The Southwest Respiratory and Critical Care Chronicles最新文献

{"title":"Compassion","authors":"C. Nugent","doi":"10.12746/swrccc.v11i48.1201","DOIUrl":"https://doi.org/10.12746/swrccc.v11i48.1201","url":null,"abstract":"","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80177321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT and Medicine: Fears, Fantasy, and the Future of Physicians","authors":"Christopher Peterson","doi":"10.12746/swrccc.v11i48.1193","DOIUrl":"https://doi.org/10.12746/swrccc.v11i48.1193","url":null,"abstract":"The generative artificial intelligence (AI) ChatGPT has attracted media attention for its ability to answer a wide variety of questions with a human-like writing style, including questions from the USMLE licensing examination. Some wonder if this indicates physicians’ eventual demise at AI’s hands. On the contrary, physicians contribute a unique skill set that technology cannot reproduce or replicate. ChatGPT also has critical limitations that will likely prevent it from replacing human operators or thinkers. Furthermore, the challenges from and worries over new technology are nothing new, with professionals and industries historically adapting to these changes.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73213426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous tracheostomy in patients with COVID-19 infection and acute respiratory failure","authors":"T. Singh, Hasham Sarwar, A. Hurtado, Ebtesam Islam","doi":"10.12746/swrccc.v11i48.1205","DOIUrl":"https://doi.org/10.12746/swrccc.v11i48.1205","url":null,"abstract":"Background: Tracheostomy is often performed in patients who need prolonged intubation. COVID -19 brought unforeseen challenges, thus altering previously established norms. In this study, the outcomes of the patients undergoing tracheostomy for respiratory failure due to COVID -19 were studied. \u0000Methods: 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. Exclusion criteria included patients undergoing surgical tracheostomies, extubation prior to the performance of a tracheotomy, and death prior to the performance of the tracheotomy. \u0000Results: The study included 49 patients after reviewing the records of 101 patients who underwent tracheostomies during the study period. The average age of the population was 59 ± 11years; 33 patients (67%) were men. The median Sequential Organ Failure Assessment (SOFA) score on admission was 2.  The median duration of mechanical ventilation prior to tracheostomy was 18 days; the median positive end expiratory pressure was 10 cm H2O and the median fraction of inspired oxygen (FiO2) was 0.45. Two patients died during the procedure, one secondary to cardiac arrest and one secondary to bleeding. Eighteen patients (38%) died after the procedure during hospitalization; the median length of mechanical ventilation for all patients was 32.5 days.  Eleven patients (22%) were eventually decannulated. Twenty patients (40%) were discharged to rehabilitation, and nine patients (18%) were discharged home. Eighteen patients (36%) were alive at the end of 90 days. Twelve patients (26%) were lost to follow up after discharge from the hospital. At the time of the tracheostomy, 16 patients (32%) had moderate ARDS as per the Berlin definition, and 12 (24%) had severe ARDS. \u0000Conclusion: Tracheostomy is an important therapeutic intervention in critically ill patients requiring mechanical ventilation.  The COVID-19 pandemic raised important concerns and uncertainties about the management of these patients and the safety of healthcare workers.  In this study, 29 patients (59%) undergoing tracheostomies recovered enough to be discharged to rehabilitation or to their homes.  The risks to patients and to healthcare workers seem reasonable, but the optimal timing is uncertain and is best tailored to each patient based on his/her clinical status and prognosis. \u0000  \u0000Keywords: COVID-19, tracheostomy, mechanical ventilation, acute respiratory failure","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80235405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy outcomes in patients with COVID-19: A retrospective chart review and literature review","authors":"Christopher Peterson, Mostafa M Abohelwa, Sima Shahbandar, Dylan M. Landis, Nandini Ray, Nabeela Manal, Patrice Lamey, A. Reddy, M. Rizi, D. Payne","doi":"10.12746/swrccc.v11i48.1203","DOIUrl":"https://doi.org/10.12746/swrccc.v11i48.1203","url":null,"abstract":"Objective: Pregnant women are at a higher risk for severe 2019 novel coronavirus (COVID-19) infection compared to non-pregnant women. Because of this, careful monitoring and studies of this population should be carried out. Here we identify the clinical characteristics, neonatal outcomes, and population demographics of COVID-positive pregnant women admitted to the University Medical Center in Lubbock, Texas. \u0000Methods: 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 \u0000Results: Thirty-six patients met inclusion criteria. The average patient age was 29 ± 4.8 years, and 61.1% of patients identified their ethnicity as Hispanic or Latino origin.  The mean length of stay was 3.3 ± 3.6 days, and the remaining number of weeks of pregnancy at delivery was 37.8 ± 2.3 weeks. No deaths occurred in the mothers; three pregnancies did not result in a live birth. Notable findings included an increased rate of pre-term births (18.2%), an increased rate of NICU admissions (16.7%), and an increased rate of gestational diabetes (13.9%) compared to national averages in pregnant women. \u0000Conclusions: Many of our findings confirmed the existing literature concerning pregnancy outcomes among COVID-19-positive pregnant women, including relatively high preterm birth and NICU admission rates. The number of women who identified their ethnicity as Hispanic or Latino was high, which may reflect the overall demographics in West Texas. Furthermore, our gestational diabetes rate was also higher than the national average, possibly reflecting the high obesity rates in this area. We recommend further research on the mechanisms of preterm birth in COVID-19 illness and on ways to improve the health and healthcare outcomes in West Texas residents.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81540255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretable artificial intelligence (AI) – saliency maps","authors":"Shengping Yang, G. Berdine","doi":"10.12746/swrccc.v11i48.1209","DOIUrl":"https://doi.org/10.12746/swrccc.v11i48.1209","url":null,"abstract":"explainability of AI models to consumers of the predictions, and to possibly improve how experts interpret the difficult examples. In biomedical imaging, the best practice may require preliminary sorting of radiographic images by interpretive AI with follow-up review by a human expert for the difficult cases.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91037347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysphagia and dyspnea due to osteophyte formation in the cervical spine","authors":"W. Derrick, A. Motes","doi":"10.12746/swrccc.v11i48.1199","DOIUrl":"https://doi.org/10.12746/swrccc.v11i48.1199","url":null,"abstract":"intrusion seem to be more common. 4 Treatment for airway obstruction due to an osteophyte includes surgical resection without fusion, but some patients are not candidates due to other comorbidity.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81208075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The COVID-19 pandemic and births in Lubbock county","authors":"G. Berdine, Shengping Yang","doi":"10.12746/swrccc.v11i48.1195","DOIUrl":"https://doi.org/10.12746/swrccc.v11i48.1195","url":null,"abstract":"","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80502453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasopharyngeal adenoid cystic carcinoma metastasis to the liver","authors":"W. Jang, Akshay Raghuram, D. Arif","doi":"10.12746/swrccc.v11i48.1173","DOIUrl":"https://doi.org/10.12746/swrccc.v11i48.1173","url":null,"abstract":"Adenoid cystic carcinoma (ACC) is a malignancy of the secretory epithelial cells of the salivary glands and constitutes less than 1% of all head and neck tumors. Metastasis occurs frequently and most commonly affects the lungs at a rate of 35 to 50%. In this case report, we present a rare case of nasopharyngeal ACC with distant 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. The foramen ovale and the optic nerve were also involved, leading to loss of vision bilaterally. Immunohistochemical staining of the biopsy eventually led to the correct diagnosis of high-grade ACC, solid type. The patient’s hospital course was complicated, with pulmonary thrombosis eventually leading to hypoxic respiratory failure and death. Although this patient was initially diagnosed with nasopharyngeal carcinoma, thorough pathologic investigations allowed for a clearer understanding of the disease, primarily ACC’s eventual distal metastasis in the patient. In the future, providers should continue to keep ACC in their differential diagnosis list when evaluating patients with head and neck tumors, with the goal of maintaining locoregional control of the tumor.Keywords: adenoid cystic carcinoma, liver metastasis, nasopharyngeal salivary glands, head and neck cancer","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91390404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of a “Back to Bedside” initiative on resident education","authors":"Nikhil Seth, M. Riaz, Anika Sikka, G. Martinez","doi":"10.12746/swrccc.v11i48.1183","DOIUrl":"https://doi.org/10.12746/swrccc.v11i48.1183","url":null,"abstract":"Background: Back to Bedside is an American Council of Graduate Medical Education (ACGME) sponsored program with the goal of giving trainees a chance to find deeper meaning in their clinical work. As technological advances have decreased the amount of time trainees are spending with patients, a program was started that gives residents the opportunity to explore their patient interaction and communication skills. Observations: Residents spent one week on an elective during which they had uninterrupted time during ten patient encounters and were able to address multiple factors. They assisted with goals of care discussions, education on illness, education on medications, and practiced their communication skills.Conclusion: Thirty-one residents participated and completed a survey after the elective. This elective proved to be of great benefit to residents in many areas. They found personal growth in their ability to communicate medical findings in an easy-to-understand format, an improvement in general communication skills, and an improvement in understanding routine and complex pathology. As effective communication is key to patient safety, this study proves that communication curricula can improve physician-patient interactions. Keywords: Communication, medical education, medical curriculum","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89703768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health literacy and social determinants of health","authors":"D. Flores, Morgan House, J. Pearson, D. Stuart","doi":"10.12746/swrccc.v11i47.1169","DOIUrl":"https://doi.org/10.12746/swrccc.v11i47.1169","url":null,"abstract":"Health Literacy and Social Determinants of Health are closely intertwined. Health disparities and inequities, overall health outcomes, understanding health information, and the ability to be fully informed about medical decisions can have long-term consequences. This connection is even more pronounced in rural and underserved urban areas where low health literacy is prevalent. This review seeks to identify correlations between health literacy and social determinants of health. It further proposes to indicate how key constituencies (healthcare organizations, healthcare providers, and patients) can further develop and disseminate health literacy initiatives to improve overall health and wellness. The research team used the Covidence database to screen, review, and extract peer-reviewed research articles for this study. The initial review identified 75 articles based on term harvesting and keyword searches considered relevant to the review. Selection, review, and characterization were performed by three reviewers on a team of four researchers. The articles’focuses are different regarding the observed impact on literacy concerning certain chronic health conditions, rural versus urban population centers, health education, ethnic and racial differentiation, and other variables. There are notable gaps in the current literature that relate to concrete methodologies to address these concerns.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84272763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}