrocortisone for Prevention of Septic Shock” (HYPRESS) study, in which patients with severe sepsis were assigned to receive a continuous infusion of 200 mg of hydrocortisone for 5 days followed by dose tapering until day 11 or placebo, found no reduced occurrence of septic shock with the use of hydrocortisone.20 Finally, a study by Venkatesh et al that compared use of hydrocortisone for 7 days to placebo in septic shock patients also found no survival benefit with the use of steroids; reduction in time for shock resolution and ICU length of stay were the only benefits of steroids in this study.21 We certainly know that cortisol levels increase in the setting of acute illness as an adaptive response for better survival; this is achieved to a large extent through decreased metabolism of cortisol and to a lesser extent through increased cortisol production. keywords: acute; cortisol; illness; insufficiency; levels; patients; shock cache: pulmonarychronicles-595.htm plain text: pulmonarychronicles-595.txt item: #472 of 658 id: pulmonarychronicles-599 author: None title: Statistics column date: None words: 201 flesch: 29 summary: Statistics column Bridging clinical perspectives with population health research Jeff A. Dennis PhD ABSTRACT Interdisciplinary research spanning clinical and population health perspectives has the potential to explore research areas that might not be examined within single respective disciplines. Bridging clinical perspectives with population health research. keywords: research cache: pulmonarychronicles-599.htm plain text: pulmonarychronicles-599.txt item: #473 of 658 id: pulmonarychronicles-6 author: None title: Sulfa allergy and therapeutic decisions date: None words: 1266 flesch: 26 summary: Patients with documented anaphylaxis with sulfonamides, or other serious drug reactions, and/or multiple medication allergies should avoid sulfonamide containing drugs and structurally related compounds. Keywords: sulfonamides, antibacterial agents/ adverse reactions, drug allergy, drug hypersensitivity References Brackett CC, Singh H, Block JH. keywords: allergy; drug; non; reactions; sulfonamide cache: pulmonarychronicles-6.htm plain text: pulmonarychronicles-6.txt item: #474 of 658 id: pulmonarychronicles-60 author: None title: BOARD REVIEW QUESTION Issue2 date: None words: 604 flesch: 46 summary: Pharmacologic options involve inhaled beta-agonists, anticholinergics, corticosteroid therapy and occasionally add-on therapy for persistent symptoms (methylxanthines and phosophodiesterase-4 inhibitors). Oral corticosteroid therapy should be used periodically for exacerbations of COPD only and regular use should be avoided.   keywords: patients; therapy cache: pulmonarychronicles-60.htm plain text: pulmonarychronicles-60.txt item: #475 of 658 id: pulmonarychronicles-601 author: None title: Regional medicine report date: None words: 285 flesch: 35 summary: Rural communities remain significant risk factors for opioid overdose and mortality in areas lacking access to opioid therapy. Keywords: Opioid, addiction, mortality, and rural communities Article citation: Kopel J. Opioid mortality in rural communities. keywords: mortality; opioid cache: pulmonarychronicles-601.htm plain text: pulmonarychronicles-601.txt item: #476 of 658 id: pulmonarychronicles-603 author: None title: Medicine in art date: None words: 1977 flesch: 67 summary: They considered two questions: (1) whether music therapy improves a patient’s sleep quality over standard care without the addition of music, and (2) whether music is actually beneficial or it is simply the reduction of background noise. This study concluded that “music therapy should routinely be prescribed for patients in the ICU” and that “the type of music should be geared toward relaxation . . . keywords: appalachia; breast; care; charms; folk; music; new; therapy cache: pulmonarychronicles-603.htm plain text: pulmonarychronicles-603.txt item: #477 of 658 id: pulmonarychronicles-605 author: None title: Commentary date: None words: 2783 flesch: 50 summary: Increased time to initial antimicrobial administration is associated with progression to septic shock in severe sepsis patients. Historically, sepsis biomarkers have lacked timeliness and specificity. keywords: care; criteria; dysfunction; organ; patients; sepsis; shock cache: pulmonarychronicles-605.htm plain text: pulmonarychronicles-605.txt item: #478 of 658 id: pulmonarychronicles-607 author: None title: Medical news date: None words: 491 flesch: 38 summary: swrccc.v7i31.607 As of October 1st, 2019, the Centers for Disease Control and Prevention (CDC) has reported 805 known cases of lung injury and 12 deaths associated with electronic cigarettes (e-cigarettes), also known as vapes, across 46 states and one U.S. territory.1 One hypothesis is that the aerosolized oils caused an inflammatory reaction in the airways and alveoli.3 Although e-cigarettes have been used as a smoking cessation tool, with a perceived view that they are safer than traditional cigarettes, the data concerning the safety of e-cigarettes have not been well-established. keywords: cigarettes; patients cache: pulmonarychronicles-607.htm plain text: pulmonarychronicles-607.txt item: #479 of 658 id: pulmonarychronicles-609 author: None title: In the clinic date: None words: 755 flesch: 60 summary: Pulmonary illness related to e-cigarette use in illinois and wisconsin—preliminary report. Characteristics of a multistate outbreak of lung injury associated with e-cigarette use, or vaping—United States, 2019. keywords: disease; patient; vaping cache: pulmonarychronicles-609.htm plain text: pulmonarychronicles-609.txt item: #480 of 658 id: pulmonarychronicles-61 author: None title: Factors affecting mortality in patients with COPD exacerbations requiring ICU admission date: None words: 2946 flesch: 47 summary: Identifying factors that strongly affect mortality in ICU patients might help clinicians make better treatment decisions and facilitate discussions with patients and their families about the prognosis. Conclusions We identified several clinically important parameters which are easily available in ICU patients and suggest that these simple parameters (low MAP, intubation, and high BUN) can help predict in-hospital mortality in patients with AECOPD requiring ICU admission. keywords: acute; admission; aecopd; copd; disease; factors; hospital; icu; mortality; patients; study cache: pulmonarychronicles-61.htm plain text: pulmonarychronicles-61.txt item: #481 of 658 id: pulmonarychronicles-611 author: None title: Medical image date: None words: 673 flesch: 38 summary: Keywords: Lymphangioleiomyomatosis, cystic lung disease, diffuse lung disease REFERENCES Kalassian KG, Doyle R, Kao P, et al. Lymphangioleiomyomatosis: new insights. Abbott GF, Rosado-de-Christenson ML, Frazier AA, et al. Lymphangioleiomyomatosis: radiologic-pathologic correlation. keywords: lung; lymphangioleiomyomatosis; patient cache: pulmonarychronicles-611.htm plain text: pulmonarychronicles-611.txt item: #482 of 658 id: pulmonarychronicles-613 author: None title: Heart failure symposium date: None words: 3486 flesch: 44 summary: 2019;139:e56–e528. Nieminen M S, Brutsaert D, Dickstein K, et al. EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population. Am J Cardiol 2005;96:11G–17G. Setoguchi S, Stevenson LW, Schneeweiss S. Repeated hospitalizations predict mortality in the community population with heart failure. keywords: acute; cardiac; failure; heart; heart failure; patients; risk; sleep; transplantation cache: pulmonarychronicles-613.htm plain text: pulmonarychronicles-613.txt item: #483 of 658 id: pulmonarychronicles-615 author: None title: Original article date: None words: 445 flesch: 47 summary: The mortality rates were 38.5% in underweight patients (BMI <18.5kg/m2), 51.1% in normal weight patients (BMI 18.5–24.9 kg/m2), 38.5% in overweight patients (BMI 25–29.9 kg/m2), and 40.2% in obese patients (BMI >30 kg/m2). Body mass index did not have an independent effect on mortality after adjusting for age, gender, and APACHE II scores; however, overweight patients required more mechanical ventilation days and had an increased LOS in the ICU and the hospital. keywords: bmi; patients cache: pulmonarychronicles-615.htm plain text: pulmonarychronicles-615.txt item: #484 of 658 id: pulmonarychronicles-619 author: None title: Abstract supplement date: None words: 44965 flesch: 45 summary: Patients typically present with a rapidly enlarging symptomatic mass, most often due to a nodal enlargement in the neck or abdomen. Extranodal involvement is common and “B” symptoms are seen in approximately 30% of patients. keywords: abdominal; acute; admission; antibiotics; artery; bilateral; biopsy; blood; cancer; cardiac; care; case; case presentation; cell; chest; chronic; clinical; conclusion; coronary; criteria; data; days; department; device; diagnosis; diffuse; discussion; disease; drug; elevated; examination; findings; follow; hepatitis; history; hospital; imaging; improvement; infection; initial; intervention; introduction; laboratory; lesions; liver; lung; lymphoma; male; management; mass; medical; medications; months; mortality; negative; non; normal; obesity; pain; pancreatitis; patient; positive; presentation; primary; pulmonary; rate; renal; report; results; review; right; risk; study; surgery; symptoms; syndrome; therapy; time; treatment; type; use; vasculitis; weeks; workup; year cache: pulmonarychronicles-619.htm plain text: pulmonarychronicles-619.txt item: #485 of 658 id: pulmonarychronicles-62 author: None title: The Supreme Court Decision on Obama Care Part II: The Impact on U.S. Health Care date: None words: 1908 flesch: 58 summary: It is well known that health care costs are much greater in the last year of life.9 This study of health care expenses in Medicare patients from 1992-1996 showed that health care cost $37,581 during the last year of life vs. $7,365 for patients who survived. The proponents of ACA argue that health care costs will decrease by treating problems in the uninsured before they become more expensive emergency room problems. keywords: aca; care; cost; health cache: pulmonarychronicles-62.htm plain text: pulmonarychronicles-62.txt item: #486 of 658 id: pulmonarychronicles-621 author: None title: Annual meeting review date: None words: 383 flesch: 29 summary: Annual meeting review Texas Chapter of the American College of Physicians Annual Meeting Highlights Nicole Abbott BPR, Cynthia Jumper MD, MPH, Drew Payne DO Corresponding author: Drew Payne Contact Information: Drew.payne@ttuhsc.edu More than 450 members attended the 2019 Texas Chapter of the American College of Physicians Annual Meeting, held in San Antonio, Texas, in October. Educational pre-course sessions offered ABIM SEP Modules, including Updates in Internal Medicine, Updates in Hospital Medicine, and a Point-of-Care Ultrasound Session workshop. keywords: medicine; updates cache: pulmonarychronicles-621.htm plain text: pulmonarychronicles-621.txt item: #487 of 658 id: pulmonarychronicles-623 author: None title: Regional medicine case report date: None words: 286 flesch: 28 summary: In an age in which non-traditional relationships are more common, Texas critical care clinicians should be familiar with informal marriage and recognize it in their patients to efficiently identify surrogates and therefore improve patient care. Modern family: Texas critical care clinicians need to know about informal marriage. keywords: care cache: pulmonarychronicles-623.htm plain text: pulmonarychronicles-623.txt item: #488 of 658 id: pulmonarychronicles-625 author: None title: Commentary date: None words: 3167 flesch: 42 summary: Their approach requires evaluation of patients with IDSA/ATS criteria for severity of pneumonia. But in this case, and even as mentioned in the references evaluated by the panel, one large observational study showed lower mortality associated with blood cultures at the time of admission.6 The ATS and IDSA panel makes an argument based on reduced length of stay (LOS) in a large retrospective study.7 This study shows that LOS was longer in patients who had blood cultures done, underwent mechanical ventilation, and were admitted to ICU. keywords: adults; cap; evidence; patients; pneumonia; quality; recommendation cache: pulmonarychronicles-625.htm plain text: pulmonarychronicles-625.txt item: #489 of 658 id: pulmonarychronicles-627 author: None title: Original article date: None words: 359 flesch: 39 summary: The Southwest Respiratory and Critical Care Chronicles 2020;8(33):7–20 From: Departments of Internal Medicine (AR, ST, CB, SPS, SS, AH, SA) and Pediatrics (TPR, SC, KB, VT), Texas Tech University Health Sciences Center, Lubbock, Texas; Department of Pharmacology and Toxicology (PTP), University of Arkansas for Medical Sciences, Little Rock, AR; McGovern Medical School of the University of Texas Health Sciences Center (MD), Houston TX. Original article Chromosomal alterations of pediatric malignancy in a West Texas population Aditya Rajan BS, Sahil Tonk, Chhanda Bose PhD, Sharda P. Singh PhD, Sriman Swarup MD, Tejaswini P Reddy BS, Santosh Chavali BS, Kishore Bhende MD, Philip T. Palade PhD, Ashly Hindle PhD, Meenakshi Darden MD, Vijay Tonk PhD, Sanjay Awasthi MD ABSTRACT Background: Comparative genomic hybridization (CGH) microarrays are used for genome-wide evaluation of copy number variations (CNV) of known prognostic significance; however, unannotated variants of uncertain significance (VUS) are frequently present. keywords: phd; texas cache: pulmonarychronicles-627.htm plain text: pulmonarychronicles-627.txt item: #490 of 658 id: pulmonarychronicles-629 author: None title: Case series date: None words: 425 flesch: 44 summary: Case series Tunneled central venous catheterization, a viable option for long-term venous access in pediatric burn patients Clayton Wagner MS, Andrea Hess BS, Jose Olascoaga MS, Nicole Van Spronsen BS, John Griswold MD ABSTRACT Introduction: Pediatric patients with severe burns often require long-term venous access over the course of their recovery. Methods: To evaluate this method of central venous catheterization, we retrospectively reviewed the charts of pediatric burn patients who received a tunneled CVC to determine the incidence of specific complications associated with this catheterization technique. keywords: patients; tunneled cache: pulmonarychronicles-629.htm plain text: pulmonarychronicles-629.txt item: #491 of 658 id: pulmonarychronicles-63 author: None title: Bullous Lung disease date: None words: 555 flesch: 57 summary: Bullectomy is comparable to lung volume reduction in patients with end-stage emphysema. Giant bullous lung disease: evaluation, selection, techniques, and outcomes. keywords: bullae; bullous; lung cache: pulmonarychronicles-63.htm plain text: pulmonarychronicles-63.txt item: #492 of 658 id: pulmonarychronicles-631 author: None title: CICU rounds date: None words: 2424 flesch: 49 summary: Prospective randomized evaluation of the watchman left atrial appendage closure device in patients with atrial fibrillation versus long-term warfarin therapy: In these patients, there is distinct clinical need for an intervention that will reduce stroke risk while minimizing potential bleeding. keywords: device; fibrillation; patients; risk; stroke; warfarin; watchman cache: pulmonarychronicles-631.htm plain text: pulmonarychronicles-631.txt item: #493 of 658 id: pulmonarychronicles-633 author: None title: Case report and focused review date: None words: 136 flesch: 22 summary: Keywords: pleural effusion, eosinophilic effusion, dermatitis Article citation: Lacy M. Eosinophilic pleural effusion: a case and a review. Eosinophilic pleural effusion is caused by myriad etiologies and is a therapeutic challenge. keywords: eosinophilic cache: pulmonarychronicles-633.htm plain text: pulmonarychronicles-633.txt item: #494 of 658 id: pulmonarychronicles-635 author: None title: Case report date: None words: 167 flesch: 34 summary: Case report Approach to refractory hypoglycemia in the setting of pancreatic mass and commonly seen pitfalls Samantha Edwards BA, Genanew Bedanie MD, Drew Payne DO ABSTRACT An 86-year-old male presented with severe hypoglycemia and encephalopathy. Keywords: Hypoglycemia, testing, pancreatic mass Article citation: Edwards S, Bedanie G, Payne D. Approach to refractory hypoglycemia in the setting of pancreatic mass and commonly seen pitfalls. keywords: hypoglycemia cache: pulmonarychronicles-635.htm plain text: pulmonarychronicles-635.txt item: #495 of 658 id: pulmonarychronicles-64 author: None title: Open Access Journals: What’s the Problem? date: None words: 933 flesch: 53 summary: Obviously, publishing fraud is quite possible and potentially explains some of the recent increase in the number of open access journals. These authors consider the recent changes in publication related to the development of the Internet, the cost associated with open access publishing, the legal issues relevant to open access publishing, and the potential downsides associated with this approach to the distribution of information. keywords: access; journals; publishing cache: pulmonarychronicles-64.htm plain text: pulmonarychronicles-64.txt item: #496 of 658 id: pulmonarychronicles-641 author: None title: Statistics column date: None words: 1774 flesch: 38 summary: Because this type of heterogeneity is a reflection of difference in individual study quality, but not the difference in intervention effect, it should be avoided whenever possible. Generally speaking, meta-analysis can be performed by using either individual subject data or analytical results from individual studies. keywords: analysis; effect; meta; studies; study cache: pulmonarychronicles-641.htm plain text: pulmonarychronicles-641.txt item: #497 of 658 id: pulmonarychronicles-643 author: None title: Regional medicine case report date: None words: 237 flesch: 30 summary: Keywords: cattle, Mycobacterium tuberculosis, transmission Article citation: Edriss H, Lee M, Nugent K. Mycobacterium tuberculosis in a calf in West Texas: a rare pathology. A rare pathology Hawa Edriss MD, Melanie Lee MSN, Kenneth Nugent MD ABSTRACT The transmission of Mycobacterium tuberculosis from humans to cattle is relatively uncommon and has not been reported in the United States. keywords: texas; tuberculosis cache: pulmonarychronicles-643.htm plain text: pulmonarychronicles-643.txt item: #498 of 658 id: pulmonarychronicles-645 author: None title: Medicine and public policy date: None words: 701 flesch: 58 summary: How does this sum compare with our ability to pay? Figure 1 illustrates the growth of health care costs in the United States since 1960. Figure 1 clearly shows that rising health care costs cannot be explained by inflation; NHE have increased from $27.2 billion in 1960 to $3.492 trillion for 2017. keywords: care; health cache: pulmonarychronicles-645.htm plain text: pulmonarychronicles-645.txt item: #499 of 658 id: pulmonarychronicles-647 author: None title: Medical image date: None words: 791 flesch: 51 summary: Bladder stones are usually associated with renal or ureteral calculi, and they rarely ever occur without associated upper urinary tract calculi.3–4 Our patient was found to have giant bladder stones in association with left kidney staghorn stones. DISCUSSION Giant bladder stones have virtually disappeared from modern literature due to increased awareness of conditions leading to urinary tract stone formation.1–2 keywords: bladder; giant; stone cache: pulmonarychronicles-647.htm plain text: pulmonarychronicles-647.txt item: #500 of 658 id: pulmonarychronicles-649 author: None title: Medical image date: None words: 713 flesch: 48 summary: The electrocardiogram in ST elevation acute myocardial infarction: correlation with coronary anatomy and prognosis. The electrocardiogram has an important role in the diagnosis and the initial evaluation of patients with suspected acute coronary syndromes.1 An ST-segment elevation can occur in several cardiac abnormalities, including acute myocardial infarction, coronary vasospasm, pericarditis, left ventricular hypertrophy, Brugada syndrome, and fascicular bundle branch blocks.2 keywords: infarction; segment cache: pulmonarychronicles-649.htm plain text: pulmonarychronicles-649.txt item: #501 of 658 id: pulmonarychronicles-65 author: None title: Keppra a magical antiepileptic medication date: None words: 2284 flesch: 51 summary: The approved indications include being used in tablet form for the adjunct treatment of adults with partial onset seizures (Dec. 1999), as an injection for adults with partial onset seizure (July 2006), for the adjunct treatment of myoclonic seizures in adults and children 12 years of age and older with juvenile myoclonic epilepsy (Aug. 2006), for adjunct treatment of primary generalized tonic-clonic seizures in adults and children six years of age and older with idiopathic generalized epilepsy (March 2007), for adjunct treatment of primary generalized tonic-clonic seizures in adults and adolescents 16 years of age and older (May 2008), and for adjunctive treatment of partial onset seizures in pediatric patients one month of age or older (Dec. 2011). It also showed that LEV was associated with control of other seizure types (e.g., absences and GTC seizures) often associated with myoclonic seizures.11 Additionally, a placebo-controlled trial evaluated the use of LEV as adjunctive therapy in patients aged 4-65-years-old with GTC seizures associated with idiopathic generalized epilepsy and data showed adjunctive LEV was associated with significantly better seizure control than placebo.12 keywords: epilepsy; lev; levetiracetam; patients; seizures; treatment cache: pulmonarychronicles-65.htm plain text: pulmonarychronicles-65.txt item: #502 of 658 id: pulmonarychronicles-651 author: None title: Medicine in art date: None words: 1955 flesch: 53 summary: How can art analysis benefit medical students, residents, fellows, and attending physicians and, ultimately, their patients? Over 20 years ago, Dr. Irwin Braverman, a dermatologist at Yale, noticed that medical students often jumped to conclusions or relied overmuch on technology when developing a diagnosis instead of depending on their own observations.1 Reasoning that exposure to art could sharpen students’ observational skills, Dr. Braverman piloted a course in analyzing art; students spent time in museums then described objectively what they saw in paintings. Artist Anna Willieme believes in art as a teaching tool, “I was always fascinated, as an artist, with the ways that art could help me observe more,”2 and designed a course for medical students and physicians—“Observation and Uncertainty in Art and Medicine.” keywords: art; icarus; lives; medicine; painting; students cache: pulmonarychronicles-651.htm plain text: pulmonarychronicles-651.txt item: #503 of 658 id: pulmonarychronicles-653 author: None title: Medical news date: None words: 429 flesch: 29 summary: The usual peak activity months are December through February, although an important number of influenza cases can be seen as late as May. According to the Centers for Disease Control and Prevention (CDC), there has been a rise in reported cases of influenza since week 45 of 2019.1 Until week 48 of 2019 up to 10.2% of respiratory specimens by clinical laboratories nationwide (total 26,576 specimens) have tested positive for influenza; most of the cases are secondary to influenza B (71.1%), followed by H1N1 and H3N2 viruses.1 keywords: disease; influenza cache: pulmonarychronicles-653.htm plain text: pulmonarychronicles-653.txt item: #504 of 658 id: pulmonarychronicles-655 author: None title: Case report date: None words: 292 flesch: 27 summary: Keywords: Clear cell renal carcinoma, echocardiography, right atrium, metastasis, incidental findings Article citation: Dean R, Maniam G, Vo T. A rare case of renal cell carcinoma with hematogenous extension into the right atrium discovered incidentally on echocardiogram. Computed tomography of the abdomen demonstrated a 5 cm right lower pole renal mass with hilar involvement and filling defects in the IVC and the right renal vein; these findings were consistent with RCC tumor thrombus extension into the renal vein, IVC, and right atrium. keywords: extension cache: pulmonarychronicles-655.htm plain text: pulmonarychronicles-655.txt item: #505 of 658 id: pulmonarychronicles-66 author: None title: News Updates issue 2 date: None words: 228 flesch: 61 summary: Here’s the story and review.   After a recent JAMA meta-analysis regarding the use of hydroxyethyl starch solutions in patients with shock, the FDA is recommending  that the volume expander solutions carry a boxed warning for increased risk of kidney injury and death. keywords: review cache: pulmonarychronicles-66.htm plain text: pulmonarychronicles-66.txt item: #506 of 658 id: pulmonarychronicles-661 author: None title: Case report date: None words: 207 flesch: 28 summary: Literature investigating recurrent giant cell tumor of soft tissue is much more limited than literature on bony recurrence, and our understanding of its etiology is still developing. Keywords: giant cell tumor, bone, soft tissue, recurrence Article citation: Homen D, Brindley G, Beaver C. Recurrences of giant cell tumor of bone within soft tissue. keywords: tumor cache: pulmonarychronicles-661.htm plain text: pulmonarychronicles-661.txt item: #507 of 658 id: pulmonarychronicles-663 author: None title: Original article date: None words: 436 flesch: 36 summary: We found that schedules that emphasize the following parameters were protective of physician WLB and burnout: <70-hour work week goals, a maximum of one on-call night per five consecutive days, providing physicians with schedule information a minimum of one month in advance, limiting the number of consecutive work days to five, and providing allotted vacation time. Keywords: Physician, work-life balance, burnout, schedule Article citation: Reinhart E, Reely K, Dowdy K, Seth N, McGrade P, Jones C, Horan MJ, Provenzano N, Ramirez P, Hammonds K, Khan S. A systematic review of burnout and its relation to work-life balance and scheduling among United States physicians. keywords: burnout; work cache: pulmonarychronicles-663.htm plain text: pulmonarychronicles-663.txt item: #508 of 658 id: pulmonarychronicles-67 author: None title: Body Packing – The way to obscure illicit drugs date: None words: 529 flesch: 46 summary: A KUB revealed multiple foreign bodies in the distal small bowel and colon which were confirmed with a CT scan of the abdomen with contrast (Panel A, Arrow) and 3D reconstructed image (Panel B, Arrow showing Drug filled Pallets). Figure 1: A KUB showed multiple foreign bodies in the area of distal small bowel and colon (Black Arrow) and 3D reconstructed image showed Drug filled Pallets (Yellow Arrow). keywords: body; drug; packing cache: pulmonarychronicles-67.htm plain text: pulmonarychronicles-67.txt item: #509 of 658 id: pulmonarychronicles-671 author: None title: Editorial date: None words: 1850 flesch: 47 summary: The target level of support often involves measurement of either the PaO2 or the peripheral O2 saturation with a goal of 60 mmHg for PaO2 and 90% for O2 saturation. This level of support typically places the patient on the plateau region of the hemoglobin-oxygen dissociation curve with the argument that additional increments in PaO2 or O2 saturation provide little additional O2 content. keywords: days; group; oxygen; patients; saturation cache: pulmonarychronicles-671.htm plain text: pulmonarychronicles-671.txt item: #510 of 658 id: pulmonarychronicles-673 author: None title: Review date: None words: 323 flesch: 47 summary: Keywords: coronavirus disease 2019, global health, respiratory illness, COVID-19 Article citation: Saa L, Iwuji K. Coronavirus Disease 2019: Coronaviruses cause a variety of respiratory diseases, ranging from the mild common cold to the lethal Middle East Respiratory Syndrome. keywords: covid-19; disease cache: pulmonarychronicles-673.htm plain text: pulmonarychronicles-673.txt item: #511 of 658 id: pulmonarychronicles-675 author: None title: Review date: None words: 484 flesch: 23 summary: Keywords: COVID-19, SARS-CoV-2, surgical masks, N95 respirator, cloth masks, effectiveness, reuse Article citation: Rossettie S, Perry C, Mohammed Pourghaed M, Mimi Zumwalt M. Effectiveness of manufactured surgical masks, respirators, and home-made masks in prevention of respiratory infection due to airborne microorganisms. It is important to continue further inquiries about the efficacy and reusability of surgical masks, respirators, and homemade masks, so that both healthcare providers and the public can collaborate to help reduce the destructive impact of SARS-CoV-2 and work toward improving the prevention of this highly infectious, potentially deadly transmissible disease. keywords: masks; respirators cache: pulmonarychronicles-675.htm plain text: pulmonarychronicles-675.txt item: #512 of 658 id: pulmonarychronicles-677 author: None title: Review date: None words: 336 flesch: 21 summary: Review Decontamination methods of personal protective equipment for repeated utilization in medical/surgical settings Abdurrahman Kharbat BSA, Adin Mizer BS, Mimi Zumwalt MD ABSTRACT The COVID-19 pandemic has affected citizens and healthcare workers worldwide due to a number of important factors. A panicked public began hoarding medical supplies and personal protective equipment (PPE), leaving healthcare workers to care for patients without adequate protection. keywords: equipment; healthcare cache: pulmonarychronicles-677.htm plain text: pulmonarychronicles-677.txt item: #513 of 658 id: pulmonarychronicles-679 author: None title: Focused review date: None words: 197 flesch: 26 summary: In addition, more investigation is needed to determine whether cigarette smoking actually lowers the risk of developing sarcoidosis. Keywords: Sarcoidosis, smoking, causation, epidemiology Article citation: Kopel J. Sarcoidosis and smoking: an unlikely duo. keywords: sarcoidosis cache: pulmonarychronicles-679.htm plain text: pulmonarychronicles-679.txt item: #514 of 658 id: pulmonarychronicles-68 author: None title: The Supreme Court Decision on Obama Care Part2 date: None words: 1598 flesch: 58 summary: Rather than shrinking health care costs, RomneyCare is already significantly over budget. The only way these government programs will reduce health care costs is to make services unavailable to anyone at any price. keywords: aca; care; costs; health cache: pulmonarychronicles-68.htm plain text: pulmonarychronicles-68.txt item: #515 of 658 id: pulmonarychronicles-681 author: None title: Statistics column date: None words: 1753 flesch: 54 summary: Statistics column Multiplicity and statistical significance Gilbert Berdine MD Corresponding author: Gilbert Berdine Contact Information: Gilbert.Berdine@ttuhsc.edu DOI: 10.12746/swrccc.v8i34.681 The New England Journal of Medicine (NEJM) has recently announced new guidelines for statistical reporting of significant findings.1 “Some Journal readers may have noticed more parsimonious reporting of P values in our research articles over the past year.” The New England Journal of Medicine is concerned that P values may be misused in some situations to misrepresent Type 1 statistical errors as statistically significant outcomes. keywords: error; type; value cache: pulmonarychronicles-681.htm plain text: pulmonarychronicles-681.txt item: #516 of 658 id: pulmonarychronicles-683 author: None title: Medicine and public policy date: None words: 1045 flesch: 69 summary: In a recent commentary, the New England of Medicine (NEJM) proposes that scarce health care resources be rationed in a fair way.2 Although reasonable people can disagree as to how coronavirus resources should be rationed, nobody can claim a right to a scarce resource. keywords: care; coronavirus; health cache: pulmonarychronicles-683.htm plain text: pulmonarychronicles-683.txt item: #517 of 658 id: pulmonarychronicles-685 author: None title: Medicine in art date: None words: 2590 flesch: 69 summary: ”9 People living through plague years surely must have thought the world was ending. Although these diseases and bubonic plague are treatable since the discovery and development of antibiotics, pandemics still occur throughout the modern era. keywords: death; kivrin; new; oxford; pandemic; people; plague; time cache: pulmonarychronicles-685.htm plain text: pulmonarychronicles-685.txt item: #518 of 658 id: pulmonarychronicles-687 author: None title: Medical image date: None words: 712 flesch: 44 summary: The least frequent complication of splenic aneurysm is splenic infarction. The underlying cause was known in two-thirds of the patients at the time splenic infarction occurred; in the others, it was diagnosed following splenic infarction.1 keywords: cases; infarction; pain cache: pulmonarychronicles-687.htm plain text: pulmonarychronicles-687.txt item: #519 of 658 id: pulmonarychronicles-69 author: None title: Sweet Seizures date: None words: 1270 flesch: 48 summary: Keywords: Hyperglycemic hyperosmolar state, epilepsia partialis continua, focal seizures, diabetes ................................................................................................................................................................................................................................................................................................................................... Introduction Epilepsia partialis continua (EPC) refers to focal and recurrent seizures that happen every few seconds to minutes for extended periods of time.1 Cerebrovascular stroke, Rasmussen’s encephalitis, and viral encephalitis can cause EPC.1 Metabolic disorders can rarely cause EPC.1,2 Case Presentation A 65-year-old woman presented with recurrent involuntary movements of both upper extremities. Conclusion EPC is a rare form of focal seizures. keywords: continua; epc; epilepsia; hyperglycemia; partialis; seizures cache: pulmonarychronicles-69.htm plain text: pulmonarychronicles-69.txt item: #520 of 658 id: pulmonarychronicles-691 author: None title: Medical image date: None words: 622 flesch: 55 summary: A study conducted to compare the diagnostic value and consistency of chest CT with initial reverse-transcription polymerase chain reaction (RT-PCR) in COVID-19 indicated that the sensitivity of chest CT in suggesting COVID-19 was 97%. Correlation of chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A report of 1014 cases. keywords: chest; covid-19; disease cache: pulmonarychronicles-691.htm plain text: pulmonarychronicles-691.txt item: #521 of 658 id: pulmonarychronicles-695 author: None title: Letter to the editor date: None words: 502 flesch: 28 summary: Despite the fear of using thrombolytic therapy in cardiac arrest patients, benefits seem to outweigh risks in patients with pulmonary embolism as the underlying etiology as suggested by the Javaudin study and our retrospective analysis. REFERENCES Cordoba D, Larumbe E, Rosales BN, et al. Use of systemic thrombolytic therapy in patients with non-traumatic cardiac arrest: A systematic review and meta-analysis. keywords: arrest; patients cache: pulmonarychronicles-695.htm plain text: pulmonarychronicles-695.txt item: #522 of 658 id: pulmonarychronicles-70 author: None title: The misleading pulse date: None words: 758 flesch: 41 summary: Table Blood gas analysis Figure 1 : Doppler ultrasonography of femoral vein showing unusual phasicity. S Afr Med J 1973; 47:1261-2. Sharma p, Salwan s. Duplication of femoral vein and its significant clinical implications. keywords: arterial; artery; flow; vein cache: pulmonarychronicles-70.htm plain text: pulmonarychronicles-70.txt item: #523 of 658 id: pulmonarychronicles-701 author: None title: Commentary date: None words: 1075 flesch: 47 summary: Conti et al. found that higher levels of interleukin-1 (IL-1) and IL-6 were associated with more severe disease.3 Huang et al. reported that pro-inflammatory cytokines, including IL2, IL7, monocyte chemoattractant protein-1 Riou J, Hauser A, Counotte MJ, et al. keywords: aging; covid-19; immune; mortality cache: pulmonarychronicles-701.htm plain text: pulmonarychronicles-701.txt item: #524 of 658 id: pulmonarychronicles-703 author: None title: Announcement date: None words: 177 flesch: 26 summary: These articles will be supplemented by material and content using the Integrated Statistics Learning Environment, a user-friendly data analytics platform hosted by the Department of Statistics & Data Science at Carnegie Mellon University (http://www.stat.cmu.edu/isle). Announcement Journal Announcement This issue of the Southwest Respiratory and Critical Care Chronicles will introduce a pilot project involving the articles published in its Statistics Column. keywords: statistics cache: pulmonarychronicles-703.htm plain text: pulmonarychronicles-703.txt item: #525 of 658 id: pulmonarychronicles-71 author: None title: Dysphagia Post-Extubation date: None words: 1372 flesch: 33 summary: Vocal quality post swallow is a key indicator of swallow safety or possible dysfunction. After a bedside/clinical examination detected several subtle signs of dysphagia, including a mild change in vocal quality post swallow and a delayed nonproductive cough, a Modified Barium Swallow revealed consistent aspiration of thin liquid. keywords: aspiration; dysphagia; patient; speech; swallow cache: pulmonarychronicles-71.htm plain text: pulmonarychronicles-71.txt item: #526 of 658 id: pulmonarychronicles-715 author: None title: Medicine and public policy date: None words: 2477 flesch: 34 summary: FERMENT IN THE FIELD OF SCHOLARLY PUBLICATION AND THE EMERGENCE OF PREDATORY PUBLISHERS Predatory publishing is a money-making phenomenon that emerged in the first decade of the 21st century, and took advantage of the internal contradictions, shortcomings, and ferment in the field of scholarly journal publication. Brown et al. suggest that due to these monopolies, researchers and scientists who needed the information contained in journal articles were obliged to pay whatever price the journal publishers asked.12 In response to the subscriptions and site-licensing fee model of the scholarly journal industry, and the throttling effect of this model on the dissemination of knowledge and information, in 2000, a number of high profile American researchers, including Nobel prize winner, Harold Varmus, sought “to catalyze a revolution in scientific publishing” by proposing a paradigm shift13 in scholarly journal publication and economics—an “open access” publication model.12 keywords: access; journals; model; predatory; publication; publishers; publishing; research cache: pulmonarychronicles-715.htm plain text: pulmonarychronicles-715.txt item: #527 of 658 id: pulmonarychronicles-717 author: None title: Clinical case review date: None words: 305 flesch: 29 summary: Keywords: Delirium tremens, alcohol withdrawal, biomarkers Article citation: Sarangi A. Alcohol withdrawal. This case review discusses the current recommended protocol for the diagnosis and treatment of delirium tremens using a review of a patient managed both in an inpatient psychiatry unit and in an intensive care unit. keywords: delirium; tremens cache: pulmonarychronicles-717.htm plain text: pulmonarychronicles-717.txt item: #528 of 658 id: pulmonarychronicles-719 author: None title: Focused review date: None words: 228 flesch: 15 summary: Mycobacterium avium complex infections in immunocompetent patients can present primarily with extrapulmonary symptoms, and this makes the diagnosis of MAC infection in these patients more difficult. This paper reviews the presentation, diagnosis, pathogenesis, and treatment of extrapulmonary MAC infections in immunocompetent patients by compiling information from case reports identified by a PubMed search. keywords: patients cache: pulmonarychronicles-719.htm plain text: pulmonarychronicles-719.txt item: #529 of 658 id: pulmonarychronicles-72 author: None title: Sepsis Screening Tools date: None words: 1327 flesch: 56 summary: The complexities of sepsis recognition can be overcome by implementing a systematic recognition program for sepsis. This morning the patient is exhibiting signs and symptoms of severe sepsis, including temperature103.5°F, HR 117 beats per minute, mean arterial pressure 58 mmHg, decreased level of consciousness, and decreased urine output. keywords: care; patient; screening; sepsis; tool cache: pulmonarychronicles-72.htm plain text: pulmonarychronicles-72.txt item: #530 of 658 id: pulmonarychronicles-723 author: None title: Medicine and public policy date: None words: 1649 flesch: 55 summary: Nobody needs insurance or a government subsidy to pay for a bandage. People who request universal access to affordable health care, including the NEJM, really want universal access to UNAFFORDABLE health care. Rather than following the advice of Confucius and calling unaffordable health care by its proper name, advocates for universal health care put an exclamation point on their request by claiming a right to all health care whether it is affordable or not. keywords: affordable; care; health; universal cache: pulmonarychronicles-723.htm plain text: pulmonarychronicles-723.txt item: #531 of 658 id: pulmonarychronicles-725 author: None title: Medical image date: None words: 1183 flesch: 44 summary: Early reversal of right ventricular dysfunction in patients with acute pulmonary embolism after treatment with intravenous tissue plasminogen activator. Our patient was not a candidate for thrombolytic therapy as he was at high risk for major hemorrhage due to a brain neoplasm and recent brain surgery.12 Recognition of McConnell’s sign and understanding that its pathogenesis involves a moderate-sized pulmonary perfusion defect provide critical care physicians additional information to reach an earlier diagnosis and improve outcomes in cases of acute pulmonary embolism. keywords: acute; embolism; mcconnell; pulmonary cache: pulmonarychronicles-725.htm plain text: pulmonarychronicles-725.txt item: #532 of 658 id: pulmonarychronicles-727 author: None title: Review date: None words: 339 flesch: 40 summary: In this paper, we review current literature in PubMed regarding psychiatric effects of COVID-19 on varying populations and what long term mental health effects warrant consideration. This has sparked perpetual worldwide fear, panic, anxiety, depression, and distress along with concern for suicide, grief, post-traumatic stress disorder (PTSD), guilt, and long term mental health disorders. keywords: covid-19; depression cache: pulmonarychronicles-727.htm plain text: pulmonarychronicles-727.txt item: #533 of 658 id: pulmonarychronicles-729 author: None title: Case report date: None words: 318 flesch: 42 summary: Case report Vape-associated lung injury in an adolescent Hannah Wilkerson BS, Ganesh Maniam BA, MBA, Ryan E. Dean BS, MBA, Matthew Goldfinger DO, Preetha Kandaswamy MD, Todd Bell, MD ABSTRACT The rise in incidence of e-cigarette or vaping product use associated lung injury (EVALI) and associated deaths has become a growing concern among public health officials. After four days of ceftriaxone and supportive treatment, he showed significant improvement and was discharged on hospital day 5 with metronidazole and amoxicillin-clavulanate. keywords: case; lung cache: pulmonarychronicles-729.htm plain text: pulmonarychronicles-729.txt item: #534 of 658 id: pulmonarychronicles-731 author: None title: Review date: None words: 260 flesch: 31 summary: Keywords: COVID-19, SARS-CoV-2, coronavirus, age, neonates, pregnancy, older adults, mechanism, comorbidities, angiotensin converting enzyme 2 Article citation: John A, Ha F, Zumwalt M. Susceptibility/manifestations of different age groups with various comorbidities to COVID-19 infection. As a result, scientists have started analyzing the variable effects of COVID-19 infection in different age groups. keywords: age cache: pulmonarychronicles-731.htm plain text: pulmonarychronicles-731.txt item: #535 of 658 id: pulmonarychronicles-733 author: None title: Regional medicine case report date: None words: 162 flesch: 42 summary: Case 1 involves an incarcerated schizophrenic patient who presented multiple times following failed enucleation attempts before finally succeeding with bilateral enucleation. The Southwest Respiratory and Critical Care Chronicles 2020;8(36)78–80 From: Department of Ophthalmology, Texas Tech University Health Sciences Center, Lubbock, Texas Submitted: 7/11/2020 Accepted: 9/28/2020 Reviewer: keywords: case cache: pulmonarychronicles-733.htm plain text: pulmonarychronicles-733.txt item: #536 of 658 id: pulmonarychronicles-735 author: None title: Medicine in art date: None words: 2050 flesch: 61 summary: Belgian painter René Magritte’s 1928 painting The Lovers could be interpreted as capturing the feeling of disorientation produced by quarantine fatigue caused by social isolation. As more and more people succumbed worldwide and the death toll mounted, responsible leaders proposed a “stay at home” protocol, hoping that social isolation would slow the spread of the virus. keywords: fatigue; health; isolation; life; people; quarantine; typhoid cache: pulmonarychronicles-735.htm plain text: pulmonarychronicles-735.txt item: #537 of 658 id: pulmonarychronicles-739 author: None title: Original article date: None words: 390 flesch: 46 summary: This study will also provide an educational guide to facilitate effective evidence-based medical research and offer insight into the developments of COVID-19 research. The Southwest Respiratory and Critical Care Chronicles 2020;8(35):42–50 From: The School of Medicine (TDJ, SMS), Penn State University College of Medicine, Hershey, PA; Department of Surgery (EO), Texas Tech University Health Sciences Center, Lubbock, TX; Department of Neurosurgery (DRH), Penn State University College of Medicine, Hershey, PA; School of Medicine (JPS), Texas Tech University Health Sciences Center, Lubbock, Texas Submitted: 6/22/2020 Accepted: 7/13/2020 Reviewer: keywords: articles; covid-19 cache: pulmonarychronicles-739.htm plain text: pulmonarychronicles-739.txt item: #538 of 658 id: pulmonarychronicles-74 author: None title: Case reports yes or no date: None words: 1266 flesch: 45 summary: Case reports can provide important information about a new disease. We have had several patients in our hospital for whom reviewing the literature identified case reports directly related to the patients we had questions about and contributed to their care. keywords: case; literature; medical; reports cache: pulmonarychronicles-74.htm plain text: pulmonarychronicles-74.txt item: #539 of 658 id: pulmonarychronicles-741 author: None title: Systematic review date: None words: 262 flesch: 29 summary: Systematic review Electroencephalographic abnormalities in COVID-19-related encephalopathies: A systematic review Jie Pan MD, PhD, Shazma Khan BSA, Smathorn Thakolwiboon MD, Dargelis Chi MD ABSTRACT Background: Acute encephalopathy is a common neurological manifestation in coronavirus disease 2019 (COVID-19) patients and presents with confusion, delirium, or poor responsiveness. The electroencephalography (EEG) patterns in COVID-19 patients remain largely unknown. keywords: covid-19; patients cache: pulmonarychronicles-741.htm plain text: pulmonarychronicles-741.txt item: #540 of 658 id: pulmonarychronicles-743 author: None title: Review date: None words: 346 flesch: 35 summary: This article also discusses the emerging controversial proposals of employing high tidal volumes and low PEEP in mechanical ventilation of COVID-19 pneumonia and will review the key concepts of lung stress and strain and the implications of “static” versus “dynamic” strain in ventilator induced lung injury. It considers the established facts of inducing lung strain with larger dynamic deformations caused by high tidal volumes and the benefit of high PEEP in homogenizing the strain distribution. keywords: covid-19; lung cache: pulmonarychronicles-743.htm plain text: pulmonarychronicles-743.txt item: #541 of 658 id: pulmonarychronicles-745 author: None title: Case report date: None words: 339 flesch: 27 summary: This case of an 18-year-old woman with a chronic wound due to recurring skin and soft tissue infections (SSTIs) highlights the complications of surgical intervention and the difficulty of dealing with recurring SSTIs. Keywords: Chronic wound, skin and soft tissue infections, polymicrobial wounds Article citation: Bharadia D, Sturgeon A, Baird D, Aldrete J. Smoldering subcutaneous polymicrobial infection concealed beneath a cast and a skin graft: delayed wound healing due to recurring soft-tissue infections. keywords: tissue; wound cache: pulmonarychronicles-745.htm plain text: pulmonarychronicles-745.txt item: #542 of 658 id: pulmonarychronicles-749 author: None title: Review date: None words: 310 flesch: 34 summary: To help understand these concerns, this review addresses the necessity of vaccines, vaccine safety and development, and vaccine hesitancy. Keywords: COVID-19, SARS-CoV-2, vaccine, vaccine hesitancy, vaccine safety/efficacy Article citation: Perry C, Mizer A, Wynn A, Kruczek C. Countering COVID-19 vaccine hesitancy. keywords: covid-19; vaccine cache: pulmonarychronicles-749.htm plain text: pulmonarychronicles-749.txt item: #543 of 658 id: pulmonarychronicles-75 author: None title: Noncompaction of the Left Ventricular Myocardium: A Cause of Syncope in a Young Patient date: None words: 1509 flesch: 42 summary: We present a 19-year-old man who presented with syncope and was later diagnosed with left ventricular noncompaction. Novel gene mutations in patients with left ventricular noncompaction or Barth syndrome. keywords: cardiomyopathy; lvnc; myocardium; noncompaction; patients; ventricular cache: pulmonarychronicles-75.htm plain text: pulmonarychronicles-75.txt item: #544 of 658 id: pulmonarychronicles-751 author: None title: Review date: None words: 310 flesch: 24 summary: Review Links between exercise/nutrition and antioxidants–protective effects on immune/respiratory systems as defense against viral infections Abdurrahman F Kharbat MBA, Stephen Rossettie MBA, Mimi Zumwalt MD ABSTRACT This paper discusses factors involved in COVID-19 pathophysiology, with a focus on nutrition, exercise, enzymatic antioxidant systems, and the interplay between immune tolerance and resistance. Exercise has been shown to have protective tolerogenic effects against viral infection due to the impact of extracellular superoxide dismutases (EC-SODs). keywords: effects; exercise cache: pulmonarychronicles-751.htm plain text: pulmonarychronicles-751.txt item: #545 of 658 id: pulmonarychronicles-753 author: None title: Case report date: None words: 395 flesch: 32 summary: Keywords: COVID-19, coronavirus, renal transplant, immunosuppression, convalescent plasma, dexamethasone, remdesivir, tacrolimus, mycophenolate mofetil Article citation: Hannabas S, Hannabas G, Pena C. Case report The use of convalescent plasma, dexamethasone and remdesivir in a renal transplant patient infected with COVID-19 Sheena Hannabas FNP-C, MSN, Gregory Hannabas MD, MPH, MPA, Camilo Pena MD ABSTRACT Background: Immunocompromised patients, such as renal transplant recipients, are a high-risk population for coronavirus disease 2019 (COVID-19) infection and complications. keywords: covid-19; dexamethasone cache: pulmonarychronicles-753.htm plain text: pulmonarychronicles-753.txt item: #546 of 658 id: pulmonarychronicles-755 author: None title: Medicine and public policy date: None words: 1666 flesch: 58 summary: A recent CDC report gives raw U.S. data for deaths attributed to COVID-19, total deaths, and population stratified by age group as of September 9, 2020.1 Figure 1 illustrates the raw data for U.S. deaths attributed to COVID-19 stratified by age group. Data are from CDC.1 DIFFICULTIES WITH THE METRIC OF COVID DEATHS Figure 2 illustrates deaths attributed to COVID-19 as a fraction of death from all causes stratified by age group. keywords: deaths; interactions; number cache: pulmonarychronicles-755.htm plain text: pulmonarychronicles-755.txt item: #547 of 658 id: pulmonarychronicles-757 author: None title: Review date: None words: 327 flesch: 24 summary: Keywords: heart failure, medical management, complications, devices, palliative care Article citation: Elmassry M, Rahman R, Paz P, Mantilla B, Scott Shurmur S, Argueta Sosa E. Medical management of decompensated heart failure in adult patients: Part 1: Definition and medical management. Review Medical management of decompensated heart failure in adult patients: Part 1: Definition and medical management Mohamed Elmassry MD, Rubayat Rahman MD, Pablo Paz MD, Barbara Mantilla MD, Scott Shurmur MD, Erwin Argueta Sosa MD ABSTRACT Acute decompensated heart failure (ADHF) is the leading cause of hospitalization in patients older than 65 years. keywords: heart; management cache: pulmonarychronicles-757.htm plain text: pulmonarychronicles-757.txt item: #548 of 658 id: pulmonarychronicles-759 author: None title: Review date: None words: 274 flesch: 18 summary: Review Medical management of decompensated heart failure in adult patients: Part 2: Organ involvement, invasive hemodynamic monitoring, device therapy, and outcomes Barbara Mantilla MD, Pablo Paz MD, Rubayat Rahman MD, Mohamed Elmassry MD, Scott Shurmur MD, Erwin Argueta Sosa MD ABSTRACT Acute decompensated heart failure is a clinical syndrome involving the congestion of vital organs, such as the kidneys, liver, and brain, leading to loss of autoregulation and multiorgan failure. Keywords: acute decompensated heart failure, organ dysfunction, medical management, device therapy Article citation: Mantilla B, Paz P, Rahman R, Elmassry M, Shurmur S, Argueta Sosa E. Medical management of decompensated heart failure in adult patients: Part 2: Organ involvement, invasive hemodynamic monitoring, device therapy, and outcomes. keywords: failure cache: pulmonarychronicles-759.htm plain text: pulmonarychronicles-759.txt item: #549 of 658 id: pulmonarychronicles-76 author: None title: BOARD REVIEW QUESTION Issue3 date: None words: 440 flesch: 54 summary: Anterior mediastinal masses are usually lymphoma, thyroid, thymoma, or teratoma. Discussion: Mediastinal masses fortunately can be categorized by compartmental location. keywords: masses; thymoma cache: pulmonarychronicles-76.htm plain text: pulmonarychronicles-76.txt item: #550 of 658 id: pulmonarychronicles-761 author: None title: MICU rounds date: None words: 209 flesch: 30 summary: MICU rounds Clinical approach to burst-suppression pattern in an intensive care unit: basic and updates Jie Pan MD, PhD, Amputch Karukote MD, Eri Shoji MD ABSTRACT A burst-suppression pattern is an electroencephalographic pattern characterized by a quasi-periodic high amplitude “burst” alternating with periods of low or flatline “suppression.” Recognizing and understanding this pattern is helpful for clinical management in intensive care units. keywords: burst cache: pulmonarychronicles-761.htm plain text: pulmonarychronicles-761.txt item: #551 of 658 id: pulmonarychronicles-763 author: None title: Focused review date: None words: 264 flesch: 33 summary: A similar finding is observed between OSA and bipolar disorder, which can be aggravated by atypical antipsychotic treatments. Studies also showed a bidirectional relationship between OSA and major depressive disorder. keywords: osa cache: pulmonarychronicles-763.htm plain text: pulmonarychronicles-763.txt item: #552 of 658 id: pulmonarychronicles-765 author: None title: Focused review date: None words: 213 flesch: 11 summary: Gaps in the existing literature and future directions in the treatment of anticholinergic hypersensitive patients being treated for dystonia are also highlighted. Focused review Management of dystonia in patients with hypersensitivity to anticholinergics Ashish Sarangi MD, Lance Mwangi BA, E.L. Domingo-Johnson BSN, Arham Siddiqui BA ABSTRACT Background: Anticholinergics are one of the first-line treatments for patients with dystonia. keywords: dystonia cache: pulmonarychronicles-765.htm plain text: pulmonarychronicles-765.txt item: #553 of 658 id: pulmonarychronicles-767 author: None title: Focused review date: None words: 164 flesch: 17 summary: Keywords: echocardiographic strain, left ventricular dysfunction, speckle tracking, myocardial dysfunction Article citation: Prieto S, Hosseini O, Sethi P. Echocardiographic strain. The Southwest Respiratory and Critical Care Chronicles 2020;8(36)58–60 From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas Submitted: 9/29/2020 Accepted: 10/6/2020 Reviewer: keywords: strain cache: pulmonarychronicles-767.htm plain text: pulmonarychronicles-767.txt item: #554 of 658 id: pulmonarychronicles-769 author: None title: Medicine in art date: None words: 2090 flesch: 57 summary: Months of dealing with the COVID-19 pandemic have increased pressure on businesses, schools, and families, but health care workers face unrelenting and often unrelieved stress and anxiety. Prepare Me: Health care workers are often asked to serve in areas for which they are not adequately trained.1 keywords: care; covid-19; health; nurses; pandemic; professionals; workers cache: pulmonarychronicles-769.htm plain text: pulmonarychronicles-769.txt item: #555 of 658 id: pulmonarychronicles-77 author: None title: News Updates issue3 date: None words: 220 flesch: 63 summary: Here’s the story and review. Email: zachary.mulkey @ttuhsc.edu   After a recent JAMA meta-analysis regarding the use of hydroxyethyl starch solutions in patients with shock, the FDA is recommending  that the volume expander solutions carry a boxed warning for increased risk of kidney injury and death. keywords: review cache: pulmonarychronicles-77.htm plain text: pulmonarychronicles-77.txt item: #556 of 658 id: pulmonarychronicles-771 author: None title: Medical image date: None words: 823 flesch: 59 summary: Most of the background shows the presence of theta waves more than delta waves. Keywords: EEG, wave patterns, encephalopathy, burst-suppression REFERENCES Marcuse LV, Fields MC, Yoo J. Rowan’s Primer of EEG. keywords: eeg; frequencies; waves cache: pulmonarychronicles-771.htm plain text: pulmonarychronicles-771.txt item: #557 of 658 id: pulmonarychronicles-773 author: None title: Statistics column date: None words: 1958 flesch: 48 summary: As has already been mentioned, due to the incorporation of prior distribution, the computation of Bayesian posterior distribution can be challenging. Bayes’s rule can also be expressed in terms of probability distributions: where f(θ) is the prior distribution of the parameter θ, f(data|θ) is the sampling density for the data, given the parameter θ, f(data) is the marginal distribution of the data, and f(θ|data) is the posterior distribution of the parameter θ. keywords: bayesian; data; distribution; posterior; probability cache: pulmonarychronicles-773.htm plain text: pulmonarychronicles-773.txt item: #558 of 658 id: pulmonarychronicles-775 author: None title: Original article date: None words: 393 flesch: 48 summary: This observational study surveys the trend of public mask usage in Amarillo, TX, over two months during the COVID-19 pandemic. We hypothesized that public mask usage would decrease during the data collection period due to “COVID Fatigue” in the region studied. keywords: mask; usage cache: pulmonarychronicles-775.htm plain text: pulmonarychronicles-775.txt item: #559 of 658 id: pulmonarychronicles-777 author: None title: Focused review date: None words: 276 flesch: 39 summary: Since the inception of COVID-19 in Wuhan, China, in late December 2019, physicians and researchers have tried to use old drugs to treat this pandemic. The diverse cellular, immunological, and antiviral mechanisms reported in the literature suggest that CQ and HCQ might be useful drugs against COVID-19. keywords: drugs cache: pulmonarychronicles-777.htm plain text: pulmonarychronicles-777.txt item: #560 of 658 id: pulmonarychronicles-779 author: None title: Case report date: None words: 362 flesch: 33 summary: Here we describe the first reported case of multisystem inflammatory syndrome in the West Texas region, presenting in a Hispanic 5-year-old girl with a recent history of COVID-19. Case report First reported case of Multisystem Inflammatory Syndrome in children in West Texas Ryan E. Dean BS, MBA, Monisha Narayanan BS, Evan Nix BS, MBA, Kinsley Stepka DO, Raphael Mattamal, MD ABSTRACT Research focusing on COVID-19-associated complications is a growing area of importance. keywords: syndrome; texas cache: pulmonarychronicles-779.htm plain text: pulmonarychronicles-779.txt item: #561 of 658 id: pulmonarychronicles-78 author: None title: Pitfalls of Split-Night Polysomnography date: None words: 1248 flesch: 60 summary: Pitfalls of Split-Night Polysomnography PDF Pitfalls of Split-Night Polysomnography Shrinivas Kambali MDa, Gilbert Berdine MDb Correspondence to Shrinivas Kambali MD Email: shrinivas.kambali@ttuhsc.edu + Author Affiliation - Author Affiliation a a pulmonary-critical care fellow at Texas Tech University Health Science Center in Lubbock, TX b a pulmonary physician in the Department of Internal Medicine, TTUHSC SWRCCC : 2013;1.(3):36-39 doi: 10.12746/swrccc2013.0103.034 ................................................................................................................................................................................................................................................................................................................................... Introduction Sleep disordered breathing is a common problem.1 At least 10% of the population suffers from sleep disorders, and they are often related to other disorders, such as hypertension, cardiovascular disease, cerebrovascular disease, pulmonary hypertension, diabetes, metabolic syndrome, and depression.2 Polysomnograms (PSG) a real important tool for diagnosis of sleep apnea. This approach has been used to diagnose sleep apnea and titrate CPAP during a single night and can reduce costs. keywords: cpap; night; sleep; split; titration cache: pulmonarychronicles-78.htm plain text: pulmonarychronicles-78.txt item: #562 of 658 id: pulmonarychronicles-783 author: None title: Focused review date: None words: 199 flesch: 39 summary: Providing adequate oral care for patients in intensive care units (ICUs) is particularly challenging, due in part to problems of caring for very sick patients in a busy stressful environment, which may result in oral care having a lower priority for nurses than other aspects of care. Keywords: Oral health; dental care; MICU dental care Article citation: Sarangi S, Simon LS, Sarangi A. Oral care strategies in patients in intensive care units. keywords: care cache: pulmonarychronicles-783.htm plain text: pulmonarychronicles-783.txt item: #563 of 658 id: pulmonarychronicles-785 author: None title: Case series date: None words: 217 flesch: 49 summary: Keywords: Spontaneous coronary artery dissection, female, intramural hematoma Article citation: Rao S, Mittal N, Ansari MM. Case series A tale of two SCADs: Spontaneous coronary artery dissection series Sanjana Rao BS, Nitish Mittal BS, Mohammad M Ansari MD ABSTRACT Spontaneous coronary artery dissection (SCAD), a relatively rare condition, occurs when a tear develops in the coronary artery wall that may slow blood flow and lead to clot formation. keywords: artery cache: pulmonarychronicles-785.htm plain text: pulmonarychronicles-785.txt item: #564 of 658 id: pulmonarychronicles-787 author: None title: Case report date: None words: 243 flesch: 34 summary: Case report The use of curved sheath technique to facilitate difficult internal carotid artery occlusions Nitish Mittal BS, Sanjana Rao BS, Mohammad M Ansari MD ABSTRACT Carotid artery occlusive disease or carotid artery stenosis, a widely prevalent disease, involves blockage of the arterial wall from atherosclerotic plaques. In this report, we present a particularly difficult case with a Type III aortic arch–right internal carotid artery stenosis. keywords: artery cache: pulmonarychronicles-787.htm plain text: pulmonarychronicles-787.txt item: #565 of 658 id: pulmonarychronicles-789 author: None title: Medical technology date: None words: 386 flesch: 22 summary: While the advantages of 3D models obtained from computed tomography (CT) and transesophageal echocardiography (TEE) over 2D TEE imaging for WATCHMAN procedural planning has been demonstrated, this project aims to directly compare 3D CT models and 3D TEE models to determine which model provides more useful information. To our knowledge, this is the only study that compares 3D models crafted from each imaging modality, and we suggest that future use of 3D modeling techniques should be based on CT scans. keywords: models cache: pulmonarychronicles-789.htm plain text: pulmonarychronicles-789.txt item: #566 of 658 id: pulmonarychronicles-79 author: None title: The role of telomere shortening in the development and progression of COPD date: None words: 5088 flesch: 55 summary: Savale et al compared telomeres length in 136 COPD patients, in 113 age and sex-matched controls, and in 42 nonsmokers without COPD.36 Patients with COPD had shorter telomeres independent of age, sex and pack-year smoking history, and COPD patients had increased levels of circulating interleukin 6 (a marker of inflammation).The decreased length in COPD occurred in all age groups in this study. Low levels of this enzyme might contribute to increased oxidant related injury in the lung in COPD patients. keywords: aging; cells; copd; disease; epub; journal; length; lung; patients; senescence; shortening; smokers; studies; telomere cache: pulmonarychronicles-79.htm plain text: pulmonarychronicles-79.txt item: #567 of 658 id: pulmonarychronicles-791 author: None title: Commentary date: None words: 951 flesch: 55 summary: While procedures play an increased role in the physician-patient relationship than they did 50 years ago, the role of physicians remains one of giving expert advice to patients about how best to improve their health. Questions (and the answers to questions) about whether symptoms imply COVID-19 disease, whether COVID-19 requires medical intervention, and, if intervention is deemed necessary, what intervention is best have become a very important part of the interactions between physicians and patients. keywords: patient; physician cache: pulmonarychronicles-791.htm plain text: pulmonarychronicles-791.txt item: #568 of 658 id: pulmonarychronicles-793 author: None title: Pilot study date: None words: 276 flesch: 14 summary: To understand the survival of hypercapnic respiratory failure patients started on home NIV therapy, a prospective study was conducted analyzing rate of survival and predictors of mortality. Pilot study Survival following initiation of non-invasive ventilation during hospitalization for chronic hypercapnic respiratory failure Benjamin Daines* BS, Nitish Mittal* BS, Amr Ismail MD, Gilbert Berdine MD ABSTRACT Patients hospitalized with chronic hypercapnic respiratory failure often have comorbidities and are at increased risk for mortality after discharge. keywords: failure cache: pulmonarychronicles-793.htm plain text: pulmonarychronicles-793.txt item: #569 of 658 id: pulmonarychronicles-795 author: None title: Focused review date: None words: 369 flesch: 39 summary: Keywords: SARS-CoV-2, COVID-19, MERS-CoV, Middle Eastern Respiratory Syndrome, SARS, SARS-CoV, Severe Acute Respiratory Syndrome, ethnicity, race, minority, gender, sex Article citation: Ha FL, John A, Zumwalt M. Gender/sex, race/ethnicity, similarities/differences among SARS-CoV, MERS-CoV, and COVID-19 patients. The Southwest Respiratory and Critical Care Chronicles 2021;9(37):9–23 From: The School of Medicine (FLH, AJ) and the Department of Orthopedics (MZ), Texas Tech University Health Sciences Center, Lubbock, Texas Submitted: 5/16/2020 Accepted: 12/24/2020 Reviewer: keywords: cov; sars cache: pulmonarychronicles-795.htm plain text: pulmonarychronicles-795.txt item: #570 of 658 id: pulmonarychronicles-797 author: None title: MICU rounds date: None words: 450 flesch: 31 summary: MICU rounds Hyponatremia, osmotic demyelination syndrome, and the importance of the patient’s history Dominique G. Gagnon MD, PhD ABSTRACT Central pontine myelinolysis (CPM), first described in 1959, is a symmetrical non-inflammatory demyelinating disease with loss of oligodendrocytes that occurs most often following a rapid correction of severe hyponatremia (i.e., <120 mmol/L). For these reasons, osmotic demyelination syndrome (ODS) is a better term. keywords: hyponatremia; syndrome cache: pulmonarychronicles-797.htm plain text: pulmonarychronicles-797.txt item: #571 of 658 id: pulmonarychronicles-799 author: None title: Medical education date: None words: 287 flesch: 27 summary: Classic clinical descriptions of disease: curing medical education with a dose of the past. To address this gap in medical knowledge, a group of students at Texas Tech University Health Sciences Center, Lubbock, Texas, have created a website documenting classic clinical disease descriptions written by some of the renowned physicians from the 19th and 20th centuries, including Osler, Flint, Gowers, etc. keywords: disease; education cache: pulmonarychronicles-799.htm plain text: pulmonarychronicles-799.txt item: #572 of 658 id: pulmonarychronicles-8 author: None title: Kartagener’s Syndrome: recurring lungs infections and COPD exacerbations date: None words: 408 flesch: 50 summary: Kartagener’s Syndrome: recurring lungs infections and COPD exacerbations PDF Kartagener’s Syndrome: recurring lungs infections and COPD exacerbations Gilbert Berdine MDa Correspondence to Gilbert Berdine MD Email: gilbert.berdine@ttuhsc.edu + Bent J., III Kartagener syndrome. keywords: kartagener; syndrome cache: pulmonarychronicles-8.htm plain text: pulmonarychronicles-8.txt item: #573 of 658 id: pulmonarychronicles-80 author: None title: Features of Polysomnography date: None words: 858 flesch: 62 summary: REM latency is a similar parameter signifying the time that it takes to reach REM sleep after the onset of sleep.   REM sleep usually makes up 20% to 25% of sleep which is spread over four to six discrete episodes.  keywords: apnea; psg; rem; sleep cache: pulmonarychronicles-80.htm plain text: pulmonarychronicles-80.txt item: #574 of 658 id: pulmonarychronicles-801 author: None title: Focused review date: None words: 251 flesch: 30 summary: Although COVID-19 vaccine is the first hurdle in an attempt to control the pandemic, the following challenges still remain: adequate vaccine doses, issues with mass distribution, global access, proper storage, and sufficient vaccine compliance. Keywords: coronavirus therapeutics, herd immunity, coronavirus vaccine, vaccine targets, clinical trials Article citation: Armin S, Wakil A, Tarbox J, Iwuji K. COVID-19 vaccination: An attempt to control the pandemic. keywords: pandemic; vaccine cache: pulmonarychronicles-801.htm plain text: pulmonarychronicles-801.txt item: #575 of 658 id: pulmonarychronicles-803 author: None title: Focused review date: None words: 309 flesch: 19 summary: This comparison outlines the important advances in the prevention and treatment of pneumonia and provides the background for understanding future challenges in identifying, treating, and preventing bacterial infections, such as pneumococcal pneumonia. Although routinely encountered in clinical practice, many clinicians do not know the historical developments in the management of pneumococcal pneumonia and their impact on public health interventions. keywords: pneumonia cache: pulmonarychronicles-803.htm plain text: pulmonarychronicles-803.txt item: #576 of 658 id: pulmonarychronicles-805 author: None title: Statistics column date: None words: 1648 flesch: 55 summary: Other tests that can be used for testing normality include the Martinez-Iglewicz test, the D’Agostino’s K-squared test, and the Ryan-Joiner normality test, etc. Many statistical tests that require a normality assumption are robust to deviations from the normality. keywords: data; distribution; normality; test cache: pulmonarychronicles-805.htm plain text: pulmonarychronicles-805.txt item: #577 of 658 id: pulmonarychronicles-807 author: None title: Medicine in art date: None words: 1271 flesch: 52 summary: Jay is concerned that “bad actors” include misinformation along with authentic news, pointing out the bogus Covid cures and vaccine fearmongering touted on social media. The Southwest Respiratory and Critical Care Chronicles 2021;9(37):84–86 From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas Submitted: 1/7/2021 Accepted: 1/9/2021 Reviewer: keywords: annus; darkness; horribilis; people; uncertainty cache: pulmonarychronicles-807.htm plain text: pulmonarychronicles-807.txt item: #578 of 658 id: pulmonarychronicles-811 author: None title: Original article date: None words: 331 flesch: 31 summary: We used regression analysis for total COVID-19 hospitalizations to provide insight into potential factors influencing COVID-19 hospitalizations and predict future hospitalizations. Original article Modeling of COVID-19 total hospitalizations in the United States Jonathan Kopel BS, Thomas E. Tenner Jr, PhD, Gregory L. Brower DVM, PhD ABSTRACT The SARS-CoV-2 (COVID-19) virus continues to increase across the globe affecting all aspects of modern life. keywords: covid-19; hospitalizations cache: pulmonarychronicles-811.htm plain text: pulmonarychronicles-811.txt item: #579 of 658 id: pulmonarychronicles-813 author: None title: Medical education date: None words: 386 flesch: 50 summary: Modifiable factors include taking USMLE Step 1 within two months of completing pre-clinical courses, motivation from anxiety, multiple-choice questions completed, unique Anki cards seen, and complete passes of First Aid for the USMLE Step 1. Conclusion: Our review suggests that although students can focus on modifiable factors to increase their score, the energy expenditure required to increase the Step 1 score by one point is unrealistic. Keywords: USMLE Step 1, performance predictors, medical school, medical student, test preparation, Step 1 modifiable predictors Article citation: Wu W, Garcia K, Chandrahas S, Siddiqui A, Baronia R, Ibrahim Y. Predictors of Performance on USMLE Step 1. keywords: step; usmle cache: pulmonarychronicles-813.htm plain text: pulmonarychronicles-813.txt item: #580 of 658 id: pulmonarychronicles-817 author: None title: Brief research report date: None words: 284 flesch: 36 summary: Keywords: Child abuse, COVID-19 pandemic, West Texas, psychological stress Article citation: Garcia H, Wyatt TG, Tucker A, Dissanaike S. Increase in child abuse injuries during the COVID-19 Pandemic in West Texas. Thus, we sought to determine whether the confluence of pandemic-related social changes would result in an increase in child abuse cases severe enough to warrant emergency medical attention in the West Texas region. keywords: abuse; child cache: pulmonarychronicles-817.htm plain text: pulmonarychronicles-817.txt item: #581 of 658 id: pulmonarychronicles-82 author: None title: Case Reports date: None words: 1390 flesch: 42 summary: Aeromonas veronii is a Gram negative bacillus usually found in fresh and brackish water in warm climates. Subsequently, Infectious Diseases was consulted due to two positive blood cultures for Aeromonas veronii. keywords: aeromonas; cultures; patient; veronii cache: pulmonarychronicles-82.htm plain text: pulmonarychronicles-82.txt item: #582 of 658 id: pulmonarychronicles-827 author: None title: Case report and focused review date: None words: 178 flesch: 34 summary: Keywords: Bradycardia, hyperkalemia, shock, AV nodal blocker, critical care Article citation: Vangipuram D, Nugent K. BRASH syndrome: More than just syncope. Furthermore, we review case reports written in recent years for common BRASH syndrome patient characteristics. keywords: brash cache: pulmonarychronicles-827.htm plain text: pulmonarychronicles-827.txt item: #583 of 658 id: pulmonarychronicles-829 author: None title: Original article date: None words: 171 flesch: 27 summary: Keywords: orbital cellulitis, subperiosteal abscess, preseptal cellulitis Article citation: Clarke C, Mitchell K. Orbital cellulitis in West Texas. Original article Orbital cellulitis in West Texas Cameron Clarke MD, Kelly Mitchell MD ABSTRACT Purpose: Identify the risk factors, microbiology, complications, and treatment outcomes of orbital cellulitis in West Texas. keywords: cellulitis cache: pulmonarychronicles-829.htm plain text: pulmonarychronicles-829.txt item: #584 of 658 id: pulmonarychronicles-83 author: None title: Azygos vein cannulation – recognition is vital for preventing complications date: None words: 1378 flesch: 47 summary: Azygos vein cannulation – recognition is vital for preventing complications Abstract/ PDF Azygos vein cannulation – recognition is vital for preventing complications Ragesh Panikkath MDa, Sian Yik Lim MDa, Deepa Panikkath MDa Correspondence to Ragesh Panikkath MD Email: ragesh.panikkath@ttuhsc.edu + Author Affiliation - Author Affiliation a residents in Internal Medicine at Texas Tech University Health Science Center in Lubbock, TX SWRCCC : 2013;1.(4):41-44 doi:10.12746/swrccc2013.0104.045 ................................................................................................................................................................................................................................................................................................................................... Abstract Inadvertent cannulation of the azygos vein can occur during central vein cannulations, especially from the left side. Central veins provide a good access for volume resuscitation and vasopressors in patients who are critically ill. keywords: azygos; cannulation; complications; tip; vein cache: pulmonarychronicles-83.htm plain text: pulmonarychronicles-83.txt item: #585 of 658 id: pulmonarychronicles-831 author: None title: Abstract supplement date: None words: 12056 flesch: 40 summary: The goal is to continue to expand the registry and contribute to improving patient outcomes. Methods: We conducted a systematic review of Pubmed and Google Scholar in accordance with PRISMA guidelines to define the current understanding of partial nerve injury presentation, non-surgical treatment, surgical repair techniques, and patient outcomes. keywords: age; analysis; bmi; burn; care; chi; chronic; control; data; depression; effects; factors; group; intervention; meta; methods; mortality; outcomes; pain; patients; post; results; review; risk; studies; study; texas; treatment; use cache: pulmonarychronicles-831.htm plain text: pulmonarychronicles-831.txt item: #586 of 658 id: pulmonarychronicles-833 author: None title: Commentary date: None words: 1503 flesch: 57 summary: What could COVID vaccines have anything to do with Fermi’s Paradox? Boris Johnson is facing a backlash after suggesting that Brits be required to hold a “vaccine passport” in order to order a pint in a British pub.4 Dr. Anthony Fauci said, “Everything will be on the table for discussion” in answer to questions about COVID-19 “vaccine passports” and mandatory vaccinations in the United States.5 President Joe Biden wants “vaccine passports” to permit dining out in the United States.6 keywords: fermi; life; paradox; vaccine cache: pulmonarychronicles-833.htm plain text: pulmonarychronicles-833.txt item: #587 of 658 id: pulmonarychronicles-835 author: None title: Medicine in art date: None words: 1434 flesch: 63 summary: This spring, as vaccines are being administered and states begin to relax their mandates on wearing masks and on social isolation, allowing restaurants, bars, and theaters to fully reopen, many people rejoiced. Athena Poppas, chief of cardiology at Brown University, maintains that depression and anxiety from months of isolation contribute to cardiovascular problems, “Loneliness and social isolation increase the risk of myocardial infarction and stroke by up to 30 percent.”3 Writing in The Atlantic, Ellen Cushing worries that we are forgetting how to be normal, “I first became aware that I was losing my mind in late December.”4 keywords: atlantic; bull; isolation; pandemic; people cache: pulmonarychronicles-835.htm plain text: pulmonarychronicles-835.txt item: #588 of 658 id: pulmonarychronicles-839 author: None title: Brief report date: None words: 190 flesch: 37 summary: Brief report The reduction in influenza rates in the United States during the COVID-19 pandemic Anna Sabu-Kurian BS, Kripa Shrestha MBBS, MPH, MS, Sharmila Dissanaike MD, FACS, FCCM ABSTRACT Influenza affects many lives worldwide each year during the months of October through February. The reduction in influenza rates in the United States during the COVID-19 pandemic. keywords: influenza cache: pulmonarychronicles-839.htm plain text: pulmonarychronicles-839.txt item: #589 of 658 id: pulmonarychronicles-84 author: None title: Metastasis of lung cancer through Batson’s plexus – very rare but possible date: None words: 1928 flesch: 52 summary: Metastasis of lung cancer through Batson’s plexus – very rare but possible Abstract/ PDF Metastasis of lung cancer through Batson’s plexus – very rare but possible Ragesh Panikkath MDa, Saba Radhi MDb, Sian Yik Lim MDa, Manoj Thankam MDb, Frank Quattromani MDc, Cynthia Ann Jumper MPH, MDd Correspondence to Ragesh Panikkath MD Email: ragesh.panikkath@ttuhsc.edu + Author Affiliation - Author Affiliation a residents in Internal Medicine at Texas Tech University Health Science Center in Lubbock, TX b fellows in Medical Oncology at TTUHSC in Lubbock, TX c a radiologist at University Medical Center, Lubbock, TX d a pulmonary physician in the Department of Internal Medicine at TTUHSC in Lubbock, TX SWRCCC : 2013;1.(4):45-49 doi: 10.12746/swrccc2013.0104.046 ................................................................................................................................................................................................................................................................................................................................... Abstract Many malignancies, like prostate, colon, and breast cancer, metastasize through Batson’s plexus (vertebral venous plexus). Although lung cancer is one of the most common cancers in the United States, its spread through Batson’s plexus is considered extremely rare. keywords: batson; cancer; lung; plexus; system; veins; venous cache: pulmonarychronicles-84.htm plain text: pulmonarychronicles-84.txt item: #590 of 658 id: pulmonarychronicles-843 author: None title: Medical image date: None words: 908 flesch: 52 summary: The incidence of testicular cancer in the USA has continued to increase, most notably in younger and older populations.1 Testicular cancer is most commonly diagnosed in stage I presenting as a testicular mass; a small percentage of patients reports back pain or metastatic disease symptoms, such as hemoptysis, cough, pain, and headache. The incidence of testicular cancer in the United States has increased over the past 20 years. keywords: cancer; cell; germ; testicular cache: pulmonarychronicles-843.htm plain text: pulmonarychronicles-843.txt item: #591 of 658 id: pulmonarychronicles-845 author: None title: Focused review date: None words: 343 flesch: 39 summary: Focused review COVID toes: A unique cutaneous indicator of COVID-19 Travis S. Dowdle BS, Todd K. Brown BS, Joshua A. Peterson BS, Kiana Banafshay BSA, Jeannie M. Nguyen MD, Ashley L. E. Sturgeon MD ABSTRACT Background: This brief review considers major aspects of COVID toes as currently understood. Media characterization, potentially leading to intense public interest in COVID toes during the summer of 2020, is also discussed. keywords: covid; toes cache: pulmonarychronicles-845.htm plain text: pulmonarychronicles-845.txt item: #592 of 658 id: pulmonarychronicles-847 author: None title: Regional medicine date: None words: 422 flesch: 38 summary: Keywords: Latent tuberculous infection, skin test, QuantiFERON test, risk factors, NHANES Article citation: Khan S, Ike C, Dennis J, Nugent K. The prevalence and characteristics of adults with latent tuberculous infection in the United States and the implications for healthcare in Texas. Regional medicine The prevalence and characteristics of adults with latent tuberculous infection in the United States and the implications for healthcare in Texas Shazma Khan BSA, Crystal Ike BS, Jeff Dennis PhD, Kenneth Nugent MD ABSTRACT The Centers for Disease Control and Prevention reported 8,916 cases of tuberculosis in 2019. keywords: test; texas cache: pulmonarychronicles-847.htm plain text: pulmonarychronicles-847.txt item: #593 of 658 id: pulmonarychronicles-849 author: None title: Focused review date: None words: 199 flesch: 18 summary: For example, recent studies have found a potential bidirectional relationship between the disease process OSAHS and neurocognitive disorders or other psychiatric disorders found in older people. Keywords: Sleep apnea, obstructive; neurocognitive disorders; Alzheimer disease; depressive disorder, major Article citation: Barrett J, Sarangi A, Nelson J. Management of obstructive sleep apnea/hypopnea syndrome in neurocognitive disorders. keywords: disorders cache: pulmonarychronicles-849.htm plain text: pulmonarychronicles-849.txt item: #594 of 658 id: pulmonarychronicles-85 author: None title: Case Reports date: None words: 1949 flesch: 51 summary: VAP patients had $35,000 more in hospital costs than those who did not develop VAP.7 Since Medicare and Medicaid reimbursements are based on the primary diagnosis at the time of admission, subsequent nosocomial infections like VAP result in a loss for the hospital.7 A large meta-analysis found that mortality rates roughly doubled in patients who developed VAP.8 Patients who develop VAP stay in the ICU for 5-7 days longer.8 In addition, the pathogens found in VAP patients tend to be drug resistant. Ventilated patients are screened for signs of worsening oxygenation (see Figure 1 for specifics). keywords: patients; pneumonia; protocol; pubmed; vae; vap; ventilator cache: pulmonarychronicles-85.htm plain text: pulmonarychronicles-85.txt item: #595 of 658 id: pulmonarychronicles-851 author: None title: Focused review date: None words: 254 flesch: 25 summary: Women who contract COVID-19 during pregnancy are at increased risk of preterm labor and other perinatal complications when compared to non-pregnant women. There is extensive literature describing COVID-19 in pregnant women, and there is evidence that this virus can infect the placenta, raising implications for maternal-fetal transmission. keywords: women cache: pulmonarychronicles-851.htm plain text: pulmonarychronicles-851.txt item: #596 of 658 id: pulmonarychronicles-853 author: None title: Review article date: None words: 218 flesch: 23 summary: Keywords: COVID-19 pandemic; ICU, depression, anxiety, burnout, healthcare workers Article citation: Sarangi A, Kim D. Exploring and managing psychiatric symptoms in ICU healthcare professionals during the ongoing COVID-19 pandemic: A focused review and guideline. Review article Exploring and managing psychiatric symptoms in ICU healthcare professionals during the ongoing COVID-19 pandemic: A focused review and guideline Ashish Sarangi MD, Dalynn Kim MS ABSTRACT Introduction: keywords: healthcare cache: pulmonarychronicles-853.htm plain text: pulmonarychronicles-853.txt item: #597 of 658 id: pulmonarychronicles-855 author: None title: Original article date: None words: 399 flesch: 33 summary: Keywords: hydralazine, emergent hypertension, urgent hypertension, intensive medical care unit Article citation: Satheeshkumar A, Atkins H, Suchartlikitwong S, Islam E. Hydralazine use for the management of hypertensive crises in a medical intensive care unit. Sixteen patients had comorbidities and/or contraindications for hydralazine use, but 12 patients received IV hydralazine and one patient received PO hydralazine. keywords: hydralazine; patients cache: pulmonarychronicles-855.htm plain text: pulmonarychronicles-855.txt item: #598 of 658 id: pulmonarychronicles-857 author: None title: Original article date: None words: 413 flesch: 44 summary: Coronary intensive care unit (CICU) mortality, CICU length-of-stay and discharge disposition were compared between elderly patients (greater than or equal to 80 years old) and younger patients (less than 80 years old), adjusted for comorbidities. Keywords: octogenarians, nonagenarians, cardiac intensive care unit, elderly, ICU mortality Article citation: Fabrizio C, Langston MC, Subedi K, Wimmer NJ, Choudhry UI, Urrutia LE. keywords: patients; years cache: pulmonarychronicles-857.htm plain text: pulmonarychronicles-857.txt item: #599 of 658 id: pulmonarychronicles-859 author: None title: Medical image date: None words: 382 flesch: 47 summary: Keywords: contact tracing, COVID-19, clusters, “hot spots” Article citation: Geeslin MM, Wells K. Contact tracing of COVID-19 infections in Lubbock County in West Texas. Through contact tracing, we were able to connect cases to one another, and we were often able to determine the origin of the outbreak in each cluster. keywords: contact cache: pulmonarychronicles-859.htm plain text: pulmonarychronicles-859.txt item: #600 of 658 id: pulmonarychronicles-86 author: None title: EDITORIALS date: None words: 767 flesch: 38 summary: Lower GI bleeding in ICU patients should prompt evaluation for ischemic colitis by multidetector computed tomography (MDCT). Müller T, Barkun AN, Martel M. Non-variceal upper GI bleeding in patients already hospitalized for another condition. keywords: acute; bleeding; patients cache: pulmonarychronicles-86.htm plain text: pulmonarychronicles-86.txt item: #601 of 658 id: pulmonarychronicles-861 author: None title: Commentary date: None words: 1631 flesch: 51 summary: A data safety monitoring system has been following vaccines during the clinical trials and before approval. While a reduction in mortality is an important metric for vaccines, and since COVID-19 has a low mortality rate, the number needed to vaccinate to prevent one death will undoubtedly be very high. keywords: covid-19; johnson; risk; safety; vaccination; vaccine cache: pulmonarychronicles-861.htm plain text: pulmonarychronicles-861.txt item: #602 of 658 id: pulmonarychronicles-863 author: None title: Statistics column date: None words: 1665 flesch: 50 summary: The anchor-based methods use external criteria (the anchor), which are often subjective, to quantify differences measured by an outcome instrument, e.g., comparing patients’ reported outcome scores to the patients’ answers to prior subjective assessments. If too coarse, then important clinical distinctions may be missed. keywords: difference; mcid; methods; patients; size cache: pulmonarychronicles-863.htm plain text: pulmonarychronicles-863.txt item: #603 of 658 id: pulmonarychronicles-865 author: None title: Focused review date: None words: 295 flesch: 27 summary: COVID-19 pandemic social distancing policies and ethical guidelines for COVID-19 treatment may exacerbate experiences of social isolation, perceived expendability, and exposure to suffering, which are associated with the three main components of the Interpersonal Theory of Suicide: thwarted belongingness, perceived burdensomeness to society, and capability for suicide. Focused review Suicide trends in the elderly during the ongoing COVID-19 Pandemic-A public health urgency Ashish Sarangi MD, Sozan Fares M.B.B.CH, Noha Eskander M.B.B.CH ABSTRACT Background: Older adults have an increased risk for suicide compared to the overall population, and the circumstances surrounding the Coronavirus Disease 2019 (COVID-19) may further increase this risk. keywords: covid-19; suicide cache: pulmonarychronicles-865.htm plain text: pulmonarychronicles-865.txt item: #604 of 658 id: pulmonarychronicles-869 author: None title: Medical image date: None words: 540 flesch: 19 summary: Medical image Ventricular septal defect causing tricuspid regurgitation with consequent pulmonary hypertension and right ventricular hypertrophy Mahmoud Abdelnabi MD, Abdallah Almaghraby MD Corresponding author: Mahmoud Hassan Abdelnabi Contact Information: Mahmoud.hassan.abdelnabi@outlook.com DOI: 10.12746/swrccc.v9i40.869 CASE A 25-year-old man complaining of grade II dyspnea was referred for transthoracic echocardiography (TTE) for further assessment of his tricuspid valve before surgical repair/replacement. Transthoracic echocardiography of peri-membranous ventricular septal defect causing tricuspid regurgitation and pulmonary hypertension. keywords: tricuspid; ventricular cache: pulmonarychronicles-869.htm plain text: pulmonarychronicles-869.txt item: #605 of 658 id: pulmonarychronicles-87 author: None title: Medicaid: An Overview date: None words: 1015 flesch: 54 summary: The future trends of Texas Medicaid depend greatly on whether Texas participates in the ACA ex­pansion of Medicaid or not. Prior to 1988, Medicaid benefits had been linked to AFDC benefits. keywords: care; dsh; medicaid; texas cache: pulmonarychronicles-87.htm plain text: pulmonarychronicles-87.txt item: #606 of 658 id: pulmonarychronicles-873 author: None title: Editor's Note date: None words: 40 flesch: 55 summary: This supplement includes abstracts created by first year medical students during the 2020 summer research program. Editor's Note Editor's Note Editor’s note: Please see the abstract supplement on the right-hand side of the journal home page. keywords: editor cache: pulmonarychronicles-873.htm plain text: pulmonarychronicles-873.txt item: #607 of 658 id: pulmonarychronicles-88 author: None title: News Updates date: None words: 294 flesch: 45 summary: A recent small randomized, controlled trial showed no help from haloperidol in delirium in critical care patients. Email: zachary.mulkey @ttuhsc.edu + Author Affiliation - Author Affiliation aDepartment of Internal Medicine, TTUHSC, Lubbock, TX. SWRCCC 2013;2(4):43. ...................................................................................................................................................................................................................................................................................................................................   keywords: care cache: pulmonarychronicles-88.htm plain text: pulmonarychronicles-88.txt item: #608 of 658 id: pulmonarychronicles-881 author: None title: Original article date: None words: 406 flesch: 33 summary: Junctional ectopic tachycardia (JET) is an uncommon arrhythmia that occurs after surgical correction of congenital heart defects. All cases of junctional ectopic tachycardia occurred post-surgery at an average of 1.67 ± 1.11 days. keywords: beirut; center cache: pulmonarychronicles-881.htm plain text: pulmonarychronicles-881.txt item: #609 of 658 id: pulmonarychronicles-883 author: None title: Focused review date: None words: 211 flesch: 31 summary: Keywords: COVID-19, pulmonary fibrosis, mechanism, treatment Article citation: Ghose M, Patel M. A review of post infectious pulmonary fibrosis in the era of COVID-19 and potential treatment options. Focused review A review of post infectious pulmonary fibrosis in the era of COVID-19 and potential treatment options Medha Ghose MD, Maehali Patel MD ABSTRACT On March 11, 2020, the World Health Organization (WHO) released a statement characterizing COVID-19 as a pandemic that has, as of October 2020, caused almost 36 million confirmed global cases and over 1 million deaths. keywords: covid-19 cache: pulmonarychronicles-883.htm plain text: pulmonarychronicles-883.txt item: #610 of 658 id: pulmonarychronicles-885 author: None title: Medical image date: None words: 804 flesch: 43 summary: Emphysematous gastritis is a potentially fatal disease that carries a mortality rate of 55–61% with systemic toxicity with or without hematemesis and melena as common presentation.5 Computed tomography is the gold standard for diagnosis with demonstration of intramural gas in the stomach.3 Management involves bowel rest, PPIs, IV fluid resuscitation and broad-spectrum antibiotics.4 Surgery is recommended in cases of clinical deterioration in patients who fail conservative therapy or present with peritonitis.5 This case of emphysematous gastritis in a middle-aged male had no clear incident event. Subsequent abdominal computed tomography scan showed emphysematous gastritis of the fundus and proximal body with perigastric fat stranding and no free air (Figure 1). keywords: case; gastric; gastritis; patient cache: pulmonarychronicles-885.htm plain text: pulmonarychronicles-885.txt item: #611 of 658 id: pulmonarychronicles-887 author: None title: Focused review date: None words: 216 flesch: 42 summary: Article citation: Iwuji K, Hyde B, Uke N. Colorectal cancer disparities and African Americans: Is it time to narrow the gap? Although the overall incidence and mortality rates of colorectal cancer are declining, African Americans have significantly higher rates of colorectal cancer than Caucasians, and they have worse 5-year survival rates. keywords: cancer cache: pulmonarychronicles-887.htm plain text: pulmonarychronicles-887.txt item: #612 of 658 id: pulmonarychronicles-889 author: None title: Medicine and health policy date: None words: 283 flesch: 30 summary: Medicine and health policy Distance learning: The “Extension for Community Healthcare Outcomes: ECHO” project: A case study Jularat Panyayen MD, Teerapat Nantsupawat MD, Wittawat Tangwijitsakul MD, Nopakoon Nantsupawat MD ABSTRACT This article reports a case conference that was part of the Extension for Community Healthcare Outcomes (ECHO®) project, which is a model of monthly telemedicine conferences on chronic disease and behavioral health, important topics for primary care teams in rural areas and for university-based specialists. The ECHO® project has proved to be a successful learning model in health care. keywords: care cache: pulmonarychronicles-889.htm plain text: pulmonarychronicles-889.txt item: #613 of 658 id: pulmonarychronicles-89 author: None title: Malnutrition in the ICU date: None words: 3837 flesch: 44 summary: Nutrition support can limit the loss of lean body mass during critical illness, and nutritional risk assessment is important to identify patients who may be benefit from nutritional intervention in the ICU.   The assessment of range of motion of upper extremities can evaluate ability of patients to feed independently and may provide information regarding problems with energy intake in patients 35-38. Conclusions Patients in critical care units for more than 1-2 days need nutritional risk assessment, including evaluation of gastrointestinal function, and close monitoring 39. keywords: albumin; assessment; body; care; energy; loss; malnutrition; nutritional; patients; serum; status; weight cache: pulmonarychronicles-89.htm plain text: pulmonarychronicles-89.txt item: #614 of 658 id: pulmonarychronicles-891 author: None title: Original article date: None words: 326 flesch: 49 summary: Keywords: Diabetic ketoacidosis, glucose levels, anion gap, basic metabolic panels, outcomes Article citation: Motes A, Fabiana Fernandez F, Edriss H. Analysis of a DKA protocol: Laboratory tests and outcomes. The mean fluid administered until anion gap closure was 3694.9 ± 2484.6 mL. The insulin dose during the first day of management was 69.5 ± 49.9 units; the mean number of point-of-care glucose levels during the first 24 hours was 21.2 ± 6. keywords: number cache: pulmonarychronicles-891.htm plain text: pulmonarychronicles-891.txt item: #615 of 658 id: pulmonarychronicles-893 author: None title: Original article date: None words: 423 flesch: 50 summary: A proportional bias (p < 0.001) indicated that the level of bias was not constant between levels of blood loss. Discussion: Blood loss during ORIF calculated by EPBL was significantly higher than RIBL. keywords: blood; loss cache: pulmonarychronicles-893.htm plain text: pulmonarychronicles-893.txt item: #616 of 658 id: pulmonarychronicles-895 author: None title: Focused review date: None words: 224 flesch: 35 summary: Dysregulation of ACE-2 has been linked to heart failure, pulmonary hypertension, and diabetic cardiovascular complications. Focused review The regulation of ACE-2 in the heart and lungs Jonathan Kopel PhD, Bojana Ristic PhD, Thomas E. Tenner, Jr., PhD, and Gregory L. Brower, DVM, PhD ABSTRACT The pathogenesis of SARS-CoV-2 infection or COVID-19 disease remains an active and rapidly evolving area of investigation. keywords: covid-19 cache: pulmonarychronicles-895.htm plain text: pulmonarychronicles-895.txt item: #617 of 658 id: pulmonarychronicles-897 author: None title: Case report date: None words: 209 flesch: 29 summary: Case report Dasatinib-induced diffuse alveolar hemorrhage Dhara Dave MD, John Kimbugwe MD, Randa Hazam MD, Saria Tasnim MD, Manish Patel MPH, MD ABSTRACT The BCR-ABL tyrosine kinase inhibitor dasatinib is a potent treatment for chronic myeloid leukemia (CML). However, it is associated with pulmonary toxicities. keywords: dasatinib cache: pulmonarychronicles-897.htm plain text: pulmonarychronicles-897.txt item: #618 of 658 id: pulmonarychronicles-90 author: None title: Risk assessment in patients with gastrointestinal bleeding date: None words: 1970 flesch: 48 summary: Recommendations Upper GI bleeding scoring systems are useful instruments to help evaluate patients with upper GI bleeding.  Key points: Upper gastrointestinal bleeding, upper GI bleeding scoring system Rockall score, Glasgow Blatchford score     References 1.         Laine L, Jensen DM. keywords: bleeding; patients; risk; rockall; score cache: pulmonarychronicles-90.htm plain text: pulmonarychronicles-90.txt item: #619 of 658 id: pulmonarychronicles-901 author: None title: Statistics column date: None words: 1781 flesch: 50 summary: Statistics column Effect size Shengping Yang PhD, Gilbert Berdine MD Corresponding author: Shengping Yang Contact Information: Shengping.Yang@pbrc.edu DOI: 10.12746/swrccc.v9i40.901 The concept of effect size is widely used in biomedical research, for example, sample size/power calculation in randomized trials, estimation statistics in data reporting and presentation, and an overall effect size estimation in meta-analysis. Would you provide a brief introduction on effect size? keywords: cohen; effect; sample; size cache: pulmonarychronicles-901.htm plain text: pulmonarychronicles-901.txt item: #620 of 658 id: pulmonarychronicles-903 author: None title: Original article date: None words: 349 flesch: 33 summary: Keywords: COVID-19; fatality; cause of death Article citation: Peterson CJ, Makram Fanous J, Mallah H, Yang S, Berdine G. Cause of death in fatal cases associated with positive COVID-19 PCR tests. Original article Cause of death in fatal cases associated with positive COVID-19 PCR tests Christopher J Peterson MS, John Makram Fanous MD, Haneen Mallah MD, Shengping Yang PhD, Gilbert Berdine MD ABSTRACT The response to the COVID-19 pandemic is heavily influenced by reported fatalities from the virus and, by implication, the criteria used to determine those fatalities. keywords: covid-19; death cache: pulmonarychronicles-903.htm plain text: pulmonarychronicles-903.txt item: #621 of 658 id: pulmonarychronicles-905 author: None title: Editorial date: None words: 1145 flesch: 48 summary: The Delta variant caused 57% of the infections in the last week of June and the first week of July.4 Dhar et al. reported that with the emergence of the Delta variant in India, there was a 10-fold rise in cases with a displacement of Alpha and Kappa lineages by Delta variants with a 3-fold increase in mortality compared to previous waves.6 Evidence from Delhi indicated that the Delta variant was associated with a high viral load, transmission rates, vaccination breakthrough, and reinfection. More research is needed to evaluate the current vaccines to determine whether they are less effective against the new variants and establish the need to modify or develop new vaccines to restore protection against emerging variants. keywords: cov-2; delta; sars; vaccine; variant cache: pulmonarychronicles-905.htm plain text: pulmonarychronicles-905.txt item: #622 of 658 id: pulmonarychronicles-907 author: None title: Commentary date: None words: 456 flesch: 57 summary: Article citation: Berdine G. Sometimes hesitancy is justified. Different groups have different risks for COVID-19. keywords: vaccinated cache: pulmonarychronicles-907.htm plain text: pulmonarychronicles-907.txt item: #623 of 658 id: pulmonarychronicles-909 author: None title: Medicine in art date: None words: 2360 flesch: 62 summary: Emerging from the long months of the Covid pandemic, residents of the United States face more than one kind of hesitation: vaccine hesitancy and vacillation between virtual and in-person learning. Eli Lebowitz, Associate Professor in the Child Study Center of Yale School of Medicine, suggests “being really forthcoming and frank” in explaining any changes in an age-appropriate way.17 Complacency, culture, and political beliefs are contributing to vaccine hesitancy in the United States, as cases of Covid-19 and its variants continue to rise. keywords: lot; new; orpheus; people; school; states; vaccine; wife cache: pulmonarychronicles-909.htm plain text: pulmonarychronicles-909.txt item: #624 of 658 id: pulmonarychronicles-91 author: None title: The role of imaging studies in critically ill medical patients with mesenteric ischemia date: None words: 2462 flesch: 49 summary: Since acute mesenteric ischemia can progress rapidly to a fatal disease, prompt diagnosis and treatment are essential to allow effective intervention. This study found that increased plasma lactate level had a sensitivity of 96% for recognizing acute mesenteric ischemia in patients with abdominal complaints 19). keywords: acute; arterial; diagnosis; ischemia; patients; pmid; pubmed; studies cache: pulmonarychronicles-91.htm plain text: pulmonarychronicles-91.txt item: #625 of 658 id: pulmonarychronicles-913 author: None title: Focused review date: None words: 353 flesch: 35 summary: We identified 4 case reports de novo IBD that occurred 2 weeks to 5 months after acute COVID-19 infection. Focused review De novo inflammatory bowel disease is a potential post-acute sequela of SARS-CoV-2 infection Thanita Thongtan MD*, Anasua Deb MD*, Sameer Islam MD ABSTRACT Background: Even though patients with inflammatory bowel disease (IBD) are not at increased risk of COVID-19 infection, patients with post-acute COVID-19 have been reported to have de novo IBD or a new diagnosis of IBD. keywords: ibd; infection cache: pulmonarychronicles-913.htm plain text: pulmonarychronicles-913.txt item: #626 of 658 id: pulmonarychronicles-915 author: Nugent, Kenneth title: CME Credit date: 2021-07-24 words: 185 flesch: 60 summary: Claiming CME credit for articles in the Southwest Respiratory and Critical Care Chronicles In order to receive CME credit for reading the selected article, you must: 1. At the conclusion of the evaluation, you will be given the opportunity to claim the appropriate amount of credit for the activity and print your CME certificate. keywords: cme cache: pulmonarychronicles-915.pdf plain text: pulmonarychronicles-915.txt item: #627 of 658 id: pulmonarychronicles-92 author: None title: Acquired non-malignant tracheoesophageal fistula secondary to esophagogastroduodenoscopy in a patient on mechanical ventilation date: None words: 944 flesch: 46 summary: Iatrogenic esophageal perforation during transesophageal echocardiography is a well-known cause of esophageal perforation and occurs with an incidence of 0.18%.2,5 In 1972 Hugh Harley reported 44 cases of TEF associated with tracheostomy with the estimated incidence to be 1 in 200.6 Jugn et al. reported a case of TEF through esophageal diverticulum in a patient who had a prolonged tracheostomy tube.7 Other documented causes are tracheostomy, lung transplantation, thyroid resection, thoracic aneurysm repair, esophageal leiomyoma enucleation, mediastinoscopy, and cervical spine surgery.2,8,9,10,11 Common presentations include cough, recurrent pneumonia, increased secretions, and evidence of gastric aspiration into the trachea while on the ventilator.1 The cuff can completely occlude the fistula which might cause atypical presentations with less cough and fewer secretions. The incidence of esophageal perforation during upper endoscopy is estimated at 0.03% and 0.11% during rigid endoscopy.2,3,4 The most common sites of iatrogenic esophageal perforation are at the normal anatomic narrowing in the hypopharynx or the cervical esophageal secondary to force exerted in attempting to pass the endoscope through the cricopharynx.2 It is most commonly associated with upper endoscopy interventions, such as esophageal dilation, high inflation pressure, previous laser or sclerotherapy, and history of esophageal cancer. keywords: esophageal; fistula; patient; tef; tracheostomy cache: pulmonarychronicles-92.htm plain text: pulmonarychronicles-92.txt item: #628 of 658 id: pulmonarychronicles-921 author: None title: Original article date: None words: 352 flesch: 37 summary: Original article Severity and case fatality rates of COVID-19: Severity and case fatality rates of COVID-19: a systematic review, meta-analysis and an exploratory meta-regression of risk factors. keywords: case; meta cache: pulmonarychronicles-921.htm plain text: pulmonarychronicles-921.txt item: #629 of 658 id: pulmonarychronicles-927 author: None title: Case report date: None words: 218 flesch: 17 summary: Keywords: thyrotoxic periodic paralysis, deep venous thrombosis Article citation: Rahesh J, Al-Sukhni L, Quraishi B, Naguib T. Upper extremity deep venous thrombosis secondary to thyrotoxic periodic paralysis with accompanying hyperphosphatemia and severe hypomagnesemia. Complications of thyrotoxic periodic paralysis reported in the literature have included cerebral venous thrombosis and lower extremity deep venous thrombosis. keywords: paralysis cache: pulmonarychronicles-927.htm plain text: pulmonarychronicles-927.txt item: #630 of 658 id: pulmonarychronicles-93 author: None title: Diaphragmatic Paralysis date: None words: 577 flesch: 36 summary: Fluoroscopy (sniff test) is used to diagnose abnormal diaphragmatic motion due to phrenic nerve injury. Prognosis remains poor in patients with bilateral paralysis, advanced lung disease, and chronic demyelinating conditions. keywords: diaphragmatic; injury; paralysis cache: pulmonarychronicles-93.htm plain text: pulmonarychronicles-93.txt item: #631 of 658 id: pulmonarychronicles-933 author: None title: Case report date: None words: 207 flesch: 24 summary: Keywords: aortic root abscess, periannular abscess, heart block, infective endocarditis Article citation: Anand R, Rahesh J, Morales C, Sethi P. Aortic root abscess – a deadly complication of UTI-induced infective endocarditis. This case highlights the importance of suspecting endocarditis in patients with sepsis and a known source of infection, especially if blood cultures do not clear or conduction abnormalities develop. keywords: abscess cache: pulmonarychronicles-933.htm plain text: pulmonarychronicles-933.txt item: #632 of 658 id: pulmonarychronicles-935 author: None title: Case report date: None words: 169 flesch: 25 summary: Case report Ileal neuroendocrine tumor without metastatic disease presenting with chronic diarrhea Jasmin Rahesh MS, MBA, Victor Mendiola BS, Baseer Quarashi BS, Srinivas Pathapati MD ABSTRACT Neuroendocrine tumors in the gastrointestinal tract, formerly known as carcinoid tumors, are benign in presentation but can quickly metastasize if not diagnosed during regular screenings, such as colonoscopies. Keywords: Gastrointestinal carcinoid tumor, colonoscopy, ileal metastasis, neuroendocrine tumor Article citation: Rahesh J, Mendiola V, Quarashi B, Pathapati S. Ileal neuroendocrine tumor without metastatic disease presenting chronic diarrhea. keywords: neuroendocrine cache: pulmonarychronicles-935.htm plain text: pulmonarychronicles-935.txt item: #633 of 658 id: pulmonarychronicles-937 author: None title: Case report date: None words: 1627 flesch: 51 summary: Both subacute and chronic lung injury can result in interstitial lung disease and sclerosis of pulmonary capillaries with findings on high-resolution computed tomography showing diffuse ground glass opacities, inter- and intralobular septal thickening of lower lobe predominance, bronchiectasis, and honeycombing.3,13 The most important treatment for lung injury secondary to long-term nitrofurantoin use is discontinuation of the drug, after which most patients usually recover within the next several weeks without any other interventions.8 Another treatment choice includes the addition of corticosteroids. Although patient 1 demonstrated modest clinical and radiographic improvement with systemic steroid therapy, her prolonged course prior to presentation suggests that she may have progressed to chronic fibrotic lung disease, which may be less reversible with steroid therapy than acute lung injury. keywords: chronic; injury; lung; nitrofurantoin; patient cache: pulmonarychronicles-937.htm plain text: pulmonarychronicles-937.txt item: #634 of 658 id: pulmonarychronicles-939 author: None title: MICU rounds date: None words: 219 flesch: 32 summary: MICU rounds Avoiding harm: Central venous access in Kartagener syndrome and other vascular anomalies Brad Snodgrass MD, FACP, Victoria Chu MS, MBA ABSTRACT Placement of internal jugular catheters is more likely to be complicated if a left-sided approach is used, assuming normal anatomy. Keywords: Kartagener syndrome, central venous access, superior vena cava, landmark technique, internal jugular vein catheterization cognitive bias Article citation: Snodgrass B, Chu V. Avoiding harm: Central venous access in Kartagener syndrome and other vascular anomalies. keywords: syndrome cache: pulmonarychronicles-939.htm plain text: pulmonarychronicles-939.txt item: #635 of 658 id: pulmonarychronicles-94 author: None title: Twiddler's syndrome date: None words: 549 flesch: 52 summary: Twiddler syndrome]. Pacemaker malfunction can cause disastrous consequences in patients who are pacemaker dependent. keywords: leads; syndrome; twiddler cache: pulmonarychronicles-94.htm plain text: pulmonarychronicles-94.txt item: #636 of 658 id: pulmonarychronicles-941 author: None title: Medicine in art date: None words: 1422 flesch: 61 summary: In a letter to his brother Theo, Van Gogh commented that Dr. Gachet was “fighting the nervous trouble from which he certainly seems to me to be suffering at least as seriously as I.”6 Van Gogh painted two portraits of Dr. Gachet; one is in the Musée d’Orsay in Paris, but the location of the more famous one is unknown.7 Van Gogh recognized a fellow sufferer and commented to Paul Gauguin (1898–1903), “I have a portrait of Dr. Gachet with the heart-broken expression of our time.”8 https://www.nytimes.com/2020/11/25/health/doctors-nurses-covid-stress.html Van Gogh V. “Letter to Theo Van Gogh.” keywords: gachet; gogh; pandemic; poetry; van cache: pulmonarychronicles-941.htm plain text: pulmonarychronicles-941.txt item: #637 of 658 id: pulmonarychronicles-943 author: None title: Commentary date: None words: 1252 flesch: 67 summary: Like new cases, Texas hospitalizations from COVID-19 are clearly in decline. Texas Department of State Health Services. keywords: daily; figure; texas cache: pulmonarychronicles-943.htm plain text: pulmonarychronicles-943.txt item: #638 of 658 id: pulmonarychronicles-945 author: None title: Statistics column date: None words: 1971 flesch: 46 summary: Although a funnel plot is a valuable method for evaluating potential publication bias, studies have shown that many researchers might not be able to visually identify publication bias using such a plot,6 and the same plot can be interpreted differently by different researchers. We will focus on publication bias in this article. keywords: analysis; bias; meta; publication; studies cache: pulmonarychronicles-945.htm plain text: pulmonarychronicles-945.txt item: #639 of 658 id: pulmonarychronicles-947 author: None title: Case report date: None words: 208 flesch: 21 summary: The Southwest Respiratory and Critical Care Chronicles 2021;9(41):60–63 From: Department of Internal Medicine (NE, MA, JDP), Texas Tech University Health Sciences Center, Lubbock, Texas; Clinical and Experimental Internal Medicine Department (MA), Medical Research Institute, Alexandria University, Alexandria, Egypt; University Medical Center, Radiology Department (RJ), Lubbock, Texas Submitted: 9/23/2021 Accepted: 10/12/2021 Reviewer: Pontine demyelination as a late complication of resolved mild COVID-19 infection. keywords: covid-19 cache: pulmonarychronicles-947.htm plain text: pulmonarychronicles-947.txt item: #640 of 658 id: pulmonarychronicles-949 author: None title: Commentary date: None words: 2534 flesch: 46 summary: Hall VJ, Foulkes S, Saei A, et al. COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study. This highlights the importance of post-marketing surveillance to monitor the safety of vaccines in real-world settings.15 Since COVID-19 vaccines have been administered in the United States for less than a year, it is not surprising that evidence for mRNA vaccine-associated myocarditis among Americans from active surveillance systems with control groups is sparse in the literature. keywords: cases; covid-19; mrna; myocarditis; persons; vaccination; vaccine cache: pulmonarychronicles-949.htm plain text: pulmonarychronicles-949.txt item: #641 of 658 id: pulmonarychronicles-95 author: None title: Reflections on a Medical Service Trip: Did we do the right thing? date: None words: 1311 flesch: 53 summary: If, as a medical team, we are not able to teach or address basic preventive aspects of certain diseases, then the treatment we provide is nothing more than patchwork and not the most important part of medical care. As physicians we personally feel that it is our duty to provide medical care to those less fortunate, but this does not come without a responsibility for patient education and disease prevention along with appropriate pharmacotherapy where indicated. keywords: care; patients; service; term; trips cache: pulmonarychronicles-95.htm plain text: pulmonarychronicles-95.txt item: #642 of 658 id: pulmonarychronicles-951 author: None title: Focused review date: None words: 362 flesch: 31 summary: Keywords: positive psychology, anxiety, review Article citation: Jeng V, Pham T, Baronia R, Kahathuduwa C, Amor W, Ibrahim Y. Efficacy of positive psychological interventions in anxiety treatment. To meet inclusion criteria, articles needed to report using positive psychological interventions with patients diagnosed with anxiety or suffering from anxiety symptoms. keywords: anxiety; treatment cache: pulmonarychronicles-951.htm plain text: pulmonarychronicles-951.txt item: #643 of 658 id: pulmonarychronicles-959 author: None title: Commentary date: None words: 1661 flesch: 45 summary: Bibliometric analyses of COVID-19 studies published early in the pandemic noted a high degree of bias in most articles. Finally, a large body of lower quality studies risks the communication of such research to the public, which may negatively impact public confidence in the scientific and medical community.20 keywords: covid-19; pandemic; quality; research; smoking; studies cache: pulmonarychronicles-959.htm plain text: pulmonarychronicles-959.txt item: #644 of 658 id: pulmonarychronicles-96 author: None title: Case Reports date: None words: 2188 flesch: 33 summary: Although human clinical trials in MRSA bacteremia or endocarditis have not been conducted, in vitro and in vivo animal models show that ceftaroline exhibits superior bactericidal activity against resistant S. aureus endocarditis compared to vancomycin, linezolid, and tigecycline.5,8,10 Moreover, rabbit endocarditis models have shown ceftaroline to be superior in sterilizing valvular vegetations compared to daptomycin and teicoplanin due to MRSA, MSSA (methicillin-sensitive S. aureus), and VISA.5,9 In rabbit MSSA, MRSA, and GISA (glycopeptide intermediate S. aureus) endocarditis models, ceftaroline was superior to daptomycin in vegetation sterilization and showed high bactericidal activity compared to tigecycline.10 The frequent monitoring that is required during vancomycin therapy, both to ensure maintenance of therapeutic trough concentrations and also to ensure lack of toxic build up, was also a challenge in treating our patient. Discussion Optimal therapy for persistent MRSA bacteremia and endocarditis is now complicated by increasing concern regarding the use of daptomycin in patients failing vancomycin therapy due to observations of daptomycin MICs rising with vancomycin MICs.1 Glycopeptides and lipopeptides are the agents of choice for serious MRSA infections, but recently clinical MRSA strains have developed reduced-susceptibility phenotypes that are associated with treatment failure.13 keywords: aureus; bacteremia; ceftaroline; daptomycin; endocarditis; methicillin; mrsa; vancomycin cache: pulmonarychronicles-96.htm plain text: pulmonarychronicles-96.txt item: #645 of 658 id: pulmonarychronicles-963 author: None title: Case report date: None words: 242 flesch: 22 summary: Keywords: Intramural hematoma, heparin-induced, small bowel obstruction, polycythemia Article citation: Rahesh J, Harris M, Ciubuc J, Al-Sukhni L, Nazim M, Murray R, Soliman B. Heparin-induced spontaneous intramural hematoma of the colon leading to small bowel obstruction The Southwest Respiratory and Critical Care Chronicles 2022;10(43):29–32 From: Department of Surgery, Texas Tech University Health Sciences Center, Amarillo, Texas Submitted: 12/20/2022 Accepted: 4/4/2022 Conflicts of interest: none This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Spontaneous intramural colonic hematoma is a relatively rare cause, seen in only 1 out of 2500 hospitalized patients with a history of anticoagulant use. keywords: hematoma cache: pulmonarychronicles-963.htm plain text: pulmonarychronicles-963.txt item: #646 of 658 id: pulmonarychronicles-965 author: None title: Original article date: None words: 386 flesch: 22 summary: There was a statistically significant relationship between the clinical diagnosis and final pathologic diagnosis (chi-squared >32.91, p-value <0.001). The clinical diagnosis of chronic cholecystitis agreed with the pathologic diagnosis of chronic cholecystitis in 45 of 54 cases (83.3%) but did not agree in 8 of 54 acute cases (14.8%); a clinical diagnosis of “symptomatic cholelithiasis” was associated with pathologic diagnosis of acute cholecystitis in 85 of 388 cases (21.9%). keywords: cholecystitis; diagnosis cache: pulmonarychronicles-965.htm plain text: pulmonarychronicles-965.txt item: #647 of 658 id: pulmonarychronicles-967 author: None title: Case report date: None words: 250 flesch: 30 summary: Keywords: Mixed phenotype acute leukemia; ETP-ALL; AML; MPAL Article citation: Rahesh J, Siddiqui A, Tumula P, Chandra R. A rare case of mixed phenotype acuteleukemia: Acute myeloid leukemia to early T-cell precursor acute lymphoblastic leukemia transformation. Case report A rare case of mixed phenotype acute leukemia: Acute myeloid leukemia to early T-cell precursor acute lymphoblastic leukemia transformation Jasmin Rahesh MBA, MS, Arham Siddiqui MBA, Praveen Tumula MD, Rahul Chandra MD ABSTRACT Mixed phenotype acute leukemia (MPAL) is comprised of both lymphoid and myeloid markers or blasts in a cell single population. keywords: acute cache: pulmonarychronicles-967.htm plain text: pulmonarychronicles-967.txt item: #648 of 658 id: pulmonarychronicles-977 author: None title: Medical education date: None words: 329 flesch: 31 summary: As used in medical schools, it looks to implement research-oriented approaches to clinical interventions and further develop the skills of medical students in evaluating and applying research. Medical education Effectiveness of evidence-based medicine instruction in medical school clerkships Dan Stuart PhD, John Griswold MD, Cathy Lovett RN ABSTRACT Introduction: The instruction of evidence-based medicine (EBM) in health sciences institutions is increasing. keywords: clerkship; medicine cache: pulmonarychronicles-977.htm plain text: pulmonarychronicles-977.txt item: #649 of 658 id: pulmonarychronicles-98 author: None title: EDITORIALS date: None words: 1152 flesch: 61 summary: In situations in which both the independent and dependent variables are quantitative variables, a scatter plot would be a good choice to present the data. A boxplot is a convenient way to depict quantitative variables through their quartiles. keywords: data; tables; variable cache: pulmonarychronicles-98.htm plain text: pulmonarychronicles-98.txt item: #650 of 658 id: pulmonarychronicles-983 author: None title: Case report date: None words: 159 flesch: 53 summary: Such cases of refractory cough should always be reviewed thoroughly to evaluate and treat any potential reversible causes. A case of multiple cough-induced rib fracture Saria Tasnim MD, Muhammad Ali Anees MD, Thien Vo MD ABSTRACT Rib fractures can occur from cough in patients with osteoporosis, malignancy, or renal disease. keywords: cough cache: pulmonarychronicles-983.htm plain text: pulmonarychronicles-983.txt item: #651 of 658 id: pulmonarychronicles-987 author: None title: Focused review date: None words: 199 flesch: 25 summary: Focused review Approaches to studying the pathogenesis of asthma Samapon Duangkham MD, Nicole Welch MD, Myrian Noella Vinan Vega MD, Sima Shahbandar MD, James A. Tarbox MD ABSTRACT A phenotype describes a group of patients who present with similar clinically observable characteristics. There are ongoing investigations that study biomarkers to define asthma phenotypes and endotypes. keywords: asthma cache: pulmonarychronicles-987.htm plain text: pulmonarychronicles-987.txt item: #652 of 658 id: pulmonarychronicles-989 author: None title: Medicine in art date: None words: 1867 flesch: 69 summary: ”1 French artist Georges de La Tour (1593–1652) captures the dramatic moment at which Job’s wife confronts him in his painting Job Mocked by his Wife (ca.1625–1650).2 In the movie It’s a Wonderful Life (1946),3 James Stewart plays George Bailey, a man who experiences so many personal and financial setbacks that, like Job, he wishes he had never been born. keywords: george; god; job; life; setbacks; wife cache: pulmonarychronicles-989.htm plain text: pulmonarychronicles-989.txt item: #653 of 658 id: pulmonarychronicles-99 author: None title: Exercise duration during pulmonary rehabilitation: an index of efficacy date: None words: 2052 flesch: 48 summary: Outcomes assessments  with pulmonary rehabilitation programs can be based on sophisticated measurements, such VO2 max and maximum watts using incremental exercise tests, endurance time on an exercise cycle, changes in daily activity, 6-minute walk distances, and, perhaps, patient specific goals. Exercise duration during pulmonary rehabilitation: an index of efficacy Abstract/ PDF Exercise duration during pulmonary rehabilitation: an index of efficacy Hoda Mojazi Amiri, MDa, Ryan McClellan, BSb, Chok Limsuwat, MDc, Kenneth Nugent, MDd Correspondence to Kenneth Nugent, MD Email: Kenneth.nugent@ttuhsc.edu + keywords: exercise; minute; patients; rehabilitation; time; training cache: pulmonarychronicles-99.htm plain text: pulmonarychronicles-99.txt item: #654 of 658 id: pulmonarychronicles-991 author: None title: Statistics column date: None words: 1840 flesch: 49 summary: Because we are interested in a time-to-event outcome, I am wondering whether there is a potential risk of introducing immortal time bias and how to avoid it. Since its first identification in the 1970s, immortal time bias has become a well-known bias and several studies have shown that results from observational studies can be invalid if immortal time bias is not accounted for.3,5–8 2. keywords: bias; exposure; immortal; time cache: pulmonarychronicles-991.htm plain text: pulmonarychronicles-991.txt item: #655 of 658 id: pulmonarychronicles-993 author: None title: Original article date: None words: 351 flesch: 28 summary: Original article Hospital-acquired pneumonia—no apparent seasonal variation: A single institution study Clayton Wagner MD, Albin John MBA, Alec Egan MD, Brandon Bradley MD, Clarissa Ramirez MD, Elmira Ahnood MD, Maricela Chavez MD, Genesy Aickareth BS, John Griswold MD ABSTRACT Unlike the clear seasonal differences that have been recorded for certain respiratory infectious illnesses, variation in hospital-acquired pneumonia (HAP) rates by time of year has not been thoroughly investigated. Analysis of hospital-wide and selected UMC hospital department respiratory NIMs data revealed no statistically significant difference in respiratory NIM rate by time of year (P = 0.25). keywords: hospital cache: pulmonarychronicles-993.htm plain text: pulmonarychronicles-993.txt item: #656 of 658 id: pulmonarychronicles-995 author: None title: Commentary date: None words: 1622 flesch: 59 summary: One can see that Part B is increasing faster than Part A and Part D. Growth in Part A has always been limited by a desire to preserve the pleasant fiction that Medicare was solvent. Historically, CMS preferred admission status since outpatient services are billed to Part B on a fee for service basis while inpatients are billed to Part A on a lump sum DRG basis. keywords: income; medicare; revenue; total cache: pulmonarychronicles-995.htm plain text: pulmonarychronicles-995.txt item: #657 of 658 id: pulmonarychronicles-997 author: None title: Commentary date: None words: 1051 flesch: 55 summary: However, President Joe Biden admits there is no national solution to the even greater number of COVID deaths on his watch. It has been previously discussed in this journal that it is very difficult to count COVID deaths even in the absence of political motivation.6 When science leads to unpleasant conclusions, politicians change definitions or manipulate statistics. keywords: covid-19; deaths; figure cache: pulmonarychronicles-997.htm plain text: pulmonarychronicles-997.txt item: #658 of 658 id: pulmonarychronicles-999 author: None title: Case series and focused review date: None words: 182 flesch: 16 summary: Case series and focused review Wild transthyretin amyloid cardiomyopathy recognition with noninvasive strategies: A case report and diagnostic approach for transthyretin-related cardiomyopathy Gaspar Del Rio-Pertuz MD, Leigh Ann Jenkins MD, Pooja Sethi MD, Erwin Argueta-Sosa MD ABSTRACT Recent studies suggest that the prevalence of wild type transthyretin cardiomyopathy (wATTR-CM) is substantially higher than previously appreciated in older adults with heart failure. Keywords: amyloid, cardiomyopathy Article citation: Del Rio-Pertuz G, Jenkins LA, Sethi P, Argueta-Sosa E. Wild transthyretin amyloid cardiomyopathy recognition with noninvasive strategies: A case report and diagnostic approach for transthyretin-related cardiomyopathy. keywords: cardiomyopathy cache: pulmonarychronicles-999.htm plain text: pulmonarychronicles-999.txt